The effect of the dopamine agonist bromocriptine (5-40 mg/day) on cerebrospinal fluid proteins and amines was studied in 7 hyperprolactinemic patients, 4 with empty sella syndrome and 3 patients with pituitary adenoma. Small as well as high doses of bromocriptine depressed the endogenously formed dopamine, noradrenalin and adrenalin. Five patients initially exhibited changes consistent with slight to marked blood-cerebrospinal-fluid (CSF) barrier disturbances and 5 abnormal CSF-protein fractions. One CSF-protein fraction (isolelectric points (pI) approximately 5.3 pH-units) became more prominent during bromocriptine treatment. Analyses of his fraction indicated that it represented a transferrin component. It is stated that bromocriptine treatment besides affecting amine and trace metal metabolism also affects protein metabolism.

Acromegaly↗

PubMedDate not supplied

Anterior cruciate ligament injuries in skeletally immature patients.

Twenty-eight consecutive, skeletally immature patients (9.9-15.0 years of age at the time of injury) with total rupture of the anterior cruciate ligament (ACL) were followed up for 3-5 years. The aims of the study were to monitor the natural course of conservative treatment, to identify variables relevant to failure of conservative treatment, and to evaluate an over-the-top procedure for ACL reconstruction by using the semitendinosus tendon and avoiding the physes. The patients were interviewed according to Lysholm knee score and Tegner activity level. Knee laxity and muscle torque were measured. Five patients insisted on immediate reconstruction. Twenty-three patients were sent to a 3-month rehabilitation program. Sixty-eight percent of the patients, who made an attempt with conservative treatment, had been operated on at follow-up. The patients not operated on were younger at injury and had a lower activity level at follow-up. The surgical procedure improved objective and subjective knee function, but there was a correlation between high activity level and a low Lysholm score.

Adolescent↗

PubMedDate not supplied

Nonnutritive sucking in tube-fed preterm infants: effects on gastric motility and gastric contents of somatostatin.

The present study investigated the way that sucking of a pacifier influences gastric secretory and motor functions in connection with tube feeding. Experiments were performed on eight preterm infants who were tube fed twice--once with and once without sucking of a pacifier. The time for tube feeding was significantly decreased and gastric retention decreased in five of seven infants when sucking a pacifier. Maternal milk was found to contain gastrin-17, somatostatin-14, and a somatostatin-like peptide larger than somatostatin-28. Somatostatin levels were significantly reduced in connection with non-nutritive sucking. Gastrin levels were increased in six of ten experiments 2 h and/or 3 h after bolus feeding, suggesting that these peptides were not only supplied by the milk, but were also released from the gastric mucosa. The presence of gastrin and somatostatin in gastric aspirates was established by use of chromatographic methods. The results indicate that somatostatin and gastrin are released into the gastric lumen in preterm infants and that sucking of a pacifier, in connection with bolus feeding, stimulates the gastric motor functions and facilitates the digestion process, probably via activation of vagal mechanisms.

Enteral Nutrition↗

PubMedDate not supplied

Bromocriptine-induced changes in hormone secretion and cell morphology in growth hormone and prolactin producing pituitary adenomas.

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Adenoma↗

PubMedDate not supplied

Gamma irradiation effects on human growth hormone producing pituitary adenoma tissue. An analysis of morphology and hormone secretion in an in vitro model system.

Irradiation-induced effects on pituitary cell morphology and secretion of growth hormone (GH) and prolactin (PRL) have been analysed using an in vitro system. Specimens for organ culture were obtained from three patients with pituitary tumours causing acromegaly but with different clinical activity of disease. Specimens were followed in vitro 1 h - 6 days after single-dose gamma irradiations (60Co) with 70, 100 and 150 Gy, respectively. These doses are used in clinical work for the stereotactic radiosurgery of pituitary adenomas. Considerable fluctuations in hormone secretion/release occurred during the first 24 h after irradiation. Following 70 Gy single dose, the GH secretion increased slightly a few days after irradiation, having been at a minimum level 24 h after exposure. When using dose of 100 and 150 Gy, however, no such increased secretion with time after irradiation was indicated. All three tumors showed individual differences concerning irradiation-induced morphological damage. Only a minor variation occurred between specimens from the same tumour. In specimens from all tumours, irrespective of dose, minor morphological changes were observed 3-5 h after irradiation. Thereafter an individual response to irradiation became apparent. One tumour displayed maximum cell damage 24 h after irradiation with 70 Gy, showing severe oedema and damage to cell organelles. The other two adenomas were only slightly damaged following irradiation with 70, 100 and 150 Gy. Numerous morphologically normal or near-normal cells were found in all specimens from the three tumours 6 days after irradation. An individual sensitivity to irradiation of pituitary tumours in vitro is documented. The great number of surviving pituitary tumour cells one week after irradiation--many with an intact ultrastructure and containing hormone granules--indicated an initial high degree of radioresistance.

Acromegaly↗