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PLASMA TESTOSTERONE AND LUTEINISING HORMONE IN XYY MEN
699
PLASMA TESTOSTERONE AND LUTEINISING HORMONE IN XYY MEN
SiR,—The plasma-testosterone level, and the levels of luteinising hormone (L.H.) in urineand plasma,3 are reported to be raised in XYY men. We have previously reported normal levels of plasma-testosterone in two XYY inmates of a penal institution.4 The plasma-L H. levels in these two men, and the levels of both hormones in three additional XYY prisoners, were as follows:
true for the women with predisposing conditions (e.g., postoperative immobilisation, diabetes, &c.). Indeed, we consider that some of the predisposing conditions from which the women with thromboembolism were suffering would be regarded as contraindications to oral contraception by their doctors. Secondly, we consider it to be too early for your statement that " the risk of coronary thrombosis curiously is unaltered " to be made. It is certainly true that there was no significant evidence of any association between the use of oral contraceptives and coronary thrombosis in our investigation, but if the effects of oral contraceptives on serum lipids and glucose tolerance are relevant to this problem, it may take some years for any change in risk was
become manifest.
to
Testosterone was measured by a double-isotope derivative technique,5 the range for normal males being O’4-l-O tg. per 100 ml. Plasma-L H. was estimated by radioimmunoassay, using chromatoelectrophoresis 6 and solid phase.’ In twenty-five normal males the range of plasma-L.H. was 8-31 mi.u. per ml. Thus our results do not indicate that the plasma levels of testosterone and L.H. are increased in XYY subjects. Dr. Papanicolaou and his colleagues2 have observed considerable fluctuations in the 24-hour urinary excretion of L.H. in XYY men. The level of urinary testosterone also appears to be higher in men in hospital than it is in ambulant normal males.8 These physiological variations, and the different technical methods used, must be considered when comparing results from different laboratories. Department of Medicine, Monash University, Medical Research Centre, Prince Henry’s Hospital, Chromosome Laboratory, St. Nicholas Hospital,
Psychiatric Clinic, H.M. Prison, Melbourne, Victoria, Australia.
BRYAN HUDSON. HENRY BURGER. SAUL WIENER GRANT SUTHERLAND. ALLEN A. BARTHOLOMEW.
ORAL CONTRACEPTIVES AND PROPHYLAXIS OF THROMBOEMBOLISM should like to make the following comments SIR,-We on your annotation on this subject (Aug. 23, p. 419). Firstly, we do not believe that any conclusion should be drawn concerning the risks of thromboembolism from oral contraceptives in patients with predisposing conditions from the data presented in our report. In fact we included a statement to this effect. The use of oral contraceptives by our controls could be used for comparison with that of the women who died, but conclusions could only be drawn from the comparison with deaths from "idiopathic" thromboembolism, not from the comparison with women who had predisposing conditions. The reason is that the control series consisted of women who, for the most part, were in normal health whilst the reverse 1.
2.
Welch, J. P., Borgaonkar, D. S., Herr, H. M. Nature, Lond. 1967, 214, 500. Papanicolaou, A. D., Kirkham, K. E., Loraine, J. A. Lancet, ii, 608.
3. 4.
5. 6. 7.
Parker, C. E. Lancet, 1969, i, 1101. Wiener, S., Sutherland, G., Bartholomew, A. A., Hudson, B. ibid. 1968, i, 150. Hudson, B., Coghlan, J., Dulmanis, A., Wintour, M., Ekkel, I. Aust. J. exp. Biol. med. Sci. 1963, 41, 235. Burger, H. G., Oliver, J. R., Davis Jenifer, Catt, K. J. ibid. 1969, 46, 541. Catt, K. J., Niall, H. D., Treger, G. W., Burger, H. G. J. clin.
Endocr. Metab. 1968, 28, 121. A. A. A., Harkness, A. A., Kirkham, K. E., Loraine, J. A., Whatmore, P. B., Brittain, R. P. Lancet, 1968, i, 220. 9. Inman, W. H. W., Vessey, M. P. Br. med. J. 1968, ii, 193. 8.
Committee on Safety of Drugs, Queen Anne’s Mansions, London S.W.1.
