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B Corenblum

Publications and source records attributed to B Corenblum.

At least 37 records · Page 2Linked to original sources
PubMed1984

The effect of a progestin on gallbladder function in young women.

Female sex hormones have been considered to be a risk factor for the development of cholesterol gallstone disease, because of increased cholesterol saturation of bile. Impaired gallbladder function is an additional factor which is suspect but unproved. We investigated gallbladder function in 10 young women on two occasions: first during the follicular phase of the menstrual cycle, when endogenous progesterone is low, and again after the ingestion of medroxyprogesterone acetate, 10 mg/day for 10 days, just prior to the next menstrual period. Another group, 15 young women, was studied during their luteal phase, when endogenous progesterone is high. Gallbladder filling and emptying in response to cholecystokinin (0.02 U/kg-min) was quantitated by 99mTc-HIDA cholescintigraphy. Gallbladder filling and emptying were no different in women in the follicular phase than in women in the luteal phase of the menstrual cycle. In both menstrual phases, the administration of the exogenous progestin significantly (p less than 0.05) reduced the fraction of hepatic bile entering the gallbladder. Gallbladder emptying was also depressed: the total amount ejected was less, the time to empty half the contents was prolonged, and the rate was slower (p less than 0.05). Thus, different phases of the normal menstrual cycle do not appear to have any effect on gallbladder function. Administration of an exogenous progestin, however, significantly impairs both gallbladder filling and emptying, factors which could predispose to the formation of cholesterol gallstones.

Adolescent↗
PubMed1983

Long-term follow-up of hyperprolactinemic women treated with bromocriptine.

Seventy-five women with hyperprolactinemia and demonstrable or suspected prolactinomas were treated with bromocriptine only and followed for 5 to 9 years. Biochemical, radiologic, and clinical responses were generally maintained in the long term, once established in the short term. Underlying mass effects on neurologic and pituitary function tended to improve, and no tumor progression was noted. Hypogonadal symptoms normalized in 68 of 75 women. Bromocriptine responses in long-term follow-up do not demonstrate any cumulative problems not seen in short-term therapy.

Adenoma↗
PubMed1982

The hyperprolactinemic polycystic ovary syndrome may not be an distinct entity.

Thirteen women with hyperprolactinemia and clinical stigmata of the polycystic ovary syndrome (PCO) had their serum prolactin (PRL) response to thyrotropin-releasing hormon (TRH) compared with two other groups of PCO. One PCO group had an elevated ratio of basal luteinizing hormone (LH) to follicle-stimulating hormone (FSH), and another had a normal ratio of basal LH to FSH. The PRL response to TRH was similar in hyperprolactinemic PCO and elevated LH PCO, and both were significantly greater than normal LH PCO and normal women. This suggests the hyperprolactinemic polycystic ovary (HPCO) is probably produced by similar central and/or peripheral mechanisms that result in the production of an elevated serum LH. These two features are probably associated in a common pathophysiologic mechanism. The HPCO syndrome does not appear to be a distinct entity but clinically must be differentiated from other causes of mild hyperprolactinemia.

Adolescent↗
PubMed1980

A rationale for the use of bromocriptine in patients with amenorrhea and normoprolactinemia.

The return of menses in amenorrheic normoprolactinemic women after treatment with bromocriptine is well documented. To determine whether an increased pituitary prolactin-secreting capacity may be the underlying mechanism, 14 women with amenorrhea were studied. None complained of galactorrhea, but in all 14 it was possible to express a few drops of milk from the nipple. All women were normoprolactinemic and had normal sellar tomography. A standard thyrotropin-releasing hormone (TRH) test was performed and bromocriptine (2.5 mg twice daily) was administered. Within 8 weeks, 9 of 14 patients had return of menses. The second group of five patients did not respond to bromocriptine. The mean prolactin response to TRH was significantly greater in those women who experienced return of menses, although there was individual overlap between both groups. This finding suggests that enhanced prolactin secretory capacity may account for amenorrhea is some apparently normoprolactinemic patients. The TRH test may serve to identify those patients who may benefit from bromocriptine.

Adult↗
PubMed1979

Idiopathic, sustained, inappropriate secretion of ADH with associated hypertension and thirst.

A 15 year old girl presented with excessive thirst and hypertension (170/110 mm Hg). Biochemical investigations revealed serum sodium 118 meq/liter, serum osmolality 238 mosmol/liter, urine sodium 90 meq/liter, urine osmolality 700 mosmol/liter, persistenly elevated serum antidiuretic hormone (ADH) levels (5.8 to 11.9 pg/ml) and no obvious cause for the hypertension. The hypertension is, at least in part, volume-related, diminishing with fluid restriction. Features of gross water intoxication (e.g., confusion, coma) have not occurred. The etiology of the inappropriate secretion of ADH is not obvious but is not thought to be due to "resetting of osmoreceptors" as evidenced by failure to maximally dilute urine following a water load test and persistently elevated serum ADH levels. A similar patient described by Epstein and associates in 1962 is presently well with persistent features of inappropriate secretion of ADH.

Adolescent↗
PubMed1979

Successful outcome of ergocryptine-induced pregnancies in twenty-one women with prolactin-secreting pituitary adenomas.

The natural history of prolactin-secreting adenomas is not known. For this reason, optimal therapy for women harboring these adenomas who desire to conceive is also unknown. Argument can be found to favor surgical excision, radiation therapy, prolactin-suppressing chemotherapy, and clinical observation. In a large series of women with prolactin-secreting pituitary adenomas, 21 have conceived and delivered healthy infants, all of whom had ergocryptine-induced prolactin suppression as the sole form of therapy. Endocrinologic, neurologic, biochemical, and radiologic assessment failed to demonstrate any obvious growth of the pituitary adenoma, except for slight enlargement of the sella turcica in one patient who delivered twins. The failure to demonstrate any worsening of the clinical state may reflect the fact that no large tumors were included in this series, only small but definite microadenomas found on sellar tomography. All of the various modalities of therapy must be considered with each patient, but this series suggests that ergocryptine treatment with careful clinical follow-up is relatively safe in patients with small pituitary tumors.

Abortion, Spontaneous↗
PubMed1978

Prediction of response to ergocryptine in the galactorrhea-amenorrhea syndrome.

Forty women with secondary amenorrhea and galactorrhea, thirty-six of whom had associated hyperprolactinemia, were studied prior to therapy with ergocryptine. Abnormal sella tomographic findings were present in 23. The findings on sellar tomography, basal serum prolactin concentrations, and pharmacologic stimulation/suppression of the serum prolactin failed to predict subsequent responders and nonresponders to ergocryptine. Pituitary stimulation for hormone responsiveness did differentiate subsequent responders to ergocryptine from nonresponders. The serum growth hormone response to hypoglycemia was the most definitive predictor. Return of apparently ovulatory function occurred in 29 patients, 11 of whom conceived and have delivered healthy infants.

Adult↗
PubMed1976

A new look at pituitary adenomas: structure elucidating function.

Cases of seven different types of surgically resected pituitary adenoma are described. Included are tumours secreting prolactin or growth hormone or both, and nonfunctioning tumours--undifferentiated and oncocytic tumours, and one tumour with cells of the adrenocorticotropin-melanocyte-stimulating hormone type. The final interpretation of a case of pituitary adenoma should include an assessment of thorough morphologic studies, using not only routine staining and light microscopy but also immunostaining and electron microscopy, to complement the biochemical, radiologic and clinical evaluation.

Acromegaly↗
PubMed1976

Localization of prolactin in chromophobe pituitary adenomas: study of human necropsy material by immunoperoxidase technique.

In order to identify prolactin-producing tumours in human pituitary glands, 45 chromophobe adenomas, obtained from unselected necropsies, have been studied by various staining procedures including the immunoperoxidase technique for the demonstration of prolactin. The presence of immunoreactive prolactin was revealed in the cytoplasm of the tumour cells in six cases (13%), indicating that the occurrence of prolactin-producing adenomas is not rare. No correlations were established between tumours and clinical history. Two adenomas were detected in female and four in male patients. The age of the patients at necropsy ranged from 28 to 75 years. Three adenomas were associated with disseminated carcinoma, two with fatal liver disease, and one with diabetes mellitus, atherosclerosis, and pyelonephritis. Manifest endocrine symptoms were not disclosed, and endocrine investigations, including measurements of blood prolactin levels, were not undertaken. Thus, direct evidence is lacking as to whether or not these tumours were actively secreting prolactin. In the non-tumorous parts of the anterior lobes the number of prolactin cells was decreased in two cases, suggesting that prolactin released from the adenoma cells suppressed prolactin production in the non-tumorous pituitary. However, the number of prolactin cells of the non-tumorous adenohypophysis seemed to be unchanged in two and increased in another two cases. The present findings conclusively proved the existence of the prolactin-producing adenomas as a distinct entity. These tumours do not stain with acid or basic dyes, they are PAS or thionin negative, and do not contain immunoreactive growth hormone. Thus, by conventional staining procedures they are indistinguishable from other chromophobe adenoma types. Herlant's erythrosin and Brookes' carmoisine methods, claimed spedifically to stain prolactin cells, failed to provide reliable results, hence their use cannot be recommended in tumour identification. Immunoperoxidase staining of prolactin is the only technique which conclusively reveals the presence of immunoreactive prolactin in the cytoplasm of the tumour cells and permits diagnosis. It is proposed that this technique be introduced in pituitary morphological studies. Its application may lead to a better understanding of problems related to prolactin-producing tumours and their secretory activity.

Adenoma, Chromophobe↗
PubMed1976

Human mixed somatotrophic and lactotrophic pituitary adenomas.

Six patients with acromegaly at examination were found to have pituitary adenomas composed of cells that secreted GH and PRL. This was demonstrated by the elevated serum hormone concentrations, by immunoperoxidase staining of 5 specimens, and by electron microscopic examination of 4. Ultrastructural characteristics, described in detail, suggest that these adenomas were mixed adenomas consisting of 2 well-defined, distinct cell types, each secreting one hormone. By immunoperoxidase staining some cells were found to contain immunoreactive growth hormone, other cells immunoreactive prolactin. No cells were detected exhibiting immunostaining for both growth hormone and prolactin. Eelctron microscopy, consistent with the results of immunostaining, revealed the presence of two distinct cell types, distinguishable from each other by their characteristic fine structural features. No intermediate forms were noted. Thus there was no evidence to suggest that one cell type might transform to the other. Present findings seem to indicate that mixed adenomas secreting growth hormone as well as prolactin and consisting of somatotrophs as well as lactotrophs do occur in the human pituitary gland. Although all the results obtained so far suggest that these tumors are composed of two distinct cell types and thus can be interpreted as representing real mixed adenomas, further work is required to establish whether or not they derive from one common progenitor.

Acromegaly↗
PubMed1976

Prolactin hypersecretion and short luteal phase defects.

The short luteal phase is commonly found in ovulating women presenting with infertility, or in amenorrheic women induced to ovulate with clomiphene. When the short luteal phase defect is accompanied by the discovery of galactorrhea, the two abnormalities may share a common underlying cause. Two cases are presented to demonstrate the short luteal phase defect as one early manifestation that may occur during the development of the amenorrhea-galactorrhea syndrome. Antiprolactin therapy may cause this menstrual disorder to revert to normal, allowing normal fertility and terminating the galactorrhea.

Adult↗
PubMed1975

Pituitary chromophobe adenomas consisting of prolactin cells: a histologic, immunocytological and electron microscopic study.

Morphologic studies of pituitary neoplasms removed by srugery from 36 human patients revealed 8 chromophobe adenomas which differed clearly from the remaining tumors. The cytoplasm of the adenoma cells failed to stain with PAS, aniline blue, adehyde fuchsin, aldehyde thionin, orange G or light green, but positively stained granules were found by using erythrosine or carmosine. Immunoperoxidase technique disclosed the presence of prolactin in the cytoplasm of some adenoma cells. The adenoma cells exhibited distinct ultrastructural features such as well developed rough surfaced endoplasmic reticulum with Nebenkern formation, prominence of Golgi apparatus, presence of misplaced exocytosis as well as pleomorphism of secretory granules with a considerable variation of size ranging from 130 to 500 nm in diameter. Thus, by electron nicroscopy the adenoma cells showed a close resemblance to prolactin cells of the non-tumouous pituitary glands except for the reduced size and number of secretory granules. Thes chromophobe adenomas are regarded as representing a distinct pathological entity clearly distinguishable from other forms of pituitary neoplasms. In view of the morphologic findings and the elevation of blood prolactin level (measured in 3 patients) the term, "sparsely granulated prolactin producing pituitary adenoma", appears to be the most appropriate one to designate these tumors.

Adenoma, Chromophobe↗