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58 巻, 12 号
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滋野 長平, 森田 陸司, 福永 仁夫, 山本 逸雄, 土光 茂治, 日野 恵, 山田 和代, 古松 芭子, 遠藤 啓吾, 向井 孝夫, 飯 ...1982 年 58 巻 12 号 p. 1473-1481
発行日: 1982/12/20
公開日: 2012/09/24
ジャーナル フリーThe effects of short term administration (12 days) of oral doses of 1, 25-dihydroxyvitamin D3 (1, 25-(OH)2D3 : 0.5μg/day) and 1α-hydroxyvitamin D3 (1α-(OH)D3 : 1.0μg/ day) on intestinal calcium absorption and serum 1, 25-(OH)2D levels were studied in 5 normal and 2 postmenopausal osteoporotic subjects. Fractional intestinal calcium absorption (mean ± SD) assessed by a whole body counting method was unchanged when measured on two separate occasions (0.242 ± 0.026 to 0.223 ± 0.022) in 5 normal male subjects ranging in age from 28 to 48 (mean = 35.4). A similar increase was observed in intestinal calcium absorption in the normal subjects when they were treated either with 1, 25-(OH)2D3 or 1α-(OH)D3 (0.091 ± 0.047 : p<0.02, 0.124 ± 0.055 : p<0.01, respectively). Serum 1, 25 (OH)2D level showed no significant change in basal state in the normal subjects (26.1 ± 13.6 to 22.4 ± 8.1pg/ml), but elevated above the basal range after administration of the two vitamin D metabolites (p<0.01, both) : the increment was significantly larger (p<0.01) after treatment with 1α-(OH)D3 (70.6 ± 20.4pg/ml) than with 1, 25-(OH)2D3 (32.1 ± 10.9pg/ml). In addition, there was a positive correlation between intestinal calcium absorption and serum 1, 25-(OH)2D levels in the normal subjects in their basal state (r=0.76, p<0.02). In two osteoporotic subjects, the increment of calcium absorption after 1α-(OH)D3 treatment was 0.180 ± 0.014 and that of serum 1, 25-(OH)2D, 58.0pg/ml (n=1).
The data suggest that in normal subjects, 1α-(OH)D3 is about half as potent as 1, 25-(OH)2D3 when administered at oral doses of 1.0μg/day or less in stimulating intestinal calcium transport. Although the two vitamin D metabolites exert their effects on the intestine and are quantitatively equivalent at these doses, there is a discordance between the changes in serum 1, 25-(OH)2D level after treatment with the two vitamin D derivatives : this might be attributed to possible direct binding of orally administered 1, 25-(OH)2D3 to its intestinal receptors and to more rapid metabolic removal of 1, 25-(OH)2D3 from the circulation.抄録全体を表示PDF形式でダウンロード (896K) -
水野 兼志, 後藤 光弘, 土岐 高久, 松井 遵一郎, 福地 総逸1982 年 58 巻 12 号 p. 1482-1486
発行日: 1982/12/20
公開日: 2012/09/24
ジャーナル フリーAngiotensin-converting enzyme activity of the aortic subcellular fractions (homogenate, mitochondria, microsomes and supernatant) was determined in normotensive and experimental hypertensive rats (1-clip, 1-kidney Goldblatt hypertensive; 1-clip, 2-kidney Goldblatt hypertensive and 2-clip, 2-kidney hypertensive rats).
The systolic blood pressure markedly elevated in each group of experimental hypertensive rats, while it did not in normotensive rats. Angiotensin-converting enzyme activity was consistently high in the microsomal and supernatant fractions of the aorta in experimental hypertensive rats as well as in normotensive rats. However, the enzyme activity from each fraction of the aorta in 1-clip, 2-kidney Goldblatt hypertensive rats was significantly higher than that in normotensive and other experimental hypertensive rats. There was no significant difference in the enzyme activity among normotensive, 1-clip, 1-kidney Goldblatt hypertensive and 2-clip, 2-kidney hypertensive rats.
The angiotensin-converting enzyme, widely distributed in subcellular fractions of the aorta, may play a possible role in the local control of vascular tone. It seems likely that increased angiotensin-converting enzyme activity in arterial tissue contributes to the initiation or development of hypertension in 1-clip, 2-kidney Goldblatt hypertension in rats.抄録全体を表示PDF形式でダウンロード (541K) -
鈴木 裕也, 竹下 栄子, 加野 象次郎, 平田 史朗, 佐藤 誠也1982 年 58 巻 12 号 p. 1487-1497
発行日: 1982/12/20
公開日: 2012/09/24
ジャーナル フリーA 28 year old woman with Hashimoto's disease was treated with desiccated thyroid and triiodothyronine (T3). She improved steadily during the first 2 to 3 months and thyroidal function tests turned to normal. Then, in spite of continuing treatment, her serum T4 level decreased gradually and she became fatigued. A serum T3 radioimmunoassay manifested an interference pattern suggested anti-T3 antibody in her serum. Ethanol-extracted serum T3 and T4 levels were low in spite of ingestion of desiccated thyroid or synthetic T3 and T4, suggesting intestinal malabsorption of T3 and T4. Antibodies against T3 and T4 were identified in her serum; affinity constants were 1.16 X 1010 and 8.73 X 108/mol respectively. After treatment with synthetic T3 and/or T4 for 20 months, the titer of anti-T3 and anti-T4 antibodies decreased, and impaired intestinal absorption of thyroid hormone improved. Then, after desiccated thyroid treatment was reinstituted, the anti-T3antibody titer again increased and intestinal absorption of thyroid hormone decreased. These results suggest the oral immunization against thyroid hormones. There was associated impairment in intestinal absorption of thyroid hormone presumably secondary to the anti-T3 and anti-T4 antibodies.抄録全体を表示PDF形式でダウンロード (1444K) -
山下 俊一, 和泉 元衛, 森田 茂樹, 平湯 秀司, 田辺 徹, 田浦 紀子, 佐藤 賢士, 森本 勲夫, 岡本 純明, 長瀧 重信1982 年 58 巻 12 号 p. 1498-1504
発行日: 1982/12/20
公開日: 2012/09/24
ジャーナル フリーThere have been few reports about the concentrations of plasma cAMP and cGMP in patients with hyper- and hypothyroidism. The aim of this study is to describe the concentrations of these plasma nucleotides and to discuss the relationship between plasma nucleotide levels and the concentrations of serum thyroid hormones and TSH in these patients.
Four hundreds and eleven serum samples were obtained from 307 outpatients, 137 of them were from patients with Graves' disease and the rest from chronic thyroiditis. The patients with Graves' disease were divided into four groups; 19 samples from untreated patients (group I), 37 from treated patients with still elevated thyroid hormone levels (group II), 64 from treated patients with normal thyroid hormone levels (group III), and 17 from patients during remission (group IV).
The patients with chronic thyroiditis were divided into two groups, 57 samples from untreated patients with hypothyroidism (group V) and 217 from patients with normal concentrations of serum thyroid hormones (group VI).
Plasma cAMP, cGMP, T3, T4, TSH and thyroglobulin (Tg) were measured by RIAs. The concentrations of plasma cAMP of groups I, II, III, IV, V and VI were 38.73 ± 9.22 pmol/ml (mean ± SD), 36.52 ± 15.78, 33.90 ± 10.90, 32.99 ± 10.31, 38.07 ± 7.08 and 38.97 ± 8.13, respectively. They were clearly higher than that of normal subjects (23.08 ± 3.47, n=10). The concentrations of plasma cGMP of groups I, II, III, IV, V and VI were 6.41 ± 2.02 pmol/ml (mean ± SD), 4.39 ± 1.35, 4.92 ± 2.30, 4.40 ± 1.50, 5.46 ± 2.93 and 4.70 ±2.30, respectively. These values were not significantly different from those of the normal controls (5.80 ± 2.08, n= 10).
There was no significant correlation between the concentrations of plasma cAMP and those of T3, T4, TSH as well as Tg in each group. However, significant positive correlations were found between the concentrations of cGMP and T3 in group I, and TSH in group V. Their linear regression coefficiencies were 0.479 (p<0.05) and 0.336 (p<0.025), respectively. A TRH stimulation test was carried out on 16 patients with chronic thyroiditis (TSH>10). A significant change was not observed in the concentrations of plasma cAMP, however, the concentrations of cGMP significantly decreased from 5.74 ± 2.04pmola (mean ± SD) to 3.53 ± 1.25 at 120 min after injection of TRH.
In summary
1) The concentrations of plasma cAMP were significantly elevated in the outpatients with thyroid dysfunction.
2) The concentrations of plasma cGMP were correlated with those of serum triiodothyronine in untreated patients with Graves' disease and with those of serum TSH in untreated patients with hypothyroidism.
3) TRH reduced plasma cGMP levels in patients with chronic thyroiditis.抄録全体を表示PDF形式でダウンロード (674K) -
宮内 昭, 舛尾 和子, 荻原 俊男, 高井 新一鼠, 松塚 文夫, 隈 寛二, 前田 昌純, 熊原 雄一, 神前 五郎1982 年 58 巻 12 号 p. 1505-1516
発行日: 1982/12/20
公開日: 2012/09/24
ジャーナル フリーMedullary thyroid carcinoma can arise as a component of multiple endocrine neoplasia (MEN) syndrome which includes adrenal pheochromocytoma. Familial medullary thyroid carcinoma with no association of other components of MEN syndrome is also reported. Epinephrine and norepinephrine excreted in 24 hour urine and/or randomly voided urine were measured for screening of pheochromocytoma in patients with medullary thyroid carcinoma of either the hereditary or sporadic type and in their relatives.
Six patients with clinical symptoms and signs suggesting pheochromocytoma had a markedly increased epinephrine and epinephrine/norepinephrine (E/N) ratio and a less dominant increase of norepinephrine in 24 hour urine. The diagnosis of pheochromocytoma was proved later at surgery. Among 10 patients with hereditary medullary thyroid carcinoma without any clinical symptoms and signs for pheochromocytoma, 6 patients had increased epinephrine and E/N ratio and normal norepinephrine, and the remaining 4 had normal epinephrine, norepinephrine and E/N ratio in 24 hour urine. The six patients with increased epinephrine and E/N ratios were regarded as having latent adrenal medullary hyperfunction. The mean ages of the 6 patients with proved pheochromocytoma, the 6 with latent adrenal medullary hyperfunction and the 4 with normal urinary catecholamine fractions were 51.3, 42.5 and 28.5 years, respectively. At least one patient in each family with hereditary medullary thyroid carcinoma had proved pheochromocytoma or latent adrenal medullary hyperfunction, leaving no family with hereditary medullary thyroid carcinoma only. Urinary epinephrine, norepinephrine and E/N ratios in patients with sporadic medullary thyroid carcinoma and relatives of patients with medullary thyroid carcinoma were not higher than those in normal subjects. Measurements of epinephrine and norepinephrine in randomly voided urine are also a valuable and convenient method for the screening of pheochromocytoma in patients with medullary thyroid carcinoma and their relatives, because they gave results similar to those in 24 hour urine.抄録全体を表示PDF形式でダウンロード (1286K) -
広田 善彦, 玉井 一, 林 吉夫, 吹野 治, 大迫 範行, 松塚 文夫, 隈 寛二, 片山 正一, 長滝 重信1982 年 58 巻 12 号 p. 1517-1526
発行日: 1982/12/20
公開日: 2012/09/24
ジャーナル フリーIngbar et al. reported that progressive failure of thyroid function, possibly due to concomitant chronic thyroiditis, developed in some patients with diffuse toxic goiter who had been successfully treated with antithyroid drugs for many years previously. However, the histological characteristics of the thyroid glands of these patients were not discussed in their report. In the present study, the thyroid functions and histological features of the thyroid glands were examined in 77 patients who had been diagnosed as having Graves' disease between 1962 and 1971.
Measurements of the thyroid functions revealed that, of the 77 cases, 41 (53.2%) were biochemical euthyroid, 30 (39.0%) were hyperthyroid, 2 (2.6%), were T3-toxicosis, 3 were hypothyroid and 1 was subclinical hypothyroid. Abnormal responses to TRH were observed in 8 of 30 euthyroid cases. Non- or hypo-response (peak value of TSH<6.2μU/ml) was observed in 5 (16.7%) and hyper-response (peak value of TSH>35μU/ml) was observed in 3 cases (10.0%). A T3 suppression test showed that three of 11 euthyroid cases examined were non-suppressible. The remaining 8 suppressible cases showed responsiveness to TRH without exception.
Histological examination of the specimen (23 cases) obtained by either subtotal thyroidectomy (14 of 30 hyperthyroid cases) or needle biopsy revealed that 14 samples had diffuse epithelial hyperplastic goiter (d.e.h.), 7 had chronic lymphocytic thyroiditis (c.l.t.) and 2 had normal thyroid tissue (n.t.t.). All cases with d.e.h. and 1 case with c.l.t. were accompanied by hyperthyroidism. Four cases with c.l.t. and 2 cases with n.t.t. were accompanied by euthyroidism. T3-toxicosis and subclinical hypothyroidism were evident in 1 case with c.l.t. respectively. 40.6% and 90.6% of hyperthyroid patients and 53.7% and 92.6% of euthyroid patients were positive in a thyroid test and microsome test respectively. Titers of the microsome test of the euthyroid patients were significantly higher than those measured in 1972.
