摘要:

SUMMARYFour normal males received a constant infusion of 0.9% NaCl for 1 hr followed immediately by 500 μg of TRH infused over the same period. A rise in serum TSH was observed in all subjects while in three there was also a significant FSH response. The prolactin response, unlike that of TSH, was markedly pulsatile indicating that different mechanisms exist for the release of these two hormones from the pituitary after TRH. Circulating levels of LH were unaffected.Ethinyl oestradiol, 30 μg daily for 3 days, was administered to two of the subjects and the infusions were repeated. Both basal FSH and LH levels were depressed, as was the FSH response to the infusion of TRH. By contrast, however, the TSH response to thyrotrophin releasing hormone was enhanced after oestrogen. In one subject the basal prolactin levels were significantly higher while in both there was an augmented prolactin response to TRH, the pulsatile pattern of release being maintaine

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1974.tb01785.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

SUMMARYIn detailed studies on seventeen volunteers, it has been shown that changes in prolactin levels during the menstrual cycle are irregular and inconsistent. Some, but not all, subjects have elevated levels at mid‐cycle, and higher levels in the luteal phase than in the follicular phase. At all stages of the cycle, prolactin levels may show short‐term random fluctuations of as much as 110%. There was no apparent relation between levels of prolactin and those of LH, FSH, oestradiol‐17β or progesterone. It is suggested that if prolactin has any role in the control of the menstrual cycle, then the normal circulating levels are considerably in excess of the threshold requirements for its

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1974.tb01786.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

SUMMARYPlasma immunoreactive thyrotrophin (TSH) responses to synthetic thyrotrophin releasing hormone (TRH) have been measured in forty‐five patients with pituitary or hypothalamic disease (largely non‐functioning and functioning pituitary tumours) tested before and/or after ablative treatment. Subnormal TSH responses usually indicated impaired pituitary function but were less sensitive indices than those of human growth hormone (HGH) after hypoglycaemia. High basal TSH values with exaggerated rises after TRH were occasionally found with hypothyroidism and impaired HGH and cortisol secretion. Delayed TSH responses were indicative of hypothalamic disease in some cases, but in others were associated with pituitary tumours without overt hypothalamic disease. Normal TRH tests were found with hypothyroidism, while five abnormal tests (four delayed) were found in euthyroid patients. Patterns of TSH response to TRH in hypothalamic‐pituitary disease are complex and their significance is not always

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1974.tb01787.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

SUMMARYThe metabolism of [7α‐3H]dehydroepiandrosterone and [4‐14C]testosterone by gynaecomastic breast tissue has been investigated and compared with that in female breast tissue. No conversion of dehydroepiandrosterone to testosterone or testosterone to 5α‐androstandiol was detected in gynaecomastic tissue in contrast to female breast tisue in which such conversions were demonstrable. This suggests that 3β hydroxysteroid dehydrogenase activity is absent in gynaecomastic tissue. The relevance of this deficiency is d

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1974.tb01788.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

SUMMARYThe oestrogen excretion of a pregnant woman, subsequently shown to have placental sulphatase deficiency, was only 1‐2 mg/24 hr, whereas pregnanediol and 17‐oxogenic steroid excretion were within the normal ranges. Plasma concentrations of oestradiol‐17β, progesterone, 17α‐hydroxyprogesterone, 11β‐hydroxycortico‐steroids and corticosteroid‐binding globulin were subnormal. Placental sulphatase activityin vitrotowards the sulphates of DHA, pregnenolone and oestrone was negligible, although extracts of a normal placenta showed high activity under identical conditions. The activities of placental enzymes concerned with metabolism of non‐conjugated steroids (3β‐hydroxysteroid dehydrogenase‐isomerase for DHA and for pregnenolone, aromatase complex and 17β‐hydroxysteroid for oestradiol‐17β) were less than those of a normal placenta but were not diminished as severely as sulphatase activity.Satisfactory uterine contractions were achieved during infusion of prostaglandin E2or Syntocinon but the cervix failed to dilate. A healthy male infant (3330 g) was delivered at term by Caesarean section.From the evidence obtained during the study of this patient it appears that (i) the presence of appropriate non‐conjugated substrates may be required for the induction of placental enzymes concerned with the metabolism of free steroids; (ii) measurement of maternal 17‐oxogenic steroid excretion may help to distinguish patients with placental sulphatase deficiency from those whose fetus has adrenal hypoplasia; (iii) further investigations, possibly involving steroid replacement therapy, are required to identify which, if any, of the alterations in plasma steroid concentrations are associated with the failu

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1974.tb01789.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

SUMMARYThe biochemical abnormalities in euthyroid subjects with autonomous thyroid nodules have been defined. Seven subjects have been studied in detail. None were hyperthyroid and conventional tests of thyroid function were normal. The characteristic abnormalities were noted on scanning. The absent response to TRH demonstrated that pituitary TSH suppression was present in all subjects. A moderate elevation of serum triiodothyronine (T3) concentration, 1.89‐3.07 ng/ml, was noted. It is concluded that autonomous nodules in the euthyroid subjects studied are associated with elevated T3levels sufficient to produce pituitary suppression but not high enough to be associated with the clinical manifestations of hyperthyroidis

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1974.tb01790.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

SUMMARYThree patients with galactorrhoea and menstrual disturbances, due to hyperprolactinaemia and of more than 2 years duration, are described. Administration of 2‐Brom‐α‐ergocryptine effectively lowered the plasma prolactin concentrations in all three patients and restored the normal cyclic ovarian activity. One pregnancy was noticed during therapy. The role of prolactin on ovarian function is discussed. 2‐Brom‐α‐ergocryptine seems to be an effective drug in the long‐term treatment of galactorrhoea associated with menstru

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1974.tb01791.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

SUMMARYMeasurements of plasma ‘cortisol’ and metacarpal mineral content were made in seventy‐two postmenopausal women of whom one half had been taking 20‐40 μg mestranol daily for 1‐3 years. Urinary free ‘cortisol’ (UFC) was also measured in just over one half of these women. Significant increases in plasma ‘cortisol’ and metacarpal mineral content were found in the mestranol treated women. The greatest bone mineral response was found in those women with plasma ‘cortisol’ concentrations in the range 36‐45 μg/100 ml. A significant inverse relationship was found between UFC and metacarpal mineral change. These findings imply that failure of the skeleton to respond to oestrogen therapy might result from a relative increase in adrenocorticoid activity. It is suggested that the measurement of plasma ‘cortisol’ and UFC may be of value in monitoring the treatment of patients o

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1974.tb01792.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

SUMMARYThe response to the subcutaneous injection of glucagon (1 mg) has been studied as a test of the ability of the pituitary to secrete ACTH and growth hormone (GH). Tests have been performed on fifteen normal subjects or patients with unrelated conditions, nine patients with pituitary tumours and seventeen with acromegaly. It is suggested that a normal response is a peak level of 5 ng/ml or more of GH (standard NIH GH 1216C) and either a rise of plasma cortisol measured by competitive protein binding of at least 4 μg/100 ml or a peak level of 7 μg/100 ml. In seventeen patients the responses were compared with those obtained in the insulin hypoglycaemia test and there was good agreement. Measurement of plasma ACTH showed that the response is at pituitary and not adrenal cortical level. Peak responses of ACTH and GH were obtrained at 150 min and of cortisol at 180 min. Plasma glucagon concentrations were falling steadily by this time although still above the control level. The mechanism of action of glucagon is not clear but does not appear to be related to fall of blood sugar. The subcutaneous injection of glucagon is not without side effects; about half the patients were nauseated and nine vomited. Nevertheless we believe that a subcutaneous glucagon test is of value for testing the pituitary reserve of ACTH and GH in situations where insulin hypoglycaemia cannot be use

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1974.tb01793.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

SUMMARYAntibodies reacting with a cytoplasmic component of Sertoli cells were detected in the serum of a 20‐year‐old man with hypogonadism and azospermia. The appearances on testicular biopsy were of Leydig cell hypoplasia and maturation arrest of the germinal cells, but apparently normal Sertoli cells. These findings contrasted with those seen in ninety‐three infertile men, in whom Sertoli cell antibodies were not found but in whom antibodies against the germinal cells were found in ten cases (11%), whilst spermatozoal antibodies were detected in twenty‐four cases (26%) and other antibodies (thyroid cytoplasmic, gastric parietal cell, mitochondrial ‘M’ and antinuclear antibodies) in seventeen cases (18%).It is postulated that autoimmunity involving the germinal or Sertoli cells may be a cause of testicular disease. The only other case in which Sertoli cell antibodies have been found was that of an infertile woman with Sjögren's disease. This raises the possibility that there may be a Sertoli cell equivalent in the ovary containing a similar range of enzymes or other antigenic components and that autoimmunity involving these components may also be a cause of infertility i

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1974.tb01794.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY