摘要:

SUMMARYThe effect of pain on plasma AVP concentration in man has previously been studied only during major surgery with general anaesthesia. Plasma AVP concentration (pAVP) and plasma osmolality (pOsm) were measured in thirty‐six patients seen in a surgical emergency department complaining of pain and in fifty‐one control subjects. No significant difference in pOsm was found, but pAVP was significantly higher in the emergency room patients in pain (M ± SEM = 4.94 ± 0.98 pmol/l compared to 2.31 ± 0.32 pmol/l in control subjects,P<0.01).In the control subjects, age was found to have a low but significant inverse correlation with pAVP (r= 0.37,P<0.01). Chronic smoking was associated with significant elevation of pAVP (3.81 ± 0.99 pmol/l in smokers vs. 1.89 ± 0.28 pmol/l in non‐smokers,P<0.02). Neither smoking nor age could account for the difference in pAVP between the pain and control groups. Thus, pain is a non‐osmolar factor capable of elevating AVP in c

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb02156.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYAbsent thyrotrophin (TSH) response to thyrotrophin releasing hormone (TRH) was found in ten of fifty consecutive nodular goitrous patients who were clinically and biochemically euthyroid. These ten patients together with a reference group engaging fifty‐eight healthy individuals matched for sex, age, and geographic region form the basis of the present study. Patients with autonomously functioning single adenomata were excluded from the investigation. In the patient group, values of serum thyroxine (T4), free T4‐index, and serum TSH did not differ significantly from those recorded in the reference group, whereas serum triiodothyronine was found to be significantly higher in the patients, although within the normal range. After selective resection of the goitre, the TSH responsiveness to TRH recovered completely. Routine indices of thyroid function, however, demonstrated no major deviation from pre‐operative levels. During a follow‐up period of 1 year, no systematic alterations were recorded in TSH response to TRH nor in the thyroid function tests, indicating maintenance of euthyroidism with restored normality within the pituitary‐thyroid axis. The present study lends support to the view that increasing functional autonomy apparently is a common trend in goitre evolution in a non‐e

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb02157.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYThyrotrophin releasing hormone (TRH) tests have been carried out on sixty‐two patients with sporadic non‐toxic nodular goitre. 61% gave a subnormal thyroid stimulating hormone (TSH) response but had normal plasma thyroxine (T4) and triiodothyronine (T3) levels. T3 administration suppressed131I uptake by the thyroid adequately in 74% of these and there was normal stimulation of thyroid uptake by exogenous TSH. Prolactin (PRL) rose normally after TRH in all the TRH non‐responders. Normal TSH response to TRH was restored by partial thyroidectomy and in some cases by propyl thiouracil administration. Possible reasons for these findings are discussed. It is concluded that these cases were truly euth

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb02158.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYThe effects of surgical stress on the metabolism of the retinol‐binding‐protein‐thyroxine‐binding‐prealbumin complex were investigated. The immediate post‐surgical period was characterized by a rapid decline in the serum concentration of retinol, retinol binding protein and triiodothyronine and an increase in the 24 h urinary excretion of retinol, retinol‐binding‐protein and thyroxine. Similar, but less pronounced, changes were seen in other subjects suffering acute myocardial infarction but were not observed in normal healthy euthyroid males or in pre‐operative euthyroid patients. The preparation of specific anti‐retinol binding protein anti‐serum and the use of this in ‘monorocket’ immunoelectroph

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb02159.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYThe first menstrual cycle after a therapeutic abortion was studied in eighteen women by measuring plasma oestradiol and progesterone concentrations and the urinary excretion of LH until the first menstruation.The plasma concentrations of oestradiol and progesterone declined rapidly, reaching low values as early as the second day after the abortion. An increase in plasma oestradiol levels was observed from the seventh post‐abortal day onwards. A peak of short duration in the plasma progesterone concentrations occurred during the increased oestradiol synthesis.The concentration of progesterone during the luteal phase of the cycle was lower than in a normal cycle, indicating an inadequate luteal function. Return of ovulation was observed in 83% of patients during the first cycle; as judged by a biphasic oestradiol profile in plasma, a mid‐cycle LH peak, and subsequent elevation of progesterone. The first LH peak was observed 16 days after the abortion.The rapid return of the ovulatory function makes immediate post‐abortal contraception a nece

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb02160.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYA 16‐year‐old boy with chronic lymphocytic thyroiditis was noted to have a low free thyroxine (T4) level, low triiodothyronine resin uptake (T3U), and high serum thyrotropin (TSH) values. Unexpectedly, markedly elevated T3 radioimmunoassay (RIA) and T4 (RIA) values, using a double antibody technique were obtained when performed directly on unextracted serum samples. Extremely low T4 (RIA) values were noted when polyethylene glycol (PEG) was used to separate bound from free hormone. The presence of circulating T3‐ and T4‐binding immunoglobulins was suspected and confirmed with the following special studies. With undiluted serum in a T3 (RIA) system, using dextran‐coated charcoal separation, 82% binding of125I‐labelled T3 occurred in the absence of specific first antibody, with 55% binding retained at 1: 7 dilution with T3‐free serum. Comparable results were obtained in the T4 (RIA) system using polyethylene glycol separation. Following ethanol extraction, low T4 (RIA) and low normal T3 (RIA) values were obtained, using a double antibody technique. There was ten‐fold greater binding by the patient's serum to rabbit anti‐human IgG in both the T3 and T4 radioassay systems as compared to controls. No preferential binding to rabbit anti‐human IgM was noted. Scatchard plot analyses for the antibodies against T3 and T4 showed high affinity constants for these hormones. With adequatel‐thyroxine therapy, an appropriate decline in serum TSH to normal was achieved. It is concluded that where RIA determinations of T3 and T4 are inconsistent with other laboratory and clinical indices, the presence of autoantibodies to thyroid hormones should be suspected and appropr

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb02161.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYIn normal subjects taking variously high, normal or low sodium diets, while potassium intake was maintained within the normal range, highly significant inverse relationships were demonstrated between 24 h urinary sodium output and the concurrent plasma concentrations of renin, angiotensin II and aldosterone. With linear coordinates, these relationships were described by rectangular hyperbolae. With logarithmic plots the relationships became rectilinear. When 24 h urinary sodium output was 75 mmol or higher, there was no worthwhile advantage in relating renin to sodium excretion; plasma angiotensin II and aldosterone, however, were significantly related inversely to urinary sodium in this range. When 24 h urinary sodium output was below 10 mmol, plasma renin, angjotensin II and aldosterone all varied over wide but elevated ranges and were not significantly related to urinary sodium excretion rates. We conclude that whereas estimations of urinary sodium may be of value in revealing latent aberrations of sodium intake, there is no distinct advantage in relating measurements of renin or angiotensin II to urinary sodium output if the diet is known to be within broad ‘normal’ limits. This should simplify the relevant blood sampling procedure under both ward and outpatient conditions. If plasma renin, angiotensin II and aldosterone are to be related to concurrent urinary sodium output, logarithmic, rather than linear, co‐ordinates, are approp

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb02162.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb02163.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb02165.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb02168.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY