摘要:

SUMMARYHuman pancreatic growth hormone releasing factor (hpGRF1–44) was given intravenously as a 100 μg bolus to 20 patients with active acromegaly. The GH‐responses were variable, ranging from an increase of 8 to 2813% from the basal level (mean ± SE, 428·136%). Sixteen GRF‐responders (Δ%± 100%) were arbitrarily distinguished from four GRF non‐responders, whose GH‐levels increased less than 100% from basal level after GRF‐administration. The outcome of the GRF‐test did not correlate with the results of other dynamic tests of GH‐secretion in acromegaly (oral glucose tolerance test, insulin hypoglycaemia, TRH‐, LHRH‐, CRF‐stimulation). In 10 patients who had not been treated before, the GH‐increments after GRF were higher than those in seven patients who had previously been subjected to transsphenoidal surgery, though they still had clinically and biochemically active acromegaly. Ten acromegalics, who were tested with GRF, were later treated surgically by the transsphenoidal route and were reevaluated with GRF‐stimulation 2 months after surgery. Eight patients appeared clinically cured of whom four had complete normalization and four had significantly lower basal and conventionally stimulated GH‐levels postoperatively. These patients also had normal postoperative GH‐responses to GRF, which had been significantly higher before surgery compared with normal controls. It is concluded that the GRF‐test in acromegaly does not help in establishing the diagnosis. The normalization of the GH‐response to GRF after transsphenoidal surgery seems to represent additional evidence for normalization of GH‐secretion, though the latter is not p

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb00203.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYWe have determined the blood groups and HLA haplotypes in 15 members in four generations of a large kindred with familial benign hypercalcaemia (familial hypocalciuric hypercalcaemia). No linkage was seen between the disorder and ABO or Rh blood groups or the HLA antigens.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb00204.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYSubjects living in iodine deficient areas were reported to have elevated serum thyroglobulin (Tg) concentrations. This finding was interpreted as related to thyroid stimulation. Discrepant results, however, were found when serum Tg concentrations were correlated either with serum TSH or with goitre size. In this study we investigated the relationships between goitre size, serum Tg and serum TSH in 488 unselected adult subjects living in an endemic area of North‐Western Tuscany (Garfagnana district). The control group comprised 352 subjects residing in a non‐endemic area. In the endemic area a high prevalence of goitre was found (80·1%), thyroid enlargement being slight to moderate in the majority of cases and very large only in six subjects. Serum Tg concentrations increased and serum TSH levels decreased with the size of goitre. Statistical analysis by the chi‐square cross correlation test showed that the converse changes of serum Tg and serum TSH in relation to goitre size were highly significant. These findings indicate that the increase of serum Tg occurring in endemic goitrous subjects may be related to factors other than TSH stimulation. Functional autonomy of the thyroid may account for the finding of low serum TSH and elevated serum Tg values in patients with large goitres. The present data do not exclude the possibility that the release of Tg is influenced by TSH stimulation, but indicate that other factors may be responsible for the increased levels of Tg found in endemic

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb00205.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYA 53‐year‐old woman with Nelson's syndrome was treated with 600 mg sodium valproate daily. Her plasma ACTH was effectively decreased, whilst the response of plasma ACTH to corticotrophin‐releasing factor (CRF) was unaltered. The result of the CRF test suggested that sodium valproate, at least in the present patient, acted at the hypothalamic

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb00206.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYA sensitive and specific radioimmunoassay for arginine vasopressin was used to compare the relative importance of changes in plasma osmolality, angiotensin II and dopamine in the regulation of vasopressin secretion in man. One hour after water loading plasma vasopressin fell from 0·40 to 0·06 pmol/1, while 8 h and 24 h fluid restriction resulted in a rise of vasopressin from 0·29 to 0·54 and 1·37 pmol/1 respectively. In contrast neither dietary sodium deprivation, when plasma angiotensin II increased 5‐fold, nor dopamine infusion, at a rate which increased circulating dopamine levels up to 244‐fold, had any effect on basal plasma vasopressin values. These results confirm that, under physiological conditions, osmoregulation is the major mechanism controlling vasopressin release and suggests that circulating angiotensin II and dopamine have no significant part

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb00207.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYThe effects of oestrogen priming on the response of serum PRL, LH and TSH to dopamine (DA) infusion have been studied in hyperprolactinaemia. Seven hyperprolactinaemic females (aged 22–57 years; basal PRL 911–5130 mU/1, normal>420 mU/1), had submaximal DA infusions (0·06 μg/kg/min) over 3 h. The DA was repeated at the same dose after pretreatment with ethinyl oestradiol (E2) 100 μg daily by mouth for 3 d, and after a further 2 week interval, following pretreatment with tamoxifen (TAM) 20 mg twice a day by mouth for 3 d. Ethinyl oestradiol pretreatment stimulated a rise in basal PRL levels in all subjects (mean ± SE, mU/1; 2903 ± 761 vs 2293 ± 684,P>0·05) while TAM produced a higher but more variable increase in basal PRL levels (mean ± SE, mU/1; 3402 ± 757,P= n.s.). The individual increments in basal PRL levels after both E2and TAM pretreatment showed a significant positive correlation with the greater decrement in PRL levels during E2and TAM primed DA infusions (E2,r= 0·93,P>0·01, TAM,r= 0·83,P>0·05). E2pretreatment produced a rise in basal LH levels in 5/7 patients, and there was a significant positive correlation between the rise in basal LH levels after E2and the decremental change in LH levels in E2primed DA infusions (r= 0·94,P>0·01). Basal TSH levels were unaffected by E2and TAM pretreatment, but during DA infusion there was a significantly greater decremental change following E2pretreatment (sum of decrements, mean ± SE mU/1; 8·1 ± 1·58 vs 4·65 ± 1·23,P>0·02). In conclusion, E2and TAM increased PRL sensitivity to the inhibitory actions of DA treatment. In contrast, E2but not TAM, exerted similar effects on the dopaminergi

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb00208.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYAbnormal steroid secretion may contribute to anovulation in insulin dependent diabetic patients with amenorrhoea. We have measured serum sex hormonebinding globulin (SHBG) and free and bound oestrogen and androgen levels in 17 such patients. As controls we included 17 patients with insulin dependent diabetes mellitus and normal menstrual cycles, 21 regularly menstruating normal women (both sampled during early follicular phase), and 23 non‐diabetic patients with amenorrhoea. The diabetic patients with normal cycles had significantly higher serum concentrations of Δ4‐androstenedione and testosterone than the normal women (P>0·01). The amenorrhoeic diabetics in contrast had significantly lower serum concentrations of SHBG, 5 α‐dihydrotestosterone and free and total oestradiol‐17β than either group of menstruating women (P>0·05), and significantly lower concentrations of Δ4‐androstenedione (P>0·01), dehydroepiandrosterone sulphate (P>0·01), testosterone (P>0·01), and oestrone (P>0·05), than the cycling diabetics. The two amenorrhoeic groups had similar free and bound sex hormone concentrations except that Δ4‐androstenedione levels were significantly lower in the diabetics (P>0·01). We conclude that the low sex hormone levels in diabetic women with amenorrhoea may be due to suppression of the hypothalamic‐pituitary axis in view of the impaired LH secretion found in these patients and that excess androgen secretion seems not to be of aetiological importance in amenorrhoea related to diabetes mellitus. The decreased steroid levels in amenorrhoeic diabetics is due to their suppressed ovarian function while the increased androgen levels in diabetics with regular cycles are p

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb00209.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYA study of the effect of α‐methyl‐1‐tryosine (metyrosine) blockade (2 g/d for 2 d) of dopamine (DA) synthesis on the PRL and TSH response to domperidone (DOM) and TRH in normal women and subjects with pathological hyperpro‐lactinaemia is reported.In the normal subjects, there was a marked increase in basal PRL (51·7 ± 11·1 vs 5·7 ± 1·0 ng/ml) and the PRL and TSH responses to DOM were abolished. The PRL response to TRH was also reduced.In the hyperprolactinaemic subjects, metyrosine had no effect on basal PRL nor on the virtually non‐existent PRL response to DOM, whereas it abolished the exaggerated TSH response.The conclusion is drawn that the response of both PRL and TSH to DA receptor blockers is really dependent upon DA inhibitory tone. A fall in this tone can also be postulated as responsible for the hyporesponsiveness of PRL to DOM frequently observed in pathological hyperprolactinaemia. In addition, the fact that metyrosine also abolished the exaggerated TSH response to DOM shows that the latter is totally dependent on enhanced DA inhibition of the thyrotrophs. Lastly, the reduced PRL response to TRH after metyrosine indicates that DA partly determines the ability of the lactotrophs t

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb00210.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYAn objective evaluation of the anti‐androgen effects of spironolactone was performed in a consecutive series of 12 hirsute patients receiving a daily dose of 150 mg; nine completed the study. Using a computer assisted image analyser, hair diameter on two weekly shavings decreased significantly over a 12 month period in three of the patients, although growth rate and mean diameter did not change in the group as a whole. Plasma testosterone fell significantly to a mean of 53% of basal levels. The mean free testosterone (derived) fell significantly to 64% of basal by the sixth month (P=>0·005) and remained significantly depressed for the remainder of the study. There was subjective benefit in hair growth and greasiness and a significant reduction in the semi‐objective Ferriman‐Gallwey index in nine of 10 subjects assessed for at least 9 months. We conclude that although spironolactone was not consistently successful, it may represent effective therapy for a sub group of patients with hir

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb00211.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

SUMMARYIntravenous infusion of somatostatin in six water loaded normal human subjects produced a prompt reduction in urine flow accompanied by a rise in urine osmolality and a decrease in free water clearance. Plasma AVP levels did not change. Somatostatin would seem to exert an antidiuretic effect directly on the kidney.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1985.tb00212.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY