摘要:

SUMMARYUsing a non‐invasive sensitive technique measuring ulnar length, short‐term growth was studied in two groups of boys with constitutional delay in growth. In one (group A) a protocol of multiple hCG injections weekly was used (3 × 1500 iu), whereas the other (group B) received a single dose of hCG weekly (1 × 1500 iu), both during 6 weeks. The two hCG protocols appeared to be equally potent in stimulating 3‐week Ulnar Growth rates (TUG‐rates), tripling the growth velocities from prepubertal to pubertal levels. After stopping hCG treatment the mean TUG‐rate decreased again to a post‐treatment level that, taking both groups together, was significantly higher than the mean pretreatment TUG‐rate. During hCG administration mean body growth rates also rose significantly in the two groups. The extent of the changes, however, only allowed evaluation for the whole group in contrast to the changes in TUG‐rates which far exceeded the limits of confidence in all but one boy. Serum alkaline phosphatase activities (APA) increased significantly during hCG treatment and almost paralleled the increase in TUG‐rates. The APA response (ΔAPA) in group A, however, was unexpectedly higher than in group B. After stopping hCG treatment the mean APA significantly decreased taking both groups together to an almost pretreatment level. The results showed that a weekly single dose hCG regimen was as effective as the weekly multiple injection protocol in stimulating TUG‐rates to pubertal levels in the groups of constitutionall

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb03141.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYCell‐mediated and humoral immunity were studied in seventeen patients with toxic multinodular goitre, ten with active Graves’disease and fourteen healthy controls. The study included determination of sheep erythrocyte and complement rosette‐forming cells in the peripheral blood, immunoglobulin levels, titres of microsomal antibodies and migration inhibition test using thyroid extract and phytohaemagglutinin. When compared with controls the patients showed a positive response to thyroid antigen in the leucocyte migration inhibition test. Microsomal antibodies were detected in seven out of ten active Graves’disease patients against two out of seventeen of those with toxic multinodular goitre. Significantly increased IgG and IgA and decreased IgM levels were found only in the toxic multinodular group. These data provide further evidence for immunological disturbances in toxic multinodular

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb03142.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYA diagnosis of chronic lymphocytic thyroiditis (CLT) was made in forty‐two children and adolescents according to Fisher's criteria. The age of the group ranged between 4±3 and 18±5 years. On the basis of serum TSH, T4 and RAI uptake, three groups of patients were distinguished at the time of diagnosis: 1, euthyroid group (n= 3) with normal TSH and T4; 2, hypothyroid group (n= 36) with high values of TSH, where three subgroups were distinguished:(a)compensated hypothyroidism (n= 14) with normal T4,(b)overt hypothy‐roidism with high or normal RAI uptake and low T4 (n= 19),(c)overt hypothyroidism with low RAI uptake and low T4 (n= 3); 3, Hyperthyroid group (n= 3) with high T4. In CLT, variability is a feature not only of the initial presentation, but also of the subsequent evolution of the disease. Sixteen patients were followed for periods between 4 months and 6 years. Thyroid function did not change in six. Six patients with compensated or overt hypothyroidism improved, four became euthyroid with normal basal TSH and T4 values, however, all three tested had an exaggerated response to TRH. Three patients who were initially hyperthyroid progressed to a state of compensated hypothyroidism. One patient with overt hypothyroidism on presentation developed hyperthyroidism after 15 months and became hypothyroid once more 8 months later. The variable clinical course of CLT is characteristic of immunological disturb

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb03143.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYTwelve patients with chronic renal failure and osteitis fibrosa were treated for periods of 1–9 months with thrice‐weekly injections of 10–200 iu salmon calcitonin. Treatment had no significant effects on symptoms of bone disease and side effects were common. A transient fall in plasma alkaline phosphatase levels occurred in only three patients, and both plasma alkaline phosphatase and hydroxyproline levels rose in the majority of patients. Radiographic signs of hyperparathyroidism increased in seven of the nine patients treated for longer than 3 months. Paired bone biopsy specimens in nine patients showed significant increases in osteoblast counts, but no changes in the indices of resorption. These treatment‐induced changes were reversed when treatment with 1,25‐dihydroxyvitamin D3was substituted for calcitonin. The use of this regimen of salmon calcitonin is not recommended in the long‐term management of hyperparathyroid bone disease in chronic re

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb03144.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYIn twenty oligospermic or azoospermic patients with elevated plasma FSH, the mean concentrations of plasma oestrone sulphate (843 ± 233 pg/ml), oestrone (54 ± 10±4 pg/ml) and oestradiol (46±6 ± 12±6 pg/ml) were found to be significantly higher than in twenty‐one normal fertile men of comparable age (593 ± 220 pg/ml, 40±6 ± 8±8 pg/ml and 33±1 ± 10±9 pg/ml respectively). SHBG binding capacity was elevated in the infertile group (infertile 3±35 ± 0±82 × 10−8M/l v. normal 2±76 ± 0±89 × 10−8M/l) but the total plasma testosterone concentrations were comparable (infertile 5435 ± 1578 pg/ml v. normal 5046 ± 1102 pg/ml). Evidence was cited to support the view that Sertoli cells, in response to an unphysiological FSH stimulation, are a likely source of excessive oestrogen production. The possible significance of increased intra‐testicular and circulating oestrogen in the altered state of testicular steroidogenic function in men with primary seminiferous

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb03145.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYIt has been shown previously that both thyrotrophin (TSH), and also immunoglobulins (Ig) derived from patients with goitrous Graves’disease, stimulate DNA‐synthesis in guinea‐pig thyroid tissue maintainedin vitro.Here we describe the use of the samein vitrosystem and methods of quantitative cytochemistry to test the effect of these substances on the generation of NADPH, which is another indicator of the potential for growth. As could be predicted by its trophic action, TSH stimulated the generation of NADPH by glucose 6‐phosphate dehydrogenase. The Ig‐fraction from normal subjects depressed this activity. The Ig‐fraction from Graves’disease patients with goitres stimulated the generation of NADPH, whereas the Ig from patients with Graves’disease but with minimal enlargement of the thyroid gland behaved like normal Ig. A similar lack of stimulation was found with Ig from patients with Pendred's syndrome, other dyshormonogenetic goitres, and autonomous single adenomas. In all specimens tested, there was good correlation between the amount of DNA‐synthesis, measured by Feulgen cytophotometry, and the activity of glucose 6‐phosphate dehydrogenase activity that generated NADPH. These results support the concept that there is a distinct type of autoantibody that influe

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb03146.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYReducing equivalents derived from the tissue re‐oxidation of NADPH (NADPH‐diaphorase) have been implicated in the peroxidation that is involved in the organification of iodine in the production of thyroid hormones. Immunoglobulin (Ig) fractions from patients with thyroid diseases and from normal controls, in a standard dose of 125 μg/ml and 0±3 μ/ml thyrotrophin (TSH) were incubated with segments of guinea‐pig thyroid gland maintainedin vitro.A quantitative cytochemical study was made on how these fractions influenced the enzyme activity. A good correlation was found between the ability of such Ig fractions to stimulate the NADPH‐diaphorase activity and (1) the degree of hyperthyroidism in the patients and (2) the amount of T3 secreted by the thyroid segmen

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb03147.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYShortness of breath is a common symptom in thyrotoxicosis and it may have a number of causes. We have studied dyspnoea, skeletal muscle power and respiratory muscle power in eleven patients who had thyrotoxicosis with no evidence of heart failure.Four patients (36·4%) had a marked improvement with treatment in the maximal inspiratory pressure developed at the mouth. All four were breathless and had a proximal myopathy before treatment. This confirms the existence of a group of thyrotoxic patients with a reversible respiratory muscle myopathy which may explain the frequent finding of breathlessness on exertion in such patients

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb03148.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYHypothalamic–pituitary–adrenocortical (HPA) function was assessed during normal daily work and family life in fifteen male brewery workers with a daily alcohol intake of 100 g or more for at least 10 years. Free urinary cortisol was determined during three baseline days and for 3 days during administration of dexamethasone 0·5 mg 6‐hourly. All subjects had normal basal urinary cortisol excretion and all except one suppressed normally upon dexame our subjects had Cushingoid‐like moon face and two of these also alo hump. There was no correlation between free urinary cortisol or dexamethasone suppression and the Cushingoid stigmata. These results suggest that chronic alcohol intakeper sedoes not influence HPA

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb03149.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

SUMMARYPlasma aldosterone (PA), plasma renin activity (PRA), extracellular fluid volume (EFV) and hepatic blood flow were measured in forty‐four patients with sustained essential hypertension and compared with forty‐two normotensive controls of same age and sex. All patients had inulin clearances within the normal range and balanced sodium intake and urinary output. In hypertensives, PA, PRA, EFV and hepatic blood flow were within normal ranges; the log‐ratio PA: PRA was significantly elevated (P<0·001). In normotensives, a negative relationship was observed between PA and EFV (r= ‐0·55;P<0·001) while a positive relationship was observed between PA and PRA (=+0·70;P<0·001). In hypertensives, the two relationships were disrupted or less significant: for a given value of EFV, PA was more elevated in hypertensives than in normotensives; for a given value of PRA, PA was more elevated in hypertensives than in normotensives. The results could not be explained on the basis of a disturbance in hepatic blood flow and/or in the metabolic clearance rate of aldosterone. The study provided evidence that, in patients with sustained essential hypertension and equilibrated sodium balance, there is an excess of plasma aldosterone relative to the levels of extracellular fluid volume and plasma renin activity. The excess is probably related to an abnormality in the adren

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1982.tb03150.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY