[International classification of impairments, disabilities and handicaps].
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Biomedical subjects
Publications and source records attributed to C Seidel.
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In 1984 we investigated 480 physically and/or mentally impaired children, in the age group 12-16 years, including 208 mentally handicapped children. They were classified with the help of the International Classifications of Disability (WHO). We analysed the frequency distributions of every item of the Classification of Disability. As a result of this analysis we suggest a reduction of the number of categories.
In the antithyroid drug therapy, an initial treatment with low doses (10-15 mg) of methimazole (MMI) leads to satisfactory improvement in nearly all cases and even 5 mg MMI are sufficient in more than 50% of all patients. Additional intake of thyroid hormones (Th) is not necessary, if the MMI-dosage is reduced accordingly to the individual course of treatment. Consequent follow -up is to recommend anyway, particularly under the higher MMI-doses and in the first time, respectively. Consecutive measurement of total T-3 helps in assessment of euthyroidism under treatment, whereas the response to MMI is indicated more correct by total T-4. Serial determinations of serum-TSH are very helpful to decide about the cessation of treatment. If any goitre growth occurs, it seems not to be TSH-mediated in every case. Skin reactions as side-effect of high MMI-doses can be prevented by use of low doses.
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Based on a sensitive TSH-RIA (measuring-range 0.2-25 mU/l, 50%-intercept 2 mU/l, coefficients of between-assay-variation 5-10%) and on nearly 1200 cases, it is demonstrated that clinical results can be received by determination of basal serum-TSH alone. Values above 0.5 mU TSH/l indicate positive TRH-tests in a good correlation between increasing basal concentrations and pituitary TSH-reserve. TSH-levels below 0.3 mU/l proceed with negative TRH-tests. In selected healthy subjects, we found all TSH-values between 0.7 and nearly 5 mU/l (means = 1.99). In euthyroid goiters, TSH-levels are normally in the same range, but in nodular goiters, subnormal values were found accumulated. TSH-levels below 0.3 mU/l are helpful to discover non-suppressibility. Hormone-treatment of goiters is successful above all in case of high-normal pretherapeutic TSH-values. "Fine-tuning" of hormone-dosage (goiter-treatment, postoperative prophylaxis, suppression-therapy in thyroid carcinoma) as well as monitoring of thyrotoxicosis-treatment is recommended to be performed by means of basal TSH-determination. In pituitary disorders, thyroid hormone-treatment seems to be necessary only at TSH-levels below 0.5 mU/l. Combination of basal TSH and total T-3 is economical and describes nearly all functional situations in diagnosis and treatment of thyroid diseases.
The studies were made in order to estimate the rate of tissue protein synthesis in euthyroid, hyperthyroid and hypothyroid rats (110 g body weight). Hyperthyroidism was simulated by daily oral application of 4,44 micrograms thyroxine (T4) and 0,89 micrograms triiodothyronine (T3)/100 g body weight. Hypothyroidism was induced by oral application of 17,8 mg of methylthiouracil (MTU) per day and 100 g body weight. In both cases the treatment lasted for 7 days. The concentration of both hormones in blood serum was twice that of the control group in the T3 + T4 treated group. The MTU application produced a decrease in T3 and T4 concentration to levels below the lower detection limits of the methods used. The fractional rate of tissue protein synthesis was estimated using the constant intravenous infusion technique with L-14C-leucine and L-14C-lysine simultaneously. The range of the fractional rate of protein synthesis was found to be higher in hyperthyroid than in control animals in all organs under study (liver, small intestine, large intestine, gastrocnemius muscle and pancreas). Protein synthesis was stimulated to the greatest extent in muscle (4,5--5,1% . d-1 in controls vs, 5,5--6,7% . d-1 in hyperthyroid animals). The influence of hypothyroidism on the rate of protein synthesis was uncertain.
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In our experience the routine measurement of basic serum TSH levels is of great value in diagnosis and therapy control of thyroid diseases. However, the reliable differentiation of normal and suppressed TSH levels requires a very sensitive and accurate radioimmunoassay. Based on a commercially available TSH-RIA-kit it is demonstrated that the prolongation of several incubation-times as well as the use of thoroughly selected, pooled "TSH-poor" human sera for establishing the standard dilutions result in a pronounced improvement of the RIA. Further assay improvement is achieved by a higher dilution of the first antibody and by reduction of the added tracer-amount, provided that the TSH used for labelling is of high quality, that the labelling-procedure is carried out under mild conditions and that the 125-I-TSH is prepared carefully by high-resolution-gel chromatography. The resulting RIA can be characterized by a between-assay coefficient of variation: 5-10% in the so-called normal range (0.8-5.0 mU TSH/l), by a lower detection-limit: 0.2 mU TSH/l and by a 50%-intercept: 2.0 mU TSH/l.
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Following a firm diagnostic and therapeutic schedule for patients with prostatic carcinoma. 89Strontium therapy was introduced for multiple metastases. Positive skeletal scintigraphy with 99mTc-EHDP induced check for affinity to Sr using 85Sr scintigraphy. Of 80 patients, multiple metastases were found in 26. Therapy with 1 mCi of 89Sr-chloride was started in 20 cases. In 8 patients, relief from severe pain appeared shortly afterward, and a further 8 it was possible to prevent the development of pain. Moderate success in 3 cases and a failure to provide relief in 1 were observed.
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