ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1991.tb03537.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1991.tb03538.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.objectiveThe effects of sex and age on serum growth hormone binding protein (GHBP) levels during adulthood were investigated.designThe levels of GHBP, insulin‐like growth factor‐I (IGF‐1), and growth hormone (GH) were determined and analysed as a function of sex and age.patientsWe studied 101 normal adults (45 men, aged 20–77 years; 56 women, aged 20–80 years).measurementsGHBP levels were determined using an Ultrogel AcA 44 minicoiumn.resultsDuring the second and third decade, GHBP levels were not different between men (22.8±1.1%) (mean ± SE) and women (23.2±0.8%). After the age of 40 years, however, GHBP levels in men were significantly decreased (19.1 ± 0.7%), and were lower than those in women (22.7±0.9%). IGF‐I levels correlated positively with GHBP levels in men (r= 0.51,P<0.01) but not in women (r= 0.16, NS).conclusionsThese results indicate that both sex and age may have some effects on the GH‐GH r

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1991.tb03539.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.objectiveTo determine if cyclical intermediate dose steroid therapy could Improve semen parameters In an Infertile man with sperm autolmmunity associated with the polyglandular autolmmune (PGA) syndrome.designSperm agglutination studies performed before, during and after three courses of cyclical intermediate dose prednisolone therapy.patientA twenty‐six‐year old man with polyglandular autolmmune syndrome, consisting of Addison's disease, hypoparathyroidism, chronic mucocutaneous candidiasis and alopecia totalis, presented with Infertility. He had normal endocrine testicular function but severe exocrine failure evidenced by a low sperm count (4.5 ± 104/ml), zero motility and universal sperm agglutination.measurementsSperm agglutination tests.resultsAt presentation the gelatin agglutination test (GAT) was strongly positive in serum (1/1204) and seminal plasma (1/64) as was the tray agglutination test (TAT) (1/32). The patient's wife had a regular menstrual cycle with normal luteal phase progesterone levels.Following three courses of cyclical prednisolone (20 mg twice daily on days 1–10 of wife's cycle, and 5 mg on days 11 and 12), sperm quantity and motility Improved consider‐ably (12 ± 106/ml, 40% respectively) and sperm agglutination tests became negative. After a fourth course of therapy the patient's wife became pregnant. Three months post‐treatment sperm motility was very low again and agglutinating activity in serum and seminal plasma increased.conclusionsThis is the first case of male infertility due to sperm autoimmunity in association with the PGA syndrome type 1. The Immunosuppressive action of cyclical intermediate dose steroid therapy led to a significant quantitative and qualitative Improvement in semen

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1991.tb03540.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.objectiveThe evaluation of cholesterol fractions and apoproteins during ovarian suppression by a GnRH agonist implant vs danazol in the treatment of endometriosisdesignA randomized study in 33 patients comparing goserelin (3.6 mg/4 weeks s.c.,n= 20) with danazol (2 ± 400 mg/day p.o.,n= 13) in patients with a laparoscopic diagnosis of endometriosis and treated for 6 months.measurementsTriglycerides, cholesterol (C), LDL‐C, HDL‐C subtractions and apoproteins A‐1 and B were measured at admission, at months 2, 4 and 6 of treatment and at month 2 post‐treatment.resultsAfter 1 month of therapy, serum oestradiol levels were maintained in the menopausal range with goserelin and in the early follicular phase range with danazol. Goserelin induced a significant elevation in HDL‐C (by 31.4%), in HDL2‐C (24.6%) and in HDL3‐C (45.7%) but no significant change in LDL‐C or in ApoA‐1 and ApoB. By contrast, danazol caused significant diminutions in HDL‐C (23.9%), HDL,‐C (56.6%) and ApoA‐1 (35.6%). Moreover, danazol increased LDL‐C (10.5%) and ApoB (29.0%,P<0.05). The lipoprotein changes during goserelin had a favourable effect on the atherogenic index (cholesterol/HDL‐C) and ApoA‐1/ApoB ratio whereas those of danazol had opposite effects. These changes reverted 2 months after danazol while HDL was still elevated after goserelin.conclusionsIn relation to cholesterol, goserelin is a safe medication. The significance of temporary adverse changes in cholesterol fractions d

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1991.tb03541.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.objectiveTo evaluate the hypothalamo‐pitultary‐adrenal (HPA) response to both mild and Intense exercise.designMaximum oxygen consumption (Vo2max.) was Initially determined. Exercise to 20% (mild) and 90% (Intense) Vo2max. was undertaken in random order. Subjects were exercised over a 5‐minute period to the required level of Intensity, which was maintained for a further 10 minutes.subjectsSix trained male athletes.measurementsBrachial vein blood was sampled before and at 5‐minute intervals during and after exercise and assayed for plasma cortisol, ACTH, arginine vasopressin (AVP), corticotrophin releasing factor (CRF), sodium and lactate levels. Haemoglobin and haematocrit were measured before and at the end of exercise. Heart rate was monitored continuously and blood pressure measured whenever blood was sampled before and after exercise.resultsMaximum heart rate was 184.2 and 82.5 (mean ± SEM) beats per minute at 90 and 20% Vo2max. respectively. Plasma volume fell by 8.7 ± 2.4% with intense exercise. Significant increases in plasma concentrations of AVP, ACTH and conisol, but not CRF, occurred during intense exercise. Plasma sodium concentration, which Increased during intense but not mild exercise, peaked at 10 minutes after the onset of exercise and preceded the rise in plasma AVP. The AVP peak clearly preceded the ACTH peak in two subjects and occurred synchronously with it in three subjects.conclusionThese results Indicate that although significant HPA activation occurs during Intense exercise, CRF does not appear to play a major role In mediating the ACTH response to an acute episode of vigorous exercise in man. AVP may be more important In th

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1991.tb03542.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.ObjectiveBronchial tumours are the most frequent cause of the ectopic ACTH syndrome. Two types of tumours are classically responsible: the relatively benign carcinoids and the highly aggressive small cell carcinomas. Both have neuro‐endocrine features and are thought to originate from the endocrine component of the bronchial tree. Our objective was to assess the sensitivity of 7B2 and secretogranin 1 as new biochemical markers of neuro‐endocrine differentiation in these tumours In comparison with gastrin releasing peptide.MethodsTissue concentration of 7B2, secretogranin 1 fragments (GAWK and CCB), gastrin releasing peptide and 8‐endorphin were measured in normal human lung (n=4), bronchial carcinoid tumours with (n=5) and with‐out (n=15) the ectopic ACTH syndrome, small cell carcinomas (n=2), squamous cell carcinomas (n=11) and adenocarcinomas (n=6). Molecular weight forms of Immunoreactive ‐ACTH, ‐GAWK, ‐gastrin releasing peptide, and ‐7B2 were also examined using gel exclusion chromatography and Western blot analysis.ResultsWe detected 7B2 immunoreactivity in 19 of 22 neuro‐endocrine lung tumours (with values ranging from<5 to 555 fmol/mg wet weight tissue), CCB immunoreactivity in 20 of 22 tumours with neuro‐endocrine features (with values ranging from<5 to 19 875 fmol mg wet weight tissue) and gastrin releasing peptide immunoreactivity In 10 of 22 neuro‐endocrine lung tumors (with values ranging from<5 to 11132 fmol/mg wet weight tissue). Immunoreactive 7B2 and CCB were detected neither In tumours with non‐endocrine features, nor in the four normal lung specimens. Differing molecular weight forms of Immuno‐reactive 7B2 in two bronchial carcinoids associated with the ectopic ACTH syndrome showed a predominant signal corresponding to a molecular weight of 22 kDa; in addition, a second signal of 19 kDa was also present. The differing molecular weight forms of Immunoreactive ACTH related peptides In the five tumours responsible for the ectopic ACTH syndrome showed, in addition to ACTH1‐35, the constant presence In variable proportions of corticotrophin‐like Intermediary lobe peptide (or ACTH15‐39). The differing molecular weight forms of Immunoreactive GAWK showed heterogeneous results with materials eluting at Kav of 0, 0.3 and 0.4 respectively. In the three bronchial carcinoids studied, two immunoreactive gastrin releasing peptide molecular weight forms were always found at Kav of 0.5 and 0.85 corresponding to gastrin releasing peptide and its fragment14‐27respectively.ConclusionOur results show that 7B2 and the two fragments of secretogranin 1 (GAWK and CCB) are the best biochemical markers of neuro‐endocrine di

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1991.tb03543.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.objectiveWe wished to assess the changes in serum IGF‐I and IGF‐ll concentrations during gonadotrophin treatment alone or with additional GH treatment and to compare follicular fluid IGF‐I and IGF‐II concentrations in the two treatment groups.designWe performed an open study of co‐treatment with GH and subsequently a randomized double blind comparison of addition of placebo or GH to clomiphene citrate and gonadotrophins.patientsWe studied previously poor responders to superovulation regimens for in‐vitro fertilization and embryo transfer, six women in an open study, four of whom had ultrasound diagnosed polycystic ovaries, and 17 women in a double blind study, 12 of whom had polycystic ovaries.measurementsWe measured serum IGF‐I and IGF‐II concentrations throughout treatment cycles. Follicular fluid concentrations were measured at the time of oocyte recovery.resultsNeither serum IGF‐I nor IGF‐ll concentrations were altered by gonadotrophin treatment alone. However, co‐treatment with GH led to a significant rise In serum IGFI concentrations In women with ultrasound diagnosed polycystic ovaries. Concentrations of IGF‐I and IGF‐ll In follicular fluid were lower than in serum, although follicular fluid IGF‐I concentrations were higher in women receiving GH than in those receiving placebo.conclusionsPoor responders to superovulation regimens may have an abnormality of growth factor response. GH co‐treatment leads to an increase in circulating IGF‐I concentrations in women with polycystic ovaries but our results do not support the hypothesis that GH stimulates IGF

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1991.tb03544.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.objectiveImpairment of linear growth is a common clinical feature In patients withβ‐thalassaemia major. Although growth hormone secretion appears to be normal in many short thalassaemic patients, it proves to be deficient in some of them. In these cases, administration of biosynthetic growth hormone seems justified. The aim of this study was to evaluate the effect of such treatment in a group of patients withβ‐thalassaemla major presenting with growth failure and impairment of growth hormone secretion.designRecombinant human growth hormone, 0.6 U/kg body weight per week, given subcutaneously In three divided doses, was administered for 12 monthspatientsEight prepubertal patients withβ‐thalassaemia‐major, presenting with severe growth retardation and Impaired growth hormone secretion In response to provocative stimuli (insulin‐induced hypoglycaemia, L‐dopa and growth hormone‐releasing hormone), were Investigated.measurementsHeight and pubertal stage of the patients, as well as plasma levels of Insulin‐like growth factor I, were determined before, during and after biosynthetic growth hormone treatment.resultsDuring the first 6 months of therapy, a significant Increase of growth velocity was observed, from a mean pretreatment value of 20.1 ± 0.45 cm/year to a value of 4.8 ± 0.66 cm/year (P<0.002). Mean growth rate at 12 months (4.1 ± 0.50 cm/year), though slightly decreased in comparison to that recorded at 6 months, was still significantly higher than basal (P<0.001). A significant Increase In plasma levels of Insulin‐like growth factor I was recorded during treatment (2.82 ± 0.47 vs 0.96 ± 0.22 U/ml,P<0.005). No side‐effects, adverse reactions or alterations in routine laboratory examinations ensued during or after therapy.conclusionsIt appears from these data that biosynthetic growth hormone administration Is worth serious consideration In patients withβ‐thalassaemia major presenting growth retardation and Imp

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1991.tb03545.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summary.objectiveNormal elderly men are reported to have decreased testicular function despite elevated gonadotrophin levels. We wished therefore to determine If changes in testicular function occur over the age range 19–80 years.designSingle fasting blood samples were obtained between 0800 and 0900 h.patientsWorking men In a large Industrial company between the ages of 19 and 60 years participated in the study.measurements fsh,serum immunoreactive Inhibin and total testosterone were measured, the latter two as measurements of Sertoll and Leydig cell function respectively.resultsThe mean baseline serum Immunoreactive inhibin level was significantly lower in men from the older age groups, 31–40 years (479 U/I), 41–50 years (439 U/I) and 51–60 years (415 U/I) than in men from the youngest age group, 21–30 years (613 U/I) while serum FSH was higher in men from the older age groups, 41–50 years (3.7 IU/I) and 51–60 years (6.1 IU/I) than In men from the youngest age group, 21–30 years (2.6 IU/I). There appears to be a change in both FSH and inhibin production, consistent with a primary decline In testicular function.There was no significant difference in testosterone levels between the older age group, age 51–60 years and the younger age group, age 21–30 years. However, testosterone levels were significantly lower in the 41–50 year age group, when compared with the 21–30 year, this significance levelling out at about age 45 years.conclusionThe data are consistent with the hypothesis that Immunoreactive inhibin reflects Inhibin bioactivity, and that inhibin plays a role in the feedback control

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1991.tb03546.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY