A clinicomorphological study of pituitary tumors associated with the clinical syndrome of acromegaly.

Transsphenoidal adenomectomy was done on 125 acromegalics. A clinicomorphological study was performed on 113 of these patients. The distribution of morphological types of tumors was similar in both sexes. In the total group it was: sparsely granulated GH cell adenomas 52.8%, densely granulated 25.7%, mixed somatotroph and lactotroph adenomas 15.9%, plurihormonal adenomas 1.8%, acidophil stem cell adenomas 2.6%, and oncocytoma 1.8%. The GH plasma level in male patients was significantly higher than in female patients. In both sexes GH secretion was highest in patients with mixed GH and PRL cell adenomas followed by patients with densely granulated GH cell adenomas. Plasma PRL levels were significantly elevated in all males, except for those with densely granulated GH adenomas where prolactinemia was normal. The mean plasma PRL levels were also elevated in females with highest values in mixed somatotroph and lactotroph adenomas. The PRL levels in female patients with densely granulated GH cell adenomas are more elevated than in female patients with sparsely granulated GH cell adenomas.

Corticotropin-releasing factor (CRF) stimulation test in normal subjects and patients with Cushing's syndrome.

The hormonal responses to human corticotropin-releasing factor (hCRF) were investigated in 6 normal subjects, 13 patients with Cushing's disease (8 with diffuse bilateral hyperplasia and 5 with nodular hyperplasia) and one patient with Cushing's syndrome due to an adrenal adenoma. hCRF (100 micrograms i.v.) was a potent stimulant of ACTH and cortisol in normal subjects. Patients with Cushing's disease due to diffuse hyperplasia showed variable ACTH and cortisol responses to hCRF. In both normal subjects and in patients hCRF consistently stimulated serum aldosterone levels. Patients with nodular hyperplasia had extremely suppressed plasma ACTH levels and no responses of ACTH, cortisol and aldosterone to hCRF like in the patient with adrenal adenoma. Our results suggest that hCRF-stimulation test may be a useful tool for differentiating pituitary and adrenal forms of Cushing's syndrome.

FSH and LH responses to LH--RH stimulation during intravenous estrogen administration in women with polycystic ovary syndrome before and after ovarian wedge resection.

FSH and LH responses to LH--RH stimulation were investigated at 0,3rd and 6th hrs in a six hours exogenous intravenous administration of 300 mg conjugated estrogens before ovarian cuneiformic resection and on the 10th day thereafter in seven patients with polycystic ovarian syndrome. Before operation exogenous pituitary LH--RH stimulation following estrogen administration increased the serum FSH concentrations and response, and decreased LH concentrations and response, while after operation a slight increase of FSH response with a concomitant excessive LH response was observed. A dual action of estrogens in modifying the pituitary gonadotrophins, as well as hypothalamic LH--RH release was supposed.