[Prolactin adenoma in a 14-year-old boy]

Prolactin dosage in delayed growth and puberty leads to the diagnosis of pituitary prolactinoma in a 14 years old boy. Adenoma's size, visual disturbance leads us to elect surgical treatment but persistent hyperprolactinemia after surgery requires medical treatment with bromocriptine.

[Value of the assay of urinary gonadotropins in pediatric endocrinology]

An assay for urinary gonadotropins (UG) performed after acetone extraction is presented. This dosage was performed either on a sample of the 24 assay urine, or on the fractionated 12 hr/12 hr urines (night/day) in normal children whose ages ranged from 2 to 20 years and in children presenting with various endocrine diseases (on about 2,000 urine samples). Normal values were established according to sex and stage of puberty. In boys, the lack of overlap between values of LH (UI/24 hr) observed in stage I (prepubescent, 9-13 yrs) and those observed in stage II represents an obvious biological marker of the onset of puberty. The night/day ratio of LH also increases close to puberty, reflecting the onset of the well-known night secretion of LH, at the time of the first stages of puberty. In girls, the preferential increase in FSH is the best criterion for the onset of puberty. In children with endocrine diseases, assay for UG/24 hr is a valuable parameter of the gonadotropic function allowing 1. to separate delayed puberty from hypogonadotropic hypogonadism; 2. to confirm a diagnosis of precocious puberty and 3. to control a treatment with LHRH analogous.

[Medroxyprogesterone acetate. Contributive treatment in congenital adrenal hyperplasia caused by 21-hydroxylase deficiency in children]

Among 59 children presenting with congenital adrenal hyperplasia due to 21-hydroxylase deficiency observed between 1976 and 1982, 12 (9 males, 3 females) aged 3 1/2 to 12 years, were treated with medroxyprogesterone acetate (MPA) associated with the usual glucocorticoid and eventually mineralo-corticoid treatment. There were two indications: precocious puberty after the onset of the gluco-mineralo-corticoid treatment; Unbalanced biological status with advancement of bone maturation. After the onset of MPA, a decrease in plasma 17-hydroxyprogesterone (17 OHP) and testosterone levels is observed, the bone maturation speed decreases when growth in height continues. MPA may be a contributive treatment for congenital adrenal hyperplasia due to 21-hydroxylase deficiency, permitting restoration of biological balance by restraining adrenal function and improving the final height prognosis.

[Somatocrinin and children in 1984. Application to the etiological diagnosis of somatotropin deficiencies]

A single acute IV injection (1 microgram/kg) of the synthetic replicate of Somatocrinin (GRF) in 40 children with growth hormone (GH) deficiency induces a marked plasma GH increase, although heterogeneous. Clinical tolerance is excellent. Compared to Propranolol + Glucagon (P + G), GRF induces a better GH response. It also discriminates better idiopathic GH deficiency (n = 13), where mean GH peak = 6.5 ng/ml (3.3 after P + G) from GH deficiency secondary to a brain tumor (n = 24) where mean GH peak = 15.5 ng/ml (5.0 after P + G) GRF induces a slight Prolactin (Prl) increase, more obvious when basal Prl is elevated. However there is no correlation between GH and Prl responses to GRF even with basal hyperprolactinemia. GH response to GRF seems to slowly decrease after radiation therapy. GRF is a new potent, well tolerated secretagogue of GH and improves the diagnostic quality of the etiology of GH deficiency.

Further characterization of the porcine LH subunits precursors in the translation products of pituitary RNAs

We have shown that the precursors of porcine LH alpha and beta subunits have similar apparent molecular weights (Biochem. Biophys. Res. Comm., 1984, 118, 254). The aim of the present study was to characterize physiochemical features which permit to distinguish these precursors from each other. We report here that these precursors can be clearly distinguished by both their tryptic digests analyzed by one-dimension electrophoresis and their behavior in two-dimension electrophoresis whose first dimension was made in a non equilibrium pH gradient (2D-NEPHGE). The 2D-NEPHGE method developed in this study appears also useful to estimate simultaneously the translation activities of pituitary hormone mRNAs without a previous immunoprecipitation.

Morphofunctional modifications associated with the inhibition by estradiol of MtTF4 rat pituitary tumor growth

The MtTF4 pituitary tumor has been induced in Fischer rats by chronic estrogen administration. Recently, we reported that sustained pharmacological treatment of Fischer rats with 17 beta-estradiol inhibited the growth of the MtTF4 tumor transplanted s.c. The present work describes the associated morphofunctional changes occurring in the tumor during 17 beta-estradiol inhibition. It is shown that a 7-day 17 beta-estradiol treatment resulted in an increase of the surface area of cells, nuclei, nucleoli, Golgi complexes, and rough endoplasmic reticulum and an increase in the number of euchromatin-rich nuclei. Flow cytometry analysis of DNA distribution suggested that estradiol affects the cell progression through the early S phase. The ratio of RNA to DNA increased significantly, reflecting cell hypertrophy. Moreover, there was a significant increase in tumor prolactin concentration and a marked enhancement in the intensity of the immunocyto-chemical reaction with rat prolactin antiserum. On the other hand, cell mitoses were dramatically decreased. These morphofunctional changes indicate that the inhibition of the tumor growth by estradiol is accompanied by an evolution of the tumor cell population towards a more differentiated state. However, it cannot be decided whether 17 beta-estradiol induces a shift from a proliferative state to a differentiated state or whether 17 beta-estradiol treatment results in a selection of a subpopulation of tumor cells that are slow growing and more differentiated.

