摘要:

SUMMARYA 48‐year‐old hypertensive diabetic woman rapidly became virilized. Urine 17‐oxo‐and oxogenic steroids and plasma testosterone, androstenedione, DHEA, DHEA‐sulphate and androstenediol were greatly elevated. Plasma cortisol was constantly high and was not suppressed by dexamethasone. Circulating immunoreactive ACTH was consistently detectable at 18–24 ng/l. A 450 g carcinoma arising from a nodular hyperplastic right adrenal gland was resected. Production by the tumour of 17α‐hydroxypregnenolone, 17α‐hydroxyprogesterone and five C‐19 steroids, but very little prenenolone, progesterone or cortisol, was shown by blood sampling, tumour culture and dramatic falls after operation. The plasma cortisol fell to half, with no diurnal variation, consistent with persistent Cushing's syndrome, and the plasma ACTH rose to 55 ng/l. She died 3 months later from a myocardial infarction. Autopsy revealed a pituitary basophil adenoma at a site where radiologically there had been an indentation in the fossa floor for at least 7 years. The left adrenal gland showed nodular hyperplasia. Therefore we conclude that mild pituitary‐dependent Cushing's syndrome may have been present for many years before development of a virilizing carcinoma. This case demonstrates that adrenal carcinoma in man can sometimes develop as a consequence of nodular adrenal hyperplasia which may in turn be due to long‐standing tr

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb03567.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYHourly integrated concentrations (IC) of growth hormone (GH), prolactin (PRL) and cortisol were determined by a continuous sampling procedure in six obese women, before and at the end of a 12 day fast, and in eight normal controls under basal conditions. Hormonal 24 h IC and nyctohemeral variations were calculated from these data. Nyctohemeral rhythms were investigated by the periodogram method.A significant increase over basal values of 24 h IC of PRL, GH and cortisol was observed at the end of the fasting period. Nyctohemeral variations‐but not nyctohemeral rhythm‐of IC‐GH were found in normal subjects. They were abolished in obese patients under basal conditions but restored during fasting. The circadian rhythm of cortisol was not altered in obesity. A shift of the normal nyctohemeral rhythm of PRL was observed in obese patients, but the normal pattern was restored during fa

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb03568.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYCardiac patients treated with the iodinecontaining drug ‘amiodarone’ undergo a significant iodine overload whch can last for months after the drug has been withdrawn. Some patients develop hyperthyroidism and others hypothyroidism. In the hyper‐ or hypothyroid patients, the indices of thyroid function are modified as usually observed in these situations. In the patients remaining euthyroid while taking amiodarone or after its withdrawal, but still under its influence as shown by the iodine overload, a ‘low‐T3 syndrome’ is observed, this state being characterized by a high total T4, a low free T4, a normal T3 resin uptake, a low total T3, a normal free T3, a high r‐T3 and a relative TSH‐unrespon

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb03569.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYBlood samples were obtained from a group of regularlycycling normal women (n =13) and a group of normal men (n= 5) at 15 min intervals for periods ranging from 9–14 h whilst the subjects remained resting quietly in bed. The concentration of plasma oestradiol was measured in a radioimmunoassay which had been carefully optirnised and the mean concentration and coefficient of variation calculated for each subject.Plasma oestradiol concentrations were found to fluctuate rapidly in all subjects. The largest sample‐to‐sample variation was found in regularly cycling women near mid‐cycle, and the least variation occurred in the male subjects. The coefficients of variation were approximately twice the intra‐assay variation confirming that the observed pulsatile patterns of secretion were not due to technical errors.An analysis of variance performed on the mean hourly concentrations from each subject showed a significant variation (P<0.001) between sampling periods with peaks occurring during the first hour of sampling (08.00–09.00 hours). This result is suggestive of the presence of a circadian rhythm although it is not

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb03570.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYThe effects of 200 μgthyrotrophin‐releasing hormone (TRH) i.v. on thyrotrophin (TSH), prolactin (PRL), growth hormone (GH) and triiodothyronine (T3) were studied in eight patients with barbiturate coma due to attempted suicide, in the same patients after recovery, in eight depressive patients and in eight normal controls. The patients with barbiturate coma presented normal basal TSH and PRL, elevated basal GH and normal PRL but blunted TSH responses to TRH; their GH concentrations varied widely without consistent relation to TRH administration. The same patients after recovery from coma presented normal TSH and PRL, slightly elevated basal GH, and normal PRL but blunted TSH responses to TRH; in four of these patients, a clear‐cut rise in GH (i.e. more than 10 ng/ml) occurred after TRH administration. The depressive patients presented normal basal TSH and PRL, slightly elevated basal GH, and normal PRL but blunted TSH responses to TRH; in four of these patients, a moderate rise in GH (less than 10 ng/ml) occurred after TRH administration. The increment in T3 concentrations 120 min after TKH was found reduced in the comatose patients only. Basal cortisol was measured in all the subjects and found elevated in the comatose patients only. It is concluded that the abnormal TSH and GH responses to TRH observed in patients with barbiturate coma are more likely related to depressive illness than to an effect of barbiturates at the pituitary level. Barbiturates might affect thyroid secre

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb03571.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYPlasma sex hormone concentrations (testosterone, (T), androstenedione (A), oestrone (El) and oestradiol (E2)) were measured in forty post‐menopausal women more than 4 years post‐normal menopause. Correlations between these and age, years post‐menopause (YPM), degree of obesity and fat mass respectively were studied. T and A, as well as El and E2 were positively correlated (P4YPM) did not show any variation as a function of age, with the possible exception of E2 which showed a tendency to decrease in the late post‐menopause. El and to a lesser extent E2 as well as the El/A ratio were significantly correlated with degree of obesity or fat mass, suggesting a possible role of fat tissue in the aromatization of androgens. Neither the T/A nor the E2/E1 ratios were correlated with fat mass, suggesting that the reduction of 17 oxo‐group does not occur in fat tissue. The El/A ratio was significantly higher than the reported conversion rate of A in El. This might suggest the existence of an additional precursor of

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb03572.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYThe possibility that propranolol may exert its beneficial actions in thyrotoxicosis by an effect on thyroid hormone concentrations has been investigated by measuring these and oxygen consumption in a group of thyrotoxic patients before and after treatment with propranolol. Following treatment a significant fall in plasma T3 concentration and oxygen consumption occurred and a direct correlation was found between these two variables. Propranolol may, therefore, exert some of its beneficial effects in thyrotoxicosis by an action on T3 metabolism.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb03573.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYPlasma prolactin concentrations were measured in thirty‐four males with pituitary tumours and twenty‐two patients (65%) were found to have hyperprolactinaemia. Plasma testosterone concentrations were subnormal in twenty‐nine patients. Ten patients with hyperprolactinaemia were treated with bromocnptine; prolactin was restored to normal values in eight patients but testosterone secretion remained deficient. Two patients were resistant to bromocriptine. Some improvement in libido and potency was obtained after restoration of normal prolactin concentrations in four cases in spite of persistently low testosterone secretion. For maximal improvement in sexual function treatmentwithbothbromocdptineand testosterone was req

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb03574.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYPregnancies complicated by placental sulphatase deficiency and with fetal adrenal hypoplasia present similar clinical features. Antepartum differential diagnosis is required to identify those newborn infants likely to be at risk from adrenal insufficiency. For this purpose, the urinary excretion, near term, of oestrogens and 17‐oxogenic steroids in six pregnancies with placental sulphatase deficiency was compared with the excretion of these groups of steroids by twenty‐one women with an anencephalic foetus. This group served as a model for congenital adrenal hypoplasia.The mean excretion of oestrogens in placental sulphatase deficiency (7.4 μmo1/24 h, mean ± SD, seventeen urines) was significantly lower (P<0.001) than that of women with an anencephalic foetus (17 ± 10 μmo1/24 h, twenty‐nine urines). In contrast, mean 17‐oxogenic steroid excretion was higher (P<0.001) in pregnancies complicated by sulphatase deficiency (46 ± 12 μmo1/24 h, seventeen urines) than in those complicated by anencephaly (26 ± 7 μmo1/24 h, twenty‐nine urines).All 24 h urine samples from women with placental sulphatase deficiency contained26 μmol 17‐oxogenic steroids, whereas all results from women with an anencephalic foetus fell outside both these limits.With these simple urinary steroid assays, it appears possible to distinguish, before delivery, between pregnancies with placental sulphatase deficiency and those with anencephaly, and, by implication, those with congenit

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb03575.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYLower body negative pressure (9‐12 kPa) was applied to ten normal subjects. Large increases in plasma arginine vasopression concentration occurred only in subjects that experienced syncopal symptoms and developed hypotension. Blood samples obtained from the superior vena cava at 1/2 min intervals during application of negative pressure showed that maximal plasma vasopressin concentrations occurred with hypotension. Chromatography of the presyncopal plasma on Sephadex G‐25 gave a large peak which eluted in the position of synthetic arginine vasopres

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb03576.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY