RESUMEN
We present nine cases of primary adrenocortical carcinoma, collected in our department of medicine and endocrinology over 25 years. In our patients, the most dependable tumor marker was urinary excretion of tetra-hydro-ll-deoxycortisol (THS), and elevated values were found in all cases where it was determined. In addition to surgical treatment, medication with o,p'-DDD was found to be of value for some of the patients. Median tumor weight was 487 g (118-2,085 g). Prognosis is difficult to predict. Median survival time after diagnosis was 34 months, but varied from three to 266 months.
Asunto(s)
Neoplasias de la Corteza Suprarrenal/patología , 17-Cetosteroides/orina , Neoplasias de la Corteza Suprarrenal/diagnóstico , Neoplasias de la Corteza Suprarrenal/tratamiento farmacológico , Adulto , Anciano , Biomarcadores de Tumor/orina , Cortodoxona/análogos & derivados , Cortodoxona/orina , Síndrome de Cushing/diagnóstico , Síndrome de Cushing/etiología , Femenino , Humanos , Hidrocortisona/sangre , Masculino , Persona de Mediana Edad , Mitotano/uso terapéutico , Metástasis de la Neoplasia , PronósticoRESUMEN
The effect of the histamine H2-receptor antagonist ranitidine on the absorption of food cobalamins was investigated in 20 healthy volunteers randomized to treatment with ranitidine or placebo for 1 week. Liver homogenates containing cobalamins labelled in vivo with cobalt-57 was obtained by repeated injections of 57Co-labelled cyanocobalamin in rabbits. Test doses (0.37 nmol) of the 57Co-labelled liver cobalamins were administered orally together with 51CrCl3 and carmine red, and the absorption of 57Co-labelled cobalamins was assessed from the ratio of the two isotopes in the stool collection that had been coloured by the carmine red. There was no significant difference in the mean absorption before (47.4%) and after (50.7%) the treatment.
Asunto(s)
Alimentos , Absorción Intestinal/efectos de los fármacos , Ranitidina/farmacología , Vitamina B 12/metabolismo , Adulto , Animales , Radioisótopos de Cobalto , Femenino , Humanos , Masculino , Conejos , Distribución AleatoriaRESUMEN
To make a food preparation containing radioactively labelled cobalamins, rabbits were given repeated injections with 57Co-labelled cyanocobalamin. The liver was removed, homogenized, and fried for 1 min or boiled for 30 min. Of the radioactivity in the fried homogenate 41.7% was recovered in the centrifuged supernatant compared with 50.8% in the boiled homogenate. The radioactivity in the supernatants had a molecular size close to that of free 57Co-labelled cyanocobalamin. Forty-two per cent of the radioactivity in the whole homogenate had been incorporated into 5-deoxyadenosyl-, 10% into methyl-, and 16.5% into hydroxy-cobalamin. To assess the validity of a double-isotope method for measuring the intestinal absorption of doses of the 57Co-labelled liver cobalamins, 51CrCl3 was used as a non-absorbable marker. In 14 healthy volunteers the correlation coefficient between the absorption measured by the double-isotope technique and the faecal excretion test was highly significant (r = 0.96, p less than 0.005), and there was only a small variation in the 57Co/51Cr ratio in successive stool collections. In 11 patients with chronic diarrhoea there was a significant correlation between the absorption measured by the double-isotope technique and the faecal excretion test (r = 0.92, p less than 0.005), but in some patients there was considerable variation in the 57Co/51Cr ratio in successive stool collections.
Asunto(s)
Radioisótopos de Cobalto , Diarrea/metabolismo , Absorción Intestinal , Vitamina B 12/metabolismo , Adulto , Anciano , Animales , Cromatografía en Gel , Enfermedad Crónica , Diagnóstico Diferencial , Diarrea/diagnóstico , Alimentos , Humanos , Factor Intrinseco/metabolismo , Hígado/metabolismo , Persona de Mediana Edad , Peso Molecular , Conejos , Transcobalaminas/metabolismo , Vitamina B 12/administración & dosificaciónRESUMEN
Obesity has a close connection with energy balance. Available methods of measurement are, however, too coarse to measure minor daily oscillations that over the months or years can indicate a rise of several kilograms. Basal metabolism is an important part of total energy consumption. This varies with age, sex and body composition. Several investigations appear to show that physical activity can raise basal metabolism. With the help of direct and indirect calorimetry it has been possible to calculate energy consumption above the basal figure. However, in calculating the energy gain through exercise it is necessary to subtract the energy consumption that would otherwise have taken place. Theories have been put forward that the different types of overweight (hyperplastic and hypertrophic) show different gains from physical training as regards weight reduction. However, classification of overweight persons in groups is somewhat uncertain. Physical activity has been found to restore to normal the metabolic changes which are often associated with obesity. There are also cases in which no loss of weight occurs. Physical training has a favourable effect in regulating appetite. Dropout from training programmes is considerable in the overweight. Associated locomotor symptoms may also complicate training. Even though there is little evidence in the literature to show that the majority of overweight persons lose significant amounts of weight without accompanying dietic restrictions, physical training is undoubtedly of great value in these groups.