bluuebunny/crossref_metadata_2025 huggingface dataset:
BROMOCRIPTINE SUPPRESSION OF TRH‐STIMULATED PROLACTIN AND THYROTROPHIN RELEASE AND ACCOMPANYING INHIBITION OF BROMOCRIPTINE INDUCED GROWTH HORMONE RELEASE BY TRH IN NORMAL MAN
Authors: BROWN P. M. , BACCHUS R. , SACHS L. , SÖNKSEN P. H. , WHEELER M.
Published: March 2008

Six normal fasting males received on four separate occasions in random order (1) a placebo tablet followed 60 min later by 200 μg of TRH intravenously (2) bromocriptine 2.5 mg orally followed by TRH intravenously (3) bromocriptine 2.5 mg orally followed by a placebo injection and (4) placebo tablet followed by placebo injection. Plasma prolactin and TSH responses to TRH were decreased following bromocriptine pretreatment. The rise of plasma growth hormone after bromocriptine was inhibited by TRH. The rise in plasma FSH seen after TRH injection was not influenced by bromocriptine pretreatment. Circulating LH and insulin concentrations were unaffected by any drug administration. These results suggest a dopaminergic influence on prolactin and TSH release in normal men, an inhibitory effect of TRH on bromocriptine stimulated growth hormone secretion, and no dopaminergic modulation of basal insulin secretion.
PLASMA LEVELS OF SOMATOSTATIN‐LIKE IMMUNOREACTIVITY–INDEPENDENCE OF KIDNEY FUNCTIÓN
Authors: LUNDQVIST GUDMAR , GUSTAVSSON SVEN , HÄLLGREN ROGER
Published: March 2008

Plasma levels of somatostatin‐like immunoreactivity (SLI) and gastrin were determined by radioimmunoassay in patients with varying degrees of renal dysfunction. The plasma SLI was not increased in patients with end‐stage renal failure as compared to healthy controls. In patients with varying degrees of renal insufficiency no significant correlation was found between the plasma SLI and kidney function as estimated by the51Cr‐EDTA‐clearance rate. In uraemic patients a significant inverse correlation was found between plasma SLI and plasma gastrin.
ECTOPIC FUNCTIONING ADRENOCORTICO‐MYELOLIPOMA IN LONGSTANDING NELSON'S SYNDROME
Authors: MASCHLER ITZHAK , ROSENMANN ELIEZER , EHRENFELD ERNEST N.
Published: March 2008

A 26‐year‐old man with the Nelson's syndrome is described, in whom an abdominal tumour developed, accompanied by recurrent Cushing's syndrome 11 years after total adrenalectomy. Upon removal the tumour was a myelolipoma containing islands of adrenocortical‐like elements. On incubation of the tumour with radioactive precursors, its capacity to produce cortisol in vitro was shown. The name adrenocortico‐myelolipoma is suggested for this tumour.
MINERALOCORTICOID REPLACEMENT IN ADDISON'S DISEASE
Authors: THOMPSON D. G. , MASON A. STUART , GOODWIN F. J.
Published: March 2008

Eight patients with treated Addison's disease were studied whilst receiving different doses of fludrocortisone together with a constant intake of glucocorticoid. Plasma renin activity (PRA), blood pressure, pulse rate and plasma potassium and urea concentrations were measured after 2‐week periods on each dose. In two patients, PRA measurements indicated that mineralocorticoid replacement therapy had been inadequate. In four others, PRA remained normal throughout the study, even after fludrocortisone had been discontinued, suggesting that the drug was unnecessary for the maintenance of normal sodium balance in these patients. Asymptomatic fludrocortisone overdosage was indicated by a low plasma potassium concentration, but not by PRA measurements which failed in this study to distinguish between adequate and excessive mineralocorticoid replacement.
PLASMA RENIN ACTIVITY AND ALDOSTERONE CONCENTRATION IN NORMAL SUBJECTS AND PATIENTS WITH SALT‐LOSING TYPE OF CONGENITAL ADRENAL HYPERPLASIA DURING INFANCY
Authors: KOSHIMIZU TAKASHI
Published: March 2008

Plasma renin activity (PRA) and aldosterone concentration (PAC) were determined in normal infants aged 20 days to 1 year as well as in normal neonates and older children. The responses of PRA and PAC to five intramuscular injections of synthetic ACTH‐Z at 6‐hour intervals while on replacement cortisol therapy were also studied in nine infants with salt‐losing type of congenital adrenal hyperplasia due to 21‐hydroxylase deficiency (CAH) of varying severity, using the data obtained in normal infants as control. The mean PRA and PAC decreased with age from the neonatal period, but in infants aged 20 days to 3 months these variables remained as high as those in newborns. They were also remarkably higher in infants aged 4 to 12 months than in older children. In two cases of CAH (cases 1 and 2) where salt wasting symptoms had been only transiently observed during the neonatal period, PAC was markedly elevated in response to ACTH administration, while in the remaining seven infants with CAH (cases 3–9) with persistent salt wasting symptoms, PAC was not elevated at all or only slightly so. PRA, on the other hand, increased with time during the ACTH stimulation in cases 3–9, while it increased and then decreased in cases 1 and 2. These findings suggest that the salt‐wasting symptoms in CAH may arise where there is a tendency toward renal salt loss due to the overproduction of ACTH‐dependent steroids characteristic of this disease, and cannot be compensated for by sufficient secretion of aldosterone. In cases 3–9, the maximal PAC under the ACTH stimulation was 17–44 ng/dl. These levels are comparable to or even higher than the normal range for control older children aged 2–8 years, but the levels were inappropriately low for the marked elevation of PRA in all of them when compared with the mean level in normal infants. Therefore, these data also seem to explain at least in part the well known clinical fact that the salt wasting symptoms in CAH are severe during infancy, requiring the administration of mineralocorticoids in addition to cortisol. However, beyond infancy only the replacement cortisol therapy is necessary to remit the symptoms.
MATERNAL SERUM PROLACTIN AND ITS RESPONSE TO TRH IN NORMAL AND COMPLICATED EARLY PREGNANCY
Authors: YLIKORKALA O. , KIVINEN S. , REINILA M.
Published: March 2008

Maternal serum prolactin levels (PRL) were measured by radioimmunoassay in thirty‐four women with either normal or complicated early pregnancy. The basal PRL level (mean ± S.D.) of 33.4 ± 16.4 ng/ml in normal pregnancy (n= 15) was similar to the level of 32.7 ± 18.8 ng/ml in threatened abortion (n= 11) and 32.8 ± 16.9 ng/ml in hyperemesis gravidarum (n= 8). Two patients, one with blighted ovum and the other with subsequent spontaneous abortion, demonstrated PRL levels lower than the range of 20–63 ng/ml in the control group. The PRL response to 200 μg of synthetic thyrotropin releasing hormone (TRH) administered intravenously was similar throughout the patient groups. The basal level of PRL in the whole series was more closely related to the level of serum oestradiol (r= 0.778, P < 0.001) than to that of serum progesterone (r= 0.442, P < 0.05). However the increments of PRL following TRH administration did not correlate with either oestradiol or progesterone.
LACK OF EFFECT OF PROLACTIN SUPPRESSION ON PLASMA DEHYDROEPIANDROSTERONE SULPHATE
Authors: METCALF M. G. , ESPINER E. A. , DONALD R. A.
Published: March 2008

In twelve patients with hyperprolactinaemia, treatment which reduced plasma prolactin from a mean of 531 μg/1 (range 68–3500 μg/1) to 8.3 μg/1 (0–27 μg/1), caused no significant change in plasma dehydroepiandrosterone sulphate (DHA‐SO4).Pre‐treatment levels of DHA‐SO4 were within the normal range in eleven out of twelve cases. The results do not support for claims that prolactin excess is associated with an increase in circulating DHA‐SO4.
EFFECTS OF HEROIN ADDICTION ON THYROTROPHIN, THYROID HORMONES AND PROLACTIN SECRETION IN MEN
Authors: CHAN VIVIAN , WANG CHRISTINA , YEUNG ROSE T. T.
Published: March 2008

Pituitary‐thyroid function in male heroin addicts and addicts after abstinence (exaddicts) was studied and compared with that of healthy euthyroid men. In heroin addicts the increases in circulating total thyroxine and triiodothyronine levels were accompanied by an increase in the thyroid hormone uptake test. These changes may reflect a quantitative increase in thyroxine binding globulin. Reverse triiodothyronine concentrations in heroin addicts were normal. The thyrotrophin‐releasing hormone elicited a diminished thyrotrophin response in heroin addicts which was significantly different from that in control subjects and ex‐addicts. An elevation of serum prolactin was noted in heroin addicts, while ex‐addicts had normal levels. Gradual recovery of pituitary‐thyroid function occurred after heroin withdrawal.
HUMAN GROWTH HORMONE (hGH) STIMULATION TESTS: THE SEQUENTIAL EXERCISE AND l‐DOPA PROCEDURE
Authors: LIBERMAN BERNARDO , CESAR FERNANDO PRESTES , WAJCHENBERG BERNARDO LÉO
Published: March 2008

Forty‐eight normal volunteers, thirteen subjects with short stature without apparent cause and thirty‐one patients with delayed growth clinically highly suggestive of growth hormone deficiency (GHD), with chronological ages of 11.4 ±0.4 years (mean±SEM), 14.0 ±0.7 years and 12.8 ± 0.8 years; height age of 11.0 ± 0.4 years, 8.9 ± 0.7 years and 6.3 ± 0.4 years and bone age of 10.7 ± 0.7 years, 9.9 ± 0.8 years and 7.5 ± 0.7 years respectively, were tested with provocative tests of human growth hormone (hGH) release—insulin‐induced hypoglycaemia, arginine infusion, l‐DOPA, exercise and sequential exercise and l‐DOPA‐in order to identify growth hormone deficiency. In the ‘normal’ subjects (control plus short stature) the sequential exercise and l‐DOPA test induced the greatest peak and integrated secretion rates of plasma hGH (16.5 ± 1.2 ng/ml and 679 ± 70 ng/ml/120 min respectively) when compared to other tests. This combined stimulus was the only one to which all ‘normal’ subjects responded: a similar degree of responsiveness has not been earlier described for other hGH‐stimuli. The responses observed with all stimuli were significantly lower (P < 0.001) in GHD group compared to the ‘normal subjects’.

Emphasis was given to the sequential exercise and l‐DOPA test as an innocuous, sensitive and simplified procedure in the evaluation of children with growth retardation.
THYROID ADENYLATE CYCLASE STIMULATING IMMUNOGLOBULINS IN THYROID DISEASES*
Authors: BECH K. , MADSEN S. NISTRUP
Published: March 2008

The occurrence of serum immunoglobulins with capacity to stimulate thyroid adenylate cyclase (TSAb) was studied in seventy‐two healthy volunteers and 120 unselected patients with various thyroid diseases. A high frequency of TSAb (82.5%, P>0.00006) was found in Graves’disease, while TSAb was present only in 13–20% of serum from patients with nontoxic nodular goitre, nontoxic diffuse goitre, toxic adenoma, toxic nodular goitre and myxoedema. These patients had low level of TSAb compared to patients with Graves’disease. In patients with Graves’disease there was no correlation between the level of TSAb and hormonal status except serum triiodothyronine (rs=0.29, P<0.05), and no relation with eye involvement or presence of microsomal thyroid antibodies was found.

