Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The hypothalamus, in addition to regulating the anterior and posterior pituitary, controls water balance through thirst, regulates food ingestion and body temperature, influences consciousness, sleep, emotion and other behaviors. Much has been learned of these effects in human disease through the clinical manifestations that occur with hypothalamic lesions. This study reviews the clinical pathologic correlations that have been made in recent years showing that regions of the hypothalamus exert functions in humans that are similar to those identified in experimental animals. Clinical pathologic correlations have not always provided precise analysis of hypothalamic function. The hypothalamus is small and often lesions that come to clinical attention achieve considerable size before their recognition, making local anatomic dissections of the effects of the lesions difficult. Nevertheless, the use of modern non-invasive techniques including CT scans and magnetic resonance imaging (MRI) have provided new information not previously available. This paper reviews several cases of hypothalamic disorder recognized recently. (1) A 33-year-old black man with hypothalamic sarcoidosis. Manifestations of hypothalamic dysfunction included panhypopituitarism, aggressive hyperphagia, polydipsia (partially due to hyperglycemia secondary to diabetes mellitus), drowsiness, depression, and irritability. (2) A 37-year-old woman with a large intrahypothalamic tumor (biopsy showed pituitary adenoma), with drowsiness, poikilothermia, lack of satiety, confusion, and memory loss. She becomes depressed when she is transiently more alert (as after hypertonic contrast-dye infusion). (3) A 60-year-old man with hypothalamic compression by a pituitary tumor, associated with syndrome of inappropriate ADH (SIADH), severe anorexia, memory loss, but preserved thirst. After surgical decompression of the tumor his appetite acutely recovered, but he developed severe hypo(poikilo)thermia. (4) A 45-year-old woman with a suprasellar craniopharyngioma presented with severe drowsiness, hyperphagia, depression, and memory loss post-operatively, which responded to antidepressants (except for the memory loss). She had extremely labile blood pressures and serum Na for about 1 week post-operatively.
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PMID:Neurologic manifestations of hypothalamic disease. 148 Jul 55

A 36-year-old man with depression, Cushingoid features and hypogonadism was found to have simultaneous pituitary-dependent Cushing's disease and marked elevation of serum prolactin (PRL). CT-scan revealed a macroadenoma with suprasellar extension. Transphenoidal surgery cured the patient's Cushing's disease, but failed to correct his hyperprolactinemia, which was controlled by subsequent bromocriptine therapy. Immunostaining of the pituitary tumor was positive for PRL as well as for ACTH, and ACTH-related peptides beta-lipotropin and beta-endorphin in two distinct tumor cell lines. This pituitary tumor is one of the few mixed PRL- and ACTH-secreting tumors documented by immunostaining. It is the second reported in a macroadenoma, in which PRL-secreting tumoral cells are much more abundant than ACTH-secreting cells.
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PMID:Cushing's disease and hyperprolactinemia due to a mixed ACTH- and prolactin-secreting pituitary macroadenoma. 165 8

Yearly episodes of edema, hypokalemia, anxiety, and depression were found to be due to cortisol and deoxycorticosterone surges secondary to a pituitary adenoma in a woman without any of the usual clinical features of Cushing's syndrome. During the long clinical remissions, she had no recognizable laboratory abnormality. She had two episodes in the year following incomplete transphenoidal pituitary tumor resection, but has had none in 2 yr since receiving radiotherapy. The episodes were caused by mineralocorticoid actions of large ACTH-induced increases in cortisol and deoxycorticosterone secretion. A history of episodic edema and hypokalemia, often attributed in women to surreptitious diuretic abuse, requires a careful search for hypercorticism even in the absence of clinical Cushing's syndrome.
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PMID:Cyclical edema and hypokalemia due to occult episodic hypercorticism. 302 28

The authors report on an acute bitemporal visual field depression with spontaneous reversibility of the defects, associated with necrotic pituitary adenoma. As the same time as the visual field defects regressed it was established by computer tomography that the suprasellar portion of the pituitary tumor had diminished in size.
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PMID:[Visual field fluctuations in necrotic hypophyseal adenoma]. 378 16

