摘要:

SUMMARYA euthyroid pubertal boy was investigated for short stature and was found to have an elevated serum thyroxine and delayed bone age. In spite of high thyroxine levels, there were no clinical signs of hyperthyroidism and kinetic studies revealed a normal rate of thyroxine metabolism. Plasma TSH levels were elevated but there was no goitre. Administration of up to 900 μg of triiodothyronine led to minimal changes in urinary hydroxyproline excretion, pulse rate and body weight. These observations indicate that this boy has a target organ insensitivity to thyroid hormones. When compared with other patients with this disorder, the studies further emphasize that this condition may have a variable clinical presentation. In addition, the extent of the target organ defect may not be evident from routine clinical and laboratory observations. The possible molecular basis of the defect is discussed

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1975.tb01519.x

出版商:Blackwell Publishing Ltd    

年代:1975

数据来源: WILEY

摘要:

SUMMARYOral administration of synthetic TRH in a dose of 80 mg/1.73 m2at 0 and 12 h to normal and constitutionally small children caused a significant increase of total serum thyroxine (T4) within 6–24 h. The mean maximal T4increment was + 3.7 ± 1.1 and + 3.8 ± 1.2 μg/dl (mean ± 1 SD) respectively in the two groups. Of seventeen euthyroid GH deficient children, fifteen showed a normal and two patients a slightly subnormal response. Of fifteen hypothyroid GH deficient children nine had a prompt and normal increase of serum T4indicating primary TRH deficiency. Two had a delayed T4response and four had no response, even after prolonged stimulation. The localization of the primary defect in these latter subjects with severe hypothyroidism can not be made by measuring T4only, since the thyroid gland may become unresponsive to TSH after longstanding TSH deficiency. TSH measurements are necessary in these circumstances for a clear localization of the primary defect. One GH deficient patient with hypothalamic TRH deficiency was treated with high oral TRH doses for 7 months and showed no side ef

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1975.tb01520.x

出版商:Blackwell Publishing Ltd    

年代:1975

数据来源: WILEY

摘要:

SUMMARYSeventeen oophorectomized women were treated for 3 month periods, in random sequence, with ethinyl oestradiol 20 and 50 μg daily and conjugated equine oestrogens (Premarin) 0.625 and 1.25mg daily. The serum cholesterol, clot lysis time, plasma fibrinogen, platelet adhesiveness and activated partial thromboplastin time remained unchanged throughout the different oestrogen regimes. There was a significant rise of serum triglyceride levels on both doses of ethinyl oestradiol but no significant change with Premarin. Serum luteinizing hormone levels were depressed most by ethinyl oestradiol 50 μg daily, although not down to the levels in premenopausal wome

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1975.tb01521.x

出版商:Blackwell Publishing Ltd    

年代:1975

数据来源: WILEY

摘要:

SUMMARYThirty patients with symptoms from ‘functionless’*pituitary tumours were treated by yttrium‐90 implants, and we report here the effects on symptoms, pituitary function and visual fields. On biopsy, about a third of the tumours showed some hormone granules. In the sixteen fully assessed at 1 year, pituitary function was improved in 25%, unchanged in 62.5%, and reduced in 12.5%. Improvement was confined to those in whom gonadotrophin secretion was the only function impaired pre‐implant.Visual field defects were present pre‐implant in ten patients (twenty eyes); at 1 year post‐implant these defects had lessened in 80% and deteriorated in only 5% of eyes. Subsequently, within 5 years of the implant the field defects had worsened or recurred in four patients, all with initially extensive suprasellar projection; further treatment was then given. Remineralization of the sella was seen after implantation in seven cases, with reduction in fossa size in five.Thus pituitary implantation appears to be a practicable and reasonably simple procedure suitable for the treatment of most cases of ‘functionless’ pituitary tumour. The ‘supressive’ doses of irradiation used are adequate to shrink most tumours without loss of

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1975.tb01522.x

出版商:Blackwell Publishing Ltd    

年代:1975

数据来源: WILEY

摘要:

SUMMARYIn nine patients with thyrotoxicosis (three patients with ophthalmopathy, one patient with T3thyrotoxicosis) we followed plasma levels of triiodothyronine (T3) and thyrotoxine (T4) and the TRH induced TSH release before and under treatment with propythiouracil (PTU), carbimazole or methimazol. The patients were observed for 2‐8 months and did not receive any thyroid hormones during this time. Before treatment the TSH responses to TRH were absent in all patients. After commencement of antithyroid drug therapy the T3and T4plasma values decreased to normal (T3) or subnormal levels (T4) within 1‐5 weeks and the patients became euthyroid, but at that time the TRH test was still negative in all patients. Moreover, there was a lag of between 2 weeks and 4 months in five of the patient before the TRH test became positive. The duration of this lag could not be correlated with any data of the history or the clinical signs. Several possible explanations for this observation are discussed. Our results suggest that the TRH‐test is not suited for the control of the therapeutic effect of antithyroid drug th

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1975.tb01523.x

出版商:Blackwell Publishing Ltd    

年代:1975

数据来源: WILEY

摘要:

SUMMARYA rapid 5 h radioimmunoassay method for the determination of progesterone and oestradiol in the plasma of non‐pregnant women is described. Due to the high specificity of the antisera used, it is possible to perform the radioimmunoassay directly on the ether extracts of plasma, without employing chromatographic purification of the steroids.Evidence is presented indicating that the rapid assay is almost as reliable as the previously described radioimmunoassay method which involves chromatography. The within‐assay and between‐assay coefficients of variation in the progesterone assay were 7.74 and 14.9 and in the oestradiol assay 7.36 and 18.1 respectively. Comparisons between increasing doses of authentic hormone and endogenous hormone extracted from plasma indicated no deviation from parallelism. Progesterone and oestradiol were assayed in 300 plasma samples by the rapid method and by the method involving chromatography. The slopes obtained by a regression analysis were close to unity for both progesterone and oestradiol (1.04 and 1.06, respectively), they‐intercepts were −0.21 and −0.16 and the correlation coefficients 0.98 and 0.88, respectively. When the data obtained by both techniques in fourteen menstrual cycles were compared, the results were practically identical.In ten repeated studies conducted by four investigators it was shown that two workers can complete the assay of both progesterone and oestradiol in twentyfive plasma samples in duplicates within 5 h. The same time is required for the assay of either progesterone or oestradiol in twenty‐five duplicates

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1975.tb01524.x

出版商:Blackwell Publishing Ltd    

年代:1975

数据来源: WILEY

摘要:

SUMMARYThe serum triiodothyronine concentration is superior to the serum thyroxine concentration, the resin uptake test and the free thyroxine index in the diagnosis of hyperthyroidism.Over a 14 month period fifty‐five patients attending an endocrine clinic with suspected thyrotoxicosis of all degrees of severity had blood taken on initial attendance and the serum was stored for routine thyroid function tests and triiodothyronine estimation. The patients were followed up and forty‐six proved to be toxic and seven to be euthyroid; two could not be classified. Analysis of the initial serum showed that the serum triiodothyronine concentration was superior to the serum thyroxine concentration, the resin uptake test and the free thyroxine index in predicting the clinical outc

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1975.tb01525.x

出版商:Blackwell Publishing Ltd    

年代:1975

数据来源: WILEY

摘要:

SUMMARYIntravenous infusions of noradrenaline and dopamine in normal saline, andl‐dopa in sodium lactate, were given to seven patients with Parkinsonism, and to five healthy volunteers. Infusions of saline and lactate were given, in a similar manner, to six additional healthy volunteers, who formed a control group. Dopamine and noradrenaline were each given in gradually increasing doses, for periods of 4 min, until a 30% increase in systolic blood pressure had occurred.l‐Dopa (320 mg) was given at a constant rate of infusion over 80 min. Plasma fluorogenic corticosteroids (cortisol) increased with dopamine, and decreased with noradrenaline. These changes were significantly different from the control group in the case of noradrenline only. ACTH values changed in a similar manner.l‐Dopa produced a consistent rise in both ACTH and cortisol that was significantly different from control subjects. The implications of these observations are disc

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1975.tb01526.x

出版商:Blackwell Publishing Ltd    

年代:1975

数据来源: WILEY

摘要:

SUMMARYThe stressful effect of a written and oral examination was studied in twenty‐two doctors sitting a postgraduate examination. The rise in the plasma cortisol was not significant in the written examination and reverted to normal values after an hour. On the other hand, there was a significant rise in the plasma cortisol during the oral examination with a pre‐enry rise in blood sugar and a fall in α‐amino nitrogen. It is concluded that whereas a written examination is not a stressful situation, an oral examination is stressful enough to be comparable to rowing and

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1975.tb01527.x

出版商:Blackwell Publishing Ltd    

年代:1975

数据来源: WILEY

摘要:

SUMMARYIn 189 of 334 patients, who had been treated with fractionated doses of radio‐iodine for Graves' disease 7–15 years ago, the serum concentrations of triiodothyronine have been estimated in addition to the following parameters: Protein bound127iodine (PB127I), free thyroxine index, cholesterol‐ and TSH‐level in serum, tendon reflex time and clinical index according to Billewitzet al.(1969). In forty‐one of the 189 sera the free T4 (AFT4) and free T3 (AFT3) concentrations were measured as well. The following hormonal and clinical patterns were observed:1Euthyroidism, with all parameters within the normal range in 148 patients (= 78.4%).2Hypothyroidism with low serum T3, PBI, AFT4, AFT3 and elevated TSH in six subjects (= 3.2%).3Persistent hyperthyroidism with increased thyroid hormone concentrations and low TSH in seven cases (= 3.7%).4In twenty‐eight clinically euthyroid patients (= 14.8%) TSH was elevated with normal PBI and AFT4. Twenty of these subjects had a low normal T3 and in nine the T3 was clearly in the hypothyroid range (40 ± 12 μg/dl).5The constellation of normal T3, low T4 and elevated TSH, which has been frequently found after radioiodine therapy, has been seen in only moderate form

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1975.tb01528.x

出版商:Blackwell Publishing Ltd    

年代:1975

数据来源: WILEY