摘要:

SUMMARYThe integrated concentration of growth hormone (ICGH) has been measured in fourteen acromegalic patients, and compared with the basal plasma growth hormone concentration (BGH). Seven patients were treated by trans‐sphenoidal pituitary surgery, and in these, similar percentage reductions of BGH and ICGH occurred after treatment. The other seven patients were treated with bromocriptine alone, and in these the percentage reduction of ICGH was significantly less than that of BGH. Measurements of basal plasma growth hormone concentration may be unreliable in assessing the response of acromegalic patients to treatment with bromocriptine. The ICGH can be measured easily on a single blood specimen obtained by continuous sampling over 24h, and may be more reliable for this purpos

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1977.tb01335.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

SUMMARYA 28‐year‐old male pseudohermaphrodite with gynaecomastia was raised as a female until the age of 17 years, at which time he developed masculine features (deepening of the voice, development of facial hair, male distribution of body hair and male body habitus) and assumed a male gender role. He had a small phallus with perineal urethra, absence of labioscrotal fusion, presence of vaginal pouch and undescended testes. The testicular biopsy showed hyalinization of the tubular basement membrane, lack of spermatogenesis and hyperplastic Leydig cells. Baseline peripheral plasma studies showed androstenedione concentrations ten times normal, low testosterone, elevated oestrone and elevated gonadotrophins. Thein vitroincubation of testicular tissue showed no significant conversion of androstenedione to testosterone. However, two types of peripheral tissues, skin fibroblasts and erythrocytes, had a normal conversion, as did the body overall as measured by the technique of androstenedione constant infusion. These studies demonstrate that the 17‐keto‐steroid reductase deficiency of the patient was limited to the

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1977.tb01336.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

SUMMARYTotal and free serum thyroxine (T4) and triiodothyronine (T3), basal serum thyrotrophin (TSH) and the serum TSH response to a standard intravenous dose of thyrotrophin releasing hormone (TRH) have been measured in fifteen men with liver cirrhosis and in eight alcoholic men with fatty liver change. All the patients studied were clinically euthyroid. In cirrhotics, total T4 and free T4 (FT4) concentrations were normal as were free T3 (FT3) concentrations but total T3 concentrations were significantly reduced and basal TSH concentrations were significantly higher than normal. Alcoholics with fatty liver change had normal basal TSH concentrations and normal total and free thyroid hormone concentrations apart from reduced FT4. Correlation of thyroid function tests with liver function (serum albumin concentration) showed significant positive correlations for serum albumin with both total T3 and FT3 and significant negative correlations with both FT4 and basal TSH. Nine of fifteen cirrhotics had an abnormal serum TSH response to TRH, the commonest abnormal pattern being a delayed response (seven patients). Three of eight alcoholics with fatty liver change also had an abnormal TSH response to TRH. These findings not only show complex disturbances in hypothalamic‐pituitary‐thyroid relationships in chronic liver disease but also provide indirect evidence of reduced extra‐thyroidal conversion of T4

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1977.tb01337.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

SUMMARYSerum prolactin and oestradiol levels were measured in 183 children who were staged for pubertal development. Mean serum prolactin levels are higher in girls than in boys at stage 3 of pubertal development. In girls prolactin levels rise at stage 2, and are higher after menarche; in boys there is no change in prolactin levels. In this study serum oestradiol correlates with prolactin in the girls, but not in the boys.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1977.tb01338.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

SUMMARYAn accurate and reproducible method for measurement of radioactive species in blood afterin vivoinjection of labelled iodothyronines is described. By extraction with high‐affinity antisera, radioactive reverse T3 and T3 are separated from serum quantitatively. Radioiodide is quantitatively separated from radio‐thyronine species and serum proteins by Sephadex G50 filtration. The residual mixture of radio‐T4 and iodoprotein is quantitatively resolved by ion‐exchange adsorption. Minimal misclassification of radiospecies occurs, and can be corrected for. Mean recoveries of various radiospecies added to serum were: radioiodide 98.9%, radio‐rT3 87.6%, radio‐l‐T3 94.5%, radio‐T4 98.0% and radioiodoprotein 94.5%. The performance of the method is superior to that of chemical methods such as trichloracetic acid precipitation, ion‐exchange or alkaline Sephadex extraction, and chromatog

