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Biomedical subjects

W Futterweit

Publications and source records attributed to W Futterweit.

At least 37 records · Page 2Linked to original sources
PubMed1986

On the expression of H-Y antigen in transsexuals.

Histocompatibility-Y (H-Y) antigen, the presumptive inducer of the mammalian testis, is present in the cells of normal males and not in the cells of normal females. Recent reports have implied that patients with transsexualism exhibit H-Y antigen phenotypes at variance with those of normal males and females and, thus, that H-Y serology might provide a tool for the diagnosis and study of the transsexual condition. We therefore evaluated blood and testicular cells from 21 male-to-female transsexuals using conventional and monoclonal H-Y antibodies. We found no evidence of abnormal H-Y phenotype. Five of the patients were interviewed postoperatively by two examiners and rated for the diagnosis of transsexualism. Three of the five were rated primary transsexual by one or both examiners, and two were rated secondary transsexual.

Adult↗
PubMed1986

Endocrine evaluation of forty female-to-male transsexuals: increased frequency of polycystic ovarian disease in female transsexualism.

A retrospective study of 40 female-to-male transsexuals was performed to investigate the frequency of endocrine dysfunction prior to hormonal treatment with testosterone. Two patients had laparoscopic evidence of polycystic ovarian disease (PCOD) prior to androgen treatment. Nine additional subjects had clinical evidence of PCOD, including ultrasonographic evidence of multicystic and enlarged ovaries in three patients and/or evidence of hirsutism and oligomenorrhea associated with increased androgen levels and/or an increased plasma luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratio. Two subjects had evidence of gonadal dysgenesis. Plasma levels of testosterone, prolactin, LH/FSH ratio, and dehydroepiandrosterone sulfate were significantly increased in 30 female transsexuals prior to testosterone treatment when compared to normal adult female controls studied in the early follicular phase of the menstrual cycle. These data indicate that female transsexuals have an increased incidence of endocrine dysfunction (32.5%) which should be investigated prior to hormonal treatment.

Adolescent↗
PubMed1986

Histopathological effects of exogenously administered testosterone in 19 female to male transsexuals.

The effects of exogenously administered testosterone were evaluated in a group of 19 female to male transsexuals who underwent bilateral salpingo-oophorectomy after a variable period of androgen therapy. The findings were compared to those in an age-matched group of 12 patients who underwent pelvic surgery for nonendocrine reasons. The most significant findings in the 19 androgen-treated female transsexuals was the finding of enlarged or borderline enlarged ovaries in 5 subjects. In addition, we found multiple cystic follicles in 17 patients (89.5%), diffuse ovarian stromal hyperplasia in 16 patients (84.2%), collagenization of the outer cortex in 13 patients, and 4) luteinization of stromal cells in 5 patients (26.3%). Findings consistent with polycystic ovaries were thus present in 13 of the 19 patients based on the presence of 3 of the above 4 findings. The data suggest that increased blood levels and presumably increased ovarian concentrations of testosterone may produce the morphological features of polycystic ovarian disease.

Adult↗
PubMed1985

Thyroid nodules in the irradiated patient--an indication for total thyroidectomy.

Eight patients who received radiation therapy to the head, neck, or chest during infancy, childhood, or adolescence are reported. In these individuals, the presenting abnormality was a nodule of the thyroid gland, which was found to be benign at surgery. All patients were subsequently found to harbor a malignant lesion of the contralateral lobe. On the basis of this study and the discussion presented, we feel that a total thyroidectomy is the indicated therapeutic procedure in previously radiated patients presenting with a cold nodule.

Adult↗
PubMed1985

Adrenocorticotropic hormone testing in idiopathic hirsutism and polycystic ovarian disease: a test of limited usefulness.

The plasma 17 alpha-hydroxyprogesterone (17-OHP) concentration was determined in the basal state and 60 minutes after cosyntropin, 0.25 mg, in 139 patients with idiopathic hirsutism (IH) and polycystic ovarian disease (PCOD). Although there was an increased response of 17-OHP in subjects with PCOD when compared with IH subjects, in no instance was stimulated 17-OHP abnormal in the presence of normal basal 17-OHP. Two subjects with 21-hydroxylase (21-OH) deficiency were discovered; both demonstrated elevated basal levels of 17-OHP. We therefore conclude that routine adrenocorticotropic hormone testing is not a useful tool in detecting 21-OH deficiency in hyperandrogenic women.

17-alpha-Hydroxyprogesterone↗
PubMed1985

Refractory biventricular heart failure in secondary hemochromatosis.

Cardiac hemochromatosis usually presents with clinical congestive heart failure and an enlarged heart. A woman with secondary hemochromatosis and features of both restrictive and congestive cardiomyopathy with a normal sized heart is described. Despite all interventions she had progressive cardiac impairment and expired eight days following presentation. The clinical and laboratory findings of 49 cases of cardiac hemochromatosis during the last 50 years are reviewed. While the disease usually progresses slowly, a significant minority die within fourteen days of recognition. Not infrequently pericardial tamponade is entertained as a cause for this rapid deterioration; however, both a restrictive and congestive cardiomyopathy appear to be responsible for this catastrophic presentation.

Adult↗
PubMed1984

Testicular steroidogenic response to human chorionic gonadotropin of fifteen male transsexuals on chronic estrogen treatment.

Fifteen transsexuals were prepared for surgery with estrogen treatment. The response to human chorionic gonadotropin (hCG) in the untreated state was similar to that of normal subjects when testosterone (T), estradiol-17 beta (E2), 17 alpha-hydroxyprogesterone (17 alpha-OHP), progesterone (P), 4-androstenedione (delta 4A), and dehydroepiandrosterone (DHA) were used as indices. Following estrogen therapy, plasma T, 17 alpha-OHP, and DHA levels were markedly reduced whereas delta 4A and P were not. In spite of the suppressive effects of estrogen, a good response to hCG was noted in such subjects in plasma levels of T, 17 alpha-OHP, and, to a lesser extent, delta 4A even after estrogen administration for 24 months. The high rates of 17 alpha-OHP to T induced by estrogen treatment is restored to normal by the administration of hCG.

17-alpha-Hydroxyprogesterone↗
PubMed1984

Dissociation of serum prolactin response to sequential thyrotropin-releasing hormone and chlorpromazine stimulation in patients with primary empty sella syndrome.

The presence of galactorrhea and/or hyperprolactinemia in patients with the primary empty sella syndrome (PESS) has been proposed to be of hypothalamic etiology. To further elucidate this possible mechanism, sequential testing of 19 subjects with PESS with 500 micrograms thyrotropin-releasing hormone (TRH), followed by the injection of 0.7 mg/kg chlorpromazine (CPZ) 150 minutes later, was compared with results obtained in 6 patients with idiopathic galactorrhea (IG) and 3 normal adult women in the early follicular phase of the menstrual cycle. The thyroid-stimulating hormone and prolactin (PRL) response to TRH was similar in all three groups. The mean maximal increase of serum PRL following CPZ, however, was 16.1 +/- 18.5 ng/ml (standard deviation) in the PESS group, whereas the mean maximal PRL response was 68.6 +/- 40.9 ng/ml in subjects with IG and 67.7 +/- 48.1 ng/ml in the seven normal women. The impaired responsiveness of CPZ in the PESS group was significant (P less than 0.05) when compared with the normal CPZ response in the other two groups. The results of this study suggest that patients with PESS may have hypothalamic dysfunction, and that sequential testing of subjects with TRH and CPZ may be of value in differentiating patients with PESS from those with IG.

Adult↗
PubMed1984

Hypothesis: aberrant puberty and the Stein-Leventhal syndrome.

We hypothesize that the Stein-Leventhal syndrome (type 1 polycystic ovarian disease: SLS-PCOD-I) results from an aberrant puberty. Abnormal neural development in the brain decreases the hypophyseal set-point for negative and positive ovarian hormone feedback. This generates a condition whereby hypophyseal luteinizing hormone (LH) secretion is inappropriately elevated compared to hypophyseal follicle-stimulating hormone (FSH) secretion and is thus termed inappropriate gonadotropin secretion (IGS). The events which create an initial state of IGS are referred to as the "generator" stage. IGS is maintained by ovarian-derived hyperandrogenemia and increased peripheral aromatization of androgens yielding elevated free serum estrone (E1) and unbound estradiol (E2) levels. E1 suppresses release of hypophyseal FSH while E2 exerts positive feedback on LH pulsatile release by increasing pituitary sensitivity to gonadotropin-releasing hormone (GnRH). Diminished circulating FSH levels decrease granulosa cell aromatase activity sufficiently to cause suboptimal ovarian conversion of LH-induced thecal androgens into estrogens. Consequently, chronic local ovarian hyperandrogenemia with associated arrested follicle maturation results in chronic anovulation. Furthermore, an elevated circulating LH/FSH ratio stimulates early development and proliferation of immature follicles causing the appearance of polyfollicular ovaries. In this effector stage of PCOD-I, a vicious cycle is fashioned wherein IGS causes polyfollicular ovaries and increased ovarian androgen production which, in turn, promotes IGS. We suggest that the etiology of this disease involves an aberrant puberty that establishes a persistent faulty hypothalamic-hypophyseal-ovarian axis.

Female↗
PubMed1983

Normal plasma gonadotropin response to gonadotropin-releasing hormone after diethylstilbestrol priming in transsexual women.

Plasma LH and FSH responses to GnRH (100 micrograms, iv) were measured in four female transsexuals with normal ovulatory menstrual cycles before and after the administration of 2.0 mg diethylstilbestrol (DES) daily for 7 days. One normal ovulatory woman was also studied in the early follicular phase of the menstrual cycle. No difference was found in the augmented response of the four female transsexuals to GnRH after DES priming from that of the normal adult female. The augmented response to GnRH found in the female transsexuals after DES treatment provides evidence that hypothalamic-pituitary feedback control is normal in the female transsexuals studied.

Adult↗
PubMed1983

Pituitary tumors and polycystic ovarian disease.

Three patients with polycystic ovarian disease and an associated pituitary tumor are described. Oligomenorrhea was present with galactorrhea in one patient, and amenorrhea was the presenting symptom in the other two. Diagnosis of the pituitary tumor was confirmed by computed tomography. Hyperprolactinemia (39.2 to 72.0 ng/ml) was present in two patients, both of whom responded promptly to the administration of bromocriptine. One nonhyperprolactinemic patient had an associated empty sella diagnosed with metrizamide cisternography. The literature of pituitary neoplasms in polycystic ovarian disease is reviewed and possible pathophysiology is discussed.

Adult↗
PubMed1980

Oral contraceptive history as a risk indicator in patients with pituitary tumors with hyperprolactinemia: a case comparison study of twenty patients.

This report presents a retrospective case comparison study of 20 hyperprolactinemic patients with pituitary adenomas treated at the Mount Sinai Hospital (1976-1079). An association between oral contraceptive (OC) use and 20 subjects with pituitary tumors was substantiated using discordant paired analysis. The comparison group consisted of appendectomy patients admitted during the same time period and matched for sex and age. The estimated relative risk was 4.0 (P less than 0.025). This study suggests that there is a significant association between OC use and pituitary tumors associated with hyperprolactinemia.

Adenoma, Chromophobe↗