PubMed Health⌕ Search

Biomedical subjects

J Salmi

Publications and source records attributed to J Salmi.

65 records · Page 4Linked to original sources

Interrelationship between TSH- and prolactin secretion in patients with prolactinoma and autoimmune thyroiditis.

The relationship between the TSH and prolactin (Prl) responses to TRH has been investigated in 36 patients with prolactinoma, in 12 patients with symptomless autoimmune thyroiditis (SAT) and in 10 patients with Graves's disease in remission (GD). Autoimmune thyroiditis in combination with prolactinoma was found in 3 patients. The TSH -response was exaggerated in 4 prolactinoma patients without autoimmune thyroiditis. Moreover, in the patients with prolactinoma and intact function of the non-tumours pituitary gland the mean TSH increment was higher than in the controls. In patients with SAT, on the other hand, the Prl-response to TRH was significantly greater than that in the controls and in patients with GD. The significance of these findings is not obvious but they suggest that TRH may be involved in the development of prolactin secreting adenomata.

Adult↗

Pituitary function in prolactinoma. Effect of surgery and postoperative bromocriptine therapy.

Forty-five women and fifteen men with prolactinomas have been treated surgically. Patients with large tumours received pituitary irradiation and postoperative hyperprolactinaemia was treated with bromocriptine. The patients have been followed-up for 6-36 months following the operation. The tumours were larger and the levels of production higher in men as compared with women. All women had amenorrhoea. Galactorrhoea was present in forty-three women but not in the men. After surgery serum prolactin levels fell significantly in all women but remained above normal in thirty-six; prolactin remained high in twelve men. Bromocriptine effectively decreased the postoperative hyperprolactinaemia. The surgical complications were oculomotor nerve paresis in one woman and one man. After surgery six (23%) women developed impaired GH secretion, six (15%) impaired thyroid function, eight (18%) impaired cortisol secretion and five (17%) impaired LH secretion in isolation or combination which had not been present preoperatively. Three patients relapsed. Fifteen women menstruated after surgery and ten began to do so during the subsequent bromocriptine treatment. Thus, menstruation was restored in all six women with microadenomas in sixteen of twenty patients with intrasellar macroadenomas and three of nineteen patients with suprasellar adenomas. The preoperative LH-reserve proved to be an important prognostic indicator. Nine patients, i.e. 50% of patients desiring fertility became pregnant. In the men gonadal function deteriorated in four patients and did not improve in any without testosterone treatment.

Adenoma↗

Pituitary function after pituitary apoplexy.

Pituitary function was studied in nine patients who had recovered from pituitary apoplexy. All the patients recovered spontaneously; none required immediate surgery. Four of the patients had acromegaly, two had pituitary-dependent Cushing's syndrome, and a "functionless" pituitary adenoma was found in three. Low serum growth hormone concentrations were observed in three patients with acromegaly whereas the concentration remained increased in the fourth one. Of the two patients with Cushing's syndrome, a selective ACTH-deficiency developed in one and Nelson's syndrome appeared with excessive secretion of ACTH in the other. Transient or persistent hypofunction of the anterior pituitary occurred in al patients. Three patients underwent hypophysectomy after respective intervals of three, eight and 12 months after pituitary apoplex. The operation revealed a hemorrhage in one functionless adenoma and a large cyst in another one. In the third patient who had acromegaly, no signs of the pituitary apoplexy were observed at operation.

Acromegaly↗

Spontaneous hypothyroidism after antithyroid treatment of hyperthyroid Graves' disease.

Out of 54 patients with hyperthyroid Graves' disease 35 remained euthyroid after treatment with antithyroid agents and have been continuously followed from 1 to 9 yr (4.85 +/- 2.55 yr, mean +/- SD). In 4 patients an exaggerated TSH response to TRH developed from 30 to 111 months after interrupting the treatment and one of them became hypothyroid 50 months (5.0 yr) thereafter. The annual incidence of subclinical hypothyroidism (exaggerated response to TRH) as calculated from the total number of observation yr was 2.5% and that of overt hypothyroidism was 0.6%. These figures are similar to those reported recently in 2 retrospective studies.

Carbimazole↗

Vitamin D and calcitonin treatment in patients with femoral neck fracture: a prospective controlled clinical study.

The effects on general and bone metabolism of femoral neck fracture patients of 0.25 micrograms alpha-calcoid given orally twice daily (n = 9) and 25 micrograms calcitonin given subcutaneously 30 times (n = 10) in 10 weeks were studied against a control (n = 11). Bone histology and histomorphometry showed non-age related osteoporosis in 30% and osteomalacia in 22% of the patients studied. Impaired serum vitamin D status was found in 47-88% of patients, secondary hyperparathyroidism and increased serum parathyroid hormone in 59% and decreased serum calcitonin levels in 69%. On histology, normal findings and non-age related osteoporosis on histology were associated with low serum levels of 25-hydroxyvitamin D3, 1,25- and 24,25-dihydroxyvitamin D3. Very high serum levels of 1,25-dihydroxyvitamin D3 and low levels of 25-hydroxyvitamin D3 occurred in fracture patients with osteomalacia. Calcitonin improved calcium balance, reduced osteoporosis and increased the serum 1,25- and 24,25-dihydroxyvitamin D3 levels but had no effect on osteomalacia. Vitamin D reduced osteomalacia, slightly increased the serum 1,25-dihydroxyvitamin D3 concentration and decreased serum levels of parathyroid hormone. Both treatments gave a similar slight decrease in serum calcitonin concentrations. A mechanism of action for the treatments is suggested.

Aged↗