Andrew G. Frantz

Galactorrhea: a study of 235 cases, including 48 with pituitary tumors.

Abstract An analysis of 235 patients with galactorrhea (5.5 per cent males) showed that 20 per cent of all patients, and 34 per cent of women with associated amenorrhea, had radiologically evident pituitary tumors; these patients had the highest serum prolactin concentrations. The largest single group (32 per cent) consisted of women with idiopathic galactorrhea without amenorrhea; prolactin was normal in 86 per cent of these cases. Five patients had the empty-sella syndrome. Prolactin response was tested in selected patients by thyrotropin-releasing hormone, chlorpromazine, L-dopa, 24-hour sampling and other means. Tests with thyrotropin-releasing hormone were most useful in identifying patients with pituitary tumors. Surgery and radiotherapy lowered prolactin to a similar degree in patients with tumor, but galactorrhea and amenorrhea often persisted after treatment. The ergot derivatives, bromergocryptine and lergotrile mesylate, lowered prolactin in all 18 patients with idiopathic hyperprolactinemia or...

Human prolactin - 24-hour pattern with increased release during sleep.

Human prolactin was measured in plasma by radioimmunoassay at 20 minute intervals for a 24-hour period in each of six normal adults, whose sleep-wake cycles were monitored polygraphically. A marked diurnal variation in plasma concentrations was demonstrated, with highest values during sleep; periods of episodic release occurred throughout the 24 hours.

The effect of running on plasma β-endorphin

Abstract Plasma β-endorphin immunoactivity was measured by RIA in 26 trained long distance runners on 35 occasions before and after running. Mean total β-endorphin immunoactivity increased from 11.8 ± 1.8 (SEM) to 17.6 ± 3.1 pg/m1 in 20 runners after an easy run ( p = .067), and from 8.2 ± 1.03 to 28.0 ± 6.3 pg/ m 1 in 15 runners after a strenuous run (p = .008). Total β-endorphin immunoactivity in the plasma extracts of 7 runners before and after the strenuous run was further characterized by Sephadex G-50 chromatography in order to separate β-endorphin from corssreacting β-lipotropin (β-LPH). A rise in β-endorphin and β-LPH concentrations after running was noted in 5 out of 7 runners.

Vasopressin and Neurophysin: High Concentrations in Monkey Hypophyseal Portal Blood

Vasopressin and its binding protein, neurophysin, were measured by radioimmunoassay in the hypophyseal portal blood of monkeys after cannulation of individual long portal veins. Mean vasopressin concentrations (13,800 picograms per milliliter) in portal blood were more than 300 times as high as those in the systemic circulation (42 picograms per milliliter). Neurophysin concentration was approximately 25 times as high in portal as in systemic blood. By immunoperoxidase techniques, high concentrations of neurophysin were demonstrated around portal capillaries of the median eminence. These studies indicate direct secretion of vasopressin and neurophysin into the portal circulation; the quantities secreted during stress may be sufficient to exert significant effects on secretion of anterior pituitary hormone.

Effects of sex steroids on brain β-endorphin

Abstract Brain β-endorphin was measured by radioimmunoassay in female rats during different stages of the estrous cycle, during pregnancy, 3 weeks after ovariectomy, and 3 weeks after ovariectomy plus estradiol or estradiol and progesterone replacement. No change in hypothalamic β-endorphin content was noted on the afternoon of diestrus, proestrus, or estrus. However, in 9 rats studied between days 8–20 of pregnancy the mean hypothalamic β-endorphin concentration of41.6 ± 2.24ng/mg protein was significantly higher than the concentration of32.7 ± 1.01 in 21 non-pregnant animals (P We conclude that physiologic concentrations of estradiol and progesterone can alter the content of brain β-endorphin and suggest that ovarian steroids may be important regulators of this brain peptide.

Prolactin: Evidence That It Is Separate from Growth Hormone in Human Blood

A highly sensitive bioassay has been developed for prolactin, which uses a mammalian end organ and which is capable of measuring the hormone in unextracted human plasma. High prolactin activity, largely neutralizable with antiserum to human growth hormone, is stimulated along with high immunoassayable growth hormone by insulin-induced hypoglycemia. High prolactin activity, not neutralizable with antiserum to growth hormone, exists with low concentrations of plasma growth hormone in postpartum patients and patients with galactorrhea.

Pergolide for the Treatment of Pituitary Tumors Secreting Prolactin or Growth Hormone

We gave pergolide mesylate, a new long-acting ergot derivative with dopaminergic properties, to 47 patients with hypersecretion of prolactin or growth hormone. Single doses produced long-lasting reductions of serum prolactin levels; after 24 hours, the values remained depressed at a mean of 28.8 per cent of the base-line value. Among 41 patients (22 women and 19 men) with hyperprolactinemia who took pergolide for three months or more, prolactin levels fell to normal in 37 and remained slightly elevated in 2. In the two patients in whom the levels fell to only 38 to 52 per cent of base line, treatment was regarded as a failure. The level of growth hormone fell to a mean of 52.8 per cent of base line in patients with acromegaly who were taking 100 micrograms of pergolide per day. Among patients for whom adequate CT scans were available, definite tumor shrinkage occurred in 10 of 13 with macroadenomas and definite or probable shrinkage in 5 of 9 with microadenomas. Menses returned in 76 per cent of treated women and testosterone levels rose in 10 of 14 men. We conclude that pergolide reduces hypersecretion and shrinks most prolactin-secreting macroadenomas. In some patients long-term pergolide therapy may be superior to surgery and x-ray treatment.

Circadian rhythms and levels of β-endorphin, acth, and cortisol during chronic methadone maintenance treatment in humans

Previous studies have shown alterations of neuroendocrine function in humans receiving any narcotic on short-term basis or short-acting narcotics on a chronic basis. In this study of 16 well-stabilized patients, it was demonstrated that normalization of hypothalamic-pituitary-adrenal axis function, as reflected by normal levels and normal circadian rhythm of levels of beta-endorphin, ACTH and cortisol, is achieved during long-term steady state methadone maintenance treatment of former heroin addicts.

Human Prolactin: Measurement in Plasma by In Vitro Bioassay

Prolactin has been measured in unextracted human plasma by a sensitive and specific in vitro bioassay. Secretory activity of breast tissue fragments from mid-pregnant mice, incubated in organ culture with human plasma, serves as the histologic end point. Sensitivity is 5 ng/ml (0.14 mU/ml) or somewhat better for ovine prolactin, and approximately 0.42 mU/ml for prolactin activity of human plasma at the dilutions used in the assay. Human growth hormone as it circulates in blood, like the material extracted from pituitary glands, is strongly lactogenic. Antisera to human growth hormone are capable of completely neutralizing the prolactin effect of large amounts (600 ng/ml) of human growth hormone added to the system. Plasma prolactin activity is less than 0.42 mU/ml in normal men and women. Of 26 patients with nonpuerperal galactorrhea, 14 had elevated prolactin activities ranging from 0.42 to 3.5 mU/ml. Growth hormone levels by radioimmunoassay were far too low, in general, to account for the observed prolactin activity. All of 14 nursing mothers, 1-30 days post partum, had elevated prolactin activity with a mean of 2.29 and a total range of 0.56-4.5 mU/ml. Growth hormone was in the low normal range in all of these subjects. Seven patients on psychoactive drugs of the phenothiazine series similarly had elevated prolactin activity with low growth hormone. Antiserum to human growth hormone, when preincubated with plasma samples from each of these three groups of subjects, produced no significant inhibition of prolactin activity. In two acromegalic patients with markedly elevated growth hormone levels, antiserum to growth hormone produced complete inhibition of prolactin activity in one and partial inhibition in the other. These studies indicate that human growth hormone and human prolactin are separate molecules, with little if any immunologic cross-reactivity, at least as demonstrated by the antisera used in this study, and that their release is governed by different physiologic mechanisms.

Diagnosis and evaluation of patients with an enlarged sella turcica

A prospective analysis of the roentgenographic and laboratory parameters in 100 patients with an enlarged sella turcica was made. Seventy-five patients had no visual symptoms: 27 had primary intrasellar tumor; 25 had the empty sella syndrome: 13 had an extrasellar process; and in 10, no final diagnosis was made because air study was omitted. However, these patients remained asymptomatic for up to three years. Eighteen of the patients with a primary intrasellar tumor had symptomatic pituitary dysfunction; nine were asymptomatic. Five of 14 patients studied had elevated plasmaproa prolactin levels. of the 25 patients with the empty sella syndrome and the 10 patients in whom no final diagnosis was made, none had any clinical endocrine or visual abnormalities, although in 10 of these 35 patients, results of laboratory studies were compatible with pituitary dysfunction. In these cases, air study was necessary to differentiate a clinically silent pituitary tumor from the empty sella syndrome. This emphasizes the high incidence of the empty sella syndrome in patients with enlarged sella, and also confirms the high incidence of hyperprolactinemia in patients with pituitary tumors.