Lewis M. Hurxthal

Assessment of adrenocortical function.

The authors discuss the clinical features of chronic adrenocortical disorders (except those due to aldosterone alterations) and indicate the laboratory tests that should be carried out to assess adrenocortical function. They also present an outline of these laboratory procedures, including the results, relative value and special significance of the tests.

Diagnosis of hypopituitarism associated with chromophobe tumor; presumed or verified.

The clinical manifestations of pituitary chromophobe tumor may be divided into those due to pressure or extension of the tumor to adjacent areas, and those due to pressure upon the pituitary gland itself, resulting in variable degrees of hormonal deficiency. It is unfortunate that the majority of persons with symptomatic chromophobe tumors first seek advice because of visual disturbances. The latter consist of blurring of vision, reduction in visual acuity, or partial loss of sight due to bitemporal hemianopsia or other field defects. Careful inquiry often reveals that other symptoms preceded the change in vision. Had these preliminary and warning signs been heeded earlier, irradiation might have saved many from serious visual defects which, in some cases, may lead to complete blindness. In addition to visual disturbances which result from local pressure, there may be other evidence of expanding tumor. Headache, for example, would naturally be expected to occur more frequently than changes in eyesight, bu...

The Bone Changes in Primary Hypogonadism

THIS report is based on observations made on nine cases of primary prepuberal hypogonadism. By this term we refer to that condition in which puberty has not taken place (absence of secondary sex characteristics), in which there is every evidence clinically of normal pituitary function, and in which there is no evidence of other endocrine disorders. When the usual and normal physiologic changes caused by a particular gland fail to appear, it is, therefore, natural to assume that the gland is deficient. It must not be forgotten, however, that such changes are produced not only by the activity of the hormone in question but also by the ability of the end organ to react to that hormone. Furthermore, if there is evidence of activity of a certain gland, as determined by biological tests which even now are relatively crude, the product of that gland may fail to produce a reaction in the end organ because the hormone may be present in an inactive form. A clear conception of these principles should simplify diagno...