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Biomedical subjects

T Lüscher

Publications and source records attributed to T Lüscher.

At least 37 records · Page 2Linked to original sources
PubMed1984

Captopril in Cushing's syndrome.

To analyse the role of the renin angiotensin system in the pathogenesis of hypertension in Cushing's syndrome ten patients with hypercorticism (five with pituitary hypothalamic dysfunction, three with adrenal adenomas and two with adrenal carcinomas) received a single oral dose of 25 mg captopril. Mean arterial pressure was then determined at short intervals over periods of up to 240 min. Plasma renin activity (PRA) was measured immediately before the administration of captopril. Eleven patients with severe essential hypertension, who showed a comparable distribution of basal PRA values, served as a control. Patients with elevated basal PRA values (greater than 3 ng/ml X 3 h) showed, both in the subgroup of cases with essential hypertension and in that with Cushing's syndrome, a statistically significant fall (P less than 0.05-P less than 0.001) in mean arterial pressure, the decrease being slightly more pronounced in essential hypertensives. On the other hand patients with normal PRA values (less than or equal to ng/ml X 3 h) exhibited only a minor fall in mean arterial pressure reaching statistical significance (P less than 0.05) only after 60 min (essential hypertension) and 180 min (Cushing's syndrome), respectively. Our results document that in patients with Cushing's syndrome the effect of captopril seems to be determined by the activity of the renin angiotensin system. Thus, in a substantial number of patients with hypercorticism, the renin angiotensin system may be an important factor in the pathogenesis of hypertension, whereas in patients with low PRA values other factors like oversecretion of mineralocorticoids may be responsible for the observed blood pressure increases.

Adult↗
PubMed1984

Primary aldosteronism due to adrenal carcinomas.

In the present study two patients with aldosterone-producing adrenal carcinomas are reported. The clinical features were characterized by hypertension and severe hypokalemia with muscular weakness, flaccid paralysis of arms and legs, diarrhea and polyuria. In both cases excessively high plasma aldosterone levels and suppressed plasma renin activity were found. In contrast to most other cases with aldosterone-secreting tumours plasma cortisol, urinary free cortisol excretion, 17-hydroxy- and 17-ketosteroids were in the normal range. There was no clinical evidence of oversecretion of sex hormones. After adrenalectomy blood pressure and serum potassium normalized and the clinical symptoms disappeared. Plasma aldosterone and urinary aldosterone secretion returned to normal, while plasma renin activity remained low. Three and a half and 6 months later primary aldosteronism and the associated clinical symptoms reappeared due to hormonally active metastases. After introducing the antitumour drug o,p'-DDD in patient 1 aldosterone secretion normalized and the clinical status of the patient markedly improved. However, 10 months after diagnosis the patient died due to a haemorrhage from a liver metastasis. In patient 2 tumour-invaded regional lymph nodes were surgically removed with only minor changes in the hormone pattern.

Adrenal Cortex Neoplasms↗
PubMed1983

[A slide program on hypertension and obesity: a simple method of patient information].

It is well established that information on their disease is one of the prerequisites for improvement of patients' compliance with therapy. The authors have therefore developed a simple slide program presenting information on hypertension and obesity. Consisting of 52 slides, it was shown in the central waiting room of the medical outpatient department at the University Hospital, Zurich. In order to assess learning, 841 patients were asked to fill in a questionnaire. 485 had seen the program and 356 served as controls with the program switched off. Four main results emerged: 1. The percentage of subjects scoring greater than or equal to 4 correct answers (of a maximum of 5) rose significantly from 22.6% to 64.2%. 2. The number of incorrect answers (maximum 3) remained unchanged. 3. Learning decreased with age. 4. Occupation did not have a significant effect on learning. The results clearly show that the program represents an effective method of teaching patients and may therefore serve to improve compliance with therapy.

Adult↗
PubMed1983

Production, characterization and clinical application of antisera to cortisol.

In the present paper the production of highly specific and sensitive antisera to cortisol is described. The antisera were generated in rabbits using both cortisol-3-monooxime and cortisol-3,20-dioxime derivatives. Bovine thyroglobulin was used as a carrier protein. Antibody characteristics were determined by radioimmunoassay procedure. Antibody titers observed after immunization with the monooxime conjugate were significantly higher (p less than 0.001) than those obtained with the dioxime conjugate. In addition, cross reactivity for various naturally occurring steroids was markedly lower and sensitivity was increased as compared to dioxime antisera (15 vs. 40-60 pg/tube). Accuracy and precision were calculated for the monooxime antiserum used in a RIA system for clinical application. A close correlation (r = 0,9802) was found between plasma cortisol values measured by radioimmunoassay and the competitive protein binding method. The concentrations obtained by the protein binding method were slightly but significantly higher than those measured by radioimmunoassay indicating higher specificity of the antibody used (p less than 0.005).

Aldosterone↗