Biomedical subjects
Publications and source records attributed to G L Nicolis.
Testicular function in the patient with Klinefelter's syndrome parallels the alterations seen with age in the normal subject. Significant decreases are seen in the Klinefelter group in the plasma level of testosterone and in the plasma testosterone/oestradiol ratio. Testicular function in the patient with Klinefelter's syndrome appears very much like that seen in a chronologically older subject.
Hyperfunctioning non-neoplastic adrenal glands may be associated with Cushing's syndrome, congenital adrenal hyperplasia, and aldosteronism. The problems in radiographic diagnosis may be resolved by correlation of the angiogram with the clinical and laboratory findings.
A 15-year-old girl with primary amenorrhea, hirsutism, and enlargement of the clitoris was found to have an increased titer of the urinary neutral 17-ketosteroids which failed to decrease after the administration of dexamethasone and an adrenal tumor was demonstrable on venography. Analysis of the adrenal venous effluent revealed gradients on the side of the tumor for testosterone, androstenedione, estradiol, and dehydroepiandrosterone sulfate. Following removal of the tumor, the hirsutism improved markedly, the menses returned, and sexual maturation progressed.
A 28-year-old man with evidence of feminization was demonstrated after 4 years of investigation to have a estrogen-secreting interstitial cell tumor. Such feminizing neoplasms are uncommon, only 37 having been described. They are usually benign and are characterized by gynecomastia, a testicular mass and, with lesser frequency, by decreased libido and potency and poor semen quality. The urinary excretion and plasma levels of estrogen are increased and, by selective testicular catheterization, the site of increased estrogen production can be localized. Secondary histologic changes occur in the nontumorous portions of the testis as well as in the contralateral testis; they are most marked in the area immediately adjacent to the tumor. Postoperatively, the gynecomastia regresses, the excessive levels of estrogen return to normal, libido improves, and the sperm count increases to normal.