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Biomedical subjects

J Nĕmec

Publications and source records attributed to J Nĕmec.

At least 145 records · Page 8Linked to original sources
PubMed1976

The influence of thyroid function on the diabetogenic action of triamcinolone in man. Glucose, insulin and growth hormone patterns after on oral glucose load.

In subjects with varying thyroid function (12 hypothyroid, 11 euthyroid and 12 hyperthyroid) an oral glucose tolerance test was performed without sensitization (OGTT) and after sensitizing with triamcinolone (TGTT). The blood glucose, serum immunoreactive insulin (IRI) and growth hormone (HGH) levels were assessed. In hypothyroid subjects a marked deterioration of the glucose tolerance was found during the TGTT as compared with OGTT, a reduction of the glucose disappearance index (GDI) and almost unchanged IRI values. The decrease of insulinogenic index (II) was not significant. In euthyroid subjects the decrease of glucose tolerance after triamcinolone was only mild, GDI values remained unaltered, IRI values and II increased. In hyperthyroid persons the decrease of glucose tolerance during TGTT was even less pronounced than in the euthyroid group, although the IRI value increased only on fasting. No significant differences of HGH pattern were observed in any group. In our patients the diabetogenic effect of triamcinolone was inversely related to the saturation with thyroid hormones and an increased response of insulin to glucose load was observed only in euthyroidism. In hyperthyroidism the participation of non-insular factors in the mechanism of maintaining the glucose tolerance after triamcinolone should be assumed.

Adult↗
PubMed1976

Diabetogenic effect of triamcinolone in man with impaired thyroid function: serum free fatty acids, inorganic phosphorus, calcium and total protein pattern after an oral glucose load.

In a group of 35 subjects (12 hypothyroid, 11 euthyroid and 12 hyperthyroid) the changes of FFA, inorganic phosphorus, calcium and total proteins were investigated during glucose tolerance test with (TGTT) or without (OGTT) triamcinolone pretreatment. In hypothyroidism the decrease of FFA during TGTT was blunted, whereas the pattern of phosphatemia was unaltered and total proteins were increased. In euthyroidism triamcinolone exerts the opposite effect on the behaviour of FFA (decline was smaller and shorter) and phosphatemia (decline was pronounced and persists for longer period). In hyperthyroidism the fasting level of FFA decreased in TGTT but during the test no significant differences in FFA and phosphatemia patterns were observed. The calcemia was not influenced by triamcinolone in any subgroup. Our results suggest the importance of thyroid function as modifying factor in some metabolic effects of triamcinolone in man. Changes in hypothyroidism are in good agreement with changes of blood glucose and insulinemia, as described previously. Opposite effect of triamcinolone on FFA and phosphatemia pattern in euthyroidism may suggest the changes of sensitivity of some peripheral tissues to insulin action. The decline of fasting level of FFA after triamcinolone in hyperthyroidism is surprising and might be of importance in maintaining unaltered glucose tolerance after triamcinolone in this subgroup.

Blood Proteins↗
PubMed1976

Critical evaluation of the diagnostic value of systolic time intervals in the diagnosis of functional thyroid diseases. Comparison of results in a highly selected and a non-selected group of patients in relation to the blood PBI and T4I levels.

The value of measuring systolic time intervals for the diagnosis of functional thyroid disorders was studied. We were able to confirm that the systolic time intervals, namely the preejection period (PEP) are significantly shortened in hyperthyroidism and protracted in hypothyroidism. We were able to prove the rectilinear correlation between the PEP interval and Ig PBI in both highly selected and unselected groups of untreated patients with thyroid disorders. We were able to show much lower diagnostic value of other systolic intervals (as Q-S2) and indices (Weissler's index) compared to PEP. We are able to enumerate some pathological cardiovascular states, where the PEP interval is considerably influenced. With due respect to above-mentioned problems, we are convinced that the PEP measurement is of real diagnostic value in the bed-side diagnosis of thyroid disorders, moreover we believe it might help to solve some theoretical problems.

Electrocardiography↗
PubMed1975

Familial occurrence of differentiated (non-medullary) thyroid cancer.

Differentiated thyroid cancers were found in mother and son. The diagnosis was made first in the boy where papillary and follicular cancer with lymph node involvement and lung metastatic dissemination was diagnosed at the age of 9. Treatment by surgery, radioiodine and thyroid hormones was highly effective. 1 year later, thyroid surgery was performed on his mother but the diagnosis of poorly differentiated follicular thyroid cancer was made only 4 years later when the primary tumour was already unresectable and distant metastases present. In spite of treatment, the disease followed a lethal course in the mother. The familial occurrence of differentiated thyroid cancer is extremely rare and this report is the first where neither previous radiation exposure nor familial colonic polyposis were detected.

Adenocarcinoma↗
PubMed1975

Earlier responses in the delay of Korotkoff sounds as compared to the Achilles reflex time in rapid changes of thyroid function in man.

In rapidly changing thyroid state Rodbard's Q-Kd interval (reflecting heart contractility) changes more rapidly, than ART (reflecting skeletal muscle contractility). After withdrawal of substitutive therapy in athyreotic patients the Q-Kd intervals prolongs more rapidly than ART and during intensive treatment of hypothyroidism the Q-Kd interval shortens more rapidly that ART. A more rapid metabolic turnover in heart muscle in comparison with skeletal muscle is proposed as suitable explanation. Practical consequences for early diagnosis of hypothyroidism and for instant functional diagnosis of thyroidal disorders are stressed.

Achilles Tendon↗
PubMed1975

Serum thyroxine estimation: clinical evaluation of a modified semiautomated method and its ability for differential diagnosis of thyroid diseases.

A modified semiautomated microchemical method for determining serum thyroxine has been described. It consists of the isolation of T4 on a column of cation exchange resin Dowex 50 W X 2 and of a fully automated determination of iodine in the ammoniacal eluate from the column after an acidic mineralization. The diagnostic value of the method has been evaluated on a small group of patients examined for suspected thyroid gland dysfunction, in comparison with a parallel determination of T4 by a CPBA method (Tetrasorb test kit). From the results it follows that the microchemical method gives the results something inferior in comparison with the CPBA technique. The differences of means between the basic diagnostic groups of patients (euthyroids, hypothyroids, and hyperthyroids) in both methods were statistically significant. The extent to which these tests can discriminate was investigated at a 5% discrimination threshold. The discriminatory ability of both methods between hyperthyroidism and euthyroidism is nearly the same. The CPBA method discriminates euthyroids from the hypothyroids better, the results of both tests, however, do not differ too much. It seems to be confirmed that irrespective of the method used, the determination of serum T4 itself can detect neither hyperthyroidism nor hypothyroidism reliably. The possible causes are discussed in this paper.

Autoanalysis↗
PubMed1975

The effect of exogenous TSH and Achilles tendon reflex time in man.

The effect of exogenous thyrotropin (TSH) -- 3 X 10 IU daily -- on Achilles tendon reflex time (ART) was investigated in the group of 38 in-patients, treated for thyroid cancer. A significant shortening of ART was recorded in a subgroup of hypothyroid persons after the 2nd and 3rd dose of TSH. Moreover, a significant correlation was proved between initial values of ART and their changes after the 2nd and 3rd TSH injection in this group. No significant interrelationship was observed between changes of thyroid function and ART after TSH administration. In interpretation of this finding the possibility of direct effect of TSH on muscle metabolism in hypothyroid man should be considered.

Humans↗