尿中Gonadotropin排泄量に関する臨床的研究
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Part 1 : Urinary gonadotropin in thyroid disorders.<BR>Observations have been made on the changes in menstruation and the urinary gonadotropin (GTP) in cases of thyroid dysfunctions.<BR>(1) In 114 cases of hyperthyroidism, 61 (53.5%) developed abnormal menstruation after the onset of the disease. It was confirmed that the incidence of abnormal menstruation increases in parallel with the severity of hyperthyroidism and that in hyperthyroidism there is a tendency toward hypomenorrhea. It seems that a certain correlation exists between amenorrhea and exophthalmos.<BR>(2) Among 15 cases of hypothyroidism the amount of menses increased in 6 and menstruation became irregular in 9. A tendency toward hypermenorrhea was observed.<BR>(3) A close relationship exists between functions of the thyroid and the gonads since menstruation improves in many patients when the thyroid function is restored to normal.<BR>(4) The urinary GTP of 21 cases of hyperthyroidism (11 males and 10 females) showed an increase or the upper limit of normal and that of 7 cases of hypothyroidism (1 male and 6 females) showed a decrease or the lower limit of normal. In 4 out of 5 cases of hyperthyroidism accompanied by exophthalmos, the urinary GTP markedly increased. This may indicate a close relationship, between GTP and TSH and EPS. The urinary estrogen was in the normal range in both categories of thyroid dysfunction.<BR>(5) In both hyperthyroidism and hypothyroidism a physiological increase in GTP characteristic to the climacterium was noted.<BR>(6) A simultaneous measurement of the urinary GTP, estrogen and pregnandiol in 2 cases of hyperthyroidism (both females) and 2 cases of hypothyroidism (both females) revealed imbalance between these hormones except in one case of hypothroidism in which menstruation remained normal before and affer the onset of the disease.<BR>The maintenance of the normal function of the gonadal system requires an adequate amount of thyroxine. In thyroid dysfunctions, not only changes in the function of the hypothalamo-hypophyseal-gonadal system but also the alteration of the sensitivity of the target organs to the tropic hormones due to the action of thyroxine, may play an important role in the development of gonadal dysfunctions.<BR>Part II : Urinary gonadotropin in various endocrine disorders.<BR>The urinary GTP was measured in serveral endocrine disorders.<BR>(1) It was normal in 2 cases of Addison's disease. In 2 cases of Cushing's syndrome it was found normal in one and decreased in the other. It was normal in one case of adrenogenital syndrome. In these 2 cases of diabetes insipidus and 6 cases of anorexia nervosa, it was found decreased.<BR>(2) In 5 cases of Simmonds' disease it was decreased in 2, but in 3 climacteric patients it remained normal. Therefore the atypical type of this disease was discussed.<BR>(3) Six cases of hypogonadism were classified into two types according to the urinary content of GTP : The first type is maldevelopment of testes per se and the second type is due to hypophyseal dysfunction. Measurement of GTP, therefore, is very useful in establishing a correct line of treatment.<BR>Part III : Urinary gonadotropin in liver diseases.<BR>The urinary GTP and estrogen were measured in 12 cases of hepatic cirrhosis and 5 cases of various liver diseases.<BR>(1) The urinary GTP in hepatic cirrhosis was either the lower limit of normal or below normal.The urinary estrogen showed relatively high values within the normal range. Hyperestrogenism due to disturbed inactivation in the liver seems to be the - cause of decreases in the urinary GTP.<BR>(2) In hepatic cirrhosis there was an inverse relationship between the urinary GTP and the serum γ-globulin.<BR>(3) In liver diseases other than cirrhosis there was no definite direction of alterations in the urinary GTP.
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