The frequency of post-partum hypopituitarism (Sheehan's syndrome) is difficult to assess. It is the purpose of this paper to ascertain the incidence of post-partum hypopituitarism in Okayama Red Cross Hospital. Out of 19,302 women who delivered at the hospital during 10 years from 1961 to 1970, we selected 1.010 women who had a blood loss of 500 ml. or more at delivery. Firstly, after having sent the selected women a questionnaire by post, we investigated whether they had Sheehan's syndrome or not from the response of the 392 women who replied to the questionnaire. Secondly, 126 of the 392 women who came to our clinic when requested were examined concerning blood picture, fasting blood glucose, and the serum levels of cholesterol, thyroxine, cortisol, GH, TSH, LH and FSH. As a control, 24 women who had had a normal delivery were examined as described above. No advanced hypopituitarism or mild hypopituitarism was found in this follow-up study. Compared with Sheehan's series in England, it was found the incidence of post-partum hypopituitarism in Okayama was presumably less than in England. Suggestions for this discrepancy are as follows: (1) competent obstetric care and a rapid blood transfusion after gross post-partum hemorrhage in Okayama Red Cross Hospital. (2) an incomplete report of the incidence of post-partum hypopituitarism due to those who did not reply to the questionnaire. (3) the rarity of the frequency of Sheehan's syndrome in Japan.
SynopsisHuman growth hormone (HGH) secretion occurred following the administration of Gly1--ACTH (1-18) octadecapeptide amide (50022-S) which was synthetized by Otsuka.The mean response curve of plasma HGH after the intravenous administration of 0.35mg of 50022-S in 23 healthy subjects was similar to that of plasma cortisol.A significant increase in plasma HGH to 0.35mg of 50022-S was observed, while there was no significant increase in plasma HGH to 0.25 mg of 1-24 ACTH, which is a corresponding dose to 0.35mg of 50022-S in cortisol response.In most of the patients who had dysfunction of hypothalamic-pituitary axis, no significant increase in plasma HGH to 0.35mg of 50022-S was observed.From these results, we conclude that Gly'-ACTH (1-18) octadecapeptide amide (50022-S) has a potency to release growth hormone from the pituitary in man.
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