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透析患者の血糖 (BG) コントロールの指標としてグリコヘモグロビン (HbA1c) およびグリコアルブミン (GA) の2つを比較検討した. 対象は, 糖尿病を有する慢性維持血液透析患者41名 (男性31名, 女性10名, 平均年齢65±9歳) であり, 全例が昼間透析である. 透析来院時に, 透析開始時, 透析中昼食前, 透析終了時の3ポイントで血糖値を, また透析開始時の採血でHbA1cとGAを測定し, それぞれの関係を検討した. また, 同日から遡り過去4週および2週間の透析開始時平均血糖値 (朝食後平均143分後) を求め, これら平均値とHbA1c, GAおよび他の因子との関係についても検討した. 結果は, GAとHbA1cとは良好な相関関係が認められた (r=0.663, p

AIあるいはFe骨症7例に対してDesferrioxamine (DFO) を長期投与し, その結果を検討した.DFO投与後, 全例骨痛の改善がみられた. 治療前に骨生検施行した7例中6例に骨石灰化前線にAIおよびFe沈着を認めた. DFO治療中の2例および治療後の2例の計4例に, AI沈着が認められた. しかし, Fe沈着の消失あるいは減弱した症例もみられ, DFO治療によってAIよりFe除去が早期にそしてより多く起こるのではないかと考えられた. また, 治療後, 臨床的にたとえ著明な改善がみられた症例でも, 組織学上完治する可能性は少ないのではないかと推定される. また, AI骨症には, AIとFeが同時に石灰化前線に沈着をみることからAI骨症はAI-Fe骨症でもあるという概念を常に念頭においておかねばなるまい.骨シンチグラムにて治療経過観察を行ったが, 殆どの症例で骨痛消失後から遅れて骨シンチグラム上の改善がみられた. DFOの投与必要期間は骨シンチグラム上の改善がみられることが大きな指標になると考えられた.

The HPLC system was used to separate and measure 10 kinds of corticoids in adrenal tissues. Calibration curves were drawn as straight lines that ranged from 1.25 to 20ng, or 1.25 to 200ng by peak area calculated with the chromatointegrator. The samples for the assay were extracted from homogenized tissues and treated with methanol to remove non-steroidal contaminants which may interfere with the ultraviolet absorption monitor. The recovery rate during the assay procedure was calculated using testosterone as the internal standard, because testosterone was not detected in any adrenal tissue examined in the present study. Contents of corticoids were measured in normal adrenal glands obtained during radical nephrectomy for renal cancer and in functioning adrenal adenomas. Steroid levels in the adrenal glands and tumors have been measured by radioimmunoassay until now, and the data obtained in the present study were compared with those in previous reports. Main steroids in normal adrenals were cortisol (F) and corticosterone (B), and there were certain amounts of 11-deoxycortisol (S), 11-deoxycorticosterone (DOC) and precursor steroids. 11 beta-hydroxy-androstenedione was the main androgen in the adrenal gland. Mineralocorticoids other than B and DOC were very low in the normal adrenals. There was a certain balance between the production of cortisol and corticosterone in normal adrenals. In functioning adenomas, the levels of F, B and aldosterone, and F to B ratios (F/B) varied according to their biological features. Although with the HPLC system it was possible to obtain the production balance of each steroid clearly in the chromatogram, we could not detect the delta 5-3 hydroxysteroids such as pregnenolone and dehydroepiandrosterone using the ultraviolet absorption monitor.

A 64-year-old man with sudden onset of quadriplegia due to marked hypokalemia was referred to our clinic with suppressed plasma renin activity in the presence of a low aldosterone level. Computerized tomography demonstrated a left adrenal adenoma, shown on adrenal scintigraphy to be functioning. The elevated basal level of plasma corticosterone and its increased response to 1-24 adrenocorticotropic hormone suggested the tumor produced corticosterone. The surgical specimen was a benign adrenocortical adenoma with excess content of corticosterone and 18-hydroxycorticosterone.

We have measured androgen receptor in whole cell, cytosol and nuclear fractions of cultured skin fibroblasts originated from the genital area. Samples were obtained from the following patients: 10 boys with phimosis, 5 boys with cryptorchism, 4 boys and a man with hypospadia, 2 infertile men and 3 normal men. Androgen receptor was measured using methyltrienolone (R1881) as the ligand according to the assay technique of Eil et al. using dispersed cell method. The results were as follows: 1. There were no significant statistical differences in the dissociation constant among the diseases. 2. Hypospadia cases showed lower maximum binding capacities (Bmax) of whole cell than phimotic boys but the difference was not statistically significant. 3. The Bmax of normal men were statistically higher than those of phimotic boys and about 80% of these receptors were seen in the nuclear fraction. We also experienced low Bmax levels in an adult hypospadia case and two infertile men. These results suggest that this method is a simple and rapid method to study both nuclear and cytosol androgen receptor at the same time. It is also suggested that there are some cases with reduced androgen receptor levels in hypospadia and infertile cases.