A 68-year-old man was admitted to the hospital because of loss of appetite, easy fatigability, and skin pigmentation. Physical examination revealed that the bilateral epididymides were enlarged and hard without tenderness. At 7 a.m., the basal cortisol level in the plasma was 22.4 ng/ml and ACTH 318 pg/ml. The clinical diagnosis was Addison's disease. Biopsy of the right epididymis revealed evidence of active tuberculosis. Hydrocortisone (18 mg/ day) and anti-tuberculous drugs were administered, and the patient became well and regained his appetite in a week.
In this case, laparotomy was not performed, but all clinical findings and the course indicated that adrenal tuberculosis was the most likely cause of Addison's disease.
CT scanning of the adrenal region demonstrated large, bilateral, homogenous, low density, and non-enhancing mass. This is the first report dealing with CT findings of Addison's disease with tuberculous epididymitis.

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Goat hypothalamic extract prepared by HC1 extraction and chromatographed on a Sephadex G-50 column showed two immunoreactive CRF peaks. Most of the immunoreactivity coeluted with synthetic ovine CRF, and a small peak eluted near the void volume. Bovine, monkey, rat and human hypothalamic extracts prepared by acid-acetone or acid-methanol extraction showed three immunoreactive peaks. Most of the immunoreactivity coeluted with ovine CRF, and other smaller peaks eluted near the void volume and slightly before arginine vasopressin. Goat hypothalamic extract showed the highest crossreactivity with anti-ovine CRF serum, followed by bovine hypothalamic extract. Less cross-reactivity was found in human, rat and monkey hypothalamic extracts. CRF immunoreactivity in goat hypothalamic extract coeluted with ovine CRF on reversed phase high performance liquid chromatography (HPLC) and main CRF immunoreactivity in human and rat hypothalamic extracts eluted slightly later than ovine CRF. These results suggest that there is a heterogeneity among the CRF molecules in these species and that goat CRF may be more similar to that of sheep CRF and the amino acid sequence or molecular weight of other animals CRF may be different from that of sheep CRF.
The monkey posterior pituitary and rat neurointermediate lobe showed similar elution patterns of CRF immunoreactivity to their hypothalamic extracts on Sephadex gel filtration and HPLC. These results indicate that the posterior pituitary contains a similar CRF to hypothalamic CRF.

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We succeeded in inducing different severities of diabetic state in C3H male mice by repeated intraperitoneal injections of various doses of SZ. SZ-induced diabetic mice were devided into four groups as follows: Group A, B, C and D. SZ, respectively, 3, 5 doses of 45 mg/kg, 5 doses of 60 mg/kg on consecutive days and one of a dose of 200 mg/kg BW. The degree of hyperglycemia and glycosuria were mild in group A and D. Group B was moderate and group C severe with ketonuria and loss of body weight. We investigated the immune response to anti-sheep red blood cells (SRBC) and the phagocytic activity of macrophages in the above mentioned various SZ-induced mice. Antibody forming activities (values of anti-SRBC plaque-forming cells (PFC) and serum agglutinin) were markedly depressed in all of SZ-diabetic groups. The degree of the suppression of antibody response to SRBC in SZ-diabetic mice corresponded with the severity of the diabetic state (C>B> A=D). However, the phagocytic activity of peritoneal macrophages in SZdiabetic mice was as high as or higher than that in normal controls, using both latex beads and immune complex as test particles. Moreover, we observed that insulin treatment reversed the defect in the immune response in SZ-diabetic mice. These results indicate that the phagocytic activity of peritoneal macrophages was retained but the antibody response was impaired in the SZ-diabetic mice, and this suggested that the impaired antibody response may be a contributing cause of increased susceptibility to infections in a diabetic state.

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An electron microscopic study was performed to clarify the effects of tunicamycin, a glycosylation inhibitor, on rat anterior pituitary cells. Tunicamycin (10, 50, and 100 μg/250 g B.W.) was intraperitoneally injected into rats, which were sacrificed 24 hrs later. Protein hormone producing GH and prolactin cells, and ACTH cells which are known to have a glycosylated precursor, showed no recognizable ultrastructural changes. TSH cells and gonadotrophs, both of which secrete glycoprotein hormones consisting of α and β subunits, showed remarkable dilatation of the rough endoplasmic reticulum, and decreased numbers of secretory granules. These results suggest that the role of glycosylation in TSH cells and gonadotrophs may have a different biological significance from that in ACTH cells.

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The effect of synthetic 1-34 fragment of human parathyroid hormone (pPTH (1-34)) on plasma adenosine 3', 5'-monophosphate (cAMP) in human subjects and the diagnostic criteria for the plasma cAMP response in an Ellsworth-Howard test were studied. 20 or 30 μg hPTH (1-34) and 200 USP Parathormone (Eli Lilly & Co.), infused intravenously over 5 min, produced very similar patterns of response in plasma cAMP, peak values being observed within 5 or 10 min after the end of the infusion. The maximum levels of plasma cAMP were over 111.5 pmol/ml in all of the normal subjects (n = 5) and patients with idiopatic hypoparathyroidism (n = 22), including those of children, but the plasma cAMP did not rise above 65.0 pmol/ml in pseudohypoparathyroidism (n = 7). There existed a significant correlation between the maximum plasma cAMP concentrations and increases in urinary cAMP excretion after infusions of both hPTH (1-34) and Parathormone. These results suggest that hPTH (1-34) has effects essentially identical to those of native PTH on plasma cAMP. We would like to propose a new diagnostic criterion in the Ellsworth-Howard test: a peak value of plasma cAMP over 100 pmol/ml after 30 μg hPTH (1-34) infusion is regarded as a normal response.

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Synthetic human pancreatic GRF (hpGRF-44) was administered as an iv bolus to 139 normal children of short stature and 63 patients with GH deficiency. After a dose of 1 and 2 μg hpGRF-44/kg BW, mean plasma GH levels peaked at 15 and 30 min, respectively, with corresponding values of 32.2 ± 3.6 and 31.8 ± 2.4 (± SE) ng/ml in normal but short children. There were no differences according to sex or age in plasma GH response to hpGRF-44 between the ages of 4 and 18 years. A similar plasma GH response was observed when 2 μg hpGRF-44/kg BW was administered two hours after lunch. The overall plasma GH response was greater than that of insulininduced hypoglycemia and was similar to that obtained in the glucagonpropranolol test.
Thirty-five of 63 patients with GH deficiency did not respond to a 2 μg hpGRF-44/kg BW. However, plasma GH increases to greater than 5 ng/ml occurred in the remaining 28 patients. Their mean GH level reached a peak at 90 min with a value of 8.8 ± 0.8 ng/ml. The peak values ranged between 5.1 and 17.8 ng/ml with a mean of 9.5 ± 0.8 ng/ml.
These results suggest that hpGRF-44 is useful for evaluating pituitary Gil reserve in children of short stature and that some patients with GH deficiency, diagnosed on the basis of established tests, have Gil responses to hpGRF-44.

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Recent reports on the isolation and identification of 19-nor-deoxycorticosterone from the urine of rats with adrenal regeneration hypertension give rise to the possibility of a role of this steroid in the pathogenesis of low renin essential hypertension. The present study was undertaken to investigate the presence of 19-nor-deoxycorticosterone in normal rat serum both by a sensitive enzyme immunoassay and by gas chromatography-mass spectrometry (GC/MS).
19-Nor-deoxycorticosterone in rat serum was separated from other steroids prior to enzyme immunoassay by using high performance liquid chromatography (HPLC). The average concentration of 19-nor-deoxycorticosterone in normal rat serum was 137 ± 62 ng/dl (mean ± SD, n=32). Pooled normal rat serum (50 ml) was purified by HPLC and the purified sample was acetylated with acetic anhydride for GC/MS measurement. The retention time and m/z ions (358, 285, and 257) on the resulting mass fragmentogram coincided in position with those of authentic 21-acetoxy-19-nor-deoxycorticosterone and acetylated normal rat serum extract.
The combined characteristics of HPLC elution, antigen-antibody reaction, GC retention and selected ion responses provided strongly evidence supporting the presence of 19-nor-deoxycorticosterone in normal rat serum.

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The effects of a growth hormone releasing factor, human pancreatic growth hormone releasing factor-44 (hpGRF-44), on growth hormone (GH) secretion in calves, heifers and cows were studied. A single intravenous (iv) injection of 0.1, 0.25, 0.5 or 1.0 μg of synthetic hpGRF-44 per kg of body weight (bw) in calves significantly elevated the circulating GH level within 2-5 min, while no increase in plasma GH was observed in saline injected control calves. The plasma GH level increased proportionally to the log dose of hpGRF-44, and reached a peak at 5-10 min (p<0.01). Subcutaneous injection of hpGRF-44 also elevated the plasma GH level, but the peak value at 15 min was 37 0/6 of that of iv injection (p<0.05). Intravenous injection of 0.25 μg of hpGRF-44 per kg of bw to female calves, heifers, and cows significantly elevated mean the GH levels from 8.5, 2.3, and 1.6 ng/ml at 0 time to peak values of 97, 26, and 11.6 ng/ml, respectively (p<0.01). The plasma GH response and basal level in calves were significantly higher than those of heifers or cows (p<0.025). The plasma GH response to hpGRF-44 as well as the basal level decreased with advancing age. The plasma GH response to hpGRF-44 and basal GH in male calves were significantly greater than those in female calves (p<0.001). These results indicate that synthetic hpGRF-44 is a potent secretogogue for bovine GH, and suggest its usefulness in the assesment of GH secretion and reserve in cattle.

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A thyroid tumor about 4 cm in diameter was removed from a 53-year-old female. The clinical features were those of common thyroid adenomas, such as soft, smooth-surfaced and round contour of the tumor, no calcification and no lymph node metastasis. However, microscopically, the tumor was composed of compact cell nests rather similar to paraganglioma without any follicle formation. Histochemical examination revealed its C-cell nature, such as argyrophilia and calcitonin activity, although no amyloid deposit was demonstrated. Extremely high levels of calcitonin were found in the stored serum taken pre-operatively, but serum carcinoembryonic antigen levels were within normal limits. The calcitonin level dropped to the normal range soon after the operation, indicating the absence of residual tumorous tissues. Thus, the tumor behaves as an adenoma with a C-cell nature. Interestingly enough, the benign counterpart of medullary carcinoma of the thyroid seems to be quite rare in humans, and no similar tumors have ever been reported. Variations of C-cell tumors will be discussed in relation to their production and secretion of carcinoembryonic antigen.

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A 13.5-year-old girl who developed puberty due to HCG production by suprasellar ectopic pinealoma was reported. This girl appeared to be in a state of precocious puberty at the age of 5 when ectopic pinealoma was first diagnosed. Her breasts started to develop at 13 years of age in spite of hypopituitarism. Plasma LH was found to increase for several months and gave rise to suspicion of the recurrence of the tumor, which was confirmed by the detection of HCG in plasma and CSF. Precocious puberty or pubertycan be a characteristic endocrinological manifestation of an HCG producing tumor not only in boys but also in girls. The measurement of plasma HCG (or LH) can be a useful tumor marker in following the clinical course of an HCG producing tumor.

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The seasonal and chronological distributions of birth dates of 820 patients with congenital hypothyroidism due to thyroid dysgenesis were analysed in eight areas in the world. The incidence had some seasonal variations in certain areas. These observations suggest that some environmental factors cause this disease.

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Twenty-seven patients with primary hypothyroidism were studied to evaluate the relationship between hepatic function and thyroid hormone deficiency in this disorder. In hypothyroidism, hypergammaglobulinemia was found in 71 %, elevated glutamic oxaloacetic transaminase (GOT) in 48 %, high lactic dehydrogenase (LDH) in 58 %, hypercholesteremia in 52 % and low elimination rate constant of indocyanin green (K_ICG) in 44 %. In each criterion of liver function, these patients were divided into two groups, normal level and abnormal level group, respectively. T3 and T4 in patients with abnormal levels of GOT, glutamic pyruvic transaminase (GPT), γ-glutamyl transpeptidase (γ-GTP), leucine aminopeptidase (LAP), alkaline phosphatase (ALP) and 45 minutes retention rate of bromsulphalein (BSP) were not different from those in the normal level group. However, T3 and T4 in patients with abnormal levels of LDH, cholesterol, cholinesterase (ChE) and K_ICG were lower than those in the normal level group. The abnormal K_ICG group had a statistically higher cardio-thoracic ratio (CTR) than the normal group (65.7 ± 18.8 % vs 50.4 ± 8.3 %, p<0.05). In patients with pericardial effusion, CTR was 65.9 ± 14.6 %, while that in patients without pericardial effusion was 49.9 ±7.5 %(p<0.05). These abnormalities of liver function were normalized in all cases after hormone replacement therapy. Liver biopsy in three cases disclosed normal liver in two cases and mild infiltration of monocyte into Glisson's capsule in one case.
These results suggested that liver damage in primary hypothyroidism was mild and reversible, and that when the degree of hypothyroidism was slight and mild, liver function was not obviously affected and that the degree of hypothyroidism was partially predicted by liver function tests such as LDH, cholesterol, ChE and K_ICG.

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Serum concentrations of thyroglobulin in healthy subjects were measured by a solid-phase immunoradiometric assay. The mean concentration of serum thyroglobulin in 53 healthy males was 5.0 ng/ml (1.0-25.9 ng/ml) and that of 57 healthy females was 5.2 ng/ml (1.0-27.7 ng/ml). Neither sex-related nor age-related change in the serum thyroglobulin level was observed.

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