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Biomedical subjects

E G Cross

Publications and source records attributed to E G Cross.

7 recordsLinked to original sources

Effect of SMS 201-995, a long-acting somatostatin analogue, on the secretion and morphology of a pituitary growth hormone cell adenoma.

The present study reports the effects of SMS 201-995, a long-acting somatostatin analogue, on blood GH levels, glucose tolerance and tumour morphology in a 36-year-old, previously untreated acromegalic woman. Treatment (50 micrograms s.c., 8-hourly) resulted in marked suppression of GH concentration and an improvement in glucose tolerance. After 10 d of treatment, the tumour was removed by transsphenoidal surgery and studied by histology, immunohistochemistry, transmission electron microscopy and morphometry. Histologically, the tumour was an acidophilic adenoma which contained immunoreactive GH in many adenoma cells. By electron microscopy, the tumour was composed of densely granulated somatotrophs containing numerous large secretory granules and many lysosomes showing crinophagy. No cell necrosis or vascular impairment were evident. Using morphometry, the tumour was compared with 10 densely granulated somatotroph adenomas, removed from acromegalic patients not treated with somatostatin. The nuclear and cytoplasmic areas of the adenoma subjected to SMS 201-995 treatment were smaller, and the lysosomes occupied more of the cytoplasmic volume than those of controls. The nuclear/cytoplasmic ratio, cytoplasmic volume densities of endoplasmic reticulum, Golgi apparatus, mitochondria, secretory granules and secretory granule diameters were within the range of control adenomas. In vitro, treated adenoma cells secreted GH and retained responsiveness to both GRH stimulation and somatostatin suppression. The morphologic findings after SMS 201-995 treatment, are consistent with suppression of GH release. There is no evidence that somatostatin has any direct cytotoxic or vasotoxic effects. It appears that SMS 201-995 represents a potent and promising drug in the medical treatment of acromegaly, however, more work is needed to elucidate the mechanism of somatostatin suppression and to provide evidence for adenoma shrinkage.

Acromegaly↗

Increased bone apposition in primary hyperparathyroidism: measurements based on short interval tetracycline labeling of bone.

Bone biopsies of 23 subjects suffering from primary hyperparathyroidism, which was proven by the demonstration of parathyroid pathology during neck surgery, were studied by morphometric analysis and short interval sequential tetracycline labelling and compared with those of 13 patients without metabolic bone disease. In 19 of these patients, abnormalities were found in the trabecular volume, resorption surface, formation surface, or in various combinations. However, no constant pattern of bone changes was observed. In 4 patients, the bone morphometric parameters were normal. The bone apposition rate, on the other hand, was elevated in all 23 subjects. The rate was re-evaluated in 4 patients 6 wk to 3 mo following successful parathyroid surgery. It fell back within the control range. These findings confirm the observation in experimental animals that parathyroid hormone stimulates bone apposition in vivo and give support to the rationale of using this hormone in the treatment of osteoporosis.

Adolescent↗

Treatment of persistent knee effusions with intra-articular radioactive gold.

Patients with a total of 112 chronic knee effusions unresponsive to the usual conservative methods of therapy were treated with intra-articular injections of radioactive gold and followed from 6 months to 5 years. Most patients in the study had rheumatoid arthritis but others had ankylosing spondylitis, psoriatic arthritis, intermittent hydrathrosis and undiagnosed synovitis. After 6 months 81% showed improvement. This figure diminished to approximately 70% at 1 and 2 years, 60% at 3 and 4 years and 50% at 5 years. The mose beneficial results were seen in patients with intermittent hydrarthrosis. Twelve patients with a synovial cyst and/or rupture improved. Patients with thin synovia and anatomic stage I or II disease did best, but those with stage III disease also did well. After the injection 33% of the patients had a reactive synovitis. A variable amount of radioactive material escaped from the knee to the regional lymph nodes and general circulation.

Age Factors↗

The treatment of persistent knee effusions with intra-articular radioactive gold: preliminary report.

Eighteen chronic knee effusions unresponsive to the usual methods of therapy were treated by intra-articular injections of radioactive gold ((198)Au) and followed up for one year. Ten patients had classical rheumatoid arthritis; three intermittent hydrarthrosis (both knees were treated in one patient); two ankylosing spondylitis, and one synovitis of undetermined cause. In 12 knees the effusion completely disappeared, usually within three months. Temporary increased pain and swelling occurred during the first week in five cases. Radiation dosimetry is discussed in detail.

Adult↗

Hypertrophic osteoarthropathy, phalangeal and synovial metastases associated with bronchogenic carcinoma.

A 61-year-old woman with bronchogenic carcinoma simultaneously developed hypertrophic osteoarthropathy (HOA), phalangeal metastases, and metastatic carcinoma of the synovium. The right knee synovium showed several blood vessels containing carcinomatous cells. Although the association of HOA phalangeal and synovial metastases in this case is likely a chance occurrence, awareness of this possibility is extremely valuable as it has important therapeutic implications.

Adenocarcinoma↗