[Effect of rifampin on the metabolism of glucocorticoids in Addison's disease]

To investigate the effect of rifampicin on the metabolism of hydrocortisone, we measured serum sodium level and blood glucose concentration before lunch in a patient with Addison's disease when treated with hydrocortisone 30 mg/day alone and together with rifampicin 450 mg/day for more than two weeks. We also studied the area under the plasma cortisol curve (AUC), half-life (T 1/2) and clearance rate (CLs) of hydrocortisone after both oral ingestion and intravenous injection of 20 mg hydrocortisone. The results showed that rifampicin increased the metabolism of cortisol by shortening of its T 1/2, increasing its CLs and decreasing its AUC. It decreases the blood sodium level and glucose concentration and makes the patient liable to have hypoglycemic symptoms before lunch. We conclude that the increase of metabolism of cortisol after simultaneous taking of rifampicin may induce adrenal crisis in Addison's disease.

[Clinical study of fifty cases of Klinefelter's syndrome]

The authors report the clinical manifestations of 50 cases of Klinefelter's Syndrome proven by chromosome studies. The number of cases with the genotype of 47 XXY, 46 XY/47 XXY, 46 XX/47 XXY and 48 XXXY were 42, 6, 1 and 1 respectively. The chief complaint of 68% of the patients was maldevelopment of sex and that of 26% was gynecomastia. One fourth of the patients was born when their mothers' age already exceeded 35. About 1/5 had low intelligence. Secondary sexual characteristics were absent in all the patients. About 2/5 had gynecomastia. The average testicular volume was 4.0-1.3 ml, but no sperm was found in their semen. Their serum testosterone concentration decreased to 5.4 +/- 5.3 mM/L, but the serum TeBG, FSH and LH levels were significantly increased to 66.8 +/- 22.0 nM/L, 24.7 +/- 7.1 IU/L and 12.3 +/- 7.3 IU/L.

[Ectopic ACTH syndrome caused by bronchial carcinoid]

A 35-year male patient with clinical and biochemical manifestations of severe hypercorticism was thought to have Cushing's syndrome of pituitary origin. However, the surgically removed pituitary adenoma was not confirmed by pathological examination. There was no improvement after transsphenoidal microsurgery Chest CT scan showed a small mass located at the upper-lobe of the right lung. This tumor (1.8 x 1.0 x 1.0 cm) was removed and one course of radiotherapy with linear accelerator was given. Remission was achieved clinically and biochemically after these therapies. The diagnosis of bronchial carcinoid was confirmed by pathological findings. Metastasis of a lymph node was also proved. The tumor cells was found to contain ACTH and related peptides with radioimmunoassay, immunocytochemistry and electron microscopy. Gel filtration of the tumor extracts showed molecular heterogeniety of ACTH related peptides and that the big-form were in large percentage.

Cyclosporin A inhibits activation-induced cell death in T-cell hybridomas and thymocytes

One mechanism by which the immune system develops the ability to discriminate self from nonself is the deletion of autoreactive T-cell clones during thymic maturation. The drug cyclosporin A (CsA) has been shown to interfere with this process, allowing the escape of normally 'forbidden' T-cell clones and the appearance of autoimmune disease. Recently, it has been demonstrated that immature thymocytes undergo programmed cell death (apoptosis) upon activation via the T-cell receptor. A similar phenomenon of activation-induced cell death (AICD) has been observed in T-cell hybridomas. Here we show that AICD in T-cell hybridomas in vitro and in thymocytes in vivo is blocked by CsA. Thus, clonal deletion may involve AICD when self-reactive, immature T cells are induced by self antigen, and CsA may cause autoimmunity by interfering with this process.

[The clinical manifestations and endocrine changes of anorexia nervosa]

We analyzed the clinical manifestations and endocrine changes of 15 cases of anorexia nervosa. One male, aged 42, and 14 females, aged 14-26 were involved in the study. The precipitating causes were chronic psychiatric trauma (60%), strain (27%) and abnormal fear of being fat (13%). All showed clinical manifestations of hypometabolism and malnutrition. Body weight decreased by 36.3 +/- 11.6% on average and 93% of the patients had lost more than 20% of their original weight. All women patients over 16 years old had amenorrhea. The daily intake of grain was less than 150 gm and had decreased by more than 67% as compared with earlier intakes. Although the patients were very thin, 3/4 could maintain ordinary indoor activities. The patients with anorexia nervosa had obvious endocrine disturbances, such as low serum FSH, LH and Ts levels and high basal serum GH and midnight serum cortisol concentrations. The response of TSH to TRH and of FSH and LH to LHRH were delayed, but serum GH and PRL levels rose normally after stimulation. All of these changes are secondary to severe body weight loss or hypofunction of the hypothalamus.

[Effect of testosterone preparations on the function of the hypothalamic pituitary axis in Klinefelter's syndrome]

This article prospectively observed the suppressive effects of the testosterone preparations on the elevated gonadotropin levels in Klinefelter's syndrome (KS). After sublingual administration of methyl testosterone 5 mg Bid, the serum T levels increased 97 and 126 ng/ml respectively in 6 normal men and 9 patients of KS and the serum FSH and LH levels did not changed significantly. After intramuscular injection of testosterone propionate 25 mg 3/week testovirone 100 mg 1/10 days and testosterone enanthate 200 mg/20 days, the serum T levels increased significantly both in 6 normal mon and 17 patients with KS. It took about 1 month for the LH levels to decrease to normal range and 3-6 months for the FSH levels to become normal. Our result indicates that it is necessary to treat the KS patients for long period to normalize the increased hypothalamic pituitary function.

Kinetics of murine delayed-type hypersensitivity response to Eimeria falciformis (Apicomplexa: Eimeriidae)

Mice recovering from a primary infection with an intestinal protozoan parasite, Eimeria falciformis (Apicomplexa: Eimeriidae), showed a classic delayed-type hypersensitivity (DTH) reaction to oocyst antigen challenge. This reaction was characterized by a biphasic pattern of footpad swelling. The first swelling peaked at 2 h after antigen challenge, whereas the second swelling peaked at 24 to 48 h after challenge. The DTH reaction was transferable with a T-cell-enriched spleen cell population from mice that had recovered from E. falciformis infection. Cytotoxic depletion of immune T cells with anti-L3T4 antibody and complement abrogated DTH transfer, indicating that L3T4-positive T cells were required. A T-cell-enriched spleen cell population from acutely infected mice suppressed the transfer of DTH with immune cells from recovered animals, implicating the existence of infection-induced immunoregulatory cells controlling the parasite-specific immune response during infection. Immune spleen cells also transferred resistance to infection as measured by oocyst production and death rate of recipients. Together, these results indicate that the DTH reaction, induced by infection with E. falciformis, is mediated by L3T4-positive T cells and is associated with resistance to infection.

Chlamydial infection in a Chinese gynecologic outpatient clinic

In an attempt to detect the presence, if any, of cervical chlamydial infection, we obtained endocervical smears from 1000 female patients attending the outpatient gynecologic and family planning clinics at Women's Hospital, Zheijiang Medical University, Hangzhou, People's Republic of China. Using direct immunofluorescent monoclonal antibody staining technique, we identified elementary bodies typical of the Chlamydia trachomatis organism in ten of the 1000 slides (1%). The only characteristic of statistical significance in this small group of infected women was the complaint of infertility for more than two years' duration, noted in six of the ten cases.

Murine major histocompatibility complex and immune response to Eimeria falciformis

The genetics of the immune response to Eimeria falciformis were investigated in three inbred and six congenic strains of mice. There were significant differences among strains in oocyst production and age-related mortality from parasitic infection. Genes within the H-2 complex and also non-H-2 genes share in the immune response to eimerian infection.

Increased plasma and pituitary prolactin concentrations in adult male rats with selective elevation of FSH levels may be explained by reduced testosterone and increased estradiol production

The roles of testosterone and estradiol in regulating prolactin concentrations were studied in acutely castrated adult male rats receiving subcutaneous Silastic implants of the sex steroids. Testosterone was administered in increasing doses, from subphysiologic to intact levels, both alone and in combination with a small, single dose of estradiol. The study was designed to assess whether a change in the relative rates of sex steroid production could account for an increase in PRL release in the absence of other testicular factors. At very low levels of plasma testosterone, FSH and LH levels were indistinguishable from castrate controls. As plasma testosterone concentration increased, both plasma FSH and LH levels were suppressed progressively to intact levels. When a subphysiologic dose of testosterone was coadministered with a small dose of estradiol, the combined effects produced a midcastrate level of FSH but maintained a normal level of LH similar to the selective increase in FSH concentration observed in men with germinal aplasia. Although PRL levels were indistinguishable in intact and castrate controls, testosterone replacement by capsule increased prolactin in a dose-related manner so that, at the physiologic level of testosterone, prolactin was elevated two-fold (P less than 0.01), similar to the level achieved with estradiol replacement alone. Pituitary prolactin levels also increased with increasing doses of testosterone but values remained within the range measured in intact controls. When estradiol was coadministered with testosterone, the combination produced different effects depending on the testosterone dose.(ABSTRACT TRUNCATED AT 250 WORDS)

Observations of Langerhans' cells in leprosy using monoclonal antibody OKT6

Changes in the Langerhans' cells (LC) in seven cases of leprosy were observed using the monoclonal antibody OKT6. In the epidermis of the lesions of most of the leprosy cases, the processes of LC were reduced or diminished. Some LC were disintegrated. In two BT cases in the upgrading (type 1) reactional stage, either increased numbers and aggregation of OKT6-positive cells in clusters or their disintegration was seen in different areas of the epidermis.

Long-term stability of aqueous solutions of luteinizing hormone-releasing hormone assessed by an in vitro bioassay and liquid chromatography

The stability of aqueous solutions of luteinizing hormone-releasing hormone (LHRH) after extended storage at various temperatures was investigated using a newly developed HPLC assay and an in vitro dispersed pituitary cell culture bioassay. Good correlations were obtained between the potency obtained by HPLC and bioassay in samples stored at 37 degrees C or subjected to different stress conditions. No significant decrease in activity of LHRH was observed in aqueous solutions stored at 37 degrees C for up to 10 weeks, at 4 degrees C for 2 years, or subjected to repeated freezing and thawing for 5 d. Heating to 60 degrees C in sterile pH 9.0 buffer up to 11 d and storage at ambient temperature in nonsterile solution for 4 months produced well-distinguished degradation products and a decrease in potency. It is concluded that sterile aqueous solutions of LHRH are stable for at least 10 weeks at 37 degrees C and, thus, could be reliably used for chronic administration when long-term stability at body temperature is important.

Preliminary observation on Langerhan's cells in leprosy

Langerhans' cells were enumerated in the skin of eight borderline and tuberculoid leprosy patients by the enzymatic histochemical demonstration of ATPase in these cells in epidermal sheets. The number of Langerhans' cells was significantly reduced in the skin lesions of these patients compared with normal appearing skin from the same patients. The morphological details of these cells were not clear under light microscopy; further study with electron microscopy is desirable.