摘要:

SUMMARYTesticular function was studied in ten men, aged between 17 and 36 years, who had received irradiation for a nephroblastoma during childhood. The dose of scattered irradiation to the testes ranged from 268 to 983 rad. Eight subjects had either oligo‐ or azoospermia (0 to 5.6 million/ml), seven of whom had an elevated serum follicle‐stimulating hormone (FSH) level. One subject showed evidence of Leydig cell dysfunction with a raised serum luteinizing hormone level (LH) and a low plasma testosterone concentration.A second group of eight prepubertal males, aged between 8 and 14 years, were studied. These had also been irradiated for abdominal malignancies during childhood and received a similar dose of irradiation to the testis as the first group studied. The plasma testosterone levels were within the normal range for prepubertal boys in all eight. The mean gonadotrophin levels were not significantly different from the mean levels of normal prepubertal males. Thus irradiation‐induced damage to the germinal epithelium in prepubertal boys produces raised FSH levels after puberty but not before it.We conclude, therefore, that inhibin has a minor role in the control of the prepubertal hypothalamic‐pituitary testicular axis and its contribution to gonadal control of gonadotrophin secretion changes with sexual mat

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01505.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYEleven women with secondary amenorrhoea and hyperprolactinaemia were treated with lisuride, a new semisynthetic ergot derivative.Acute administration of lisuride (100 μg orally) significantly suppressed serum prolactin (PRL) levels in nine out of eleven subjects. In these nine patients, prolonged treatment with lisuride (50–200 μg daily) lowered PRL levels into the normal range, menstrual cycles were resumed and eight patients ovulated.Two patients, in whom lisuride failed to lower PRL levels into the normal range, did not resume normal menstruation.These data demonstrate that lisuride may be used clinically to lower PRL levels and to restore cyclic gonadotrophin secretion and ovulation in amenorrhoeic patients with hyperprolactinae

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01506.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYSulpiride, a dopamine receptor blocker which raises prolactin, was given to six women with idiopathic amenorrhoea for 10 days and to eleven women with regular cycles for 3 to 6 months. The latter group developed galactorrhoea and amenorrhoea during treatment. Basal LH and FSH concentrations showed no significant changes. At 3 months but not at 10 days (amenorrhoea group) or 6 months (regular menses group) the area‐under‐the‐curve of LH response to LHRH was increased. FSH responses to LHRH was not altered. The significance of these results to the hyper‐prolactinaemia‐amenorrhoea syndromes are

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01507.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYFifty cases of bilateral non‐toxic goitre, largely unselected, have been studied using fine needle aspiration cytology (without local anaesthesia); four techniques of thyroid antibody tests; serum thyroid biochemistry (including radioimmunoassay of TSH) and clinical evaluation. Autoimmune thyroiditis was found cytologically in 64%; simple colloid goitre in 24%; subacute thyroiditis of de Quervain in 10%. Aspiration cytology was the most sensitive means of detecting autoimmune thyroiditis and subacute thyroiditis. Two antibodies directed against the intra‐cellular cyto‐plasmic antigen‐the complement fixation test and an immunofluorescent antibody were of lesser value in detecting autoimmune thyroiditis (80% positivity) though equal to each other. Serum TSH was of some value‐being elevated in 63% of cases of autoimmune thyroiditis and in no cases of simple colloid goitre. Two major cytological subtypes of autoimmune thyroiditis have been described‐with significant differences in duration of goitre, mode of presentation, frequency of hypo‐thyroidism, and response to thyroxine therapy. The high frequency of autoimmune thyroiditis in this series suggests that endemic goitre is unlikely in West

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01508.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYThe effect of somatostatin on the insulin response to an acute intravenous glucose load was studied in five normal subjects before and after induction of hypercalcaemia. In the normocalcaemic state, the insulin response to glucose was depressed by somatostatin. In the hypercalcaemic state, insulin responses to glucose in the presence of somatostatin, were partially restored and appeared to be related to the level of increment of serum ionized calcium. It is concluded that, in the human being, hypercalcaemia and somatostatin have opposite actions on glucose‐stimulated insulin secretio

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01509.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYThe present study was undertaken to evaluate long‐term effects of spironolactone on basal serum oestrone, oestradiol, testosterone, LH and prolactin concentrations in hypertensive male patients. Serum prolactin response to TRH was also evaluated. Patients were divided into two groups: a conventional‐dosage group, consisting of six males with essential hypertension who took 75 to 150 mg of spironolactone daily for 12 weeks, and a high‐dosage group, consisting of two males with idiopathic hyperaldosteronism who took 300 mg of spironolactone daily for more than 40 weeks.In the conventional‐dosage group, serum oestrone concentrations significantly increased (P>0.01) at 12 weeks, serum oestradiol concentrations gradually increased throughout the study period, however, the increments were not statistically significant (P>0.2). Basal serum testosterone, LH and prolactin concentrations were not significantly changed throughout the study period. Enhancement of serum prolactin response to TRH was not found in any of the patients in the conventional‐dosage group.In the high‐dosage group, serum oestrone maintained high levels from the beginning of this study, and serum oestradiol concentrations increased with the development of gynaecomastia. Serum testosterone, LH and prolactin concentrations did not show any definite change throughout the study period.Thus, long‐term spironolactone treatment increased the serum levels of oestrone and oestradiol in hypertensive men followed by the development of gynaecomastia. The elevations in circulating oestrogens could well explain the oestrogenic side‐effects of spironola

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01510.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYSeven hypothyroid women (six postmenopausal and one premenopausal) were treated with 200 or 300 μg of levo‐T4 daily in order to suppress the secretion of TSH and its alpha and beta subunits. After such therapy, serum TSH and beta subunit of TSH (TSH‐β) levels were usually not detectable. Serum alpha decreased from a mean value of 4.5 ± 0.8 ng/ml to 2.8 ± 0.4 ng/ml (P>0.01). Serum LH and FSH levels were unchanged. Oestrogen administration (20 mg diethylstilboestrol daily for 3 or 5 days) to these patients further decreased mean serum alpha to 1.9 ± 0.2 ng/ml (P>0.005). In addition serum LH, FSH, and the beta subunits of LH and FSH decreased with oestrogen treatment. In separate experiments glucocorticoids (dexamethasone 4 mg every 6 hours for 10 doses) were administered to eight normal individuals, four women with decreased thyroid reserve, and one hyper‐thyroid woman. Not only did basal and TRH‐stimulated TSH secretion decrease, but secretion of alpha and TSH‐β also decreased after dexamethasone administration, with the largest fall in the patients with decreased thyroid reserve. The change in these thirteen patients’ alpha subunit increment after TRH administration was from a mean of 1.6 to 1.0 ng/ml with glucocorticoids; the change in TSH‐β was from a mean of 1.1 to 0.7 ng/ml. Serum LH and FSH concentrations were not altered by glucocorticoid administration. These studies have demonstrated two different pools of alpha subunits in the pituitary gland. Thyroid hormone and glucocorticoids decreased secretion of alpha subunits arising from the thyrotroph; oestrogen decreased secretion of alpha subunits arising

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01511.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYThe relationship between mid‐luteal plasma levels of progesterone and prolactin was studied in 75 women with regular menstrual cycles. Eighteen women had normal prolactin (mean 260 ± 51.7 mU/l) and normal progesterone levels (mean 67 ± 21.3 nmol/l). Thirty‐nine women had elevated prolactin levels (mean 850 ± 503 mU/l); progesterone levels were normal in all cases (mean 61 ± 22.3nmol/l). Eighteen women had evidence of luteal deficiency (mean progesterone 15.3 ± 7.7 nmol/l); prolactin levels were normal in all cases (mean 243 106 mU/l). There was no correlation between plasma prolactin and progesteron

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01512.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYRegular measurement of thyroidal radioiodine uptake has been widely used as a means of monitoring continued extrapituitary stimulation of the thyroid during the treatment of thyrotoxicosis with carbimazole and triiodothyronine (T3). However, it is unclear to what extent the serum T3 level may vary at the time of testing, nor what effect this might have on the uptake of radioiodine. Two studies have been undertaken. In the first, serum T3 levels in twenty‐four thyrotoxic patients were measured at intervals during an 18‐month course of carbimazole combined with T3, 20 μg qid. Considerable variations in the highest and lowest levels of serum T3 were found both between and within individuals. The second study was on twenty‐three thyrotoxic patients thought to be entering remission because the iodine uptake after 5 months of drug treatment had fallen to less than 50% of the pretreatment value (suppressors). The changes in uptake of radioiodine after 5 and then 6 months of treatment were compared in seven patients, who received carbimazole and T3 throughout, with the corresponding changes in the remaining sixteen patients, whose T3 alone was withdrawn prior to the uptake test at month 6. The mean degree of suppression remained unchanged by month 6 in the first group. In the second group, however, the mean uptake rose significantly, and nine of the sixteen patients would have been classified as non‐suppressors at the sixth month (i.e. uptake greater than 50% the pretreatment value) had their failure to maintain high serum levels of T3 gone undetected. The first study indicated this could well happen in routine circumstances, and it is suggested that the reliability of suppression tests be checked with simultaneous measurement of

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01513.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYIn order to determine the effect of dihydrotestosterone on the feed‐back mechanism of the hypothalamo‐pituitary testis axis, seven men were subjected to LH‐RH tests before and after treatment with dihydrotestosterone.Our results clearly show that DHT at least in pharmacological doses, inhibits directly basal LH‐RH and gonadotrophin secretion, without affecting the pulsatile gonadotrophin release or impairing the pituitary response to LH‐RH. The physiological significance of these observations remains however to

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01514.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY