摘要:

SUMMARYSodium valproate (DPA or Na‐dipropylacetate), an anticonvulsant drug activating the endogenous GABAergic system, was administered orally at the dose of 400 mg to seventeen normal women 1 h before intravenous injections with three drugs which stimulate prolactin (PRL) release: TRH (200 ųg bolus; six subjects); domperidone (5 mg bolus; six subjects); and sulpiride (5 mg bolus; five subjects). DPA pretreatment significantly blunted PRL response to both domperidone and sulpiride injections without affecting the PRL response to TRH. In particular, the quantitative PRL secretion (areas under curves) following domperidone and sulpiride tests appeared significantly reduced after DPA treatment in comparison to placebo (P<0·02 andP<0·01 for domperidone and sulpiride respectively). These results indicate that the pharmacological enhancement of the endogenous GABAergic system by DPA may blunt PRL response to both central and peripheral dopamine receptor blockade. These observations suggest that a GABAergic pathway inhibiting PRL secretion at the hypothalamic level competes, at least in part, with the dopaminergic system. Conversely, the lack of any effect of DPA on PRL response to TRH seems to suggest that pituitary TRH receptors are independent of any GABAergic con

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00080.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYCalcitonin‐like peptides have been identified in the serum of normal subjects and of medullary thyroid carcinoma (MTC) patients. Using specific homologous radioimmunoassays (RIA) in combination with reversed‐phase high performance liquid chromatography and gel permeation chromatography under denaturing conditions, we have recognized major components which coeluted with human calcitonin‐(1–32), PDN‐21, a carboxyl‐terminal flanking peptide derived from the calcitonin mRNA sequence, and salmon calcitonin‐(1–32). An additional 12000 molecular weight peak possibly represents a human calcitonin‐PDN‐21 polyprotein. In both the human calcitonin‐(1–32) (normal value<0·043 ngEq/ml; MTC 140·80 ngEq/ml, mean value±SEM) and the PDN‐21 (normal value<0·050 ngEq/ml; MTC 33·6±16·5 ngEq/ml) RIAs, serum levels were increased in MTC patients. Circulating levels of the salmon calcitonin‐like peptide were indistiguishable between normal subjects (0·038 ± 0·006 ngEq/ml) and

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00081.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYThyroglobulin (Tg) concentrations in the aspirates of various types of cystic neck masses were measured by RIA to assess the usefulness of this determination in differential diagnosis. The subjects consisted of 16 patients, whose final diagnoses were all established on the basis of operative results; three patients had follicular thyroid adenomas (F‐Ad), 11 had papillary thyroid carcinomas (P‐Ca), one had a thyroglossal duct cyst (TDC) and one had a lateral cervical cyst (LCC). Tg concentrations in the cyst fluids of F‐Ad and P‐Ca were very high (0·042–2·83 mg/ml) compared with serum Tg concentrations. There was no difference in Tg concentrations in the fluids of P‐Ca between primary lesions (n= 5) and metastatic lesions (n= 6). On the other hand, Tg concentrations of TDC and LCC were very low (<100 ng/ml). Difficulty was experienced in diagnosing three patients, even though they had been examined by all nonsurgical diagnostic techniques. However, an occult thyroid carcinoma with lymph node metastasis was diagnosed by demonstrating a high Tg concentration in the aspirate of the cystic lymph node. T3 concentrations in cyst fluids of F‐Ad were higher than those of P‐Ca. T3 concentrations in the fluids of P‐Ca, TDC and LCC did not differ, and were similar to serum T3 levels. Cytology of cyst fluids was positive in four of 10 patients examined with P‐Ca. In conclusion, we can clearly confirm the thyroid origin of a cystic neck mass by demonstrating a high Tg concentration in the aspirate. This is especially useful for diagnosis in patients with thyroid carcinoma, including occult thyroid carcinomas with cystic

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00082.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYA quantitative cytochemical assay for the measurement of total NADPH formation in guinea pig thyroid tissue following incubation with thyroid stimulators was validated and applied to the measurement of such stimulators in IgG concentrates prepared from human plasma. Pentose shunt enzyme activity was not uniformly distributed in thyroid tissue but this could be overcome and NADPH generation in such tissue used to assess accurately thyroid stimulators if a sufficient number of thyroid cells were measured. Specificity studies showed that antiserum to human IgG significantly diminished the NADPH generating capacity of IgG concentrates prepared in plasma from goitrous patients while antiserum to h‐TSH had no such effect. The measurement of thyroid growth stimulating immunoglobulins (TGI) depended not only on the amount of NADPH generated but also on the IgG concentration at which maximum responses occurred. TGI present in goitrous GRAVES' disease were 10 times more potent than those present in euthyroid goitre, while such stimulators when present in toxic nodular goitre appeared to possess an intermediate potency. This finding, when taken together with the demonstration that TSH stimulation decreased intercellular differences in pentose shunt activity, provides experimental evidence for the hypothesis that an acute intense growth stimulus affecting all thyroid cells produces the diffuse hyperplasia characteristic of GRAVES' disease. In contrast, the weaker stimulus observed in nodular goitre may, over a period of time, result in the asymmetric hyperplasia commonly observed in this conditio

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00083.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYThe prolactin response to TRH in a group of patients with Kallmann's syndrome was found to be significantly lower compared to a group of hypergonadotrophic hypogonadal patients. Since levels of testicular products are comparably low in both groups, we hypothesize that high endogenous LHRH production might be associated with an increased prolactin response to TRH. In support of this, we were, indeed, able to establish a positive correlation between the magnitude of the prolactin response to TRH and basal and LHRH‐stimulated LH/FSH levels (the latter serving as an index of endogenous LHRH production) in: (1) eugonadal men, (2) men with Kallmann's syndrome, (3) oestrogen‐treated agonadal men, (4) men with severely impaired spermatogenesis and, (5) agonadal men. A direct relation between LHRH and the prolactin response to TRH was demonstrated in a group of eugonadal men, the prolactin response to TRH being greater after prolonged LHRH pretreatment. We speculate that an increase of endogenous or exogenous LHRH might be associated with decreased hypothalamic dopamine secretion which could directly increase prolactin synthesis. Indirectly, decreased dopamine secretion could augment the potency of TRH in releasing prolac

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00084.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYA group of 89 individuals with essential hypertension was evaluated with several measurements including the neurophysin believed to be the human oxytocin neurophysin (OT‐Np), and the human vasopressin neurophysin (VP‐Np). The neurophysins are proteins synthesized within cells of the supraoptic and paraventricular nuclei in conjunction with their respective hormones oxytocin and vasopressin as part of a common precursor molecule and so may reflect the simultaneous presence in plasma of their associated hormones. A poor but statistically significant correlation was noted between levels of OT‐Np and renin activity in plasma (PRA) either supine (r= 0·248) or erect (r= 0·255). Levels of OT‐Np averaged 1·75 ng/ml and were inversely correlated with creatinine (r= ‐ 0·252), supine blood pressure (r= ‐ 0·450), plasma volume (r= ‐ 0·327), and 24‐hour urine sodium (r= ‐ 0·313). Levels of Ot‐Np could be suppressed by infusion of physiologic saline. Levels of OT‐Np were lower in the volume expanded state and were positively correlated with the quantity of sodium excreted into a 24‐hour urine collected after the infusion (r= 0·426) and inversely correlated with the supine systolic (r= ‐ 0·379) and supine diastolic (r= ‐ 0·455) blood pressures recorded after the infusion of saline. Oestrogen, a stimulus to the secretion of OT‐Np, did not account for the elevation of OT‐Np observed in the study, since mean levels of oestradiol (E2) in a subset of the patients with elevated OT‐Np (E2= 36 pg/ml) were not different from levels in subjects with lower values of OT‐Np (E2= 45 pg/ml). Levels of VP‐Np averaged 0·85 ng/ml and correlated positively with PRA (r= 0·353) and 24‐hour urine excretion of dopamine (r= 0·44), and inversely with age (r= ‐ 0·263), blood pressure, and 24‐hour urine excretion of sodium (r= ‐ 0·226). Erect posture caused an elevation of VP‐Np. Therefore, levels of OT‐Np and VP‐Np respond to certain physiological stimuli and levels of OT‐N

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00085.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYThirteen normal children, seven males and six females, during early puberty (I‐II according to Tanner), have been studied. Each subject was injected at weekly intervals and in random order with 100 μg of LHRH, 0·2 mg/kg of naloxone and 0·9% saline in single bolus. The gonadotrophin response was evaluated. The administration of naloxone failed to elevate LH levels in any of the subjects studied, even in those who showed a clear gonadotrophin response to LHRH. Unlike the response noted in adults, endogenous opiates do not appear to exert a tonic inhibitory influence on LH secretion during early pu

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00086.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYWe report a case of subacute thyroiditis complicated by thyrotoxic myopathy. Previously thyrotoxic myopathy has been described as being associated with GRAVES' disease. The patient in this study was a 35‐year‐old man who developed proximal dominant muscular weakness and atrophy during the course of subacute thyroiditis. His myopathic symptoms regressed as his serum thyroxine and triiodothyronine levels returned to normal, however it took a relatively long period of time for them to do so. This suggests that marked myopathy may develop even in cases of subacute thyroiditis if the thyrotoxic state persists for a long period of t

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00087.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYAndrogen levels were measured before and during 12 months of treatment with cyproterone acetate (50 mg 5th to 16th day of cycle) and ethinyl oestradiol (50 μg 5th to 26th day of cycle) in 26 patients suffering from dysfunctional hirsutism. Patients were included in whom androgen levels after a dexamethasone suppression test fell above the range found in normal non‐hirsute women on dexamethasone. Eighty percent of patients showed a substantial improvement of their Ferriman and Gallwey score after 12 months of treatment. During the treatment the mean level of testosterone was 64%, androstenedione 55%, testosterone oestradiol binding globulin 365%, apparent free testosterone 30%, dihydrotestosterone 74%, 5‐androstanediol 43%, dehydroepiandrosterone 44%, 5‐androstenediol 67% and dehydroepiandrosterone sulphate 74% of basal levels. From the results it is concluded that this treatment is effective both clinically and biochemically in reducing hyperandro

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00088.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYThyroid function and exposure to dietary goitrogenic factors (iodine deficiency and thiocyanate overload) were studied at birth and from birth to 7 years in 200 neonates and 347 children living in the severe endemic goitre area of Ubangi, Northern Zaire. Serum T4 was at the lower limit of normal at birth (104 ± 4 nmol/1) and stayed at that level during the first year of life (123 ± 9) (NS), but decreased to 75 ± 8 (P<0·001) at 2–4 years and to 62 ± 6 (P<0·001) at 5–7 years of age. Mean serum FT4 decreased from 10·4 ± 0·9 pmol/1 during the first year to 8·2 ± 1·0 (NS) at 2–4 years (NS) and to 7·7 ± 0·9 (P<0·05) at 5–7 years. Mean serum TSH was 10·4 (8·4‐12·9) m U/1 (geometric mean ± 1 SEM) during the first year, 10·1 (7·5‐13·7) (NS) at 2–4 years and 24·3 (18·5–31·9) (P<0·05) at 5–7 years. Mean serum T3 was 3·23 ± 0·12 nmol/1 during the first year and remained stable thereafter. The frequencies of low T4 (T450 mU/1), and low T4 and T3 (T3<1·69 nmol/l) were twice as high at 5–7 years as in the first year (respectively 65%, 42% and 15%). The urinary iodide concentration of the children was stable and low throughout the study period. By contrast, serum thiocyanate concentration which was high at birth (129 ± 5 ųmol/1) decreased to normal values between 3 and 12 months of age and increased again during and after weaning (1 to 3 years of age) to reach a value of 138 ųmol/l which was comparable to that observed in adults in the same area. Thiocyanate concentration was high (133 ± 7 ųmol/l) in the mothers' serum but low in the mothe

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00089.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY