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Biomedical subjects

H L Krüskemper

Publications and source records attributed to H L Krüskemper.

At least 19 recordsLinked to original sources
PubMed1988

[Subtotal thyroidectomy as a superior therapeutic principle in the treatment of endocrine ophthalmopathy: a comparison with retrobulbar irradiation and thyrostatic therapy alone].

In order to investigate the influence of near total thyroidectomy on the course of endocrine ophthalmopathy (E.O.) in patients with Graves' disease, 29 patients with goitre and E.O. were classified before and after (up to 18 months) operation by use of a special ophthalmopathy index. 14 patients without goitre served as controls; they get only antithyroid drug treatment (ADT) (E.O. I and II, n = 7) or additional retoorbital irradiation (E.O. III and IV, n = 7, linear accelerator, 20 Gray). 20 out of 29 operated patients showed an improvement in the E.O., 4 a deterioration, 5 were unchanged. 3 out of 7 not operated patients with mild E.O. showed an amelioration during ADT, 4 no change. Additional radiotherapy in 7 patients with severe E.O. caused an improvement in the clinical condition of 3 patients, 3 patients deteriorated and 1 patient showed no change. It is concluded that adequate near total thyroidectomy has a positive effect on the clinical course of E.O. in patients with Graves' disease and E.O.

Follow-Up Studies↗
PubMed1988

Serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin in chronic renal failure.

Serum 1,25-dihydroxyvitamin D (1,25(OH)2D) is normal in some patients with chronic renal failure. We studied the question, whether factors known to regulate the serum 1,25(OH)2D concentration such as parathyroid hormone, calcium, phosphate and especially the serum 25 hydroxy vitamin D (25 OH D) concentration are related to circulating levels of serum 1,25(OH)2D in such patients. We found no correlation between these serum parameters and 1,25(OH)2D. Our data indicate that other factors are of more importance for the regulation of serum 1,25(OH)2D in this situation.

Calcifediol↗
PubMed1988

Abnormalities in estrogen, androgen, and insulin metabolism in idiopathic hemochromatosis.

Of 44 male patients with idiopathic hemochromatosis who were diagnosed at an early stage without morphological or biochemical evidence of liver disease, 25% suffered from impotence and 34% manifested glucose intolerance. Impotence was correlated with a 50% reduction in plasma testosterone, resulting from a 63% decrease in testosterone production. Testicular atrophy was caused by insufficient secretion of gonadotropins due to the selective accumulation of iron in gonadotropic cells of the pituitary gland. However, peripheral sexual hormone metabolism, in particular the conversion of androgens to estrogens, remained unaltered. It was therefore possible to employ substitution therapy successfully with testosterone in these men, and hyperestrogenism was not observed as a side effect. The pathogenetic factors in the development of diabetes mellitus in patients with idiopathic hemochromatosis include impaired insulin secretion caused by the selective deposition of iron in B-cells of the pancreas and insulin resistance due to iron accumulation in the liver. In particular, the insulin resistance is markedly improved after depletion of body iron stores by phlebotomy treatment, resulting in lower insulin requirements in patients with insulin-dependent diabetes as well as improvement of carbohydrate metabolisms in about half of the patients with non-insulin-dependent diabetes. We have concluded that hypogonadism and carbohydrate intolerance are caused by the specific distribution pattern of excess iron in the organism, accompanied by functional impairment of affected parenchymal cells.

Adult↗
PubMed1987

[Silent adrenal gland tumors in patients with adrenogenital syndrome].

Adrenal tumors accidently detected by CT scan are increasingly seen in patients without clinical signs of adrenal diseases. We studied whether enhanced adrenal stimulation is of importance in the development of adrenal tumors. For this purpose 22 patients with adrenogenital syndrome (AGS) were studied by CT scan. One of these patients suffered from C-11 beta-hydroxylase-, one from C-3 beta-hydroxy steroid dehydrogenase-, and 20 from C-21-hydroxylase deficiency. The average adrenal size of these patients was 506 +/- 79 mm2 as compared to 132 +/- 8 mm2 in the controls (P less than 0.001). Only two patients with the late onset form revealed adrenal glands of normal size. There was a significant correlation between adrenal size and patients' age (P less than 0.01). Females with the simple virilizing form revealed adrenal glands larger than those of the late onset form (640 +/- 169 vs 308 +/- 56 mm2). Eighteen patients with AGS exhibited one (n = 11) or several (n = 7) adrenal tumors, the size of which was 5-9 mm in diameter in 9, 10-20 mm in 7, and more than 50 mm in 2 patients. There was a significant correlation between adrenal hyperplasia and tumor diameter (P less than 0.001). No correlation was found between tumor size and plasma concentrations of testosterone or 17-hydroxyprogesterone, patients' age at the time of diagnosis, or clinical signs of androgenization. Again, tumors were larger in females suffering from the simple virilizing form of AGS than in those with the late onset form (14.8 +/- 5.5 vs 7.7 +/- 0.8 mm).(ABSTRACT TRUNCATED AT 250 WORDS)

17-alpha-Hydroxyprogesterone↗
PubMed1987

[Significant association of HLA-B8 with systemic lupus erythematosus and with specific serological markers].

Analysis of the HLA antigens of the A, B and C locus of 87 patients with systemic lupus erythematosus (SLE) revealed a significant elevation for HLA-B8 of 64% as compared to 22% in a healthy control group (n = 1850) (P less than 0.000001). Owing to the known linkage disequilibrium of this genetic marker with the HLA-A1 antigen, the HLA phenotype A1, B8 was found in 55% of the SLE patients (P less than 0.000001). Moreover, a significant association of the HLA-B8 in 82% (P less than 0.025) of Ro antibody-positive SLE patients (n = 22) and in 84% (P less than 0.025) of Ha antibody-positive patients (n = 19) was striking. A more frequent occurrence of this HLA antigen could also be detected in patients with a persistent nDNA antibody elevation and in patients with manifestation of the disease before the 40th year of life as compared to patients who manifested it later. An association of the HLA-B8 antigen with a raised disease activity of SLE can be inferred.

Adult↗
PubMed1987

Attempts towards a serological diagnosis of ankylosing spondylitis.

Polytene chromosomes of salivary glands as well as nuclear proteins from Kc-cells of Drosophila melanogaster have been used as substrate to identify and evaluate the diagnostic value of crossreacting antibodies present in sera of AS patients. The diagnostic significance of the recently described anti-93D antibody (Lakomek et al., 1984) was confirmed by screening sera of patients with definite or suspected AS using cytoimmunofluorescence on the polytene chromosomes. In addition, four new antibodies could be identified in AS sera by immunoblotting. Simultaneous detection of these antibodies supports the diagnosis of AS and is most useful in diagnosis of early stages of this disease.

Adult↗
PubMed1987

[Nuclear antibodies as serologic markers in progressive systemic scleroderma].

In all, 36 patients with progressive systemic sclerosis (29 women, 7 men) were studied clinically and immunologically; 15 patients had acrosclerosis (type I) and 21, sclerosis extending beyond the wrist (type II). The sera of all patients were evaluated for ANA (HEp-2-cells), Scl-70, centromere and other ENA antibodies. The centromere antigen was characterized by immunoblotting. All patients had high-titer ANA antibodies (100%); 36% of patients had the Scl-70 antibody (a marker antibody for PSS); and in 22% of our patients a centromere antibody was detected. In all cases the anti-centromere sera reacted with a 19.5-kd polypeptide and in 2 cases they reacted with 23- and 25.5-kd proteins in addition. In patients with centromere antibodies there was increased organ involvement (heart, lung, kidney) compared with patients who had anti-Scl-70 or other nuclear antibodies.

Antibodies, Antinuclear↗
PubMed1986

The measurement of 11 beta, 17 beta-dihydroxy-4-androsten-3-one (11 beta-hydroxytestosterone) by radioimmunoassay in human plasma.

A radioimmunoassay (RIA) is described for the measurement of 11 beta,17 beta-dihydroxy-4-androsten-3-one (11 beta-hydroxytestosterone) in human plasma. The reliability criteria of the new RIA were similar to those of other steroid hormone radioimmunoassays. The mean plasma 11 beta,17 beta-dihydroxy-4-androsten-3-one level for healthy young subjects was 1.31 +/- 0.32 nmol/l (means +/- SD) in males and 1.19 +/- 0.35 nmol/l in females at 8 a.m.; during the night, there was a marked decrease, and at 11 p.m. the recorded values were 0.41 +/- 0.15 nmol/l and 0.46 +/- 0.14 nmol/l, respectively. During the corticotropin stimulation test, 11 beta,17 beta-dihydroxy-4-androsten-3-one increased from 1.03 +/- 0.33 nmol/l to 1.31 +/- 0.41 nmol/l, while in dexamethasone suppression tests a decrease from 2.04 +/- 0.82 nmol/l to 0.25 +/- 0.05 nmol/l was seen. In contrast, chorionic gonadotropin administration on 3 consecutive days did not influence plasma concentrations of 11 beta,17 beta-dihydroxy-4-androsten-3-one.

Adult↗
PubMed1985

Selective effects of gold (III) on parathyroid hormone-, prostaglandin E2- and guanine nucleotide-sensitive adenylate cyclase.

Gold(III) (Au(III)) up to 0.25 microM increased parathyroid hormone- and prostaglandin E2-sensitive chick osteoblast adenylate cyclase activity without affecting 5'-guanylylimidodiphosphate-stimulated enzyme activity. Au(III) at 5-50 microM inhibited hormone- and nucleotide-mediated activation of adenylate cyclase. Basal adenylate cyclase activity was not influenced by Au(III) in the given concentrations. Treatment of membranes with 5'-guanylylimidodiphosphate prior to incubation with Au(III) prevented the inhibitory effect of Au(III) on adenylate cyclase. Our data suggest that Au(III) alters the response of adenylate cyclase to agonists most likely through interaction with specific sulfhydryl groups associated with the enzyme system.

Adenylyl Cyclases↗
PubMed1985

[A serological criterion for Bechterew's disease. Demonstration of a new antibody specificity with polytene chromosomes].

A new antibody reacting with an antigen from polytene chromosomes of Drosophila melanogaster has been found in serum of patients with Bechterew's disease. This antigen-antibody system differs from other nuclear antibodies (anti-RNP, anti-Sm, anti-Ha/SS-B) in that it is not detectable by counter-immunoelectrophoresis. The antibody could be detected in 24 out of 62 Morbus Bechterew sera in which the antibody did not strictly correlate with the appearance of HLA-B27 antigen. The new antibody specificity is a specific serological finding in patients with Bechterew's disease and is therefore suitable for use as a diagnostic, and perhaps also as a prognostic test for this type of spondylarthritis till now assumed to be seronegative.

Adolescent↗
PubMed1985

Conversion of androgens to estrogens in idiopathic hemochromatosis: comparison with alcoholic liver cirrhosis.

Hypogonadism is common in patients with some liver diseases, such as idiopathic hemochromatosis (IHC) and alcoholic cirrhosis (AC). However, gynecomastia, a typical feature in AC, does not occur in IHC. To determine the hormonal basis for this difference, the following parameters were determined in patients with IHC and AC as well as in normal men: plasma concentrations of androgens and estrogens, metabolic clearance and production rates of androstenedione and testosterone, and the contribution of peripheral conversion of androstenedione and testosterone to the circulating estrogens. Severe impotence in both patients with IHC and those with AC was associated with more than 50% reduction in plasma testosterone. The reduction was due to 63% and 70% decreases in testosterone production in IHC and AC, respectively. The MCRs were less affected in IHC and AC (19% and 37% reductions, respectively). In IHC, the fall in testosterone concentrations was accompanied by decreased production and plasma concentrations of androstenedione, a precursor for estrogen synthesis. In contrast, production and plasma concentrations of androstenedione were significantly increased in AC. Patients with IHC had estradiol und estrone levels similar to those in normal men (mean +/- SD, 16.2 +/- 4.6 vs. 20.3 +/- 3.7 pg/ml; P = NS), whereas in AC, estradiol and estrone were significantly elevated (38.0 +/- 5.3 and 68.5 +/- 17.2 pg/ml, respectively). In IHC, sex hormone-binding globulin levels were in the same range as in the normal men, whereas sex hormone-binding globulin was increased in AC. In IHC, the instantaneous contribution of plasma androstenedione to estrone and estradiol was normal, whereas that of plasma testosterone to plasma estrogens was decreased by about 50%. In contrast, in AC, the instantaneous contribution of plasma androstenedione to estrogens was greatly enhanced, and that of testosterone was in the normal range. Since the MCRs of androgens and the conversion ratios of androgens to estrogens indicate normal peripheral metabolism of sex hormones in IHC, decreased androgen formation implies decreased testicular synthesis. This was confirmed by a significantly decreased LH level in IHC (5.5 +/- 1.9 vs. 10.5 +/- 3.1 mU/ml in normal men), indicating pituitary failure. In AC, however, increased LH (20.0 +/- 2.7 mU/ml) may be indicative of primary testicular failure. These results confirm clinical features of hypogonadism and normal estrogenic activity in patients with IHC.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Stability of steroids in plasma over a 10-year period].

In order to examine whether plasma samples may be used for steroid analysis after long periods of storage, cortisol, testosterone, oestrone and oestradiol were remeasured in samples, which had been analysed 1.3-10.8 years earlier. The method for the measurement of these steroids was unchanged over this period. The results demonstrate that at a temperature of -25 degrees C steroids remained stable. Only cortisol and testosterone concentrations showed a small, insignificant decrease (6-9%) after 3 to 4 years of storage. These differences are well within the range of the precision of the method (interassay variation), which over a period of 11 years was 9.4%, 8.0%, 10.0% and 9.5% for cortisol, testosterone, oestrone and oestradiol, respectively. It is concluded that steroid hormones in human plasma are stable in our laboratory, and that they might be analysed even after more than 10 years of storage at -25 degrees C.

Blood Preservation↗
PubMed1984

[No effect of digitalis on sex and adrenal hormones in healthy subjects and in patients with congestive heart failure].

Digoxin was studied to see whether it impairs adrenal function and feminizes male subjects by changing plasma sexual hormones; both have been reported on previously. In eight healthy male subjects neither estrone (38.7 +/- 7.7 vs 35.4 +/- 3.2 pg/ml) nor estradiol (35.8 +/- 6.4 vs 32.2 +/- 3.9 pg/ml) nor testosterone (6.32 +/- 0.74 vs 6.45 +/- 0.73 ng/ml) were found to be altered by digoxin administration (plasma levels 1.55 +/0- 0.27 ng/ml) lasting 35 days. The same was true of free testosterone (147 +/- 24 vs 142 +/- 19 pg/ml) and free estradiol (657 +/- 77 vs 615 +/- 78 fg/ml). Even maximal stimulation of the adrenal and gonadal glands by adrenocorticotropic hormone (ACTH) and human chorionic gonadotropin (hCG) did not exhibit any digoxin-induced alterations in the synthesizing capacity of steroid hormones, as shown by plasma cortisol (increase from 128 +/- 18 to 389 +/- 18 ng/ml) and testosterone (from 5.96 +/- 0.90 to 10.33 +/- 1.19 ng/ml). Furthermore, seven subjects on digoxin were observed over a period of 150-210 days; they did not show any increase of estrogens. This was also found in three subjects when estrogen levels were elevated initially due to extreme obesity. Also, 35 patients who took beta-methyldigoxin (n = 8), beta-acetyldigoxin (n = 20) and digitoxin (n = 7) from 1 to 9 (mean: 1.9) years demonstrated normal plasma concentrations of gonadal and adrenal steroids, irrespective of duration of application or the digitalis compound.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗
PubMed1984

A new serologic marker in ankylosing spondylitis.

Sera of patients with ankylosing spondylitis (AS) were screened for the presence of antibodies by indirect immunofluorescence staining of polytene chromosomes of Drosophila melanogaster. Thirty-nine percent of the sera tested contained antibodies which selectively reacted with an antigen(s) present at the chromosomal locus 93D after heat shock treatment. This indicates a novel antibody specificity in a subgroup of AS patients and may provide a new aid in the diagnosis of AS.

Adolescent↗