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Biomedical subjects

T Agner

Publications and source records attributed to T Agner.

35 records · Page 2Linked to original sources

Thyroid disease in pustulosis palmoplantaris.

An increased frequency of thyroid autoantibodies has been reported in patients with palmar and plantar pustulosis (PPP). This study was undertaken to determine the frequency and type of thyroid disease in 32 patients with this disease compared with a control group. Thyroid disease was demonstrated in 53% of the patients with PPP as compared to 16% in the matched control group. Fourteen patients with PPP had an enlarged thyroid and in six there were thyroid autoantibodies. There appears to be an increased incidence of goitre and thyroid autoantibodies in PPP with a decrease in the level of the thyroid hormones.

Autoantibodies

Quantification of the DMSO-response--a test for assessment of sensitive skin.

The DMSO-test has been suggested as a means of assessing skin sensitivity. When DMSO is applied to the skin a whealing response is provoked, and the magnitude of the response depends on the susceptibility of the individual. In this study clinical grading, along with transepidermal water loss measurement (TEWL), electrical conductance, laser Doppler flowmetry and ultrasound skin thickness measurement have been used for quantification of the DMSO-response. It is concluded that TEWL measurement, electrical conductance and ultrasound skin thickness measurement are all suitable methods for quantifying the DMSO-response, while laser Doppler flowmetry, due to interference from oedema formation, should not be used for this purpose. The ultrasound technique was quick and simple to handle as compared to the other bioengineering methods. The DMSO-test is an interesting and realistic possibility as a test for skin sensitivity and, with new bioengineering methods, the separate phenomena comprising the response can be evaluated and quantified, improving the objectivity of the test.

Adult

Skin reactions to irritants assessed by non-invasive bioengineering methods.

Pathophysiological components of irritant contact dermatitis caused by 3 chemically-different irritants were investigated. 20 healthy volunteers were patch tested with sodium lauryl sulphate, nonanoic acid and hydrochloric acid on the flexor side of the upper arm. The skin response was evaluated after 24, 48 and 96 h by visual scoring and measured by the following bioengineering methods: transepidermal water loss measurement, electrical conductance for measurement of skin hydration, laser Doppler flowmetry for measurement of cutaneous blood flow and 20 MHz ultrasound A-scan for measurement of skin thickness. In spite of homogeneous inflammatory responses, significant differences in the severity of the injury to the skin barrier function caused by the different irritants were found. Also significant differences between irritants were found in the time course of development of maximum irritant reactions. Bioengineering methods indicating inflammatory responses (measurement of blood flow and skin thickness) were helpful in quantifying the irritant response in general, while bioengineering methods indicating epidermal damage (measurement of TEWL and electrical conductance) were helpful in classifying the individual irritants.

Adult

Different skin irritation abilities of different qualities of sodium lauryl sulphate.

A marked variation in the concentration of sodium lauryl sulphate (SLS) used for irritant patch testing is found in the literature, but is hitherto unexplained. In the present study, 2 different qualities of SLS were tested clinically on healthy volunteers. The skin responses were evaluated by visual scoring as well as by non-invasive measurement of transepidermal water loss (TEWL), blood flow and oedema. A significant difference in the skin response to the 2 qualities was found both clinically and by non-invasive methods used for quantitation. 5 different qualities of SLS were investigated by high-performance liquid chromatography (HPLC). Marked discrepancies in the quantity of C12 carbon chains in the products were found, offering an explanation for the proven difference in the clinical response. It is concluded that only SLS qualities of high purity should be used for irritant patch testing, and that both the quality and the purity of SLS should be stated.

Adult

Androgens and estrogens in postmenopausal insulin-treated diabetic women.

Diabetic women may have an increased risk of developing endometrial carcinoma. Ovarian and adrenal activity seem to be factors in the genesis of this cancer. We have measured serum sex hormone-binding globulin (SHBG), free and bound fractions of estrogens and androgens, and gonadotropins in 20 consecutive postmenopausal insulin-treated diabetic women and 16 normal postmenopausal women. The diabetics were nonketoacidotic, without nephropathy and without proliferative retinopathy. The groups were comparable regarding age and percent ideal body weight. The diabetic group had significantly increased serum levels of estrone (P less than 0.001), estrone sulfate (P less than 0.05), 17 beta-estradiol (P less than 0.02), and SHBG (P less than 0.001). Levels of testosterone, delta 4-androstenedione, and dehydroepiandrosterone sulfate tended to be higher (not significantly) in the diabetics. FSH and LH levels were similar in the two groups, while serum PRL was significantly lower in the diabetic group (P less than 0.02). The hormonal changes in the diabetics were not related to control of the diabetes. We conclude that total estrogen levels are increased in postmenopausal women with insulin-treated diabetes mellitus. High SHBG levels in these patients tend to keep the free fractions of sex hormones within normal limits.

Aged

Levels of alpha-subunits of gonadotropins can be increased in Zollinger-Ellison syndrome, both in patients with malignant tumours and with apparently benign disease.

To evaluate the value of intact hCG, the beta-subunit of hCG and the common alpha-subunit of the glycoprotein hormones as tumour markers in patients with gastrinomas, we investigated 30 patients with the Zollinger-Ellison syndrome. Fifty-seven percent of the patients with malignant disease (N = 7) and 45% of those with active and apparently benign disease (N = 20) had raised values of circulating alpha-subunit. Detectable levels of hCG or hCG-beta were found in 7 patients of whom 4 had malignant disease. Radical tumour resection in 2 patients resulted in normalisation of elevated levels of alpha-subunit, and in one patient who developed metastases, the alpha-subunit values became elevated simultaneously. By chromatographic studies we found that the alpha-subunit-like reacting substance in serum eluted as the normal free alpha-subunit in 8 patients, but in one patient with metastatic disease we found evidence for production of a larger molecular form of alpha-subunit. The results indicate that the common alpha-subunit is a valuable tumour marker in patients with gastrinomas, whereas hCG-beta is only seldomly elevated. Single estimates of any of the hormonal fragments seem not to relate with malignancy, whereas a rise in alpha-subunit concentration in some patients may be related to the development of malignancy.

Adult

Contact thermography for assessment of skin damage due to experimental irritants.

Irritant dermatitis after application of experimental irritants was studied by means of contact thermography. Sixteen healthy persons were patch-tested, using the following irritants: Sodium lauryl sulphate, benzalkonium chloride, nonanoic acid, hydrochloric acid, croton oil, sapo kalinus and sodium hydroxide. A main finding was that croton oil after 24 h caused a warm skin lesion, and sodium lauryl sulphate after 96 h caused a cold skin lesion. This study emphasizes the differences in the skin reactions to different irritants.

Croton Oil

Micturition pattern in hyperthyroidism and hypothyroidism.

Micturition pattern was investigated in 61 consecutive patients with thyroid disease. The patients were divided into three groups: hyperthyroid, hypothyroid, and euthyroid. Micturition pattern was examined after the first visit to the hospital and again six months later, when thyroid function had been restored to normal. Hyperthyroid patients had significantly increased micturition frequency as well as nocturia compared with their own control group when euthyroid (p less than 0.01). Hypothyroid patients had reduced micturition frequency compared with their own control group (p = 0.05). No significant changes were found in the euthyroid group. Which mechanisms might be responsible for the relationship between thyroid function and micturition pattern is debatable, and calls for further urodynamic and electrophysiologic studies. One conclusion is that thyroid disease should be borne in mind when patients present with unexplained urinary frequency or retention.

Female

Skin reactions to irritants assessed by polysulfide rubber replica.

Skin damage after application of experimental irritants was evaluated under blind conditions and by the use of polysulfide rubber replica. Closed patch tests with 7 different irritants, solvents and empty chambers were applied to 16 volunteers, and the skin damage was evaluated visually and by a replica technique after 24, 48 and 96 h. We found that 3 of the irritants (sodium lauryl sulphate, hydrochloric acid and croton oil) were capable of causing specific and significantly different patterns of skin damage. The patterns could be divided into papular (hydrochloric acid, croton oil) and non-papular (sodium lauryl sulphate, sapo kalinus, sodium hydroxide) types. Nonanoic acid caused a non-paular pattern, but propanol, used as a solvent, by itself also produced a non-papular pattern. The time between application of the irritant and appearance of the characteristic alteration in the skin surface differed, depending on the irritant applied.

Adult

Pituitary-thyroid function and thyrotropin, prolactin and growth hormone responses to TRH in patients with chronic alcoholism.

Basal plasma concentrations of thyroxine (T4), 3,3',5-triiodothyronine (T3), free T4 index (TF4I), free T3 index (FT3I) reverse T3, 3,3',5-triiodothyronine (rT3), resin T3 uptake (TR3U), thyroxine-binding globulin (TBG), thyrotropin (TSH), prolactin (PRL) and growth hormone (GH) as well as thyrotropin releasing hormone (TRH) stimulated TSH, PRL and GH were investigated in 31 consecutive male patients (mean age 41 years) with chronic alcoholism. According to the histology of their liver biopsies the patients were divided into three groups: patients with normal livers, steatosis and cirrhosis. The control group consisted of 30 healthy males. The patients had abstained from alcohol for at least one week when studied, and they were on a nutritionally adequate diet. All had consumed a daily minimum of 52 g ethanol for at least 5 years. None of the patients had severe or decompensated liver disease. The patients had significantly reduced T3 and rT3 plasma levels compared to normals. Patients with cirrhosis of the liver had increased TBG and normal RT3U levels, while those without cirrhosis had increased RT3U and normal TBG levels. Plasma concentrations of basal as well as TRH-stimulated TSH and PRL were unchanged in alcoholic patients, whereas basal as well as stimulated GH levels were increased in cirrhotic alcoholics. It is concluded that alcohol per se influences T3 levels, but not the part of the hypothalamic-pituitary axis studied, and that the binding proteins are mostly determined by the degree of liver disease.

Adult

Increased dopaminergic activity inhibits basal and metoclopramide-stimulated prolactin and thyrotropin secretion.

The influence of physiological to pharmacological doses of dopamine (DA) on basal and metoclopramide (MTC)-stimulated PRL and TSH secretion was studied in 11 regularly menstruating women between days 3 and 8 of the cycle. In groups of 6, the women received 5-h infusions of either 5% glucose or DA in a solution of 5% glucose at a rate of 12-16 ml/h, adjusted according to weight. Infusion rates of DA were 0.04 microgram/kg . min (low), 0.4 microgram/kg . min (medium), and 4.0 micrograms/kg . min (high). After 3 h of infusion, 10 mg MTC were given iv. Blood samples were collected every 15 min from 1 h before to 2 h after the infusion, for a total of 8 h, for measurements of PRL and TSH. The mean serum PRL concentrations declined significantly (P less than 0.05) during DA infusions to nadir values of 62 +/- 5% (+/- SEM; low), 43 +/- 3% (medium), and 43 +/- 6% (high) of the basal levels, whereas basal TSH levels declined significantly, to 64 +/- 5% of basal levels (P less than 0.05), during both the medium and high dose DA infusions. On paired comparisons, the hormone responses to MTC were lower (P less than 0.05) during the infusion of high dose DA (PRL, 2286 +/- 495% vs. 891 +/- 328%; TSH, 100 +/- 43% vs. 60 +/- 15%), but were not changed when MTC was given during the low and medium doses of DA. A rebound phenomenon was found for PRL (P less than 0.05) after the medium and high doses of DA and for TSH (P less than 0.05) after the high dose. These results indicate that doses of DA considered physiological inhibit PRL and TSH secretion and larger doses inhibit their responses to the DA antagonist MTC.

Adult

Increased reduction in fasting C-peptide is associated with islet cell antibodies in type 1 (insulin-dependent) diabetic patients.

A cohort of 82 patients with Type 1 (insulin-dependent) diabetes was followed prospectively for 24 months, and 54 of them for 30 months, to study the relationship between fasting levels of immunoreactive C-peptide and titres of islet cell antibodies. After diagnosis, fasting C-peptide rose temporarily for 1-6 months of insulin therapy and declined continuously thereafter. While islet cell antibodies were present among 55% of the newly diagnosed patients, only 31% remained positive at 30 months. Their antibody titres decreased from 1:81 at diagnosis to 1:3. Only 3 patients (4%) who were islet cell antibody negative at diagnosis became positive later. The median C-peptide values among the persistently islet cell antibody positive patients decreased from 0.11 pmol/ml at 18 months, to 0.09 pmol/ml at 24 months, to 0.06 pmol/ml at 30 months compared to 0.18 (p = 0.04), 0.15 (p = 0.05) and 0.16 (p less than 0.003) pmol/ml, respectively, for the islet cell antibody negative patients. The median slope for the latter was -0.09 compared to -0.19 for the islet cell antibody positive patients (p = 0.01). These differences were reflected in increasing dosages of insulin, since patients remaining antibody-positive for 30 months were given 1.3-1.4 times more insulin (p = 0.01-0.004) than the antibody negative patients. This study demonstrates that islet cell antibodies may be a useful marker for predicting an increased rate by which endogenous B cell function is lost in Type 1 diabetes.

Adolescent

Effects of lithium on circadian cycles in food and water intake, urinary concentration and body weight in rats.

Circadian cycles in food and water intake, urinary concentration and body weight were studied in normal rats, lithium-polyuric rats, rats with hereditary diabetes insipidus and rats infused continuously with arginine vasopressin (ADH) 10 mU/hr IV. Normal rats showed characteristic cycles in body weight and urine flow and osmolality with diuresis in the dark (eating and drinking period) and antidiuresis in the light (resting) period. ADH-infusion eliminated the circadian cycle in urine osmolality, but not in urine flow, suggesting that factors besides. ADH mediate the antidiuresis during the resting period. Rats with ADH-deficient diabetes insipidus showed obliteration of all circadian cycles studied, indicating the importance of the renal concentrating mechanism for the amplitude of the circadian-cycles, observed in normal rats. In rats treated with lithium, circadian cycles in body weight and urine osmolality were absent. However, there was a significant circadian variation in urine flow and food and water consumption with peak values during the light period, when normal rats showed minimal values. It is concluded that in rats lithium causes marked changes in circadian cycles, which probably cannot be explained by its effect on the renal concentrating mechanisms alone.

Animals

Remission in IDDM: prospective study of basal C-peptide and insulin dose in 268 consecutive patients.

To elucidate beta-cell function, insulin requirement, and remission period in insulin-dependent diabetes mellitus (IDDM), a study was undertaken comprising 268 patients consecutively admitted to Steno Memorial Hospital with newly diagnosed IDDM. The patients were characterized by sex, age, and seasonal variation at onset of diabetes mellitus. During the first 36 mo of the disease, an evaluation was performed for basal C-peptide, HbA1c, and insulin dose per kilogram. Total remission was interpreted as complete discontinuation of insulin therapy for at least 1 wk while still metabolically well controlled, and partial remission was interpreted as an insulin need that was less than or equal to 50% of the insulin dose at discharge from the hospital. During the first 18 mo of the disease, 12.3% of the patients entered total remission (median 6 mo), and 18.3% of the patients entered partial remission (median 6 mo). Patients entering remission had significantly higher basal C-peptide levels than those who did not. Sex, age, and initial HbA1c levels did not influence the frequency of remission.

Adolescent