摘要:

SUMMARYSuperactive analogues of gonadotrophin releasing hormone and testosterone, when administered together, synergistically inhibit gonadotrophin secretion and spermatogenesis in the rat. In order to determine whether testosterone also enhanced gonadotrophin suppression by GnRH agonist in the human male, two groups of four normal male volunteers first received either 10 or 100 μg of a GnRH agonist D(Nal2)6GnRH (GnRH‐A) daily for 10 d. After at least a 50 d recovery period, the same subjects received a single injection of 200 mg of testosterone oenanthate (TE) on day 1 in addition to the same dose of GnRH‐A daily for 10 d. Serum LH, FSH and testosterone (TS) concentrations were measured dailyjust prior to the next analogue dose, and on days 1 and 10 at 0, 1, 2, 4, 6, 8, 12, 16 and 24 h after the analogue injection.Daily administration of both 10 and 100 μg of GnRH‐A alone resulted in an early phase of stimulation followed by progressive decline in LH, FSH and testosterone to levels below baseline by day 10 despite continued administration of GnRH‐A. Addition of testosterone to 10 μg of GnRH‐A resulted in hormonal responses identical to those seen with GnRH‐A alone. Combined treatment of testosterone with 100 μg of GnRH‐A did not blunt the peak LH and FSH responses on day 2, but resulted in significantly lower LH (mean integrated responses: 187 ± 30 vs. 234 ± 42 mIU‐d/ml) and FSH (mean integrated responses: 20·6 ± 3·3 vs. 32·8 ± 4·2 mIU‐d/ml) responses from days 3 to 11. By day 11, all subjects receiving combined treatment (GnRH‐A 100 μg+testosterone oenanthate) had undetectable serum FSH levels. In contrast, serum FSH concentrations on day 11 after treatment with GnRH‐A alone were 43·6 ± 8·9% of control and none of the subjects had values below the limit of detection. Serum testosterone levels in the combined treatment group did not fall below baseline by day 10 in either the 10 (161·4 ± 48%) or the 100 μg GnRH‐A groups (104·6 ± 11·2%), while in the group receiving GnRH‐A alone, testosterone levels declined to 45·6 ± 8·3% and 80±18·8% with the 10 and 100 μg dose respectively.We conclude that addition of a suppressive dose of testosterone to an appropriate dose of GnRN‐A significantly enhances gonadotrophin suppression by GnRH‐A in the human male. Combined use of testosterone and GnRH‐A might be of importance in the development of a male contraceptive to achieve the desired suppre

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00066.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYThe effect of dydrogesterone, a retro‐progesterone on the spontaneous mid‐cycle surge of gonadotrophin in regularly cycling women, was investigated. Blood samples were collected through two complete cycles in six subjects. The first untreated cycle acted as a control for the second cycle during which dydrogesterone (10 mg twice daily) was administered. The start of treatment ranged from day 1 (one subject), mid follicular phase (three subjects) to post‐ovulation (two subjects). In all subjects where dydrogesterone was given before ovulation, the mid‐cycle gonadotrophin surge was either abolished or markedly diminished. Despite this follicular growth occurred in all four subjects and subsequently luteinisation was observed in three. Dydrogesterone given after ovulation did not produce any alteration in endocrine profiles but menses was postponed in both subjects.Thus dydrogesterone can mimic the known blocking actions of progesterone on the mid‐cycle gonadotrophin surge and can support a secretory fehdometrium for a limited period in the absence of endogenous pro

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00067.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYThe role of serotonin in the prolactin, growth hormone, ACTH and cortisol responses to hypoglycaemia has been investigated in normal subjects using a selective serotonin (5HT2) receptor antagonist, ketanserin. Circulating concentrations of these hormones were measured after administration of insulin (0·1 units/kg body weight iv) to eight normal male subjects with and without simultaneous iv ketanserin (10 mg). Plasma glucose fell to less than 2·0 mmol/l in all subjects and was unaffected by ketanserin. Ketanserin induced a 50% decrease in the serum prolactin response to hypoglycaemia, 45 and 60 min after administration of insulin (increase in serum prolactin at 60 min: 1145 ± 295 mU/l without ketanserin; 558 ± 176 mU/l with ketanserin,P<0·05). The peak ACTH response was reduced by 30% (95·3 ± 33·6 ng/l without ketanserin; 60·0 ± 22·9 ng/l with ketanserin,P<0‐05) but the plasma cortisol response was not significantly altered. The serum growth hormone response was unaffected by serotonin blockade. These findings suggest that serotonin, probably acting through 5HT2receptors, is involved in the stimulation of prolactin and ACTH release but not in the release of growth hormone, during insulin induced h

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00068.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYThe presence of anti‐TSH receptor antibodies in the sera of 32 patients with untreated GRAVES' disease, 21 patients with euthyroid autonomous multinodular goitre, nine patients with Hashimoto's disease and 22 normal controls, was investigated by means of a direct and quantitative immunoprecipitation assay (IPA). A comparison was made between the IPA anti‐TSH receptor antibody titres, the thyrotrophin‐binding inhibitor immunoglobulins (TBII) index determined by radio‐receptor assay and the presence of circulating immune complexes (CIC); no correlation was found. Twenty‐six (81%) of the 32 untreated patients with GRAVES' disease were IPA‐positive; 16 (50%) had a positive TBII index. None of the patients with euthyroid autonomous multinodular goitre and none of the normal controls were IPA‐positive and their TBII index was normal in all cases. Of the nine patients with Hashimoto's disease seven were IPA‐positive and three had a positive TBII index. Of ten patients with GRAVES' disease still in remission none was IPA‐positive and their TBII index was normal. Of 18 patients who relapsed after treatment, 13 were IPA‐positive and only five had a positive TBII index. In seven patients with GRAVES' disease studied serially, anti‐TSH receptor antibodies remained present in the sera of four, although the TBII indices normalized. For the five patients who relapsed, a rise in the anti‐TSH receptor antibody titre at the time of the relapse was observed. It is concluded that not all anti‐TSH receptor antibodies cause TSH‐binding inhibition in the radio‐receptor assay, and further evidence has been obtained that anti‐TSH receptor antibodies are the cause of the hyperfunctioning of the t

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00069.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYIn 63 consecutive patients with primary hyperparathyroidism (HPT) a prospective screening study was undertaken for coexistent multiple endocrine neoplasma‐(MEN)‐syndrome type 1. The screening consisted of a clinical examination, a radiological examination of the sella turcica with skeletal tomography (and in equivocal cases computed tomography), visual field examination by perimetry and a hormonal evaluation including measurements of the serum levels of prolactin, gastrin, pancreatic polypeptide (PP) and subunits of human chorionic gonadotrophin (HCG‐α and β). Clinical examination did not reveal any signs of endocrine disease suggestive of a MEN‐1 syndrome. In only one case there was a radiological abnormality of the sella turcica; this patient had an empty sella syndrome and a raised serum prolactin value. All other prolactin values were within the normal range. In 41% of the patients raised serum gastrin levels were found; these tended to normalize after parathyroidectomy. As a group, patients with raised gastrin values were older than the others and generally they had hypo‐ or achlorhydria. The serum PP levels were raised in 28% of the patients but there was no clinical evidence of a pancreatic tumour in any of these cases, and the serum HCG‐α and β levels were within the normal range in all patients but two. We conclude that the incidence of MEN‐1 syndrome in unselected patients with primary HPT must be low, and that investigations for this syndrome are justified only in HPT patients with specific symptoms or with a positi

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00070.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYPituitary responsiveness to gonadotrophin‐releasing (LHRH) and thyrotrophin‐releasing (TRH) hormones was studied in 19 epileptic patients receiving long‐term carbamazepine or phenytoin therapy and 14 normal control subjects. Baseline prolactin levels were normal in the patients; 2 h after LHRH‐TRH the prolactin levels in women on carbamazepine were significantly higher than in the controls, but apart from this, no other differences were found. Baseline LH levels were raised in male patients and the response to LHRH‐TRH was exaggerated in all patients on carbamazepine. FSH levels were normal throughout. The exaggerated LH response is consistent with primary hypogonadism caused by enhanced sex hormone metabolism, secondary to hepatic enzyme induction by the antiepilep

