bluuebunny/crossref_metadata_2025 huggingface dataset:
PLASMA ANDROGENS IN WOMEN WITH HYPERPROLACTINAEMIC AMENORRHOES
Authors: BASSI F. , GIUSTI G. , BORSI L. , CATTANEO S. , GIANNOTTI P. , FORTI G. , PAZZAGLI M. , VIGIANI C. , SERIO M.
Published: March 2008

Cortisol, androstenedione, testosterone, dehydroepiandrosterone sulphate (DHAS) and free dehydroepiandrosterone (DHA) were measured in plasma of ten women affected by amenorrhoea with hyperprolactinaemia and eleven women affected by secondary hypothalamic amenorrhoea; twelve normal women at the second day of the menstrual cycle were used as controls. All subjects were hospitalized and 17‐ketosteroids, 170H‐corticosteroids and total dehydroepiandrosterone were also measured in urine.

Plasma DHAS was increased in all subjects affected by amenorrhoea with hyperprolactinaemia, while plasma DHA and urinary DHA were significantly increased in this group in comparison to other groups. Plasma cortisol, androstenedione and testosterone and urinary 17‐oxosteroids and 170H‐corticosteroids were not significantly different in the three groups.

In subjects affected by amenorrhoea with hyperprolactinaemia treated with bromocriptine a clear decrease of DHAS correlating with a decrease of plasma prolactin was observed.

Since in women DHAS seems to be almost exclusively secreted by the adrenal gland and most of the circulating DHA is derived from adrenal secretion, these data suggest that human prolactin can stimulate DHAS production by the adrenal cortex.
THE EFFECT OF ENDOGENOUS OESTROGEN ON PLASMA AND URINARY CALCIUM AND PHOSPHATE IN OOPHORECTOMIZED WOMEN
Authors: LINDSAY R. , COUTTS J. R. T. , HART D. M.
Published: March 2008

Using a specific radioimmunoassay, significant levels of plasma oestradiol can be detected in the blood of oophorectomized women. In these women the plasma concentration of oestradiol correlates positively with the body fat content. Low circulating concentrations of oestradiol are associated with increased values for serum phosphate and alkaline phosphatase, but no significant change in serum calcium. The fasting urinary calcium creatinine ratio is inversely related to circulating plasma oestradiol concentration which also correlates, in a more complex way, with the renal threshold for phosphate (TmPO4/GFR). It is suggested that oestrogen production may be an important factor in determining bone loss in post‐menopausal women.
LUNG TUMOURS AND ACTH PRODUCTION
Authors: BLOOMFIELD GLENYS A. , HOLDAWAY I. M. , CORRIN B. , RATCLIFFE J. G. , REES G. M. , ELLISON MORAG , REES LESLEY H.
Published: March 2008

ACTH levels measured by N‐ and C‐terminal immunoassays and cytochemical bioassay, were measured in fourteen lung tumours not associated with the ectopic ACTH syndrome and in macroscopically normal lung tissue taken from the same patients at thoracotomy. Significant concentrations of immunoactive (>3 ng/g wet weight) and bioactive (>0.2 ng/g wet weight) ACTH were found in all the carcinoid and oat cell tumours (n = 9), a combined tumour (poorly differentiated adenocarcinoma with large cell carcinoid elements), and a poorly differentiated squamous cell tumour. All the carcinoid tumours contained more C‐ than N‐terminal ACTH immunoactivity. The squamous cell tumours (n =2), anaplastic tumours (n = 2) and adenocarcinoma contained insignificant ACTH levels. There was a good correlation between the ACTH levels and the presence of secretory granules in the tumours examined ultrastructurally. All the macroscopically normal samples of lung tissue contained immuno and bioactive ACTH‐like material, the levels of which correlated well with ACTH levels in the tumour tissue. It is suggested that all lung tumours of carcinoid or oat cell type synthesize ACTH‐like materials although clinical evidence of the ectopic ACTH syndrome may be absent. The presence of ACTH‐like materials in non‐tumorous lung tissue in patients with lung cancer may indicate a low level of ACTH production throughout the lung or sequestration of ACTH containing granules secreted by the tumour.
EFFECT OF CORTISOL TREATMENT ON HORMONAL RELATIONSHIPS IN CONGENITAL ADRENAL HYPERPLASIA
Authors: BACON GEORGE E. , SPENCER MARTHA L. , KELCH ROBERT P.
Published: March 2008

The temporal relationship between administration of cortisol and serum 17α‐hydroxyprogesterone was investigated in five patients aged 9‐19 years with congenital adrenal hyperplasia due to 21‐hydroxylase deficiency. There was marked variability in the 17α‐hydroxyprogesterone response (determined hourly for 24 h) of individual patients to administration of cortisol. Mean concentration was less than 0.030 μmol/l in one patient but 0.519μ mol/l in another. Levels were higher in all patients while off treatment, and were greatest in those with salt‐losing adrenal hyperplasia. Growth hormone secretion was not suppressed by treatment with cortisol. Withdrawal of cortisol for 3 days resulted in a significant decrease in the mean serum FSH/LH ratio and a rise in serum testosterone in all subjects. Episodic release of gonadotrophins persisted in the adolescent patients.
THE CARDIOVASCULAR AND LIPID STATUS OF PERNICIOUS ANAEMIA PATIENTS WITH AND WITHOUT THYROID ANTIBODIES
Authors: RAMSAY IAN , KRASSAS G. , McHARDY‐YOUNG S.
Published: March 2008

A study has been undertaken of the cardiovascular and lipid status of patients with pernicious anaemia (PA). There was no evidence of elevated cholestrol, triglyceride and lipoprotein concentrations nor of an increased prevalence of ischaemic heart disease and peripheral vascular disease in those patients who had positive thyroid antibodies compared with those who had not.

There were also no significant differences in cardiovascular or lipid status in the antibody positive patients between those who had an exaggerated thyroid stimulating hormone (TSH) response to thyrotrophin releasing hormone (TRH) and those who had a normal or impaired response. It is suggested that an exaggerated response to TRH in these PA patients usually indicates ‘compensated euthyroidism’ and not ‘subclinical hypothyroidism’ or ‘premyxoedema’ and that they are no more at risk for cardiovascular disease than are PA patients with no evidence of thyroid abnormality.
C‐PEPTIDE AND INSULIN DURING BLOCKADE OF THE HYPERGLYCAEMIC RESPONSE TO SURGERY BY EPIDURAL ANALGESIA
Authors: BRANDT M. R. , KEHLET H. , FABER O. , BINDER CHR.
Published: March 2008

Insulin secretion, as expressed by peripheral plasma insulin and C‐peptide levels, was studied during and after abdominal hysterectomy in six patients having general anaesthesia and in six patients having epidural analgesia. The hyperglycaemic response to surgery was abolished during epidural analgesia. Insulin as well as C‐peptide levels in plasma were low and unchanged during general anaesthesia and low and slightly decreasing during epidural analgesia. Conclusions: (1) Insulin secretion to the hyperglycaemic stimulus is blocked during surgery; (2)abolition of the hyperglycaemic response to surgery by epidural analgesia is not caused by an increased insulin secretion.
NORMAL EXCRETION OF VASOPRESSIN AND THE EFFECT OF EVERYDAY ACTIVITY
Authors: WATERS A. K. , PENN W. P.
Published: March 2008

The urinary excretion of arginine vasopressin (AVP) was measured by bioassay in normal subjects at rest, on reduced physical activity and on routine everyday activity. The values obtained under rest conditions were all less than 10 mu/24 h with a mean less than 6.6 mu/24 h. Excretion of vasopressin increased with increasing activity, despite free access to water, to mean values of 17 mu/24 h and 29 mu/24 h under conditions of reduced and routine every day activity respectively.

The syndrome of inappropriate secretion of antidiuretic hormone is being reported in an increasing number of disorders (Moses et al., 1976). For absolute diagnosis increased production of arginine vasopressin (AVP), the antidiuretic hormone in humans, should be demonstrated in addition to the criteria stated by Bartter & Schwartz (1967). Plasma levels of AVP reflect the situation at a fixed point in time only and do not necessarily relate directly to overall water metabolism. Estimations of 24 h urine AVP output have been employed for several years and are useful for studying AVP secretion over a prolonged period. Such samples also avoid the problem found in short‐term studies of an increased AVP output with increased urine flow rate (Fabian et al., 1969).

Howevwer, the total daily excretion of AVP by normal subjects has not been extensively investigated. Reported mean levels vary from 8 mu/24 h (Lee, 1963) to over 51 mu/16 h (Goldman & Luchsinger, 1956). The values reported by various authors are listed in Table 1. There may have been variations in the conditions of collecting the urine samples, and although the method of collection, pH, temperature, and type of container used is usually stated, rarely has comment been made about the activity of the subject throughout the collection period. Similarly it has been shown that smoking is a powerful stimulus to AVP secretion (Mayer, 1960; Taylor & Walker, 1951; Burn & Grewal, 1951) and yet smoking habits of subjects have not always been ascertained in studies on 24 h AVP excretion. Further, there appears to be no report concerned with the effect of posture and everyday activity on urinary AVP excretion. Kozlowski et al. (1967) have measured changes in blood concentration of AVP during physical exercise but only in short‐term (20 min) studies. Segar & Moore (1968) also used plasma concentration to assess variations of AVP with posture, but again not over a prolonged period of time.

This paper reports an investigation of urinary AVP excretion under resting conditions and the effect upon it of crude increments of physical activity during which fluid intake was unrestricted.
NYCTOHEMERAL SECRETION OF GROWTH HORMONE IN NORMAL CHILDREN OF SHORT STATURE AND IN CHILDREN WITH HYPOPITUITARISM AND INTRAUTERINE GROWTH RETARDATION
Authors: HOWSE P. M. , RAYNER P. H. W. , WILLIAMS J. W. , RUDD B. T. , BERTRANDE P. V. , THOMPSON C. R. S. , JONES L. A.
Published: March 2008

A continuous blood sampling technique has been used to monitor human growth hormone (GH) during sleep in fourteen normal short children (age range 6.5‐15.0 years), twelve hypopituitary children (2.8‐17.3 years), three children with psychosocial GH deficiency (4.0‐13.0 years), and three children with intrauterine growth retardation (9.5‐11.3 years). The mean GH level of a 5 h sleep period (22.30‐03.30 hours) was used to represent the GH response to sleep. The GH response to insulin induced hypoglycaemia (IST) was also determined. In normal short children there was a significant relationship between 5 h mean GH levels and chronological age. The curve defining this relationship was similar to the third centile linear growth velocity curve. The 5 h mean GH levels of the hypopituitary and psycho‐social GH deficiency children were more than 2 SD below the age related mean established for normal short children. The children with intrauterine growth retardation demonstrated values which were more than 2 SD above the age related mean.

The evaluation of serum growth hormone (GH) during sleep, has recently been used as a test of pituitary function in growth retarded children (Eastman & Lazarus, 1973; Wise et al., 1975). Interpretation of the response is difficult because normal GH values during sleep have not been established.

We have used a continuous blood sampling technique to define the range of nocturnal GH levels for normal short children. The sleep GH response of children with hypopituitarism, psychosocial GH deficiency and intrauterine growth retardation (IUGR) has been similarly investigated and is reported with reference to the range established for normal short children.
THYROXINE AND TRIIODOTHYRONINE LEVELS IN HYPERTHYROID PATIENTS DURING TREATMENT WITH PROPRANOLOL
Authors: HARROWER A. D. B. , FYFFE J. A. , HORN D. B. , STRONG J. A.
Published: March 2008

Serum triiodothyronine (T3) and thyroxine (T4) levels were measured in twelve hyperthyroid patients before and after treatment with propranolol, 40 mg four times daily, for 2 weeks. There was a significant fall in serum T3 and a significant rise in serum T4 concentrations in the group as a whole and it was concluded that the clinical effectiveness of propranolol in hyperthyroidism may be mediated in part by its action on the peripheral metabolism of thyroid hormones. Propranolol treatment should be withdrawn gradually as removal of the suppressive action of the drug on thyroid hormone metabolism is potentially hazardous, particularly in patients with ischaemic heart disease.
EFFECTS OF ORALLY ADMINISTERED OESTRADIOL DECANOATE ON PLASMA OESTRADIOL, OESTRONE AND GONADOTROPHIN LEVELS, VAGINAL CYTOLOGY, CERVICAL MUCUS AND ENDOMETRIUM IN OVARIECTOMIZED WOMEN
Authors: KICOVIC P. M. , LUISI M. , FRANCHI F. , ALICICCO E.
Published: March 2008

. Six ovariectomized women with the uterus left in situ were given a daily oral dose of 0.5 mg of oestradiol decanoate in oil for 14 days. After a single dose of oestradiol decanoate mean plasma oestradiol rose from 26.8 pg/ml to 66.8 pg/ml within 30min. There was a further rise to 100–110 pg/ml (P < 0.001) remaining at the same level over a 24 h period. On repeated daily administration of oestradiol decanoate this rise continued reaching the mean value of 187.1 pg/ml (P < 0.001) at 2 weeks, while plasma oestrone remained at the same level (147.1 pg/ml) as it was at 24 h. The ratio of plasma oestrone:oestradiol was < 1 at 2 weeks. Plasma FSH and LH fell progressively during the medication. Changes of the Maturation Index, cervical mucus Ferning and Spinnbarkeit demonstrated the strong ‘peripheral’ activity of this dose of oestradiol decanoate. All endometrial specimens showed late proliferative changes at 2 weeks. It was concluded that the favourable properties of oestradiol decanoate offer new possibilities for a more physiological oestrogen supplementation therapy.
INFLUENCE OF PRESYNCOPE AND POSTURAL CHANGE UPON PLASMA ARGININE VASOPRESSIN CONCENTRATION IN HYDRATED AND DEHYDRATED MAN
Authors: BAYLIS P. H. , HEALTH D. A.
Published: March 2008

Plasma arginine vasopressin concentrations were measured in five healthy volunteers during postural change under conditions of dehydration and normal hydration. A rise in plasma arginine vasopressin was observed only after dehydration and standing for 40 min. Five further volunteers who developed presyncopal symptoms during orthostasis had exceedingly high plasma arginine vasopressin levels. Changes in plasma arginine vasopressin concentration occurred with no significant alterations in plasma osmolality.
THE ACTION OF THYROID HORMONE
Authors: BERNAL JUAN , REFETOFF SAMUEL
Published: March 2008

Thyroid hormone affects both developmental and metabolic processes. It has a relatively specific effect on the synthesis of a number of enzymes and other proteins. The fundamental cellular mechanism of action seems to be at the level of genetic regulation. It involves interaction with nuclear receptors, leading to an activation of the protein synthesizing machinery. How binding to receptors is coupled to genetic activation is completely unknown. At least part of the metabolic effects of thyroid hormone could be mediated through an interaction with mitochondria and cell membrane, and with some enzymatic systems such as adenylcyclase.
REDUCTION OF PLASMA TRIIODOTHYRONINE (T3) INDUCED BY PROPRANOLOL
Authors: LOTTI GAETANO , DELITALA GIUSEPPE , DEVILLA LUISA , ALAGNA SERGIO , MASALA ANTONIO
Published: March 2008

The effect of propranolol on plasma triiodothyronine (T3), thyroxine (T4) and triiodothyronine uptake by Sephadex G‐25 (RT3U%) was studied in fourteen thyrotoxic patients and eight normal volunteers. 40 mg of propranolol as a single oral dose caused significant reduction in total serum T3 which began 60 min after administration. No significant changes were observed in T4 and RT3U% values. Plasma T3 levels remained suppressed during a 5 day course of treatment with propranolol. These results suggest that propranolol has a direct effect on peripheral metabolism of T3 rather than on thyroid hormone secretion.
THE EFFECT OF ORAL GLUCOSE ON VON WILLEBRAND FACTOR ACTIVITY IN NORMAL AND DIABETIC SUBJECTS
Authors: GRAVES J. M. , COLWELL J. A. , NAIR R. M. G. , SARJI K. E.
Published: March 2008

We have previously noted increased platelet aggregation and high von Willebrand factor activity in patients with chemical diabetes. In this paper we have studied platelet aggregation, plasma glucose, insulin, free fatty acids, growth hormone, and von Willebrand factor activity during the glucose tolerance test in six normal and six chemical diabetic subjects. The results suggest that von Willebrand factor activity is suppressed coincident with the rise of glucose and insulin and provide further evidence of hormonal and metabolic control of levels of von Willebrand factor activity.
INCREASING GROWTH WITH RAISED CIRCULATING SOMATOMEDIN BUT NORMAL IMMUNOASSAYABLE GROWTH HORMONE
Authors: HOFFENBERG R. , HOWELL A. , EPSTEIN S. , PIMSTONE B. L. , FRYKLUND L. , HALL K. , SCHWALBE S. , RUDD B. T.
Published: March 2008

Two patients are described with elevation of circulating somatomedin A concentration but normal growth hormone levels. One, a young male, appeared clinically acromegalic; the other, a young female, was tall with kyphoscoliosis, and her appearance resembled Marfan's syndrome. In both patients plasma growth hormone concentration was suppressible by hyperglycaemia. It is suggested that their clinical syndromes resulted from excessive somatomedin activity.
OESTROGEN‐PROGESTOGEN ORAL CONTRACEPTIVES AND URINARY CALCIUM EXCRETION
Authors: GOULDING A. , MCCHESNEY R.
Published: March 2008

To examine the effects of age and use of oestrogen‐progestogen oral contraceptive agents (OCA) on urinary calcium excretion, 24 h urine collections were obtained from 525 women aged 16‐69 years during a health survey, and measurements made of the amounts of calcium, creatinine, sodium, potassium and magnesium excreted. Younger women using OCA excreted more potassium and creatinine but less calcium, and less calcium and magnesium relative to creatinine, than corresponding controls using no OCA. Older women excreted less creatinine, but significantly greater amounts of calcium, sodium, potassium and magnesium relative to creatinine than younger women.

It is postulated that the diminished urinary calcium excretion observed in women using OCA resulted from suppression of bone resorption by oestrogens in OCA.
PREVENTION BY SOMATOSTATIN OF RISE IN BLOOD PRESSURE AND PLASMA RENIN MEDIATED BY BETA‐RECEPTOR STIMULATION
Authors: ROSENTHAL JULIAN , ESCOBAR‐JIMENEZ FERNANDO , RAPTIS SOTIRIOS
Published: March 2008

The interrelationships of increased plasma renin and elevated blood pressure following acute β‐stimulation by orciprenaline and its prevention by somatostatin was studied in normal man. During somatostatin infusion basal values of renin and blood pressure were unchanged. Following orciprenaline both variables increased significantly. Combination of somatostatin and orciprenaline reduced the rise in plasma renin activity by 49%, mean arterial blood pressure by 21% and heart rate by 19%, compared with β‐stimulation alone.

The results indicate that the inhibitory action of somatostatin on plasma renin activity may be mediated via β‐receptors. The lesser increase of blood pressure under somatostatin plus orciprenaline also indicates a possible inhibitory effect of somatostatin on β‐adrenergic receptors.
MORPHOLOGY OF PROLACTIN PRODUCING ADENOMAS
Authors: KOVACS K.
Published: March 2008

Prolactin cell adenomas, not uncommonly found among tumours arising from the human pituitary gland, are regarded as representing a distinct pathological entity. They can be separated into three types: (1) densely granulated prolactin cell adenomas; (2) sparsely granulated prolactin cell adenomas; (3) mixed adenomas; consisting of prolactin cells and of growth hormone cells.

By light microscopy, using conventional staining procedures, prolactin cell tumours correspond to acidophilic‐chromophobic adenomas and cannot be distinguished reliably from other adenoma types. Positive cytoplasmic staining of adenomatous prolactin cells can often be obtained by Herlant's eryfhrosin or by Brookes’carmoisine methods. Immunoperoxidase technique reveals the presence of immunoreactive prolactin in the cytoplasm of adenoma cells. By electron microscopy, densely granulated adenomatous prolactin cells closely resemble resting prolactin cells seen in the non‐tumorous pituitary. Decrease in size and number of secretory granules, proliferation of rough‐surfaced endoplasmic reticulum membranes, formation of Nebenkerns, prominence of Golgi complex, presence of misplaced exocytosis are characteristic fine structural features of sparsely granulated adenomatous prolactin cells.

Although more work is required to correlate structure with secretory activity, it is justified to conclude that morphologic features of prolactin cell adenomas are sufficiently distinctive to permit their identification. Immunostaining and electron microscopy are valuable techniques revealing the cell type from which pituitary adenomas derive.
OUTCOME OF SUB‐TOTAL THYROIDECTOMY FOR THYROTOXICOSISIN ICELAND AND NORTHEAST SCOTLAND
Authors: THJODLEIFSSON B. , HEDLEY A.J. , DONALD D. , CHESTERS M. I. , KJELD M. , BECK J.SWANSON , CROOKS J. , MICHIE W. , HALL R.
Published: March 2008

A comparative study of the outcome of surgical treatment for thyrotoxicosis was carried out in two countries with dissimilar dietary iodine levels. In the area with a high iodine level (Iceland) the prevalence of post‐operative hypothyroidism was five times lower, but recurrent hyperthyroidism was five times hgher, than in the area with lower iodine levels (northeast Scotland). The total morbidity reached comparable levels in the two samples. The prevalence of positive thyroid antibody tests and serum thyrotrophin levels was lower and the functional capacity of the thyroid remnant higher in the area with the higher dietary iodine intake. The study provides further evidence that there are important regional differences in the prevalence of factors known to influence the response to surgical treatment of thyrotoxicosis which should be taken into account when planning treatment services.
THYROID FUNCTION IN DIETARY AMENORRHOEA
Authors: THOMSON J. E. , BAIRD S. G. , THOMSON J. A.
Published: March 2008

Abnormalities of thyroid function are well known to occur in anorexia nervosa. A commoner problem is the patient with secondary amenorrhoea due to weight loss, who does not have true anorexia nervosa. Eight such patients were studied and compared to a normal control group. Total and free thyroxine, total and free triiodo‐thyronine were found to be significantly lower in the amenorrhoea patients. No difference in basal thyroid stimulating hormone or reverse triiodothyronine levels were found. In three of four patients who had thyrotrophin releasing hormone tests performed a prolonged response was found. These results indicate that abnormal thyroid function tests may be found in this milder form of the disease. In addition, the normal reverse triiodothyronine levels suggest the possibility of two mechanisms existing, whereby T3 levels may be lowered in nutritional disorders.
BONE DISEASE IN CHILDREN WITH CHRONIC RENAL FAILURE; THERAPY WITH l α ‐HYDROXY VITAMIN D3
Authors: POSTLETHWAITE R. J. , HOUSTON I. B.
Published: March 2008

Results of l α‐hydroxy vitamin D3 therapy in twelve children with renal bone disease are described. Nine of the twelve children showed a good response to 0.04–0.08μg/kg/day. Hypercalcaemia was the only side effect and proved easy to manage because of the short half‐life of lα‐OHD3.
PROPHYLACTIC 1α‐HYDROXYVITAMIN D3 THERAPY IN HAEMODIALYSIS PATIENTS
Authors: WALKER G. S. , PEACOCK M. , AARON J. , ROBINSON P. J. A. , DAVISON A. M.
Published: March 2008

Twenty‐seven patients starting regular haemodialysis were treated with a 1 μg daily dose of l α‐hydroxyvitamin D3 and concurrent aluminium hydroxide therapy to prevent hyperphosphataemia. There was an increase in plasma calcium, but no significant improvement in plasma alkaline phosphatase activity or parathyroid hormone levels. Metastatic calcification progressed but was never a severe clinical problem. Quantitative bone histology showed a significant decrease in resorptive surfaces confirmed radiologically, but there was no significant decrease in forming surfaces. The expected increase in forming surfaces with length of dialysis was however prevented.
SPINAL CALCIUM CHANGES WITH 1α‐HYDROXYVITAMIN D3
Authors: DABEK J.T. , ROBINSON B.H.B. , NAIK R.B. , AL‐HITI K.
Published: March 2008

During treatment of renal osteodystrophy with lα‐hydroxyvitamin D3 in eleven patients, regional changes in the skeleton have been compared with long‐term calcium balance as assessed by whole‐body calcium. Radial bone changes did not correlate well with calcium balance, but spinal calcium changes were of a similar magnitude when changes were large. Bone alkaline phosphate changes correlated well with changes in spinal calcium, but less well with changes in radial bone density.
THE EFFECT OF lα‐HYDROXYVITAMIN D3 WITH AND WITHOUT OESTROGENS ON CALCIUM BALANCE IN POST‐MENOPAUSAL WOMEN
Authors: MARSHALL D.H. , NORDIN B.E.C.
Published: March 2008

Balance studies were performed in thirty‐three post‐menopausal women (all but five having vertebral crush fractures or femoral neck fractures) in the basal state and on treatment with l α‐hydroxyvitamin D3 and/or oestrogenic hormones. The results suggest that the effectiveness of oestrogen therapy is limited by calcium malabsorption and the effectiveness of l α‐hydroxyvitamin D3 is limited by oestrogen deficiency. The best results were obtained with combined therapy to remedy what appears to be two distinct deficiencies.

To minimize the risks of hypercalcaemia and the possible risks of hormone therapy, we suggest that the treatment of choice in post‐menopausal osteoporosis may be l α‐hydroxyvitamin D3 1μg daily and ethinyloestrodiol 25 μg daily for 3 weeks in every 4. Patients on a low dietary intake of calcium should probably be given calcium supplements. With this regimen, it should not be necessary to screen patients initially for calcium malabsorption or oestrogen deficiency because the majority of patients present with a combination of the two factors.
1α‐HYDROXYVITAMIN D3 IN PRIMARY HYPERPARATHYROIDISM
Authors: BOYLE I.T. , FOCELMAN I. , BOYCE B. , THOMSON J.E. , BEASTALL G.H. , McINTOSH W.B. , McLENNAN I.
Published: March 2008

The surgcal management of primary hyperparathyroidism with severe bone disease (and tertiary hyperparathyroidism) has frequently been complicated by severe and prolonged post‐operative hypocalcaemia. In seven such cases a short pre‐operative course of l α‐hydroxy vitamin D3 has been found to abolish these adverse features virtually completely and even to diminish pre‐operative symptoms where present. Exacerbation of hypercalcaemia has not occurred and this regimen is thus recommended as a routine measure.
1α‐HYDROXYVITAMIN D3 IN THE TREATMENT OF NUTRITIONAL AND METABOLIC RICKETS AND OSTEOMALACIA
Authors: GERTNER J.M. , BRENTON D. B. , EDWARDS R.H.T.
Published: March 2008

Five patients with nutritional osteomalacia or rickets and six children with rickets unresponsive to physiological doses of vitamin D were treated with 1α‐hydroxy‐vitamin D3 (lα‐OHD3). Patients with nutritional osteornalacia responded to l‐2μg/day of lα‐OHD3. The most striking findings were rises in plasma calcium and, in one case, a decrease in faecal calcium. In some cases there was a rise in plasma phosphorus, alkaline phosphatase remained unchanged. There was radiological healing.

In three patients with cystinosis and one with hypophosphatsemia and Barrter's syndrome 2μg of lα‐OHD3 produced healing of rickets. Plasma phosphate rose on treatment, possibly by a suppression of parathyroid activity. The response to such low doses of lα‐OHD3 suggests impaired lα‐hydroxylation of 25‐hydroxyvitamin D in these patients. A patient with intestinal malabsorption was resistant to high doses of lα‐OHD3 by mouth but responded to parenteral administration. A boy with osteopetrosis and the biochemical changes of rickets was resistant to large doses of lα‐OHD3 presumably because of failure of osseous response.
SEX HORMONES IN MALE PATIENTS WITH CHRONIC RENAL FAILURE. I. THE PRODUCTION OF TESTOSTERONE AND OF ANDROSTENEDIONE
Authors: VAN KAMMEN E. , THIJSSEN J.H.H. , SCHWARZ F.
Published: March 2008

The production of testosterone (Te) and androstenedione (A) has been studied in twenty‐three patients with chronic renal failure. Four of the patients were being prepared for haemodialysis (HD) treatment — non‐HD patients — nineteen were on chronic HD treatment, five of whom had been nephrectomized bilaterally. Data are presented on plasma Te and A levels, on the response to HCG and on changes after HD. The Metabolic Clearance Rate (MCR), blood production rate and the mutual interconversion of both steroids were determined together with the plasma sex hormone binding globulin capacity.

In all groups of patients, plasma levels of Te were low and stimulation with HCG resulted in an insufficient increase in plasma Te levels, indicating Leydig cell deficiency in chronic uraemic males. In addition, a tendency to increased metabolic breakdown of Te was observed, most probably caused by a deficient synthesis of the sex hormone binding globulin. In patients with high peripheral degradation of Te, the testicles were able to produce about normal amounts of Te.

In the non‐HD patients an increase in the MCR and blood production rate of A was found. This may be due to an alteration in the testicular steroid secretion. The other groups of patients did not show differences in the production of A when compared with normal males. No significant changes in plasma levels of Te and A were observed during HD treatment.

The picture emerging from our data is similar to the one observed in population groups with severe protein malnutrition.
POTENTIATION OF THE HYPOTHALAMIC‐PITUITARY‐ADRENAL RESPONSE TO METYRAPONE BY l‐DOPA IN ACROMEGALIC PATIENTS
Authors: HSU TAH‐HSIUNG
Published: March 2008

The effects of l‐DOPA administration on hypothalamic‐pituitary‐adrenal function were studied in five normal subjects and in five patients with active acromegaly. In acromegalic patients, oral l‐DOPA (500 mg every 4 h for six doses) failed to alter the urinary excretion of 17‐hydroxycorticoids (17‐OHCS), 17‐oxosteroids (17‐OS), and tetrahydro‐11‐desoxycortisol (tetrahydro‐comp S). However, when cortisol synthesis was blocked with oral metyrapone, enhancement of excretion of 17‐OHCS, 17‐OS, and tetrahydro‐comp S by l‐DOPA became apparent in acromegalic patients but not in the normals. In patients with acromegaly, on the day of metyrapone administration, the mean excretion rates of 17‐OHCS, 17‐OS, and of tetrahydro‐comp S were 8.6 mg, 6.4 mg and 4.1 mg/24 h, respectively. When 500 mg l‐DOPA was co‐administered with metyrapone, the corresponding values increased significantly (P<0.01) to 14.9 mg, 9.0 mg and 7.7 mg/24 h. This effect of l‐DOPA was not observed in the normal subjects. It was concluded that l‐DOPA markedly enhanced the hypothalamic‐pituitary‐adrenal response to metyrapone in acromegalic patients, but not in normal subjects. l‐DOPA (or one of its metabolites) probably acts upon a noradrenergic or a dopaminergic system located in the hypothalamus to alter the release of ACTH. The unusual pituitary‐adrenal response to l‐DOPA in acromegaly may reflect: (1) a supersensitive reaction of the pituitary‐adrenal axis to l‐DOPA; (2) a paradoxical response of the pituitary‐adrenal axis to l‐DOPA; or (3) a subtle pituitary‐adrenal dysfunction.
BROMOERGOCRYPTINE TREATMENT OF ACROMEGALY PERSISTING FOLLOWING CONVENTIONAL THERAPY
Authors: HOLDAWAY I. M. , FRENGLEY P. A. , SCOTT D. J. , IBBERTSON H. K.
Published: March 2008

Bromoergocryptine has been used to lower growth hormone concentrations in ten patients with acromegaly in whom previous attempts at pituitary ablation had failed to cure the disorder. Plasma immunoreactive and plasma receptor‐reactive growth hormone concentrations together with plasma somatomedin concentrations and urinary excretion of immunoreactive growth hormone were used to assess the response to treatment. Casual immunoreactive hormone concentrations in plasma were lowered to less than 8 mu/l and to less than 5 mu/l during glucose infusion in seven patients, and urinary growth hormone excretion was also brought into the normal range (<40 μu/12 h) in this group. There was at least a 40% reduction in these measurements in the remaining three patients who had the highest basal hormone concentrations of the group. Plasma somatomedin fell with treatment in eight patients, and intravenous glucose tolerance improved in seven of eight patients tested. Used in modest dosage (up to 15 mg/day) bromoergocryptine can lower plasma and urinary growth hormone and plasma somatomedin concentrations in acromegalic patients in whom previous treatments have decreased but not cured hormone overproduction.
EFFECT OF FLUPHENAZINE ON PITUITARY FUNCTION IN MAN
Authors: CHALMERS R. J. , BENNIE E. H. , JOHNSON R. H.
Published: March 2008

SUMMARY. The growth hormone (hGH) and prolactin (hPRL) response to insulin induced hypoglycaemia was studied in six alcoholics on two occasions before and after treatment with a single intramuscular injection of fluphenazine (Modecate). On both occasions blood samples were taken at intervals before and after the intravenous injection of soluble insulin (0.1 u/kg body weight). The patients were investigated on the first occasion, 2–7 days after cessation of drinking and they all demonstrated an adequate hGH response. They then received an injection of fluphenazine (Modecate 12.5 mg) and were reinvestigated 1 week later. The hGH response to hypoglycaemia was significantly impaired after treatment with fluphenazine. Basal hPRL concentrations were significantly increased and increased concentrations of hPRL in response to hypoglycaemia occurred after treatment. We conclude that a single injection of fluphenazine (Modecate 12.5 mg) has a marked effect on hypothalamic‐pituitary mechanisms controlling hGH and hPRL release.
FAILURE OF SOMATOSTATIN TO DIAGNOSE ORGANIC HYPERINSULINISM
Authors: LO CASCIO V. , GALVANINI G. , ADAMI S. , CINTI S. , BIANCHI I. , COMINACINI L. , SCURO L. A.
Published: March 2008

SUMMARY. In four patients with organic hyperinsulinism (two with surgically proven β‐cell adenomas of the body of the pancreas) a standard tolbutamide test during continuous somatostatin infusion (5 μg/min) was carried out. Tolbutamide‐induced insulin release was completely inhibited by somatostatin as in normal subjects. These results suggest that the inhibition test with somatostatin does not seem to be a better or safer way of diagnosing insulin producing tumours.
BEHAVIOUR OF PLASMA RENIN ACTIVITY AND ALDOSTERONE DURING THE FIRST 72 H OF LIFE
Authors: SPARANO F. , SCIARRA F. , NATOLI G. , MERCURI M. A. , ODOARDI A. , COLANGELO E.
Published: March 2008

Plasma rerun activity (PRA) and plasma aldosterone concentrations (PAC) were determined in fifty normal newborns during the first 72 h of life. PRA was elevated in all cases and tends to increase from the first (6.79 ± 0.69SE ng/ml/h) to the third day of life (8.24 ± 0.96SE ng/ml/h). PAC was also elevated and rose from 24.06 ± 3.23SE ng/dl on the first day to 39.20 ± 4.25SE ng/dl on the third day. No significant correlation was observed between PRA and PAC. Serum sodium was within the normal range, whereas serum potassium was slightly elevated during the first 48 h of life. The physiological significance of the high levels of PRA and PAC in newborns is not clear at present. Many factors may be involved in the increased activation of the renin‐angiotensin‐aldosterone system: low blood pressure, hypersensitivity of the macula densa to catecholamines, relative insensitivity of the immature kidney to aldosterone, hyperkalaemia and other control mechanisms for aldosterone secretion all of which probably operate simultaneously during the first days of life.
THE EFFECT OF LISURIDE HYDROGEN MALEATE IN THE HYPERPROLACTINAEMIA‐AMENORRHOEA SYNDROME: CLINICAL AND HORMONAL RESPONSES
Authors: DE CECCO L. , FOGLIA G. , RAGNI N. , ROSSATO P. , VENTURINI P.L.
Published: March 2008

Eleven women with secondary amenorrhoea and hyperprolactinaemia were treated with lisuride, a new semisynthetic ergot derivative.

Acute administration of lisuride (100 μg orally) significantly suppressed serum prolactin (PRL) levels in nine out of eleven subjects. In these nine patients, prolonged treatment with lisuride (50–200 μg daily) lowered PRL levels into the normal range, menstrual cycles were resumed and eight patients ovulated.

Two patients, in whom lisuride failed to lower PRL levels into the normal range, did not resume normal menstruation.

These data demonstrate that lisuride may be used clinically to lower PRL levels and to restore cyclic gonadotrophin secretion and ovulation in amenorrhoeic patients with hyperprolactinaemia.
THE VARIATION IN SERUM TRIIODOTHYRONINE (T3) ACHIEVED DURING SUPPRESSION TESTING IN THYROTOXICOSIS
Authors: WILKIN T. J. , ISLES T. E. , NEWTON R. W. , GUNN A. , CROOKS J. , BECK J. SWANSON
Published: March 2008

Regular measurement of thyroidal radioiodine uptake has been widely used as a means of monitoring continued extrapituitary stimulation of the thyroid during the treatment of thyrotoxicosis with carbimazole and triiodothyronine (T3). However, it is unclear to what extent the serum T3 level may vary at the time of testing, nor what effect this might have on the uptake of radioiodine. Two studies have been undertaken. In the first, serum T3 levels in twenty‐four thyrotoxic patients were measured at intervals during an 18‐month course of carbimazole combined with T3, 20 μg qid. Considerable variations in the highest and lowest levels of serum T3 were found both between and within individuals. The second study was on twenty‐three thyrotoxic patients thought to be entering remission because the iodine uptake after 5 months of drug treatment had fallen to less than 50% of the pretreatment value (suppressors). The changes in uptake of radioiodine after 5 and then 6 months of treatment were compared in seven patients, who received carbimazole and T3 throughout, with the corresponding changes in the remaining sixteen patients, whose T3 alone was withdrawn prior to the uptake test at month 6. The mean degree of suppression remained unchanged by month 6 in the first group. In the second group, however, the mean uptake rose significantly, and nine of the sixteen patients would have been classified as non‐suppressors at the sixth month (i.e. uptake greater than 50% the pretreatment value) had their failure to maintain high serum levels of T3 gone undetected. The first study indicated this could well happen in routine circumstances, and it is suggested that the reliability of suppression tests be checked with simultaneous measurement of serum T3.
STIMULATION BY GROWTH HORMONE OF SOMATOSTATIN RELEASE FROM THE RAT HYPOTHALAMUS IN VITRO
Authors: SHEPPARD M. C. , KRONHEIM S. , PIMSTONE B. L.
Published: March 2008

SUMMARY Growth hormone (GH) has been shown to cause a dose‐dependent increase in the release of immunoreactive somatostatin from the rat hypothalamus in vitro, thus providing further evidence that GH may be involved in a ‘short loop’ feedback, controlling its own secretion via hypothalamic somatostatin release.
THE EFFECT OF PAIN ON PLASMA ARGININE VASOPRESSIN CONCENTRATIONS IN MAN
Authors: KENDLER K. S. , WEITZMAN R. E. , FISHER D. A.
Published: March 2008

The effect of pain on plasma AVP concentration in man has previously been studied only during major surgery with general anaesthesia. Plasma AVP concentration (pAVP) and plasma osmolality (pOsm) were measured in thirty‐six patients seen in a surgical emergency department complaining of pain and in fifty‐one control subjects. No significant difference in pOsm was found, but pAVP was significantly higher in the emergency room patients in pain (M ± SEM = 4.94 ± 0.98 pmol/l compared to 2.31 ± 0.32 pmol/l in control subjects, P < 0.01).

In the control subjects, age was found to have a low but significant inverse correlation with pAVP (r= 0.37, P < 0.01). Chronic smoking was associated with significant elevation of pAVP (3.81 ± 0.99 pmol/l in smokers vs. 1.89 ± 0.28 pmol/l in non‐smokers, P < 0.02). Neither smoking nor age could account for the difference in pAVP between the pain and control groups. Thus, pain is a non‐osmolar factor capable of elevating AVP in conscious man.
EFFECT OF SELECTIVE GOITRE RESECTION ON ABSENT THYROTROPHIN RESPONSE TO THYROTROPHIN RELEASING HORMONE IN IDIOPATHIC EUTHYROID GOITRES
Authors: BLICHERT‐TOFT M. , CHRISTIANSEN C. , AXELSSON C. K. , EGEDORF J. , IBSEN H. , IBSEN J.
Published: March 2008

Absent thyrotrophin (TSH) response to thyrotrophin releasing hormone (TRH) was found in ten of fifty consecutive nodular goitrous patients who were clinically and biochemically euthyroid. These ten patients together with a reference group engaging fifty‐eight healthy individuals matched for sex, age, and geographic region form the basis of the present study. Patients with autonomously functioning single adenomata were excluded from the investigation. In the patient group, values of serum thyroxine (T4), free T4‐index, and serum TSH did not differ significantly from those recorded in the reference group, whereas serum triiodothyronine was found to be significantly higher in the patients, although within the normal range. After selective resection of the goitre, the TSH responsiveness to TRH recovered completely. Routine indices of thyroid function, however, demonstrated no major deviation from pre‐operative levels. During a follow‐up period of 1 year, no systematic alterations were recorded in TSH response to TRH nor in the thyroid function tests, indicating maintenance of euthyroidism with restored normality within the pituitary‐thyroid axis. The present study lends support to the view that increasing functional autonomy apparently is a common trend in goitre evolution in a non‐endemic area.
SPORADIC NON‐TOXIC GOITRE: AN INVESTIGATION OF THE HYPOTHALAMIC–PITUITARY–THYROID AXIS
Authors: MORGANS M. E. , THOMPSON B. D. , WHITEHOUSE S. A.
Published: March 2008

Thyrotrophin releasing hormone (TRH) tests have been carried out on sixty‐two patients with sporadic non‐toxic nodular goitre. 61% gave a subnormal thyroid stimulating hormone (TSH) response but had normal plasma thyroxine (T4) and triiodothyronine (T3) levels. T3 administration suppressed 131I uptake by the thyroid adequately in 74% of these and there was normal stimulation of thyroid uptake by exogenous TSH. Prolactin (PRL) rose normally after TRH in all the TRH non‐responders. Normal TSH response to TRH was restored by partial thyroidectomy and in some cases by propyl thiouracil administration. Possible reasons for these findings are discussed. It is concluded that these cases were truly euthyroid.
THE INTER‐RELATIONSHIP OF THYROID HORMONES, VITAMIN A AND THEIR BINDING PROTEINS FOLLOWING ACUTE STRESS
Authors: RAMSDEN D. B. , PRINCÉ H. P. , BURR W. A. , BRADWELL A. R. , BLACK E. G. , EVANS A. E. , HOFFENBERG R.
Published: March 2008

The effects of surgical stress on the metabolism of the retinol‐binding‐protein‐thyroxine‐binding‐prealbumin complex were investigated. The immediate post‐surgical period was characterized by a rapid decline in the serum concentration of retinol, retinol binding protein and triiodothyronine and an increase in the 24 h urinary excretion of retinol, retinol‐binding‐protein and thyroxine. Similar, but less pronounced, changes were seen in other subjects suffering acute myocardial infarction but were not observed in normal healthy euthyroid males or in pre‐operative euthyroid patients. The preparation of specific anti‐retinol binding protein anti‐serum and the use of this in ‘monorocket’ immunoelectrophoresis are also described.
A SMALL DOSE OF SOMATOSTATIN INHIBITS THE PENTAGASTRIN STIMULATED GASTRIC SECRETION OF ACID, PEPSIN AND INTRINSIC FACTOR IN MAN
Authors: SCHRUMPF E. , VATN M. H. , HANSSEN K. F. , MYREN J.
Published: March 2008

The effect of a small dose of somatostatin (0.05 mg/h) on the gastric secretion of acid, pepsin and Intrinsic Factor (IF) after stepwise increases in the dose of pentagastrin was examined in six healthy volunteers. The gastric secretion of acid, pepsin and IF in response to pentagastrin was significantly reduced by a continuous infusion of somatostatin. The pattern of inhibition indicates that somatostatin is a competitive inhibitor of pentagastrin in the stimulation of gastric secretion of both acid, pepsin and IF. This finding supports the hypothesis of a direct effect of somatostatin on the exocrine secretory cells of the stomach.
THE SECRETION OF THYROTROPHIN WITH IMPAIRED BIOLOGICAL ACTIVITY IN PATIENTS WITH HYPOTHALAMIC–PITUITARY DISEASE
Authors: PETERSEN V. B. , MCGREGOR A. M. , BELCHETZ P. E. , ELKELES R. S. , HALL R.
Published: March 2008

We describe here two patients with hypothyroidism due to pituitary‐hypothalamic disease in whom basal thyrotrophin (TSH) levels measured by radioimmunoassay (RIA) were elevated yet when measured by a cytochemical bioassay (CBA) were found to be normal. This finding and the absence of the normal rise of thyroid hormones in response to thyrotrophin‐releasing hormone (TRH) mediated release of TSH confirms for the first time the secretion of TSH with impaired biological activity. Primary thyroid disease as a cause for the elevated immunoreactive TSH was excluded by the absence of circulating thyroid antibodies and by a normal thyroidal radioiodine uptake response to exogenous TSH.
STUDIES ON CERTAIN ASPECTS OF PROGESTERONE AND CORTISOL DYNAMICS BEFORE, DURING AND AFTER LABOUR
Authors: BATRA S. , GRUNDSELL H.
Published: March 2008

Concentrations of progesterone, cortisol, free (unbound) progesterone and cortisol binding capacity (CBG) in blood samples were measured serially from 3 weeks preceding delivery to 5 days post partum. There was no change in total plasma progesterone in the last few weeks of pregnancy or during labour but after delivery the concentration of progesterone decreased significantly. Cortisol concentrations showed no change in the last 3 weeks of pregnancy but increased considerably (by 67%) during labour and remained at this high level until at least 2 h post partum, decreasing thereafter. At 5 days post partum the cortisol concentrations were significantly lower than those found a few weeks before labour. The fraction of free progesterone did not change during labour but there was a significant rise in percentage free progesterone 2 h post partum. This rise in percentage free progesterone coincided with the highest concentration of plasma cortisol and a relatively low plasma progesterone. The fraction of free progesterone decreased 1 day post partum to levels that were similar to or slightly lower than those existing before delivery. There was no change in the concentration of CBG before or during labour or at least until 5 days post partum. These results generally support the suggestion that the rise in cortisol concentration during labour can lead to an increase in the fraction of free progesterone.