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  • 1
    Electronic Resource
    Electronic Resource
    Amiodarone-treated patients with suppressed TSH test are at risk of thyrotoxicosis (1985)
    Springer
    Journal of molecular medicine 63 (1985), S. 168-175 
    Details
    ISSN: 1432-1440
    Keywords: Amiodarone ; Thyrotoxicosis ; TRH-TSH test ; Thyroxine ; Triiodothyronine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Therapeutic use of the potent antiarrhythmic drug amiodarone requires early detection of impending hyperthyroidism, a potentially life-threatening adverse reaction in cardiac patients. Since amiodarone inhibits peripheral conversion of thyroxine (T4) to triiodothyronine (T3), serum T4 and T3 levels become unreliable parameters of thyroid function. In 44 patients treated with amiodarone for a median period of 7.3 months, up to seven TRH-TSH tests were performed. The TSH response to TRH was normal in 23 patients, partially suppressed in eight, totally suppressed in eight and overshooting in five patients. Two of the eight patients with suppressed TRH-TSH tests were clinically hyperthyroid, in four others thyrotoxicosis developed within 1 to 2 1/2 months after the first observation of a suppressed TSH response, while two patients remained euthyroid. In all patients with negative TRH-TSH tests, TSH response to TRH returned to normal between 2 and 29 months after withdrawal of amiodarone. We conclude that the TRH-TSH test, repeated at intervals, is a reliable tool for assessing thyroid function in patients on long-term treatment with amiodarone. Patients with a suppressed response under amiodarone therapy are at risk of developing thyrotoxicosis. Normalization of the TSH response indicates that this risk is over.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01732171
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  • 2
    Electronic Resource
    Electronic Resource
    Serum concentrations of amiodarone during long term therapy. Relation to dose, efficacy and toxicity (1983)
    Springer
    European journal of clinical pharmacology 24 (1983), S. 485-494 
    Details
    ISSN: 1432-1041
    Keywords: amiodarone ; pharmacokinetics ; therapeutic serum level ; thyroid function ; antiarrhythmic therapy ; adverse effects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary In 17 patients on long term therapy with amiodarone, serum drug levels measured by HPLC were related to pharmacological effects. At steady state, serum levels were directly proportional to the dose, 5 mg/kg per day leading to an average serum level of approximately 2.5 µmol/l. The non-amiodarone level of iodine averaged 4-times higher than the level of amiodarone iodine. The elimination half-life of amiodarone ranged from 21 to 78 days, and of non-amiodarone iodine from 24 to 160 days. Control of arrhythmias was satisfactory in all 12 evaluable patients, when the serum amiodarone level exceeded 1.5 µmol/l. Deterioration of vision and polyserositis occurred only at amiodarone levels above 4 µmol/l. Tentatively, a therapeutic range of 1.5 to 4 µmol/l is proposed. In contrast, thyroid dysfunction was observed at any amiodarone level. In view of the narrow therapeutic window, therapy with amiodarone may be optimized by monitoring its serum level and in addition, thyroid function should be regularly checked.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00609891
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  • 3
    Electronic Resource
    Electronic Resource
    Pharmacokinetics of amiodarone, desethylamiodarone and other iodine-containing amiodarone metabolites (1985)
    Springer
    European journal of clinical pharmacology 29 (1985), S. 417-423 
    Details
    ISSN: 1432-1041
    Keywords: amiodarone ; desethylamiodarone ; iodine ; pharmacokinetics ; thyroid function ; toxicity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary In 23 patients treated with the iodine-containing antiarrhythmic drug amiodarone, the plasma concentrations of amiodarone, desethylamiodarone and iodine have been studied. Besides amiodarone and desethylamiodarone, a pool of iodine-containing substances, NANDAI (non-amiodarone-, non-desethylamiodarone-iodine), was present. At steady state the iodine content of NANDAI amounted to 64% and the iodine content of amiodarone plus desethylamiodarone to 36% of total serum iodine. At steady state 26% of the NANDAI fraction was made up of inorganic iodide, the average plasma concentration of which was at least 40 times above the upper limit of the normal range. The serum elimination half-life of NANDAI of 57–160 days exceeded that of amiodarone (35–68 days) and of desethylamiodarone (31–110 days). At steady state the serum concentration of desethylamiodarone appears to be related to the concentration of amiodarone by a Michaelis-Menten type function, yielding a Km of amiodarone of 2.45 µmol/l and a maximal desethylamiodarone concentration of 3.61 µmol/l.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00613455
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  • 4
    Electronic Resource
    Electronic Resource
    Red cell filtration by paper filters (1979)
    Springer
    Annals of hematology 39 (1979), S. 333-344 
    Details
    ISSN: 1432-0584
    Keywords: Erythrozytenfiltrierbarkeit ; Papierfilter ; Filterpapier-Kalibrierung ; Filterability of red cells ; Paper filters ; Calibration of filter papers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A method for the assessment of red cell filterability with paper filters is described. Two milliliters of a washed red cell suspension with a hematocrit of 50 % was filtered through a filter paper cone in a glass funnel and the filtration half-time (FT 1/2) was measured. The filter papers were calibrated by previous measurement of the filtration time for the suspending solution, the calibration time (CT). A linear correlation between CT and FT 1/2 was found for individual red cell suspensions (p 〈 0.001) as well as for a normal population (p 〈 0.001). Consequently, the index FT1/2/CT should represent a more reproducible parameter than FT1/2 and experimentally this appears to be the case. In fact, elimination of erratic values in a normal population was realized. Furthermore, discrimination between normal and abnormal values was improved and the coefficient of variation of single measurements passed from 28.4 to 9.4%. The reproducibility and reliability of this extremely simple method are therefore decisively enhanced without complication of the procedure.
    Notes: Zusammenfassung Es wird eine Methode zur Untersuchung der Erythrozytenfiltrierbarkeit mit Papierfiltern beschrieben. Zwei ml einer gewaschenen Erythrozytensuspension mit HÄmatokrit 50% wurden durch einen Papierfilter in einem Glastrichter filtriert und die Filtrationshalbwertzeit (FT 1/2) gemessen. Zuvor erfolgte die Kalibrierung der Filterpapiere durch Messung der Filtrationszeit für die Suspensionslösung (Kalibrierungszeit, CT). Zwischen FT/2 und CT zeigte sich eine positive lineare Korrelation sowohl für die einzelne Erythrozytensuspension (p 〈 0,001) als auch für ein gesundes Kollektiv (p 〈 0,001). Deshalb sollte der Index FT1/2/CT einen besser reproduzierbaren Parameter darstellen als FT1/2. TatsÄchlich wurden damit erratische Werte in einem gesunden Kollektiv eliminiert, die Unterscheidung von normalen und pathologischen Werten wurde sicherer und der Variationskoeffizient der Einzelmessung sank von 28,4 auf 9,4 %. Reproduzierbarkeit und VerlÄ\lichkeit dieser extrem einfachen Methode wurden somit ohne Komplizierung des technischen Vorgehens entscheidend verbessert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01014196
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  • 5
    Electronic Resource
    Electronic Resource
    Fluid trapping of erythrocytes under hypoosmolar conditions (1987)
    Springer
    Annals of hematology 54 (1987), S. 239-245 
    Details
    ISSN: 1432-0584
