摘要:

SUMMARYIn order to investigate the endocrine requirements for induction of follicle maturation, ovulation and luteal function we have measured plasma LH and FSH concentrations in 109 cycles induced by treatment with LHRH in 25 women with amenorrhoea of diverse aetiology. The major clinical and endocrine subgroupings were polycystic ovarian disease (PCO), Kallmann's syndrome, weight related amenorrhoea and hyperprolactinaemia. By analysis of variance of the LH and FSH concentrations obtained three times per week in the follicular phase in 77 ovulatory cycles (including 24 conception cycles), we found that in women with PCO the mean LH concentration was 19·5 IU/1. In hyperprolactinaemia and secondary amenorrhoea of non‐specific aetiology the mean LH concentration was 11·6 IU/1 and in patients with hypogonadotrophic hypogonadism and weight‐related amenorrhoea it was 7·2 IU/1. These mean LH concentrations were significantly different from each other (P<0·001). We speculate that the high LH concentrations in the follicular phase may impair the final stages of oocyte maturation and so contribute to the infertility of these patients. FSH concentrations in the follicular phase were lower in patients with hypogonadotrophic hypogonadism and weight‐related amenorrhoea than in other groups. Although the differences were statistically significant (P<0·001) the difference was small (mean FSH in hypogonadotrophic hypogonadism and weight‐related amenorrhoea 4·3 IU/1vs6·3 IU/1 in the others) and of uncertain biological significance. During the luteal phase, no differences between any of the groups in LH and FSH concentrati

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb01122.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYThe glucagon‐stimulated insulin and C‐peptide release in patients with active acromegaly, cured acromegalic patients and healthy controls were studied. There was an elevation of the fasting insulin levels in active acromegalics and the fasting C‐peptide levels in both patient groups. After i.v. injection of glucagon the insulin and C‐peptide levels increased. The highest levels were recorded in active acromegalics, but cured patients also had higher levels than the control group. The insulin/C‐peptide ratio was increased in active acromegalics in comparison with that found for inactive acromegalics and normal controls. In addition, the plasma half‐lives (T1/2) of endogenous insulin and C‐peptide were measured. It was found that theT1/2for insulin was increased in active acromegalics only. From this study we conclude that even when the treatment of acromegaly is effective insulin and C‐peptide secretion do not normalize due, probably, to increased synthesis and release upon stimulation of the pancreatic β‐cells. In active acromegaly the removal of insulin is pro

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb01123.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYThe pathogenesis of Plummer's disease (localized thyroid autonomy) is incompletely known. It has been shown that a normal thyroid follicle can harbour cells with widely different properties, and hyperactive follicles may arise from cells with both high replicating and hormonogenic potencies under the influence of chronic mild stimulation. We now find thyroid growth‐stimulating immunoglobulins (TGI) to be present in low or intermediate titre in the serum of 7 of 9 patients with Plummer's disease. Haemagglutinating antibodies against thyroid microsomal antigen were present in low titre in two of these as well as in three of 21 other patients with this disorder. Two of the patients had a suppressible goitre in addition to the autonomous nodule. One of these is described in more detail. The possibility is discussed that autoimmunity may play a pathogenic role in Plummer's disease. TGI, in relatively low litres as found here, could exert the chronic mild stimulation supposed to be the prime event in the generation of hyperactive follicles. Whether autonomy is intrinsically present in these follicles or triggered by stimulation, remains to be established. Hyperthyroidism supervenes only when the mass of autonomous cells surpasses a certain limit. It appears that these patients with Plummer's disease should be included in the multidimensional spectrum of autoimmune thyroid diseas

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb01124.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYTwo hundred and forty‐three patients with amenorrhoea associated with weight loss were studied. At the onset of amenorrhoea, regardless of percentage weight loss, basal levels of LH were low and LH responses to LHRH were impaired. However, both basal and stimulated levels of FSH were comparable to normal. With resumption of menstruation, the basal and stimulated levels of LH were found to rise to normal, while FSH responses continued to exceed normal. However, 16·6% of 66 unimproved cases had normal responses but remained amenorrhoeic. Furthermore, amenorrhoea persisted in 71% of 31 patients with complete recovery of body weight. No significant correlation was noted between percentage weight loss and responsiveness to LHRH, nor between recovery of body weight and resumption of menstruation. Return to normal weight is desirable for resumption of normal cyclic menstruation and hypothalamic‐pituitary function, but is not always effec

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb01125.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYWe have reanalysed the clinical and laboratory data on 196 individuals with Graves' disease. The consensus of two clustering techniques and a new method of allocating patients to a cluster resulted in two groups of patients, those with a severe and others with a mild disease. The severe disorder is characterized by a high frequency of HLA‐B8 and‐Al, a low complement level, high titres of circulating immune complex and anti‐thyroglobulin antibody, a high lymphocyte transformation index and serum T3 level, a low level of active E‐rosettes, large goitres and a high value for the Crooks test. The mild disorder shows a higher frequency of HLA‐B12 and an abnormally low absolute lymphocyte number. A weight was calculated for each character according to the relative frequency in the two clusters. A total score could then be calculated for each patient based on their clinical and laboratory findings. There were two distinct distributions of scores corresponding to the two subgroups. This suggests different aetiological factors which may be more easily studied in these more homogeneous groups. Prognostic predictions can be made using the score. The risk of recurrence and the frequency and severity of ophthalmopathy increases dramatically as the score increases. The use of the score in making therapeutic decisions needs to

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb01126.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYPreviously we have demonstrated that sperm counts of normal young men decreased during constant subcutaneous infusion of the LHRH agonist buserelin (118 or 230 μg/d). In order to test whether azoospermia can be achieved with higher doses, seven young men received 450 μg buserelin subcutaneously daily for 12 weeks via extracorporeal osmotic minipumps. To avoid symptoms of androgen deficiency, oral supplementation with 80 mg/d testosterone undecanoate (TU) was initiated in week 5 and was increased to 120 mg/d by week 8. Follow‐up after treatment lasted for another 12 weeks. In order to evaluate possible psychotropic effects of treatment‐related endocrine changes, continuous psychometric testing was performed focusing on personality, emotions and sexuality. After an initial rise, both serum LH and FSH returned to normal. FSH was below normal during the 3rd–5th week following treatment. LHRH stimulation tests performed at the end of treatment showed pituitary desensitization. Serum T (always measured between 0800 and 1300 h at least 12 h after last TU) tended to decrease by week 7 and remained slightly depressed until the end of treatment while libido, potency and emotional well‐being remained unchanged. While testicular volumes showed a reduction from week 7 of treatment to week 10 post‐treatment, sperm counts decreased only insignificantly from 65 ± 10 to 44 ± 14 million per ml in week 12 post‐treatment. Severe oligo‐ or azoospermia was not observed in any of the seven men. It is concluded that full androgen substitution by TU can drastically delay if not abolish the antifertility effect of LHRH‐induced pituit

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb01127.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYDaily measurements of serum oestradiol, progesterone, Schwangerschaftspro‐tein 1 (SP1) and hCG were made in 13 menstrual cycles during which conception occurred. The assays were continued until 21 d after ovulation. SP1was detected in maternal blood 8–14 d after ovulation and hCG 9–13 d after ovulation. We conclude that these two proteins are secreted simultaneously but independently by the syncytiotropho

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb01128.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYA LH‐releasing hormone (LHRH) analogue was administered to subjects with elevated circulating LH concentrations and elevated androgens (polycystic ovary syndrome, PCO) and also to a control group with normal menstrual rhythm and normal LH and androgens. In both groups circulating LH concentrations were reduced to low and indistinguishable concentrations. Oestradiol, oestrone, androstenedione and testosterone levels were all reduced by treatment in both groups. However, the reduction in androgen concentrations was less marked in the patients with PCO. The oestrogen/androgen ratios remained relatively unaltered, but the testosterone levels remained slightly elevated in the PCO patients after treatment. The results suggest that patients with PCO syndrome show a disorder of androgen metabolism independent of elevated LH concentration

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb01129.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYExtracts from the tumours of three patients with oncogenic osteomalacia stimulated renal adenylate cyclase in a parathyroid hormone (PTH) responsive system. The stimulation was suppressed by a specific PTH antagonist. These observations suggest that osteomalacia‐producing tumours exert some of their effects through PTH‐like material acting on PTH recept

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb01130.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYMany of the endocrine agents currently used to treat symptomatic benign breast disease modify the action or secretion of prolactin. We have compared the responses to hormonal therapy with dynamic assessment of prolactin control in 29 patients with cyclical mastalgia and in 7 patients with non‐cyclical mastalgia. The tests of prolactin release used were direct stimulation by TRH or dopaminergic blockade by domperidone. These were carried out before treatment in the mastalgic patients and also in 22 age‐matched asymptomatic controls. The response to treatment was assessed using a special pain chart and visual linear analogue scale. Patients with cyclical mastalgia could be divided into two groups: those in whom the peak prolactin release was exaggerated (>4000 mU/1) and those in whom the prolactin release was less marked and similar to control subjects and patients with non‐cyclical mastalgia. Patients in the cyclical mastalgia group with a high peak prolactin release responded to hormonal treatment significantly more frequently (90%) than those with a normal prolactin release (50%). Basal prolactin levels did not correlate with the response to treatment. In the non‐cyclical mastalgia group, no patient had peak prolactin release>4000 mU/1 and none responded to therapy. This study indicates that dynamic tests of prolactin release in cyclical mastalgia may be useful in predicting the subsequent satisfactory response to endocrine therapy if a high peak prolactin release is

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb01131.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY