Clinics in Endocrinology and Metabolism最新文献_第7页

Index 指数

Clinics in Endocrinology and Metabolism Pub Date : 1986-02-01 DOI: 10.1016/S0300-595X(86)80050-0

引用次数: 0

2 Intra-islet insulin—glucagon—somatostatin relationships 胰岛内胰岛素-胰高血糖素-生长抑素的关系

Clinics in Endocrinology and Metabolism Pub Date : 1986-02-01 DOI: 10.1016/S0300-595X(86)80041-X

Ellis Samols, Susan Bonner-Weir, Gordon C. Weir

引用次数: 142

3 Paracrine functions of somatomedins 生长激素的旁分泌功能

Clinics in Endocrinology and Metabolism Pub Date : 1986-02-01 DOI: 10.1016/S0300-595X(86)80042-1

Louis E. Underwood, A. Joseph D'ercole, David R. Clemmons, Judson J. Van Wyk

引用次数: 123

7 Paracrine regulation of follicular maturation in primates 灵长类动物卵泡成熟的旁分泌调节

Clinics in Endocrinology and Metabolism Pub Date : 1986-02-01 DOI: 10.1016/S0300-595X(86)80046-9

Sharon A. Tonetta, Gere S. dizerega

引用次数: 16

Intra-islet insulin-glucagon-somatostatin relationships. 胰岛内胰岛素-胰高血糖素-生长抑素的关系。

Clinics in Endocrinology and Metabolism Pub Date : 1986-01-01 DOI: 10.1007/978-3-642-69019-8_9

E. Samols, S. Bonner-Weir, G. Weir

引用次数: 98

Histopathology of the pituitary 垂体组织病理学

Clinics in Endocrinology and Metabolism Pub Date : 1985-11-01 DOI: 10.1016/S0300-595X(85)80077-3

I. Doniach

{"title":"Histopathology of the pituitary","authors":"I. Doniach","doi":"10.1016/S0300-595X(85)80077-3","DOIUrl":"10.1016/S0300-595X(85)80077-3","url":null,"abstract":"<div><p>The cytoplasmic secretory granules of corticotrophs in the anterior pituitary are basophil in trichrome stains and periodic acid-Schiff positive in the histochemical stain for glycoprotein due to their content of the glycosylated 16000 N-terminal fragment of the precursor protein proopiomelanocorticotrophin (POC). The granules show a positive immunocytochemical reaction to antibodies raised against ACTH, β- endorphin and N-terminal fragments of POC. A small subset of corticotrophs contains immunoreactive αMSH in addition. Immunocytochemistry shows the corticotrophs to constitute about 15–20% of the anterior pituitary cells arranged both singly and in clumps. They are distributed in the median wedge and anteriorly, laterally and posteriorly adjacent to the pars nervosa which is often ‘invaded’ by corticotroph basophils. The αMSH subset is prominent in the rudimentary intermediate lobe and is scattered anteriorly in the pituitary of the human fetus. Crooke cell hyalinization is associated with pathologically maintained hypercortisolaemia and with glucosteroid therapy. The hyalinization is demonstrated in ultrastructure to be due to massive accumulation of intermediate cytoplasmic filaments 7–8 nm in diameter that are normally present in only small number. The change is associated with a varying degree of loss of secretory granules.</p><p>In untreated Addison's disease there is a marked increase in the number of corticotrophs, many of which are arranged in distended alveoli to form micronodules. The vast majority of cases of pituitary-dependent Cushing's disease and all cases of Nelson's syndrome are associated with a basophil or chromophobe adenoma. These give a positive immunocytochemical reaction with anti-ACTH, β-endorphin and N-terminal POC. In ultrastructure the cells of the chromophobe adenomas are seen to contain sparse secretory granules that are usually smaller than those in the chromophil adenomas. There are only very few reports of pituitary-dependent Cushing's disease found to be due to immunocytochemically confirmed corticotroph hyperplasia with or without a corticotroph adenoma. A few cases have been described in which the adenoma cells show Crooke's hyalinization, associated in one example with secretion of a big ACTH found more typically in ectopic ACTH-secreting tumours. A group of cases due to corticotroph adenoma has been reported whose excessive ACTH secretion is reduced by treatment with the dopamine agonist bromocriptine, in which it is suggested that the tumour cells arise from a subset of corticotrophs of pars intermedia origin. A puzzling finding has been the incidence of immunoreactive corticotroph adenomas that are not associated with any evidence of clinical or biochemical Cushing's disease. These have been noted in surgically resected material as well as in postmortem pituitaries.</p></div>","PeriodicalId":10454,"journal":{"name":"Clinics in Endocrinology and Metabolism","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1985-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0300-595X(85)80077-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14136033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 24

Congenital adrenal hyperplasia 先天性肾上腺增生

Clinics in Endocrinology and Metabolism Pub Date : 1985-11-01 DOI: 10.1016/S0300-595X(85)80082-7

