Endocrine and neurophysiologic responses of the pituitary to insulin-induced hypoglycemia: a review.
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Adrenocorticotropic Hormone↗
Biomedical subjects
H R Fish
Publications and source records attributed to H R Fish.
Macronodular adrenal hyperplasia with hypothalamic-pituitary-adrenal suppression by ultra-high-dose dexamethasone: regression following hypophysectomy.
Cushing's syndrome associated with macronodular adrenal hyperplasia (MAH) may present with high-dose dexamethasone (dex) nonsuppressible hypercortisolemia. This has been interpreted as suggesting a primary adrenal disorder, leading to recommendations for curative adrenalectomy in these cases. The present case of MAH demonstrates high urinary and serum cortisol levels, sufficiently suppressed only by ultra-high-dose (32 mg/day X 2 day) dex, with parallel reduction of plasma adrenocorticotrophin noted as well. Subsequent clinical cure by transsphenoidal hypophysectomy and identification of a pituitary adenoma confirmed the secondary nature of adrenal cortical hypersecretion. The conceptual evolution of macronodules and altered feedback dynamics of the hypothalamo-pituitary-adrenal axis in MAH are briefly discussed.
Adrenal Gland Diseases↗
Exhaust entry monitored automatically with flame ionization and indicator tubes.
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Air Ionization↗
Subunit equilibria of the 7S nerve growth factor protein.
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Centrifugation, Density Gradient↗
Postsplenectomy sepsis caused by group B streptococcus (S. agalactiae) in an adult patient with diabetes mellitus.
Overwhelming postsplenectomy infection (OPSI) due to group B streptococcus developed in an insulin-dependent diabetic patient. The illness began with nonspecific symptoms, followed rapidly by hypotension and disseminated intravascular coagulation. The early institution of appropriate antibiotics, fluid replacement and pressor agents resulted in a favorable clinical outcome. The association of group B streptococcal infection and diabetes mellitus is discussed. The defects in normal host defenses associated with asplenic state and diabetes mellitus are further emphasized. This is the first case report linking the association of OPSI, diabetes mellitus and group B streptococcal septicemia.
Adult↗