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Biomedical subjects

P D Lees

Publications and source records attributed to P D Lees.

23 records · Page 2Linked to original sources

Hyperprolactinemia, intrasellar pituitary tissue pressure, and the pituitary stalk compression syndrome.

The intrasellar pressure has been studied in a consecutive series of 24 patients undergoing transsphenoidal surgery for pituitary adenoma. The mean intrasellar pressure for the group was 23 +/- 2.5 mm Hg (+/- standard error of the mean), with a mean pulse pressure of 3.5 +/- 1 mm Hg. The waveform partly resembled the arterial configuration. The results are correlated with the radiological and endocrinological features of the tumors. A hypothesis is proposed to explain the mechanism of hyperprolactinemia associated with the pituitary stalk compression syndrome.

Adenoma↗

Opioid modulation of LH secretion in the ewe.

Administration of opioid agonists and antagonists and measurement of resulting hormone changes were used to study the possible effects of opioids on reproductive function in the ewe. Intravenous administration of the long-acting methionine-enkephalin analogue FK33-824 (250 micrograms/h for 12 h) to 3 ewes during the follicular phase of the oestrous cycle depressed episodic LH secretion. This effect was reversed by administration of the opiate antagonist naloxone (25 mg/h) in combination with the FK33-824 treatment; in fact LH secretion was enhanced by the combined regimen. Naloxone (25 mg/h for 12 h) administered alone to 3 ewes in the follicular phase also enhanced LH secretion. In 3 animals treated with FK33-824 during the follicular phase, progesterone remained basal for 14 days after treatment, suggesting that ovulation was blocked. Jugular venous infusion of naloxone (25, 50 or 100 mg/h for 8h) into 5 ewes during the early and mid-luteal phase of the cycle resulted overall in a significant increase in mean plasma LH concentrations and LH episode frequency. To investigate whether endogenous opioids suppress LH release in seasonally anoestrous sheep, naloxone was infused intravenously into mature (25, 50 or 100 mg/h for 8 h) and yearling ewes (12 . 5, 25 or 50 mg/h for 8 h) during early, mid- and late anoestrus and plasma LH concentrations were measured. In the mature ewes, there was a trend for naloxone to increase LH values during the early anoestrous period but naloxone was without effect during mid- and late anoestrus. In the yearlings, naloxone infusion consistently increased plasma LH concentrations as a result of a significant increase in LH episode frequency. These experiments indicate that endogenous opioid peptides probably modulate gonadotrophin secretion during both the follicular and luteal phases of the oestrous cycle. However, the follicular phase of the sheep cycle is of short duration, and there may be residual effects of luteal-phase progesterone during this period. Secondly, there may be an age-dependent effect of naloxone on LH secretion during seasonal anoestrus in the ewe, with opioids playing a part in the suppression of LH in young but not in mature animals.

Anestrus↗

Renal size as a prognostic factor in childhood acute lymphoblastic leukemia.

A single-film intravenous pyelogram was performed on 87 children with acute lymphoblastic leukemia at presentation. The kidney size was measured and a standard deviation score based on patient height was calculated. There was a tendency of renal enlargement, with 21 patients (24%) having scores of over 1 SD and 6 (7%) over 2 SD. A trend of shorter duration of first remission with increasing renal size was shown to be statistically significant (P = 0.036). This trend was not quite statistically significant (P = 0.087) whenthe analysis was confined to 54 "better-risk" patients (WBC less than 20 X 10(9)/liter and no mediastinal mass), and was much weaker and not significant in 33 "poor-risk" patients (P = 0.62).

Child↗

Indices of apoptosis and proliferation as potential prognostic markers in non-functioning pituitary adenomas.

OBJECTIVE: Non-functioning pituitary adenomas (NFAs) are a distinct group of pituitary adenomas, which comprise approximately 20% of pituitary adenomas. Although most pituitary adenomas are benign, there is a subset of adenomas that behaves in an aggressive fashion, with either invasion of the surrounding structures or recurrence. The aim of this study was to investigate whether the behaviour of NFAs can be predicted using immunohistochemical markers that label proliferating and apoptotic cells, including a new marker for apoptosis (M30 CytoDEATH). This is the first study to analyse both the proliferation labelling index (LI) and the apoptotic index (AI) in NFAs and to correlate the labelling indices of these histological markers with tumor growth rate as measured by 2 postoperative MRI scans. MATERIAL AND METHODS: 40 patients in total were included in the study. 20 patients with high growth rate and percentage change in the pituitary adenoma volume as assessed on 2 postoperative MRI scans were age/sex matched to 20 patients with low growth rate or percentage change. RESULTS: There is no significant statistical difference of the histological and immunohistochemical indices assessed between cases and controls. CONCLUSION: The routine assessment of the proliferation and the apoptotic markers used in this study in NFAs has no prognostic value.

Adenoma↗