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Biomedical subjects

B Migdalska

Publications and source records attributed to B Migdalska.

At least 37 records · Page 2Linked to original sources

Results of neurosurgical treatment by a transsphenoidal approach in 10 patients with Nelson's syndrome.

Ten patients with Nelson's syndrome, nine women and one man, aged 22 to 61 years, were treated neurosurgically by a transsphenoidal approach. In four patients, microadenomas were found, ranging in diameter from 4 to 10 mm. Microscopically, mixed adenoma was diagnosed in six cases, basophilic adenoma in three patients, and chromophobe adenoma in one patient. The presence of argyrophilic nerve fibers in the adenoma tissue was noted in one case. The time of observation after transsphenoidal surgery ranged from 6 months to 10 years. Clinical remission was achieved in eight patients; in two of them, radiation therapy was used to complement surgical treatment. In two patients, recurrence of the pituitary neoplasm was observed; anaplasia was revealed at the second operation in one of them. Radiation therapy might be a useful adjunct to neurosurgery in Nelson's syndrome, especially in patients with anaplastic adenoma.

Adenoma↗

Successful pregnancy following surgery for a masculinizing adrenocortical carcinoma.

A 16-year-old girl with a masculinizing adrenal carcinoma treated surgically is presented. Following surgery a full clinical and steroid remission has been achieved, without any adjuvant chemotherapy. In the 7th year after the surgical treatment the patient became pregnant. Pregnancy and labour were uncomplicated. The patient continues in complete remission, and her son has been noted to have normal development at 21 mth of age.

Adolescent↗

Nelson's syndrome: incidence and prognosis.

Fifty patients bilaterally adrenalectomized for Cushing's disease were followed for 1 to 22 (mean, 12) years. In 14 of them (28%) Nelson's syndrome appeared within 1.5 to 12 (mean, 4.8) years after adrenalectomy. All the patients were deeply pigmented, 12 had a radiologically demonstrable tumour and six had visual defects. Plasma ACTH levels ranged from 450 to 8000 ng/l. However in every case at least one estimation during circadian studies equalled 2000 ng/l. One patient with an anaplastic pituitary tumour died 3 years after the discovery of the tumour. Anaplasia was also diagnosed in another patient with recurrence of pituitary tumour after a transsphenoidal operation. Symptoms of tumour infarction occurred in two patients, followed by clinical remission of Nelson's syndrome. In the majority of cases the course was benign. We conclude that all cases, however, should be followed indefinitely because Nelson's tumours are not infrequently aggressive.

Adenoma↗

Effect of hydrocortisone on ACTH, growth hormone, insulin and glucose in the blood of bilaterally adrenalectomized patients.

This study is aimed at elucidating the mechanism of paradoxical rise in plasma ACTH levels in response to glucocorticoids, observed by several authors in bilaterally adrenalectomized patients with Cushing's disease. Six control subjects and fourteen patients bilaterally adrenalectomized for Cushing's disease were given a dose of 200 mg hydrocortisone sodium succinate by 3-5 mm i.v. injection. Plasma ACTH (in 6 patients), serum cortisol, growth hormone (GH) and insulin and blood glucose levels were estimated at 0, 30, 60, 90, and 120 minutes. The administration of hydrocortisone significantly suppressed plasma ACTH levels only at 60 min. In one case a slight rise in ACTH level during the test was observed. A significant fall in blood glucose levels was found only in the adrenalectomized patients. No significant changes in serum insulin and GH levels were noted. The possible mechanisms are discussed, especially the potential role of transient glucose deficiency in the pathophysiology of plasma ACTH increase in response to hydrocortisone in the bilaterally adrenalectomized patients.

Adrenalectomy↗

Two pregnancies in a woman with Cushing's syndrome treated with cyproheptadine. Case report.

A young woman with Cushing's syndrome who had had amenorrhoea for six years was treated with cyproheptadine and became pregnant five months later. Treatment with cyproheptadine was continued till six weeks after delivery by which time all the features of Cushing's syndrome had disappeared. The baby developed normally but died of gastroenteritis when four months old. Two years later the patient became pregnant again without further treatment. Pregnancy and labour were uncomplicated and mother and son did well. A full remission of Cushing's syndrome was confirmed two months after delivery.

Adult↗