摘要:

SUMMARYThe role of the adrenal cortex in the pathogenesis of hypertriglyceridaemia associated with the intake of oral contraceptive agents containing oestrogen has been investigated in rats.Bilateral adrenalectomy reduced the activity of hepatic enzymes regulating lipogenesis (acetyl CoA carboxylase, fatty acid synthetase) and decreased plasma triglyceride concentrations. On the other hand, the administration of high dosage corticosterone induced the activity of hepatic enzymes with consequent elevation in serum triglyceride levels.In animals with intact adrenals the administration of oestradiol: (a) raised plasma triglyceride levels, (b) enhanced the activity of hepatic enzymes, and (c) increased the adrenal cortex: body weight ratio. The effects (a) and (b) were not observed when both adrenals were removed prior to oestrogen therapy. High dosage corticosterone replacement was found to be essential for the oestradiol to produce its effects on hepatic enzymes and plasma triglyceride levels.The results suggest a regulatory role for the adrenal cortex in the homeostasis of plasma triglyceride concentration and that the hypertriglyceridaemia induced by the oestrogen containing preparations might be secondary to alterations in adrenocortical function.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1976.tb01946.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYHypocalcaemia is a well‐recognized manifestation of magnesium deficiency. We have studied seventeen patients with this syndrome in an attempt to determine the pathogenesis of the hypocalcaemia. Mean initial serum calcium concentration was 5.6 mg/dl and mean initial serum magnesium concentration was 0.75 mg/dl. Serum immunoreactive parathyroid hormone (IPTH) was measured in sixteen patients in the untreated state. Despite severe hypocalcaemia, serum IPTH was either undetectable (<150 pg/ml) or normal (<550 pg/ml) in all but two patients. Serial measurments made during the initial 4 days of magnesium therapy in four patients showed an increase in serum IPTH within 24 h, but a delayed increase in serum calcium, which required approximately 4 days to reach normal values. The effect of the rapid normalization of serum magnesium on serum IPTH and serum calcium concentration was studied in three patients. Within 1 min after 144‐300 mg of elemental magnesium was administered i.v., serum IPTH had risen from undetectable to 3600 pg/ml and 1725 pg/ml in two patients and from 425 pg/ml to 937 pg/ml in the third. Serum calcium concentrations were unchanged after 30‐60 min. These data provide evidence for impaired parathyroid gland function in most of the magnesium deficient patients. The rapidity with which serum IPTH rose in response to magnesium therapy indicates that this may reflect a defect in parathyroid hormone (PTH) secretion rather than its biosynthesis. The failure of serum calcium concentration to increase during the initial days of magnesium repletion, at a time when serum IPTH concentrations were normal or elevated, suggests end‐organ resistance to PTH in these patients.The renal response to PTH was examined in two magnesium deficient patients by measurement of urinary cyclic AMP excretion following administration of parathyroid extract. In both patients there was a minimal increase in urinary cyclic AMP concentrations. In contrast, when the hepatic response to glucagon was teste

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1976.tb01947.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARY257 patients have been reviewed 1‐5 years (mean 3 years 2 months) after receiving one of five dose regimes of125I for thyrotoxicosis. The cumulative incidence of hypothyroidism was 34% and of persistent thyrotoxicosis 17%. The group receiving doses between 351 and 500 μCi/g had the highest proportion of euthyroid patients (65%) with the lowest requirement for repeat therapy (46%). In the euthyroid patients, increasing dose of125I was associated with progressive decline in mean thyroxine (T4) level and free thyroxine index (FTI) within the respective normal ranges, and increase in mean thyroid stimulating hormone (TSH) level to above the normal range. Euthyroid patients with elevated TSH levels had significantly lower T4 and FTI values compared with those with normal TSH, and showed a 3‐4‐fold increased rate of development of hypothyroidism over 1 year. Euthyroid patients with elevated T3 levels remained euthyroid during the subsequent year and mean T3 levels declined significantly, suggesting that abnormally elevated T3 levels after125I do not generally indicate impending relapse of thyrotoxicosis.It is concluded that the potential advantages of125I therapy for thyrotoxicosis in reducing the incidence of hypothyroidism have not been realized in pr

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1976.tb01948.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYThe administration of human chorionic gonadotrophin (HCG) to dexamethasone‐suppressed men caused parallel changes in the concentration of plasma testosterone and in the urinary output of androsterone+aetiocholanolone, total 17‐oxosteroids and oestrogens. Discrepant results occurred in only four of the thirty‐seven men tested. With these exceptions, the response to HCG could be followed as well by measuring androsterone+aetiocholanolone, 17‐oxosteroid or oestrogen excretion rates as by following plasma testosterone levels. The most sensitive index of response was the rate of appearance of oestrogens in urine, and the next that of androsterone+aetiochol

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1976.tb01949.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYA series of sixty‐two women with pituitary tumours, but having neither acromegaly nor Cushing's disease, has been analysed with respect to mode of presentation. Thirty‐six (58%) presented with amenorrhoea and galactorrhoea and a further fifteen (24%) presented with amenorrhoea only. Pretreatment prolactin levels were available in thirty‐four of these patients and in twenty‐seven (79%) hyperprolactinaemia was found, this occurring in the absence of a history of galactorrhoea in four out of ten cases.In addition, among a series of twenty‐five unselected women with unexplained galactorrhoea, we have found twelve pituitary tumours, amenorrhoea being a feature of all twelve cases.We conclude that the incidence of hyperprolactinaemia in women with apparently functionless pituitary tumours is much higher than previously estimated and suggest that serum prolactin should be assayed in all patients with such tumours even in the absence of a history of galactorrhoea. All patients with unexplained galactorrhoea should have careful radiological investigation for a possible pituita

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1976.tb01950.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYA technique for the measurement of five conjugated steroids (dehydroepiandrosterone sulphate, pregnenolone sulphate, testosterone sulphate, dihydrotestosterone sulphate and testosterone glucuronide) in human seminal plasma is described. The steroid sulphates and testosterone glucuronide were measured by radioimmunoassay after solvolysis and enzyme hydrolysis, respectively. In all cases the recognized criteria of assay reliability were fulfilled.In a group of men with established fertility, dehydroepiandrosterone sulphate had the highest concentration and testosterone sulphate had the lowest (mean levels of 1.04 μmoles/l and 1.52 nmoles/l, respectively). The levels of pregnenolone sulphate, dihydrotestosterone sulphate and testosterone glucuronide were 30.3, 4.37 and 38.8 nmoles/l, respectively. In all cases the levels of conjugated steroid exceeded the levels of the corresponding unconjugated compound

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1976.tb01951.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYIn order to provide information on the endocrine effects of vasectomy, unconjugated pregnenolone, dehydroepiandrosterone, androstenedione, testosterone, dihydrotestosterone, oestrone and oestradiol were analysed in the blood plasma of twenty Mexican men on two occasions before and 1, 3, 6 and 12 months after vasectomy. Vasectomy appeared to be associated with a significant decrease in the plasma levels of pregnenolone, dehydroepiandrosterone and androstenedione and a significant increase in the levels of dihydrotostrone and oestrone. A probably significant increase in oestradiol levels took place 12 months after vasectomy but not before. No consistent changes were found in testosterone (up to 12 months) or in FSH and LH levels (up to 6 months) after vasectomy.The unconjugated steroids indicated above, except oestrone, were also estimated, whenever possible, in seminal plasma specimens obtained from thirty‐nine subjects (including the twenty indicated above) on the same occasions. Vasectomy was associated with a highly significant decrease of seminal plasma dihydrotestosterone levels on all occassions and a significant decrease in androstenedione levels after 6 and 12 months. After 12 months there was a decrease in dehydroepiandro‐sterone and an increase in oestradiol; these changes were both probably significant.In another preliminary study, the levels of pregnenolone sulphate, dehydroepiandrosterone sulphate, testosterone glucuronide, testosterone sulphate and dihydrotestosterone sulphate were estimated before and 1 month after vasectomy in the seminal plasma of fourteen to seventeen subjects. Testosterone glucuronide fell, probably significantly, but other conjugates were unchanged.The data indicate that vasectomy may be associated with significant changes in the circulating and in seminal plasma levels of several steroids. The gradual nature of some of the changes observed suggests the necessity of conducting in several centres large‐scale, long‐term studies on vasectomized subjects and on a carefully matched contro

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1976.tb01952.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYA single fasting level of serum prolactin was measured in each of sixty control subjects and eighty‐three psychiatric patients of both sexes who had been on neuroleptic therapy for 2‐4 weeks (acute treatment) or at least 5 years (chronic treatment) and who were aged either 17‐45 or 48‐85 years. All groups of patients had significantly higher mean prolactin levels than controls. Gender, age group of women, and exposure to acute or chronic treatment were significant variables determining the magnitude of neuroleptic‐induced elevation of prolactin. In some of the groups, dose, duration of chronic therapy, and concomitant administration of anticholinergic drugs also influenced prolactin levels.Whereas all acutely treated women had prolactin values above the control range, one out of twelve (8.3%) of the women aged 17‐45 years and six out of fourteen (42.9%) of the women aged 48‐85 years who were under chronic treatment had normal values. Normal prolactin levels were also found in five out of sixteen (31.2%) of the acutely treated and nine out of twenty‐four (37.5%) of the chronically treated men a

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1976.tb01953.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYIntravenous glycine injection (250 mg/kg of body weight) resulted in growth hormone release in normal children but not in those with growth hormone deficiency diagnosed by insulin‐induced hypoglycaemia. In the latter significantly higher peak concentrations of serum α‐amino nitrogen were also found. False negative responses to glycine (no GH release) were observed in two patients of short stature but normal pituitary function. In them the peak levels of serum α‐amino nitrogen were lower than in those with hypopituitarism. We propose the clinical use of glycine as an inexpensive and innocuous procedure for the detection of GH deficiency in children. A post‐glycine GH peak greater than 10.0 mu/1 seems to be a good index of an intact G

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1976.tb01954.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SummaryThe radiation dose, delivered to the hypothalamic‐pituitary region, has been calculated in thirty‐nine children irradiated for brain tumours and in seventeen children who had received prophylactic cranial irradiation for acute leukaemia. All subjects had an insulin tolerance test at least 2 years after their radiotherapy. There is a significant inverse correlation between radiation dose and peak GH response. Thirty‐seven of the fifty‐six patients showed an impaired GH response and thirty‐six of these received more than 2900 rads. Only five patients who received such a dose showed normal GH responses and four of these were aged over 13 years when treated.In conclusion, cerebral irradiation is a potent cause of GH deficiency in

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1976.tb01955.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY