摘要:

Eleven patients with active acromegaly resistant to conventional therapy were treated with bromocriptine for 15 (12–22) months by increasing the daily dose stepwise from 5 to 10–60 mg. A satisfactory response was achieved in all but one of the eight patients, in whom the mean diurnal level of serum GH was less than 50 ng/ml, whereas patients with grossly elevated serum GH levels responded poorly. In the longterm, no overall effects on glucose tolerance or plasma insulin (IRI) levels were observed but the chemical diabetes of three patients ameliorated in two. On the other hand, a dose‐dependent acute suppressive effect of bromocriptine on plasma IRI response to oral glucose was observed, suggesting a direct effect of bromocriptine on the release of insulin from beta cells. Bromocriptine seems to be a good alternative in the treatment of patients with acromegaly who have not responded to conventional th

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02703.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Ten patients with subtle primary hyperparathyroidism and intermittent hypercalcaemia were followed serially for periods of 2–18 months (mean 10 months). Fasting serum calcium was elevated (<10·6 mg/dl) in only 20% of determinations and fluctuated widely (9·1–11·2 mg/dl), yet the patients displayed a continuous, rather than episodic, basic disease process as defined by increases in nephrogenous cyclic AMP and serum iPTH. Identical findings were noted in short‐term (2–3 successive days) studies in twelve patients.In response to a 1000 mg oral calcium tolerance test, twelve patients with primary hyperparathyroidism and intermittent hypercalcaemia (basal serum calcium 10·2 ± 0·2 mg/dl, mean ± SD) displayed: (1) hyperabsorption of calcium (mean calciuric response twice normal); (2) induced‐hypercalcaemia (mean serum calcium 11·4 mg/dl, with a mean increase of 1·2 mg/dl versus 0·2 mg/dl in normal subjects); and (3) abnormal parathyroid suppressibility (nephrogenous cyclic AMP 2·66 ± 0·57 nmol/100 ml GF versus 0·95 ± 0·40 nmol/100 ml GF in normal subjects, mean ± SD). The patients demonstrated striking hypercalciuria (452 ± 123 mg/24 h) on a 1000 mg metabolic calcium diet. Serum levels of 1,25(OH)2D3, measured in ten patients, were markedly elevated at 90 ± 20 pg/ml (mean ± SD), and there was a strong positive correlation between the values for 1,25(OH)2D3and the calciuric response to the calcium tolerance test (r=0·75,P<0·001).These results (1) indicate that the calcium tolerance test is a simple and reliable technique for diagnosis of patients with primary hyperparathyroidism and intermittent hypercalcaemia, and (2) emphasize the important pathophysiologic features of this subtle clinical variant

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02704.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Serum prolactin, TSH and GH levels were measured in thirty healthy volunteers in fasting conditions and following oral administration of 200 mg nomifensine. In addition, the effect of the drug on serum prolactin and TSH response to synthetic TRH was studied in twenty normal subjects. Inhibition of endogenous catecholamine reuptake by nomifensine significantly inhibited prolactin release whereas it had no effect on TSH and GH levels. Nomifensine administration had no appreciable effect on the TRH‐induced release of TSH and prolacti

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02705.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Abnormalities in parathyroid hormone (PTH) secretion or vitamin D action or metabolism have been suggested as pathogenetic factors in the bone disease associated with chronic glucocorticoid therapy. We have found normal plasma PTH values in forty‐eight adult asthmatic patients on chronic glucocorticoid therapy, twelve asthmatics treated without glucocorticoids and ten adults on short‐term, high‐dose glucocorticoid therapy for non‐asthmatic illnesses. The mean serum 25‐OHD level in the glucocorticoid‐treated asthmatics was not significantly different from a disease control group of asthmatic patients not on glucocorticoids, but nine such patients had abnormally low 25‐OHD levels. Our results indicate that in asthmatic patients on chronic glucocorticoid therapy: (1) PTH and 25‐OHD values are usually normal regardless of dose or duration of therapy and (2) there is a subset of patients with low 25‐OHD values which may reflect unusual sensitivity t

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02706.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

In ten obese euthyroid subjects the concentration of thyroxine (T4), tri‐iodothyronine (T3) and reverse T3 (rT3) were assayed in serum and of T4 and T3 in urine before and after 2 weeks of 2·1 MJ (500 Kcal) per day diet. Mean serum T4 was unchanged, while T3 decreased and rT3 increased. Urinary excretion of both T4 and T3 decreased after diet. In six subjects the concentrations of serum thyroxine binding globulin (TBG), thyroxine binding prealbumin (TBPA) and albumin were measured before and after diet. Free T4 and T3 were calculated using a formula based on measured concentration of hormones and their binding proteins. Calorie restriction resulted in a significant decrease in TBG and a greater decrease in TBPA, while albumin was unchanged. Calculation of free hormones showed a fall in absolute free T3 and rise in percentage free T3, but a rise in both absolute and per cent free T4. Our data indicate a selective effect of calorie restriction on the concentrations of TBPA and to a lesser extent TBG and confirm previous reports of altered peripheral monodeiodination of T4. Decreased urinary excretion of T4, despite a calculated increase of free T4 in serum, suggests intrarenal metabolic adjustment, the mechanism of which awaits elucidati

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02707.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

The mean control level of 11‐deoxycortisol as determined by radioimmunoassay in eighty‐one human amniotic fluid samples was 1·20 ± 0·07 ng/ml. Markedly elevated levels were found at term in amniotic fluid of two pregnancies with fetuses affected with 11 β‐hydroxylase deficiency, congenital adrenal hyperplasia (135·0 and 64·0 ng/ml respectively) as well as in the maternal serum of one of these cases (28·0 ng/ml). It is suggested that the determination of 11‐deoxycortisol in amniotic fluid be a prenatal diagnostic test for 11 β‐hydroxylase deficiency congenital ad

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02708.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Levels of unconjugated oestradiol‐17β (E2) and testosterone (T) and total oestriol (E3) were measured hourly for 6 h after intra‐amniotic (i.a.) (100–200 mg) or intravenous (i.v.) (100 mg) injection of dehydroepiandrosterone sulphate (DHEA‐S) in a series of twenty‐six women with mid‐trimester abortion. Amniotic fluid E2and T levels were elevated significantly 1–6 h after the i.a. injection of DHEA‐S, while the E3level in amniotic fluid did not change. The i.a. administration also induced significant rises in serum E2and T levels between 1 and 6 h and in the serum E3level between 2–6 h. The i.v. injection of DHEA‐S was accompanied by significantly elevated serum levels of E2and T, while the E3concentration remained unchanged. It appears that following maternal i.v. administration or an amniotic fluid injection, DHEA‐S is rapidly converted to E2and T, and these accumulate in both the maternal circulation and the amniotic fluid. E3, however, is formed only after i.a. administration of DHEA‐S, and is selectively transport

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02709.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Little is currently known about the factors controlling somatostatin secretion. A radioimmunoassay has been developed that is sufficiently specific and sensitive to be used for physiological studies of circulating levels in man. During insulin‐induced hypoglycaemia a rise in plasma somatostatin was seen in each of ten subjects studied. Although this paralleled the rise in circulating glucagon and growth hormone, no individual relationships were found either between these variables or to any change in cortisol or insulin C‐peptide. In contrast no rise in somatostatin was seen during surgical stress. Thus, contrary to expectation, circulating somatostatin levels can be altered by metabolic stimuli. It seems likely that this peptide may serve an endocrine as well as a paracrine role since its modulating effects may occur not only near to but also at a distance from the site of secretion. It is not yet clear whether the somatostatin measured comes from the hypothalamus, any other part of the central nervous system or the gastrointestinal tr

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02710.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

The response of aldosterone to manipulations of the renin‐angiotensin and hypothalamic‐pituitary‐adrenal systems has been studied in thirteen patients with primary aldosteronism due to a single adenoma (ten patients) or bilateral hyperplasia (three patients). The aldosterone response to dietary sodium restriction was small and variable, although urinary aldosterone excretion increased in nine out of twelve studies. The response of patients with hyperplasia could not be distinguished from those with adenoma. All patients were unresponsive to salt loading. By contrast, plasma aldosterone fell in all patients after overnight dexamethasone (1 mg) and increased after brief (1 h) physiological ACTH stimulation. During prolonged erect posture, plasma aldosterone increased in the three patients with hyperplasia and decreased or remained unchanged in patients with ademona. Changes in plasma renin activity were similar in both groups. These studies show that patients with primary aldosteronism, while largely unresponsive to manipulations of sodium balance, retain sensitivity to small and acute changes in ACTH. The different behaviour of patients with hyperplasia to prolonged erect posture cannot be explained by insensitivity to ACTH, but could be due to a relative increase in sensitivity to angiot

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02711.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

The aim of this study was to establish whether or not a peptide with chromatographic and immunological properties of β‐endorphin exists in human plasma. Using direct chromatography under conditions designed to minimize generation of β‐endorphin and β‐MSH from β‐LPH, we invariably found a peptide with β‐endorphin immunoreactivity eluting in the position of βh‐endorphin on gel chromatography in samples of plasma from patients with elevated ACTH and LPH levels. β‐MSH was only found in the plasma of one patient with the e

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1980.tb02712.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY