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Biomedical subjects

P C Scriba

Publications and source records attributed to P C Scriba.

At least 73 records · Page 4Linked to original sources
PubMed1987

Autoimmunity to pancreatic juice in Crohn's disease. Results of an autoantibody screening in patients with chronic inflammatory bowel disease.

The sera of 59 patients with Crohn's disease (CD) and of 46 patients with ulcerative colitis (UC) were tested for autoantibodies (Aab) by indirect immunofluorescence with modern histochemical techniques using 19 different human tissues as antigenic substrates. Control collectives consisted of 19 patients with coeliac disease and of 100 healthy subjects. It was possible to demonstrate a specific marker for CD: Aab against exocrine pancreas (Pab) were present in 39% of the CD sera (UC 4%, coeliac disease 0%, healthy controls 3%). High Pab titres were only detectable in CD sera (29%). The CD-related autoantigen was demonstrated to be a component of normal pancreatic juice. Pab in CD were fundamentally different from those sometimes occurring in chronic and acute pancreatitis. It is suggested that CD is caused by autoimmune reactions against a component of pancreatic juice. Pab in CD correspond to Aab against intestinal goblet cells (Gab), which occurred exclusively in UC (28%). Pab and Gab, but obviously none of the other Aab investigated in this study, are of diagnostic value in chronic inflammatory bowel disease.

Adult↗
PubMed1986

Prevalence of goitre and hypothyroidism in Southern Tanzania: effect of iodised oil on thyroid hormone deficiency.

In the Southern Highlands of Tanzania the prevalence of endemic goitre due to iodine deficiency is in the range of 90% and hypothyroidism in the range of 50% of schoolchildren. The present study confirms these data and documents the beneficial effect of Lipiodol injections on thyroid function in children around the age of puberty compared with untreated children from the same villages. On the other hand, a decrease in the prevalence of goitre could not be shown. A beneficial effect is shown for infants of mothers who received iodine during pregnancy. It seems that this form of supplementation is sufficient for breast fed children for more than three years, even when a second child has been delivered in the meantime. In contrast, older siblings of these babies may become hypothyroid when breast feeding is stopped. The determination of thyroid autoantibodies in iodine treated and untreated children and in young adults showed no increasing prevalence of positive findings thus excluding iodine induced chronic thyroiditis at least in the young target population.

Adolescent↗
PubMed1986

Parathyroid localization.

Twenty-nine consecutive patients with suspected primary hyperparathyroidism were examined preoperatively using ultrasound, sonographically guided fine needle aspiration, and aspirate immunostaining for PTH. In 25 patients, localization of enlarged parathyroid glands was successful. In 2 patients, the tumors were located retrosternally and, thus, could not be detected by ultrasound. One patient had a multinodular goiter which impeded localization. In 1 patient with renal osteodystrophy, 2 enlarged parathyroid glands in the neck were not visualized preoperatively. Cytology was not diagnostic, although some cytological features were suggestive of parathyroid cells. Immunostaining of the aspirated smears for PTH, however, correctly diagnosed all preoperatively localized lesions. Ultrasound should be the routine procedure of choice for preoperative localization of abnormal parathyroid glands in primary hyperparathyroidism. Fine needle aspiration and immunocytochemistry can supply confirmation, if necessary.

Adolescent↗
PubMed1986

Goitre epidemiology: thyroid volume, iodine excretion, thyroglobulin and thyrotropin in Germany and Sweden.

Thyroid volume of 1397 German and 303 Swedish adults were estimated by sonography. Thyroid size of 6-16 year old Germans (n = 619) was determined and compared with findings on palpation. Thyroid volume was more than twice as great in German (21.4 +/- 15.6 ml, mean +/- SD) than in Swedish adults (10.1 +/- 4.9 ml). The echopattern was abnormal in 16% of the Germans and in 3.6% of the Swedes. German children have a thyroid volume ranging from 1.8 +/- 0.4 ml at 6 years to 10.8 +/- 6.0 ml at 16 years of age. Palpation is by comparison an unreliable method for determining thyroid size. In Germany, the iodine excretion was less in children (n = 619, 39.5 +/- 30.5, 34.1 micrograms I/g creatinine, mean +/- SD, median) than in adults (n = 1193, 83.7 +/- 94.4, 62.6), (P less than 0.001) and much lower than that observed in Sweden (adults n = 98, 170.2 +/- 93.3, 141.4; 13 year olds n = 113, 172.9 +/- 224.1, 124), (P less than 0.0001). Serum thyrotropin concentration was significantly higher (P less than 0.001) in Sweden (n = 62, 1.49 +/- 0.82 mU/ml), than in Germany (n = 91, 0.97 +/- 0.52 mU/ml), while serum thyroglobulin was increased in Germany (n = 91, 72.6 +/- 50.6 micrograms/l) as compared to Sweden (n = 62, 23.5 +/- 17.4), (P less than 0.0001). These results indicate the goitrogenic effect of iodine deficiency and the continuing need for an effective iodine prophylaxis in the FRG.

Adolescent↗
PubMed1985

Inconsistent stimulation of plasma ACTH through corticotropin-releasing factor in a patient with central Cushing's disease due to pituitary adenoma.

Three uncommon findings were observed in a case of Cushing's disease due to macroadenoma: no suppression of plasma ACTH during an 8-mg dexamethasone test, a negative corticotropin-releasing factor test, and a normal X-ray of the sella turcica. Despite these findings, the diagnosis of pituitary was confirmed Cushing's syndrome by computerized tomography and a transphenoidal operation.

Adenoma↗
PubMed1985

[Goiter epidemiology. IV. Thyroid volumes in German and Swedish school children].

Thyroid volume was determined by ultrasound in 13-year-old school-children (n = 2244) from 23 places in the Federal Republic of Germany and in 224 school-children from Stockholm (where there is adequate iodine supply). The results show that thyroid size gradually increases from north to south. There are clear endemic nests in the central region of the Federal Republic of Germany. Mean thyroid volume in Swedish children was 4.2 ml, in German children 9.3 ml. More than one third of German children have a larger thyroid volume than the largest volume measured in Swedish children. The results support the need for iodine-salt prophylaxis for the entire German Federal Republic.

Adolescent↗
PubMed1985

TRH: pathophysiologic and clinical implications.

Thyrotropin releasing hormone is thought to be a tonic stimulator of the pituitary TSH secretion regulating the setpoint of the thyrotrophs to the suppressive effect of thyroid hormones. The peptide stimulates the release of normal and elevated prolactin. ACTH and GH may increase in response to exogenous TRH in pituitary ACTH and GH hypersecretion syndromes and in some extrapituitary diseases. The pathophysiological implications of extrahypothalamic TRH in humans are essentially unknown. The TSH response to TRH is nowadays widely used as a diagnostic amplifier in thyroid diseases being suppressed in borderline and overt hyperthyroid states and increased in primary thyroid failure. In hypothyroid states of hypothalamic origin, TSH increases in response to exogenous TRH often with a delayed and/or exaggerated time course. But in patients with pituitary tumors and suprasellar extension TSH may also respond to TRH despite secondary hypothyroidism. This TSH increase may indicate a suprasellar cause for the secondary hypothyroidism, probably due to portal vessel occlusion. The TSH released in these cases is shown to be biologically inactive.

Animals↗
PubMed1985

Iodine deficiency, hypothyroidism, and endemic goitre in southern Tanzania. A survey showing the positive effects of iodised oil injections by TSH determination in dried blood spots.

UNLABELLED: The Ukinga and Uwanji regions, located in the southern highlands of Tanzania, were studied for the degree of iodine deficiency and the incidence of goitre and hypothyroidism, respectively. A urinary iodine excretion as low as 17.6 +/- 9.3 micrograms/g creatinine was observed in Wangama village. The mean goitre prevalence in 27 villages in Uwanji ranged between 65 and 96% (n = 3031 schoolchildren). Of 681 pregnant women from Ukinga 79.6% had goitre. The prevalence of cretinism as estimated on clinical criteria was 3% in Magoye (Uwanji). A normal serum TSH (below 2.1 mU/l) was observed in only 12 out of 66 school children before iodine prophylaxis, whereas the T4/TBG ratio was decreased in 36 of 63 cases. Blood spot TSH levels in newborn infants (n = 219) from mothers without iodine supplementation were above 12 mU/l in 45%. In contrast, only 20.3% of the newborn (n = 118) had elevated blood spot TSH (p less than 0.002) when the mothers had received an iodised oil injection during pregnancy. Most of the newborn (n = 18; 75%) of the latter group with elevated TSH (n = 24) came from mothers who had received the iodine injection only 1-25 days before delivery. Maternal iodine prophylaxis in late pregnancy does not increase the rate of neonatal hypothyroidism. CONCLUSIONS: It has been confirmed that severe iodine deficiency resulting in endemic goitre, cretinism, and hypothyroidism is prevalent in the regions studied. Dried blood spot TSH determinations may serve as an index for the efficiency of iodine prophylaxis programmes. Such a programme was carried out with relatively little expenditure and effort on a large scale basis.

Adolescent↗
PubMed1985

Comparative study of hormonal counter-regulation during GCIIS-guided insulin hypoglycemia tests using human insulin (recombinant DNA) and pork insulin.

Human insulin (BHI, recombinant DNA) and pork insulin (PI) were compared in 10 healthy volunteers. Using a glucose controlled insulin infusion system for the performance of the insulin hypoglycemia test (IHT), a comparable dosage of both insulins had to be infused (BHI 0.129 +/- 0.007 vs PI 0.115 +/- 0.01 U/kg; mean +/- SEM). Blood glucose slopes and nadirs did not differ significantly (BHI 30 +/- 2 vs PI 29 +/- 2 mg/dl). There was no difference in C-peptide inhibition (minimum for BHI 0.50 +/- 0.08 vs PI 0.42 +/- 0.08 micrograms/l). Maximum hormone responses were identical for ACTH (BHI 78.4 +/- 11.3 vs PI 76.0 +/- 8.7 pg/ml), cortisol (BHI 246 +/- 20 vs PI 252 +/- 15 ng/ml) and GH (BHI 43.8 +/- 7.3 vs PI 49.4 +/- 6.7 ng/ml). Peak levels of prolactin did not differ significantly (BHI 1,335 +/- 315 vs PI 1,766 +/- 614 microU/ml). The urinary excretion pattern of epinephrine in three 120 min periods before, during and after IHT was identical (before IHT: BHI 0.9 +/- 0.2 vs PI 0.6 +/- 0.1 micrograms/120 min; during IHT: BHI 12.6 +/- 2.2 vs PI 13.4 +/- 2.5 micrograms/120 min; after IHT: BHI 2.5 +/- 0.7 vs PI 3.7 +/- 1.3 micrograms/120 min). No differences in the minima of serum potassium levels were observed (BHI 3.38 +/- 0.04 vs PI 3.33 +/- 0.05 mmol/l). We conclude that the biological effects of human insulin and pork insulin are comparable. Our data do not support the assumption of a different hypothalamic handling of human insulin (recombinant DNA) and porcine insulin.

Adrenocorticotropic Hormone↗
PubMed1985

Simplified evaluation and documentation of data from glucose controlled insulin infusion systems--artefact handling.

A computerized method for artefact handling, which occurs during recording and evaluation of data from glucose controlled insulin infusion systems (GCIIS) is demonstrated: Recording phase: "Interrupt"-Mode: Restoring of the original linear data-time relation is achieved by using an additional time channel. Analogous treatment of time- and parameter files allows correct correlation. "Communication I/O error": An error-handling subroutine prevents break of program caused by lead characters which occur during restarting the GCIIS thereby disturbing GCIIS-microcomputer communication. Risk of data loss caused by breakdown of electric current is minimized by an appropriate interaction between intermediate store and floppy disk for data transfer. Evaluation phase: Implausible data: Obstruction of double lumen catheter as well as loss of glucose sensor sensitivity result in inappropriate data with consecutive incorrect computation of glycemic indices such as MAGE and M-value. Zero-values: During "HOLD"-mode, all blood glucose values are set to zero by the GCIIS causing forbidden arithmetic operations. These artefact periods are marked in the prepared time-file, deleted and interpolated subsequently. In conclusion, our method permits automatic artefact handling during the recording phase and complete correct data processing during the evaluation phase.

Blood Glucose↗
PubMed1984

An evaluation of four different luminescence immunoassay systems: CELIA (chemiluminescent immunoassay), SPALT (solid-phase antigen luminescence technique), ILMA (immunoluminometric assay) and ILSA (immunoluminometric labelled second antibody). A critical study of macro solid phases for use in immunoassay systems, Part III.

The performance of different solid-phase luminescence immunoassays has been documented using four different assay concepts. These are CELIA (chemiluminescence immunoassay), SPALT (solid-phase antigen luminescence technique), ILMA (immunoluminometric assay) and ILSA (immunoluminometric labelled second-antibody assay). CELIA is analogous to a solid-phase radioimmunoassay and uses a labelled antigen, SPALT and ILSA use a labelled second (species-specific) antibody and ILMA a labelled substance-specific antibody, i.e. analogous to the immunoradiometric assay. Both bioluminescent and chemiluminescent labels have been used. Pyruvate kinase was used for bioluminescence and diazoluminol and N-(4-amino-butyl)-N-ethyl isoluminol hemisuccinamide for chemiluminescence. Relevant quality-control parameters and reference ranges have been given for the optimised assays. Assays described are: thyroxine, thyroxine binding globulin, cortisol, caeruloplasmin, ferritin and C-reactive protein. Luminescence immunoassays with coefficients of variation comparable with radioimmunoassay have been designed, values of under 5% being obtainable within the working range of the assay.

Animals↗
PubMed1984

Insulin hypoglycaemia test guided by a glucose controlled insulin infusion system.

Insulin hypoglycaemia test (IHT) for assessment of hypothalamic-pituitary-adrenocortical (HPA) function in patients with pituitary tumours is usually performed by bolus injection of insulin, a procedure which includes the risk of overdosage and/or the need of repeated administration. This study describes that a glucose controlled insulin infusion system (GCIIS) permits to perform the IHT with standardized hypoglycaemia. Ten healthy volunteers and 10 patients with pituitary tumours were studied using the GCIIS (Biostator) on static control (Mode 1:1, BI 35, QI 10, RI 20, FI 300). Insulin administration was discontinued and the GCIIS used only for monitoring of blood glucose (BG), when BG had fallen below 40 mg/dl and initial clinical symptoms for hypoglycaemia were observed. In controls, the GCIIS guided IHT achieved a sufficient degree of hypoglycaemia (BG 27.6 +/- 2.0 mg/dl; mean +/- SEM) and physiological responses for GH (peak 49.4 +/- 6.7 ng/ml), Prl (peak 1766 +/- 614 microU/ml), ACTH (peak 76.0 +/- 8.7 pg/ml) and cortisol (peak 252 +/- 15 ng/ml). The total amount of insulin given was 0.115 +/- 0.012 U/kg. In the patients with pituitary tumours however, the required insulin dose varied markedly from 0.090 (pituitary insufficiency) to 0.340 U/kg (Cushing's syndrome). Minimum BG obtained was 32.5 +/- 1.9 mg/dl. Partial impairment of hypothalamic-pituitary function and, in particular, patients requiring exogenous cortisol supplementation during stress, could be identified. In conclusion, special advantages of the GCIIS-guided IHT are: Optimal insulin dosage with standardized hypoglycaemia due to automatic adjustment to the individual insulin sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenocorticotropic Hormone↗