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Biomedical subjects

D A Montgomery

Publications and source records attributed to D A Montgomery.

At least 19 recordsLinked to original sources

The insulins.

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Animals

Relation of high-density lipoprotein cholesterol concentration to type of diabetes and its control.

Serum cholesterol and high-density lipoprotein (HDL) cholesterol concentrations were measured in 192 diabetics (94 with juvenile-onset and 98 with maturity-onset diabetes) and 177 non-diabetic controls. Hb A1C, an index of blood sugar control, was also measured in the diabetics. Serum cholesterol concentrations were similar in all the diabetics and controls, but HDL cholesterol concentrations were lower in patients with maturity-onset diabetes than in those with juvenile-onset diabetes and controls. There was no correlation in diabetics between HDL cholesterol and Hb A1C. We conclude that HDL cholesterol concentrations are abnormally low in patients with maturity-onset diabetes but essentially normal in those with juvenile-onset diabetes. They are not related to diabetic control.

Adult

Cushing's syndrome: 20 years after adrenalectomy.

The long term results (over 20 years) of our first 13 patients treated by adrenalectomy for Cushing's syndrome are described. Twelve survived operation and 5 of these died within 5 years, but thereafter the expectation of life of the treated patients was similar to that of the general population. At 20 years 7 patients were alive and 6 were well. If modern therapeutic measures to control adrenocortical function before operation has been available 20 years ago, some of the early deaths might have been prevented.

Adolescent

Catecholamine sensitivity in hyperthyroidism and hypothyroidism.

1. Catecholamine sensitivity in hyper- and hypothyroidism has been studied using a standardised isoprenaline sensitivity test. 2. Seven patients with hyperthyroidism and seven with hypothyroidism were tested both when showing evidence of thyroid dysfunction and again when euthyroid. 3. No significant differences were seen in heart rate responses to isoprenaline when patients became euthyroid compared to their response when either hyperthyroid or hypothyroid. 4. These results indicate that sensitivity to catecholamines is not altered in thyroid dysfunction and, in particular, that hypersensitivity does not occur in spontaneous hyperthyroidism.

Adult

Hypothyroidism in pregnancy.

Two mothers with hypothyroidism gave birth to normal infants. In one patient there was good evidence that maternal hypothyroidism improved during the last trimester due to placental transfer of fetal thyroid hormone. If pregnancy is advanced when the diagnosis of hypothyroidism is made, it would seem that replacement therapy may be withheld without detriment to the fetus.

Adolescent

ACTH and cortisol response to bromocriptine, and results of long-term therapy, in Cushing's disease.

Plasma corticotrophin (ACTH) was lowered in 4 out of 5 patients with pituitary dependent Cushing's syndrome (one of whom was studied only after bilateral adrenalectomy) after a single oral dose of 2.5 mg bromocriptine, but plasma cortisols were unaltered in the 3 patients in whom it was measured. Three patients were observed during treatment with bromocriptine for 16 to 87 weeks. One improved symptomatically while maintained on a combination of metyrapone and bromocriptine, but plasma ACTH levels remained high even when the dose of bromocriptine was increased to 20 mg daily. Bromocriptine therapy was discontinued after 16 weeks in the second patient due to the development of mental depression. Her clinical features had not improved during this time. The third patient, who also underwent a course of pituitary irradiation, became, and remains, symptom free, with satisfactory plasma ACTH and cortisol levels for the 87 weeks he has received bromocriptine. The role of bromocriptine in the management of Cushing's disease seems limited despite the fact that plasma ACTH may fall after a test dose of the drug.

Administration, Oral

Secretin: high plasma levels in diabetes mellitus.

Plasma immunoreactive secretin levels were measured in 22 newly diagnosed non-ketotic, maturity-onset diabetics and 10 healthy control subjects during 50 gram oral glucose tolerance test (OGTT). The test was repeated in the diabetic group after 6 months' dietary treatment. At diagnosis the fasting secretin levels in the diabetics were higher than in control subjects but fell within the normal range following dietary treatment. In the diabetics there was a significant positive correlation between the fasting glucose and fasting secretin levels at the time of diagnosis. Suppression of secretin levels occurred during the OGTT, both in diabetic and control subjects.

Diabetes Mellitus

Endocrine disorders.

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Abortion, Therapeutic