John E. Bethune

Congenital Generalized Lipodystrophy Accompanied by Cystic Angiomatosis

Abstract Five siblings had congenital generalized lipodystrophy and systemic cystic angiomatosis. Manifestations of each disease and a suggested mechanism of cause related to rapid mobilization of ...

The Role of Adrenocorticoids in the Inappropriate Antidiuretic Hormone Syndrome

Abstract Twenty patients with all of the characteristics of the inappropriate antidiuretic hormone (ADH) syndrome were observed at the Los Angeles County General Hospital in the past 2 years. The v...

Human growth hormone and α2-macroglobulin: A study of binding☆

Abstract The availability of a pure human α 2 -macroglobulin ( α 2 -M) preparation has prompted a re-examination of its reported binding with human growth hormone (HGH). Incubation of labeled HGH preparations with α 2 -M did not show significant binding as measured by paper chromatoelectrophoresis, starch gel electrophoresis, or gel filtration. Although a small proportion of HGH traveled with α 2 -M, an analysis of the results suggests that this is not due to binding by the major component of α 2 -M. These studies indicate that the major component of α 2 -M cannot serve as a carrier protein for HGH in human plasma. An expression for the behavior of a dissociating system in gel filtration, applicable to the particular conditions employed in this study, is developed and discussed.

Interpretation of thyroid function tests

The development of radioimmunoassays over the past 20 years has expanded our knowledge of thyroid physiology and improved our management of thyroid disease. The use of these tools in neonatal screening for congenital hypothyroidism alone has reduced the incidence of mental retardation in the industrialized world. Based on an accurate physical examination, the judicious use of immunoassays for thyroxine, triiodothyronine, and thyrotropin and the use of thyroglobulin and thyroid microsomal antibodies will allow the general physician to confidently delineate common thyroid disorders in the great majority of patients. The additional use of an ultrasensitive thyrotropin assay, thyroid scans, and fine-needle aspiration biopsy will complete the accurate diagnosis of the great majority of thyroid diseases. The ultrasensitive thyrotropin assay may become the universal thyroid function test. The major pitfalls in the use of these tests lies in the variable effect chronic illness has on the most frequently used tests: thyroxine and triiodothyronine. Tests for these thyroid hormones, which in the relatively well outpatient are highly accurate, may in the ill, hospitalized patient become very misleading.