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00071.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYPlasma β‐endorphin‐like immunoreactivity was studied in 43 pregnant women at 36 weeks gestation and in 23 of these at delivery and 24 h post‐partum; an attempt made to correlate changes with various social, psychological and obstetric factors, including the ‘post‐natal blues’. β‐endorphin levels were elevated at 36 weeks gestation and term, increased to very high levels during labour and fell rapidly within 1 h of delivery. A negative correlation was observed between the woman's estimate of her pain in labour and the β‐endorphin levels post‐partum, suggesting an analgesic role for β‐endorphin in labour. A positive correlation was also observed between the levels of β‐endorphin at delivery and the woman's attitude to her pregnancy at 36 weeks and a negative correlation between the ‘post‐natal blues score’ and the β‐endorphin level at 36 weeks. However, the ‘blues’ did not correlate either with the β‐endorphin level at delivery or 24 h post‐partum nor with its rate of fall in the first 24 h. Our general finding that there was no consistent social, psychological or obstetric factor which predisposes women to develop ‘post‐natal blues’ still supports the hypothesis that humoral factors, of which β‐endorphin may be one, rather than psychological

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00072.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYPlasma somatomedin activity was measured in 12 patients who had sustained non‐fatal musculo‐skeletal injuries. It was depressed for 2‐3 d after injury, but this depression bore no relationship to the catabolic response to injury which, as judged by urinary nitrogen excretion, was maximal at about one week. The depression of somatomedin activity may have been related to the high plasma cortisol concentrations observed during the first few days after injury. Plasma growth hormone concentrations were high acutely after injury but rapidly returned to normal. The changes in plasma somatomedin activity were thus unrelated to those in growth hormone, but were very similar to those in plasma insulin concentrations. A marked positive relationship was observed between plasma insulin concentrations and urinary nitrogen excretion, indicating unresponsiveness of protein metabolism to the normal anabolic effects of insulin. The study showed, however, that this was not as a result of low somatomedin act

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00073.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYWe have evaluated thirty patients with malignant metastatic phaeochromocytoma with regard to clinical features, indices of catecholamine secretion, histology of lesions and a number of imaging procedures including scintigraphy with the recently developed sympathetic tissue‐seeking radiopharmaceutical131I‐metaiodobenzylguanidine (131I‐MIBG). The primary tumour was extraadrenal in 13 cases. The commonest site of metastases was the axial skeleton (20 cases), followed by liver (four cases), lymph nodes (four cases), peritoneum (two cases) and lung (three cases). The malignancies were indolent, the mean time following the initial diagnosis was 9·18 years (range 0 to 33 years) and the mean duration of known metastases 3·71 years (range 0 to 18 years). There was a wide range of abnormalities in plasma and urinary catecholamines which did not correlate with the extent of tumour spread, histological pattern (mitotic index, Zellballen pattern, capsular or vascular invasion pleomorphism or necrosis) or131I‐MIBG uptake by tumour deposits.131I‐MIBG scintigraphy was found to be a useful technique for determining the extent of metastatic disease in most cases (26 of 30) and in some patients (16 of 30) was more sensitive than other radiological procedures. No false positive scans were

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00074.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SUMMARYThe activity of 17β‐hydroxysteroid dehydrogenase and aromatase was studied in adipose tissue taken from women aged between 22 and 83 years with benign or malignant breast lesions. The benign and malignant groups showed no significant differences in the mean activities of either of the enzymes studied. Under the experimental conditions used, the rate of conversion of oestrone to oestradiol varied markedly between subjects (6‐169 ng oestradiol/mg protein/h), and there was a positive correlation between oestrone reduction and the total body weight of the tissue donor. In contrast, although the apparent Kmfor oestradiol (0·1–2·6 μmol/1) was lower than that for oestrone (9–14 μmol/1) the maximum velocity for oestrone production was very low (10–50 pmol/mg protein/h), and there was no obvious correlation with the age or body weight of the tissue donor. Aromatase activity in breast fat was at the lower end of the normal range of activity previously reported for abdominal adipose tissue, and there was no correlation between oestrone production and age

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1984.tb00075.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY