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Exhaustion and coronary heart disease: the history of a scientific quest.

This paper describes the development of the concept "vital exhaustion", the epidemiological evidence that this state belongs to the precursors of different manifestations of coronary artery disease, and the biological plausibility of the association between exhaustion and coronary artery disease. It further describes the main results of a randomized, controlled trial designed to determine whether a behavioural intervention reduces the risk of a new coronary event.

Six-hour selective REM sleep deprivation increases the expression of the galanin gene in the hypothalamus of rats.

The effect of short-term selective REM sleep deprivation (RSD) on the gene expression of galanin in the rat hypothalamus was examined using in situ hybridization histochemistry. Monitoring an electroencephalogram (EEG) and electromyogram (EMG) on an on-line computer screen, as the RSD rats entered REM sleep, they were gently stroked on their backs using a brush to wake them during the RSD period. Galanin mRNA levels in the preoptic area (POA) were significantly increased by RSD for a period of 6 h. RSD had no significant effect on the mRNA levels of corticotrophin-releasing factor (CRF), argin

The radiological approach to precocious puberty.

Precocious puberty is caused by a heterogeneous group of disorders, which range from idiopathic to malignant tumours. The radiologist's role is to help: (1) differentiate precocious puberty from pubertal variants; (2) identify the underlying cause of precocity if present; and (3) assess for effectiveness of treatment. This pictorial review discusses the types of precocious puberty and their underlying aetiologies, differentiates precocious puberty from pubertal variants and illustrates the appropriate imaging evaluation for the patient diagnosed with precocious puberty.

Brain beta-endorphin and other opioids are involved in restraint stress-induced stimulation of the hypothalamic-pituitary-adrenal axis, the sympathetic nervous system, and the adrenal medulla in the rat.

Opiates and opioids have complex effects on the hypothalamic-pituitary-adrenal axis, and they stimulate the sympathetic nervous system. This study was designed to clarify the role of brain beta-endorphin in the mechanism by which stress increases plasma concentrations of adrenocorticotropin (ACTH), epinephrine (E), and norepinephrine (NE). Intracerebroventricular (i.c.v.) administration of beta-endorphin to rats significantly increased plasma ACTH levels at doses of 0.09, 0.3, and 1.5 nmol, and plasma E and NE levels at doses of 0.3 and 1.5 nmol. The rise of plasma ACTH, E, and NE levels by 0.

Ectrodactyly-ectodermal dysplasia-clefting syndrome and hypothalamo-pituitary insufficiency.

We report on 2 brothers with ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome and hypothalamo-pituitary insufficiency. Both had hypogonadotropic hypogonadism. One brother had partial TSH and prolactin deficiency, and the other had mild primary hypothyroidism, due most probably to irradiation therapy which he had undergone a few years earlier because of Hodgkin disease. The association of hypogonadotropic hypogonadism with EEC was reported once previously. Hypothalamopituitary dysfunction could be considered as yet another manifestation of EEC syndrome. This report reconfirms that EEC

Precocious puberty in children with neurofibromatosis type 1.

We undertook a comprehensive study of children with neurofibromatosis type 1 (NF-1) cared for in a large multidisciplinary clinic to determine the prevalence of precocious puberty and its relationship to optic pathway tumors (OPTs). Precocious puberty was diagnosed in 7 of 219 children with NF-1 (5 boys and 2 girls) examined between Jan. 1, 1985, and April 20, 1993. All seven children had OPTs involving the optic chiasm; they represented 39% of children with NF-1 and chiasmal tumors (95% confidence interval, 17% to 64%). Eleven prepubertal children (aged 2 to 10 years) with NF-1 and OPTs, and

Long-term intracerebroventricular corticotropin-releasing hormone administration induces distinct changes in rat splenocyte activation and cytokine expression.

The effects of long-term corticotropin-releasing hormone (CRH) infusion in the lateral ventricle of the rat on hypothalamic-pituitary-adrenocortical (HPA) axis parameters and on the immune system function were studied. Compared with infusion of vehicle, the CRH treatment produced a sustained overactivity of the HPA axis, as evidenced by elevated plasma ACTH and corticosterone levels, increased anterior pituitary POMC messenger RNA (mRNA) expression, and adrenal enlargement. Long-term CRH treatment also inhibited body weight gain and reduced thymus and spleen weight. In the CRH-treated animals,

Progestin treatment in the dog. II. Effects on the hypothalamic-pituitary-adrenocortical axis.

The effects of two synthetic progestins, medroxyprogesterone acetate (MPA) and proligestone (PROL), on the hypothalamic-pituitary-adrenocortical (HPA) axis were studied in two groups of eight ovariohysterectomized dogs each. Eight injections of long-acting progestins were administered at 3-week intervals. Recovery of the HPA axis was studied in four dogs of each group in the following 6 months. Basal levels of adrenocorticotrophin (ACTH) and cortisol in plasma and the urinary corticoid/creatinine ratio were measured. The responsiveness of the HPA axis was investigated by stimulation with ovine

[The significance and characteristics of the LHRH test in diagnosing precocious puberty development in girls: the stimulated LH/FSH quotient differentiates between central precocious puberty and premature thelarche].

LHRH tests (100 micrograms i.v.) were performed in 31 girls with central precocious puberty (PP); the girls were participating in an international multicentre trial for the treatment of PP with the LHRH agonist decapeptyl in microspheres, together with 18 girls with premature thelarche (PT). Assignment to these two groups was made after 6 months to 5 years of clinical follow-up. LH and FSH were determined centrally using a polyclonal RIA. Basal LH and FSH levels and stimulated LH levels were significantly higher in PP patients (p less than 0.001), but the stimulated FSH levels were not signifi

The hypothalamic-pituitary-adrenal axis in partial (late-onset) 21-hydroxylase deficiency.

Patients with late-onset congenital adrenal hyperplasia (LOCAH) due to partial 21-hydroxylase deficiency have no clinical or biochemical evidence of hypocortisolism. In contrast, patients with the classical forms of CAH frequently develop adrenal insufficiency, characterized by elevated plasma ACTH and low serum cortisol levels. To examine the various components of the hypothalamic-pituitary-adrenal axis in patients with LOCAH, we studied 12 patients with this disorder (10 females and 2 males; age range, 51/2-36 yr). Plasma ACTH and serum cortisol, 17-hydroxyprogesterone (17-OHP), and androste

Treatment of true precocious puberty with a potent luteinizing hormone-releasing factor agonist: effect on growth, sexual maturation, pelvic sonography, and the hypothalamic-pituitary-gonadal axis.

We used the LHRH agonist D-Trp6-Pro6-N-ethylamide LHRH (LHRH-A) to treat 19 children (12 girls and 7 boys) with true precocious puberty. Fourteen patients had idiopathic true precocious puberty, 4 had a hamartoma of the tuber cinereum, and 1 had a hypothalamic astrocytoma. Basal gonadotropin secretion and responses to native LHRH decreased within 1 week of initiation LHRH-A therapy, and sex steroid secretion decreased within 2 weeks to or within the prepubertal range. Ultrasonographic evaluation of the uterus indicated a postmenarchal size and shape in all 11 girls studied before treatment, wh

[The prehypophyseal-gonadal system in the normal male and in some forms of testicular dyscrinism. Evaluation studies in basic conditions and after stimulation].

The secretion values of the two seric gonadotropins and of plasmatic testosterone have been estimated in a casuistry of normal males subdivided in groups of 8 to 95 years of age, and of primitive and secondary testicular dyschrinia. In one part of this casuistry, normal and primitive hypogonadics, we have estimated the response to the intravenous administration of Gn-RH. Among the results which have been obtained, it appears that physiologic hypogonadism of the elderly is a primary phenomenum, not hypophyso-dependent. In the hypophysiary stimulus test, the response of gonadotropins in those ol

Sexual precocity in association with septo-optic dysplasia and hypothalamic hypopituitarism.

Sexual precocity in association with abnormalities of the central nervous system is well known, but its occurrence with hypothalamic hypopituitarism is most unusual. We report five females with septo-optic dysplasia, blindness, and multiple pituitary tropic hormone deficiencies: all were growth hormone and adrenocorticotropic hormone deficient; two had diabetes insipidus; one had sexual precocity, and one had early pubertal maturation, whereas three were prepubertal and responded to administration of synthetic gonadotropin-releasing hormone. These children retained ability to secrete gonadotro

Endocrine disturbances in patients with congenital aqueductal stenosis.

Congenital stenosis of the aqueduct of Sylvius is reported to be associated with sella turcia enlargement and clinical and laboratory abnormalities of the hypothalamic-pituitary-target-organ axis. It is a surgically reversible lesion. In the present report, 3 female patients with this lesion were studied with tests of basal endocrine function, as well as insulin tolerance tests, response to metyrapone and determination of circadian periodicity of plasma cortisol levels. In one patient all testing was normal and no surgery was performed. In 2 other patients the insulin tolerance test revealed e

Dynamic MRI in the congenital agenesis of the neural pituitary stalk syndrome: the role of the vascular pituitary stalk in predicting residual anterior pituitary function.

OBJECTIVE: Magnetic resonance imaging (MRI) without contrast medium is unable to give detailed information on the hypothalamic-pituitary structures. MRI using gadopentetate dimeglumine (Gd-DTPA), and dynamic MRI, were performed in patients with hypopituitarism previously diagnosed as having anterior pituitary hypoplasia, ectopic posterior pituitary and unidentified pituitary stalk (1) to determine whether Gd-DTPA improves the delineation of hypothalamic-pituitary structures; (2) to verify whether, if so, such improvement can be correlated with residual pituitary function in patients subjected

Grading Central Diabetes Insipidus Induced by Immune Checkpoint Inhibitors: A Challenging Task.

Central diabetes insipidus (CDI) is a rare endocrine disease deriving from an insufficient production or secretion of anti-diuretic hormone. Recently, CDI has been reported as a rare side effect triggered by immune checkpoint inhibitors (ICI) in cancer patients. Despite its current rarity, CDI triggered by ICI is expected to affect an increasing number of patients because of the expanding use of these effective drugs in a growing number of solid and hematologic malignancies. An appropriate assessment of the severity of adverse events induced by anticancer agents is crucial in their management,

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… | Central diabetes insipidus | Nephrogenic diabetes insipidus Autoimmune/ Inflammatory ( 2 – 6 ) | •Lymphocytic hypophysitis •Xanthogranulomatous hypophysitis •IgG4 disease •Anti-vasopressin neuron antibodies •Guillain-Barré syndrome | — Congenital (genetic) ( 1 , 7 – 12 ) | •AVP-neurophysin II gene … Out of these side effects, 1,144 (18.8%) were pituitary events, including hypophysitis (835 reports), hypopituitarism (268 reports), pituitary enlargement ( 52 ), other ( 18 ), while CDI was reported in 7 out of 1,072 (0.7%) of the registered hypophysitis/hypopituitarism cases. …

Reversal of chronic restraint-induced HPA axis dysregulation and depressive-like behaviour by chronic escitalopram treatment in rats: involvement of SERT.

Chronic restraint stress (CRS) upregulates serotonin transporter (SERT) in adrenal glands and sensitizes restraint-induced corticosterone (CORT) secretion. We analysed the effect of chronic escitalopram (ECT) treatment on these CRS-induced changes. Rats were submitted to CRS or control conditions (CTRL) for 14 days; at day 8, animals received vehicle (VEH) or ECT treatment for 7 days. On day 15, SERT expression in adrenals was analysed by immunohistochemistry, Western blot, and RT-PCR; baseline and restraint-induced ACTH and CORT secretion was also determined. The effect of ECT on 5-HT turnove

Androgen loss accelerates brain tumour growth via HPA axis activation.

Many cancers, including glioblastoma (GBM), show a male-biased incidence and associated worse outcomes1. The mechanisms that underlie this sex difference remain unclear but may involve an immune response2 that is partly driven by sex hormones such as androgens. Such hormones are thought to suppress antitumour T cell immunity and to promote tumour progression3,4. However, here we report a previously unreported tumour-suppressive role for androgens in brain tumours. Using mouse models, we demonstrate that androgen loss via castration accelerates intracranial tumour growth, whereas the opposite e