bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECTS OF NORGESTREL AND ETHINYLOESTRADIOL INGESTION ON SERUM LEVELS OF SEX HORMONES AND GONADOTROPHINS IN MEN
Authors: KJELD J. M. , PUAH C. M. , KAUFMAN B. , LOIZOU S. , VLOTIDES J. , GWEE H. M. , KAHN F. , SOOD R. , JOPLIN G. F.
Published: March 2008

DL‐norgestrel and ethinyloestradiol were ingested separately and in combination by six healthy men. Serum levels of testosterone, 5α‐dihydrotestosterone, oestradiol, FSH, LH and prolactin were measured before (basal), during and after ingestion of the combined drugs. Ethinyloestradiol 50 μg and DL‐norgestrel 500 μg for nine days lowered the levels of testosterone to 8% (1·25 nmol/l = 0·36 ng/ml), 5α‐dihydrotestosterone to 22% (0·39 nmol= 106 pg/ml), oestradiol to 46%(0·025 nmol/l = 6·88 pg/ml), FSH to 31% (0·55 U/l)and LH to 61% (2·37 U/l) of the basal values. All levels had risen on the third day after stopping the drugs and had recovered to pretreatment values within a week. Prolactin values did not show any definite trend of change during the treatment. In three men ethinyloestradiol alone, 50 μg daily for 5 days, reduced serum levels of all three sex hormones to approximately 80% of basal levels and FSH to 70% but left LH and prolactin levels unchanged. In three men DL‐norgestrel alone, 525 ug daily for 4 days, reduced the androgen levels to below 40% of the basal levels, but had little effect on oestradiol levels. FSH, LH and prolactin levels were reduced to 63%, 70% and 65% respectively by the 4 days of DL‐norgestrel treatment. The 26 h effects of DL‐norgestrel were studied in three men who ingested 1050 ug of the drug in one dose. Serum testosterone and 5α‐dihydrotestosterone levels had their greatest depression (30% and 60% respectively) at 12 to 14 h after the ingestion, whereas serum levels of DL‐norgestrel peaked at 2 h after the ingestion. In this study serum FSH levels showed a clear depression in two men but LH and prolactin levels did not change. The results show a powerful effect of DL‐norgestrel in reducing serum androgen levels in men, an effect which may be partly mediated through the concurrent suppression of the pituitary gonadotrophins.
THE CIRCADIAN VARIATION OF IMMUNOREACTIVE LIPOTROPHIN AND ITS RELATIONSHIP TO ACTH AND GROWTH HORMONE IN MAN
Authors: MULLEN P. E. , JEFFCOATE W. J. , LINSELL C. , HOWARD R. , REES LESLEY H.
Published: March 2008

There is a clear circadian rhythm of plasma immunoreactive LPH in man with the trough occurring between 22.00 h and 03.00 h and the peak between 07.00 h and 08.00 h, immediately after waking. At all times circulating LPH and ACTH levels follow each other closely. However, no correlation was observed between LPH levels and either plasma GH or the stage of sleep.
URINARY FREE CORTISOL EXCRETION IN PATIENTS WITH HYPERSEROTONINAEMIA FROM THE CARCINOID SYNDROME
Authors: FELDMAN JEROME M.
Published: March 2008

To determine if patients with chronic hyperserotoninaemia from the carcinoid syndrome have increased basal adrenocortical function, I have determined the urinary free Cortisol excretion of seventeen patients with carcinoid tumours and the carcinoid syndrome, twelve patients with carcinoid tumours without the carcinoid syndrome and seventeen normal subjects. There was no significant difference in the urinary free Cortisol excretion of the patients with carcinoid tumours and the carcinoid syndrome (133±20±0 nmoles/24 h), patients with carcinoid tumours without the carcinoid syndrome (115±29 nmoles/24 h) and the normal subjects (96 ±r 9 nmoles/24 h). There was no correlation between the urinary free Cortisol secretion and urinary 5‐hydroxyindoleacetic acid or serum serotonin concentration in the patients with the carcinoid syndrome. There was a suggestion that patients with 5‐hydroxytryptophan (5‐HTP) secreting carcinoid tumours had higher urinary free Cortisol excretion than patients with predominantly serotonin (5‐HT) secreting carcinoid tumours. This may be due to the fact that the non‐polar 5‐HTP molecule penetrates the blood‐brain barrier more effectively than the polar 5‐HT molecule. 5‐HTP is then converted to 5‐HT within the brain. None of the twenty‐nine patients with carcinoid tumours had clinical or laboratory evidence of the ectopic ACTH syndrome.
THE EFFECTS OF PROLONGED ADMINISTRATION OF D‐SER(TBU) 6‐LH‐RH‐EA10 (HOE 766) IN SUBJECTS WITH HYPOGONADOTROPHIC HYPOGONADISM
Authors: SMITH R. , DONALD R. A. , ESPINER E. A. , STRONACH S.
Published: March 2008

Nine patients with hypogonadotrophic hypogonadism (five due to isolated gonadotrophin deficiency and four due to craniopharyngioma) were treated with daily subcutaneous injections of a long acting LHRH analogue, Hoe 766. Therapy was continued for between 27 and 38 weeks and doses varied between 1–25 and 5 μg per day. At monthly intervals patients were assessed by their LH and FSH response to 100 μg of LHRH and by second hourly sampling for LH, FSH and testosterone for the 24 hours after their Hoe 766 dose. Regardless of the diagnosis or the dose of Hoe 766 the LH response to Hoe 766 and to LHRH deteriorated with increasing duration of therapy. Plasma FSH values became low after only 1 week of therapy and failed to improve. Peak plasma testosterone during therapy correlated with peak plasma LH regardless of the duration of treatment (r = 0±43, P < 0±05, n = 22). Peak plasma LH on LHRH stimulation tests correlated with peak plasma LH on Hoe 766 24 hour studies independently of the length of treatment or the dose of Hoe 766 (r=0±62, P < 0±01, n = 18). In this group of patients peak plasma LH on LHRH stimulation tests did not correlate with basal plasma LH. Throughout the study in all patients testosterone was subnormal at 08.00 h. If testosterone rose after Hoe 766 it did so within the first 12 hours following the injection and had returned to baseline levels by 08.00 h the following day. It is concluded that prolonged daily administration of Hoe 766 within the dose range studied leads to loss of pituitary LH and FSH responses to both Hoe 766 and LHRH. Our results suggest that the loss of LH responsiveness is not due to testosterone feedback inhibition or selective resistance to Hoe 766, but may be explained by depletion of gonadotrophin stores in the pituitary gland.
INTERMITTENT CUSHING'S DISEASE WITH SPONTANEOUS REMISSION
Authors: SCOTT R. S. , ESPINER E. A. , DONALD R. A.
Published: March 2008

A patient with well documented Cushing's syndrome, associated with excessive secretion of ACTH, was studied over a 20 month period. During this time there were three episodes of spontaneous biochemical remission and except for a 7 day period of exacerbation the patient has had normal Cortisol production for the last 15 months. During this recent prolonged remission period, repeat pituitary function testing demonstrated persistent abnormalities of the hypothalamic pituitary axis, in that ACTH failed to respond to a hypoglycaemic stimulus. However in all other respects adrenal function was normal with preservation of diurnal rhythmicity of cortisol and ACTH, and intact dexamethasone suppressability of cortisol. The additional unusual features of normal GH and TSH responses to stimulation, during either remission or exacerbation, suggest a subtle and localized hypothalamic defect in this case.
SERUM ANDROGEN CONCENTRATIONS IN NEONATES AND YOUNG INFANTS WITH CONGENITAL ADRENAL HYPERPLASIA DUE TO 21‐HYDROXYLASE DEFICIENCY*
Authors: PANG S. , LEVINE L. S. , CHOW D. M. , FAIMAN C. , NEW M. I.
Published: March 2008

Concentrations of androstenedione (Δ4‐A), dehydroepiandrosterone (DHA), testosterone (T), and 17‐hydroxyprogesterone (17‐OHP) were measured in cord sera and in sera of normal and sick infants from birth to 18 months of age, and were compared with those of five male and five female infants with congenital adrenal hyperplasia due to 21‐hydroxylase deficiency (CAH). Cord blood androgen concentrations (Δ4‐A, DHA, T) in three affected CAH newborns and 17‐OHP in two of these infants did not differ from those of normal newborns (twenty females, thirty‐four males). Postnatally, in infants with CAH, both Δ4‐A and 17‐OHP was highly elevated while DHA was not different from that of normal or sick infants. However, one very sick infant with both elevated Δ4‐A and 17‐OHP was ultimately proven to be normal. T in all affected CAH females (70–650 ng/dl) was clearly elevated compared to normal and sick infants (<5–38 ng/dl). T concentrations in four of the five male infants with CAH (60–295 ng/dl) were indistinguishable from the T concentrations in normal newborn males (25–458 ng/dl). Following treatment, longitudinal studies of 17‐OHP and androgens in these infants with CAH showed significantly positive correlation between 17‐OHP and Δ4‐A in both male (r = 0.74) and female (r = 0.8) infants while a positive correlation between 17‐OHP and T was present only in female infants (r=0–97). Thus, serum Δ4‐A was as useful as 17‐OHP for both diagnosis and therapeutic monitoring of CAH in both sexes while T was useful only in female infants. Of interest was that T in the male infants with CAH rapidly decreased with glucocorticoid administration and remained low (< 2–11 ng/dl) for 3–4 weeks during the period when T is normally high. This suggests that in CAH the T was adrenal in origin and that testicular T was suppressed in the untreated state. These data support the presence of a negative feedback effect by excess adrenal sex steroids o n the hypothalamic‐pituitary‐gonadal axis in young male infants with CAH.
AMYLOID GOITRE IN FAMILIAL MEDITERRANEAN FEVER
Authors: DANOVITCH G. M. , ROITH D. LE , SOBEL R. , SIKULERd E. , STRAUS R.
Published: March 2008

Three patients known to suffer from familial Mediterranean fever (FMF), systemic amyloidosis and chronic renal failure developed large amyloid goitres. Amyloid goitre is an extremely rare complication of systemic amyloidosis not previously described in FMF. The clinical and pathological features of these three cases were similar to those previously described in amyloid goitre. In two of the patients abnormalities in thyroid function were consistent with those documented in chronic renal failure. There was evidence of hypothyroidism in a third patient. There was no evidence of amyloid induced dysfunction of other endocrine organs.
INTERRELATIONS BETWEEN PLASMA AND TISSUE CONCENTRATIONS OF 17 β‐OESTRADIOL AND PROGESTERONE DURING HUMAN PREGNANCY
Authors: BATRA S. , BENGTSSON L. P. , SJÖBERG N‐O.
Published: March 2008

Oestradiol and progesterone concentration in plasma, decidua, myometrium and placenta obtained from women undergoing Caesarian section at term and abortion at weeks 16–22 of pregnancy were determined. There was a significant increase in oestradiol concentration (per g wet wt) both in placenta, decidua and myometrium from mid‐term to term. Both at mid‐term and term oestradiol concentrations in decidua and myometrium were much smaller than those in the plasma (per ml). Progesterone concentration in placenta and in myometrium did not increase from mid‐term to term where it increased significantly in decidua. Decidual and myometrial progesterone concentrations at mid‐term were 2–3 times higher than those in plasma, but at term the concentrations in both these tissues were lower than in plasma. The ratio progesterone/oestradiol in plasma, decidua, myometrium and placenta at mid‐term was 8.7, 112.2, 61.4 and 370.0, respectively, and it decreased significantly in the myometrium and placenta but was nearly unchanged in plasma and decidua at term. The general conclusion to be drawn from the present study is the lack of correspondence between the plasma concentrations and the tissue concentrations of female sex steroids during pregnancy.
PRECOCIOUS PUBERTY ASSOCIATED WITH PRIMARY HYPOTHYROIDISM IN A MONGOL GIRL
Authors: HANCOCK K. W. , STITCH S. R. , CHAPMAN C.
Published: March 2008

A mongol child suffering from hypothyroidism who presented with precocious puberty is described. A presumptive diagnosis of idiopathic precocious puberty was first made and she was treated initially with medroxyprogesterone acetate, and later with cyproterone acetate. The diagnosis of primary hypothyroidism was made late because of misleading results of protein bound iodine estimations. Subsequently, thyroid medication resulted in a prompt return to the normal range of the previously elevated levels of plasma gonadotrophins, thyroid stimulating hormone and plasma and urinary oestrogens, but the serum prolactin remained elevated for several months after therapy was begun.
INCREASED PLASMA ACTIVITIES OF N‐ACETYL‐β‐D‐GLUCOSAMINIDASE ISOENZYMES IN HUMAN DIABETES MELLITUS
Authors: POON P. Y. W. , DORNAN T. L. , ELLIS R. B. , TURNER R. C.
Published: March 2008

Plasma N‐acetyl‐β‐D‐glucosaminidase activities are raised in maturity‐onset insulin‐dependent diabetic patients. Continuous gradient DEAE‐cellulose column chromatography and assay of heat‐stable enzyme activity both show that the activities of all isoenzymes are equally increased rather than a previously described increase of specific isoenzymes. Plasma enzyme activities are similarly increased in patients with and without diabetic retinopathy, and correlate with simultaneous plasma glucose concentrations.
ELEVATED THYROXINE‐BINDING GLOBULIN WITH X‐CHROMOSOME LINKED INHERITANCE
Authors: BUCHANAN B. D. , HAGEN G. A.
Published: March 2008

A new kindred with elevated levels of serum thyroxine‐binding globulin (TBG) as an inherited trait has been reported. Of the twenty‐four family members tested, three males and nine females had elevated serum TBG. The pedigree was consistent with an X‐chromosome linked mode of inheritance.
RELATIONSHIP BETWEEN PLASMA PROLACTIN CONCENTRATION AND PITUITARY FUNCTION IN PATIENTS WITH A PITUITARY ADENOMA
Authors: HAGEN C. , LINDHOLM J. , SUENSON E. , RIISHEDE J. , HUMMER L. , JACOBSEN H.H.
Published: March 2008

The influence of hyperprolactinaemia on endocrine functions in forty‐two consecutive patients with untreated pituitary tumours was studied. Patients with acromegaly, Cushing's disease and Nelson's syndrome were excluded. Sixteen patients (eleven men and five women) had a pituitary adenoma with suprasellar extension and twenty‐six (eleven men and fifteen women) had a small intrasellar tumour. Basal plasma prolactin concentration was measured in all. Thyroid function was assessed by plasma thyroxine (T4) and TSH concentrations, adrenocortical function and growth hormone (GH) secretion by the maximum plasma Cortisol, adrenocorticotrophin (ACTH) and GH concentrations, respectively, during insulin‐induced hypoglycaemia (ITT). Gonadal function was studied by measuring plasma concentrations of luteinizing hormone (LH), follicle stimulating hormone (FSH), oestradiol‐17β and in men, testosterone. On the basis of computer assisted tomography of the sella turcica, the tumour volume was calculated. The basal plasma prolactin concentration was elevated in 69% of the patients. Decreased GH secretion was the most frequent pituitary dysfunction (78%) followed in men by gonadal insufficiency (77%), adrenocortical insufficiency (31%) and thyroid insufficiency (21%). There was no difference between patients with elevated and normal plasma prolactin concentration as to the tumour volume and any of the endocrine variables.
INCREASED ALDOSTERONE SECRETION INDUCED BY SULPIRIDE
Authors: COSTA G. , FRISINA N. , DE PASQUALE R.
Published: March 2008

Sulpiride induces an increase in plasma prolactin and a simultaneous increase of aldosterone release in man. In isolated and superfused bovine adrenal glands, prolactin does not increase aldosterone production even in high concentrations, whereas sulpiride induces a significant and long lasting increase in the production of this hormone and a concomitant increase in the tissue levels of cAMP. This suggests a direct effect on the biosynthesis of aldosterone.
EFFECTS OF SULPIRIDE INDUCED HYPERPROLACTINAEMIA IN PATIENTS WITH TURNER'S SYNDROME
Authors: LOLI P. , RIOLO A. , BONOMO M. , RONZONI M. , BOTALLA L. , GELLI D.
Published: March 2008

In order to evaluate the interference of prolactin (PRL) on some aspects of pituitary‐gonadal derangement observed in patients with hyperprolactinaemic amenorrhoea (HA), a GnRH stimulation test (100 μg i.v.) was performed on twenty‐one patients with hyperprolactinaemia without evidence of pituitary tumour and in nine subjects with Turner's syndrome (TS) before and after sulpiride administration (200 mg/day orally, for 3 months). In patients with HA an enhanced response of gonadotrophins to GnRH was observed. In patients with TS a further increase of the gonadotrophin hyper‐responsiveness to the releasing hormone occurred when hyperprolactinaemia was induced by chronic sulpiride administration. Since, in these patients, appreciable ovarian steroido‐genesis is lacking, a direct effect of the increased plasma PRL at the hypothalamo‐pituitary level is likely. In hyperprolactinaemic amenorrhoea pituitary hyper‐responsiveness may not be due to PRL effect on ovarian steroidogenesis.
A COMPARISON OF NEPHROGENOUS CYCLIC AMP, TOTAL URINARY CYCLIC AMP AND THE RENAL TUBULAR MAXIMUM REABSORPTIVE CAPACITY FOR PHOSPHATE IN THE DIAGNOSIS OF PRIMARY HYPERPARATHYROIDISM
Authors: ALSTON W. C. , ALLEN K.R. , TOVEY J. E.
Published: March 2008

A determination was made of total urinary adenosine 3′‐5′cyclic monophosphate (UcAMP), nephrogenous cyclic AMP (NcAMP) excretion and also of the renal tubular maximum reabsorptive capacity for phosphate TmPO4/GFR (all expressed as a function of the glomerular filtrate) in fourteen patients with primary hypercalcaemic hyperparathyroidism and twelve control normal subjects. The hyperparathyroid patients gave a mean excretion of UcAMP (7·0 ± 45·68 nmol/100 ml GF; mean ± SEM), NcAMP (6·19 ± 0·64 nmol/100 ml GF) which were significantly greater (P < 0·001) than those of normal controls, (2′45 ± 0·15nmol/100 ml GF and 1·25 ± 0·12nmol/100 ml GF) respectively. The difference between the patients and controls for the maximum renal tubular reabsorptive capacity for phosphate (TmPO4/GFR) (patients 0·55 ± 0·04, controls 1·05 ± 0·05 mmol/l GFR) was also highly significant (P<0·001). Statistical evaluation of the results obtained from the patients with primary hyperparathyroidism revealed that there was a positive correlation between the level of plasma calcium and immunoreactive parathyroid hormone (PTH) (r=+0·46), NcAMP(r=+0·337), UcAMP (r=+0·36), and an inverse correlation with the TmPO4/GFR (r=−0·62). There was also a positive correlation between plasma immunoreactive PTH and NcAMP(r=+0·31), and UcAMP(r=+0·35), and an inverse correlation with the TmPO4/GFR (r=−0–39). Successful removal of a single parathyroid adenoma in six patients was associated with a highly significant fall in the excretion of UcAMP, NcAMP, and a rise in the TmPO4/GFR (P<0·005). The combination of a low TmPO4/GFR and a high excretion of UcAMP or NcAMP in the presence of hypercalcaemia is highly suggestive of primary hyperparathyroidism in the absence of clinical evidence of malignant disease.
THE EFFECT OF PROPRANOLOL WITHDRAWAL ON THYROID HORMONES IN NORMAL AND HYPERTHYROID SUBJECTS
Authors: ROSS P. J. , JONES M. K. , JOHN R.
Published: March 2008

Blood thyroid hormone levels were measured during, and for 6 days after, treatment with propranolol (160 mg/day, 4–8 weeks) in five hyperthyroid patients and six normal volunteers. In hyperthyroid patients triiodothyronine (T3) and free triiodothyronine index (FT3I) rose to peak levels 60 h after propranolol withdrawal without significant change in thyroxine (T4) or Thyopac‐3 test. In normal subjects no significant change in thyroid hormone levels was seen during propranolol treatment or withdrawal. The rise in T3 and FT3I coincides with, and may contribute to, the rebound increase in adrenergic activity after propranolol withdrawal in hyperthyroidism.
IN VIVO AND IN VITRO STUDIES ON THE EFFECT OF METOCLOPRAMIDE ON ALDOSTERONE SECRETION
Authors: EDWARDS C. R. W. , AL‐DUJAILI E. A. S. , BOSCARO M. , QUYYUMI S. , MIALL P. A. , REES LESLEY H.
Published: March 2008

Metoclopramide, a dopamine antagonist drug, elevated plasma aldosterone and prolactin levels without significantly affecting plasma renin activity, ACTH or potassium. Studies with isolated perfused rat zona glomerulosa cells showed that metoclopramide could directly stimulate aldosterone release and that this action was blocked by dopamine. These results suggest that dopamine may play an important inhibitory role in the control of aldosterone secretion.
GONADAL‐PITUITARY HORMONE LEVELS IN GYNAECOMASTIA
Authors: McFADYEN I. J. , BOLTON A. E. , CAMERON E. H. D. , HUNTER W. M. , RAAB G. , FORREST A. P. M.
Published: March 2008

Plasma levels of LH, FSH, oestradiol 17β and testosterone were measured in twenty‐two men with gynaecomastia. The group was divided by age into those under and those over 50‐years‐old and the mean hormone levels of the two groups were compared with two groups of age‐matched normal men. In the young men with gynaecomastia LH and consequently the LH: FSH ratio was lower than in controls. Older patients with gynaecomastia had higher values of both LH and FSH than normal controls but the LH: FSH ratio was similar in the two groups. A pulsatile pattern of LH was present only in the young controls. Older controls had higher FSH levels than younger controls. In older men with gynaecomastia oestradiol levels and the oestradiol: testosterone ratio were higher than in those without.
SERUM THYROGLOBULIN CONCENTRATIONS AND 131I WHOLE BODY SCANS IN THE DIAGNOSIS OF METASTASES FROM DIFFERENTIATED THYROID CARCINOMA (AFTER THYROIDECTOMY)
Authors: PACINI F. , PINCHERA A. , GIANI C. , GRASSO L. , BASCHIERI L.
Published: March 2008

SUMMARY. Measurements of circulating thyroglobulin (hTg) and 131I whole body scan were performed in 101 patients with differentiated thyroid carcinoma who had been subjected to surgical thyroidectomy and 131I ablation of remaining thyroid tissue. All 45 patients with positive scans (i.e. functioning metastases) had elevated hTg concentrations. Of fifty‐six patients with negative scans forty‐two had undetectable or very low hTg levels and were considered to be free of metastatic thyroid tissue, whereas fourteen showed the presence of non‐functioning metastases in the clinical and/or radiological examination. In this group of patients, eleven had elevated serum hTg levels while the other three patients had detectable hTg concentrations within the normal range. These results indicate that serum hTg measurements correlate very well with scan findings and have the added advantage of detecting non‐functioning metastases which would not be detected by scanning. We concluded that measurement of serum hTg may be used together with scanning, as the first step in the follow‐up of thyroidectomized patients with differentiated thyroid carcinoma.
LACK OF EFFECT OF SOMATOSTATIN ON THYROID GLAND FUNCTION IN GRAVES' DISEASE
Authors: SKARE S. , FREY H. M. M.
Published: March 2008

Five women with Graves' disease, 26–52 years of age, with serum concentrations of triiodothyronine (T3) 4·8–9·2 nmol/l and thyroxine (T4) 200–320 nmol/l were studied. A 26 h infusion of cyclic somatostatin (Bachem), 6 mg in isotonic saline solution was administered. Radioactive iodine i.v. (125I or 131I) was given immediately after the start of this infusion. Serum T3, T4 and conversion rate (CR%= PBRI: total RI × 100) were determined four times during the infusion, then daily for a week. The same studies, related to an injection of radioiodine, were performed during a control week when no somatostatin was administered. Arginine‐stimulated insulin and growth hormone (hGH) concentrations were considerably lowered by the somatostatin infusion. No difference in serum T3, T4 or CR between the week that started with somatostatin infusion and the control week was observed. Twelve‐26 h after the somatostatin infusion started, all patients experienced gastrointestinal symptoms, which lasted 2–6 h after somatostatin withdrawal. Somatostatin in the dose given does not inhibit thyroid gland function in Graves' disease.
THE EFFECT OF CYPROTERONE ACETATE ON SERUM TESTOSTERONE, LH, FSH, AND PROLACTIN IN MALE SEXUAL OFFENDERS
Authors: JEFFCOATE W. J. , MATTHEWS R. W. , EDWARDS C. R. W. , FIELD L. H. , BESSER G. M.
Published: March 2008

The anti‐androgen, cyproterone acetate, was administered in a dose of 100 mg/day to eight adult male sexual offenders for 21–31 days. Serum testosterone fell to subnormal levels within 7 days and remained low for 6–28 days after treatment was stopped. The fall in testosterone was accompanied by a fall in serum luteinizing hormone (LH) and follicle stimulating hormone (FSH), and a rise in serum prolactin. All subjects experienced a decrease in libido and in frequency of masturbation. The probable mechanisms of action of cyproterone acetate are discussed, as is its potential role in the management of sexual offenders. These studies suggest that measurement of serum testosterone could be used as an index of compliance in sexual offenders treated with cyproterone acetate who are released on parole.
GLYCOPROTEIN HORMONE α SUBUNIT SECRETION BY PITUITARY ADENOMAS: INFLUENCE OF EXTERNAL IRRADIATION
Authors: MACFARLANE I. A. , BEARDWELL C. G. , SHALET S. M. , DARBYSHIRE P. J. , HAYWARD ELIZABETH , SUTTON M. L.
Published: March 2008

In ninety‐nine patients with pituitary adenomas, forty‐six with acromegaly, the serum level of the glycoprotein hormone α subunit was elevated in eighteen cases. Thirteen of these were acromegalic and one had an FSH‐producing tumour. Alpha levels varied little during the day, from one day to the next and over a 6 month period. In twenty‐five patients with a variety of other hypothalamic‐pituitary disorders examined, one patient with a craniopharyngioma had a mildly elevated α level. External pituitary irradiation was followed by an acute and often transient fall in α level in several of these patients. Of the fifty‐four patients with pituitary adenomas who had received external irradiation before testing, only five had elevated α subunit levels compared with thirteen patients of the forty‐five who had not been irradiated. This difference in incidence of elevated α level was statistically significant (P < 0·025). We conclude that external irradiation may reduce a subunit level chronically in many patients with pituitary adenoma.
CSF AND PLASMA SOMATOSTATIN LEVELS IN ACROMEGALY
Authors: WASS J. A. H. , PENMAN ERICA , MEDBAK S. , REES LESLEY H. , BESSER G. M.
Published: March 2008

Cerebrospinal fluid (CSF) and plasma levels of somatostatin have been measured in patients with active acromegaly and the results compared to those obtained in patients with non‐endocrine diseases. Plasma levels have also been studied in acromegalics given oral glucose. The mean CSF somatostatin level in twenty patients without endocrine disease was 76 pg/ml (range 46–112) which did not diner significantly from that found in eight acromegalics (mean 87 pg/ml, range 48–160). Plasma somatostatin in twenty‐two acromegalic patients on no medical treatment was 43 pg/ml (range 9–113), not significantly different from values in a normal control population. There were no differences in the somatostatin levels of non‐diabetic acromegalics. After oral glucose, there was a rise in circulating somatostatin in eleven out of twelve acromegalic patients, and this rise did not differ from that seen in normal subjects. It is probable that altered somatostatin secretion is neither the cause nor the result of acromegaly; however it is possible that local changes in somatostatin concentration which are not reflected in peripheral plasma or CSF levels may occur near the site of its production.
HYPERPROLACTINAEMIA DURING PROLONGED LACTATION: EVIDENCE FOR ANOVULATORY CYCLES AND INADEQUATE CORPUS LUTEUM
Authors: DELVOYE P. , DELOGNE‐DESNOECK J. , ROBYN C.
Published: March 2008

Serum progesterone and prolactin were measured in single blood samples collected from 176 mothers during a lactation period of 2 years and from fifty‐six non‐lactating, non‐pregnant and regularly menstruating women from the Kivu region (Zaire). On the basis of serum progesterone levels, evidence of corpus luteum activity was obtained in 61% of non‐lactating women; but only 20% of non‐amenorrhoeic lactating mothers. This suggests an increased incidence of anovulatory cycles and/or cycles with short luteal phases among nursing mothers. The incidence of corpus luteum activity was 8% in amenorrhoeic lactating mothers. In this 8% recurrence of ovulation preceded return of menstruation. Mean serum progesterone was significantly higher and serum prolactin significantly lower in the non‐lactating women than in the nursing mothers. This suggests that although ovulation occurs, corpus luteum activity is inadequate in hyperprolactinaemic nursing mothers.
NORMAL AND MALIGNANT BREAST TISSUE IS A TARGET ORGAN FOR 1, 25‐(OH)2 VITAMIN D3
Authors: EISMAN J. A. , MACINTYRE I. , MARTIN T. J. , FRAMPTON R. J. , KING R.J.B.
Published: March 2008

Malignant and benign human breast tumours as well as rabbit breast tissue were examined for specific receptors for 1,25‐dihydroxyvitamin D3 using competitive binding studies and sucrose density gradient analysis. Classical high affinity, low capacity receptors for 1,25‐dihydroxyvitamin D3 were found in breast and node tissue in seven of ten patients with breast cancer and in all three patients with benign neoplasms. An inflammatory breast mass showed no binding. Similar receptors were found in breast tissue from pregnant and lactating rabbits. Taken with other recent data, these results suggest that 1,25‐dihydroxyvitamin D3 may activate calcium transport in the malignant as well as in the normal lactating breast.
LONG TERM SPIRONOLACTONE AND THE ADRENAL CORTEX IN ESSENTIAL HYPERTENSION
Authors: LEWIS P. S. , GORCHEIN A. , JAMES VIVIAN H. T. , MAY C. N. , HORTH C. E.
Published: March 2008

In view of recent evidence that spironolactone may inhibit synthesis of corticosteroids by a direct effect on the adrenal cortex, adrenocortical function was studied in eight patients with essential hypertension who had been treated with spironolactone from 3 months to 14 years. Their 24 h renal excretion of adrenocorticoid metabolites and the responses of cortisol, aldosterone and 18‐hydroxy‐1 l‐deoxycorticosterone (18‐OH‐DOC) to an incremental infusion of tetracosactrin (1–24 ACTH) were compared with those in eight patients with recently diagnosed essential hypertension who had received no spironolactone. The spironolactone‐treated group had a significantly higher excretion of aldosterone, whilst the excretion of other adrenocorticoid metabolites did not differ. The same group also required less tetracosactrin to stimulate a detectable rise of plasma cortisol and 18‐OH‐DOC, they had greater plasma 18‐OH‐DOC responses at all infusion rates and, at the lowest infusion rates, had greater aldosterone responses. These results indicate that long‐term spironolactone therapy does not inhibit adrenocortical function and may have some stimulatory effects.
PITUITARY SURGERY FOR ENDOCRINE DISORDERS
Authors: NABARRO J. D. N.
Published: March 2008

The use of pituitary surgery for patients with over‐production of growth hormone, corticotrophin and prolactin is reviewed. The value of specialized neuroradiological techniques is discussed including computerized tomography, air‐encephalography and cavernous sinus venography. The indications for transcranial as opposed to trans‐sphenoidal surgery are considered.

The place of trans‐sphenoid surgery in the treatment of acromegaly is emphasized and the indications for surgical treatment are reviewed.

The two syndromes due to over‐production of ACTH are considered—Cushing's disease and Nelson's syndrome. The increasing use of pituitary surgery for the treatment of Cushing's syndrome due to increased ACTH production is noted, but a warning is given about the small ACTH‐secreting pulmonary carcinoid tumour that may closely mimic Cushing's disease. The difficulties encountered in trying to treat patients with Nelson's syndrome are stressed. It is recommended that in the rare case where total adrenalectomy is required in Cushing's disease, pituitary irradiation should be given before or shortly after adrenalectomy.

The present position relating to the surgical treatment of the small prolactin‐secreting pituitary tumour is reviewed. Published data and personal experience suggests that for many of these patients, treatment with bromocriptine is preferable to trans‐sphenoidal surgery. Large prolactinomas usually need trans‐frontal surgery and X‐ray therapy, sometimes followed by bromocriptine treatment.

The need for steroid cover for pituitary surgery is discussed and it is suggested that a glucocorticoid with less salt‐retaining action than cortisol should be used. The importance of post‐operative endocrine assessment is emphasized and a convenient method suggested. The incidence of complications after trans‐sphenoidal surgery is low, although panhypopituitarism occurred in 14% of the cases reported.
AN IMPROVED METHOD FOR THE DETECTION OF HETEROZYGOSITY OF CONGENITAL VIRILIZING ADRENAL HYPERPLASIA
Authors: LEJEUNE‐LENAIN C. , CANTRAINE F. , DUFRASNES M. , PREVOT F. , WOLTER R. , FRANCKSON J. R. M.
Published: March 2008

A modified short ACTH test for the detection of heterozygote carriers of 21‐hydroxylase deficiency (21‐OHD) was applied to twenty‐one controls and fourteen parents of children with 21‐OHD. The following modifications were introduced: (1) Endogenous ACTH was suppressed by dexamethasone administration prior to the test, (2) Plasma 17‐hydroxyprogesterone (17‐OHP), cortisol (F), progesterone (P), corticosterone (B) and Δ4‐ androstenedione (A) were measured, (3) Variables studied were the ratio of plasma increments (A) between precursors and end products, (4) Data were analysed by a step‐wise discriminant analysis. Significant alterations in the metabolic pathway of F, B and A were demonstrated. The discriminant analysis showed that the addition of B pathway data did not improve the discrimination potency of the test performed on F pathway data. The combination of variates which provided the best discrimination was the logarithmic sum of Δ 170HP/ΔF at 15 and 30 min. It led to a 94% correct classification for normals and carriers.
LEYDIG CELL DYSFUNCTION AND GYNAECOMASTIA IN ADULT MALES TREATED WITH ALKYLATING AGENTS
Authors: FRIEDMAN N. M. , PLYMATE S. R.
Published: March 2008

Three adult males presented with gynaecomastia, small testes and clinical features of androgen deficiency after treatment with alkylating agents. Laboratory evaluation revealed elevated serum follicle stimulating hormone and luteinizing hormone. Serum testosterone levels were in the low normal range. Treatment with testosterone oenanthate relieved the symptoms of androgen deficiency in addition to reducing the size and tenderness of the gynaecomastia. It is postulated that in addition to the well documented effects of alkylating agents on the seminiferous tubules, a state of ‘compensated Leydig cell dysfunction’ is induced. The relative decrease in serum testosterone and concomitant lowering of the testosterone to oestrogen ratio may act as a stimulus for breast development. Therefore, treatment with exogenous testosterone would be expected to be effective.
CIRCULATING SOMATOSTATIN AFTER FOOD AND GLUCOSE IN MAN
Authors: WASS J. A. H. , PENMAN ERICA , DRYBURGH JILL R. , TSIOLAKIS D. , GOLDBERG P. L. , DAWSON A.M. , BESSER G. M. , REES LESLEY H.
Published: March 2008

Using a recently validated radioimmunoassay, changes in circulating somatostatin have been measured in normal subjects after food (a standard breakfast), and oral and intravenous glucose. After the standard breakfast, a clear and sustained rise in plasma somatostatin was seen in all subjects from a mean value (± 1 SE) of 28 ± 7 pg/ml to a mean peak value, at 60 min of 57 ± 11 pg/ml. When glucose was taken by mouth a significant but smaller rise was seen, but intravenous glucose caused no significant change in plasma somatostatin. A rise in circulating somatostatin after feeding has not previously been demonstrated in normal man and it is suggested that somatostatin may have an important endocrine role in the gut.
CORTISOL, GROWTH HORMONE AND PROLACTIN RESPONSES TO INSULIN‐INDUCED HYPOGLYCAEMIA IN HYPERTHYROID PATIENTS BEFORE AND DURING β‐ADRENOCEPTOR BLOCKADE
Authors: NILSSON O. R. , ANDERBERG B. , KARLBERG B. E. , KAGEDAL B.
Published: March 2008

Two β‐adrenoceptor blocking agents, metoprolol (β‐1‐selective) and propranolol (non‐selective), were used in the treatment of hyperthyroid patients. The response of pituitary stress hormones to insulin‐induced hypoglycaemia was investigated before and during β‐adrenoceptor blockade. Treatment with metoprolol (n= 10) or propranolol (n= 10) produced no changes in the cortisol or prolactin responses to hypoglycaemia. Moreover the growth hormone response remained unaltered during treatment with metoprolol. A small, but statistically significant, augmentation of growth hormone response was obtained during treatment with propranolol. When twelve subjects, euthyroid after final conventional treatment (surgery, radioiodine or thyrostatic drugs), were re‐examined, the cortisol and prolactin responses were unchanged, although growth hormone concentrations reached a slightly higher maximum value (P > 0·01). It was concluded that treatment with β‐blocking agents in hyperthyroid subjects has no clinically important influence on the release of pituitary stress hormones during hypoglycaemia.
THE EFFECTS OF ARGININE, INSULIN AND METOCLOPRAMIDE ON GROWTH HORMONE, PROLACTIN AND CORTISOL RELEASE IN CHILDREN
Authors: IJAIYA K. , ROTH B. , SCHWENK A.
Published: March 2008

The growth hormone (GH) and prolactin (PRL) responses to metoclopramide (MCP) were compared to those with arginine and insulin‐induced hypoglycaemia in eight children. While a significant rise in GH release after stimulation with arginine and insulin occurred in all subjects (P > 0·05), no significant increase after MCP ingestion was observed. Metoclopramide, a dopamine antagonist, stimulated PRL release in all children, while arginine and insulin‐induced hypoglycaemia stimulation tests showed variable PRL responses. A statistically significant increase in cortisol secretion 5 h following MCP was observed (trend test, Cox & Stuart, 1955) (P > 0·05), but the plasma concentration at this time was still within the normal range. Metoclopramide stimulation is not a suitable test for growth hormone deficiency in children.
CONVERSION OF DEHYDROEPIANDROSTERONE SULPHATE TO OESTROGENS IN INTRAHEPATIC CHOLESTASIS AND OTHER COMPLICATIONS OF PREGNANCY
Authors: YLÖSTALO P. , KAUPPILA A. , REINILÄ M. , TUIMALA R. , YLIKORKALA O.
Published: March 2008

The aim of the present study was to determine whether pregnancy complications themselves influence the conversion rate of dehydroepiandrosterone sulphate (DHAS) to oestrogens during pregnancy. 100 mg of DHAS was given intravenously to seven women with intrahepatic cholestasis of pregnancy, nine women with preeclampsia, nine diabetics, ten with twins and eight women with normal pregnancy between 31–40 weeks of gestation. Serum oestradiol (E2) and oestriol (E3) were measured with specific radioimmunoassays before and 1–5 h after DHAS injections. A significant oestradiol elevation following DHAS was similar in each group. By contrast there was an oestriol elevation (P < 0·05) only in intrahepatic cholestasis of pregnancy. The results indicate that: (1) pregnancy complication itself does not affect the conversion rate of DHAS to oestradiol, (2) in patients with intrahepatic cholestasis there is a disturbed E3 metabolism which may be due to an increased placental permeability to exogenous DHAS or to a decreased metabolism of E3 by maternal liver.
ENDOCRINE INFLUENCES ON SERUM ACID‐ETHANOL SOLUBLE NON‐SUPPRESSIBLE INSULIN‐LIKE ACTIVITY (NSILA‐S)
Authors: FRANKLIN R. C. , RENNIE G. C. , BURGER H. G. , CAMERON D. P.
Published: March 2008

Serum levels of the acid‐ethanol soluble component of non‐suppressible insulin‐like activity (NSILA‐S) have been measured by bioassay in patient with hyperprolactinaemia, hypothyroidism, thyrotoxicosis and diabetes mellitus, and in normal subjects administered prednisone, oestrogens or androgens. Hyperprolactinaemia per se did not influence serum NSILA‐S, however when GH was deficient prolactin hypersecretion may have maintanied serum NSILA‐S. Thyroid hormones, insulin and steroids did not appear to influence serum NSILA‐S. These results suggest that regulation of the serum concentration of NSILA‐S is not a common effector mechanism by which these hormones influence statural growth in man.
INSULIN‐LIKE GROWTH FACTOR AND ITS CARRIER PROTEIN IN HYPOPITUITARY AND HYPOTHYROID CHILDREN AND ADULTS
Authors: DRAZNIN B. , BURSTEIN P. J. , HEINRICH U. E. , JOHNSON CAROLYN B. , EMLER CAROL A. , SCHALCH D. S.
Published: March 2008

Utilizing radioligand assays for the somatomedin, insulin‐like growth factor (IGF), and its carrier protein (CP), we have compared their serum levels in normal subjects with those in patients with hypopituitarism and hypothyroidism. The mean (±SEM) serum IGF concentration in children (n= 32, 2–13 yr, 929 ± 46 μU/ml) was virtually identical to that in adults (n= 20, 18–50 yr, 916·29 μU/ml), while CP levels in the former (1·8 ± 0·1 mg/ml) were significantly lower (P < 0·01) than in the latter (2·9 ± 0·1 mg/ml). Both serum IGF and CP were significantly decreased (P < 0·001) in hypopituitary children (n= 5, 6–8 yr, 377 ± 52 μU/ml and 0·9 ± 0·1 mg/ml respectively). Likewise, serum IGF and CP were significantly reduced (P < 0·05) in hypothyroid children (n= 10, 1–15 yr, 497 ± 24 μU/ml and 0·8 ± 0·1 mg/ml respectively) and adults (n= 12, 25–55 yr, 723 ± 40 μU/ml and 1·8 ± 0·2 mg/ml respectively). Growth hormone therapy (4 days) significantly increased (P < 0·05) serum IGF in hypopituitary children (336 ± 80 to 559 ± 59 μU/ml) but did not change the CP level (0·7 ± 0·2 to 0·7 ± 0·1 mg/ml). Thyroxine therapy (4–8 months) significantly increased (P < 0·05) both serum IGF and CP levels in hypothyroid children (497 ± 24 to 666 ± 38 μU/ml, and 0·8 ± 0·1 to 1·0 ± 0·1 mg/ml respectively) but had no effect in adults (723 ± 40 to 937 ± 132 μU/ml, and 1·8 ± 0·2 to 2·1 ± 0·2 mg/ml respectively). These studies indicate that growth retardation in children with hypopituitarism and hypothyroidism is associated with significant reductions in serum IGF and CP levels that are corrected, at least in part, by adequate hormone replacement therapy.
THYROTROPHIN BINDING INHIBITING IMMUNOGLOBULINS IN GRAVES' DISEASE BEFORE, DURING AND AFTER ANTITHYROID THERAPY, AND ITS RELATION TO LONG‐ACTING THYROID STIMULATOR
Authors: DOCTER R. , BOS G. , VISSER T. J. , HENNEMANN G.
Published: March 2008

Thyrotrophin binding inhibiting immunoglublins (TBII) were measured in twenty‐five patients with unequivocal hyperthyroid Graves' disease with a radioreceptor assay for TSH before, during and at the end of treatment with antithyroid drugs and triiodothyronine. To assess the outcome of this therapy patients were followed for 10–90 months (mean 63 months). Before treatment there was a significant correlation between TBII activity and serum thyroxine (r =−0·48, P < 0·05) and between TBII activity and 24 hour 131I thyroid uptake (r =−0·57, P < 0·01). No relationship was found between TBII activity and 20 min, 4 hour and 48 hour 131I thyroid uptakes before institution of therapy. During treatment a significant correlation between TBII index and 20 min 131I thyroid uptake was found (r =−0·55, P < 0·001). Both before and during treatment there was a significant correlation between TBII and LATS activity (r =−0·65, P < 0·001). From the magnitude of this correlation coefficient it can be concluded that related, although not the same immunoglobulins, are measured with the two assay techniques. It is not possible to predict the occurrence of a relapse from the presence or absence of TBII activity at the end of treatment in this group of patients. The relapse rate was four out of eight for patients without TBII activity in their serum at the end of treatment and five out of nine for patients with TBII activity. From the data presented it can be concluded that although there is a significant relation between TBII activity and some indices of thyroid function before and during treatment, the correlation coefficients are too small to conclude that TBII alone is responsible for the hyperfunction of the thyroid. The same conclusion can be drawn from the fact that TBII activity has no prognostic value in relation to a possible relapse.
HLA ANTIGENS AND THYROID AUTOANTIBODIES IN PATIENTS WITH GRAVES' DISEASE AND THEIR FIRST DEGREE RELATIVES
Authors: MATHER B. A. , ROBERTS D. F. , SCANLON M. F. , MUKHTAR E. D. , DAVIES T. F. , SMITH B. REES , HALL R.
Published: March 2008

Patients with Graves' disease (n= 105) had an increased frequency of HLA‐B8 (40%) and a reduced frequency of HLA‐B12 (24·8%) when compared with random controls (n=117; 24·8% and 40·2% respectively). Comparison of patients with their first degree relatives (n= 118) shows the frequency deviations in these antigens to be characteristic of the families from which patients with Graves' disease are drawn, rather than of the disease itself. The haplotypes, identified in eighty‐six patients and 113 relatives, indicate that the excess of HLA‐B8 in patients and their relatives is primarily due to the haplotype 1–8. The relative risk for an HLA‐B8 individual of developing Graves' disease is 2·02, whilst the relative risk for an individual of haplotype 1–8 is 4·23. No significant associations were found between the incidence of any HLA antigen or combination thereof and the presence or absence of thyroglobulin and thyroid microsomal antibodies, or antibodies which interact with the TSH receptor.
BROMOCRIPTINE TREATMENT OF PATIENTS WITH ACROMEGALY RESISTANT TO CONVENTIONAL THERAPY
Authors: PELKONEN R. , YLIKAHRI R. , KARONEN S.‐L.
Published: March 2008

Eleven patients with active acromegaly resistant to conventional therapy were treated with bromocriptine for 15 (12–22) months by increasing the daily dose stepwise from 5 to 10–60 mg. A satisfactory response was achieved in all but one of the eight patients, in whom the mean diurnal level of serum GH was less than 50 ng/ml, whereas patients with grossly elevated serum GH levels responded poorly. In the longterm, no overall effects on glucose tolerance or plasma insulin (IRI) levels were observed but the chemical diabetes of three patients ameliorated in two. On the other hand, a dose‐dependent acute suppressive effect of bromocriptine on plasma IRI response to oral glucose was observed, suggesting a direct effect of bromocriptine on the release of insulin from beta cells. Bromocriptine seems to be a good alternative in the treatment of patients with acromegaly who have not responded to conventional therapy.
PARATHYROID HORMONE AND 25‐HYDROXYVITAMIN D LEVELS IN GLUCOCORTICOID‐TREATED PATIENTS
Authors: SLOVIK D. M. , NEER R. M. , OHMAN J. L. , LOWELL F. C. , CLARK M. B. , SEGRE G. V. , POTTS J. T.
Published: March 2008

Abnormalities in parathyroid hormone (PTH) secretion or vitamin D action or metabolism have been suggested as pathogenetic factors in the bone disease associated with chronic glucocorticoid therapy. We have found normal plasma PTH values in forty‐eight adult asthmatic patients on chronic glucocorticoid therapy, twelve asthmatics treated without glucocorticoids and ten adults on short‐term, high‐dose glucocorticoid therapy for non‐asthmatic illnesses. The mean serum 25‐OHD level in the glucocorticoid‐treated asthmatics was not significantly different from a disease control group of asthmatic patients not on glucocorticoids, but nine such patients had abnormally low 25‐OHD levels. Our results indicate that in asthmatic patients on chronic glucocorticoid therapy: (1) PTH and 25‐OHD values are usually normal regardless of dose or duration of therapy and (2) there is a subset of patients with low 25‐OHD values which may reflect unusual sensitivity to glucocorticoids.