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Biomedical subjects

D Mühlenstedt

Publications and source records attributed to D Mühlenstedt.

At least 19 recordsLinked to original sources
PubMed1979

[Familial endocrine adenomatosis (author's transl)].

The combination of pituitary and thyroid gland adenomatosis is reported in four family members of two generations. This finding of dominant inheritance is discussed with special reference to multiple familial adenomatosis, also known as Wermer's syndrome. The endocrine status including dynamic function tests is presented. It is our intention to point out that in cases of monoglandular adenomatosis clinical attention should be directed not only to anterior pituitary and thyroid gland but also to their possible incidence with tumours of the parathyroid gland and the islet cell organ.

Adenoma, Islet Cell↗
PubMed1979

[Gonadoblastoma and overgrowing dysgerminoma in Turner mosaicism [45, XO/46, Xi (Xq)] (author's transl)].

It is well established that the Y-chromosome is associated with germ cell tumor development. There is a considerable tumour risk in XY- and XY/XO-gonadal dysgenesis. In the absence of Y-chromosome germ cell tumours are extremely rare. The history of a patient with 45 XO/46 Xi (Xq)-karyotype is presented, who had a gonadoblastoma with overgrowing dysgerminoma. According to basal body temperature recordings, this patient ovulated up to the age of 22 years. After this cyclical ovarian function was exhausted; histologically no primordial follicles could be detected. Gonadotropin as well as prolactin binding sites in the tumours could not be demonstrated, suggesting hormone independency and complete malignant transformation of the tumor. In general the clinician should be aware of a possible germ cell tumour development in the absence of a Y-chromosome. However as far as the clinical management of patients with dysgenetic gonads is concerned, prophylactic gonadectomy is only indicated in the presence of a Y-chromosome.

Adult↗
PubMed1979

Sexual differentiation of the hypothalamus in gonadal agenesis and testicular feminization.

Cyclical hypothalamic function was investigated in three patients with an XY karyotype and female external genitalia; in one of them we diagnosed gonadal agenesis, and in the other two testicular feminization. We studied the effect of estradiol and progesterone on gonadotropin release. The patient with gonadal agenesis had cyclical hypothalamic function, but this cyclical function was suppressed in the patients with testicular feminization in whom no LH secretion could be provoked by steroid stimulation. These observations support the concept that hypothalamic sexual differentiation is due to testosterone (which is locally converted to estradiol in the hypothalamus).

Androgen-Insensitivity Syndrome↗
PubMed1979

[Pregnancy and delivery combined with hereditory angioneurotic edema (author's transl)].

Two deliveries in a patient combined with hereditory angioneurotic edema are reported. Although even the smallest trauma can lead to life threatening edema the tendency to edema is reduced during pregnancy. Neither in the vagina nor the vulva the deliveries caused edema. The episiotomy did not cause a concomitant edema of the vulva, despite the predilection of the external genital organs for edema. It is possible that a correlation between the gonadotrophin level and the tendency to edema exists in hereditory angioneurotic edema.

Adult↗
PubMed1979

[The influence of highly purified hCG on the immunocompetence of human lymphocytes and DNA repair system].

PHA-stimulation of human T-lymphocytes, a parameter of cellular immunocompetence, can be suppressed by highly purified human chorionic gonadotropin (hCG) in a dose-dependent manner. This was shown spectrophotometrically and by the mitosis index. Our results are in agreement with H3-thymidine incorporation studies. We further investigated the DNA repair system in UV-light- and hCG-explsed lymphocytes. It could be shown that DNA repair-replication is disturbed by hCG. Such repair disturbances may cause reduced H3-thymidine incorporation in PHA-stimulated and hCG-treated lymphocytes. It is probably on this molecular level that hCG influences the immunocompetence of human lymphocytes.

Antibodies↗
PubMed1978

[Tumour regression in pituitary adenoma by bromocriptin (author's transl)].

A 35 year old patient with longstanding amenorrhea-galactorrhea due to a pituitary macroadenoma has been observed for a period of more than 2 years. During this time tumour expansion was radiologically evident. A full term pregnancy was responsible for most of the tumour growth. Following postpartum period Bromocriptin treatment led to considerable regression of the adenoma. Recalcification of sella structures and an involuted sella volume was radiologically evident. With reference to the experimental investigations of Lloyd (1975) and following the suggestions of L'Hermite (1977) and Vaidya (1977) this tumour regression is interpreted as being due to the antimitotic effect of Bromocriptin via inhibition of c-AMP and DNA.

