Treatment of diabetes insipidus.
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Biomedical subjects
Publications and source records attributed to R V Randall.
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The morphologic features of four pituitary adenomas, removed from 2 men and 2 women between 31 and 62 years of age, are reported. The tumors contained growth hormone (GH), prolactin (PRL), and one or more glycoprotein hormones--usually thyrotropin (TSH). Three tumors were associated with acromegaly and one with hyperprolactinemia. Hyperthyroidism was not evident in any of the patients. In the tumors of acromegalic subjects, GH-containing cells were the most numerous, whereas PRL cells were dominant in the adenoma accompanied by hyperprolactinemia. Electron microscopy revealed plurimorphous tumors comprised of various proportions of morphologically different cell types: densely granulated GH cells, TSH-like cells, and the less common mammosomatotrophs and PRL cells. It is suggested that pituitary adenomas producing GH, PRL, and glycoprotein hormones derive from the same precursor; their immunocytochemical profile, fine structural appearance, and endocrine function may depend on the degree and direction of the cellular differentiation.
The whole molecule of human somatomedin C (SM-C) prepared by the total synthesis method was used as an antigen to produce an antiserum for a radioimmunoassay. Since plasma proteins that bind SM-C interfere with the assay, a method was developed that uses acid dissociation followed by C-2 cartridge extraction to strip SM-C from its binding proteins before assay. This assay has no cross-reactivity with human proinsulin or insulin-like growth factor II (IGF-II). The SM-C values in 339 normal subjects showed age-dependence, increasing from childhood to a peak at age 14 to 16 years and decreasing sharply before adulthood. In adults, the SM-C values decreased gradually with age. All 13 patients with acromegaly who were tested had an increased SM-C value, with no overlap with the normal range. The 12 patients with prolactinoma but non-growth-hormone-producing pituitary tumor had no increase in SM-C. Two children with pituitary deficiency had low SM-C values; one of these children received growth hormone therapy, and his SM-C value increased from undetectable to normal. By three weeks after discontinuation of the therapy, his SM-C value was again undetectable. Of 20 children with short stature and constitutional delay of growth and development, SM-C was below normal in 70 percent and normal in 30 percent. Two patients with malnutrition had below-normal SM-C values.
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