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Biomedical subjects

H Kainz

Publications and source records attributed to H Kainz.

6 recordsLinked to original sources

Clinical evaluation of new assays for determination of serum calcitonin concentrations.

In order to test the clinical usefulness of new commercially available kits for determination of calcitonin serum concentrations, we investigated the family (N = 10) of a patient with medullary thyroid carcinoma and bilateral pheochromocytoma including his affected son, 10 athyreotic patients, totally thyroidectomized for non-medullary thyroid cancer, and 4 normal volunteers. Pentagastrin tests were performed in all subjects. Serum calcitonin levels before and after pentagastrin were determined by 4 kits. Kits A and B are immunoradiometric assays of the sandwich-type, kits C and D are radioimmunoassays, D being the one hitherto routinely used. Our results show that the new assays (kits A, B and C) have a better diagnostic accuracy in screening for medullary thyroid cancer than the RIA (kit D), hitherto used, where basal values overlapped with normals. Although basal values of normals were mostly near the detection limit of all 4 kits, kits A and B were sensitive enough to detect stimulation of calcitonin secretion by pentagastrin in all subjects with intact thyroid glands and kit C in most of them. The lack of increase in calcitonin after pentagastrin observed by kits A, B and C in athyreotic patients suggests deficiency of secretion of this hormone. Only kit D was unable to show this deficiency.

Adrenal Gland Neoplasms

[Can the thyrotropin (TSH) suppressive dose of L-thyroxine (T4) be individually predicted in athyroid patients?].

TSH-suppressive doses of L-thyroxine (T4) are needed in the treatment of athyreotic cancer patients in order to prevent metastases. We were interested to know whether the TSH-suppressive dose can be predicted on a body weight-or body surface basis in athyreotic individuals, which might save them the control TRH-test. 92 athyreotic patients (22 men, 70 females; age 25-81, mean 50.4 yrs; body weight ranging from 48-114 kg, mean 73), who have been operated for differentiated thyroid cancer and who have had at least one treatment ablative doses of 131-I, were investigated. After 4 weeks without thyroid hormone supplementation (checked by TSH serum concentration above 20 microU/ml) patients were set on 150 mcg of L-T4/day. TSH serum concentration before and 20' after 200 mcg of TRH were measured by the ultrasensitive TSH kit of Behringwerke. Total and free T4 as well as total T3 were also measured by radioimmunoassay kits. TRH tests were performed 6 weeks after start of treatment in 51 patients and 8 or more weeks respectively in 41 patients. Only the inclusion of the influence of age (multiple correlation) yielded a significant positive correlation between basal TSH and L-T4 dose/body weight.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

HLA-DR and differentiated thyroid cancer. Lack of association with the nonmedullary types and possible association with the medullary type.

One hundred twenty-seven white European patients with differentiated thyroid cancer were typed for human lymphocyte antigen (HLA) DR specificities. There was no significant deviation from the HLA-DR distribution observed in 160 normal patient controls, neither in the entire group nor in the patient groups with nonmedullary types of thyroid cancer (61 with papillary and 44 with follicular, all nonradiation associated). Also, subdivision of patients with nonmedullary thyroid cancer according to age at diagnosis, presence of metastases, and presence of thyroglobulin antibodies in serum showed no significant deviation from the HLA-DR distribution. For the patients with medullary thyroid cancer (only sporadic [n = 20] or inherited isolated [n = 2] forms, no multiple endocrine neoplasias), there was a significant increase of HLA-DR2 (11 of 22 cases [50%]) in comparison with control patients (22%; P corrected to 0.02; relative risk, 3.6). These data suggest, in contrast to previous reports, that there is no genetic influence on the development of nonmedullary types of differentiated thyroid cancer. Medullary thyroid cancer without multiple endocrine neoplasia, however, may be associated with HLA-DR2.

Carcinoma

Changes in biochemical parameters during complete thyroid hormone deficiency of short duration in athyreotic patients.

The effect of withdrawal of suppressive therapy with thyroid hormones (200 micrograms L-thyroxine/day) on serum biochemical profiles and blood cell counts were studied in ten athyreotic thyroid carcinoma patients. After 14 days off therapy, all patients but one were still clinically and biochemically euthyroid. Twenty-eight days without thyroid hormones resulted in severe clinical and biochemical (TT4, TSH) hypothyroidism. At that time, the following parameters changed significantly: CPK activities increased (in five of ten patients above normal) as well as activities of SGOT, SGPT, and LDH (means and s.d.s within the respective normal ranges). Total cholesterol and triglycerides increased within the normal range. There were minimal but significant increases of serum creatinine and of mean corpuscular volume of erythrocytes as well as decreases of serum sodium and calcium. Our study underlines the importance of further investigation if pathologic biochemical or hematologic parameters are obtained in athyreotic patients after 4 wk withdrawal of thyroid hormone therapy.

Adult