We have previously reported that 5,5'-diphenylhydantoin (DPH) inhibits total cellular and specific nuclear T3 binding by cultured GC cells, a rat pituitary tumor cell line that produces GH. DPH decreased competitively the rate of T3 accumulation by GC cells and noncompetitively inhibited specific nuclear T3 binding as well. To determine the biological consequences of these DPH effects on cellular and nuclear T3 binding, we studied the effect of DPH on the growth rate and GH production of GC cells cultured in Dulbecco's Modified Eagle's Medium with 10% serum. Incubation with T3 stimulated the GC cell growth rate in a dose-dependent manner. The half-maximal growth rate was achieved at a T3 concentration of 0.18 nM, and the maximal effect was observed at 0.4 nM T3. Addition of DPH to GC cells cultured with 0.15 nM T3 resulted in a dose-dependent decrease in the GC cell growth rate. The half-maximal depression of the rate of GC cell growth occurred at 185 microM DPH, a concentration that results in an approximately 50% decrease in cellular and nuclear T3. The DPH-induced decrease in GC cell growth was abolished by the addition of increasing concentrations of T3 (maximal concentration, 1.0 nM). Similarly, DPH effected a dose-dependent decrease in GH production in cells cultured with physiological concentrations of T3 (0.15 nM). The decrease in GH production of cells incubated with 200 microM DPH was associated with a decrease of similar magnitude in GH mRNA. These findings suggested that the DPH effect on GH production was mediated at a pretranslational level. Addition of increasing concentrations of T3 up to 5 nM completely abolished the DPH-associated decrease in GH production. Finally, studies of the effects of DPH on cell growth and GH production in cultures maintained with T3-depleted conditions were carried out to detect putative agonist activity of DPH. In the present investigation, we were unable to detect agonist activity of DPH that was more than 10-15% of the effect of maximal doses of T3. The data suggest that DPH attenuates the action of T3 in GC cells, probably because of a decrease in the steady state concentrations of cellular and nuclear T3. These attributes of DPH suggest that the drug or related analogs may serve as prototypes of agents that may decrease thyroid hormone activity at target tissues.
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PMID:5,5'-Diphenylhydantoin (phenytoin) attenuates the action of 3,5,3'-triiodo-L-thyronine in cultured GC cells. 399 15

70 women were treated for amenorrhea which occurred after having used O.C.s (oral contraceptives) (41 Non-Ovlon, 16 Ovosiston, 10 Sequence Ovosiston, and 3 Gravistat). The patients were given 2 tablets of chlormadinon or Ovosiston monthly; those who wanted to become pregnant received clomiphene on the 5th-9th days of the menstrual cycle. 2/3 of the patients had had stable menstrual cycles before O.C. use; these patients more often became pregnant. Age and length of O.C. use could not be correlated to the subsequent incidence of pregnancy. Estrogen, FSH, and LH values were within normal ranges. Hyperprolactinemia was found in 48% of the 23 who had post-pill amenorrhea; 6 of these had a galactorrhea-amenorrhea syndrome, and 1 a pituitary tumor. Endometrial currttage smears were taken from 31 patients: in 23 cases advanced proliferation without or with little functional capacity was observed, in 7 cases a severe endometrial depression was found, and in 1 case a secretory phase was observed. Ovulation was induced in 23 of the 31 patients to whom Clomiphene had been administered; in 12 cases pregnancy occurred. Of 51 patients, 27 became pregnant, half within the first half year of treatment; 2 patients had twins, 2 had spontaneous abortions.
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PMID:[Anovulation syndrome in nulligravidae following intake of hormonal contraceptives (author's transl)]. 746 23

While depression is common in Cushing's syndrome from whatever cause (pituitary, adrenal, or ectopic adrenocorticotropic hormone-secreting tumor or hyperplasia, or exogenous administration of glucocorticoids) and hypercortisolemia is prevalent in major depression, any association between seasonal affective disorder and Cushing's syndrome is unknown. We present a case of seasonal bipolar disorder, gradually worsening for more than 9 years (1985-1994), accompanied by increasing osteoporosis, mild weight gain, and slight truncal obesity in a middle-aged woman. In January 1991, her seasonal affective disorder was successfully treated with light therapy, but in the following year, bipolar mood swings with a seasonal pattern emerged, which were refractory to light therapy and antidepressants but responsive to lithium. In August 1992, she became depressed despite a 1500-mg lithium daily dosage along with light therapy, and, in 1993, a diagnosis of Cushing's disease (Cushing's syndrome as a result of a pituitary adrenocorticotropic hormone-secreting tumor) was made. The pituitary tumor was removed in February 1994, and pituitary function was fully restored by 1996. While the symptoms of Cushing's syndrome subsided, her bipolar illness continued to require maintenance treatment with low doses of lithium but did not require light therapy.
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PMID:A case of seasonal bipolar disorder exacerbated by Cushing's disease. 1572 34

Increasingly, patients with pituitary disease are evaluated and treated at cancer centers. In many ways, these patients resemble patients with other malignant brain tumors. Although the majority of pituitary adenomas are benign, the physical, emotional, and cognitive changes that these patients experience on their well-being is malignant. Pituitary disease causes a variety of physical illnesses resulting from the alterations in the hypothalamic-pituitary-end organ axis. In addition, patients with pituitary diseases may experience many emotional problems, including depression, anxiety, behavioral disturbances, and personality changes, above and beyond the many reactions these patients may have to the myriad of adjustments that they must make in their lives. There is a growing understanding that pituitary patients may experience these emotional problems as a result of long-term effects that the pituitary tumor itself, treatment, and/or hormonal changes have on the hypothalamic-pituitary-end organ axis. The authors present a series of cases, in which patients with pituitary disease were diagnosed and treated for depression and showed little response to the treatment for depression. When the diagnosis of apathy syndrome was considered and treatment implemented, the patients' condition improved. A review of the literature on apathy, hypothalamic-pituitary-end organ axis dysfunction, and treatment for apathy syndrome is included.
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PMID:Apathy and pituitary disease: it has nothing to do with depression. 1593 68

Controversy surrounds the efficacy and safety of 17beta-estradiol (E2)-mimetic therapies to women for treatment of menopausal symptoms. An important question is the nature of the trophic actions of E2-mimetics in the brain for behavioral processes versus in the periphery for beneficial effects related to osteoporosis, or unwanted proliferative effects in the reproductive tissues, such as mammary glands and uterus. Of recent interest are the effects of selective estrogen receptor modulators, which can have tissue specific actions, for these processes. In the present study, the effects were determined of E2 alone, or co-administered with a selective estrogen receptor modulator, raloxifene, for anxiety-like, depression-like, and trophic peripheral effects in ovariectomized rats that were exposed to a chemical carcinogen (7,12-dimethylbenz(a)anthracene), or not. Once per week, rats were administered vehicle, E2 (0.09 mg/kg) and/or raloxifene (1 mg/kg) subcutaneously 44-48 h before testing in a positive control, E2-dependent behavior (lordosis), depression (forced swim test), and anxiety (elevated plus maze) behavioral assays. In addition to behavioral endpoints, incidence and number of tumors, and tumor, pituitary gland, and uterine weight 14 weeks after carcinogen-exposure, and weekly hormone treatments, were analyzed. Rats administered 7,12-dimethylbenz(a)anthracene had an increased number and size of tumors, compared with vehicle treatment. E2 + raloxifene increased the number of tumors. Administration of E2 or E2 +raloxifene, but not raloxifene alone, increased pituitary and uterine weight, compared with vehicle administration. E2 or E2 + raloxifene, but not raloxifene alone, also increased the incidence of lordosis and reduced the depression-like behavior in the forced swim test (i.e. decreased time spent immobile) compared with vehicle administration. However, administration of E2 or raloxifene reduced anxiety behavior in the elevated plus maze (i.e. increased time spent on the open arms of the maze), compared with vehicle treatment. Together these data show that E2 and/or raloxifene can have some effects to alter the behavior of ovariectomized rodents, depending upon the task. As well, E2, with or without raloxifene, can also have clear trophic actions in peripheral tissues, such as carcinogen-induced tumors, uterus, and pituitary glands.
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PMID:Raloxifene and/or estradiol decrease anxiety-like and depressive-like behavior, whereas only estradiol increases carcinogen-induced tumorigenesis and uterine proliferation among ovariectomized rats. 2048 May 45

A 7-year-old male neutered domestic short-haired cat had depression for 5 months and acute blindness. A lesion at the level of the rostral and middle cranial fossae was suspected. A large pituitary mass compressing the optic chiasm was detected in magnetic resonance images and there was also evidence of recent intratumoral hemorrhage, leading to a diagnosis of pituitary apoplexy; these findings were confirmed at postmortem examination. Pituitary apoplexy is a clinical syndrome characterized by acute neurologic signs related to hemorrhagic infarction within a pituitary tumor. Pituitary apoplexy should be considered in patients with acute onset of blindness and altered mental status.
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PMID:Imaging diagnosis: pituitary apoplexy in a cat. 2254 79


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