[Hypophyseal gonadotropin secretion in sexual precocity with McCune-Albright's syndrome]

In three young girls with isosexual precocity and fibrous dysplasia of bones, plasma gonadotropins (LH and FSH) response to releasing hormone (LH-RH) has been much under the mean response in true female precocious puberty. These data and those previously reported in the literature suggest that MacCune-Albright's syndrome correlates to an hypothalamo-pituitary dysfunction rather than to a true prematurity.

Adrenal and ovarian vein androgen levels and laparoscopic findings in hirsute women

Hirsute women pose a diagnostic dilemma when urinary 17-ketosteroid and serum testosterone levels are normal. To locate the site of androgen excess in 19 hirsute women, blood samples were collested from the left ovarian and adrenal veins via a catheter insertedinto the right femoral vein. Laparoscopy and bilateral ovarian biopsies were also preformed in 18 of the 19 patients studied. Nine women had elevated 17ketosteroid (fivepatients) and/or antecubital serum testosterone (five patients) levels. Fourteen womanhad elevated testosterone concentrations distributed as follows: ovarian vein (six), adrenal vein (one), adrenal and ovarian veins (seven). Androstenedione was elevated in theovarian vein (seven) and both adrenal and ovarian veins (11) in 18 patients. Laparoscopic examinations revealed that less than 50 per cent of the enlarged ovaries could be detected by pelvic examination. Histologic studies suggested that these patients comprised two groups: a group (six patients) who appeared to ovulate and a group (12 patients) who lacked evidence of ovulation.

Sexual precocity associated with a hypothalamic tumour. Effects of sex hormone therapy

A case of sexual precocity of unusually early onset and associated with a hypothalamic tumour is described. The effects of ethinyl oestradiol and medroxyprogesterone acetate treatment have been monitored by plasma testosterone, FSH, and LH estimations. The results suggested a partial suppression of the tumour's influence, the mechanism of which is discussed.

Urinary gonadotrophins in the Sertoli-Cell-only syndrome

In order to study the hypophyseal-testicular axis in males with complete absence of germinal epithelium, the urinary total hypophyseal gonadotrophins (HG), urinary follicle stimulating hormone (FSH) and urinary luteinizing hormone (LH) were measured by specific bioassays in 12 males with classical Sertoli-cell-only syndrome and compared with HG, FSH, and LH in normal and castrated men. HG and FSH were significantly higher than HG and FSH in normal men (P smaller than 0.0025, P smaller than 0.0005, respectively), but significantly lower than in castrated men (P less than 0.001, P less than 0.01, respectively). LH was not different from LH of normal men, but significantly lower than in castrated men (P less than 0.0005). All patients had normal excretion of androgen metabolites (androsterone plus aetiocholanolone) but a dexamethasone suppression test, performed in 8 subjects, revealed that in 2 cases of testicular origin, the values were below the normal range. The excretion of oestrogens was within the normal range. The presented data support the concept that the germinal epithelium produces a substance capable of inhibiting FSH secretion from the hypophyses, the Sertoli cell itself, however, having a basal production of this inhibitor. The finding of low excretion of testicular androgen metabolites in some of the patients and normal urinary LH, indicates that disturbances in the LH-testosterone feedback mechanism in such patients may occur and that the previous concept of isolated defects of spermatogenesis in all such patients was erroneous.

Urinary gonadotrophins following castration of men

The excretion of total hypophyseal gonadotrophins (HG), follicle stimulating hormone (FSH) and luteinizing hormone (LH) was studied in 13 castrated men aged 23 to 56 years, mean 38.8 years. All the men were castrated for legal reasons. The time from castration to the investigation varied from 4 weeks to 24 years. Four of the subjects were studied from the time before surgery until 4 weeks after castration. The mean excretion of HG, FSH and LH was statistically significantly higher than that of normal men of the same age i. e. by 8, 9 and 3 times higher respectively. The FSH/LH ratio was in the mean 2.8. Following orchiectomy FSH rose more rapidly and to a higher level than LH. The maximal level of FSH was reached within 1–2 weeks after castration in contrast to LH which did not consistently reach the maximal level within 4 weeks. This difference in FSH and LH levels after castration supports the concept that FSH and LH are regulated independently in man.