Showing papers in "The Journal of Clinical Endocrinology and Metabolism in 1961"
TL;DR: A method was developed for the semiquantitative assessment of body hair growth, and suitable for use in the study of clinical problems associated with hirsuties in women, and an “hormonal” score obtained by adding the gradings obtained from 9 of the 11 sites is being employed in clinical studies.
Abstract: A method was developed for the semiquantitative assessment of body hair growth, and suitable for use in the study of clinical problems associated with hirsuties in women. Five gradings based on densities and areas involved, were determined for each of 11 sites. Findings from application of the method to a control group of 430 women (ages, 15–74 years) are reported. Hair tended to increase on the face and disappear from all other sites with advancing years. In younger age groups a significant amount of hair was found on the forearm and leg in most subjects, but a zero grading was much the commonest finding at all other sites. It is suggested that 2 factors may be involved: one of protective nature with main expression on the forearm and leg, and the other related to hormone levels or sensitivity, with clearest expression elsewhere. An “hormonal” score obtained by adding the gradings obtained from 9 of the 11 sites (excluding the forearm and leg) is being employed in clinical studies.
2,292 citations
TL;DR: The mechanism of action of diphenylhydantoin is apparently extrathyroidal, since this drug depressed the PBI level in hypothyroid patients maintained with a constant dosage of desiccated thyroid, as well as in 7 of 8 euthyroid subjects, which depressed the serum PBI concentration.
Abstract: The mean serum protein-bound iodine (PBI) level in 36 cases of cerebral disease with seizures treated by administration of diphenylhydantoin was 3.81±0.14 (s. e.)μg. per 100 ml. This was significantly lower than the corresponding mean PBI level in 12 cases of cerebral seizure not so treated, viz., 5.39 ± 0.16 μg. per 100 ml. Despite the occurrence of PBI levels as low as 2.4 μg. per 100 ml. in the diphenylhydantoin group, there was no clinical evidence of hypothyroidism in any of the patients and there were no significant alterations in the other parameters of thyroid function. In 7 of 8 euthyroid subjects, diphenylhydantoin also depressed the serum PBI concentration. The mechanism of action of diphenylhydantoin is apparently extrathyroidal, since this drug depressed the PBI level in hypothyroid patients maintained with a constant dosage of desiccated thyroid. Diphenylhydantoin added in vitro consistently increased the uptake of I131-labeled 3,5,3′-triiodothyronine by red blood cells incubated with plasma...
144 citations
TL;DR: The metabolism of endogenously produced and exogenous tracer doses of labeled hydrocortisone was studied in euthyroid subjects, in spontaneous hyperthyroidism, in myxedema, and following administration of triiodothyronine.
Abstract: The metabolism of endogenously produced and exogenous tracer doses of labeled hydrocortisone was studied in euthyroid subjects, in spontaneous hyperthyroidism, in myxedema, and following administration of triiodothyronine. It was found that an elevated level of thyroid hormone caused pronounced alteration in the metabolism of hydrocortisone toward 11-ketonic metabolites, together with an absolute increase in the endogenous production of the adrenal hormone. In hypothyroidism the converse of these effects was found, in that the metabolism of hydrocortisone was shifted toward the production of 11-hydroxy metabolites together with a decreased formation of hydrocortisone from endogenous sources. A mechanism is suggested for these changes in the production and metabolism of hydrocortisone.
131 citations
TL;DR: The rate of local recurrence in the thyroid area was significantly lower in patients treated by total thyroidectomy than in those treated only by unilateral subtotal lobectomy, and the survival rates for patients with papillary or follicular carcinoma were higher than for those with anaplasti...
Abstract: At the University of California Hospitals a study has been made of the 390 patients with thyroid carcinoma who were observed in the 40-year period between 1920 and 1959. Thyroid carcinoma was found in both lobes at the time of the “initial operation” in 19 per cent of these patients, and regional lymph node metastases were reported at one time or another in 42 per cent. These data warrant a more radical surgical approach to thyroid carcinoma. During the past fifteen years, therefore, the majority of such patients at the University of California have been treated by more radical forms of thyroidectomy. The rate of local recurrence in the thyroid area was significantly lower in patients treated by total thyroidectomy than in those treated only by unilateral subtotal lobectomy. Cumulative survival rates were higher for patients with papillary carcinoma than for those with follicular carcinoma, and the survival rates for patients with papillary or follicular carcinoma were higher than for those with anaplasti...
