[Study of the dopaminergic system in various neuroendocrine diseases using the sulpiride test]. / Izuchenie dofaminergicheskoi sistemy pri razlichnykh neiroéndokrinnykh zabolevaniiakh s pomoshch'iu testa s sul'piridom.

Altogether 25 patients with acromegaly, 19 patients with prolactinomas, and 6 patients with nonfunctioning hypophyseal tumors (NHT) were investigated. Dopaminergic regulation of PRL, STH, TSH, LH and FSH was investigated with sulpiride (an antagonist of peripheral action) in all the patients. In acromegaly, irrespective of the presence of hyperprolactinemia, one can observe dysfunction of the central dopaminergic system (DAE) and DAE-regulation of adenohypophyseal hormones. Signs of disordered hormonal DAE-regulation are disorder of the normal ejection of PRL and pathological ejection of TSH in response to administration of DA antagonists. The results of investigations revealed both an enhanced tone of the DAE-system and insufficiency of DAE-control of hormonal secretion in patients with different hypophyseal tumors and other neuroendocrine diseases.

[Results of remote gamma-therapy in acromegaly patients]. / Rezultaty distantsionnoi gamma-terapii u bol'nykh akromegaliei.

A study was made of the condition of 44 acromegalic patients at various time after gamma-beam therapy. It has shown that therapeutic efficacy depends on initial sizes of adenomas and the level of growth hormone as well as on the time of observation. At late terms after therapy normalization of the level of growth hormone was observed in 41% of patients, clinical improvement in 44%, the absence of and effect in 15%. Radiation therapy resulted in a decrease in some hypophyseal functions in some of the patients and postradiation hyperprolactinemia in 56% of patients with the normal level of prolactin before therapy. The main shortcoming of radiation therapy was the length of time, necessary for achieving a therapeutic effect.

[The sexual function of men with acromegaly]. / Sostoianie polovoi funktsii u muzhchin, bol'nykh akromegaliei.

Some acromegalic male patients (50%) have weakened sexual function accompanied by a decrease in the levels of LH, FSH and testosterone. Hyperprolactinemia of various degrees was observed in 11 of 13 patients (84%). The summary index SFM (the male sexual formula) and a PRL level showed negative correlation. There was no significant difference in LH response to LH-RH administration between patients with normal and disturbed sexual function. Radiation therapy, in particular proton-beam therapy, produced no negative influence on male sexual function in a long-term period after therapy.

[The results of hypophyseal irradiation with a proton beam in acromegaly patients]. / Rezul'taty oblucheniia gipofiza protonnym puchkom u bol'nykh agromegaliei.

The investigation of 26 acromegalic patients long after irradiation of the pituitary body with a proton beam showed clinical and hormonal improvement in 38% of the patients, clinical improvement without complete growth hormone normalization in 46%, and the absence of any effect in 15%. The latter was mainly a result of partial irradiation of pituitary adenoma. Some patients after proton irradiation demonstrated signs of adenohypophyseal functional insufficiency, more marked in patients with a decreased level of Gy (over 5 ng/ml). A conclusion is that proton beam therapy is effective (provided all criteria for patients' eligibility are observed) and can be used as an independent method for the treatment of acromegalic patients.

[The soft tissues of the foot in acromegaly]. / Sostoianie miagkikh tkanei stopy pri akromegalii.

X-ray investigation of foot soft tissues and measurement of foot soft tissue thickness (FSTT), clinical examination and determination of the level of plasma STH were performed in 43 previously untreated patients with acromegaly and in 9 patients in clinical remission. The results obtained suggest that elevated FSTT over 22 mm and changes in foot soft tissues are characteristic for acromegaly. A conclusion is that determination of the state of foot soft tissues and a FSTT value can serve as an auxiliary sign for the diagnosis of early stages of disease as well as for the assessment of a degree of activity and efficacy of long-term results of therapy of acromegaly.

[Endocrine function in the late period after radiation therapy of acromegaly]. / Endokrinnye funktsii v otdalennye sroki posle luchevoi terapii akromegalii.

The results of treatment of pituitary adenomas manifested by the acromegaly syndrome with catamnestic follow-up of up to 10 years are discussed. The dynamics of changes in acromegaly and various endocrine functions with the use of distance gamma therapy and proton beam irradiation were studied in the comparative aspect, on the basis of which the indications for these methods of radiotherapy in acromegaly were specified.

[Mechanisms of disturbance of the secretion of prolactin in patients with acromegaly]. / Mekhanizmy narusheniia sekretsii prolaktina u bol'nykh akromegaliei.

Metoclopramide (DA-antagonist, M) tests were performed in 21 patients with acromegaly and in controls; the levels of adrenohypophyseal hormones were determined before and after drug administration. Irrespective of the basal level of prolactin (P) all the patients demonstrated a decrease in stimulated P secretion which was more noticeable in patients with hyperprolactinemia. The hyperergic response of TSH to M administration was observed in some of the patients with acromegaly. Such a response indicated an elevated tone of the dopaminergic (DA) system. The results obtained were suggestive of dysfunction of DA regulation of P secretion in all the patients with acromegaly.