摘要:

SUMMARYThe LH and FSH responses to 100 pg LHRH in a combined pituitary stimulation test were compared in five normal men during infusions of somatostatin‐28 (SS‐28) and somatostatin onadotrophin hormone secretion by SS‐14 and SS‐28 suggest that these hypothalamic peptides may play a part in the regulation of LH and FSH secretion.SS‐28 significantly reduced both LH and FSH responses to LHRH comparedwith control infusions. SS‐14 did not significantly alter the FSH response but caused a significant reduction in the LH concentration 75 and 90 min afterL HRH injection. These findings demonstrate that SS‐28 has distinct biological activity in addition to its role as a putative precursor of SS‐14. Inhibition of gonadotrophin hormone secretion by SS‐14 and SS‐28 suggest that these hypothalamic peptides may play a part in the regulation of L

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01569.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYHypothalamo‐pituitary‐adrenal (HPA) function was studied using tetracosactrin and insulin hypoglycaemia tests in eleven asthmatic patients who were receiving or had taken oral steroids. The patients had been on prednisone, 5–20 mg/day for 2–17 years. As the dose was reduced they used beclomethasone inhalation, up to 800 μg/day.Seven insulin hypoglycaemia tests were performed when the patients had been off oral steroids for 15–37 months. Plasma cortisol responses were normal in all seven, three had subnormal responses of ACTH.In five patients serial tetracosactrin and insulin hypoglycaemia tests were performed during reduction of steroid dose. Two patterns of recovery of HPA function were observed. In one, both hypothalamo‐pituitary and adrenal function seemed to return simultaneously, in the other normal response to tetracosactrin appeared before that to insulin hypoglycaemia. One patient had normal ACTH and cortisol responses to the stress of a vasovagal attack, but failed to respond to subsequent hypoglycaemia.We conclude that a normal response to tetracosactrin does not indicate recovery of the HPA axis after stopping prolonged oral steroid therapy for asthma, and that patients should continue to carry steroid therapy cards for at least 5 years after such treatment has been

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01570.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYAn ornithine infusion test was performed in fifty‐four children with constitutional short stature. The ornithine infusion induced an elevated level of GH at 45 min (mean value = 873 pmol/1) and a similar rise of cortisol levels (mean value = 544 nmol/1). An important peak of ACTH appeared 15 min before the increase of cortisol. In three panhypopituitary dwarfs studied, no elevation of GH or cortisol was observed. The well tolerated ornithine infusion test allows the simultaneous study of the somatotropic and corticotropic pituitary secretions in children with delayed growt

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01571.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYA 48‐year‐old female with hypercalcaemia diagnosed 3 years prior to admission is described. The patient underwent x‐ray therapy of the neck for keloid scars 35 years prior to the diagnosis of hypercalcaemia. The hypercalcaemia was found to be the result of primary hyperparathyroidism. A cystic parathyroid adenoma was identified during surgery and was, on microscopic examination, composed of oxyphil cells rich in mitochondria. The cystic fluid contained 360 times higher C‐terminal PTH than peripheral serum and almost 4000 times higher PTH as intact 1–84 amino acid residue species. We concluded that previous X‐ray irradiation was related to the pathogenesis of the patient's parathyroid adenoma. The mild nature of the patient's hyperparathyroidism was possibly related to the composition of the tumour of oxyphil cells, known to be a poorly functioning variant of the parathyroid cell. Since parathyroid‘cysts’are obviously necrotic parathyroid adenomas, aspiration of the cysts alone cannot be expected to be curative and, therefore, it is recommended to treat cystic parathyroid adenomas by surgi

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01572.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYA distinction is made between large and small prolactinomas. They have different presenting symptoms, sex distribution and natural history. From a series of 263 patients with obviously enlarged pituitary fossae on lateral skull x‐ray, seventy‐four were identified as having chromophobe adenomas and thirty‐four of these are believed to have prolactinomas (46%). It is pointed out that an enlarged pituitary fossa is not necessarily due to a pituitary tumour. Levels of prolactin are given for patients with craniopharyngiomas, hypothalamic disorders, Cushing's syndrome, Nelson's syndrome and acromegaly. It is emphasized that a modestly elevated prolactin level with an enlarged pituitary fossa does not mean that the patient has a prolactinoma, the hyperprolactinaemia may be due to interference with the hypothalamic prolactin inhibiting mechanism. The special problems of acromegaly are discussed.The thirty‐four large prolactinomas diagnosed before treatment were supplemented by fourteen more cases diagnosed on prolactin measurements made after the initial operation. In addition to forty‐eight large prolactinomas, 103 small prolactinomas were identified. Only thirty‐six of the latter were treated surgically, the diagnosis in the other sixty‐seven cases being presumptive. The presenting symptoms and sex incidence are reviewed.Review of the forty‐eight cases of large prolactinoma shows that it may be an unpleasant invasive tumour. Treatment by transfrontal or transphenoidal surgery may occasionally result in a cure but the results are disappointing. X‐ray therapy is relatively ineffective. Bromocriptine may produce dramatic response but occasional cases are relatively resistant to its action. The value of serial prolactin measurements to monitor tumour growth is stressed.In relation to the small prolactinomas, a number of questions are considered. It seems likely that in the sixty‐seven patients not explored surgically, the majority had microadenomas. The results of transsphenoidal surgery in thirty‐six patients with higher prolactin levels are reported (twenty cured by surgery alone, two rendered panhypopituitary). The natural history of the small prolactinoma is discussed, the reported incidence of small prolactinomas at autopsy is noted, seven patients followed for from 3 to 6 years showed no change in the prolactin level. The advice to be given to a patient with a small prolactinoma who wishes to get pregnant is reviewed. It is suggested that special care should be exercised if the prolactin level exceeds 4000 mU/1. The floor of the pituitary fossa should be scrutinized on tomograms and the upper limit by computerized tomography. If close observation of the patient is possible through pregnancy, bromocriptine may be given to restore ovulation. If the prolactin level rises excessively or a visual field defect occurs, bromocriptine should be restarted at once.The effect of x‐ray therapy on prolactin levels in fifteen patients (14 after surgery) is reported. High prolactin levels are little changed, four patients with lower initial levels (<7000 mU/1) achieved normoprol

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01573.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYThe presence of inhibin like peptide which is biologically active in reducing FSH secretion in castrated rats and suppressing hCG‐induced increase in ovarian weights of immature mice, is reported for the first time in gastric aspirates of normal men. Immunological characteristics of this peptide were similar to inhibin extracted from human seminal plasma. The concentration of inhibin‐like peptide measured by RIA developed for seminal inhibin is more than thirty‐fold higher in gastric aspirates compared with

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01574.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYGlucose handling and insulin secretion were studied in chronic haemodialysis patients and correlated with circulating levels of immunoreactive pancreatic polypeptide (PP). No correlation was found between the elevated basal levels of PP and the K‐rate or the maximum insulin response after a single intravenous injection of glucose. Fifty‐three per cent of the patients had a normal glucose tolerance defined as a K‐rate more than 1. This group of uraemics had a tendency to an exaggerated insulin response compared with the controls but no significant changes of serum‐PP levels after a glucose stimulus were observed. In contrast, uraemic patients with a K‐rate less than 1 and normal insulin response, showed significant increases of serum‐PP at 4 and 6 min after glucose administration. Among all uraemic patients we found a significant inverse correlation between the K‐rate and the early PP response (Pc0.05) and a significant positive correlation between the K‐rate and the early insulin response (P

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01575.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYThe species specificity of TSH binding inhibitory antibodies was compared for patients with untreated Graves' hyperthyroidism, past Graves' hyper‐thyroidism, active ophthalmopathy with past hyperthyroidism, and subacute thyroiditis, by measuring inhibition of TSH binding to plasma membranes prepared from human, guinea‐pig, calf, pig, and dog thyroid glands in a radioreceptor assay. Results were expressed as TSH binding inhibition indices (TBII). Broad species reactivity was demonstrated. This was greatest with pig and least with guinea‐pig thyroid membranes. Immunoglobulin (Ig) from patients in whom strongly positive tests with human thyroid preparations were demonstrated were usually strongly positive with all other species tested, whereas Ig from patients which were less strongly positive with human were, generally, also less positive with the other species. There was a tendency for greater species reactivity of TSH binding inhibiting antibodies from patients with treated Graves' hyperthyroidism (with or without eye disease) than of those from untreated patients with Graves' hyperthyroidism or subacute thyroiditis. Combining the data from all groups, correlation between TBII for human membranes and those of other species was best for dog and least for guinea‐pig. It is concluded that the TSH binding inhibiting antibody is a polyclonal antibody against a single antigen at or near the TSH receptor, and that the degree of reactivity with its antigen in other species depends, mainly, on the amount of antibody present in th

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01576.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYMelatonin was estimated by RIA in samples taken at 24.00 h and 08.00 h from twenty‐one male chronic schizophrenics and twelve age‐sex matched controls and subsequently in more frequent nocturnal samples from nine of the chronic schizophrenics. The 24.00 h melatonin level and the 24.00/08.00 h melatonin ratio were significantly reduced in the chronic schizophrenic patients. Similar results, with no evidence of subsidiary peaks of melatonin secretion, were obtained in those patients who were retested. No relationships between melatonin secretion and age or anterior pituitary hormone secretion were demonstrated, but an effect of body weight was noted which accounted, in part, for the difference between schizophrenics and controls. These results suggest that the low levels of melatonin noted in studies on depressed patients may not be specific and that body weight must be controlled in subsequent studies of melatonin secretion in patients with psychiatric dise

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01577.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYSerum concentrations of 25‐hydroxyvitamin D (25‐OHD), 24,25‐dihydroxy‐vitamin D [24,25(OH)2D] and immunoreactive parathyroid hormone (PTH) were determined in elderly patients with fracture of the femoral neck and in age‐matched controls during summer, winter and early spring in southern Finland. The expected seasonal variation in 25‐OHD values was observed in both patients and controls, though the patient group had significantly lower values during winter (P<0.02) and spring (P<0.01). The 24,25(OH)2D: 25‐OHD ratio remained constant in both patients and controls throughout the study. A significant negative correlation between PTH and 25‐OHD values was found in the patient group. Thus, vitamin D deficiency may contribute to the high incidence of femoral neck fractures in elderly people, and the increased PTH activity, observed in many patients with these fractures, is secondary to vitam

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb01578.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY