摘要:

Abstract:An evaluation of dynamic pituitary function tests in patients with pituitary tumours. J. D. Best, F. P. Alford, D. J. Chisholm, P. Mowat, K. Henderson and R. McD. Anderson,Aust. N.Z. J. Med., 1982, 12, pp. 231–240.In a prospective study of 26 patients with macroadenoma of the pituitary (14 secretory and 12 non‐secretory), basal and stimulated pituitary hormone levels were used to detect hypothalamic dysfunction and to examine pituitary hormone secretion before and after hypophysectomy. Suprasellar tumour extension with hypothalamic compression occurred in 18 patients but was not consistently associated with hormonal tests indicative of hypothalamic dysfunction. In patients with secretory tumours, secretory activity was adequately assessed by basal hormone levels alone, which showed that surgery reduced hormone levels by a mean 85% in acromegaly and by a mean 55% in prolactinomas. Pre‐operatively, pituitary reserve of hormones not being hypersecreted was often normal, despite large tumour size and hypothalamic compression. Even after apparently complete pituitary removal at surgery, normal responses to stimulatory tests could sometimes be detected. Conventional dynamic tests are only of limited value in the assessment of hypothalamo‐pituitary dysfunction in patients with large pituitary tumours and should not be used indiscriminately in such individuals requiring surgery.SummaryThis study evaluated whether dynamic pituitary function tests are: (i) useful in assessing tumour size and the presence of hypothalamic compression; (ii) able to distinguish between tumour or hypothalamic dysfunction; (iii) useful in assessing hormonal functional status of residual pituitary tissue. The results clearly demonstrate that currently available tests do not contribute to the assessment of tumour size, the presence or otherwise of hypothalamic compression or dysfunction. The results do indicate, however, that they maybe useful in the assessment of residual pituitary function in the postoperative period. Future attention must be directed towards the development of newer tests35which might give more specific information on hypothalamic control of hormone se

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb03803.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:Cholesterol and (ipoprotein‐cholesterol levels in Western Australian rural diabetics. J. R. L. Masarei, I. J. Constable, K. Stanton and R. E. Davis, Aust. N.Z. J. Med., 1982, 12, pp. 241–247.Total cholesterol, high‐density lipoprotein‐cholesterol (HDL‐C) and non‐HDL‐cholesterol (non‐HDL‐C) were measured in the serum of diabetics from four country regions in Western Australia in order to document the levels and to examine the relationships between treatment mode, degree of diabetic control and lipid concentrations. In most age groups total cholesterol and non‐HDL‐C did not differ from levels in a large reference population, but HDL‐C levels were generally lower. Male NIDDM patients on insulin had greater HDL‐C levels than patients on oral hypoglycaemics, but their degree of control as determined by the level of glycosylated haemoglobin was poorer, and amongst female patients on insulin those with higher HDL‐C levels had poorer control. These results confirm previous reports of higher HDL‐C levels in patients on insulin, but are contrary to reports suggesting that better control is associ

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb03804.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:A comparison of serum thyroglobulin measurements and whole body131l scanning in the management of treated differentiated thyroid carcinoma. J. P. Galligan, J. Winship, T. van Doom and R. H. Mortimer, Aust. N.Z. J. Med., 1982,12, pp. 248–254.Serum thyroglobulin levels were measured by a sensitive radioimmunoassay in 76 patients whose differentiated thyroid carcinoma had been treated by surgery with or without subsequent administration of radioactive iodine (131l). Examination of the results of 105 concomitant whole body131l scan results and serum thyroglobulin levels showed a high degree (83 8%) of concordance between these two techniques. A significant correlation (r = 0.670, plt;0001) was found between serum thyroglobulin levels and quantitative131l uptake in the neck and/or metastases in 42 patients in whom this was measured.Although a high degree of congruence was found between the results of131l scans and the presence or absence of circulating thyroglobulin, 13 patients with negative scans using conventional doses of1311 had measurable levels of thyroglobulin. Eight of these patients had or subsequently developed evidence of residual thyroid tissue or metastatic carcinoma.The measurement of serum thyroglobulin levels in patients previously treated for differentiated carcinoma offers a more convenient and more sensitive method of detecting residual normal or neoplastic thyroid tissue than does whole body scanning with131

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb03805.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:Ontogeny of the secretory immune system in man. M. Gleeson, A. W. Cripps, R. L. Clancy, A. J. Husband, M. J. Hensley and S. R. Leeder, Aust. N.Z. J. Med., 1982, 12, pp. 255–258.Immunoglobulin and albumin concentrations and Escherichia coliantibody levels were determined in a prospective study of saliva taken from 63 healthy infants during the first year of life. Albumin and IgG were present in high concentrations at birth (57±6 and 35 ±8 mg/l respectively) and decreased in parallel to low values at two months of age. IgA was detected by three weeks of age. The IgA concentration fluctuated until six months of age, after which constant values were observed (14±3 mg/l). Low levels of salivary IgM (2–4 ± 1–2 mg/l) were demonstrated in 37% of infants at four weeks of age. NoE. coli antibody was detected. There was no significant difference between breast‐fed and formula‐fed infants. These findings suggest: (i) that mucosal membrane permeability is not restricted to the gut; (ii) that changes in mucosal permeability are non specific and not restricted to the uptake of specific food protein or ingestion of maternal milk; (Hi) maternal IgG may contribute to mucosal defence in the neonate; (iv) fluctuations in the concentration of IgA may reflect a balance between intense antigenic stimulation in the gut in the first weeks of life and immune regulatory mechanisms and (v) ingestion of maternal milk does not modify the patter

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb03806.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:Immunological types of lymphoproliferative disorders in a cohort: a 4‐year study*. R. M. Lowenthal, P. J. Sawyer, J. N. Lickiss, R. W. H. Harlow, S. M. Kirov and G. M. Woods, Aust. N.Z. J. Med., 1982, 12, pp. 258–262.Immunological testing of malignant cells and serum from most cases of lymphoproliferative disorders (LPD) allows the cell type to be characterised as of B, T or “null” lymphocyte origin. Regional differences in the incidence of neoplasms of these types have been reported. Furthermore, most published series have drawn cases from referral institutions rather than the general population. In order to determine the true incidence in a cohort we surveyed an entire population, that of Tasmania, an island state of Australia with a population of 410,000, during a defined period, the years 1977‐80 inclusive, for the occurrence of LPD. A total of 248 cases was discovered, made up of 133 cases of non‐Hodgkin's lymphoma (NHL), 30 of chronic lymphocytic leukaemia (CLL), 18 of acute lymphoblastic leukaemia (ALL), 54 of multiple myeloma (MM), eight of macroglobulinaemia (MGA) and five others. We identified B lymphocytes by the presence of surface membrane immunoglobulin (Smlg) and their ability to rosette with mouse red blood cells, and T lymphocytes by their ability to rosette with sheep red blood cells. Laboratory testing was performed in 201 (81%) of the cases and characterisation of the cell of origin as of B, T or “null” type was successful in 158 (64%). Of these 158, 136 (86%) were B, 4 (3%) T, and 18 (11%) “null”. On B cell subtyping by heavy and light chain Ig analysis the Tasmanian series, compared with other reports, had an apparent paucity of B‐CLL, MM and MGA of k subtype (57k to 12ñ, k.ñ ratio 4 8:1) and an unusual incidence of B‐CLL with the double Ig heavy chain combination M + G. Surveys of this type may help to point to environmental or other factors importan

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb03807.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:Phase II study of cyclophosphamide, vincristine and D.T.I.C. ± B.C.G. in the treatment of malignant melanoma. M. J. Byrne and P. M. Reynolds, Aust. N.Z. J. Med., 1982,12, pp. 263–266.Fifty‐three patients with advanced metastatic malignant melanoma were treated with DTIC, vincristine and cyclophosphamide in a 28 day cycle. In addition, 39 were vaccinated with BCG. The BCG treated group showed no significant advantage in response or survival over those treated with chemotherapy alone. Response rate in nodes draining vaccinated areas was not greater than that in equivalent nodes in non‐BCG treated patients. Of 50 patients evaluable for response, two showed CR, 15 PR for an overall response rate of 34% (median duration 20 weeks, range 4–77 + weeks). Metastatic sites did not influence response rate. Median survival of all treated patients was 26 weeks, responders 42 weeks, non‐responders 18 weeks, plt;0025. This regimen may be superior to

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb03808.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:Ischaemic heart disease in New Zealand Maori and non‐Maori: an age adjusted incidence in hospitalised patients over 10 years with emphasis on clinical features in the Maori. C. P. Dancaster and R. C. Tait, Aust. N.Z. J. Med., 1982, 12, pp. 267–270.The average annual incidence in patients admitted to hospital with ischaemic heart disease is lower among Maori than non‐Maori but Maori females under 55 years are particularly susceptible. The age adjusted incidence in this group is twice that of white females.One‐third of Maori patients had auricular fibrillation and large hearts and it is suggested that these patients have cardiomyopathy, probably alcohol induced, in addition to ischaemic heart disease. This group had the highest hospital mortality rate, 43%. The 30% hospital mortality rate among all Maori is three times that of non‐Maori. Risk factors examined in the Maori included obesity (present in 65%), diabetes (in 30%), gout (in 23%) and hypertension (in 17%) of patients with ischaemic hear

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb03809.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:The antiarrhythmic effect of intravenous disopyramide in an open study. A. M. Tonkin, W. F. Heddle, J. H. N. Bett, R. J. Kemp, G. L. Donnelly, G. I. C. Nelson, E. Manolas and J. G. Sloman, Aust. N.Z. J. Med., 1982, 12, pp. 271–275.The antiarrhythmic effect of intravenous disopyramide phosphate was assessed in a multicentre open study of 141 patients admitted to coronary care units. Disopyramide was administered in a bolus dose of 2 mg/kg over 10 min with an optional second bolus of 1 mg/kg and infusion of 0–4 mglkglhour. Atrial fibrillation was terminated in 57% of 56 patients, supraventricular tachycardia in 82% of 11 patients, ventricular tachycardia in 88% of 17 patients and premature ventricular contractions were controlled in 85% of 55 patients. Atrial flutter was terminated in only 2 of 17 patients (12%).Side effects occurred in 38% of the patients, the most frequent being those relating to anticholinergic properties of the drug (15%) or systemic hypotension (13%). Occasionally worsening of the arrhythmia (4%), QRS widening (3%) or apparent hypertension (2%) were noted.It was concluded that intravenous disopyramide is an effective antiarrhythmic agent in the coronary care unit setting, but that side effects require close monitoring of dos

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb03810.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:Renal lesions in leptospirosis. K. N. Lai, I. Aarons, A. J. Woodroffe and A. R. Clarkson, Aust. N.Z. J. Med., 1982, 12, pp. 276–279.Renal function studies and kidney biopsies were performed in four patients presenting with renal insufficiency and acute Leptospira pomona infection. The renal lesion in all patients revealed acute interstitial nephritis. There was no evidence of immunologically mediated disease in three patients who were biopsied seven, eight and eight days respectively following the onset of symptoms. The fourth, in whom there was no evidence of prior renal disease, and whose biopsy was performed 16 days after symptoms began, showed glomerular Clq, and C3 immunofluorescence and mesangial, subepithelial and intramembranous dense deposits by electron microscopy. In addition, circulating immune complexes were demonstrated in this patient. These findings suggest that in this instance at least, the renal lesions of Leptospira pomona infections can be immunologically mediated. Because this may well be a transient phase, the timing of investigations could be crucial to its detectio

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb03811.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Abstract:Crigler‐Najjartype 1 syndrome: absence of hepatic bilirubin UDP‐glucuronyl transferase activity and therapeutic response to light. G. C. Farrell, J. L. Gollan, S. M. B. Stevens and J. M. Grierson, Aust. HZ. J. Med., 1982, 12, pp. 280–285.A 16‐year‐old boy with severe congenital unconjugated hyperbilirubinaemia is described in whom mental retardation occurred as an isolated neurological deficit. The diagnosis of Crigler‐Najjar type 1 syndrome was supported by an extreme and persistent elevation of serum unconjugated bilirubin (650 nmol/), failure of administered phenobarbitone to lower serum bilirubin concentration and family history of a similarly affected sibling. Hepatic bilirubin UDP‐glucuronyl transferase activity determined in vitro by a sensitive new enzyme assay was found to be absent using bilirubin or bilirubin monoglucuronide as substrate. Phototherapy for 12 hours each night produced a partial but highly significant reduction in serum bilirubin concentration, which was not influenced further by the administration of c

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1982.tb03812.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY