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 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied 2 members of a family suffering from paroxysmal attacks elicited by tactile stimuli. The attacks consist of burning pain of the stimulated body part, followed by either complete collapse or tonic posturing. Noxious stimuli provoke episodes regardless of their somatic location, whereas it is only necessary for nonnoxious stimuli to be applied to specific trigger zones, such as the rectum, to provoke attacks. Episodes are most commonly precipitated by bowel movement, leading to extreme fear of defecation and resultant fecal retention. An ictal electroencephalographic video recording revealed only slowing of the background; however, serum prolactin was significantly elevated postictally. The attacks were completely suppressed by carbamazepine and resumed on discontinuing the medication. These attacks may represent a form of reflex epilepsy manifested by autonomic nervous system dysfunction.
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PMID:Familial rectal pain: a type of reflex epilepsy? 836 60

Two cases of pituitary adenoma associated with a parasellar cyst are reported; only one similar case has been described previously. Even though such an association may be coincidental, a pathogenetic relationship between the two lesions in one of our cases may be assumed: shrinkage of the prolactin-secreting pituitary adenoma by means of bromocriptine therapy did, in fact, cause collapse of the cyst. Such an occurrence must not be disregarded in considering the therapeutic approach.
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PMID:Pituitary adenoma and parasellar cysts. 238 48

Recovery of gonadotropin-secreting function of the pituitary during the early puerperium has been studied in women with postpartum hemorrhage of 500 g and more during the first 2 h after expulsion of the placenta but without circulatory collapse. On day 4 postpartum, the concentrations of erythrocytes, hemoglobin, and hematocrit were significantly lower in puerperal women with postpartum hemorrhage than in normal puerperal women. On day 20 postpartum, administration of 100 micrograms synthetic luteinizing hormone-releasing hormone (LHRH) significantly increased serum follicle-stimulating hormone (FSH), but not luteinizing hormone, in puerperal women with severe postpartum hemorrhage of more than 1,000 g, but the FSH response to LHRH was significantly lower in these women than in normal women on the same postpartum day. All puerperal women were lactating and there was no significant difference in serum prolactin levels between normal puerperal women and puerperal women with postpartum hemorrhage. These results indicate that blood loss in the amount of more than 1,000 g during the first 2 h after expulsion of the placenta may cause perturbation to some extent in recovery of gonadotropin-secreting function of the pituitary during the early puerperium, even if there are no complications by circulatory collapse and disabled lactation.
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PMID:Retardation in gonadotropin-secreting function of the pituitary during the early puerperium in women with postpartum hemorrhage but without circulatory collapse. 392 38

The present ultrastructural morphometric study was performed to examine the mechanism of prolactin (PRL) secretion in lactating rats, compared with the alteration in serum and pituitary PRL as measured by radioimmunoassay. After 8 hours separation from pups, the pituitary PRL content double but serum PRL levels dropped markedly, whereas, in PRL cells, the granule content increased and dilated rough endoplasmic reticulum (RER) was observed. Until 30 min. after renewed suckling, a marked increase in the serum PRL was observed and the RER transformed frequently, ie. collapse (1, 30 min.) and dilation (5, 15 min.). However, the pituitary PRL and the granule content did not change noticeably. Between 60 and 240 min. after the renewed suckling, the serum PRL decreased gradually, and the pituitary PRL and the granule content showed a prominent decrease. However, the dilated RER and the well-developed Golgi apparatus were clearly observed. The results indicate that: The interrupted suckling stimulus does not suppress de novo synthesis of PRL. Renewed suckling immediately induces not only release but also de novo synthesis of PRL. Until 30 min. after renewed suckling, PRL is mainly released directly from RER, which mechanism is differently from the release by exocytosis of secretory granules that can be observed after 30 min. of renewed suckling.
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PMID:[Ultrastructural morphometric method for the measurement of prolactin release and synthesis in the rat pituitary induced by suckling stimulus]. 641 86

The conformations of human, equine, and porcine pituitary prolactins, as evidenced by various optical properties, have been compared. The alpha-helix contents of all three proteins are essentially identical to each other (60 +/- 5%), as well as to prolactins isolated from other mammalian species. Direct absorption (zero and second-order), difference absorption, fluorescence emission, and circular dichroism spectra suggest that the majority of tyrosine and tryptophan side chains in these three proteins exist in very similar microenvironments within the folded forms of the hormones. Thus, the general conformational properties of these molecules are closely related to each other, and to other mammalian prolactins. Molar extinction and absorptivity values have been obtained at the absorption maximum of each species. In addition, a second molar extinction value has been determined at a particular wavelength found to be different for each, and which appears to be independent of the conformational state of the molecule. These absorptivities are useful in providing accurate prolactin concentrations in the 10(0) to 10(-2) mg/ml range. On incubation with the proteolytic enzyme thermolysin, all three hormones display an initial, short lag period during which little conformational change can be detected by difference absorption spectroscopy. For human and porcine prolactins, subsequent rates of proteolytically induced conformational collapse were found to be essentially identical. However, under similar conditions, equine prolactin loses its conformation significantly more slowly.
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PMID:Studies on prolactin: conformational comparison of human, equine, and porcine pituitary prolactins. 666 32

In male hamsters, exposure to a short photoperiod results in a significant decrease in median eminence (ME) dopamine (DA) concentrations. The mechanism responsible for this decrease in DA is unknown. The experiments described in this paper were designed to examine the effects of photoperiod on DA metabolism and synthesis in the ME to determine if a change in these processes is responsible for the short-photoperiod-induced decrease in ME DA concentrations. In the first experiment, the metabolism of DA in tuberoinfundibular dopamine (TIDA) neuronal terminals was determined by measuring ME concentrations of 3,4-dihydroxyphenylacetic acid (DOPAC; a major metabolite of DA) and DA in male and female hamsters housed in long and short photoperiods. In both males and females, exposure to the short photoperiod induced a collapse of the reproductive system and a reduction in circulating prolactin. In males, but not in females, exposure to the short photoperiod reduced ME DA concentrations; however, DOPAC concentrations were not affected by photoperiod. Thus, the decrease in ME DA seen in males is not the result of an increase in DA metabolism. In the second experiment, tyrosine hydroxylase (TH) activity in the ME of males was determined by injecting animals housed in long and short photoperiods with a L-aromatic amino acid decarboxylase inhibitor (NSD 1015) and measuring 3,4-dihydroxyphenylalanine (DOPA). Consistent with Experiment 1, ME DA concentrations were significantly decreased in gonadally regressed males housed in a short photoperiod; however, ME DOPA accumulation was not affected. Thus, the observed decrease in DA is not the result of a decrease in TH activity in the ME. The results of the experiments presented here indicate that (1) in males but not females, the decrease in circulating prolactin seen in animals housed in a short photoperiod for 12 weeks is associated with a decrease in ME DA concentrations, and (2) the decrease in ME DA seen in males housed in a short photoperiod is not the result of an increase in DA metabolism or a decrease in synthesis by TIDA neurons.
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PMID:The effect of short-photoperiod exposure on tuberoinfundibular dopamine neurons in male and female Syrian hamsters. 787 72

A 45-year-old woman had pyrexia, headaches, collapse and hyponatraemia. Intracerebral abscess, bacterial meningitis and subarachnoid haemorrhage were excluded. She was given intravenous antibiotics and gradually recovered. One month later she was readmitted with diplopia, headache and vomiting. Serum sodium was low (107 mmol/l) and a diagnosis of inappropriate ADH secretion was made. MRI scan showed a suprasellar tumour arising from the posterior pituitary gland. A skin rash gradually faded. Serum cortisol, prolactin, gonadotrophins and thyroid hormone levels were low. A pituitary tumour was removed trans-sphenoidally, she had external pituitary radiotherapy, and replacement hydrocortisone and thyroxine. She was well for 12 months when she developed progressive weakness and numbness of both legs. Examination suggested spinal cord compression at the level of T2 where MRI scanning showed an intradural enhancing mass. This spinal tumour was removed and her neurological symptoms disappeared. Nine months after this she developed facial pain and nasal obstruction. CT scan showed tumour growth into the sphenoid sinus and nasal cavities. A right Cauldwell-Luc operation was done and residual tumour in the nasal passages was treated by fractionated external radiotherapy and Prednisolone. Histological examination of the specimens from pituitary, spinal mass, and nasal sinuses showed Rosai-Dorfman disease, a rare entity characterized by histiocytic proliferation, emperipolesis (lymphophagocytosis) and lymphadenopathy. Aged 48 she developed cranial diabetes insipidus. Although Rosai-Dorfman syndrome is rare, it is being reported with increasing frequency, and should be borne in mind as a possible cause of a pituitary tumour.
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PMID:Rosai-Dorfman disease presenting as a pituitary tumour. 1034 67

Push/pull hemodiafiltration (HDF) is characterized by alternate repetition of filtration and backfiltration during hemodialysis with high-flux membrane. In the pressure-controlled push/pull (PC P/P) HDF system, which is the newest push/pull HDF system, there are about 25 repetitions of dilution and concentration of the blood while it passes through the hemodiafilter. Hence, the PC P/P is functionally close to the predilution mode of on-line HDF. In the PC P/P, body fluid is replaced usually by more than 120 L of dialysate during the 4 h treatment. In selecting a hemodiafilter for PC P/P, one must be certain that the blood flow channels in the hemodiafilter do not collapse by the positive pressure on the dialysate side in the backfiltration phase. Thus, the polyacrylonitrile hollow-fiber hemodiafilter and polysulfon hollow-fiber hemodiafilter are suitable for PC P/P. In the short term, PC P/P has been reported to be effective against joint pain, itchiness, insomnia, irritability, and restless leg syndrome experienced by hemodialysis patients. Midterm clinical effectiveness of PC P/P includes the requisite lowering of the erythropoietin dose and improvement in skin pigmentation. The albumin loss per treatment with the PC P/P was significantly lower than that with the conventional HDF approach when a protein-permeable membrane is used. In terms of the removal rate of prolactin, no significant difference was found between PC P/P and conventional HDF. On the other hand, the removal rates of myoglobin and beta2M, where molecular size was smaller than prolactin, was significantly greater with the PC P/P than with conventional HDF.
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PMID:Push/pull hemodiafiltration: technical aspects and clinical effectiveness. 1061 32

We report a 38-year-old Syrian woman who presented with progressive breathlessness, hypotension and circulatory collapse. Echocardiogram revealed a large pericardial effusion with evidence of cardiac tamponade. There was a history of secondary amenorrhoea, loss of axillary and pubic hair following childbirth at 28 years of age. Investigations revealed low levels of gonadotrophins, oestrogen, prolactin and thyrotrophin but normal levels of basal and post-synacthen (ACTH) cortisol. An MRI of the sella showed atrophic changes of the pituitary. She was treated with intravenous fluids, dopamine infusion, intravenous hydrocortisone and thyroxine replacement. The clinical suspicion of Sheehan syndrome facilitated early administration of corticosteroids, adequate thyroxine replacement and rapid resolution of pericardial effusion.
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PMID:Cardiac tamponade as a presenting manifestation of Sheehan syndrome. 1926 38

A 25-year-old woman presented with a history of secondary amenorrhoea for the last 3 years, coinciding with her delivery. She delivered at home and had massive postpartum haemorrhage. She was brought in a state of circulatory collapse to the nearest teaching hospital, where she was resuscitated. She developed anaemia, septicaemia and extradural empyema. The complications were managed and the woman improved. Presently, she approached us for infertility. She was investigated and diagnosed with postpartum hypopituitarism, that is, Sheehan's syndrome. Her gonadotrophin levels, luteinising hormone/follicle-stimulating hormone, were normal, serum oestradiol was low and serum prolactin was also on the lower side. She had started with genital atrophy and was given three cycles of cyclic oestrogen +progesterone combination. Ovulation was induced. She conceived and her antenatal period was uneventful. She delivered a full-term baby vaginally. However, she had inadequate lactation after delivery and lost the baby at one-and-a-half months' age due to gastroenteritis.
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PMID:A ray of hope for a woman with Sheehan's syndrome. 2338 98


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