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P. Bösze, Zs. Kóvacs, J. Egyed, J. László, and G. Szilágyi

Abstract.

Plasma TSH and Prl responses to iv TRH (200 μg) were studied in 21 euthyroid patients with streak gonad syndrome which is characterised by high levels of FSH and LH and low level of oestrogen and in 9 healthy women. The syndrome is associated with a variety of chromosome complements. Basal TSH and Prl responses to TRH were normal in patients with streak gonads irrespective of their chromosomal complements. Peak levels of both the TSH and Prl occurred at 15–30 min following TRH. The data might suggest that in hypergonadotrophic oestrogen deficiency neither the TSH nor the Prl response to TRH are attenuated. It does not seem that the associated chromosome anomalies alter the TSH and Prl responses to TRH in euthyroid affected patients.

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SL Asa, K Kovacs, E Horvath, FA Laszlo, and I Domokos

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F. A. László, I. Szijj, J. Kocsis, and K. Kovács

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F. A. László, I. Szijj, F. Durszt, and K. Kovács

ABSTRACT

The hypoglycaemic action of synthetic human 1,39-corticotrophin was determined in mice and its effectiveness compared with highly purified porcine corticotrophin.

Synthetic human 1,39-corticotrophin (0.01 mg = 1.0 IU) and porcine corticotrophin (1.0 IU) induced a transient hypoglycaemia. After the administration of the porcine corticotrophin the decrease in the blood glucose concentration was somewhat more marked and prolonged. Adrenocortical activity was not necessary for the development of hypoglycaemia. In adrenalectomized mice, dexamethasone substitution by increasing the initial blood glucose content, made the effect more pronounced. Pretreatment with corticotrophin reduced the extent of the alloxan-induced transitory hyperglycaemia. On the other hand, it did not influence the high blood glucose values in manifest alloxan diabetic animals.

It is possible that corticotrophin induces hypoglycaemia through insulin release. This is an extra-adrenal effect of corticotrophin as it is also observed in adrenalectomized mice.

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István Szabolcs, Zsuzsa Kovács, Judit Gönczi, Tibor Kákosy, Miklós Góth, Orsolya Dohán, László Kovács, and Géza Szilágyi

Szabolcs I, Kovács Z, Gönczi J, Kákosy T, Góth M, Dohán O, Kovács L, Szilágyi G. Prevalence of thyroid dysfunction in different geriatric subpopulations from a moderately iodine-deficient Hungarian region. Comparative clinical and hormonal screening. Eur J Endocrinol 1995;133:294–9. ISSN 0804–4643

The aim of this study was to investigate the prevalence of thyroid dysfunction in different geriatric subpopulations from a moderately iodine-deficient Hungarian region and to compare the efficacy of clinical versus hormonal screening. A screening study was done on 279 chronically ill geriatric patients (Group I) and 256 consecutive hospital admissions over 60 years of age (Group II). The method of clinical screening was different from those used so far: the object was not to search for symptoms of hypo- or hyperthyroidism but to find any sign justifying a further thyrotrophin-based biochemical evaluation, i.e. history of thyroid disease or goitre or any clinical sign of hormonal dysfunction. The rates of overt hypothyroidism, overt hyperthyroidism, subclinical hypothyroidism and subclinical hyperthyroidism discovered by the hormonal screening were 2.9, 1.1, 3.6 and 5.7% in Group I and 3.5, 2.3, 3.9 and 2.0% in Group II. The sensitivities of the clinical screening to suspect overt or overt + subclinical dysfunctions were, respectively, 0.82 and 0.64 in Group I and 1.0 and 0.7 in Group II (or 0.67 and 0.4 if the clinical investigation was done not by an endocrinologist but by the medical attendants). A primarily clinical investigation-based screening would have spared 171/279 thyrotrophin estimation in Group I and 161/256 in Group II, but would have missed 2/11 overt and 11/26 subclinical dysfunctions in Group I. In Group II, no overt but 9/15 subclinical dysfunctions would have been lost in this way. Our approach of a clinical investigation-based screening was rather efficient in suspicion of overt thyroid dysfunction but failed to detect many cases with subclinical dysfunction. As there is increasing evidence from the literature on the clinical importance of subclinical thyroid dysfunction states, the primary screening method should be biochemical, at least in the elderly sick. The prevalence of overt and subclinical dysfunctions would justify the screening of chronically ill hospitalized geriatric patients.

I Szabolcs, HIETE I. Bel, Budapest, PO Box 112, H-1389, Hungary

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Ferenc Laczi, Ferenc A. László, Gábor L. Kovács, Gyula Telegdy, Anna Szász, János Szilárd, Jan M. van Ree, and David de Wied

Abstract. Intranasal treatment with desglycinamide9-(Arg8)-vasopressin (DGAVP) improved certain aspects of cognitive functions of patients with acquired and congenital diabetes insipidus and of alcoholic patients with mild cognitive impairments. Patients with Korsakoff's syndrome, presenting with severe cognitive impairments, were resistent to DGVP treatment. DGAVP treatment did not affect blood pressure and water metabolism. The action of DGAVP on cognitive functions is probably mediated by centrally located target sites and may be expressed only in patients in whom these target sites are unimpaired.

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Zita Tarjányi, Gergely Montskó, Péter Kenyeres, Zsolt Márton, Roland Hágendorn, Erna Gulyás, Orsolya Nemes, László Bajnok, Gábor L Kovács, and Emese Mezősi

Objective

The role of cortisol in the prediction of mortality risk in critical illness is controversial in the literature. The aim of this study was to evaluate the prognostic value of cortisol concentrations in a mixed population of critically ill patients in medical emergencies.

Design

In this prospective, observational study, measurement of total (TC) and free cortisol (FC) levels was made in the serum samples of 69 critically ill patients (39 males and 30 females, median age of 74 years) at admission (0 h) and 6, 24, 48, and 96 h after admission.

Methods

Cortisol levels were determined using HPLC coupled high-resolution ESI-TOF mass spectrometry. The severity of disease was calculated by prognostic scores. Statistical analyses were performed using the SPSS 22.0 software.

Results

The range of TC varied between 49.9 and 8797.8 nmol/l, FC between 0.4 and 759.9 nmol/l. The levels of FC at 0, 6, 24, and 48 h and TC at 0, 6 h were significantly elevated in non-survivors and correlated with the predicted mortality. The prognostic value of these cortisol levels was comparable with the routinely used mortality scores. In predictive models, FC at 6, 24, and 48 h proved to be an independent determinant of mortality.

Conclusions

The predictive values of FC in the first 2 days after admission and TC within 6 h are comparable with the complex, routinely used mortality scores in evaluating the prognosis of critically ill patients. The cortisol response probably reflects the severity of disease.

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F. Laczi, J. M. van Ree, A. Wagner, Zs. Valkusz, T. Járdánházy, G. L. Kovács, G. Telegdy, J. Szilárd, F. A. László, and D. de Wied

Abstract.

The effects of desglycinamide9-arginine8-vasopressin (DG-AVP) on memory processes have been studied in patients with central diabetes insipidus (DI) and in non-diabetic control patients. Acute im injection of DG-AVP improved some aspects of short-term memory. Subchronic intranasal administration of DG-AVP facilitated short-term memory more consistently and in addition improved long-term memory. DG-AVP increased the attention, but only in the non-diabetic subjects. The effects of DG-AVP on memory processes persisted after discontinuation of treatment. DG-AVP did not affect the parameters for water and electrolyte metabolism, blood pressure and pulse rate neither in DI nor in the control patients. Thus, the memory effects of DG-AVP are probably mediated by a direct action on the central nervous system.