摘要:

SUMMARYThe presence at presentation of hyperprolactinaemia and abnormalities on high resolution computed tomographic (CT) scanning of the pituitary gland have been documented in 19 patients with primary hypothyroidism. The changes on thyroid hormone replacement were followed for up to 28 months after presentation. At presentation serum PRL was elevated in 12 subjects (454 to 2612 mU/1); after stabilization of thyroid replacement PRL remained raised in 9 patients (525 to 1888 mU/1) despite 10‐18 months of treatment. Pretreatment CT scans showed enlarged pituitaries in 11 patients with suprasellar extension in five. In 11 patients there was initially an area of low attenuation suggesting a microadenoma and on rescanning this appearance remained in five patients. Hyperprolactinaemia in hypothyroid patients does not always return to normal with thyroid hormone replacemen

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb01155.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYDiurnal serum GH patterns were determined in 10 acromegalic patients before treatment, after 3 d continuous s.c. pump infusion and then after 3 d with three equal daily s.c. injections in both instances totalling 100 μg/24 h. Subcutaneous injections (33 μg) induced impressive suppression of serum GH lasting 3‐6 h in eight patients followed by escape to pretreatment values before the next injection. In contrast, continuous infusion resulted in greater and more stable 24 h suppression to the levels reached at the nadir between injections. Suppression of mean 24 h serum GH below 5 ng/ml was achieved by pump treatment in four patients, while two patients had mean values between 5 rig/ml and 10 ng/ml. In four patients occasional or all levels were above 10 ng/ml (24 h average 12.4‐102 ng/ml) implying either that adequate suppression by the SMS 201‐995, was impossible during the 3 d pump infusion period, or that the dose administered was inadequate. Carbohydrate tolerance was unaffected in either regimen, indicating that reduction in insulin antagonistic hormones balanced inhibition of insulin release. Interestingly, and in contrast to somatostatin, SMS 201‐995 did not inhibit TSH release. No untoward effects were observed at the moderate dosage and blood clinical chemistry was unchanged. Fairly constant diurnal serum SMS 201‐995 values were obtained during pump infusion, while levels undulated inversely with serum GH during injection treatment. Average diurnal serum somatostatin‐C immunoreactivity (all patients) decreased from 496 ± 129 (mean ± SD) to 385 ± 100 ng/ml (P<0 003) during pump treatment and did not decrease further during the following 3 d injection treatment

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb01156.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYPhospholipase C activity was measured in human endometrium using an assay based on the release of total labelled water soluble products (inositol, inositol phosphates) from L‐3‐phosphatidyl‐[2‐3H] inositol. The enzyme was shown to be calcium dependent and to have an optimum pH of 5.5. There was no difference between proliferative phase and secretory phase endometrium with respect to phospholipase C activity either in women with normal menstrual blood loss (proliferative phase: 3.7 ± 0.7 (mean ± SD), secretory phase: 4.5 ± 2.0 nmol/mg protein/min) or in those complaining of severe menorrhagia (proliferative phase: 5.8 ± 2.8, secretory phase: 7.0 ± 2.8 nmol/mg protein/min). However, women complaining of severe menorrhagia had significantly higher endometrial phospholipase C activity than those in the normal group (P<0.01 andP<0.02 for proliferative and secretory phases respectively). Endometrial phospholipase C activity was also elevated in the presence of other gynaecological disorders, e.g. dysmenorrhoea, adenocarcinoma of the cervix and endometrial hyperplasia. The results indicate that phospholipase C activity in human endometrium is not related to the stage of the menstrual cycle but that in the presence of menorrhagia and other gynaecological disorders, activity is increased. Phospholipase C could be implicated in the generation of arachidonic acid for prostaglandin synthesis which may in turn be associated with these a

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb01157.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYThe monocyte procoagulant activity (PCA) production assay has been shown to be a good parameter of cell‐mediated immunity. We have studied antigen‐specific PCA production in peripheral blood mononuclear cells from patients with Graves’disease to determine the effect of the treatment on the cell‐mediated immune response. Peripheral blood mononuclear cells from patients with untreated or relapsed Graves’disease produced significantly greater PCA with thyroid antigen stimulation than those from normal subjects. Patients both on antithyroid drugs in the hyperthyroid state and within 3 months post‐131I therapy also produced significantly larger amount of PCA than normal subjects. However, there was no significant difference in PCA production with thyroid antigen stimulation between normal subjects and patients on anti‐thyroid drugs in the euthyroid state, or patients over 3 months post‐131I therapy. The ratio of positive to negative PCA production in patients on anti‐thyroid drugs in the euthyroid state or over 3 months post‐131I therapy was significantly lower than in untreated or relapsed Graves’disease patients. Mononuclear cells from patients on propylthiouracil responded to propylthiouracilin vitroby production of PCA. Cells from normal subjects, untreated Graves’disease patients, or patients with Hashimoto's thyroiditis did not produce PCA with propylthiouracil stimulation. Mononuclear cells from patients who were on propylthiouracil for more than 3 months produced greater PCA than those on the drug for less than 3 months, suggesting sensitization of lymphocytes to propylthiouracil during the course of treatment. However, after131I therapy, they gradually became unresponsive to propylthiouracil. This study has shown that the activity of the antigen‐specific response assessed by PCA production in mononuclear cells from Graves’disease patients declined after treatment, suggesting that the treatment exert

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb01158.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYThe relationship between the pituitary‐thyroid axis and the metabolism of catecholamines has been studied in 33 maternal, arterial and venous cord blood specimens obtained at the time of normal vaginal delivery, following uncomplicated pregnancies. Ten fetal cord blood samples were collected at the time of elective caesarean section. Levels of noradrenaline and 3,4‐dihydroxyphenyl‐acetic acid (DOPAC) were measured in all these samples, using the high performance liquid chromatography (HPLC)‐electrochemical detection method, and TSH was measured by radioimmunoassay. In cord arterial blood samples at vaginal delivery the levels of plasma noradrenaline and serum TSH were significantly increased, but those of DOPAC, which reflects central dopaminergic activity, were unchanged when compared to samples obtained at elective caesarean section. Within the same samples there was a significant correlation between the levels of plasma noradrenaline and those of serum TSH. Noradrenaline is believed to have a stimulatory and dopamine an inhibitory influence on TSH secretion. The fetal thyroid gland seems to respond adequately to the stimulus of TSH at term. The present study suggests that catecholamines, especially noradrenaline, may regulate secretion of TSH from the pituitary gland in the fetus at delivery and that elevation of TSH probably induces a subsequent rapid increase in thyroid hormones in the

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb01159.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYTwelve patients with subacute thyroiditis were divided into two groups and treated with prednisolone or salicylate. The initially elevated T4, T3, free T4 (FT4), free T3 (FT3) and erythrocyte sedimentation rate (ESR) were reduced during the early phase within about 4 weeks in both groups. The serum levels of thyroglobulin (Tg) were elevated in both groups treated with salicylate and prednisolone (252 ± SD 117 ng/ml and 233 ± SD 157 ng/ml, respectively) at initial examination. The serum level of Tg declined during the early phase with prednisolone treatment, and it reached normal values at the end of the early phase (17 ± SD 15 ng/ml). With salicylate treatment, the decline of levels of Tg was delayed and it was elevated (80 ± SD 34 ng/ml) despite normal levels of thyroid hormones and ESR at the end of early phase. The serum level of Tg at the end of the early phase of prednisolone treated was significantly lower than that of salicylate treatment (P<001). It is suggested that the effect of prednisolone on rapid decrease of Tg may be related to its inhibitory action of intrathyroid hydroly

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb01160.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYThe effect of oral glucose (40 g/m2body surface area) on the leucocyte22Na efflux rate constants (ERC) was studied in 13 normal weight and 10 obese subjects. The ouabain‐sensitive22Na ERC was higher in leucocytes isolated from fasting obese subjects (median [range] for obese 2.77 [2.33‐3.11]vs normals 1.91 [1.57‐2.77] h‐1,P&0.001). There was no difference in the ouabain‐resistant22Na ERC. Oral glucose raised the ouabain‐sensitive22Na ERC after 2 h in normal subjects (1.91 [1.57‐2.77] to 2.41 [2.11‐3.02]h‐1,P&0.001). The ouabain‐resistant22Na ERC fell from 0.71 [0.32‐1.10] to 0.46 [0.35‐0.68]h‐1,P&0.008. Conversely, in obese subjects, the ouabain‐sensitive ERC fell (2.77 [2.33‐3.11] to 2.59 [2.11‐2.92]h‐1,P&0‐06). There was no significant change in ouabain‐resistant22Na ERC 2 h after oral glucose. The fasting leucocyte22Na ouabain‐sensitive ERC correlated with fasting plasma insulin levels and insulin resistance (rs= 0.48,P&0.01 for both). The change in this ERC with oral glucose correlated with the incremental insulin response over 2 h (rs= ‐0.53,P&0‐006) and to the insulin resistance (rs= ‐0.56,P&0.003). The failure of oral glucose to stimulate the leucocyte sodium pump in obesity could partially account for the defect in dietary thermogenesis in obesity. This defect in stimulation of the

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb01161.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYThe usefulness of a limited nocturnal GH profile has been evaluated for the assessment of physiological GH secretion. We have analysed the complete overnight GH and sleep profiles of 20 short prepubertal children, sampled at 15‐min intervals. The mean age was 9.1 years (range 4.3‐11.7 years) and mean height velocity standard deviation score (SDS) ‐ 1 0 (range ‐ 2.4 to + 0.4). The sleep stage in which the maximal GH value was reached varied considerably between the patients. Only 55% achieved the maximal GH value during the first slow‐wave sleep period, and 65% in the first 2 h of sleep. The maximal values during the first slow‐wave period correlated weakly with the sum of the nocturnal peak values and the total area under the curve of the complete GH profile. None of these parameters correlated with height velocity. We conclude that at present there is no substitute for complete overnight or 24 h GH profiles for the assessment of physiological GH secretion, but the clinical significance of the variations seen rema

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb01162.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYFifty‐one patients with hyperprolactinaemia (23 with macroadenoma, 23 with microadenoma, and five with idiopathic hyperprolactinaemia) were treated with bromocriptine for 2‐12 years (4.9 ± 2.9 years, mean ± SD). During therapy, the serum PRL levels were suppressed into the normal range in all but five patients. In these five patients, despite the high circulating PRL, gonadal function returned to normal in three, while in the other two gonadotrophin reserve was impaired even before therapy. Gel chromatography showed that one of these patients had a high proportion of a large molecular weight form of PRL. Twenty‐four patients received bromocriptine as the sole method of treatment for over 2 years (3.4 ± 2.3 years). In five out of the 24 subjects (21 %), serum PRL remained normal with no clinical symptoms after prolonged drug withdrawal (1‐4 years). Twenty‐one patients received radiotherapy in conjunction with bromocriptine therapy. Of these 11 had prior surgery. After a follow‐up of 6.0 ± 3.0 years after radiotherapy, serum PRL remained within the normal range in 6 out of 21 subjects (29%), 1‐4 years after bromocriptine withdrawal. One of the patients had impaired GH response to insulin hypoglycaemia developing after radiotherapy. We conclude that prolonged bromocriptine treatment is an effective treatment

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb01163.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYAmiodarone therapy results in marked changes in circulating thyroid hormone and TSH concentrations in man. In the present study we have demonstrated that amiodarone treatment of the rat increases serum TSH and pituitary cytoplasmic concentrations of TSH β and a subunit messenger RNAs (mRNAs) and reduces PRL mRNA as measured by cytoplasmic dot hybridization with specific complementary (c) DNA probes. The fall in circulating TSH and TSH mRNA resulting from thyroid hormone treatment was less marked in animals receiving amiodarone in addition to T3 and T4. In contrast, in the hypothyroid state, increases in serum TSH, TSH β and α mRNA, and reductions in PRL and GH mRNA were less marked in rats treated with amiodarone. In studies of rat anterior pituitary cells in primary monolayer culture we demonstrated a direct effect of amiodarone on PRL gene expression which was antagonized by T3. Changes in circulating thyroid hormone concentrations and deiodination of T4 and T3 induced by amiodaronein vivomay be important in the regulation of pituitary hormone gene expression but we have, in addition, shown a direct interaction between amiodarone and T3 effects on the anterior pituitary ce

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1987.tb01164.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY