摘要:

Two young adults with idiopathic adrenal calcification are described. In one patient the calcification was probably secondary to adrenal haemorrhage in the neonatal period. Neither patient exhibited clinical features suggestive of adrenal cortical insufficiency, and baseline serum cortisol levels were normal. The corticosteroid responses to ACTH administration and to other provocative tests indicated that both glucocorticoid and mineralocorticoid reserve was normal. One patient showed an appropriate epinephrine response to insulin‐induced hypoglycaemia. We conclude that even extensive adrenal calcification may be compatible with completely normal adrenal function. Since, however, little is known of the natural history of this condition, lifelong follow‐up of such patients is advi

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02717.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Twenty women using oral contraceptives and complaining of impaired sexual function were compared with twenty women without sexual problems, matched for age and oral contraceptive. Whilst the sexual behaviour differed in the two groups, the plasma testosterone, androstenedione, oestradiol and SHBG concentrations were very similar. The total androgen levels were low in both groups. Plasma testosterone and oestradiol concentrations were correlated with measures of sexual interest in the no‐problem group, but not in the problem group. Administration of exogenous androstenedione to women in the problem group, using a double blind cross‐over comparison with a placebo, failed to improve their sexual function except in one case. The majority of women showed a rise in androgen and oestradiol between day 24 of one pill cycle and day 4 of the next. The possible behavioural indications of this pattern are discus

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02718.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

In sixty‐two patients with hyperprolactinaemia and a pituitary tumour (without growth hormone excess) we studied the importance of the size of the sella turcica plus extrasellar tissue (if present) in relation to the prevalence of extrasellar extension and impaired hormonal reserve. A lateral tumour area,Vof 3 cm2, turned out to be a critical value both in the development of extrasellar extension of the pituitary adenoma as well as in the development of insufficiency of the pituitary‐gonadal, ‐thyroidal and ‐adrenal axis. Extrasellar extension occurred in 44% of the patients. Below the value of 3 cm2(n= 36) there was only one patient with radiologically detectable significant suprasellar extension. Above the value of 3 cm2twenty‐four out of twenty‐six patients had significant extrasellar extensions at radiological and perimetrical examination. Taking the size of the sella only, extrasellar extension occurred in one third of the cases with a sellar size between 2 and 3 cm2. There was a strongly positive correlation between (log) tumour size and (log) basal prolactin level (P<0·0005). LH, FSH, TSH and ACTH secretion were evaluated by the consecutive administration of LHRH, TRH and metyrapone. Negative correlations were observed between (log) pituitary tumour size and (log) basal LH, FSH and TSH (respectivelyP<0·005,P<0·005,P<0·025) and between (log) tumour size and (log) Δ LH, Δ FSH, Δ TSH and the plasma Compound S concentration after metyrapone (respectivelyP<0·0005,P<0·005,P<0·01,P<0·025). Again the value of the index of tumour size (3 cm2) proved to be critical. Above 3 cm2a highly significant increase in the incidence of insufficient responses to the stimuli mentioned was observed. Pituitary tumour size may be one of the most important indices used in the management of patients with hyperprolactinaemia

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02719.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Vasopressin concentrations were measured in the cord blood of thirty infants, thirteen delivered vaginally and seventeen by Caesarean section. There was no correlation with maternal values but the concentration following vaginal delivery (13·5 μu/ml ± 7·9 SD) was significantly higher than that following Caesarean section (4·2 μu/ml ± 6·6 SD). Gestational age did not affect the concentrations, which fell during the first week of life and then rose gradually in term and pre‐term infants. High levels were found in seven sick babies. There was no correlation in the first 3 weeks of life between plasma vasopressin and plasma or urine osmolality in well and si

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02720.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

We have measured the plasma concentrations of sex steroids and sex hormone‐ binding globulin (SHBG) in twenty‐three massively obese women and ten age‐matched lean female volunteers. In the obese women increased plasma testosterone (obese 3·2 ± 0·5 nmol/1 controls 1·7 ± 0·5 nmol/1,P<0·3) and androstenedione concentrations (obese 9·7 ± 1·2 nmol/1, controls 4·4 ± 0·6 nmol/1,P=<0·01) an increased ratio of oestrone:oestradiol (obese 2·4 ± 0·4, controls 1·0 ± 0·1,P=<0·1) and decreased SHBG levels (obese 30 ± 4 nmol/1, controls 60 + 8 nmol/1,P=<0·001) were found. Obesity differed from the polycystic ovary syndrome (in which a similar pattern of changes of sex steroid concentrations and binding are seen) in that it was associated with normal increases in serum luteinizing hormone (LH) follicle stimulating hormone (FSH) levels in response to the administration of LHRH. We conclude that the common occurrence of menstrual abnormalities in obesity results from abnormal secretion and binding of sex steroids. In addition, the unaltered secretion of LH and FSH in the presence of such changes is evidence for a disor

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02721.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

A patient is discussed who originally presented with retroperitoneal fibrosis, and subsequently developed both pituitary fibrosis and testicular fibrosis. Replacement of testicular tissue by fibrosis has not previously been described in this condition, while we have only been able to find a single previous report of pituitary fibrosis. Fibrous replacement of testis and pituitary should be considered as a further manifestation of the midline fibrosing syndrome.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02722.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

A prospective serological study of patients with recently diagnosed juvenileonset diabetes mellitus was carried out to determine neutralizing antibody responses to Coxsackie B viruses. The sera were tested with and without staphylococcal protein A absorption, to selectively ascertain whether specific IgM or IgG antibody predominated. Of eleven patients studied, ten had reciprocal antibody titres of sixteen or greater to at least one serotype. Three patients showed no reduction in titre in at least one serum sample after protein A absorption, suggesting a predominant IgM‐specific primary response to a recent infection by a Coxsackie B virus. The findings support the possibility that at least some cases of juvenile‐onset diabetes mellitus are closely related to Coxsackie B virus infecti

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02723.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

In view of the ability of long acting thyroid stimulator (LATS) containing sera and IgG samples to stimulate the adrenal cortex of the mouse, it was decided to study the effect of incubation of LATS containing IgG with human thyroid and adrenal homogenates. Whereas incubation with human thyroid gland abolished (loss>80%) both the thyroid and adrenocortical stimulatory effects of LATS, incubation with human adrenal gland resulted in a minimal loss (20%) of both of these stimulatory activities; the magnitude of this loss was no greater than that attributable to non‐specific absorption observed with liver and kidney homogenates by previous workers. It is suggested thata, human and mouse thyroid receptors for TSH/LATS are similar and that adrenocortical receptor for ACTH/LATS are different; andb, the inability of human adrenal homogenates to neutralize LATS explains the absence of hyperadrenocorticism in patients with Graves’dise

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02724.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

The presence of bilateral basal ganglia calcification was sought in nine patients with post‐operative and two patients with primary hypoparathyroidism, using computerized axial tomography (CAT) and plain skull radiographs. Calcification was detected with CAT in seven patients; five with post‐operative and both with primary hypoparathyroidism, but in only one was it demonstrable on plain X‐ray films. The presence of calcificaton appeared to be related to the duration of the disease and possibly the degree of control of serum calcium. Six of the seven patients with cerebral calcification also had cataracts. The incidence of basal ganglia calcification in hypoparathyroidism is probably much greater than previously recognized, especially in post‐operative hypoparathy

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02725.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Mean plasma levels of LH, FSH, PRL, and sex‐hormone binding globulin (SHBG) were raised in twenty‐seven epileptics on anticonvulsants compared with age matched controls. Sexual activity appeared to be reduced. Anticonvul‐ sant therapy results in raised SHBG levels which may be associated with a lowered free testosterone level as indicated by raised LH levels and lowered sexual act

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02726.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY