摘要:

SUMMARYThe effects of the oral synthetic oestrogens, diethylstiboestrol and chlorotrianisene, have been studied in healthy male volunteers and in patients with prostatic carcinoma. The plasma levels of follicle stimulating hormone, luteinizing hormone and testosterone decreased significantly during treatment with diethylstilboestrol. Although plasma levels of testosterone decreased during treatment with chlorotrianisene, levels of follicle stimulating and luteinizing hormones were not significantly suppressed. This pattern of response was observed both in healthy males and in patients with prostatic carcinoma, regardless of whether chlorotrianisene was used as the primary therapy in the latter group or following therapy with diethylstilboestrol or orchidectomy. The capacity of the sex steroid binding globulin for testosterone was increased following prolonged administration of both agents. It is concluded that suppression of plasma testosterone levels observed during chlorotrianisene therapy is the result of a direct effect on the testis and that this agent may be of value in studies of gonadotrophin physiology.Although the palliative effect of treating prostatic carcinoma with synthetic oestrogens such as diethylstilboestrol (DES) and chlorotrianisene (CTA) has been known for many years, the mechanism of this action is obscure. It is generally believed that reduction of circulating androgens secondary to suppression of pituitary gonadotrophin secretion is the main effect, but it is possible such drugs have direct effects both on the testis and the carcinoma. During investigations designed to evaluate the mode of action of these two drugs, an interesting difference emerged between their effects on serum levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH). An earlier study had demonstrated that when a patient who had been previously treated with DES was given CTA, plasma levels of testosterone remained low despite rising levels of FSH and LH (Burgeret al., 1972). This paper reports the results of more detailed investigations of the effects of DES and CTA in healthy volunteers and in patients with carcinoma of the prostate.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb01715.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYThe production of ACTH, gastrin and glucagon by a pancreatic islet cell tumour is reported. The tumour contained at least two distinct cell types on electron microscopy. The fulminating hypercorticism was efficiently controlled with metyrapone and aminoglutethimide, but streptozotocin was not an effective anti‐tumour agen

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb01716.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYThe interaction between the mechanisms involved in the LH, FSH, growth hormone, prolactin, ACTH and TSH responses to the synthetic LH and FSH releasing hormone, thyrotrophin releasing hormone and insulin induced hypoglycaemia was studied in twelve normal male volunteers. Each subject acted as his own control and the test procedures were performed individually and in combination. The simultaneous administration of one releasing hormone with another or with insulin in no way modified the hormonal responses to either releasing hormone or to hypoglycaemia. Clinical testing with these procedures may therefore be performed simultaneously, so that the pituitary reserve for the five anterior pituitary hormones may be assessed together in under 2 hr. In addition it has been shown that TRH releases a small amount of FSH but not LH in male subjects.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb01717.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYThe sensitivity of the radioimmunoassay for serum TSH has been tested against a direct method for assessment of thyroid function. Fifteen healthy euthyroid volunteers received an oral dose of 80 μCi125I in order to label endogenously produced thyroid hormones. Five days later 20 μCi131I‐T4were injected intravenously to serve as an internal reference source of T4deiodination rate. The TSH response to an oral dose of 3 mg TRH given on two consecutive days was evaluated by radioimmunoassay and by determination of urinary125/131I ratios.An increase of the urinary125/131I ratio of the order of 200% (P<0.01 andP= 0.02) indicated an identical stimulation of the thyroid gland on both days. Following the first dose of TRH the serum TSH the serum TSH level rose by an average of 35% (P<0.05) whereas no change of TSH concentration could be detected on the second day of TRH administration. The findings indicate that mild TSH‐mediated stimulation of the thyroid gland may escape detection by radioimmunoassay of serum TSH concentration. Thus, the sole failure of serum TSH levels to rise by a measurable amount does not at present constitute proof for the autoregulatory nature of an observed change of thyroid fun

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb01718.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYUrinary thyroxine and triiodothyronine levels, when corrected for creatinine excretions, were significantly elevated in 5‐day‐old infants as compared with levels in normal adults and women during the third trimester of pregnancy. This was consistent with the finding that their free thyroxine index was increased and suggests that the circulating levels of free thyroid hormones are raised in early infancy. Circulating levels of thyroid‐stimulating hormone were not significantly different at 6 days as compared with adult v

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb01719.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYUsing a double antibody radioimmunoassay (RIA) for the measurement of serum triiodothyronine (T3), the present study was undertaken to define the role of this hormone in normal and abnormal thyroid states. Other tests of thyroid function performed included measurement of serum thyroid stimulating hormone (TSH, euthyroid range<0.2‐3.6 μU/ml by RIA) and free thyroxine index (FTI, 4.6‐10.0).In forty‐six normal subjects (aged 18‐40 years) serum T3ranged from 75 to 177 with a mean value of 128 ng/100 ml. This differed significantly (P<0.01) from that of the mean T3level of nine subjects taking oral contraceptives (174 ng/100 ml). The administration of 200 μg i.v. synthetic thyrotrophin releasing hormone to six normal subjects produced a significant serum T3elevation in all with a mean increase at 120 min of 56%. Serum T3values in hyperthyroidism were as follows: diffuse goitre (n= 14, mean 600 ng/100 ml, range 290‐1150); multinodular goitre (n= 8, mean 283, range 179‐440); Solitary nodule (n= 4, mean 258, range 195‐305): T3‐toxicosis (n= 2, mean 262). There was no overlap with the normal range. Twenty patients with severe primary hypothyroidism (FTI 0.2‐4.3, serum TSH 83‐1546 μU/ml) had a mean serum T3level of 42 ng/100 ml. Eighteen patients were studied following drug or radioiodine treatment of thyrotoxicosis. All were clinically euthyroid but had elevated serum TSH (6.0‐84 μU/ml). Serum T3in this group was normal (87‐185 ng/100 ml) whereas T4was low in eleven. It is concluded that serum T3measurements provide a reliable index of thyroid function, facilitate the diagnosis of T3‐toxicosis and correlate with the clinical status during and after treatment of thyrotoxicosis in a more appropriate manner than do T4measure

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb01720.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYFourteen patients whose thyroid glands had been ablated for carcinoma were given intravenous or oral thyrotrophin releasing hormone (TRH) at intervals after stopping replacement thyroid hormone. Despite continuing the TRH infusion, serum thyrotrophin (TSH) rose to reach a peak at 120 min after the start of the infusion, and then fell again towards the pre‐treatment values. Significant responses were seen by 4 days after stopping triodothyronine (T3), but progressively increased with longer intervals off T3. Oral TRH gave a similar pattern of responses. Patients maintained on thyroxine (T4) and changed to T34 weeks prior to treatment had smaller TSH responses to TRH than patients maintained continuously on T3. It would seem that: (1) TRH promotes TSH release faster than it promotes synthesis of new hormone under the conditions studied, and (2) that long‐term administration of T3suppresses TSH secretion from the pituitary in response to TRH less than thyroxine. While it is possible to elevate the serum TSH levels of these patients with thyroid carcinoma into the rane normally seen in primary hypothyroidism by the use of TRH prior to administration of radioiodine without production of clinical symptoms of hypothyroidism, we do not yet know whether such elevation is of benefit in treatm

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb01721.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYThe effects of oestrogen administration on various parameters of testosterone metabolism (metabolic clearance rate, plasma concentration, production rate, level of binding to plasma proteins) were studied in normal men. Oral oestrogen administration (ethinyl oestradiol, 0.05 mg b.i.d. for 4 days) decreased the metabolic clearance rate (32%), plasma concentration (49%) and production rate (65%) and increased the level of binding of testosterone to plasma proteins (4.6%); the testosterone‘free index’ (plasma concentrationX% unbound) decreased by 75%. An intravenous infusion of oestrogen (i.v. injection of 5 mg stilboestrol diphosphate followed by constant infusion of 47.5 μg/min for 30 min prior to and during the experiment) had no significant effects on the above parameters. The net effect of oral oestrogen administration is to decrease the amount of testosterone available for entry into tissues. The testosterone ‘free index’ showed a significant correlation with the metabolic cleara

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb01722.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYThirty‐four patients with ophthalmic Graves' disease were investigated by routine thyroid function tests, by measurement of the serum thyroid‐stimulating hormone (TSH) response to thyrotrophin‐releasing hormone (TRH) and by measurement of the serum triiodothyronine (T3) levels.The patients could be divided into four groups according to their response to TRH—normal, impaired, absent and exaggerated. Those with normal responses had routine thyroid function tests and serum T3levels which in general did not differ from normal control values. Those with impaired and with absent responses showed routine thyroid function tests which approached the hyperthyroid range together with significant elevation of serum T3levels. It is suggested that they might represent examples of ‘subclinical T3thyrotoxicosis’. Patients with exaggerated responses had routine thyroid function tests near the lower end of the normal range and could be regarded as suffering from ‘subclinical hypothyroidism’. There was a good correlation between a normal TRH response and normal thyroid suppressibility by T3, and between impaired and absent responses and impaired thyroid suppressibility. It is evident that the TRH test which is safer, shorter and more convenient, can replace the T3suppression test in routine clinical practice. The response to TRH also provided information on the activity of the eye signs, a normal response was associated with improving eye signs whereas impaired, absent or exaggerated responses were associated with static signs or actual deterioration. The TRH test is of value in the diagnosis of unilateral exophthalmos since about three‐quarters of the patients in this series showed some abnormality. The wide range of TRH response and of circulating thyroid hormone levels is to be expected since the thyroid is not subject to the normal finely‐balanced negative feed‐b

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb01723.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYUsing a quantitative histological technique, four unselected patients with primary hyperparathyroidism were investigated and all were found to have a delayed or defective mineralization of osteoid, although their diet contained an adequate amount of vitamin D. This abnormality was most marked in the one patient with radiological bone disease. Mineralization of osteoid occurred during subsequent vitamin D administration, together with an improvement in45Ca absorption by the gut; osteoclast numbers and serum acid phosphatase levels also increased.We suggest that (1) endogenous vitamin D deficiency and hyperparathyroidism frequently co‐exist, (2) vitamin D metabolism is abnormal in hyperparathyroidism, and (3) radiological loss of bone density and erosions in hyperparathyroidism are due to impairment of the process of bone repair, i.e. there is defective mineralization of the osteoid which is laid down by osteoblasts to fill the resorption lacuna

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb01724.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY