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Biomedical subjects

C W Hilton

Publications and source records attributed to C W Hilton.

23 records · Page 2Linked to original sources

Virilization due to a Leydig cell adrenal adenoma.

Virilizing adrenal adenomas are rare, and Leydig cell adenomas of the adrenal rarer still. Our patient, a 60-year-old virilized woman, was found to have a Leydig cell adenoma. Virilization associated with normal 17-ketosteroid and elevated testosterone levels necessitates excluding an adrenal cause. Although one might expect high testosterone levels to suppress gonadotropins, this is not the case. In addition to other studies recommended for assessing the incidentally discovered adrenal mass, we would add a testosterone assay.

17-Ketosteroids↗

Adrenal insufficiency in the acquired immunodeficiency syndrome.

Patients with the acquired immunodeficiency syndrome (AIDS) often have signs and symptoms suggestive of adrenal insufficiency. Reports in the literature suggest that adrenal insufficiency may be relatively common in patients with AIDS based on the finding of destructive adrenal lesions in a large number of the patients studied. In no series, however, has standard testing for adrenal reserve been done in an unselected population of patients with AIDS. We found a normal response to a standard, short adrenocorticotropic hormone test in 11 consecutive patients with AIDS (P less than .0005). Thus, although adrenal involvement by various destructive lesions may be common in patients with AIDS, clinically significant adrenal insufficiency does not appear to be common.

Acquired Immunodeficiency Syndrome↗

Intratubular calcium phosphate deposition in acute analgesic nephropathy in rabbits.

Earlier chronic studies using both animal and human autopsy material have suggested that the initial lesion of analgesic nephropathy is papillary necrosis with secondary cortical interstitial nephritis. The present study was designed to define ultrastructural changes in renal tubules exposed to high levels of analgesics. Female New Zealand White rabbits were given 5-7 g APC and sacrificed after periods of 6 to 36 hours. As early as 6 hours after treatment, hydroxyapatite crystallite aggregates were seen impacted in Segment III (straight segment) of the proximal tubule at the cortico-medullary junction. Ultrastructural changes included selective calcification of the brush border, mitochondrial calcification, and peroxisomal changes. It was concluded, on the basis of ultrastructural changes, that calcification of altered tubular cells may be an initial event in analgesic nephropathy.

Analgesics↗

Identification and characterization of cyclo(His-Pro)-like immunoreactivity in amniotic fluid.

Amniotic fluid (AF) from 25 term pregnancies was analyzed for cyclo(His-Pro)-like immunoreactivity (CHP-LI). CHP-LI was detected in all AF samples and was indistinguishable from synthetic CHP by immunoidentity, by gel chromatography on Sephadex G-25, and by high pressure liquid chromatography. The mean concentration of CHP-LI in AF was 13,622 +/- 1288 pg/ml (+/- SE) and concentrations were not altered by maternal labor. Plasma concentrations of CHP-LI were similar in 4 pregnant and 4 control subjects [2260 +/- 432 pg/ml vs. 2162 +/- 419 pg/ml (+/- SE), respectively]. We conclude that 1) CHP-LI is readily detected in AF from term pregnancies and is indistinguishable from synthetic CHP, and 2) concentrations of CHP-LI in human AF are significantly higher than concentrations of maternal plasma CHP-LI, suggesting CHP AF originates by mechanisms other than diffusion from maternal plasma.

Amniotic Fluid↗

Identification of cyclo(His-Pro)-like immunoreactivity in human follicular fluid: correlation with steroid and peptide hormones.

OBJECTIVE: The purpose of this study was to evaluate human follicular fluid (FF) for the presence of cyclo(His-Pro)-like immunoreactivity (CHP-LI). After verifying its presence, we quantitated the levels and investigated correlations with other follicular parameters, including hormone levels. METHODS: Follicular fluid was collected from female volunteers undergoing controlled ovarian hyperstimulation. Fluid was collected by follicular puncture, either transvaginally (in vitro fertilization) or laparoscopically (gamete intrafallopian transfer) at the time of oocyte retrieval (N = 137). Follicular size was determined ultrasonographically. Assays for steroid and peptide hormones were determined with commercially available radioimmunoassay kits. CHP-LI was measured using a previously reported assay; parallel dilution curves and column chromatography aided in immunoidentity. RESULTS: The mean FF CHP-LI concentration (13.10 +/- 1.83 nmol/L, N = 137) was greater than the corresponding serum values (9.42 +/- 2.45 nmol/L; N = 21) (P < .05). Large follicles (20 mm or greater; 14.45 +/- 1.74 nmol/L) contained significantly more CHP-LI than either medium follicles (16-19 mm; 11.51 +/- 1.88 nmol/L) or small follicles (15 mm or smaller; 10.83 +/- 2.12 nmol/L) (P < .05). Positive correlations were found between FF CHP-LI values and corresponding FF progesterone and prolactin concentrations (r = 0.67 and 0.62, respectively; P < .05). CONCLUSION: Mean CHP-LI levels in the FF are greater than those in the corresponding serum. We suggest that the neuropeptide may be originating from either peptidase cleavage of precursor peptides or from granulosa cell production.

Adult↗