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Biomedical subjects

R V Randall

Publications and source records attributed to R V Randall.

At least 55 records · Page 3Linked to original sources

Neurosurgical management of acromegaly. Results in 82 patients treated between 1972 and 1977.

A consecutive series of 82 acromegalic patients who underwent transsphenoidal surgery during a 5-year period is presented. Preoperative and postoperative values for human growth hormone (HGH) were available in 80 cases. Microadenomas were present in 18 patients with a mean preoperative HGH value of 25.2 ng/ml, diffuse adenomas in 39 patients with mean of 53.8 ng/ml, and invasive adenomas in 25 with mean of 68.0 ng/ml. There was no operative mortality. The results reflected the classification of the tumors, with apparent cures accomplished in 87.5% of previously untreated patients with microadenoma, all of whom had anterior pituitary function preserved. The percentages of apparent cures in cases of diffuse adenoma (68%) and invasive adenoma (54%) were much less satisfactory. Transsphenoidal microsurgery is capable of achieving good results, particularly in patients with microadenoma.

Acromegaly↗

Cure of acromegaly by operative removal of an islet cell tumor of the pancreas.

We studied a 30 year old woman in whom acromegaly was cured by operative removal of a large cystic beta cell adenoma of the pancreas. We detected substantial amounts of immunoreactive human growth hormone (hGH)-like activity in a tumor tissue extract. Extracts of the tumor and a normal human pituitary gland eluted from a Sephadex G-75 column in two identical peaks. Serial dilutions of the tumor extract displaced radioactive 125I hGH parallel to a standard curve. Surprisingly, an extract of a normal human pancreas contained large amounts of hGH-like activity and gave results similar to those of the tumor extract on gel chromatography and on serial dilution displacement in the growth hormone immunoassay. Paper electrophoretic studies of 125I hGH after incubation with normal pancreatic and tumor extracts with and without enzyme inhibitors suggested that pancreatic proteolytic enzymes damaged the 125I hGH used in growth hormone radioimmunoassay and produced a false detection of hGH.

Acromegaly↗

Suprasellar extension of tumor associated with increased cerebrospinal fluid activity of growth hormone.

The diagnosis of hormonally active acromegaly has been aided by the radioimmunoassay for human growth hormone (hGH). We report a case in which baseline plasma hGH levels were elevated minimally and partial suppression during the glucose tolerance test occurred. Subsequent hGH assay of the cerebrospinal fluid, however, confirmed active acromegaly and correctly predicted suprasellar extension of the tumor.

Acromegaly↗

Effect of dietary D-penicillamine on metabolism of copper in the rat.

When normal rats were put on a diet containing d-penicillamine equivalent to a dosage of about 1.75 g/day in a 70-kg man, there was a prompt, marked decrease in biliary excretion of copper and of radiocopper after its intravenous administration. Urinary copper increased as tissue copper levels decreased; this decrease was most pronounced in bone marrow, kidney, lung, and spleen. Plasma copper increased and p-phenylendiamine oxidase activity increased. Fecal copper decreased modestly, which was probably attributable to decreases in food intake and biliary copper. Copper-toxic rats, already hypercupriuric, excreted more urinary copper when given d-penicillamine.

Animals↗