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Biomedical subjects

J G Ljunggren

Publications and source records attributed to J G Ljunggren.

At least 19 recordsLinked to original sources
PubMed1992

Occurrence of ophthalmopathy after treatment for Graves' hyperthyroidism. The Thyroid Study Group.

BACKGROUND: Ophthalmopathy caused by Graves' disease may first appear or worsen during or after treatment for hyperthyroidism. It is not known, however, whether choosing to treat hyperthyroidism with antithyroid drugs, iodine-131, or surgery affects the development or aggravation of Graves' ophthalmopathy. METHODS: We studied 168 patients with hyperthyroidism caused by Graves' disease, stratified into two age groups--20 to 34 years (54 patients, group 1) and 35 to 55 years (114 patients, group 2). The patients in group 1 were randomly assigned to treatment with methimazole for 18 months or subtotal thyroidectomy, and those in group 2 to either of these two treatments or to iodine-131 therapy. All the patients received thyroxine to avert hypothyroidism, except those treated with iodine-131, who received thyroxine only if hypothyroidism developed. The duration of follow-up was at least 24 months. RESULTS: Twenty-two patients (13 percent) had infiltrative Graves' ophthalmopathy at randomization. During follow-up, ophthalmopathy developed for the first time in 22 patients (13 percent) and worsened in 8 patients (5 percent). The frequency of the development or worsening of ophthalmopathy was similar among the patients in group 1 (medical therapy, 4 of 27 patients [15 percent]; and surgery, 3 of 27 patients [11 percent]). In group 2, ophthalmopathy developed or worsened in 4 of the 38 patients (10 percent) treated medically, 6 of the 37 patients (16 percent) treated surgically, and 13 of the 39 patients (33 percent) given iodine-131 (P = 0.02 for the comparison between the iodine-131 subgroup and the others combined). The risk of the development or worsening of ophthalmopathy increased as pretreatment serum triiodothyronine concentrations increased. CONCLUSIONS: As compared with other forms of antithyroid therapy, iodine-131 is more likely to be followed by the development or exacerbation of Graves' ophthalmopathy.

Adult↗
PubMed1979

Serum T3 and T4 determinations during the TRH test as a complement to improved discriminatory power in suspect hyperthyroidism.

The aim of the study was to determine whether the addition of T3 and T4 determination in connection with a routine TRH-test could increase the discriminatory power of the test. Thus, forty-one patients with suspect hyperthyroidism were examined and samples for T3 and T4 and TSH determinations were drawn prior to the administration of TRH and at 20 and 60 min thereafter. The results showed that the addition of these thyroid hormone estimations did not increase the clinical value of the TRH-test.

Adult↗
PubMed1979

The influence of endogenous cortisol on the peripheral conversion of thyroxine in patients with acute myocardial infarction.

A study was performed to elucidate whether endogenous cortisol, as previously suggested, could be responsible for the decreased T3 levels seen in euthyroid patients with acute myocardial infarction. Levels of these hormones as well as levels of T4 and reverse-T3 were monitored in 31 consecutive patients admitted to the Coronary Care Unit with symptoms of precordial pain or with acute arrhythmias. Sixteen of the patients had proven myocardial infarction, the remaining 15 were used as a control group. The results demonstrated that a reduction of T3 levels was seen in the infarction group without evidence of a statistically significant difference between the daily mean cortisol levels. No significant difference could be observed in T4 or reverse-T3 levels in the two groups or in T3 levels in the control group. It is concluded that the decrease in T3 levels is not a consequence of the increased levels of endogenous cortisol.

Acute Disease↗
PubMed1979

T4, T3 and reverse-T3 determinations in connection with the TRH test in the evaluation of possible hyperthyroidism.

One disadvantage of the TRH test is that an absent or blunted TSH response is seen not only in hyperthyroid patients but also in some normal subjects. The aim of the present study was to elucidate whether the discriminatory power between eu- and hyperthyroidism could be increased by determining the T3 and T4 levels before and after the TRH administration. The study population consists of 30 patients referred for evaluation of suspected hyperthyroidism. The results show that all but one of the patients (n=20) who had T3 levels within the normal reference limits increased these levels after TRH administration, whether their TSH response was normal or blunted. One patient's T3 levels decreased after TRH. All the patients (n=10) who had T3 levels within the hyperthyroid range showed a decrease after TRH. The decrease was significantly correlated (r=0.90) to the magnitude of the increase. No consistent T4 and no change in reverse-T3 response was obtained. The addition of T3, T4 or reverse-T3 determinations in connection with the TRH test does not seem to increase the discriminatory power of the test.

Adult↗
PubMed1979

The role of endogenous cortisol in patients with non-thyroidal illness and decreased T3 levels.

The aim of the study was to elucidate if endogenous cortisol, as previously suggested, could be involved in the mechanism behind the reduced serum T3 levels seen in euthyroid patients with various non-thyroidal illnesses. The correlation between the serum levels of T3 and cortisol was investigated in 41 hospitalized patients with non-thyroidal illness during hyperpyrexia. The results showed a correlation coefficient of -0.94, indicating a close reciprocal association between the two hormones. Cortisol may thus be one factor associated with the decreased T3 levels seen in euthyroid patients with non-thyroidal illness. The results also indicate a close parallelism between the total and free T3 levels during hyperpyrexia.

Body Temperature↗
PubMed1978

Sympathetic innervation and noradrenaline content of normal human thyroid tissue from fetal, young, and elderly subjects.

In man, as well as in the mouse, there is morphologic and functional evidence for a direct, stimulatory influence of the sympathetic nervous system on the secretion of thyroid hormone by noradrenaline (NA), released from interfollicular adrenergic nerve terminals. In mice and rats, an age-related reduction of the sympathetic innervation of the thyoid has recently been observed. In the present study, possible age-related variations of the sympathetic innervation and the concentration of NA in human thyroid tissue were examined. Interfollicular adrenergic nerve terminals were studied by fluorescence histochemistry, and the tissue concentration of NA was measured by fluorometry. In apparently normal thyroid tissue, obtained from fetuses, young (20-45), and elderly (greater than 60) euthyroid people with thyroid cancer or hyperparathyroidism, the number of interfollicular adrenergic nerve terminals appeared to be reduced with increasing age, and the thyroid tissue concentration of NA was significantly lower in elderly than in young people. These findings may have functional importance.

Adult↗
PubMed1978

The effect of propranolol on serum levels of T4, T3 and reverse-T3 in hyperthyroidism.

The effect of propranolol (40 mg t.d.s.) on the peripheral levels of T4, T3 and reverse-T3 was studied in 26 patients with hyperthyroidism. The compounds were measured by specific radioimmunoassay techniques. The levels were followed for five weeks and compared with the levels before treatment. The results show that propranolol had no significant effect on the peripheral levels of T4 despite a rapid amelioration of clinical symptoms. A significant reduction of T3 levels was obtained during the first to fourth week of treatment. No significant decrease was obtained after the fourth week. A significant elevation in reverse-T3 levels was obtained during the second to fourth week of treatment. No significant change was obtained either during the first week or after the fourth week. Inconsistent fluctuations in hormone levels, both before and during treatment, could be seen in individual cases. The results suggest that the reduction of clinical symptoms must be caused by an extrathyroidal action of propranolol which does not seem to involve the pituitary gland.

Adult↗
PubMed1978

Radioimmunoassay of triiodothyronine and thyroxine in capillary blood.

A radioimmunoassay technique for the estimation of T3 and T4 levels in capillary blood is described and evaluated in comparison to a simultaneously drawn and equally analyzed sample from the cubital vein. A total number of 236 samples thus received from the capillary and the vein from euthyroid, hypo- and hyper-thyroid patients were collected. For both T3 and T4 a good correlation (r = 0.94) was obtained. The clinical implication would especially be for paediatric practice.

Capillaries↗
PubMed1977

Comparison between serum thyroxine and triiodothyronine estimation and the TRH test in the routine diagnosis of hyperthyroidism.

Serum T3 and T4 levels have been determined by a radioimmunoassay technique and the TRH test has been performed in 50 patients in whom hyperthyroidism could not be ruled out by the first clinical examination alone. Each patient was then further evaluated in order to establish the state of the thyroid function. The extent to which the determination of T3 or T4 could replace the TRH test in the routine diagnosis of hyperthyroisism was evaluated. The results showed that 26 of the 50 patients had normal thyroid function and 24 had hyperthyroidism. No patient in the normal groups and all but one in the hyperthyroid group had T3 levels above the upper normal limit (2 S.D.). Two of the patients in the normal group and 19 in the hyperthyroid group had T4 levels above the upper normal limit (2 S.D.). Twenty of the patients in the normal group showed a normal TSH response to TRH (increment is greater than 3.0 micronU/ml); the remaining 6 showed an impaired or absent response. Twenty of the hyperthyroid patients had no response and four had a slightly positive response to TRH. No hyperthyroid patient had a TSH response exceeding 3.0 micronU/ml. It is concluded that the determination of T3 is superior to both the determination of T4 and the TRH test for the laboratory discrimination between eu- and hyperthyroidism.

Adult↗
PubMed1977

The effect of body temperature on thyroid hormone levels in patients with non-thyroidal illness.

During studies on the mechanism underlying the low serum T3 levels in euthyroid patients with various acute and chronic non-thyroidal illnesses, it became evident that body temperature may be one parameter associated with changes in serum T3 levels. Forty-nine hospitalized, euthyroid patients with hyperpyrexia caused by various non-thyroidal illnesses were studied. The levels of serum T3 were found to decrease gradually with increasing body temperature. T3 was already below the normal level +/- 2 S.D. at a body temperature of around 38 degrees C. Such low T3 levels as were seen at temperatures of above 40 degrees C are observed in thyroid patients only during severe hypothyroidism. The levels of T4 and TSH remained unchanged and within the normal range regardless of body temperature. The levels of reverse-T3 in the sera analyzed were found to be unchanged in some cases, while in others they paralleled body temperature. It is concluded that the body temperature must be taken into consideration when studying the serum levels of T3.

Adolescent↗
PubMed1976

Radioimmunoassay of triiodothyronine in human serum with special reference to methodological problems.

A radioimmunoassay for measuring the level of triiodothyronine in human serum has been developed and studied with respect to interference from hormone-binding substances present in human serum. Dextran-coated charcoal was used for the separation of free and antibody-bound hormone. ANS (8-anilino-1-naphthalenesulfonic acid) was used to reduce the interference from hormone-binding substances in serum. Extraction of the hormone by ethanol before the radioimmunoassay did not solve the problem of interference, even in the presence of an internal standard. The protein concentration in the assay system strongly influenced the charcoal adsorption of free and antibody-bound hormone, and optimal concentrations for both proteins and ANS had to be worked out to get a reliable assay for unextracted serum.

Anilino Naphthalenesulfonates↗
PubMed1976

Rapid simultaneous radioimmunoassay for the measurement of triiodothyronine and thyroxine in unextracted human serum.

A rapid simultaneous radioimmunoassay for the measurement of triiodothyronine and thyroxine in unextracted human serum is described. The method requires 25 mul serum. Approximately 150 human sera can be tested for triiodothyronine and thyroxine levels in one day by one technical assistant. The triiodothyronine levels in peripheral venous blood in euthyroid subjects and in patients with various thyroid diseases are as follows: euthyroid (50) 115 +/- 22 (mean +/- SD) ng/100 ml, hypothyroid (20) 33 +/- 35 (mean +/- SD) ng/100 ml and hyperthyroid (20) 411 +/- 142 (mean +/- SD) ng/100 ml. The corresponding levels for thyroxine are: 6.9 +/- 1.3, 2.0 +/- 1.4 and 21.4 +/- 5.2 mug/100 ml. The levels of triiodothyronine in the thyroid venous blood are higher (P less than 0.05) than in the peripheral venous blood. The levels of thyroxine in the thyroid venous blood was not significantly higher than in peripheral venous blood.

Binding Sites, Antibody↗
PubMed1976

Concentration of thyroxine, tri-iodothyronine and thyroglobulin in the thyroid lymph.

Human thyroid lymphatic fluid was collected from 8 patients operated upon for thyroid tumours. All tumours were of small size and localized to one lobe. The lymph was collected from the side opposite the tumour. The levels of thyroxine and tri-iodothyronine in the lymph were determined by a radioimmunoassay technique in 7 of the patients. The thyroglobulin content of thyroidal lymph from one patient was analysed. The results demonstrate higher levels of thyroxine and tri-iodothyronine in the human thyroid lymphatic fluid as compared with those seen in peripheral or thyroid venous blood. Evidence for the presence of thyroglobulin in the human thyroid lymphatic fluid was obtained.

Adult↗