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Biomedical subjects

O L Myking

Publications and source records attributed to O L Myking.

34 records · Page 2Linked to original sources

Human chorionic gonadotropin in early normal and pathologic pregnancy. Discordant levels in peripheral maternal blood and blood from the uterine and abdominal cavities.

Human chorionic gonadotropin was assayed in 25 cases after first-trimester induced abortion, in 45 cases of spontaneous abortion in the first trimester, and in 27 cases of ectopic pregnancy. Blood was obtained from an antecubital vein and from the uterine cavity. In the cases of ectopic pregnancy blood was also obtained from the abdominal cavity. In the group of induced abortion the human chorionic gonadotropin levels in peripheral maternal blood did not differ significantly from the levels in the uterine cavity. In the groups of spontaneous abortion and ectopic pregnancy the human chorionic gonadotropin levels were significantly higher in blood from the uterine cavity and the abdominal cavity, respectively. In four cases (three with spontaneous abortion and one with an ectopic pregnancy) human chorionic gonadotropin was not detectable in peripheral maternal blood, while it was found in blood from the uterine and abdominal cavities.

Abdomen↗

Evaluation of new serum and urine tests in cases of suspected pathologic early pregnancy.

Two pregnancy tests, ModEL serum hCG Assay and ModEL Urine hCG Assay, were evaluated using sera and urine from 46 patients suspected of pathologic early pregnancy, of whom 22 patients had spontaneous abortion and 9 an ectopic pregnancy. ModEL Serum hCG Assay had a 100% sensitivity and specificity, thus demonstrating its value in these cases. With a sensitivity of 94% and a specificity of 87%, ModEL Urine hCG Assay gave poorer results. Both tests have a relative high "detection limit" of 25 U/l (serum) and 50 U/l (urine) which may impair their ability to distinguish between presence and absence of pregnancy by very low levels of hCG.

Abortion, Spontaneous↗

Circulating catecholamine and potassium concentrations early in acute myocardial infarction: effect of intervention with timolol.

In a prospective study, 20 patients with a first acute myocardial infarction and no current treatment with diuretics or cardioactive drugs were randomized to treatment with intravenous timolol (10 patients) or placebo (10 patients). Plasma adrenaline, noradrenaline, and serum potassium were estimated at baseline (mean +/- SD 3.6 +/- 0.8 hours after the onset of the infarction) and 4 hours after the start of treatment. The patient selection criteria embraced a low-risk study population. Before treatment, the serum potassium concentrations correlated inversely with plasma adrenaline but not with plasma noradrenaline concentrations. A rise of serum potassium (mean +/- SD mmol/L) from 4.1 +/- 0.3 to 4.4 +/- 0.4 (p less than 0.05) in the placebo group and from 4.0 +/- 0.4 to 4.5 +/- 0.5 (p less than 0.05) in the timolol group was in multivariate analysis associated with infarct size, estimated as cumulative creatine kinase release, in the placebo group, and with the mean individual plasma adrenaline concentrations in the timolol group. By reversing the effect of adrenaline from a decrease to an increase in the serum potassium concentrations, timolol changes the relationships between circulating adrenaline, potassium, and infarct size.

Aged↗

Conjugated and unconjugated plasma oestrogens in men with chronic alcoholism and in normal men.

The plasma concentrations for unconjugated and conjugated oestrone, oestradiol-17 beta and oestriol, were measured in 25 male patients with chronic alcoholism and 25 healthy male blood donors of the same age. All persons had normal weight and were free of medication. The patients with chronic alcoholism consisted of 15 persons with and 10 without hepatomegaly. Liver biopsy was performed in the persons with hepatomegaly. Unconjugated oestrogens were separated on LH-20 micro columns after extraction with diethyl ether. Oestrogen sulphates were extracted and separated after hydrolysis with sulphatase, and glucuronides were extracted and separated after hydrolysis with glucuronidase. In the patients with hepatomegaly the plasma concentrations of unconjugated oestrone, oestradiol-17 beta and oestriol were significantly increased, and the plasma levels for the same oestrogen sulphates were significantly decreased, whereas a moderate increase was observed for oestriol glucuronide. The patients without hepatomegaly revealed a significantly lower plasma concentration for oestrone sulphate, whereas no difference was seen for the remaining oestrogen components. The ratio oestrone sulphate to oestrone was significantly reduced in both groups of patients. A significant decrease for the ratio oestradiol sulphate to oestradiol and oestriol sulphate to oestriol was seen only in the patients with hepatomegaly.

Alcoholism↗

Plasma concentrations and transperitoneal transport of native insulin and C-peptide in patients on continuous ambulatory peritoneal dialysis.

The insulin and C-peptide response to glucose (50 g), given intraperitoneally or enterally, and the elimination rate of these compounds has been studied in five nondiabetic patients on continuous ambulatory peritoneal dialysis (CAPD). The fasting C-peptide concentrations were three to ten times the normal values, whereas the fasting plasma insulin concentrations were within normal limits. After intraperitoneal glucose administration, a more marked hyperglycemia (P less than 0.05) and a more long lasting hyperinsulinemia (P less than 0.05) were found than after the enteral glucose load. The relative change in plasma C-peptide was slower and less pronounced in both experiments. Estimated total body clearance (Kt) for insulin was higher than for C-peptide (P less than 0.01), but dialysis clearance (Kd) for C-peptide was higher than for insulin in both experiments (P less than 0.01). The markedly elevated fasting C-peptide concentrations in plasma can be explained only partly by the absence of normal kidney function and suggests a continuously increased production of C-peptide during CAPD treatment. This was not reflected by the fasting plasma insulin concentrations. C-peptide measurements in plasma and dialysate during CAPD could be helpful in evaluating the beta-cell function in patients in need of exogenous insulin.

Adult↗

Human chorionic gonadotropin in maternal plasma after induced abortion, spontaneous abortion, and removed ectopic pregnancy.

Human chorionic gonadotropin (hCG) in maternal serum was analyzed by a hCG-beta-subunit, radioimmunoassay (hCG-beta-RIA) in 36 cases after induced first-trimester abortion, 35 cases of spontaneous abortion in the first trimester, and in 35 cases of ectopic pregnancy to determine the time between the apparent removal of all trophoblastic tissue by surgical intervention and the disappearance of hCG from the blood. In the cases with induced abortion, hCG was detectable from 16 to 60 days, with a median of 30 days after uterine evacuation, in those with spontaneous abortion from nine to 35 days with a median of 19 days, and in the cases of ectopic pregnancy from one to 31 days with a median of eight, five days after laparotomy d. In the cases with induced abortion, hCG was detectable from 16 to 60 days, with a median of 30 days after uterine evacuation, in those with spontaneous abortion from nine to 35 days with a median of 19 days, and in the cases of ectopic pregnancy from one to 31 days with a median of eight, five days after laparotomy d. In the cases with induced abortion, hCG was detectable from 16 to 60 days, with a median of 30 days after uterine evacuation, in those with spontaneous abortion from nine to 35 days with a median of 19 days, and in the cases of ectopic pregnancy from one to 31 days with a median of eight, five days after laparotomy and removal of the affected tube. There was a significant correlation between the initial hCG levels and the disappearance time in each series. The demonstrated disappearance times are longer than previously recognized, which should be appreciated when hCG is analyzed after termination of early pregnancy.

Abortion, Induced↗

Glucose, insulin and C-peptide kinetics during continuous ambulatory peritoneal dialysis.

The insulin and C-peptide kinetics due to glucose (50 g), given intraperitoneally or enterally has been compared in five non-diabetic patients on continuous ambulatory peritoneal dialysis (CAPD). The fasting C-peptide concentrations were three to ten times the normal values whereas the fasting plasma insulin concentrations were within normal limits. After intraperitoneal glucose administration a more marked hyperglycaemia (p less than 0.05) and a more long lasting hyperinsulinaemia (p less than 0.05) was found than after the enteral glucose load. The relative change in plasma C-peptide was slower and less pronounced in both experiments. C-peptide concentration in plasma did not differ significantly between the two experiments. Estimated total body clearance (Kt) for insulin was higher than for C-peptide (p less than 0.01), but dialysis clearance (Kd) for C-peptide was higher than for insulin in both experiments (p less than 0.01).

Adult↗

ACTH suppression after oral administration of cortisone in Addisonian and adrenalectomized patients.

Plasma cortisol and the corresponding ACTH concentrations were determined before, and for 6 h following a single oral dose of 25 mg cortisone acetate in 7 patients with Addison's disease, 6 patients adrenalectomized for Cushing's disease and 1 patient adrenalectomized for congenital adrenal hyperplasia. The basal plasma cortisol concentrations 12 h after an evening dose of cortisone acetate 12.5 mg were below 100 nmol/l, and the corresponding ACTH concentrations were markedly elevated in all patients. Great interindividual variations were found in cortisol peak concentrations (Cmax) and the time to peak values, but without significant differences between the two patient groups. The maximal ACTH suppression occurred within 60-330 min after the cortisol Cmax, and was not significantly different in the two groups. The suppressed plasma ACTH concentrations were considerably above normal in 3 of the patients with Addison's disease and in 4 of the 6 patients adrenalectomized for Cushing's disease, including 2 patients with Nelson's syndrome. A similar degree of impaired ACTH suppression in patients with Addison's disease as in adrenalectomized patients suggests the occurrence of a secondary hypothalamic-pituitary dysfunction with ACTH hypersecretion in Addison's disease. The adequacy of the commonly used adrenocortical replacement therapy and its possible relation to the impaired ACTH suppression is discussed.

Addison Disease↗

Plasma cortisol concentrations after oral substitution of cortisone in the fasting and non-fasting state.

Nine corticosteroid-substituted patients received oral cortisone acetate in the fasting state and together with a breakfast meal. Plasma cortisol concentrations were determined before, after 30 min, and at 1-hour intervals until 6 hours after drug ingestion. There were great interindividual variations in the time to peak values (tmax), the peak concentrations (Cmax), and the areas under the time-concentration curves (AUC0--6h). The AUC and Cmax values were significantly increased when cortisone tablets were ingested with food compared to the values obtained in the fasting state (p less than 0.01 and p less than 0.05 respectively), whereas tmax values were not significantly different. The differences were minor and probably without clinical implications.

Addison Disease↗

The influence of carbamazepine on thyroid hormones and thyroxine binding globulin in hypothyroid patients substituted with thyroxine.

Carbamazepine (CBZ) decreases the serum concentration of thyroid hormones. It is proposed that CBZ increases the extra-thyroidal metabolism of thyroid hormones. In order to test this hypothesis CBZ was given to nine hypothyroid patients substituted with thyroxine (T4). A significant decrease in serum concentrations of T4, calculated free T4 (FT4), triiodothyronine (T3), and calculated free T3(FT3) was found after 3 weeks of CBZ medication. The serum concentrations of TSH and the T4:T3 ratios were unaltered, while the serum concentrations of T4-binding globulin (TBG) increased markedly in eight of the nine patients. These findings support the hypothesis of a CBZ induced increase in the extra-thyroidal metabolism of thyroid hormones.

Adult↗

Influence of carbamazepine on serum thyroxine and triiodothyronine in patients with epilepsy.

Hypothyroidism induced by anti-epileptic drug treatment gave rise to thyroid function test studies in patients treated with carbamazepine (CBZ) only. In 42 patients on long-term CBZ treatment thyroxine (T4), free T4-index (FT4I), and triiodothyronine (T3) concentrations in serum were significantly lower than in controls, while triiodothyronine uptake (T3U) and thyrotropin (TSH) concentrations did not differ between patients and controls. In 12 patients starting on CBZ, means T4, calculated FT4 and thyroxine binding globulin (TBG) were 1-5 months later reduced compared to the initial levels. Thus, CBZ reduced thyroid hormones, TBG and FT4I. A CBZ-induced increase in conversion and metabolism of the thyroid hormones could explain this effect. The normal T3U values and decreased concentrations of TBG make a competitive CBZ binding to TBG less probable. Although the thyroid hormones levels were found lowered in the patients, all remained clinically euthyroid during the study.

Adolescent↗

A human IgA myeloma protein interacting with staphylococcal alpha-toxin and protein A.

High anti-staphylolysin activity was found in the serum from a patient with multiple myeloma. The activity was confined to the monoclonal IgA protein and was dependent on an intact Fc part of the molecule. An Fc-dependent interaction with protein A was also demonstrated. In addition, a part of the monoclonal IgA was found to be complexed with alpha2-macroglobulin. The results imply an unusual Fc-reactivity of the IgA protein.

Adult↗