摘要:

SUMMARYThyroid volume was measured by ultrasonography in 50 healthy adults (25 males, 25 females, age 20‐70 years) living in the non‐iodine deficient area of Amsterdam. Thyroid volume was 10‐7 ± 4–6 ml (mean ± SD, range 2.7‐20.4 ml). No relation was found between thyroid volume and any of the following parameters: plasma TSH, T4, T3, thyroglobulin (Tg), urinary iodine excretion, tobacco and alcohol consumption. Thyroid volume in males (12.7 ± 4.4 ml) was greater than in females (8.7 ± 3.9 ml,p =0.0014), but no sex difference was observed in the ratio of thyroid volume to body weight (males, 0.16 ± 005 ml/ kg; females 013 ± 0.06 ml/kg; NS). Thyroid volume was positively related to body weight, but not to age. We conclude that the sex difference in thyroid volume is due to the difference in body weight between males and females. Lean body mass is presumably the most important physiological determinant of thyroid size in subjects living in a non‐iodi

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb00784.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYThe relation between circulating 1,25‐dihydroxyvitamin D (l,25(OH)2D) levels and intestinal calcium absorption–as determined by an oral calcium load test–was studied in 16 patients with hypercalcaemia of malignancy (HM) and 16 with hypercalcaemic primary parathyroidism (HPT). In the HPT group serum calcium rose significantly after the oral calcium load and the increment correlated significantly with 1,25(OH)2D levels. While 1,25(OH)2D levels were raised to within the hyperparathyroid range in a number of HM patients, there was no correlation between change in serum calcium and 1,25(OH)2D level in the HM group and serum calcium did not rise significantly after the oral calcium load. HM patients with detectable or raised 1,25(OH)2D levels typically had few, or no, bone metastases in association with squamous lung cancers. A high proportion of these patients exhibited other aspects of hyperparathyroid‐like activity such as increased renal tubular calcium reabsorption, depressed renal tubular phosphate reabsorption and elevated urinary cyclic AMP excretion. Conversely, HM patients with undetectable 1,25(OH)2D levels typically had extensive metastatic bone disease in association with breast carcinoma and were less likely to exhibit other hyperparathyroid‐like features. It is postulated that in the former, the ‘inappropriately’ detectable or raised 1,25(OH)2D levels may have been due to enhanced renal la‐hydroxylase activity stimulated by the parathyroid hormone (PTH)‐like effect of a non‐PTH ectopic humoral mediator. In the latter the suppressed 1,25(OH)2D levels would be the predicted result of a non humorally mediated hypercalcaemia. It is currently unclear why intestinal calcium absorption was depressed in all HM patients when 1,25(OH)2D levels were normal or raised in some cases. It is possible, however, that in HM there is ‘end organ’ resistance to the effects of 1,25(OH)zD due to a generalize

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb00785.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYLH pulse secretion changes during the menstrual cycle from a rapid regular pattern in the follicular phase to a slower and irregular pattern in the luteal phase. To determine whether the irregular LH pulse pattern in the luteal phase reflects altered GnRH secretion or altered pituitary responsiveness to GnRH, we gave low dose GnRH pulses (25 ng/kg i.v.) every 2 h or every hour for 10 or 12 d to three women with isolated GnRH deficiency. After 4 d of GnRH alone, oestradiol (E2) was given and after 6 d progesterone (P) was added to mimic the hormonal milieu of the luteal phase. LH and FSH were measured every 4 h throughout and also every 20 min for 6 or 12 h, before and after GnRH alone (day 0 and day 4), after E2(day 6), and after E2+ P (day 10 and day 12). Both GnRH pulse frequencies resulted in a rapid increase in plasma FSH to peaks on day 4 (every 2 h) and day 2 and 3 (every hour). FSH concentrations then declined as plasma E2rose to 50–80 pg/ml reflecting the selective inhibitory effect of E2on FSH release. Plasma LH was also increased after the hourly GnRH injections and this regimen was associated with a more rapid rise in E2reflecting follicular maturation. In contrast to the differences in mean hormone concentrations, administration of GnRH at both frequencies resulted in sustained one‐on‐one responsiveness of LH that was maintained in the presence of both oestrogen and progesterone at mid‐luteal phase concentrations. We conclude that the slow frequency of LH pulses observed during the luteal phase reflects decreased GnRH pulse frequency rather than impaired pituitary responsiveness

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb00786.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYEnolase isozymes (α enolase and γ enolase) in the extracts of adrenal tumours (phaeochromocytoma, adenoma of primary aldosteronism and Cushing's syndrome, and neurinoma) were determined by means of enzyme immunoassay systems. The mean ± SEM, respectively, of α and γ enolase levels were 2.5 ± 0.37 μg/mg protein and 3‐2 ± 0–69 μg/mg protein for 9 phaeochromocytomas, 15.2 + 3.1 μg/mg protein and 0.65 ± 0.18 μg/mg protein for three adenomas with primary aldosteronism, 10.8 ± 3.0 μg/mg protein and 0.23 ± 0.02 μg/mg protein for five adenomas causing Cushing's syndrome, and 3.8 ± 0.88 μg/mg protein and 0.30 ± 0.15 μg/mg protein for three neurinomas. Thus, the γ enolase concentration in the extract of phaeochromocytoma was higher than that of other adrenal tumours. The serum level of γ enolase was determined in 36 patients with adrenal tumours and 26 normal controls by radioimmunoassay. The mean + SEM of γ enolase level was 5.4 ± 0.3 ng/ml in normal controls, 91 ± 0.9 ng/ml for 10 patients with phaeochromocytoma, 6.3 ± 0.3 ng/ml for 11 with primary aldosteronism, 5.5 ± 0.4 ng/ml for 11 with Cushing's syndrome, and 5.1 ± 0.7 ng/ml for four with neurinoma. Thus, patients with phaeochromocytoma had a significantly higher serum γ enolase levels than did those with tumours derived from adrenal cortex and normal controls. In patients with phaeochromocytoma, serum γ enolase levels showed a significant positive correlation with urinary adrenaline levels (P<0.05), and after resection the elevated level of γ enolase fell significantly (P<0.05) and returned to normal. These results indicate that γ enolase in serum may be a useful marker for the differential diagnosis of adrenal tumours and therapeu

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb00787.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYA patient with thyrotoxic Graves' disease had an apparent measurable level of serum TSH (2–5 μU/ml) by double‐antibody radioimmunoassay (RIA). The serum IgG bound with both [125I]human(h)TSH and [125I]bovine(b)TSH. The [125I]hTSH binding was more effectively displaced by human than bovine TSH, whereas [125I]bTSH binding was displaced exclusively by bTSH. Scatchard analyses revealed that [125I]hTSH binding showed two components, whereas [125I]bTSH binding had only one component. Serum TSH determined by RIA became undetectable 21 months after antithyroid drug treatment with a parallel decrease of [125I]hTSH binding IgG activity. Four thyrotrophin binding inhibitory immunoglobulins (TBII) from other patients did not interfere with the binding of the patient's serum to [125I]h‐ or bTSH. Furthermore, the in‐vitro thyroid stimulating activities of three thyroid stimulating antibodies (TSAb) were not affected by the addition of this patient's IgG. On the other hand, this patient's Ig (3 mg/ml) abolished the in‐vitro thyroid stimulation by bTSH (100 /μU/ml), but did not affect that by hTSH (100 /μU/ml). The anti‐hTSH antibody, TSH receptor antibody and anti‐bTSH antibody in the serum, which contains TSAb as well as anti‐TSH antibodies, could be partially purified by hTSH‐agarose and subsequently by guinea pig fat cell membrane affinity absorptions. However, the anti‐hTSH antibody fraction obtained had both hTSH binding activity and thyroid stimulating activity, and this fraction did not show any inhibitory effect on the in‐vitro thyroid stimulation of autologous TSH receptor antibody or hTSH. The possible significance of anti‐T

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb00788.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYCV 205–502, an octahydrobenzo(g)quinoline, is a new non‐ergot long‐acting prolactin inhibitor. The substance was given to 24 hyperprolactinaemic women for 7 d. The women were randomized to one of three dose regimens, 0.01 mg, 0.03 mg or 0.06 mg daily. Two patients in each group were given placebo. Frequent blood samples were obtained during days 1, 7 and 8. The prolactin levels in serum were depressed dose‐dependently in all patients given active substance. In group 1 (0.01 mg) the dose was insufficient to induce normal serum prolactin levels except in one woman, while two women in group 2 (0.03 mg) and four in group 3 (0.06 mg) became normoprolactinaemic. The depressant effect on prolactin secretion lasted for 24 h in group 2 and 3. Side‐effects were mild and transient. No change in blood pressure was observed. CV 205–502 was an effective and long‐acting drug for treatment of patients with hyperprolactinaemia in this short‐term study and this new drug deserves investigation of its usefulness in long

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb00789.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYSeventy‐six healthy, early postmenopausal women (aged 45–54 years) were allocated to 2 years of treatment with a cyclic combination of 2 mg oestradiol valerate (21 d) and 1 mg cyproterone acetate (11 d) or placebo. Sixty‐five women (86%) completed the study. In the placebo group the bone mineral content in the forearms (measured by single photon absorptiometry) and the bone mineral content in the lumbar spine and total skeleton (measured by dual photon absorptiometry) decreased significantly and at the same magnitude (P<0001), whereas all bone mass measurements remained unchanged in the hormone‐treated group. In the hormone‐treated group there was a significant decrease in biochemical estimates of bone turnover (serum alkaline phosphatase, serum phosphate, fasting urinary calcium and hydroxyproline), whereas these values were unchanged in the placebo treated group. We conclude that treatment with a cyclic combination of 2 mg oestradiol valerate and 1 mg cyproterone acetate is effective as prophylaxis of postmenopausal

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb00790.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYThe IgG subclass distribution of autoantibodies to thyroglobulin and thyroid microsomal antigen was studied in 21 patients with Graves' disease during fluctuations in total IgG class autoantibody levels induced by various forms of therapy. In addition, changes in autoantibody subclass distributions were investigated during the natural course of Hashimoto's disease in seven patients taking thyroxine. The autoantibodies were principally of subclasses IgGl and/or IgG4 in Graves' patients although IgG2 contributed significantly to thyroglobulin antibodies in 5/7 Hashimoto sera. In Graves' disease the distribution of microsomal and thyroglobulin antibodies among the IgG subclasses remained essentially unchanged over periods of 6 months‐2 years whether autoantibody levels decreased during carbimazole therapy or increased transiently following13lIodine treatment or subtotal thyroidectomy. Similar observations were made for thyroglobulin antibodies in Hashimoto patients studied over 2½‐4 years; furthermore, the IgG subclass distribution of microsomal antibodies was usually different from that of thyroglobulin antibodies in the same patient. These observations suggest that the microsomal and/or thyroglobulin antibody subclass distribution is characteristic for a particular individual and may be regarded as the ‘fingerprint’ of an individual's response to these thyroid auto

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb00791.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYThe plasma arginine vasopressin (AVP) response to insulin‐induced hypoglycaemia was investigated in 27 children with short stature. None had diabetes insipidus. Six patients were excluded from further analysis because of hypothalamo‐pituitary dysfunction. Of the remainder, 14 were prepubertal (Tanner 1) and seven were pubertal (Tanner 2–4). Both groups had similar height velocity retardation. There was a significant rise of AVP of 3.4±1.3 pmol/1 at 30 min in the pubertal group (P<0.05) but no significant change in prepubertal patients. There was a significant relationship between chronological age and AVP response 30 min after insulin (r= 0.45,P<0.05) and a closer correlation between bone age and AVP response (r= 0.62,P<0.01). The data suggest that insulin‐induced hypoglycaemia does not reliably stimulate AVP secretion in children and that this response is related to age and pubert

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb00792.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYCholinergic receptor blockade has been shown to abolish GH secretion in a variety of physiological and pharmacological situations in normal subjects. We have investigated the effect of pirenzepine on nocturnal GH secretion in young adult patients with Type I insulin‐dependent diabetes mellitus. Five patients (three male, two female; aged 20‐27 years) were studied in a randomized order on two days separated by at least 1 week. All patients showed episodes of slow wave sleep on each occasion and this was followed by peaks of GH release when placebo alone was administered (range of GH peaks 6–115 mU/1). In contrast, cholinergic muscarinic receptor blockade with pirenzepine (100 mg orally at 2200 and 2400 h) completely abolished nocturnal GH release in each individual without altering the occurrence of slow wave sleep itself. Mean plasma glucose levels at each sampling time between each study did not differ significantly. The ability to abolish nocturnal GH secretion may be important in the field of diabetes, since excess GH secretion is implicated in several acute metabolic and chronic microvascular complications of the di

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb00793.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY