Severe hypercalcemia (serum calcium, 4.37-4.84 nmol/L) was found in a 70-yr-old man who had a small cell carcinoma of the lung with multiple metastases. The plasma immunoreactive PTH concentration was markedly elevated, as measured in three different PTH assays [N-terminal PTH, 4,650 ng/L (normal, 230-630); midregion PTH, 13,850 ng/L (normal, 180-560); C-terminal PTH, 9,900 ng/L (normal, less than 1,300)], but at autopsy the parathyroid glands were histologically normal. The PTH concentration of a liver metastasis was 503.5 ng/g wet wt (normal liver, less than 4.2-5.9), and the PTH in the tumor extract eluted at nearly the same position as synthetic human PTH-(1-84) on gel filtration chromatography. Northern blot analysis revealed PTH mRNA in the tumor as a single band of 0.9 kilobase. These results indicate that the ectopic PTH production by the lung cancer was the cause of hypercalcemia in this patient.

No abstract

SynopsisWith the purpose of investigating the pathogenesis of obesity and hyperinsulinemia in rats with hypothalamic lesions (HTL), HTL were made in vagotomized rats, and the development of obesity was serially followed In order to elucidate the cause of obesity, we have studied the pathogenesis of obesity in rats with hypothalamic lesions (HTL) and the following results have been reported previously.1. Rats with HTL have a tendency of hyperphagia from the early stage afer HTL and become markedly obese. 2. Fatty acid composition in the adipose tissue shows a decrease of the linoleic: palmitic ratio, and it is mimicked by the administration of insulin to normal rats (Kuwata, 1970). 3. Plasma immunoreactive insulin (IRI) level is markedly elevated, and the pancreatic islets are enlarged after HTL (Chikamori et al., 1973). 4. These alterations observed in the rats with HTL are not influenced by either restriction of food intake (Suzuki, 1970) or hypophysectomy (Hamajo, 1974). 5. Plasma free fatty acid (FFA) and triglyceride levels are elevated in the rats with HTL and the plasma levels of triglyceride and IRI are correlated with the body weight, grade of obesity and the weight of epididymal fat (Chikamori et al., 1973). These results indicate that hyperinsulinemia plays a significant role in the development of obesity in rats with HTL.The hyperinsulinemia in rats with HTL has been attributed to hyperphagia due to HTL (Hales and Kennedy, 1964), increases in insulin antagonists accompanying obesity (Salans et al., 1968), and insulin hypersecretion from the pancreas mediated by the vagal nerve system (Frohman and Bernerdis, 1971), but exact mechanism has been still unknown. Therefore, the present experiments were designed to study the effect of vago-

Omuro goiter is a congenital condition characterized by euthyroidism with a high familial incidence which was discovered in a fishing village in Kochi Prefecture, Japan.

Recently, a high incidence of goiter was discovered at Omuro i.n Okitsu Village, a small fishing village facing the Pacific Ocean in Kochi Prefecture in Japan. Since Okitsu Village consists of three separate communities, Omuro, Go and Ura, the incidence of goiter was investigated in each community. In a survey of all 455 children from nursery schools, primary and junior high schools in Okitsu Village, the incidence was 13.4% in Omuro, 3.7% in Go and 1.1% in Ura. The incidence was thus particularly high in Omuro and also the degree of the goiter size in this community was greater than that found in others. In a survey of all 482 inhabitants of the Omuro Community, 39 patients with goiter including 11 cases, which had extremely large goiter, were discovered, the incidence being 8.1%. Cases of goiter were frequently observed in several generations of a single family. The incidence ratio for men to women was 1 to 1.4. Although in this Omuro Community the inhabitants are economically poor and there are frequent cases of consanguineous marriage within the community, there is no noteworthy difference in environmental conditions from those two adjacent communities. Therefore, external factors which are often considered as causes of goiter, such as iodine deficiency in the environment, intake of goitrogen, nutritional deficiency of protein and vitamins, etc. or excess of calcium and from the fact that the high incidence of goiter runs in families, the cases of goiter reported here may be caused by intrinsic metabolic disorders.