Dual effects of estradiol on normal and tumor pituitary cell multiplication

We have compared the effects of estradiol on the [3H]thymidine (TdR) incorporation into the DNA of 2 rat tissues whose growth is controlled by estradiol in vivo in 2 opposite directions: the normal anterior pituitary and the MtF4 pituitary tumor transplanted under the kidney capsule. Small pieces of pituitary or tumor from Fischer rats, treated or not by estradiol in silastic tubing, were incubated in vitro with [3H]TdR. The [3H]TdR incorporated per microgram DNA was decreased in tumor after 2 to 8 day-estradiol treatment while simultaneously, in the same rats, it was increased in the pituitary. In addition, we studied the effect of estradiol in vitro on the F4C1 cell line obtained from the MtF4 tumor. A dose-dependent decrease of both the [3H]TdR incorporated into DNA and the DNA amount was observed between 10(-6) and 10(-5) M estradiol. These results suggest that the control of the pituitary or MtF4 tumor growth by estradiol in vivo is in part due to an inhibition of cell multiplication. Although estradiol inhibits the growth of a clone of MtF4 tumor cells in vitro we cannot decide whether or not the in vivo effect of estradiol is direct.

Effect of hydrocortisone on intravenous glucose tolerance in small-for-gestational-age infants

The effects of hydrocortisone (H) hemisuccinate (10 mg/kg) on intravenous glucose tolerance (1 g/kg) was studied in eight full term small-for-gestational-age (SGA) infants and compared to seven control infants at mean age of 41 h. After H, the rate of glucose disappearance was (mean +/- SD) 0.92 +/- 0.27 vs 1.24 +/- 0.31% min in controls (p less than 0.01). Glucose space was similar after H: 449 +/- 62 ml/kg and in the control group 468 +/- 75 ml/kg. At 5 and 15 min, although higher in the H group, mean plasma glucose was not significantly different. The difference became significant at 30 min (t = 2.00; p = 0.05), 45 (t = 2.298; p less than 0.05) and 60 min (t = 2.48; p less than 0.02). Plasma insulin concentration did not change after glucose injection in the control group. After H administration, plasma insulin increased: the basal median value was less than 5 mU/ml (range less than 5-18) and at 60 min it rose to 30 mU/ml (range 7.5-89). These data suggest that in newborn infants corticoids induce a reduced peripheral uptake of glucose independent of insulin secretion.

[Diencephalic cachexia (A. Russel's syndrome). Apropos of 3 cases. Importance of transfontanelle ultrasonography]

Three children with diencephalic tumours are described. In these cases, the main clinical features are extreme emaciation and nystagmus. Ultrasonography and computed tomography demonstrated the tumour. In one case, high levels of growth hormone were observed. In the three cases, the tumour was a glioma.

Effects of estradiol on translation activity of Poly(A)-rich RNA from pituitary tumor whose growth is inhibited by estradiol

Fischer rats bearing s.c. MtTF4 pituitary tumor were treated for 15 days with Silastic implants containing or not 17 beta-estradiol. Poly(A)-rich RNA was translated in a rabbit reticulocyte lysate system. The translation products were analysed by one and two-dimensional polyacrylamide gel electrophoresis. It is shown that estradiol affects the translation activities of a limited number of mRNAs. Some of the effects observed, such as the stimulation of PRL mRNA and the relative inhibition of GH mRNA are similar to those previously reported in normal pituitary. Other modifications are specific of the pituitary tumor: the stimulation of the mRNA activities coding for 26,000 and 33,000 dalton proteins. These results indicate that the inhibition of tumor growth by 17 beta-estradiol is accompanied by a specific modulation of mRNA translation activity and is not a non specific toxic effect.

Treatment of hypogonadotropic hypogonadal male patients with the luteinizing hormone-relasing hormone (LH-RH) anolog D-Ser(TBU)6 EA10 LH-RH: transient disappearance of gonadotropin stimulation

We have studied the effect of prolonged treatment with a long-acting luteinizing hormone-releasing hormone (LH-RH) analog (D-Ser-(TBU)6 EA10 LH-RH in six patients with isolated gonadotropin deficiency. Before treatment, all subjects responded to LH-RH (100 microgram intravenously [IV]); one responded immediately, and five after 5 daily infusions of LH-RH (200 microgram). Treatment by LH-RH analog (348 microgram every 2 days with a nasal spray for 90 or 120 days) is only efficient for 1 month; a consistent increase in serum LH and a slight increase in testosterone (T) were observed in all patients, but no increase of serum follicle-stimulating hormone (FSH) was detectable. Then a paradoxical effect appeared: LH and T levels returned to the basal values. Moreover, this treatment induced refractoriness of the pituitary to LH-RH for several months after the end of treatment. The appearance of antibodies to LH-RH and LH-RH analog was eliminated. A pituitary response was obtained in three patients when a new LH-RH stimulation was repeated 7 and 11 months after the end of treatment. The mechanism of this pituitary desensitization is discussed.