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1977.tb01339.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

SUMMARYA survey has been conducted in Whickham, County Durham, to determine the prevalence of thyroid disorders in the community. Two thousand seven hundred and seventy‐nine people (82.4% of the available sample) were seen in the survey. The prevalence of overt hyperthyroidism was 19/1000 females rising to 27/1000 females when possible cases were included, compared with 1.6–2.3/1000 males. The prevalence of overt hyothyroidism was 14/1000 females rising to 19/1000 females when possible cases were included, compared with less than 1/1000 males. The prevalence of spontaneous overt hypothyroidism (excluding iatrogenic cases) was 10/1000 females or 15/1000 females including unconfirmed cases. Minor degrees of hypothyroidism were defined on the basis of elevated serum thyrotrophin (TSH) levels in the absence of obvious clinical features of hypothyroidism. TSH levels did not vary with age in males but increased markedly in females after the age of 45 years. The rise of TSH with age in females was virtually abolished when persons with thyroid antibodies were excluded from the sample. TSH levels above 6 mu/1 were shown to reflect a significant lowering of circulating thyroxine levels and showed a strong association with thyroid antibodies in both sexes, independent of age. Elevated TSH levels (>6mu/l) were recorded in 7.5% of females and 2.8% of males of all ages. Thyroglobulin antibodies were present in 2% of the sample. Thyroid cytoplasmic antibodies were present in 6.8% of the sample (females 10.3%, males 2.7%) and their frequency did not vary significantly with age in males but increased markedly in females over 45 years of age. 3% of the sample (females 5.1%, males 1.1%) had thyroid antibodies and elevated TSH levels and the relative risk of a high TSH level in subjects with antibodies was 20:1 for males and 13:1 for females, independent of age. Small goitres (palpable but not visible) were found in 8.6% of the sample and obvious goitres (palpable and visible) in 6.9%. Goitres were four times more common in females than in males and were most commonly found in younger rather than older females. TSH levels were slightly but not significantly lower in those with goitre than in those without goitre. There was a weak association between goitre and antibodies in females but not ma

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1977.tb01340.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

SUMMARYThe age and sex distribution of ischaemic heart disease (IHD), other vascular disorders and serum lipid concentrations and the possible association between these factors and thyroid failure have been examined in a community survey. A past history of IHD occurred in 7.5% of males and 4.8% of females.‘Chest pain on effort’was found in 7.4% of males and 7.8% of females and‘possible infarction’in 5.4% of males and 3.8% of females. Major ECG changes were found in 4.7% of both sexes and minor changes in 6.5% of males and 11% of females. Intermittent claudication was present in 4.8% and cerebrovascular accidents had occurred in 2% of the sample. Diastolic blood pressures greater than 100mmHg were found in 13% of all males and 11% of all females. Cholesterol concentrations were normally distributed. Mean cholesterol rose by approximately 0.25 mmol/1/decade in both sexes to reach a maximum in the 55–64 years age group and declined slightly thereafter. Trigly‐ceride values were skewed to the right and increased by 0.2 mmol/1/decade in males up to the 45–54 years age group and by 0.1 mmol/1/decade in females to a peak in the 65–74 years age group — and declined after these ages. Electrophoresis revealed Type IIa patterns in 3% of males and 9% of females, IIb in 1% of both sexes and Type IV in 13% of males and 3% of females. There was no association in males between IHD and thyroid antibodies or minor degrees of thyroid failure. There was a weak association between minor ECG changes and minor degrees of hypothyroidism (but not thyroid antibodies) in females which was independent of other variables. The significance of this observation depends upon the interpretation of the ECG abnormalities and will only be established by longitudinal studies. No association was noted between lipid concentrations and thyroid antibodies or minor degrees

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1977.tb01341.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

An Introduction to clinical Endocrinology. By JOHN A. THOMSONTheProstaglandins, Volume 3. Ed. by P. W. RAMWELL

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1977.tb01342.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1977.tb01343.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY