Unusual hyperthyroxinemia caused by endogenous thyroxin antibodies.
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Biomedical subjects
Publications and source records attributed to J Standefer.
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We describe a semiautomated, enzymatic method of analysis for ethylene glycol in plasma. Glycerol dehydrogenase (EC 1.1.1.6) from Enterobacter aerogenes, which has high specificity for ethylene glycol, is mixed with 3 microL of specimen in a centrifugal analyzer. NAD+ is added to initiate the reaction, and 450 s after an initial 90-s delay, the absorbance at 340 nm is measured. Monthly calibration with a five-point calibration curve is sufficient to provide between-day precision (CV) of 2% to 5%. The detection limit is 0.3 mmol/L with a CV of 10%. There is no significant interference from ethanol, methanol, isopropanol, acetone, lactate, or glycerol.
The purpose of this study was to investigate the effect of norfloxacin on theophylline elimination. Ten normal volunteers were studied. In a randomized crossover sequence, each subject received 6 mg of aminophylline per kg of body weight by a 30-min intravenous infusion on day 4 of taking norfloxacin (400 mg every 12 h) or while drug free. Mean theophylline clearance decreased and mean elimination half-life increased after norfloxacin administration (from 0.036 +/- 0.006 to 0.033 +/- 0.004 liter/h per kg and from 8.7 +/- 1.2 to 9.5 +/- 1.5 h, respectively; P less than 0.05, Wilcoxon signed-ranks test). We conclude that norfloxacin taken in recommended doses for 3 days has a small inhibitory effect on theophylline metabolism that would probably not cause clinically important elevations in theophylline concentrations in most patients.
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This study explored the relationship between metyrapone blockade of endogenous cortisol secretion and the plasma concentration of basal ketone bodies in insulin-dependent diabetic man. Endogenous cortisol secretion was reduced with metyrapone administration (as assessed by a reduction in plasma cortisol and an increase in deoxycortisol concentration) and then simulated with two different schedules of exogenous cortisol administration. Our results demonstrate that administration of metyrapone suppresses plasma cortisol concentration which may then be elevated by the oral ingestion of cortisol. The suppression of endogenous cortisol secretion with metyrapone results in a 50% reduction in basal plasma ketone body concentration. When endogenous cortisol secretion was simulated with the oral administration of 30 mg cortisol, plasma ketone body concentration returned to that concentration observed in the control study. When 60 mg cortisol were administered in divided dosages to the diabetic subjects, hyperketonemia resulted. These results suggest that the normal diurnal variation in plasma cortisol concentration may modulate the basal plasma ketone body concentration in diabetic man. The mechanism of this modulation may be a direct effect of cortisol or may be secondary to cortisol's lipolytic activity and/or its effects on elevating plasma glucagon concentration.
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I describe an assay for serum estriol during pregnancy, which does not require prior extraction or chromatography of the serum. Fifty microliters of 20-fold diluted serum can be assayed to detect as little as 20 pg of estriol. For a 20 mug/liter serum estriol concentration the CV was 16%; for 100 mug/liter concentration it was 5%. There was no significant interference by serum "binding" proteins. The assay measures unconjugated estriol, estriol conjugated with either sulfate or glucuronide at the 3' position, and a portion of the estriol 16 alpha (beta-D-glucuronide). Serum estriol concentrations increase during gestation from a low at 20 weeks of less than 10 mug/liter to a high of 100-150 mug/liter at term. Serum estriol values correlate well with those for urinary total estrogens and with values for human placental lactogen in serum at various gestational ages.
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Fifty-seven patients with a strong clinical suspicion of cervical myelopathy were studied with body coil magnetic resonance (MR) and conventional myelography or CT myelography. Eight patients were believed to have normal studies with both modalities. There were six patients with syringomyelia; four with an intramedullary tumor; one with an arteriovenous malformation; 19 with cervical spondylosis at multiple levels; eight with cervical spondylosis at a single level; four with extensive rheumatoid arthritis; four with extradural neoplasm; two with trauma; and one patient with an epidural abscess. In this study, body coil MR was the superior examination for the evaluation of an intramedullary process. It was as diagnostic as myelography in one case of an extramedullary intradural lesion. In patients with extradural disease, body coil MR was the superior study in 45%, equivalent to myelography in 37%, and, although still diagnostic, inferior to myelography in 17%. In 8% of the cases, body coil MR was at best equivocal, whereas myelography was diagnostic. It appears that in technically adequate studies, MR is at least equivalent to myelography in its ability to delineate disease. A superior MR study provides a better appraisal of the size and character of the spinal cord as well as the degree of both anterior and posterior defects on the subarachnoid space and neural structures. In addition, MR is as good as conventional myelography for the identification of extrinsic cervical cord lesions producing cervical myelopathy. Finally, an additional small group of 30 patients were studied with a prototype surface coil to determine its advantages relative to body coil imaging. Each patient had correlative myelography. As with body coil MR, imaging with the surface coil was believed to be more informative than conventional myelography in four patients with intramedullary lesions. The remaining 26 patients suffered from cervical spondylosis. Surface coil MR was believed to be more informative than myelography in six cases (23%), equivalent to myelography in 19 (73%), and less diagnostic than myelography in one (4%). The improved spatial resolution with the use of the surface coil was believed to increase the accuracy of MR.