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Biomedical subjects

P Marsden

Publications and source records attributed to P Marsden.

At least 55 records · Page 3Linked to original sources

A comparison of thyrotropin- and dibutyryl cyclic AMP- induced thyroglobulin iodination in cultured human thyroid cells.

The relative degree of 125-I labelling of thyroglobulin-- bound mono-iodotyrosine (MIT) and di-iodotyrosine (DIT) in isolated, cultured human thyroid cells has been compared following exposure of 125-I supplemented cells to 100 mU/ml of bovine thyrotropin (TSH) or 1.0 mM dibutyryl cyclic AMP (dBcAMP) for 96 hours. Pronase digestion of the lysed cells and Sephadex G-10 fractionation of the digested lysates revealed a predominance of [125-I]MIT over [125-I]DIT in both sets of experimental cells as well as in controls. Levels of [125-I]DIT, however, were only enhanced above control values in cells incubated with TSH. These findings suggest that an increase in availability of intracellular iodide, following cellular exposure to TSH, may facilitate a preferential synthesis of DIT relative to that of MIT. This theory offers an explanation for the differential effects of TSH and dibutyryl cyclic AMP on the levels of newly--synthesised T4 recovered from the cells used in this study, and from the culture medium in a previous investigation.

Bucladesine↗

Thyrotoxicosis and hypercalcaemia: response to antithyroid drugs and salmon calcitonin.

Four patients with thyrotoxicosis, hypercalcaemia and metabolic bone disease are described. One of them had a 'hot nodule', T3 toxicosis and a parathyroid tumour and another had thin bones, subperiosteal cortical bone erosions and complete dysphagia. Hypercalcaemia persisted during treatment with antithyroid drugs in two patients, both of whom had hyperparathyroidism. The administration of salmon calcitonin to these two patients before starting antithyroid treatment produced an immediate and sustained fall in serum calcium and urinary hydroxyproline levels. Calcitonin administration should be of value in the early management of hypercalcaemic patients.

Alkaline Phosphatase↗

Rapid radioimmunoassay of triiodothyronine on Sephadex G-25 by the Ames kit.

A rapid kit method for the determination of serum triiodothyronine levels is described. The method was satisfactory in cases of thyrotoxicosis, but its lower sensitivity in euthyroid patients gave higher levels (range 2.3-3.3 nM/liter) than normally found. The kit would be of value as a rapid method (little over 3 hr) to screen patients suspected of early or T3 thyrotoxicosis.

Contraceptives, Oral↗

Hormonal pattern of relapse in hyperthyroidism.

22 patients with Grave's disease were followed up for up to a year after antithyroid drug therapy was discontinued. Clinical assessment and serum T3, T4, and thyroid-stimulating-hormone (T.S.H.) estimations were done serially and simultaneously. Serum T3 or T4 concentrations may be elevated briefly in the first few weeks after antithyroid drugs are stopped, as a rebound effect not necessarily indicative of subsequent relapsf. Clinical relapse of hyperthyroidism with subsequent improvement on antithyroid drugs occurred in 13 patients. Of these 13, serum T3 concentrations became elevated before serum T4 concentrations in 5, thus predicting the subsequent development of clinical hyperthyroidism. In the remaining 8 patients who relapsed, serum T4 was elevated a month before the serum T3. Hyperthyroidism was diagnosed clinically after elevated serum T3 concentrations in 11 patients and at the same time in 2 patients. The mean period of "biochemical hyperthyroidism" in these 11 patients was 12 weeks, with a range of 1 to 56 weeks. During this period 9 of the 11 had minor clinical changes attributable to hyperthyroidism. It is concluded that serial estimations of serum T3 provide the most reliable method of monitoring relapse in hyperthyroidism.

Carbimazole↗

Serum triiodothyronine concentration in the diagnosis of hyperthyroidism.

The serum triiodothyronine concentration is superior to the serum thyroxine concentration, the resin uptake test and the free thyroxine index in the diagnosis of hyperthyroidism. Over a 14 month period fifty-five patients attending an endocrine clinic with suspected thyrotoxicosis of all degrees of severity had blood taken on initial attendance and the serum was stored for routine thyroid function tests and triiodothyronine estimation. The patients were followed up and forty-six proved to be toxic and seven to be euthyroid; two could not be classified. Analysis of the initial serum showed that the serum triiodothyronine concentration was superior to the serum thyroxine concentration, the resin uptake test and the free thyroxine index in predicting the clinical outcome.

Adenoma↗

Serum triiodothyronine in solitary autonomous nodules of the thyroid.

Seventeen patients with solitary autonomous nodules of the thyroid were studied. Eight had clinical features of hyperthyroidism though in some the clinical manifestations were mild. The serum T3 concentration was elevated in all patients with hyperthyroidism but the serum T4 and free thyroxine index were within the normal range in five. All patients with hyperthyroidism subsequently responded to treatment. These findings suggest a high incidence of preferential T3 hypersecretion in hyperthyoidism associated with solitary autonomous thyroid nodule. A further nine patients with single autonomous nodules were clinically euthyroid with normal serum T3 and T4 concentrations and remained euthyroid from 6 to 24 months on serial review.

Chromatography, Gel↗

A comparative study of serum total thyroxine estimation on unextracted serum by radioimmunoassay and by competitive protein binding.

A rapid and precise radioimmunoassay (RIA) for serum total thyroxine (T4) on as little as 1-10 mul of unextracted serum is described. Results in hypothyroidism (overt and borderline), in euthyroid subjects in pregnant and oestrogen-medicated subjects, and in hyperthyroidism (overt and borderline) are compared with the results on the same sera by an established competitive protein binding technique (Ames' Tetralute) on unextracted serum from a different laboratory. The correlation between the two methods was excellent (r= 0.94) and no significant difference between overall appeared to measure total T4 Reliaby in sera containing only 1-3 or 2-6 nmol/1. Both methods predicted the clinical outcome in borderline hypothyroidism and borderline hyperthyroidism equally well and both gave normal results in T3-toxicosis. It is concluded that both techniques reliably measure total T4- RIA appears to have advantages of sensitivity and precision (especially in the hypothroid range), of simplicity, and of low cost.

Binding, Competitive↗

Evaluation of a kit (Thyrolute) for the combined determination of serum total thyroxine and sequential free thyroxine index using Sephadex G-25 and 125I-thyroxine.

A new kit (Thyrolute, Ames) for the combined determination of serum total thyroxine (T-4) and sequential free thyroxine index (F.T.I.) using Sephadex G-25 and 125-thyroxine was evaluated in 136 patients and normal subjects. The T-4 determination was virtually identical to that used in the Ames Tetralute kit and had a similar accuracy and precision. The sequential F.T.I. was compared with a two-stage F.T.I. The two F.T.I.s showed highly significant correlations in the various groups of patients except euthyroid women with raised thyroxine-binding globulin (TBG) (pregnant or oral contraceptive). The overlap found for the sequential F.T.I. between euthyroid, hypothyroid, and thyrotoxic patients was slightly inferior (9%) to that found with the two-stage F.T.I. (6%), but its diagnostic success rate was higher than that of the serum T-4 determination alone. Serial observations of serum T-4 and sequential F.T.I. were also made on eight patients receiving carbimazole-therapy for hyperthyroidism. The sequential F.T.I. showed complete parallelism with serum T-4 regardless of thyroid status, so that it was of no practical value in these patients. It was concluded that the sequential F.T.I kit would be of most value in the smaller hospital laboratory lacking facilities for the radioimmunoassay of thyroid hormones and thyroid stimulating hormone.

Adolescent↗