118 citations
TL;DR: Results indicate that sodium retention with human growth hormone in man is independent of aldosterone secretion, and the magnitude of sodium retention was increased in primary aldosteronism, possibly because of the potassium-depleted state.
Abstract: The administration of 10 mg. of human growth hormone within four hours produced a mean retention of approximately 30 mEq. of sodium and potassium per twenty-four hours in 3 of 5 normal subjects receiving a constant dietary intake; there was no change in urinary aldosterone. In 2 there was slight retention—without the rise in aldosterone that was found in a more prolonged study. Urinary sodium decreased after administration of human growth hormone in 2 patients with primary aldosteronism who had been refractory to daily intramuscular injections of 20 mg. of desoxycorticosterone acetate for four days. The magnitude of sodium retention was increased in primary aldosteronism, possibly because of the potassium-depleted state. Sodium retention was also observed in a bilaterally adrenalectomized subject after human growth hormone was administered. Results indicate that sodium retention with human growth hormone in man is independent of aldosterone secretion.
113 citations
TL;DR: A detailed description of extraction and paper ehromatographie techniques for themeasurement of urinary 6β-hydroxycortisol is presented, together with experimental data from which this and other separation procedures have been devised.
Abstract: A detailed description of extraction and paper ehromatographie techniques for themeasurement of urinary 6β-hydroxycortisol is presented, together with experimental data from which this and other separation procedures have been devised. 6β-Hydroxycortisol appears to be the chief unconjugated urinary metabolite of cortisol. Increased levels, both absolutely and in relation to total steroid excretion, were noted in cases of Cushing's syndrome and after administration of ACTH. Evidence for the presence of several new urinary steroids is presented, and definitive identification of one, 6α-hydroxycortisol, is reported in human urine for the first time.
110 citations
TL;DR: Intravenous sodium tolbutamide tests were performed in patients with proven insulomas, functional hyperinsulinism, mild diabetes mellitus and associated postprandial hypoglycemia, severe adrenal insufficiency, and liver disease and provided supportive evidence that the primary mechanism of action of the sulfonylureas is release of pancreatic insulin.
Abstract: Intravenous sodium tolbutamide tests were performed in patients with 1) proven insulomas, 2) functional hyperinsulinism, 3) mild diabetes mellitus and associated postprandial hypoglycemia, 4) severe adrenal insufficiency, and 5) liver disease. Healthy subjects were used as controls. Administration of sodium tolbutamide to patients with functioning islet-cell adenomas usually produced a greater degree of hypoglycemia than was observed in the other subjects studied. Of much greater significance, however, were the prolonged periods of hypoglycemia in the insuloma patients. After removal of the insulomas the response to tolbutamide became normal. Persistence of tolbutamide-induced hypoglycemia: 1) is a valuable adjunct in the diagnosis of insuloma, 2) is due, in part, to release of excessive amounts of insulin from the insuloma, and 3) is supportive evidence that the primary mechanism of action of the sulfonylureas is release of pancreatic insulin. From a clinical point of view the intravenous tolbutamide tes...
110 citations
TL;DR: There was a progressive and significant decrease in the urinary excretion of 17-OH-CS with aging, and alterations in cortisol metabolism were associated with a significant increase in the level of cortisol metabolism in the old men.
Abstract: In this study the influence of old age on adrcnocortical function and cortisol metabolism was investigated, along with renal, hepatic and thyroid function in 15 young men (25–40 years old) and 50 old men (60–96 years old). By the criteria of 8-a.m. plasma levels of free and conjugated 17-hydroxycorticosteroids (17-OH-CS) and the plasma corticoid response to ACTH stimulation, no significant change in adrenocortical function could be demonstrated with advancing age. However, there was a progressive and significant decrease in the urinary excretion of 17-OH-CS with aging. Following intravenous administration of a standard dose, cortisol disappeared from the circulation at a significantly slower rate in the old men. The maximal levels of plasma conjugated 17-OH-CS observed after cortisol infusion were statistically the same for all ages, but the rate of decay from peak values was slower in the older subjects. These alterations in cortisol metabolism were associated with a significant increase in the level of ...
103 citations
TL;DR: Plasma epinephrine and norepinephrine concentrations were measured by the ethylenediamine technic before and during hypoglycemia in 11 patients undergoing insulin-coma therapy and in patients treated for more than three weeks, the control values were significantly elevated.
Abstract: Plasma epinephrine and norepinephrine concentrations were measured by the ethylenediamine technic before and during hypoglycemia in 11 patients undergoing insulin-coma therapy. In 6 studies carried out during the first week of treatment, plasma epinephrine levels increased from a mean value of 0.2 μg. per liter (control) to 1.4 μg. per liter following administration of insulin. In 9 studies carried out during the second and third weeks of therapy, the control values were significantly elevated (0.9 μg. per liter), although peak epinephrine concentrations reached after insulin were similar to those observed during the first week. In 9 studies performed in patients treated for more than three weeks, the control epinephrine concentration was 0.15 μg. per liter and no significant increase was observed during hypoglycemia. Norepinephrine levels remained unchanged in the 2½-hour period following administration of insulin in these subjects. However, a significant increase was noted in samples obtained between tw...
97 citations
TL;DR: A column method utilizing the anion-exchange rosin Dowex-1 is described for the determination of thyroxine in serum, and values comparable to those for butanol-extracted iodine were obtained, and additions of inorganic iodine or iodotyrosines did not affect the reliability.
Abstract: A column method utilizing the anion-exchange rosin Dowex-1 is described for the determination of thyroxine in serum. Values comparable to those for butanol-extractable iodine were obtained, and additions of inorganic iodine or iodotyrosines did not affect the reliability. Analyses of sera containing in vitro additions of organic iodine compounds which interfere with the PBI and in most cases the BE1, gave results which suggested the possible usefulness of the column method. Furthermore, the pattern of thyroxine elution with the column method, as determined by the iodine content of 3 successive 1.0-ml. fractions, was helpful in predicting the validity or nonvalidity of the result. When the BEI and columnte chniques were applied to cases in which elevated serum PBI values did not correlate with the clinical findings, there was some evidence for better specificity of the column method. Neither of the methods was helpful in most cases involving both inorganic iodine and PBI values in excess of 25 μg. per 100 ml.
97 citations
TL;DR: The average 24-hour secretion rate of cortisol, as determined from the excretion of any one of the four major urinary metabolites, THF, ATHF, THE, or cortolone, for 8 elderly men was 75 per cent of that for 8 young men.
Abstract: The average 24-hour secretion rate of cortisol, as determined from the excretion of any one of the four major urinary metabolites, THF, ATHF, THE, or cortolone (20α and 20β), for 8 elderly men was 75 per cent of that for 8 young men. When the secretion rates were expressed as mg. per gm. of creatinine por twenty-four hours, the average rates were essentially the same—14 mg. versus 15 mg., for both groups of subjects. These findings substantiate those obtained for the mean total 24-hour excretions of THF, ATHF, THE and cortolone, which for 23 elderly men was approximately 70 per cent of that for the 23 young men. When these values are expressed as mg. per gm. of creatinine, the mean of 4.9 mg. for young men compares with that of 4.7 mg. for elderly men. In both age groups there were essentially similar proportions of the two 11-hydroxyl (THF, ATHF) to the two 11-ketone substituted metabolites (THE, cortolone), and of the three 5β (THF, THE, and cortolone) to the one 5α (ATHF) cortisol metabolite. Aging, by...
TL;DR: Qualitative differences between thyrotropin and the thyroid activator of hyperthyroidism were found in serum fractionation studies by means of starch-block electrophoresis, chromatography on a column of diethylaminoethyl cellulose, and determinations by the percolation method of Bates.
Abstract: The thyroid activator of hyperthyroidism was distinguished from thyrotropin by its prolonged action in an assay for thyrotropin. It was sought in the serum of 10.1. persons and was found in: (a) 8 of 9 persons with exophthalmos and hyperthyroidism; (b) 19 of 25 persons without exophthalmos but with hyperthyroidism; (c) 19 of 23 persons with hyperthyroidism in the past but with persisting exophthalmos; (d) 11 of 14 persons with exophthalmos who had never had hyperthyroidism; and (e) only 1 of 25 persons with no history of either exophthalmos or hyperthyroidism. Included in these observations were 4 positive results on the serum of patients who had features of hypopituitarism due to pituitary-ablative surgery. Qualitative differences between thyrotropin and the thyroid activator of hyperthyroidism were found in: 1) serum fractionation studies by means of starch-block electrophoresis, chromatography on a column of diethylaminoethyl cellulose, and determinations by the percolation method of Bates; and 2) “hal...
TL;DR: It is suggested that duration of the overhydrated state is a critical factor in determining the development of a reduced renal responsiveness to vasopressin.
Abstract: An evaluation of the effects of prolonged administration of vasopressin on water and electrolyte metabolism was made in 5 studies on 4 human subjects. In subjects receiving a high fluid intake, an initially rapid expansion of total body water associated with an excessive urinary excretion of sodium was observed. Ultimately, however, urinary osmolality declined, daily urinary output rose, and body water balance was re-attained. Concomitantly, excessive natriuresis and net loss of body sodium ceased, despite the presence of an expanded body fluid volume. Although administration of vasopressin and a high fluid intake was continued, a new steady state was achieved. This was characterized by persistent overhydration and hyponatremia. It is suggested that duration of the overhydrated state is a critical factor in determining the development of a reduced renal responsiveness to vasopressin. This response was never observed prior to the seventh day of vasopressin administration, and in two studies occurred when o...
TL;DR: A simple, reproducible, in vitro test of thyroid function was developed based upon the uptake of I131-triiodothyronine from serum by the anion exchange resin, IRA-400, in the formate cycle, and the elevated resin uptake values in active thyrotoxicosis fell after therapy.
Abstract: A simple, reproducible, in vitro test of thyroid function was developed based upon the uptake of I131-triiodothyronine from serum by the anion exchange resin, IRA-400, in the formate cycle. One milliliter of serum which had been equilibrated with I131-triiodothyronine was added to 1 milliliter of resin in a calibrated tube. The mixture was shaken for ninety minutes and assayed in a well counter. After three washings with water the resin was counted again to determine the resin uptake. The findings (mean ± standard deviation) were: 1) hypothyroidism, 27 ± 3.3 per cent; 2) euthyroid subjects, 35 ± 2.2 per cent; 3) thyrotoxicosis, 53 ± 7.8 per cent. The elevated resin uptake values in active thyrotoxicosis fell after therapy. In pregnancy, the values were depressed to the hypothyroid level or lower. Contamination with organic and inorganic iodine did not interfere with the test.
TL;DR: Clinical improvement following therapy was associated with a drop in the urinary excretion of NE and VMA, indicating that there may be biochemical differences among neuroblastomata, even though the tumors may be of similar histologic appearance.
Abstract: This study concerns the urinary excretion of norepinephrine (NE), cpinephrine (E) and 3-methoxy-4-hydroxymandelic acid (VMA) in 5 infants and children with neuroblastomata and 1 child with a ganglioneuroblastoma. Prior to treatment by surgery, radiation or hemotherapy (alone, or in combination), 3 of the patients excreted increased amounts of both NE and VMA. One patient excreted slightly increased amounts of NE, but VMA output was very high. Another had a normal output of VMA, but a greatly elevated output of NE. In the remaining patient, both NE and VMA excretions were normal. The output of epinephrine was not increased in any of the cases. In general, clinical improvement following therapy was associated with a drop in the urinary excretion of NE and VMA. With progression of the disease, the excretion of these compounds again increased. These findings indicate that there may be biochemical differences among neuroblastomata, even though the tumors may be of similar histologic appearance. Delineation of ...
TL;DR: The data favor the view that, in cases of islet-cell tumor, leucine acts by potentiating the peripheral action of insulin.
Abstract: Three patients with islet-cell tumor of the pancreas are presented. All had severe fasting hypoglycemia relieved by the administration of glucose. However, 1 had a normal intravenous tolerance curve and 2 did not show any sensitivity to intravenous glucagon-free insulin. The effects of leucine and glycine on the blood sugar level were studied. Administration of leucine consistently caused accentuation of the tumor-induced hypoglycemia—the fall ranging from 21 to 76 per cent below the fasting level—accompanied by clinical symptoms, whereas administration of glycine caused no appreciable changes. Following extirpation of the tumors, leucine provoked no significant degree of hypoglycemia. In 2 normal subjects and in 5 patients with functional hypoglycemia, administration of leucine caused no changes in the blood sugar levels. The data favor the view that, in cases of islet-cell tumor, leucine acts by potentiating the peripheral action of insulin.
TL;DR: Following short-term treatment of the hypothyroid state with thyroxine or triiodothyronine, there was a greater increase in TmPAH than in GFR and RPF, suggesting that this is the primary effect of active thyroid agents on the kidney.
Abstract: Twenty-two patients were studied by means of discrete renal function analysis—7 with hyperthyroidism, 3 with hypothyroidism, and the remainder with other clinical states—before and after treatment with triiodothyroninc or thyroxine. Following definitive therapy of the hyperthyroid state, there was a greater depression in renal hemodynamic functions (GFR and RPF) than in renal tubular activity (TmPAH), probably due to reduction in cardiovascular dynamics. Following short-term treatment of the hypothyroid state with thyroxine or triiodothyronine, there was a greater increase in TmPAH than in GFR and RPF, suggesting that this is the primary effect of active thyroid agents on the kidney.
TL;DR: Twenty-two women, found to have circulating antithyroid antibody (AAB) either before or during pregnancy, were observed during 23 pregnancies, and clinical evidence of hypothyroidism was found in the living off spring at birth or at the time of follow-up examination for as long as 2 years after birth.
Abstract: Twenty-two women, found to have circulating antithyroid antibody (AAB) either before or during pregnancy, were observed during 23 pregnancies. The maternal AAB titers began to fall as early as the first trimester, tended to strike a plateau at a low level in the third trimester, and rose again during the first few months after the termination of pregnancy. These antibodies were demonstrated in the cord blood of 8 newborn infants of 9 mothers who had demonstrable circulating AAB at the time of delivery, but could not be demonstrated in the cord blood of 7 newborn infants of mothers whose AAB titers had fallen to zero by the time of delivery. AAB disappeared from the blood of all infants during the first 3 months of life. No clinical evidence of hypothyroidism was found in the living off spring at birth or at the time of follow-up examination for as long as 2 years after birth. The levels of serum protein-bound iodine at birth in 6 newborn infants with proved transplacental transfer of AAB, and later in 4 o...
TL;DR: The results of the application of the new procedure to 38 euthyroid patients, 15 patients with hyperthyroidism and 13 patients with hypothyroidism, are presented.
Abstract: A new method for assessing both glucose utilization and response to insulin is presented. The technique eliminates certain shortcomings of previous methods, which have yielded widely varying results in patients with abnormal thyroid function. The results of the application of the new procedure to 38 euthyroid patients, 15 patients with hyperthyroidism and 13 patients with hypothyroidism, are presented. In the euthyroid group, the mean specific rate constant for glucose utilization (K) was .0349; for the hyperthyroid patients it was .0325; and for the hypothyroid patients it was .0269. The mean K value for the hypothyroid patients was significantly less than that for the euthyroid patients, whereas the mean K value for the hyperthyroid patients was not significantly different from that for the euthyroid patients. In the euthyroid group, insulin resulted in a mean increase in K of 59 per cent. The hyperthyroid patients showed a significantly greater response (+ 104 per cent) to insulin. The hypothyroid pati...
TL;DR: Sex chromosome complexes XXY, XXXY and XXYY have now been demonstrated in chromatin-positive males with seminiferous tubule dysgenesis in Klinefelter’s syndrome, and the basic requirement in the cytogenetics of the syndrome appears to be the presence of at least two X chromosomes in combination with at least one Y chromosome.
Abstract: Chromosome studies were carried out on 2 mentally defective male patients with Klinefelter’s syndrome, whose interphase nuclei contained, in many instances, 2 masses of sex chromatin. In both patients the chromosome number was 48, or 2 in excess of the normal diploid number for man, in cells derived from blood, bone marrow and skin. Analysis of metaphase plates showed a chromosome complement of 22 pairs of normal autosomes and an XXXY sex chromosome complex. In one of the patients, cells derived from 1 of 4 skin biopsy specimens exhibited further chromosome anomalies that presumably arose during cultivation of the cells in vitro. Sex chromosome complexes XXY, XXXY and XXYY have now been demonstrated in chromatin-positive males with seminiferous tubule dysgenesis. The basic requirement in the cytogenetics of the syndrome appears to be the presence of at least two X chromosomes in combination with at least one Y chromosome.
TL;DR: It is concluded that the cystic structures of the Stein-Leventhal ovary have the capacity to synthesize greater amounts of progesterone and androstenedione.
Abstract: Steroid biosynthesis by normal and abnormal ovarian tissue was studied in vitro, From the incubation media, 6 substances were isolated; 5 of these were characterized as unchanged progesterone, 17α-hydroxy progesterone, androstenedione, 20α-hydroxy-4-pregnene-3-one and 17α,20α-dihydroxy-4-prcgnene-3-one. Correlation of synthetic pattern and production rates with morphology revealed that follicular and thecal tissues were active in 17-hydroxylation and that capsular, stromal and connective tissue were active in 20-reduction. Specimens from Stein-Leventhal ovaries and other luteinized structures yielded the largest amounts of 17α-hydroxyprogesterone. Increased quantities of androstenedione were produced by the luteinized portions of the Stein-Leventhal ovaries. Medullary islets of theca luteal cells were not impressively active in either 17-hydroxylation or side-chain cleavage to androstenedione. It is concluded that the cystic structures of the Stein-Leventhal ovary have the capacity to synthesize greater a...
TL;DR: It is concluded that for any given level of plasma cortisol, the patient with Cushing’s disease main...
Abstract: The present study was undertaken in search of a definitive answer to the question of whether the pituitary secretes abnormal quantities of corticotropin (ACTH) in Cushing’s disease (hypercortisolism due to bilateral adrenal hyperfunction). It was postulated that if the primary disorder in Cushing’s disease were a derangement of pituitary function it should not be corrected by removal of the adrenal glands. In such patients it should then be possible to control plasma cortisol levels while observing plasma ACTH levels. Two groups of patients were studied: 10 who had been treated for Cushing’s disease by bilateral adrenalectomy, and 8 who had Addison’s disease without prior history of Cushing’s disease. Although the amounts of cortisol administered and the plasma 17-hydroxycorticosteroid values were similar for the two groups, blood ACTH levels were consistently higher in the patients with Cushing’s disease. It is concluded that for any given level of plasma cortisol, the patient with Cushing’s disease main...
TL;DR: A difference of binding behavior is evidence that the binding sites induced by estrogen are qualitatively different from those on normal corticosteroid-binding globulin.
Abstract: The binding of cortisol-4-C14 and aldosterone-H3 by serum from pregnant or estrogen-treated subjects was directly compared to the binding by serum from control subjects in a system of double equilibrium dialysis. Increased binding of cortisol-4-C14 could be demonstrated by “estrogen” plasma under conditions of minimal cortisol loading only at 37°C. and not at 4°C. This difference of binding behavior is evidence that the binding sites induced by estrogen are qualitatively different from those on normal corticosteroid-binding globulin. The total concentration of cortisol-binding protein induced by estrogens may be two or three times greater than that of corticosteroid-binding globulin. Under physiologic conditions of temperature, aldosterone-H3 is bound primarily by albumin, but at 4° C. aldosterone-H3 is bound about equally by albumin and corticosteroid-binding globulin. At 4° C. the estrogen-induced binding system does not have appreciable affinity for aldosterone-H3.
TL;DR: Methods for the determination of cortisol and corticostcrone in blood are critically reviewed with special reference to work on human blood with some of the more refined methods as well as the more widely used cruder techniques reviewed in terms of available data.
Abstract: Methods for the determination of cortisol and corticostcrone in blood are critically reviewed with special reference to work on human blood. The period covered is 1954 to the end of 1960, but some earlier work has been included. The collection and storage of blood samples, methods of extraction, purification, separation and determination are discussed in detail. Some of the more refined methods as well as the more widely used cruder techniques are reviewed in terms of available data on their sensitivity, precision, accuracy and specificity. Data are also presented on normal plasma corticosteroid levels at various times of day.
TL;DR: Plasma levels of 17-hydroxycorticosteroids during the night and day were studied in 22 cases of Cushing's syndrome; the normal diurnal variation was lacking in most of these patients; instead, the night levels were higher than normal.
Abstract: Plasma levels of 17-hydroxycorticosteroids (17-OH-CS) during the night and day were studied in 22 cases of Cushing's syndrome. The normal diurnal variation was lacking in most of these patients; instead, the night levels were higher than normal. The mean concentration of plasma 17-OH-CS often differed markedly between different days, but the absence of diurnal variation persisted even in the presence of a lower level of plasma steroids. In 3 subjects, however, there was a decrease in steroid levels during the night; in 2, the values approached the normal range. Data are presented on a few patients with a monosymptomatic clinical picture and normal urinary excretion of 17-ketogenic steroids. Theoretical and diagnostic implications based on the absence of variation in plasma 17-OH-CS concentration are discussed.
TL;DR: Two different mechanisms of pituitary activation were evaluated by studying serial changes in plasma 17-hydroxycorticosteroid levels in response to intravenously administered purified lipopolysaccharide pyrogen (Lipexal) and a propanone compound, SU-4885, to provide a means for distinguishing between normal subjects and patients with panhypopituitarism, Addison’s disease or Cushing's syndrome.
Abstract: Two different mechanisms of pituitary activation were evaluated in 34 normal subjects, 5 patients with anterior pituitary insufficiency, 3 with adrenocortical insufficiency, 2 with Cushing’s syndrome, and 3 with acromegaly, by studying serial changes in plasma 17-hydroxycorticosteroid levels in response to intravenously administered purified lipopolysaccharide pyrogen (Lipexal) and a propanone compound, SU-4885. These responses were compared to those observed following the intramuscular administration of 80 units of corticotropin gel. Similar studies were performed on 15 subjects maintained with corticotropin or corticosteroid therapy. The plasma 17-hydroxycorticosteroid responses to these tests provide a means for distinguishing between normal subjects and patients with panhypopituitarism, Addison’s disease or Cushing’s syndrome. Four hours after the fourth injection of corticotropin gel (administered intramuscularly in doses of 80 units every eight hours) there is complete separation between the ranges ...
TL;DR: The findings indicate that the thyroid gland traps a normal quantity of iodine, but lacks the capacity to utilize it efficiently to form thyroid hormone.
Abstract: A comprehensive study of iodine metabolism is reported in 40 cases of Hashimoto's thyroiditis. The results showed a dissociation between the mean absolute (or stable) iodine uptake by the thyroid (2.0 ;μg. per hour, which was normal) and the serum level of protein-bound iodine (2.5 μg. per 100 ml., which was significantly decreased). These findings indicate that the thyroid gland traps a normal quantity of iodine, but lacks the capacity to utilize it efficiently to form thyroid hormone. This faulty utilization of iodine is apparently a form of acquired dyshormonogenesis. Evidence of its nature is provided by the frequent discharge of iodine from the thyroid gland following administration of potassium perchlorate and by the presence of a butanol-insoluble iodinated protein in the plasma in many cases. The intrathyroidal exchangeable iodine was markedly reduced in almost all cases. This, and not the presence of the butanolinsoluble iodinated protein, explains the frequent discrepancy between the high level ...
TL;DR: Preliminary investigations were carried out in a widespread endemic goiter area (Uele) in the north of the former Belgian Congo, demonstrated not only by the high incidence of goiter, but also by the frequency of associated syndromes such as dwarfism, mental deficiency and cretinism.
Abstract: Preliminary investigations were carried out in a widespread endemic goiter area (Uele) in the north of the former Belgian Congo. The natives were usually in poor nutritional condition. The severe endemicity was demonstrated not only by the high incidence of goiter, but also by the frequency of associated syndromes such as dwarfism, mental deficiency and cretinism. Hypothyroidism was fairly common, but no case of toxic goiter was observed. The thyroid function of 166 goitrous and nongoitrous subjects was studied by means of I127 and I131 determinations. The average thyroidal I131 uptake was 75.3 per cent of the dose after twenty-four hours, and the thyroidal clearance rate was 43.83 ml per minute. The mean value for serum I127 concentration in untreated goitrous patients was in the low-normal range (4.03 μg. per 100 ml.), and in 56 per cent of 118 patients studied the level was below 4 μg. per 100 ml. Elevated PBI131 values were noted mostly in untreated young adults. All the data reflected the attempt of ...