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Biomedical subjects

H Kaufman

Publications and source records attributed to H Kaufman.

At least 91 records · Page 5Linked to original sources
PubMed1980

Evaluation of the renin-aldosterone system during hypo- and hyperglycemia in children and adolescents.

The effect of hypo- and hyperglycemia on the renin-aldosterone system was studied in 10 endocrinologically normal children. Insulin-induced hypoglycemia caused an elevation of plasma renin activity (PRA) up to 371 +/- 23% (mean +/- SEM) over the basal level (p less than 0.001) and of the plasma aldosterone level up to 243 +/- 7% (mean +/- SEM) over the basal values (p less than 0.001). Hyperglycemia caused an elevation of PRA up to 135 +/- 40% (mean +/- SEM) over the basal values (p less than 0.05) and a reduction in the plasma aldosterone level to 53 +/- 12% (mean +/- SEM, p less than 0.01). It is suggested that the widely used diagnostic procedures, the insulin tolerance and oral glucose tolerance tests, be also applied for the investigation of the renin-aldosterone system.

Adolescent↗
PubMed1980

Detection of cancer in patients by reduced lymphocytic cortisol metabolism-enhancing effect.

A double-blind study was done on the plasma from 59 hospitalized patients to determine whether a diminished lymphocytic cortisol metabolism-enhancing effect among cancer patients could be used to distinguish them from persons with noncancerous diseases. Known concentrations of human lymphocytes from healthy donors were incubated with cortisol in media containing 50% phosphate-buffered saline (PBS) and 50% of one of the following additives: 1) homologous plasma (HP), 2) plasma from the patient being tested, or 3) additional PBS. Plasma in which the metabolism-enhancing effect was less than 70% of that obtained with HP was considered to be that of a cancer patient. Among the 19 patients known to have cancer, there were only two false-negative results, whereas among the 40 patients diagnosed as having noncancerous diseases, there were six false-positive results. Thus the test findings and the pathologic diagnosis were obviously correlated in approximately 90% of the patients.

Adolescent↗
PubMed1980

Congenital adrenal hyperplasia diagnosed in a middle-aged woman.

Short stature, severe hirsutism, an enlarged clitoris and lack of vaginal introitus were manifest in a 55-year-old female karyotype, male phenotype patient brough up as a female. The hormone profile suggested congenital adrenal hyperplasia due to 21-hydroxylase adrenal enzyme deficiency. Follicle-stimulating hormone and luteinizing hormone levels were 122.5 and 100.3 mIU/ml, respectively, within the normal range for a postmenopausal woman. Computerized axial tomography revealed a large cystic tumor connected to the right adrenal gland. Both the right adrenal gland and the cyst were removed. The adrenal cortex showed diffuse hyperplasia and contained a well-defined nodule. The case was interesting because we had the opportunity of examining a patient of advanced age with untreated congenital adrenal hyperplasia and because of the very rare combination of adrenogenital syndrome with nodular hyperplasia and a cystic tumor, which was most probably a degenerated adenoma.

Adrenal Glands↗
PubMed1980

Superiority of bromocriptine over pyridoxine in the treatment of patients with acromegaly or galactorrhea.

Sixteen patients, eight with acromegaly and eight with galactorrhea, were treated with pyridoxine (600 mg/day) for a three-month period. The clinical and biochemical changes induced by the drug were compared with those induced by bromocriptine (2.5 to 50 mg/day) administered for the same length of time to the same patients. Pyridoxine induced lowering of growth hormone and prolactin levels in two acromegalic patients. In only one patient with galactorrhea after irradiation of the hypophysis for active acromegaly did pyridoxine treatment stop and galactorrhea and induce renewal of menstrual bleeding without significantly changing the basal prolactin levels. In another patient with a chromophobe adenoma of the hypophysis, it reduced the excessively elevated prolactin levels. On bromocriptine therapy, all the patients reported signifcant clinical improvement paralleled by significant drops in plasma growth hormone and prolactin. It appears that at the dosages administered bromocriptine is preferable to pyridoxine in the treatment of patients with acromegaly or galactorrhea.

Acromegaly↗
PubMed1979

Transitory hypoadrenalism due to long-term treatment with antiovulatory compounds.

A considerable number of women receiving antiovulatory compounds or estrogens complain of weakness and fatigability, suggesting a state of clinical hypoadrenalism. For this reason, levels of plasma ACTH and plasma cortisol were determined in 25 women with such complaints both during treatment and at various intervals after cessation of this treatment. The results obtained showed that there was a significant inhibition of ACTH secretion during long-term treatment with antiovulatory compounds or estrogens, and in half of the cases, there was a delay in normalization of the pituitary-adrenal axis following interruption of the drug, supporting a state of transitory hypoadrenalism.

Adrenal Insufficiency↗
PubMed1979

Successful treatment of Cushing's disease with o,p'-DDD followed by pituitary irradiation in a 19-year-old male patient.

A 19-year-old male patient with Cushing's disease was treated for 15 months with a gastric-insoluble preparation of o,p'-DDD. The daily o,p'-DDD dose (range, 2 to 12 g) was adjusted periodically according to the urinary excretion of 11-hydroxycorticosteroids. Because of a rise in the plasma ACTH level from 135 to 300 pg/ml 12 months after the start of the o,p'-DDD therapy, the dose was reduced from 6 to 2 g/day and external pituitary irradiation (4,480 rads) was initiated. Insulin-induced hypoglycemia and stimulation tests with luteinizing-hormone-releasing factor and thyrotropin-releasing hormone, performed before initiation of o,p'-DDD and six months after pituitary irradiation, did not reveal any disturbance in the secretion of human growth hormone, thyroid-stimulating hormone, luteinizing hormone, follicle-stimulating hormone or prolactin. The clinical and laboratory signs of Cushing's disease disappeared gradually, and the patient tolerated the drug well, even at a dose of 12 g/day. The only abnormalities found during o,p'-DDD treatment were low serum thyroxine levels, which returned to normal after discontinuation of the drug, and a transient drop in thrombocyte count. At present, two years after the discontinuation of o,p'-DDD therapy and pituitary irradiation, the patient is symptom free and receives no medication.

Adult↗
PubMed1978

Transplant size and elevated intraocular pressure. Postkeratoplasty.

Elevated intraocular pressure after keratoplasty is a well-recognized phenomenon both in aphakia and in combined lens extraction and penetrating keratoplasty. Ninety-two consecutive cases of penetrating keratoplasty procedures were studied. These were randomly assigned to group A or B. Group A received a donor transplant 0.5 mm larger than the recipient bed. Group B received donor buttons equal in size to the recipient bed. Intraocular pressure was measured preoperatively and daily until the patients were discharged. Group A, which had aphakic penetrating keratoplasty or the combined procedure (0.5-mm larger button), also had significantly lower intraocular pressures (P less than .001) than group B (same size button). There was no difference in postoperative intraocular pressure between groups A and B for those who had phakic penetrating keratoplasties. A larger donor size can alleviate induced "aphakic keratoplasty glaucoma."

Aged↗
PubMed1978

Unilateral adrenalectomy and pituitary irradiation in the treatment of ACTH-dependent Cushing's disease in children and adolescents.

In four juvenile patients with Cushing's disease, the therapeutic approach used was unilateral adrenalectomy followed by irradiation of the pituitary. The follow-up time of these patients has ranged from 1.5 to 10 years. All four are clinically well. Concentrations of adrenal steroids are within normal limits and they require no additional medication. It is felt that this method gives young patients the chance for normal growth and pubertal development as well as a normal social life, so important in the stressful adolescent years, thus avoiding the handicap incurred by bilateral adrenalectomy and the consequent requirement for continuous substitution therapy.

Adolescent↗
PubMed1978

Gonadotrophin release in untreated congenital virilising adrenal hyperplasia.

A 9.9-year-old boy and a 9.8-year-old girl with virilising congenital adrenal hyperplasia were subjected to an IV LH-RH (luteinising hormone-releasing hormone) test (so microgram/m2 before initition of therapy with corticosteroids. The pattern of response of LH and follicle-stimulating hormone to LH-RH was found to correspond to the stage of their precocious sexual development and advanced bone age, but not to their chronological age. This finding has implications with regard to the mechanism controlling gonadotrophin secretion at puberty.

Adrenocortical Hyperfunction↗
PubMed1978

Pregnancy in a case of Nelson's syndrome.

A woman suffering from Cushing's disease from the age of 17 who had been treated consecutively with pituitary irradiation, bilateral partial adrenalectomy and o,p'-DDD (Mitotane, USP) presented the clinical picture of Nelson's syndrome (hypoadrenalism with secondary hypersecretion of ACTH and MSH) at the age of 32. Under substitution therapy with corticoids she became pregnant for the first time at the age of 38. The course of the pregnancy was normal and at term she was delivered of a normal child by Cesarean section. The materno-fetal relationship, the increased risk of pituitary infarction during pregnancy and the possible teratogenic effect of chemotherapy in such cases are discussed.

Adrenal Cortex Hormones↗
PubMed1977

Gonadal function in Bloom's syndrome.

Five patients with Bloom's syndrome aged from 2 8/12 to 27 years, all of whom had hypogonadism, were subjected to an i.v. LHRH test and two of them to an i.m. HCG test. There was increased responsiveness of plasma LH and FSH, indicating that the hypogonadism is primary in nature and of early development. The tubular element of the testis seems to be mainly affected, as indicated by the particularly high FSH response to LHRH stimulation, a history of sterility in the two adult patients and documented azoospermia in one of them. The Leydig cells seem to be less affected and secrete sufficient androgens to enable puberty within acceptable normal limits. Hypogonadism seems to be a major characteristic of Bloom's syndrome.

Abnormalities, Multiple↗
PubMed1977

Plasma LH and FSH response to LRH and plasma testosterone levels in boys with irregular puberty.

Nineteen boys with irregular puberty (IP), defined as a discrepancy of two or more pubertal stages between the criteria for genitalia and that for pubic hair, were subjected to a standard LRH test (50 microng/m2, iv) and the response of gonadotrophins as well as the basal levels of plasma testosterone, LH and FSH were compared to those of boys with normal, regular puberty. When the results were plotted against the pubertal stage for genitalia (Pg), it was found that in the boys with IP the basal plasma testosterone levels were lower and the response of plasma LH to LRH stimulation lesser than in the controls. However, when these parameters were plotted against the pubertal stage for pubic hair (Ph) it was found, that in the boys with IP the plasma testosterone levels were significantly higher and the response of both LH and FSH stimulation greater than in the control group. It was concluded that irregular puberty in boys may be regarded as a normal variation. The delayed development of sexual hair and penile length, and retarded pubertal growth spurt and bone age maturation seen in these boys, with normal testicular development, may be explained by a temporary reduced peripheral sensitivity to androgens and a compensatory effort by the pituitary, manifested in increased secretion of LH and testosterone, relatively to their pubertal stage for pubic hair.

Adolescent↗
PubMed1976

Evaluation of pituitary-adrenal function in patients with chronic bronchial asthma following substitution of steroid treatment with disodium cromoglycate (Lomudal).

In a group of 32 steroid-dependent asthmatic patients an attempt was made to replace steroid treatment with disodium cromoglycate (Lomudal). Withdrawal of steroids was accompanied by a transitory stage of combined corticotropin-Lomudal treatment for 6 to 8 mo. Pituitary-adrenal function was assessed by ACTH and Metopirone test. Before treatment an impairment of pituitary-adrenal function was found in most of our patients, although in 26 patients a normal increment of plasma cortisol was found after ACTH stimulation. At the end of the combined treatment, 17 patients are now on Lomudal with normal pituitary-adrenal function, 9 patients need small quantities of steroids occasionally, and 6 patients are steroid-dependent.

17-Hydroxycorticosteroids↗