Sensitive urine tests and human chorionic gonadotrophin secreted during ectopic pregnancy.
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Chorionic Gonadotropin↗
Biomedical subjects
S M Joubert
Publications and source records attributed to S M Joubert.
The insulin and glucose response to an oral glucose load in non-insulin-dependent diabetes in the young. A study of 4 families.
Four Indian families with three-generation transmission of non-insulin-dependent diabetes were studied. Only 30% of the siblings were diabetic. The mean age of onset of diabetes was 20,1 years; 25% of the diabetics were obese, while all non-diabetic family members were of normal weight. All consenting living family members (12 diabetics and 16 non-diabetics) were subjected to an oral glucose tolerance test. After glucose administration, the 12 diabetics displayed a delayed and attenuated insulinaemic response. The area under the insulin curve and the insulin-glucose ratio were lower in the diabetics.
Adolescent↗
Breast cancer prognosis in three different racial groups in relation to steroid hormone receptor status.
Follow-up studies on 466 patients over a 5-year period showed Whites to have an overall significantly longer disease-free interval and survival than Blacks and Asians. No racial differences in prognosis were seen in patients with Stage II disease (p greater than 0.2) but in Stage III, White patients had significantly longer disease-free periods than Blacks or Asians; the same was not true of survival. Whites had a 67% incidence of cytoplasmic estrogen receptor (CER) positive tumors compared with only 49% in Blacks and 41% in Asians. When tumors were assayed for CER, nuclear estrogen receptor (NER), and cytoplasmic progesterone receptor (CPR), there were no racial differences in the proportions of tumors containing all 3 receptors, but significant variations were found in neoplasms with no receptors and in those with apparently defective receptors. In White patients receptor status had no influence on prognosis (p greater than 0.3). Black patients whose tumors contained both CER and NER had a significantly better time to recurrence than those whose tumors lacked these receptors, while in Asian women the presence of CER alone, or CER together with NER, or CER, NER, and CPR, was indicative of a significantly longer disease-free period.
Breast Neoplasms↗
Antibodies to the thyroid gland and to the thyrotrophin receptor in African and Indian thyrotoxic patients.
Sixty two thyrotoxic patients, 34 African and 28 Indian, were studied in order to assess the prevalence of thyroid antibodies and TSH binding inhibitory activity (TBI): 45 had Graves' disease and 17 had toxic nodular goitres. Microsomal and thyroglobulin antibodies were positive more often in Indian than in African patients with Graves' disease (microsomal 52% vs 37.4%, P less than 0.05; thyroglobulin 38.1% vs 4.2%, P less than 0.001). Patients with toxic nodular goitres had a lower prevalence of positive microsomal antibodies (P less than 0.01), but not of thyroglobulin antibodies (P = 0.1) when compared with patients with Graves' disease. TBI activity measured by a radioreceptor assay was positive in 43 of the 45 (95%) patients with Graves' disease and only 1 of the 17 patients (5.9%) with toxic nodular goitre. It thus appears that TBI activity is a sensitive marker in the diagnosis of Graves' disease and that there is a lower prevalence of thyroglobulin and microsomal antibodies in African patients compared with Indian patients.
Africa↗
Prolactin secretion in Sheehan's syndrome. Responses to thyrotropin-releasing hormone and metoclopramide.
The prolactin response to thyrotropin-releasing hormone (TRH) and metoclopramide was studied in 16 patients with Sheehan's syndrome and 16 matched controls in the follicular phase. Metoclopramide resulted in a greater prolactin response than TRH did in the controls. However, both stimuli failed to evoke any appreciable prolactin response in the patients with Sheehan's syndrome. Since metoclopramide is generally free of side effects and far cheaper than TRH, we recommend the prolactin response to metoclopramide as the preferred screening test in the diagnosis of Sheehan's syndrome.
Adult↗
Insulin secretion during intravenous glucose tolerance tests in non-insulin-dependent diabetes in the young.
The phasic response of insulin to intravenous glucose was studied in 9 patients with non-insulin-dependent diabetes in the young (NIDDY), with 3-generation transmission of the disease; and 9 age-, weight- and sex-matched reference subjects. Furthermore, 10 non-diabetic siblings of these diabetic patients were submitted to the same test procedure in an attempt to identify a prodrome of impaired glucose tolerance. In comparison to the controls and non-diabetic family members, the diabetics had no first phase insulin release. In addition, the non-diabetic siblings had insulin and glucose responses similar to those of the reference subjects. Therefore, it would appear that there is no prodromal phase in this discrete syndrome of NIDDY.
Adult↗
Various methods for determining urinary choriogonadotropin evaluated for the early diagnosis of ectopic pregnancy.
We evaluated the accuracy, sensitivity, specificity, and performance characteristics of seven methods for determining urinary choriogonadotropin in the early diagnosis of ectopic pregnancy in 46 patients with gynecological emergencies. The kits examined included immunoenzymometric assays (Tandem Icon hCG, Model Plus, Diapreg-25, Pregnastick, Nimbus) and reverse hemagglutination inhibition assays (NeoPregnosticon 75 Duoclon, Pregtest). We found immunoenzymometric assays to be the most sensitive procedures (lowest detection limits) for qualitatively detecting hCG secreted by ectopic pregnancy. We concluded that the Tandem Icon best meets our criteria and we advocate its use in the emergency room or ward as the first-line investigation of ectopic pregnancy. In addition, the use of Diapreg-25 has many theoretical advantages as an extremely sensitive index of choriogonadotropin status because of its ability to detect very low concentrations of beta subunit.
Chorionic Gonadotropin↗
Arginine-stimulated acute phase of insulin secretion in non-insulin-dependent diabetes in the young.
The acute insulin response to a 5 g pulse of arginine monohydrochloride was studied in 10 patients with non-insulin-dependent diabetes in the young (NIDDY) and 10 age-, weight- and sex-matched control subjects. All diabetics belonged to families in which non-insulin-dependent diabetes was transmitted through 3 generations. Mean peak insulin responses were similar in both groups (84.1 +/- 10.6; 68.2 +/- 8 microU/ml, p greater than 0.5). However, it is well known that hyperglycaemia accentuates the insulin response to non-glucose stimuli. To test this hypothesis, 5 of the diabetics were subjected to an intravenous insulin tolerance test, prior to the administration of the arginine pulse. At this lowered glucose level, the beta-cell secretory response was significantly decreased in the diabetics (C-peptide peak responses 2.5 +/- 0.3 vs 4.4 +/- 0.7 ng/ml, p less than 0.02). Thus it can be concluded that hyperglycaemia enhances the insulin secretory response to non-glucose stimuli and that following correction of the hyperglycaemia patients with NIDDY have an attenuated insulinaemic response.
Adult↗
A bedside urine test for human choriogonadotropin (hCG) as sensitive as serum radioimmunoassays.
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Chorionic Gonadotropin↗
Pituitary tumours in African and Indian patients.
Over a five year period 55 patients with pituitary tumours (35 African and 20 Indian patients) were seen at the Endocrine Unit, King Edward VIII Hospital. Of the 33 patients with secretory tumours 20 had GH-secreting tumours (acromegaly), 8 prolactinomas and 5 ACTH-producing tumours (Cushing's disease); in addition 4 of the patients with acromegaly probably had combined GH and prolactin secreting tumours. The group with non-secretory tumours comprised 13 patients with craniopharyngioma, 7 with chromophobe adenomas and 2 patients with parasellar tumours. The majority of patients with non-secretory tumours were of African descent. Hormonal deficiencies present in the patients tested, were as follows: GH deficiency 73.3%; hypocorticolism 66.7%; hypogonadism 35.9% and hypothyroidism 14%. It thus appears that the patients in the present study differ from populations studied elsewhere with respect to the relative frequency of the various secretory tumours and the prevalence of certain hormonal deficiencies.
Acromegaly↗
Changes in amniotic fluid prostaglandins with oxytocin-induced labor.
Amniotic fluid prostaglandin levels were measured serially in 15 patients who underwent successful induction of labor and compared with those of patients presenting in spontaneous labor. At comparable cervical dilation the induced group demonstrated significantly lower prostaglandin levels. Four of these patients delivered without any increment in prostaglandins while in the remaining patients increases in prostaglandins followed the attainment of efficient uterine contractions by several hours. These data support the hypothesis that oxytocin acts directly on myometrial cells and not primarily by prior generation of prostaglandin synthesis in the membranes.
Amniotic Fluid↗
Estrogen and progesterone receptors in breast cancer among women of different racial groups.
No differences in steroid hormone receptor status were detected in premenopausal breast cancer patients of different races. In postmenopausal women, 65% of Whites were found to have tumors positive for cytoplasmic estrogen receptors (CER) compared with 58, 52, and 41% in women of mixed race, Blacks, and Asians, respectively. The proportions of tumors which contained a full complement of receptors (CER, nuclear estrogen receptors, and cytoplasmic progesterone receptors) were similar in Blacks, Whites, and Asians in each menopausal group. In postmenopausal patients, significantly fewer White women had tumors devoid of all receptors, while having a higher incidence of tumors with an abnormal or defective receptor distribution. Neither the stage of the disease nor the degree of nodal involvement appeared to affect receptor status in any population group, but very large tumors had fewer receptors. White patients with large neoplasms had a significantly higher incidence of CER than Blacks or Asians. Similar observations were made for White patients presenting with Stage III disease, whose tumors were greater of histological Grade I tumors were positive for CER, compared with Grade III neoplasms. Indications are that receptor status is inherent to the natural history of the disease and is not influenced by clinical features.
Adult↗
Sensitivity to the antilipolytic action of insulin in non-insulin-dependent diabetes in the young.
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Adult↗
Is there a place for the estimation of free tri-iodothyronine levels in the diagnosis of hypothyroidism?
In this study free thyroxine (fT4) and free tri-iodothyronine (fT3) levels were assayed in 87 patients with a clinical diagnosis of hypothyroidism who had elevated thyrotrophin (TSH) levels (greater than 5.5 mU/l). fT4 levels were decreased in 72 of these 87 patients. However, only 44 of the 72 patients with low fT4 levels and increased TSH levels had a decreased concentration of fT3. The remaining 28 patients had normal fT3 levels. It appears that fT3 levels have little, if any, place in screening for hypothyroidism.
Adolescent↗
Clinical patterns of presentation of breast cancer in women of different racial groups in South Africa.
The ages at presentation of white patients with breast cancer were found to be significantly higher than those of blacks, Indians and coloureds; 73% of white women fell into the postmenopausal group, in marked contrast to only 35% of Indians, while blacks and coloureds had similar proportions of pre- and post-menopausal patients. A significantly higher incidence of poorly differentiated tumours was seen in Indian and black patients. Blacks showed a significant tendency to present with more advanced disease, while whites were generally diagnosed at a much earlier stage.
Adult↗
In vitro chloroquine-resistant Plasmodium falciparum malaria in the Natal/Kwazulu area.
Blood samples from 77 patients with Plasmodium falciparum malaria resident in the Natal/Kwazulu area, were tested for chloroquine resistance by an in vitro microtechnique; 6 of these patients were infected by asexual parasites which proved resistant in varying degrees to chloroquine. Resistance, expressed in terms of picomoles chloroquine base per well in which schizont development was completely inhibited, ranged from 16 pmol to greater than 24 pmol. On the evidence it would appear likely that these patients were infected during visits to Mozambique or areas immediately bordering Mozambique.
Adult↗
Idiopathic premature ovarian failure. A clinical and biochemical study.
Thirty-five black patients with premature ovarian failure were studied. All had normal female karyotypes. Vasomotor symptoms were present in 62% of patients and 60% experienced dyspareunia. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were raised and circulating oestradiol levels were low in all patients. Ten patients consented to provocative challenge with gonadotrophin-releasing hormone and thyrotrophin-releasing hormone (TRH). After testing, FSH and LH levels were exaggerated in all 10 patients. During TRH administration, thyroid-stimulating hormone levels were within normal limits in 5 patients, elevated in 4 and low in 1. Prolactin responses were raised in 1 patient, subnormal in 1 and within the reference range in 8.
Adult↗
Lipid and lipoprotein aberrations in Indian patients with non-insulin-dependent diabetes in the young.
The present study was undertaken to examine the lipid and lipoprotein status of 85 Indian patients with non-insulin-dependent diabetes in the young (NIDDY) and 85 matched Indian controls. There were no significant differences between patients and controls with regard to total serum cholesterol, low-density lipoprotein (LDL) cholesterol or apoprotein A-I (apo A-I) levels. However, serum triglyceride and apo-protein B (apo B) levels (females only) were significantly higher and serum high-density lipoprotein (HDL) cholesterol levels significantly lower in the NIDDY patients than in the controls. Serum triglyceride values correlated significantly with glycosylated haemoglobin levels (r = 0,23), HDL cholesterol (r = -0,37) and apo B levels (r = 0,42). The hypertriglyceridaemia and increased apo B levels appeared to emanate from the very-low-density lipoprotein class. Since HDL cholesterol levels were decreased and apo A-I levels were normal, these findings could be interpreted as reflecting an abnormal HDL composition. Obesity did not appear to have a significant influence on the lipid and lipoprotein abnormalities manifested by the patients in this study.
Adolescent↗