OBJECTIVETo discuss the clinical pathology and management of mixed growth hormone- and prolactin (GH-PRL) cell adenoma.

METHODEight patients (4 men and 4 women, with the mean age of 32.3 year old and duration of symptoms 12 months) underwent examination of serum endocrine and magnetic resonance imaging. Clinical manifestations included headache, physiognomy of acromegalic patient, large pudgy hands and foots, menstrual dysfunction, amenorrhea, galactorrhea, and descending vision. Patients underwent transsphenoidal microsurgery of mixed GH-PRL pituitary adenoma between 1986 and 2004.

RESULTSThe hypersecretion of GH and PRL was relieved after operation. Headache was obviously improved in all patients. In 5 cases the menstrual dysfunction and amenorrhea were recovered. In 4 cases the galactorrhea and descending vision disappeared.

CONCLUSIONSThe diagnosis of mixed GH-PRL pituitary adenoma can be made according to the results examination of serum endocrine, pathology and clinical manifestations. Its endocrine features are related to the invasion extent of the adenoma. The transsphenoidal approach is the preferred treatment for mixed GH-PRL pituitary adenoma.

Adenoma ; diagnosis ; pathology ; secretion ; Adolescent ; Adult ; Female ; Growth Hormone ; secretion ; Humans ; Male ; Pituitary Neoplasms ; diagnosis ; pathology ; secretion ; Prolactin ; secretion ; Prolactinoma ; diagnosis ; pathology ; secretion

OBJECTIVETo observe the effect differences between acupoint Tuina and simple instruction and education to improve the lactation of the parturient after delivery.

METHODSFifty-six cases of primipara were divided into an acupoint Tuina group (28 cases) and a control group (28 cases) according to the order of entering group, the acupoint Tuina group was treated with Tuina intervention at local acupoint of the breast and distant acupoint on the basis of the instruction and education of breast feeding; the control group was treated with simple instruction and education of breast feeding. The differences of lactation amount, the level of serum prolactin at 48 h after delivery and the time start to lactate of the parturient in both groups were observed.

RESULTSThe serum prolactin of the parturient at 48 h after delivery of (416.33 +/- 144.29) ng/mL in acupoint Tuina group was obviously higher than that of (320.06 +/- 187.55) ng/mL in control group, there were much more parturient with sufficient milk in acupoint Tuina group after treatment, and the time start to lactate was earlier than that of control group.

CONCLUSIONThe acupoint Tuina is good for parturient to lactate early and lactate more, it is necessary to make further research.

Acupuncture Points ; Adult ; Animals ; Female ; Humans ; Lactation ; Massage ; Milk, Human ; secretion ; Prolactin ; blood ; Young Adult

OBJECTIVETo explore the efficacy of Tuina for postpartum lactation and work out a optimal protocol involved.

METHODSWith a randomized, controlled and clinical method, 84 primiparas were divided into a Tuina group and a control group. While patients in the control group received rooming-in conventional managements, those in the Tuina group were additionally treated with Tuina, including local manipulations on breasts combined with acupoint manipulations. The colostrum-time, lactation quantity and prolactin were observed to make the comparisons between two groups.

RESULTSThe scores of lactation quantity after 1th, 2nd, 3rd of the treatment were 1.660 +/- 0.785, 2.530 +/- 1.030, 2.880 +/- 1.171 in Tuina group and 1.270 +/- 0.533, 1.460 +/- 0.811, 1.500 +/- 0.583 in control group respectively, where there were significant differences in each time stage between two groups (all P < 0.001). The time of colostrum was (21.6 6 +/- 10.508) h in the Tuina group and (22.5 +/- 9.762) h in the control group, in which the difference was not statistically significant (P > 0.05). The levels of prolactin (314.35 +/- 110.37) ng/mL and (321.56 +/- 109.61) ng/mL in Tuina group, (385.78 +/- 85.19) ng/mL and (340.12 +/- 103.10) ng/mL in control group before and after treatment, there were no significant differences (both P > 0.05).

CONCLUSIONPostpartum Tuina on breasts could increase the quantity of lactation and delay the decreasing of the levels of prolactin, which contributes primiparas to lactate more and sooner.

Adult ; Amobarbital ; Breast ; secretion ; Breast Feeding ; Colostrum ; secretion ; Drug Combinations ; Female ; Humans ; Lactation ; Milk, Human ; secretion ; Postpartum Period ; physiology ; Prolactin ; metabolism ; Secobarbital ; Young Adult

In our previous study, we demonstrated that immobilization stress blocked estrogen-induced luteinizing hormone(LH) surge possibly by inhibiting the synthesis and release of gonadotropin-releasing hormone (GnRH) at the hypothalamic level and by blocking estrogen-induced prolactin (PRL) surge by increasing the synthesis of dopamine receptor at the pituitary level in ovariectomized rats. The present study was performed to determine whether immobilization stress affects pituitary LH responsiveness to GnRH, and whether endogenous opioid peptide (EOP) and dopamine systems are involved in blocking LH and PRL surges during immobilization stress. Immobilization stress was found to inhibit basal LH release and to completely abolish LH surge. However, the intravenous application of GnRH agonist completely restored immobilization-blocked LH surge and basal LH release. Treatment with naloxone did not exert any effect on immobilization-blocked LH surge but increased basal LH release during immobilization stress. Pimozide did not affect immobilization-blocked LH surge or basal LH release. Naloxone also decreased immobilization-induced basal PRL release, but had no effect on immobilization-blocked PRL surge. Immobilization-increased basal PRL levels were augmented by pimozide treatment and immobilization-blocked PRL surge was dramatically restored by pimozide. We conclude that immobilization stress does not impair pituitary LH response to GnRH, and that the immobilization stress-induced blockage of LH surge is probably not mediated by either the opioidergic or the dopaminergic system. However, immobilization-blockade of PRL surge may be partly mediated by the dopaminergic system.
Animal ; Estradiol/*pharmacology ; Female ; Gonadorelin/*pharmacology ; Immobilization ; Luteinizing Hormone/*secretion ; Naloxone/pharmacology ; Opioid Peptides/physiology ; Ovariectomy ; Prolactin/*secretion ; Rats ; Rats, Sprague-Dawley ; Receptors, Dopamine/physiology ; Stress/*metabolism

OBJECTIVETo detect serum prolactin (PRL) level in patients with systemic lupus erythematosus (SLE) and its correlations to SLE activity and interleukin-6 (IL-6) by peripheral blood mononuclear cells (PBMCs).

METHODSAn electrochemiluminescence assay was employed to examine the serum content of PRL in 40 SLE patients and 20 healthy subjects, and the levels of IL-6 secretion by the PBMCs were detected using enzyme-linked immunosorbent assay.

RESULTSSLE patients showed a significantly higher serum level of PRL than healthy subjects, which was especially obvious in the active stage of the disease (P=0.000. Serum PRL in SLE patients was found to positively correlate to SLE Disease Activity Index (SLEDAI) (r=0.568, P=0.000). SLE patients with hyperprolactinemia showed a significantly higher level of IL-6 secretion by the PBMCs than those with normal serum PRL level (P=0.000). IL-6 secretion by the PBMCs isolated from SLE patients with normal PRL level and from healthy controls, especially the latter, increased significantly after stimulation of the cells with recombinant human PRL in vitro (P=0.000).

CONCLUSIONSerum PRL may play a role in the pathogenesis of SLE. An elevated PRL level is closely related to SLE activity and can be used to assess SLE activity. Increased serum PRL level can up-regulate the secretion of IL-6 by the PBMCs.

Case-Control Studies ; Female ; Humans ; Interleukin-6 ; blood ; Leukocytes, Mononuclear ; secretion ; Lupus Erythematosus, Systemic ; blood ; Male ; Prolactin ; blood

The aim of this study is to evaluate pituitary-ovarian function at different postpartum periods during the lactational amenorrhea in order to understand the mechanism by which puerperal lactation is associated with a protracted period of amenorrhea and natural infertility. Ninety four lactating women and 119 lactating women with menstruation, aged between 21 and 38 years, volunteered for this study. The pituitary was relatively insensitive to LH-RH during the first 3 weeks following delivery. The recovery of FSH responsiveness to LH-RH occurred earlier than that of LH. Normal FSH response resumed in the 2nd week while the LH response, although not normal, started at the 3rd week postpartum. Pituitary responsiveness after the 5th week postpartum was similar to that occurring in normally menstruating women, except that FSH response was exagerated. Serum prolactin levels were elevated above 160 ng/ml until the 5th week postpartum and decreased to 84.2 ng/ml in the 6th week postpartum. It appears that at least one reason for anovulation during the first four weeks following delivery is the relative insensitivity of the pituitary to hypothalamic stimulation. Prolactin does not seem to modulate pituitary responsiveness to LH-RH. In order to clarify hormonal profiles during the lactational amenorrhea beyond the 5th week puerperium, serum levels of LH, FSH, prolactin, estradiol and progesterone were determined during different postpartum periods. Serum FSH and LH levels during 1-10 months postpartum were similar to basal levels seen during the normal menstrual cycle. Serum estradiol concentrations throughout 1-10 months postpartum, however, were significantly decreased as compared with the levels during the follicular phase of the normal menstrual cycle. Serum prolactin levels were elevated throughout 1-10 months postpartum in lactating amenorrhic women but decreased as the postpartum period lengthened. As compared with lactating amenorrhic women, lactating women with resumed menstruation showed a decrease in prolactin levels from 89.20 ng/ml to 51.39 ng/ml at 1-3 months, from 75.08 ng/ml to 49.99 ng/ml at 4-6 months, and from 54.73 ng/ml to 28.74ng/ml at 7-10 months postpartum. These results suggest that the apparent anovulation seen beyond 5th week postpartum during lactation was not due to pituitary insensitivity to LH-RH. Rather, prolactindependent mechanism interfering with cyclic activity may be operative during long term lactation.
Amenorrhea/etiology* ; Female ; Gonadorelin/pharmacology ; Gonadotropins, Pituitary/secretion ; Human ; Lactation* ; Ovary/physiology* ; Pituitary Gland/physiology* ; Pregnancy ; Prolactin/physiology ; Puerperium*

It has become increasingly clear that cytokines play an important role in modulating neuroendocrine regulation, especially in the secretion of corticotropin (ACTH) in the pituitary. Oncostatin M (OSM), a cytokine of IL-6 family has been reported to increase ACTH secretion and pro-opiomelanocortin (POMC) transcription in murine corticotroph pituitary tumor cells (AtT20 cells). The present study was undertaken to determine the effects of OSM on hormonal release in primary culture of rat pituitary cells. Growth hormone or prolactin release was not affected by OSM. OSM (1 nM) stimulated ACTH release (35.1% increase versus control, p>0.001) in dispersed pituitary cells of rat to a lesser extent than in AtT20 cells. Corticotropin releasing hormone (CRH) (10 nM) also induced a 2.3-fold increase of ACTH secretion (p>0.001), but co-treatment of OSM and CRH did not exhibit any synergistic effect on ACTH secretion. We conclude OSM has a stimulatory effect on ACTH secretion in normal rat pituitary cell cultures, and OSM acts mainly on corticotroph, supporting the potential role of OSM to modulate immune-endocrine regulation in the pituitary.
Animal ; Cells, Cultured ; Corticotropin/secretion* ; Cytokines/pharmacology ; Cytokines/metabolism* ; Inflammation Mediators/pharmacology ; Inflammation Mediators/metabolism* ; Male ; Peptides/pharmacology ; Peptides/metabolism* ; Pituitary Gland/metabolism* ; Pituitary Gland/drug effects ; Pituitary Gland/cytology ; Prolactin/secretion* ; Rats ; Rats, Inbred WF ; Somatotropin/secretion*

It has become increasingly clear that cytokines play an important role in modulating neuroendocrine regulation, especially in the secretion of corticotropin (ACTH) in the pituitary. Oncostatin M (OSM), a cytokine of IL-6 family has been reported to increase ACTH secretion and pro-opiomelanocortin (POMC) transcription in murine corticotroph pituitary tumor cells (AtT20 cells). The present study was undertaken to determine the effects of OSM on hormonal release in primary culture of rat pituitary cells. Growth hormone or prolactin release was not affected by OSM. OSM (1 nM) stimulated ACTH release (35.1% increase versus control, p>0.001) in dispersed pituitary cells of rat to a lesser extent than in AtT20 cells. Corticotropin releasing hormone (CRH) (10 nM) also induced a 2.3-fold increase of ACTH secretion (p>0.001), but co-treatment of OSM and CRH did not exhibit any synergistic effect on ACTH secretion. We conclude OSM has a stimulatory effect on ACTH secretion in normal rat pituitary cell cultures, and OSM acts mainly on corticotroph, supporting the potential role of OSM to modulate immune-endocrine regulation in the pituitary.
Animal ; Cells, Cultured ; Corticotropin/secretion* ; Cytokines/pharmacology ; Cytokines/metabolism* ; Inflammation Mediators/pharmacology ; Inflammation Mediators/metabolism* ; Male ; Peptides/pharmacology ; Peptides/metabolism* ; Pituitary Gland/metabolism* ; Pituitary Gland/drug effects ; Pituitary Gland/cytology ; Prolactin/secretion* ; Rats ; Rats, Inbred WF ; Somatotropin/secretion*

Amyloid ; metabolism ; Humans ; Male ; Middle Aged ; Pituitary Neoplasms ; metabolism ; pathology ; surgery ; Plaque, Amyloid ; pathology ; Prolactin ; secretion ; Prolactinoma ; metabolism ; pathology ; surgery ; Synaptophysin ; metabolism

BACKGROUNDOver one million soldiers were treated for battle- or training-fatigue during World War II. Of all ground combat troops, 37% were discharged for psychiatric reasons due to fatigue. The neuroendocrinological and immunological systems played important roles in the work-related fatigue of military personnel. The aim of this study was to investigate the characteristics of fatigue associated with military operations, and we observed changes in the regulatory functions of the neuroendocrinological and immunological systems that may provide theoretical support for improving the combat effectiveness of armies.

METHODSA total of 240 soldiers from the Field Artillery regiment were selected as subjects. Researchers and subjects received training before participating in the study. Data of the subjects' medical histories, physical examinations, scores on a fatigue assessment scale, and assessments of pituitary-adrenal hormones (adrenal cortical hormone (ACTH), cortical hormone (F), and 24-hour urine-free cortisol (UFC)), pituitary-gonadal hormones (luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, estradiol (E2), and prolactin (PRL)), pituitary-thyroid hormones (thyroid-stimulating hormone (TSH), thyroxine (TT4), triiodothyronine (TT3), free thyroxine (FT4), and free triiodothyronine (FT3)), and cellular immune parameters (CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+), B, and NK cells) were investigated before and after large-scale and high-intensity field exercises. Data were statistically analyzed with Student's t test using SPSS software (version 13.0), and P values < 0.05 were deemed to be significant.

RESULTSAfter the high-intensity military training, the scores on the fatigue scale reflected significant increases of feeling of unpleasantness among soldiers. Additionally, the symptom checklist showed notable increases in somatization scores and significant decreases in psychoticism scores. After intensive military work, levels of plasma ACTH, F, and UFC of soldiers were decreased (P < 0.01). The level of testosterone decreased significantly after the maneuver ((23.51 ± 6.49) versus (18.89 ± 5.89) nmol/L; P < 0.001), whereas the thyroid function (TT3, FT4, and FT3) was markedly increased after the maneuver (P < 0.01). The number of CD3(+), CD4(+), CD4(+)/CD8(+) cells, and B lymphocytes were decreased (P < 0.05), and NK cells were increased (P < 0.001) after the maneuver.

CONCLUSIONSFollowing high-intensity military operations, the psychological tolerance of soldiers was depressed. And the hypoadrenocorticism (the functional decreases of hypothalamic-pituitary-gonadal and abnormal pituitary-thyroid axis) contributed to the increased levels of fatigue. Hypoimmunity may increase the susceptibility to diseases after high-intensity military operations.

Adolescent ; Adrenal Glands ; secretion ; Adult ; Endocrine System ; metabolism ; Estradiol ; blood ; Follicle Stimulating Hormone ; blood ; Humans ; Hydrocortisone ; blood ; Luteinizing Hormone ; blood ; Male ; Military Personnel ; Pituitary Gland ; secretion ; Pituitary Hormones ; blood ; Prolactin ; blood ; Testosterone ; blood ; Thyroid Hormones ; Thyrotropin ; blood ; Thyroxine ; blood ; Triiodothyronine ; blood ; Young Adult