摘要:

SUMMARYThree different forms of testosterone (T) replacement therapy were compared; they were the intramuscular injection of mixed testosterone esters 250 mg; the subcutaneous implantation of 6 x 100 mg pellets of fused testosterone; and the oral administration of testosterone undecanoate (TU) 80 mg twice daily. Six hypogonadal males were treated with oral TU for an eight week period, during which time serial serum hormonal estimations were performed over 10 h at the initiation and after four and eight weeks of therapy. Serum T levels showed marked variability both between subjects and within the same subject on different occasions. We attribute this to variability in absorption of TU, which is formulated in oleic acid. The overall mean T level calculated from the areas under the profiles of TU was 120 nmol/1. Hormone responses to injected T esters were studied in nine hypogonadal males. Serum T rose to supraphysiological peak concentrations (mean 71 nmol/1) 24‐48 h after an injection, followed by an exponential decay to reach baseline concentrations after 2‐3 weeks. The overall calculated mean T level in subjects receiving testosterone esters 250 mg every three weeks was 27‐7 nmol/1. Subcutaneous implantation of testosterone in six hypogonadal men produced a gradual rise in serum T followed by a slow decline, with T levels remaining within the normal range for 4‐5 months. The calculated overall mean T level over 21 weeks after implantation was 170 nmol/1. Serum oestradiol (Ej) levels remained within the normal male range throughout the study periods on both TU and T implant therapy but showed a supraphysiological peak (mean 347 pmol/1) 24‐48 h after a T injection. 5α‐dihydrotestosterone (DHT) levels appeared to parallel those of T on the three forms of therapy, with DHT:T ratios being highest for TU therapy. This was also true for the target organ metabolite 5α‐androstane‐3α, 17β‐diol. At the doses studied drug costs were similar for T implantation (every 5 months) and T ester injections (every 3 weeks), but were 7‐8 times higher for TU (80 mg twice a day). We conclude that T implantation remains overall the most physiological form of androgen replacement therapy, is generally well accepted and attended by few side effects; TU may have a useful role in the in

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03448.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYChanges in prolactin concentration during single suckling episodes in twenty breast‐feeding women from four to 40 weeks post partum have been investigated. Basal prolactin concentration and the increase in prolactin secretion in response to single suckling episodes and amount of milk taken by the infant were both independent of time post partum until the introduction of supplementary feeds, when a significant decrease with time was apparent. Basal concentrations of prolactin were dependent upon the interval between suckling episodes, and the magnitude of the prolactin response varied with the time of day when suckling took place. The relationship between acute suckling episodes and the long term pattern of prolactin secretion over time post partum is discusse

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03449.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYThe effect of metoclopramide, a dopamine blocker, on arginine vasopressin (AVP) secretion was investigated in normal males. After a bolus injection of metoclopramide (10 mg), all subjects (n= 7) demonstrated an increase of 80‐3% (from 0.71 ±0.12 (Mean ± S.E.) to 1.28 ± 0.24 pg/ml,P± 0005) in plasma AVP at 15 min. In controls (n =7) plasma AVP levels did not change after saline injection (2 ml). Because plasma osmolality and blood pressure did not change, the elevation of plasma AVP levels induced by treatment with metoclopramide may be due to its central effect as a dopamine inhibitor. Although plasma AVP levels increased again at 90 and 120 min after a bolus injection of metoclopramide, accompanying falls in blood pressure (4‐5%) make the interpretation concerning the contribution of dopamine to AVP secretion in a late phase uncertain. In summary, plasma AVP levels were shown to be significantly increased by a metoclopramide bolus, suggesting that AVP secretion is under tonic inhibition by d

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03450.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYWe have studied a women who presented at the age of 51 with a large FSH and a‐subunit producing pituitary adenoma. Following insertion of ventriculo‐peri‐toneal shunts and external pituitary irradiation there was no change in the elevated serum concentrations of FSH, and α‐subunit over a four year period although she developed both ACTH and TSH deficiency. Various drugs, however, did alter the FSH and α‐subunit concentrations and these changes suggest possible mechanisms controlling FSH secretion. Ethinyloestradiol 0.03 mg daily for three weeks suppressed serum FSH to 77% of the basal level (240 ± 35 i.u./l to 184 ±20 i.u./l) but α‐subunit rose to 130% of basal level (281±50 ng/ml to 366±40 ng/ml). On ethinyloestradiol 01 mg daily, FSH suppressed to 17% of basal (40 ±11 i.u./l) with no change in a‐subunit concentration, while on 0.2 mg daily suppression of FSH was similar but α‐subunit fell to 59% of basal (190 ±28 ng/ml). Dexamethasone, 3 mg daily for one week reduced FSH to 53% of the initial concentration and α‐subunit to 74% while bromocriptine 7.5 mg daily for three months, reduced FSH to 39% and α‐subunit to 66% of basal. Neither thyroxine, 0‐2 mg daily for four weeks, nor an LHRH analogue, (Buserelin, Hoechst) 200 μg, three times daily for three months elicited any effect. Chromatography on Sephadex G100 showed that serum FSH and α‐subunit both had Kavvalues somewhat lower than those of their standard counterparts (FSH, 0‐20 vs 0‐25; α‐subunit 0‐35 vs 045). We conclude that the dissociation between changes in FSH and α‐subunit after giving oestrogen, bromocriptine and dexamethasone suggests that these drugs inhibit the synthesis of both a and β‐subunits of FSH with the latter being more sensitive to their effects. The results seem inconsistent with the alternative possibility of impaired release of both subunits or impaired α‐β combin

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03451.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYA 44‐year old man presented with loss of sexual interest and erectile failure and together with his wife was treated successfully with sexual counselling. He was subsequently found to have been hyperprolactinaemic before and after sex therapy. Comparison of bromocriptine with placebo in two double blind studies showed a modest increase in sexual interest when his prolactin levels fell to normal. In this case, the principal effect of hyperprolactinaemia was on sexual interest. His main problems, erectile impotence and decline in sexual activity, resulted from his and his wife's psychological reaction to this modest hormonal effect. Hyperprolactinaemia appears to have a similar effect to testosterone deficiency in me

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03452.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYA radioimmunoassay for immunoreactive γ‐MSH (IR‐γ‐MSH) in human plasma has been developed. The assay is capable of detecting normal basal circulating levels which range from<20‐100 ng/1 at 0900 h. Plasma levels are raised concomitantly with ACTH during insulin induced hypoglycaemia and CRF stimulation and suppressed with dexamethasone. Chromatographic characterisation of IR‐γ‐MSH in plasma demonstrates a major peak of IR‐γ‐MSH, corresponding to purified glycosylated N‐terminal pro‐opiome‐lanocortin 1‐76, when IR‐γ‐MSH is secreted from the pituitary. In contrast IR‐γ‐MSH produced ec

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03453.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYSerum thyroglobulin (Tg) levels were determined in preterm neonates. Very high values were found at birth. A significant negative correlation was observed between Tg levels and gestational age. A longitudinal study indicates that a very sharp decrease in Tg levels occurred after birth. Three weeks after birth, the values were close to the values of full‐term neonates. These high hTg values could result either from an increased turnover of hTg or from a lower clearance rate of this iodoprotei

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03454.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYThe accurate antenatal diagnosis of placental sulphatase deficiency (PSD) is essential if this condition is to be distinguished from others in which levels of oestrogen are low. In this study we have evaluated a simple protocol determining the serum oestradiol response to 50 mg of dehydroepiandrosterone sulphate (DHEAS) given intravenously to twelve women with low serum or urinary oestrogens. Seven of the women had PSD confirmed by other means, the remaining five had other reasons for the low oestrogen levels. In affected pregnancies the rise in oestradiol was lower, the peak occurred earlier and the level fell towards baseline at 60 min. In the unaffected women, timing of the peak value was not consistent and there was no trend towards basal values at 60 min. There was clear discrimination between the two groups at all times after the injection. but the separation was greater at 60 min.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03455.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYIn the United Kingdom, about half the patients with Graves' disease who are given antithyroid drugs are still in remission one year after treatment is stopped. The most widely held view is that such remission rates are due only to the biochemical effects of the drugs, the disease either spontaneously remitting or abating when the immune system is no longer subject to the stimulatory effects of excessive thyroid hormone. We review here the accumulating evidence against both of these alternatives. In contrast, there is now a large body of work which shows that thyrotrophin receptor antibody levels, central to the aetiology of Graves' hyperthyroidism, fall during antithyroid treatment and that remission may be related to this fall in a fashion which is dependent on the dose and duration of treatment. This immunosuppressive effect is supported by experimental data and on the basis of these results we propose that antithyroid drugs may modify the natural history of Graves' disease and contribute to the remission which occurs in a proportion of treated patients.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03456.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Book Review in this Articles:Pediatric and Adolescent Endocrinology Case Studies MarianoCastro‐Magana&PlatonJ. Collipp.Integrative Neurohumoral Mechanisms Ed. by E. Endr$ouczi, D.deWied, L. Angelucci&U. ScapagniniThe Discovery of Insulin By MichaelBlissInternational Perspectives in Urology, Volume 4: Aspects of Male Infertility Ed. by RalphdeVereWhiteOral ContraceptivesEndocrine Aspects of Aging Ed. StanleyG. KorenmanIntraovarian Control Mechanisms Ed. CorneliaP. Channing&SheldonJ. SegalProgress in Clinical and Biological Resear

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb03457.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY