摘要:

SUMMARYHormone secretion by ten functionless human pituitary adenomas in cell culture has been measured, and compared with tissue immunocytochemistry and electron microscopy, as well as results with a normal pituitary. Patients presented following routine x‐ray and had no clinical or biochemical endocrine abnormality apart from one male with raised serum FSH and PRL, normal LH, and low testosterone. Of the ten adenomas, nine secreted both LH and FSH in cell culture and five of these also secreted PRL, one did not secrete any anterior pituitary hormones (ACTH was not measured). No GH or TSH was detectable in the cultures of the nine LH/FSH secretors excluding the possibility of contamination by normal anterior pituitary. The normal pituitary cells secreted all anterior pituitary hormones; the amounts of FSH/LH being comparable with those of the adenomas. Immunostaining confirmed the cell culture results and showed the adenoma FSH/LH cells to be scattered singly or in small groups of two to five cells with both hormones usually being in the same cell. PRL where found was in separate cells. Hormone granules were small (50–160 nm), round or irregular and scattered in the cytoplasm of rounded cells of low secretory activity. The negatively staining cells were not different ultrastructurally to those staining positively. It is concluded that a significant proportion of functionless pituitary adenomas have detectable low levels of LH/FSH secretion often accompanied by PRL when examined by cell culture or immunocytochemistry. Although these adenomas were endocrinologically quiescent activity could have been masked because of post‐menopausal secretion and one male probably had an FSH‐secreting

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00643.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYWe have previously reported increased testosterone and androstenedione concentrations and decreased sex hormone binding globulin (SHBG) concentrations in the plasma of massively obese women. We now report that these plasma hormone concentrations return to normal in twelve of the same women after substantial weight reduction and these changes are associated with more normal menstrual cycles. We conclude that body weight and fat are important determinants of sex steroid secretion and binding and thus influence menstrual function.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00644.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYThe non‐steroidal anti‐inflammatory agent fenclofenac competitively inhibits the binding of thyroxine (T4) and triiodothyronine (T3) by thyroxine‐binding globulin (TBG). Eight male volunteers completed a 4‐week study during which they took fenclofenac 600 mg twice daily. The concentration of fenclofenac in serum reached a plateau after 1 week of therapy after which the mean concentration (± SEM) of the drug in serum was 78–6 ± 6–2 mg/l. During the steady state period on treatment there were reductions of the mean serum concentrations of total T4 to 35% (P<0·001), total T3 to 55% (P<0·001), free T4 to 69% (P<0·001) and free T3 to 90% (NS) of the respective pretreatment values.There were also significant changes in the concentrations of thyrotrophin and reverse T3 in serum. After starting treatment with fenclofenac serum concentrations of thyrotrophin fell to a nadir after 2–4 days at which time the mean concentration was 34% (P<0·01) of the pretreatment value, whilst reverse T3 values increased to a maximum of 136% (P<0·001) of the pretreatment values over 1–2 days. There was subsequently an increase of the thyrotrophin and a reduction in reverse T3 concentrations to normal by 2 weeks of treatment. Transient pituitary suppression was also suggested by the response to thryotrophin‐releasing hormone (TRH): 7 days after starting fenclofenac the mean thyrotrophin response was 62% (P<0·001) of the pretreatment value. After 4 weeks of fenclofenac the response of TRH had returned to normal. After discontinuing fenclofenac there was a transient increase in the mean concentration of thyrotrophin in serum, to 129% of the pretreatment value (P<0·001), with a subsequent return to normal. Four weeks after discontinuing fenclofenac the serum concentrations of thyroid hormones an

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00645.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYEffects of oestradiol, bromocriptine, and bromocriptine plus oestradiol, on basal and GnRH stimulated gonadotrophin concentrations were studied in normo‐(group 1,n= 7) and hyperprolactinaemic (group 2,n= 6) patients with secondary amenorrhoea. Before drug administration, hyper‐responsiveness of LH, but normal FSH responses to GnRH were observed in most patients. Oral administration of 2 mg oestradiol for 4 days resulted in increased 17β‐oestradiol levels in plasma in normal women (n= 6) in the early follicular phase of the cycle, and in groups 1 and 2. During oestradiol administration plasma LH concentration increased significantly and there was an increase of LH and FSH responses to GnRH in normal subjects, but not in amenorrhoeic women. In groups 1 and 2 basal FSH levels were suppressed but no change in GnRH stimulated gonadotrophin responses was seen. Bromocriptine (5 mg per day for 5 days) significantly decreased prolactin concentrations and increased 17β‐oestradiol levels in plasma in group 2 but not in group 1. The mean plasma 17β‐oestradiol concentration had increased to levels similar to those obtained during oestradiol administration alone. The mean LH response to GnRH was suppressed in group 2, but not in group 1. Basal and GnRH‐stimulated plasma FSH concentrations were not changed by bromocriptine treatment. Compared with the GnRH induced LH response during bromocriptine alone, bromocriptine treatment plus oestradiol administration resulted in a significantly increased LH response in group 2. This was not found in group 1.The present results suggest that there is an increased dopamine activity and inhibition of GnRH at the hypothalamic level and a relative dopamine deficiency at the pituitary level in hyperprolactinaemic patients. Normoprolac‐tinaemic patients with hypothalamic amenorrhoea have increased dopaminergic activity at the hypothalamic, as well as the, pituitary level, or alternatively that the LH release is not influenced by dopamine in these patients. Finally bromocriptine sensitizes LH‐secreting cells to GnRH in hyperprolactinaemic, but not in normoprolac

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00646.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYSerum levels of the growth factor non‐suppressible insulin‐like activity (NSILA‐S) have been measured in eleven pregnant women with diabetes mellitus during pregnancy and immediately (2 days) after birth. A significant increase in mean levels was observed with increasing gestation, reaching a peak at the time of delivery and subsequently returning to non‐pregnant levels within 2 days. The NSILA‐S levels in diabetic pregnancies were not different from those in non‐diabetic pregnancies and there were no significant correlations between NSILA‐S and birth weight, maternal diabetic control, age or duration of diabetes or the treatment required. The physiological role of high NSILA‐S levels during pregnancy still requi

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00647.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYCimetidine, an H2receptor antagonist, was given for 6 weeks to six normal male volunteers to study the effects on pituitary, adrenal, thyroid, and testicular hormone secretion. Patients were studied before (day 1) and after (day 42) cimetidine (300 mg four times daily) therapy, and four of the six were restudied after discontinuing cimetidine for 1 month (day 72). Basal TSH concentrations and responses to TRH administration as well as T3 RIA and T4 resin uptakes did not change during or after cimetidine therapy. The diurnal rhythm of plasma cortisol and maximum cortisol response to insulin (0·15 u/kg) were similar on days 1 and 42, but urinary free cortisol excretion fell 31% (P<0·01). Response of GH to exercise, 100 g carbohydrate ingestion and insulin were unchanged, but mean nocturnal GH secretion decreased 33% (P<0·025) on cimetidine, and returned to baseline on day 72. The 24‐h plasma prolactin profile was unchanged as was the prolactin response to insulin and TRH stimulation. Plasma FSH was not altered, but mean LH concentrations decreased 20% on cimetidine and continued to decline (45% of day 1 levels) after discontinuation of cimetidine (P<0·01). Spontaneous LH pulse amplitude declined slightly on day 42, but became significantly lower on day 72 (P<0·01) while pulse frequency increased modestly on day 72 (P<0·05). Peak LH responses to gonadotropin‐releasing hormone were also reduced on cimetidine therapy (P<0·02). Plasma testosterone concentrations did not change but plasma oestradiol concentrations were 38% lower (P<0·025) after cimetidine was discontinued.H2histamine receptors are involved in the control of multiple hormone secretory patterns and blockade of these receptors by cimetidine alters hormone profiles. These changed patterns have to be considered in the interpretation of hormone measurements in patients receiving cimetid

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00648.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYTwo patients with Nelson's syndrome and one patient after bilateral adrenalectomy for Cushing's disease, without any evidence of Nelson's syndrome, were studied with respect to the effect of hydrocortisone, naloxone and valproic acid (a GABA transaminase inhibitor) on ACTH secretion. Hydrocortisone suppressed plasma ACTH concentrations to normal in the patient without Nelson's syndrome, but failed to do so in the two patients with Nelson's syndrome. Naloxone and valproic acid caused a decline in plasma ACTH concentrations in the patients with Nelson's syndrome, but produced no change in the patient without Nelson's syndrome. Secretion of ACTH may thus be influenced by both opiate peptides and by gamma aminobutyric acid, as well as by the cortisol concentrations, these agents may act at different sites to inhibit ACTH release by the tumour.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00649.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYThis study deals with serum prolactin concentrations during various conditions in the early puerperium in an attempt to investigate some characteristics of the mechanisms responsible for the regulation of the lactotrophes. In nursing, in non‐nursing, non‐medicated and in non‐nursing, bromocriptine‐treated women prolactin and 17β‐oestradiol were measured during the early puerperium. In the first and the third group this was repeated during and after challenge with oestradiol‐benzoate. The pituitary responsiveness to TRH was also determined in these two groups, challenged and unchallenged with oestradiol‐benzoate. Nursing women had higher prolactin levels than the non‐nursing groups, while bromocriptine decreased prolactin to very low levels. Non‐nursing non‐medicated women had prolactin values between those of nursing and those of bromocriptine‐treated mothers. The already elevated prolactin levels in nursing women were not influenced by chronic oestradiol administration. In non‐nursing puerperal women treated with bromocriptine, exogenous oestradiol caused a significant rise in plasma prolactin. The prolactin response to TRH in nursing women was clearly reduced in comparison with the normal menstrual cycle. In the bromocriptine‐treated group the basal concentration of prolactin and its response to TRH stimulation was similar to normal non‐pregnant women. In nursing and in non‐nursing women treated with bromocriptine prolactin responses to TRH were increa

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00650.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYPatients with prolactin‐secreting pituitary tumours have a diminished prolactin (PRL) response after administration of a variety of stimulatory agents, including thyrotrophin‐releasing hormone (TRH), chlorpromazine (CPZ) and insulin‐induced hypoglycaemia. We examined responses to these agents in sixty‐seven women with PRL‐secreting tumours before and after trans‐sphenoidal surgery. Twenty‐nine of the women were cured as denned by restoration of normal serum PRL concentrations and resumption of regular menses. One year following trans‐sphenoidal surgery, patients with normal PRL concentrations and regular menses had normal PRL responses to TRH, while the responses to CPZ and insulin hypoglycaemia were not improved. The reversible impairment of PRL response to TRH reflects suppressed function of normal PRL‐secreting cells, and the persistence of abnormal PRL responses to provocative stimuli after successful tumour removal may reflect some fundamental defect in the regulation of PRL secretion in patients with PRL‐secreting adenomas.When growth hormone (GH) reserve after insulin hypoglycaemia was represented as the mean absolute increment above the basal concentration and compared with normal subjects, women with PRL‐secreting tumours had a diminished response that returned to normal after successful surgery. This reversible impairment of GH secretion is not adequately reflected by standard criteria for GH response and suggests that PRL may have a role in the regul

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00651.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

SUMMARYIn the sera of patients with Graves' disease abnormal thyroid ‘stimulating’ immunoglobulins have been demonstrated byin vivoandin vitroassay systems. Conflicting results have been reported when thyroid stimulating and thyrotrophin (TSH)‐binding inhibiting activities have been compared. The present study was performed in forty‐nine hyperthyroid Graves' patients to ascertain the relationships among TSH‐binding inhibiting immunoglobulins (TBII), measured by a radio‐receptor assay, thyroid stimulating antibody (TSAb), assayed by stimulation of adenylate cyclase‐cAMP system in human thyroid plasma membranes, and LATS, measured by McKenzie's mouse bioassay. TBII was detected in twenty‐one of forty‐nine (42·9%), TSAb in thirty‐five of forty‐nine (714%) and LATS in nineteen of forty‐nine (38·8%). TBII was also present in four of sixteen (25%) patients with other thyroid autoimmune disorders. When the results obtained with the different techniques were compared, correlation was found between LATS response and TSAb activity (r = 0·53,P<0·001), while there was no correlation between TSAb and TBII activities and between LATS response and TBII activity. These data confirm that TSAb is a specific and sensitive marker of Graves' disease and suggest that TBII activity is not necessarily synonymous with thyroid stimulation, and could reflect a different phenom

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1981.tb00652.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY