The described tumours were rather large

The described tumours were rather large and after their excision it was not possible to reach normalisation of function of a pituitary body and sexual glands. METHODICAL DETAILS CONCERNING THE ESTIMATION OF CONDITION GIPOTALAMO-GIPOFIZARNOJ OF SYSTEM The description of methods of research resulted further does not apply for exhaustive completeness, and concerns only what are as cheap ultracet it is established by the practice, the most useful in diagnostics of disturbances of secretion of hormones of a pituitary body. Indications to their application and detailed interpreting of results are stated in the previous sections. CORTICOTROPIN Definition of initial level Definition of maintenance in plasma demands unconditional on - laboratory researches. In norm of size fluctuate from 20 to 80 pg/ml though their estimation demands simultaneously definition of level of a hydrocortisone. Definition of level of a hydrocortisone in plasma still keeps the value as a fine method of an estimation of secretion at research of function of a pituitary body if only it is proved the cortex of adrenals. Fluctuations in norm, according to the majority of laboratories, make 50-250 mkg/l. Daily scope in norm makes not less than 50 mkg/l. The daily egestion of 17-Construction Department is peer 4 12 mg, and a free hydrocortisone at healthy adult persons - 20 100 mkg. assays Insulinic hypoglycaemia. A technique.
This assay should be spent in the morning after night starvation. Into an ulnar vein of the patient enter a needle filled with a solution. Intravenously enter usual insulin in doses, sufficient for depression of level of a glucose into bloods on 50 or not less than on 400 mkg/l. Usually 0, 1 ED/KG, though for this purpose is required at suspicion on (i.e. At adiposity, an acromegalia and syndrome ) a dose enlarge to 0,15 ED/KG, and at strong suspicion on a hypopituitarism reduce to 0,05 UNITS/KG If there are signs and symptoms of adrenergic excitation, it is possible to consider hypoglycemic stimulus adequate even at insufficient depression of level of Saccharum in blood. If there was no neither that, nor another, the test should be repeated with use of a larger dose of insulin. On a case of unexpectedly sharp hypoglycaemia near at hand always there should be a solution Dextrosums (50 ). Glucose level in blood register on 0, 15, 30, 45, 60, 90 and 120th minute after an insulin injection. Concentration of a hydrocortisone in plasma measure on 0, 30, 60, 90 and 120th minute. Under indications assay with an insulinic hypoglycaemia can be spent simultaneously with TRG - or Gnrg-tests. Not changed indicators. The glucose colchicine side effects minimum level in blood should be registered on 30-45th minute. In norm the hydrocortisone maintenance raises at least on 100 mkg/l and reaches level not less than 200 mkg/l. Interpreting of results. Normal reaction specifies on gipotalamo-gipofizarno-adrenal system. The changed reaction speaks nothing about a place of disturbance of this system. For the proof cortexes of adrenals it is necessary to spend the test with . At initially high level of a hydrocortisone, that often meets at the patients who are in a condition of stress, reaction to an insulinic hypoglycaemia can decrease or be absent. It is lowered also at the patients receiving in assay or shortly before it exogenous glucocorticoids, at a syndrome and illness and at patients with depressive diseases. Risk. Yet will not expire term during which the hypoglycaemia is most expressed, all patients should be under immediate observation of the doctor. Assay should not be spent at patients with clinical signs of insufficiency of a cortex of adrenals, and at the indicating in the anamnesis on insufficiency of coronary or cerebral vessels its carrying out demands extreme care. . In the beginning stimulation spent by peroral introduction of a preparation with the collecting of four consecutive daily assays of urine. This long procedure basically has given way to faster intravenously spent test though because of small demand for intravenous use now it is a little accessible. Intravenously spent assay. A technique. in a dose of 35 mg/kg (the maximum dose 1) slowly enter intravenously into 250-500 ml of an isotonic solution of Sodium chloridum during 4 to the patient.. Blood samples for definition 11-dezoksikortizola (bond S) and a hydrocortisone take on 2, 4 and 5th hour. Not changed indicators. Depression of level of a hydrocortisone testifies to sufficient suppression of biosynthesis of hormones in plasma below 80 mkg/l. The maximum concentration 11-dezoksikortizola should exceed 30 mkg/l. Interpreting of results. Adequate depression of level of a hydrocortisone in plasma confirms