摘要:

SUMMARYA rare form of true hermaphroditism with hypogonadism, gynaecomastia, presence of an intrascrotal uterus, and 46 XX karyotype, is reported. It is the third published case in the literature since 1965. The presence of H‐Y antigen and of testicular tissue in the absence of a Y chromosome is discusse

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00698.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYA follow‐up study was performed on subjects with symptomless autoimmune thyroiditis in order to obtain information on the natural course of the disease. Seven out of the twenty‐two subjects with symptomless autoimmune thyroiditis became hypothyroid within 4–48 months of observation, whereas fifteen subjects were still euthyroid after an observation period of 26–102 months. The yearly incidence of hypothyroidism in symptomless autoimmune thyroiditis was 7–3%.The basal serum thyrotrophin (TSH) level as well as the response in serum TSH to thyrotrophin releasing hormone (TRH) was initially elevated in all subjects who developed hypothyroidism. The annual incidence of hypothyroidism was 26% in the subjects with an initially elevated TSH level. Serum TSH was initially normal in all but one of the eleven subjects with symptomless autoimmune thyroiditis in whom it was measured, and who remained euthyroid. In this group the TRH response was initially slightly exaggerated in three out of ten subjects. It was not performed in five subjects. During the follow‐up, serum TSH and its response to TRH also became normal in these cases. An elevated basal serum TSH value is thus highly indicative of subsequent hypothyroidism, and these subjects with symptomless autoimmune thyroiditis should be carefully

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00699.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYSerum and testicular concentrations of testosterone were determined by radioimmunoassay in four prepubertal patients (Tanner's genital stage G1) with unilateral cryptorchidism and in ten pubertal patients with different degrees of genital development (stages G2‐G5), five with unilateral and five with bilateral cryptorchidism. In every case, testicular testosterone concentration was determined in the cryptorchid gonad. Two prepubertal autopsy cases were also studied. Results were compared with scrotal testes of adult subjects. Pubertal development resulted in a gradual increase in tubule diameter on microscopic examination notwithstanding the abnormal position of the gonad. As expected, serum testosterone also increased gradually throughout sexual development. Testicular testosterone concentration however increased to adult levels at early stages of puberty. Mean concentrations and ranges were: G1, 26 ng/g (range 7–49,n= 6); G2 + G3, 660 (range 37–1357,n= 6); G4 + G5, 438 (range 272–702,n= 4) and adults 520 (range 356–663,n= 4). This resulted in similar testicular: serum testosterone ratios in G1, G4 + G5 and adults but a high ratio in G2 + G3. Patients of groups G2 + G3 did not have elevation of serum gonadotrophins and did not show Leydig cell hyperplasia. Therefore, in early puberty, when peripheral tissues are exposed to low testosterone levels, seminiferous tubules of cryptorchid gonads might already receive high androgen st

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00700.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYTo study effects on pituitary‐adrenocortical activity of a sustained block of angiotensin II formation, six ‘drug‐resistant’ patients with essential hypertension were studied before and during treatment with an inhibitor of the angiotensin‐converting enzyme (Captopril, SQ 14,225). The drug was given in increasing doses (100–400 mg/day) for 2 weeks whilst patients received a moderately restricted sodium intake (60–80 mmol/day). Immunoreactive ACTH, cortisol, aldosterone, plasma renin activity (PRA) and the activity of the angiotensin‐converting enzyme (ACE) were measured in blood samples drawn at 0800–0900 h. Urinary excretion of cortisol and aldosterone were measured in 24‐h urine collections. Further information on pituitary‐adrenocortical function was obtained by measuring serial plasma corticosteroid levels after submaximal stimulation with a synthetic ACTH preparation. ACTH and cortisol did not change an observation which does not support the hypothesis that glucocorticoid activity is influenced by a decrease in plasma angioten

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00701.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYThe effect of potassium depletion on glucose tolerance, plasma insulin and plasma glucagon was studied in six normal young female subjects. Negative potassium balance was induced by a diet low in potassium, together with frusemide (40 mg/day), for 3 days. Studies were performed during a period of potassium depletion and were repeated during potassium depletion in five subjects taking indomethacin (150 mg/day), an inhibitor of prostaglandin biosynthesis. Mean plasma potassium concentration was reduced from 4·2 ± 0·1 mmol/l to 3·3 ± 0·1 mmol/l, and was 3·2 ± 0·1 mmol/l during administration of indomethacin. Potassium depletion had no significant effect on the levels of plasma glucose, either fasting or following a 100 g oral glucose load, although the peak rise in plasma glucose after oral glucose was delayed (from 30 to 60 min). There was a decrease in the fasting plasma insulin concentration from 10·0 ± 1·3 mu/l to 6·7 ± 0·6 mu/l and a significant suppression of the early (30 min) insulin response to oral glucose from 126·0 ± 23·5 mu/l to 74·0 ± 19·2 mu/l. The insulin: glucose ratio during the first 60 min following oral glucose was significantly decreased from 43·7 ± 7·3 mu insulin/mmol glucose to 30·6 ± 7·3 mu insulin/mmol glucose. Furthermore, the suppression of plasma glucagon secretion that normally follows oral glucose was not observed. Administration of indomethacin during potassium depletion had no significant effect on plasma glucose, insulin or glucagon concentrations. These data indicate that short‐term potassium depletion in normal young females impairs the early insulin response to oral glucose but does not significantly alter overall glucose tolerance. Failure of an indomethacin effect suggests that the defect in insulin secretion may not be mediated by an increased

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00702.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYIn a rat anterior pituitary dispersed cell system, angiotensin II was found to stimulate the release of ACTH at concentrations ranging from 100 pmol/l to l μmol/l, with a maximal response being given by 10 nmol/l. The angiotensin II antagonist, saralasin, was able to block completely at a concentration of l μmol/l the stimulation of ACTH induced by 10 nmol/l angiotensin II, but had no effect on the basal release. The log dose‐response curve for ACTH release by angiotensin II was shifted to the right in a parallel fashion by saralasin 10 nmol/l, suggesting competitive antagonism. The stimulation of ACTH release by a rat stalk‐median eminence extract or by arginine vasopressin was unaffected by saralasin. The data are interpreted as suggesting that rat corticotrophs contain angiotensin II receptors, and that these may be involved in ACTH release in response to hypovolaemic s

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00703.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYIn eight clinically and biochemically euthyroid patients undergoing routine major non‐thyroidal surgery preoperative and daily postoperative serum concentrations of total and free thyroid hormones were measured. Thyrotro‐phin‐releasing hormone (TRH) tests were performed preoperatively and on the first 3 postoperative days. There was a significant fall in mean serum total and free triiodothyronine (T3) concentrations on the postoperative days and mean reverse T3 concentrations rose reciprocally. There was no significant change in mean basal thyroid‐stimulating hormone (TSH) values, but there was a significant increase in the mean TSH response to TRH on the first postoperative day. The mean TSH response then declined sequentially until day 3 while mean free T3 concentrations remained significantly depressed. Mean serum free thyroxine (T4) concentrations remained normal during the study. Intrapituitary conversion of T4 to T3 or other down regulatory mechanisms could explain this rapid adaptation of the pituita

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00704.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYThe effects of the histamine H2‐receptor antagonists, ranitidine and cimetidine on prolactin (PRL), thyroid stimulating hormone (TSH), and growth hormone (GH) were studied in six normal males. Intravenous bolus injections of saline and of 50, 100, and 200 mg ranitidine and 300 mg cimetidine were tested. Ranitidine (100 and 200 mg) and cimetidine (300 mg) caused a significant increase in PRL secretion, whereas saline and ranitidine (50 mg) did not. TSH and GH secretion were unaffected by all doses. A dose‐response relationship between ranitidine and PRL was established, and a dose of 65 mg ranitidine was found to be the minimal effective PRL‐releasing dose. Plasma ranitidine concentration was measured by specific RIA. The results indicate an effect of H2‐receptor antagonists on physiological functions in the control of PRL secretion. Histamine, therefore, may play a role in the regulation of PRL se

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00705.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYTechniques for pre‐operative localization of aldosterone‐secreting adrenal adenomas were studied in thirty‐seven patients, each with hypertension and biochemical evidence of primary hyperaldosteronism and each later having adrenal surgery (thirty‐two adenomas, five bilateral adrenal hyperplasia).Bilateral adrenal vein catheterization was attempted in all cases; it was successful on the left side in all patients and in 92% of cases on the right. Adrenal vein plasma samples were obtained from the left side in 92% and from the right in 73% of cases. Adrenal vein plasma aldosterone measurements correctly indicated the presence of tumour in twenty‐eight cases but falsely predicted unilateral adenoma in two cases of bilateral adrenal hyperplasia. Adrenal venography also correctly predicted unilateral adrenal adenomas in twenty‐six cases but falsely suggested the presence of tumour in three cases of bilateral adrenal hyperplasia.Computed tomography (CT) was used in the last eight cases. In seven instances the predictions (six adenomas, one bilateral adrenal hyperplasia) were confirmed at surgery. However, the remaining patient harboured an adenoma 20 mm in diameter which was not detected by CT although diagnosed both by adrenal venography and adrenal vein aldosterone measurements.Ultrasound detected adenoma in only three of twenty‐two cases examined. Although further comparative studies of the type described here are required, the results of computed tomography are promising and suggest that this non‐invasive technique might well become the first choice procedure in localizing aldosterone‐s

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00706.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYTo investigate the influence of thyroid hormones on intermediary metabolism in man, hormone and metabolite profiles were obtained over a 12‐h period of normal meals and activity in eight hypothyroid subjects before and during thyroxine replacement therapy, and in sixteen matched controls.The fasting blood glucose concentration and the mean 12‐h blood glucose concentration were normal in hypothyroid subjects but the blood glucose response to breakfast was exaggerated. Fasting blood lactate and pyruvate levels were normal but post‐prandial hyperlactataemia and hyperpyruvicaemia were found and mean 12 h values for lactate (hypothyroid 1·08 ± 0·06 v. control 0·77 ± 0·03 mmol/l,P<0·01) and pyruvate (0·10 ± 0·01 v. 0·08 ± 0·003 mmol/l,P<0·01) were elevated. Blood alanine concentrations were elevated only in the evening. Although plasma non‐esterified fatty acid levels were normal, fasting blood glycerol levels were decreased (0·06 ± 0·01 v. 0·08 ± 0·01 mmol/l,P<0·001) and this decrease persisted throughout the 12‐h period. Blood total ketone body concentrations did not differ from controls, but, as for plasma NEFA and blood glycerol, the normal preprandial rise in concentration was absent. Serum insulin, glucagon and growth hormone concentrations did not differ from control values at any time.Six months of thyroxine (T4) treatment produced a rise in blood glycerol concentrations (mean 12 h value during T4 therapy, 0·06 ± 0·01; before T4 therapy, 0·04 ± 0·005 mmol/l;P<0·01) but not to control values (0·08 ± 0·01 mmol/l). Concentrations of glucose and other gluconeogenic precursors were unaltered by therapy but the insulin response to meals and the mean 12 h se

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00707.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY