摘要:

SUMMARYIt has been postulated, based on data in animals and the fact that the cortisol‐adrenal androgen ratio is different before and after adrenarche, that prolactin (Prl) may modulate adrenal androgen secretion. As one way of testing this hypothesis, cortisol, androstenedione (A), dehydroepiandrosterone (DHA), and dehydroepiandrosterone sulphate (DHAS) were measured by radioimmunoassay in the sera of thirteen patients with suspected or proven pituitary tumours and marked chronic elevations of serum Prl (range 68–990 ng/ml, mean 198.9 ng/ml). Values for cortisol, A, DHA, and DHAS were not significantly different between the groups of normal controls and patients with elevated Prl concentrations. This is interpreted as negative evidence for the theoretical connection between Prl and adrenal androgen secret

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01344.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYThe production of testosterone (Te) and androstenedione (A) has been studied in twenty‐three patients with chronic renal failure. Four of the patients were being prepared for haemodialysis (HD) treatment — non‐HD patients — nineteen were on chronic HD treatment, five of whom had been nephrectomized bilaterally. Data are presented on plasma Te and A levels, on the response to HCG and on changes after HD. The Metabolic Clearance Rate (MCR), blood production rate and the mutual interconversion of both steroids were determined together with the plasma sex hormone binding globulin capacity.In all groups of patients, plasma levels of Te were low and stimulation with HCG resulted in an insufficient increase in plasma Te levels, indicating Leydig cell deficiency in chronic uraemic males. In addition, a tendency to increased metabolic breakdown of Te was observed, most probably caused by a deficient synthesis of the sex hormone binding globulin. In patients with high peripheral degradation of Te, the testicles were able to produce about normal amounts of Te.In the non‐HD patients an increase in the MCR and blood production rate of A was found. This may be due to an alteration in the testicular steroid secretion. The other groups of patients did not show differences in the production of A when compared with normal males. No significant changes in plasma levels of Te and A were observed during HD treatment.The picture emerging from our data is similar to the one observed in population groups with severe protein mal

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01345.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYThe peripheral venous plasma concentrations of gonadotrophins (LH and FSH), prolactin (Prl), cortisol, dehydroepiandrosterone (DHA), dehydroepiandrosterone‐sulphate (DHA‐S), pregnenolone (Δ5P), progesterone (P), 17‐hydroxyprogesterone (17P), androstenedione (A), testosterone (T), dihydrotestosterone (DHT) and oestradiol (E2) were measured in girls at different stages of sexual development (from P1 to P4–5 according to Tanner, 1962). Both gonadotrophins increase progressively during sexual maturation, to reach the highest concentrations in P4–5. However, the FSH values were significantly lower in these P4–5 pre‐menarchal girls than those found in adult women in the early follicular phase. No significant changes were found in plasma Prl, cortisol and 17P levels during pubertal development; in contrast, plasma concentrations of DHA tripled from P1 to P4–5, reaching adult levels. A progressive rise was also found in DHA‐S plasma levels. A significant, but less evident increase was found in Δ5P and P plasma concentrations, from group P1 to P4–5. A, T and DHT levels rose progressively and significantly from P1–2 to the end of sexual maturation. In the case of E2, only a moderate increase was found during pubertal development.All these data indicate that during pubertal development, there is a progressive reduction in the sensitivity towards oestrogen of the hypothalamic centres controlling gonadotrophin secretion.Prl does not seem to be involved in human sexual maturation, while important changes have been found in adrenal androgens. The constant levels of 17P and cortisol, in comparison with the behaviour of DHA, DHA‐S, T and A, seem to indicate that during this period of life, the adrenal gland is stimulated by unknown factors other than ACTH, acting on the adrenal androgen‐producing cells and responsible for the reported rises

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01346.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYFasting lipid concentrations have been measured in fifty treated juvenile diabetics, their siblings and parents to determine which types of hyperlipoproteinaemia co‐exist with juvenile diabetes and whether the abnormalities relate to diabetic control, or represent familial disorders. Lipid concentrations amongst the parents did not differ from adult controls. Triglyceride concentrations were significantly higher in those diabetic children with fasting blood glucose concentrations>10 mmol/l than those with concentrations<10 mmol/l. The latter group had similar trigly‐ceride levels to non‐diabetic siblings. Cholesterol concentrations were not related to fasting blood glucose and were similar in diabetic and sibling controls. Hyperlipoproteinaemia (types IIa, IIb and IV) was present in ten of the diabetic patients. Six of the nine diabetic patients with raised cholesterol had at least one parent with cholesterol in the highest quintile for the control population, whereas only six of the forty‐one with lower levels had parents in this category. A similar trend for cholesterol was apparent amongst the non‐diabetic siblings. However, no association was apparent between the triglyceride levels of diabetics (or their siblings) and parents. Thus although hyperlipidaemia associated with juvenile diabetes appears to be largely due to inadequate control, raised cholesterol concentrations frequen

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01347.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYThe effects ofl‐DOPA administration on hypothalamic‐pituitary‐adrenal function were studied in five normal subjects and in five patients with active acromegaly. In acromegalic patients, orall‐DOPA (500 mg every 4 h for six doses) failed to alter the urinary excretion of 17‐hydroxycorticoids (17‐OHCS), 17‐oxosteroids (17‐OS), and tetrahydro‐11‐desoxycortisol (tetrahydro‐comp S). However, when cortisol synthesis was blocked with oral metyrapone, enhancement of excretion of 17‐OHCS, 17‐OS, and tetrahydro‐comp S byl‐DOPA became apparent in acromegalic patients but not in the normals. In patients with acromegaly, on the day of metyrapone administration, the mean excretion rates of 17‐OHCS, 17‐OS, and of tetrahydro‐comp S were 8.6 mg, 6.4 mg and 4.1 mg/24 h, respectively. When 500 mgl‐DOPA was co‐administered with metyrapone, the corresponding values increased significantly (P<0.01) to 14.9 mg, 9.0 mg and 7.7 mg/24 h. This effect ofl‐DOPA was not observed in the normal subjects. It was concluded thatl‐DOPA markedly enhanced the hypothalamic‐pituitary‐adrenal response to metyrapone in acromegalic patients, but not in normal subjects.l‐DOPA (or one of its metabolites) probably acts upon a noradrenergic or a dopaminergic system located in the hypothalamus to alter the release of ACTH. The unusual pituitary‐adrenal response tol‐DOPA in acromegaly may reflect: (1) a supersensitive reaction of the pituitary‐adrenal axis tol‐DOPA; (2) a paradoxical response of the pituitary‐adrenal a

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01348.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYBromoergocryptine has been used to lower growth hormone concentrations in ten patients with acromegaly in whom previous attempts at pituitary ablation had failed to cure the disorder. Plasma immunoreactive and plasma receptor‐reactive growth hormone concentrations together with plasma somatomedin concentrations and urinary excretion of immunoreactive growth hormone were used to assess the response to treatment. Casual immunoreactive hormone concentrations in plasma were lowered to less than 8 mu/l and to less than 5 mu/l during glucose infusion in seven patients, and urinary growth hormone excretion was also brought into the normal range (<40 μu/12 h) in this group. There was at least a 40% reduction in these measurements in the remaining three patients who had the highest basal hormone concentrations of the group. Plasma somatomedin fell with treatment in eight patients, and intravenous glucose tolerance improved in seven of eight patients tested. Used in modest dosage (up to 15 mg/day) bromoergocryptine can lower plasma and urinary growth hormone and plasma somatomedin concentrations in acromegalic patients in whom previous treatments have decreased but not cured hormone overproducti

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01349.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYThe investigation of a patient with a suspected disorder of calcium metabolism is most rapidly and efficiently performed by observing a standard procedure, the initial stages of which are simple and mandatory, the later stages more complex and determined by the initial results and the depth of investigation required. Needless to say, the investigations are preceded by history taking and routine physical examination.The following account is a summary of available procedures, most of which have been described elsewhere in greater detail (Nordinet al., 1976a).

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01350.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARYThe effect of acute oral administration of metergoline on serum thyrotrophin and prolactin levels in six patients with primary hypothyroidism was studied. Metergoline 4mg by mouth caused a significant decrease in the concentration of serum thyrotrophin and prolactin in all subjects. There was no consistent change in serum thyroxine and triiodothyronine concentrations during the experiment. These findings suggest that metergoline inhibits prolactin and thyrotrophin secretion by a direct action on the hypothalamus or pituitary gland.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01351.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARY. The growth hormone (hGH) and prolactin (hPRL) response to insulin induced hypoglycaemia was studied in six alcoholics on two occasions before and after treatment with a single intramuscular injection of fluphenazine (Modecate). On both occasions blood samples were taken at intervals before and after the intravenous injection of soluble insulin (0.1 u/kg body weight). The patients were investigated on the first occasion, 2–7 days after cessation of drinking and they all demonstrated an adequate hGH response. They then received an injection of fluphenazine (Modecate 12.5 mg) and were reinvestigated 1 week later. The hGH response to hypoglycaemia was significantly impaired after treatment with fluphenazine. Basal hPRL concentrations were significantly increased and increased concentrations of hPRL in response to hypoglycaemia occurred after treatment. We conclude that a single injection of fluphenazine (Modecate 12.5 mg) has a marked effect on hypothalamic‐pituitary mechanisms controlling hGH and hPRL rele

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01352.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

SUMMARY. In four patients with organic hyperinsulinism (two with surgically proven β‐cell adenomas of the body of the pancreas) a standard tolbutamide test during continuous somatostatin infusion (5 μg/min) was carried out. Tolbutamide‐induced insulin release was completely inhibited by somatostatin as in normal subjects. These results suggest that the inhibition test with somatostatin does not seem to be a better or safer way of diagnosing insulin producing tu

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1978.tb01353.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY