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Measurements of 1,25 (OH)2D3 and other metabolites of vitamin D in a patient with oncogenic osteomalacia confirm the selective, reversible deficiency of 1,25 (OH)2D3 in this syndrome, and indicate the rapidity of normalization (within days) of the hormone level and associated hypophosphatemia after resection of the tumor. In this patient, the tumor was an intranasal hemangiopericytoma.

Summary:The respiratory stimulant effect of progesterone has been known for many years and has led to the hypothesis that this hormone protects young, premenopausal women from disordered breathing and apnea during sleep. Therefore, sleep, breathing, and gonadal hormone parameters were evaluated for 11 normal, menstruating women during times of high and low progesterone levels. No sleep or breathing parameter changed significantly with varying levels of progesterone. Although normal women show a significant change in progesterone levels across the course of the menstrual cycle, the levels achieved did not produce significant changes in breathing parameters. Key Words: Hormones-Progesterone-Apnea-Normal women-Sleep.The respiratory stimulant effect of certain hormones has been known for many years. One hormone for which this action has best been demonstrated is progesterone. The relative hyperventilation during pregnancy and the lowered alveolar carbon dioxide tension during the luteal phase of the menstrual cycle suggests that high progesterone levels, a factor common to both, is an active agent (1-3).To further assess the role of progesterone in sleep-disordered breathing in postmenopausal women, Block et a1. (4) compared older postmenopausal women with younger premenopausal controls. He found that 60% of the postmenopausal women had some type of sleep event (desaturation, hypopnea, or apnea) while only 11% of the younger women displayed such events. He postulated that the younger women were protected from these sleep events by the respiratory stimulant effects of circulating progesterone or the ratio of progesterone to androgenic hormones. Since the data of Block et a1. (4) suggest a contribution of progesterone to sleep-related breathing disorders, we evaluated normal premenopausal women during the luteal and follicular phases of the menstrual cycle when progesterone reached naturally occurring peaks and nadirs. METHODSSubjects included 11 women aged 22-38 years, who had regularly occurring menstrual cycles. None had sleep or breathing complaints and none were excessively sleepy during

Clinical observations, hormonal measurements, and olfactory tests have been performed in six patients (five male, one female) with hypogonadotropic hypogonadism and anosmia\p=m-\Kallmann'ssyndrome. All were deficient in gonadotropins and all had an obvious decrease in their primary and secondary sex characteristics. All were verified as anosmic. One patient had a craniotomy, and agenesis of the olfactory bulbs was identified. Although the five male patients had normal basal 17-hydroxycorticosteroid ( 17\ x=r eq-\ OHCS) levels, administration of metyrapone in two of them failed to lead to the predicted rise in these levels, suggesting a defective pituitary reserve. A disorder of hypothalamic dysfunction is suggested, involving the control of releasing factors with hypogonadism and anosmia as the clinical markers. Our experience suggests that the syndrome is not rare and that all hypogonadal patients should be questioned about their sense of smell.Physi ci ans encounter patients who have failed to achieve sexual ma¬ turation and, in order to institute ap¬ propriate treatment, they must make a differential diagnosis of the eunuchoidal state. One such hypogonad¬ al group was first described by Kallmann in 19441 and, curiously, all his pa¬ tients lacked the sense of smell. He was primarily concerned with the ge¬ neric aspects and "Kallmann's syn¬ drome" (hypogonadotropic hypogo¬ nadism with anosmia) was largely overlooked until 1967. Indeed, a re¬ view of the physiology of olfaction written by one of us in that year2 failed to include Kallmann's syn¬ drome as a cause of anosmia. No such diagnoses were made in our center until, in 1969, we adopted the proce¬ dure of questioning each hypogonadal patient about his sense of smell. Since then, six such patients have been identified, and a description of their clinical features and endocrine functions constitute the basis of this report. Patient Summaries Patient 1.-A 33-year-old white man was referred for evaluation of small gen¬ italia. He had never experienced pubertal changes. While in military service he was found to have chromatin-negative hypo¬ gonadotropic hypogonadism and was con¬ sidered to have hypopituitarism. Brief