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Biomedical subjects

E Reschini

Publications and source records attributed to E Reschini.

At least 37 records · Page 2Linked to original sources

A black adrenocortical adenoma causing Cushing's syndrome not imaged by radiocholesterol scintigraphy.

In a 33-year-old female patient with left adrenal tumour and Cushing's syndrome, adrenocortical scintigraphy with radiocholesterol did not image the tumour nor the suppressed contralateral gland. Histology showed a black adrenocortical adenoma composed only of compact cells; there was no evidence of malignancy. This demonstrates that non-visualization of the adrenal glands in a patient with Cushing's syndrome is not invariably due to adrenal carcinoma. The literature on black adrenal adenomas causing Cushing's syndrome is reviewed.

Adenoma↗

Asymptomatic parathyroid adenoma manifested by intratumoral hemorrhage.

A 48-year-old woman whose past history was unrevealing presented with sudden swelling of the neck with pain and dysphonia. Neck ultrasonography suggested the possibility of hemorrhage in a parathyroid adenoma. Surgical exploration revealed a hemorrhagic parathyroid adenoma of the chief cell type. This event is exceedingly rare, but should be considered in the differential diagnosis of suddenly appearing masses of the neck region.

Adenoma↗

Growth hormone and ACTH secretory dynamics in Turner's syndrome.

The secretory dynamics of GH and ACTH were studied in 14 patients with Turner's syndrome. The parameters investigated were plasma GH and cortisol responses to hypoglycemia, plasma cortisol circadian rhythm and suppressibility by dexamethasone, and response of urinary Porter-Silber chromogens to metyrapone. The results were mostly normal. These data do not support the hypothesis suggesting an abnormality of hypothalamic-pituitary function in Turner's syndrome.

17-Hydroxycorticosteroids↗

Male pseudohermaphroditism due to 17-hydroxylase deficiency.

A 27-year-old phenotypic female presented with primary amenorrhea, severe hypertension, and hypokalemia. At the age of puberty sexual development had not occurred; in particular, sexual hair had not grown. Past history revealed an episode of subarachnoid hemorrhage and several episodes of ventricular tachyarrhythmia. Karyotype was 46, XY. The steroids requiring 17-hydroxylation (cortisol, testosterone, pregnanetriol, 17-ketosteroids, 17-hydroxycorticosteroids) were low, while those not requiring 17-hydroxylation (progesterone, deoxycorticosterone, corticosterone) were high, demonstrating 17-hydroxylase deficiency. The corticosterone/deoxycorticosterone ratio was relatively low, suggesting an associated partial deficiency of 11-hydroxylase.

Adrenal Hyperplasia, Congenital↗

Cushing's syndrome due to unilateral adrenal nodular hyperplasia with incomplete inhibition of the contralateral gland.

A 57-year-old woman was demonstrated to be affected by adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome. Computed-axial tomography of the abdomen demonstrated an expansion of the left adrenal. In apparent contrast with these findings, adrenal scintigraphy demonstrated radiocholesterol uptake also by the right gland. At surgery, the left adrenal was found to be hard and enlarged and was excised, while the right gland was found of normal appearance and left in place. Histologic examination of the excised gland demonstrated nodular hyperplasia. Early after surgery, plasma cortisol returned to normal values with a normal circadian rhythm and complete inhibition by low dose dexamethasone; the response of plasma cortisol to ACTH was normal. The patient represents a rare case of unilateral adrenal nodular hyperplasia. Radiocholesterol uptake by the contralateral gland and early recovery from adrenal atrophy after surgery are exceptional findings and suggest incomplete inhibition of endogenous ACTH.

17-Hydroxycorticosteroids↗

Corticotropin releasing factor stimulates cAMP formation in pituitary corticotropic tumor cells.

Addition of corticotropin-releasing factor (CRF) to membranes from two ACTH-secreting pituitary tumors strikingly increased in a dose-dependent fashion adenylate cyclase (AC) activity. Significant stimulation was already apparent at 10(-9)M CRF. Stimulation of AC activity by CRF in membranes from non-tumoral tissue adjacent to tumoral corticotrophs was considerably lower, and was lacking in membranes from a growth hormone secreting tumor. These data correlated well with in vivo pre-surgery and post-surgery ACTH responsiveness to CRF of the tumor bearing patients. Basal AC activity was higher in pituitary adenomas than in non-tumoral adjacent tissue. It is concluded that 1) a CRF-sensitive AC exists in ACTH-secreting tumor cells and, 2) increased sensitivity to CRF, as evidenced by greater stimulation of AC activity, may be responsible for the increased ACTH output of tumoral corticotrophs.

Acromegaly↗

Uptake of 75Se-selenocholesterol by an adrenal cortical carcinoma and its metastases.

Adrenal scintigraphy with 75Se-selenocholesterol was performed in a patient with Cushing's syndrome due to a right adrenal tumor. The tumor was faintly but clearly imaged. The liver was sharply imaged and the liver uptake did not reveal the usual decrease after the first week postinjection. The liver image was still clearly evident in the last scintiphotos taken 26 days after injection of radiocholesterol. At operation a right adrenocortical carcinoma was removed and the right lobe of the liver was found to be almost completely replaced by metastatic adrenal tissue.

Adrenal Cortex Neoplasms↗

Plasma ACTH-response to the corticotropin releasing factor in patients with Cushing's disease. Comparison with the lysine-vasopressin test.

In three female patients with Cushing's disease, 100 micrograms of synthetic ovine corticotropin releasing factor (CRF) were administered before surgery and 1 week after transsphenoidal microadenomectomy. In these patients a test with lysine-vasopressin (LVP), 10 U intramuscularly, was also performed before and after pituitary surgery. Before surgery, both stimuli induced a clear increase in plasma ACTH and cortisol in all patients; the response of ACTH to CRF was of greater magnitude. Postoperatively, the responses were virtually absent in two patients, but were still present in the third one in whom the removal of adenoma had been partially unsuccessful. The CRF test was also performed in a female patient with Cushing's syndrome due to adrenal adenoma; in this patient no responses of plasma ACTH and cortisol to CRF were recorded. This paper demonstrates that pituitary microadenomas causing Cushing's disease may retain the ability to respond to CRF; this stimulus may be useful in the differential diagnosis between ACTH-dependent and independent Cushing's syndrome; the lack of response after microadenomectomy indicates successful removal of the tumor. CRF is more potent than LVP in releasing ACTH at the doses employed.

Adenoma↗

Plasma and urine cyclic nucleotide levels in patients with hyperthyroidism and hypothyroidism.

Plasma levels and 24-h urinary excretion of cyclic AMP and cyclic GMP were measured in 18 patients with hyperthyroidism, 7 patients with hypothyroidism and 25 normal subjects. Mean plasma and urinary levels of both cyclic AMP and cyclic GMP were significantly positive correlations between the serum thyroid hormone levels and plasma and urinary cyclic nucleotide concentrations were also found, suggesting that the elevated extracellular cyclic nucleotide levels in hyperthyroidism are probably a consequence of increased secretion of thyroid hormones. In the hypothyroid patients the extracellular cyclic nucleotide concentrations did not differ significantly from those of the normal subjects.

Adolescent↗

Effect of dopamine infusion on serum prolactin concentration in normal and hyperprolactinaemic subjects.

The serum prolactin response to intravenous dopamine infusion (5 micrograms . kg-1 . min-1) was measured in twenty-one healthy subjects, in seven hyperprolactinaemic patients without evidence of a pituitary tumour, and in twenty-one patients with prolactinomas. Mean serum prolactin values were significantly suppressed in all three groups, without any significant difference between the degree of suppression. A decrease of serum prolactin to below 50% of basal values occurred in fifteen healthy subjects, in four patients without evidence of pituitary tumour, and in fourteen patients with prolactinomas. These findings demonstrate that most human prolactin-secreting pituitary adenomas are normally suppressible by exogenously administered dopamine and that dopamine infusion is not able to distinguish between tumorous and non-tumorous hyperprolactinaemia. Since intravenously infused dopamine is believed to inhibit prolactin secretion by acting at pituitary level, it is suggested that a normal functioning of pituitary dopamine receptors is maintained in most human prolactinomas.

Adenoma↗

Antiserotonin treatment of hyperprolactinemic amenorrhea: long-term follow-up with metergoline, methysergide, and cyproheptadine.

Twenty patients affected by hyperprolactinemic amenorrhea-galactorrhea have been treated with one or more of the following serotonin antagonists: metergoline, methysergide, and cyproheptadine. Among the 11 patients without evidence of pituitary tumor resumption of menses was observed in five, two of whom had ovulatory cycles; one patient became pregnant; ovulations occurred only during treatment with metergoline. In the group of nine patients with enlarged sellae, three experienced isolated episodes of bleeding, while two had three and four menses each, respectively; all cycles were anovulatory. Plasma prolactin levels and galactorrhea were favorably affected by treatment only in a minority of amenorrhea-galactorrhea patients with and without tumors.

Amenorrhea↗

Inhibitory effect of calcitonin on growth hormone and insulin secretion in man.

The effect of calcitonin administration on basal and arginine-stimulated growth hormone and insulin plasma levels was investigated. The intramuscular injection of synthetic salmon calcitonin (100 U MRC) in five normal subjects produced a significant decrease (p less than 0.05) in insulin concentration. The same amount of calcitonin given 15 min before an arginine infusion test in seven normal subjects significantly reduced the response of growth hormone (p less than 0.025) and insulin (p less than 0.005) to the stimulus.

Adult↗