These results suggest that after medical treatment, 1) most of the patients with Graves' disease who had a prolonged clinical remission had c.l.t. in thyroid tissue, 2) some patients with Graves' disease become hypothyroid at the terminal stage of chronic thyroiditis.抄録全体を表示PDF形式でダウンロード (1202K) -
第2報 合成L-T4治療による影響中村 重徳, 伏見 勝正, 上久保 啓太, 坂田 茂樹, 安田 圭吾, 奥山 牧夫, 三浦 清1982 年 58 巻 12 号 p. 1527-1543
発行日: 1982/12/20
公開日: 2012/09/24
ジャーナル フリーWe previously reported that two sisters with juvenile hypothyroidism due to Hashimoto's thyroiditis (Case 1 : 13 years old, Case 2 : 10 years old) had antibodies against thyroid hormones. Treatment was started with 12.5μg of L-T4 per day in Jan. 1980. The doses were gradually increased, and after 1 year of treatment, both patients were clinically euthyroid on 100μg of L-T4 per day, and the heights of Case 1 and of Case 2 had increased by 9cm and by 10cm, respectively. Serum TSH levels were decreased from 1088μU/ml to 1.7μU/ml in Case 1, and from 1300μU/ml to 2.1μU/ml in Case 2. The titers of antithyroglobulin antibodies as measured by solid phase RIA decreased in both patients after the treatment.
The bindings of 125I-T3 and of 125I-T4 to sera in the presence of 8-anilino-1- naphthalene sulfonic acid to block binding to TBG (non-treated sera) were markedly higher in the two patients before therapy than those in ten normal controls (11.8% and 52.3% in Case 1, 46.8% and 21.5% in Case 2, and 5.9 ± 0.6% and 4.1 ± 0.5% (mean ± SD) in the controls, respectively). After the 1 year treatment, the bindings of 125I-T3 and 125I-T4 decreased to normal levels in Case 1 (5.8% and 3.8%, respectively). In Case 2, the 125I-T4 binding decreased to the normal level (4.7%), whereas the125T3 binding decreased but still remained above the normal level (10.6%). In order to exclude the interference of endogenous and/or therapeutic thyroid hormones with the binding of labelled hormones to sera, the sera were treated with dextran-coated charcoal at pH3.0 (acid-treated sera). The bindings of 125-T3 and 125 I-T4 to acid-treated sera were clearly higher in both patients before therapy than those in ten normal controls (16.9% and 60.7% in Case 1, 75.0% and 46.4% in Case 2, and 6.9 ± 0.7% and 6.8 ± 0.7% (mean ± SD) in the controls, respectively), and these values were compatible with those from non-treated sera. After the 1 year treatment, however, the results of acid-treated sera were different from those of non-treated sera. That is, the bindings of 125I-T3 and of 125I-T4 to acid-treated sera from both patients decreased but remained above normal levels (9.3% and 26.5% in Case 1, and 29.4% and 22.5% in Case 2, respectively). These results indicate the presence of antibodies against thyroid hormones even in the euthyroid state during L-T4 treatment, and also the data obtained from the non-treated sera were affected by endogenous and/or therapeutic thyroid hormones. The importance of acid-charcoal treatment for the detection of anti-thyroid hormone antibodies during thyroid hormone administration was suggested.
In the serum from another sister of the reported patients, we also found unusual T4binding proteins which were only detected by the acid-charcoal treatment. The implications of decrement of anti-thyroglobulin antibodies and of anti-thyroid hormone antibodies were discussed.抄録全体を表示PDF形式でダウンロード (1585K) -
長江 光芳, 久保田 俊郎, 矢追 良正, 鈴木 明, 西 望, 斉藤 幹, 熊坂 高弘1982 年 58 巻 12 号 p. 1544-1552
発行日: 1982/12/20
公開日: 2012/09/24
ジャーナル フリーSixteen normal pregnant woman at delivery were administered 10mg of Metoclopramide (MCP) intravenously, and the Prolactin (PRL) levels in the maternal plasma and in the amniotic fluid were measured by RIA before and after the administration, and in the umbilical plasma after the administration. Eight other pregnant women at term were studied similarly without the administration of MCP and served as the control. In this experiment, there was a significant increase only in the maternal plasma PRL but not in the amniotic fluid PRL nor in the umbilical plasma PRL.
Furthermore, by using an intrauterine pressure catheter and a maternal intravenous canula we measured the amniotic fluid PRL and the maternal plasma PRL about every 20 minutes during 3 hours before and after the intravenous administration of MCP 10mg. The maternal plasma PRL increased promptly and remained high for 150 minutes, while there was no significant change in the amniotic fluid PRL. This obvious discrepancy supports the hypothesis that decidua is the source of amniotic fluid PRL and suggests an independent regulation of amniotic fluid PRL.抄録全体を表示PDF形式でダウンロード (886K)
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