bluuebunny/crossref_metadata_2025_split huggingface dataset:
HYPOTHALAMIC HYPOPITUITARISM FOLLOWING EXTERNAL RADIOTHERAPY FOR TUMOURS DISTANT FROM THE ADENOHYPOPHYSIS
Authors: PERRY‐KEENE D. A. , CONNELLY J. F. , YOUNG R. A. , WETTENHALL H. N. B. , MARTIN F. I. R. 
Published: March 2008

SUMMARYThree cases of panhypopituitarism and five of isolated growth hormone dificiency which occurred following previous external irradiation of tumours distant from the adenohypphysis are described. The hypothalamic pituitary region received between 2800 and 12000 rads in each case, 1‐9 years before endocrine deficiency was recognized. Evidence is presented that th esite of damage is in the region of the hypothalamus rather than the pituitary gland itself.Individuals treated with X‐ray therapy in whom the hypothalamic‐pituitary region is exposed to irradiation would appear to be at risk of developing some degree of delayed hypothalamic‐pituitary dysfunction.Early reports of the effects of external radiotherapy on hypothalamo‐hypophyseal function suggested that the pituitary gland was resistant to damage from irradiation, but that the hypothalamus and adjacent neural tissues were more sensitive (Kelly et al., 1951; Arnold, 1954). Radiotherapy to malignant tumours distant from the pituitary has not been thought to result in endocrine dysfunction even when the hypothalamo‐hypophyseal region was included in the field of irradiation (de Schryver et al., 1973). Only three reports of documented hypopituitarism following external radiotherapy in such circumstances have been recorded (Tan & Kunaratnam, 1966; Larkins & Martin, 1973; et al., 1975).This paper details the endocrine status of eight patients treated by radiotherapy for malignant disease distant from the pituitary, in whom the hypothalamus was also irradiated. Two of these patients have been reported previously (Larkins & Martin, 1973) and all were found to have severe or partial hypopituitarism.
EFFECTS OF OESTROGENS ON PROLACTIN AND THYROTROPHIN RESPONSES TO TRH IN WOMEN DURING THE MENSTRUAL CYCLE AND UNDER ORAL CONTRACEPTIVE TREATMENT
Authors: REYMOND M. , LEMARCHAND‐BÉRAUD TH. 
Published: March 2008

SummaryThe effects of physiological and pharmacological variations of oestrogens on prolactin and thyrotrophin (TSH) secretion have been studied during the menstrual cycle and under oral contraceptive treatment.Ten women were tested for prolactin and TSH responses to 200 μg TRH in the early follicular (days 4‐6), periovulatory (days 14‐15) and luteal phases (days 22‐26) of the same menstrual cycle. Circulating plasma prolactin levels did not significantly vary in three phases, but TSH basal levels were lower in the luteal than in the follicular and periovulatory periods. The prolactin response to TRH was significantly enhanced in the periovulatory phase, while the TSH response was slightly decreased.Seven women on sequential contraceptives exhibited increased basal and TRH‐induced prolactin secretion during the oestrogen treatment, with an unaltered TSH secretion throughout therapy. Treatment with combined contraceptives did not alter either basal or TRH‐induced prolactin secretion in eight women, but basal TSH secretion and its response to TRH were both reduced.These data show that oestrogens may produce different regulatory effects on prolactin and TSH secretion, particularly in the pituitary sensitivity to TRH stimulation. Physiological variations of oestrogen secretion such as those observed during the menstrual cycle can likewise modify prolactin levels. These results could provide some support for a regulatory role for prolactin in the menstrual cycle.
MODIFICATION BY SEX STEROIDS OF LHRH RESPONSE IN THE POLYCYSTIC OVARY SYNDROME
Authors: SHAW R. W. , DUIGNAN N. M. , BUTT W. R. , LOGAN‐EDWARDS R. , LONDON D. R. 
Published: March 2008

SUMMARYExogenously administered oestradiol or progesterone was found to induce augmentation of LH and FSH release in response to LHRH administration in patients with the polycystic ovary (PCO) syndrome. The effect of oestradiol upon LH release in the patients was significantly less than the augmented release induced in normal women (P < 0.02). In contrast, progesterone induced a significantly greater LH release in PCO patients than normal women studied during the early follicular phase (P < 0.001) but less than that in normal women studied during the mid‐follicular phase of the cycle (P < 0.01). The effects on FSH release in the PCO patients were less marked but similar to those in normal women with comparable basal steroid levels.The results suggest that both oestradiol and progesterone can modify the hypothalamic‐pituitary axis in the PCO syndrome in a manner similar to that observed in normal women and a failure of these ‘positive feedback’ mechanisms does not appear to be the cause of the ovulatory deficiency in this syndrome.
THE CONTROL OF GONADOTROPHIN RELEASE IN WOMEN WITH HYPERPROLACTINAEMIC AMENORRHOEA: EFFECT OF OESTROGEN AND PROGESTERONE ON THE LH AND FSH RESPONSE TO LHRH
Authors: GLASS M. R. , SHAW R. W. , WILLIAMS J. W. , BUTT W. R. , LOGAN‐EDWARDS R. , LONDON D. R. 
Published: March 2008

SUMMARYThe effect of the administration of oestradiol benzoate and of progesterone on the subsequent response to LHRH has been investigated in women with hyperprolactinaemia. There was an amplification in the release of LH in four out of ten patients and of FSH in one out of ten patients at 44 h after the administration of 2·5 mg oestradiol benzoate. The average amount of LH released before and after oestrogen did not change, but there was a significant decrease in the amount of FSH released. There was no correlation between the LH released and the oestradiol concentration in serum at the time of the LHRH tests but there was a negative correlation between the FSH released and the oestradiol concentration (r= 0.507; P < 0.05). These results contrast with those obtained in normal subjects in the follicular phase of the cycle when there is a positive correlation of oestrogen concentrations and the amount of LH and FSH released. As in normal subjects, bowever, a significant suppression of basal FSH concentrations, persisting until 44 h, was produced by the oestrogen (P < 0.01).Seven out of eleven patients showed an amplification of LH response and six out of eleven an FSH response 20 h after the administration of 25 mg progesterone. The mean amplifications are not significantly different from those of normal subjects tested in the early follicular phase of the cycle, but are significantly less than those tested in the mid follicular phase of the cycle (LH P < 0.001; FSH P < 0.01). This may be related to the serum concentrations of oestradiol which in patients with hyperprolactinaemia are significantly less than those found in the mid follicular phase of the cycle (P < 0.05).These results indicate that in women with hyperprolactinaemia oestrogen negative feedback, necessary for cycle initiation, is normal: failure of ovulation may be related to failure of positive feedback to oestrogen. Oestrogen‐negative feedback is unopposed and this may explain the follicullar development and lack of oestrogen in the mid‐follicular phase.
HORMONAL VARIATIONS IN SECONDARY AMENORRHOEA DURING THE METYRAPONE TEST
Authors: MAZZI C. , RIVA L. P. , BERNASCONI D. 
Published: March 2008

SUMMARYThe occurrence of uterine bleeding following administration of Metyrapone in cases of secondary amenorrhoea and oligomenorrhoea led the authors to measure pituitary, gonadal and adrenal hormone levels, before and after the oral administration of this drug in sixteen patients, in an attempt to provide an interpretation of this phenomenon. There were expected changes in plasma ACTH and urinary 17‐hydroxycorticosteroids, but no variations were noted in serum FSH and LH, plasma oestradiol and urinary oestrogens; the most important alterations occurred in plasma progesterone and urinary pregnanetriol levels. It is suggested that bleeding occurs because of the changes which are induced in plasma progesterone levels.
1‐ALPHA‐HYDROXYCHOLECALCIFEROL IN THE TREATMENT OF HYPOCALCAEMIC PSYCHOSIS
Authors: GERTNER J. M. , HODSMAN A. B. , NEUBERGER J. N. 
Published: March 2008

SUMMARYTwo patients with profound hypocalcaemia due to uraemia and hypopara‐thyroidism respectively presented with alterations of mental state as their dominant symptom. 1‐Alpha‐hydroxycholecalciferol (1‐α‐OHD3) was chosen as the principal therapy because of its potency and rapid action. In both patients the plasma calcium was restored towards normal and the symptoms relieved within a very short period. The cases illustrate the role of 1‐α‐OHD3 in severe hypocalcaemia due to two different causes and provide experience on which to base treatment regimes for future patients similarly afflicted.
SUBCELLULAR PROGESTERONE IN HUMAN MYOMETRIUM DURING LATE PREGNANCY
Authors: HAUKKAMAA M. , WICHMANN K. 
Published: March 2008

SUMMARYSamples of myometrium were obtained from twenty‐two patients undergoing caesarian sections for various obstetric indications. The myometrium was homogenized and divided into four subcellular fractions (crude nuclear, mitochondrial, microsomal and cytosol). The concentration of endogenous progesterone in these fractions was determined by radioimmunoassay. In addition the concentration of oestrone and oestradiol of fifteen cytosolic fractions was determined.The subcellular concentration of progesterone (pg/mg protein) in human myometrium was higher in samples taken during labour than in samples taken at elective caesarian sections. This finding was statistically significant in the crude nuclear (P < 0.005) and the microsomal (P < 0.05) fractions. The absolute concentration of progesterone was lowest in the nuclear and highest in the microsomal fraction. The relative progesterone concentrations in the four subcellular fractions were the same in both groups. The data show that there is no significant decrease in myometrial progesterone associated with labour in man.The mean concentration of oestrone was higher than the mean oestradiol concentration in the cytosol fraction of human myometrium in late pregnancy. This study shows that a completely different oestrogen ratio exists in myometrium than in plasma.
TRIGLYCERIDE FATTY ACIDS CONFIRM A CHANGE IN DIETARY FAT
Authors: MOORE R. A. , OPPERT S. , EATON P. , MANN J. I. 
Published: March 2008

SUMMARYThe pattern of triglyceride fatty acids has been shown to alter rapidly when normolipaemic individuals eating a normal‘western’diet rich in saturated fats were changed to a diet low in cholesterol and high in polyunsaturated fats. The proportion of triglyceride linoleate was used to monitor the adherence to dietary advice of eleven primary hypercholesterolaemic patients (Type II) presenting to a lipid clinic. Patients adhering to diet showed a fall in serum cholesterol and a rise in triglyceride linoleate; recalcitrant patients showed little change. The estimation of triglyceride linoleate may be an important adjunct to clinical judgement in assessing dietary resistance before resource to drug therapy in hypercholesterolaemic patients.
THE PITUITARY‐THYROID AXIS FOLLOWING SURGERY FOR THYROTOXICOSIS: THYROTROPHIN‐RELEASING HORMONE TESTS IN DIFFUSE THYROID HYPERPLASIA AND TOXIC UNINODULAR GOITRE
Authors: BROWNLIE B. E. W. , JENSEN C. A. , TURNER J. G. , MACBETH W. A. A. G. , DONALD R. A. 
Published: March 2008

SUMMARYThe pituitary‐thyroid axis was assessed 1 month after surgery by thyrotrophinreleasing hormone (TRH) testing in thirty thyrotoxic patients treated by subtotal thyroidectomy and eleven patients with toxic uninodular goitre. All toxic nodule patients gave essentially normal TRH responses and have remained clinically and biochemically euthyroid at follow‐up. Only seven of the thirty subtotal thyroidectomy patients had normal TRH tests when assessed 1 month post thyroidectomy —sixteen patients showed increased response, six gave flat responses, and one showed an anomalous minimal response. Follow‐up TRH tests 12 months postthyroidectomy have shown a tendency for TRH responsiveness to return towards normal, but two patients with flat TRH tests have required radioiodine for relapse and four TRH hyperresponders are currently receiving thyroxine replacement therapy.
INCREASED PROLACTIN AND THYROTROPHIN SECRETION FOLLOWING ORAL METOCLOPRAMIDE: DOSE‐RESPONSE RELATIONSHIPS
Authors: HEALY D. L. , BURGER H. G. 
Published: March 2008

SUMMARYFour normal men received 1, 5, 10 and 20 mg doses of oral metoclopramide, a dopamine receptor antagonist, or placebo to determine the effect of this drug on anterior pituitary hormone secretion. Increases in serum prolactin (PRL) occurred even after the 1 mg tablet (P < 0.01) while maximal responses were observed 60 min after ingestion of the 20 mg tablet (mean 27.8 ng/ml; range 25.6–30.3 ng/ml). Serum PRL levels peaked 60–90 min after ingestion of any dose of metoclopramide and values remained significantly elevated (P< 0.05) for up to 8 h after the tablet.Increases in serum thyrotrophin (TSH) also occurred after the 10 and 20 mg doses of metoclopramide. Peak responses were seen at 120–180 min, with significant elevation (P < 0.05) persisting from 60 to 240 min after ingestion. No consistent changes in serum FSH, LH or GH were observed and no side‐effects were reported.It was concluded that metoclopramide elevated serum PRL and TSH. The threshold dose of metoclopramide required for these effects was different for the two hormones; their peak responses occurred at different times and the duration of the elevation was dissimilar, suggesting a mechanism other than the release of hypothalamic thyrotrophin‐releasing hormone (TRH).
ENDOGENOUS ADRENERGIC REGULATION OF RENIN RELEASE IN NORMOTENSIVE MAN
Authors: HSU L. , LILLEY J. J. , STONE R. A. 
Published: March 2008

SUMMARYExogenous infusion of catecholamines in man and electrical stimulation of renal nerves in anaesthetized animals have suggested the importance of adrenergic influence on renin release. We have studied the effect of endogenous adrenergic stimulation on renin release in seventeen apparently healthy, unanaesthetized normotensive men (mean arterial pressure < 100 mmHg). All subjects were ingesting an unrestricted salt diet, excreting > 100 mEq sodium per 24 h. Plasma renin activity (PRA), expressed as nanograms angiotensin I per millilitre per hour, increased 4.1±0.76 ng/ml (range 0.3–9.7 ng/ml) in all subjects 5 h after ingestion of 80 mg frusemide. Amyl nitrite inhalation and cold pressor testing produced the appropriate haemodynamic alterations but failed to increase PRA significantly (P>0.05). The alpha agonist, phenylephrine, decreased PRA from an average basal level of 1.21±0.16 ng/ml to 0.83±0.13 ng/ml, and the alpha blocker, phentolamine, increased PRA from an average initial level of 1.26±0.3 ng/ml to 3.61±0.6 ng/ml. Repeat inhalation of amyl nitrite with alpha blockade further elevated PRA to 4.36±0.97 ng/ml in contrast to the effect of amyl nitrite alone. These data suggest that endogenous stimulation of sympathetic nerves with amyl nitrite inhalation or cold pressor testing is not associated with measurable increase in PRA. Alpha adrenergic stimulation with phenylephrine causes a significant decrement in PRA, and alpha blockade with phentolamine significantly increases PRA. Amyl nitrite inhalation in the presence of alpha blockade further elevated PRA in direct contrast to the effect of amyl nitrite alone. Haemodynamic correlates, the elevation of PRA with alpha blockade, and the decrement of PRA with alpha stimulation suggest that alpha adrenergic receptor inhibition may account for the lack of PRA increase with endogenous sympathetic stimulation.
ALTERATIONS IN SERUM PROLACTIN HETEROGENEITY BY PROVOCATIVE TESTS IN A PATIENT WITH A PITUITARY TUMOUR
Authors: GALA R. R. , VAN DE WALLE CYNTHIA , HOFFMAN W. H. 
Published: March 2008

SUMMARYThe proportion of serum prolactin heterogeneity were investigated in a patient with a pituitary adenoma producing both prolactin and growth hormone. Glucose tolerance (GTT) and insulin tolerance (ITT) tests were performed alone and in combination with chlorpromazine both before and after hypophysectomy. Serum prolactin multiple forms were separated by Sephadex G‐100 column chromatography at 3°C. None of the provocative tests altered the already elevated serum prolactin either before (300 ng/ml) or after (100 ng/ml) hypophysectomy. Chlorpromazine or ITT did not alter the proportion of prolactin heterogeneity; GTT, whether in conjunction with chlorpromazine or alone and both before and after hypophysectomy, increased the proportions of the larger molecular species. In five tests in which the GTT was not performed the prolactin heterogeneity was as follows: ‘void volume’, 4.9%; ‘big’, 13.1%; ‘little’, 82.1%; in those experiments in which the GTT was performed the proportions of prolactin heterogeneity were: ‘void volume’, 13.5%, ‘big’, 19.2%; ‘little’, 67.3%.
COEXISTING PRIMARY EMPTY SELLA SYNDROME AND ACROMEGALY*
Authors: MOLITCH M. E. , HIESHIMA G. B. , MARCOVITZ S. , JACKSON I. M. D. , WOLPERT S. 
Published: March 2008

SUMMARY The‘empty’sella syndrome is now a more frequent diagnosis due to the increased use of pneumoencephalography in the evaluation of the enlarged pituitary fossa. This syndrome has also been classified into a‘primary’form in which there has been no prior pituitary irradiation or surgery, and a ‘secondary’ form in which the empty sella is found after such procedures. Most patients with the primary empty sella syndrome are found to have normal pituitary function while about 30% have varying degrees of hypopituitarism (Neelon et al., 1973).It is not widely appreciated, however, that the primary empty sella may harbour a pituitary tumour with resultant acromegaly. In this report we describe two such patients who presented with active acromegaly. This entity of pituitary tumour in a primary empty sella merits careful consideration since the coexistence of these two findings may influence the therapeutic approach that might otherwise be appropriate for the pituitary tumour.
IS THE GROWTH‐HORMONE RESPONSE TO INSULIN DUE TO HYPOGLYCAEMIA, HYPERINSULINAEMIA OR A FALL IN PLASMA FREE FATTY ACIDS?
Authors: WEST T. E. T. , SÖNKSEN P. H. 
Published: March 2008

SUMMARYSeven normal male volunteers were given a 2 h intravenous infusion of insulin (2 mu kg‐1 min‐1). During the first hour, in which normoglycaemia was maintained by glucose infusion, no detectable increase in growth hormone (GH) secretion occurred. When controlled symptomatic hypoglycaemia was produced during the second hour of the insulin infusion a brisk rise in plasma GH concentration was observed in all the subjects studied. Since it was possible that the falls in the concentration of plasma free fatty acids (FFA) occurring during infusion of insulin also acted as a stimulus to GH release the study was repeated in four subjects but normoglycaemia was maintained throughout the entire 2 h period of insulin infusion. In these experiments there was no rise in plasma GH concentration although a similar fall in plasma FFA was produced. These results clearly indicate that hypoglycaemia per se was the important stimulus to GH secretion and not hyperinsulinaemia or a lowering of plasma FFA. Furthermore there appeared to be a threshold hypoglycaemic stimulus to GH secretion. In no subject was a rise in plasma GH seen without a fall in plasma glucose greater than 1.4 mmol/l. Prolonged mild hypoglycaemia did not stimulate GH secretion.
SERUM PROLACTIN AND OESTRADIOL LEVELS AT DIFFERENT STAGES OF PUBERTY
Authors: THORNER M. O. , ROUND JOAN , JONES ANN , FAHMY D. , GROOM G. V. , BUTCHER SUSAN , THOMPSON K. 
Published: March 2008

SUMMARYSerum prolactin and oestradiol levels were measured in 183 children who were staged for pubertal development. Mean serum prolactin levels are higher in girls than in boys at stage 3 of pubertal development. In girls prolactin levels rise at stage 2, and are higher after menarche; in boys there is no change in prolactin levels. In this study serum oestradiol correlates with prolactin in the girls, but not in the boys.
EFFECT OF STILBOESTEROL THERAPY ON THYROTROPHIN‐RELEASING HORMONE (TRH) RESPONSIVENESS IN MALES
Authors: SMYTH P. P. A. , TURNER J. J. , O'DONOVAN D. K. 
Published: March 2008

SUMMARYTRH responsiveness was investigated in twenty‐four males (aged 66‐83 years) undergoing stilboesterol therapy for carcinoma of the prostrate. Twelve were taking 2‐6 mg daily by mouth for periods of 5 days to 12 months (mean 5 months) (Group A) and the remainder were on daily i.v. doses of 250‐500 mg for periods of 3‐10 days (mean 8 days) (Group B). In the former group TRH responsiveness was enhanced compared to age matched controls. A contrary effect was observed in the latter group in that the group mean TRH response was significantly lower than that of Group A or of the control group. Basal serum TSH values were unchanged in Group A compared to controls, but a significant elevation in the basal mean value was observed in Group B.The mechanism of action of stilboesterol in the subjects studied remains to be elucidated. Our data are in keeping with either a hypothalamic or pituitary locus for such actions.
THYROID FUNCTION AND ANTIBODY STUDIES IN PERNICIOUS ANAEMIA
Authors: KRASSAS G. , McHARDY‐YOUNG S. , RAMSAY IAN , FLORIN‐CHRISTENSEN A. 
Published: March 2008

SUMMARYThyroid antibodies were demonstrated in 57% of thirty pernicious anaemia patients without overt thyroid disease. Elevated basal thyroid stimulating hormone (TSH) levels and an enhanced TSH response to thyrotrophin releasing hormone (TRH) only occurred in thyroid antibody positive subjects; by contrast the thyroid antibody negative subjects in the older age group frequently had undetectable basal TSH levels and an impaired TRH response. Thyroid hormone concentrations provided no absolute evidence of hypothyroidism in any of the patients.
GLUCAGON AND DIABETES
Authors: WARNE G. L. , ALFORD F. P. , CHISHOLM D. J. , COURT J. 
Published: March 2008

SUMMARYIn order to determine whether glucagon levels of diabetic subjects are suppressible, alpha cell responsiveness to acute insulin administration (0.1 units/kg intravenously) was determined in fourteen juvenile onset, healthy diabetic and eight control subjects. In the diabetics, insulin produced a significant but slow fall in blood glucose over 60 min (P<0.01). On the other hand, glucagon levels fell dramatically in all diabetics to undetectable levels (P<0.001). Only one diabetic became hypoglycaemic and he alone showed a rebound rise of glucagon at 60 min. The rate of fall of blood glucose in the diabetic subjects was not influenced by the basal glucagon level (r= 0.13) or the rate of fall of plasma glucagon (r= 0.04). The glucose and glucagon responses of control subjects to insulin administration were in sharp contrast to the diabetics: blood glucose levels fell rapidly to hypoglycaemic levels and were associated with a major rise in glucagon levels (mean rise 116 pmol/1, P<0.001).We conclude that alpha cell hyperfunction in human diabetes can be completely suppressed by insulin administrtion and is therefore not autonomous, and that the slow rate of fall of blood glucose following insulin administration in diabetics is not secondary to glucagon excess.