METABOLIC CHANGES RESULTING FROM 90YT IRRADIATION OF THE PITUITARY IN A PATIENT WITH CUSHING'S SYNDROME

1959 ◽  
Vol 19 (4) ◽  
pp. 366-376 ◽  
Author(s):  
R. V. BROOKS ◽  
R. R. McSWINEY ◽  
D. MATTINGLY ◽  
F. T. G. PRUNTY
Keyword(s):  
Cushing’S Syndrome ◽  
Plasma Corticosterone ◽  
Cushing's Syndrome ◽  
The Body ◽  
Fatty Tissue ◽  
Thyroid Activity ◽  
Adrenocortical Activity ◽  
Adrenocortical Hyperplasia ◽  
Positive Urine ◽  
Low Levels

SUMMARY A detailed metabolic study has been made of a 48-year-old woman with Cushing's syndrome associated with presumed adrenocortical hyperplasia. The patient was shown to be secreting excessive amounts of cortisol. The urine contained low levels of aldosterone, but there was a hypokalaemic alkalosis. Plasma corticosterone was not raised. Destruction of the pituitary by insertion of 90Yt seeds produced clinical improvement and amelioration of hypertension. The adrenocortical activity promptly subsided to below normal levels. Negative nitrogen and calcium balances became positive, urine calcium fell and hyperglycaemia disappeared. The condition of hypokalaemic alkalosis was restored to normal and aldosterone excretion increased. The decline in thyroid activity was slower than that of adrenocortical activity. Calculation of the distribution of muscular and fatty tissue in the body showed that treatment produced an improvement. The significance of some of these changes is discussed.

ETHINYLOESTRADIOL IN THE PRE-OPERATIVE TREATMENT OF A SEVERE CASE OF CUSHING'S SYNDROME DUE TO ADRENOCORTICAL HYPERPLASIA

1963 ◽  
Vol 42 (2) ◽  
pp. 195-208 ◽  
Author(s):  
N. Norman ◽  
J. H. Vogt
Keyword(s):  
Cushing’S Syndrome ◽  
Clinical Remission ◽  
Severe Case ◽  
Cushing's Syndrome ◽  
Maximal Response ◽  
Oestrogen Treatment ◽  
Biochemical Characteristics ◽  
Adrenocortical Activity ◽  
Adrenocortical Hyperplasia ◽  
Response Capacity

ABSTRACT An extremely severe case of Cushing's syndrome due to adrenocortical hyperplasia is presented. The patient was treated with 0.5 mg of ethinyloestradiol four times daily for 106 days with short interruptions. The treatment caused a clinical remission with correction of the abnormal biochemical characteristics of the disease. The output of corticosteroids fell markedly, and the maximal response capacity of the adrenal cortex was reduced. Stressful stimuli continued to elicit an increase in corticosteroid excretion, and the pituitary-adrenal feed-back mechanism was preserved at the lower level of adrenocortical activity. It became evident, however, that the treatment in this patient did not provide a complete cure, and bilateral adrenalectomy was performed. Further trial with oestrogen treatment in this disease is recommended.

scholarly journals Orbital manifestations of hypercorticism

2021 ◽  
Vol 16 (4) ◽  
pp. 4-13
Author(s):  
Maria O. Korchagina ◽  
Alexey A. Trukhin ◽  
Natalya Yu. Sviridenko
Keyword(s):  
Cushing’S Syndrome ◽  
Molecular Mechanisms ◽  
Cushing's Syndrome ◽  
The Body ◽  
Graves Disease ◽  
Fatty Tissue ◽  
Factors Affecting ◽  
Ocular Manifestations

Nowadays, Cushing's syndrome (hypercortisolism) and its manifestations are well studied. The main symptoms of hyper-cortisolism are obesity, osteoporosis, cardiomyopathy, muscle atrophy, skin thinning and purple stretch marks (striae) on the body. In practice, obesity and osteoporosis are the most frequent symptoms that are found in 90% of cases. However, there are some patients with an implicit clinical picture of hypercorticism. Some cases might concomitant with exophthalmos. This review describes a rare symptom of hypercortisolism — exophthalmos. Exophthalmos is a pathological protruding of eyeballs. This symptom is known in the context of TED that occurs most commonly in patients with Graves' disease. The article compares the mechanisms of development of eye symptoms in Cushing's syndrome and thyroid diseases, especially the Graves' disease. It discusses possible molecular mechanisms leading to exophthalmia in patients with Cushing's syndrome. Factors affecting adipogenesis in vitro and in vivo are studied, in particular factors leading to an increase of orbital fatty tissue against of elevated cortisol levels. Hormonal signaling and transcription cascades responsible for adipocyte differentiation into mature fat cells are presented. Other orbital manifestations of hypercortisolism, which occur relatively rare in practice, are also discussed in the article. These include glaucoma as well as cataract, Lisha nodules and central serous chorioretinopathy. Clinical cases of Cushing's syndrome with different ocular manifestations are considered and appropriate conclusions have been drawn.

ACTH-lndependent Bilateral Macronodular Adrenocortical Hyperplasia Caused Cushing’s Syndrome

1997 ◽  
Vol 58 (4) ◽  
pp. 259-262 ◽  
Author(s):  
Akira Miyajima ◽  
Jun Nakashima ◽  
Masaaki Tachibana ◽  
Shim Baba ◽  
Kaoru Nakamura ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Adrenocortical Hyperplasia

scholarly journals Decreased ligand affinity rather than glucocorticoid receptor down-regulation in patients with endogenous Cushing's syndrome

2000 ◽  
pp. 472-476 ◽  
Author(s):  
NA Huizenga ◽  
WW De Herder ◽  
JW Koper ◽  
P de Lange ◽  
D AJ v Lely ◽  
...  
Keyword(s):  
Glucocorticoid Receptor ◽  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
The Body ◽  
The Other ◽  
Down Regulation ◽  
Ligand Affinity ◽  
Other Hand ◽  
Receptor Number ◽  
Cortisol Levels

OBJECTIVE: Glucocorticoids (GCs) serve a variety of important functions throughout the body. The synthesis and secretion of GCs are under the strict influence of the hypothalamo-pituitary-adrenal axis. The mechanisms of action of GCs are mediated by the intracellular glucocorticoid receptor (GR). Over the years, many studies have been performed concerning the regulation of GR expression by GC concentrations. METHODS: In the present study, we determined the characteristics of the GR in peripheral mononuclear blood leukocytes (PBML) from thirteen patients with endogenous Cushing's syndrome and fifteen control subjects, using a whole cell dexamethasone binding assay. Furthermore, cortisol concentrations were determined in order to investigate a possible relationship between serum cortisol levels and receptor characteristics. RESULTS: There were no differences in mean receptor number between patients and controls. On the other hand, a significantly lower ligand affinity was identified in cells from patients with Cushing's syndrome compared with controls. A complete normalisation of the ligand affinity was observed after treatment in the only patient tested in this respect, whereas the receptor number was not affected. In patients, there was a statistically significant negative correlation between cortisol concentrations and ligand affinity, which was not found in controls. CONCLUSION: Receptor down-regulation does not occur in PBML from patients with endogenous Cushing's syndrome. On the other hand, there seems to be a diminished ligand affinity which possibly reflects receptor modification in response to exposure to the continuously high cortisol levels in patients with Cushing's syndrome. This assumption is substantiated by the fact that in one patient a normalisation of the ligand affinity after complete remission of the disease was seen.

CHANGES IN THYROID ACTIVITY AT LOW ATMOSPHERIC PRESSURES AND AT HIGH ALTITUDES, AS TESTED WITH 131I

1952 ◽  
Vol 8 (4) ◽  
pp. 308-320 ◽  
Author(s):  
F. VERZÁR ◽  
E. SAILER ◽  
V. VIDOVIC
Keyword(s):  
Atmospheric Pressure ◽  
Atmospheric Oxygen ◽  
The Body ◽  
Normal Velocity ◽  
High Altitudes ◽  
Low Oxygen ◽  
Thyroid Activity ◽  
Natural Conditions ◽  
Adrenocortical Activity ◽  
Low Atmospheric Pressure

The activity of the thyroid gland of rats was observed by measuring the uptake of 131I in the living animal over a period of several days. The method is described in detail, and the importance of iodine contained in the diet or applied to the skin, in affecting the results, is stressed. Reduction of the atmospheric pressure to 250 and 380 mm Hg decreases the uptake of 131I. The lower the pressure, the less iodine is concentrated in the thyroid. Under natural conditions a small decrease of thyroid activity at an altitude of 3450 m (490 mm Hg) can be noticed, but not at 2010 m altitude (592 mm Hg). The depression of the thyroid is temporary; after some days 131I is taken up again with normal velocity. At low atmospheric pressure (below 480 mm Hg) the body temperature decreases, but this, too, is restored to normal in 3–4 days. The adaptation of thyroid activity to low atmospheric (oxygen) pressure may play an important part during acclimatization to high altitudes. The mechanism underlying the alteration in thyroid function and, in particular, the relation between the thyroid and adrenocortical activity is discussed. It is suggested that the increased adrenocortical activity and the decrease of thyroid activity observed at low oxygen or atmospheric pressure may be inter-connected.

scholarly journals Cortisol responsiveness to insulin-induced hypoglycemia in Cushing's syndrome with huge nodular adrenocortical hyperplasia.

1986 ◽  
Vol 33 (4) ◽  
pp. 479-487 ◽  
Author(s):  
KOZO HASHIMOTO ◽  
YOSHIRO KAWADA ◽  
KAZUHARU MURAKAMI ◽  
TERUHIKO HATTORI ◽  
SHUSO SUEMARU ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Adrenocortical Hyperplasia

Properties of partially purified thymidine kinase in adrenal tissue of hyperplasia, adenomatous hyperplasia, adenoma and carcinoma of patients with Cushing's syndrome.

1980 ◽  
Vol 93 (2) ◽  
pp. 208-215 ◽  
Author(s):  
Hajime Nawata ◽  
Ken-ichi Kato ◽  
Hiroshi Ibayashi
Keyword(s):  
Adrenal Gland ◽  
Thymidine Kinase ◽  
Cushing’S Syndrome ◽  
Adrenocortical Carcinoma ◽  
Catalytic Properties ◽  
Deae Cellulose ◽  
Cushing's Syndrome ◽  
Adrenocortical Adenoma ◽  
Adenomatous Hyperplasia ◽  
Adrenocortical Hyperplasia

Abstract. Thymidine kinase (TK) was partially purified from adrenal tissues with adrenocortical hyperplasia, adenomatous hyperplasia, adenoma and carcinoma from patients with Cushing's syndrome and from normal adrenal glands. Adrenocortical carcinoma, adenoma, hyperplasia and nodule and hyperplastic portion of adenomatous hyperplasia contained higher concentration of TK than normal adrenal gland. By DEAE-cellulose column chromatography, adrenocortical carcinoma gave two peaks (Peak I and Peak II) of TK, while in other adrenal tissues the second peak (Peak II) was only slightly detected or hardly detected. TK in all these tissues was identical with respect to pH optimum, metal requirement and inhibition by dTTP. dCTP inhibited TK activities of normal adrenal gland and the hyperplastic portion of adenomatous hyperplasia by 55%, respectively, but hardly affected the activity of the nodule of adenomatous hyperplasia, adenoma, hyperplasia and carcinoma. TK from hyperplastic portion of adenomatous hyperplasia showed the intermediate heat stability between the heat-stable enzyme from normal adrenal gland and the heat-labile enzyme from adrenocortical carcinoma, adenoma, hyperplasia and the nodule of adenomatous hyperplasia. The apparent Km for thymidine from adenocortical carcinoma (Peak I and Peak II) was 5.0 and 11.1; adenoma, 4.8; hyperplasia, 5.5; adenomatous hyperplasia (nodule, 5.0 and hyperplastic portion, 19.8) and normal adrenal gland, 25.0 μm. These observations indicated that TK with different catalytic properties existed in various human adrenal tissues. They also demonstrated that TK isolated from the nodule of adrenocortical adenomatous hyperplasia had similar properties as adrenocortical adenoma, while TK from the hyperplastic portion had the intermediate catalytic properties between normal adrenal gland and adrenocortical hyperplasia.

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