Data are presented concerning a 60-year-old woman with untreated congenital adrenocortical hyperplasia due to 21-hydroxylase deficiency, who presented with a tumour of the left adrenal gland. Steroid excretion was partly suppressed with dexamethasone. After removal of the tumour, the excretion of several steroid fractions decreased substantially, but suppression by dexamethasone remained inadequate. Preoperatively, plasma ACTh was elevated in the afternoon and decreased only slightly after dexamethasone administration. After surgery, cortisol secretion decreased markedly, whereas ACTH dysregulation became more prominent. Negative feedback failure precluded the use of normal suppressive therapy with low doses of glucocorticosteroids and led to the therapeutic removal of the right adrenal gland, which showed histological signs of nodular hyperplasia.
We evaluated the analytical performance of the Hitachi 704 automatic analyzer. The spectrophotometer showed a linearity of response at 340 nm up to 2.8 A. Photometric imprecision measured bichromatically at 340 and 376 nm was 0.49% at 0.16 A, 0.14% at 0.46 A, and 0.17% at 0.76 A. Imprecision of the sample probe was 0.4% for 5, 10, and 20 microL, and the volume delivered deviated -2.4%, -4.4%, and -4.2% from these preset volumes, respectively. Imprecision of the reagent probe over the range 50 to 500 microL ranged from 0.14% to 0.29%; volume delivered deviated from +1.7% to +4.4%). At equilibrium, the temperature in the cuvets was 29.8 (SD 0.05) degree C as measured by cresol red spectrophotometry. No sample carryover was detected. Reagent carryover was detected when a bilirubin assay was preceded by a total protein assay and when lactate dehydrogenase was measured after alanine aminotransferase. Imprecision for nine tests at three concentrations ranged from 1.1% to 4.4%. Comparison of methods with the SMAC II as reference method showed good results. Precision was better than reported for the Hitachi 705 automatic analyzer.
SUMMARYA simple and specific method for the determination of iodoamino acids (IAA) and hormonal iodine (HI) in serum is presented. 0.5 ml serum is allowed to run through a small column with a cation exchange resin. To isolate IAA, the column is washed with water and eluted with ammonia. To isolate HI, the column is washed with borate buffer, then with water and eluted with ammonia. After removal of the ammonia by heat, the organic iodine compounds are digested with chloric acid. Iodine is assayed by ceric sulphate-arsenious acid calorimetry. Normal values for IAA ranged from 3.6 to 7.2 pg iodine/roe ml serum (mean value 5.10 yg iodine/roe ml), and for HI from 3.0 to 6.0 ,uug iodine/roe ml serum (mean value 4.30 pg iodinejroo ml).
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