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Biomedical subjects

B Nygaard

Publications and source records attributed to B Nygaard.

At least 19 recordsLinked to original sources
PubMed1996

Interaction between microwave-induced brain hyperthermia and high dose rate radiation in the BT4 An brain glioma in rats.

The cerebral BT4An glioma model in BD IX rats was used to study the effect of hyperthermia given in combination with radiotherapy (thermoradiotherapy) in the treatment of brain tumours. A single treatment with high dose rate radiation was given to a local brain field. Local brain hyperthermia was given at 42.4 degrees C for 45 min by externally applied microwaves (700 MHz), immediately before radiotherapy (10 Gy). In a pilot study, thermoradiotherapy increased the median life span with 20 days compared to controls, which was significantly better than that observed after radiotherapy alone (7 days). In an extended experiment the corresponding figures for thermoradiotherapy, hyperthermia alone and radiotherapy alone were 12.5, 3.5, and 3.5 days, respectively. Thermoradiotherapy was significantly better than radiotherapy and hyperthermia alone. There was no acute mortality in these experiments. Neurological side-effects were infrequent, of slight degree and reversible. The present study shows that a survival benefit of adding hyperthermia to radiotherapy can be achieved without unacceptable neurological side-effects in an animal glioma model.

Animals↗
PubMed1996

Improvement of upper airway obstruction after 131I-treatment of multinodular nontoxic goiter evaluated by flow volume loop curves.

Symptoms of tracheal-esophageal compression are often related to a large nontoxic goiter. The aim of the present study was to evaluate to what degree upper airway obstruction, as measured by flow volume loops, FIF50% and FEF50%/FIF50% (Forced Expiratory Flow at 50% of the vital capacity/ Forced Inspiratory Flow at 50% of the vital capacity) exists in nontoxic multinodular goiter, and whether changes occur after 131I-treatment. Thirteen patients with large multinodular nontoxic goiters were evaluated by estimation of FIF50%, FEF50%/FIF50% ratio and a graphic plot of the flow volume loop curve before and three, six and 12 months after treatment with 131I. FIF50% increased over 12 months from median 1.79 l/sec (range 1.46-3.02) to 2.84 l/sec (1.13-5.69) (p = 0.01). A progressive increase was seen over time (p = 0.001, trend analysis). The FEF50%/FIF50% ratio decreased from in 1.45 (0.32-2.26) to 1.03 (0.43-2.13) 12 months after treatment (p < 0.001). A progressive decrease was seen over time (p = 0.001, trend analysis). By visual evaluation 11 had a flow volume loop curve typical for an upper airway obstruction and in 9 patients the FEF50%/FIF50% ratio was > 1.2. In conclusion we found that upper airway obstruction is present in patients with multinodular nontoxic goiter, and seems to be reduced after 131I-treatment. Flow volume loop curves and measurement of FEF50% and FIF50% are important estimates for upper airway obstruction in these patients.

Aged↗
PubMed1996

Marked hepatotoxicity associated with losartan treatment.

Losartan represent a novel approach in the treatment of hypertension. Clinical trials have reported a very low incidence of side effects. We describe two patients who developed increases in alanine/aspartate amino transferase of 8 and 15 times the upper normal limit, as well as thoracic pain, after a short time of treatment with losartan. The increase resolved after discontinuing losartan treatment.

Angiotensin Receptor Antagonists↗
PubMed1995

[Does Iodine 131 treatment of goiter result in an acute increase of the volume and function of the thyroid gland?].

Many textbooks claim that radioiodine (131I) treatment should be avoided in treatment of a goitre with substernal extension, due to fear of acute swelling of the gland with resulting respiratory problems. We examined patients with multinodular goitre, either nontoxic (n = 20) or toxic (n = 10) after treatment with 131I. An ultrasonically determined thyroid volume and thyroid function variables were investigated before and two, seven, 14, 21, 28 and 35 days after treatment. In nontoxic goitres the thyroid volume did not increase significantly, the maximum increase in the median volume being 4% on day 7. Serum levels of free T3 and free T4 indices increased by 20% (day 7) and 13% (day 14) (p = 0.002), respectively. Likewise thyroid volume in toxic nodular goitre did not change significantly after 131I treatment. None of the patients presented symptoms of tracheal compression. We conclude that 131I treatment of nontoxic as well as toxic multinodular goitre does not seem to increase thyroid volume.

Adult↗
PubMed1995

[False results on elevated triiodothyronine values in radioimmunoassay].

Five patients with falsely elevated serum triiodothyronine (T3) concentrations (> 9 nmol/l) in a radioimmunoassay are reported. The high T3-values disagreed with the other thyroid variables investigated as well as with the clinical observations. In sera from all patients a normal non-specific binding of T3 was found, thus excluding abnormal serum-protein-binding of the hormone. An ethanol extraction of T3 from serum before RIA reduced the T3 content in serum from all patients to normal levels (2.0-2.4 nmol/l). These findings indicate the presence in the sera of substances, probably of protein nature, that were interfering with the assay by binding the reagent-antibody and not the antigen. Addition of non-immune rabbit serum prevented this interference and normalized the T3-values (1.8-2.4 nmol/l). Thus the interfering substance in T3-RIA could be an anti-rabbit antibody, the interaction of which can be eliminated by a minor modification of the assay making it possible to differentiate true from false T3-values.

Adult↗
PubMed1995

[Problems in thyroid function screening using thyroid stimulating hormone. A case of thyrotoxicosis caused by a thyroid stimulating hormone-secreting pituitary tumor].

UNLABELLED: In a new consensus report from the Danish Society of Internal Medicine a sensitive TSH assay is recommended for screening for thyroid diseases. A patient with thyrotoxicosis, normal serum TSH and a TSH-secreting pituitary adenoma is described. Other reasons for discrepancies between thyroid clinical status and serum TSH are mentioned: Target organ resistance to thyroid hormone, interference in the radioimmunoassay with heterophilic antibodies and insufficient production of TSH because of pituitary disease. IN CONCLUSION: Screening with TSH is acceptable, but if any discrepancy between TSH values and the clinical picture is found, further tests must be made.

Adenoma↗
PubMed1995

Is calculation of the dose in radioiodine therapy of hyperthyroidism worth while?

OBJECTIVE: The persistent controversy as to the best approach to radioiodine dose selection in the treatment of hyperthyroidism led us to perform a study in order to compare a fixed dose regime comprising doses of 185 370 or 555 MBq based on gland size assessment by palpation only, with a calculated 131I dose based on type of thyroid gland (diffuse, multinodular, solitary adenoma), an accurate thyroid volume measurement, and a 24-hour 131I uptake determination. DESIGN: Prospective randomized study. PATIENTS: Two hundred and twenty-one consecutive hyperthyroid patients referred for 131I treatment. Four Patients who died for reasons unrelated to hyperthyroidism, 7 lost to follow-up and 47 who did not receive antithyroid drugs after treatment, were excluded. The remaining 163 patients (143 women) were studied, divided into subgroups according to the type of gland. They all received antithyroid drugs prior to 131I treatment and this was resumed 7 days after treatment for a period of 3 weeks. MEASUREMENTS: Thyroid function variables were determined approximately 2 weeks before 131I treatment, and again 1, 2, 3, 6, 9 and 12 months after treatment. Prior to 131I therapy the size of the thyroid gland was determined by ultrasound and a 24-hour uptake of 131I was carried out. Thyroid volume was also estimated 12 months after 131I therapy in 78 of the 163 patients. Twelve months after the initial 131I dose patients could be classified as euthyroid, hyperthyroid or hypothyroid. RESULTS: Neither in the group of 163 patients nor within the three subgroups of hyperthyroidism could any significant difference in outcome between the two treatment regimes be demonstrated. Thirty-two of 78 patients (41%) in the calculated dose group and 30 of 85 patients (35%, NS) in the fixed group were classified as hyperthyroid. Seven of 78 (9%) in the calculated dose group and 6 out of 85 (7%, NS) in the fixed dose group were classified as permanently hypothyroid. Finally, 39 of 78 (50%) in the calculated dose group and 49 of 85 (58%, NS) in the fixed group were euthyroid at 12 months after 131I treatment. One year after 131I therapy thyroid volume was reduced from 59.3 +/- 9.2 (mean +/- SEM) to 36.2 +/- 6.6 ml (average reduction 39%) in the calculated dose group (P < 0.001). This reduction did not differ significantly from the fixed dose group where thyroid volume declined from 61.6 +/- 6.1 to 41.17 +/- 4.7 ml (average reduction 32%) (P < 0.001). CONCLUSIONS: A semiquantitative approach is probably as good as the more elaborately calculated radioiodine dose for treatment of hyperthyroidism. It is clearly more cost effective and allows the use of predetermined standard doses.

Adult↗
PubMed1994

[Long-term effect of 131I therapy of multinodular non-toxic goiter].

