摘要:

SUMMARYA 5‐year‐old girl with the McCune‐Albright syndrome presented with precocious puberty secondary to autonomously functioning ovarian cysts, followed by true central puberty. Progression from gonadotrophin‐independent to gonadotrophin‐dependent precocious puberty may occur from elevated sex steroid levels leading to the early maturation of the hypothalamic‐pit

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb03263.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYFour fully breast‐feeding women at 6 weeks post partum were injected with LHRH (0.1 μg/kg) every 94 min by pulsatile infusion pump. While follicular development occurred in all women, and evidence of luteinization was apparent in three out of four, normal ovulation and luteal function did not occur. This suggests that a simple disturbance in the pulsatile pattern of LHRH secretion may not, in itself, be enough to explain the suppression of ovarian activity during lactati

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb03264.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYThe effect of oral administration of desmopressin (DDAVP) solution was investigated in six patients with cranial diabetes insipidus of varying aetiology. All patients experienced a prompt and prolonged antidiuresis. Nine patients have been managed with oral DDAVP tablets for up to 5 months and all preferred this route of administration to intranasal application using a rhinyle. Oral DDAVP gives excellent and convenient control in cranial diabetes insipidus.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb03265.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYElevation of immunoreactive LH and reduced testosterone production are consistent features of Leydig cell dysfunction in uraemic hypogonadism. To investigate further Leydig cell regulation in uraemia, we measured plasma bioactive LH (B‐LH) and immunoreactive LH (I‐LH), as well as FSH, testosterone, creatinine, urea and albumin in seven uraemic men before and after haemodialysis and compared them to levels both in eugonadal controls (n =10) and in men with primary testicular damage (n= 10). Plasma B‐LH was increased in uraemic men compared with both nonuraemic control groups. Plasma I‐LH and FSH were increased and testosterone decreased in uraemic men compared to eugonadal controls. In comparison with nonuraemic men with primary testicular damage, plasma I‐LH levels were similar but FSH and testosterone lower in uraemic men. As a consequence, the ratio of B‐LH to I‐LH (LH:B/I ratio) was decreased in men with primary testicular damage but normal in uraemic men. A single session of haemodialysis decreased creatinine (50–5%) and urea (58.5%) and increased B‐LH (47.7%), I‐LH (32.9%), FSH (24.4%), testosterone (15.8%) and albumin (17.8%) levels, but the LH:B/I ratio was unchanged. Increases in gonadotrophin levels were greater than could be accounted for by haemoconcentration suggesting that dialysis may also ameliorate uraemic suppression of the hypothalamus and pituitary. Ultrafiltrates of human uraemic plasma (mol wt<25000) had no inhibitory effect on in‐vitro steroidogenesis by isolated rat Leydig cells making circulating uraemic‘middle‐molecule’‐type toxins unlikely to be involved in causing lowered testosterone levels in uraemic men. These qualitative abnormalities of plasma LH in uraemia indicate that the pathogenesis of uraemic testicular dysfunction involves additional defects in regulation of Leydig cell function beyond that

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb03266.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYA new radioreceptor assay for insulin‐like growth factor‐II (IGF‐II), using receptors on ovine placental membranes, is described. Half‐maximal displacement of specifically bound radioiodinated human IGF‐II tracer was seen at 1.0 ng/tube of unlabelled IGF‐II. The cross‐reactivity of IGF‐I was 1%, and insulin was entirely without effect. Measured on serum samples from 100 healthy adults, the mean IGF‐II concentration (±SD) was 576 ± 160 ng/ml. Identical mean values were seen for all adult age groups up to 65 years. The mean value for 10 acromegalic adults was 583 ± 155 ng/ml, and for 9 GH‐deficient subjects, 161 ± 26 ng/ml (P<0.001 compared to normals). Of eight patients with chronic renal failure, none had an IGF‐II level less than 2SD above the normal mean. No significant effect of renal dialysis was seen. In groups of patients with gastric, breast, lung, testicular, oat cell, ovarian, colonic and prostatic carcinoma, Hodgkin's lymphoma, non‐Hodgkin's lymphoma, sarcoma and teratoma (5–12 patients per group), mean IGF‐II levels were in the lower part of the normal range. Thus this study does not provide evidence supporting a role for excessive IGF‐II production in the gr

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb03267.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYThe capability of the anterior pituitary gland to secrete GH in response to an intravenous injection of growth hormone‐releasing factor (GRF) and insulin‐induced hypoglycaemia was evaluated in 9 healthy male subjects ranging in age between 37 and 52 years old. Plasma GH response to 100 /μg human GRF showed considerable intersubject variation and the increment of the peak value from the basal did not exceed 5 ng/ml in four out of 9 subjects. In contrast, insulin‐induced hypoglycaemia resulted in a consistent stimulation of GH that exceeded 21 ng/ml in all subjects. The mean peak GH response after insulin‐induced hypoglycaemia was significantly higher than that after GRF (27·4±1·6 vs 10·6±1·9 ng/ml). These results demonstrate that a significant divergence exists in plasma GH responses between the two provocative tests in the middle‐aged subjects and suggest that the stimulation of GH following insulin‐induced hypoglycaemia is not mediated solely

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb03268.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYSerum prolactin concentrations were measured in nine untreated hypothyroid infants and 23 euthyroid controls. In the former group the serum prolactin concentrations were tenfold higher than the controls (352 vs 34 μg/1), declining gradually upon treatment. Although serum prolactin concentrations can be mildly elevated in adults with hypothyroidism, congenital hypothyroidism causes a profound and probably uniform hyperprolactinaemia; furthermore, the hormone concentration correlates directly with the simultaneous TSH concentration. The physiological importance, if any, of the hyperprolactinaemia in the fetus or neonate is uncertain

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb03269.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYIn order to establish the influence of dopaminergic, á‐adrenergic and cholinergic pathways on GRF‐mediated GH release we have studied the GH responses to GRF 1–29 (100 or 50 μg as i.v. bolus) alone and in combination with metoclopramide (MCP, 10 mg, i.v.), thymoxamine (THYM, 210 μg/min, 150 min infusion), and atropine (1.2 mg, i.v.). We have also investigated any possible interaction between TRH and GRF in view of the reported inhibitory effects of TRH infusion on stimulated GH release. Dopaminergic and á‐adrenergic blockade with MCP and THYM respectively, did not have any effect on the GH responses to GRF. This lack of effect strongly suggests that any action which these neurotransmitters may exert on GH secretion is not at a pituitary level. TRH did not modify the GH response to GRF suggesting that the inhibitory effect on stimulted GH secretion is exerted at a hypothalamic level. In contrast, GH responses to GRF were significantly reduced by prior administration of atropine. These data support the view that cholinergic pathways play an important role in the regulation of GH secretion and such control may be exerted at both hypothalamic and pitui

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb03270.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYTwo sisters aged 13 and 19 years suffering from familial Cushing's syndrome due to nodular adrenocortical dysplasia are described. Pituitary adrenocortical function tests indicated the presence of adrenal autonomy. Adrenal scintigraphy showed bilateral symmetrical uptake indicating the bilateral character of the autonomous process. Complete adrenalectomy was performed in both girls. The adrenals were of about normal weight showing numerous dark brown pigmented nodules and small perivascular lymphocytic infiltrates. Serum immunoglobulin preparations obtained from both girls stimulated adrenocortical cell growth in a cytochemical bioassay system. It is proposed that circulating growth factors may be involved in the pathogenesis of the disease.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb03271.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYTo clarify age‐related changes in the plasma renin activity (PRA)‐aldosterone (ALDO) system in relation to urinary sodium (Na) excretion in pseudohypoal‐dosteronism type I (PHA), we followed a patient with PHA serially by measuring the hormonal balance and urinary electrolyte excretion for 5 years. The patient was diagnosed as PHA mainly on the basis of extremely high PRA (170 ng/ml/h) and ALDO (1670 ng/dl) despite massive urinary Na excretion, a normal ALDO/PRA ratio (mean value = 11), and the ineffectiveness of 9a‐fluorocortisol (Florinef) to reduce urinary Na excretion and PRA‐ALDO. The pattern of reduction in PRA‐ALDO with age in this patient was almost identical with that of normal infants and children and was most remarkable during the first 18 months of life. During this period, there were statistically significant correlations between age and each of the following values: PRA (r=−0.753,n= 9,P<0.05), ALDO (r=−0.736,n= 11,P<0.01) and urinary ALDO excretion (r=−0.840,n= 9,P<0.01). But the reduction of PRA‐ALDO in this patient was not the result of increased urinary Na excretion with age. Although PRA and ALDO values in this patient did decrease with age, they were still high compared with age‐matched controls, suggesting a marginal state of Na balance. Thus, we conclude that PRA‐ALDO levels in PHA decrease with age in the same pattern as in normal infants and children without a significant change in urinary Na excretion, possibly through increased renal conservation of Na, the mechanism of which should be clar

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb03272.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY