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H K Rjosk

Publications and source records attributed to H K Rjosk.

At least 19 recordsLinked to original sources
PubMed1985

[Value of nuclear magnetic resonance tomography in the diagnosis and therapy outcome of prolactinomas].

30 MR tomographies were performed in 15 patients suspected of having a prolactinoma on account of clinical examinations and test in the chemical laboratory. The T1 and T2 times of the adenomas were determined quantitatively. In addition, high resolution CT imaging had been performed in all patients. The signal performance of the normal pituitary gland determined in 11 healthy persons on the basis of quantitatively measured T1 and T2 times, was found to largely correspond with that of grey matter of the brain. Of the 14 confirmed prolactinomas, 11 were microadenomas and 3 macroadenoma. Solid adenomas were identified by enhanced T1 values. It was possible to differentiate these from cystic, haemorrhagic and necrotic tumour components by differences in signal performance. 7 patients on drug therapy with dopamine agonists were controlled by means of MR tomography. No measurable size reduction of tumour was seen in 3 patients with cystic or haemorrhagic tumour components. On the other hand, tumour reduction was seen after brief drug therapy in 2 macroprolactinomas and one microprolactinoma. An essential advantage offered by MR is, besides the absence of exposure to radiation, in the first place the better and more precise information on the relative position of the adenoma with reference to the vessels and the optic chiasm, and, secondly, better identification of cystic and haemorrhagic processes within the prolactinoma.

Adenoma↗
PubMed1979

[Human prolactin (author's transl)].

Human prolactin (hPRL) is the most recent anterior pituitary hormone in human endocrinology, whose structure has been elucidated in 1977. The possibility to measure hPRL in serum has led to a rapid increase of our knowledge of prolactin-physiology and -pathophysiology in men. hPRL is the only anterior pituitary hormone which is under predominantly inhibitory hypothalamic control. The effects of prolactin in the various species differ considerably, whereas in men it acts mainly upon the mammary gland and the gonadal system. Hyperprolactinemia leads typically to hypogonadism, amenorrhea and frequently galactorrhea. The hyperprolactinemia-hypogonadism-syndrome has been identified as a separate entity in recent years. Because of the relative frequency of this disease prolactin measurements have become of great importance in the diagnosis of sterility. Depending on the cause of hyperprolactinemia a neurosurgical, radiotherapeutical or medical treatment is indicated.

Amenorrhea↗
PubMed1979

Persisting suppression of prolactin secretion after long-term treatment with bromocriptine in patients with prolactinomas.

The effect of bromocriptine withdrawal after long-term treatment on prolactin levels has been investigated in thirty-seven patients with prolactinomas. In ten patients with macroprolactinomas and post-operatively excessively high prolactin levels persisting suppression of prolactin secretion after bromocriptine withdrawal has been observed. This effect was not observed in patients with microprolactinomas or macroprolactinomas with only moderately elevated prolactin levels. The degree of persisting suppression correlated to the height of prolactin levels before treatment and to the duration of bromocriptine therapy. No correlation was found between the rise of prolactin levels after bromocriptine withdrawal and withdrawal time. It is suggested that the persisting suppression of prolactin levels is a sequence of reduction in tumour size. This anti-proliferative action of bromocriptine seems to be specific for the prolactin secreting cells in macroprolactinomas with high proliferation rate and high prolactin turn-over. These findings offer new possibilities in the management of patients with macroprolactinomas.

Adenoma↗
PubMed1978

Treatment of patients with prolactinomas.

Fifty-one female patients with prolactin producing tumors (PRL 1100 to 88,000 microU/ml) and 26 male patients with prolactin producing tumors (PRL 6500 to 400,000 microU/ml) were studied. Only 25% of the females had visual field defects which were present in 70% of the males. All females had amenorrhea but only 35 had galactorrhea. Hypopituitarism was rarely seen in the females but in most of the male patients. Twenty-four females and all male patients were operated (transphenoidal or transfrontal operation). PRL normalized in only eight females and in none of the males. Two patients became pregnant postoperatively, four after postoperative treatment with bromocriptine. Bromocriptine induced regular menses in 4 other patients operated by transsphenoidal route. Eight patients with microadenoma (PRL less than 4000 microU/ml) were treated with bromocriptine alone of whom two became pregnant. The males were also treated with bromocriptine leading to a significant fall of the PRL level accompanied by improvement of libido, sexual potency and headache. Two patients received radiation postoperatively, which led to a fall of PRL and improvement of visual fields. Since PRL levels remained low after withdrawal of bromocriptine for several months an antiproliferative effect of this drug is suggested. Thus differential therapy of PRL producing tumors is possible: In females selective neurosurgery can alone or combined with medical therapy normalize PRL secretion and ovarian function. In patients with microadenoma bromocriptine alone can be successful. In patients with inoperable large tumors radiation should be advocated. Additional bromocriptine therapy may be helpful to stop tumor growth and alleviate the effects of hyperprolactinemia.

Adenoma↗
PubMed1978

[Drug therapy of hyperprolactinemia and acromegaly].

Hyperprolactinemia can be treated medically. Thus all patients with a normal sella turcica and those patients with only slight enlargement of the sella turcica can be treated medically with the dopaminagonist bromocriptine. This treatment is also indicated in paitents with postoperative persisting hyperprolactinemia. In contrast to hyperprolactinemia medical therapy of acromegaly is still in the experimental stage, through the dopaminagonist bromocriptine induces a decrease of growth hormone levels and improvement of the disease in many patients with acromegaly.

Acromegaly↗
PubMed1978

[The olfactor-genital syndrome (author's transl)].

1. Only FSH was increased after intravenous administration of 0.025 mg of GnRH in 2 female patients suffering from olfacto-genital syndrome. LH-serum-concentrations increased significantly, only when 0.1 mg GnRH was applicated intravenously twice with an interval of one hour.2. The response of hPRL-secretion to 0.2 mg TRH was found normal in both patients. However, when 25 mg chlorpromacine were administered intramuscularly, only one patient responded with an adequate rise of serum-hPRL. 3. One patient became pregnant during treatment with HMG/HCG. The clinical course of pregnancy was quite normal. HPL- and HCG-levels were in the normal, hPRL in the low normal range during pregnancy.

Adult↗
PubMed1977

Metastatic choriocarcinoma transplanted with cadaver kidney: a case report.

A unique case of a metastasising choriocarcinoma, inadvertently transplanted to a man from a female cadaver kidney is reported. When the kidney was removed six days after transplantation, arterial blood vessel infiltration by chorio-carcinoma cells and high levels of human chorionic gonadotropin (HCG) in the serum of the recipient indicated an haematogenous dissemination of viable neoplastic cells. The immunosuppressive therapy was discontinued after removal of the graft and the HCG levels in the recipient gradually decreased over a periode of eight weeks, indicating a slow immunologic rejection of the tumor cells. The recipient committed suicide seven months after the transplantation had failed. No metastases were found at a legal autopsy. It seems advisable, whenever there is evidence that neoplastic cells might have been transfered by a homograft, to remove the graft and discontinue the immunosuppressive therapy. Neoplastic cells already disseminated can still be eliminated when the immunologic system is intact and not suppressed.

Cadaver↗
PubMed1977

[Monitoring of the results of the treatment of chorionic carcinoma (author's transl)].

Because of the high sensitivity and specificity of the method, radio-immunologic determination of the Beta Subunit HCG in the serum is superior to other methods of monitoring the therapeutic results of the treatment of chorionic carcinoma. A ratio of 225 to 1 of HCG concentrations in the serum versus the cerebral spinal fluid is evidence against the probability of a metastasis of chorionic carcinoma in the central nervous system. Following successful treatment of chorionic carcinoma it is advisable to determine the serum HCG with the Beta Subunit method weekly during the first two months and montly in the succeeding two years and thereafter at three months intervals.

Adult↗
PubMed1976

[Clinical relevance of prolactin. Results of a round-table (author's transl)].

1. The physiological regulation of prolactinsecretion and the causes of hyperprolactinemia are described. 2. Main symptomes of hyperprolactinemia are disturbances of the menstrual cycle and galactorrhea. 3. Treatment of hyperprolactinemia without pituitary tumor is possible using CB 154. 4. In patients showing an enlarged sella turcica a selective hypophysectomy or treatment with CB 154 have to be considered carefully. 5. Suppression of postpartal lactation is achieved very effectively with CB 154.

Female↗