摘要:

SUMMARYLevels of oxytocin (OT) and PRL were measured in plasma drawn before and during intermittent mechanical pump and tactile stimulation of the breast in five normal cycling women and 19 women in the third trimester of pregnancy. OT was significantly increased above baseline in response to breast stimulation in two of five cycling women and PRL increased in one of the two OT responders. In pregnant women, mean OT post nipple stimulation was significantly higher than pre nipple stimulation whereas PRL did not increase significantly. The response of OT to nipple stimulation occurred in 18 of 19 pregnant women compared to only two of five normal cycling women but the magnitude of the OT response in pregnant women was less than in cycling women or post‐partum lactating women previously studied in this laboratory. In one non post‐partum woman who induced lactation for the purpose of breast‐feeding an adopted infant, OT and PRL were measured before and during mechanical pump and tactile stimulation before initiation of breast‐feeding. OT increased during mechanical pump and tactile stimulation of the breast, as well as suckling, whereas PRL increased only in response to suckling. Levels of LH were measured in plasma every 20 min for 160 min at the following times: before initiation of breast‐feeding, during induced lactation while breast‐feeding, and 30 d after discontinuation of breast‐feeding. Despite the development of oligomenorrhoea during the period of breast‐feeding, levels of progesterone were not suppressed and LH was released in a normal pu

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb01670.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYA controversy still exists in regard to hypothalamic pituitary function long‐term after cure of hypercortisolism due to Cushing's disease. In an attempt to resolve this controversy, we have studied 15 patients, treated at least 6 years previously, by bilateral adrenalectomy. None of these patients had had pituitary‐directed therapy. The maximum increment response of serum TSH in response to TRH was<5 mU/l in 13 of the 15. Serum PRL response to TRH, GH response to insulin‐induced hypoglycaemia, gonadotrophin responses to LHRH and nocturnal PRL secretion were normal in all patients studied. When nocturnal GH secretion was corrected for age, body mass index and menopausal status it was definitely abnormal in only two patients. The mean nocturnal GH secretion did not differ from that measured in a control group of Addisonian patients. The series of patients also did not differ significantly from the Addisonian patients in relation to the pattern of changes in plasma ACTH, over 24 h after an 0800 h oral dose of hydrocortisone. There was a significant rise in plasma ACTH between 2200 h and 0600 h in both groups of patients. The plasma ACTH concentrations were significantly higher in post‐adrenalectomy patients. Hypothalamic pituitary function is normal in the long‐term in the majority of patients treated by bilateral adrenalectomy for Cushing'

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb01671.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYPituitary carcinoma is defined as a malignant pituitary tumour associated with blood‐ or lymph‐borne metastases. Cushing's disease is frequently present in patients with this condition. After adrenalectomy for Cushing's disease, a 37‐year‐old man developed Nelson's syndrome resulting from a pituitary carcinoma with metastases to the spinal cord, cauda equina, heart, liver, and pancreas. The primary tumour and its metastases showed immunocytochemical staining for ACTH, β‐lipotrophin, and variably for β‐endorphin and α‐melanocyte stimulating hormone (α‐MSH). A coincidental glioblastoma was also present. Nine cases of Cushing's disease associated with pituitary carcinoma, including the present patient, are documented in the literature. The case reported is only the second in which immunohistochemical staining of the primary pituitary tumour and its metastases was performed, and the first in which ACTH‐related peptides, in addition to ACTH itself, were demonstrated i

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb01672.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYAn in‐vitro perifusion system was used to investigate GnRH release from fetal (21–23 weeks gestation) human hypothalami in response to dopamine (DA) and the DA receptor antagonist haloperidol. Administration of 1 μmol/l DA during five perifusions in which 1 μmol/l haloperidol was added to the medium failed to alter basal GnRH release. In contrast DA evoked a rapid and sustained 95·8 ± 20·3% increase (P>0·01) in GnRH release during five matching perifusions with medium containing the α‐adrenergic antagonist phentolamine. While exposure to 0·01 μmol/l DA failed to alter basal GnRH release during three perifusions, 0·1 μmol/l DA elicited a 145·7 ± 65·2% increase (P>0·05) in GnRH release in three matching perifusions, indicating a dose‐dependent effect. These studies demonstrate that DA can stimulate in‐vitro release of GnRH from the mid‐gestation fetal human hypothalamus by a DA r

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb01673.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYThere is now good evidence that anti‐thyroid drugs such as methimazole have immunomodulatory effects which may be important in the treatment of patients with Graves' disease, but the immunological mechanisms by which these agents act are not clear. This study has examined the effect of methimazole on four important soluble mediators of the immune response, interleukin‐1 (IL‐1), interleukin‐2 (IL‐2), γ‐interferon (γ‐IFN) and B‐cell differentiation factor (BCDF). When peripheral blood mononuclear cells from normal subjects were stimulated with mitogens (phytohaemagglutinin, concanavalin A or pokeweed mitogen) in the presence of 10–100 μmol/l methimazole, there was an increase in IL‐2 activity in the culture supernatants. This effect was apparent between 24 and 60 h: enhanced proliferation of T‐cells was also seen in methimazole‐supplemented cultures. There was no effect of the drug on IL‐2 receptor expression or on IL‐1 and γ‐IFN production. BCDF was increased by methimazole in one of three experiments with pokeweed mitogen but not in three experiments with concanavalin A. These results suggest that the enhancement of mitogen‐stimulated T‐cell proliferationin vitrowith methimazole is due to an increase in the IL‐2 available to the T‐cells in these cultures. Thus the in‐vivo immunological effects of these drugs are likely to be complex since they may have at least two, possibly related, actions on the intrathyroidal lymphoid infiltrate, namely inhibiting oxygen ra

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb01674.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYAlcohol abuse leads to impotence, infertility and feminisation. Patients with chronic alcoholism have impaired hypothalamic‐pituitary function, but the effect of acute alcohol intake on hypothalamic function is unclear. The present study investigated the effect of ethanol ingestion on the pulsatile release of LH.Eight healthy male volunteers, aged 24–36 years, were investigated on a control day and a study day. Blood was sampled every 15 min for 8 h. On the study day ethanol was ingested, 1·5 ml/kg as an initial dose with supplements to maintain mean levels at 110–140 mg%. LH was measured on each sample by specific radioimmunoassay. Testosterone was measured at 0, 90 and 360 min. Data were analysed for pulsatile release by visual inspection, iterative computerized analysis and for longer period secretion by spectral analysis. Pulsatile release of LH was shown for all subjects on both days. Ethanol increased median LH levels (4·8 vs 5·55), but not by a significant amount. LH pulse amplitude was increased by ethanol ingestion, 3·7 vs 5·4 IU/I;P>0.05. Spectral analysis demonstrated a release of LH with a wavelength of 240 min which was unchanged by ethanol administration. Testosterone levels were

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb01675.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYIn agreement with previous authors we found patients with Graves' disease to have an increased incidence of the DR 3 antigen. We could find no association, however, between the presence of the antigen and relapse after carbimazole treatment. A concordant HLA status and thyrotrophin receptor antibody (TRAb) index, obtained at either 6 or 12 months after the start of treatment could only predict cases of relapse and remission in a minority of patients making this of very limited clinical use. The TRAb index obtained at 12 months after the start of medical therapy could accurately predict cases of relapse and remission for the next 3 years in 24/30 patients studied.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb01676.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYIn 44 patients with acromegaly treated by transsphenoidal pituitary microsurgery, the relationship between changes in pre‐ and post‐operative GH dynamics and postoperative fasting plasma GH levels was examined to clarify which is the optimal approach for evaluating postoperative removal of the tumour. TRH, LHRH and bromocriptine tests, which act directly on the pituitary somatotroph, and the oral glucose tolerance test (oGTT) and insulin tolerance test (ITT), which act via hypothalamus, were carried out pre‐ and post‐operatively. Abnormal responses postoperatively were found in most patients with fasting postoperative plasma GH over 5 ng/ml. In 24 patients with postoperative fasting plasma GH level of 5 ng/ml or below, 7 of 17 (41%) showed abnormal responses in the TRH test, 2 of 5 (40%) in the LHRH test and 3 of 13 (23%) patients in the bromocriptine test. All patients with a fasting plasma GH level less than 10 ng/ml, except for those with panhypopituitarism, showed normal responses to ITT and the paradoxical increases with the oGTT were absent. These results indicate that abnormal responses caused by a direct action on adenoma cells do not necessarily disappear even when the fasting plasma GH level is below 5 ng/ml. Abnormal responses caused by indirect actions, through the hypothalamus, disappear when the level is less than 1

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb01677.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYIn the present study, the possible relationship between melatonin secretion as reflected by nocturnal melatonin excretion (2000 h‐0800 h) and the pituitary‐adrenocortical axis was investigated. Nocturnal urinary melatonin excretion and plasma cortisol levels were determined in 41 children with weight problems before and after a single oral dose of dexamethasone. A first group of 15 individuals with normal cortisol cycle (12·2 ± 1·4 at 0800 h and 3·1 ± 0·5 μg/100 ml at 1700 h), and levels below 1·0 μg/100 ml after dexamethasone, showed a highly significant increase in melatonin excretion during the night following dexamethasone treatment (63·5 ± 5·5 ng/12 h vs 33·6 ± 3·0 for the control night,P>0·001). This increase was observed from prepuberty to young adulthood (pubertal stages PI—PV). In a second group of 16 subjects with mean cortisol levels similar at 0800 h and 1700 h (10·7 ± 1·3 and 9·3 ± 1·5 μg/100 ml respectively), but with a normal cortisol suppression after dexamethasone administration, nocturnal melatonin excretion increased from 21·2 ± 2·1 to 33·4 ± 3·0 ng/12 h (P>0·01). A significant increase was found in prepubertal children (PI) whereas no change was observed at the end of pubertal development (stages PIV‐PV). A third group of 10 patients with both low amplitude cortisol cycles (16·2 ± 2·5 and 10·8 ± 2·4 μg/100 ml) and abnormal cortisol suppression after dexamethasone administration (9·1 ± 2·4 μg/100 ml), showed no increase in melatonin excretion (24·2 ± 2·7 and 24·9 ± 3·7 ng/12 h). However, one patient with delayed puberty had increased melatonin excretion after dexamethasone. No relationship was found between body weight and melatonin excretion. Six subjects with delayed puberty had high melatonin excretion before dexamethasone and showed a marked increase after dexamethasone treatment (76·1 ± 7·2 ng/12 h vs 38·6 ± 6·9 for the control night,P>0·001), whatever the cortisol cycles and levels of suppression. Our results suggest a relationship between the patterns of cortisol and melatonin secretion. However, further studies are necessary to prove whether there exist interactions between the pituitary‐adrenal axis and the pineal gland and whether the response of melatonin to

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb01678.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

SUMMARYCell culture methods were used to assess whether human pituitary adenomas secreting GH and associated with clinical acromegaly also secreted the structurally unrelated glycoprotein hormone α‐subunit. Thirty‐two tumours, together with peri‐adenomatous tissue from two of them and three normal pituitaries were studied. Anterior pituitary hormones were measured by radioimmunoassay and included PRL, TSH, LH, FSH, and ACTH, as well as GH and α‐subunit. Normal pituitary tissues secreted all hormones assayed. All 32 tumours secreted GH ranging from 241 to 5556 ng/2 × 105cells/24 h and 12 (37·5%) secreted α‐subunit in amounts which could not be accounted for by cross‐reaction of other hormones or contamination by normal pituitary tissue, and which ranged from 10·3 to 73·5 ng/2 × 105cells/24 h. Ten other tumours also secreted α‐subunit but in very small amounts, not exceeding 1·8 ng/2 × 105cells/ 24 h. PRL was secreted from 21 tumours (6679, and small amounts of other hormones, chiefly LH and TSH, were occasionally secreted from tumours. These cell culture studies would suggest that pituitary adenomas causing acromegaly are hormonally heterogeneous and that PRL and glycoprotein a‐subunit are commonly

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1986.tb01679.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY