摘要:

SUMMARYA patient is described with tumours in the region of the pineal gland and anterior hypothalamus associated with high levels of hCGβ in the serum and cerebrospinal fluid (CSF). He presented aged 19, with hypopituitarism, but persistent secondary sexual characteristics. LH immunoreactivity in serum was due to the hCGβ which probably caused the elevated level of testosterone. Following cranial irradiation the tumour became undetectable and hCGβ was eradicated from the serum and CSF. The patient later died because of an intramedullary metastasis of choriocarcinoma in the cervical spinal cord.The endocrine details of six previously reported intracranial neoplasms which have been shown to secrete hCGβ are reviewed. Only two of these involved the pineal region. Chorionic gonadotrophin production by this tumour enabled early detection of its recurrence. It is unclear how often precocious puberty is caused by tumours producing hCGβ, but patients presenting either with that problem or a pineal tumour should have circulating hCGβ mea

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01609.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYThe changes of plasma pancreatic polypeptide (PP) and plasma gastrin following acute insulin‐induced hypoglycaemia (0.15 U/kg) were examined in six normal subjects, six tetraplegic subjects (preganglionic sympathectomy) and six tetraplegic subjects given atropine (combined adrenergic denervation and cholinergic blockade).Adequate hypoglycaemia was achieved in all three groups. The normal rise of plasma PP following hypoglycaemia was present in the tetraplegic group without atropine but was abolished in the tetraplegic subjects given atropine. There was no significant rise in plasma gastrin following hypoglycaemia except in the tetraplegic group given atropine.These results confirm that the secretion of PP in response to acute hypoglycaemia is mediated via cholinergic activity, while gastrin secretion appears to be inhibited in normal subjects by a vagal cholinergic mechanis

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01610.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYTo determine the LH release response to clomiphene citrate in children with virilizing congenital adrenal hyperplasia (CAH), we examined six patients with glucocorticoid‐treated virilizing CAH, five girls and one boy, chonological age (CA) 4 years 2 months‐15 years 9 months and bone age (BA) range 8–18 years. All the patients but one, were treated with nocturnal dexamethasone. Their ages at the onset of treatment ranged from 2 years 6 months to 13 years 8 months. An additional boy (CA = 4 years 3 months and BA = 7–8 years) was studied 10 days after removal of a virilizing adrenal adenoma. Clomiphene citrate (3mg/kg/day) was administered orally in two doses/day for 8 days. Venous blood was collected on days 0, 4, 6 and 8. Two patients were also studied in consecutive years. In three patients no increase was noted over the basal levels of LH, but in the others LH rose during clomiphene administration. In two patients studied in consecutive years, there was detectable shift of LH release pattern. The basal LH levels and the sum of responses (day 4, 6 and 8) to clomiphene citrate and particularly their decimal logarithms were statistically significantly correlated with their respective BA. These results confirm that previous prolonged exposure to elevated concentrations of adrenal sex steroids, in children with treated virilizing CAH, may induce precocious maturation of the hypothalamic pubertal mechanism of LH secretion. This maturation was closely correlated with the degree of skeletal mat

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01611.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYMyotonic dystrophy (MD) is a systemic genetic disorder predominantly affecting musculature. Although endocrine disturbances have been described, data relating to thyroid gland involvement are sparse and conflicting. To further investigate this aspect, twenty MD patients and twenty age‐and sex‐matched controls were studied. All were clinically euthyroid and there were no significant differences between circulating levels (mean ± SD) of T4 (101±5 ± 28±2 v. 103±8 ± 27±7 nmol/1), T3 (1±86 ± 0±57 v. 2±15 ± 0±47 nmol/1), rT3 (0±39 ± 0±14 v. 0±42 ± 0±09) nmol/1) or TSH (2±6 ±0±5 v. 2±4 ± 0±8 mu/1) or between T3 resin uptakes (97 ± 8 v. 98 ± 11%). TSH responses following TRH stimulation were significantly less in the MD patients (323 ± 141 ± 529 ± 240%;P<0±0025). The mean maximum TSH levels achieved were 6±7 ± 3±6 mu/1 (MD) and 17±1 ±7±2 mu/1 (controls);P<0±005. Two patients had multinodular goitres (MNG) and one a single thyroid nodule. Thyroid scans were normal except for patchy uptake in the two MNG patients. There was no abnormal incidence of circulating thyroid microsomal or thyroglobulin antibodies, and thyrotrophin binding inhibitory immunoglobulin levels were normal in four patients. It is concluded that in MD: 1 palpable thyroid gland abnormalities occur with increased frequency, 15% (three/twenty) in the present study and 20% (twenty/102 case reports) from a review of the literature; 2 TSH responses to TRH are significantly reduced; 3 circulating

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01612.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYThe case reported is of a 46‐year‐old woman who had congenital adrenal hyperplasia due to a 21‐hydroxylase deficiency, and in whom there was the development of an ACTH secreting pituitary tumour. The patient was untreated with glucocorticoids until the age of 32 years when she presented with infertility. She next presented with amenorrhoea at the age of 44 years when she was found to have an enlarged pituitary fossa. Despite treatment with bromocriptine and adequate doses of dexamethasone, the tumour enlarged and required operative treatment 1 year later. Before and after operation, plasma ACTH levels were between 300 and 400 ng/1, immunocytochemistry showed staining for ACTH and other structurally related pro‐opiocortin peptides but for no other hormones, and the tumour secreted large amounts of ACTHin vitro.The report of this case is to our knowledge the first account of a feedback tumour in congenital adrenal hyperplasia and provides yet another reason why patients with this condition should be treated, and good control a

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01613.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYThe hormonal status of thirteen chronic male alcoholics with histologically proved alcoholic liver cirrhosis and that of sixteen non‐cirrhotic chronic alcoholics with a similar drinking history were studied after the abstinence of 7–14 days. Low levels of plasma testosterone and moderately elevated concentrations of plasma LH were seen in cirrhotics but not in non‐cirrhotics. In cirrhotics, testosterone values showed positive correlations with levels of serum albumin and plasma prothrombin. The responses of LH and FSH secretions to LHRH stimulation were similar in the two groups as were the basal FSH values. Plasma concentrations of oestradiol were within normal limits in all patients. In both groups however, basal levels of plasma PRL and oestrone were increased, significantly more so in cirrhotics than in non‐cirrhotics. The latter group was characterized by an exaggerated response of PRL secretion to TRH stimulation. SHBG concentrations were within normal range in both groups.In conclusion, our results emphasize the role of alcohol‐induced liver damage in the pathogenesis of sex hormone disturbances of chronic male alcoholics without neglecting, however, the direct effects of alcohol abu

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01614.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYThe thyroid stimulators TSH and thyroid stimulating immunoglobulins (TSI) have previously been distinguished in a cytochemical section bioassay (CBA) by the different times at which they caused maximum increase of lysosomal membrane permeability within guinea‐pig thyroid follicular cells. The present study demonstrates that the times at which maximum stimulation occurs in the assay depends not only on the type (TSH or TSI) but also on the concentration of the stimulator. At higher concentrations of stumulator earlier times of maximum stimulation were observed for both TSH and TSI. When both stimulators were simultaneously present in plasma at higher concentrations a single peak of stimulatory activity occurred. Neutralization studies using specific antisera revealed that the single peak represented a merging of TSH and TSI peaks. These findings explain the lack of parallelism to the standard curve seen at higher concentrations of TSH or TSI in the CBA. They emphasize the necessity of measuring plasma samples at a variety of dilutions in order to achieve parallelism and to avoid intra‐assay interference between TSH and TSI. When these conditions are observed CBA can be used to detect TSH and TSI with extreme sensitivity even when both are simultaneously present in pla

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01615.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYThe excretion of FSH, LH, oestrogens and pregnanediol was monitored once weekly in urine samples collected from eight peri‐menopausal women aged 44–55 years (median, 52 years). Observations were commenced between 5 and 15 weeks before the menopause and were continued for 22–30 weeks after final menstruation. Amenorrhoea of>2 years duration in association with a persistent elevation in gonadotrophin output was considered proof of the post‐menopausal state.No clear hormonal change occurred at the time of the menopause. During the peri‐menopause there is a transition from the regular ovulatory cycles of pre‐menopausal women to the unvarying high gonadotrophin and low oestrogen excretion which is generally regarded as being characteristic of post‐menopausal women. In the group studied, post‐menopausal levels of FSH and LH were common before and episodes of high oestrogen excretion were not uncommon after final menstruation. Menstrual failure appeared to occur spontaneously at some stage during the transition from the pre‐ to the post‐menopausal state, and not to be associated with its conclusion. From the hormonal point of view the immediately post‐menopausal period could not be distinguished from the long cycles of peri‐menopausal women. This suggests that an endometrial rather than a hormonal event might determine the time at which menstruation stops during th

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01616.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYThe effect on serum PRL levels of lowering serum oestradiol (E2) concentration by short‐term administration of an aromatase activity inhibitor, hydrotestolactone (HT), was studied in six healthy male subjects. After HT administration serum E2levels decreased from 68 ± 5±8 to 26 ± 2±5 pmol/1 (mean ± SE,P<0±05). These E2changes were accompanied by a significant decrease in mean 2‐h PRL levels from 11±2 ± 2±1 to 6±5 ± 1±6 ng/ml mean ± SE,P<0±05). The evaluation of individual percentage change from basal concentrations showed a varying decrease in all subjects. These findings suggest that under physiological conditions E2may be one of the factors which control blood PRL conc

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01617.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01618.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY