bluuebunny/crossref_metadata_2025 huggingface dataset:
COMPARISON BETWEEN THYROID STIMULATING AND TSH‐BINDING INHIBITING IMMUNOGLOBULINS OF GRAVES' DISEASE
Authors: MACCHIA E. , FENZI G. F. , MONZANI F. , LIPPI F. , VITTI P. , GRASSO L. , BARTALENA L. , BASCHIERI L. , PINCHERA A.
Published: March 2008

In the sera of patients with Graves' disease abnormal thyroid ‘stimulating’ immunoglobulins have been demonstrated by in vivo and in vitro assay systems. Conflicting results have been reported when thyroid stimulating and thyrotrophin (TSH)‐binding inhibiting activities have been compared. The present study was performed in forty‐nine hyperthyroid Graves' patients to ascertain the relationships among TSH‐binding inhibiting immunoglobulins (TBII), measured by a radio‐receptor assay, thyroid stimulating antibody (TSAb), assayed by stimulation of adenylate cyclase‐cAMP system in human thyroid plasma membranes, and LATS, measured by McKenzie's mouse bioassay. TBII was detected in twenty‐one of forty‐nine (42·9%), TSAb in thirty‐five of forty‐nine (714%) and LATS in nineteen of forty‐nine (38·8%). TBII was also present in four of sixteen (25%) patients with other thyroid autoimmune disorders. When the results obtained with the different techniques were compared, correlation was found between LATS response and TSAb activity (r = 0·53, P < 0·001), while there was no correlation between TSAb and TBII activities and between LATS response and TBII activity. These data confirm that TSAb is a specific and sensitive marker of Graves' disease and suggest that TBII activity is not necessarily synonymous with thyroid stimulation, and could reflect a different phenomenon concomitantly produced.
OESTROGEN STIMULATED NEUROPHYSIN IN PREGNANCY AND LACTATION
Authors: McHUGH ROSEMARY E. , MARVIN SUSAN C. , SHIRLEY ANNE , BUTT W. R. , LYNCH S. S. , GLASS M. R. , MARTIN R. H.
Published: March 2008

Serum concentrations of oestrogen stimulated neurophysin (ESN) were measured throughout pregnancy in thirty‐one women and until 6 weeks post‐partum in a further twenty‐three. During pregnancy ESN rose progressively and values during labour were similar to those immediately before delivery. There were significant correlations (P < 0–05) between serum ESN and oestradiol values measured in samples from four patients. After delivery the concentration of ESN fell rapidly to the range for non‐pregnant women by 5 days post‐partum, whether the mothers lactated or not, and remained fairly constant for the next 6 weeks. Bromocriptine or metoclopramide, drugs which affect prolactin secretion, were without effect on ESN values.

At 8 days post‐partum in sixteen of the eighteen patients studied there was an increase in ESN concentration 30 min after suckling commenced. At 6 weeks similar changes occurred in five of ten subjects studied. In contrast, at 8 days there was no significant change in ESN in four mothers who bottle fed their babies over the 90 min studied. The relationship between ESN and hormonal changes during pregnancy and lactation is discussed in the light of these results.
IS 1,25‐DIHYDROXY‐CHOLECALCIFEROL HARMFUL TO RENAL FUNCTION IN PATIENTS WITH CHRONIC RENAL FAILURE?
Authors: CHRISTIANSEN C. , RØDBRO P. , CHRISTENSEN MERETE S. , HARTNACK BIRGITTE
Published: March 2008

Seventeen undialysed adult patients with chronic renal failure took part in a controlled study of the effects of 1,25(OH)2D3 and D3. After a 6‐month observation period the patients were allocated at random to two groups for 6 months of treatment with either 1,25(OH)2D3 (mean dose 0·5 μg daily) or D3 (dose 100 μg daily). Treatment was then discontinued and the patients were studied for a further 6 months.

Serum iPTH was decreased in both groups but most markedly in the 1,25(OH)2D3 group in which the iPTH values became normal. Serum creatinine increased during treatment in both groups. In the group receiving 1,25(OH)2D3 this was coupled to an increase in serum calcium within the normal range.

Our data demonstrate that 1,25(OH)2D3 treatment in patients with chronic renal failure leads to a further reduction in renal function, which may be partially reversible. Physicians should therefore be reluctant to give vitamin D analogues to patients with chronic renal failure unless they have severe symptomatic renal osteodystrophy.
AUTOIMMUNE THYROIDITIS: A CONDITION RELATED TO A DECREASE IN T‐SUPPRESSOR CELLS
Authors: THIELEMANS C. , VANHAELST L. , DE WAELE M. , JONCKHEER M. , VAN CAMP B.
Published: March 2008

Monoclonal antibodies recognizing specific antigenic determinants of peripheral T‐lymphocytes (OKT3PAN), helper T‐cells (OKT4IND) and suppressor T‐cells (OKT8SUP) were used to study the immune regulation in autoimmune thyroiditis. An indirect immunofluorescence microscopy method was employed to quantify the number of different subtypes. In addition, B‐lymphocytes were also studied using a fluorescent surface Ig detection technique. Patients with autoimmune thyroiditis—independent of their clinical status—show a decrease in the number of suppressor T‐lymphocytes. This finding, in agreement with other functional tests, indicates that the autoimmune phenomenon is linked to a decreased T‐suppressor activity.
INTER‐RELATIONSHIP BETWEEN CHANGING PATTERNS OF LHRH AND GONADOTROPHINS IN THE MENSTRUAL CYCLE
Authors: SARDA A. K. , BARNES M. A. , NAIR R. M. G.
Published: March 2008

Optimum conditions for a sensitive and highly precise radioimmunoassay of LHRH were established. Precipitation and removal of interfering substances and concentration of the resultant LHRH extracts from peripheral plasma were also achieved. Using these methods, daily plasma LHRH levels in females with normal menstrual cycles were measured and correlated with the corresponding LH and FSH levels. The levels of LHRH in the peripheral plasma of postmenopausal females, as well as eugonadal males, were also determined.

The LHRH profile in normal cycling women was found to be cyclic but the peak LHRH levels were observed at the beginning of the rise in LH and FSH levels and preceded the midcycle surge of gonadotrophins. The LHRH levels in the luteal phase (19·8 ± 1·1 pg/ml, mean ± SEM) were significantly (P < 0·01) higher than those in the follicular phase (16·5 ± 0·5 pg/ml) of the menstrual cycle. A high degree of correlation (r = 0·91) was seen between the immunoreactivity and biological activity of the extracted LHRH.
ENDOCRINE EFFECTS OF DOMPERIDONE: A PERIPHERAL DOPAMINE BLOCKING AGENT
Authors: BROWN G. M. , VERHAEGAN H. , GREIDANUS T. B. VAN WIMERSMA , BRUGMANS J.
Published: March 2008

In the present study, effects of domperidone, a peripheral dopamine blocking agent, on prolactin and growth hormone were examined to determine whether dopamine regulation of these hormones involved structures external to the blood‐brain barrier. A clearcut elevation in prolactin was produced by domperidone. GH response to apomorphine was partially blocked by domperidone.
ALLOSUPPRESSOR T LYMPHOCYTES ABOLISH MIGRATION INHIBITION FACTOR PRODUCTION IN AUTOIMMUNE THYROID DISEASE: EVIDENCE FROM RADIOSENSITIVITY EXPERIMENTS
Authors: TOPLISS D. J. , OKITA N. , LEWIS M. , ROW V. V. , VOLPÉ R.
Published: March 2008

The ability of normal T lymphocytes to abolish the production of migration inhibition factor by antigen‐sensitized T lymphocytes of Graves' disease (GD) and Hashimoto's thyroiditis (HT) in response to thyroid antigen has been studied by a modified migration inhibition factor test using isolated T lymphocytes alone. The production of migration inhibition factor was consistently abolished when normal T lymphocytes were mixed with GD or HT T lymphocytes in various ratios (1:9, 2:8, 5:5) as reported previously (Okita et al., 1980b). However, prior in‐vitro irradiation (1000 rad) of the normal T lymphocytes resulted in loss of their ability to abolish migration inhibition factor production by the antigen‐sensitized T lymphocytes of GD and HT. The effect is consistent with the radiosensitivity of suppressor T lymphocytes and indicates that the effect of normal T lymphocytes on GD and HT T lymphocytes is one of allosuppression. The results support the view that there is a defect in suppressor T cell function in GD and HT.
VASOPRESSIN FUNCTION IN HYPERCALCAEMIA
Authors: BAYLIS P. H. , MILLES J. J. , WILKINSON R. , HEATH D. A.
Published: March 2008

Vasopressin function and thirst were studied in fourteen hypercalcaemic patients (ten hyperparathyroid and four disseminated malignant disease). Ten patients had decreased renal concentrating ability which reversed within a few days in the majority of patients whose hypercalcaemia was corrected by parathyroidectomy. Although eight patients complained of thirst, none showed a lowered threshold of thirst appreciation during hypertonic saline infusion. Osmoregulation of vasopressin secretion was not reduced in any patient, but the hyperparathyroid group had an exaggerated vasopressin response to osmotic stimulation. We conclude that a partial, reversible nephrogenic diabetes insipidus occurs in at least 70% of hypercalcaemic patients irrespective of cause, which accounts for the polyuria induced by hypercalcaemia.
RISE IN PLASMA GROWTH HORMONE IN RESPONSE TO EXOGENOUS LRH IN KLINEFELTER'S SYNDROME
Authors: DICKERMAN Z. , RACHMEL A. , GIL‐AD I. , PRAGER‐LEWIN RUTH , GALATZER A. , LARON Z.
Published: March 2008

In a group of sixteen patients with Klinefelter's syndrome (KS) aged from 2 years 8 months to 31 years, a study was made of the plasma growth hormone (hGH) response to LRH (50 μg/m2 i.v.; n= 16), TRH (200 μg i.v.; n= 14) and insulin‐induced hypoglycaemia (0·1 u R.I,/kg i.v.; n= 6). There was a rise in hGH following LRH from a level below 5 ng/ml during fasting to a level above 8 ng/ml (P < 0·001) in nine (56·3%) of the sixteen patients tested; a similar response was found in only one of a control group of fifteen boys matched for age. TRH stimulation led to a rise in hGH in one of the fourteen KS patients tested, with none in the control group. Insulin‐induced hypoglycaemia elicited a normal response of hGH in the six KS patients tested, from 1·8 ± 0·7 to 16·5 ± 3·7 ng/ml, (M ± SD, P < 0·001). Basal prolactin (PRL) levels were normal in the KS patients (9·4 ± 4·1 ng/ml, M ± SD) but the response to TRH stimulation was significantly higher (63·3 ± 40 ng/ml; P < 0·01) than that of the control group (30 ± 15 ng/ml). Plasma gonadotrophin levels and the response to LRH stimulation were increased in all of the KS patients except those below the age of 13. Plasma TSH levels and the response to TRH stimulation as well as the levels of serum thyroxine were found to be normal in all the KS patients tested.

The abnormal rise of hGH following LRH stimulation and of PRL following TRH stimulation suggests a disturbance in the neuroendocrine regulation mechanisms of these hormones in KS.
INFLUENCE OF SOMATOSTATIN ON PLASMA CYCLIC AMP AND METABOLIC SUBSTRATE RESPONSES TO I.V. ADRENALINE AND GLUCAGON IN HUMANS
Authors: MADSEN S. NISTRUP , CHRISTENSEN S. ENGKJÆR , HANSEN AA. PRANGE , THODE J.
Published: March 2008

The influence of somatostatin (a bolus injection of 250 μg i.v. followed by 6 μg/min for 40 min) on the plasma cyclic AMP, insulin, glucose and non‐esteri‐fied fatty acid (NEFA) responses to i.v. adrenaline (0·07 μg/kg body‐weight/min for 20 min) and the plasma cyclic AMP, insulin and glucose responses to a bolus injection of i.v. glucagon (0·01 mg/kg BW) were studied in normal subjects.

Somatostatin suppressed the insulin response to glucagon and inhibited the insulin rebound observed on termination of adrenaline infusion. The plasma glucose response to glucagon was exaggerated by somatostatin, reflecting insulin deficiency. Neither the plasma glucose nor plasma non‐esterified fatty acid responses to adrenaline were influenced by somatostatin.

Adrenaline produced a three‐fold and glucagon a twenty‐fold rise in plasma cyclic AMP after 15 min. This was not influenced by concurrent somatostatin infusion, indicating that somatostatin is not a universal inhibitor of hormone stimulated adenylate cyclase activity. This is supported by the failure of somatostatin to inhibit the metabolic actions of glucagon and adrenaline thought to be mediated by cyclic AMP.
A CARBOXY‐TERMINAL SPECIFIC ASSAY FOR HUMAN PARATHYROID HORMONE
Authors: MANNING R. M. , ADAMI S. , PAPAPOULOS S. E. , GLEED J. H. , HENDY G. N. , ROSENBLATT M. , O'RIORDAN J. L. H.
Published: March 2008

An homologous carboxy‐terminal specific immunoradiometric assay for human parathyroid hormone (PTH) has been developed which uses an antiserum raised in a goat against intact human PTH. This assay has been applied to the measurement of circulating PTH in man; the reference preparation was a 53–84 fragment prepared from native human parathyroid hormone. PTH was detectable in all the normal subjects studied (range 0·1–0·79 ng/ml) and elevated concentrations were found in a group of patients with primary hyperparathyroidism (range 0·82–25·5 ng/ml). Carboxy‐terminal hormone concentrations were particularly raised in uraemic subjects (range 1–02–52–5 ng/ml) but some patients with vitamin D deficient osteomalacia had concentrations within the normal range (0·5–2·4 ng/ml). All patients with pseudohypoparathyroidism had elevated concentrations (range 1·0–2·8 ng/ml) and in patients with idiopathic or surgical hypoparathyroidism the concentration ranged from undetectable to 0·4 ng/ml. These results have been compared with those obtained using an amino‐terminal specific assay. In normal subjects carboxy‐terminal immuno‐reactive hormone concentrations were, on average, three times higher than those measured in the amino‐terminal assay (C:N ratio 3·28). In patients with secondary hyperparathyroidism this ratio was dependent on renal function and the plasma calcium concentration. The disappearance of endogenous carboxy‐and amino‐terminal PTH from the circulation of a patient with primary hyperparathyroidism was studied. Amino‐terminal reactive PTH disappeared much more rapidly (t½= 1·5 min) than carboxy‐terminal hormone (t½= 2·75 h). It is hoped that the carboxy‐terminal specific assay described here will be of value in the further study of the secretion and metabolism of PTH.
EFFECT OF PROLONGED ADMINISTRATION OF RANITIDINE ON PITUITARY AND THYROID HORMONES, AND THEIR RESPONSE TO SPECIFIC HYPOTHALAMIC‐RELEASING FACTORS
Authors: PASQUALI R. , CORINALDESI R. , MIGLIOLI M. , MELCHIONDA N. , CAPELLI M. , BARBARA L.
Published: March 2008

We have studied, in a double blind controlled trial, 30 male patients with duodenal ulcer to evaluate the effect of prolonged oral administration of ranitidine (150 mg bd for 4 weeks), a new H2‐receptor antagonist, on basal PRL, LH, FSH and TSH concentrations, on their response to specific releasing hormones, and on basal and TRH‐stimulated levels of thyroid hormones. Neither the basal levels of PRL, FSH, LH and TSH, nor their response to stimulation with appropriate releasing hormone were affected by ranitidine. Basal concentrations of T4 and its levels after TRH stimulation at 40 min (but not at 20, 60 and 120 min) were lower after ranitidine treatment (P < 0·05); basal and stimulated T3 and rT3 were unaffected. These results could suggest a possible role of histamine in thyroxine regulation but further studies are required.
THE EFFECT OF BROMOCRIPTINE ON INSULIN SECRETION AND GLUCOSE TOLERANCE IN PATIENTS WITH ACROMEGALY
Authors: FEEK C. M. , BEVAN J. S. , TAYLOR SUE , BROWN N. S. , BAIRD JOYCE D.
Published: March 2008

The oral administration of bromocriptine 5 mg 6‐hourly to twelve patients with acromegaly for a mean period of 12 (range 3–27) months significantly reduced whole blood glucose, plasma insulin and plasma growth hormone (GH) concentrations during a 50 g oral glucose tolerance test (OGTT). After this period of treatment, bromocriptine was withdrawn for 48 h resulting in a significant rise in whole blood glucose, plasma insulin and plasma GH concentrations during a repeat OGTT. It is concluded that bromocriptine therapy improves glucose tolerance in acromegaly by suppressing GH secretion and consequently GH‐mediated antagonism of insulin.
EFFECT OF CIMETIDINE ON SERUM PROLACTIN IN NORMAL WOMEN AND PATIENTS WITH HYPERPROLACTINAEMIA
Authors: CARLSON H. E. , CHANG R. J. , MEYER NANCY V. , LU K. H. , JUDD H. L.
Published: March 2008

In normal women, intravenous injection of the H2‐antihistamine, cimetidine, provoked a 3–4 fold rise in serum prolactin, without changes in serum growth hormone, thyrotrophin, or gonadotrophins. Hyperprolactinaemic patients with pituitary tumours, idiopathic hyperprolactinaemia or hypothalamic lesions demonstrated little or no rise in serum prolactin (expressed as a percentage increment) in response to cimetidine; these responses were significantly more blunted than the prolactin responses to intravenous TRH in the same subjects. Post‐partum women also demonstrated blunted percentage prolactin responses to cimetidine, although responses to TRH were, in most patients, normal. Dynamic testing of prolactin secretion with cimetidine is no more useful than TRH in distinguishing tumourous from non‐tumourous hyperprolactinaemia.
CIRCULATING PROSTANOID LEVELS, BOTH BASAL AND DURING THE CHLORPROPAMIDE ALCOHOL FLUSH, IN NON‐INSULIN DEPENDENT DIABETES
Authors: BARNETT A. H. , KOULLAPIS E. N. , NICOLAIDES K. , PYKE D. A. , SPILIOPOULOS A. J.
Published: March 2008

Circulating basal levels of prostanoids were measured in non‐insulin dependent diabetics (NIDDs) who showed chlorpropamide alcohol flushing (CPAF), with and without diabetic complications, and in non‐diabetic controls. Prostanoids were also measured during CPAF in those diabetics in whom CPAF is or is not blocked by indomethacin and also in CPAF‐negative patients. There was no significant difference in circulating prostanoids between diabetics with and without severe vascular disease. The level of prostaglandin F, however, was significantly higher in the diabetic than in the non‐diabetic subjects (mean ± SEM PGFM 521 ± 23 v. 414 ± 18 pmol/l respectively P < 0·01). In the group in whom CPAF could be blocked by indomethacin there was a significant rise in thromboxane during CPAF when compared with basal values (mean ± SEM 905 ± 48 v. 688 ± 46 pmol/l respectively P < 0·01) which was abolished by prior administration of indomethacin. There was no significant rise in prostacyclin or PGF. The group in which CPAF could not be blocked by indomethacin and the CPAF negative group showed no rise in any of the prostanoids measured.

These findings support the concept of at least two different groups of CPAF positive NIDDs, one in which prostanoids are involved in CPAF and one in which they are not. It is the group in which prostanoids are involved in CPAF who seem to be highly protected against vascular disease.
THE MEASUREMENT OF SERUM THYROGLOBULIN IN THE PRESENCE OF THYROGLOBULIN ANTIBODIES
Authors: RATCLIFFE J. G. , AYOUB L. A. W. , PEARSON D.
Published: March 2008

In a significant proportion of patients with thyroid disorders, thyroglobulin antibodies (TgAb) invalidate double‐antibody radioimmunoassays (RIA) for thyroglobulin (Tg). A modified RIA procedure for determining serum Tg in the presence of TgAb, is described. Two measurements are made on each sample.

Ratio of immunoglobulin (Ig)‐bound thyroglobulin to free thyroglobulin (bound:free ratio). This is measured by the distribution of a trace quantity of 125I‐Tg between bound and free fractions.

Concentration of free, i.e. unbound thyroglobulin. This is measured in the supernatant after precipitation of IgG‐bound Tg.

Then, bound Tg = B:F x (free Tg) and total Tg = (bound Tg) + (free Tg). Critical factors examined in the validation of the modified method were: (1) use of immunologically intact 125I‐Tg (specific activity ± 5 mCi/mg); (2) equilibration of tracer Tg with endogenous serum Tg, and (3) clean separation of IgG‐bound and free fractions of Tg with goat anti‐human IgG. Recovery of added Tg in the presence of TgAb was 105% and interassay precision of total Tg assay was ≤ 9·3%. In euthyroid subjects without TgAb, the correlation between total Tg levels by the modified and standard double‐antibody method was 0·931. The correlation was much poorer in the presence of TgAb (r = 0·752) reflecting their interference in the standard method. Reference ranges for serum total Tg levels by the modified method in euthyroid, hyper‐and hypothyroid subjects with and without TgAb are detailed.
SPONTANEOUS HYPOTHYROIDISM IN SYMPTOMLESS AUTOIMMUNE THYROIDITIS. A LONG‐TERM FOLLOW‐UP STUDY
Authors: GORDIN A. , LAMBERG B.‐A.
Published: March 2008

A follow‐up study was performed on subjects with symptomless autoimmune thyroiditis in order to obtain information on the natural course of the disease. Seven out of the twenty‐two subjects with symptomless autoimmune thyroiditis became hypothyroid within 4–48 months of observation, whereas fifteen subjects were still euthyroid after an observation period of 26–102 months. The yearly incidence of hypothyroidism in symptomless autoimmune thyroiditis was 7–3%.

The basal serum thyrotrophin (TSH) level as well as the response in serum TSH to thyrotrophin releasing hormone (TRH) was initially elevated in all subjects who developed hypothyroidism. The annual incidence of hypothyroidism was 26% in the subjects with an initially elevated TSH level. Serum TSH was initially normal in all but one of the eleven subjects with symptomless autoimmune thyroiditis in whom it was measured, and who remained euthyroid. In this group the TRH response was initially slightly exaggerated in three out of ten subjects. It was not performed in five subjects. During the follow‐up, serum TSH and its response to TRH also became normal in these cases. An elevated basal serum TSH value is thus highly indicative of subsequent hypothyroidism, and these subjects with symptomless autoimmune thyroiditis should be carefully followed‐up.
AUTOANTIBODIES TO THYROGLOBULIN CROSS REACTING WITH IODOTHYRONINES
Authors: PEARCE C. J. , BYFIELD P. G. H. , EDMONDS C. J. , LALLOZ M. R. A. , HIMSWORTH R. L.
Published: March 2008

Serum thyroxine was consistently immeasurable by radioimmunoassay in an elderly patient with myxoedema after successful treatment with oral thyroxine. Abnormal binding of thyroxine was suspected and shown to be due to the presence in serum of antibodies of the IgG variety. The characteristics of these antibodies with respect to their binding of thyroxine (T4), triiodothyronine (T3), reverse triiodothyronine (rT3) and human thyroglobulin (Tg) were systematically studied. Three preparations of Tg, and T4, T3 and rT3 were examined for their ability to compete with 125I‐Tg, 125I‐T4, 125I‐T3 and 125I‐rT3 for binding to the antibodies. For each tracer used the order of competitive efficiency was Tg > T4 > T3 > rT3. This provides for the first time direct evidence that iodothyronine reacting antibodies occurring in man are generated against Tg. All three iodothyronines were able to inhibit tracer binding of labelled iodothyronines completely, the order of effectiveness being T4 > T3 > rT3, suggesting antibodies with one type of binding site and that these were probably raised against a Tg sequence incorporating T4, although there was some evidence for the existence of a minor subpopulation of antibodies with higher specificity for T3. Complete displacement of labelled Tg by cold iodothyronines, however, was not possible. The experimental evidence suggests two classes of Tg antibodies, 70% of which were directed towards the T4 containing region, and 30% directed against other part(s) of the Tg molecule. Despite the presence of such Tg antibodies conventional haemagglutination tests of the patient's serum for Tg antibodies were negative.
CLINICAL EXPERIENCE WITH 75Se SELENOMETHYLCHOLESTEROL ADRENAL IMAGING
Authors: SHAPIRO B. , BRITTON K.E. , HAWKINS L. A. , EDWARDS C. R. W.
Published: March 2008

The results of quantitative adrenal imaging using 75Se selenomethylcholesterol in sixty‐two subjects are analysed. The adrenal area was localized by a renal scan, lateral views of which enabled adrenal depth to be estimated. The first nineteen cases were scanned with a rectilinear scanner and the remaining forty‐three cases imaged with a gamma camera. Quantitation of adrenal uptake was performed on computer‐stored static images obtained 7 and 14 days post‐injection of 75Se selenomethylcholesterol (3 and 6 days in the first ten cases studied). Normal uptake was found to be 0·07–0·30% of the administered dose. Overall predictive accuracy of the type of adrenal disorder of thirty‐two patients with Cushing's syndrome was 90·6%, this included twelve cases of Cushing's disease (mean uptake 0·58%), seven ectopic ACTH syndromes (mean uptake 0·69%), five unilateral adenomata (mean uptake 0·93%), three post adrenalectomy regrowths (mean uptake 1·37%), three adrenal carcinomas (mean uptake 0·01%), one congenital hyperplasia (mean uptake 3·4%) and one unilateral nodular hyperplasia. Overall predictive accuracy of the cause of Conn's syndrome in twenty‐two cases was 86·4%; this included thirteen cases of bilateral hyperplasia (mean uptake 0·34%), eight unilateral adenomata (mean uptake 0·47%) and one patient with mineralocorticoid excess in whom the cause has not been confirmed. The mean uptake in the normal adrenal in cases of unilateral adenoma was 0·19% (range 0·07–0·30%). Causes of unsatisfactory adrenal imaging are examined. The procedure is recommended as the localizing and lateralizing technique of choice in Cushing's syndrome except where due to adrenal carcinoma, and as an important non‐invasive technique in Conn's syndrome for the lateralization of adenoma.
SODIUM, POTASSIUM AND AGE: POSSIBLE DETERMINANTS OF PLASMA RENIN ACTIVITY AND ALDOSTERONE DURING CHILDHOOD (AGE 4–16)
Authors: GOLDFARB DALIA , SACK J. , IAINA A. , ELIAHOU H.
Published: March 2008

The renin‐angiotensin‐aldosterone system was studied in fifty healthy children aged 4–16 years under normal sodium and potassium intake. The plasma renin activity (PRA) and plasma aldosterone (PA) decreased with age: r =−0·30, P < 0·05 for plasma renin activity and r =−0·33, P < 0·05 for plasma aldosterone. Significant negative correlation was obtained between plasma renin activity and the 24‐h urinary sodium excretion; r =−0·40, P < 0·01. This relationship remained significant when the daily urinary sodium excretion was corrected for 1·73 m2 body surface area (BSA); r =−0·40, P < 0·01. Using the multivariance analysis, plotting the plasma renin activity against the two combined parameters (24‐h urinary sodium excretion and age), no improvement was obtained (r = 0·38, P > 0·05). This finding suggests that during childhood, sodium rather than age has a major modulatory role on plasma renin activity. With advancing age the plasma aldosterone showed a significant positive correlation coefficient with plasma renin activity (r = 0·29, P < 0·05). Multivariance analysis between plasma aldosterone and the two combined parameters, plasma renin activity and age, significantly improved the correlation coefficient (r = 0·42, P < 0·05) suggesting that both plasma renin activity and age play a dominant modulatory role in the control of plasma aldosterone during childhood. Neither 24‐h urinary sodium excretion, nor 24‐h urinary potassium excretion, improved the multiple correlation coefficient with plasma aldosterone when added to plasma renin activity and age.
A RISE IN THE GLOMERULAR FILTRATION RATE AS THE CAUSE OF A‘PARADOXICAL’INCREASE IN URINARY FREE CORTISOL DURING DEXAMETHASONE SUPPRESSION IN A PATIENT WITH AN ADRENAL ADENOMA: A CASE REPORT
Authors: HAIGH S. E. , TEVAARWERK G. J. M.
Published: March 2008

A 57‐year‐old woman who presented with depression and hypertension for which she had received anti hypertensive therapy including diuretics was found to have Cushingoid features. All medication was stopped and subsequent investigation demonstrated markedly elevated urinary free cortisol (UFC) levels. An increase in UFC occurred in response to the low dose dexamethasone suppression test and a further increase was noted during the high dose test. Plasma cortisol levels did not change significantly. Detailed examination of the data revealed that over the 6‐day testing period the plasma creatinine had fallen from 1·4 mg/dl to 0·7 mg/dl while the creatinine clearance had doubled—presumably due to withdrawal of the diuretic. When the UFC was expressed per 100 ml of plasma filtered, there was no difference between any of the daily excretions. We conclude that a concurrent increase in glomerular filtration rate is one mechanism by which a‘paradoxical’increase in UFC in response to dexamethasone suppression may occur.
PARATHYROID FUNCTION AFTER PARATHYROIDECTOMY: EVALUATION BY MEASUREMENT OF URINARY cAMP
Authors: SPIEGEL A. M. , MARX S. J. , BRENNAN M. F. , BROWN E. M. , DOWNS R. W. , GARDNER D. G. , ATTIE M. F. , AURBACH G. D.
Published: March 2008

We measured urinary cyclic AMP (UcAMP) excretion after parathyroidectomy in order to assess postoperative parathyroid function. Patients undergoing successful treatment for primary hyperparathyroidism were divided into three groups based on therapy required to correct postoperative hypocalcaemia: 1 (n= 44) vitamin D not required; 2 (n= 17) vitamin D required temporarily (< 1 year); 3 (n= 10) vitamin D required permanently (> 1 year).

Patients in group 1 experienced only brief (< 7 days) hypocalcaemia. UcAMP fell immediately postoperatively and returned to the normal range (in the majority) within 7 days. Group 2 showed the most severe hyperparathyroidism as judged by preoperative serum calcium, alkaline phosphatase and UcAMP and eight of seventeen showed radiographic evidence of osteitis fibrosa cystica (OFC). Patients in this group developed severe hypocalcaemia postoperatively, but in the majority UcAMP was elevated in proportion to the degree of hypocalcaemia and could be suppressed by raising serum calcium. Hypocalcaemia in these patients was presumably due to calcium entry into bone associated with healing of skeletal disease. Group 3 patients also developed severe postoperative hypocalcaemia but showed significantly lower UcAMP excretion than groups 1 or 2.

We conclude that measurement of UcAMP excretion is helpful in the diagnosis and management of postparathyroidectomy hypocalcaemia. The combination of low UcAMP and hypocalcaemia more than 7 days after parathyroidectomy indicates hypoparathyroidism that will usually but not always require permanent therapy with vitamin D. Postoperative hypocalcaemia accompanied by increased UcAMP indicates that parathyroid gland function persists and that lifelong treatment with vitamin D will generally not be required.
THYROID STIMULATING ANTIBODIES (TSAb) IN PATIENTS WITH GRAVES' DISEASE UNDERGOING ANTITHYROID DRUG TREATMENT: INDICATORS OF ACTIVITY OF DISEASE
Authors: KARLSSON F. A. , DAHLBERG P. A.
Published: March 2008

Thyroid‐stimulating antibodies (TSAb) were studied in patients with Graves' disease using a method based on cAMP production in isolated human thyroid membranes. Stimulation was detected in forty‐one (82%) of fifty patients with untreated Graves' disease. In these subjects, the TSAb levels were correlated with the thyroid hormone levels. Among twenty patients treated for 1–2 months with carbimazole, 16 (80%) had positive TSAb. During prolonged treatment TSAb gradually diminished and finally normalized. In fifteen patients, it was possible to compare TSAb levels after cessation of previous medical therapy with TSAb levels at relapse. In nine of these patients, an increase of the TSAb level within the normal range at the time of relapse was found, in four the litres were positive.

The results indicate that positive TSAb litres are markers of active Graves' disease and suggest that in such patients antithyroid therapy should be continued. A normal TSAb titre after anti‐thyroid therapy does not exclude the possibility of relapse.
ALTERED ENDOCRINE RESPONSE TO PARTIAL THYROIDECTOMY IN PROPRANOLOL‐PREPARED HYPERTHYROID PATIENTS
Authors: FEELY J. , CROOKS J. , FORREST A. L. , HAMILTON W. F. D. , GUNN A. , BROWNING MARGARET C. K.
Published: March 2008

The endocrine response to partial thyroidectomy in a group of twenty hyperthyroid patients prepared with propranolol alone was compared to that of a matched control group of ten euthyroid patients. In propranolol‐prepared patients the glucose response to surgery was reduced (P< 0·05) for up to 4 h post‐operatively and biochemical hypoglycaemia was noted in one patient. Both thyroxine and triiodothyronine (T3) fell significantly, associated with a marked rise in reverse T3. Growth hormone levels were higher (P<0·05) both pre‐and post‐operatively in propranolol‐prepared patients, whereas prolactin levels, although similar pre‐operatively, were lower (P<0·05) in these patients post‐operatively. Cortisol and ACTH levels were lower (P < 0·05) both before and following thyroidectomy in propranolol‐prepared patients. These results suggest that the endocrine response to surgical stress is markedly altered in propranolol‐prepared hyperthyroid patients.
EFFECTS OF CHANGE IN BODY POSTURE ON PLASMA AND SERUM ELECTROLYTES IN NORMAL SUBJECTS AND IN PRIMARY ALDOSTERONISM
Authors: SONKODI S. , NICHOLLS M. G. , CUMMING A. M. M. , ROBERTSON J. I. S.
Published: March 2008

We observed that change in body posture from the supine to the erect position in normal volunteers was associated with a rise in circulating potassium and a fall in sodium concentrations, irrespective of whether the electrolytes were measured in serum or plasma, or whether head‐up tilt or ambulation was used. In patients with primary aldosteronism, the fall in serum sodium and rise in serum potassium with ambulation tended to obscure the characteristic electrolyte abnormalities of that syndrome. These changes in potassium and sodium could contribute to the rise in aldosterone secretion on orthostasis. The body posture of patients should be considered in the interpretation of plasma and serum electrolyte levels.
hCG‐STIMULATION OF TESTICULAR STEROIDOGENESIS DURING INDUCED HYPER—AND HYPOPROLACTINAEMIA IN MAN
Authors: MARTIKAINEN H. , VIHKO R.
Published: March 2008

In order to elucidate the role of prolactin in the regulation of testicular steroidogenesis in man, hyper‐ and hypoprolactinaemia were induced by sulpiride (group 2) and bromocriptine (group 3) administration in eight and nine young adults, respectively, and the responses of testosterone and six other steroids to a single dose of 5000 iu hCG were compared with those obtained under basal conditions (group 1) in eight men. During hyperprolactinaemia (group 2) the responses of pregnenolone, progesterone, 17‐hydroxyprogesterone, testosterone and 5α‐dihydrotestosterone tended to be greater than in the control and hypoprolactinaemia groups, but these changes were not statistically significant. In contrast to the behaviour of these steroids, oestradiol showed diminished peak values at 24–36 h after hCG in the sulpiride‐treated group and the response was significantly smaller (P < 0·01) than during hypoprolactinaemia. These findings suggest that testicular aromatization is modulated by prolactin and thus the partial inhibition of oestradiol production, observed during short‐term hyperprolactinaemia, may result in a better androgen response to hCG.
PLASMA ANDROGENIC ACTIVITY IN WOMEN WITH ACNE VULGARIS AND IN HEALTHY GIRLS BEFORE, DURING AND AFTER PUBERTY
Authors: ODLIND V. , CARLSTRÖM K. , MICHAËLSSON G. , VAHLQVIST A. , VICTOR A. , MELLBIN T.
Published: March 2008

The possible relationship between plasma androgenic activity and acne vulgaris was investigated. Plasma testosterone and sex hormone binding globulin (SHBG) levels were determined in healthy girls during different stages of puberty, in healthy adult women and in women with acne vulgaris. Testosterone increased during puberty, whereas SHBG decreased during the early stages before it increased and stabilized in late puberty. Healthy adult women and women with mild acne vulgaris had similar plasma concentrations of testosterone and SHBG. Women with severe acne vulgaris had testosterone levels in the same range but the SHBG levels were significantly lower than those of healthy women and women with mild acne. These results show a high androgenic activity in the intermediate stages of puberty, when acne vulgaris is a common complaint and an increased androgenic activity in adult women with severe acne vulgaris.
THE INFLUENCE OF EXOGENOUS OESTRADIOL BENZOATE ON THE PITUITARY RESPONSIVENESS TO LHRH DURING THE PUERPERIUM IN WOMEN
Authors: VEMER H. M. , ROLLAND R.
Published: March 2008

The FSH and LH response to 25 μg LHRH was measured in lactating women and the results compared to a similar group in whom lactation was suppressed by administration of bromocriptine shortly after delivery. The response was also measured in both groups after “challenge” with oestradiol benzoate. In lactating women the FSH response to LHRH was diminished following the oestradiol challenge, as compared with that in unchallenged women. At the same time the LH responses were low in both circumstances, indicating a negative feedback effect of oestradiol. However, the oestradiol challenge resulted in a significantly increased response of FSH and LH to LHRH in bromocriptine‐treated puerperal women, i.e. a positive feedback effect of oestradiol.

We concluded that this and previous experiments favour the hypothesis that the lactational amenorrhoea during hyperprolactinaemia is caused by hypothalamic changes due to a predominance of the negative feedback system.
SERUM CONCENTRATIONS OF DIHYDROTACHYSTEROL‐2 IN THE TREATMENT OF OSTEOPOROSIS AND HYPOPARATHYROIDISM
Authors: BOSCH R. , THIJSSEN J. H. H. , DUURSMA S. A.
Published: March 2008

A method for the quantitative estimation of dihydrotachysterol‐2 is described using high performance liquid chromatography coupled to an UV monitor. Since radioactive labelled DHT2 is not available, recovery is based on the assumption that dihydrotachysterol‐2 and cholecalciferol behave identically during chromatic procedures. Evidence is presented to support this assumption. In patients treated with DHT2 the serum concentrations of DHT2 rose in proportion to the administered dose.
ALTERATIONS IN THYROID HORMONE METABOLISM DURING CHEMOTHERAPY IN PATIENTS WITH TESTICULAR CARCINOMA
Authors: WILLEMSE PAX H. B. , SLEIJFER DIRK TH. , SLUITER WIM J. , KOOPS HEIMEN SCHRAFFORDT , DOORENBOS HIERONYMUS
Published: March 2008

In a prospective study, the effects of chemotherapy on thyroid function in patients with non‐seminoma testicular carcinoma were evaluated. Thirty‐one patients were studied; in sixteen immunoassayable HCG was present, but altered thyroid function could not be established.

In fifteen patients an exaggerated TSH response to TRH was observed. In these patients, although T3 and T4N values were normal, basal TSH levels were higher compared to patients with a normal TSH response, probably due to preceding lymphangiography.

During chemotherapy, T4N, T3 and rT3 levels rose significantly, but basal TSH levels and the TSH response to TRH decreased. In contrast, the prolactin responses to TRH increased. The observed changes in thyroid function during chemotherapy appear to result from delayed thyroid hormone clearance, probably caused by an effect of chemotherapy on deiodinating enzyme activity. This would result, in an increase in T4N and rT3 levels and a fall in TSH levels and in the TSH response to TRH. Furthermore, after therapy the raised T4N and lowered TSH levels remained, whilst the FT3 level did not change either during or after therapy, suggesting an unaltered hypothalamic/pituitary axis.
THE RESPONSE OF PROLACTIN TO CHLORPROMAZINE STIMULATION IN MEN WITH HYPOGONADOTROPHIC HYPOGONADISM AND EARLY PUBERTAL BOYS: RELATIONSHIP TO SEX STEROID EXPOSURE*
Authors: WINTERS S. J. , JOHNSONBAUGH R. E. , SHERINS R. J.
Published: March 2008

The effect of chlorpromazine (CPZ) on prolactin (PRL) secretion was studied in fourteen sexually immature males; nine with idiopathic hypogonadotrophic hypogonadism and five who proved to be normal early pubertal boys. Initially, clinical features and basal levels of testosterone, LH and FSH in serum collected in the morning and the gonadotrophin responses to LHRH stimulation were similar in all subjects. Following CPZ the early pubertal boys increased PRL levels by at least 15 ng/ml, responses similar to those of normal men, whereas no subject with complete hypogonadotropism increased PRL by more than 5 ng/ml. Two subjects with incomplete hypogonadotropism (‘fertile eunuchs’) exhibited responses similar to normals.

Treatment with human chorionic gonadotrophin (hCG) or testosterone enhanced the PRL response to CPZ in three of six hypogonadotrophic subjects. Ten additional hypogonadotrophic men studied while receiving long term treatment with hCG or testosterone also manifested normal responses to CPZ. These data indicate that lack of sex steroid exposure, rather than a more generalized hypothalamic disorder, explains the attenuated PRL response to CPZ found in untreated men with idiopathic hypogonadotrophic hypogonadism. Moreover, CPZ‐stimulated PRL secretion may prove to be of practical value in distinguishing hypogonadotrophics from boys with delayed puberty.
DEMONSTRATION OF CIRCULATING 1,24,25‐TRIHYDROXYVITAMIN D3 IN MAN BY RADIOIMMUNOASSAY
Authors: CLEMENS T. L. , FRAHER L. J. , SANDLER L. M. , O'RIORDAN J. L. H.
Published: March 2008

1,24,25‐trihydroxyvitamin D3 has been detected in human serum using a sensitive radioimmunoassay. Tritiated 1,24,25‐trihydroxyvitamin D3 was synthesized biologically and used as tracer to monitor the recovery of endogenous metabolite during isolation from serum. Circulating 1,24,25(OH)3D3 in normal subjects ranged from 9·3 to 18·5 pmol/l but was not detectable (> 2·3 pmol/l) in serum from nephrectomized subjects. The trihydroxy metabolite was elevated in three out of four vitamin D deficient subjects who were being treated with vitamin D3.
SOMATOSTATIN‐28 INHIBITS LHRH‐STIMULATED GONADOTROPHIN SECRETION IN MAN
Authors: MILLAR R. P. , KLAFF L. J . , BARRON J. , LEVITT N. S . , LING N.
Published: March 2008

The LH and FSH responses to 100 pg LHRH in a combined pituitary stimulation test were compared in five normal men during infusions of somatostatin‐28 (SS‐28) and somatostatin onadotrophin hormone secretion by SS‐14 and SS‐28 suggest that these hypothalamic peptides may play a part in the regulation of LH and FSH secretion.

SS‐28 significantly reduced both LH and FSH responses to LHRH comparedwith control infusions. SS‐14 did not significantly alter the FSH response but caused a significant reduction in the LH concentration 75 and 90 min afterL HRH injection. These findings demonstrate that SS‐28 has distinct biological activity in addition to its role as a putative precursor of SS‐14. Inhibition of gonadotrophin hormone secretion by SS‐14 and SS‐28 suggest that these hypothalamic peptides may play a part in the regulation of LH and FSH secretion.
A PEPTIDE IN GASTRIC SECRETION WITH INHIBIN‐LIKE PROPERTIES
Authors: SHETH N. A. , VAZE A. Y. , SHETH A. R.
Published: March 2008

The presence of inhibin like peptide which is biologically active in reducing FSH secretion in castrated rats and suppressing hCG‐induced increase in ovarian weights of immature mice, is reported for the first time in gastric aspirates of normal men. Immunological characteristics of this peptide were similar to inhibin extracted from human seminal plasma. The concentration of inhibin‐like peptide measured by RIA developed for seminal inhibin is more than thirty‐fold higher in gastric aspirates compared with serum.
REDUCED NOCTURNAL MELATONIN SECRETION IN CHRONIC SCHIZOPHRENIA: RELATIONSHIP TO BODY WEIGHT
Authors: FERRIER I. N. , ARENDT J. , JOHNSTONE E. C. , CROW T. J.
Published: March 2008

Melatonin was estimated by RIA in samples taken at 24.00 h and 08.00 h from twenty‐one male chronic schizophrenics and twelve age‐sex matched controls and subsequently in more frequent nocturnal samples from nine of the chronic schizophrenics. The 24.00 h melatonin level and the 24.00/08.00 h melatonin ratio were significantly reduced in the chronic schizophrenic patients. Similar results, with no evidence of subsidiary peaks of melatonin secretion, were obtained in those patients who were retested. No relationships between melatonin secretion and age or anterior pituitary hormone secretion were demonstrated, but an effect of body weight was noted which accounted, in part, for the difference between schizophrenics and controls. These results suggest that the low levels of melatonin noted in studies on depressed patients may not be specific and that body weight must be controlled in subsequent studies of melatonin secretion in patients with psychiatric disease.
SERUM LEVELS OF 25‐HYDROXYVITAMIN D, 24,25‐DIHYDROXYVITAMIN D AND PARATHYROID HORMONE IN PATIENTS WITH FEMORAL NECK FRACTURE IN SOUTHERN FINLAND
Authors: KNORRING JOHAN VON , SLÄTIS PÄR , WEBER THEODOR H. , HELENIUS TUULA
Published: March 2008

Serum concentrations of 25‐hydroxyvitamin D (25‐OHD), 24,25‐dihydroxy‐vitamin D [24,25(OH)2D] and immunoreactive parathyroid hormone (PTH) were determined in elderly patients with fracture of the femoral neck and in age‐matched controls during summer, winter and early spring in southern Finland. The expected seasonal variation in 25‐OHD values was observed in both patients and controls, though the patient group had significantly lower values during winter (P < 0.02) and spring (P < 0.01). The 24,25(OH)2D: 25‐OHD ratio remained constant in both patients and controls throughout the study. A significant negative correlation between PTH and 25‐OHD values was found in the patient group. Thus, vitamin D deficiency may contribute to the high incidence of femoral neck fractures in elderly people, and the increased PTH activity, observed in many patients with these fractures, is secondary to vitamin D deficiency.
THE EFFECTS OF SULPHYDRYL REAGENTS ON THE NEUTRALIZATION OF LATS BY HUMAN THYROID EXTRACTS
Authors: SHISHIBA YOSHIMASA , OZAWA YASUNORI , SHIMIZU TAEKO , OHTSUKI NATSUKO
Published: March 2008

LATS has already been shown to be neutralized by an unknown antigenic substance in human thyroid tissue. This antigen has been presumed to be a TSH receptor. To examine this hypothesis, we sought to determine whether SH reagents capable of altering the characteristics of TSH receptors in thyroidal crude membrane fractions caused an alteration in the LATS neutralization activity of the same fraction. Diamide (10−3m) which was shown to enhance 125I‐TSH binding to TSH receptors by increasing the binding affinity of the receptor, significantly increased the neutralization of LATS by the crude membrane fraction. Dithiothreitol (10−3m) which was shown to inhibit 125I‐TSH binding by decreasing the affinity of the receptor, significantly decreased the neutralization of LATS by the fraction. This indicates that TSH receptors and the thyroidal factor capable of neutralizing LATS share a common property in terms of the effects of SH reagents and is compatible with the idea that the LATS neutralizing activity of thyroidal crude membrane fraction is due to binding by the TSH receptor or its fragments.