W. H. W. INMAN M. P. VESSEY.
SCREENING FOR VITAMIN B12 DEFICIENCY SIR,-One is heartened to see that you advocate the development of a screening procedure to detect vitamin-B12 deficiency in an at-risk population (Aug. 9, p. 309). I suggested this in 19651 when I reviewed 12 cases personally treated in the course of 18 months’ consultative psychiatric practice-cases which had been followed up for a minimum of 1 year at that time. There were 5 patients in whom vitamin-B12 levels were critically low among 44 female admissions presenting with depression as a main finding in the 65+ years age-group. The necessity of diagnosing these cases has been amply demonstrated many times since my original paper, but, as yet, quite a number of doctors are not aware that the first features of vitamin deficiency are often of a psychiatric nature. St. Luke’s Hospital, Armagh, N. Ireland.
W. A. G. MACCALLUM.
IRRADIATION OF SENSITISED LYMPHOCYTES SIR,-The finding of Dupuy et awl. that delayed hypersensitivity is transferable with plasma from X-irradiated, sensitised guineapigs, is of considerable interest. The most likely explanation is that a factor responsible for cellmediated immunity, normally bound to cells, is released into the plasma by irradiation. A number of humoral factors have been implicated in delayed-hypersensitivity reactions.3 We have investigated whether the factor responsible for the inhibition of leukocyte migration in vitro is released from human lymphocytes by irradiation in vitro. The cell donors were individuals with strong delayed hypersensitivity to Brucella abortus. Lymphocytes were isolated from peripheral blood,4 washed twice, and resuspended (1 x 10’ lymphocytes per ml.) in Hanks’ medium fortified with glucose. The suspension was irradiated with 1000 rads from a 60CO source and immediately centrifuged. 100 .1. of the cell-free supernatant was added to 1-ml. culture chambers, and the migration of leucocytes from a person not sensitised to brucella was studied.5 The results of three such experiments were uniformly negative. In no case was the migration of leucocytes from non-sensitised donors inhibited by the supernatant of 1. 2. 3.
MacCallum, W. A. G. J. Ir. med. Ass. 1965, 57, 187. Dupuy, J.-M., Perey, D. Y. E., Good, R. A. Lancet 1969, i, 551. Meuwissen, H. J., Stutman, O., Good, R. A. Semin. Hemat. 1969,
4. 5.
Hellung-Larsen, P., Andersen, V. Exp. Cell Res. 1968, 50, Bendixen, G., Søborg, M. Dan. med. Bull. 1969, 16, 1.
Ismail,
6, 28. 286.
PLASMA TESTOSTERONE AND LUTEINISING HORMONE IN XYY MEN
SiR,—The plasma-testosterone level, and the levels of luteinising hormone (L.H.) in urineand plasma,3 are reported to be raised in XYY men. We have previously reported normal levels of plasma-testosterone in two XYY inmates of a penal institution.4 The plasma-L H. levels in these two men, and the levels of both hormones in three additional XYY prisoners, were as follows:
true for the women with predisposing conditions (e.g., postoperative immobilisation, diabetes, &c.). Indeed, we consider that some of the predisposing conditions from which the women with thromboembolism were suffering would be regarded as contraindications to oral contraception by their doctors. Secondly, we consider it to be too early for your statement that " the risk of coronary thrombosis curiously is unaltered " to be made. It is certainly true that there was no significant evidence of any association between the use of oral contraceptives and coronary thrombosis in our investigation, but if the effects of oral contraceptives on serum lipids and glucose tolerance are relevant to this problem, it may take some years for any change in risk was
become manifest.
to
Testosterone was measured by a double-isotope derivative technique,5 the range for normal males being O’4-l-O tg. per 100 ml. Plasma-L H. was estimated by radioimmunoassay, using chromatoelectrophoresis 6 and solid phase.’ In twenty-five normal males the range of plasma-L.H. was 8-31 mi.u. per ml. Thus our results do not indicate that the plasma levels of testosterone and L.H. are increased in XYY subjects. Dr. Papanicolaou and his colleagues2 have observed considerable fluctuations in the 24-hour urinary excretion of L.H. in XYY men. The level of urinary testosterone also appears to be higher in men in hospital than it is in ambulant normal males.8 These physiological variations, and the different technical methods used, must be considered when comparing results from different laboratories. Department of Medicine, Monash University, Medical Research Centre, Prince Henry’s Hospital, Chromosome Laboratory, St. Nicholas Hospital,
Psychiatric Clinic, H.M. Prison, Melbourne, Victoria, Australia.
BRYAN HUDSON. HENRY BURGER. SAUL WIENER GRANT SUTHERLAND. ALLEN A. BARTHOLOMEW.
