RESUMO
Among women with 46,XY gonadal dysgenesis, there is a high incidence of gonadal tumors. Because of evidence of a connection between occurrence of those tumors, H-Y phenotype, and breast development, we surveyed 55 cases of 46,XY gonadal dysgenesis and 12 related cases involving chromosomal and/or skeletal abnormalities. Our survey, including three new cases presented here, indicates that H-Y phenotype but not breast development may be related to the development of the gonadoblastoma-dysgerminoma. Thus among women with 46,XY gonadal dysgenesis, there are H-Y- and H-Y+ classes, but gonadal tumors are found almost exclusively in the H-Y+ class. Yet one of our patients may represent an exception to the association of H-Y+ phenotype and gonadal tumors in this syndrome.
Assuntos
Mama/crescimento & desenvolvimento , Disgerminoma/genética , Disgenesia Gonadal 46 XY/genética , Disgenesia Gonadal/genética , Antígeno H-Y/genética , Neoplasias Ovarianas/genética , Adolescente , Adulto , Transformação Celular Neoplásica , Criança , Di-Hidrotestosterona/análise , Disgerminoma/etiologia , Estradiol/análise , Estrona/análise , Feminino , Disgenesia Gonadal 46 XY/metabolismo , Humanos , Hidrocortisona/análise , Neoplasias Ovarianas/etiologia , Fenótipo , Prolactina/análise , Testosterona/análiseRESUMO
Of 1,203 patients who received radiation treatment for acne vulgaris between 1940 and 1968, 302 patients were recalled and examined, 121 at Geisinger Medical Center and the remainder by their local physicians. Radiation records were reviewed on all patients. Lead-rubber and cones had been used as shielding. Mean age at the time of exposure was 21 years and mean total exposure was 692 R. Palpable nodular thyroid disease was found in eight patients (2.6%). Of these, thyroid carcinoma was detected in two patients (0.66%). Although the number of patients examined was small, the incidence of carcinomas was unexpectedly high. We conclude that follow-up examination is worthwhile for patients previously treated by irradiation for acne vulgaris.
Assuntos
Acne Vulgar/radioterapia , Lesões por Radiação/etiologia , Doenças da Glândula Tireoide/etiologia , Adenoma/etiologia , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/etiologia , Neoplasias da Glândula Tireoide/etiologia , Fatores de TempoRESUMO
We investigated the participation by endogenous opioid peptides in the control of prolactin and gonadotropin secretion in 5 normal men and 6 normal women, and in 4 men and 5 women with persisting hyperprolactinemia following transsphenoidal pituitary microsurgery for prolactinomas. Iv administration of the specific opiate-receptor antagonist, naloxone hydrochloride (0.2 mg/kg bolus), failed to affect serially sampled serum prolactin levels in normal male or female subjects. With prolactinoma patients, naloxone suppressed hyperprolactinemia to 37% and 32% of mean control values in 2 of 4 males, but in none of 6 females. When luteinizing hormone was serially sampled under the same conditions, 5 of 5 normal males (but no female, normal or abnormal) demonstrated a monophasic increase in serum LH concentrations after injection of the antagonist. The LH peak was 55 +/- 4% above basal levels (p less than 0.01). In contrast to normal men, only one of 4 hyperprolactinemic male patients manifested a stimulatory response of LH to naloxone. Among all 20 subjects, none exhibited a change in FSH levels acutely after naloxone. These data suggest that: i) naloxone will not fulfill its postulated role as an ideal therapy of hyperprolactinemia and hypogonadotropism, at least in women; ii) endogenous opioids may participate in the neuroendocrine regulation of LH secretion in the normal human, iii) male-female differences may modify the role of endogenous opioids; and iv) some male patients with hyperprolactinemia exhibit defective opioid-related neuroregulation of LH secretion.
