Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UNIPROT:P01189 (beta-endorphin)
 21,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We evaluated a new, commercially available two-site immunoradiometric assay (IRMA) for corticotropin (ACTH) in human plasma. The precision and detection limit were an improvement over radioimmunoassay (RIA). Addition of ACTH 1-24 or ACTH 18-39 to plasma containing ACTH 1-39 resulted in a decrease in measured ACTH. Results by both IRMA and RIA are reported and compared for normal subjects, patients with Cushing's disease, and patients with ectopic ACTH. Effects of administering dexamethasone, metyrapone, ACTH 1-24, and corticoliberin were evaluated. The present assay is more sensitive, specific, and reproducible than RIA. The presence of fragments of ACTH or "big" ACTH that are reactive in RIA may lead to artifactually low ACTH concentrations by IRMA. Therefore, RIA may still be necessary for differential diagnosis of ectopic ACTH syndromes. However, the IRMA is an improvement for evaluating pituitary--adrenal function in patients with low concentrations of ACTH in plasma.
 ...
PMID:A new immunoradiometric assay for corticotropin evaluated in normal subjects and patients with Cushing's syndrome. 253 71

Previous reports have emphasized the value of bilateral and simultaneous catheterization of the inferior petrosal sinus for the measurement of both basal and oCRH (ovine Corticotropin Releasing Hormone) stimulated ACTH levels to determine the site of the microadenoma in the pituitary and for the differential diagnosis of Cushing's disease. This method is mainly employed in those patients whose hormonal studies are ambiguous and whose CT-scans and NMR (Nuclear-Magnetic-Resonance) results yield inconclusive or negative findings. Ten patients were studied: 9 were under evaluation for Cushing's disease and one was a "relapse" (4 yrs after transsphenoidal microadenomectomy). In all patients, except two who are awaiting surgery and one who was a "relapse", surgical findings were consistent with the ipsilateral hypersecretion (one had a central microadenoma). These results confirm that bilateral and simultaneous catheterization of the inferior petrosal sinus associated with a oCRH stimulus could be of great help in localizing the site of the adenoma and therefore improve the results of surgery. Moreover, this methodology may be of great value in diagnosing ectopic secretion.
 ...
PMID:[Use of catheterization of the inferior petrosal sinus in the diagnosis of Cushing's disease]. 255 88

In addition to prolonged glucocorticoid therapy (not discussed here), at least five other conditions cause Cushing's syndrome. They are excessive corticotropin secretion by the pituitary gland (which results in Cushing's disease), ectopic production of corticotropin by malignant nonpituitary tumors, benign adrenal adenoma, adrenal carcinoma, and primary adrenocortical nodular dysplasia. Each can be distinguished by a specific pathophysiologic process that triggers the adrenal glands to overproduce glucocorticoids. At present, diagnosis of Cushing's syndrome or disease relies heavily on the dexamethasone (Decadron, Hexadrol) suppression test. After diagnosis, other studies, including computed tomography, magnetic resonance imaging, and corticotropin radioimmunoassay, can be used to localize the site of the lesion. Treatment, of course, depends on the underlying cause.
 ...
PMID:Cushing's syndrome. How to pinpoint and treat the underlying cause. 255

The combined intravenous injection of TRH and GnRH elicited paradoxical responses of plasma beta-endorphin in active and successfully treated pituitary dependent Cushing's disease as well as in ectopic ACTH syndrome and in congenital adrenal hyperplasia. No response was observed in Cushing's syndrome due to adrenal tumours. It is concluded that an abnormal response to inappropriate releasing hormones cannot verify the existence of a pituitary corticotrophic microadenoma.
 ...
PMID:Paradoxical response of plasma beta-endorphin to combined administration of TRH and GnRH in adrenal disorders. 255 25

Endocrinologists from University Hospital in Frankfurt, West Germany, compared data on 19 women 20-36 years old who had taken oral contraceptives (OCs) for at least 4 months before the study (cases) with those of 12 age matched women who took no OCs for at least 6 months before the study (controls). The goal of the study was determine the reliability of total cortisol, unbound salivary and serum cortisol, and adrenocorticotropic hormone (ACTH) parameters in the dexamethasone (2mg) suppression test under conditions of chronically high estrogen levels due to OC use. Radioimmunoassay techniques were used to measure baseline and post-dexamethasone levels of all parameters. Equilibrium dialysis was used to measure unbound serum cortisol. The mean baseline levels for all parameters were considerably greater in the cases than in the controls: total serum cortisol (32.7 mcg/dl vs. 15.6mcg/dl; p .001), free salivary cortisol (9.6ng/ml vs. 5.6ng/ml; p .01), ACTH (50.8pg/ml s. 34.2pg/ml; p .05), and free serum cortisol (6.3 mg/ml vs. 4.2 ng/ml; p .01). This suggested that estrogens exert a direct stimulatory effect on the corticotroph axis separate from a corticosteroid-binding globulin mediated increase of total cortisol. TOtal and free salivary cortisol levels after the dexamethasone suppression test for the 1 groups were not statistically significant (2.3 mcg/dl vs. 1.7 mcg/ml vs. 1.1ng/ml, respectively). On the other hand, ACTH suppression was significantly better for cases than it was for controls (2.2pg/ml vs. 5.3 pg/ml; p .001). These data indicate that post-dexamethasone measurements of ACTH or free cortisol in women taking OCs are not needed since total cortisol measurements provide the information needed. Therefore physicians should not use the dexamethasone suppression test to diagnose Cushing's disease in women using OCs.
 ...
PMID:The dexamethasone suppression test and long-term contraceptive treatment: measurement of ACTH or salivary cortisol does not improve the reliability of the test. 256 Sep 85

From January 1962 through April 1988, 188 patients with Cushing's syndrome were hospitalized at the Veterans General Hospital. Iatrogenic Cushing's syndrome was found in 123 (65.4%) of the patients. The other 43 patients (22.9%) had excess secretion of adrenocorticotropin (ACTH) and 22 patients (11.7%) had benign or malignant adrenocortical tumors. The clinical features and the functional reserve of the adrenal glands in those patients with iatrogenic Cushing's syndrome were evaluated. A retrospective analysis of the diagnostic rate of the various endocrine evaluations and the radiological examinations was also carried out. Four approaches were used in the management of Cushing's syndrome: (1) pituitary surgery, (2) pituitary irradiation, (3) adrenal surgery, and (4) drug therapy. Both the clinical and hormonal responses to these four management types were evaluated. The endocrinological, radiological, surgical and pathological experiences of 25 patients with Cushing's disease treated with pituitary surgery are presented. Five patients (20%) had an atypical endocrine pattern (20% false-negative). Twenty-four patients received a pituitary CT scan and 16 patients (66.7%) had positive CT findings. Of these 25 patients, 19 had pathology-proven microadenomas (less than 1cm), one had macroadenoma (greater than 1cm) and 5 had no evidence of adenomatous tissue. Among the 22 patients with adrenal Cushing's syndrome, 4 (18%) were suffering from adrenocortical carcinoma and 18 (82%) with benign adrenal tumors. The incidence of left adrenal adenoma was approximately twice that of right adrenal adenoma. The cure rate of adrenocortical adenoma by surgical treatment with unilateral adrenalectomy was excellent, but for adrenocortical carcinoma was poor.
 ...
PMID:Cushing's syndrome: analysis of 188 cases. 262 29

Cushing's syndrome represents a constellation of symptoms of various origins. In most patients, detailed endocrinologic and radiologic testing will differentiate between Cushing's disease, adrenal adenoma, adrenal carcinoma, primary bilateral nodular hyperplasia, and ectopic corticotropin-producing tumors. Although adrenal surgery affords rapid and reliable remission in patients with Cushing's syndrome, it is associated with significant morbidity and mortality. Complications can be minimized by careful perioperative preparation. The indications for adrenal surgery for Cushing's disease have been altered radically by the success and low morbidity of transsphenoidal surgery. Total adrenalectomy is indicated in patients with bilateral nodular hyperplasia and should be considered for adults who have failed selective pituitary adenectomy or hypophysectomy and in whom ectopic corticotropin secretion has been unequivocally ruled out. At the Lahey Clinic, total adrenalectomy is performed through an anterior abdominal incision. Anterior approaches are especially indicated in those patients who require abdominal exploration for other intra-abdominal pathologic conditions that require surgery. Total adrenalectomy is indicated in the very rare patient who has Cushing's syndrome caused by ectopic corticotropin production when the patient is severely ill, a primary tumor is not found, and medical therapy fails or is poorly tolerated. Small adrenal tumors are best approached through a flank incision. Larger potentially malignant tumors should be approached through a thoracoabdominal incision.
 ...
PMID:Surgical management of Cushing's syndrome. 266 80

The effectiveness of ketoconazole for the therapy of Cushing's syndrome, both of adrenal and pituitary origin, was retrospectively evaluated. To this end, the clinical and hormonal results in 5 patients were assessed. There were 4 females and one male, with ages ranging between 17 and 64 years. Three of them, who had Cushing's disease, received sustained treatment with ketoconazole when other therapeutic measures had failed. The two remaining patients (one with Cushing's disease and the other with adrenal adenoma) were treated with this drug in the preoperative period to alleviate the deterioration in the clinical condition caused by hypercortisolism. The clinical evolution of the patients is described, as well as the plasma adrenocorticotropin (ACTH) and the free cortisol in 24 hour urine in the subsequent controls. In view of the study results, we feel that ketoconazole is an effective treatment for the long term control of Cushing's syndrome. In addition, it may be also useful as preoperative therapy in those patients severely deteriorated by the sustained hypercortisolism.
 ...
PMID:[Evaluation of the treatment of Cushing's syndrome using ketoconazole]. 269 99

The MR images of 27 patients with clinically and biochemically suspected Cushing disease were evaluated retrospectively in a blinded fashion. The MR interpretation was compared with detailed operative diagrams and operative and pathologic reports. The examinations were performed on a 1.5-T MR system with thin-section sagittal and coronal T1-weighted (short TR/TE) images. Each pituitary half was considered separately (54 "halves"). Twenty-one pituitary halves were considered to have glandular abnormalities on MR. Compared with surgical findings, 17 MR findings were true positives and four were false positives (one pars intermedia cyst, three normal tissue). Of the 33 pituitary halves considered normal on MR, 26 were true negatives and seven were false negatives. MR had an overall sensitivity of 71% and a specificity of 87% for these adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas. A focal glandular hypointensity identified on coronal images was the most sensitive predictor of adenoma location. Sagittal images were not useful in either detection or localization. Upward convexity of the gland and deviation of the stalk were less useful indicators. Abnormalities of the sellar floor were the least reliable. In comparison with the capabilities of CT detection of microadenomas described in the current literature, it appears that high-field thin-section MR of the sella is the most sensitive imaging method for preoperative localization of ACTH-secreting adenomas in patients with Cushing disease.
 ...
PMID:High-resolution MR imaging of pituitary microadenomas at 1.5 T: experience with Cushing disease. 278 69

The paper is concerned with the results of a study of the level of plasma ACTH, cortisol and prolactin before and after i. v. injection of LHRH to 20 patients with Itsenko-Cushing disease and to 5 healthy persons. In healthy persons LHRH injection caused no significant changes in the level of plasma ACTH, cortisol and prolactin. Patients with Itsenko-Cushing disease who had a high basal level of corticotropin on the 30th min after i.v. LHRH injection demonstrated a significant increase in the hormone level. A response to LHRH injection was absent in patients with a normal basal level of corticotropin and in healthy persons. A statistically significant increase in cortisol concentration was noted on the 60th min after LHRH injection in some of the patients responding to LHRH by a high ACTH level. LHRH injection was not accompanied by significant changes in the level of plasma prolactin in either of the subgroups.
 ...
PMID:[Dynamics of the corticotropin, cortisol and prolactin content of the blood plasma of women with Itsenko-Cushing disease administered luliberin]. 282 33


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>