M.O. Savage

引用次数: 5

Histopathology of the human adrenal cortex 人肾上腺皮质的组织病理学

Clinics in Endocrinology and Metabolism Pub Date : 1985-11-01 DOI: 10.1016/S0300-595X(85)80078-5

A. Munro Neville, M.J. O'hare

引用次数: 87

The CRFs and their control: Chemistry, physiology and clinical implications CRFs及其对照:化学、生理和临床意义

Clinics in Endocrinology and Metabolism Pub Date : 1985-11-01 DOI: 10.1016/S0300-595X(85)80079-7

Glenda Gillies, Ashley Grossman

{"title":"The CRFs and their control: Chemistry, physiology and clinical implications","authors":"Glenda Gillies, Ashley Grossman","doi":"10.1016/S0300-595X(85)80079-7","DOIUrl":"10.1016/S0300-595X(85)80079-7","url":null,"abstract":"<div><p>The 41-amino acid CRF fulfils all the criteria for a corticotrophin releasing factor, although considerable evidence suggests that other factors, particularly VP, also play a physiologically significant role in controlling ACTH release. Although human CRF has now been identified as a 41-residue peptide, most studies to date have used oCRF-41 in their exploration of the physiology and pathology of the hypothalamic-pituitary-adrenal axis. Low doses of oCRF-41 appear to be safe, and for specific tests of the readily-releasable pool of ACTH and related peptides 100 μg is a practical dose for most purposes. Although serious side-effects have only been noted at doses above 100 μg, it is reasonable to monitor all patients administered CRF-41 with great care, and in particular to be alert to hypotension, especially in patients with corticosteroid deficiency. There is little doubt that, in combination with the standard insulin-tolerance test, the CRF test is a useful means of diagnosing hypothalamic or portal dysfunction in patients with secondary adrenal failure. However, in the diagnosis and differential diagnosis of Cushing's syndrome, the role of the CRF test remains unclear. In normal subjects, a high basal cortisol level usually inhibits the response to CRF, such that a greatly enhanced response is suggestive of pituitary-dependent Cushing's syndrome. In patients with diagnosed ACTH-dependent Cushing's syndrome, an absent response to CRF predisposes towards an ectopic source of ACTH. However, there are exceptions in all directions, and it is uncertain whether the CRF test will prove of greater value than the traditional procedures, such as the dexamethasone suppression test. The differential diagnosis of depression and Cushing's disease may be its greatest value.</p><p>In terms of treatment, there are as yet few data on the usefulness of CRF in expediting recovery of the pituitary-adrenal axis following long-term suppression, such as in patients with Cushing's syndrome treated by removal of a unilateral adenoma or trans-sphenoidal microadenomectomy. It is possible that such treatment may eventually be a useful application of CRF, although data are not yet available.</p></div>","PeriodicalId":10454,"journal":{"name":"Clinics in Endocrinology and Metabolism","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1985-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0300-595X(85)80079-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14136035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 42

Adrenocortical insufficiency 肾上腺皮质机能不全

Clinics in Endocrinology and Metabolism Pub Date : 1985-11-01 DOI: 10.1016/S0300-595X(85)80084-0

C.W. Burke

{"title":"Adrenocortical insufficiency","authors":"C.W. Burke","doi":"10.1016/S0300-595X(85)80084-0","DOIUrl":"10.1016/S0300-595X(85)80084-0","url":null,"abstract":"<div><p>Adrenocortical insufficiency causes difficulty in diagnosis and morbidity out of proportion to its rarity, because of the non-specific, multi-system nature of the clinical features. Most of these are due to cortisol deficiency. Prominent features are well-known ones such as weight loss and asthenia, and hypoglycaemia. Less prominent in recent accounts are those due to failure of cellular sodium export and to vasopressin excess, which are frequent and clinically significant. For this reason, the clinical features of isolated ACTH deficiency, isolated glucocorticoid deficiency and Addison's disease overlap greatly. In addition, cortisol deficiency has secondary endocrine effects, e.g. glucocorticoid-reversible hypothyroidism, hyperprolactinaemia and hypercalcaemia. Further overlap between the various steroid insufficiency syndromes occurs because of the association of various organ-specific autoimmune endocrinopathies with Addison's disease. Over 80% of Addison's disease is of the autoimmune type, though almost any systemic destructive process can cause similar steroid insufficiency.</p><p>Demonstration of adrenal insufficiency requires various combinations of tetracosactrin adrenal stimulation tests, and hypoglycaemia or equivalent tests, if the cause is ACTH deficiency but the correct test can only be chosen to suit a firm clinical diagnosis. The treatment of adrenocortical insufficiency is described.</p></div>","PeriodicalId":10454,"journal":{"name":"Clinics in Endocrinology and Metabolism","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1985-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0300-595X(85)80084-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14136037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 221