Properties of monoclonal TSH-receptor antibodies and binding proteins of thyreotropin (TSH).
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Biomedical subjects
Publications and source records attributed to W Meng.
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Serum levels of growth hormone (GH: arithmetic mean of three measurements eight hours apart), somatomedin C (SmC), alkaline phosphatase activity and the bone isoenzyme of alkaline phosphatase (as the liver/bone isoenzyme ratio) were measured in 26 patients with acromegaly (11 men and 15 women; mean age 45.5 [24-66] years), 18 in the active and eight in the nonactive phase of the disease. Activity was characterized by a raised (660 [330-1149] ng/ml), inactivity by a normal (186 [40-300] ng/ml) SmC concentration. All 18 patients with active acromegaly had an abnormally low liver/bone isoenzyme ratio (mean of 0.66 [0.01-1.28]). In seven of the eight patients with inactive acromegaly it was within normal limits. Thus measurement of bone alkaline phosphatase, which is significantly cheaper than that of SmC, is suitable for assessing activity.
The testing of a SCN- dose (32 mg NaSCN/kg oral 21 d long) which is about 100 fold above the alimentary SCN(-)-uptake on guinea pig has shown neither histologic/morphometrical nor clinical clue to thyrostatic effect. In 6 regions of the GDR (1,349 persons) has not been secured epidemiologically any relationship between SCN- serum level as well as SCN- urine level and goiter. The partly in the tendency low increase of SCN- level by patients with bland goiter was always under the levels of smokers without goiter, exceeded indeed the threshold of significance in the area of Werdau. In the industrial agglomeration areas the I(-)-SCN(-)-quotient at the most unfavourable cases ran to 3.5 (Halle, smoker, struma), was consequently close to the critical level of the goiter risk.
The interdisciplinary iodine prophylaxis in the GDR is a successful measure for control of ID. The iodization of nearly all the salt is planed perhaps with reduction of the iodine concentration. However, next further steps may be done in cooperation of the Interdisciplinary Iodine Commission with the "Arbeitskreis: Jodmangel" in the FRG.
We tested the clinical valency of the TSH-receptor antibody (TBIAb) determination (TRAK assay, Fa. Henning) for the differential diagnostics of various diseases of the thyroid gland (n = 259), particularly of the hyperthyroidism. In 110 out of 114 basedowians TBAIAb could be proved (sensitivity 96%). The specifity to healthy persons (n = 20) was 100%, to the disseminated autonomy (n = 61) 92%. In 43 bland strumas and 22 cases of primary hypothyroidisms no circulating TBIAb were found. Of 40 cases of Basedow's hyperthyroidism the TBIAb titres were pursued during a 12-month methimazol therapy. In these cases was shown that negative antibody titres at the end of the treatment were connected with an essentially lower rate of early relapses than positive ones. Moreover, a highly dosed application of methimazol revealed a more favourable tendency than a low dosed one. From this we conclude that the TBIAb measurement with a commercial kit is a sensitive, sufficiently specific and practicable method for the differential diagnostics of hyperthyroidism and that to a certain degree it allows conclusions on the course of Basedow's disease after thyrostatic long-term therapy.
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Gynaecomasty is no disease sui generis, but a symptom which may underlie different causes. Steroidal substances, above all oestrogens play a dominating role in these cases. Diagnostic and therapeutic measures must comply with the known causal factors. The gynaecomasty during puberty exhibits a high spontaneous retrogression rate. Only seldom an operative correction becomes necessary.
Issuing from the physical principles of the ultrasound technique and the explanation of the different investigation methods, the possibilities of the ultrasonic diagnosis are demonstrated on own results in 1,166 cases of struma nodosa and 154 palpatorically and radiologically, respectively, localised enlargements of the organs or demands of space in the abdominal region. The establishment of 46 cysts in 357 scintigraphically warm nodes of the thyroid gland allows the conclusion that a relatively high percentage of the warm nodes contains solid cold regions. In several cases the ultrasonic diagnosis makes a clear diagnosis, in other cases it is an important supplementation to the other diagnostic possibilities. The A-picture-apparatuses produced in the GDR are suitable for the differential diagnosis of palpatorically or radiologically localised enlargements of the organs or space demands. In diffuse diseases of the organs and for the search of disturbances in extended regions B-picture-apparatuses with improved resolving power are necessary.
This paper deals with the activity of glucose-6-phosphate dehydrogenase in patients with hyper- and hypothyroidism as well as in hyperthyroxinaemic rats. The activity of glucose-6-phosphate dehydrogenase is enhanced in red blood cells of hyperthyreotic patients and hyperthyroxinaemic animals. The activity will be decreased to normal range in patients by administration of antithyreotic drugs, such as thiamazole. Patients with hypothyroidism exhibit decreased enzymatic activity. It is suggested that thyroid hormones stimulate the HMP-shunt in red blood cells as a defence mechanism against additional oxidative stress.
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It is reported on the behaviour of the fasting serum levels of the free fatty acids and the free glycerol in patients with hyper- and hypothyroidism. The two parameters were significantly increased in hyperfunction of the thyroid gland, whereas a decrease was found in hypofunction. The possible causes are discussed with the help of literature.
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It is reported on in vitro tests of the thyroid gland in 7 males with normal weight and 9 adipose ones. No clear difference was found in the two groups. The TSH level, too, after TRH stimulation is not significantly different so that a latent primary hypothyroidism cannot be ascertained.
A survey is given on the therapy of hyperthyroidism, hypothyroidism and the bland struma including the thyrogenic crises. Indications and contraindications of the therapeutic measures available are described. During the therapy of hyperthyroidism the suppression test for the control of the course is recommended. Furthermore it is shown that the thyroxine is more favourable for the long-term treatment than triiodine thyronine or the combination preparations offered at present. But the rules described for the treatment of diseases of the thyroid gland must always be adapted to the individual case.
In a 33-year-old man with Wilson's disease a nephrotic syndrome appeared as a severe complication under penicillamine therapy. Under strong observation and exact controls of protein in the urine, leucocytes, differential blood picture and thrombocytes after interruption of the medication and retrogression of the side-effects a retarding new stabilisation of penicillamine can take place. Other side-effects of penicillamine observed as well as control measures under a long-term treatment with penicillamine are briefly discussed.