The aim of this study was to investigate the long term effect of 131I treatment on thyroid function and size in patients with non-toxic multinodular goitre. The subjects were 69 consecutive patients with multinodular non-toxic goitre selected for 131I treatment and followed for a minimum of 12 months. Outcome measures were standard thyroid function variables and ultrasonically determined thyroid volume before and after treatment. Fifty-nine patients were treated with a single dose of 131I, 12 with two doses, and one with four doses. In 45 patients treated with one dose who remained euthyroid the median thyroid volume was reduced from 73 (interquartile range 50-106) ml to 29 (interquartile range 23-48) ml at 24 months. The median reduction was 40 (22-48) ml, half of which occurred within three months. Patients treated with two doses as well as those developing hypo- or hyper-thyroidism also had a significant reduction in thyroid volume. Eleven patients developed hypothyroidism (cumulative five year risk 22%). Side effects were few. In conclusion we find that 131I treatment of multinodular non-toxic goitre is an attractive alternative to surgery.

Adult↗
PubMed1994

[Who counsels young people on contraception?].

In October 1989 a representative sample consisting of 359 women (response rate = 77.9%) and 400 women (response rate = 76.3%) aged 16-20-years old was interviewed by the professional interviewer staff of the Institute for Social Research. The purpose of the investigation was to illustrate whether AIDS and "Safe sex"-campaigns have influenced young people. This paper deals with data about contraceptive counselling. The majority (284 (79.1%) among women and 270 (67.5%) among men) would attend the general practitioner for contraceptive guidance. The public Contraceptive Guidance Clinics are considered an alternative source of service. In all, 38.2% of females and 29.3% of males knew of the existence of a clinic. This knowledge was not associated with age or education of the respondent. Among men information about the clinic was associated with sexual experience. Schools appear to be an effective channel of information. In the county of Ribe more than 80% among both sexes knew th public clinic.

Adolescent↗
PubMed1994

Long-term follow-up of thyroid scintigraphies after 131I therapy of solitary autonomous thyroid nodules.

The aim of the present study was to assess thyroid scintigraphies after 131I treatment of autonomous thyroid nodules with respect to evolution of the hot nodules as well as the extranodular tissue. A 99mTc pertechnetate scintigraphy was carried out 1-16 years (median 8 years) after 131I treatment of a solitary autonomous nodule in 66 patients remaining euthyroid. At the time of diagnosis, 9 of the patients were euthyroid and 57 were hyperthyroid, of whom 27 received antithyroid drug therapy prior to 131I treatment. The scintigraphies were evaluated twice by 4 specialists (3 endocrinologists and 1 specialist in nuclear medicine). There was total agreement between the 4 observers in 50 and 52% in the first and second evaluation, respectively. The interobserver variation was evaluated by means of omega coefficients and omega ranged from 0.18 to 0.76 indicating poor to substantial agreement. A solitary autonomous nodule with suppression of the extranodular thyroid tissue persisted in 50% of the patients, whereas a solitary cold nodule, homogeneous uptake or inhomogeneous uptake was found in 15, 22, and 13%, respectively. We conclude that although euthyroidism is achieved by radioiodine treatment, a hot nodule suppressing the 99mTc pertechnetate in the extranodular tissue is still found in 50% of the patients even when serum TSH has been normal for years. Antithyroid drug therapy prior to 131I treatment was more frequent in this group of patients.

Adult↗
PubMed1994

Acute changes in thyroid volume and function following 131I therapy of multinodular goitre.

OBJECTIVE: Many textbooks claim that radioiodine (131I) treatment should be given with care to a goitre with substernal extension, for fear of acute swelling of the gland and thus respiratory problems. Since 131I is used increasingly in the treatment of non-toxic as well as toxic goitre we have evaluated the acute changes in thyroid volume following 131I therapy. DESIGN: Evaluation of potential acute changes in thyroid volume and function after 131I treatment in patients with non-toxic goitre treated because of compression symptoms or for cosmetic reasons, as well as in patients with toxic goitre. PATIENTS: Out-patients with multinodular goitre, either non-toxic (n = 20) or toxic (n = 10). Excluded were patients with a substernal goitre. MEASUREMENTS: Ultrasonically determined thyroid volume and standard thyroid function variables were investigated before and 2, 7, 14, 21, 28 and 35 days after treatment. RESULTS: In non-toxic goitres the thyroid volume did not increase significantly, the maximum increase in the median volume being 4% on day 7. Serum levels of free T3 and free T4 indices increased by 20% (day 7) and 13% (day 14) (P = 0.002), respectively. Likewise thyroid volume in toxic nodular goitre did not change significantly after 131I treatment (maximum median increase was 2%). None of the patients presented symptoms of tracheal compression. CONCLUSIONS: 131I treatment of non-toxic as well as toxic multinodular goitre does not seem to increase thyroid volume.

