ISSN:1663-2818    

DOI:10.1159/000184800

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

High-dose estradiol therapy for reduction of final height may be complicated by severe side effects such as deep vein thrombosis. We report a 14.6-year-old girl with tall stature. In order to reduce final height she was treated with ethinylestradiol and medroxyprogesterone. After arthroscopy she suffered acute deep venous thrombosis of her left leg. Despite being monitored at short intervals, coagulation parameters such as AT III and protein C indicated no development of thrombosis. Medical height reduction with estrogen should be accompanied by heparinisation during longer-lasting periods of immobilisation.

ISSN:1663-2818    

DOI:10.1159/000184801

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:1663-2818    

DOI:10.1159/000184802

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

We report a case of a 25-year-old man with Cushing’s syndrome due to an ACTH and CRH-producing thymic carcinoid. Immunohistology and radioimmunoassay demonstrated CRH and a lesser amount of ACTH in the resected primary tumor. After a symptom-free period, the tumor recurred, and the patient died. Tumor obtained at autopsy contained mainly ACTH and lesser quantities of CRH. We conclude that this thymic carcinoid initially produced mainly CRH and then transformed to secrete mainly ACTH, suggesting that endocrine tumors may change their functional phenotyp

ISSN:1663-2818    

DOI:10.1159/000184803

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The effect of an i.v. infusion of somatostatin (SRIH) (4.1 μg/min/180 min) on angiotensin II (ANG II infusion for 60 min of successively increasing doses of 4, 8 and 16 ng/kg/min; each dose for 20 min)-stimulated growth hormone (GH) and corticotropin (ACTH) release was studied in 7 normal men. In addition, 7 additional normal subjects were tested with ANG II alone (as described above), GH-RH (0.1 μg/kg body weight as an i.v. bolus) alone or the combination of GH-RH and ANG II. The ACTH response to ANG II was not modified by SRIH infusion; in contrast, the GH response to ANG II was significantly reduced by the concomitant treatment with SRIH. On the other hand, the administration of GH-RH together with ANG II produced peak GH levels comparable to the sum of the individual responses to ANG II and GH-RH, given alone. These findings provide evidence that the stimulatory effect of ANG II on GH, but not ACTH secretion, is under the inhibitory control of somatostatin, suggesting an interaction between ANG II and SRIH in regulation of GH secretio

ISSN:1663-2818    

DOI:10.1159/000184804

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Impairment of growth is a hallmark of hypothyroidism in animals. The ability of the thyroid hormone-thyroid hormone receptor complex to regulate gene transcription may be relevant to the growth impairment associated with hypothyroidism. To study the role of thyroid hormone in the expression of the GH receptor (GHR) and GH-binding protein (GHBP) gene, we examined the serum and liver tissue of female and male hypothyroid (thyroidectomized), thyroxine-treated thyroidectomized and euthyroid control rats. Compared to the control and to the thyroxine-treated group, the hypothyroid rats had significantly lower serum levels of thyroxine, increased levels of TSH, and decreased rates of weight gain. GHR and GHBP mRNA levels in liver were estimated by ribonuclease protection assays. In female rats, the levels of hepatic GHR and GHBP mRNA were increased in the hypothyroid group compared to euthyroid controls (p < 0.001 for GHR and p < 0.05 for GHBP). In contrast, in males the hypothyroid state was associated with decreased levels of GHR (p < 0.001) and GHBP (p < 0.001) mRNA levels compared to euthyroid controls. In both females and males, administration of thyroxine for a period of 2 weeks to the thyroidectomized rats prevented these changes in GHR and GHBP mRNA levels in liver. The differences observed between females and males could not be attributed to differences in the circulating levels of GH at sacrifice (female vs. male, 9.9 ± 1.3 vs. 13.9 ± 6.5 ng/ml). We conclude that (1) thyroid hormone affects the transcription of the GHR/GHBP gene; (2) there is a distinct sexual dimorphism in the effect of hypothyroidism on the expression of the GHR/GHBP gene, and (3) this effect is reversible following amelioration of the hypothyroid state. We speculate that regulation of expression of the GHR/GHBP gene by thyroid hormones involves multiple thyroid response elements that have opposite effects depending on the status of other factors such as sex hormone

ISSN:1663-2818    

DOI:10.1159/000184805

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Two hundred and forty-seven patients with uterine fibroids were randomized to surgery alone or 3 months’ Zoladex® (Zeneca, Macclesfield, Ches., UK) followed by surgery. Zoladex significantly reduced uterine and fibroid volumes (p = 0.0001). There was a significantly (p = 0.002) greater mean rise in haemoglobin from entry to preoperation in the Zoladex group (1 g/dl) compared with the surgery-alone group (0.3 g/dl) as well as a tendency towards easier surgery, and reduced operative blood loss. Zoladex-treated patients had a significantly (p = 0.016) shorter hospital stay and pelvic pain and abdominal pressure symptoms were significantly (p < 0.0001) reduced in this group. Zoladex was well tolerat

ISSN:1663-2818    

DOI:10.1159/000184806

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Hypoglycaemia is the most important acute side effect of insulin therapy for diabetes in children. In general, children have more vigorous counterregulatory hormone responses to hypoglycaemia than adults. Children with diabetes may lose their glucagon responses to a falling blood glucose but persistence of brisk catecholamine, cortisol and growth hormone responses, coupled with the insulin resistance natural to puberty, may contribute to unstable diabetes control. Despite this, there is some evidence that younger children may not experience or at least express autonomic symptoms to the same degree as do adults. Furthermore, recurrent hypoglycaemia may induce defects in the counterregulatory responses and increase the risk of severe hypoglycaemia. Avoidance of moderate hypoglycaemia in clinical management may restore normal warning. There is research evidence to suggest that the human brain may be able to use non-glucose fuels to support its metabolism and function during hypoglycaemia but this is not yet translatable into clinical practice and care to avoid hypoglycaemia in daily life remains the patients’ best protectio

ISSN:1663-2818    

DOI:10.1159/000184807

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

An extremely rare case of a 39-year-old man with Nelson’s syndrome and paratesticular tumours is presented. The patient had undergone bilateral adrenalectomy at the age of 23 years for Cushing’s syndrome. Later he developed skin and mucosal hyperpigmentation, Nelson’s syndrome was diagnosed, and he underwent transfrontal hypophysectomy. At age 29, the presence of paratesticular tumours was noted which were excised together with the left testis. The preoperative levels of testosterone, produced by the paratesticular tumours, were extremely high; they fell after su

ISSN:1663-2818    

DOI:10.1159/000184808

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

A 51-year-old male was admitted to our hospital because of diabetic ketoacidosis. His symptoms were promptly improved with intensive insulin therapy, but his plasma glucagon immunoreactivity measured by the OAL-123 radioimmunoassay (RIA) system showed persistently high values (3,090-3,210 pg/ml). A computed tomographic scan, abdominal angiography and endoscopic examination of his gastrointestinal tract showed no evidence of glucagonoma. After removing the immunoglobulin fraction from the plasma, his immunoreactive plasma glucagon level returned to normal. Moreover, the immunoglobulin G fraction purified from the patient’s plasma inhibited the binding of [125I]glucagon to rabbit antiglucagon antiserum, OAL-123. Dot-blot analysis demonstrated that the immunoglobulin G of this patient cross-reacted against OAL-123. Therefore, it was considered that the prominent hyperglucagonemia in this patient was due to the presence of IgG, which interfered with the measurement of plasma-immunoreactive glucago

ISSN:1663-2818    

DOI:10.1159/000184809

出版商:S. Karger AG    

年代:1996

数据来源: Karger