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Biomedical subjects

M Góth

Publications and source records attributed to M Góth.

At least 37 records · Page 2Linked to original sources
PubMed1995

Incidentally detected adrenal tumours (incidentalomas): histological heterogeneity and differentiated therapeutic approach.

OBJECTIVES: To find a differentiated therapeutical approach to incidentalomas. DESIGN: Prospective study of incidentalomas: their histology, hormonal activity, and growth if primarily non-operated. SETTING: Admissions to an academic tertiary care centre because of incidentaloma. PATIENTS: Thirty-eight female, 25 male, 27-85 years old. INTERVENTIONS: Ultrasound, computed tomography and adrenal scintigraphy when appropriate; investigations to exclude malignancy giving metastasis into the adrenal gland; ACTH, cortisol, aldosterone, renin activity, androgene, catecholamine measurements; surgery or follow-up. MAIN OUTCOME MEASURES: Rate of malignancy; linkage of tumour size to probability of malignancy; prevalence of tumours with subtle hormone excess. RESULTS: Cortical adenomas occurred in 13/31, metastases in 7/31 of the histologically confirmed cases. In 10/31 cases, the computed tomography indicated a size that was smaller than the pathological size (mean = 20 mm). 20.6% of all incidentalomas and 61.5% of the 13 operated corticol adenomas showed subtle hormonal activity. Twenty-seven incidentalomas < 30 mm were followed-up (3-41 months; mean 18 months) and showed growth in only one case. Sensitivity, specificity, and predictive value (PV) of a tumour > or = 30 mm to indicate malignancy were: 1.0, 0.56 and 0.27, respectively. The PV of a < 30 mm tumour to exclude malignancy was 1.0. CONCLUSIONS: Oncological screening tests are necessary in all incidentalomas. Tumours > or = 30 mm should be operated but smaller ones can be followed-up, because they are usually benign and rarely show progressive growth. Cortical adenomas with subtle hormonal overproduction and hypertension, diabetes or osteoporosis should be operated, irrespective of their size, but in the absence of relevant clinical symptoms they can be followed-up.

Adrenal Cortex Hormones↗
PubMed1995

Prevalence of thyroid dysfunction in different geriatric subpopulations from a moderately iodine-deficient Hungarian region. Comparative clinical and hormonal screening.

The aim of this study was to investigate the prevalence of thyroid dysfunction in different geriatric subpopulations from a moderately iodine-deficient Hungarian region and to compare the efficacy of clinical versus hormonal screening. A screening study was done on 279 chronically ill geriatric patients (Group I) and 256 consecutive hospital admissions over 60 years of age (Group II). The method of clinical screening was different from those used so far: the object was not to search for symptoms of hypo- or hyperthyroidism but to find any sign justifying a further thyrotrophin-based biochemical evaluation, i.e. history of thyroid disease or goitre or any clinical sign of hormonal dysfunction. The rates of overt hypothyroidism, overt hyperthyroidism, subclinical hypothyroidism and subclinical hyperthyroidism discovered by the hormonal screening were 2.9, 1.1, 3.6 and 5.7% in Group I and 3.5, 2.3, 3.9 and 2.0% in Group II. The sensitivities of the clinical screening to suspect overt or overt+subclinical dysfunctions were, respectively, 0.82 and 0.64 in Group I and 1.0 and 0.7 in Group II (or 0.67 and 0.4 if the clinical investigation was done not by an endocrinologist but by the medical attendants). A primarily clinical investigation-based screening would have spared 171/279 thyrotrophin estimation in Group I and 161/256 in Group II, but would have missed 2/11 overt and 11/26 subclinical dysfunctions in Group I. In Group II, no overt but 9/15 subclinical dysfunctions would have been lost in this way. Our approach of a clinical investigation-based screening was rather efficient in suspicion of overt thyroid dysfunction but failed to detect many cases with subclinical dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

The reaction of adenohypophysis hormones in primary hyperparathyroidism and after surgical treatment.

The anterior pituitary hormone serum levels of 13 patients of both sexes were examined for basal secretion and response to TRH-GnRH stimulus before and after parathyroidectomy. The patients were suffering from hyperparathyroidism of parathyroid adenoma origin. After the operation, the previously high serum calcium and low serum phosphate levels decreased (P < 0.001). The serum parathyroid hormone (PTH) concentration, too, decreased significantly. After surgery, the basal and stimulated secretion of thyrotropin (TSH) showed a significant increase (P < 0.02 and P < 0.05, respectively). Significantly higher prolactin (PRL) levels were measured after surgery in those patients whose PRL levels were normal both before and after the operation. No significant change was observed in patients with hyperprolactinaemia. After surgery an increased spontaneous growth hormone (GH) secretion was found, while the basal luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretions remained unchanged. In postmenopausal women the stimulated FSH secretion decreased (P < 0.05), while the decrease of the stimulated LH secretion was not significant. The results suggest that extracellular calcium may modify the secretion of certain adenohypophysis hormones and their stimulus-induced response.

Adenoma↗
PubMed1993

[The place of insulin-like growth factor I in the diagnosis of acromegaly].

Insulin-like growth factor-I (IGF-I) and basal growth hormone (GH) (average of GH values measured at -20 an 0 minutes) levels were measured in 32 (29 treated, 3 untreated) patients with acromegaly. In 15 patients IGF-I and basal GH values were normal. In 12 patients both GH and IGF-I were elevated. In 5 cases normal basal GH and elevated IGF-I levels were found. We assume that elevated serum level of IGF-I is a reliable sign of acromegalic activity. Compared to this, the basal GH level proved to be a much less reliable indicator to predict or exclude active acromegaly (sensitivity: 0.7, specificity: 1, positive predictive value: 1, negative predictive value: 0.75).

Acromegaly↗
PubMed1988

Effect of simultaneously administered iopanoic acid and thyrotropin releasing hormone (TRH) on thyroid hormone metabolism in euthyroid subjects.

The cause of serum T4 elevation after iopanoic acid administration was searched in euthyroid subjects. 3 gr iopanoic acid was given per os to 9 healthy volunteers (group I), in other 5 volunteers a TRH test was performed prior to iopanoic acid administration (group II). In group I TSH, T4, FT4I and rT3 levels increased, in group II T3 and FT3I decreased, but no TSH, T4, FT4I increase was seen, obviously, because of the exhaustion of pituitary TSH content by TRH. On the ground of the findings T4 elevation caused by iopanoic acid is predominantly consequence of TSH release and not that of inhibited T4 conversion rate.

Adult↗
PubMed1986

Comparison of the serum hormone levels and histological findings in pituitary adenomas.

UNLABELLED: Thirty patients with pituitary adenomas were investigated: 20 with growth hormone producing acromegaly, 7 with prolactinoma and 3 with hormonal inactive adenoma. The correlation between the serum PRL, GH, TSH, levels, their response to 200 micrograms i.v. TRH, measured before the transsphenoidal adenomectomy and the size, the light microscopic (H.E. and Mallory staining), immunocytochemical and ultrastructural (performed in 17 cases) picture of the adenomas were evaluated. CONCLUSIONS: (a) there is no close correlation between the hormone granules detected in the pituitary adenoma cells - by light microscopic, immunocytochemical and electron microscopic methods - and the serum hormone levels, their response to TRH; (b) in hormonally active adenomas the immunocytochemical as well as the ultrastructural findings could be negative; (c) in one disease more hormones could give an immunopositive reaction; (d) in any types of investigated adenomas the TSH immunopositivity was always accompanied by PRL immunopositivity (6 cases); (e) the size and the clinical (serum) or cytological hormone activity of the adenomas were independent of one another; (f) the basal serum hormone level shows the hormonal activity of the pituitary adenoma best of all.

Acromegaly↗
PubMed1986

Differences in pituitary trophormone release between menstruating and non-menstruating acromegalic women.

The reaction of PRL, TSH, GH, LH and FSH has been studied after the administration of TRH and LHRH to 15 acromegalic women of fertile age. According to the presence or absence of menstruation the patients were divided into 2 groups: 8 patients menstruated regularly, 7 had secondary amenorrhoea. The results of the two groups were compare with each other and to findings in a group of healthy controls (9 women). It was found that in secondary amenorrhoea basal PRL values significantly exceeded those registered in the menstruating group and in the controls. PRL reaction was similar in the controls and the secondary amenorrhoea group, but the menstruating patients showed lower values than those of the control group. TSH release did not differ in the three groups. In secondary amenorrhoea paradoxical GH-reaction after TRH-LHRH in the 15th minute significantly exceeded the value of the menstruating group and its whole course pointed to a more intensive reaction. In secondary amenorrhoea both basal LH and FSH secretion as well as LH and FSH release fell far below the values of the menstruating group. The onset of amenorrhoea was not related to the duration of acromegaly. Disturbances of gonadotrophin secretion may be induced by disorders of regulatory mechanisms as well as by the damaging effect of the adenoma on normal pituitary tissue.

Acromegaly↗
PubMed1985

Effects of a 72-hour prostacyclin infusion on the hormone levels in patients with obliterative arterial disease.

Effects of a 72-h prostacyclin (PGI2) infusion (5 ng/kg/min) on hormone levels were studied in 11 patients (5 males, 6 females) suffering from obliterative arterial disease of the lower extremities. ACTH, cortisol, TSH, prolactin (Prl), GH, LH, FSH, T3, T4, calcitonin, parathyroid hormone (PTH), insulin, plasma renin activity (PRA), aldosterone and testosterone levels were measured at -15, 0, 30, 120, 240 min and 24, 48, 72 and 96 h after the infusion. During the first 240 min Prl and GH levels showed an increase that was thought to be either an effect of release of hormones or a consequence of stress. At the same time the thyroid hormones, T3, T4 and calcitonin decreased, presumably owing to an alteration in the blood flow to the thyroid gland. All these hormone levels returned to normal at 24 h in spite of the infusion continuing. PRA increased only during the second half of the infusion. No changes were found in the levels of ACTH, cortisol, TSH, LH, FSH, PTH, insulin, aldosterone and testosterone during the infusion. Five diabetics showed the same hormonal changes as the non-diabetics and their blood sugar levels remained unaffected during and after the procedure.

Adrenocorticotropic Hormone↗
PubMed1985

Growth hormone producing pituitary adenoma and meningioma.

A 59 years old woman is presented with acromegaly caused by an adenoma of the hypophysis, mixed cell-type and with a meningioma fibromatosum localized centroparietally. Both tumours were operated successfully, first the meningioma was removed. The hormone levels did not change after the operation of the meningioma, but normalized after the removal of the hypophysis adenoma. The simultaneously occurrence--without previous irradiation--of such tumours is very rare.

Acromegaly↗
PubMed1985

Liquid crystal thermography of the thyroid.

The results of 102 thyroid liquid crystal thermography (LCT) examinations are discussed. Clinical and laboratory examination, scintigraphy, ultrasonography and LCT were performed in all of the cases. LCT is not suitable for obtaining morphological data and not accurate enough in evaluating thyroid function, but it is a good additional study. It is inexpensive, not hazardous and fast, and can be the first examination in an endocrine outpatient clinic as well as in the follow up of patients with thyroid disease.

Adolescent↗
PubMed1984

Effect of a somatostatin analogue on trophic hormone levels in acromegalic patients with elevated hGH after adenomectomy and treatment with bromocriptine.

Five female acromegalic patients who had undergone surgical adenomectomy, but still had elevated hGH serum levels, were treated with bromocriptine, 5-15 mg daily, for at least 4 months without a satisfactory response. In an attempt to lower serum hGH levels, p-NH2-Phe4-D-Trp8-somatostatin was administered, 100 micrograms as an i.v. bolus, followed by infusion of 250 micrograms over a 4 hour period. The analogue decreased hGH levels by about 50% in 3 out of 5 patients, both during bromocriptine treatment and also in its absence. Of the remaining two patients, one showed a decrease in hGH levels in response to the analogue only during bromocriptine treatment and the other only without it. Saline infusion after bromocriptine administration did not induce a decrease in hGH levels in three of these patients. Somatostatin analogue caused a fall in serum insulin levels in all but one patient, who had diabetes mellitus and in whom serum insulin was undetectable. Both hGH and insulin levels showed a significant rebound after infusion of the analogue, but returned to basal levels within 24 hours. Prolactin did not change during the analogue infusion in 4 patients with normal PRL levels. However, in one patient in whom prolactin and hGH levels were elevated during bromocriptine treatment, the infusion of somatostatin analogue decreased both hormones. The analogue induced no changes in serum TSH, FSH and LH levels of any of the patients.

Acromegaly↗