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  • 1
    Electronic Resource
    Electronic Resource
    Stumme Nebennierentumoren bei Patienten mit Adrenogenital Syndrom (1987)
    Springer
    Journal of molecular medicine 65 (1987), S. 627-633 
    Details
    ISSN: 1432-1440
    Keywords: Silent adrenal tumors ; Adrenogenital syndrome ; Computer tomography ; Hyperplasia ; Plasma hormone concentrations ; Late onset form ; Simple virilizing form
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Adrenal tumors accidently detected by CT scan are increasingly seen in patients without clinical signs of adrenal diseases. We studied whether enhanced adrenal stimulation is of importance in the development of adrenal tumors. For this purpose 22 patients with adrenogenital syndrome (AGS) were studied by CT scan. One of these patients suffered from C-11β-hydroxylase-, one from C-3β-hydroxy steroid dehydrogenase-, and 20 from C-21-hydroxylase deficiency. The average adrenal size of these patients was 506±79 mm2 as compared to 132±8 mm2 in the controls (P〈0.001). Only two patients with the late onset form revealed adrenal glands of normal size. There was a significant correlation between adrenal size and patients' age (P〈0.01). Females with the simple virilizing form revealed adrenal glands larger than those of the late onset form (640±169 vs 308±56 mm2). Eighteen patients with AGS exhibited one (n=11) or several (n=7) adrenal tumors, the size of which was 5–9 mm in diameter in 9, 10–20 mm in 7, and more than 50 mm in 2 patients. There was a significant correlation between adrenal hyperplasia and tumor diameter (P〈0.001). No correlation was found between tumor size and plasma concentrations of testosterone or 17-hydroxyprogesterone, patients' age at the time of diagnosis, or clinical signs of androgenization. Again, tumors were larger in females suffering from the simple virilizing form of AGS than in those with the late onset form (14.8±5.5 vs 7.7±0.8 mm). Our investigations show that adrenal tumors are found almost regularly (82%) in patients suffering from AGS. Incidence and size of these tumors appear to correlate to the degree as well as the duration of adrenal stimulation. As these tumors are benign, it is suggested that in case of accidental detection of silent adrenal tumors, an adrenogenital syndrome should be excluded by endocrinological tests.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01875496
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  • 2
    Electronic Resource
    Electronic Resource
    Endokrinologische Funktionsdiagnostik der hypothalamo-hypophysären Insuffizienz (1979)
    Springer
    Journal of molecular medicine 57 (1979), S. 487-497 
    Details
    ISSN: 1432-1440
    Keywords: Pituitary insufficiency ; Combined insulin hypoglycaemia/LH-RH/TRH-Test ; Sheehan syndrome ; Chromophobic adenoma ; Craniopharyngioma ; Acromegaly ; Prolactin-producing tumors ; Hypothalamo-pituitary dwarfism ; Hypophysenvorderlappeninsuffizienz ; kombinierter Insulinhypoglykämie/LH-RH/TRH-Test ; Sheehan-Syndrom ; Chromophobes Adenom ; Craniopharyngiom ; Akromegalie ; Prolaktinom ; Diencephalo-hypophysärer Zwergwuchs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die funktionsdynamische Diagnostik des Zwischenhirn-Hypophysensystems erfolgte bei Patienten mit Sheehan-Syndrom, chromophobem Adenom, Craniopharyngiom, Prolaktin-produzierenden Hypophysentumoren, Akromegalie, hypothalamo-hypophysärem Minderwuchs und konstitutionell bedingter Entwicklungsverzögerung. Dabei wurde ein kombinierter Insulinhypoglykämie/LH-RH/TRH-Test angewandt, um die Häufigkeit und das Ausmaß der Hypophysenvorderlappeninsuffizienz zu beurteilen. Bei den genannten Erkrankungen fand sich nahezu regelmäßig — die Akromegalie ausgenommen — eine somatotrope Insuffizienz. Relativ häufig lag auch eine Beeinträchtigung der gonadotropen Funktion vor, wobei im allgemeinen ein pathologischer LH-RH-Test mit einem mehr oder weniger ausgeprägten Androgenmangel korreliert. Eine adrenocorticotrope Insuffizienz bestand bei den meisten Patienten mit Sheehan-Syndrom, chromophobem Adenom und Craniopharyngiom, während sie bei der Akromegalie und beim hypothalamo-hypophysären Minderwuchs seltener nachzuweisen war, woraus sich die jeweilige Notwendigkeit einer Substitution mit Corticoiden ergibt. Der TRH-Test spiegelt das Bestehen einer sekundären Hypothyreose nur unvollkommen wider und kann bei organischen Prozessen im Zwischenhirn-Hypophysenvorderlappenbereich durchaus normal ausfallen, so daß für die Frage einer Schilddrüsenhormonsubstitution die T3- und T4-Bestimmung im Blut entscheidend ist. Sowohl mit dem LH-RH- als auch mit dem TRH-Test ist eine eindeutige Trennung der hypothalamischen von der hypophysären Ursache der Insuffizienz nicht möglich.
    Notes: Summary A functional diagnosis of the diencephalo-hypophyseal system was carried out in patients with Sheehan syndrome, chromophobic adenoma, craniopharyngioma, prolactin-producing pituitary tumours, acromegaly, hypothalamo-pituitary dwarfism and constitutional retardation. A combined insulin hypoglycaemia/LH-RH/TSH test was performed to define frequency and extent of anterior pituitary insufficiency. With these illnesses, almost generally, a somatotropic insufficiency (except in acromegaly) was found. An impairment of gonadotropic function was often present, in general a pathologic LH-RH test correlating with a more or less developed androgen deficiency. An adrenocorticotropic insufficiency was found in most patients with sheehan syndrome, chromophobic adenoma and craniopharyngioma while in acromegaly and hypothalamo-pituitary dwarfism it was present less frequently, necessitating a substitution with corticoids. The TRH test reflects only incompletely a secondary hypothyroidism, and can be normal with organic processes of the diencephalo-hypophyseal region, making a T3 and T4 estimation in the blood decisive for a thyroid hormone substitution. A clear-cut separation of the hypothalamic from the pituitary cause of the insufficiency is neither possible with the LH-RH nor with the TRH test.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01487819
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  • 3
    Electronic Resource
    Electronic Resource
    Durchführung und Interpretation des Metopironkurztests (1972)
    Springer
    Journal of molecular medicine 50 (1972), S. 1049-1055 
    Details
    ISSN: 1432-1440
    Keywords: Metyrapone test ; total corticoids/blood ; 11-deoxycorticoids/blood ; 11-oxycorticoids/blood ; competitive protein binding ; interpretation ; side effects ; normal subjects ; obesity ; liver disease ; hypothyroidism ; thyrcotoxicosis ; acromegaly ; hypopituitarism ; adrenal insufficiency ; Metopirontest ; Gesamtcorticoide/Blut ; 11-Deoxycorticoide/Blut ; 11-Oxycorticoide/Blut ; kompetitive Proteinbindungsmethode ; Interpretation ; Nebeneffekte ; Normalpersonen ; Adipositas ; Hypo- und Hyperthyreose ; Akromegalie ; adrenale und hypophysäre Insuffizienz
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einem Metopironkurztest werden 4 g Metopiron (M) innerhalb von 2 1/2 Std oral appliziert. 11-Deoxy-, 11-Oxy- und Gesamtcorticoide in den Plasmaproben (vor Testbeginn sowie 2, 4 und 8 Std nach initialer Metopirongabe) werden mit Tetrachlorkohlenstoff bzw. Dichlormethan extrahiert und mit Hilfe einer kompetitiven Proteinbindungsmethode bestimmt. Zwischen der 11-Oxycorticoidausgangskonzentration (8.00 Uhr;t=0; vor M-Einnahme) und der 11-Deoxycorticoid-maximalkonzentration (16.00 Uhr;t=8 Std) besteht eine signifikante Korrelation (r=0,84), so daß sich mit der Regressionsgeraden ein M-Test eindeutig beurteilen läßt. Als normales Testergebnis werden Werte innerhalb des 1s-Streubereiches betrachtet, während Werte, die unterhalb des 1s- und innerhalb des 2s-Streubereiches liegen, als grenzwertig und solche, die sich unterhalb des 2s-Streubereiches befinden, als pathologisch angesehen werden. Mit Hilfe dieses Auswertungsverfahrens wurden die M-Tests von Patienten nach langjähriger Corticoidtherapie und von solchen mit Myokardinfarkt, Adipositas, Lebercirrhose, Hypothyreose, Hyperthyreose, Akromegalie sowie adrenaler und hypophysärer Insuffizienz beurteilt.
    Notes: Summary In a shortened Metyrapone-test 4 g of Metyrapone (M) are orally administered during 2 1/2 hrs. The concentrations of 11-deoxy-, 11-oxy- and total corticosteroids in plasma samples, taken before and 2, 4 and 8 hrs after starting the application of M, are estimated by means of a competitive protein binding radioassay. Evaluating 25 M-tests of endocrinologically healthy subjects a significant correlation was found (r=0,84) between the initial concentrations of 11-oxycorticosteroids (800 a.m.;t=0) and the maximal concentrations of 11-deoxycorticosteroids (400 p.m.;t=8 hrs). In interpreting the M-tests we consider normal all results near the regression line, as borderline those below the 1s-region and as pathological all those which are below the 2s-level of the regression line. Thus “normal”, “still normal” and “pathological” tests can be well defined. The results of M-tests evaluated from plasma samples of patients suffering from various diseases such as myocardial infarction, obesity, liver cirrhosis, hypothyroidism, thyreotoxicosis, acromegaly, hypopituitarism and adrenal insufficiency are presented and interpreted by this method.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01486766
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