    Keywords: Osmolality ; Erythrocytes ; Rheology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 125I albumin was used to assess the amount of trapped fluid after microhematocrit centrifugation of erythrocytes suspended in buffers of different osmolality. Surprisingly the total amount of trapped fluid per volume unit of packed erythrocytes decreased with decreasing osmolality of the suspending buffer despite erythrocyte swelling. However, if the contribution of the individual erythrocyte to the trapped fluid was calculated, the trapped fluid per erythrocyte did not change between 311 mosm/kg and 256 mosm/kg. For osmolalities below 256 mosm/kg a significant increase of trapped fluid was obtained. It is concluded that the packing ability of erythrocytes is not impaired in suspending fluid of moderate to severe infraphysiological tonicity. The daily clinical experience that considerable degrees of plasma hypoosmolality are tolerated in vivo without hemolysis or impairment of oxygen transport by erythrocytes may be explained by the excellent ability of shape adaptation of erythrocytes to each other and to other surfaces such as vascular endothelia. The method of trapped fluid determination might be of potential value as a complementary method in the evaluation of erythrocyte rheology if the amount of trapped fluid is related to the individual erythrocyte.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00594200
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  • 6
    Electronic Resource
    Electronic Resource
    Leiomyosarkom in der Schilddrüse – Primärtumor oder Metastase? (1994)
    Springer
    Der Pathologe 15 (1994), S. 303-307 
    Details
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Schilddrüse ; Dünndarm ; Leiomyosarkom ; unbekannter Primärtumor ; Key words Thyroid gland ; Small intestine ; Leiomyosarcoma ; Unknown primary tumour
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In a 69-year-old female patient a moderately pleomorphic spindle-cell thyroid tumour measuring 5 cm in diameter was initially misinterpreted as primary anaplastic thyroid carcinoma. During clinical investigations to elucidate the cause of severe anaemia, 17 months later an ulcerated duodenal leiomyosarcoma was detected and removed by duodenopancreatectomy. Reevaluation of the thyroid nodule led to revision of the initial diagnosis to metastatic leiomyosarcoma. Six months later the patient died from cerebral stroke. Autopsy findings confirmed the diagnosis of primary leiomyosarcoma of the duodenum with initial manifestation as thyroid metastasis.
    Notes: Zusammenfassung Bei einer 69 jährigen Patientin wurde ein 5 cm großer, mäßig pleomorpher spindelzelliger Schilddrüsentumor zunächst als primäres anaplastisches Schilddrüsenkarzinom verkannt. Erst im Rahmen einer 17 Monate später durchgeführten Anämieabklärung wurde ein 7 cm durchmessendes duodenales Leiomyosarkom entdeckt und mittels Duodenopankreatektomie reseziert. Die erneute Beurteilung der Primärhistologie führte zur Revision der initialen Diagnose und zur Einstufung des Schilddrüsentumors als metastatisches Leiomyosarkom. Die Patientin verstarb weitere 6 Monate später an einem apoplektischen Insult. Die Autopsiebefunde bestätigten die Einschätzung des Tumorleidens als ein initial durch die Schilddrüsenmetastase manifest gewordenes intestinales Sarkom.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002920050059
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  • 7
    Electronic Resource
    Electronic Resource
    Hyperventilation-induced changes of blood cell counts depend on hypocapnia (1994)
    Springer
    European journal of applied physiology 69 (1994), S. 402-407 
    Details
    ISSN: 1439-6327
    Keywords: White blood cells ; Erythrocytes ; Hyperventilation ; Adrenaline ; Noradrenaline
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Voluntary hyperventilation for 20 mm causes haemoconcentration and an increase of white blood cell and thrombocyte numbers. In this study, we investigated whether these changes depend on the changes of blood gases or on the muscle work of breathing. A group of 12 healthy medical students breathed 36 l· min−1 of air, or air with 5% CO2 for a period of 20 min. The partial pressure of CO2 decreased by 21.4 mmHg (2.85 kPa;P 〈 0.001) with air and by 4.1 mmHg (0.55 kPa;P 〈 0.005) with CO2 enriched air. This was accompanied by haemoconcentration of 8.9% with air (P 〈 0.01) and of 1.6% with CO2 enriched air (P 〈 0.05), an increase in the lymphocyte count of 42% with air (P 〈 0.001) and no change with CO2 enriched air, and an increase of the platelet number of 8.4% with air (P 〈 0.01) and no change with CO2 enriched air. The number of neutrophil granulocytes did not change during the experiments, but 75 min after deep breathing of air, band-formed neutrophils had increased by 82% (P 〈 0.025), whereas they were unchanged 75 min after the experiment with CO2 enriched air. Adrenaline and noradrenaline increased by 360% and 151% during the experiment with air, but remained unchanged with CO2 enriched air. It was concluded that the changes in the white blood cell and platelet counts and of the plasma catecholamine concentrations during and after voluntary hyperventilation for 20 min were consequences of marked hypocapnic alkalosis. It was found that minimal changes of the blood gases, the muscle work of breathing, the chest movements or mechanical influences on the spleen did not contribute to hyperventilation-induced changes of these variables.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00865403
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  • 8
    Electronic Resource
    Electronic Resource
    Creatine kinase and creatine kinase MB in endurance runners and in patients with myocardial infarction (1985)
    Springer
    European journal of applied physiology 54 (1985), S. 40-45 
    Details
    ISSN: 1439-6327
    Keywords: Creatine kinase ; Kinetics ; Myocardial infarction ; Running ; Age
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Following a 100 km race creatine kinase (CK) creatine kinase MB (CKMB) activities were serially measured in well trained athletes and compared with enzyme activities in patients with acute myocardial infarction (AMI). The half-time of disappearance of CK (CKt 1/2) was 1.75±0.70 days in runners who trained within the 1st week after the race, and was 0.81±0.18 days in patients with AMI, P〈0.005. CKt 1/2 in runners was shorter (1.17±0.28 days) when no training was performed in the first postrace week. CKt 1/2 was linearly correlated with age (P〈0.01) in the runners but not in the patients. CKMBt 1/2 was 1.30 and 1.11 days in two runners and 0.56±0.10 days in patients with AMI (P〈0.05). In line with histologic and enzymatic findings in skeletal muscle of long distance runners as reported by other workers, our kinetic data provide further evidence that CK and CKMB are released from muscular compartments in runners other than those in patients with AMI.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00426296
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  • 9
    Electronic Resource
    Electronic Resource
    Creatine kinase and creatine kinase MB in endurance runners and in patients with myocardial infarction (1986)
    Springer
    European journal of applied physiology 54 (1986), S. 675-675 
    Details
    ISSN: 1439-6327
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00943360
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  • 10
    Electronic Resource
    Electronic Resource
    The mean red cell volume in long distance runners (1986)
    Springer
    European journal of applied physiology 55 (1986), S. 49-53 
    Details
    ISSN: 1439-6327
    Keywords: Mean red cell volume ; Hematocrit ; Plasma volume ; Exercise ; Red cell creatine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Red cell indices were determined in 6 well trained runners before and after a 100 km race, and Coulter Counter (CC) determinations compared with calculated values derived from centrifuged hematocrit (ctrf), red cell count (CC) and hemoglobin measurements. The following changes were observed immediately after the race, as compared to values 3 days before: MCV(ctrf) decreased by 4.9% (p〈0.001), MCV(CC) increased by 1.9% (p〈0.05), MCHC(ctrf) increased by 4% and MCHC(CC) decreased by 3%. The increase in MCV(CC) suggests that intraerythrocyte osmolality was increased, this probably leading to swelling of the cells induced by a shift of water from the diluting Coulter Counter solution into the red cells prior to the MCV measurement. The decrease in MCV(ctrf) immediately after the race was not correlated with the increase in plasma osmolality. This suggests that plasma osmolality alone was not the key factor for regulation of red cell volume. The changes in MCV(ctrf), which contributed to a surprising stability of the hematocrit value and plasma volume, might represent a physiological principle for the maintenance of a favourable blood viscosity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00422892
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