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Journal Article 2012; 33(1): 42-47 PubMed PMID: 22467111 Citation  Keywords:  Adenoma:metabolism, Humans, Pituitary Neoplasms, Prevalence, Prolactinoma, Retrospective Studies,.   

OBJECTIVES: The prevalence of pituitary tumours has recently been identified to be higher than previously thought. The aim of our study was to assess the occurrence of hypothalamic-pituitary tumours in 20-year material of the Department of Endocrinology and Metabolic Diseases, Polish Mother`s Memorial Hospital - Research Institute, Lodz, Poland.

METHODS: We analyzed medical data of 845 patients, hospitalized from 1990 to 2009 due to presumptive diagnosis of hypothalamic-pituitary tumour. Among 340 cases with confirmed diagnosis, 278 tumours were classified as micro- or macroadenomas. Tumour type and size, as well as patient gender and age, were evaluated. In 252 tumours the exact volume was calculated, and 4 volume subgroups were assessed for each aforementioned parameter separately.

RESULTS: Prolactinomas and - at the next place - non-functioning adenomas were the most frequent, followed by pituitary tumors of non-epithelial origin, and - finally, the rarest - other secreting adenomas. Prolactinomas were found mostly in females (p=0.028), while non-functioning adenomas in males (p=0.045). Prolactinomas and non-functioning adenomas were found to be predominantly microadenomas (p<0.0001 and p=0.0003, respectively), while mixed-type adenomas were mostly macroadenomas (p=0.028). In females microadenomas were the most frequent (p<0.0001). Moreover, in persons under 50 years of age microadenomas predominated, whereas in older adults macroadenomas mostly occurred.

CONCLUSION: To conclude, our retrospective, single-centre study provides relevant estimates of prevalence of hypothalamic-pituitary tumours in the era of modern diagnostic tools and indicates that our data are comparable with results regarding other populations worldwide....

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Case Reports 2011; 32(6): 741-747 PubMed PMID: 22286799 Citation  Keywords:  Base Sequence, DNA Mutational Analysis, Female, Homeodomain Proteins:genetics, Humans, Hypopituitarism:complications, Middle Aged, Molecular Sequence Data, Mutation, Psychotic Disorders:etiology,.   

INTRODUCTION: Untreated congenital hypopituitarism in adult patient is - nowadays - a very rare observation.

CASE: A 52 years old female patient, was referred to the Department of Psychiatry for psychotic symptoms, manifested as auditory pseudohallucinations with delusional interpretation, significant psychomotor agitation, anosognosia, attempts of symptom dissimulation and negativism. At admission, attention was drawn to her short stature and low body weight. Because of general weakness, she was hardly moving, her skin was pale, dry, cold, little elastic and desquamating. Neither axillary nor pubic hair could be traced. Basic studies revealed anaemia, significant hyponatraemia and hypercholesterolaemia. Hormonal tests confirmed diagnosis of hypopituitarism. Genetics studies revealed mutations (150delA and 296_297delAG) in PROP1 gene. Combined somatic and neuroleptic treatment considerably improved the physical and psychic status of the patient, as well as strengthened her social functioning.

CONCLUSIONS: An exogenous, psychotic episode identified in the patient was induced by multihormonal hypopituitarism and disappeared after hormonal replacement therapy....

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Journal Article 2011; 32(6): 805-810 PubMed PMID: 22286791 Citation  Keywords:  Animals, Hypothalamo-Hypophyseal System:physiology, Male, Myocardium:cytology, Oxytocin:metabolism, Pituitary-Adrenal System:physiology, RNA, Messenger:metabolism, Rats, Rats, Inbred Lew, Rats, Sprague-Dawley, Receptors, Oxytocin:genetics,.   

OBJECTIVES: Oxytocin (OT) is a neuropeptide acting both as a peripheral hormone and in the brain as neurotransmitter and neuromodulator. In addition to its well-known effects on milk-ejection and uterine contraction, OT was shown to exert neuroendocrine regulation of heart functions. The aim of this study was to investigate the expression of mRNA of OT receptors (OTR) in rat hearts by real-time quantitative PCR (qPCR). The study was performed in Sprague-Dawley (SD) and Lewis (LE) rat strains, the latter having lower activity of HPA axis.

METHODS: We used adult male SD and LE rats. OTR mRNA expression was detected in all heart chambers by comparing their threshold cycle values (CT) to CT of reference gene β-actin. The relative expression ratios were calculated using the 2-ΔΔCT method. The specificity of reaction of primary antibody with OTRs was tested by Western Blot and localization of OTR in the heart compartments was performed by immunofluorescence with commercial OTR specific antibodies.

RESULTS: We found expression of OTR mRNA in all heart compartments. The expression of OTR mRNA in both atria (LA, RA) was much higher than in the ventricles (RV, LV). By using two-way ANOVA we found no statistical differences between corresponding compartments of SD and LE rats. Immunohistochemical studies showed that OTR staining is not related to neuronal tissue and findings from left atrium indicate that prevalent localization of OTR is on cell membranes of cardiomyocytes.

CONCLUSIONS: The finding of expression of OTR mRNA by real-time qPCR and proof of OTR staining by immunohistochemistry in all heart compartments indicate that OT and its receptors may have function as a cardiovascular hormone. The differences in the HPA axis activity, as is exemplified in Sprague-Dawley and Lewis rat strain, do not project in the expression of OTR mRNA under basal condition. The effect of activity of HPA on OTR expression should be studied under stimulated conditions as it was performed in the behavioral studies....

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Journal Article 2011; 32(6): 769-773 PubMed PMID: 22286790 Citation  Keywords:  Animals, Cells, Cultured, Estradiol:pharmacology, Female, Follicle Stimulating Hormone:secretion, Intracellular Signaling Peptides and Proteins:metabolism, Luteinizing Hormone:secretion, Neuropeptides:metabolism, Orexins, Ovariectomy, Pituitary Gland:cyto.   

OBJECTIVES: Orexin A (OxA) is a regulatory neuropeptide which is involved in the control of various autonomic and neuroendocrine functions. It regulates sleep-wake cycle, food intake and modulates the hypothalamic and pituitary hormones secretion. Orexin A acts through two types of receptors, which proved to exist in the pituitary. This may indicate the possibility of direct action of OxA on the adenohypophysis level. The aim of this study was to evaluate the direct effect of orexin A on gonadotropin (LH and FSH) release from cultured pituitary cells of immature female rats as well as mature female rats (ovariectomized and ovariectomized and estradiol treated rats).

MATERIAL AND METHODS: The effect of 0.1 nM and 100 nM orexin A on LH and FSH release from anterior pituitary cells after 1 h of incubation was examined in immature female rats (IM) as well as mature female (ovariectomized - M/OVX; and ovariectomized and estradiol treated - M/OVX+E2) rats. The concentration of LH and FSH in medium was determined by RIA method.

RESULTS: Orexin A at a dose of 0.1 nM and 100 nM significantly stimulated LH secretion in IM group. In M/OVX group release of LH was inhibited by OxA only in higher dose (100 nM). No effect of orexin A on FSH secretion was found.

CONCLUSIONS: OxA may directly modulate LH secretion from cultured pituitary cells and it has the contradictory effect on LH release in immature and ovariectomized mature female rats....

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Case Reports 2011; 32(5): 627-630 PubMed PMID: 22167133 Citation  Keywords:  Craniopharyngioma:complications, Diabetes Mellitus, Type 2:drug therapy, Female, Humans, Hypoglycemic Agents:therapeutic use, Pituitary Neoplasms:complications, Postoperative Complications:drug therapy, Young Adult,.   

: A 23-year-old non-diabetic woman presented to our emergency room with progressive headache. She was diagnosed with craniopharyngioma and received tumor resection. Her blood glucose level was within the normal limit before surgery, and she had no family history of diabetes. Three months after the surgery, acute hyperosmolar hyperglycemic state developed. After 4 months of follow-up, her diabetes persisted but improved with oral antidiabetic drugs. This is the third case report of diabetes developing several months after craniopharyngioma tumor resection. The possible mechanisms of cranipharyngioma or its surgery inducing diabetes mellitus are hypothalamic obesity or hypothalamic damage. The degree of hypothalamic damage before the operation is predictive of diabetes development, and blood glucose level monitoring is important for these patients....

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Journal Article 2011; 32(4): 475-480 PubMed PMID: 21876512 Citation  Keywords:  Adult, Biomarkers:metabolism, Circadian Rhythm:physiology, Dehydroepiandrosterone Sulfate:metabolism, Humans, Hydrocortisone:metabolism, Hypothalamo-Hypophyseal System:physiology, Male, Pituitary-Adrenal System:physiology, Reference Values, Saliva:metabol.   

OBJECTIVES: Because the cortisol awakening response (CAR) has received increasing attention as a useful index of adrenocortical activity, the primary objective of this study was to investigate the presence of an awakening response for various salivary biomarkers of adrenocortical activity, including dehydroepiandrosterone-sulphate (DHEA-S), which acts as a cortisol antagonist, and α-amylase, which is a predictor of circulating catecholamine activity. Salivary biological indicators are considered to be valuable markers of hypothalamus-pituitary-adrenal (HPA) axis diurnal activity.

METHODS: In an attempt to overcome problems associated with non-adherence to the requested sampling protocol, only young, healthy males with a physiological CAR value (defined as a 50% increase in salivary cortisol within 30 min after waking) were included in the study (67 out of 102 who initially enrolled met this criterion).

RESULTS: Our results suggested that, as is already known for cortisol, DHEA-S and α-amylase have significant awakening responses. In addition, daily profile of salivary cortisol, α-amylase and DHEA-S fluctuations were analysed. Significant correlations were found between salivary cortisol, DHEA-S and α-amylase levels. The results showed that cortisol and DHEA-S concentrations were inversely correlated with α-amylase levels.

CONCLUSION: This correlation confirmed the distinctiveness of the two regulatory systems: salivary cortisol and DHEA-S concentrations reflect the activity of the HPA axis, whereas α-amylase activity is more closely related to sympathetic activity. In addition, the present study emphasizes the potential value of saliva collection (which is both easy and stress-free) in monitoring changes of adrenal function, confirming that multiple sampling (especially within 1 h after awakening) is necessary to reliably characterise biomarker activity when investigating neuroendocrine changes under various conditions....

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Journal Article 2011; 32(4): 442-448 PubMed PMID: 21876493 Citation  Keywords:  Adolescent, Adult, Dehydroepiandrosterone Sulfate:blood, Female, Humans, Hydrocortisone:blood, MMPI, Male, Middle Aged, Personality:physiology, Pituitary-Adrenal System:physiology, Retrospective Studies, Stress, Psychological:physiopathology, Type A Perso.   

OBJECTIVES: Dehydroepiandrosterone-sulphate (DHEAS) physiologic relevance remains controversial. However, several central nervous system and behavioural effects of DHEAS have been described. We explored the relation between DHEAS and both pituitary-adrenal axis reactivity and personality in human subjects.

DESIGN: We studied 120 consecutive patients assisted at the out patient endocrine department of a public central hospital before medical treatment. Personality was evaluated with the Minnesota Multiphasic Personality Inventory (MMPI) and the pituitary-adrenal axis reactivity was assessed with the CRH test.

RESULTS: Baseline DHEAS was inversely related to peak/basal cortisol (parcial r=-0.454, p<0.05) response to CRH infusion. DHEAS reactivity in the CRH test was directly related to the Deviant Behaviour triad (BD) (r=0.257, p<0.05) and type A personality (AP) (r=0.295, p<0.05). Basal ACTH was directly related to baseline DHEAS (r=0.366, p<0.001) and together with age and gender explained 34% of DHEAS variability.

CONCLUSIONS: DHEAS may be a protective factor against an excessive cortisol response when people are under stress situations. Personality may be related to DHEAS reactivity....

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Case Reports 2011; 32(3): 238-241 PubMed PMID: 21712786 Citation  Keywords:  Atrophy, Brain:diagnostic imaging, Fatal Outcome, Female, Humans, Hydrocortisone:blood, Hypokalemia:etiology, Magnetic Resonance Imaging, Middle Aged, Pituitary ACTH Hypersecretion:pathology, Tomography, X-Ray Computed,.   

: We present a 56-year-old patient with cyclic Cushing's disease (CCD) observed for 28 months, who presented clinically and biochemically with alternating episodes of hyper-, normo- and hypocortisolemia. The course of the disease was fatal, the patient died due to severe hypokalemia....

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