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Biomedical subjects

A Kasperlik-Załuska

Publications and source records attributed to A Kasperlik-Załuska.

At least 19 recordsLinked to original sources

[Glucose tolerance in adrenocortical hyperfunction. Analysis of 100 cases].

Glucose tolerance was assessed in 100 cases of adrenocortical hyperfunction (79-Cushing's disease and 21-Cushing's syndrome). Overt diabetes was found in 19 cases. Of the remaining 81 patients 37 had normal glucose tolerance, in 23 glucose tolerance was impaired and in 21 patients diabetes was diagnosed. Glucose tolerance expressed as 60 and 120 min glucose values did no correlate with hormonal parameters of adrenocortical hyperfunction nor with age of the patients and degree of obesity. The authors discuss the complex mechanism of the effect of glucocorticoid excess on glucose tolerance.

Adolescent↗

Pituitary apoplexy: endocrine, surgical and oncological emergency. Incidence, clinical course and treatment with reference to 799 cases of pituitary adenomas.

Authors analyzed retrospectively the incidence of pituitary apoplexy in a series of 799 pituitary adenomas with respect to the long term follow-up of the patients. Focal vascular abnormalities in histological specimens of tumours, regarded as morphological suggestion of past apoplexy (haemorrhage, ischaemic infarction or necrosis), were established in 113 out of 783 surgical cases (14.4%). Acute clinical onset, justifying the clinical diagnosis of pituitary apoplexy, occurred in 39 patients only (5% of the whole series), 19 of them were subjected to urgent surgical decompression due to severe neurological deficit. The haemorrhagic character of apoplexy was established in most cases requiring immediate surgery. The detailed clinical picture of this condition and its management are discussed with respect to the long term prognosis. On this basis the authors suggest the necessity of surgical treatment in every case of pituitary apoplexy, taking into account not only neurological recovery, but also endocrine and oncological aspects of the disease. The observation that pituitary apoplexy may be a "marker" of tumour invasiveness (even in small, "enclosed" adenomas) is highlighted.

Adenoma↗

Clinical applications of radioimmunoassay of the alpha-subunit of glycoprotein hormones.

The radioimmunoassay of alpha-subunit adapted in our laboratory was widely evaluated. Three different antisera (anti-pituitary alpha-subunit, anti-alpha-TSH and anti-alpha-hCG), the labelled preparations of pituitary alpha-subunit and alpha-hCG, and cross-reactivity with intact glycoprotein hormones (MRC standards of LH, FSH, hCG and TSH) were tested for their potential influence on the results of the assay. The basal levels of alpha-subunit were measured in 48 healthy young men, 48 normally menstruating women, 33 menopausal women, 37 pregnant women and 70 patients with pituitary adenoma. In addition a possibility of pulsatile secretion of alpha-subunit was investigated in 9 healthy young women, the ranges of alpha-subunit concentrations found were as follow (means +/- SD): 1.2 +/- 0.4 micrograms/l--in young men, 1.1 +/- 0.4 micrograms/l--in young women, 3.2 +/- 0.7 micrograms/l--in postmenopausal women, 1-54 micrograms/l--in pregnant women, and between 2.6 and 44.0 micrograms/l in 14 of 70 patients with pituitary adenoma. There were good correlations of results for 3 different antisera and their cross-reactivity with LH, FSH, hCG and TSH were just as low. In conclusion, the alpha-subunit assay appears clinically useful and should be widely applied in routine endocrinological diagnostics.

Adenoma↗

[Evaluation of a method for determining ACTH concentration in samples of serum obtained by catheterization of inferior petrosal sinuses in diagnosis of Cushing's disease].

A method consisting in the catheterization of lower petrosal sinuses aimed at obtaining blood samples for the determination of ACTH concentration has been applied in diagnostically difficult cases of Cushing's disease. The appearance of ACTH concentration gradient between the blood originating from the immediate vicinity of pituitary and the peripheral venous blood confirmed the hypophyseal etiology of hypercortisolemia. The gradient of ACTH concentration between the two petrosal sinuses made possible the localization of a microadenoma in the anterior lobe of pituitary. The diagnostic conclusions obtained by the above method have been confirmed during the surgery.

Adrenocorticotropic Hormone↗

A correlative study between cortisol and ACTH in Cushing's disease following bilateral adrenalectomy and in Nelson's syndrome.

Correlation analysis was used to investigate the interrelation between plasma ACTH and serum cortisol concentrations determined at 8:00, 12:00, 16:00 and 22:00 h in 48 patients bilaterally adrenalectomized for Cushing's disease, including 23 patients with a pituitary adenoma (Nelson's syndrome). In the patients without evidence of a pituitary adenoma a significant inverse correlation was found at 8:00, 16:00, 22:00 h and additionally when all the pairs of estimations were analyzed. In a full-blown Nelson's syndrome an inverse correlation was not proved (p = 0.05). During remission in Nelson's syndrome an inverse correlation between cortisol and ACTH concentrations was stated at 8:00 h and after the evaluation of all the pairs of estimations. The results of our studies have shown that exogenous cortisol exerts a partial inhibitory action on ACTH secretion in patients bilaterally adrenalectomized for Cushing's disease. In active Nelson's syndrome this influence is questionable, it comes however into prominence during remission.

Adrenalectomy↗

The effect of magnesium valproate on plasma ACTH concentrations in Nelson's syndrome.

Sodium valproate, a gamma-aminobutyric acid (GABA) agonist, was found to decrease plasma ACTH concentration in some cases of Cushing's disease and Nelson's syndrome. In this study we have investigated the influence of magnesium valproate (MV), a newly introduced salt of valproic acid, on plasma ACTH levels in 8 patients with Nelson's syndrome. The daily dose, 1200 mg of MV, significantly decreased plasma ACTH level at 10 p.m. compared with placebo. A single dose of 400 mg of MV, led to a reduction in plasma ACTH concentration only in two out of seven patients during a four-hour observation. The fall in plasma ACTH level in the same patients at 10 p.m., after the next two doses of this drug, suggests that single dose may be insufficient for introducing GABA-dependent reduction in ACTH release. During a long-term therapy with MV, in all three patients investigated a marked decrease in plasma ACTH was observed. Our results suggest that magnesium valproate may be useful during chronic therapy in some patients with ACTH hypersecretion.

Adrenocorticotropic Hormone↗