The results indicate that the human thyroid adenylate cyclase assay system with 1 hour incubation periods is a sensitive method for detection of immunoglobulins with TSH‐like capacity to stimulate the thyroid gland.
ECTOPIC PITUITARY ADENOMAS
Authors: RASMUSSEN P. , LINDHOLM J.
Published: March 2008

We report here four cases representing different forms of ectopic pituitary adenomas localized: (1) in the nasal cavity, (2) in the sphenoidal sinus, (3) on the sphenoidal wing and (4) on the petrous temporal bone. Ectopic pituitary adenomas may probably occur in extrasellar pituitary tissue deposited along the route of fetal development or as a result of intracranial dissemination of adenomatous cells during operation. It is assumed that in some cases ectopic pituitary tissue may retain endocrine function leading to a sustained pituitary function even after a radical hypo‐physectomy.
UNALTERED BASAL PROLACTIN SECRETION DURING SHORT‐TERM OESTRIOL TREATMENT IN POST‐MENOPAUSAL WOMEN*
Authors: L'HERMITE M. , BADAWI M. M. , MICHAUX‐DUCHENE A. , ROBYN C.
Published: March 2008

Six post‐menopausal women were submitted, at 1 month interval, to oral oestriol treatment for 14day periods at daily doses of 2 and 6 mg. Blood samples were collected for LH, FSH and PRL measurements (by RIA) every other day during treatments as well as during a 14‐day control period. Though the effect on LH levels was questionable, oestriol resulted in a clear and significant, although moderate, gradual decrease of mean FSH levels. At the doses used, which are effective in the treatment of menopausal symptoms, but are devoid of any proliferative effect upon the endometrium, oestriol failed to induce any stimulatory effect on basal PRL secretion in these post‐menopausal women.
MEASUREMENT OF 1,25‐DIHYDROXYCHOLECALCIFEROL IN MAN BY RADIOIMMUNOASSAY
Authors: CLEMENS T. L. , HENDY G. N. , PAPAPOULOS S. E. , FRAHER L. J. , CARE A. D. , O'RIORDAN J. L. H.
Published: March 2008

1α,25‐dihydroxycholecalciferol (1,25‐(OH)2D3) has been measured in human serum by radioimmunoassay. The assay uses a high titre antiserum raised in sheep against 1,25‐(OH)2D3‐25‐hemisuccinate, conjugated to bovine serum albumin. The sensitivity of the assay is 10 pg/tube. Other hydroxylated forms of vitamin D3 cross react with the antiserum and are therefore removed from serum extracts by chromatography on Sephadex LH 20 followed by high pressure liquid chromatography. The mean (± SEM) serum 1,25‐(OH)2D3 concentration for a group of healthy adult subjects was 41 ± 2.5 pg/ml. None was detected in anephric patients and the concentration was low or undetectable in patients with chronic renal failure.
THE INFLUENCE OF BROMOCRIPTINE ON SERUM LEVELS OF GROWTH HORMONE AND OTHER PITUITARY HORMONES AND ITS METABOLIC EFFECTS IN ACTIVE ACROMEGALY
Authors: ROELFSEMA F. , GOSLINGS B. M. , FRÖLICH M. , MOOLENAAR A. J. , VAN SETERS A. P. , SLOOTEN H. VAN
Published: March 2008

The effect of treatment with bromocriptine for 12–18 months on serum GH and metabolic responses was studied in sixteen patients with active acromegaly. Of this group ten patients showing a sustained GH reduction of more than 50% during an 8 h bromocriptine test, proved to be responsive to long‐term therapy. In the responding patients GH levels decreased to 38% of the pretreatment level after 12 months of therapy. A dose higher than 10 mg did not produce a significantly greater effect. Prolactin and LH levels decreased in all patients, FSH levels showed a significant rise. Testosterone levels in the male patients increased significantly, indicating that the state of hypogonadism can at least be partially reversed. The GH levels became normal in only one patient. We conclude that the role of bromocriptine in acromegaly is limited and selective pituitary operation and/or irradiation is preferred as definitive treatment in most patients.
DISSOCIATED THYROXINE, TRIIODOTHYRONINE AND REVERSE TRIIODOTHYRONINE LEVELS IN PATIENTS WITH FAMILIAL GOITRE DUE TO IODIDE ORGANIFICATION DEFECTS*
Authors: CHAN VIVIAN , WANG CHRISTINA , YEUNG ROSE T. T.
Published: March 2008

The thyroid function of patients with three different types of organification defect was studied. All patients were characterized by a high thyroidal 13 I uptake and a positive perchlorate discharge. Patients with Pendred's syndrome who had goitre and congenital nerve deafness were mostly euthyroid with normal circulating thyroid hormone levels. Only two of them had compensated euthyroidism with elevated total T3, high basal TSH and delayed return to basal value after TRH. The patients who were euthyroid with large goitres and normal hearing had elevated total T3 and an exaggerated TSH response to TRH. The thyroid function of these two groups of patients contrasted with that of goitrous cretins, who were clinically hypothyroid with low circulating total T4, increased T3 and decreased rT3 levels. The data suggest that in patients with intrathyroidal iodine deficiency secondary to organification defect, there is preferential T3 production in an effort to maintain euthyroid state, and this is further substantiated in the case of gross thyroid insufficiency either by enhanced peripheral conversion of T4 to T3, or reduced metabolic clearance of T3 and increased clearance of rT3, resulting in elevated T3 and decreased rT3 levels.
THE INHERITANCE OF POLYCYSTIC OVARIAN DISEASE AND A POSSIBLE RELATIONSHIP TO PREMATURE BALDING
Authors: FERRIMAN D. , PURDIE A. W.
Published: March 2008

We have examined the prevalence of a history of hirsuties, alone or associated with oligomenorrhoea and infertility, among first degree female relatives of 284 hirsute patients with or without oligomenorrhoea, and found it to be significantly higher than that in controls (P< 0.001). The prevalence of a history of premature balding among first degree male relatives of 136 such patients was also significantly higher than that in controls (P<0.001). We found relative prevalences of the respective conditions among mothers and daughters and among fathers and brothers suggestive in both cases of modified dominant forms of inheritance. These data and evidence from the literature suggest the possible existence of a single genetically determined disorder with hirsuties, oligomenorrhoea, infertility and commonly but not invariably enlarged polycystic ovaries occurring among affected female members, and with premature balding among affected male members. The prevalence of a history of oligomenorrhoea and infertility together was also examined among first degree relatives of forty‐five non‐hirsute patients with oligomenorrhoea and enlarged ovaries demonstrated by gynaecography and found significantly greater than that in controls (P< 0.001). The prevalence among forty‐five similar patients but with gynaecographically normal‐sized ovaries was greater than that in controls but the difference fell short of significance (P= 0.06). The data suggest the existence of a genetically determined disorder consisting of oligomenorrhoea, infertility and commonly but not invariably enlarged polycystic ovaries. Again the relative prevalences among mothers and sisters suggest a modified dominant form of inheritance. Neither the prevalence of hirsuties among first degree female relatives nor of premature balding among first degree male relatives differed from controls in these non‐hirsute patients. This suggests that the two disorders are aetiologically distinct. Their possible pathogeneses, which remain obscure, are discussed. A steroid receptor organ anomaly is one possibility.
CHANGES OF URINARY CYCLIC AMP EXCRETION AND PLASMA PARATHYROID HORMONE LEVELS BEFORE AND AFTER PARATHYROIDECTOMY IN PATIENTS WITH PRIMARY HYPERPARATHYROIDISM
Authors: ONISHI T. , TSUJI M. , MORIMOTO S. , OKADA Y. , ARIMA M. , ITATANI H. , KINOSHITA K. , SONODA T. , KUMAHARA Y.
Published: March 2008

Urinary cyclic AMP excretion and plasma parathyroid hormone(PTH) levels were examined in three patients with primary hyperparathyroidism before and after parathyroidectomy. Plasma PTH and urinary cyclic AMP in the individual patients decreased in parallel following parathyroidectomy. During surgery there was a statistically significant correlation between PTH levels and cyclic AMP excretion in individual patients. These findings support the claim that the rate of urinary cyclic AMP excretion reflects endogenous PTH activity in patients with primary hyperparathyroidism.
CIMETIDINE INDUCED PROLACTIN (PRL) RELEASE IN THYROID DISEASE
Authors: MACARON C. , KYNCL M. , SINGH S. P.
Published: March 2008

Effects of acute intravenous administration of cimetidine on serum levels or PRL, TSH, LH and FSH were investigated in six healthy euthyroid, five hypothyroid and five hyperthyroid patients. Cimetidine failed to alter serum TSH levels in the hypothyroid patients. There was no change in LH and FSH levels except in two euthyroid subjects in whom significant rise in LH occurred. However, in all subjects, whether euthyroid, hypo‐ or hyperthyroid, the serum PRL concentration increased two to three fold above basal levels. The peak levels of serum PRL occurred at 15 min following the drug administration. The response was not blunted in the older age group. We conclude that unlike the TRH‐mediated PRL release, the cimetidine‐induced PRL release is independent of the levels of thyroid hormone.
FREE THYROXINE (FT4) AND FREE TRIIODOTHYRONINE (FT3) IN AUTONOMOUS THYROID NODULES
Authors: LANGER M. , MADEDDU G. , COSTANZA C.
Published: March 2008

Total and free thyroid hormones (T3, T4, FT3 and FT4), TSH and its response to TRH were determined in sixty‐three patients affected by autonomous thyroid nodules: mean concentrations of free T3 (FT3) were significantly higher in hot nodules (suppressing extranodular tissue on the scan) as compared to warm ones, even in those cases where total T3 and T4 were within normal ranges (hot nodules, group as a whole: 8.8 ± 3.5 pg/ml; warm nodules: 5.3 ± 1.2; hot nodules with normal total T3 and T4 concentrations: 7‐5 ± 3). Also the clinical condition of thyrotoxicosis appeared to be correlated with FT3 concentrations (toxic patients, group as a whole: 9.6 ± 4.0 pg/ml; euthyroid patients: 6.8 ± 3.1; toxic patients with normal values of T3 and T4: 8.3 ± 2.8). On the contrary the correlation of total and free thyroid hormone concentrations with the response of TSH to TRH was not significant.
TESTICULAR FUNCTION IN POST PUBERTAL MALE PSEUDOHERMAPHRODITISM
Authors: CAMPO S. , STIVEL M. , NICOLAU G. , MONTEAGUDO C. , RIVAROLA M.
Published: March 2008

Testicular endocrine function was studied in twelve post pubertal patients with male pseudohermaphroditism and 46 XY chromosomal constitution. Patients were divided into three groups, four subjects who became feminized during puberty, five who became masculinized during puberty and three who were castrated before puberty. Serum dehydroepiandrosterone, progesterone, 17‐hydroxyprogesterone, androstendione, testosterone, dihydrotestosterone, LH and FSH were determined by radioimmunoassay. Patients of the first group had the clinical characteristics of testicular feminization secondary to absence of the androgen receptor. One of the five patients of the second group had deficient testosterone secretion but no enzymatic defect could be demonstrated. One of the subjects castrated before puberty had a deficiency in 17,20‐desmolase. Therefore, evidence of a failure of the fetal testes could be found in only two of the twelve patients studied.
TESTICULAR ENDOCRINE FUNCTION IN PARAPLEGIC MEN
Authors: HAYES P. J. , KRISHNAN K. R. , DIVER M. J. , HIPKIN L. J. , DAVIS J. C.
Published: March 2008

The responses of FSH and LH to the injection of LHRH were studied in fifteen paraplegic men and ten normal controls. The basal FSH levels in the paraplegic men were elevated in eight cases, basal LH being raised in nine cases. The responses of FSH were exaggerated in fourteen patients, and LH responses were exaggerated in nine patients. Only one patient was normal in respect of both hormones. Subnormal plasma testosterone was found in three patients. This depressed testicular function could not be explained as being due to spread of urinary tract infection and a direct neurological effect is the probable explanation.
SALIVARY 17α‐HYDROXYPROGESTERONE IN CONGENITAL ADRENAL HYPERPLASIA
Authors: WALKER R. F. , HUGHES I.A. , RIAD‐FAHMY D.
Published: March 2008

A specific radioimmunoassay having the sensitivity (4 pg/tube) and precision required for the routine determinations of 17α‐hydroxyprogesterone concentrations in mixed whole saliva, parotid fluid and plasma has been developed. The correlation between 17α‐hydroxyprogesterone concentrations in matched samples of saliva and parotid fluid was excellent (r = 0.98): therefore saliva, being easier to collect, was used exclusively in later studies. The median 17α‐hydroxyprogesterone concentration in mixed whole saliva collected from thirty‐two healthy children was 390 pmol/litre ranging from 90–1520 pmol/litre. In a group (n=14) of treated CAH patients having a C21 hydroxylase deficiency, 17α‐hydroxyprogesterone showed a 20 fold greater variation, ranging from 67 pmol/litre in patients receiving excessive glucocorticoid dosage to 26300 pmol/litre in inadequately treated patients. A close correlation (r = 0.91) in 17α‐hydroxyprogesterone levels was observed in matched samples of saliva and plasma collected between 09.00 and 10.00 h from these patients. Concentrations of 17α‐hydroxyprogesterone in saliva therefore could well replace those in plasma for monitoring treatment of these patients. Matched samples of mixed whole saliva, parotid fluid and plasma were also collected from one inadequately treated female patient at frequent intervals over a 24 h period. Two other patients, one male and one female, collected matched samples at 30 min intervals for 4 h following Synacthen stimulation. The pattern of 17α‐hydroxyprogesterone in these samples suggests that salivary steroid concentrations are of potential value in assessing endocrine function in conditions such as CAH, where frequent sampling over prolonged periods is required.
HORMONE PROFILE IN PREMENSTRUAL TENSION: EFFECTS OF BROMOCRIPTINE AND DIURETICS
Authors: ANDERSCH B. , ABRAHAMSSON L. , WENDESTAM C. , ÖHMAN R. , HAHN L.
Published: March 2008

Plasma levels of prolactin, FSH, LH, progesterone and 17–β‐oestradiol in twenty women with premenstrual tension were compared with those in twenty controls. The former group was studied also during treatment with bromocriptine. The mean prolactin level in the PMT group was lower in the follicular phase than in the luteal phase (P < 0.±01), but there was no difference between the PMT and control group in the luteal phase. No differences were found between the controls and the PMT group in FSH, LH, 17–β‐oestradiol and progesterone levels in the luteal phase. Bromocriptine suppressed prolactin concentrations (P <0.±01), but had no effect on the FSH, LH, 17‐B‐oestradiol or progesterone levels.
GLUCOSE AND FREE FATTY ACID TURNOVER IN THYROTOXICOSIS AND HYPOTHYROIDISM, BEFORE AND AFTER TREATMENT
Authors: SAUNDERS J. , HALL S. E. H. , SÖNKSEN P. H.
Published: March 2008

Glucose and free fatty acid (FFA) turnover (RT) were measured by isotopic methods in groups of patients with thyrotoxicosis and hypothyroidism and compared with normal subjects. Patients with thyrotoxicosis were then studied after treatment with oral propranolol and again after treatment with carbimazole. Patients with hypothyroidism were studied again after treatment with thyroxine. Glucose RT was increased by about a third in thyrotoxicosis (12·7 μmol.min.−1 kg−1±1·0 SEM compared to 9·5 ± 0·5 in normal subjects) while FFA RT was doubled (12·5 μmol. min.−1 kg−1± 1·2 compared to 6·3 ± 0·9 in normals). Propranolol was without effect, but carbimazole normalized these variables. In hypothyroidism both glucose and FFA RT were normal (9·1±0·7 and 6·7 ± 0·9 respectively). Mean glucose and FFA RT both rose following thyroxine treatment, but not significantly; the post−treatment values remaining within the normal range (10·3±0·7 and 7·0±1·3 respectively). Oxidation of FFA, as estimated by I4CO2 excretion, was increased in thyrotoxicosis (42·8%±2·9 SEM compared to 34·8 ± 2·3 in normal subjects) and fell with carbimazole treatment (34·7 ± 4·1). In hypothyroid subjects FFA oxidation increased following thyroxine treatment (from 34·4 ± 3·3 to 46·2±3·6).
EVALUATION OF THE THREE HOUR METYRAPONE TEST IN ADULTS
Authors: BEST J. D. , ALFORD F. P. , DONALD R. A.
Published: March 2008

The prolonged metyrapone test is used to assess the hypothalamic‐pituitary‐adrenal axis. The dynamic responses of cortisol, ACTH and 11‐deoxycortisol over the 3 h of the single morning dose metyrapone test have been examined in fourteen normal adult subjects. In every case there was a rapid, sustained fall in cortisol, but the resultant ACTH responses were extremely variable and in two subjects did not exceed values obtained during the control studies. The rise in 11‐deoxycortisol was also variable and in several instances occurred without any significant elevation in ACTH. In these cases, the rise in 11‐deoxycortisol may be due to a normal level of production of steroids with a shift from cortisol to 11‐deoxycortisol induced by the metyrapone. Thus, the hypothalamic‐pituitary‐adrenal axis may not be adequately tested, and this together with the high incidence of unpleasant side effects, makes the 3 h oral metyrapone test unsatisfactory for routine use in adults.
INCREASE IN OXYTOCIN SECRETION AT EJACULATION IN MALE
Authors: OGAWA SATSUKI , KUDO SHINICHI , KITSUNAI YOSHIICHI , FUKUCHI SOITU
Published: March 2008

In this study changes in plasma oxytocin levels were determined before and after ejaculation in patients with abnormal spermatogenesis. Plasma oxytocin levels rose significantly after ejaculation (P<0·001, n= 17) There was no obvious correlation between plasma oxytocin levels and sperm count, sperm motility or the number of abnormal forms. Oxytocin may play a role in the precipitation of ejaculation in males.
MOLECULAR WEIGHT FORMS OF IMMUNOREACTIVE CALCITONIN IN A PATIENT WITH MEDULLARY CARCINOMA OF THE THYROID: DYNAMIC STUDIES WITH CALCIUM, PENTAGASTRIN AND SOMATOSTATIN
Authors: BERTAGNA X. Y. , BLOOMGARDEN Z. T. , RABIN D. , ROBERTS L. J. , ORTH D. N.
Published: March 2008

We have examined the characteristics of circulating immunoreactive human calcitonin (IR‐hCT) by studying its different molecular weight (MW) forms under various secretory conditions in a patient with medullary carcinoma of the thyroid. Plasma IR‐hCT (318 mg/l basal) increased 9 and 12 times, respectively, after calcium (0·3 mg/kg/min over 10 min i.v.) and pentagastrin (3·2 μg i.v.) administration. Somatostatin infusion (500 μg/h) caused a 41% decrease in plasma IR‐hCT and markedly diminished the responses to both pentagastrin and calcium. Sephadex G50 chromatography separated different IR‐hCT forms: hCT itself predominated after stimulation with either calcium or pentagastrin (52% and 62%, respectively), while it was reduced in the basal state (33%) and following somatostatin (11%); reciprocal changes were observed for the higher MW forms. Under denaturing conditions, with or without reducing agent, total plasma IR‐hCT was resolved into one major peak co‐eluting with 125I‐hCT. Thus, the hCT monomer appears to be the major secretory product of the medullary carcinoma of the thyroid studied here. The predominance of higher MW forms in the basal state reflects their slower plasma disappearance rate. These high MW forms are mainly the result of aggregation or non‐covalent protein binding of the hCT monomer.
THE DIAGNOSIS OF CUSHING'S SYNDROME USING 131I‐19‐IODOCHOLESTEROL UPTAKE AND ADRENAL IMAGING
Authors: ORTEGA D. , FOZ M. , DOMÉNECH‐TORNÉ F. M. , TRESÁNCHEZ J. M.
Published: March 2008

Uptake measurements and visualization of the adrenal glands were performed using 131I‐19‐iodocholesterol in ten healthy subjects and fourteen patient suffering from Cushing's syndrome (nine hyperplasias and five adenomas). The normal range in healthy subjects (average uptake value ± 2 SD) is 0·12–0·27% for both adrenals. In patients with Cushing's syndrome the uptake values ranged from 0·321 to 1·497 %. Normal bilateral images were obtained in all the healthy subjects as well as in eight of the patients with hyperplasia, whilst the remaining patient with hyperplasia showed distinctly enlarged glands. In contrast, an image of the diseased side only was obtained in patients with adrenal adenomas. We conclude that radiocholesterol studies in Cushing's syndrome allow confirmation of the diagnosis, definition of the pathophysiologic type of disease and lateralization of adrenal adenomas.
SECRETION OF ACTH, LPH AND β‐ENDORPHIN FROM HUMAN PITUITARY TUMOURS IN VITRO
Authors: GILLIES GLENDA , RATTER SALLY , GROSSMAN ASHLEY , GAILLARD R. , LOWRY P. J. , BESSER G. M. , REES LESLEY H.
Published: March 2008

Basal and stimulated secretion of immunoreactive ACTH, LPH and β‐endorphin from four human pituitary tumours has been studied in vitro using a superfused, isolated cell system. Chromatography of cell secretions under acid‐dissociating conditions demonstrated that the human tumour cells released immunoreactive peptides with the elution profiles of αh (1–39) ACTH, βh‐LPH, γh‐LPH and βh‐endorphin confirming that βh‐endorphin is secreted by human pituitary tumour cells and is not formed by enzymic cleavage from βh‐LPH in blood. No α‐ or βh‐MSH, nor any higher molecular weight forms of ACTH or LPH were detected. The cells from all four tumours responded to stimulation with rat stalk‐median eminence extract (SME) and synthetic AVP with a concomitant release of ACTH, β‐LPH, γ‐LPH and γ‐endorphin. In contrast to the isolated rat anterior pituitary cells, the pattern of responses to SME and AVP were indistinguishable and the release provoked by rat SME could be accounted for virtually entirely by its vasopressin content. No stimulation of release was observed when the cells were exposed to a variety of biogenic amines. Addition of hydrocortisone to the perfusion buffer of two tumours resulted in a slow inhibition of both basal and stimulated ACTH and LPH release. These data demonstrate that human pituitary tumour tissue from patients with Cushing's disease and Nelson's syndrome can be studied in vitro and that such studies may contribute to a greater understanding of the aetiology of these diseases.
HUMAN α‐LACTALBUMIN AND HORMONAL FACTORS IN PREGNANCY AND LACTATION
Authors: MARTIN R. H. , GLASS M. R. , CHAPMAN C. , WILSON G. D. , WOODS K. L.
Published: March 2008

Serum α‐lactalbumin was monitored throughout pregnancy in twelve women and in a separate group of nineteen women during the first 3 months postpartum. During pregnancy α‐lactalbumin rose significantly until the mid trimester (P < 0·001). From then until term, concentrations remained stable. Concentrations during labour were significantly higher (P < 0·01) than those seen at term, α‐lactalbumin, 17β‐oestradiol and progesterone concentrations behaved similarly during the first week of the puerperium in both lactating (n= 10) and non‐lactating (n= 9) subjects. A large surge of α‐lactalbumin closely followed the clearance of high circulating concentrations of sex steroids in both groups. Prolactin concentrations were significantly greater (P < 0·02) in lactating subjects by the third postpartum day.

By the third postpartum week α‐lactalbumin concentrations in lactating subjects had stabilized at labour levels in a milieu of high prolactin levels and depressed production on 17β‐oestradiol and progesterone. Conversely, in non‐lactating subjects α‐lactalbumin concentrations fell, as did prolactin, coincidental with a rise in 17β‐oestradiol, progesterone concentrations remaining barely detectable. The apparent control mechanisms for human α‐lactalbumin secretion and thus, lactation, are discussed in the light of the data presented.
LACK OF EFFECT OF INTRAVENOUS LHRH ON PLASMA NORADRENALINE IN MAN
Authors: JÜRGENSEN H. J. , CHRISTENSEN N. J. , LADEFOGED S. , MICIC S.
Published: March 2008

One hundred μg of LHRH was given intravenously to two male and two female subjects. Plasma noradrenaline did not change following LHRH, in contrast to findings reported by others. There was no change in heart rate and systolic arterial blood pressure. LH increased significantly as expected.
BROMOCRIPTINE SUPPRESSES THE THYROTROPHIN RESPONSE TO THYROTROPHIN RELEASING HORMONE DURING HUMAN PREGNANCY
Authors: YLIKORKALA O. , KIVINEN S. , RÖNNBERG L. , VIINIKKA L.
Published: March 2008

Thyrotrophin (TSH) responses to 200 μg ofintra venous thyrotrophin releasing hormone (TRH) were measured in fifteen healthy women in normal early pregnancy before and at the end of a bromocriptine treatment of 5·0–7·5 mg daily for 1–2 weeks. Bromocriptine did not change the basal levels of TSH, triiodothyrone (T3) and thyroxine (T4) during pregnancy. Before the start of bromocriptine, TRH caused a significant TSH elevation from 12·8 ±0·5 μu/ml (mean±SE) to 21·2 ±1·9 μu/ml after 20 min. During bromocriptine intake, TRH caused a TSH elevation from 11·9±0·4 μu/ml to only 15·5±1·1 μu/ml which is significantly less (P < 0·001) than before bromocriptine. Similarly, the mean maximal TSH increment of 8·4±1·5 μu/ml before bromocriptine was greater (P < 0·001) than that of 3·8±60 μu/ml during bromocriptine intake. When women were retested with TRH before and during bromocriptine after legal abortion, bromocriptine did not change the basal levels of TSH, T3 and T4 or the TSH response to TRH. Therefore, the TSH inhibition caused by bromocriptine is specifically related to the pregnancy itself, but the mechanism for this inhibition remains unknown.
THE EFFECT OF ATENOLOL ON SERUM THYROID HORMONES IN HYPERTHYROID PATIENTS
Authors: HOW J. , ANDP A. S.M. KHIR , BEWSHER D.
Published: March 2008

SUMMARY. The effect of the 4bT‐1 ‐adrenoceptor blocking agent, atenolol, on serum levels of thyroxine (T4), triiodothronine (T3) and reverse triiodothyronine (rT3) was studied in twelve hyperthyroid patients. While all patients improved symptomatically after treatment with atenolol 100 mg twice daily for 2 weeks, there were no significant changes in the serum T3 or rT3 concentrations. The serum T4 level showed a small but statistically significant fall. These data do not support the hypothesis that the beneficial clinical effects of β‐adrenoceptor blocking drugs in thyrotoxicosis are mediated by an action on the peripheral metabolism of thyroid hormones.
THE DOSE‐RESPONSE RELATIONSHIP OF ACTH AND CORTISOL IN CUSHING'S DISEASE
Authors: WOLFSEN ADA. R. , ODELL W. D.
Published: March 2008

The dose‐response relationship between plasma ACTH and plasma cortisol was examined in normal subjects, patients with Addison's disease and patients with Cushing's disease. Plasma cortisol and ACTH levels were measured every half‐hour from 06.00 h to 10.00 h and from 16.00 h to 18.00 h during a control day and during 1 to 3 days of continuous cortisol infusion. A plot of mean morning plasma ACTH versus the log of mean plasma cortisol revealed a similar dose‐response relationship in normal and Addisonian subjects. Total plasma cortisol was four times more potent in suppressing mean morning ACTH in normal and Addisonian subjects, than in patients with Cushing's disease. When plasma cortisol was undetectable, there was no significant difference between mean morning ACTH concentrations in Addisonian patients and in adrenalectomized Cushing's patients. The glucocorticoid feedback control of ACTH in Cushing's disease had dose‐response characteristics similar to those in Addison's disease and normal subjects, except for decreased sensitivity to cortisol feedback suppression of ACTH.
SERUM STEROIDS AND PITUITARY HORMONES IN FEMALE PUBERTY: A PARTLY LONGITUDINAL STUDY
Authors: APTER D.
Published: March 2008

Pubertal development of 200 normal girls, 7–17 years of age, was investigated in a partly longitudinal manner with two examinations 1·5 years apart. Samples from postmenarchal girls were taken on days 6–9 and 20–23 of the menstrual cycle. Serum pregnenolone, progesterone, 17‐hydroxyprogesterone, dehydroepiandrosterone, androstenedione, testosterone, 5α‐dihydrotestosterone, androsterone, oestradiol and cortisol as well as ACTH, FSH, LH and prolactin were measured radioimmunologically and were related to bone age, breast and pubic hair developmental stages, and gynaecological age. In the samples of premenarchal girls as well as at the follicular phase of postmenarchal girls the concentration of all the steroids increased with age. Of all the steroids measured, serum dehydroepiandrosterone and pregnenolone displayed the earliest increase, from the youngest age group of 7·5 years onwards. Serum oestradiol, testosterone and androstenedione increased rapidly from the bone age group of 9·5 years (subjects 9·0–9·9 years of age) onwards, in close association with the appearance of the first physical signs of puberty. A marked increase in these three steroids continued until 13·5 years, the age at which menarche took place. Menarche was followed by a plateau of 1–2 years duration and then a second increase took place up to the two oldest age groups (17·5 and 18·5 years bone age), a trend seen in the follicular phase levels of all the steroids measured. The 5α‐dihydrotestosterone/testosterone ratio decreased with increasing testosterone concentration. Serum oestradiol, testosterone, androstenedione, dehydroepiandrosterone and FSH showed no overlapping in the 2·5–97·5% range of concentrations and androsterone and LH in the 16–84% range between pre‐pubertal and postmenarchal subjects. Pregnenolone, progesterone, 17‐hydroxyprogesterone, 5α‐dihydrotestosterone, cortisol, ACTH and prolactin overlapped even in the 16–84% range between these two groups of subjects. In postmenarchal girls, about 80% of the cycles were anovulatory in the first year after menarche, 50% in the third and 10% in the sixth year. The background of the majority of the anovulatory cycles seems to be a physiological variant of the pattern seen in the polycystic ovary syndrome: the levels of testosterone, androstenedione and LH were increased in anovulatory cycles compared to ovulatory ones.
CONTROL OF GONADOTROPHIN SECRETION BY STEROID HORMONES IN CASTRATED MALE TRANSSEXUALS. I. EFFECTS OF OESTRADIOL INFUSION ON PLASMA LEVELS OF FOLLICLE‐STIMULATING HORMONE AND LUTEINIZING HORMONE
Authors: GOH H. H. , CHEW P. C. T. , KARIM S. M. M. , RATNAM S. S.
Published: March 2008

Twenty‐four infusions of oestradiol (E2) in graded doses ranging from 0–200 μg administered over a period of 7 hours were carried out in eleven healthy male transsexuals who had undergone sex reassignment at least 3 months previously. Plasma levels of follicle‐stimulating hormone (FSH), luteinizing hormone (LH) and E2 were analysed by radioimmunoassay, while sex hormone binding globulin (SHBG) was measured using 3H‐testosterone as the saturating ligand. Infusion of 5–200 μg of E2 raised plasma E2 to levels ranging from 38·4–367·8 pg/ml which represent 83%–800% of levels found in a control group of sixty‐three normal males. SHBG capacity remained unchanged at all doses of E2 studied. No change in plasma levels of FSH and LH was observed in control infusions and infusion of 5 μg of E2. From 10 μg‐200 μg, suppression of plasma levels of FSH was noted at the 5–7 hour period. The suppression increased up to 20 μg and thereafter the levels of FSH remained constant. On the other hand, the suppression of LH increased up to the highest E2 dose (200 μg) studied. Further, significant suppression of LH occurred earlier than the 5–7 hours as the dose of E2 increased. These observations are consistent with the conclusions that: (1) E2 plays a part in the regulation of secretion of FSH and LH in men; and (2) at doses higher than physiological, E2 exerts a differential effect on the secretion of FSH and LH.
DOMPERIDONE: A NOVEL AGENT FOR THE INVESTIGATION OF ANTERIOR PITUITARY FUNCTION AND CONTROL IN MAN
Authors: POURMAND M. , RODRIGUEZ‐ARNAO M. D. , WEIGHTMAN D. R. , HALL R. , COOK D. B. , LEWIS M. , SCANLON M. F.
Published: March 2008

Administration of the novel agent domperidone (10 mg iv), which combines the properties of specific dopamine receptor blockade and inability to cross the blood‐brain barrier, leads to acute and significant TSH and PRL release in man. This suggests that the in vivo site of action of endogenous dopamine in the inhibitory control of these two hormones is either the anterior pituitary or median eminence, since these tissues lie outside the blood‐brain barrier. This class of drug is of potential value both clinically and experimentally in the investigation of anterior pituitary control mechanisms.
PRIMARY HYPERPARATHYROIDISM WITH INTERMITTENT HYPERCALCAEMIA: SERIAL OBSERVATIONS AND SIMPLE DIAGNOSIS BY MEANS OF AN ORAL CALCIUM TOLERANCE TEST
Authors: BROADUS A. E. , HORST R. L. , LITTLEDIKE E. T. , MAHAFFEY J. E. , RASMUSSEN H.
Published: March 2008

Ten patients with subtle primary hyperparathyroidism and intermittent hypercalcaemia were followed serially for periods of 2–18 months (mean 10 months). Fasting serum calcium was elevated (< 10·6 mg/dl) in only 20% of determinations and fluctuated widely (9·1–11·2 mg/dl), yet the patients displayed a continuous, rather than episodic, basic disease process as defined by increases in nephrogenous cyclic AMP and serum iPTH. Identical findings were noted in short‐term (2–3 successive days) studies in twelve patients.

In response to a 1000 mg oral calcium tolerance test, twelve patients with primary hyperparathyroidism and intermittent hypercalcaemia (basal serum calcium 10·2 ± 0·2 mg/dl, mean ± SD) displayed: (1) hyperabsorption of calcium (mean calciuric response twice normal); (2) induced‐hypercalcaemia (mean serum calcium 11·4 mg/dl, with a mean increase of 1·2 mg/dl versus 0·2 mg/dl in normal subjects); and (3) abnormal parathyroid suppressibility (nephrogenous cyclic AMP 2·66 ± 0·57 nmol/100 ml GF versus 0·95 ± 0·40 nmol/100 ml GF in normal subjects, mean ± SD). The patients demonstrated striking hypercalciuria (452 ± 123 mg/24 h) on a 1000 mg metabolic calcium diet. Serum levels of 1,25(OH)2D3, measured in ten patients, were markedly elevated at 90 ± 20 pg/ml (mean ± SD), and there was a strong positive correlation between the values for 1,25(OH)2D3 and the calciuric response to the calcium tolerance test (r=0·75, P<0·001).

These results (1) indicate that the calcium tolerance test is a simple and reliable technique for diagnosis of patients with primary hyperparathyroidism and intermittent hypercalcaemia, and (2) emphasize the important pathophysiologic features of this subtle clinical variant of primary hyperparathyroidism.
ALDOSTERONE REGULATION IN PRIMARY ALDOSTERONISM: INFLUENCE OF SALT BALANCE, POSTURE AND ACTH
Authors: ESPINER E. A. , DONALD R. A.
Published: March 2008

The response of aldosterone to manipulations of the renin‐angiotensin and hypothalamic‐pituitary‐adrenal systems has been studied in thirteen patients with primary aldosteronism due to a single adenoma (ten patients) or bilateral hyperplasia (three patients). The aldosterone response to dietary sodium restriction was small and variable, although urinary aldosterone excretion increased in nine out of twelve studies. The response of patients with hyperplasia could not be distinguished from those with adenoma. All patients were unresponsive to salt loading. By contrast, plasma aldosterone fell in all patients after overnight dexamethasone (1 mg) and increased after brief (1 h) physiological ACTH stimulation. During prolonged erect posture, plasma aldosterone increased in the three patients with hyperplasia and decreased or remained unchanged in patients with ademona. Changes in plasma renin activity were similar in both groups. These studies show that patients with primary aldosteronism, while largely unresponsive to manipulations of sodium balance, retain sensitivity to small and acute changes in ACTH. The different behaviour of patients with hyperplasia to prolonged erect posture cannot be explained by insensitivity to ACTH, but could be due to a relative increase in sensitivity to angiotensin.
PITUITARY FUNCTION TESTS IN SHEEHAN'S SYNDROME
Authors: SHAHMANESH M. , ALI Z. , POURMAND M. , NOURMAND I.
Published: March 2008

Fourteen patients with a typical history of Sheehan's syndrome underwent pituitary function tests with simultaneous injections of 100 μg LH‐RH, 200 μg TRH and 0·05–0·1 units of soluble insulin per kg body weight. Serum prolactin levels remained unchanged in all of eleven subjects given TRH. GH levels did not rise after hypoglycaemia in five subjects. In contrast serum LH and FSH rose significantly in twelve out of fourteen subjects given LHRH and serum TSH rose significantly in five out of seven subjects given TRH. It is concluded that pituitary function is relatively preserved for LH and FSH but not for prolactin and GH in Sheehan's syndrome. It is further suggested that absence of a rise in prolactin following TRH stimulation may provide the most sensitive test of pituitary hypofunction in postpartum haemorrhage.