Die quantitative Bestimmung einzelner Liquorproteine in der Diagnostik entzündlicher ZNS-Erkrankungen im Kindesalter

This is a report on two 10-year-old girls with a decompensated autonomous adenoma of the thyroid gland. Both girls were clinically euthyroid. In one girl there was no response of the thyrotropic cells of the anterior pituitary lobe to TRH stimulation for a short time during the first postoperative weeks. The diagnostic and therapeutic procedure in the case of nodular transformations in the thyroid area is discussed.     

Effect of triiodothyronine on (Na++K+)-adenosine triphosphatase and (Na++Mg2+)-dependent phosphorylated intermediate in rat salivary glands

The present studies concern the effect of triiodothyronine (T₃) on rat salivary (Na⁺+K⁺)-adenosine triphosphatase (NaK-ATPase). The results indicate that T₃ selectively increased submandibular and parotid NaK-ATPase units with a single, large dose of T₃, different dosage of T₃, three successive doses of T₃ given on alternate days, and physiological doses of T₃ with daily injection for 2 weeks. Sublingual NaK-ATPase was insensitive to T₃ in the above experiments. The effect of T₃ on submandibular and parotid NaK-ATPase is selective since Mg-ATPase and 5-nucleotidase showed no significant differences under different thyroid status. The lack of response of NaK-ATPase to reverse T₃, further substantiates the specificity of T₃ on salivary NaK-ATPase.This study was supported by the Uniformed Services University of the Health Sciences Grant No. 818 CO 7623 and NIH-AM28590     

Mechanism of trifluralin-induced thyroid tumors in rats

Trifluralin, an herbicide, has been reported to cause a significant increase in thyroid follicular cell tumors in male Fischer 344 rats. This study was designed to determine the mechanism of thyroid hyperactivity after trifluralin exposure. A group of 15 male Fischer 344 rats were exposed to trifluralin-fortified (6500 ppm) diet for 2 weeks. The time weighted average daily intake of trifluralin was 441+/-77 mg/kg/day. Ten rats of the group were sacrificed and the sera analyzed for T3, T4, and TSH levels. The livers were also analyzed for selected T4-specific UGT gene expression and total UGT enzyme activity. In the trifluralin treated rats, the serum T3 and T4 levels decreased by 17% and 90%, respectively and TSH increased by 37% more than the control rats. Trifluralin-induced total hepatic UGT enzymes (2.4-fold) and mRNA expression of selected hepatic UGT isozymes (UGT1A1, 1.4-fold; UGT1A6, 6.4-fold; UGT2B1, 3.7-fold). For the remaining 5 rats in the group, bile was collected for 2 h and analyzed for free and conjugated T3 and T4. The total amount of T4 in bile more than doubled in trifluralin treated rats. Trifluralin treatment increased bile flow, caused a 3.2-fold increase in biliary elimination of conjugated T4 and 63% increase in conjugated T3. Based on these data, the decrease in total serum T3 and T4 levels in the trifluralin treated rats was due to enhanced peripheral metabolism and an increase in bile flow that results in a compensatory increase in TSH synthesis and secretion. The increased levels of TSH with chronic exposure to trifluralin would exert a continuous stimulation of the thyroid gland leading to cellular hypertrophy and proliferation predisposing to the development of follicular cell tumors in rats.     

Systematic review on the treatment of deceased organ donors

Background

Currently, there is no consensus on which treatments should be a part of standard deceased-donor management to improve graft quality and transplantation outcomes. The objective of this systematic review was to evaluate the effects of treatments of the deceased, solid-organ donor on graft function and survival after transplantation.

Thyroid hormone testing by tandem mass spectrometry

In the euthyroid person, absolute free thyroxine concentrations remain constant and correlate with the tissue hormone level, its biologic effect and the metabolic status of the patient. However, most circulating thyroid hormone is bound to plasma proteins and only a minute amount is in the unbound free form. Studies have shown that current free thyroxine immunoassays are binding protein dependent. Novel high-performance liquid chromatography tandem mass spectrometry (LC/MS/MS) methods have successfully dealt with problems inherent in many immunoassays for thyroid hormones and afforded improved specificity and accuracy in thyroid hormone measurements.We emphasize problems with thyroid hormone testing employing immunoassays including direct and indirect thyroid hormone immunoassays, sample processing, methods of free hormone separation and review the emerging role of liquid chromatography-tandem mass spectrometry in thyroid hormone testing. The latest generation of tandem mass spectrometers has superior limits of quantification, permitting omission of previously employed derivatization steps.Liquid chromatography-tandem mass spectrometry affords the specificity, precision, and limits of quantification necessary for the reliable measurement of thyroid hormones, enhancing diagnostic capabilities, and affording the profiles of the iodothyronines and thyronamines. These methods are especially important in states of disease and during pregnancy when protein binding is a factor that interferes with other methods for thyroid hormone analysis.     

急性脑血管病患者血清cTnT和T3水平变化的意义

目的探讨急性脑血管病患者血清肌钙蛋白T(cTnT)、总三碘甲腺原氨酸(T3)的水平及临床价值。方法选取经颅脑CT确诊的急性脑血管病患者80例,其中脑出血38例,脑梗死42例。并选60例健康体检者作为对照组。观察记录各组对象入院时、入院后第3天和第7天血清cTnT和T3水平。结果与对照组比较,入院时急性脑血管病患者cTnT显著上升,T3水平显著降低,差异有显著性(P<0.01),但随着病情缓解cTnT与T3均有所变化。脑出血与脑梗死cTnT水平比较,差异无显著性,但T3水平脑出血组降低更明显,差异有显著性(P<0.05)。神经功能受损程度越严重,cTn-T、T3含量越高。结论急性脑血管病患者存在血cTnT、T3异常,并与急性脑血管病病情严重程度有关,检测cTnT、T3对临床辅助判断急性脑血管病病情和预后具有重要指导意义。     

晚期血吸虫病患者甲状腺激素监测的临床意义

目的观察晚期血吸虫病患者血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、反三碘甲状腺原氨酸(rT3)及其比值的升降变化,评价其预后判断价值。方法将138例晚期血吸虫病患者按尿钠排泄率分为轻型(35 mmol/d)85例、中型(10～30 mmol/d)27例、重型(<10 mmol/d)26例。用放射免疫法检测晚期血吸虫病患者治疗前、后和30名正常对照者T3、T4、rT3水平,计算T3/rT3比值及T4/rT3比值,同时检测肝功能指标[总胆红素(TBil)、总蛋白(TP)、白蛋白(Alb)、丙氨酸氨基转移酶(ALT)],分析其与肝脏功能代偿机制的相关性及其与预后的关系。结果 138例晚期血吸虫病患者中轻型患者T3、T4水平均低于正常对照组(P<0.05),中、重型组较轻型组下降幅度更大(P<0.01、P<0.001);患者组rT3水平与正常对照组比较有不同程度升高,且中、重型组较轻型组上升幅度更为明显(P<0.001)。T3/rT3及T4/rT3比值随患者临床分型的加重(轻、中、重型)而进一步下降(P<0.01、P<0.001)。26例晚期血吸虫病重型患者中伴难治性腹水者治疗前T3/rT3及T4/rT3比值均低于伴非难治性腹水者(P<0.001);出院时伴非难治性腹水患者T3/rT3及T4/rT3比值明显升高(P<0.05),而伴难治性腹水患者则持续降低(P<0.05),提示预后不良。动态监测26例晚期血吸虫病重型患者T3/rT3及T4/rT3比值,19例最终痊愈患者逐渐上升直至恢复至正常水平,4例病情加重者呈逐步下降趋势,而3例死亡病例则快速下降至最低值(0.10±0.05)。结论晚期血吸虫病患者T3/rT3和T4/rT3比值变化为肝功能受损的敏感指标,其动态监测对晚期血吸虫病患者的预后判定有重要意义。     

BNP、cTnI、T3联合检测对老年心力衰竭的临床价值

目的探讨B型钠尿肽（BNP）、肌钙蛋白I（cTnI）、3-碘甲状腺原氨酸（T3）联合检测对老年心力衷竭（HF）诊断、治疗、判断严重程度等方面的临床价值。方法检测92例诊断为HF的患者和61例对照组的血BNP、cTnI、T3水平。评价各指标的敏感性和特异性,分析3项指标联合检测的诊断价值。结果HF组与对照组、HF组不同心功能分级问的BNP、cTnI、T3水平比较差异均有统计学意义（P〈0．05）。HF组3项指标联合检测明显高于单项检测（P〈0．05）。结论联合检测血BNP、cTnI、T3对HF早期诊断、治疗、判断严重程度具有重要临床意义。