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Recent in-vivo studies made by Deshpande, Jensen, Carson, Bulbrook & Doouss (1970) concerned with the synthesis of androgens by the human adrenal gland have again emphasized the equivocal nature of the results available on this subject. The present communication describes how results contrary to those obtained in vivo were derived from investigations in vitro: this prompts us to suggest that further studies are necessary on the control of androgen production. Evidence has been obtained (Ichii, Forchielli, Cassidy, Rosoff & Dorfman, 1962; Kase & Kowal, 1962; Ward & Grant, 1963) for the presence in various pathological types of human adrenal tissue of the enzyme systems necessary for the conversion of progesterone to adrenal androgens, while Deshpande et al. (1970) showed that in vivo, 17α-hydroxyprogesterone rather than dehydroepiandrosterone (DHA) is the more important precursor of androstenedione. On the other hand Cohn & Mulrow (1963) showed in both hyperplastic and neoplastic adrenal tissue
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SUMMARY
Plasma growth hormone (GH) levels were measured in 55 patients with advanced breast cancer, before and 3 months after pituitary ablation either by yttrium-90 implantation or by transethmoidal hypophysectomy. It was found that four of the 46 patients tested before ablation had an 'absent' GH response to insulin-induced hypoglycaemia. A comparison of the GH response to insulin-induced hypoglycaemia after yttrium implantation and transethmoidal hypophysectomy revealed no difference between the two procedures in the degree of pituitary ablation achieved. A partial GH deficiency occurred in 30% of patients after yttrium implantation but in only 4% after transethmoidal hypophysectomy.
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SUMMARY
Plasma growth hormone (GH) levels during insulin hypoglycaemia were measured in 30 women with implants of 90Y in the pituitary for advanced breast cancer. There was evidence of continued pituitary activity in six patients (20%), the rise in plasma GH level being greater than 4 ng/ml during hypoglycaemia. Thirteen patients (43%) were regarded as having complete ablations because they had no GH response and a fasting level of less than 4 ng/ml. In the remaining 11 patients (37%) there was no rise in the GH level during hypoglycaemia, but there were significant fasting levels. From the post-mortem evidence it was concluded that these patients also had adequate ablations.
This test is shown to be of more value in estimating residual pituitary function than routine tests of thyroid or adrenal function.
