Increase of proopiomelanocortin-related peptides during subjective menopausal flushes

The present study reports the plasma levels of gonadotropins (luteinizing hormone, follicle-stimulating hormone), proopiomelanocortin-related peptides (adrenocorticotropic hormone, beta-endorphin, and beta-lipotropin), and cortisol in eight menopausal women experiencing frequent hot flushes. beta-Endorphin and beta-lipotropin levels were measured by radioimmunoassay after extraction and Sephadex G-75 column chromatography. Plasma levels of adrenocorticotropic hormone (after extraction), luteinizing hormone, follicle-stimulating hormone, and cortisol were measured by specific radioimmunoassay. All hormone levels showed a prompt and significant rise on occurrence of hot flushes (18 total recordings), remained high for 15 minutes, and decreased to basal levels 35 minutes later. The evaluation of the behavior pattern of single hormone levels revealed a more pronounced increase of proopiomelanocortin-related peptides and cortisol than of gonadotropins (p less than 0.01).

Impaired circadian rhythmicity of beta-lipotrophin, beta-endorphin and ACTH in heroin addicts

The circadian rhythm of plasma proopiocortin-related peptides was studied in 15 heroin addicts and in 6 sex- and age-matched controls. ACTH, beta-lipotrophin, (beta-LPH), beta-endorphin (beta-EP) and cortisol were measured by RIA either directly (cortisol), or after plasma extraction (ACTH) and Sephadex G-75 gel chromatography (beta-LPH and beta-EP) every 4 h from 8 a.m. to 8 p.m. and again at 8 a.m. the next morning. The means of the two 8 a.m. measurements of beta-LPH (2.67 +/- 0.34 fmol/ml, mean +/- SE), ACTH (2.74 +/- 0.71) and cortisol (218 +/- 31 pmol/ml) levels in heroin addicts were significantly lower than those in controls (6.28 +/- 0.61, 10.1 +/- 0.74 and 364 +/- 27, respectively, P less than 0.01) while beta-EP concentrations in heroin addicts (5.1 +/- 0.6) were similar to those of healthy volunteers (6.44 +/- 0.56). In controls, all three peptides and cortisol show a circadian rhythm of secretion, the lowest values being in the evening and the highest ones in the morning. Heroin addicts partially lack this phenomenon showing constant levels of the three proopiocortin-related peptides throughout the day, with a slight but significant decrease of plasma cortisol. In the 7 subjects who took heroin throughout the study, no systematic changes were observed in the three proopiocortin-related peptides, while it seems that this group of addicts shows a cortisol decrease in the evening to a lesser extent than subjects receiving methadone maintenance only.(ABSTRACT TRUNCATED AT 250 WORDS)

Lack of correlation between amniotic fluid and maternal plasma contents of beta-endorphin, beta-lipotropin, and adrenocorticotropic hormone in normal and pathologic pregnancies

Reported are the concentrations of beta-endorphin, beta-lipotropin, and adrenocorticotropic hormone (ACTH) in the amniotic fluid and plasma of 40 healthy pregnant women at different stages of gestation. Moreover, the amniotic fluid levels of the three peptides were evaluated in 20 other pregnant women affected by different pathologic conditions (Cooley's disease, gestosis, diabetes, placental insufficiency, etc.). A silicic acid extraction procedure was performed on the samples. Each extract was subjected to Sephadex G-75 column chromatography, and the two fractions corresponding to beta-lipotropin and beta-endorphin were collected, freeze-dried, and assayed by two specific radioimmunoassays. Levels of ACTH were measured by radioimmunoassay directly on the extracts. Levels of beta-endorphin in amniotic fluid showed the highest values in the first trimester (173 +/- 30 fmol/ml, mean +/- SEM) but were significantly decreased in the second (75.2 +/- 14) and third trimesters (14.3 +/- 1.8). An inverse trend characterized plasma levels of beta-endorphin, which showed a progressive increase from the first trimester to term (10.4 +/- 11.1). Amniotic fluid levels of beta-lipotropin remained stable during the first (48.6 +/- 6.3) and second (54.6 +/- 11.1) trimesters, but decreased significantly in the third trimester (17.9 +/- 2.3). The plasma concentrations of beta-lipotropin showed the highest levels in the first trimester (10.9 +/- 0.9), and decreased significantly at term (8.9 +/- 1.3). Last, amniotic fluid levels of ACTH decreased from 55.3 +/- 4.75 fmol/ml in the first trimester to 12.5 +/- 1.16 in the second trimester, and rose again in the third trimester to 34.4 +/- 6.6 fmol/ml. Plasma levels of ACTH were characterized in the first two trimesters by values twice those recorded for nonpregnant women, and decreased at term to 8.9 +/- 1.4 fmol/ml. In the pregnant patients with fetuses affected by Cooley's disease (second trimester) and in those with edema-proteinuria-hypertension (EPH) gestosis (third trimester), amniotic fluid levels of beta-endorphin, beta-lipotropin, and ACTH were in the same range as those in healthy pregnant women.

Circadian rhythm of testosterone and prolactin in the ageing

The role which testicular hormones have on the decrease of sexual function in ageing men is still uncertain, but of primary interest. Previously, it has been known that the impairment of Leydig cell activity is a causal factor in the decreasing sexual function in ageing men. The present study is an evaluation of some chronobiological aspects, which directly or indirectly concern the 'Gonadostat' in ageing men, in order to determine of any change of the hypothalamic-pituitary axis occurs during the ageing process. The results from a group of 18 young men aged between 21 and 37 were compared with the results from a group of 28 older men between the ages of 67 and 98. The daily variations of testosterone (T) levels were determined in both groups of men as its circadian rhythm is well known in adult men. Moreover, the nocturnal secretory pattern of prolactin (PRL) was studied in 6 of the 28 elderly men. When comparing the usual increase of T levels in adult men, which occurs in the morning, there were no significant differences found in the older group of men between early morning and evening. The PRL levels showed no nocturnal increase in 4 of the 6 men. A hormonal impairment in the central nervous system may, in fact, be associated with the testicular deficiency leading to the decrease in sexual function of ageing men.

Endocrinological features and endometrial morphology in climacteric women receiving hormone replacement therapy

Prolactin (PRL), follicle stimulating hormone (FSH), luteinizing hormone (LH), oestrone (E1), and oestradiol (E2) levels were determined in 204 women who were receiving hormone replacement therapy for their climacteric symptoms. The changes in these hormone levels and the endometrial morphology were studied in order to determine the effects of the replacement therapy. The women were divided into two groups: the first group of 120 women was treated with conjugated oestrogens administered cyclically, plus norethisterone acetate. The second group of 84 women received oral oestriol succinate, also administered cyclically but without additional progestogens. The oestrogen-progestogen therapy resulted in a disappearance of the climacteric symptoms and a significant decrease of FSH and LH levels. Oestriol therapy was less effective than the conjugated oestrogens as a replacement therapy. Oestriol therapy also resulted in a less remarkable decrease of gonadotrophin levels. There were no significant changes in prolactin levels in either group of women. The endometrial histology did not change significantly after either of the two hormone replacement therapies.

An intrauterine progesterone contraceptive system (52 mg) used in pre- and peri-menopausal patients with endometrial hyperplasia

An intrauterine progesterone contraceptive system (IPCS) (52 mg) was inserted in 25 women with cystic endometrial hyperplasia. Among these women, 11 complained of heavy climacteric symptoms and also received an oestrogen replacement therapy consisting of conjugated oestrogens (0.625 mg/day) administered cyclically for 3 out of 4 wk. Prior to the therapy and after 6 mth of treatment, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), oestrone (E1) and oestradiol (E2) plasma levels were measured and endometrial histology was evaluated. In the women receiving IPCS treatment alone, there were no significant changes in FSH, LH, PRL, E1 and E2 plasma levels. However, there were remarkable changes found in their endometrial histology. In the remaining women receiving both treatments there was a sharp decrease in FSH and LH plasma levels and an increase in E1 and E2 plasma levels, while the prolactin levels remained unchanged. With the exception of two of these women, the endometrial histology changed remarkably. The endometrial morphology of the two exceptions remained unchanged. All climacteric symptoms disappeared after the administration of both IPCS and the oestrogen replacement therapy. The remarkable changes which did occur in the endometrial histology resulted in a less active glandular epithelium and stromal decidual formation, thus proving a useful effect of treatment.

Prolactin and certain obstetric stress conditions

Prolactin levels were evaluated during certain stress conditions, obstetric or gynecologic surgical interventions, labor, and birth. In 68 patients undergoing voluntary abortion, prolactin levels were measured to study the effect of anesthetics and of dilatation and curettage on hormonal secretion. Prolactin levels were evaluated in five patients undergoing elective cesarean section and in five post-menopausal patients undergoing total abdominal hysterectomy with bilateral oophorectomy. Moreover, prolactin concentration in serial samples of blood was estimated in 32 normal patients with spontaneous vaginal delivery at term and in 16 newborns at term after 30-60 and 120 min following birth. Prolactin responsiveness to TRH was evaluated in 12 newborns at the 4th day of life. Plasma prolactin levels rose in all the stress conditions investigated except in labor, during which hormone levels showed a decrease starting 2 h before delivery and reaching the lowest value 1 h prior. From this moment on there was a remarkable rise in prolactin concentration, with a peak 1 h after delivery. The decrease in prolactin levels during labor could possibly be due to an increase in dopaminergic activity. Moreover, the finding of no variation of prolactin levels during induced abortion in a group of patients pretreated with methysergide supports the view that the serotoninergic system also affects prolactin release.

[Prolactinomas and "idiopathic" hyperprolactinemia. Case series]

Endocrine features in 22 women affected by idhyopatic hyperprolactinemia and in ten women affected by prolactin secreting adenoma have been assessed basic levels of FSH, LH, E2, T3, T4, and PRL were evaluated and dynamic tests by GnRH, TRH and bromocryptine were performed prolactin basal value and TRH dynamic test show some value in differentiating hydiopatic hyperprolactinaemia from prolactynomas, but no hormon by itself nor dynamic test show a reliable effectiveness for this diagnosis.

Behaviour of HPL and GH plasmatic rate in pregnant women at different times of their pregnancy during dynamic tests

The authors have studied the effects of an oral or intravenous glucose load, of insulinic hypoglycemia, of arginine and the effects of the 2-deoxi-glucose on the plasmatic concentration of HPL and GH on pregnant women at different times during their pregnancy. None of the used tests seemed able to modify in any way the plasmatic concentration of the placental lactogen hormone; the somatotropinic response to the different stimuli happens to be lower than that found in non pregnant women of the same age. We and by asserting that unlike what happens with the GH, there does not exist a direct "feedback" between the modifications of plasmatic concentration of the main underlayers and HPL.

[Longitudinal study of 5 patients with "primary empty sella" (author's transl)]

The clinical symptoms and the radiographic findings of five female patients with "primary empty sella" were studied. The patients were treated with corticosteroid therapy and the clinical syndrome, with the exception of optic subatrophy of the left eye in one patient and of both eyes in another patients, improved in all of them. In subsequent controls, the radiographic findings did not show any evolution suggesting that the cause of the empty sella syndrome is a potentially regressive element (endocranial hypertension?). The small number of our cases does not prove with any certainty that corticosteroid treatment, was beneficial but as improvement occurred and in all the subjects this therapy should be tried in other patients with "empty sella" syndrome. The possible improvement of the empty sella syndrome has to be taken into account before deciding on surgical intervention.

Surgical treatment of congenital club foot. (Comparison of the results of Codivilla's operation with those of Turco's modification)

The purpose of this paper is to compare the results of the classical Codivilla operation with those obtained from the same operation as modified by Turco. The authors have assessed ninety one feet in sixty eight patients treated between 1968 and 1975. The severity of each foot was assessed before and after corrective treatment according to the classification of Manes et al., 1975. The results were determined according to the classification of Mastragostino et al., 1976, based on the clinical, radiographic and functional findings. In this connection, the authors attached particular importance to the dorsiflexion test. Based on their findings in this survey, the authors assert that Turco's modification of the classical Codivilla operation enhances the results.