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Biomedical subjects

S Franks

Publications and source records attributed to S Franks.

At least 181 records · Page 10Linked to original sources
PubMed1980

Effect of catechol oestrogens on induced ovulation in the immature rat.

The 'positive feedback' effect of exogenous oestradiol-17 beta in advancing ovulation induced by pregnant mare serum gonadotrophin (PMSG) has been used in the present study as a model in which to test the possible oestrogenic or antioestrogenic effects of the catechol oestrogens, 2-hydroxyoestradiol (2-OHE2) and 4-OHE2. Sprague-Dawley rats of 26 days of age were injected with 20 i.u. PMSG together with either vehicle alone or test steroids. The animals were killed 72 h later and the Fallopian tubes were examined for the presence of ova. Advancement of induced ovulation by treatment with oestradiol was confirmed; 2-OHE2, in doses of up to 100 micrograms, influenced neither the time of ovulation nor the number of ova present but 4-OHE2 was equipotent with oestradiol in doses varying from 0.5 micrograms (the minimum effective dose for both steroids) to 10 micrograms. The possible antioestrogenic effect of 2-OHE2 was tested by giving a 100 micrograms dose either at the same time or 2 h before PMSG plus 2 micrograms oestradiol or 4-OHE2. The effects of oestradiol and 4-OHE2 were not altered by this treatment. These data show that, in this model of 'positive feedback', 2-OHE2 has neither an oestrogenic nor an antioestrogenic action but that 4-OHE2 has a potent oestrogenic action, thus raising the question of a physiological role for 4-OHE2 in the regulation of ovulation.

Animals↗
PubMed1979

Use of bromocriptine in hyperprolactinaemic anovulation and related disorders.

Bromocriptine has been successfully used to treat hyperprolactinaemic disorders of ovulation; treatment with 5.0 to 7.5 mg daily results in normalisation of serum prolactin concentration and restoration of ovulatory menstruation in most patients with hyperprolactinaemic amenorrhoea or oligomenorrhoea. It is equally effective in hyperprolactinaemic patients with pituitary tumours as in those with normal pituitary x-rays, but the choice of bromocriptine as primary treatment in the former group (especially in those patients who desire pregnancy) is a matter of some controversy and requires careful judgement. Bromocriptine has also been used, with reported success, in infertility associated with luteal insufficiency, the polycystic ovary syndrome, normoprolactinaemic amenorhoea and ovulatory infertility. However, its role in the treatment of these disorders will remain uncertain until more extensive, adequately controlled clinical trials are availabe.

Amenorrhea↗
PubMed1978

Endocrine aspects of bromocriptine therapy in Parkinsonism.

Plasma growth hormone (GH) concentrations in Parkinsonian patients following 3 months optimum therapy with bromocriptine showed no significant change from pretreatment values, whilst plasma prolactin concentrations were uniformly suppressed. Pretreatment GH and prolactin levels were unrelated to clinical disability, and no correlation between hormonal changes and therapeutic response was found. These results suggest the presence of different dopaminergic receptor mechanisms for GH and prolactin release as well as between the extrapyramidal and neuroendocrine systems.

Bromocriptine↗
PubMed1978

Hyperprolactinaemia and impotence.

Clinical, laboratory and radiological findings were evaluated in twenty-nine men who had raised serum prolactin concentrations and pituitary tumours. Twenty-one had functionless pituitary tumours ('prolactinomas') and eight had acromegaly. Supraseller extension was detected in twenty of the twenty-six men who had lumbar airencephalography. Three patients were studied before, sixteen before and after and ten only after pituitary ablative therapy. Seventeen of these men complained of complete lack of libido and impotence and six had impaired libido and sexual potency; only six patients in this series denied reproductive symptoms. Thirteen of the impotent subjects had small soft testes, ten reduced facial and body hair and three had marked gynaecomastia. No features of hypogonadism were noted in the six patients without reproductive symptoms and none of the patients had galactorrhoea. Serum prolactin concentrations were higher and serum testosterone concentrations lower in the impotent men compared with those with normal sexual potency. Serum LH and FSH (both basal and in response to LHRH) oestradiol and oestrone concentrations were not different between the two groups and, except in those with post-operative hypopituitarism, were within the normal range. Following successful lowering of prolactin concentrations by surgery or bromocripitine or both, serum testosterone rose and potency returned; by contrast failure to lower prolactin concentrations was associated with persistent impotence and hypogonadism. The endocrine profile of low serum testosterone concentrations with gonadotrophins which had not risen into the range usually seen in primary hypogonadism (together with the parallel increase of LH and testosterone in one patient studied sequentially during treatment which suppressed prolactin levels to normal), suggested that the impaired gonadal function was caused by a prolactin-mediated disturbance of hypothalamic-pituitary function.

Acromegaly↗
PubMed1978

Prolactin secretion in patients with chromophobe adenomas of the pituitary: incidence and presentation of hyperprolactinaemia: results of surgical treatment.

In order to assess the frequency of hyperprolactinaemia in patients with "functionless" pituitary tumours, serum prolactin concentrations have been measured (by radioimmunoassay) in 111 patients with enlargement of the sella turcica who do not have acromegaly, Cushing's syndrome or Nelson's syndrome. The diagnosis of a chromophobe adenoma was confirmed in 76 patients who underwent surgery and was presumptive in the remaining 35. 45 of 64 (70%) patients studied before treatment and 15 of 47 assessed only after pituitary surgery had hyperprolactinaemia. Patients with raised prolactin levels usually presented with amenorrhoea or impotence, whereas reproductive disorders were rare in normoprolactinaemic patients. In many cases the presence of an underlying pituitary tumour was not initially suspected. The results of pituitary surgery were assessed in 25 patients with a chromophobe adenoma; of the 21 hyperprolactinaemic patients, surgery was most successful in those who had a small tumour treated by transsphenoidal adenomectomy. In conclusion, chromophobe adenomas formerly described as "functionless" are commonly associated with hypersecretion of prolactin and the hyperprolactinaemic patients frequently present with amenorrhoea or impotence. Prolactin levels should be measured in all patients with AMENORRHOEA or impotence and in patients with known (or suspected) pituitary tumours, before or after pituitary surgery.

Adenoma, Chromophobe↗
PubMed1977

Post-"pill" amenorrhoea--cause or coincidence?

The relationship of contraceptive history to diagnostic category of amenorrhoea was analysed in 131 consecutively investigated cases of secondary amenorrhoea. Amenorrhoea occurred in 52 patients immediately after discontinuing the oral contraceptive. Twenty-two had had amenorrhoea before oral contraceptive treatment and 23 patients before the episode of non-contraceptive-related amenorrhoea investigated here. When these cases were excluded from analysis there was no significant difference in the distribution of any of the diagnostic categories between those who had used the oral contraceptive and those who had not. The results suggest that using oral contraceptives does not cause subsequent amenorrhoea.

Age Factors↗
PubMed1977

Prevalence and presentation of hyperprolactinaemia in patients with "functionless" pituitary tumours.

Serum-prolactin concentrations were measured in 111 patients who had radiological abnormalities of the pituitary but no evidence of acromegaly, Cushing's syndrome, or Nelson's syndrome. Raised prolactin levels were found in 45 of 64 (70%) patients studied before treatment and in 15 of 47 patients studied after pituitary surgery. The majority of hyperprolactinaemic patients presented with amenorrhoea or impotence; galactorrhoea was uncommon. By contrast, reproductive disorders were rare in patients with normal prolactin levels. It is concluded that pituitary tumours previously described as "functionless" are frequently associated with hypersecretion of prolactin and that such tumours usually present as reproductive disorders. In the investigation of patients with amenorrhoea or impotence serum-prolactin should be measured and skull radiology performed if the prolactin level is raised. Prolactin should be measured in all patients with abnormal pituitary X-rays both before and after pituitary surgery.

Adenoma↗
PubMed1977

Management of hyperprolactinaemic amenorrhoea.

Results of treatment of 52 patients with amenorrhoea associated with hyperprolactinaemia are presented. All patients had a detailed radiological examination of the pituitary fossa, including lateral tomography in every patient and air encephalography in those in whom a pituitary tumour was suspected. There were 17 patients with untreated pituitary tumours, 5 patients with previously treated pituitary tumours and persisting hyperprolactinaemia, and 30 patients with normal pituitary radiology. Patients with pituitary tumours were treated either by transsphenoidal or transfrontal surgical extirpation of the tumour, followed, if necessary, by external irradiation and/or bromocriptine, Four patients were treated with external irradiation as primary therapy, and three patients who did not wish to conceive were treated with bromocriptine as primary therapy. Patients with normal radiological appearances were treated with bromocriptine as primary treatment. Ovulatory menstrual cycles developed in 42 patients and there were 19 pregnancies. Those ovulating but not conceiving had adequate nonendocrine factors to account for the disparity. Failure of response was seen in 10 patients and was due to inadequate fall of prolactin in response to surgery (2 patients), external irradiation (3 patients) and bromocriptine (1 patient), and gonadotrophin deficiency which developed after surgery in 3 patients but was present pre-operatively in 1. The relative merits of treatment by surgery, external irradiation and bromocriptine are discussed and a policy of treatment outlined.

Adult↗
PubMed1976

Clinical and endocrine features of hyperprolactinaemic amenorrhoea.

The clinical, radiological and endocrine findings in thirty-five women with hyperprolactinaemia and amenorrhoea are described. Twelve patients had radiological evidence of a pituitary tumour and six were tested after pituitary ablation. Seventeen patients with hyperprolactinaemia and normal pituitary X-rays were also studied. None was on any drug known to increase prolactin secretion and all patients were euthyroid when tested. Basal serum prolactin concentrations were high in the group with untreated pituitary tumours and in those with normal X-rays. The levels were variable in the post-ablation cases. The increase of prolactin after TRH was subnormal in all of the groups. Serum oestradiol concentrations were low in most patients and nineteen of twenty-one patients tested had no withdrawal bleeding after treatment with a progestogen. Mean serum gonadotrophin concentrations (basal and after LHRH) were normal in twenty-nine patients but subnormal in four post-ablative cases. Anovulatory responses to clomiphene were obtained in nineteen of twenty patients tested. Fifteen patients were treated with bromocriptine; twelve ovulated and eight became pregnant; two not responding had impaired LH and FSH production. Hyperprolactinaemic amenorrhoea is a common disorder with characteristic endocrine features. Galactorrhoea is unusual (30%). Treatment with bromocriptine lowers prolactin concentrations and rapidly repairs the reproductive defect.

Adult↗
PubMed1976

Basal stimulated prolactin levels in childhood.

Basal serum prolactin concentrations have been measured in 50 normal prepubertal children. There was no significant difference in prolactin levels between males and females and all concentrations were within the normal range for adult females (3-15 mug/l). Prolactin concentrations before and during insulin hypoglycaemia and intravenous thyrotrophin releasing hormone (TRH) have been measured in normal children of short stature, in children with isolated growth hormone (GH) deficiency and in those with hypothalamo-pituitary disease. There was no difference in either basal or stimulated prolactin levels in the normal group compared with the isolated GH-deficient group. In most of the children with hypothalamo-pituitary disease basal prolactin concentrations were within the normal range but there was an impaired response to both hypoglycaemia and TRH. Basal and stimulated levels of prolactin are compared in the same subjects with those of GH, thyroid stimulating hormone and the gonadotrophins and the clinical value of the dynamic tests described is discussed.

Adolescent↗
PubMed1976

Prolactin concentrations in patients with acromegaly: clinical significance and response to surgery.

Basal serum prolactin and growth hormone (GH) concentrations were measured by radioimmunoassay in forty patients with acromegaly. GH concentrations were elevated in all patients studied before treatment and prolactin levels were raised in seven of twenty-six patients. Of the thirty-two patients reviewed after treatment (which in most cases was transsphenoidal hypophysectomy) twenty-five had GH concentrations below 5 ng/ml and twenty-nine had normal prolactin levels. In eighteen patients hormone measurements were made both before and after hypophysectomy: though GH levels fell in all but one, prolactin fell in only six patients. They were not significantly changed in eleven patients. There was no correlation of GH and prolactin either before or after surgery. Seven patients had greatly elevated prolactin levels and in four of these there was evidence of upward extension of a pituitary tumour on air encephalogram (AEG). Only one patient with a normal prolactin level had an abnormal AEG. Two patients with elevated prolactin concentrations and normal AEGs had a parallel fall of prolactin and GH in response to surgery. Four of the five hyperprolactinaemic men complained of loss of libido: in three gonadotrophin concentrations before and after treatment were normal. We conclude that there is no overall correlation of GH and prolactin levels in patients with acromegaly. Seven of twenty-six untreated patients (27%) had hyperprolactinaemia. We suggest that in these patients a raised prolactin level may be due either to interference with the normal inhibitory control mechanism of prolactin by suprasellar extension or, more rarely, to secretion of both GH and prolactin by the tumour itself. A high prolactin concentration may be the cause of the impotence of which some patients with acromegaly complain.

Acromegaly↗
PubMed1975

Incidence and significance of hyperprolactinaemia in women with amenorrhea.

Serum prolactin and gonadotrophin concentrations were measured by radioimmunoassay in 106 women with amenorrhoea. Prolactin was normal in those with weight related disorders, primary ovarian failure, those with a variety of systemic diseases and in those in whom amenorrhoea followed treatment with the oral contraceptive and in unexplained primary amenorrhoea. Gonadotrophin concentrations in the above patients were normal except in those with primary ovarian failure. Prolactin was elevated in eight of forty patients (20%) with functional secondary amenorrhoea and was greatly raised in all but one of the thirteen women in this series with pituitary tumours (five of whom were studied only after treatment). Only three patients in each of the last two groups had galactorrhoea. Gonadotrophin levels were normal or slightly raised in all of the hyperprolactinaemic patients apart from those studied after hypophysectomy. Four hyperprolactinaemic patients (three with pituitary tumours and one with functional amenorrhoea) who did not have galactorrhoea have been treated with bromocriptine. Prolactin secretion was reduced in all patients and, in the two with normal gonadotrophins, ovulatory menstruation was resumed. One became pregnant in the second ovulation cycle after starting treatment. We conclude that, despite the rarity of galactorrhoea, hyperprolactinaemia is common in patients with functional amenorrhoea and in those with pituitary tumours. Treatment with bromocriptine in patients with normal gonadotrophins restores ovulation when the infertility is due to prolactin excess.

Adult↗