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Biomedical subjects

K Moridera

Publications and source records attributed to K Moridera.

At least 19 recordsLinked to original sources

Serum growth hormone-binding protein, insulin-like growth factor-I, and growth hormone in patients with liver cirrhosis.

We determined serum growth hormone-binding protein (GHBP), insulin-like growth factor-I (IGF-I), and growth hormone (GH) levels in patients with cirrhosis and in age-matched control subjects, and investigated their relationships. Serum GHBP levels in cirrhotic patients (14.6% +/- 3.9%) (means +/- SD) were significantly lower than those in normal subjects (20.4% +/- 4.7%). GHBP levels had positive correlations with cholinesterase (r = .58, P less than .001) and Normotest (r = .66, P less than .001), both of which represent liver function in cirrhotic patients. Basal GH levels in cirrhotic patients (range, 0.35 to 13.0 micrograms/L; median, 3.9 micrograms/L) were significantly higher than those in normal subjects (0.015 to 6.0 micrograms/L; 0.19 microgram/L). GHBP levels in cirrhotic patients correlated positively with IGF-I levels (r = .39, P less than .01), and negatively with GH levels (r = -.33, P less than .01). These results may indicate that the serum GHBP level reflects the number of hepatic GH receptors, and that the high basal GH level observed in cirrhotic patients is, at least in part, attributable to decreased clearance of GH by these receptors.

Bilirubin

Growth hormone binding protein in Werner's syndrome.

OBJECTIVE: GH and growth hormone binding protein in Werner's syndrome were investigated to elucidate their relation to the short stature. DESIGN: The levels of GH binding protein and GH response to insulin-induced hypoglycaemia were determined. GH binding protein levels and its Scatchard analysis in Werner's syndrome were compared with those in normal subjects. PATIENTS: Three patients with Werner's syndrome (one man aged 45 years and two women aged 39 and 38 years) and 41 normal subjects (18 men and 23 women aged 39.3 +/- 5.5 years, mean +/- SD) were studied. MEASUREMENTS: GH binding protein levels were determined using an Ultrogel AcA44 minicolumn and GH levels were measured by a highly sensitive enzyme immunoassay. RESULTS: Two out of three patients with Werner's syndrome had GH binding protein levels above the mean +/- 2SD value in normal subjects. GH secretion was impaired in Werner's syndrome as judged by the low GH response to insulin-induced hypoglycaemia. CONCLUSIONS: Elevated GH binding protein levels may lead to an increase in the bound form of GH, which is probably less bioactive, resulting in growth failure in association with the impaired GH secretion in Werner's syndrome.

Adult

Autoantibody to human prolactin in patients with idiopathic hyperprolactinemia.

We have demonstrated the presence of anti-PRL autoantibody in 5 patients with idiopathic hyperprolactinemia. The clinical features were suggestive of a weak biological activity of PRL, such as regular menses and no galactorrhea. Total PRL levels were markedly elevated (685 +/- 386 micrograms/L) (mean +/- SD) and the proportion of the bound form was 90.7 +/- 7.1%. Scatchard analysis revealed a low-affinity, high-capacity antibody: the association constant was 0.73 +/- 0.56 x 10(7) mol-1 and the maximal binding capacity was 2139 +/- 1792 micrograms/L. Gel filtration study showed that a substantial amount of PRL (64.6 +/- 19.5%) was eluted at the position of 150,000-170,000 mol wt PRL (big-big PRL). Immunoprecipitation study using the chain-specific antibodies showed that the anti-PRL autoantibody belonged to kappa-type immunoglobulin G. These results may indicate that there exists autoantibody-related hyperprolactinemia, especially in those with particularly high serum PRL levels, who had previously been diagnosed as "idiopathic" hyperprolactinemia.

Adult

A normal ovulatory woman with hyperprolactinemia: presence of anti-prolactin autoantibody and the regulation of prolactin secretion.

We present the case of a normal ovulatory woman with marked hyperprolactinemia and no evidence of a pituitary adenoma on CT and MRI. Gel filtration studies showed that most immunoreactive PRL was eluted as 150K-170K macroprolactin. Anti-PRL autoantibody was detected and Scatchard analysis revealed a low-affinity (the association constant: 1.29 x 10(7) l/mol), high-capacity (the maximal binding capacity: 1174 micrograms/l) antibody. Dopamine had little suppressive effect on PRL levels and an antidopaminergic agent elicited an augmented response of PRL secretion. These results suggest that the presence of anti-PRL autoantibody may delay the clearance of PRL and/or may alter the central regulation of PRL secretion.

Adult

Hypokalemic paralysis associated with distal renal tubular acidosis.

A 68-year-old man had hydronephrosis due to ureteral stones for two months earlier and then increasing muscle weakness developed. A 30-year-old woman had rapidly progressive quadriparesis. In both cases, severe hypokalemia with metabolic acidosis was observed and the diagnosis of distal renal tubular acidosis was made. The former was considered to be an idiopathic incomplete form and the latter was a secondary complete form associated with Sjögren syndrome. Hypokalemic paralysis may occur as a complication of distal renal tubular acidosis.

Acidosis, Renal Tubular

[A case of pregnancy-induced lymphocytic adenohypophysitis complicated by postpartum painless thyroiditis].

We report a patient with pregnancy-induced lymphocytic adenohypophysitis complicated by postpartum painless thyroiditis. A 27-year-old female noticed visual field defect in the 36th week of pregnancy. After delivery in the 39th week by cesarean section, she was admitted for close examination. Goiter was not palpable, and postpartum galactorrhea was not observed. Routine examination revealed no abnormal findings. On October 8, 1989, magnetic resonance imaging (MRI) revealed a tumor image (height 22.4mm) from the sella turcia to suprasellar cistern with a lower signal intensity than that of the white matter on T1 weighted images and a high signal intensity on T2 weighted images. Gd-DTPA contrast images showed a symmetrical and homogeneous tumor image at the same site. However, the posterior lobe of the pituitary gland appeared normal. These findings suggested lymphocytic adenohypophysitis. The LH was less than 0.3mIU/ml. The FSH (7.8mIU/ml), PRL (12ng/ml), GH (1.6ng/ml) and cortisol (10 micrograms/dl) levels were normal. T4 was 5.3 micrograms/dl, T3 67ng/dl, fT4 0.53ng/dl, which indicated mild hypothyroidism, but the TSH was normal. TRH test showed a slight increase in TSH and no response of PRL. Insulin tolerance test showed delayed response of GH and normal response of cortisol. LHRH test revealed no response of LH and delayed response of FSH. Anti-GH3 cell antibody and anti-thyroglobulin antibody were positive, but the anti-AtT20 cell antibody was negative. Since visual disturbance improved, and slight reduction in the mass (height 20.1mm) was confirmed by MRI after delivery on October 21, her course was observed without treatment. After 1 month, the LH became detectable, but the PRL and cortisol decreased to 2.5ng/ml and 6.0 micrograms/dl, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Effects of sex and age on serum GH binding protein levels in normal adults.

OBJECTIVE: The effects of sex and age on serum growth hormone binding protein (GHBP) levels during adulthood were investigated. DESIGN: The levels of GHBP, insulin-like growth factor-I (IGF-I), and growth hormone (GH) were determined and analysed as a function of sex and age. PATIENTS: We studied 101 normal adults (45 men, aged 20-77 years; 56 women, aged 20-80 years). MEASUREMENTS: GHBP levels were determined using an Ultrogel AcA 44 minicolumn. RESULTS: During the second and third decade, GHBP levels were not different between men (22.8 +/- 1.1%) (mean +/- SE) and women (23.2 +/- 0.8%). After the age of 40 years, however, GHBP levels in men were significantly decreased (19.1 +/- 0.7%), and were lower than those in women (22.7 +/- 0.9%). IGF-I levels correlated positively with GHBP levels in men (r = 0.51, P less than 0.01) but not in women (r = 0.16, NS). CONCLUSIONS: These results indicate that both sex and age may have some effects on the GH-GH receptor-IGF-I axis.

Adult

LH- and FSH-secreting pituitary adenoma in a postmenopausal woman.

Gonadotropin secreting pituitary adenomas have been reported with increasing frequency in men, but they are still rarely recognized in women. We report a 52-year-old postmenopausal woman with LH- and FSH-secreting pituitary adenoma. She had increased LH (37.0 +/- 13.7 IU/l) (mean +/- SD) and FSH (109.9 +/- 26.7 IU/l) but these concentrations were within normal ranges in 80 postmenopausal women (LH: 29.7 +/- 18.3 IU/l, FSH: 104.0 +/- 43.9 IU/l). The administration of GnRH and conjugated estrogen resulted in normal response of LH and FSH. No abnormal response of gonadotropin to TRH and bromocriptine was observed. After transsphenoidal adenomectomy both LH and FSH decreased (LH: 11.1 +/- 4.2 IU/l, FSH: 37.0 +/- 9.6 IU/l). An immunocytochemical study revealed that the adenoma cells synthesize both LH and FSH. The rarity of gonadotropin secreting pituitary adenomas in women could be the result of greater difficulty in recognition due to an increase in serum gonadotropin in postmenopausal women.

Adenoma

The polymorphism linked to the human insulin gene: its lack of association with either IDDM or NIDDM in Japanese.

Polymorphism of 5' portion of the human insulin gene was examined in 188 unrelated Japanese subjects (49 normal, 71 with IDDM, and 68 with NIDDM) using restriction endonuclease analysis. Restriction fragments were classified according to the insertion size: Class 1 (600 base pairs), Class 2 (1300 base pairs), and Class 3 (2000 base pairs). We found a very high frequency of Class 1 alleles (96.8%) and a low frequency of both Class 2 (0.8%) and Class 3 alleles (2.4%) and that approximately 94% of the genotypes were Class 1/Class 1 homozygote. In addition, there was no correlation of allelic or genotypic frequency with NIDDM or IDDM. We conclude that length polymorphism of the human insulin gene cannot be a useful marker for diabetes in Japanese.

Diabetes Mellitus, Type 1

The prevalence of diabetic autonomic neuropathy indicated by abnormal R-R interval variation.

The variation in R-R interval in ECG has been reported to decrease in diabetics with autonomic neuropathy. To investigate the diagnostic value of heart rate monitoring and the prevalence of diabetic autonomic neuropathy, R-R interval variations (CVs) were measured, and the relationships between CV and MCV, FCV, SCV, retinopathy, nephropathy, peripheral neuropathy, and duration of diabetes were investigated. 70 diabetics aged 19 approximately 74 were studied. A total of 100 consecutive R-R intervals on ECG were analyzed by computer. 16 patients (22.8%) of 70 had one or more symptoms of autonomic neuropathy, while the prevalence of diabetic autonomic neuropathy indicated by abnormally low CV was 41.4%. Diabetics with retinopathy, nephropathy or peripheral neuropathy had significantly lower CVs than diabetics without these complications (p less than 0.01). The correlation coefficients for CV and duration of diabetes, and CV and SCV were -0.69 and 0.57 respectively (p less than 0.01). CV (%) of R-R interval was a useful parameter for the determination of diabetic autonomic neuropathy and our results showed that autonomic nerve damage was more prevalent than were symptoms of autonomic neuropathy.

Adult

Restoration of normal pituitary gonadotropin reserve by administration of luteinizing-hormone-releasing hormone in patients with hypogonadotropic hypogonadism.

To elucidate whether diminished pituitary gonadotropin reserve can be restored by repeated stimulation with luteinizing-hormone-releasing hormone, plasma luteinizing hormone and follicly-stimulating hormone responses were studied before and after daily intravenous infusion of 400 mug of luteinizing-hormone-releasing hormone for two to 23 days, in patients with hypogonadotropic hypogonadism of various causes. In five of nine patients with isolated gonadotropin deficiency, the impaired plasma luteinizing hormone response was restored to normal after treatment for seven days or more, whereas it was unchanged in four patients treated for less than five days. However, six patients with anorexia nervosa regained normal responses after three to five days' treatment. Five of nine patients with organic hypothalamopituitary lesions also showed normal responsiveness after five to seven days' treatment. These results suggest that the response to the test after repeated administration of luteinizing-hormone-releasing hormone is of value for the diagnosis of hypogonadism of hypothalamic origin.

Adolescent