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Biomedical subjects

D F Archer

Publications and source records attributed to D F Archer.

At least 91 records · Page 5Linked to original sources
PubMed1978

Galactorrhea, amenorrhea, hyperprolactinemia, and an empty sella.

Increased serum prolactin (hPRL) and increased volume of the sella turcica as detected by roentgenography are compatible with a pituitary adenoma. The empty sella syndrome can increase sella volume, but is usually associated with minimal, if any, endocrine dysfunction. The present case details a young woman with amenorrhea, galactorrhea, elevated serum hPRL, and roentgenographic evidence of an enlarged sella turcica. Pneumoencephalography with hypocycloidal polytomography is interpreted as both an empty sella, and evidence of a pituitary adenoma. The etiology and endocrine findings in the empty sella syndrome are discussed.

Adenoma↗
PubMed1977

The role of lactogenic hormones in the pregnant woman and the fetus.

Evaluation of the roles of prolactin and placental lactogen in pregnancy in primates has revealed mammotropic, fetal osmoregulatory, metabolic, and steroidogenic roles, which appear to protect the uterine contents during late pregnancy and prepare the fetus for the changes in nutrition at the time of delivery.

Amniotic Fluid↗
PubMed1977

Current concepts of prolacting physiology in normal and abnormal conditions.

Currently the physiology and pathophysiology of pituitary prolactin secretion are under intensive investigation. Development of sensitive, specific radioimmunoassays for hPRL and improved roentgenographic techniques have increased the diagnostic acumen for incipient pituitary microadenomas. Several modalities of treatment are available at the present time which can result in improvement in the clinical symptoms of the amenorrheagalactorrhea syndromes. Eponymic classification of amenorrhea-galactorrhea syndromes should be discarded and appropriate diagnostic studies initiated to determine the etiology of the inappropriate breast secretion and/or elevated serum hPRL level.

Adenoma↗
PubMed1976

Pituitary gonadotropin response in women with idiopathic hyperprolactinemia.

Inappropriate lactation and idiopathic hyperprolactinemia are frequently associated with amenorrhea. In these individuals, peripheral levels of follicle-stimulating hormone (hFSH) are usually normal, and luteinizing hormone (hLH) levels are often found in the low-normal range. The present study was undertaken to evaluate the functional capacity of the pituitary by the response of hFSH and hLH to synthetic gonadotropin-releasing hormone (Gn-RH). Six women with amenorrhea, inappropriate breast secretion, and idiopathic hyperprolactinemia (prolactin levels ranged from 45 to 355 ng/ml) were given 100 mug of Gn-RH intramuscularly. Serum hFSH and hLH levels were assessed in samples obtained at 15-minute intervals over the next 2-hour period. Initial hFSH levels were normal in all women, with a mean of 242 +/- 72 ng/ml. The absolute increase after Gn-RH administration averaged 486 +/- 193 ng/ml. Serum hLH was below normal in three of the six women, and normal in the remaining three women initially. The absolute increase averaged 1308 +/- 315 ng/ml. The greatest percentage increase in hLH was found in the women with the subnormal basal titers. In these women, hLH rose from a mean of 22 ng/ml to a mean of 1092 ng/ml. These data demonstate an exaggerated increase in hFSH and hLH levels after exogenous Gn-RH administration. This suggests that the amenorrhea associated with elevated serum prolactin levels is principally of hypothalamic origin.

Amenorrhea↗
PubMed1976

Ovarian response to exogenous gonadotropins in women with elevated serum prolactin.

To determine if elevated serum prolactin hPRL inhibits ovarian steroidogenesis and contributes to the amenorrhea associated with galactorrhea syndromes, the following study was performed. Four women with amenorrhea, galactorrhea, and elevated serum hPRL levels were treated with menopausal gonadotropins (Pergonal) for the associated infertility. Urinary estrogen response was comparable to that in normal ovulatory women in each patient. Ovulation occurred in 3 of the 4 women with resultant conception and normal pregnancies. There was no evidence to support the contention that elevated hPRL interferes with ovarian function.

Amenorrhea↗
PubMed1975

Amenorrhea and galactorrhea: results of therapy with 2-Brom-alpha-ergocryptine (CB-154).

Administration of Brom-ergocryptine (CB-154) has a dramatic effect on breast secretion. Inhibition of lactation occurs within three to four weeks in women with amenorrhea and galactorrhea. Resumption of normal ovulatory function was documented by serum progesterone levels, as well as pregnancy, in three of four women attempting to conceive. Serum prolactin levels become normal following initiation of Brom-ergocryptine. Discontinuation of Brom-ergocryptine was found to result in a return of both inappropriate lactation and elevation of serum prolactin in this study. No deleterious side effects of Brom-ergocryptine have been found in any of the volunteers either clinically or on the basis of sequential laboratory studies.

Adult↗
PubMed1975

Response of serum prolactin to exogenous stimulation.

Previous observations by other workers indicating suppression of serum prolactin (hPRL) by water loading could not be confirmed. Sequential testing using an acute water load in patients with various clinical diagnoses did not aid conclusively in differentiating functional hyperlactinemic states from pituitary adenoma. It was of interest that the acute ingestion of water resulted in a triphasic response in serum hPRL levels. The response to breast stimulation was more marked in patients with excessive breast hypertrophy and galactorrhea. This was in contrast to patients with hypo- or hyperthyroidism, anorexia nervosa, and our normal subjects. In response to breast stimulation, there was no difference among the normal group, women with functional hyperlactinemia, and patients with proven pituitary adenoma. When they were compared with other patient groups in this study, marked responsiveness was found in patients with amenorrhea and galactorrhea, amenorrhea with elevated hPRL levels without galactorrhea, breast hypertrophy, and adrenal overactivity in response to these two stimuli. The physiologic mechanisms resulting in the increase in serum hPRL levels seen in these patients remain unclear at the present time.

Adenoma↗