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PubMed1992

[Gynecologic endocrinology].

Today, the specialty gynaecological endocrinology covers a very large field of physiological and pathophysiological mechanisms as well as endocrine diseases related to the ovarian axis. Gynaecological endocrinological processes accompany a wife from pregnancy and birth to the late postmenopause, passing through puberty, irregularities of the menstrual cycle, androgenization and infertility. The present review intends to give an overview on the different ways of investigation and of treatment typical for each endocrine problem in gynaecology and to point to some easily accessible literature.

Diagnosis, Differential↗

PubMed2005

[Endocrinologic problems in children with Down syndrome].

This "Endocrinologic health care guide" was prepared for individuals with Down syndrome. We hope this will serve as a reference for primary care physicians. We presented clinical characteristics, laboratory issues and treatment of children with Down syndrome and endocrinologic problems: abnormalities of thyroid function, obesity, diabetes mellitus, obesity, fertility control.

Down Syndrome↗

PubMed2006

[Evaluation of the tumor of the pituitary gland (hypophysis) between 2000-2005. On the intensive care of The Endocrinology Clinic of the Clinical Center of the University of Sarajevo].

INTRODUCTION: Tumors of the pituitary gland can be adenomas, and more often, cancers, representing 10-15% of intracranial neoplasm. We make a difference between them according to their size, expansion, hormone's activity and local and endocrinological manifestations. The goal of the research was to reveal the presence of tumors of the pituitary gland in the period 2000-2005 among patients hospitalized on the Intensive Care of the Endocrinology Clinic. PATIENTS AND METHODS: Data from anamnesis of all patients with verified tumor of the pituitary gland between 2000.-2005 were used in the research work. RESULTS: Total number of patients with the tumor of pituitary gland was 40, 29 women and 11 men, and 35 % of patients were aged between 45 and 60. Main symptoms: headache -16, eye trouble -17, sexual dysfunction -8, growth of acres -5, and others symptoms -8 patients. There were 23 (57,5%) cases of micro adenoma and 17 (42,5 %) macro adenomas. From the total number of patients 23 were operated, 8 micro adenomas and 15 macro adenomas. The number of secreting adenomas was 25 (62,5 %) and 15 (37,5 %) were non-secreting. Secreting adenomas were: prolactinomas--14, acromegalies -7, Cushing syndromes -2, TSH producing -2. Non-secreting adenomas were: craniopharyngeomas--11, meningiomas -2, and 2 non-secreting micro adenomas. Most of prolactinomas were treated with drugs, and 3 cases of prolactinoma were operated. 6 cases of acromegaly were operated and 1 micro adenoma is still under medical supervision, with the therapy of bromocriptine. 3 of those patients have the residuum, and 4 of them have high level of hGH. 11 craniopharyngeomas were operated and all patients, except one, are under substitution therapy. 2 meningiomas were operated and those patients are also under substitution therapy. 1 case of TSH producing tumor was operated, but residuum and hyperthyroidism are still presents, and the micro adenoma, for the hyperplasia reason, disappeared with adequate substitution therapy. The Cushing syndrome, confirmed with MRI diagnostics, wasn't operated; it remained under conservative therapy, and in the other case, where we didn't isolate a pathological substrate, the patient exited. CONCLUSION: Tumors of the pituitary gland we mainly treat applying surgery methods, together with post operational substitution therapy or additional therapy with drugs. Only prolactinomas are tumors which are successfully treated with drugs.

Female↗

PubMed2006

Female infertility: role of vaginal hormonal cytology, endometrial biopsy and endocrinological evaluation.

Female infertility can be categorised into those who fail to ovulate (anovulatory infertility) because of some defect at hypothalamic-pituitary-ovarian axis and those who are ovulatory (ovulatory infertility), but are infertile because of some lesion present in genital tract. The role of vaginal hormonal cytology, endometrial biopsy and endocrinological evaluation in the detection of ovulation and various ovulatory dysfunction was studied in 42 infertile female patients. On the basis of cytological findings, of the 42 patients, 14 were found to be ovulatory, 26 anovulatory (which include 5 cases of atrophic changes) and 2 inconsistent due to inflammatory changes. Endometrial biopsy showed evidence of ovulation in 15, anovulation in 27 cases. Hormonal evaluation indicated some sort of endocrinological disorders in 15 patients, which may underlie anovulatory infertility in these patients, while results were within normal range in the rest 27 patients. Results of vaginal cytology and endometrial biopsy showed correlation in respect to ovulation in 93.33% of the cases.

Anovulation↗

PubMed1976

[Endocrinological evaluation of sellar and suprasellar tumor cases (the 2nd report);--on postoperative pituitary function (author's transl)].

Fifty-six cases of sellar and suprasellar tumors were examined endocrinologically before and 3 weeks after surgery. 1) Hyporeactive cases of GH & ACTH were more frequently found in pituitary adenoma (100% and 23% respectively than in craniopharyngioma (86% and 14% respectively) before surgery. 2) GH secretion was impaired 3 weeks after surgery in all the cases. 3) ACTH secretion impaired preoperatively in 5 cases of pituitary adenoma improved in 3 cases 3 weeks after surgery. 4) Hyporeactivity of LH, FSH and TSH was found more frequently after surgery than before. 5) Almost all the cases of tuberculum sellae meningioma were endocrinologically normal before surgery. 6) ACTH, LH, FSH and prolactin secretion in cases of tuberculum sellae meningioma was not impaired after surgery, but TSH secretion in these cases became hyporeative in 4 of 5 cases after surgery.

Acromegaly↗

PubMed1990

[Acne vulgaris: morphologic, endocrinologic and psychosomatic aspects].

25 male patients suffering from acne vulgaris were examined by means of endocrinological, morphological, and 5 psychometric procedures in order to check the correlations and interactions between the psychological and dermatological aspects of the disease. In comparison with a control group, the acne patients did not show any striking endocrinological abnormalities; we found no correlation between the extensiveness of the lesions and the level of DHEA sulphate. All the psychological tests yielded results deviating from those achieved by the representative controls, but they were comparable with those of other patients suffering from psychosomatic diseases. The individual feeling of being "disfigured" found its expression in self-consciousness, lack of trust in his/her own body, as well as the clinically relevant difference between his/her conception of self and the ideal of self. During times of enhanced psychosocial strains subjectively assumed by the patients, the lesions increased and the patients were disturbed in social interaction and communication. Surprisingly, we did not find any correlation between the clinical status and significant psychometric findings. Our results show that in acne vulgaris, the individual experience of wanting physical attractiveness, associated with a predominantly neurotic depressive personal structure, may play a central part in a disturbed process of interaction with the environment and suggest the influence of psychic factors in the pathogenesis of acne vulgaris.

Acne Vulgaris↗

PubMed1990

[Methods and clinical applications of positron emission tomography in endocrinology].

Positron emission tomography (PET) allows to detect in coincidence photons issued from annihilation between positrons and electrons nearby situated. Tomographic detection (plane by plane) and tomographic reconstruction will lead to the quantitation of radioactive distribution per voxel, in the organ of interest. Recent tomographs can acquire simultaneously several transaxial slices, with a high sensitivity and a spatial resolution of 3-5 mm. Commonly used positron emitters have a short half-life: 2, 10, 20 and 110 min for 150, 13N, 11C and 18F, respectively. The use of these isotopes requires on line production of radionuclides and synthesis of selected molecules. In endocrinology, PET allows among others to study noninvasively the receptor density of hormone-dependent neoplasms such as breast, uterus, prostate tumors and prolactinomas. These last tumors represent a particular entity because of several combined characteristics: high turnover rate of amino acids, high density of dopaminergic receptors and response to bromocriptine (analogue of dopamine inhibiting the secretion of prolactin) in relation to the level of receptors. Because PET permits to evaluate the density of dopaminergic receptors and the metabolism of amino acids, theoretical response of the prolactinoma to bromocriptine can be predicted, the achieved therapeutic efficacy can be estimated and the long-term follow up of tumor growth can be assessed. This example illustrates the clinical value of PET in endocrinology.

Breast Neoplasms↗

PubMed1990

[Cell lines in experimental endocrinology].

Cell lines derived of endocrine tissues which are most frequently employed in experimental endocrinology are described. The cell lines represent a useful experimental model for the study of the control of synthesis and release of hormones and hormone-like agents as well as for the study of mechanisms of action of these agents in target tissues at the cellular and subcellular level. A number of the cell lines know so far are able to grow in serumfree media. These media are completely defined. This approach is promising for further progress in cellular endocrinology.

Animals↗

PubMed1989

[Endocrinology: lessons from the past, hopes for the future].

The social importance of endocrinology is apparent from an analysis of the prevalence of endocrinopathies in the CSSR. They affect (incl. diabetes and eufunctional goitre) some 10% of the population. The author submits a brief account of the development of knowledge of hormones and of Nobel prizes awarded for hormone research. On some examples he demonstrates the importance of endocrinology for other medical disciplines: the interrelationship of stress and infectious reactions via interleukin 1, the discovery of a series of new growth and immune factors; the participation TNF (cachectin, tumour necrosis factor) in pathological processes (tumours, atherosclerosis); vasoactive peptides EDRF (endothelium derived relaxation factor), endothelin (vasoconstriction), GM-CSF (granulocyte-macrophage colony stimulating factor) in treatment of radiation sickness and adjuvans in chemotherapy; interleukins. These new peptide hormones are words in the complex cellular signal alphabet the importance of which in the control of cellular activities we are beginning to understand.

Endocrine System Diseases↗

PubMed1989

[Endocrinological development in girls during puberty].

I) Endocrinological changes in girls during puberty are characterized by the progressive elevation of pituitary, ovarian and adrenal hormones except PRL. Longitudinal study revealed significant increases in both LH, FSH and estradiol occurred between 2 years to one year before menarche. PRL levels, however, increased between 3 to 2 years before menarche and the levels dropped significantly one year before the onset of the first menses. Serum levels of androstenedione and estrone in girls were higher than that in boys. Among steroids, the levels of 5 alpha-androstanediol decreased significantly before the menarche suggesting the physiological role of this hormone on the onset of puberty. In regard to the correlation between hormone levels and sexual developments, DHA-S levels and body weights correlated well with the breast development. Grasping power correlated well with serum testosterone levels in girls. II) The clinical and endocrinological aspect of menstrual disorders during adolescent were also examined. The majority of the patients complaining of functional uterine bleeding and amenorrhea showed high LH and normal FSH levels. Episodic secretion of LH was absent in girls of primary and secondary amenorrhea due to hypothalamic impairment.

Adolescent↗

PubMed1988

[2 surgically treated cases of adrenocortical carcinoma producing steroid hormones without endocrinological symptoms--case report and a review of cases in the Japanese literature].

We have experienced two male cases of an adrenocortical carcinoma that have produced steroid hormones without endocrinological symptoms. Both men were admitted to hospital because of an abdominal pain and left hypochondral tumors. In each case, an abdominal CT, an ultrasonogram and an angiogram demonstrated a left adrenal tumor, and levels of blood dehydroepiandrosterone sulfate, etiocholanolone, pregnenolone sulfate and urine 17 KS were elevated. The tumors were resected and the histology revealed that they were adrenocortical carcinomas. Postoperatively, the levels of their urine hormones returned to normal values, though in one man recurrence occurred a year later. Only 8 cases of an adrenocortical carcinoma that has produced steroids without specific endocrinological symptoms have been reported in Japan, and we also report on two cases herein.

17-Ketosteroids↗

PubMed1988

The endocrinology of extrapyramidal system disorders.

The study of endocrinologic changes in Parkinson's disease, Huntington's disease, and tardive dyskinesia may elucidate the pathophysiology of these disorders, especially the presence of hypothalamic lesions. There is probably a decrease in PRL concentrations in Parkinson's disease, and there may be an increase in TSH response to TRH stimulation. It is not clear if there is any change in GH concentrations in Parkinson's disease. There appears to be a robust increase in GH concentrations in Huntington's disease, and there may be a small increase in PRL as well. At present no endocrinologic abnormality has been well documented in tardive dyskinesia.

Dyskinesia, Drug-Induced↗

PubMed1988

The endocrinology of extrapyramidal system disorders.

Dyskinesia, Drug-Induced↗

PubMed1985

The endocrinology of stress.

With the advance in hormone assay techniques it has been demonstrated that stress may be characterised by a number of endocrinological changes which are not limited solely to the secretion of catecholamines and adrenal steroids. This article reviews the effects of various stressors on these and other hormones. Aviation is a source of a wide range of stressors including radial acceleration (+Gz) Since its magnitude and duration may be controlled experimentally by using the human centrifuge, it is possible to quantify such a stressor when investigating endocrinological markers of stress. Sustained +Gz acceleration results in a "dose-dependent" secretion of cortisol, i.e. the higher the acceleration, the greater the cortisol secretion. In addition, increases in the concentrations of arginine vasopressin and catecholamines occur but these are not accompanied by changes in prolactin or growth hormone.

Acceleration↗

PubMed1980

[New enzymatic and endocrinological aspects in two cases of Werner's syndrome (author's transl)].

Results of endocrinological studies and of the investigation of intraerythrocytic glycolytic pathway carried out in two patients with Werner's syndrome are presented. An increase of glyceraldehyde 3-phosphate and 3-phospho-glycerokinase has been observed, but the significance of these original findings is still unknown. An hyperinsulinism after oral glucose overload has been demonstrated too. This finding, which has been reported by other authors, probably reflects a peripheral resistance to insulin action. Other endocrinological abnormalities were a decrease in the T3:T4 quotient and a slight delay in the FSH-LH peak to LH-RH.

Adult↗

PubMed1983

[Morphological and endocrinological study of theca cell tumor during pregnancy].

With a theca cell tumor of the ovary associated with pregnancy, an extremely rare occurrence in a 30 years old primigravida at 15 weeks of gestation, morphological and endocrinological studies were performed. The tumor was composed of cell-nests scattered among a fibromatous structure. The round or polygonal cells are rich in eosinophilic cytoplasm, resembling theca internal cells. The histochemical activity of 3 beta-HSD and G-6-PDH was demonstrated in these cells. They had the ultrastructures characteristic for steroid-producing cells, in some of which immature and mature Reinke crystalloid-like structures were identified. Mature ones were infrequently observed in contrast to the numerous immature ones. It is considered that a few cells might have differentiated into Leydig cells in the course of differentiation into thecomatous cells from ovarian stroma or mesenchyme. Judged from the rapid enlargement in early pregnancy, this tumor may depend on hCG. Serum estradiol was decreased immediately after removal of the tumor even at 15 weeks of gestation. Histochemical, ultrastructural and endocrinological findings suggest that the tumor was secreting mainly estradiol at the time of the operation.

3-Hydroxysteroid Dehydrogenases↗

PubMed1983

Endocrinologic and metabolic factors in atypical presentations of slipped capital femoral epiphysis. Report of four cases and review of the literature.

Although the usual etiology of slipped capital femoral epiphysis (SCFE) is idiopathic, there are many underlying endocrinologic, biomechanical, metabolic, and connective tissue abnormalities that increase the predisposition to slippage. Four case reports and a review of the literature demonstrate tht hypopituitarism, renal rickets, radiation therapy, hypoestrogenic states, and chemotherapy can be associated with SCFE. Awareness of the variety of conditions under which SCFE can occur is an important factor in providing early diagnosis, since many patients undergo slippage at atypical ages. In metabolically and endocrinologically abnormal patients, surgical stabilization may need to be augmented by autologous bone grafting to ensure successful epiphyseodesis.

Adult↗

PubMed1978

[Endocrinological evaluation of pituitary function in the prognosis of hypothalamo-pituitary disorders (author's transl)].

Chronological endocrine changes accompanying various diseases in the hypothalamo-pituitary region (183 cases) were collectively studied by evaluating both endocrinological symptoms and anterior pituitary functions, with the following results : 1) Endocrine disorders following the operation, trauma and subarachnoideal hemorrhage in the pituitary-diencephalic region varied in the order of a) subclinical, b) clinical and c) paradoxical. This trend was especially marked in young cases of pituitary adenoma and of craniopharyngioma. 2) In young patients, the secretion of anterior pituitary hormones was markedly improved, particularly, TSH showed hypersecretion. The clinical symptom, however, remained unimproved. 3) The alteration associated with the adhesion of pituitary-diencephalic region was significant for the endodrine disorders. Such alteration was observed at 2--6 months after traumatic subarachnoideal hemorrhage. 4) The endocrine disorder developed and exacerbated in 6 months to 2 years after radio therapy of the pituitary-diencephalic region. 5) For the estimation of recurrence of tumors in the pituitary-diencephalic region endocrinological assessment was very useful.

Adenoma, Chromophobe↗