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Biomedical subjects

K Hackenberg

Publications and source records attributed to K Hackenberg.

At least 37 records · Page 2Linked to original sources

Treatment of isolated gonadotropin deficiency in men with synthetic LR-RH and a more potent analogue of LH-RH.

Six patients with idiopathic isolated gonadotropin deficiency (IGD) were treated with 100 microgram LH-RH s.c. 3 times daily, leading to subnormal increases of serum gonadotropin (Gn) and testosterone (T) levels, and promoting puberty from stage I to stage II-III of TANNER. S.c. administration of 100 microgram of the more potent and longer-lasting analogue 6-D-Leu-10-Des-Gly-ethylamide-LH-RH induced LH and FSH rises after the very first application in these patients for more than 12 h. However, long-term therapy with the analogue (100 microgram s.c./day) did not improve hypogonadism. Paradoxically, on daily treatment (8 patients) with 6-D-Leu-10-Des-Gly-ethylamide-LH-RH the FSH serum levels fell after 1 week and the LH levels after 8 weeks of treatment.

Adolescent

[T-cells in thyroid disease (author's transl)].

Thymus-derived peripheral blood lymphocytes were studied in untreated (n = 18), methimazole-treated (n = 28) thyrotoxicosis, after radioiodine (n = 14), in Hashimoto thyroiditis (n = 7) and in euthyroid goiter (n = 7). The results were compared with normal persons (n = 40) without thyroid disease. There was no significant difference in the total and relative counts of T-cells either between the different groups nor compared with the controls. These findings confirm that T-cells in peripheral blood cannot give any information about activity or prognosis of the various thyroid diseases. Thus T-cells give no further suggestion concerning the possible pathogenetic role of cell-mediated-immunity.

Goiter

[Unusually high iodine excretion in hyperthyroidism in an iodine-poor area].

In 27 thyrotoxic patients and in 177 healthy controls from the area of Essen we studied the total urinary iodine excretion. Whereas the iodine excretion was only 43.7 +/- 27.3 mug iodine per g creatine in the controls, the corresponding average value was significantly higher in thyrotoxic patients. It amounted to 193.3 +/- 201.7 mug iodine per g creatinine. This finding can not be explained by selection of patients with autonomous adenomas and contamination with iodine. Possible causes are an increased daily iodine uptake by increased dietary intake or iodine containing drugs that might not be remembered by the patients and increased renal clearance of iodine. Strong evidence for a contamination with iodine is the finding of increased differences between measured and calculated PBI, the latter being derived from T4 (D). The differences averaged in both groups 5.3 and 3.2 mug/100 ml. Our data can not exclude a basedowification of preexisting goiters. This unexpected finding gives rise to corresponding investigations in other thyroid centers.

Adult

Long-term treatment of acromegaly with bromocryptine: postprandial HGH levels and response to TRH and glucose administration.

Fourteen patients with acromegaly were treated with bromocryptine (CB 154, Sandoz), 4 X 2.5 mg, for periods of up to eleven months. One patient did not tolerate the drug, ten of the remaining thirteen experienced considerable clinical improvement. There was a dose-dependent suppression of plasma growth hormone levels, but growth hormone response to TRH injection and to glucose administration was still present during therapy although reduced. TSH response to TRH was not significantly altered. The suppressive power of bromocryptine on growth hormone appears to be related to the mechanism by which TRH stimulates growth hormone secretion in acromegaly, but long-term administration of this drug may be successful in spite of an absent response to TRH in some cases. Bromocryptine appears to be a safe and effective drug for the treatment of acromegaly.

Acromegaly

Effects of growth hormone release-inhibiting hormone and bromocryptine (CB 154) in states of abnormal pituitary-adrenal function.

Growth hormone release-inhibiting hormone (GHR-IH) was administered to five patients with abnormal pituitary-adrenal function. There was immediate suppression by about 50% of ACTH levels in two patients who had undergone bilateral adrenalectomy because of Cushing's disease; one of them had Nelson's syndrome. Bromocryptine (2-5 mg) suppressed ACTH levels by 62-67% for more than 6 h in these patients. GHR-IH did not significantly influence cortisol secretion by an adrenal carcinoma and only slight changes were seen in two patients with Addison's disease. The possible therapeutic implications are discussed.

Adrenal Gland Diseases

[Abnormal hypothalamic-hypophyseal regulation as a new endocrine sign in the testicular feminisation syndrome (author's transl)].

In a 38-year-old woman with the testicular feminisation syndrome (TFS) there were increased serum levels of LH and FSH, despite normal testosterone levels, ranging from 808 to 1330 ng/dl. The patient exhibited complete end-organ resistance to androgens, as well as decreased free testosterone fraction of 1.5 percent. On stimulation with LH-RH there was enhanced LH reaction to 15 ng/ml, while FSH levels remained unchanged. Fluoxymesterone did not suppress LH and testosterone, as it did in normal controls. But the functional Leydig-cell reserve could be normally stimulated with HCG. Our results apparently confirm the suspected reduction in sensitivity of the hypothalamic-pituitary axis to androgens and suggest that this plays an important part in the pathogenesis of TES.

Adult

Serum triiodothyronine 7-15 years after fractionated low dose radioiodine therapy of thyrotoxicosis.

In 189 of 334 patients, who had been treated with fractionated doses of radioiodine for Graves' disease 7-15 years ago, the serum concentrations of triiodothyronine have been estimated in additition to the following parameters: Protein bound 127-iodine (PB-127-I), free thyroxine index, cholesterol- and TSH-level in serum, tendon reflex time and clinical index according to Billewitz et al. (1969). In forty-one of the 189 sera the free T4 (AFT4) and free T3 (AFT3) concentrations were measured as well. The following hormonal and clinical patterns were observed: (1) Euthyroidism, with all parameters within the normal range in 148 patients (equals 78-4%). (2) Hypothyroidism with low serum T3, PBI, AFT4, AFT3 and elevated TSH six subjects (equals 3-2%). (3) Persistent hyperthyroidism with increased thyroid hormone concentrations and low TSH in seven cases (equals 3-7%). (4) In twenty-eight clinically euthyroid patients (equals 14-8%) TSH was elevated with normal PBI and AFT4. Twenty of these subjects had a low normal T3 and in nine the T3 was clearly in the hypothyroid range (40 plus or minus 12 mug/dl). (5) The constellation of normal T3, low T4 and elevated TSH, which has been frequently found after radioiodine therapy, has been seen in only moderate form in ten cases.

Adult