Size of the sella turcica and its relation to iron deficiency anemia: a prehistoric example

This paper examines the usefulness of volume and area assessments of the sella turcica from radiographs in order to aid in the differential diagnosis of iron deficiency anemia in past populations. Lateral and posterior-anterior radiographs were taken of each cranium in the sample. The length, depth, and width of the sella turcica were then measured directly from the appropriate view, and subsequently the volume and area were calculated for each. The 20-25 year-old cohort was found to yield the most promising results; however, a statistical difference was not found to exist using the volume or area. The width dimension was found to be of far more use than any other in this study. In no instance was any feature of typical porotic hyperostosis, visually or radiographically, found to be statistically correlated with any difference in the dimensions of the sella turcica. A discussion of how the various dimensions of the sella turcica react to changes in size of the hypophysis cerebri is presented.     

Association of adverse perinatal events with an empty sella turcica in children with growth hormone deficiency

High-resolution computed tomography (HR-CT) of the hypothalamo-pituitary region was performed in 26 consecutive children presenting with growth hormone deficiency (GHD) at one clinic. 58% had an empty sella turcica (ES) and 42% a full sella turcica (FS). There was no difference between the ES and FS groups for mean (+/- 95% confidence limits) presentation age (ES 6.7 (+/- 1.8) years, FS 5.6 (+/- 2.2) years), height standard deviation score (SDS) (ES -3.9 (+/- 0.8), FS -3.3 (+/- 0.5] nor head circumference SDS (ES -1.9 (+/- 1.1), FS -0.7 (+/- 1.1]. There were significant associations between the ES group and a history of adverse perinatal events (p less than 0.001) and multiple pituitary deficiency (p = 0.014). Growth hormone response to an acute growth hormone releasing factor test showed no association with HR-CT diagnosis. Sella turcica volumes were calculated from the HR-CT scans. All sella volumes were small; mean SDS for height was -2.6 (+/- 0.2). There was no difference in sella volume SDS between the ES and FS groups (ES -2.9 (+/- 0.3), FS -2.5 (+/- 0.4]. Adverse perinatal events may cause an ES and GHD by compromising the blood supply to the pituitary gland or infundibulum.     

Responses of growth hormone to metoclopramide in normal women and amenorrheic women with or without hyperprolactinemia

Response of growth hormone (GH) release to metoclopramide (MCP), a dopamine antagonist, was evaluated in normal women, hyperprolactinemic-amenorrheic patients with pituitary microadenoma and normoprolactinemic-amenorrheic patients. Mean basal concentrations of serum GH and prolactin (PRL) in amenorrheic patients were not significantly different from those in normal women except PRL concentrations in hyperprolactinemic patients. Serum GH concentrations significantly increased after MCP administration in normal women and normoprolactinemic-amenorrheic patients, but not in hyperprolactinemic patients. Dopamine causes modest and transient GH secretion in some subjects. Therefore MCP is not likely to stimulate GH secretion through its effect as a dopamine antagonist, and the mechanism of action of MCP on GH secretion is not known. Although the cause of the absence of GH response to MCP in hyperprolactinemic patients is unclear, it may be related to the increased hypothalamic dopaminergic tone which is operative in such patients or it may reflect a direct action of PRL on hypothalamic-pituitary GH regulation.     

Clinical use of metoclopramide test in the diagnosis of women with hyperprolactinemia

14 women with elevated prolactin (PRL) serum levels (greater than 25 ng/ml) were given 2.5 mg of metoclopramide, by bolus intravenous injection, to evaluate its diagnosic potential as a stimulus for PRL release. Following metoclopramide injection there was a prompt increase in serum PRL in normal subjects and in patients with moderate PRL elevations associated with galactorrhea-oligomenorrhea. The women with amenorrhea-galactorrhea regardless of the presence of absence of a pituitary tumor, showed a blunted response. Metoclopramide failed to induce TSH secretion in all cases. In conclusion: the use of the metoclopramide test provides no additional clinical information to that furnished by the basal serum PRL concentration for the hyperprolactinemic patient.     

Prostaglandin metabolism in relation to the bowel habits of women

A relationship between the menstrual cycle, changes of bowel habits and concentrations of plasma prostaglandin (PG)E2, PGF2 alpha, 6-keto-PGF1 alpha and thromboxane (TX)B2 in 3 groups of 8 women with different bowel habit were determined. The concentrations of PGE2, PGF2 alpha and TXB2 were significantly higher in the group who had bowel habits smoother than usual at menses compared to those who had experienced constipation throughout cycle or at menses. However, no differences between at mid-cycle and at menses were observed in the groups who had experienced constipation. These results suggest that constipation of young women is related to the inherited inability of patients to synthesize and secrete PGs in plasma and possibly in small intestine.     

Effect of pretreatment with metoclopramide on plasma prolactin response to methergoline

The Authors examined 20 voluntary women without endocrine diseases. The women took 4 mg of metergoline orally and 30-60-90-120-180-240 minutes after the medicament was given the serum prolactin levels were tested. After 3 weeks, 14 among 20 subjects repeated the test assuming during the 3 days before 50 mg of metoclopramide orally once a day. The Authors found a remarkable decline of prolactin serum levels after metergoline administration in all subjects. After metoclopramide administration prolactin serum levels increased meaningly. Metergoline administration gave again considerable fall of prolactin serum levels in the 14 subjects. From the data the Authors affirm that metergoline inhibits prolactin secretion with an antiserotonine action     

Clinical Characteristics and Pituitary Dysfunction in Patients with Metastatic Cancer to the sella

ObjectiveMetastatic disease to the sella is uncommon and there are limited available data regarding the clinical aspects of this disease. We therefore sought to characterize the clinical demographics of sellar metastases.MethodsRetrospective chart review of adults treated at Stanford University Medical Center from 1980 to 2011 with metastatic disease to the sella.ResultsA total of 13 subjects were identified (9 females). The mean age at diagnosis was 55 years (range, 25 to 73 years). A total of 6 patients (46%) had breast car-cinoma, 3 (23%) had renal cell carcinoma, 2 (15%) had squamous cell carcinoma of the head and neck, 1 had bronchoalveolar carcinoma of the lung, and 1 had nodular sclerosing Hodgkin’s lymphoma. The most common presenting signs and symptoms were headache (58%), followed by fatigue (50%), polyuria (50%), visual field defects (42%), and ophthalmoplegia (42%). Seventy-five percent of patients presented with at least one pituitary hormone insufficiency, which included 6 patients (50%) with diabetes insipidus (DI). Eight (67%) subjects had secondary hypothyroidism and 5 (45%) had secondary adrenal insufficiency. Of the patients with stalk involvement, 86% had DI. All patients had a prior diagnosis of malignancy, with a mean duration of 95 months.ConclusionThe most common neoplastic sources to the sella were breast and renal cell carcinomas. Secondary hypothyroidism was the most common endocrine abnormality, followed by DI and adrenal insufficiency. Newonset central hypothyroidism and DI along with known malignancy in a patient with a sellar lesion should raise the suspicion of a metastatic source. (Endocr Pract. 2013; 19:914-919)     

Immunocytochemical localization and spatial relation to the adenohypophysis of a somatostatin-like and a corticotropin-releasing factor-like peptide in the brain of four amphibian species

Summary The distribution of somatostatin (SRIF) — and corticotropin-releasing factor (CRF)-like — immunoreactive material was studied in the brain of four amphibian species (Ambystoma mexicanum, Pleurodeles waltlii, Xenopus laevis, Rana ridibunda) by use of immunocytochemistry. A wide network of SRIF-immunoreactive fibers and numerous perikarya were observed in all amphibians examined, with a dense accumulation of nerve endings in the external layer of the median eminence (ELME). In the representatives of the four amphibian species the CRF-like system was more circumscribed. Immunoreactive perikarya were present in the preoptic area, mainly in a ventrobasal position, and in the interpeduncular nucleus. The tract running along the ventral part of the tuber cinereum ends in the ELME facing the rostroventral lobe of the pars distalis that contains corticotrophs. CRF fibers were scarce or absent in the neural lobe. In all species studied in the present work, CRF fibers end in the area of the ELME close to the pituitary lobe containing corticotrophs. This correlation is similar to that reported for the Japanese quail and several teleosts.This work was supported by a grant from the Belgian Nationaal Fonds voor Geneeskundig Wetenschappelijk Onderzoek and the CNRS     

Functional activity of rat adenohypophysis cells in a primary monolayer culture and the effect of several regulators on it]

Some peculiarities of labeled growth hormone (GH) and prolactin (PL) secretion in the 5-day monolayer culture of the rat adenohypophysis was studied. The hormones from the culture medium were obtained by electrophoresis on polyacrylamide gel. Natrium-dibutyril of cyclic adenosine-3',5'-monophosphate and theophylline, stimulated the GH and PL secretion. Thyrotropin-releasing hormone (TRH) increased the incorporation of 14C-1-leucine into the cell protein, stimulated PL secretion, but did not act on the GH release. Somatostatin completely abolished the GH secretion mediated by theophyllin, but not that of PL. Some peculiarities in the formation of labeled GH and PL pool in the cells and secretion of these hormones into the culture medium are discussed.