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Case Reports 2005; 26(6): 757-758 PubMed PMID: 16380671 Citation  Keywords:  Aged, Atrophy, Diagnosis, Differential, Empty Sella Syndrome:complications, Fatigue:diagnosis, Female, Hormones:therapeutic use, Humans, Hydrocortisone:therapeutic use, Hypopituitarism:complications, Inflammation:complications, Magnetic Resonance Imaging,.   

: A 75-year-old woman complained about progressing fatigue. She appeared somnolent, but fully oriented and in no acute distress. Her face was pale and puffy. She did not show any signs of focal neurological disease, and the remainder of the physical examination was unrevealing. Routine laboratory tests were unremarkable except for hyponatremia and mildly decreased levels of free T3 and free T4, with TSH in the normal range. Pituitary function tests demonstrated secondary adrenal insufficiency and hypothyroidism. Magnetic resonance imaging (MRI) unmasked hypophysitis with the characteristic findings of homogeneous gadolinium uptake of the pituitary and a prominent pituitary stalk ('dural tail sign', arrows in Fig. 1 A and B, sagittal and coronal views). Substitution of hydrocortisone and levothyroxine resulted in rapid and sustained improvement of all symptoms and normalisation of laboratory findings. MRI abnormalities normalized within the following six months. At follow-up three years later, MRI signs had further regressed and demonstrated an empty sella (Fig. 2 A and B)....

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Comparative Study 2005; 26(5): 468-472 PubMed PMID: 16264417 Citation  Keywords:  Animals, Cells, Cultured, Female, Galanin:administration & dosage, Injections, Intravenous, Injections, Intraventricular, Ovariectomy, Pituitary Gland:drug effects, Pituitary Hormones:blood, Rats, Rats, Inbred WKY,.   

OBJECTIVES: Galanin and its receptors are widely distributed within the central and peripheral nervous system, especially in hypothalamus including preoptic area, paraventricular nucleus (PVN), supraoptic nucleus (SON) and median eminence. Galanin plays an important role in the control of food intake, energy expenditure, reproduction, water balance and various neuroendocrine functions. Galanin may affect hormones release, but the exact mechanism of the peptide action remains unclear and possible direct effects of galanin on the pituitary are controversial. The aim of this study was to examine the effects of galanin on pituitary hormones release after the central and peripheral administration of the peptide.

MATERIAL AND METHODS: (i) Experiment I - Intracerebroventricular (icv) administration of galanin: Galanin at a concentration of 0.5 microg in 5microl vehicle (artificial cerebrospinal fluid) or equal volume of the vehicle was slowly (1microl/min) infused into the third ventricle with an automatic pump (CMA/100; Sweden) through an inner cannula inserted into the guide cannula. After the end of the infusion the rats were transferred to their home cages with free access to food and water. At 60 min after the infusion of galanin or vehicle, animals were decapitated and trunk blood was collected in plastic tubes containing 1000 IU aprotinin (inhibitor of protease) per each ml of blood. (ii) Experiment II - Intravenous (iv) injection of galanin: Galanin in a dose of 10 microg in 300 microl of saline or 300 microl of saline alone was injected into the tail vein. After the injection the animals were transferred to individual cages with free access to food and water. At 60 min after the injection of galanin or saline, animals were decapitated, and trunk blood was collected in plastic tubes containing 1000 IU of aprotinin (Trascolan). The blood samples were centrifuged (3000 rpm for 20 min at 4 degrees C). Serum samples were frozen until hormonal analyses were performed. Serum rLH, rFSH, rPRL, rGH, rTSH concentrations were measured with RIA methods.

RESULTS: Galanin administered icv increased significantly rPRL and rTSH levels (p<0.01, p<0.05, respectively). Plasma rPRL and rTSH concentrations were not changed after iv injection of galanin. Galanin injected centrally inhibited significantly rGH release (p<0.01), however, galanin given iv stimulated rGH (p<0.01). Serum rLH and rFSH concentrations were not changed after icv and iv injections of galanin.

CONCLUSION: Galanin may be involved in the modulating mechanism of pituitary hormones release....

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Case Reports 2005; 26(5): 499-502 PubMed PMID: 16264411 Citation  Keywords:  Adrenal Insufficiency:complications, Adrenocorticotropic Hormone:deficiency, Adult, Autonomic Nervous System:physiopathology, Chromosomes, Human, Pair 12:genetics, Conjunctival Diseases:complications, Electroencephalography, Epilepsy:genetics, Hormone Rep.   

: Allgrove syndrome is a rare autosomal recessive disease with achalasia, alacrima, adrenocortical insufficiency, autonomic neuropathy and other neurological disturbances. A case of two brothers with Addison s disease from early childhood is presented. The younger brother with Addison disease died at the age of 5. The older brother was treated for adrenocortical insufficiency from the age 3, and then treated for achalasia and epilepsy from the age of 5. The patient is currently 26 years old and suffers from achalasia and adrenocortical insufficiency. He also suffers from alacrima, autonomic neuropathy, epilepsy and other damages of the central and peripheral nervous system. The clinical picture is typical for Allgrove or 4A syndrome, and the diagnosis was confirmed by means of molecular analysis of a new AAAS gene mutation....

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Case Reports 2005; 26(5): 533-535 PubMed PMID: 16264405 Citation  Keywords:  Adult, Anticonvulsants:therapeutic use, Brain:pathology, Bromocriptine:therapeutic use, Encephalomalacia:complications, Hormone Antagonists:therapeutic use, Humans, Hyperprolactinemia:complications, Infertility, Male:complications, Magnetic Resonance Imag.   

OBJECTIVES: To describe successful oral bromocriptine therapy for hyperprolactinemia accompanied by seizure disorder and encephalomalacia identified during infertility evaluation.

MATERIALS & METHODS: A 32 year-old male with an unspecified seizure disorder was referred for infertility consultation. The initial seizure was at age 12, and was treated sequentially with phenytoin, phenobarbitol, and carbamazepine monotherapy which was maintained for six years and then discontinued. At age 26, a second seizure was experienced and 150mg lamotrigine b.i.d. was initiated. When the patient married it was discovered that erection was impossible; tadalafil was administered without success. At our center, total testosterone was low at 107ng/dl and semen analysis revealed oligoasthenozoospermia. Serum prolactin was 79.3ng/ml; visual field examination was normal. Brain MR showed no pituitary enlargement. However, encephalomalacia of the right occiptal lobe with porencephalic dilation of the occipital horn of the right lateral ventricle was present.

RESULTS: The patient was initially placed on 2.5mg/d bromocriptine but after three months only a nominal reduction of serum prolactin was achieved. Serum prolactin normalized (25.4ng/ml) after bromocriptine was increased to 7.5mg/d. Repeat semen analysis showed overall sperm concentration of 85M/ml, 30% motility and 12% normal forms morphology (Kruger strict criteria). Total testosterone level was 191ng/dl after final bromocriptine dose was attained, which was well tolerated.

DISCUSSION: Bromocriptine has an established role in the management of hyperprolactinemia, particularly in women. For males with elevated serum prolactin even when associated with focal encephalomalacia and seizure disorder, bromocriptine therapy can offer safe benefits including improved semen parameters and normal serum testosterone levels....

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Clinical Trial 2005; 26(5): 599-602 PubMed PMID: 16264395 Citation  Keywords:  Adult, Emotions:physiology, Humans, Hydrocortisone:metabolism, Male, Memory:physiology, Saliva:metabolism,.   

OBJECTIVES: The aim of this study was to examine (i) the influence of cortisol on both prospective and retrospective memory performance and (ii) the role of emotional valence in both types of memory.

METHODS: Thirty-four male students participated in a memory task, which measured both prospective and retrospective memory performance. Baseline salivary cortisol levels were assessed.

RESULTS: Spearman's rank order correlation analysis showed a significant positive correlation between salivary cortisol levels and retrospective memory performance for neutral words. Cortisol levels were not significantly correlated with prospective memory performance for either negative nor neutral words.

CONCLUSIONS: The present results indicate chronic cortisol levels are positively associated with retrospective memory at relatively low concentration ranges, but not prospective memory, in healthy young men. Implications for evaluating the beneficial effects of low-dose cortisol treatment on posttraumatic stress disorder is discussed....

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Journal Article 2005; 26(5): 603-608 PubMed PMID: 16264394 Citation  Keywords:  Adolescent, Adult, Birth Weight:physiology, Breech Presentation, Cesarean Section, Female, Humans, Infant, Newborn, Myasthenia Gravis:physiopathology, Pregnancy, Pregnancy Complications:physiopathology, Retrospective Studies, Thymectomy, Thyroiditis, Auto.   

OBJECTIVE: The aim of the study was to evaluate the effect of Myasthenia gravis (MG) on the course of pregnancy, labor and delivery, and the condition of neonate.

DESIGN AND SETTINGS: Retrospective chart review of pregnant patients with MG hospitalized in tertiary care center over 12 year period was performed. Course of MG before and during pregnancy, mode of delivery, and condition of the newborn were analyzed.

RESULTS: There was 42 913 deliveries in the Polish Mother's Research Institute in Lodz during analyzed period. Thirteen patients with MG were identified, giving the incidence of 3/10 000 live births. Mean age of the patients was 28 years, range 18 - 36 years. Average time since diagnosis was 9 years. Eleven women with MG delivered at term (one twin pregnancy), and two babies were born prematurely. In seven patients pregnancy was ended via normal spontaneous vaginal delivery (NSVD), one was forceps extraction, four patients had elective Cesarean Section (CS), and two had emergency CS. Indications for CS were purely obstetrical. Spontaneous vaginal deliveries were speedy. None of the patients had exacerbation of MG during current pregnancy. Mean birth weight of the newborns was 3014,3 g, range 1730 g to 3700 g. Mean Apgar score was 8,7 at 1 minute and 8,9 at 5 minutes. Only one neonate (second twin) developed Transient Neonatal Myasthenia Gravis (TNMG).

CONCLUSIONS: Myasthenia gravis did not have significant effect on the course of pregnancy or mode of delivery. In the twin pregnancies it is possible that only one twin will present with the symptoms of TNMG....

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Comparative Study 2005; 26(5): 459-462 PubMed PMID: 16264390 Citation  Keywords:  Animals, Female, Injections, Intravenous, Injections, Intraventricular, Leptin:administration & dosage, Ovariectomy, Pituitary Hormones:blood, Radioimmunoassay, Rats, Rats, Inbred WKY,.   

OBJECTIVE: It has been reported that leptin plays an important role in the regulation of food intake and energy expenditure. There are controversial opinions about effects of leptin on the hormonal system. The aim of this study was to estimate the effect of leptin on pituitary hormones release after central and peripheral administration.

METHODS: Leptin was injected intracerebroventricularly (icv) in a dose of 0.5 microg/5microl aCSF (artificial cerebrospinal fluid) for 5 min in Wistar Kyoto rats. At 60 and 120 min after injections the animals were decapitated. Leptin in a dose of 10 microg in 300 microl of saline was administered intravenously (i.v). At 60 mins the animals were decapitated. Serum rLH, rFSH, rPRL, rTSH, rGH concentrations were measured with RIA methods.

RESULTS: After central (icv) injection of leptin we observed an increase of rGH, rTSH and a decrease of rPRL. However, after peripheral (iv) injection of leptin we found a decrease of rGH and rTSH and an increase of rPRL. We did not find any significant changes in LH and FSH after icv and iv injection of leptin.

CONCLUSIONS: The opposite effects of leptin on pituitary hormones release were observed due to the method of leptin administration. Leptin may play a modulating role in the mechanism of pituitary hormones release....

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Comparative Study 2005; 26(5): 463-467 PubMed PMID: 16264389 Citation  Keywords:  Animals, Bombesin:administration & dosage, Cells, Cultured, Female, Injections, Intravenous, Injections, Intraventricular, Ovariectomy, Pituitary Gland:drug effects, Pituitary Hormones:blood, Rats, Rats, Inbred WKY,.   

OBJECTIVES: Functional studies indicate that bombesin may be involved in many physiological functions, including sensory transmission, the regulation of central autonomic pathways, thermoregulation, secretion of pituitary hormones, gastric and pancreatic secretion, food intake and satiety.

MATERIAL AND METHODS: In order to evaluate the role of bombesin in the mechanism of pituitary hormones release the effects of bombesin on rGH, rTSH, rPRL, rFSH and rLH release were investigated in female Wistar-Kyoto rats. In studies 'in vitro' bombesin in a dose of 1nM, 10nM, 100nM was administered to pituitary cell culture. After 60, 120, 240 min. of incubation pituitary hormones were measured. In studies 'in vivo' bombesin was injected intraventricularly (icv) in a dose of 0.5 microg/5 microl aCSF (artificial cerebrospinal fluid) for 5 min. (experiment I). In experiment II bombesin was administered intravenously (iv) in a dose of 10 microg. After 60 min, 120 mins the animals were decapitated and serum rGH, rPRL, rTSH, rLH, rFSH concentrations were measured with RIA methods.

RESULTS: Bombesin stimulated rLH, rPRL, rTSH release from cultured pituitary cells. A slight increase of GH was also observed. After intravenous (iv) injection of bombesin an increase in serum rPRL and rGH levels was found. However, the intraventricular (icv) administration of bombesin leads to decrease of serum rGH, rPRL and rTSH concentrations.

CONCLUSION: Our studies 'in vitro' and 'in vivo' indicate that bombesin may be involved in the modulation of pituitary hormones release....

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