摘要:

Prolactin secretion has been evaluated in seven male and six female patients with isolated gonadotrophin deficiency (IGD). The subjects were challenged with the dopaminergic antagonist, metoclopramide (10 mg) and TRH (200 μg) before, during and after cessation of hormonal treatment. Five females received three consecutive 21‐day courses of ethinyl oestradiol (0·1 mg daily) at monthly intervals and the remaining subject conjugated oestrogens (Premarin 0·625 mg daily) according to a similar protocol. Treatment of the males with hCG (pregnyl) 5000 iu twice weekly led to a rise in oestradiol and testosterone levels. Two males were receiving pergonal (human menopausal gonadotrophin) in addition. In the untreated state in both males and females, basal oestradiol and PRL levels were decreased as were the PRL responses to metoclopramide and TRH as compared with normal controls. During treatment in both groups, there was an increase in basal PRL levels as well as PRL response to the two stimuli, which became indistinguishable from the controls. Cessation of treatment was associated with a rapid decrease in basal PRL levels and PRL elevation following metoclopramide and TRH. In contrast to the effect of hCG, the administration of two non‐aromatizable androgens (mesterolone and fluoxymesterone) had no effect on basal and TRH‐induced PRL secretion. The administration of clomiphene citrate during hCG treatment in one male IGD patient produced a decrease in the basal and stimulated PRL response.It is concluded that the low basal PRL levels and impaired PRL responses to stimulation are not an inherent component of the syndrome of IGD, but a consequence of the abnormal steroi

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb02756.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Patients with Cushing's syndrome may be discriminated from normal subjects on the basis of their respective neutral urinary steroid profile. In the former group, evidence is presented that lowered levels of T3 secondary to hypercortisolism, decrease the liver enzymes associated with 5α‐ reductase and 11β‐hydroxy steroid dehydrogenase activity. As a result the metabolism of cortisol and androstenedione in Cushing's syndrome yields an unique pattern dominated by 5β and 11β‐hydroxy steroid me

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb02757.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The relationship between the sympathetic nervous system and cardiovascular responses has been studied indirectly in ten hyperthyroid patients and age matched euthyroid controls. Nyctohemeral variations in heart rate, and heart rate and blood pressure responses to exercise were measured before and during β‐blockade with slow‐release propranolol. Both groups showed a parallel variation in heart rate over 24 h, with an increase in heart rate in the hyperthyroid group that was the same during the day (27·9 ± 0·95 beats/min) and during the night (26·7 ± 0·75 beats/min). Similarly, the increase in resting heart rate (32·7 ± 4·4 beats/min) in the hyperthyroid group was close to the increase in peak exercise‐induced heart rate (25·0 ± 4·7 beats/min). Adequate β‐blockade was achieved in all subjects as evidenced by a percentage reduction in peak exercise heart rate of 25–45%. Propranolol caused a greater reduction in daytime than night‐time heart rate in both groups and blunted the response to exercise. Following β‐3‐blockade, the mean percentage reduction in heart rate and systolic blood pressure during exercise, and heart rate responses over 24 h were similar in hyperthyroid and euthyroid groups. The closest correlation between thyroid hormone levels and heart rate was that of serum total tri‐iodothyronine (T3) and nocturnal heart rate during β‐bockade (r = 0.92;P<0·001). It is concluded that excess circulating thyroid hormones exert a direct effect on the cardiovascular system additive to the sympathetic nervous system and that there is no evidence of adrenergic

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb02758.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Plasma renin activity was measured in thirty‐one subjects with Type 1 diabetes and proliferative retinopathy, and in seventeen matched diabetic subjects without evidence of any complications of their disease. The two groups were comparable for age, sex, smoking habits and duration of diabetes. Systolic and diastolic blood pressures were significantly higher in the patients with retinopathy (P<0·025 andP= 0·05 respectively) and HbA1 was greater (P<0·005) than in the patients without complications. Plasma renin activity, both lying and standing, was higher in the patients with retinopathy than in the uncomplicated group (P<0·05 for each). There were no correlations between plasma renin activity and mean blood pressure, HbA1 or fasting blood glucose. These findings raise the possibility that the renin‐angiotensin system might be implicated in the pathogenesis of diabetic microvascular

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb02759.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The response of the parathyroids to an infusion of calcium has been studied in patients with secondary hyperparathyroidism due to either vitamin D deficiency or to chronic renal failure. Two specific homologous immunoradiometric assays for human parathyroid hormone (PTH) have been used to assess the response, one specific for the amino‐terminus (N‐PTH), the other specific for the carboxy‐terminus (C‐PTH) of the molecule.In both the vitamin D deficient and the uraemic patients, in response to a 4 mg/kg/h infusion of calcium generally for 4 h, suppression of N‐PTH was similar, falling to around 20–30% of the initial value. In the uraemic subjects, the degree of suppression was inversely related to the initial plasma calcium (r= 0·9,P<0·001). Measured with the C‐PTH assay, the response was generally less, particularly in the uraemic subjects in whom it was often preceded by an initial rise in C‐PTH.In both groups of subjects, suppression of N‐PTH began as soon as the plasma calcium began to rise and before hypercalcaemia was produced. At the end of the infusion the concentration of N‐PTH rose quickly, although the plasma calcium was still high. In four uraemic subjects the rate of infusion of calcium was reduced after 1–1·5 h to limit the rise in plasma calcium. As the calcium approached a plateau, the concentration of N‐PTH was found to rise again.These results indicate the importance of using PTH assays of well defined specificity to evaluate autonomy, and show that the degree of suppression achieved is dependent both on renal function and basal plasma calcium. In addition, these observations suggest that the direction and rate of change of plasma calcium are important in the control of secret

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb02760.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Metoclopramide, a dopamine antagonist, stimulates aldosterone secretion in normal man. We studied the response of plasma aldosterone, plasma renin activity, cortisol, sodium, potassium and serum prolactin to a 10‐mg intravenous dose of metoclopramide in six dexamethasone suppressed patients with aldosteronism (four with adrenal adenoma, two with bilateral adrenal hyper‐plasia) and in six dexamethasone suppressed normal male volunteers. All subjects were studied on anad libitumsodium diet. Patients were supplemented with oral potassium prior to study.Sodium and potassium were not different between groups and did not change following metoclopramide. Cortisol was suppressed to less than 3 μg/dl throughout the study in all subjects. Basal plasma renin activity was significantly lower in the patients as compared with controls (P<0·05), and did not change in either group following metoclopramide.Basal aldosterone levels were not significantly different in patients as compared with controls, although patients did tend to have higher levels. The incremental and integrated response of aldosterone to metoclopramide in patients was significantly greater than controls (P<0·01). The percentage increase in aldosterone was greater than controls in five of the six patients.Basal prolactin was higher in the patients than in the controls. All subjects had a significant rise in prolactin to metoclopramide (P<0·05). Five of six patients had an increased response of prolactin when compared to the controls and the four female patients had a significantly greater rise in prolactin as compared to the normals (P<0·01).These data suggest that increased dopaminergic activity plays a compensatory role in inhibiting aldosterone secretion in patients with aldosteronism. It appears unlikely that a decrease of dopaminergic inhibition is involved in the pathogenesis of aldosteronism due to either adenoma or bilateral hyp

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb02761.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The antigenicity of HCG was tested in twenty‐three young healthy men receiving two different HCG preparations (A and B). Each subject received 5000 i.u. HCG intramuscularly daily for three consecutive days, followed by another course, 3 weeks later, of 5000 i.u. HCG injections daily for 3 days. Two of the fifteen subjects treated with preparation A developed HCG antibodies in response to the HCG injections.The results show that although HCG is of human origin and also occurs normally in men, it may induce antibody formation even after brief treatmen

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb02762.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The behavioural effects of exogenous testosterone in men with marginally low circulating androgen levels were investigated. Four adult men with Klinefelter's syndrome, low normal testosterone levels and normal sexual activity and interest were given testosterone undecanoate (TU 160 mg daily by mouth; Organon International) and placebo using a double blind cross‐over design. A modest increase in sexual interest was observed during TU administration compared to placebo, though there were no effects on self‐reported mood or energy, or on erectile responsiveness in the laboratory. Increase in circulating hormone levels during TU administration was more marked for DHT than for testosterone. The possible implications of this are discus

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb02763.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb02764.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb02765.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY