Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0432222 (SEM)
 47,337 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We investigated an unselected series of 55 patients with treated or untreated hyperthyroid Graves' disease, assessing their clinical and laboratory status and ophthalmological findings, including the difference in intraocular pressure (dIOP) between upgaze and straight gaze using applanation tonometry. An increased dIOP (greater than 2 mm Hg) was detected in only 22% of Graves' patients [who had a mean dIOP of 3.5 +/- 1.6 (+/- SEM) mm Hg]. dIOP did not correlate with age, sex, age at disease onset, duration of disease, mode of antithyroid treatment, or thyroid function testing at the time of examination. Mean Hertel exophthalmometry measurements in patients with a dIOP greater than 2 mm Hg were 22.0 +/- 2.9 mm compared with 18.4 +/- 3.7 mm in those with a dIOP less than 2 mm Hg (P less than 0.027, by Wilcoxon rank sum test). Only 58% of patients with increased dIOP had clinical exophthalmos, but all had other evidence of Graves' eye disease. Computed tomographic scanning revealed significant proptosis and/or orbital muscle involvement in all of the patients with increased dIOP.
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PMID:Prevalence and clinical associations of intraocular pressure changes in Graves' disease. 298 92

The 95% confidence limits of exophthalmometer measurements have been defined by a single observer in 105 individuals who had no known thyroid disease, and found to be 10.5-18.8 mm. Measurements in 308 patients with thyrotoxicosis have shown that exophthalmos (greater than 19 mm) of one or both eyes was present in 21.3% of the patients. Among the 122 thyrotoxic patients whose exophthalmometer measurements could be performed annually for 3-19 years after correction of the thyrotoxicosis (usually with 131I), exophthalmos remained stable in 78.7%, worsened in 15.6% and became less severe in 5.7% of the patients. Transantral decompression of the orbits was performed in 15 patients with rapid subjective improvement in all and reduction in exophthalmometer measurements of 3.6 +/- 0.5 (mean +/- SEM) mm, and no serious side-effects. In view of these findings, transantral decompression should be considered more frequently in the treatment of severe or cosmetically damaging exophthalmos.
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PMID:Prevalence, natural history and surgical treatment of exophthalmos. 365 83

Three hundred and thirty Graves' disease patients (258 F. 72 M. ; mean age = 50 +/- 07 years) were treated by 131I from 1961 to 1979 ; 57 % had a goiter and 32 % had exophthalmos. One or several doses of radioiodine were given to each patient without dosimetry. The mean total dose (+/- SEM) was = 8,51 +/- 0,44 mCi and the mean for the first dose 4,34 +/- 4 ans 54,8 % of the patients received only one dose but 10,3 % of them had more than 3 doses. Data obtained by actuarial methods showed 66 % of the cases to be in remission in less than 2 years ; the frequency of hypothyroidism increased steadily by 3 % every year to give 15 % at 5 years and 30 % at 10 years. Remission was slower to occur in goitrous subjects and hypothyroidism was less frequent in this group despite doses significantly higher of radioiodine (p less than 0,001). Recovery was also slower among exophthalmos patients. Finally, the mean 3-hour radioiodine uptake and plasma T3 level were significantly lower six months after the first therapeutic dose among those who were cured of thier hyperthyroidism within two years.
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PMID:[The treatment of Graves' disease with antithyroid drugs and small doses of radioiodine (author's transl)]. 616 43

Excessive ingestion of vitamin A during pregnancy causes teratogenic effects on the offspring. However, many of these modifications have not been described at the cellular level. The objective of the present study was to characterize alterations of the smooth muscle cells of the esophagus of rat fetuses. On the tenth day after conception, 42 pregnant rats (5 months of age) subdivided into 6 groups received a single intraperitoneal injection of vitamin A at doses of 30,000, 40,000, 50,000, 70,000, 100,000 or 150,000 IU. Seven pregnant control rats received saline solution. After the twentieth day of pregnancy, the fetuses were delivered by cesarian section and weighed and the length of their umbilical cords was measured. Histologic sections were obtained from the esophagus and characterized with the light microscope under oil immersion. There was a significant increase in the nuclear volume of the cells of esophageal smooth muscle from treated animals compared to the control group. The median for the group treated with 100,000 IU of vitamin A (23.8 microns 3) was significantly greater than that for the control group (12.3 microns 3). The body weight (reported as mean +/- SEM) of fetuses treated with the various doses of vitamin A was lower (1.78 +/- 0.18, 1.77 +/- 0.08, 1.48 +/- 0.20, 1.72 +/- 0.11, 1.70 +/- 0.09 and 1.54 +/- 0.13 g, respectively) than that of the control group (2.14 +/- 0.13 g). The mean length of the umbilical cord of fetuses treated with 30,000 (1.66 +/- 0.15 cm), 40,000 (1.78 +/- 0.18 cm), 50,000 (1.58 +/- 0.15 cm), 70,000 (1.90 +/- 0.19 cm), 100,000 (1.58 +/- 0.24 cm) and 150,000 IU (1.48 +/- 0.11 cm) vitamin A was significantly shorter when compared with the mean length of the umbilical cords of control fetuses (2.1 +/- 0.46 cm). Malformations in treated animals such as agnathia, palpebral aplasia, hepatomegaly, exophthalmos, fochomelia and spina bifida were observed macroscopically.
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PMID:Effects of hypervitaminosis A on rat fetus esophagus smooth muscle cells. 858 Aug 85

1. Orbital accumulation of hydrophilic, interstitial glycosaminoglycans (GAGs) and subsequent expansion of retrobulbar tissue lead to the clinical manifestation of exophthalmos in patients with Graves' eye disease. 2. A highly specific method to determine the concentration and biochemical composition of different GAGs was developed in order to obtain a sensitive test system for the activity of the disease. By means of this method, GAG excretion in 24 h urine collections of 56 patients and 21 controls was analysed by precipitation with cetylpyridinium chloride and potassium acetate in ethanol, followed by sequential enzymic hydrolysis with chondroitin AC lyase, chondroitin ABC lyase and hyaluronate lyase, with HPLC analysis of the resulting alpha, beta-unsaturated disaccharides by anion-exchange chromatography. 3. Concentrations of GAG, chondroitin sulphate A (CA), dermatan sulphate (DS) and hyaluronic acid (HA) were determined in patients and controls, with high recovery rates [72.2 +/- 5.3%, mean +/- SEM; detection limit, 4.2 micrograms/l (0.01 mumol/l)], revealing marked differences in urinary concentrations of total GAG and HA, as well as an elevation of CA in patients compared with controls. 4. Method sensitivity was 0.86 for patients with active Graves' eye disease, and 0.87 for patients with untreated ophthalmopathy, whereas specificity was 1.0 for patients with inactive disease. Patients with increased GAG concentration responded well to steroids and/or orbital irradiation (before therapy: GAG, 111.49 +/- 40.32; CA, 59.58 +/- 21.34; DS, 25.05 +/- 8.12; HA, 26.88 +/- 11.63 mg/24 h; during therapy: GAG, 54.22 +/- 10.94; CA, 20.52 +/- 4.58; DS, 17.65 +/- 3.46; HA, 16.05 +/- 3.69 mg/24 h), whereas GAG excretion increased markedly 2-3 months after stopping prednisone therapy in patients with still active eye disease (GAG, 109.9 +/- 10.51; CA, 63.8 +/- 7.34; DS, 24.1 +/- 5.07; HA, 22.0 +/- 6.28 mg/24 h). 5. This sensitive method determines the nature of renally excreted GAGs, reflecting the aberrant synthesis pattern of fibroblasts in patients with Graves' disease.
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PMID:HPLC glycosaminoglycan analysis in patients with Graves' disease. 917 26

Graves' ophthalmopathy is a complex disease whose pathogenesis is thought to be autoimmune. The treatment of Graves' disease is considered to be related to the progression of Graves' ophthalmopathy. There have been no long-term prospective studies on the natural course of Graves' ophthalmopathy. In this study we assessed the influence of subtotal thyroidectomy on the outcome of Graves' ophthalmopathy, comparing it with that of radioactive iodine treatment. Altogether 287 untreated patients with Graves' disease referred to Ito hospital in 1989 were followed prospectively for 5 years. A group of 67 patients were treated with radioactive iodine, and 18 patients underwent surgery. Proptosis of the eyes was measured in all patients using Hertel's exophthalmometer. The mean value of proptosis in patients with untreated Graves' disease was 14. 8 +/- 0.2 mm (mean +/- SEM), and after 5 years it increased slightly to 15.0 +/- 0.2 mm. The mean changes of proptosis in patients treated surgically and patients given radioactive iodine were -0.01 +/- 0.22 and 0.93 +/- 0.28 mm, respectively (p < 0.05). In patients treated by subtotal thyroidectomy, ophthalmopathy did not change in 77.8%; it progressed in 5.6% and was alleviated in 16.7%. In patients treated with radioactive iodine, the ophthalmopathy did not change in 86.6%, progressed in 10.4%, and was alleviated in 3.0%. These findings indicate that surgery can be a better treatment than radioactive iodine for Graves' patients with ophthalmopathy.
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PMID:Effect of subtotal thyroidectomy on natural history of ophthalmopathy in Graves' disease. 960 87