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Biomedical subjects

F D Rosenthal

Publications and source records attributed to F D Rosenthal.

At least 37 records · Page 2Linked to original sources
PubMed1983

Alterations in systolic time intervals in primary hypothyroidism as a consequence of warming.

The systolic time intervals (STI) of the preejection period, left ventricular ejection time and their ratio are influenced by thyroid function, the ratio increasing as thyroid secretion diminishes. We have previously shown that the majority of patients with primary hypothyroidism have a subnormal body temperature and that warming such individuals is accompanied by a fall in circulating levels of serum T4, T3, and TSH. On this occasion we studied 24 patients with primary hypothyroidism. Fifteen of these were warmed at rest in bed for 48 h; the remaining 9 control patients were rested for the same period, but not heated. Four euthyroid volunteers were warmed for 24 h, as were a further 5 hypothyroid subjects. Estimations of STI, T4, and T3 were made in all individuals at the beginning and end of the study period. In all warmed hypothyroid patients there was a rise in rectal temperature and a simultaneous increase in the STI. There was a significant fall in serum T4 and T3 levels in those hypothyroid subjects warmed for 48 h, but not in those warmed for 24 h; the latter, however, showed a significant fall in circulating TSH levels. In the 4 warmed euthyroid volunteers there was no significant alteration in STI and there was no change in T4, T3, and TSH levels in the 2 subjects in whom they were measured. Thus, left ventricular function deteriorates with warming in patients with primary hypothyroidism.

Body Temperature↗
PubMed1982

Early remission in thyrotoxicosis produced by short courses of treatment.

Twenty-eight patients with Graves' disease were treated with short-term antithyroid drug therapy. i.e. treatment was discontinued as soon as they became euthyroid. This was less than 4 months in all patients. Ten patients remained euthyroid, although in two of these, thyrotoxicosis recurred after the patients had been euthyroid for more than 2 months. The other 18 patients relapsed within 12 weeks of stopping therapy, and only two have become euthyroid after a further 12 month period of treatment. All patients who remitted were thyrotoxic for the first time whereas all patients with a past history of thyroid disease relapsed. Positive thyroid microsomal antibody titres were more frequent in patients who remitted, otherwise there were no indicators of a favourable outcome. The remission rate with antithyroid therapy which is only continued until the patient becomes euthyroid is similar to that for treatment lasting 12--18 months. Short-term therapy has the advantage of savings in both patient and clinician time.

Carbimazole↗
PubMed1981

Effects of rest, exercise and warming on serum creatine kinase levels in primary hypothyroidism.

1. Serum creatine kinase and oral temperature were measured in 20 patients with primary hypothyroidism before and after 48 h bed rest. Fifteen of these patients were heated during the 48 h period. The remaining five acted as control subjects. In addition, creatine kinase and oral temperature were measured in five control subjects after a 30 min period of exercise and again after a 30 min period of resting. 2. The oral temperature rose and the serum creatine kinase levels fell only in those patients who were actively warmed. In the control subjects the period of exercise followed by resting caused no significant change in creatine kinase levels. 3. A subnormal body temperature appears to be an important determinant of the raised serum creatine kinase levels seen in patients with primary hypothyroidism.

Body Temperature↗
PubMed1981

Lymphadenopathy in coeliac disease.

We present two cases of adult coeliac disease whose major clinical feature was marked lymphadenopathy. One patient also displayed a peripheral lymphocytosis which varied with treatment of the underlying disease.

Adult↗
PubMed1981

Hemiaplasia of the thyroid with thyrotoxicosis.

Four patients with hemiaplasia of the thyroid gland presented with thyrotoxicosis. Each patient was noted to have unilateral goiter without palpable thyroid tissue on the contralateral side. Investigation of these patients included measurements of serum L-T4, T3, thyroglobulin, thyroid microsomal antibody, long acting thyroid stimulator (LATS), and long acting thyroid stimulator protector (LATS-P). In addition, an 131I thyroid scan was performed on each patient and was repeated after TSH administration (TSH stimulation test). Three patients underwent surgery; information from the remaining patient was obtained from postmortem examination. In three patients, LATS and LATS-P were undetected, and these subjects were found to have adenomas. LATS-P, without LATS, was detected in the remaining patient, and she was found to have diffuse hyperplasia. From our cases as well as a search of the world literature, three points arise. 1) Hemiaplasia is found only when attention is drawn to the thyroid gland through some other abnormality, e.g. thyrotoxicosis or goiter. The true incidence of hemiaplasia, therefore, is unknown. 2) A TSH stimulation test is essential to differentiate hemiaplasia from a hot nodule with contralateral thyroid suppression. 3) The measurement of thyroid-stimulating immunoglobulins may be helpful in distinguishing toxic adenoma from Graves' disease without exophthalmos.

Adenoma↗
PubMed1980

TSH responses to temperature in primary hypothyroidism.

We have studied the serum TSH responses to alterations in body temperature by heating twelve patients with primary hypothyroidism for 48 h and determining the initial and final TSH levels. In four control patients we estimated the TSH responses to rest and exercise. In a group of three patients, the TSH levels were recorded at frequent intervals over a 48 h period, during which they were rested and subsequently warmed. Our results show that in the twelve patients initially investigated, there was a significant fall in TSH. In the smaller group of three patients studied more intensively, TSH levels were inversely related to cutaneous and core temperature. In primary hypothyroidism alterations in body temperature influence the levels of circulating TSH.

Bed Rest↗
PubMed1980

Hyperparathyroidism: a prerequisite for Zollinger-Ellison syndrome in multiple endocrine adenomatosis Type 1--report of a further family and a review of th literature.

A family with Multiple Endocrine Adenomatosis Type 1 (MEA 1) is described. Of the 59 members, 15 were affected. Zollinger-Ellison syndrome was present in six individuals of whom the five available for study had hyperparathyroidism. The youngest of these patients with Zollinger-Ellison Syndrome was 25 years old. Hyperparathyroidism alone was present in nine individuals of whom the eldest was 30 years old. Three other members had raised serum gastrin levels but lacked symptoms suggestive of Zollinger-Ellison syndrome and in these individuals, the serum calcium levels were normal. A review of the literature confirms the finding that, in MEA 1, Zollinger-Ellison syndrome has not been shown to occur in the absence of hypercalcaemia. Screening of affected members of such families can therefore be restricted to the measurements of serum calcium levels.

Adolescent↗
PubMed1979

Bone lesions in systemic acne (acne fulminans).

An 18-year-old West Indian male presented with severe sternal pain and an exacerbation of facial acne. Radiographs of the sternum revealed several lytic lesions which appeared as hot areas on successive technetium bone scans. Painful areas over the right iliac crest and left greater trochanter likewise appeared as transient hot areas on successive scans. Histology of affected bone revealed reactive changes only. High dose prednisolone provided rapid alleviation of pain, which recurred on reducing the dose to less than 10 mg daily. Auto-immune complex disease has been considered the most likely aetiological mechanism of systemic acne (acne fulminans), but lytic lesions of bone have never previously been reported in auto-immune disorders.

Acne Vulgaris↗
PubMed1979

Gilbert's syndrome: evidence of morphological heterogeneity.

Hepatic ultrastructure was examined by electron microscopy in 25 patients with Gilbert's syndrome and the changes in the smooth endoplasmic reticulum quantified by grid technique. Thirteen patients showed gross hypertrophy of the smooth endoplasmic reticulum (SER). These were designated Gilbert's EM Positive. The remaining 12, designated Gilbert's EM Negative, did not differ significantly from normal controls. The EM Positive group showed a significantly greater percentage response to caloric restriction (P less than 0.01) and an exaggerated response to nicotinic acid stimulation when compared with the EM Negative group and normal controls. These results suggest that SER hypertrophy is not, as previously suggested, a constant feature of Gilbert's syndrome but rather a characteristic of a distinct subpopulation.

Adolescent↗
PubMed1978

Felty's syndrome.

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Felty Syndrome↗
PubMed1978

The association of HLA-B8 with visceral disease in systemic sclerosis.

Seventy-one patients with systemic sclerosis (SS) were typed for twenty-seven HLA alleles of the A and B loci, and the findings were related to both the extent of visceral disease and tests of cellular immune competence in a subgroup of fifty-two of these patients. Nineteen pa;ients with widespread visceral involvement and more rapidly progressive disease had an increased frequency of HLA-B8 (relative risk = 4.14; P less than 0.05) when compared to thirty-three less severely affected patients and 3000 controls. Patients with severe and progressive disease also had defective cell-mediated immunity with reductions in both the numbers of circulating thymus-dependent (T) lymphocytes and in the lymphocyte transformation response to phytohaemagglutinin. These findings suggest that a genetic factor, such as an abnormal immune response gene, may be involved in the progression of the disease.

Adult↗
PubMed1977

Secondary pituitary hyperplasia in Addison's disease.

In patients with Addison's disease, whether treated or untreated for the previous 24 hours, hydrocortisone produced only a partial suppression of their elevated adrenocorticotrophic-hormone (A.C.T.H.) levels. This is comparable to untreated myxoedema, in which administration of triiodothyronine fails to inhibit secretion of thyrotrophin (T.S.H.). In myxoedema, however, continued treatment produces normal T.S.H. levels. Inadequate A.C.T.H. suppressibility in patients with Addison's disease while on treatment may be due to the maintenance of a secondary pituitary hyperplasia by inadequate replacement therapy. This may be clinically important, especially in the genesis of Nelson's syndrome.

Addison Disease↗
PubMed1976

Thyrotoxic vomiting.

In seven patients vomiting played an important part in the presentation of thyrotoxicosis. Vomiting does not always indicate severe thyroid disease, and the diagnosis in patients presenting with this symptom may be long delayed.

Adult↗