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Biomedical subjects

R M Blizzard

Publications and source records attributed to R M Blizzard.

At least 91 records · Page 5Linked to original sources

Prednisone therapy for alopecia areata. A follow-up report.

Eighteen patients treated with prednisone on alternate days for varying degrees of alopecia areata (AA) were examined a mean of 15 months after discontinuation of the drug. Despite an initial response to the therapy, long-term benefit was not thought to be substantial. Numerous side effects related either to systemic corticosteroids or to AA were apparent during the course of therapy, as well as at the time of the evaluation reported herein. Acne, obesity, lenticular opacities, mild hypertension, and impaired adrenocorticotropic hormone (ACTH) reserve were among the findings noted. Long-term treatment was not accompanied by an obvious beneficial change in the natural course of AA. Because of the potentially serious side effects and the lack of substantial improvement in the eventual course, alternate-day prednisone therapy is not recommended for long-term use in AA.

Adolescent↗

Measurement of the production rate of human luteinizing hormone using the urinary excretion technique.

Labeled and/or unlabeled human luteinizing hormone (hLH) was injected into normal and abnormal males and into hypopituitary patients. In two patients, two phases of disappearance (T 1/2) were found to be 1.2 and 2.4 hr. Labeled and unlabeled hormone were excreted in the same proportion. Of the injected hormone, normal males excreted 10.1% plus or minus 0.9%, hypopituitary patients excreted 11.4%- 17.5% and two other patients excreted 10.3% and 5.3% over 48 hr. The urinary excretion of unlabeled hLH in normal males was 22.1 plus or minus 4.9 IU/24 hr. The production rate of hLH in normal males was 224.3 plus or minus 65.3 IU/24 hr and, in the two abnormal males, was five times higher. The advantages of this methodology are discussed.

Adult↗

Circadian variation of integrated concentration of growth hormone in children and adults.

A portable constant withdrawal pump was used to determine consecutive 30-min integrated concentrations of growth hormone (ICGH) for a 24-h period in 18 normal subjects, ages 5 to 28 yr. Seven prepubertal, 5 pubertal and 6 young adult subjects were studied under conditions of normal activity. Pubertal, prepubertal, and adult subjects had peaks during waking hours as well as during sleep, but peaks in the adults were usually lower than in the children. Using an analysis of variance, a significant (P smaller than 0.01) downward trend of ICGH was observed to occur during sleep. During waking hours a significant variation (P smaller than 0.01 by analysis of variance) was found with low levels in the first few hours after awakening and an upward trend as the evening approached. Food intake had no significant effect on ICGH nor did the introduction of the indwelling catheter. The mean apparent half-life values of growth hormone calculated on the basis of 87 episodes with 3 or more points on the downslope was 40.1 min. This is significantly higher than the known true half-life of the hormone, suggesting that complete secretory inactivity after a secretory episode is an infrequent event.

Adolescent↗

Lack of correlation between gonadotropin and adrenal androgen levels in agonadal children.

To evaluate the relationship between the secretion of gonadotropins and adrenal androgens, patients with gonadal agenesis were evaluated by (a) administering human luteinizing hormone (hLH) for 5 days with or without estrogen pretreatment to agonadal patients who had prepubertal LH levels; (b) correlating circulating gonadotropin levels with adrenal androgens in 45 patients; and (c) comparing adrenal androgens with gonadotropins after long-term administration of estrogen or androgens. Results are as follows: (a) No alteration in serum concentrations of dehydroepiandrosterone (DHA), dehydroepiandrosterone sulfate (DHAS), estrone (E1), testosterone (T), or in excretion of urinary 17-ketosteroid (17 KS) occurred after the administration of hLH. (b) No clearcut relationship between endogenous level of LH or FSH and DHA OR DHAS was demonstrated although a coincident increase of all hormones with age occurred. (c) Administration of estrogen to patients with gonadal agenesis did not affect their levels of DHA and DHAS although those patients given androgen developed higher DHAS, but not DHA, levels. Hence, increasing gonadotropin concentrations would not appear to be a primary etiologic factor in the maturation of the adrenal.

17-Ketosteroids↗

Critical analysis of methods for estimating production rates of FSH.

The urinary excretion method and the constant infusion technique were used to estimate hFSH production rates (PR) in three normal men (aged 25-40 years). Both studies were also done in a hypophysectomized nine year old boy. The PR of hFSH in the urinary excretion studies ranged from 20.0 to 45.7 IU/24 h, whereas the constant infusion studies yielded PR'S OF 68.7 to 107.8 IU/24 h. Possible reasons for the discrepancy of the results obtained by the two methods are discussed. In the hypophysectomized patient, the metabolic clearance rate (MCR) of infused hFSH was much lower (4.3 ml/min) than in the normal adults (7.8 to 12.0 ml/min) and was not affected by the dose of hFSH given.

Adult↗

The effect of danazol in sexual precocity.

The effect of Danazol, a synthetic 2,3 isoxazol derivative of 17 alpha-ethinyl testosterone, was assessed in three girls and two boys with sexual precocity. Progression of sexual development ceased during administration of Danazol; the effect upon growth rate and skeletal maturation was equivocal. Serum estrogen and progesterone concentrations in the girls were lower during treatment; serum testosterone and dehydroepiandrosterone levels in the boys were also lower. Serum and urinary luteinizing hormone concentrations were inconsistently suppressed. No effect upon follicle-stimulating hormone levels could be demonstrated. Although Danazol appears to inhibit sexual development, this study indicates that the pituitary-gonadal axis is not completely suppressed. Growth rate is not reverted to normal, and virilization may occur among girls. Because undesirable side effects may outweight desirable results, careful consideration is recommended before Danazol is prescribed in the management of sexual precocity.

17-Ketosteroids↗