ORAL CONTRACEPTIVES AND PROPHYLAXIS OF THROMBOEMBOLISM should like to make the following comments SIR,-We on your annotation on this subject (Aug. 23, p. 419). Firstly, we do not believe that any conclusion should be drawn concerning the risks of thromboembolism from oral contraceptives in patients with predisposing conditions from the data presented in our report. In fact we included a statement to this effect. The use of oral contraceptives by our controls could be used for comparison with that of the women who died, but conclusions could only be drawn from the comparison with deaths from "idiopathic" thromboembolism, not from the comparison with women who had predisposing conditions. The reason is that the control series consisted of women who, for the most part, were in normal health whilst the reverse 1.
2.
Welch, J. P., Borgaonkar, D. S., Herr, H. M. Nature, Lond. 1967, 214, 500. Papanicolaou, A. D., Kirkham, K. E., Loraine, J. A. Lancet, ii, 608.
3. 4.
5. 6. 7.
Parker, C. E. Lancet, 1969, i, 1101. Wiener, S., Sutherland, G., Bartholomew, A. A., Hudson, B. ibid. 1968, i, 150. Hudson, B., Coghlan, J., Dulmanis, A., Wintour, M., Ekkel, I. Aust. J. exp. Biol. med. Sci. 1963, 41, 235. Burger, H. G., Oliver, J. R., Davis Jenifer, Catt, K. J. ibid. 1969, 46, 541. Catt, K. J., Niall, H. D., Treger, G. W., Burger, H. G. J. clin.
Endocr. Metab. 1968, 28, 121. A. A. A., Harkness, A. A., Kirkham, K. E., Loraine, J. A., Whatmore, P. B., Brittain, R. P. Lancet, 1968, i, 220. 9. Inman, W. H. W., Vessey, M. P. Br. med. J. 1968, ii, 193. 8.
Committee on Safety of Drugs, Queen Anne’s Mansions, London S.W.1.
W. H. W. INMAN M. P. VESSEY.
SCREENING FOR VITAMIN B12 DEFICIENCY SIR,-One is heartened to see that you advocate the development of a screening procedure to detect vitamin-B12 deficiency in an at-risk population (Aug. 9, p. 309). I suggested this in 19651 when I reviewed 12 cases personally treated in the course of 18 months’ consultative psychiatric practice-cases which had been followed up for a minimum of 1 year at that time. There were 5 patients in whom vitamin-B12 levels were critically low among 44 female admissions presenting with depression as a main finding in the 65+ years age-group. The necessity of diagnosing these cases has been amply demonstrated many times since my original paper, but, as yet, quite a number of doctors are not aware that the first features of vitamin deficiency are often of a psychiatric nature. St. Luke’s Hospital, Armagh, N. Ireland.
W. A. G. MACCALLUM.
IRRADIATION OF SENSITISED LYMPHOCYTES SIR,-The finding of Dupuy et awl. that delayed hypersensitivity is transferable with plasma from X-irradiated, sensitised guineapigs, is of considerable interest. The most likely explanation is that a factor responsible for cellmediated immunity, normally bound to cells, is released into the plasma by irradiation. A number of humoral factors have been implicated in delayed-hypersensitivity reactions.3 We have investigated whether the factor responsible for the inhibition of leukocyte migration in vitro is released from human lymphocytes by irradiation in vitro. The cell donors were individuals with strong delayed hypersensitivity to Brucella abortus. Lymphocytes were isolated from peripheral blood,4 washed twice, and resuspended (1 x 10’ lymphocytes per ml.) in Hanks’ medium fortified with glucose. The suspension was irradiated with 1000 rads from a 60CO source and immediately centrifuged. 100 .1. of the cell-free supernatant was added to 1-ml. culture chambers, and the migration of leucocytes from a person not sensitised to brucella was studied.5 The results of three such experiments were uniformly negative. In no case was the migration of leucocytes from non-sensitised donors inhibited by the supernatant of 1. 2. 3.
MacCallum, W. A. G. J. Ir. med. Ass. 1965, 57, 187. Dupuy, J.-M., Perey, D. Y. E., Good, R. A. Lancet 1969, i, 551. Meuwissen, H. J., Stutman, O., Good, R. A. Semin. Hemat. 1969,
4. 5.
Hellung-Larsen, P., Andersen, V. Exp. Cell Res. 1968, 50, Bendixen, G., Søborg, M. Dan. med. Bull. 1969, 16, 1.
Ismail,
6, 28. 286.