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Biomedical subjects

F H Doyle

Publications and source records attributed to F H Doyle.

At least 37 records · Page 2Linked to original sources
PubMed1976

Treatment of Nelson's syndrome by pituitary implantation of yttrium-90 or gold-198.

Eight patients with Nelson's syndrome were treated with a pituitary implant of yttrium-90 or gold-198 four to 16 years after adrenal surgery. All had considerable pigmentation. One already had cranial nerve abnormalities and visual field defects and had had both a craniotomy and deep x-ray treatment. Radiographs showed that the pituitary fossa was abnormal in seven patients. A biopsy performed in six cases showed mucoid (or basophil) adenoma in all. In the four specimens examined ACTH was identified by electron microscopy or immunofluorescence, or both. Patients were followed up after pituitary implantation for three months to 12 years. All showed decreased pigmentation, and six became normal. Four patients regained normal ACTH levels and the other two studied had decreased levels. In no case did new cranial nerve disease or further sellar expansion develop since operation, and two patients showed remodelling of the sella. Complications were temporary leakage of cerebrospinal fluid and diabetes insipidus in one patient and gonadotrophin deficiency in another.

Adenoma↗
PubMed1976

Galactrorrhoea, hyperprolactinaemia and pituitary tumours in the female.

A series of sixty-two women with pituitary tumours, but having neither acromegaly nor Cushing's disease, has been analysed with respect to mode of presentation. Thirty-six (58%) presented with amenorrhoea and galactorrhoea and a further fifteen (24%) presented with amenorrhoea only. Pretreatment prolactin levels were available in thirty-four of these patients and in twenty-seven (79%) hyperprolactinaemia was found, this occurring in the absence of a history of galactorrhoea in four out of ten cases. In addition, among a series of twenty-five unselected women with unexplained galactorrhoea, we have found twelve pituitary tumours, amenorrhoea being a feature of all twelve cases. We conclude that the incidence of hyperprolactinaemia in women with apparently functionless pituitary tumours is much higher than previously estimated and suggest that serum prolactin should be assayed in all patients with such tumours even in the absence of a history of galactorrhoea. All patients with unexplained galactorrhoea should have careful radiological investigation for a possible pituitary tumour.

Adolescent↗
PubMed1976

Radiological and histological findings in six patients with alpha-chain disease.

Detailed radiological and histological features of alpha-chain disease are presented against a background of the clinical and biochemical findings. The separation of this syndrome from other varieties of "Mediterranean" lymphoma is emphasized. The radiologist should in some instances be able to suggest the diagnosis in his differential diagnosis of abnormalities seen on examination of the small bowel. The histopathologist should be able to provide a diagnosis from examination of a peroral jejunal biopsy. One patient with this relatively uncommon disease had evidence of a hypertrophic osteoarthropathy. Two of the six patients had a transient episode of acute abdominal distension which resolved on conservative management.

Adolescent↗
PubMed1976

The pituitary fossa in Cushing's syndrome. A retrospective analysis of 93 patients.

A retrospective analysis of the pituitary fossa in 93 patients with Cushing's syndrome is presented. Radiological evidence of a pituitary tumour was found in 20 of 86 patients with pituitary-dependent disease (23%). In 11 of the 20 patients, the diagnosis depended on analysis of lateral tomograms. None of the seven patients with disease which was not pituitary-dependent had evidence of an abnormal sella. One of 20 controls without known endocrine disease had an abnormal sella.

Adolescent↗
PubMed1975

The effect of yttrium-90 implantation on endocrine function and visual fields in patients with "functionless" pituitary tumors, with biopsy and radiological findings.

Thirty patients with symptoms from "functionless" pituitary tumours were treated by yttrium-90 implants, and we report here the effects on symptoms, pituitary function and visual fields. On biopsy, about a third of the tumours showed some hormone granules. In the sixteen fully assessed at 1 year, pituitary function was improved in 25%, unchanged in 62-5%, and reduced in 12-5%. Improvement was confined to those in whom gonadotrophin secretion was the only function impaired pre-implant. Visual field defects were present pre-implant in ten patients (twenty eyes); at 1 year post-implant these defects had lessened in 80% and deteriorated in only 5% of eyes. Subsequently, within 5 years of the implant the field defects had worsened or recurred in four patients, all with initially extensive suprasellar projection; further treatment was then given. Remineralization of the sella was seen after implantation in seven cases, with reduction in fossa size in five. Thus pituitary implantation appears to be a practicable and reasonably simple procedure suitable for the treatment of most cases of "functionless" pituitary tumour. The "supressive" doses of irradiation used are adequate to shrink most tumours without loss of pituitary function.

Adenoma↗