Norman M. Kaplan

THE EFFECT OF ACTH, RENIN, ANGIOTENSIN II, AND VARIOUS PRECURSORS ON BIOSYNTHESIS OF ALDOSTERONE BY ADRENAL SLICES

Angiotensin II has been shown to increase the excretion (1) and secretion (2) of aldosterone by normal human subjects, and the secretion of aldosterone by hypophysectomized, nephrectomized dogs (3-5). In the latter preparation (3), renin, which leads to the liberation of angiotensin in the circulation (6), has been shown to stimulate aldosterone secretion. The present studies were done to determine whether angiotensin and renin can act directly on the adrenal cortex. It will be shown that angiotensin II, like ACTH, does have such a direct effect, and renin does not. The effect of various precursors on the biosynthesis of aldosterone was determined and compared with their effect in the presence of ACTHand angiotensin II. In this way, we have sought to identify and compare the loci of action of ACTHand angiotensin II in the biosynthesis of aldosterone.

PRIMARY ALDOSTERONISM WITH MALIGNANT HYPERTENSION.

THE hypertension seen in all reported cases of primary aldosteronism caused by an adrenal adenoma has been of a benign and not rapidly progressive nature.1 On the other hand, an increased secretion...

HYPOGONADISM IN YOUNG MEN (WITH EMPHASIS ON KLINEFELTER'S SYNDROME)

Excerpt Significant advances have recently been made in our understanding of sexual differentiation and maturation. Reports on the application of this knowledge to the differential diagnosis of hyp...

Successful pregnancy following hypophysectomy during the twelfth week of gestation

Panhypopituitarism followed the surgical removal of a chromophobe adenoma from a woman in the twelfth week of pregnancy. The patient received hydrocortisone, desiccated thyroid and vasopressin, and the pregnancy proceeded to term in normal fashion. Minimal lactation occurred post partum. Hormonal excretion was similar to that observed in normal pregnancy. This case illustrates that, provided adequate replacement therapy is given, complete or nearly complete functional ablation of the pituitary during the latter part of the first trimester is compatible with normal human pregnancy. THE origins of many of the hormonal changes observed during pregnancy remain obscure. In particular, evidence in the human concerning the role of the pituitary gland in producing these changes and, even more basic, in maintaining gestation, is understandably meager. Since gonadotropin deficiency accompanies panhypopituitarism and precludes ovulation, such evidence can be obtained only when pituitary deficiency develops after conception. Spontaneous pituitary necrosis is rare during pregnancy; when it occurs, fetal death has been invariable. Little and associates (1) reported that pregnancy was successful in a patient hypophysectomized during the twenty-sixth week. The present report describes endocrine studies, both before and after the delivery of a living child, in a patient whose pituitary was removed during the twelfth week of pregnancy.