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Biomedical subjects

L J Hipkin

Publications and source records attributed to L J Hipkin.

17 recordsLinked to original sources
PubMed1992

The induction of amenorrhoea.

A survey has shown that many women favour eliminating menstruation and it has been suggested that therapeutic induction of amenorrhoea might be an advantage in female personnel mobilised for war. The traditional method has been to take the oral contraceptive pill continuously. This produces weight gain and other side-effects; spotting and breakthrough bleeding can be a problem initially. The method is however cheap. The Gonadotrophin Releasing Hormone (GnRH) analogue, goserelin, is extremely effective, produces less side-effects, but it is very expensive. Two synthetic steroids, danazol and gestrinone, are moderately effective, have a variety of prominent side-effects and are also quite expensive. With all these drugs normal menstruation resumes in the cycle after they are discontinued. Although goserelin has many advantages over the continuously taken contraceptive pill, its cost precludes it from consideration as a means of eliminating menstruation.

Amenorrhea↗
PubMed1990

Identical twins discordant for Kallmann's syndrome.

A 20 year old male patient presented with lack of sexual development. On examination he was eunuchoidal and hypogonadal, and olfactory function testing showed he was anosmic. Biochemical investigations proved he was hypogonadotrophic. Kallmann's syndrome was therefore diagnosed. His appearance was very different from his alleged identical twin who had undergone a normal puberty and had normal plasma testosterone and gonadotrophin levels. However, the twin was hyposmic. Genetic fingerprinting confirmed the twins were identical. Why Kallman's syndrome was incompletely expressed in one of them is unexplained. The parents and a normally menstruating sister had normal olfactory function.

Adult↗
PubMed1990

Thyrotoxicosis in a patient with Addison's disease.

We report the case of a patient who suffered recurrent episodes of hypoadrenal crisis, despite conventional replacement therapy for Addison's disease. She was found to have hyperthyroidism and after this was treated, she had no further relapse. Thyrotoxicosis should be considered when patients taking replacement therapy for Addison's disease present in hypoadrenal crisis.

Addison Disease↗
PubMed1979

Testicular endocrine function in paraplegic men.

The responses of FSH and LH to the injection of LHRH were studied in fifteen paraplegic men and ten normal controls. The basal FSH levels in the paraplegic men were elevated in eight cases, basal LH being raised in nine cases. The responses of FSH were exaggerated in fourteen patients, and LH responses were exaggerated in nine patients. Only one patient was normal in respect of both hormones. Subnormal plasma testosterone was found in three patients. This depressed testicular function could not be explained as being due to spread of urinary tract infection and a direct neurological effect is the probable explanation.

Adolescent↗
PubMed1978

Failure to suppress adrenal function in congenital adrenal hyperplasia (21-hydroxylase deficiency). Three case reports.

Three patients, aged 14, 16, and 32 years respectively, with congenital adrenal hyperplasia (21-hydroxylase deficiency) are described. Excessive adrenal activity and ACTH secretion could not be suppressed with doses of corticosteroids sufficient to cause iatrogenic Cushing's syndrome, even though part of the steroid dosage was administered in the late evening. The resistance to feed-back suppression was of the same order as that seen in Cushing's syndrome. Adrenalectomy was performed in the 16-year-old girl, and was followed by a menarche. Adrenalectomy was considered inadvisable in the other two patients.

Adolescent↗
PubMed1977

Feto-maternal bidirectional mixed lymphocyte reaction and survival of fetal allograft.

Maternal and fetal lymphocytes were tolerant of each other in the bidirectional mixed lymphocyte reaction. This seems to be the principal reason why the mother does not reject the fetal allograft. Tolerance between maternal and fetal cells must be largely due to a genetic mechanism, because the bidirectional mixed lymphocyte reaction between parents and older children was much reduced compared with that between randomly selected pairs of controls. This weak reaction disappeared when immunosuppressive agents were given to one member of the parent/child pair, whereas the mixed lymphocyte reaction between unrelated individuals was not abolished by similar immunosuppression. It is suggested that this genetic mechanism is distinct from the HLA system. Tolerance between maternal and fetal cells was not demonstrated in the unidirectional mixed lymphocyte reaction, suggesting that this tolerance requires the viability of the two cell populations.

Female↗
PubMed1977

Pulmonary function in acromegaly.

The lung volumes of 12 female and eight male patients with acromegaly, chosen because of the absence of associated cardiorespiratory disease, were determined physiologically and radiographically. Enlarged lung volumes were found in half the males but in none of the females, due allowance being made for the presence of a significant thoracic kyphosis. Upper airway narrowing was suggested by an increase in the expiratory-inspiratory flow rate ratio in six patients, four of whom were male, and acromegaly of the larynx was confirmed in the three subjects who consented to laryngoscopy. Upper airway obstruction is more likely to account for respiratory death in acromegaly than disordered pulmonary function in enlarged acromegalic lungs. Neither of these respiratory findings could be correlated with the fasting level of growth hormone but there was a suggestion that they were more likely to occur when the duration of the disorder was longer.

Acromegaly↗
PubMed1976

Plasma oestriol and human placental lactogen measurements in patients with high risk pregnancies.

Maternal plasma oestriol and human placental lactogen (HPL) were measured serially in 383 at-risk pregnancies. Eight-five infants were growth retarded and 122 developed fetal distress or neonatal asphyxia. Of the infants whose mothers had either abnormal plasma oestriol or HPL levels, 58 per cent were growth retarded, while 65 and 73 per cent in each group respectively developed fetal distress. The incidence of fetal complications when both plasma oestriol and HPL were abnormal was consistently greater than 66 per cent.

Asphyxia Neonatorum↗
PubMed1975

Treatment of acromegaly with bromocryptine.

Four men and 4 women with active acromegaly were treated with bromocryptine for 4 to 5 weeks. Serum growth hormone levels response to a glucose load were measured before and in the last weed of treatment. In only 1 patient was the grwotoh hormone response rendered normal by the drug. This patient, but none of the others, also showed an improvement in glucose tolerance and a reductin of the raised serum insulin levels during the glucose load. In three of the 8 patients vomiting was troublesome side effect of treatment.

Acromegaly↗
PubMed1975

Relation between thyroid function and serum levels of long-acting thyroid stimulator.

Bioassays of long-acting thyroid stimulator (LATS) were performed in three groups of subjects: in normal controls, in thyrotoxic patients before and serially after 131-I treatment, and in patients with hypopituitarism. Of the untreated thyrotoxic patients, 27.7% had raised serum LATS levels initially. There was no correlation between the relapse rate after 131-I therapy and the initial or subsequent LATS titres: in particular, thyrotoxicosis sometimes recurred after an initially high LATS titre had fallen into the normal range. The distribution of the results of LATS assays in the hypopituitary patients was significantly different from that in the normal subjects; 4 out of 27 hypopituitary patients had LATS levels above the normal range, although they had no thyrotoxicosis. On the other hand, the majority of the patients with hypopituitarism, 19 out of 27, had LATS titres below the mean normal level, possibly due to deficiency of a substance we have termed pseudo LATS. These results raise doubts about a direct causative role for LATS in most cases of thyrotoxicosis.

Biological Assay↗
PubMedDate not supplied

Do plasma glycoproteins induce lymphocyte hyporesponsiveness and insulin resistance?

Depression of lymphocyte transformation and an increase in insulin resistance are common to pregnancy, oral contraceptive use, widespread malignancy, infection, and tissue destruction. We suggest that these abnormalities are caused by a rise in the plasma-glycoprotein level which is also common to these clinical states. There is evidence that glycoproteins can inhibit cell division, lymphocyte transformation, and the action of hormones on target cells. Because of the increase in plasma glycoprotein the cells in many organs and their hormone receptors may have a thicker coating of glycoproteins which blunts their response to variuos stimuli.

Cell Division↗