Adenoma↗
PubMed1978

[Clinical endocrine investigations in patients with pituitary adenoma (author's transl)].

LH-RH tests of hypothalamo-pituitary gonadotropinfunction were performed in 26 patients with pituitary adenomata before and after prolactin suppression and/or surgical treatment. Various degrees of galactorrhea together with menstrual disorders were the key symptoms in all patients. There was a significant association of elevated prolactin levels with impaired LH-responses. Seven patients have undergone transspenoidal dissection of the pituitary adenoma and in five of them the pituitary LH-response reverted to normal (R2) after surgery. Nine of 15 amenorrhoic patients had a recurrence of menstrual cyclicity, partly biphasic within 3 months and a normalized LH-response after Bromocriptin therapy. 19 of our patients were desirous of pregnancy. Five pregnancies were confirmed within 4 months of treatment.

Adenoma, Acidophil↗
PubMed1978

Gonadotrophin release during chronic administration of D-ser (TBU)6 LH-RH-EA in functional amenorrhoea.

Six women with long-standing functional amenorrhoea were treated with 5 microgram of D-Ser (TBU)6 LH-RH-EA twice daily for 14 days. The functional states of the gonadostats, as assessed by a 25 microgram LH-RH test dose, varied widely before the treatment was started whereas at the end of it they were uniformly low. In all patients D-Ser (TBU)6 LH-RH-EA induced gonadotrophin release, the peak values occuring between day 1 and 3 of therapy. Despite further injections mean gonadotrophin levels declined rapidly therafter and remained in the basal range for the rest of the study. Release of oestradiol was very uncharacteristic. No consistent ovarian response pattern was observed during the analogue administration. It is obvious that chronic stimulation with D-Ser (TBU)6 LH-RH-EA leads to a decreased responsiveness of the pituitary gland.

Adult↗
PubMed1978

[A case of spontaneous rupture of the uterus (author's transl)].

A 22 year old primigravida at 40+ weeks gestation had an i.v. induction of labour with 5-10 mU/min oxytocin for 3 h which resulted in fetal distress without bleeding at 5 cm dilatation at station -3, vertex transverse. At emergency Caesarean section an occult rupture of the uterus was found. Maternal height 168 cm, weight 71.0 kg. Fetal length 53 cm, weight 4080 g. The problems of spontaneous rupture of the uterus without detectable prior damage of the uterine wall are discussed.

Adult↗
PubMed1977

Prolactin oversuppression.

Patients with primary infertility due to hyperprolactinemic corpus luteum insufficiency and oligomenorrhea were treated with Bromocriptin. Suppression of serum prolactin for up to four menstrual cycles resulted in a normalisation of the length of the cycle(32 vs 28 days) as well as of luteal progesterone secretion. In addition, ovulation occurred earlier after than before treatment (on day 14 vs day 18). When, however, prolactin concentrations reached levels of less than 120 muU/ml (3 ng/ml), which were observed during the 5th and 6th treatment course, reappearance of shortened luteal phase occurred probably due to oversuppression of prolactin. Premenstrual spottings were observed too. The data presented indicate that minimal prolactin is required for normal follicular maturation and luteal development. On the other hand, the gonadostat may be susceptable to the dopaminergic stimulus of Bromocriptin to a different extent as oversuppression of prolactin is not observed in hyperprolactinemic anovulatory syndromes. Thus, treatment with Bromocriptin requires a continuous monitoring of serum prolactin as well as individual treatment regimens.

Bromocriptine↗
PubMed1977

[Pseudohermaphroditism due to XY gonadal absence syndrome (author's transl)].

A case about a 16 year old individual is presented, in whom no internal genitals and vagina were found; no signs of breast development, axillary and pubic hair growth could be detected. The external genitals were hypoplastic. A sinus urogenitalis was present. The sex chromosome pattern was normal male (XY). On both sides of the pelvic wall rudiments of the Fallopian tube were observed by laparoscopy. Testosterone, estradiol, 17 alpha-OH-progesterone as well as androstendione-secretion could not be stimulated by HCG. Basal and LH-RH stimulated gonadotropins indicated a hypergonadotropic state. Height and bodyweight were in the range of a 12-year old boy, the bone age correlated with 14 years.

Adolescent↗