Adult↗
PubMed1993

Radioiodine treatment of multinodular non-toxic goitre.

OBJECTIVE: To investigate the long term effect of radioactive iodine on thyroid function and size in patients with non-toxic multinodular goitre. DESIGN: Consecutive patients with multinodular non-toxic goitre selected for radioactive iodine treatment and followed for a minimum of 12 months (median 48 months) after an intended dose of 3.7 MBq/g thyroid tissue corrected to a 100% uptake of iodine-131 in 24 hours. PATIENTS: 69 patients with a growing multinodular non-toxic goitre causing local compression symptoms or cosmetic inconveniences. The treatment was chosen because of a high operative risk, previous thyroidectomy, or refusal to be operated on. MAIN OUTCOME MEASUREMENTS: Standard thyroid function variables and ultrasonically determined thyroid volume before treatment as well as 1, 2, 3, 6, and 12 months after treatment and then once a year. RESULTS: 56 patients were treated with a single dose of 131I, 12 with two doses, and one with four doses. In 45 patients treated with one dose and remaining euthyroid the median thyroid volume was reduced from 73 (interquartile range 50-106) ml to 29 (23-48) ml at 24 months in the 39 patients in whom this was measured during follow up. The median reduction was 40 (22-48) ml (60% reduction, p < 0.0001), half of which occurred within three months. Patients treated with two doses as well as those developing hypothyroidism and hyperthyroidism had a significant reduction in thyroid volume. Eleven patients developed hypothyroidism (cumulative five year risk 22%, 95% confidence interval 4.8% to 38.4%). Side effects were few: three cases of hyperthyroidism and two cases of radiation thyroiditis. Only one patient was dissatisfied with the result; she was referred for operation six months after treatment. CONCLUSIONS: A substantial reduction in thyroid volume accompanied by a low incidence of hypothyroidism and few side effects makes the use of radioactive iodine an attractive alternative to surgery in selected cases of non-toxic multinodular goitre.

Adult↗
PubMed1993

[The clientele at a clinic of occupational medicine--a medical statistical review].

To elucidate changes over time in the patient clientele examined at the department of occupational medicine, Aalborg Sygehus Nord, in the period 1982-1991, 4956 registrations related to referral and examination were studied in a retrospective investigation. The number of patients working at the time of examination has been steadily declining during the period. The number of patients with toxic encephalopathy is declining, while the number of patients with diseases in the musculoskeletal system is growing. Pregnant women with possible risk in the occupational environment and patients with cancers and mental illness form only a small part of the patient clientele in this department of occupational medicine. It is concluded that there have been changes in the patient clientele in the period 1982-1991. The small number of occupied patients diminishes the possibilities of replacement in work. Shorter periods of sickness and better possibilities for rehabilitation are expected to improve the situation in such a way, that the department of occupational medicine will be involved in health problems in the occupational environment in the future.

Adolescent↗
PubMed1993

Thyroid volume and morphology and urinary iodine excretion in a Danish municipality.

In order to throw light upon the eventual need for iodine supplementation in Denmark, four age groups of women (15, 30, 45 and 60 years) from the Holbaek municipality were invited for a clinical and ultrasound study of thyroid volume, structure and function. Of the 570 women invited, 391 accepted and were divided into the following groups: group I: 15 years, N = 113; group II: 30 years, N = 100; group III: 45 years, N = 98; group IV: 60 years, N = 80. The results were as follows the thyroid gland was palpable in 39% and visible in 16% of the entire group; 19% had a family history of thyroid disorders and 7.6% had a previous thyroid disorder. Thyroid volumes (median (range)) as measured by ultrasound were 12 ml (4-29 ml), 18 ml (5-47 ml), 18 ml (7-64 ml) and 18 ml (9-51 ml) in groups I-IV, respectively. The calculated 24-h iodine excretion was 65 micrograms (19-365 micrograms), 88 micrograms (15-274 micrograms), 97 micrograms (40-737 micrograms) and 83 micrograms (50-999 micrograms) in groups I-IV, respectively. An abnormal echo structure was present in 3, 10, 21 and 30%, respectively. Defining a goitre as a thyroid volume above 28 ml indicated a goitre prevalence of 17% in females aged 30-60 years in the Holbaek area of Denmark. Among the 60-year-old women, 3% had a clinically significant goitre (WHO grade III). Thyroid volume did not correlate with iodine excretion. The benefit of iodine supplementation is discussed.

Adolescent↗