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68 巻, 1 号
選択された号の論文の6件中1～6を表示しています
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GnRH分泌に伴う神経活動の変化西原 真杉, 比留間 弘美, 森 裕司1992 年 68 巻 1 号 p. 1-10
発行日: 1992/01/20
公開日: 2012/09/24
ジャーナル フリーGonadal function in mammals depends on gonadotropins secreted from the pituitary gland in a pulsatile manner. This pulsatility is governed by the periodic activation of the hypothalamic GnRH pulse generator. By means of multiple unit activity (MUA) recording techniques, characteristics increases in the neuronal activity, each of which is associated with the initiation of pulsatile LH secretion, have been recorded in the medial basal hypothalamus of the monkey, rat and goat. An unambiguous unitary relationship between the increased electrical activity (volley) and the LH pulse under a variety of physiological and experimental conditions indicates that the MUA volleys represent the electrical activity of the GnRH pulse generator. Hypothalamic MUA recordings provide direct access to the central component of the neuroendocrine control system which governs reproductive function.抄録全体を表示PDF形式でダウンロード (826K) -
小林 正1992 年 68 巻 1 号 p. 11-18
発行日: 1992/01/20
公開日: 2012/09/24
ジャーナル フリーType B insulin resistance syndrome is characterized by the presence of a circulating anti-insulin receptor antibody which inhibits insulin action. The syndrome is usually associated with autoimmune diseases, acanthosis nigricans and hyperinsulinemia. The antibody causes insulin resistance by inhibiting insulin binding to insulin receptors, decreasing insulin receptor number, i. e. down regulation of insulin receptors, and desensitizing insulin receptors which leads to decreased insulin signal transduction through insulin receptors. It also has the ability to elicit insulin action associated with or without increased autophosphorylation of insulin receptors. The antibody usually binds to the insulin receptor with decreased association rate and decreased dissociation rate. The antibody which elicits insulin action without activation of kinase activity of insulin receptors may induce conformational change of insulin receptors. These characteristic features of the anti-insulin receptor antibody may be informative in solving the mechanism of insulin action and may be a useful tool to study insulin receptor functions.抄録全体を表示PDF形式でダウンロード (739K) -
石塚 文平, 栗林 靖, 渡辺 研一, 大野 祐子, 斎藤 馨, 石井 明治, 浜田 宏, 藤林 繁, 染谷 一彦1992 年 68 巻 1 号 p. 19-29
発行日: 1992/01/20
公開日: 2012/09/24
ジャーナル フリーA 24-year-old female with significant ovarian hypertestosteronism, who responded well both to gonadotropin releasing hormone (GnRH) agonist and cyclic administration of estrogen and gestagens in terms of suppressing circulating testosterone levels is reported.
The patient' s menstrual periods had been regular since menarche at the age of 12 until she became ammenorrheic at the age of 20. She visited our facility in November 1988 after receiving three cycles of estrogen and gestagen replacement therapy from a previous physician which caused withdrawal bleeding. Clomiphen citrate reportedly failed to induce apparent ovulation. On her first visit with us, she was 160cm tall weighing 47kg with apparent hoarseness but not with hirsutism. Pelvic examination revealed significant clitoromegaly but otherwise normal external and internal genitalia. Laparoscopic examination disclosed that her uterus appeared to be normal with bilateral ovaries relatively small (4×4×3cm) without tumorous or polycystic appearance. Histological examination of her ovaries obtained at laparoscopy showed several primary follicles with mild infiltration of the stromal cells. No thickened tunica albuginea or cystic formation were observed. These findings did not support either polycystic ovary or hyperthecosis.
Serum testosterone (T) levels were extremely high (7.1ng/ml), while serum androstenedione levels were only slightly above normal range (3.1ng/ml). Urine 17-KS excretion was slightly increased (6.1mg/day), while 17-OHCS output was within normal range (4.0mg/day). Basal serum LH and FSH levels were within normal range and LH pulse frequency was reduced to 1 in 4 hours. Administration of dexamethasone 1mg/day for 2 days did not suppress circulating T and free T levels but lowered serum cortisol concentration and urine excretion of 17-OHCS. Blood glucose and insulin levels were within normal limits and their responses to oral glucose administration were normal.
Abdominal and pelvic ultrasonography and computed tomography as well as adrenal scintigraphy did not reveal any tumorous lesions in bilateral adrenals and ovaries. Administration of GnRH agonist, Buserelin 900,μg/day, suppressed circulating T concentrations to 0.7ng/ml in 8 days, while it had no significant effects on DHEA and DHEA-S levels. After 16 weeks of Buserelin administration, ovulation was successfully induced by hMG administration. Cyclic estrogen and gestagen replacement therapy by Kaufmann's schedule for 2 cycles also suppressed serum T levels to normal, female range.
Thus, the present case represents non ·neoplastic, non-PCO, ovarian hypertestosteronism which responded well both to GnRH agonist and estrogen and gestagen replacement therapy in terms of lowering circulating T levels.抄録全体を表示PDF形式でダウンロード (2179K) -
三浦 史博1992 年 68 巻 1 号 p. 30-38
発行日: 1992/01/20
公開日: 2012/09/24
ジャーナル フリーThe demonstration that exogenous atrial natriuretic polypeptide (ANP) has markedly lowered plasma antidiuretic hormone (ADH) suggests a possible negative control of endogenous ANP on the secretion of ADH from the posterior hypophysis. To test this possibility and to clarify the role of ADH and ANP in the pathophysiology of essential hypertension (EHT), the responses of ADH and ANP to a hypertonic saline infusion were investigated in EHT patients and normotensive subjects (NT).
Twenty inpatients with EHT (10 males and 10 females; 50.5±6.5y) and 10 NT subjects (5 males and 5 females; 50.6±7.8y) underwent a 20 min intravenous infusion of hypertonic saline (2.5% NaCl; 0.25m1/kg/min) in a fasting state. Blood samples were drawn before and 10, 20, 30, 45 and 60 min after the infusion and analyzed for ADH and ANP as well as plasma osmolarity (Posm), Na and albumin.
Basal levels of ADH and ANP were not significantly different between NT and EHT. ADH was rapidly increased by the infusion in both groups; however, its percent increase was much higher in EHT than in NT during and after the infusion. Surprisingly, a highly significant negative correlation between ADH and ANP was found before and after the infusion in both groups.
Although blood pressure was not changed significantly, the enhanced response of ADH to a sodium and volume load may play a role in part in the pathophysiology of EHT. In addition, it has been suggested that a possible suppression by ANP on the secretion of ADH may be one of the mechanisms of the diuretic action of ANP.抄録全体を表示PDF形式でダウンロード (806K) -
中山 智祥, 相馬 正義, 影浦 博信, 阿部 好伸, 伊藤 みき, 渡辺 昌司, 渡辺 吉康, 泉 洋一, 波多野 道信1992 年 68 巻 1 号 p. 39-50
発行日: 1992/01/20
公開日: 2012/09/24
ジャーナル フリーWe report here a case of Sipple's syndrome, and we also analyze the relationship between the type of hypertension and urinary excretion of catecholamines in Sipple's syndrome based on the literature in Japan.
One hundred and fourteen cases of Sipple's syndrome have been reported in Japan. The hypertension of patients with Sipple's syndrome shows a ratio of fitful hypertension to continual hypertension of 6 to 1, whereas the ratio is 1 to 1.5 in patients whose pheochromocytoma is not accompanied by Sipple's syndrome. The patients with Sipple's syndrome, being pheochromocytomatie can be classified into the adrenaline (U-AD) dominant type and noradrenaline (U-NA) dominant type based on the catecholamine excretion in the urine. The U-AD predominant (U-AD/U-NA>0.4) patients mostly reveal fitful hypertension, while patients with continual hypertension hardly show U-AD predominant.抄録全体を表示PDF形式でダウンロード (1293K) -
南場 雅章, 菊池 健次郎, 小村 博昭, 鈴木 真一郎, 佐藤 直利, 大友 透, 高田 珠, 丸崎 茂, 飯村 攻1992 年 68 巻 1 号 p. 51-61
発行日: 1992/01/20
公開日: 2012/09/24
ジャーナル フリーThis study was conducted to elucidate renal uric acid metabolism in patients with primary aldosteronism (PA; 16 cases) as compared with normotensive subjects (NT; 25 cases) and essential hypertensives (EHT; 51 cases).
All subjects were hospitalized and received a regular diet (Na; 120 mEq,K; 75 mEq, daily) for more than two weeks, after which renal clearance tests were performed, and serum uric acid (SUA), fractional excretions of uric acid (FEUA), sodium (FENa), and inorganic phosphorus (FEP) were evaluated. Plasma aldosterone concentration (PAC) was measured in 16 patients with PA before treatment and in 8 patients after adrenalectomy.
SUA was lower in PA than in either NT or EHT, and this lowering was more obvious in male subjects. In NT, PA and EHT, FEUA, an index of renal excretion of uric acid, correlated negatively with SUA and positively with FENa and FEP, which reflected sodium reabsorption at the renal total tubules and proximal tubules, respectively. Although FENa was nearly the same in all the three groups, FEUA and FEP were significantly higher in PA than in EHT or NT. However, no significant correlation was found between PAC and SUA or FEUA in PA.
In PA a significant increase of SUA, and decreases of FEUA and FEP were observed after the removal of adenoma compared to before the surgery.
These results suggest that uric acid transport might be closely related to sodium transport in the renal tubules, particularly at the proximal site, and also lead to the conclusion that the lower SUA in PA resulted from the suppression of reabsorption and/or an enhancement of secretion of uric acid in the proximal tubules, being related to the so-called escape phenomenon.抄録全体を表示PDF形式でダウンロード (1027K)
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