摘要:

SUMMARYWe have studied the effect of direct infusion of nutrients into the duodenum of normal subjects on circulating plasma somatostatin, insulin, gastrin and gastric inhibitory polypeptide (GIP) levels. Six normal subjects were given on four separate occasions 150 ml of isotonic solutions containing 100 calories of carbohydrate, protein, or fat, and a control solution of saline, by infusion into the second part of the duodenum. Plasma somatostatin rose slightly after carbohydrate, mean basal 30 ± 3 pg/ml, peak 46±16 pg/ml at 15 min; and more markedly after protein, peak 57 ± 9 pg/ml at 30 min. However, fat was the most potent intraduodenal stimulus to plasma somatostatin release into circulation, peak 101 ± 11 pg/ml at 30 min. The plasma insulin rise was greatest after carbohydrate, peak 68 ± 10 i.u., but there was a significant rise after protein also, peak 34 ±6 i.u. Plasma gastrin rose significantly after protein only, peak 70 ± 22 pg/ml. Plasma GIP rose markedly after carbohydrate, basal 506 ± 50 pg/ml, peak 1480 ± 120 pg/ml. Protein was also a potent stimulus of circulating plasma GIP release, peak 1200 ± 190 pg/ml, while fat was the least potent, peak 730±190 pg/ml. Thus, calorie for calorie, fat is the most potent intraduodenal nutrient stimulus of circulating somatostatin. We postulate therefore that somatostatin may be an enterogastrone–a circulating hormone released by intraduodenal fat which inhibits gastric acid secretion. Fat is the least potent intraduodenal nutrient stimulus of circulating GIP release. This is evidence against the hypothesis that circulating GIP acts as an en

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03461.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYMammary gigantism is a rare complication of D‐penicillamine treatment. We report a further case with pathological and endocrine details together with a review of the seven cases previously reported and possible mechanism

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03462.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYFourteen patients, aged 22‐35 years, complaining of infertility and failing to ovulate on clomiphene, were treated with GnRH administered in pulses at 90 min intervals. Four patients received a total of eight courses of GnRH given subcutaneously and 13 were given a total of 20 months of treatment with GnRH given intravenously. Serum concentrations of immunoreactive GnRH were measured in six patients before administration of the drug and at regular intervals for 60 min after subcutaneous and intravenous injections of 5, 10 and 20 μg GnRH. Maximum concentrations of GnRH were reached by 5‐10 min after subcutaneous injections and within 2 min after intravenous injections. The peak concentrations were 3.6‐6.3 times and the sums of increments were 2.0‐3.9 times greater following intravenous injections than after subcutaneous injections. Subcutaneous treatments extended for 15‐29 days with doses of 5‐20 μg per pulse. Only one patient ovulated as judged by the luteal phase progesterone and ultrasonic scanning of the follicle. Intravenous treatments were from 12‐22 days with doses of 10 μg per pulse and 16 treatments out of 20 were ovulatory with four pregnancies. HCG (5000 i.u.) was given when ultrasonic scanning indicated adequate follicular growth, but in eight of the cycles, including three of the pregnancies, the follicle had ruptured before HCG was given. Pulsatile administration of GnRH proved to be an effective treatment for infertility in hypogonadotrophic hypogonadism. Possible reasons for the better results by intravenous rather than subcutaneous injectio

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03463.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYCalcium antagonists are widely used for the treatment of cardiovascular disorders, especially ischaemic heart disease. It has been demonstrated that these drugs, eitherin vitroor acutely administered in humans, inhibit the basal and stimulated secretion of pituitary hormones by blocking calcium influx through slow calcium channels. To see if a similar effect could be detected after their chronic administration, we studied the basal, TRH‐ and LHRH‐stimulated TSH, PRL, LH and FSH release in 18 male subjects with chronic stable angina before and on the 30th day of oral treatment with verapamil (n=8; 80 mg three times a day) or with nifedipine (n=10; 10 mg three times a day). Neither drug had any effect on basal TSH, PRL, LH and FSH values or on their response to the specific hypothalamic‐releasing hormones. These results suggest that the chronic administration of calcium antagonists, at the usual therapeutic doses, does not effect the process of stimulus‐secretidn coupling of anterior pituitary hormones, ruling out any impairment of the related target glands which have been expected on the basis of previous

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03464.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYWe have analysed immunoassayable thyroglobulin (hTg) secretion from both normal and abnormal isolated human thyroid cells after short‐term monolayer culture. All cells were sensitive to more than 10 μU/ml bTSH when assessed by intracellular cyclic AMP accumulation in the presence of a phosphodiesterase inhibitor. hTg release was stimulated in all cells by bTSH in a dose related manner and with a detectable response within 24 h. Basal hTg secretion rates were greater in cells derived from benign follicular adenomata (range 1‐1–2‐2 ng/105cells/h, n=4) than in normal human thyroid cells (range 0‐1‐0‐65 ng). Therefore it appears likely that hTg secretion by adenomatous thyroid cells was a likely contributor to increased serum hTg in patients with single follicular adenomata. We conclude that simple human thyroid cell monolayers have potential for the further study of hTg secretion and its

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03465.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYIn 1976 we initiated a prospective study to specify the usefulness of thyroid stimulating antibody (TSAb) determinations in predicting the outcome of post‐antithyroid drug treatment for Graves' disease. This study was carried out on 55 patients, who were either treated for six (n= 16) or 18 months (n= 39) and followed up for an additional two‐year period. TSAb was determined on whole serum in 29 patients before and at the end of treatment, and in 26 patients at the end of treatment only. These determinations were carried out using a sensitive and reproducible microassay based on cAMP accumulation in human thyroid cell cultures. Before treatment, TSAb ranging from 170 to 1529% was present in 28/29 patients and reached significantly low levels at the end of treatment whatever its duration. TSAb was undetectable in 24/55 patients at the end of treatment. 8/16 'short‐treated’ and 18/39‘long‐treated’ patients remained in remission. As expected, initial TSAb levels had no predictive value. End‐treatment TSAb values, when low (±350%) or negative did not correlate with later evolution: in these 39 patients, relapse rate was 41%. In contrast, 13/16 patients with end‐treatment TSAb ± 350% relapsed. Relapses tended to occur earlier in patients with the highest TSAb levels. TSAb determined again during follow‐up was negative in each of the 18 patients in remission, and positive in 8/10 patients at the time of relapse, whatever its level at the end of the drug course. This study confirms that only high end‐treatment TSAb levels are predictive of relapse. In the other cases, TSAb had no prognostic value. Overall, it was shown that TSAb levels appear to reflect only partially, the activity of the underlying disturba

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03466.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYTo explore the mechanism for the hypogonadism associated with prolactin hypersecretion in men we examined luteinizing hormone (LH) secretory profiles in four hyperprolactinaemic men before and during treatment with bromocriptine. Pretreatment serum prolactin levels were increased 4‐100 fold and serum testosterone levels were low in three men and low‐normal in the fourth subject. Mean LH levels were low‐normal and the frequency of spontaneous LH secretory episodes was less than normal in three of four men. Bromocriptine reduced serum prolactin levels to normal; subsequently, serum testosterone levels increased and libido and potency improved markedly in each man. The rise in serum testosterone levels was associated with an increase in mean LH concentrations and in LH pulse frequency. Mean follicle‐stimulating hormone levels also increased during bromocriptine treatment. Insofar as each LH pulse is believed to reflect a discharge of gonadotrophin releasing hormone from the anterior hypothalamus, our data suggest that a major abnormality in hyperprolactinaemic men with hypogonadism is a disorder of the neuroregulatory mechanism for pulsatile gonadotrophin‐releasing hormone

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03467.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYSerum levels of thyroxine and triiodothyronine during pregnancy were measured in women from a severely iodine deficient region in the highlands of Papua New Guinea. Subsequently the children born to these women were examined when aged 10‐12 years and measures made of intellectual ability and motor competence. A significant correlation between these measures in the children and the maternal thyroxine but not maternal triiodothyronine level was observed. It is speculated that maternal thyroxine and not triiodothyronine may be essential for normal neurological maturation of the fetus before the fetal thyroid becomes functiona

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03468.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYPostural hypotension due to low aldosterone secretion was the presenting feature of idiopathic haemochromatosis in a 35‐year‐old man. Repeated venesection is beneficial in this disease but it is suggested that aldosterone deficiency be excluded before treatment to avoid depletion of circulating vol

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03469.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYAldosterone and renin responses to head‐up tilt (60° for 1 h) and angiotensin II infusions (2, 5 and 10 ng/kg/min) 1 h later were compared in six normal subjects during infusions of somatostatin (3 ±g/kg/min) or saline. The infusions were performed on separate days two weeks apart. The increase in aldosterone due to exogenous angiotensin II and orthostasis were significantly attenuated by somatostatin. Neither the increase in plasma renin activity (PRA) nor the angiotensin II mediated suppression of PRA were affected by somatostatin. These findings are consistent with the recent observation that somatostatin suppresses aldosterone release in response to angiotensin II in rat adrenal cells in culture and they indicate a possible role for somatostatin in the regulation of aldosterone secret

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03470.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY