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F Raue

Publications and source records attributed to F Raue.

At least 145 records · Page 8Linked to original sources

1,25-Dihydroxyvitamin D3 suppresses dexamethasone effects on calcitonin secretion.

1,25-Dihydroxyvitamin D3 (1,25(OH)2D3) and dexamethasone (DEX) influence synthesis and secretion of various hormones. Recent reports concerning the interaction of the two steroids revealed opposite--agonistic as well as antagonistic--effects in different biological systems. As calcitonin (CT) gene expression is affected by both agents, inhibited by 1,25(OH)2D3 and stimulated by DEX, we utilized CT secretion and storage as a model to study the combined effects of the two hormones. A human C cell carcinoma cell line (TT) was used, incubating the cells for a period of 4 days with 1,25(OH)2D3 and DEX alone and in combination. 1,25(OH)2D3 resulted in a decrease, whereas DEX resulted in a increase of CT secretion and content. Combining the two steroids, 1,25(OH)2D3 surprisingly abolished the stimulation of DEX on CT secretion and content. The underlying mechanism is yet unclear and could be envisioned to include steroid receptor regulation or gene transcription.

Animals↗

[Therapy of hirsutism in females with adrenal enzyme defects of steroid hormone biosynthesis: comparison of dexamethasone with cyproterone acetate].

In patients with adrenal hirsutism or enzyme deficiencies in steroidogenesis, elevated adrenal androgens could be normalized by dexamethasone. We were interested to see if dexamethasone would be as effective as cyproterone acetate in treating hirsutism in selected patients with adrenal pathogenesis. Therefore 28 patients with hirsutism of adrenal origin or enzyme deficiency were treated cyclically either with cyproterone acetate and ethinylestradiol (2 mg cyproterone acetate + 0.035 mg ethinyl-estradiol days 1-21, +10 mg cyproterone acetate days 1-15) (n = 15) or with 0.25-0.5 mg dexamethasone daily at 10 pm (n = 13). In the dexamethasone group there was a significant drop in dehydroepiandrosterone and dehydroepiandrosterone sulfate levels within 9 months, but there was a diminution in hirsutism in only four women (31%); in four out of seven menstrual irregularities decreased. In the cyproterone acetate group hirsutism diminished significantly in 66% (n = 10) without suppression of adrenal androgens. Weight gain occurred in a few cases in both groups; other side effects developed in 33% in the cyproterone acetate group. Preselection of patients with hirsutism is useful with respect to diagnosis; adrenal pathogenesis should not generally indicate dexamethasone treatment of hirsutism unless there is a desire for pregnancy, because cyproterone acetate is a more powerful agent in reducing hair growth.

3-Hydroxysteroid Dehydrogenases↗

[A registry of medullary thyroid cancer in West Germany].

A register for medullary thyroid carcinoma (MTC) in FRG has been set up by the "German Medullary Thyroid Carcinoma Study Group" in 1988. The aim is to provide a basis for collaborative work on MTC especially in the hereditary forms (i.e. multiple endocrine neoplasia [MEN] type IIa, IIb). For these hereditary varieties reliable screening tests exist and, if the disease is detected by family screening in an early stage, curative surgery is possible. Until now 408 patients (234 female, 174 male) with MTC have been reported by 17 cooperative centers. The mean age at diagnosis was 45.5 years. 25% (n = 104) are hereditary forms, most of them MEN IIa (n = 86), 13 are MEN IIb and 18 belong to the familial variety without other endocrinopathy. The mean age at diagnosis for MEN IIa was 36.5 years, MEN IIb 26.9 and for the pure familial form 27.5 years. As 33 patients per year have been diagnosed since 1982, nearly 25% of all expected cases of MTC in FRG have been registered.

Adult↗

In vitro detection of neutralizing antibodies after treatment of Paget's disease of bone with nasal salmon calcitonin.

To elucidate the biologic relevance of circulating sCT antibodies, an in vitro bioassay system for the detection of neutralizing antibodies was developed utilizing the human breast carcinoma cell line T47D. We reasoned that the inhibition of the dose-dependent cAMP response to sCT in the T47D assay system by anti-sCT antibodies could be used to determine the in vivo relevance of these antibodies. In this report the clinical course of nine patients with Paget's disease of bone treated with intranasal sCT was correlated with the presence of 125I-sCT binding and neutralizing antibodies. Of these seven patients, four were found to have neutralizing antibodies; the appearance of the antibodies coincided with the development of resistance. One of these patients was subsequently treated with human calcitonin and revealed a good response to the treatment. There was no clinical resistance observed in the three patients with 125I-sCT binding antibodies but no neutralizing antibodies; no resistance was observed in two patients without 125I-sCT binding or neutralizing antibodies. We conclude that this new technique to determine the biologic relevance of circulating anti-sCT antibodies may be an useful adjunct for determining the cause of resistance in patients treated with sCT.

Administration, Intranasal↗

Combination chemotherapy of advanced medullary and differentiated thyroid cancer. Phase II study.

A group of 20 patients with advanced medullary (MTC) or differentiated thyroid carcinoma (DTC) received a combination chemotherapy of doxorubicin (50 mg/m2), cisplatin (60 mg/m2) and vindesine (3 mg/m2). In the 18 (10 MTC, 8 DTC) evaluable patients only 1 partial remission (in a patient with MTC) and 3 minor responses (in 3 patients with DTC) were observed. These responses lasted for 15, 9, 13, and 22 months, respectively. Three MTC patients suffered from progressive disease and "no change" was seen in the other 11 patients. Toxicity, including 1 severe case of cardiomyopathy, was considerable. Thus, the combination chemotherapy of doxorubicin, cisplatin and vindesine has failed to prove superior to the commonly applied doxorubicin monotherapy in patients with advanced medullary or differentiated thyroid carcinoma.

Antineoplastic Combined Chemotherapy Protocols↗

A study of complaints and their relation to vertebral destruction in patients with osteoporosis.

Patients with spinal osteoporosis suffer from vertebral deformation, loss of height and back pain, as well as from functional limitations and alterations of mood. So far little is known about the extent of these clinical symptoms at all and whether they are related in a predictable manner to the fractures or damages of bone structure. In the present study we investigated the relation between vertebral deformation and clinical symptoms in 70 patients with osteoporosis. Clinical data like pain, functional limitations and parameters of mood were examined by a standardized questionnaire. The numbers of vertebral fractures were determined, and the vertebral destruction was quantified using the Spine Deformity Index (SDI). The symptoms and functional limitations were graded and correlated to the SDI and the number of fractures. Our results underline a relation between the extent of vertebral deformation and the reduction in quality of life by pain, functional limitations and alterations of mood. This relationship was absent or less evident, if the number of fractures was taken into account. Besides the difficulties concerning the grading and quantification of clinical symptoms and outcome of disease, our study revealed that there is a causal relation between the extent of vertebral destruction measured by the SDI and the extent of these clinical parameters.

Adult↗

[Combination therapy with adriamycin, cisplatin and vindesine in C cell carcinoma of the thyroid].

Ten patients with advanced medullary thyroid carcinoma were treated with the combination of adriamycin (50 mg/m2), cisplatin (60 mg/m2) and vindesine (3 mg/m2). Only one partial remission (PR) was seen. There were six "no changes" and three "progressive diseases (PD)". Comparing with data from the literature the polychemotherapy of adriamycin, cisplatin and vindesine seems not to be superior to the mostly employed adriamycin-monotherapy. The tumor-markers calcitonin (CT) and carcinoembryonic antigen (CEA) were pathologically elevated in any case. During chemotherapy they proved to be valuable parameters of the course of the disease. In the patient with PR the CT- and CEA-serum levels reflected the clinical remission. In the patients with PD, however, they rose continuously.

Adolescent↗

Internalization of calcitonin receptors in primary rat kidney cell cultures.

Cultured rat kidney cells possess specific calcitonin receptors and a calcitonin-responsive adenylate cyclase. At 37 degrees C bound 125I-salmon calcitonin becomes increasingly resistant to acid washing. If 125I-salmon calcitonin is removed from the medium after binding, bound hormone decreases over the next 5 h. Monensin, which blocks lysosomal processing, inhibits the decrease of bound hormone. These data indicate that calcitonin receptors are internalized after binding of hormone in kidney cells. Cycloheximide prevents internalization, when it is administered 4 h before 125I-salmon calcitonin binding is studied. Pre-incubation of the cells with 10(-7) mol/l unlabelled salmon calcitonin decreases specific binding; recovery of binding needs 48 h to occur. The long time interval for recovery makes it unlikely that calcitonin receptors recycle. This is the first demonstration that normal rat kidney cells internalize calcitonin after binding. It might contribute to the loss of calcitonin bioactivity which is seen after continuous administration.

Adenosine Triphosphate↗

New operative strategy in the treatment of metastasizing medullary carcinoma of the thyroid.

Medullary carcinoma of the thyroid (MTC) is exceptional in that the hormone calcitonin produced by the tumor cells represents a specific and sensitive tumor marker. Careful screening by serial calcitonin determinations following pentagastrin stimulation allows for the early detection of metastatic disease. We have adopted a method of meticulous modified radical neck dissection to eradicate persistent or recurrent MCT in 11 patients treated over a 15-month period. This surgical approach resulted in potentially curative treatment in two patients. Effective tumor reduction was achieved in another seven. Two patients have persistent or progressive disease despite maximum efforts to eradicate malignant tissue. Follow-up is presently incomplete in one patient. Postoperative complications included recurrent nerve paralysis (n = 3), hypoparathyroidism (n = 2), muscular weakness (n = 2) and Horner's syndrome (n = 3). The majority of nervous complications improved spontaneously. It is concluded that the adopted method of meticulous modified radical neck dissection offers the chance of cure to some patients and results in the removal of substantial tumor mass in the majority of others. Postoperative problems are mostly temporary and are deemed acceptable.

Adult↗

Changing concepts in the management of hereditary and sporadic medullary thyroid carcinoma.

Recent linkage of the gene for multiple endocrine neoplasia type 2A and 2B to the centromeric region of chromosome 10 has provided new insight into the causes of medullary thyroid carcinoma and has provided tools to diagnose gene carriers status for this syndrome with greater than 90% certainty. This review focuses on how these advances influence the clinical management of both sporadic and hereditary medullary thyroid carcinoma and discusses how tests based on the genetic linkage studies will aid in the early diagnosis and treatment of this syndrome. In addition, the authors have focused on several controversial management questions regarding the type and extent of surgery for this thyroid tumor, the management of the patient with metastatic disease, and the approach to management of other manifestations of multiple endocrine neoplasia types 2A and 2B. This review attempts to provide a balanced overview of these complex issues.

Adrenal Gland Neoplasms↗

[Primary hyperaldosteronism without arterial hypertension].

Treatment-resistant hypokalaemia (2.27 mmol/l) developed in a 43-year-old woman. Plasma renin activity was depressed (0.24 ng/ml.h), aldosterone and hydroxycorticosterone concentrations were elevated (123 ng/dl and 688 ng/dl, respectively). Mean blood pressure value (30 readings) was 133/88 mm Hg. An adrenal adenoma was diagnosed by ultrasound, computed tomography and subtraction angiography and then removed. Postoperatively the signs of hyperaldosteronism (Conn's syndrome) regressed and the average blood pressure was 112/76 mm Hg. Blood-gas analysis, which preoperatively had shown a minimal metabolic alkalosis, now revealed a mild metabolic acidosis. Preoperatively present bilateral renal calcifications in the region of the papillary tips were confirmed by computed tomography. An acid loading test revealed diminished renal acid secretion, making the diagnosis of distal renal-tubular acidosis. The latter, in combination with the primary hyperaldosteronism, may have been the cause of the low blood pressure, unusual in Conn's syndrome.

18-Hydroxycorticosterone↗

[3 beta-hydroxysteroid dehydrogenase deficiency and 21-hydroxylase deficiency in hirsutism].

Of 218 women with hirsutism 16 (7%) were found to have partial 21-hydroxylase deficiency, while 38 (17%) had partial 3 beta-hydroxysteroid dehydrogenase deficiency. Six women (3%) had a steroid constellation which resembled that of an augmented adrenarche. In the women with enzyme deficiency over-weight and abnormal menstruations were more frequent (50%) than in those without such deficiency (33%). The degree of hirsutism and age at diagnosis were similar in those with and those without partial enzyme deficiency. Furthermore, the diagnosis of partial enzyme deficiency could only be made with certainty by the ACTH stimulation test, because with sole measurement of basal levels (17-hydroxyprogesterone and 21-desoxycortisol in 21-hydroxylase deficiency, and 17-hydroxypregnenolone and dehydroepiandrosterone in 3 beta-hydroxysteroid dehydrogenase deficiency) the enzyme defects are in most instances not revealed.

3-Hydroxysteroid Dehydrogenases↗

Role of voltage-dependent calcium channels in secretion of calcitonin from human medullary thyroid carcinoma cells.

Extracellular calcium concentration is an important regulator of calcitonin secretion. We used primary cell cultures of human medullary thyroid carcinoma to study the role of voltage dependent calcium channels for stimulus secretion coupling. Increasing extracellular calcium concentration (1.6-5.0 mM) in the medium caused a dose dependent release of calcitonin. The calcium channel activator BAY K 8644, a dihydropyridine, stimulated calcitonin secretion in a dose dependent manner (10(-7)-10(-5) M). This effect was completely inhibited by equimolar concentrations of the calcium channel blocker nifedipine and abolished in the absence of extracellular calcium. Similarly, nifedipine suppressed the stimulatory action of extracellular calcium. The effects of calcium and BAY K 8644 with and without nifedipine suggest that calcium influx via voltage dependent calcium channels plays an important role in calcitonin secretion. The primary cell culture of human medullary thyroid carcinoma is a good model for the study of stimulus secretion coupling.

3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗

[Primary hyperparathyroidism--changes in the disease picture].

Two groups of patients with primary hyperparathyroidism, one early group surgically treated operated between 1970 and 1979 (n = 90), and the other late group from 1980 to 1984 were compared concerning signs, symptoms and laboratory parameters in order to find out the changing trends in the clinical spectrum of this disease during these years. The decade of manifestation decreased from the age of sixty to fifty. The most common mode of presentation in the early group were renal (30%), gastrointestinal (27%), and osseous (18%) symptoms of primary hyperparathyroidism, and 21% symptoms due to hypercalcemia. In the later series severity of the typical symptoms decreased, diagnosis was made in nearly half of the patients (47%) by the incidental finding of hypercalcemia on routine biochemical screening. Careful investigation revealed that the severity but not the occurrence of organic and functional manifestations differed between the two groups. Mean serum calcium level decreased from 3.4 mmol/l in the early group to 3.1 mmol/l in the recent series. Parathyroid hormone level was increased in 90% respectively 79% of the patients. The localization of the parathyroids was done in 58% by ultrasound in the late group. Diagnosis was clearly made in 60% of the recent group by the combination of elevated serum calcium and parathyroid hormone levels and two associated symptoms. Diagnosis was more difficult in 10% when serum calcium was elevated and only one symptom was present. There is a trend in symptoms of primary hyperparathyroidism from typical "disease of stones, bones and abdominal groans" to a mild and nearly asymptomatic presentation detected by routine calcium screening.

Adult↗