摘要:

SUMMARYThe stimulation of growth hormone release in children by L‐dopa has been studied. An oral dose of 0.5 g L‐dopa was administered to fourteen children with, and to fifteen children without, hypothalamic‐pituitary insufficiency. In the control group, L‐dopa induced a release of pituitary growth hormone, the peak of which occurred from 30 to 60 min after ingestion. Nine out of fifteen control subjects showed peak levels of plasma growth hormone greater than 8 ng/ml. None of the patients with hypothalamic‐pituitary insufficiency showed levels greater than 5 ng/ml. In five out of six children with measurable amounts of plasma HGH, and in fourteen children with a lack of HGH, there was a good correlation between the HGH response after L‐dopa, insulin hypoglycaemia and arginine infusion. It is concluded that the administration of one oral dose of L‐dopa can be used as a provocative test of growth horm

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb03478.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYThirty‐three cases of primary hyperparathyroidism have been followed up after initial diagnosis for a mean period of 5 years and 5 months. The recurrence rate over the follow‐up period was 15%. Recurrence was limited to cases with involvement of other endocrine glands, a family history of hyperparathyroidism or multiple involvement of the parathyroid glands discovered at operation. These three factors can therefore be regarded as prognostic indices of a high recurrence risk; they are common, occurring in an estimated 39% of cases. When they exist, an attempt to visualize all parathyroid tissue at operation should be made and, if multiple gland involvement is present, the treatment of choice is subtotal para‐thyroide

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb03479.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYTo study the possibility of secondary hyperparathyroidism in patients with Paget's disease treated with calcitonin over a long period, we investigated parathyroid function in eleven patients treated with salmon calcitonin (CT) for up to 23 months and in one patient treated with human CT. Basal plasma calcium, immuno‐reactive parathyroid hormone (PTH) and serum phosphorus levels were all in the normal range before and after the treatment and did not change significantly during the treatment. In all patients, an acute fall in calcium and a rise in PTH occurred after the initial injection of CT. The rise in PTH was proportional to the fall in calcium and similar to that observed in normal subjects. After treatment, the rise in plasma PTH remained the same in relation to the fall in calcium, indicating that the responsiveness of the parathyroid glands to the hypocalcaemic challenge was unaltered, and that secondary hyperparathyroidism was not present in these patient

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb03480.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYPeripheral blood leucocytes from healthy subjects (control leucocytes) and from patients with Hashimoto's thyroiditis or idiopathic myxoedema, were incubated with 2‐3‐day‐old human thyroid cells in monolayer cultures. After 5‐6 days the Hashimoto leucocytes appeared to induce more thyroid cell destruction than control leucocytes. Thyroid cell function (measured by cell to medium (C/M) ratios of131I) was reduced in cultures incubated with Hashimoto leucocytes, compared to those incubated with control leucocytes. This effect was not mediated by liberation of thyroid antibodies into the medium, but rather from a direct leucocyte/thyroid cell interaction with a resultant liberation of lysozymes. Preliminary observations indicated that the effect of the Hashimoto leucocytes on thyroid cells could be prevented by prior incubation of the former with anti‐thymocyte globulin; this suggested that sensitized lymphocytes may be directly responsible for the thyroid tissue injury of Hashimoto's disease, perhaps with the adjunctive cooperation of the non‐specific macrophages. Leucocytes from patients with idiopathic myxoedema (with low or absent circulating thyroid antibodies) did not have any effect on the thyroid cells, perhaps because the concentration of peripheral sensitized lymphocytes may possibly have declined in the

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb03481.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYFollowing intravenous injection of a pharmacological dose of dexamethasone, there was a prompt fall in both C‐terminal and N‐terminal plasma immunoreactive ACTH levels in nineteen subjects with Addison's disease. Intravenous infusion of cortisol, sufficient to give physiological plasma levels in three of these subjects, induced a fall in plasma C‐terminal immunoreactive ACTH concentration only when plasma corticosteroid levels exceeded 20–25 μg/IOO ml. Thus although negative feedback control of ACTH secretion was still operative in these subjects, it seems likely that this mechanism of ACTH regulation had diminished sensitivity compared with that found by other workers in normal ind

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb03482.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYThe course of thyrotoxicosis treated with antithyroid drugs has been studied in detail in 105 thyrotoxic patients. Each patient was seen at intervals of 1–3 months over a period of more than 4 years and thus an average of thirty serial tests of thyroid function were made on each patient. Forty‐three patients remitted after one course of antithyroid drugs. In another forty‐three patients the disease either required operative treatment or was still active 4 years after the start of therapy. The remaining nineteen patients fell into an intermediate group.In the light of the variable course of the disease, we conclude that most patients with Graves' disease under 45 years are best treated initially with antithyroid drugs. Reassessment of thyroid function at 6‐monthly intervals during and for a period after antithyroid drug therapy is useful and permits selection of the most appropriate method of tr

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb03483.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYThe isolation and partial characterization of a peptide with C‐terminal corticotrophic immunoactivity from a bronchial carcinoid tumour associated with the ectopic ACTH syndrome is described. It resembles corticotrophin‐like intermediate lobe peptide (CLIP) in amino acid composition and end group analyses. It is suggested that the specific measurement of circulating CLIP may serve as a biochemical marker of tumour activ

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb03484.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYThe thyroidal component of the response to thyrotrophin releasing hormone (TRH) has been studied by measurement of serum triiodothyronine (T3) and thyroxine (T4).In normal subjects a significant increase in serum T3 followed intravenous administration of TRH 200 μg. A less consistent increase was detected in serum T4 concentration.Oral TRH at a dose of 40 mg caused a significant rise in serum T4 in normal subjects. The increase in T4 at 24 hr was considered to provide a convenient index of pituitary and thyroidal response.Fourteen patients with pituitary disease, of whom twelve were euthyroid, were investigated by an oral TRH test. The majority of these patients retain a normal pituitary TSH reserve though a small group can be identified in whom it is diminished.A significant correlation was obtained between the T4 and TSH response to oral TRH. It is suggested that measurement of serum concentration of thyroid hormone is of value in the assessment of the pituitary response to TRH and the integrity of the pituitary‐thyroid ax

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb03485.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

SUMMARYSerial measurements of99Tcmuptake have been made in thirty thyrotoxic patients treated with carbimazole and L‐triiodothyronine. All patients were followed up for a minimum period of 1 year at which time eighteen patients were still in remission and twelve had relapsed.Four of the twenty‐one patients who had a normal99Tcmuptake at the time treatment was discontinued relapsed within 6 months. Only one of the nine patients whose uptake at the end of treatment was above normal achieved a remission. Changes in99Tcmuptake during the first 6 months of treatment were less informative and proved to be of limited value in predicting the outcome of treatment.In the whole group of patients99Tcmuptake fell during the first 6 months by about 40%, this change being highly significant. The decline in thyroid activity coincided with the time at which treatment was started. It is suggested that treatment with an antithyroid drug may modify the course of the dise

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb03486.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

After 20 years in the wilderness, 3,5,3′‐triiodo‐l‐thyronine (T3) has come back home, for it is exactly 20 years since Gross&Pitt‐Rivers (1952) first drew attention to its presence in human serum. A few years later Pitt‐Riverset al. (1955) demonstrated its formation from thyroxine (T4) given to patients with athyreotic myxoedema, and in 1957 Maclagenet al. reported thyrotoxicosis with elevated plasma concentration of T3 and normal concentration of T4‐the first identifiable instance of what is now referred to as ‘T3 toxicosis’. Despite these early suggestions of significant physiological and pathological contributions, T3 was regarded as a minor and unimportant iodinated compound until the development of an improved biochemical assay (Sterlinget al., 1969) paved the way for wider recognition of its role in health and disease and stimulated the development of a sensitive and dependable radioimmunoassay. In the past few years information about the action, metabolism and clinical significance of T3 has rapidly accrued; this review attempts to put together some of this new and exciting information. Because methods for the assay of T3 in biological fluids have only recently been introduced, the validity of the various techniques will be

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1973.tb03487.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY