WorldWideScience

Sample records for bromocriptine

  1. Bromocriptine

    Science.gov (United States)

    ... hyperprolactinemia caused by certain types of tumors that produce prolactin, and may shrink these tumors. Bromocriptine (Parlodel) is also used alone or with other treatments to treat acromegaly (condition in which there is too much growth hormone in the body) and Parkinson's disease (PD; a ...

  2. Recurrent prolactinoma and meningioma following irradiation and bromocriptine treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kolodny, J.; Dluhy, R.G.

    1985-01-01

    This case report describes a 45-year-old man with a massive extrasellar prolactinoma, treated initially with surgery and radiotherapy, who experienced a dramatic reduction of the bulk of his tumor but persistence and subsequent progression of an extrasellar portion while receiving long-term bromocriptine therapy, despite stable, suppressed prolactin levels. Although the residual tumor was thought to be adenomatous tissue unresponsive to bromocriptine, a meningioma was ultimately diagnosed. Because the meningioma may have been radiation-induced, clinicians are reminded to consider a second neoplasm in cases of apparent bromocriptine treatment failures, especially when prolactin levels are stable.

  3. [Use of Bromocriptin tablets in physiologic and pathologic hyperprolactinemia].

    Science.gov (United States)

    Farkas, M; Tárczy, C; Tasiné Tóth, E; Bérczy, J; Gyetvai, G

    1992-01-01

    The authors used Bromocriptine tablet, made by Chemical Works of Gedeon Richter Ltd. in 11 cases to alleriate a physiological milk secretion and in 15 cases as a treatment for extra-puerperal galactorrhea. Under treatment the serum prolactin level dropped exponentially while under Norcolut administration a linear regression was shown and the mammary activity abated after 14 days. The best method for treating the physiological hyperprolactinemia is to give the Bromocriptine before starting milk secretion. In cases of extra-puerperal galactorrhea. The patients become free from complaint after 8 weeks. In both cases the dose was 5-7.5 mg Bromocriptine. When galactorrhea and amenorrhoea occur together during the treatments second month menstruation begins and in two cases unwanted pregnancies happened. It has been found that the latent functional hyperprolactinemia can also be galactorrhea. The result were verified in ten cases by testing the metoclopramide-burden.

  4. Antiparkinsonian potential of interaction of LEK-8829 with bromocriptine.

    Science.gov (United States)

    Zivin, M; Sprah, L; Sket, D

    1998-05-22

    The ergoline derivative, LEK-8829 (9,10-didehydro-N-methyl-(2-propynyl)-6-methyl-8-aminomethylerg oline), has been proposed as a potential atypical antipsychotic drug with antagonistic actions at dopamine D2 and serotonin 5-HT2 and 5-HT1A receptors (Krisch et al., 1994, 1996). LEK-8829 also induces contralateral turning in rats with 6-hydroxydopamine-induced unilateral lesion of dopamine nigrostriatal neurons. Turning is blocked by SCH-23390 (R(+)-chloro-8-hydroxy-3-methyl-1-phenyl-2,3,4,5-tetrahydro-1H-3-benzaze pine), a dopamine D1 receptor antagonist. It has been suggested that LEK-8829 could have beneficial effects in parkinsonian patients suffering from psychotic episodes induced as a side-effect of antiparkinsonian treatment with dopamine D2 receptor agonists. Therefore, we now investigated the interaction of LEK-8829 with the dopamine D2 receptor agonist bromocriptine (2-bromo-alpha-ergokryptine) in 6-hydroxydopamine-lesioned rats. Treatment with either LEK-8829 (3 mg kg(-1)) or bromocriptine (3 mg kg(-1)) induced a vigorous contralateral turning response. The cumulated number of turns induced by the treatment with both drugs combined was not significantly different from the cumulated number of turns induced by single-drug treatment. The pretreatment with SCH-23390 (1 mg kg(-1)) did not have a significant effect on the bromocriptine-induced turning but significantly decreased the turning observed after the combined LEK-8829/bromocriptine treatment. We conclude that in the 6-hydroxydopamine model, the turning behaviour mediated by the LEK-8829/bromocriptine combination may be the result of opposing activity of both drugs at dopamine D2 receptors with concomitant stimulation of dopamine D1 receptors by LEK-8829. Therefore, LEK-8829 may have a potential for the therapy of parkinsonism complicated by dopamine D2 receptor agonist drug-induced psychosis.

  5. Bromocriptine as a new therapeutic agent for peripartum cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Sandeep Chopra

    2012-01-01

    Full Text Available Peripartum cardiomyopathy (PPCM is a poorly understood, rare disorder in which left ventricular systolic dysfunction and symptoms of heart failure occur between the last month of pregnancy and the first 5 months postpartum. Recent data suggest that uncontrolled oxidative stress leads to the activation of the prolactin cleaving enzyme cathepsin D that in turn leads to an increase in a cleaved 16 kDa prolactin. This cleaved form that has an angiostatic and proapoptotic role appears to drive the disease by adversely impacting the endothelium and cardiomyocyte. Bromocriptine that reduces the prolactin production by dopamine agonist actions may improve outcomes in patients with peripartum cardiomyopathy by eliminating the cleaved form of prolactin despite the activation of the cleaving enzyme. In limited case reports and proof of concept studies use of bromocriptine in the early stages has been shown to improve outcomes in patients with peripartum cardiomyopathy. However, larger randomized control study is still awaited.

  6. Transient intrasellar collection of air during bromocriptine treatment of a prolactinoma

    Energy Technology Data Exchange (ETDEWEB)

    Fagel, W.J.; Smith, S.J.; Vijver, J.C.M. van der; Hekster, R.E.M.

    1986-07-01

    A patient is described with a large prolactinoma with expansion into the sphenoid sinus. During bromocriptine treatment an intrastellar area of gas developed, continuous with the air in the sinus. No operation was performed, bromocriptine was continued. During the regression of the tumor, the area of air disappeared.

  7. Caveolin-1 sensitizes rat pituitary adenoma GH3 cells to bromocriptine induced apoptosis

    Directory of Open Access Journals (Sweden)

    Huang Mu-Chiou

    2007-03-01

    Full Text Available Abstract Background Prolactinoma is the most frequent pituitary tumor in humans. The dopamine D2 receptor agonist bromocriptine has been widely used clinically to treat human breast tumor and prolactinoma through inhibition of hyperprolactinemia and induction of tumor cell apoptosis, respectively, but the molecular mechanism of bromocriptine induction of pituitary tumor apoptosis remains unclear. Caveolin-1 is a membrane-anchored protein enriched on caveolae, inverted flask-shaped invaginations on plasma membranes where signal transduction molecules are concentrated. Currently, caveolin-1 is thought to be a negative regulator of cellular proliferation and an enhancer of apoptosis by blocking signal transduction between cell surface membrane receptors and intracellular signaling protein cascades. Rat pituitary adenoma GH3 cells, which express endogenous caveolin-1, exhibit increased apoptosis and shrinkage after exposure to bromocriptine. Hence, the GH3 cell line is an ideal model for studying the molecular action of bromocriptine on prolactinoma. Results The expression of endogenous caveolin-1 in GH3 cells was elevated after bromocriptine treatment. Transiently expressed mouse recombinant caveolin-1 induced apoptosis in GH3 cells by enhancing the activity of caspase 8. Significantly, caveolin-1 induction of GH3 cell apoptosis was sensitized by the administration of bromocriptine. Phosphorylation of caveolin-1 at tyrosine 14 was enhanced after bromocriptine treatment, suggesting that bromocriptine-induced phosphorylation of caveolin-1 may contribute to sensitization of apoptosis in GH3 cells exposed to bromocriptine. Conclusion Our results reveal that caveolin-1 increases sensitivity for apoptosis induction in pituitary adenoma GH3 cells and may contribute to tumor shrinkage after clinical bromocriptine treatment.

  8. Long-term treatment with high-dosage bromocriptine in advanced Parkinson's disease.

    Science.gov (United States)

    Jansen, E N; Meerwaldt, J D

    1987-01-01

    Long-term follow-up indicated that levodopa as a replacement therapy merely improves the parkinsonian symptoms, and does so for only a limited number of years. The reason for this tachyphylaxis or declining efficacy in levodopa therapy and the increasing number and intensity of various distressing difficulties in the management of Parkinson's disease, such as dyskinesias and on-off phenomena, is the main subject of many recent studies. It is still widely accepted that levodopa provides the best therapeutic tool for Parkinson's disease. Bromocriptine, an ergot derivative, is the main clinically used dopamine agonist, and it has been established as a valuable adjunct in the treatment of Parkinson's disease. Bromocriptine is most useful in patients with a declining efficacy of levodopa treatment, in patients with diurnal oscillations in motor performance, especially in patients with wearing-off phenomena, and in patients with onset and end-of-dose dyskinesias. The question of bromocriptine dosage, required to obtain an optimal benefit and a decreased rate of late adverse reactions, is quite controversial. The trend has been to lower daily dosage of bromocriptine, i.e., low doses suffice in patients with mild, early disease. Higher doses of bromocriptine seem to be required in patients with severe parkinsonian deficits. In this retrospective study of 8 years experience with high dosage of bromocriptine in levodopa response-losing parkinsonian patients, the adjunction of bromocriptine had a clear-cut but short-lasting beneficial effect on the disability scores.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Study to assess the role of bromocriptine in treatment of diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Anuj Kumar Pathak

    2016-04-01

    Conclusions: From this study, we concluded that individually both metformin and bromocriptine were effective in controlling hyperglycemia but metformin was better in achieving normal mean FBS. Further studies are required to ascertain the consistency in hypoglycemic effect of bromocriptine as well as its effect in lipid profile and cardiovascular outcomes. Study taking different doses of bromocriptine or with increasing the duration of study can elaborate its role in achieving proper glycemic control over time. [Int J Basic Clin Pharmacol 2016; 5(2.000: 423-428

  10. No effect of chronic bromocriptine therapy on levodopa pharmacokinetics in patients with Parkinson's disease.

    Science.gov (United States)

    Contin, M; Riva, R; Martinelli, P; Albani, F; Baruzzi, A

    1992-12-01

    We studied the effect of chronic bromocriptine cotherapy on levodopa kinetics in seven patients with Parkinson's disease who were receiving levodopa therapy. Plasma levodopa concentrations were measured after a standard oral levodopa fasting dose over a 5-hour period, on two different sessions, without and with bromocriptine at a fixed daily dose of 15 mg. We found no statistically significant difference in the rate and extent of levodopa absorption between the two treatments, with minimal intrasubject variability. Our observations suggest that chronic bromocriptine cotherapy is unlikely to affect the plasma levodopa pharmacokinetics under standardized intake conditions or to contribute to a less predictable pattern of drug plasma concentrations.

  11. Agentic extraversion modulates the cardiovascular effects of the dopamine D2 agonist bromocriptine.

    Science.gov (United States)

    Wacker, Jan; Stemmler, Gerhard

    2006-07-01

    A recent psychobiological theory postulates a dopaminergic basis for the agency facet of extraversion, leading to the prediction that this personality trait modulates the psychophysiological effects of dopaminergic drugs. A single dose of the dopamine D2 receptor agonist bromocriptine reduces blood pressure in healthy volunteers. However, it is currently unknown whether this hypotensive effect of bromocriptine is modulated by agentic extraversion. Therefore, we measured resting cardiovascular activation in groups of healthy male volunteers either high or low in agentic extraversion, either under bromocriptine (1.25 mg) or placebo. Focusing the analyses on activation components derived from 18 cardiovascular variables, we found that bromocriptine reduces alpha-adrenergic activation in the sample as a whole, whereas the effects on beta-adrenergic and cholinergic activation are modulated by agentic extraversion.

  12. CT follow-up of microprolactinomas during bromocriptine-induced pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Dietemann, J.L.; Bonneville, J.F.; Portha, C.; Cattin, F.; Mollet, E.

    1983-06-01

    In the last few years complete or partial regression of prolactinomas has been demonstrated in nonpregnant women treated by bromocriptine. Thus bromocriptine therapy appears as an attractive alternative to surgery for management of infertility related to hyperprolactinemia. However, numerous reports emphasized the possibility of an excessive growth of the pituitary adenoma with visual field defects during the last 3 months of pregnancy. To avoid these complications, the authors followed with serial CT scans the growth of microprolactinoma at the 5th of 6th month of pregnancy. Among six pregnant women, one patient presented a marked upward extension of the adenoma. Bromocriptine was then reintroduced and the effectiveness in reducing tumor growth was proved by CT scan at the 7th month. Regarding low risk of using intravenous iodinated contrast medium in pregnant women and of fetal radiation damage, the authors emphasize the value of CT in the follow-up of bromocriptine-induced pregnancies.

  13. Study to assess the role of bromocriptine in treatment of diabetes mellitus

    OpenAIRE

    Anuj Kumar Pathak; Subodh Kumar; Manish Kumar; Harihar Dikshit

    2016-01-01

    Background: Bromocriptine is a dopamine D2 receptor agonist and a sympatholytic agent used very frequently in treatment of hyperprolactinemia, Parkinsonism and acromegaly. Its quick release formulation has been approved for treatment of type 2 diabetes mellitus as an adjunct to diet and exercise. This study evaluated the antihyperglycemic effect of quick release bromocriptine in alloxan induced diabetic rats. Methods: 24 albino rats were taken and divided into four groups of six rats in ea...

  14. Bromocriptine-Induced Hyperglycemia in Nonobese Diabetic Mice: Kinetics and Mechanisms of Action

    Science.gov (United States)

    Durant, Sylvie; Coulaud, Josiane; Homo-Delarche, Francoise

    2007-01-01

    The effects of bromocriptine (10 mg/kg), known to inhibit prolactin secretion and lower autoimmune processes, were studied on glucose homeostasis in non-fasted non-obese diabetic mice, a spontaneous model of type 1 diabetes. Hyperglycemia was observed 120 and 240 min after i.p. but not s.c. injection. Bromocriptine administration i.p. led to rapid and marked hyperglycemia characterized by sexual dimorphism with males having higher glycemia than females. Bromocriptine induced a rapid but transient decrease in insulinemia in males only and biphasic increases in glucagon levels and a sustained stimulatory effect on circulating corticosterone in both sexes. Bromocriptine-induced hyperglycemia involved D2-dopaminergic receptors, as demonstrated by the inhibitory effect of the D2-dopamine antagonist, metoclopramide (10 mg/kg). Simultaneous injection of bromocriptine and metoclopramide also blocked the rise in blood corticosterone. In conclusion, by inducing hyperglycemia, i.p. bromocriptine administration to prediabetic autoimmune mice may counteract its beneficial anti-immunostimulatory effects. PMID:18084676

  15. Effects of preoperative bromocriptine treatment on prolactin-secreting pituitary adenoma surgery

    Science.gov (United States)

    CAO, YINGXIAO; WANG, FENGJU; LIU, ZHENBO; JIAO, BAOHUA

    2016-01-01

    Pituitary adenomas are benign intracranial endocrine tumors, accounting for ~10% of intracranial tumors. The aim of the present study was to analyze the effects of preoperative treatment with bromocriptine on the surgical treatment and postoperative complications of prolactin-secreting pituitary adenomas (prolactinomas). Data from 102 patients whose prolactinomas were surgically treated between March 2006 and March 2010 were retrospectively reviewed in the present study. The study group included 54 patients who had been treated preoperatively with bromocriptine. The patients were examined by magnetic resonance imaging (MRI) of the head and coronal computed tomography (CT) scanning, after which the pathological diagnosis of prolactinoma was confirmed. A total of 64 patients underwent total resection surgery through the nose and sphenoid sinus, and 25 patients underwent subtotal resection surgery or excision of a large portion of the tumor, leaving only a small quantity of residual tumor or tumor capsule. Patients were followed up for 1–9 months using MRI and measurements of serum prolactin levels. Seven patients were lost to follow-up. The results of the present study demonstrated that patients who were treated with large doses of bromocriptine or used bromocriptine chronically suffered from an increased rate of surgical difficulties and postoperative complications, as compared with the patents who had not been pre-treated with bromocriptine. In conclusion, oral administration of bromocriptine is important in the treatment of prolactinoma tumors. However, large doses or long-term use of bromocriptine may increase difficulties in surgery or postoperative complications, and reduce its ability to treat prolactinonas, as it can lead to hardening of the tumor tissue and capsules, and aggravate pituitary stalk adhesions. PMID:27168837

  16. Amisulpride versus Bromocriptine in Infantile Autism: A Controlled Crossover Comparative Study of Two Drugs with Opposite Effects on Dopaminergic Function.

    Science.gov (United States)

    Dollfus, Sonia; And Others

    1992-01-01

    This study compared the clinical efficacy of a dopaminergic antagonist (amisulpride) and a dopaminergic agonist (bromocriptine) with 9 children (ages 4-13) with autism and probable severe mental retardation. The amisulpride acted preferentially on specific autism symptoms and the bromocriptine on motor hyperactivity and attention symptoms.…

  17. Bromocriptine for an acromegalic patient. Improvement in cardiac function and carpal tunnel syndrome.

    Science.gov (United States)

    Luboshitzky, R; Barzilai, D

    1980-10-17

    A 64-year-old woman with active acromegaly of 33 years' duration, severe carpal tunnel syndrome, and subclinical heart disease was treated with bromocriptine mesylate. Within eight months of therapy, basal growth hormone (GH) levels decreased from 90.0 to 7.0 ng/mL, and hand volume was reduced from 375 to 295 mL. Concomitantly, echocardiographic studies showed normal left ventricular size and function. Electromyographic studies demonstrated normal function in both median nerves. Bromocriptine may correct cardiac dysfunction and carpal tunnel syndrome in acromegaly either by reduction of GH oversecretion or by a direct effect of bromocriptine on dopamine receptors in the heart and peripheral nerve endings.

  18. Bromocriptine therapy in acromegaly. A long-term review of 35 cases.

    Science.gov (United States)

    Sachdev, Y; Gopal, K; Garg, V K

    1981-04-01

    Bromocriptine (CB-154, Parlodel, Sandoz) was given to 35 acromegalic patients for a period of 6-36 months. Basal and post-therapy endocrine functions including estimation of serum growth hormone (GH) profile; and GH kinetics during oral glucose tolerance test, augmented insulin tolerance test and thyrotrophin releasing hormone test were determined. The pituitary tumour size was delineated by a pneumoencephalogram. The mean GH levels ranged from 14 micrograms/l to 316 micrograms/l. Bromocriptine suppressed GH values to 5 micrograms/l or less in 16 patients and less than 10 micrograms/l in a further 6 patients. In 33 patients GH values fell to 50% of the basal value or less. There was no significant GH reduction in 2 'nonresponders'. Bromocriptine did not block the stress-induced GH secretion. It did not disturb pituitary functions other than prolactin which was suppressed much earlier and was maintained with smaller doses. GH suppression on the other hand was shortlived and rebounded when the drug was omitted. It had no adverse effect on tumour size in 2 patients having suprasellar extension of the tumour. Bromocriptine improved carbohydrate tolerance and sexual function although it did not affect insulin and gonadotrophin values. It seems reasonable to offer a trial of bromocriptine in all patients with acromegaly where therapy is deemed necessary as it is well tolerated, has insignificant side effects and no adverse drug interactions. Its high cost and prolonged course are obvious disadvantages. Caution should be exercised in cases with suprasellar extension and visual field involvement.

  19. Effects of bromocriptine on CSF proteins and amines in patients with empty sella syndrome, acromegaly and prolactin producing pituitary adenomas.

    Science.gov (United States)

    Brismar, K; Sidén, A; Werner, S

    1981-01-01

    The effect of the dopamine agonist bromocriptine (5-40 mg/day) on cerebrospinal fluid proteins and amines was studied in 7 hyperprolactinemic patients, 4 with empty sella syndrome and 3 patients with pituitary adenoma. Small as well as high doses of bromocriptine depressed the endogenously formed dopamine, noradrenalin and adrenalin. Five patients initially exhibited changes consistent with slight to marked blood-cerebrospinal-fluid (CSF) barrier disturbances and 5 abnormal CSF-protein fractions. One CSF-protein fraction (isolelectric points (pI) approximately 5.3 pH-units) became more prominent during bromocriptine treatment. Analyses of his fraction indicated that it represented a transferrin component. It is stated that bromocriptine treatment besides affecting amine and trace metal metabolism also affects protein metabolism.

  20. Bromocriptine mesylate: Food and Drug Administration approved new approach in therapy of non-insulin dependant diabetes mellitus with poor glycemic control

    OpenAIRE

    Yogendra Keche

    2010-01-01

    Food and Drug Administration (FDA) approved bromocriptine mesylate, a quick release formulation, 0.8 mg tablets, as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Bromocriptine products were previously approved by the FDA for the treatment of pituitary tumors and Parkinson's disease. Bromocriptine is thought to act on circadian neuronal activities within the hypothalamus to reset abnormally elevated hypothalamic drive for increased plasma ...

  1. Peripartum Cardiomyopathy Presenting with Predominant Left Ventricular Diastolic Dysfunction: Efficacy of Bromocriptine

    Directory of Open Access Journals (Sweden)

    Piercarlo Ballo

    2012-01-01

    Full Text Available Management of patients with peripartum cardiomyopathy (PPCM is still a major clinical problem, as only half of them or slightly more show complete recovery of left ventricular (LV function despite conventional evidence-based treatment for heart failure. Recent observations suggested that bromocriptine might favor recovery of LV systolic function in patients with PPCM. However, no evidence exists regarding its effect on LV diastolic dysfunction, which is commonly observed in these patients. Tissue Doppler (TD is an echocardiographic technique that provides unique information on LV diastolic performance. We report the case of a 37-year-old white woman with heart failure (NYHA class II, moderate LV systolic dysfunction (ejection fraction 35%, and severe LV diastolic dysfunction secondary to PPCM, who showed no improvement after 2 weeks of treatment with ramipril, bisoprolol, and furosemide. At 6-week followup after addition of bromocriptine, despite persistence of LV systolic dysfunction, normalization of LV diastolic function was shown by TD, together with improvement in functional status (NYHA I. At 18-month followup, the improvement in LV diastolic function was maintained, and normalization of systolic function was observed. This paper might support the clinical utility of bromocriptine in patients with PPCM by suggesting a potential benefit on LV diastolic dysfunction.

  2. Peripartum cardiomyopathy presenting with predominant left ventricular diastolic dysfunction: efficacy of bromocriptine.

    Science.gov (United States)

    Ballo, Piercarlo; Betti, Irene; Mangialavori, Giuseppe; Chiodi, Leandro; Rapisardi, Gherardo; Zuppiroli, Alfredo

    2012-01-01

    Management of patients with peripartum cardiomyopathy (PPCM) is still a major clinical problem, as only half of them or slightly more show complete recovery of left ventricular (LV) function despite conventional evidence-based treatment for heart failure. Recent observations suggested that bromocriptine might favor recovery of LV systolic function in patients with PPCM. However, no evidence exists regarding its effect on LV diastolic dysfunction, which is commonly observed in these patients. Tissue Doppler (TD) is an echocardiographic technique that provides unique information on LV diastolic performance. We report the case of a 37-year-old white woman with heart failure (NYHA class II), moderate LV systolic dysfunction (ejection fraction 35%), and severe LV diastolic dysfunction secondary to PPCM, who showed no improvement after 2 weeks of treatment with ramipril, bisoprolol, and furosemide. At 6-week followup after addition of bromocriptine, despite persistence of LV systolic dysfunction, normalization of LV diastolic function was shown by TD, together with improvement in functional status (NYHA I). At 18-month followup, the improvement in LV diastolic function was maintained, and normalization of systolic function was observed. This paper might support the clinical utility of bromocriptine in patients with PPCM by suggesting a potential benefit on LV diastolic dysfunction.

  3. Bromocriptine treatment associated with recovery from peripartum cardiomyopathy in siblings: two case reports

    Directory of Open Access Journals (Sweden)

    Drexler Helmut

    2010-03-01

    Full Text Available Abstract Introduction Peripartum cardiomyopathy is a rare form of cardiomyopathy, with heterogeneous presentation occurring in women between one-month antepartum and six months postpartum. It carries a poor prognosis and a high risk of mortality. Case presentation We report the development of peripartum cardiomyopathy in two sisters, 27- and 35-year-old African women, one of whom presented with a large left ventricular thrombus. Subsequently, both patients were treated with bromocriptine, heparin and standard therapy for heart failure (angiotensin converting enzyme inhibitors, beta-blockers and diuretics. During follow-up, the left ventricular thrombus observed in one patient degraded. Neither patient experienced a thrombotic event, and both experienced continuous improvements in cardiac function and New York Heart Association stage. Conclusion The development of peripartum cardiomyopathy in two sisters indicates that there may be a genetic basis for this type of cardiomyopathy, and that women with a positive family history for peripartum cardiomyopathy may have an increased risk of developing the disease. This is also the first report of a patient experiencing degradation of a large left ventricular thrombus under standard therapy for heart failure with bromocriptine. It suggests that the use of bromocriptine in association with adequate anti-coagulation and heart failure therapy may be beneficial and safe.

  4. Body weight changes in female patients with prolactinoma treated with bromocriptin

    Directory of Open Access Journals (Sweden)

    Z. Velija-Ašimi;

    2007-08-01

    Full Text Available The aim of this study was to determine the body weight changes in female patients with bromocriptin treated prolactinoma. Seventeen hyperprolactinemic pre-menopausal female with prolactinoma, aged 18-45 years, with body mass index (BMI 30+/-2,1kg/m2 were included. Basal insulin level was measured in all patients as well as concentrations of luteinizing hormone (LH, follicle-stimulating hormone (FSH, estrogens, testosterone, thyroid-stimulating hormone (TSH and prolactin (PRL. All patients were treated with bromocriptine. PRL levels significantly decreased after six months of the treatment (3543+/-1211 vs.1130+/-588 μIU/ml, p<0.05. After a year of the treatment PRL level was normalized (560+/-297 μIU/ml. Mean body weight did not significantly change during the first 6 months but after a two-year period it significantly decreased (27.6+/-1,4kg/m2. Waist/hip ratio did not significantly change. Normalization of menstrual cycle and libido was obtained in all patients. The results of this study suggest that hyperprolactinemia may be regarded as a reversible cause of obesity in female patients with prolactinoma, and bromocriptin has an important role in the weight loss and insulin decreasing and normalization of gonadotropin secretion as well.

  5. Comparison between bromocriptine and selegiline in treatment of parkinson`s disease

    Directory of Open Access Journals (Sweden)

    Alijan Ahmadi Ahangar

    2005-01-01

    Full Text Available Parkinson's disease is a common degenerative disease that causes rigidity, bradykinesia and rest tremor in patients. Available treatments include levodopa (the major drug and other supplementary drugs (bromocriptine or selegiline which can reduce such disabilities, but because of the necessity of their uses for a long term treatment, many side effects are being expected. Thus, due to lack of sufficient reports about efficacy and side effects of such supplementary drugs, this experimental study was carried out. Seventy seven patients (50 men and 27 women with the average age of 68±8.42 years were divided into three groups. In group A, levodopa and trihexyphenidyl (Artan® were administered to 18 patients. In group B, selegiline (Deprenyl® was used as a supplementary and was administered with levodopa and trihexyphenidyl for 25 patients. In group C, bromocriptine was used in place of selegiline, for 34 patients. In a three year period, the patients were followed up, in conformity with UPDRS (Unified Parkinson's Disease Rate Scale. In this experimental study, group C showed better physical activities in comparison with group A and group B, in spite of having better conditions at the first year showed totally little differences in comparison with group A. With a view to side effect particularly dyskinesia; there was little side effect in group C. On the basis of results of this investigation it appears that bromocriptine as a supplementary drug in comarison to selegiline has fewer side effects.

  6. Terguride as a new anti-hyperprolactinemic agent: characterization in rats and dogs in comparison with bromocriptine.

    Science.gov (United States)

    Mizokawa, T; Akai, T; Nakada, Y; Yamaguchi, M; Nakagawa, H; Hasan, S; Rettig, K J; Wachtel, H

    1993-11-01

    Terguride, a derivative of the ergot alkaloid, was characterized as a new anti-hyperprolactinemic agent in rats and dogs in comparison with bromocriptine. Terguride was found to bind selectively to the pituitary dopamine D2-receptors with a high affinity (Kd = 0.39 nM). In reserpinized rats, terguride at 0.03 mg/kg, p.o. significantly reduced the serum prolactin (PRL) level. The PRL lowering effect and the effective dose were longer lasting and about 30 times lower than those of bromocriptine, respectively. In rats bearing estrogen-induced pituitary prolactinoma, chronic terguride induced shrinkage of the prolactinoma as well as reduction of the high serum PRL level. In lactating rats, terguride (1.0 mg/kg, s.c.) reduced milk production in the mammary gland, whereas bromocriptine showed no significant effect up to 10 mg/kg, s.c. Terguride (10 mg/kg, p.o.) did not induce any stereotypy and hypermotility in reserpinized rats, while bromocriptine induced both stereotypy and hypermotility significantly at 10 mg/kg, p.o. In dogs, terguride, like bromocriptine, reduced the serum PRL level, but did not affect the serum levels of growth hormone and luteinizing hormone. In dogs, bromocriptine induced both emesis and PRL-lowering at almost the same dose, whereas emesis-inducing doses of terguride were about 100 times higher than the PRL-lowering dose. These results suggest that terguride as a dopamine D2-agonist is a potent inhibitor of PRL secretion with less neurotropic side effects compared to bromocriptine, and thus a useful drug for the treatment of galactorrhea and hyperprolactinemia including prolactinoma.

  7. Bromocriptine mesylate: Food and Drug Administration approved new approach in therapy of non-insulin dependant diabetes mellitus with poor glycemic control.

    Science.gov (United States)

    Keche, Yogendra

    2010-04-01

    Food and Drug Administration (FDA) approved bromocriptine mesylate, a quick release formulation, 0.8 mg tablets, as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Bromocriptine products were previously approved by the FDA for the treatment of pituitary tumors and Parkinson's disease. Bromocriptine is thought to act on circadian neuronal activities within the hypothalamus to reset abnormally elevated hypothalamic drive for increased plasma glucose, triglyceride, and free fatty acid levels in fasting and postprandial states in insulin-resistant patients. Adverse events most commonly reported in clinical trials of bromocriptine included nausea, fatigue, vomiting, headache, and dizziness. These events lasted a median of 14 days and were more likely to occur during initial titration of the drug. Due to novel mechanism of action, single daily dose, and lower incidence of stroke, myocardial infarction and vascular events, bromocriptine may act as landmark in treatment of type 2 diabetes.

  8. Lack of tumor reduction in hyperprolactinemic women with extrasellar macroadenomas treated with bromocriptine

    Energy Technology Data Exchange (ETDEWEB)

    Boulanger, C.M.; Mashchak, C.A.; Chang, R.J.

    1985-10-01

    Three patients with hyperprolactinemia and large extrasellar pituitary macroadenomas were treated with bromocriptine, 10 mg daily, for 8 weeks. In spite of correction of their amenorrhea, galactorrhea, and hyperprolactinemia, radiologic evaluation by CT scan failed to show evidence of tumor shrinkage. After surgical resection, histologic examination revealed that PRL-secreting cells comprised only a small portion of the tumor cell population in two patients and in the third patient were completely absent. These cases illustrate that large nonfunctional pituitary tumors may mimic signs and symptoms of a prolactinoma and stress the importance of adequate radiologic evaluation during medical management. 8 references, 3 figures.

  9. Sex-related changes in tumor consistency in prolactinoma patients after bromocriptine pretreatment

    Institute of Scientific and Technical Information of China (English)

    Yimin Huang; Feng Hu; Kang Wu; Juan Chen; Ran Li; Hao Xu; Ting Lei

    2016-01-01

    Objective It has long been reported that prolactinomas treated with bromocriptine increase fibrosis and may af ect surgical outcomes. We retrospectively studied 238 consecutive patients with histopathological y confirmed prolactinomas undergoing microsurgery in a single neurosurgery department of Tongji Hospital (Wuhan, China) from 2012 to 2015 in order to evaluate tumor consistency changes after bromocriptine pretreatment and surgical outcomes. Methods We divided the patients into four groups: males in the dopamine agonist (DA) group, females in the DA group, males in the no DA group, and females in the no DA group, and we compared the surgery process, specimen Masson staining, and clinical outcomes of the four groups. According to a previously published classification, the operative notes from an experienced neurosurgeon were reviewed to classify the consistency of tumors as “fibrous” or “nonfibrous”. Results No dif erences in tumor consistency were found in male patients with or without DA treatment. However, in female patients with DA treatment, tumors were likely to be harder in texture than the tumors of female patients without DA treatment. Despite tumor consistency dif erences between sexes, the tumor biological remission rate was similar between groups, as was the rate of tumor resection. Discussion Our study indicates that preoperative DA therapy impacts tumor consistency in female pa-tients but not male patients. Although the surgical and histopathological outcomes are not influenced, these findings may provide useful information for the choice of operative approach and surgery process for pitu-itary adenoma.

  10. Effectively managing intractable central hyperthermia in a stroke patient by bromocriptine: a case report

    Directory of Open Access Journals (Sweden)

    Yu KW

    2013-05-01

    Full Text Available Kuo-Wei Yu,1,* Yu-Hui Huang,2,3 Chien-Lin Lin,1,4,* Chang-Zern Hong,5 Li-Wei Chou1,41Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 2School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 3Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan; 4School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 5Department of Physical Therapy, Hungkuang University, Taichung, Taiwan*These authors contributed equally to this workAbstract: Central hyperthermia is characterized by a rapid onset, high temperature, marked temperature fluctuation, and poor response to antipyretics and antibiotics. Although poststroke central hyperthermia is common, prolonged instances are rare. We report a case of prolonged central fever after an intracranial hemorrhage. Before the accurate diagnosis and management of central fever, the patient underwent long-term antibiotic use that led to pseudomembranous colitis. Bromocriptine was used to treat the prolonged central hyperthermia, after which the fever did not exceed 39°C. A week later, the body temperature baseline was reduced to 37°C and a low-grade fever with minor temperature fluctuation occurred only a few times. No fever occurred in the month following the treatment. After the fever subsided, the patient could undergo an aggressive rehabilitation program.Keywords: bromocriptine, central hyperthermia, fever, stroke

  11. Kinetic profiling an abundantly expressed planarian serotonergic GPCR identifies bromocriptine as a perdurant antagonist

    Directory of Open Access Journals (Sweden)

    John D. Chan

    2016-12-01

    Full Text Available The diversity and uniqueness of flatworm G protein coupled receptors (GPCRs provides impetus for identifying ligands useful as tools for studying flatworm biology, or as therapeutics for treating diseases caused by parasitic flatworm infections. To catalyse this discovery process, technologies optimized for mammalian GPCR high throughput screening need be transposed for screening flatworm GPCRs. Here, we demonstrate the utility of a genetically encoded cAMP biosensor for resolving the properties of an abundantly expressed planarian serotonergic GPCR (S7.1R. Application of this methodology resolved the real time kinetics of GPCR modulation by ligands and demonstrated a marked difference in the kinetic action of antagonists at S7.1R. Notably, bromocriptine caused a protracted inhibition of S7.1R activity in vitro and a protracted paralysis of planarian movement, replicating the effect of S7.1R in vivo RNAi. The lengthy inhibition of function caused by bromocriptine at this abundantly expressed GPCR provides a useful tool to ablate serotonergic signaling in vivo, and is a noteworthy feature for exploitation as an anthelmintic vulnerability.

  12. Seasonal patterns of circulating progesterone and prolactin and response to bromocriptine in the female tammar Macropus eugenii.

    Science.gov (United States)

    Tyndale-Biscoe, C H; Hinds, L A

    1984-01-01

    Concentrations of prolactin and progesterone in the plasma of female tammars (Macropus eugenii) were measured during lactational quiescence and seasonal quiescence and during the period of natural resumption of reproduction after the summer solstice in December. Prolactin concentrations were consistently low (less than 40 ng/ml) during the period of declining day length and consistently elevated (greater than 40 ng/ml) during the period of increasing day length. Basal levels of progesterone were lowest (118.9 +/- 9.1 pg/ml) at the winter solstice and highest (244.1 +/- 21.0 pg/ml) at the summer solstice. Treatment with bromocriptine (CB154) did not depress prolactin levels at either time of the year but during February to June a single injection of 5 mg/kg body wt induced development of the quiescent corpus luteum (CL) and the diapausing embryo was reactivated. In February and March the level of progesterone increased in association with the developing CL, but after treatment at the winter solstice in June plasma progesterone did not increase although pregnancy was successfully completed. From September through November only 1 of 50 females responded to bromocriptine. None responded to bromocriptine given at the summer solstice in December, but all these animals spontaneously reactivated 2 weeks later. The difference in response of female tammars to bromocriptine treatment in the two halves of the year suggests that different endocrine controls operate in lactational and seasonal quiescence and that the latter is more complex.

  13. Subchronic Oral Bromocriptine Methanesulfonate Enhances Open Field Novelty-Induced Behavior and Spatial Memory in Male Swiss Albino Mice

    Directory of Open Access Journals (Sweden)

    Olakunle James Onaolapo

    2013-01-01

    Full Text Available This study set out to assess the neurobehavioral effects of subchronic, oral bromocriptine methanesulfonate using the open field and the Y-maze in healthy male mice. Sixty adult Swiss albino mice were assigned into three groups. Controls received normal saline, while test groups received bromocriptine methanesulfonate at 2.5 and 5 mg/kg/day, respectively, for a period of 21 days. Neurobehavioral tests were carried out on days 1 and 21 after administration. Open field assessment on day 1 after administration revealed significant increase in grooming at 2.5 and 5 mg/kg, while horizontal and vertical locomotion showed no significant changes. Day 1 also showed no significant changes in Y-maze alternation. On day 21, horizontal locomotion, rearing, and grooming were increased significantly at 2.5 and 5 mg/kg doses after administration; also, spatial memory was significantly enhanced at 2.5 mg/kg. In conclusion, the study demonstrates the ability of oral bromocriptine to affect neurobehavior in normal mice. It also suggests that there is a cumulative effect of oral bromocriptine on the behaviors studied with more changes being seen after subchronic administration rather than after a single oral dose.

  14. Effectively managing intractable central hyperthermia in a stroke patient by bromocriptine: a case report.

    Science.gov (United States)

    Yu, Kuo-Wei; Huang, Yu-Hui; Lin, Chien-Lin; Hong, Chang-Zern; Chou, Li-Wei

    2013-01-01

    Central hyperthermia is characterized by a rapid onset, high temperature, marked temperature fluctuation, and poor response to antipyretics and antibiotics. Although poststroke central hyperthermia is common, prolonged instances are rare. We report a case of prolonged central fever after an intracranial hemorrhage. Before the accurate diagnosis and management of central fever, the patient underwent long-term antibiotic use that led to pseudomembranous colitis. Bromocriptine was used to treat the prolonged central hyperthermia, after which the fever did not exceed 39°C. A week later, the body temperature baseline was reduced to 37°C and a low-grade fever with minor temperature fluctuation occurred only a few times. No fever occurred in the month following the treatment. After the fever subsided, the patient could undergo an aggressive rehabilitation program.

  15. Impulse control disorder in a patient on long-term treatment with bromocriptine for a macroprolactinoma.

    Science.gov (United States)

    Thondam, Sravan Kumar; Alusi, Sundus; O'Driscoll, Kieran; Gilkes, Catherine E; Cuthbertson, Daniel J; Daousi, Christina

    2013-01-01

    Impulse control disorders (ICDs) constitute socially disruptive behaviors such as pathological gambling, impulsive eating, compulsive shopping, and hypersexuality. These conditions are well recognized in patients on dopamine agonist (DA) therapy for Parkinson disease. Dopamine agonists are widely used as first-line agents in the treatment of prolactinomas, but ICDs in this group of patients are relatively rare, perhaps because of lower therapeutic doses used. A review of the literature yielded only a few cases of ICDs in patients on DA treatment for prolactinomas. These symptoms are perhaps underreported because of lack of awareness among patients and health care professionals. Impulse control disorders are recognized psychiatric disorders that have significant psychological and social implications, and patients need to be counselled about this rare possibility when embarking on prolonged DA therapy. We describe a young patient with severe, socially disruptive impulsivity manifesting with pathological gambling who had been on long-term bromocriptine therapy for a macroprolactinoma.

  16. Real Time Imaging of Biomarkers in the Parkinson's Brain Using Mini-Implantable Biosensors. II. Pharmaceutical Therapy with Bromocriptine

    Directory of Open Access Journals (Sweden)

    Patricia A. Broderick

    2009-12-01

    Full Text Available We used Neuromolecular Imaging (NMI and trademarked BRODERICK PROBE® mini-implantable biosensors, to selectively and separately detect neurotransmitters in vivo, on line, within seconds in the dorsal striatal brain of the Parkinson’s Disease (PD animal model. We directly compared our results derived from PD to the normal striatal brain of the non-Parkinson’s Disease (non-PD animal. This advanced biotechnology enabled the imaging of dopamine (DA, serotonin (5-HT, homovanillic acid (HVA a metabolite of DA, L-tryptophan (L-TP a precursor to 5-HT and peptides, dynorphin A 1-17 (Dyn A and somatostatin (somatostatin releasing inhibitory factor (SRIF. Each neurotransmitter and neurochemical was imaged at a signature electroactive oxidation/half-wave potential in dorsal striatum of the PD as compared with the non-PD animal. Both endogenous and bromocriptine-treated neurochemical profiles in PD and non-PD were imaged using the same experimental paradigm and detection sensitivities. Results showed that we have found significant neurotransmitter peptide biomarkers in the dorsal striatal brain of endogenous and bromocriptine-treated PD animals. The peptide biomarkers were not imaged in dorsal striatal brain of non-PD animals, either endogenously or bromocriptine-treated. These findings provide new pharmacotherapeutic strategies for PD patients. Thus, our findings are highly applicable to the clinical treatment of PD.

  17. Chronic treatment with long-acting bromocriptine does not affect duration of the breeding season, voluntary food intake, body weight, or wool growth in the Scottish blackface ewe.

    Science.gov (United States)

    Curlewis, J D; Sibbald, A M; Milne, J A; McNeilly, A S

    1991-01-01

    The aim of this study was to determine whether suppression of the seasonal increase in prolactin concentrations by chronic treatment with the dopamine agonist bromocriptine would affect onset of anoestrus, voluntary food intake, body weight, and wool growth in a seasonal breed of sheep. Groups of eight Scottish Blackface ewes were injected i.m. each week with either the vehicle (Group A) or 2.0 mg (Group B), 6.0 mg (Group C), or 18.0 mg (Group D) of bromocriptine in a long-acting formulation, commencing on 18 January and terminating on 25 July (midwinter to midsummer in the northern hemisphere). Immediately before the bromocriptine injection, blood samples were taken for progesterone and prolactin determination. Voluntary food intakes were measured daily, and body weights were recorded every fortnight. Estimates of wool growth were made by weighing wool clipped from a measured area of skin once a month. Treatment had no effect on onset of anoestrus, voluntary food intake, body weight, or wool growth. Plasma prolactin concentrations increased significantly in all groups during the treatment period. From January to April, all doses of bromocriptine significantly reduced prolactin concentrations but later in the study (May and June) prolactin was significantly suppressed in Group D only, although even in this group prolactin concentrations increased between March and June. Pituitary prolactin content, measured at the end of the study in July, was also suppressed by bromocriptine. The gradual increase in prolactin concentrations in ewes receiving chronic bromocriptine was further investigated by treating a fifth group of ewes (Group E) with 18.0 mg of long-acting bromocriptine each week, commencing on 20 June.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. A sensitive and rapid HPLC-MS/MS method for the quantitative determination of trace amount of bromocriptine in small clinical prolactinoma tissue.

    Science.gov (United States)

    Zang, Qingce; Liu, Yang; He, Jiuming; Yue, Xiaofei; Zhang, Ruiping; Wang, Renzhi; Abliz, Zeper

    2015-05-01

    Usually, insufficient intratumoral concentration of therapeutic drugs is one of the reasons for tumor treatment failure. However, little is known about intratumoral distribution of bromocriptine in non-responding prolactinomas because of extremely low drug concentration and small prolactinoma tissue samples. In this study, a sensitive, rapid and high-throughput quantitative bioanalytical method has been established by using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) for the determination of bromocriptine at trace level in human prolactinoma tissue. As little as 20 mg (wet weight) tissue sample was required and total analysis time was 6 min in this method. The assay quantifies over a linear range of 50 fg/mg to 5 pg/mg, and has a 25 fg/mg limit of detection at a signal/noise ratio of 3. This validated method was successfully used to quantitatively determine bromocriptine in clinical post-operative bromocriptine-sensitive and -resistant prolactinomas. The results revealed bromocriptine concentration in resistant prolactinomas (0.49-1.25 pg/mg) was significantly higher than that in sensitive prolactinomas (0.057-0.47 pg/mg). These results provided direct evidence to demonstrate the reseaon for failure of bromocriptine treatment in some patients with prolactinoma was "intrinsic" tumor (cell) resistence, rather than insufficient drug concentration in tumor tissue. Additionaly, this HPLC-MS/MS method has been shown to be suitable for bromocriptine analysis in small amount tissue sample and could be adapted for therapeutic drug monitoring of other clinical medicine.

  19. Differential morphological effects in rat corpora lutea among ethylene glycol monomethyl ether, atrazine, and bromocriptine.

    Science.gov (United States)

    Taketa, Yoshikazu; Inoue, Kaoru; Takahashi, Miwa; Yamate, Jyoji; Yoshida, Midori

    2013-07-01

    Ethylene glycol monomethyl ether (EGME) or atrazine induces luteal cell hypertrophy in rats. Our previous study suggested that EGME stimulates both new and old corpora lutea (CL), while atrazine stimulates new CL. Bromocriptine (BRC) is known to suppress the luteolysis in rats. This study investigated the light- and electron-microscopic luteal changes induced by EGME, atrazine, or BRC. Female rats were treated with EGME (300 mg/kg/day), BRC (2 mg/kg/day), EGME and BRC (EGME + BRC), or atrazine (300 mg/kg/day) for 7 days. Luteal cell hypertrophy induced by EGME, EGME + BRC, and atrazine was subclassified into the following two types: CL hypertrophy, vacuolated type (CL-V) characterized by intracytoplasmic fine vacuoles, and CL hypertrophy, eosinophilic type (CL-E) characterized by eosinophilic and abundant cytoplasm. The proportions of CL-V and CL-E were different among the treatments. BRC-treated old CL showed lower proportion of endothelial cells and fibroblasts than normal old CL. Ultrastructural observation revealed that the luteal cells of CL-V contained abundant lipid droplets, whereas those of CL-E in EGME and EGME + BRC groups showed uniformly well-developed smooth endoplasmic reticulum. No clear ultrastructural difference was observed between the control CL and atrazine-treated CL-E. These results indicate that EGME, atrazine, and BRC have differential luteal morphological effects.

  20. Effects of bromocriptine and radiation on the size and activity of estrogen-induced rat prolactinomas

    Energy Technology Data Exchange (ETDEWEB)

    Hori, Tomokatsu; Numata, Hideharu; Hokama, Yasuo; Muraoka, Kiyoaki; Saito, Yoshikazu (Tottori Univ., Yonago (Japan). School of Medicine); Kawamoto, Kaoru

    1985-01-01

    Estrogen-induced rat prolactinomas were produced after seven weekly injections of 2.5 mg of estradiol valerate. The rats were treated with various combinations of therapeutic agents. They were divided into four groups including the bromocriptine (CB) treated group, irradiated group, combined CB and radiation treated group, and finally the control group. Serum concentrations of prolactin and weights of tumors containing pituitary tissues were measured and statistically compared. The suppressing effect of CB against prolactinomas was well demonstrated in their hormonal activities. But it alone was not effective in reducing the size of prolactinomas. Concerning irradiation, on the 17th day it alone was not effective in reducing hormonal activities of rat prolactinomas. In the chronic stage, on the 30th day radiation alone was effective in reducing hormonal activity. Throughout the experiment CB was more potent than radiation in reducing hormonal activity. Concerning the size reducing effect, combined use of CB with radiation was significantly effective. If CB is not sufficient in reducing the size and hormonal activity of human prolactinoma, its combined use with radiation may be suggested.

  1. An SLE patient with prolactinoma and recurrent granulomatous mastitis successfully treated with hydroxychloroquine and bromocriptine.

    Science.gov (United States)

    Zhang, L-N; Shi, T-Y; Yang, Y-J; Zhang, F-C

    2014-04-01

    Granulomatous mastitis (GM) is a rare benign mammary lesion in which autoimmunity and hyperprolactinemia are considered possible etiological factors. GM has a high frequency of relapse and may lead to chronic ulceration and fistula if not treated properly. Here we report a case of a 22-year-old systemic lupus erythematosus (SLE) patient with three years' disease duration, stable on prednisone and hydroxychloroquine, who was found to have prolactinoma and recurrent GM after she discontinued medication on her own accord. The patient subsequently recovered and remained free of GM relapse under treatment of prednisone, hydroxychloroquine and bromocriptine. Though autoimmune disorders and prolactinoma were reported in GM, a coexisting condition of SLE, prolactinoma, and granulomatous mastitis has rarely been observed in one patient. We suggest our case as an illustrative example of the complex interaction between autoimmunity, neuroendocrine dysfunction, and manifestations in the breast: Immunological disturbances in the background of SLE, coupled with elevated prolactin levels secondary to a prolactinoma, may have predisposed the patient to the development of GM. The mammary lesion recovered and maintained free of relapse under immunosuppressive and antiprolactinemic therapy.

  2. Effects of postnatal bromocriptine injection on thyroid function and prolactinemia of rats at adulthood.

    Science.gov (United States)

    Carvalho, Janaine C; Lisboa, Patricia C; de Oliveira, Elaine; Peixoto-Silva, Nayara; Nobre, Jessica L; Fraga, Mabel C; Manhães, Alex C; Moura, Egberto G

    2016-10-01

    Previously, we demonstrated that maternal prolactin inhibition at the end of lactation, using bromocriptine (BRO), leads to an increase in leptin transfer via milk and induces the adult progeny to present hypothyroidism, leptin resistance and metabolic syndrome (obesity, hyperglycemia, hypertriglyceridemia, lower HDL). To test if these alterations are due to direct BRO action on the pups, in the present study we evaluated the long-term effects of direct injection of BRO (0.1μg/once daily) in male Wistar rats from postnatal (PN) day 1 to 10 (early treatment) or from PN11 to 20 (late treatment) on: food intake, body mass, cardiovascular parameters, hormone profile, hypothalamic leptin signaling, glucose homeostasis and thyroid hormone-dependent proteins. The respective controls were injected with methanol-saline. Offspring were killed at adulthood (PN180). Adult PN1-10 BRO-treated animals had lower food intake, hypoprolactinemia, lower leptin action (lower OBR-b, STAT-3 and SOCS-3 mRNA levels in the arcuate nucleus), lower TRH-TSH-thyroid axis as well as lower thyroid hormone markers. On the other hand, adult animals that were BRO-treated during the PN11-20 period showed hyperphagia, higher blood pressure, higher prolactinemia and OBR-b, higher TRH and plasma T3, hypercorticosteronemia as well as higher Dio2 and UCP1 mRNA expression in the brown adipose tissue. Glucose homeostasis was not changed treatment in either period. Our data show that early and late dopamine overexposure during lactation induces diverse metabolic disturbances later in life, increasing the risk of thyroid dysfunction and, consequently, changes in prolactinemia.

  3. Anterior ventral tegmental area dopaminergic neurons are not involved in the motivational effects of bromocriptine, pramipexole and cocaine in drug-free rats.

    Science.gov (United States)

    Ouachikh, Omar; Dieb, Wisam; Durif, Franck; Hafidi, Aziz

    2014-04-01

    Dopamine dysregulation syndrome in Parkinson's disease has been attributed to dopamine replacement therapies and/or a lesion of the dopaminergic system. Dopaminergic neuronal loss targets the substantia nigra and the ventral tegmental area (VTA). We hypothesize that dopamine replacement therapy is responsible for the potential reinforcement effect in Parkinson's disease, by acting on the neuronal reward circuitry. We previously demonstrated that the posterior (p) VTA, which projects to the nucleus accumbens (NAc), is implicated in the motivational effect of dopamine receptor agonists in 6-OHDA bilateral pVTA-lesioned drug-free animals. In the present study we investigated the implication of the anterior (a) VTA in the potential reinforcement effect of dopamine receptor agonists. Using the conditioned place preference (CPP) behavioral paradigm, we investigated the motivational effects of dopamine receptor agonists (bromocriptine and pramipexole), and cocaine in rats with a 6-OHDA bilateral lesion of the aVTA. Bromocriptine and pramipexole did not induce a significant CPP at 1mg/kg in both sham and bilateral 6-OHDA-lesioned rats. However bromocriptine induced CPP only at a dose of 3mg/kg in both animal groups. Moreover cocaine, which is known to increase dopamine release, induced reinforcing effects in both 6-OHDA-lesioned and sham rats. Our data show a lack of involvement of aVTA dopamine neurons in the motivational effects of bromocriptine, pramipexole and cocaine.

  4. Effects of bromocriptine on serum prolactin levels, pituitary weight and immunoreactive prolactin cells in estradiol-treated ovariectomized rats: an experimental model of estrogen-dependent hyperprolactinemia

    Directory of Open Access Journals (Sweden)

    M.F. Ribeiro

    1997-01-01

    Full Text Available The present study was designed to assess the effects of bromocriptine, a dopamine agonist, on pituitary wet weight, number of immunoreactive prolactin cells and serum prolactin concentrations in estradiol-treated rats. Ovariectomized Wistar rats were injected subcutaneously with sunflower oil vehicle or estradiol valerate (50 or 300 µg rat-1 week-1 for 2, 4 or 10 weeks. Bromocriptine (0.2 or 0.6 mg rat-1 day-1 was injected daily during the last 5 or 12 days of estrogen treatment. Data were compared with those obtained for intact control rats. Administration of both doses of estrogen increased serum prolactin levels. No difference in the number of prolactin cells in rats treated with 50 µg estradiol valerate was observed compared to intact adult animals. In contrast, rats treated with 300 µg estradiol valerate showed a significant increase in the number of prolactin cells (P<0.05. Therefore, the increase in serum prolactin levels observed in rats treated with 50 µg estradiol valerate, in the absence of morphological changes in the pituitary cells, suggests a "functional" estrogen-induced hyperprolactinemia. Bromocriptine decreased prolactin levels in all estrogen-treated rats. The administration of this drug to rats previously treated with 300 µg estradiol valerate also resulted in a significant decrease in pituitary weight and number of prolactin cells when compared to the group treated with estradiol alone. The general antiprolactinemic and antiproliferative pituitary effects of bromocriptine treatment reported here validate the experimental model of estrogen-induced hyperprolactinemic rats

  5. Timed Bromocriptine-QR Therapy Reduces Progression of Cardiovascular Disease and Dysglycemia in Subjects with Well-Controlled Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Bindu Chamarthi

    2015-01-01

    Full Text Available Background. Type 2 diabetes (T2DM patients, including those in good glycemic control, have an increased risk of cardiovascular disease (CVD. Maintaining good glycemic control may reduce long-term CVD risk. However, other risk factors such as elevated vascular sympathetic tone and/or endothelial dysfunction may be stronger potentiators of CVD. This study evaluated the impact of bromocriptine-QR, a sympatholytic dopamine D2 receptor agonist, on progression of metabolic disease and CVD in T2DM subjects in good glycemic control (HbA1c ≤7.0%. Methods. 1834 subjects (1219 bromocriptine-QR; 615 placebo with baseline HbA1c ≤7.0% derived from the Cycloset Safety Trial (this trial is registered with ClinicalTrials.gov Identifier: NCT00377676, a 12-month, randomized, multicenter, placebo-controlled, double-blind study in T2DM, were evaluated. Treatment impact upon a prespecified composite CVD endpoint (first myocardial infarction, stroke, coronary revascularization, or hospitalization for angina/congestive heart failure and the odds of losing glycemic control (HbA1c >7.0% after 52 weeks of therapy were determined. Results. Bromocriptine-QR reduced the CVD endpoint by 48% (intention-to-treat; HR: 0.52 [0.28−0.98] and 52% (on-treatment analysis; HR: 0.48 [0.24−0.95]. Bromocriptine-QR also reduced the odds of both losing glycemic control (OR: 0.63 (0.47−0.85, p=0.002 and requiring treatment intensification to maintain HbA1c ≤7.0% (OR: 0.46 (0.31−0.69, p=0.0002. Conclusions. Bromocriptine-QR therapy slowed the progression of CVD and metabolic disease in T2DM subjects in good glycemic control.

  6. The effect of octreotide and bromocriptine on expression of a pro-apoptotic Bax protein in rat prolactinoma.

    Directory of Open Access Journals (Sweden)

    Jolanta Kunert-Radek

    2004-03-01

    Full Text Available It is well established that disruption of apoptosis may lead to tumor initiation, progression or metastasis. It is also well documented that many anticancer drugs induce apoptosis. In the earlier studies, the dopamine D2 receptor agonist bromocriptine (BC and somatostatin analog octreotide (OCT were found to inhibit the growth of the estrogen-induced rat prolactinoma. Our previous investigations, applying the TUNEL method showed the involvement of the pro-apoptotic effect in the action of BC, and to a lesser degree, in the action of OCT. The aim of the present study was to investigate whether the pro-apoptotic action of these drugs involves the increased expression of Bax--a member of Bcl-2 protein family which is known to play an important role in the regulation of apoptosis. Male four-week Fisher 344 rats were used in the experiment. Capsules containing diethylstilboestrol (DES were implanted subcutaneously. Six weeks after the implantation the rats were given OCT (2 x 25 microg/animal/24, BC (3 mg/kg b.w./24 h or OCT and BC at the above doses for 10 days. Bax expression was detected by immunohistochemistry. Prolactin (PRL in blood serum was measured by radioimmunoassay (RIA. It has been found that both OCT and BC, alone or in combination, significantly reduce the tumor weight. Both OCT and BC suppressed PRL levels, but the inhibitory effect of BC was stronger than that of OCT. It has been found that the treatment with OCT and BC, alone or in combination, causes a significant increase in Bax expression in the rat prolactinoma cells. Our findings indicate that anti-tumoral action of bromocriptine and to some extent the action of octreotide in the experimental rat prolactinoma is connected with the induction of apoptosis and is associated with increased Bax expression.

  7. The effect of short-term metformin treatment on plasma prolactin levels in bromocriptine-treated patients with hyperprolactinaemia and impaired glucose tolerance: a pilot study.

    Science.gov (United States)

    Krysiak, Robert; Okrzesik, Joanna; Okopien, Boguslaw

    2015-05-01

    Metformin was found to affect plasma levels of some pituitary hormones. This study was aimed at investigating whether metformin treatment has an impact on plasma prolactin levels in bromocriptine-treated patients with hyperprolactinaemia and impaired glucose tolerance. The study included 27 patients with hyperprolactinaemia, who had been treated for at least 6 months with bromocriptine. Based on prolactin levels, bromocriptine-treated patients were divided into two groups: patients with elevated (group A, n = 12) and patients with normal (group B, n = 15) prolactin levels. The control group included 16 age-, sex- and weight-matched hyperprolactinaemia-free individuals with impaired glucose tolerance (group C).The lipid profile, fasting plasma glucose levels, the homeostatic model assessment of insulin resistance ratio (HOMA-IR), glycated haemoglobin, as well as plasma levels of prolactin, thyrotropin and insulin-like growth factor-1 (IGF-1) were assessed at baseline and after 4 months of metformin treatment (2.55-3 g daily). In all treatment groups, metformin reduced HOMA-IR, plasma triglycerides and 2-h postchallenge plasma glucose. In patients with hyperprolactinaemia, but not in the other groups of patients, metformin slightly reduced plasma levels of prolactin, and this effect correlated weakly with the metabolic effects of this drug. Our study shows that metformin decreases plasma prolactin levels only in patients with elevated levels of this hormone. The obtained results suggest that metformin treatment may bring some benefits to hyperprolactinaemic patients with coexisting glucose metabolism disturbances already receiving dopamine agonist therapy.

  8. „Mid-stimulation psychosis” in the course of in vitro fertilization procedure with the use of clomiphene citrate and bromocriptine – case study

    Directory of Open Access Journals (Sweden)

    Holka-Pokorska, Justyna

    2014-10-01

    Full Text Available Aim. A few cases of psychosis induced by clomiphene citrate have been described so far. However, data on the prevalence of psychotic symptoms among women treated for infertility are inconclusive. Still a little is known about possible psychiatric complications of medications used in assisted reproduction techniques (ART. We present a case of a patient who developed transient psychotic symptoms in the course of the in vitro fertilization procedures. To our knowledge, this is the first case of ‘mid-stimulation psychosis’, which has been observed during ART using clomiphene citrate and bromocriptine. The aim of this study is to describe the determinants of pharmacotherapy undertaken in ART, which can result in the development of psychotic symptoms. Methods. The case presentation Conclusions. The use of clomiphene citrate for ovulation induction in combination with bromocriptine used for chronic hyperprolactinemia is a likely mechanism that might have triggered psychotic symptoms in the case presented. However, combination therapy with clomiphen citrate and bromocriptine may be the pharmacological model of hyper-dopaminergia followed by chaotic changes in serum estrogen levels and might lead to an increased sensitivity of dopamine receptors. The above therapeutic schema may increase susceptibility to the development of psychotic symptoms in treated women. This impact should be considered in the case of any psychotic complications in patients undergoing assisted reproduction techniques.

  9. Bromocriptine increased operant responding for high fat food but decreased chow intake in both obesity-prone and resistant rats

    Energy Technology Data Exchange (ETDEWEB)

    Thanos, P.K.; Wang, G.; Thanos, P.K.; Cho, J. Kim, R.; Michaelides, M.; Primeaux, S.; Bray, G.; Wang, G.-J.; Volkow, N.D.

    2010-10-27

    Dopamine (DA) and DAD{sub 2} receptors (D2R) have been implicated in obesity and are thought to be involved in the rewarding properties of food. Osborne-Mendel (OM) rats are susceptible to diet induced obesity (DIO) while S5B/P (S5B) rats are resistant when given a high-fat diet. Here we hypothesized that the two strains would differ in high-fat food self-administration (FSA) and that the D2R agonist bromocriptine (BC) would differently affect their behavior. Ad-libitum fed OM and S5B/P rats were tested in a FSA operant chamber and were trained to lever press for high-fat food pellets under a fixed-ratio (FR1) and a progressive ratio (PR) schedule. After sixteen days of PR sessions, rats were treated with three different doses of BC (1, 10 and 20 mg/kg). No significant differences were found between the two strains in the number of active lever presses. BC treatment (10 mg/kg and 20 mg/kg) increased the number of active lever presses (10 mg/kg having the strongest effect) whereas it decreased rat chow intake in the home cage with equivalent effects in both strains. These effects were not observed on the day of BC administration but on the day following its administration. Our results suggest that these two strains have similar motivation for procuring high fat food using this paradigm. BC increased operant responding for high-fat pellets but decreased chow intake in both strains, suggesting that D2R stimulation may have enhanced the motivational drive to procure the fatty food while correspondingly decreasing the intake of regular food. These findings suggest that susceptibility to dietary obesity (prior to the onset of obesity) may not affect operant motivation for a palatable high fat food and that differential susceptibility to obesity may be related to differential sensitivity to D2R stimulation.

  10. Bromocriptine loaded chitosan nanoparticles intended for direct nose to brain delivery: pharmacodynamic, pharmacokinetic and scintigraphy study in mice model.

    Science.gov (United States)

    Md, Shadab; Khan, Rashid A; Mustafa, Gulam; Chuttani, Krishna; Baboota, Sanjula; Sahni, Jasjeet K; Ali, Javed

    2013-02-14

    The primary aim of this study was to investigate the potential use of chitosan nanoparticles as a delivery system to enhance the brain targeting efficiency of bromocriptine (BRC) following intranasal (i.n.) administration. The BRC loaded chitosan nanoparticles (CS NPs) were prepared by ionic gelation of CS with tripolyphosphate anions. These NPs had a mean size (161.3 ± 4. 7 nm), zeta potential (+40.3 ± 2.7 mV), loading capacity (37.8% ± 1.8%) and entrapment efficiency (84.2% ± 3.5%). The oral administration of haloperidol (2mg/kg) to mice produced typical Parkinson (PD) symptoms. Catalepsy and akinesia outcomes in animals receiving BRC either in solution or within CS NPs showed a reversal in catalepsy and akinesia behavior when compared to haloperidol treated mice, this reversal being specially pronounced in mice receiving BRC loaded CS NPs. Biodistribution of BRC formulations in the brain and blood of mice following i.n. and intravenous (i.v.) administration was performed using optimized technetium labeled (99mTc-labeled) BRC formulations. The brain/blood ratio of 0.47 ± 0.04, 0.69 ± 0.031, and 0.05 ± 0.01 for BRC solution (i.n.), BRC loaded CS NPs (i.n.) and (i.v.) respectively, at 0.5h are suggestive of direct nose to brain transport bypassing the blood-brain barrier. Gamma scintigraphy imaging of mice brain following i.v. and i.n. administrations were performed to determine the localization of drug in brain. The drug targeting index and direct transport percentage for BRC loaded CS NPs following i.n. route were 6.3 ± 0.8 and 84.2% ± 1.9%. These encouraging results confirmed the development of a novel non-invasive nose to brain delivery system of BRC for the treatment of PD.

  11. Bromocriptine increased operant responding for high fat food but decreased chow intake in both obesity-prone and resistant rats.

    Science.gov (United States)

    Thanos, Panayotis K; Cho, Jacob; Kim, Ronald; Michaelides, Michael; Primeaux, Stefany; Bray, George; Wang, Gene-Jack; Volkow, Nora D

    2011-02-01

    Dopamine (DA) and DA D₂ receptors (D2R) have been implicated in obesity and are thought to be involved in the rewarding properties of food. Osborne-Mendel (OM) rats are susceptible to diet induced obesity (DIO) while S5B/P (S5B) rats are resistant when given a high-fat diet. Here we hypothesized that the two strains would differ in high-fat food self-administration (FSA) and that the D2R agonist bromocriptine (BC) would differently affect their behavior. Ad-libitum fed OM and S5B/P rats were tested in a FSA operant chamber and were trained to lever press for high-fat food pellets under a fixed-ratio (FR1) and a progressive ratio (PR) schedule. After sixteen days of PR sessions, rats were treated with three different doses of BC (1, 10 and 20 mg/kg). No significant differences were found between the two strains in the number of active lever presses. BC treatment (10 mg/kg and 20 mg/kg) increased the number of active lever presses (10 mg/kg having the strongest effect) whereas it decreased rat chow intake in the home cage with equivalent effects in both strains. These effects were not observed on the day of BC administration but on the day following its administration. Our results suggest that these two strains have similar motivation for procuring high fat food using this paradigm. BC increased operant responding for high-fat pellets but decreased chow intake in both strains, suggesting that D2R stimulation may have enhanced the motivational drive to procure the fatty food while correspondingly decreasing the intake of regular food. These findings suggest that susceptibility to dietary obesity (prior to the onset of obesity) may not affect operant motivation for a palatable high fat food and that differential susceptibility to obesity may be related to differential sensitivity to D2R stimulation.

  12. Copulation is reactivated by bromocriptine in male rats after reaching sexual satiety with a same sexual mate.

    Science.gov (United States)

    Rojas-Hernández, Jorge; Juárez, Jorge

    2015-11-01

    Male sexual satiety has been associated with a decrease in dopamine levels. Spontaneous recovery of copulatory behavior begins at least 72 h after sexual satiety is reached or in the condition in which a sexually-satiated male is exposed to a new receptive female distinct from the one with which sexual satiety was reached. The aim of the present study was to explore whether dopaminergic activation by bromocriptine (BrCr) can reactivate copulatory behavior with the same sexual mate immediately after sexual satiety is reached. Male rats were divided into three groups exposed to one of the following three conditions: 1) administration of 2 mg/kgs.c. of BrCr and exposure to the same female with whom sexual satiety was previously reached; 2) administration of 0.3 mLs.c. of the vehicle solution with exposure to the same female with whom sexual satiety was reached; and, 3) exposure to a new receptive female after sexual satiety was reached. Results showed that BrCr significantly reactivated copulatory capability in sexually-satiated males with the same receptive female. In contrast, no males in the vehicle group ejaculated with the same female after reaching sexual exhaustion. Copulation was reactivated by BrCr in a way similar to that observed in untreated males exposed to a new receptive female (i.e., the Coolidge effect). The reversal of sexual satiety in the males treated with BrCr could be explained by its action on D2 family receptors, which promotes a reactivation of sexual motivation at a level sufficient to allow renewed copulation with the same female mate.

  13. Effect of Chinese Herbs Bu-shen on Expression of Pituitary PRL-R and PrRP-R in the Bromocriptine-induced Hypoprolactin Rat Abortion Model

    Institute of Scientific and Technical Information of China (English)

    Hai-yan WANG; Sui-qi GUI; Fang-xian LU; Li-min LU; Lin CAO

    2003-01-01

    Objective To study the effect of Chinese herbs preparation Bu-shen on pituitary prolactin-releasing peptide receptor(PrRP-R) and prolactin receptor(PRL-R) expression in the bromocriptine-induced rat abortion modelMaterials & Methods Female SD rats were divided into five groups randomly. Group A,B,C and D were injected with bromocriptine [0.3 mg/(kg*d)] during the pregnant day 6~8, respectively. Group B was given powder of Bu-shen herbs [3 g/(kg*d)]. Group C was injected with prolactin (8 IU) twice a day and Group D with progesterone [(8 mg/kg*d) in the pregnant day 1~11. The rats in Group E were normal pregnant rats. All these rats were killed at the pregnant day 12 to observe the expression of PrRP-R, PRL-R from the pituitary using RT-PCR.Results The pregnant rate and total number of litters in Group A were significantly lower than those in Group B, C, D and E (P<0.01) and the expression of PrRP-R and PRL-R in the pituitary of Group A was higher than that of any other group.Conclusion Preparation Bu-shen plays a regulatory role in the secretion of prolactin possibly via modulating rats' hypothalamus and pituitary.

  14. Update on glycemic control and weight reduction with bromocriptine treatment%溴隐亭降糖及减重的研究进展

    Institute of Scientific and Technical Information of China (English)

    包薇萍; 郑仁东; 刘超

    2013-01-01

    Recently, timed-release bromocriptine (cycloset), a sympatholytic dopamine D2 receptor agonist, has been approved by the U. S. Food and Drug Administration (FDA) for the treatment of T2DM. Bromocriptine acts on the central nervous system and improves insulin sensitivity through its regulation on glycolipid metabolism, opening a new way for the treatment of T2DM. In addition, it may be used for obesity for weight reduction and the effect is good.%溴隐亭为多巴胺受体激动剂.近年来,研制出的溴隐亭快速释放剂型——甲磺酸溴隐亭片(Cycloset),已被美国食品和药品管理局(FDA)批准用于治疗T2DM.作为一种作用于中枢神经系统的降糖药,其可通过改善糖脂代谢,减轻IR而发挥降糖作用,为T2DM的治疗另辟蹊径.另外,本药对于肥胖的治疗,已取得了显著的效果.

  15. Effect of Chinese Herbs Bu-shen on PRLR, PR, ER mRNA of Decidue in Bromocriptine-induced Hypoprolactin Rat Abortion Model

    Institute of Scientific and Technical Information of China (English)

    Kun-ming LI; Sui-qi GUI; Li-hui JIANG; Li-min LU

    2003-01-01

    Objective To explore the effect of Chinese herbs on PRLR, PR, ER mRNA of decidue in Bromocriptine-induced hypoprolactin abortion rat model from gene transcription level, and observe the changes of blood PRL, P, E2.Methods RT-PCR method was taken to analyses the differences of PRLR, PR, ER mRNA in decidue between model group (A group) and model + herbs group (A + H group); RIA was taken to measure the serum levels of PRL, P, E2.Results PRLR, PR mRNA expression in decidue of Group A was significantly lower than the A+H group (P0.05); the abortion rate of Group A was 67%, Group A+H was 17%, the difference was significant; as for the PRL and P level of day 7~10, the A group was significantly lower than the A+H group (P<0.05).Conclusion Bromocriptine could induce abortion by declining the blood PRL, P level and downregulating PRLR, PR mRNA expression in decidue. Chinese herbs might maintain pregnancy by promoting PRL, P secretion and upregulating PRLR, PR mRNA expression in decidue.

  16. Correlation between resistance to bromocriptine and plasma prolactin level in patients with prolactinoma.%垂体泌乳素腺瘤患者溴隐亭耐药与血清PRL水平的关系

    Institute of Scientific and Technical Information of China (English)

    张湘衡; 牟永告; 赛克; 杨群英; 魏大年; 蒋小兵; 钟鸣谷; 王振宁; 陈忠平

    2011-01-01

    Objective To observe the relationships between resistance to bromocriptine and plasma prolactin level in patients with prolactinoma, so as to provide evidence for early diagnosis. Methods The clinical data of 105 patients with prolactinomas were collected. According the response to bromocriptine therapy, subjects were divided into bromocriptine - sensitive group ( n = 86 ) and bromocriptine - resistant group ( n = 19 ), respectively. The baseline plasma prolactin levels were analysed by t - test between the two groups. Results Significantly higher baseline prolactin level was observed in bromocriptine - sensitive group than that in bromocriptine - resistant group ( P < 0. 05 ). Conclusion High plasma prolactin level predicts sensitive respond to bromocriptine therapy in patients with prolactinoma. However, biological correlative factors should be considered in prediction of the drug resistance. The conrrelation between expression of dopamine D2 receptor in tumor tissue and drug - resistance is worth further research.%目的 了解在对溴隐亭耐药和有效的泌乳素腺瘤患者间,早期血清PRL水平是否存在差异.方法 收集了105例垂体泌乳素腺瘤患者的临床资料,根据溴隐亭疗效分为有效组和耐药组,其中有效组86例,耐药组19例.对两组患者药物治疗前血清PRL水平进行比较.结果 有效组中患者早期血清PRL水平为(689.4±136.9)μg/L高于耐药组的(410.9±121.9)μg/L,差异有统计学意义(P<0.05).结论 血清PRL水平高的患者可能对药物有敏感性倾向,但要准确预测耐药现象,还应当结合分子生物学相关指标.多巴胺D2受体及其两种亚型D2s(short)和D2l(long)在肿瘤组织中的表达水平与耐药现象的相关性,值得进一步研究.

  17. Bromocriptine improves glycaemic control and serum lipid profile in obese Type 2 diabetic subjects: a new approach in the treatment of diabetes.

    Science.gov (United States)

    Cincotta; Meier; Cincotta Jr

    1999-10-01

    Bromocriptine, a potent dopamine D(2) receptor agonist, has been shown to reduce insulin resistance, glucose intolerance and hyperlipidaemia in both numerous animal studies and in Phase II studies. Bromocriptine has been used worldwide for over 20 years to treat Parkinson's disease, macroprolactinoma and other disorders; it has been found to be generally safe. We therefore investigated the possible beneficial effects of Ergoset(R) (Ergo Science Corp.), a new quick release formulation of bromocriptine, on glycaemic control and serum lipid profile in obese Type 2 diabetic subjects in two large Phase III studies. A large, randomised, double-blind placebo-controlled study was conducted in which Ergoset was given once daily at 8 am. (4.8 mg maximum dose) for 24 weeks as adjunctive therapy to sulphonylurea (485 subjects) to obese Type 2 diabetics held on a weight- maintaining diet. Treatment efficacy parameters included change from baseline in glycated haemoglobin A(1c) (HbA(1c)), fasting and post-prandial serum glucose, insulin, triglyceride and free fatty acid levels. Baseline glycated haemoglobin, fasting glucose, insulin, triglyceride and free fatty acid levels did not differ between treatment groups. and on average were 9.4 +/- 0.05%, 222 +/- 2 mg/dl, 24 +/- 1 µU/ml, 248 +/- 11 mg/dl, and 850 +/- 32 µEq/l, respectively. A similarly designed study of Ergoset as monotherapy in Type 2 diabetics (154 subjects) with similar baseline clinical characteristics was conducted. Addition of Ergoset treatment to sulphonylurea reduced percent glycated HbA(1c) by 0.55 (P fasting and post-prandial glucose by 23 and 26 mg/dl (P fasting and post-prandial triglycerides by 72 and 63 mg/dl (P fasting and post-prandial free fatty acids by 150 and 165 µEq/l (P < 0.05), relative to placebo. Twelve percent of all Ergoset subjects, compared to 3% of placebo subjects, withdrew from the study due to adverse events. The most common events causing withdrawal were nausea, dizziness, asthenia

  18. Validity of a radioimmunoassay for serum and pituitary prolactin in adult male rats. Effects of bromocriptine and thyrotropin-releasing hormone

    Energy Technology Data Exchange (ETDEWEB)

    Andre, M. Grizard, G.; Boucher, D. (Faculte de Medecine, 63 - Clermont-Ferrand (France))

    1981-01-01

    Validity of a radioimmunoassay for rat prolactin (PRL) in serum and pituitary is analysed in adult male rats. Data are presented bearing on the accuracy, precision and sensitivity of the method. Serum levels and pituitary content are respectively ranged from 2,56 to 28,03 ng PRL RP/sub 2/ ml/sup -1/ and from 7,36 to 21,44 ..mu..g PRL RP/sub 2/ per gland in intact animals. Treatment with bromocriptine (10 days) results in a decrease of serum PRL levels and pituitary PRL contents. In progesterone-estradiol benzoate pretreated rats, serum PRL levels are increased 20 min after the injection of TRH.

  19. 溴隐亭对大鼠催乳素瘤细胞表达bcl-2、Bax的影响%Effect of bromocriptine on expression of Bax and bcl-2 in rat prolactinoma

    Institute of Scientific and Technical Information of China (English)

    杨雪梅; 徐春; 梁立武; 程海梅

    2012-01-01

    目的 研究溴隐亭对大鼠催乳素(prolactinoma,PRL)瘤表达bcl-2、Bax的影响.方法 (1)用皮下植入17β-雌二醇的方法制备大鼠催乳素瘤模型,同时设立10只大鼠为对照组;(2)将成功诱发出催乳素瘤的大鼠随机分2组,分别给予自来水(安慰剂组)、溴隐亭(溴隐亭组)灌胃,对照组也给予安慰剂灌胃,用药4周后处死动物,垂体称重,测定PRL、Bax、bcl-2的表达水平.结果 (1)17β-雌二醇组大鼠血清PRL水平[(4236.9±416.9) vs (121.2±12.8) ng/ml]和垂体重量[(62.0±5.1) vs (13.8±1.2) mg]均明显高于对照组(P<0.01),证实17β-雌二醇组成功诱发出大鼠泌乳素瘤.(2)溴隐亭组血清PRL水平和垂体重量低于安慰剂组(P<0.01),bcl-2表达水平较安慰剂组明显下降[(1.8±0.5) vs (4.0±0.6),P<0.01],Bax表达水平明显增高[(4.5±0.6) vs ( 1.0±0.3),P<0.01].结论 抑制bcl-2的表达,刺激Bax的表达,从而促进催乳素瘤细胞的凋亡可能是溴隐亭抗催乳素瘤的重要机制之一.%Objective To study the effect of bromocriptine on expression of Bax and bcl -2 in rat prolactinoma. Methods Firstly, to develop prolactinoma rats model. Adult Wistar rats were divided into two groups at random. The rats in control group were subscutaneously implanted with a blank implant . Rats in 17 p - estradiol group were implanted with 17 p - estradiol - containing implants. Secondly, Rats in 17p - estradiol group were divided into two groups at random, i. e. placebo group and bromocriptine group. Water was given to rats in placebo group. Bromocriptine was orally adminstered to rats in bromocriptine group. After 4 weeks of treatment, all the animals were sacrificed. Each pituitary gland was weighed. Serum prolactin(PRL) levels were measured by RIA. Expression level of Bax and bcl -2 in pituitary tissue were measured by Western blotting. Results (1) The weights of pituitary gland and PRL levels in 17p - estradiol group were significantly higher than those

  20. Effect of Bromocriptine on the Expression of Pit-1 in Prolactinoma Rats%溴隐亭对大鼠泌乳素瘤表达Pit-1的影响

    Institute of Scientific and Technical Information of China (English)

    邱文娟; 张绍峰; 徐春

    2013-01-01

    OBJECTIVE To investigate the effect of bromocriptine on the expression of Pit-1 in prolactinoma rats. METHODS Firstly, to prepare prolactinoma model in rats. Adult Wistar rats were divided into two groups at random. The rats in control group were subseutaneously implanted with a blank implant. Rats in 17β-estradiol group were implanted with 17β-estradiol-contaimng implants. Secondly, rates in 17β-estradiol group were divided into two groups at random; model group and bromocriptine group. Water was administrated to rats in model group. Bromocriptine (0. 225 mg·kg-1·d-1 ) were orally administrated to rats in bromocriptine group, the rats in control group were orally administrated with water. After four weeks of treatment, all the animals were executed. Each pituitary gland was weighed. Serum prolactin( PRL) levels were measured by RIA method. Pit-1 mRNA levels in pituitary tissue were measured by RT-PCR method. RESULTS The weights of pituitary gland and PRL levels in 17β-estradiol group were individually higher than those in control group (P <0.001). The expression levels of Pit-1 mRNA in bromocriptine group was obviously lower than that in model group ( P < 0. 001). CONCLUSION Bromocriptine has potential preventive effect to estrogen-induced rat pro-lactinoma. The decrease of Pit-1 mRNA level may be involved in the mechanism of anti-prolactinoma effect of bromocriptine.%目的 研究溴隐亭对大鼠泌乳素瘤表达Pit-1的作用.方法 皮下植入17β-雌二醇制备大鼠泌乳素瘤模型,将成年雌性大鼠随机分为2组,正常对照组植入空白硅胶管,17β-雌二醇纽植入装有17β-雌二醇的硅胶管;将成功诱发出泌乳素瘤的17β-雌二醇大鼠随机分2组,分为模型组、溴隐亭组(0.225 mg· kg-1·d-1),用药4周后处死动物,垂体称重,用放免法测定血清泌乳素水平,用反转录聚合酶链反应方法分析组织垂体Pit-1的表达水平.结果 17β-雌二醇组大鼠血清泌乳素水平和垂体质

  1. Effectiveness and safety of bromocriptine on treating prolactinoma in China: systematic review and Meta - analysis%国内溴隐亭治疗垂体催乳素瘤的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    何伟亮; 袁芳; 张亚卓; 杨少华

    2012-01-01

    Objective To evaluate the effectiveness and safety of bromocriptine on treating prolactinoma in China.Methods Case - controlled trials of bromocriptine on treating prolactinoma in China were collected,and systematic review and Meta - Analysis were conducted.Results A total of 8 case -control trials involving 1559 patients were included,and the average follow -up time was more than 6 months.As for the total effective rate and the incidence of side effects,no significant differences were found between bromocriptine and transsphenoidal microsurgery ( OR = O.80,95% CI:O.38 - 1.67,P = O.55 ) or (OR =3.70,95% CI:0.61 - 22.29,P =O.15),respectively. Conclusion Observational evidence supports that treatments of prolactinoma using bromocriptine compared to transsphenoidal microsurgery in China have no difference regarding the effective rate and the incidence of side effects.%目的 评价国内溴隐亭治疗垂体催乳素瘤的疗效和安全性.方法 搜集国内溴隐亭与经蝶窦入路显微手术治疗催乳素瘤的病例对照试验文献,对符合纳入标准的研究使用统计软件RevMan 5.1.0完成荟萃分析.结果 共纳入8篇回顾性对比分析文献研究,总计1 559例患者,平均随访时间6个月以上,利用随机效应模型进行荟萃分析,与经蝶窦入路显微手术组相比,溴隐亭组降低催乳素(PRL)分泌有效率的合并OR =0.80(95% CI:O.38 ~1.67),P=0.55,不良反应发生率的合并OR=3.70(95%CI:0.61~22.29),P=0.15.结论 国内的有限证据表明,与经蝶窦入路显微手术相比,口服溴隐亭在降低催乳素瘤患者血PRL水平和不良反应发生率方面差异没有统计学意义.

  2. Bromocriptine Mesylate Attenuates Amyotrophic Lateral Sclerosis: A Phase 2a, Randomized, Double-Blind, Placebo-Controlled Research in Japanese Patients.

    Directory of Open Access Journals (Sweden)

    Eiichiro Nagata

    Full Text Available Bromocriptine mesylate (BRC, a dopamine D2 receptor agonist has been shown to confer neuroprotection, sustained motor function and slowed disease progression in mouse models of amyotrophic lateral sclerosis (ALS Here we report a first in human trial in ALS.A multicenter, Riluzole add-on, randomized, double-blind, placebo controlled 102-week extension BRC clinical trial.The trial was conducted between January 2009 and March 2012 on 36 Japanese ALS patients. A 12-week treatment with Riluzole observational period was followed by combined treatment (Riluzole + BRC; n = 29 or Riluzole + placebo; n = 7. The dosing commenced at 1.25 mg/day increasing in steps at two weeks intervals to a maximum of 15 mg/day. The efficacy of BRC was evaluated by comparing BRC and placebo groups upon completion of stepwise dosing at 14 weeks 2 points (1st endpoint and upon completion or discontinuation of the study (2nd endpoint of the dosing.Statistics analyses revealed a marginal BRC treatment efficacy with P≦20%to placebo by 1st and 2nd endpoint analysis. In the 1st endpoint analysis, BRC group was significantly effective on the scores of ALSAQ40-communicaton (P = 1.2%, eating and drinking (P = 2.2%, ALSFRS-R total (P = 17.6%, grip strength (P = 19.8% compared to the placebo group. In the 2nd endpoint analysis, differences between the scores of Limb Norris Scale (P = 18.3%, ALSAQ40-communication (P = 11.9%, eating and drinking (P = 13.6%, and neck forward-bent test (P = 15.4% of BRC group were detected between the two groups. There was no significant difference between the treatment groups for adverse events or serious drug reactions incidence.BRC sustains motoneuronal function at least in part through BRC treatment. Further analysis involving a Phase 2b or 3 clinical trial is required but BRC currently shows promise for ALS treatment.UMIN Clinical Trials UMIN000008527.

  3. 垂体催乳素腺瘤患者妊娠期服用溴隐亭的疗效分析%Analysis of treating prolactinoma patients with bromocriptine during pregnancy

    Institute of Scientific and Technical Information of China (English)

    连伟; 刘念; 王任直; 幸兵; 姚勇

    2015-01-01

    Objective To explore the therapeutic efficacies and the timing of taking bromocriptine during pregnancy in patients with pituitary prolactinoma.Methods The clinical data were analyzed retrospectively for 230 women with pituitary prolactinoma at our hospital from January 2001 to May 2014.During January 2001 to December 2007,120 cases were selected as control group.During January 2008 to May 2014,110 cases were recruited into treatment group.When found pregnant,the control group immediately withdrew while the treatment group continued the original dose of bromocriptine.Results The rate of embryo stopping was 16.7% (20/120) in control group.As compared with the rate of natural population,the difference was statistically significant (P < 0.05); the rate was 0.91% (1/110) in treatment group.As compared with natural population,the difference had no significance (P > 0.05).No significant inter-group difference existed in embryonic malformation rate (P > 0.05).Conclusion Pituitary prolactinoma patients should continue the original dose of bromocriptine for at least 4 months instead of immediate withdrawal during pregnancy.For those with large adenoma,bromocriptine should be taken throughout pregnancy.Blood levels of prolactin,progesterone,human chorionic gonadotropin (HCG) and visual dysfunction should be monitored every 2 weeks.If the levels of progesterone and HCG are low,they should be timely supplemented.If prolactin rises too rapidly and visual dysfunction worsens,the dose of bromocriptine should be appropriately increased.Taking bromocriptine during pregnancy can significantly reduce the rate of embryo stopping without improving the rate of embryo deformity.Thus use of bromocriptine is both safe and necessary.%目的 探讨垂体催乳素腺瘤患者妊娠期服用溴隐亭药物治疗的临床治疗效果及服药时间的选择.方法 回顾性分析2001年1月至2014年5月期间北京协和医院神经外科门诊收治的230例未手术垂体催乳素

  4. Cabergoline or bromocriptine for prolactinoma?

    Directory of Open Access Journals (Sweden)

    Nicolás Triantafilo

    2016-09-01

    Full Text Available Resumen Cabergolina y bromocriptina son los fármacos más utilizados en el manejo del prolactinoma. Si bien cabergolina, un agonista dopaminérgico de vida media larga, tendría algunas ventajas desde el punto de vista fisiopatológico, no está claro si esto se traduce en un real beneficio. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos dos revisiones sistemáticas que en conjunto comprenden 12 estudios relevantes para la pregunta, incluyendo cinco estudios controlados aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que la cabergolina es superior a la bromocriptina en la mejoría de la oligomenorrea/amenorrea y la galactorrea, probablemente aumenta la probabilidad de embarazo, y se asocia a menos efectos adversos. No está claro si cabergolina también es más efectiva sobre el crecimiento del tumor porque la certeza de la evidencia es muy baja.

  5. Cabergoline or bromocriptine for prolactinoma?

    Science.gov (United States)

    Triantafilo, Nicolás; Castro-Gutiérrez, Victoria; Rada, Gabriel

    2016-09-15

    Cabergolina y bromocriptina son los fármacos más utilizados en el manejo del prolactinoma. Si bien cabergolina, un agonista dopaminérgico de vida media larga, tendría algunas ventajas desde el punto de vista fisiopatológico, no está claro si esto se traduce en un real beneficio. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos dos revisiones sistemáticas que en conjunto comprenden 12 estudios relevantes para la pregunta, incluyendo cinco estudios controlados aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que la cabergolina es superior a la bromocriptina en la mejoría de la oligomenorrea/amenorrea y la galactorrea, probablemente aumenta la probabilidad de embarazo, y se asocia a menos efectos adversos. No está claro si cabergolina también es más efectiva sobre el crecimiento del tumor porque la certeza de la evidencia es muy baja.

  6. 溴隐亭治疗利培酮致女性中度高催乳素血症的临床研究%Clinical study of Bromocriptine in treatment of moderate hyperprolactinemia caused by Risperidone

    Institute of Scientific and Technical Information of China (English)

    秦卫红; 魏时懿; 张军勐

    2014-01-01

    Objective:To discuss the efficacy of Bromocriptine in treatment of hyperprolactinemia cause by Risperidone and an-alyze the possibility of psychiatric symptom fluctuation for female patients with schizophrenia. Methods:According to the ICD-10, 59 female inpatients diagnosed as schizophrenia and got the mild hyperprolactinemia (100ug/ Lt0. 001(59), Pt0.001(59),P<0.001〕,BPRS 量表前后3次评定结果进行比较无显著差异。结论:本研究证实溴隐亭治疗利培酮所致女性中度高催乳素血症有实际临床应用价值,其有效性和安全性均非常可靠。

  7. Clinical analysis of different routes of administration of bromocriptine in treating women with hyperprolactinemia%溴隐亭不同给药途径治疗女性高泌乳素血症临床分析

    Institute of Scientific and Technical Information of China (English)

    朱春燕

    2015-01-01

    Objective To observe the clinical efficacy of different routes of administration of bromocriptine treatment of women with hyperprolactinemia. Methods 128 cases with hyperprolactinemia were selected from Jan 2010 to Dec 2013 in our hospital, they were randomly divided into the experimental group(n=63) and the control group(n=65), the experimental group was given vaginal bromocriptine, the control group was given oral bromocriptine method, the efficacy of three months after treat-ment were compared. Results Two groups after treatment compared with before treatment , the difference was statistically sig-nificant in PRL (P0.05), the experimental group of clinical symptoms after treatment of menstrual disorders, amenorrhea, lactation, hirsutism proportional compared with the control group was no significant difference (P>0.05). Conclusion Different routes of administration of bromocriptine had no significant difference in the efficacy of the disease, it can be formulated according to individual differences in the patients' indi-vidualized treatment plan, and avoid adverse reactions occurring and shorten the course.%目的:观察溴隐亭不同给药途径治疗女性高泌乳素血症的临床疗效。方法选取我院2010年1月~2013年12月于我院妇科就诊的高泌乳素血症患者128例,随机分为试验组(63例)和对照组(65例),试验组予阴道放置溴隐亭治疗,对照组口服溴隐亭,3个月后进行疗效对比。结果两组治疗不同时期血清催乳素(PRL)水平均与治疗前相比,差异有统计学意义(P<0.05)。试验组治疗后0.5个月、1个月、2个月、3个月PRL水平与对照组比较差异无统计学意义(P>0.05),试验组治疗后月经失调、闭经、泌乳、多毛等临床症状发生率与对照组比较差异无统计学意义(P>0.05)。结论采用溴隐亭治疗女性高泌乳素血症,不同的给药途径对疾病的疗效无明显差异,因此可根据患者

  8. Uso da bromocriptina associado a hiperestimulação ovariana controlada em pacientes más respondedoras Bromocriptine method associated with ovarian stimulation in poor responder patients

    Directory of Open Access Journals (Sweden)

    Rodrigo Coelho Franco

    2004-06-01

    Full Text Available OBJETIVO: avaliar a resposta ovariana de pacientes más respondedoras submetidas ao método da bromocriptina. MÉTODOS: foi realizado estudo prospectivo com 10 pacientes más respondedoras em programa de fertilização in vitro. Pacientes endocrinologicamente normais com menos de 38 anos de idade, que apresentaram ciclos anteriores de má resposta a hiperestimulação ovariana controlada, foram submetidas a 12 ciclos com o método da bromocriptina. O referido método utilizou a bromocriptina, um agonista dopaminérgico, no ciclo precedente com a finalidade de bloquear a produção da prolactina. Ao interromper a medicação no início do ciclo de hiperestimulação ovariana conseguiu-se um efeito rebote da prolactina que otimizou a sua concentração sérica, melhorando a qualidade dos oócitos e embriões. Foram analisadas as concentrações séricas de prolactina e estradiol, o número de folículos produzidos, o número e a qualidade dos oócitos captados e embriões clivados e as taxas de fertilização e gravidez. RESULTADOS: foi observada redução na quantidade de ampolas de gonadotrofinas utilizadas, nos dias de indução, melhora no recrutamento folicular, na captação de oócitos, na morfologia dos embriões e nas taxas de fertilização e gravidez. A taxa de fertilização foi de 77,7%, a taxa de gravidez 44,4% e a taxa de bebê em casa de 25%. CONCLUSÕES: este estudo sugere que o método da bromocriptina melhora o recrutamento folicular e o desenvolvimento embrionário, resultando em aumento da taxa de fertilização e gravidez em pacientes más respondedoras quando comparado com o esquema tradicional de hiperestimulação ovariana. Estudos com maior casuística controlada são necessários para se confirmarem os dados aqui encontrados.OBJECTIVE: to assess the ovarian response of poor responsive patients, submitted to the bromocriptine method. PACIENTS AND METHODS: a prospective clinical trial for the in vitro fertilization (IVF

  9. Management of cerebrospinal fluid leakage following treatment of prolactinomas with bromocriptine:a report of 2 cases and literature review%溴隐亭治疗垂体泌乳素腺瘤后并发脑脊液漏处理二例报道并文献复习

    Institute of Scientific and Technical Information of China (English)

    蔡梅钦; 秦峰; 王辉; 李文胜; 凌聪; 郭英

    2010-01-01

    目的 探讨溴隐亭治疗侵袭性垂体泌乳素腺瘤后并发脑脊液漏的原因、临床表现及处理方法.方法 分析中山大学附属第三医院神经外科收治的2例溴隐亭治疗后并发脑脊液漏的垂体泌乳素腺瘤患者的临床资料,并复习相关文献.结果 2例肿瘤均广泛侵犯颅底,在溴隐亭治疗后1个月内发生脑脊液漏.1例经停药及脑室外引流处理后脑脊液漏停止,另一例经停药、经蝶手术修复漏口及腰大池置管外引流后脑脊液漏停止.在腩脊液漏好转2周后均继续予以较小剂量溴隐亭治疗,随诊3年和9个月无脑脊液漏复发,血泌乳素水平渐下降,肿瘤渐缩小.结论 溴隐亭治疗合并颅底破坏的垂体泌乳素腺瘤时有并发脑脊液漏的可能.停药、手术修复漏口及脑脊液外引流是治疗此类并发症的有效方法.继续小剂量溴隐亭治疗可使肿瘤缓慢缩小并减少脑脊液漏发生的可能.%Objective To investigate the causes,clinical manifestations and treatments of cerebrospinal fluid(CSF)leakage following the treatment of prolactinomas with bromocriptine.Methods The data of 2 patients with prolactinomas and CSF leakage following bromocriptine treatment,were retrospectively analyzed and the associated literatures were reviewed.Results Two patients with massive invasive prolactinomas eroding the skull base developed CSF leakage within 1 month after commencing bromocriptine treatment.Bromocriptine treatment was stopped and external ventficular drainage was performed in 1.Bromocriptine treatment was stopped and transsphenoidal surgery in debulking the tumor and sealing the leakage with fibrin glue was performed in the other patient.The bromocriptine treatment was resumed with a lower dose in both patients and the CSF leakage never recurred in the follow-up of 9-36 months;the serum prolactin decreased and the tumor shrank gradually.Conclusions CSF leakage may develop in bromocriptine-treated patients

  10. 溴隐亭治疗垂体泌乳素微腺瘤和大腺瘤的疗效比较%Comparison on curative effect of bromocriptine treating pituitary prolactin micro-adenoma and large adenoma

    Institute of Scientific and Technical Information of China (English)

    吴胜华; 陈景海; 王小青

    2011-01-01

    AIM: To compare bromocriptine in the treatment of pituitary prolactin micro-adenoma and the clinical effect of large adenomas. METHODS: There were sixty cases with pituitary prolactin micro-adenoma and 30 cases with large adenoma. Two groups were orally administered bromocriptine, the amount of night began with 1. 25 mg, increased 1. 25 mg every 3 d, until 2. 5 mg, tid. The serum prolactin and pituitary magnetic resonance were detected beforetreatment and 28 weeks after treatment. RESULTS : The serum prolactin level decreased significantly in the same gender group (P<0. 01) of the two groups after 28 weeks treatment than before treatment. The serum prolactin level in micro-adenoma group returned to normal, while those in large adenoma group both men and women remained above normal. There were significantly differences between the same gender before and after treatment of the prolactin levelin the two groups (P<0. 05). After 28 weeks, prolactin pituitary micro-adenoma cure rate was 16.67%, total effective rate was 75%, while non-pituitary prolactin macro-adenoma group found that the tumor disappeared, the total efficiency was only 46.67%. CONCLUSION: Bro-mocriptine treatment of pituitary prolactin micro-adenoma can return serum prolactin to normal level, pituitary prolactin adenomas shrink oreven disappear; while prolactin macroadenoma should adopt comprehensive treatment model, such as drugs or surgery combined with radiation therapy.%目的:比较溴隐亭治疗脑垂体泌乳素微腺瘤和大腺瘤的临床疗效.方法:脑垂体泌乳素微腺瘤60例;大腺瘤30例.两组均予口服溴隐亭,开始量每晚为1.25 mg,隔3d增加1.25 mg,直到2.5 mg,Tid;在治疗前及治疗后28周分别测定血清泌乳素,同时做脑垂体磁共振.结果:两组治疗28周后血泌乳素值比治疗前同性别组显著下降(P<0.01),微腺瘤组血泌乳素基本恢复正常,但大腺瘤组无论男女,血泌乳素值仍超过正常值,微腺瘤组与大腺瘤组

  11. 溴隐亭联合大剂量维生素B6治疗高泌乳血症疗效观察%Effect of Bromocriptine combined with large doses of vitamin B6 in treatment of hyperprolactinemia

    Institute of Scientific and Technical Information of China (English)

    谭庆玲

    2011-01-01

    Objective: To explore the role of Bromocriptine combined with large doses of VitB6 in treatment of hyperprolactinemia. Methods: 163 cases with hyperprolactinemia were randomly divided into two groups, the observation group of 82 cases, took Bromocriptine and vitamin B6, the control group of 81 cases, took Bromocriptine, serum PRL after treatment 1, 2, 3, 4, 5, 6 months. Results: Both groups had no significant difference in serum PRL before treatment (P>0.05), the serum PRL levels of observation group was significantly lower than that of the control group after treatment 6 months (P< 0.01). Observation group, 75 patients with serum PRL was normal, accounting for 91.46%, with 68 cases of withdrawal, 82.92%; in the control group, 64 cases of normal serum PRL, accounting for 79.01%, with 41 cases of withdrawal, accounting for 50.61%. Observation group had no side effects of nausea and vomiting, in control group, 8 cases showed symptoms of nausea and vomiting; 1 case of observed group, 2 cases of control group, because they could not insist on taking the drug serum PRL rebound phenomenon. Stop taking Bromocriptine 6 months later, the observation group had no recurrence, recurrence in the control group with 2 cases. Conclusion: Bromocriptine combined with large doses of vitamin VitB6 in treatment of hyperprolactinemia can shorten the course of treatment, reduce the dosage of Bromocriptine, reduce side effects.%目的:探讨溴隐亭联合大剂量维生素B6在高泌乳血症治疗中的作用.方法:门诊高泌乳血症患者163例,随机分为两组,观察组82例,服用溴隐亭和维生素B6,对照组81例,服用溴隐亭,于服药后的1、2、3、4、5、6个月测定血清PRL.结果:治疗前两组血清PRL水平无明显差异(P>0.05).治疗6个月后,观察组血清PRL明显低于对照组(P<0.01).观察组有75例血清PRL正常,占91.46%,68例停药,占82.92%;对照组有64例血清PRL正常,占79.01%.有41例停药,占50.61%.观察组中无恶

  12. Surgery versus bromocriptine for female patients with prolactinoma in China:A Meta-a-nalysis%手术与溴隐亭治疗中国女性催乳素瘤的Meta分析

    Institute of Scientific and Technical Information of China (English)

    冯毅; 蔡冰; 张龙龙; 王丽萍

    2014-01-01

    目的:应用循证医学系统评价方法对手术与口服溴隐亭治疗中国女性催乳素瘤的疗效和安全性进行系统评价,以期为中国女性催乳素瘤的治疗提供临床决策依据。方法:检索Cochrane library、PubMed、Em-base、中国生物医学文献服务系统( SinoMed)、中国期刊全文数据库( CNKI)和中文科技期刊数据库( VIP)中关于外科手术与口服溴隐亭对中国女性催乳素瘤的病例对照文献,并补充检索纳入研究的参考文献,根据纳入和排除标准筛选文献、提取资料并进行质量评价后,使用RevMan 5.1软件进行Meta分析,检索时间从各数据库建库至2013年1月31日。结果:纳入5篇研究共466名诊断明确的女性垂体催乳素瘤患者。Meta分析结果显示:在治疗6月后的PRL水平、治疗有效率和临床症状改善情况(月经改善或恢复率和泌乳改善或停止率)方面,手术与口服溴隐亭疗效差异无明显统计学意义( P>0.05)。两组患者短期并发症的发生率差异无明显统计学意义(OR=1.00,95%CI:0.22-4.62,P=1.00)。结论:目前国内手术与溴隐亭治疗女性催乳素瘤的疗效和短期并发症差异均无统计学意义。但本研究纳入的文献量较少且质量不高,尚需更多高质量研究(如多中心随机对照试验等)来进一步明确两种治疗方法的疗效与并发症。%Objective:To evaluate the efficacy and safety of surgery versus bromocriptine for patients with prolacti-noma and provide evidence for the treatment of female prolactinoma patients in China. Methods:The databases Co-chrane library,PubMed,Embase,SinoMed,CNKI and VIP was electronically searched,and the relevent references of the included papers were also manually searched. The studies of surgery versus bromocriptine for patients in China with prolactinoma were included,the quality of included studies were evaluated and analyzed by RevMan 5. 1 soft

  13. Control Study of Pramipexole and Bromocriptine in Treating Parkinson's Disease%普拉克索与溴隐亭治疗帕金森病的对照研究

    Institute of Scientific and Technical Information of China (English)

    杨永; 张雪玲

    2014-01-01

    Objective To study the clinical efficacy of pramipexole and bromocriptine combined madopar in treating primary Parkinson's disease(PD) and its effect on depressive symptoms. Methods 124 patients with primary PD were divided into the pramipexole group (group A) and the bromocriptine group(group B), 62 cases in each group. The group A was given oral pramipexole and madopar, while the group B was treated by bromocriptine and madopar. The course of treatment was for 12 weeks. The Unified Parkinson's Disease Rat-ing Scale(UPDRS) score, Madopar dosage and Hamilton Depression Scale (HAMD) score were observed and recorded. The modified Webster Scale and UPDRS scores were adopted to evaluate the clinical efficacy and the occurrence situation of adverse reactions were recorded. Results The UPDRS Ⅲ, Ⅱ scores in the two groups were dropped, but the score decrease of the group A was more signifi-cant than that of the group B( P ﹤ 0. 05), the UPDRS Ⅳ scores after treatment in the two groups were significantly decreased than be-fore treatment( P ﹤ 0. 05), but the difference between the two groups had no statistical significance; the two groups could reduce the av-erage daily dosage of madopar( P ﹤ 0. 05), but the difference between the two groups had no statistical significance; the total effective rate of the group A was 88. 71% , which was significantly higher than 75. 81% in the group B( P ﹤ 0. 05); the HAMD scores after treatment in the group A was significantly lower than before treatment( P ﹤ 0. 05), while the group B had no significant change com-pared with before treatment; the occurrence rate of adverse reactions was 16. 13% in the group A and 17. 74% in the group B, the ad-verse reactions in the two groups were low and mild. Conclusion Pramipexole combined with madopar can significantly improve the UPDRS score and the HAMD score of primary PD patients, reduce the daily dosage of madopar with high total effective rate and safety, which has clinical

  14. Neuroleptic malignant syndrome : Successful treatment with bromocriptine

    NARCIS (Netherlands)

    Verhoeven, W.M.A.; Elderson, Arthur; Westenberg, H.G.M.

    1985-01-01

    The neuroleptic malignant syndrome (NMS) is a potentially fatal complication of antipsychotic drugs and is characterized by severe muscle rigidity, hyperpyrexia, and autonomic dysfunctions. The pathogenesis of NMS is considered to be related to dopamine-receptor blockade in the basal ganglia and hyp

  15. 溴隐亭不同给药时机对高泌乳素血症妇女促性腺激素诱导排卵的影响%Effects of different administration timing of bromocriptine in the treatment of patients with hyperprolactinemia

    Institute of Scientific and Technical Information of China (English)

    王慧玉; 陈丽红

    2015-01-01

    目的:探讨溴隐亭不同给药时机对高泌乳素血症( HPRL)妇女促性腺激素诱导排卵的影响。方法80例高泌乳素血症不孕不育妇女按照促卵泡激素药物促排方式,随机分为对照组与观察组各40例。对照组,肌注促性腺激素( HMG)75~150 U,同时口服2.5 mg・ d-1;观察组,先口服溴隐亭2.5 mg・ d-1,再给与HMG治疗。结果观察组,促排卵周期数、平均用药天数、雌二醇( E2)水平及妊娠率分别为47个、(6.94±0.82) d、(192.32±15.39) pg・ mL-1及40.00%,对照组分别为56个、(13.42±1.98) d、(91.18±5.49) pg・ mL-1及15.00%,2组上述指标差异均有统计学意义( P<0.05);2组用药前后血清泌乳素(PRL)水平差异均具有统计学意义(P<0.05),但2组各用药阶段PRL水平差异无统计学意义( P>0.05)。结论先用溴隐亭治疗高泌乳素血症之后,再用促卵泡激素药物促排卵治疗不育疗效较为理想。%Objective To evaluate the effects of different administration timing of bromocriptine in the treatment of patients with hyperprolactine-mia.Methods Eighty women with hyperprolactinemia were randomized divided into treatment and control groups with each 40 cases.Patients in the control group were given human menopausal gonadotropin ( HMG ) 75-150 U intramuscular injection followed by oral bromocriptine 2.5 mg・ d-1 at the same time.Treatment group was given bromocriptine 2.5 mg・ d-1 firstly and then given HMG.Results The Stimulate ovulation cycle number, mean administration days, serum estradiol(E2) level and pregnancy were 47,(6.94 ±0.82) days,(192.32 ±15.39) pg・ mL-1 and 40.00% in the treatment group and 56, ( 13.42 ±1.98 ) days, (91.18 ±5.49)pg・ mL-1 and 15.00%in the control group.The serum level of prolactin was significant decreased in the two groups after treat-ment with statistical difference ( P0

  16. Late development of resistance to bromocriptine in patients with invasive prolactinomas: report of five cases%侵袭性泌乳素腺瘤溴隐亭治疗后的迟发性耐药现象:5例报告

    Institute of Scientific and Technical Information of China (English)

    吴哲褒; 苏志鹏; 于春江

    2006-01-01

    @@ 溴隐亭(bromocriptine,BRC)作为治疗泌乳素腺瘤的一线药物,不仅能有效控制肿瘤体积,同时可使血清泌乳素(prolactin,PRL)下降至正常水平[1,2].但临床上仍有10%~20%泌乳素腺瘤患者在长时间溴隐亭治疗过程中血清PRL水平未能恢复正常,甚至出现肿瘤持续增长的情况,即耐药现象[3,4].迟发性耐药非常少见,目前文献多数为个案报道.本文复习我院从2000年6月至2004年7月期间随访资料完整的5例侵袭性泌乳素腺瘤(KnospⅢ或Ⅳ级泌乳素腺瘤)经溴隐亭治疗后发生迟发性耐药现象,报告如下.

  17. Galactogogue Action of Guiqi Tongru Mixture on Rat Model of Bromocriptine-induced Postnatal Lack of Lactation%归芪通乳合剂对溴隐亭诱导大鼠产后缺乳的催乳作用

    Institute of Scientific and Technical Information of China (English)

    万鹏; 聂慧; 邓时贵

    2013-01-01

    目的 观察归芪通乳合剂对缺乳大鼠模型血清催乳素(PRL)、雌二醇(E2)、多巴胺(DA)水平的影响,探讨其催乳机制.方法 建立溴隐亭诱导的大鼠缺乳模型,采用酶联免疫法检测归芪通乳合剂对缺乳大鼠血清PRL、E2、DA水平的影响.结果 与溴隐亭缺乳大鼠模型组比较,归芪通乳合剂各剂量组能显著提高溴隐亭缺乳大鼠血清PRL、E2含量(P<0.05),降低DA的水平(P<0.05).结论 归芪通乳合剂催乳机制与提高PRL、E2含量及降低DA的水平有关.%Objective To observe the effect of Guiqi Tongru Mixture on serum prolactin, estradiol and dopamine in rats with postnatal lack of lactation. Methods Rat model of postnatal lack of lactation was induced by bromocriptine. The expression of serum prolactin, estradiol and dopamine in the model rat was detected by enzyme -linked immunosorbent assay. Results Compared with the model group, the serum prolactin and estradiol contents of Guiqi Tongru Mixture groups were increased significantly (both P < 0.05), while the dopamine expression level was decreased significantly(P< 0.05). Conclusion The lactagogue mechanism of Guiqi Tongru Mixture may be related to its increase of prolactin and estradiol contents and to its inhibition of dopamine expression.

  18. 联合应用溴隐亭和针灸疗法治疗特发性高催乳素血症合并不孕的疗效观察%clinical observation of Bromocriptine combined Acupuncture and moxibustion of idiopathic hyperprolactine and the infertility

    Institute of Scientific and Technical Information of China (English)

    颜小利; 胡钧

    2014-01-01

    目的:观察联合应用溴隐亭和针灸疗法治疗特发性高催乳素血症合并不孕症的临床疗效。方法:将我院收治的60例特发性高催乳素血症合并不孕症患者根据就诊的次序随机分为对照组和观察组,每组各30例患者。为对照组患者使用溴隐亭进行治疗,为观察组患者在使用溴隐亭的基础上加用针灸疗法进行治疗,对比观察两组患者出现不良反应的情况、性激素水平的变化及妊娠结局。结果:两组患者在进行治疗后其PRL的水平均明显降低,LH、FSH、E、P的水平明显上升,与治疗前相比差异显著(p 0.05), after treatment, LH, FSH, E, P level was statistically significant (p <.0.001); observed number of cases of drug reactions occur group than the control group; observation group and a half after treatment the pregnancy rate was higher. Conclusion: Acupuncture combined bromocriptine treatment of idiopathic infertility high prolactin hyperlipidemia and clear clinical efficacy, adverse drug reaction rate can increase sex hormone levels and pregnancy, worthy of clinical application.

  19. 自拟补肾疏肝汤联合溴隐亭用于特发性高催乳素血症性不孕患者的临床研究%Clinical observation on the treatment of idiopathic hyperprolactinemia infertility by self-designed Bushen Shugan decoction combined with bromocriptine

    Institute of Scientific and Technical Information of China (English)

    黄礼云

    2013-01-01

    目的 探讨自拟补肾疏肝汤联合溴隐亭治疗特发性高催乳素血症不孕症的有效性.方法 将诊断为特发性高催乳血症不孕患者80例,随机分为两组各40例.对照组单用溴隐亭,治疗组在对照治疗的基础上加用自拟补肾疏肝汤治疗.比较两组治疗后临床症状、卵泡发育情况,统计排卵率、妊娠率;随访停药后血清中催乳素水平及妊娠结局,评估复发情况.结果 治疗组临床症状改善明显,排卵率、妊娠率、复发率分别为72.5% (29/40)、60.0% (24/40)、10.0% (4/40);对照组的排卵率、妊娠率、复发率分别为27.5% (11/40)、20.0% (8/40)、35.0% (14/40),两组比较差异均有统计学意义(x2分别为16.200、13.333、7.168,P均<0.05).治疗组所有妊娠者均为足月产,无流产、早产及胎儿畸形,妊娠结局良好.结论 自拟补肾疏肝汤联合溴隐亭治疗特发性高催乳素血症不孕具有临床疗效好、副作用小、排卵率及妊娠率高、复发率低及妊娠结局好的特点.%Objective To evaluate the clinical efficacy of the treatment of idiopathic hyperprolactinemia infertility by Chinese medicine combined with bromocriptine.Methods 80 patients diagnosed of idiopathic hyperprolactinemia infertility were randomly recruited into a control group and a experimental group.The control group was treated with bromocriptine alone and the experimental group was treated additionally with self-designed Bushen Shugan decoction on the basis of the control group.The improvement of the clinical symptoms and follicular development were compared between the two groups.The data of ovulation and pregnancy rate was collected.The serum prolactin level and pregnancy outcomes afterdrug withdrawal was followed up and the recurrences was evaluated.Results The follicular development of the experimental group was improved greatly.Its ovulation rate was 72.5%(29/40),pregnancy rate was 60.0% (24/40) and recurrence rate was

  20. Effectively managing intractable central hyperthermia in a stroke patient by bromocriptine: a case report

    OpenAIRE

    2013-01-01

    Kuo-Wei Yu,1,* Yu-Hui Huang,2,3 Chien-Lin Lin,1,4,* Chang-Zern Hong,5 Li-Wei Chou1,41Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 2School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 3Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan; 4School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 5Department of Physical ...

  1. [Bromocriptine: could it be the cure for post-surgical akinetic mutism?

    Science.gov (United States)

    Arevalo-Saenz, A; Pedrosa-Sanchez, M; Sola, R G

    2017-01-16

    Introduccion. El mutismo acinetico se considera una alteracion del estado motivacional de la persona, por el cual el paciente es incapaz de iniciar respuestas verbales o motoras de caracter voluntario, aun teniendo preservadas las funciones sensomotoras y de vigilancia. Caso clinico. Varon de 43 años, intervenido de una fistula arteriovenosa del cerebelo complicada con hidrocefalia, que respondio espectacularmente al tratamiento con bromocriptina. Conclusion. Tipicamente se ha descrito el mutismo acinetico como una complicacion transitoria de las cirugias de la fosa posterior. Sin embargo, tambien puede aparecer tras multiples fallos valvulares en pacientes con hidrocefalia.

  2. Aromatic Amino Acid Decarboxylase Deficiency Not Responding to Pyridoxine and Bromocriptine Therapy: Case Report and Review of Response to Treatment

    OpenAIRE

    2014-01-01

    Aromatic L-amino acid decarboxylase (AADC) deficiency (MIM #608643) is an autosomal recessive inborn error of monoamines. It is caused by a mutation in the DDC gene that leads to a deficiency in the AADC enzyme. The clinical features of this condition include a combination of dopamine, noradrenaline, and serotonin deficiencies, and a patient may present with hypotonia, oculogyric crises, sweating, hypersalivation, autonomic dysfunction, and progressive encephalopathy with severe developmental...

  3. Real Time Imaging of Biomarkers in the Parkinson's Brain Using Mini-Implantable Biosensors. II. Pharmaceutical Therapy with Bromocriptine

    OpenAIRE

    Patricia A. Broderick; Kolodny, Edwin H.

    2009-01-01

    We used Neuromolecular Imaging (NMI) and trademarked BRODERICK PROBE® mini-implantable biosensors, to selectively and separately detect neuro-transmitters in vivo, on line, within seconds in the dorsal striatal brain of the Parkinson’s Disease (PD) animal model. We directly compared our results derived from PD to the normal striatal brain of the non-Parkinson’s Disease (non-PD) animal. This advanced biotechnology enabled the imaging of dopamine (DA), serotonin (5-HT), homovanillic acid (HVA) ...

  4. Real Time Imaging of Biomarkers in the Parkinson's Brain Using Mini-Implantable Biosensors. II. Pharmaceutical Therapy with Bromocriptine

    OpenAIRE

    Patricia A. Broderick; Kolodny, Edwin H.

    2009-01-01

    We used Neuromolecular Imaging (NMI) and trademarked BRODERICK PROBE® mini-implantable biosensors, to selectively and separately detect neurotransmitters in vivo, on line, within seconds in the dorsal striatal brain of the Parkinson’s Disease (PD) animal model. We directly compared our results derived from PD to the normal striatal brain of the non-Parkinson’s Disease (non-PD) animal. This advanced biotechnology enabled the imaging of dopamine (DA), serotonin (5-HT), homovanillic acid (HVA) a...

  5. Endonasal endoscopic transsphenoidal chiasmapexy using a clival cranial base cranioplasty for visual loss from massive empty sella following macroprolactinoma treatment with bromocriptine: case report.

    Science.gov (United States)

    Alvarez Berastegui, G Rene; Raza, Shaan M; Anand, Vijay K; Schwartz, Theodore H

    2016-04-01

    Visual deterioration after dopamine-agonist treatment of prolactinomas associated with empty sella syndrome and secondary optic apparatus traction is a rare event. Chiasmapexy has been described as a viable treatment option, although few cases exist in the literature. Here, a novel endonasal endoscopic approach to chiasmapexy is described and its efficacy is demonstrated in a case report. A 55-year-old female patient with a history of a giant prolactinoma and 14 years of treatment using dopaminergic agonist therapy presented to our institution with a 1-month history of visual changes. Neuroophthalmological examination confirmed severe bitemporal field defects, and MRI revealed a large empty sella with downward optic chiasmal herniation. Endoscopic endonasal chiasmapexy was performed by elevating the chiasm with lumbar drainage and filling the clival and sellar defect with an extradural liquid (HydroSet; a cranioplasty bone cement), and a piece of AlloDerm was used to cover and cushion the chiasm. Postoperative imaging demonstrated successful anatomical elevation of the optic apparatus, and the patient showed functional improvement in the visual field at 3 months postoperatively. Although rare, massive empty sellar and chiasmal descent from macroadenoma treatment can result in progressive visual loss. Here, a novel technique of endonasal endoscopic extradural cranioplasty aided by lumbar drainage is reported, which appears to be an effective technique for stabilizing and possibly reversing anatomical and visual deterioration.

  6. Effects of bromocriptine mesylate on homocysteine and high-sensitivity C-reactive protein levels in patients with type-2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Mitra Niafar

    2016-03-01

    Results: In 64 patients (46 completed 6 months of treatment, age was 55±7 years and the duration of T2DM was 8.0±4.4 years. On enrollment, mean HbA1c, FPG, hs-CRP and HOMC levels were 9.0±1.3 percent, 184±42 mg/dL, 3.8±3.4 mg/dl and 10.8±6.2 micromole/L; respectively. Mean decrease of 0.7±1.1 percent for HbA1c (P=0.001 and 22±44 mg/dL for FPG was observed (P=0.002. HOMC levels decreased to 8.5±5.2 micromole/L (P=0.011 while hs-CRP levels remained unchanged at 3.7±2.9 mg/dL (P=0.835. Conclusion: While HOMC and HbA1c levels decreased significantly after 6 months of treatment with BROM-QR in patients with T2DM, serum levels of hs-CRP, total cholesterol and triglyceride did not significantly change.

  7. Clinical investigation of bromocriptine treating in hypomenorrhea amenorrhea and galactorrhea%月经过少闭经溢乳症60例临床观察

    Institute of Scientific and Technical Information of China (English)

    黎秀琼; 林芸; 谭晓燕

    2004-01-01

    目的:探讨用溴隐亭治疗月经过少、闭经、溢乳症的临床效果,以及溴隐亭的治疗用量及疗程.方法:回顾分析总结1995~2000年诊治60例月经过少、闭经、溢乳症的临床资料,用溴隐亭治疗,先从小剂量1.25 mg/日治疗1周,第2周开始增加剂量至2.5 mg/日,第3周5 mg/日,症状改善后逐渐减量,至少量1.25 mg/日维持1~1.5月.结果:经用溴隐亭治疗后,3例垂体微腺瘤者症状消失,月经来潮;11例月经过少,3例治疗后2~8周月经量增多,3例治疗4~12周妊娠(其中2例为高PRL);51例溢乳患者,47例治疗后溢乳停止,4例明显减少;继发不孕10例,治疗期间妊娠6例(其中4例为高PRL),治疗后妊娠1例.结论:溴隐亭是药物治疗垂体泌乳素瘤的首选有效药物,对高PRL引起的月经量少、闭经及不孕治疗效果好,对某些不明原因的乳房溢乳、继发不孕可考虑使用溴隐亭治疗.

  8. Drug: D03165 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available or interaction hsa04540(1813) Gap junction Enzyme: CYP3A4 [HSA:1576] map07057 Antiparkinson...01 Bromocriptine D03165 Bromocriptine (USAN/INN) USP drug classification [BR:br08302] Antiparkinson Agents D

  9. Congenital fibrosarcoma in complete remission with Somatostatin, Bromocriptine, Retinoids, Vitamin D3, Vitamin E, Vitamin C, Melatonin, Calcium, Chondroitin sulfate associated with low doses of Cyclophosphamide in a 14-year Follow up.

    Science.gov (United States)

    Di Bella, Giuseppe; Toscano, Rosilde; Ricchi, Alessandro; Colori, Biagio

    2015-01-01

    At birth, a male child presented a 6 cm tumour in the right leg. The tumour was partially removed after just 12 days. Histology showed a congenital fibrosarcoma associated with reactive lymphadenitis. A first cycle of adjuvant chemotherapy did not prevent the rapid progression of the disease. Subsequent evaluation for surgical removal raised serious concerns due to the need for a major operation involving total amputation of the right leg and hemipelvectomy. Since surgery could not exclude the possibility of disease recurrence and since the traditional cycles of chemotherapy did not offer any possibility of a cure, the parents opted for the Di Bella Method. The combined use of Somatostatin, Melatonin, Retinoids solubilized in Vit. E, Vit. C, Vit. D3, Calcium, and Chondroitin sulfate associated with low doses of Cyclophosphamide resulted in a complete objective response, still present 14 years later, with no toxicity and without the need for hospitalization, allowing a normal quality of life and perfectly normal adolescent psycho-physical development.

  10. The effect of Dopamine receptor agonists on twich response of Guinea-pig ileum longitudinal muscle and its relation to Nitric Oxide

    Directory of Open Access Journals (Sweden)

    Keshavarz M

    1998-09-01

    Full Text Available In this study the effects of bromocriptine and apomorphine (dopamine receptor agonists on electrical field induced twitch response of longitudinal muscle of guinea-pig illeum was investigated. Bromocriptine and apomorphine dose dependently inhibited illeal contraction. IC50 for this inhibitory effects were 6.22±0.645×10^-7 M and 5.48±0.647×10^-6 M, respectively. sulpiride (a specific D2 dopamine receptor antagonist with concentration of 10^-5 M inhibited the effects of these agonists. Yohimbine (an ?2 adrenergic receptor antagonist only blocked the inhibitory effect of bromocriptine but failed to block apomorphine inhibitory effects. L-NAME (nitric oxide synthetase inhibitor with concentration of 10^-3 M blocked the effects of bromocriptine and apomorphine. These data suggest that there is inhibitory presynaptic dopamine receptors in cholinergic terminals of guinea-pig ileum and its function is related to formation of nitric oxide.

  11. Porcine stress syndrome: an animal model for the neuroleptic malignant syndrome?

    Science.gov (United States)

    Keck, P E; Seeler, D C; Pope, H G; McElroy, S L

    1990-07-01

    The porcine stress syndrome is a genetic disorder of swine which, like neuroleptic malignant syndrome, is characterized by hyperthermia, muscle rigidity, and autonomic dysfunction. We investigated the porcine stress syndrome as a possible animal model for neuroleptic malignant syndrome in two ways. First, we administered haloperidol and lithium carbonate, alone and in combination, to susceptible and resistant swine. Second, we attempted to prevent the syndrome by pretreating animals with bromocriptine. Porcine stress syndrome was induced in 2 of 3 susceptible and 1 of 3 resistant swine by combined treatment with lithium and haloperidol, but was not triggered by treatment with lithium or haloperidol alone. Pretreatment with bromocriptine conferred no protection against the syndrome.

  12. Galactorrhea in a 14-year-old girl.

    Science.gov (United States)

    Panamonta, Ouyporn; Pakawut, Nawarut

    2006-08-01

    The authors report a 14-year-old girl who had galactorrhea with regular menstruation. Furthermore, this galactorrhea case was associated with hyperprolactinemia and prolactinoma. The patient tolerated and responded well to therapy with bromocriptine. The serum prolactin levels decreased from 103.27 ng/mL to 24.25 ng/mL after 8 weeks of treatment and 12.48 ng/mL after 6 months of treatment. No pituitary tumor was demonstrated after 12 months of therapy and the galactorrhea had not recurred 1 year after ending the bromocriptine treatment.

  13. Neuroleptic malignant syndrome (a case report.

    Directory of Open Access Journals (Sweden)

    Patkar A

    1991-07-01

    Full Text Available An adult schizophrenic patient developed neuroleptic malignant syndrome following treatment with parenteral haloperidol. An early recognition of the syndrome, immediate discontinuation of the offending agent and prompt treatment with bromocriptine and lorazepam produced a good recovery. The various features of the case are discussed in view of the potential lethality of the syndrome.

  14. Massive reduction of tumour load and normalisation of hyperprolactinaemia after high dose cabergoline in metastasised prolactinoma causing thoracic syringomyelia.

    NARCIS (Netherlands)

    Uum, S.H.M. van; Alfen, N. van; Wesseling, P.; Lindert, E.J. van; Pieters, G.F.F.M.; Nooijen, P.T.G.A.; Hermus, A.R.M.M.

    2004-01-01

    In 1970 a 20 year old woman presented with a pituitary chromophobe adenoma for which she underwent transfrontal pituitary surgery. In 1978 she had to be reoperated on because of local tumour recurrence, resulting in hypopituitarism. Bromocriptine (5 mg/day) was given for 15 years, but the plasma pro

  15. Vanishing tumor in pregnancy

    Directory of Open Access Journals (Sweden)

    M V Vimal

    2012-01-01

    Full Text Available A patient with microprolactinoma, who had two successful pregnancies, is described for management issues. First pregnancy was uneventful. During the second pregnancy, the tumor enlarged to macroprolactinoma with headache and blurring of vision which was managed successfully with bromocriptine. Post delivery, complete disappearance of the tumor was documented.

  16. Peripartum kardiomyopati

    DEFF Research Database (Denmark)

    Bretler, Ditte-Marie; Jørgensen, Casper Haslund; Olesen, Jonas Bjerring;

    2009-01-01

    Peripartum cardiomyopathy is a rare and potentially fatal disease with peripartum heart failure in previously healthy women. A brief review of the literature is provided with emphasis on recent data indicating that an antiangiogenic cleavage product of prolactin contributes to the molecular...... mechanisms underlying peripartum cardiomyopathy, and that blocking the release of prolactin with bromocriptine can ameliorate the condition. Udgivelsesdato: 2009-Jan-5...

  17. Peripartum kardiomyopati

    DEFF Research Database (Denmark)

    Bretler, Ditte-Marie; Jørgensen, Casper Haslund; Olesen, Jonas Bjerring;

    2009-01-01

    Peripartum cardiomyopathy is a rare and potentially fatal disease with peripartum heart failure in previously healthy women. A brief review of the literature is provided with emphasis on recent data indicating that an antiangiogenic cleavage product of prolactin contributes to the molecular...... mechanisms underlying peripartum cardiomyopathy, and that blocking the release of prolactin with bromocriptine can ameliorate the condition....

  18. History of current non-insulin medications for diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Celeste C. L. Quianzon

    2012-10-01

    Full Text Available This article is a brief review of the current non-insulin agents for diabetes mellitus in the United States, namely, sulfonylureas, biguanides, thiazolidinediones, meglitinides, α-glucosidase inhibitors, glucacon-like peptide-1 receptor agonists, dipeptidyl-peptidase-4 inhibitors, amylin agonists, bromocriptine, and colesevelam.

  19. Interactions between antiparkinsonian drugs and ABCB1/P-glycoprotein at the blood-brain barrier in a rat brain endothelial cell model.

    Science.gov (United States)

    Vautier, Sarah; Milane, Aline; Fernandez, Christine; Buyse, Marion; Chacun, Helene; Farinotti, Robert

    2008-09-05

    Parkinson's disease is a neurodegenerative disorder that requires treatment by dopaminergic agonists, which may be responsible for central side effects. We hypothesized that the efflux transporter ABCB1/P-glycoprotein played a role in brain disposition of antiparkinsonian drugs and could control central toxicity. We aimed to evaluate antiparkinsonian drugs as ABCB1 substrates and/or inhibitors in rat brain endothelial cells GPNT, in order to predict potential clinical drug-drug interactions. Among the antiparkinsonian drugs tested, levodopa, bromocriptine, pergolide and pramipexole were ABCB1 substrates. However, only bromocriptine could inhibit ABCB1 functionality with an IC(50) of 6.71 microM on Rhodamine 123 uptake and an IC(50) of 1.71 microM on digoxine uptake. Thus, bromocriptine at 100 microM is responsible for an increase of levodopa intracellular transport of about 2.05-fold versus control. Therefore, we can conclude that bromocriptine is a potent drug for medicinal interactions in vitro. Hence, in patients with Parkinson's disease, these results may be considered to optimise treatments individually.

  20. Drug: D00780 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available on hsa04728(1813) Dopaminergic synapse Enzyme: CYP3A4 [HSA:1576] map07057 Antiparkinsonian agents map07213 D... nervous system and sensory organs 11 Agents affecting central nervous system 116 Antiparkinson...mesilate (JP16); Bromocriptine mesylate (USP) USP drug classification [BR:br08302] Antiparkinson Agents Dopa

  1. The Relationship between Statins and Prostate Cancer Prevention

    Science.gov (United States)

    2011-09-01

    relationship between vitamin D, bone mineral density, and parathyroid hormone in the National Health and Nutrition Examination Survey. Osteoporosis Int... physical function associated with testosterone administration in older men with mobility limitation. J Gerontol A Biol Sci Med Sci. 2011; DOI: 10.1093...Quick release bromocriptine (Cycloset ™) improves glycaemic control in patients with diabetes failing metformin/sulfonylurea combination therapy

  2. Non-opiate β-endorphin fragments and dopamine—VI Behavioural analysis of the interaction between γ-type endorphins and dopaminergic systems in the nucleus accumbens of rats

    NARCIS (Netherlands)

    Ree, J.M. van; Király, I.

    1984-01-01

    Injection of small doses of apomorphine, bromocriptine and the new ergoline compound, GYKI-32887 into the nucleus accumbens decreased locomotor activity when rats were tested in a small open field. This effect was observed following injection of 1 pg of these substances; GYKI-32887 being more potent

  3. Hyperprolactinemia in Women of Reproductive Age: Etiology, diagnosis, and management

    OpenAIRE

    Yuen, Basil Ho

    1992-01-01

    Galactorrhea-amenorrhea syndrome and infertility are manifestations of elevated prolactin levels. Numerous functional and tumorous conditions can cause hyperprolactinemia; prolactinoma is the most common tumor. The dopamine agonist agent bromocriptine controls hypersecretion, shrinks prolactinomas, and will restore menstruation and alleviate galactorrhea in most patients.

  4. Agonistic actions of pergolide on firing activity of dopamine neurons in substantia nigra compacta area%培高利特对黑质多巴胺神经元放电活动的激动作用

    Institute of Scientific and Technical Information of China (English)

    张雪翔; 金国章; 魏月芳

    1995-01-01

    目的:研究D2受体激动剂培高利特(pergolide,Per)对大鼠黑质多巴胺(DA)神经元放电活动的影响,并与溴隐亭(bromocriptine,Bro)作比较,同时验证Per在整体动物有无D1激动剂性质.方法:胞外单细胞电活动记录技术.结果:二个药物均能抑制敏感及不敏感的DA神经元自发放电活动.Per的ID50值为11.9μg kg-1,而Bro为7.8 mg kg-1,Per比后者强很多.选择性D2受体拮抗剂螺哌隆(spiper-one,0.25 mg kg-1)或者选择性D1受体拮抗剂Sch-23390(1-2 mg kg-1)可以减弱放电抑制.然而Bro引起的放电抑制并不都能为spiperone所减弱.结论:Per在整体动物有很强的D2受体激动剂作用,比Bro强650倍.也有弱的D1受体激动剂的性质.%AIM: To study the potency of pergolide as a D2 receptor agonist on the firing activity of substantia nigra compacta (SNC) dopamine (DA) neurons compared with that of bromocriptine and to determine whether pergo1ide has the nature of D1 receptor agonist in vivo. METHODS: Extracellular single unit recording techniques. RESULTS: Both pergolide and bromocriptine decreased the spontaneously firing rate of "sensitive" and "insensitive" DA cells. In regard of ID50 values,pergolide (11.9, 95 % fiducial limits, 5.7-25.1 μg kg-1 ) was more potent than bromocriptine (7.8, 95 % fiducial limits, 3.3-18. 5 mg kg-1). The discharge inhibition of pergolide was attenuated following the injection of selective D2 receptor antagonist spiperone 0. 25 mg kg-1 or selective D1 receptor antagonist Sch-23390 1- 2 mg kg-1.However, the inhibition caused by bromocriptine was not always attenuated by spiperone.CONCLUSION: Pergolide is 650 times more potent than bromocriptine at D2 receptors, and possesses D1 receptor agonist characteristics in vivo.

  5. Addictive and nonaddictive smoking as related to responsivity to neurotransmitter systems.

    Science.gov (United States)

    Netter, P; Toll, C; Lujic, C; Reuter, M; Hennig, J

    2002-09-01

    In a double-blind crossover design on 36 male smokers, differences in hormone responses to a serotonergic (citalopram) and dopaminergic (bromocriptine) challenge were tested, to compare transmitter responsivities in addicted and pleasure-motivated smokers with respective controls. A general score of smoking addiction, according to DSM IV criteria, was associated with a blunted prolactin decrease to bromocriptine, indicating a possible nicotine-induced desensitization of DA receptors. The single questionnaire-based symptom of tolerance was associated with a blunted cortisol response to citalopram, indicating a particular desensitization of serotonin receptors. Nontolerant but addicted subjects exhibited increased serotonergic responsivity, interpreted as resulting from low serotonin levels associated with lack of impulse control. The questionnaire-based score of pleasure-motivated (='indulgent') smoking was associated with high dopaminergic activity (pronounced prolactin responses), confirming findings obtained in subjects exhibiting reward-related personality factors.

  6. Computed tomography of pituitary microadenoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung-Il; Katto, Keiichi; Tanaka, Teruhiko; Kosaka, Shiro; Kaimori, Mitsuhiro (Aomori Prefectural Central Hospital (Japan))

    1983-08-01

    Thirteen pituitary microadenomas detected by Delta Scan 2020 are presented, and their CT findings are analyzed in points of size, shape, limit, density and contrast enhancement. All are demonstrated as a round, well defined and homogeneous mass, and are enhanced by contrast medium. The average size is 6.2 by 7.6 mm in diameter. Two of them are prolactinoma, and are treated by Bromocriptine. The prolactinomas vanished on CT scan, 6 months after administration of Bromocriptine. Eleven of them are nonfunctioning. Five are operated and the others are followed by CT scan. In detection of pituitary microadenoma, overlapping scanning with thin-slice is necessary and coronal scanning is often helpful. The adenoma greater than 5 mm in diameter may be detectable.

  7. Giant invasive prolactinomas

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, F.Y.; Vesely, D.L.; Jordan, R.M.; Flanigan, S.; Kohler, P.O.

    1987-11-01

    Two of the largest prolactinomas ever documented that have been followed for nine and 10 years, respectively, demonstrate how aggressive prolactinomas may become and how difficult invasive prolactinomas are to treat. One of these prolactinomas invaded both internal auditory canals and simultaneously grew inferiorly, reducing the bony support of the skull and necessitating the patient to utilize both hands to hold his head up. The second patient's prolactinoma invaded the sphenoidal, ethmoidal, and cavernous sinuses. Both of these patients had neurosurgical debulking of their tumors followed by radiation therapy. Neither patient's prolactin levels decreased significantly during their first five years post-surgically, at which time bromocriptine was added. Since then, there has been a gradual lowering of serum prolactin levels and a decrease in the size of these tumors. These cases demonstrate that prolonged treatment and very large doses of bromocriptine may be necessary for tumor reduction in patients with invasive prolactinomas.

  8. Cabergoline therapy for Macroprolactinoma during pregnancy: A case report

    Directory of Open Access Journals (Sweden)

    Shahzad Hira

    2012-10-01

    Full Text Available Abstract Background We assessed the safety of Cabergoline therapy during pregnancy in a lady with hyperprolactinemia intolerant to Bromocriptine. Case presentation We report the case of a 31 year old lady who presented to us with uncontrolled hyperprolactinemia. A pituitary Macroadenoma was demonstrated by MRI. Due to intolerance to Bromocriptine, Cabergoline was started. The patient improved and subsequently conceived. MRI in the second trimester demonstrated further reduction in the tumor size. It was decided to continue Cabergoline throughout pregnancy to ensure further reduction in tumor size until delivery and to hold Cabergoline during postpartum period to allow for an adequate interval of breastfeeding. At 37 weeks of gestation, the patient delivered a healthy baby. Conclusion We were able to safely treat macroprolactinemia in our patient during pregnancy with cabergoline. This case report contributes to the relatively meager data available which advocates the safety of cabergoline therapy in pregnant hyperprolactinemic patients.

  9. Immunoreactive prolactin in breast milk and plasma of women with hyperprolactinemia, galactorrhea and menstrual dysfunction.

    Science.gov (United States)

    Yuen, B H

    1986-01-01

    Prolactin levels were measured by radioimmunoassay in paired breast milk and plasma samples of 11 hyperprolactinemic women with galactorrhea and various menstrual disorders (amenorrhea, n = 8; oligomenorrhea, n = 2; luteal phase defect, n = 1) before and during treatment with bromocriptine (Parlodel, Sandoz). Pretreatment levels of prolactin in the milk and plasma were 80 +/- 13 ng/mL (mean +/- SEM) and 47 +/- 7 ng/mL (P less than 0.05), respectively. While on treatment, the concentration gradient for prolactin remained in favour of the milk, with values for milk and plasma 59 +/- 11 and 29 +/- 3 ng/mL (P less than 0.01), respectively. Thus, bromocriptine lowered the prolactin concentrations in both breast milk and plasma. Since prolactin in milk is biologically active, these findings may be relevant to the initiation and maintenance of lactation in women with abnormal lactogenesis.

  10. Peripartum cardiomyopathy (A literature review

    Directory of Open Access Journals (Sweden)

    Farveh Vakilian

    2014-07-01

    Full Text Available Heart failure (HF is a serious and growing public health concern, which has many causes. Pregnancy is a critical condition with significant hemodynamic and immunologic changes. Peripartum cardiomyopathy (PPCM is a disease of unknown cause in which left ventricular (LV dysfunction occurs during the last trimester of pregnancy or the early puerperium. PPCM is known to be the most common cardiovascular cause of severe complications in pregnancy.  Risk factors for peripartum cardiomyopathy include advanced maternal age, twin pregnancy, smoking, pregnancy-related hypertension and preeclampsia, multiparity, African descent, and long-term tocolysis. Oxidative stress and some inflammatory markers have been diagnosed in PPCM pathophysiology. Recent observations have suggested that bromocriptine might favor recovery of LV systolic function in patients with PPCM. Patients developed peripartum cardiomiopathy treated with bromocriptine showed significantly improved LV ejection fraction and heart failure symptoms. This article tries to have a short review on this clinical scenario.

  11. 脊髓损伤后自发性溢乳一例%Spontaneous galactorrhea after spinal cord injury:1 case report

    Institute of Scientific and Technical Information of China (English)

    杨枭雄; 宋科冉; 唐家广

    2016-01-01

    Objective To report a complete spinal cord injury female patient with spontaneous galactorrhea. Methods The relationship between the spontaneous galactorrhea and spinal cord injury was discussed by the analysis of galactorrhea, blood prolactin and MRI ( Magnetic Resonance Imaging ) of the pituitary gland. Results Spontaneous galactorrhea occurred 6 months after the injury, and the prolactin level was 100.70 ng / ml immediately. It turned to 1.63 ng / ml with oral bromocriptine 1 month later, while it raised gradually without oral bromocriptine. Galactorrhea appeared repeatedly without rules. Conclusions Abnormal autonomic nervous reflex after the spinal cord injury manifests as abnormal sympathetic nerve reactions below the neurological level, but galactorrhea is not mentioned in the current assessment criteria. Breast tissues are regulated by autonomic innervation and hormone. As an important part of lactation reflex pathway, signal transduction pathway damage always leads to abnormal sensation or reflection, affecting the milk secretion to a certain extent.

  12. Follow-up of patients with pituitary tumors before and after operation, medical treatment and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Gasser, R.W.; Finkenstedt, G.; Skrabal, F. (Innsbruck Univ. (Austria). Medizinische Klinik)

    1981-01-01

    From 1976 till 1981 56 patients with pituitary tumors were observed. From a total of 51 adenomas 17 prolactinomas (33.3%), 15 acromegalies (29.4%), 4 Cushing-syndromes (7.8%), 1 TSH-producing adenoma (1.9%) and 14 hormone-inactive adenomas (27.4%) were found. In addition, there were 4 craniopharyngeomas and 1 intrasellar meningeoma. For the individual types of adenomas prae- and postoperative hormonal data after transcranial resp. transsphenoidal adenomectomy are listed. Prolactinomas responded well to bromocriptine therapy in some cases, whereas acromegalies showed no remission after bromocriptine. After radiotherapy of 4 recidive-adenomas remission in one case was seen. Problems and objects of long-term-care of patients with pituitary tumors are discussed.

  13. Olanzapine induced neuroleptic malignant syndrome.

    Science.gov (United States)

    Patra, Bichitra Nanda; Khandelwal, Sudhir K; Sood, Mamta

    2013-01-01

    An 18 year old male diagnosed as a case of bipolar affective disorder (BPAD), developed neuroleptic malignant syndrome (NMS) following treatment with olanzapine (20 mg per day), an atypical antipsychotic drug. NMS is usually seen with typical antipsychotic drugs. The patient was diagnosed as a case of NMS, offending agent was immediately withdrawn and prompt treatment with bromocriptine and levodopa produced a good recovery. The various features of the case are discussed in view of the potential mortality of the syndrome.

  14. The effect of D2 agonist versus D2 antagonist on the fear behavior in the male rats using plus-maze method: the prospective study

    Directory of Open Access Journals (Sweden)

    Sabzehkhah S

    2009-11-01

    Full Text Available "nBackground: Dopaminergic is the most important neurotransmitter is fear. The dopaminergic mesolimbic pathway has essential role in excitable behavior, and it's role in Parkinson disease. The aim of this research in study, the effect of dopaminergic pathway in fear response. "n"nMethods: The elevated plus maze was used in combination with the percentage of time spent in the open arms of the maze (OAT% and the percentage of entries into the open arms (OAE% to measure fear. Increases in the OAT% and OAE% indicate an anxiolytic effect (reduction in anxiety, whereas decreases in the OAE% and OAT% indicate an anxiogenic effect. After five days, the rats were injected with saline and different doses of sulpiride and Bromocriptine."n"nResults: Results showed that intracerebroventricular administration of sulpiride, in the doses of 5, 20μg/rat and bromocriptine, D2 agonist in doses 65, 95μg/rat produced a significant effect comparing to sham groups (p<0.05. While intracerebroventricular administration of sulpiride 15, 10μg/rat, and bromocriptine 70, 80μg/rat, did not show any significant effect comparing with sham group (p<0.05. In the current research intracerebroventricular administration of sulpiride, D2 antagonist at the doses of 5, 10, 15, 20μg/rat and Bromocriptine, D2 agonist in the doses of 65, 70, 80, 95μg/rat were used and theire effect on the fear behavior were studied. "n"nConclusions: The possible effect of Dopaminergic system in the fear process, especially D2 receptor increase fear.

  15. Resultados visuales en pacientes con macroprolactinoma tratados con agonistas de dopamina

    OpenAIRE

    Cuevas,José Luis; Fernández, Verónica; Rojas, David; Wohllk, Nelson; González, Óscar; Torche, Esteban

    2013-01-01

    Background: Dopamine agonists (DA) effectively reduce tumor size of macroprolactinomas, with the consequent improvement of eventual visual impairment. Aim: To study the visual outcomes in patients with macroprolactinoma treated with DA. Material and Methods: Retrospective cohort study which included patients with macroprolactinoma controlled at a Neuro-endocrinology and Neuro-ophthalmology Department between 1997'and2011, and treated exclusively with DA (bromocriptine or cabergoline). Patient...

  16. Radioiodine therapy in a patient with papillary thyroid carcinoma associated with breast uptake; hyperprolactinemia due to empty sella syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Moon Sun; Park, Chan H.; Seo, Jung Ho [College of Medicine, Ajou Univ., Suwon (Korea, Republic of); Kim, Kyoung Rae [Yungdong Sevrance Hospital, Seoul (Korea, Republic of)

    1998-01-01

    We report a 37 year-old-female patient with papillary thyroid cancer treated by surgery who demonstrated residual thyroid and bilateral breast uptake on a diagnostic I-131 whole body scan. She had an extrathyroidal extension needing I-131 ablative therapy. Her galactorrhea was investigated and treated with low doses of bromocriptine prior to I-131 therapy. Her galactorrhea was was due to the decreased secretion of PIF induced by empty sella.

  17. [Effect of combined treatment with dopamine receptor agonists and antagonists of aldosterone on the performance of daily blood pressure monitoring in patients with hypertension and concomitant obesity].

    Science.gov (United States)

    Lyzogub, V G; Sobol', V O; Dolynna, O V; Kuz'mins'ka, L A

    2012-01-01

    In hypertensive patients with concomitant obesity observed decrease in activity of dopaminergic system in conjunction with increased activity of the renin-angiotensin-aldosterone system. Identified changes point to the advisability of appointing this group of patients the dopamine receptor agonist - bromocriptine-KV and antagonist of aldosterone - veroshpiron. As a result of treatment was an increase in dopamine levels in the urine, a decrease of aldosterone in the blood, normalization of the daily blood pressure monitoring.

  18. Daidzin and daidzein suppress free-choice ethanol intake by Syrian golden hamsters.

    OpenAIRE

    Keung, W M; Vallee, B L

    1993-01-01

    Syrian Golden hamsters prefer and consume large and remarkably constant amounts of ethanol in a simple two-bottle free-choice regimen. Ethanol intake is significantly suppressed by zimelidine, bromocriptine, buspirone, and lithium carbonate, pharmacological agents that have been shown to be beneficial in controlling ethanol intake in alcohol-dependent humans. These results suggest that this ethanol-drinking animal model has high "predictive validity" and can be used effectively in the search ...

  19. Managing Prolactinomas During Pregnancy: Mini Review

    Directory of Open Access Journals (Sweden)

    Mussa eAlmalki

    2015-05-01

    Full Text Available Prolactinomas are the most prevalent functional benign pituitary tumors due to a pituitary micro- or macroadenoma. The majority of patients presents with infertility and gonadal dysfunction.A dopamine agonist (DAs (bromocriptine or cabergoline is the treatment of choice that can normalize prolactin levels, reduce tumor size and restore ovulation and fertility. Cabergoline generally preferred over bromocriptine because of its higher efficacy and tolerability. Managing prolactinomas during pregnancy may be challenging. During pregnancy, the pituitary gland undergoes global hyperplasia due to a progressive increase in serum estrogens level that may lead to increase of the tumor volume with potential mass effect and visual loss.The risk of tumor enlargement may occur in 3 % of those with microadenomas, 32 % in those with macroadenomas that were not previously operated on and 4.8% of those with macroadenomas with prior ablative treatment. Though both drugs appear to be safe during pregnancy, the data on fetal exposure to DAs during pregnancy have been reported with bromocriptine far exceeds that of cabergoline with no association of increased risk of pregnancy loss and premature delivery. It is advisable to stop the use of DAs immediately once pregnancy is confirmed, except in the case of women with invasive macroprolactinomas or pressure symptoms. This review outlines the therapeutic approach to, prolactinoma during pregnancy, with emphasis on the safety of available DA therapy.

  20. Studies on sensitivity of zebrafish as a model organism for Parkinson′s disease: Comparison with rat model

    Directory of Open Access Journals (Sweden)

    Dinesh T Makhija

    2014-01-01

    Full Text Available Objective: To determine the utility of zebra fish as an animal model for Parkinson′s disease (PD in comparison with rat model. Materials and Methods: MTT assay was performed on rat and zebrafish brain synaptosomal fractions using rotenone as a neurotoxic agent. Quercetin and resveratrol were used as standards to compare anti-apoptotic activity in both organisms. Catalepsy was induced in zebrafish by exposing them to haloperidol (9 μM solution. Drug-treated groups were exposed to bromocriptine and pramipexole, 30 min prior to haloperidol exposure at the dose of 2, 5, and 10 μg/mL. Swimming speed, time spent in the bottom of the tank, and complete cataleptic time were evaluated to assess behavioral changes. In rats, catalepsy was induced using haloperidol (1.25 mg/kg i.p.. Drug-treated groups received bromocriptine (2.5 mg/kg. and pramipexole (1 mg/kg orally. Bar test, block test, and locomotor activity were carried out to assess behavioral changes. Results: Resveratrol and quercetin showed comparable inhibition of apoptosis in rats and zebrafish. In anti-cataleptic study, bromocriptine and pramipexole-treated groups showed significant difference (P < 0.05 in behavioral parameters as compared to haloperidol control group in both the experimental organisms. Results obtained from fish model were in correlation with rat model. Conclusion: Findings of the present study revealed that zebrafish model is highly sensitive and can be used for basic screening of drugs against PD.

  1. Parkinson's disease treatment may cause impulse-control disorder via dopamine D3 receptors.

    Science.gov (United States)

    Seeman, Philip

    2015-04-01

    In treating Parkinson's disease with dopaminergic agonists, such as pramipexole, ropinirole, pergolide, rotigotine, apomorphine, or bromocriptine, it has been observed that a significant number of patients develop impulse-control disorders, such as compulsive shopping, pathological gambling, or hypersexuality. Because the dopamine agonists have high affinities for the dopamine D2 and D3 receptors, the drug dissociation constants of these drugs at the functional high-affinity states of these receptors, namely D2High and D3High, were compared. The data show that, compared to the other dopamine agonist drugs, pramipexole has a relatively high selectivity for the dopamine D3 receptor, as compared to D2, suggesting that the D3 receptor may be a primary target for pramipexole. There is a trend showing that the proportion of impulse-control disorders is related to the selectivity for D3 receptors over D2 receptors, with pramipexole having the highest association with, or frequency of, impulse-control disorders. While the number of studies are limited, the proportion of patients with impulse-control disorder in Parkinson patients treated with an add-on agonist were 32% for pramipexole, 25% for ropinirole, 16% for pergolide, 22% for rotigotine, 10% for apomorphine, and 6.8% for bromocriptine. Clinically, temporary replacement of pramipexole by bromocriptine may provide relief or reversal of the impulsive behavior associated with selective D3 stimulation by either pramipexole or ropinirole, while maintaining D2 stimulation needed for the anti-Parkinson action.

  2. Hyperprolactinemia after neonatal prolactin (PRL) deficiency in rats: evidence for altered anterior pituitary regulation of PRL secretion.

    Science.gov (United States)

    Shah, G V; Shyr, S W; Grosvenor, C E; Crowley, W R

    1988-05-01

    Previous findings from this laboratory suggest a role for milk-borne PRL in the development of the inhibitory neuroendocrine controls over PRL secretion. Thus, rats that consumed milk deficient in PRL on days 2-5 postpartum show reduced concentrations and turnover of DA in the median eminence and elevated serum levels of PRL at 30-35 days of age. The present experiments were undertaken to investigate whether these consequences of neonatal PRL deficiency persist beyond puberty, and whether alterations in pituitary responsiveness to hypothalamic hormones may be involved. Lactating rats received sc injections of either saline or the dopamine (DA) agonist bromocriptine (125 micrograms/rat.day) on each of days 2-5 postpartum, a treatment that reduces the amount of PRL in milk without abolishing lactation. Blood samples were obtained from male and female offspring at various postnatal ages, and PRL concentrations were determined by RIA. Serum PRL concentrations in offspring from both groups were low until after weaning, but the female offspring of bromocriptine-treated mothers showed significantly elevated serum PRL between days 30 and 90 postpartum. Male offspring of bromocriptine-treated mothers also had transiently increased serum PRL levels, which returned to control levels by day 40. The turnover rate of DA in the median eminence, calculated from the rate of decline after synthesis inhibition, was reduced on day 35 in neonatally PRL-deficient offspring, as shown previously. However, no differences in DA turnover between the two groups were apparent on day 60, indicating a recovery of normal dopaminergic activity. Anterior pituitary cells of 100-day-old control and neonatally PRL-deficient animals were dispersed, cultured for 3 days, and then exposed to either TRH, to stimulate PRL release, or to the DA agonist bromocriptine, which inhibits PRL release. Pituitary cells of neonatally PRL-deficient offspring were almost completely unresponsive to bromocriptine with

  3. 中西医结合治疗垂体泌乳素微腺瘤疗效分析%Efficacy Analysis of Integrative Medicine Treatment for Prolactin-secreting Pituitary Microadenoma

    Institute of Scientific and Technical Information of China (English)

    凌聪; 胡细玲; 何海勇; 蔡梅钦

    2012-01-01

    Objective : To explore normative , more effective medication for pituitary prolactinoma via the comparision of Traditional Chinese medicine combined with Bromocriptine and single Bromocriptine treating the pituitary prolactinoma. Methods : 50 selected female patients with prolactinoma were divided into two groups , 25 patients in each group. The two groups accepted the treatment of Traditional Chinese medicine combined Bromocriptine respectively, and the decrease of the prolactin levels, curative rate, effective rate and incidence of side effectives were analyzed statistically. Results : The prolactin levels of the two groups were significantly different 3 months after treatment, not significantly different 6 months or 9 months after treatment. The prolactin levels of the groups were significantly different before and after treatment respectively. The curative rate was significantly different, and the effective rate was not significantly different. Conclusion : Traditional Chinese medicine combined with Bromocriptine and single Bromocriptine are effective on decreasing prolactin level. Traditional Chinese medicine combined Bromocriptin is more effective in meliorating menses and asisting pregnancy than single Bromocriptin.%目的:通过对中医联合溴隐亭和单纯溴隐亭治疗垂体泌乳素微腺瘤的效果比较,探讨规范、更有效的垂体泌乳素微腺瘤的药物治疗方法.方法:将入选的50例垂体泌乳素微腺瘤女性患者随机分成两组,每组25例.两组病人分别接受中药加溴隐亭和单纯溴隐亭治疗.比较两种治疗方法在降低催乳素水平、治愈率、有效率和不良反应发生率等方面的差异,并做相应的统计学处理.结果:两组治疗后催乳素水平在治疗后3个月有显著差异,在6个月和9个月均无显著差异;两组治疗前后的催乳素水平均有显著差异;两组的治愈率有显著差异,有效率无显著差异.结论:中西医结合与单纯西药对降低

  4. Suppurative meningitis: A life-threatening complication in male macroprolactinomas

    Directory of Open Access Journals (Sweden)

    Farida Chentli

    2013-01-01

    Full Text Available Background: Suppurative meningitis (SM or bacterial meningitis is a life-threatening condition, which is exceptionally due to pituitary tumors (PT. Our aim was to analyze its frequency among male macroprolactinomas (MPRL deemed to be aggressive, to report the cases we observed in our practice and describe the circumstances under which SM appeared. Materials and Methods: We retrospectively analyzed 82 male MPRL in order to look for a history of well proved SM and the circumstances under which SM appeared. We also took into account the possibility of SM relapsing. Results: Four out of 82 male MPRL had SM = 4.87%. Three consulted for SM symptoms. SM was confirmed in Infectious Diseases department, but only one had rhinorrhea. Hormonal assessment and cerebral magnetic resonance imaging pleaded for aggressive prolactinomas. After antibiotics, SM was sterilized. Then, MPRL were treated with bromocriptine, which normalized prolactin and reduced PT. SM never relapsed. The 4 th case was hospitalized for a large multidirectional prolactinoma invading and/or arising from the skull base. He was operated on 3 times and then he was given Bromocriptine. After 3 months, he had rhinorrhea and then SM which was successfully treated by antibiotics. SM never relapsed after tumor reduction. Conclusion: SM was demonstrated in 4.87%. SM has revealed MPRL in 3 cases and appeared after bromocriptine intake in the 4 th one. Endocrinologists should be aware of this severe condition, which can be avoided by repairing as soon as possible the bony defect secondary to aggressive tumors, unless it is clogged by fibrosis: What probably happened in our cases.

  5. Decreasing prolactin levels leads to a lower diving effort but does not affect breeding success in Adélie penguins.

    Science.gov (United States)

    Cottin, Manuelle; Chastel, Olivier; Kato, Akiko; Debin, Marion; Takahashi, Akinori; Ropert-Coudert, Yan; Raclot, Thierry

    2014-02-01

    Current research on seabirds suggests a key role of hormones in the trade-off between self-maintenance and parental investment through their influence on foraging decisions during the breeding period. Although prolactin is known to have major effects on parental care, its role in foraging behavior has rarely been investigated in seabirds to date. The aim of this study was to assess the influence of an experimental decrease in prolactin levels on foraging decisions and its consequences on breeding success in free-living seabirds. To achieve this, we implanted bromocriptine (an inhibitor of prolactin secretion) in male Adélie penguins (Pygoscelis adeliae), monitored their foraging behavior using time-depth recorders over several trips, and recorded their reproductive output. On average 8±0.5days after implantation, we showed that bromocriptine administration led to an efficient decrease in prolactin levels. However, no differences were seen in foraging trip durations between bromocriptine-implanted birds and controls. Moreover, the time spent diving and the number of dives performed per trip were similar in both groups. By contrast, all diving parameters (including diving efficiency) were negatively affected by the treatment during the first at-sea trip following the treatment. Finally, the treatment did not affect adult body condition or chick growth and survival. Our study highlights the short-term negative effect of low prolactin levels on diving effort, but indicates that a short-term and/or low-magnitude decrease in prolactin levels alone is not sufficient to modify consistently the body maintenance or the parental investment of Adélie penguins.

  6. [Psychosomatic aspects of stress].

    Science.gov (United States)

    Okuse, S; Anzai, T

    1992-03-01

    We established the Bromocriptine test for the dopaminergic function of the hypothalamopituitary gland. The secretion patterns of plasma GH and PRL to 2.5 mg Bromocriptine, a dopamine receptor agonist, were classified into two types; a response type and a non-response type. The former showed an increase in plasma GH levels and suppression of PRL secretion; the latter showed no change in GH after Bromocriptine administration. The response type cases corresponded to psychosocial stress by neurotic and maladaptive behavior. The non-response type cases corresponded to psychosocial stress by alexithymic and over adaptive behaviors. Case Presentation 1. Essential Hypertension: a. 56-year old male, response type, blood pressure elevated by stress in daily life. Psychosomatic treatment: advice about blood pressure measurement at his home, brief psychotherapy and drug therapy. b. 53-year-old male, non-response type, type A behavior. Psychosomatic treatment: advice to increase awareness of body-mind relationships of his disorder, self-control training and drug therapy. 2. Gastric ulcers: a. 40-year-old male, response type, CMI IV region (Neurotic tendencies). Psychosomatic treatment: autogenic training and drug therapy. b. 28-year-old male, non-response type, high JAS scores(Over adaptative behavior). Psychosomatic treatment: advice to increase awareness of body-mind relationships of occurrence of his ulcers, to induce change in his perceptions of way of life, to encourage taking rest. 3. Technostress syndrome: a. 23-year-old female, response type, technoanxiety. Psychosomatic treatment: advice to make her take rest, and change in arrangements at her working place. b. 27-year-old male, non-response type, technodependent. Psychosomatic treatment: Fasting therapy. This therapy changed the non-response pattern to normal.

  7. Trial of Oral Metoclopramide on Diurnal Bruxism of Brain Injury

    Science.gov (United States)

    Yi, Ho Sung; Seo, Mi Ri

    2013-01-01

    Bruxism is a diurnal or nocturnal parafunctional activity that includes tooth clenching, bracing, gnashing, and grinding. The dopaminergic system seems to be the key pathophysiology of bruxism and diminution of dopaminergic transmission at the prefrontal cortex seems to induce it. We report two patients with diurnal bruxism in whom a bilateral frontal lobe injury resulted from hemorrhagic stroke or traumatic brain injury. These patients' bruxism was refractory to bromocriptine but responded to low-dose metoclopramide therapy. We propose that administering low doses of metoclopramide is possibly a sound method for treating bruxism in a brain injury patient with frontal lobe hypoperfusion on positron emission tomography imaging. PMID:24466522

  8. Neuroleptic malignant syndrome: A diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Reshma P Ambulkar

    2012-01-01

    Full Text Available We report the case of a 7-year-old girl operated for craniopharyngioma who developed hyperkalemic cardiac arrest in the post-operative period. She was diagnosed as Neuroleptic malignant syndrome (NMS and the causative drug was carbamazepine. It was essentially a diagnosis of exclusion, and treatment was mainly supportive in form of withdrawal of the neuroleptic medication (carbamazepine and administration of dantrolene and bromocriptine. Although, relatively uncommon, NMS can be fatal. NMS presents a clinical challenge as the patient outcome depends on its prompt recognition and treatment.

  9. Neuroleptic malignant syndrome in cycloserine-induced psychosis

    Directory of Open Access Journals (Sweden)

    Neena S Sawant

    2015-01-01

    Full Text Available A 33-year-old multidrug-resistant tuberculosis female patient diagnosed as cycloserine-induced psychosis developed several neuroleptic side effects such as extrapyramidal reaction, neuroleptic malignant syndrome, and drug-induced parkinsonism while she was being treated with initially haloperidol and then olanzapine over a period of 2 months . Patient′s antipsychotic medications were withdrawn, and treatment with bromocriptine showed prompt recovery. The multiple neurological adverse effects which the patient developed had implications on the management of the complications as well as her illness.

  10. Olanzapine induced neuroleptic malignant syndrome

    Directory of Open Access Journals (Sweden)

    Bichitra Nanda Patra

    2013-01-01

    Full Text Available An 18 year old male diagnosed as a case of bipolar affective disorder (BPAD, developed neuroleptic malignant syndrome (NMS following treatment with olanzapine (20 mg per day, an atypical antipsychotic drug. NMS is usually seen with typical antipsychotic drugs. The patient was diagnosed as a case of NMS, offending agent was immediately withdrawn and prompt treatment with bromocriptine and levodopa produced a good recovery. The various features of the case are discussed in view of the potential mortality of the syndrome.

  11. Neuroleptic malignant syndrome in cycloserine-induced psychosis.

    Science.gov (United States)

    Sawant, Neena S; Kate, Natasha S; Bhatankar, Swaroop S; Kulkarni, Prathamesh S

    2015-01-01

    A 33-year-old multidrug-resistant tuberculosis female patient diagnosed as cycloserine-induced psychosis developed several neuroleptic side effects such as extrapyramidal reaction, neuroleptic malignant syndrome, and drug-induced parkinsonism while she was being treated with initially haloperidol and then olanzapine over a period of 2 months. Patient's antipsychotic medications were withdrawn, and treatment with bromocriptine showed prompt recovery. The multiple neurological adverse effects which the patient developed had implications on the management of the complications as well as her illness.

  12. Pituitary Prolactinoma Imaged by 99mTc-Sestamibi SPECT/CT in a Multiple Endocrine Neoplasia Type 1 Patient.

    Science.gov (United States)

    Pan, Yu; Lv, Jing; Guo, Rui; Pan, Mengyi; Zhang, Yifan

    2016-06-01

    A 35-year-old woman who had undergone bilateral inferior parathyroidectomy for primary hyperparathyroidism was referred to our hospital to evaluate the cause of irregular menses, galactorrhea, and paroxysmal headache. Multiple endocrine neoplasia type 1 was then suspected for the high levels of plasma prolactin, parathyroid hormone, serum calcium, insulin, and related symptoms. A Tc-sestamibi SPECT/CT acquired to evaluate parathyroid glands unexpectedly revealed an increased accumulation in the pituitary gland, which was further confirmed by enhanced magnetic resonance imaging as a pituitary microadenoma. Bromocriptine treatment gradually reduced the prolactin level.

  13. Clinical application of [sup 11]C-NMSP to the patients with pituitary adenoma other than prolactinoma

    Energy Technology Data Exchange (ETDEWEB)

    Momose, Toshimitsu; Teramoto, Akira; Nishikawa, Junichi; Inoue, Yusuke; Watanabe, Toshiaki; Sasaki, Yasuhito (Tokyo Univ. (Japan). Faculty of Medicine)

    1993-06-01

    The existence of dopamine D[sub 2] receptors in the pituitary adenoma (PA) is an important factor for bromocriptine therapy. In order to evaluate the D[sub 2] receptors in PA, [sup 11]C-N-methylspiperone (NMSP) and positron emission tomography was performed in a variety of pituitary adenomas other than prolactinoma. Eight patients with PA including four non-functioning adenomas, two growth hormone (GH) secreting adenomas, one adrenocorticotrophic hormone (ACTH) secreting adenoma and one thyroid stimulating hormone (TSH) secreting adenoma and ten normal healthy volunteers were examined. Seventy hundred and forty MBq of [sup 11]C-NMSP was injected and dynamic scan was performed from the time of injection to 80 min postinjection. The time dependent regional radioactivity in the striatum (st) and in the tumor tissue (tm) was measured and the binding rate, [alpha], was calculated according to the following equation: Cst, tm/Ccbl=[alpha]x[integral][sub 0][sup t]Ccbl dt/Ccbl+1. The ratio of total radioactivity in the striatum or tumor over total activity in the cerebellum was plotted versus 'normalized time', which was obtained by dividing integrated cerebellar radioactivity by actual cerebellar radioactivity for each timepoint. In three patients with PA, two scans were performed before and three hours after oral intake of 2.5 mg of bromocriptine. The [alpha] values for PA and normal striatum were 0.031[+-]0.023 (0.017-0.088) and 0.042[+-]0.006 (0.034-0.049), respectively. Bromocriptine reduced [alpha] value to various degree in PA (13-56%) but not in striatum (-3.7-3.3%). Our data suggest that in some of PA other than prolactinoma, dopamine D[sub 2] receptors existed but that nonspecific binding also contributed to the radioactivity in the tumor tissue. And it also supports the idea that in PA, bromocriptine directly combines with D[sub 2] receptor but in striatum, it might affect receptors other than D[sub 2] receptor itself. (author).

  14. Pharmacological characteristics of catalepsy induced by intracerebroventricular administration of histamine in mice: the importance of muscarinic step in central cholinergic neurons.

    Science.gov (United States)

    Onodera, K; Shinoda, H

    1991-05-01

    Histamine-induced catalepsy was antagonized potently by scopolamine, an antimuscarinic drug, and partially blocked by sparteine. Neither methylatropine nor antinicotinic drugs could reverse histamine-induced catalepsy. These results indicate the greater importance of muscarinic receptors rather than their nicotinic counterparts in histamine-induced catalepsy. Various antiparkinson drugs, i.e. biperiden and trihexyphenidyl, which have antimuscarinic activity or dopamine agonists, i.e. L-dopa, amantadine and bromocriptine, could antagonize the histamine-induced catalepsy to various degrees. Thus, catalepsy induced by icv histamine can be evoked not only by an activation of the histamine receptor, but also indirectly due to cholinergic and dopaminergic imbalance.

  15. Kleine-Levin and Munchausen syndromes in a patient with recurrent acromegaly.

    Science.gov (United States)

    Jungheim, K; Badenhoop, K; Ottmann, O G; Usadel, K H

    1999-02-01

    Hypothalamic disease often affects the patients' personality and this also applies to pituitary tumors with suprasellar extension. We report on a patient with a 12-year history of recurrent acromegaly, treated with three transphenoidal operations, single field radiation therapy and bromocriptine/octreotide administration. During the course of follow-up she presented with self-inflicted anemia and Kleine-Levin syndrome (hypersomnia, hyperphagia and hypersexuality). Furthermore, she developed post-radiation necrosis within the right temporal lobe. Whether her neurological and personality disorders result - at least partially - from the acromegaly or the temporal lobe necrosis remains unclear.

  16. Peripartum cardiomyopathy: a contemporary review.

    Science.gov (United States)

    Shah, Tina; Ather, Sameer; Bavishi, Chirag; Bambhroliya, Arvind; Ma, Tony; Bozkurt, Biykem

    2013-01-01

    Peripartum cardiomyopathy is a rare and potentially fatal disease. Though approximately half of the patients recover, the clinical course is highly variable and some patients develop refractory heart failure and persistent left ventricular systolic dysfunction. It is diagnosed when women present with heart failure secondary to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause of heart failure is found. Etiology remains unclear, and treatment is similar to other cardiomyopathies and includes evidence-based standard heart failure management strategies. Experimental strategies such as intravenous immunoglobulin and bromocriptine await further clinical validation.

  17. Neuroleptic malignant syndrome in cycloserine-induced psychosis

    Science.gov (United States)

    Sawant, Neena S.; Kate, Natasha S.; Bhatankar, Swaroop S.; Kulkarni, Prathamesh S.

    2015-01-01

    A 33-year-old multidrug-resistant tuberculosis female patient diagnosed as cycloserine-induced psychosis developed several neuroleptic side effects such as extrapyramidal reaction, neuroleptic malignant syndrome, and drug-induced parkinsonism while she was being treated with initially haloperidol and then olanzapine over a period of 2 months. Patient's antipsychotic medications were withdrawn, and treatment with bromocriptine showed prompt recovery. The multiple neurological adverse effects which the patient developed had implications on the management of the complications as well as her illness. PMID:26069374

  18. Neuroleptic Malignant Syndrome: A Case Aimed at Raising Clinical Awareness

    Directory of Open Access Journals (Sweden)

    Jad Al Danaf

    2015-01-01

    Full Text Available A 60-year-old man with a history of bipolar disorder on risperidone, bupropion, and escitalopram was admitted for community acquired streptococcal pneumonia. Four days later, he developed persistent hyperthermia, dysautonomia, rigidity, hyporeflexia, and marked elevation of serum creatine phosphokinase. He was diagnosed with neuroleptic malignant syndrome (NMS and improved with dantrolene, bromocriptine, and supportive therapy. This case emphasizes the importance of considering a broad differential diagnosis for fever in the ICU, carefully reviewing the medication list for all patients, and considering NMS in patients with fever and rigidity.

  19. Galactorrhea Following Citalopram Treatment: A Case Report and Discussion

    Directory of Open Access Journals (Sweden)

    Horst J. Koch

    2011-01-01

    Full Text Available We report the case of a 25-year-old women suffering from major depression who was treated with citalopram for several weeks with doses between 20 mg and 60 mg. She gradually developed marked mydriasis within 2 months after treatment and subsequently neuritis nervi optici. Moreover, abrupt galactorrhea occurred after 2 months of treatment. All neuro-ophthalmological, neurophysiological, clinical laboratory, and neuroradiological diagnostic efforts did not reveal an underlying organic pathophysiology. The ocular symptoms disappeared rapidly after the discontinuation of citalopram and pulse therapy with methyl-prednisolone. However, galactorrhea persisted for a few weeks necessitating treatment with bromocriptine.

  20. Preventive and treatment value of dopamine receptor agonists in ovarian hyperstimulation syndrome%多巴胺受体激动剂在卵巢过度刺激综合征的防治价值

    Institute of Scientific and Technical Information of China (English)

    杨蕊; 马彩虹

    2012-01-01

    The vascular endothelial growth factor (VEGF) is a crucial element for increased vascular permeability which determines ovarian hyperstimulation syndrome (OHSS). Dopamine receptor agonists can selectively inhibit VEGF-induced vascular permeability without interfering with angiogenesis. Vascular endothelial growth factor receptor-2 (VEGFR-2) phosphorylation reduction seems to he associated with this effect. The preventive use of dopamine receptor agonists reduces the risk of OHSS in women after ovarian stimulation for in vitro fertilization (IVF). Statistically, evidence of their preventive effect on the severe OHSS is not as clear as on the moderate OHSS. The use of dopamine receptor agonists does not influence the outcome of IVF cycles. The occurrence of obstetric or neonatal complications is similar with that in control groups. The oral administration of cahergoline is the best studied dopamine receptor agonists regimen in the prevention of OHSS. High-dose quinagolide is rarely applied due to its intolerable side effects. Oral bromocriptine can also be occasionally associated with severe gastric discomfort, although less frequently than with quinagoline. Rectal bromocriptine is used with more and more frequency because of its safety, but it still requires further study. Although published data suggest that dopamine agonists also improve the clinical evolution of established OHSS, no randomized controlled trials have been reported to confirm their effectiveness. The use of dopamine receptor agonists may be combined with with other strategies to prevent or control OHSS, such as GnRH antagonists, in order to improve its efficacy.

  1. Neuroleptic malignant syndrome associated with haloperidol use in critical care setting: should haloperidol still be considered the drug of choice for the management of delirium in the critical care setting?

    Science.gov (United States)

    Dixit, Deepali; Shrestha, Pranabh; Adelman, Marc

    2013-07-12

    A 48-year-old man was brought to the emergency department because of intoxication. The patient was in respiratory distress, subsequently intubated for airway protection. On hospital day 5, he was diagnosed with delirium. Haloperidol was initiated at 5 mg intravenous every 6 h and titrated up to a dose of 60 mg /day over 5 days. On hospital day 18, his temperature peaked to 107.1°F. Other symptoms included mental status change, muscular rigidity and autonomic dysfunction. Neuroleptic malignant syndrome (NMS) associated with haloperidol was suspected. No other causes for these symptoms were present. Concurrent medications were reviewed and ruled out for possible drug-induced fever. Haloperidol was discontinued and dantrolene and bromocriptine was initiated. The temperature decreased to 102.2°F within 3 h and other symptoms resolved overtime. The temporal relationship between the patient's fever decline with the discontinuation of haloperidol, and improvement with dantrolene and bromocriptine, the diagnosis was believed to be haloperidol-induced NMS.

  2. Transsphenoidal surgery for a life-threatening prolactinoma apoplexy during pregnancy.

    Science.gov (United States)

    Witek, Przemysław; Zieliński, Grzegorz; Maksymowicz, Maria; Zgliczyński, Wojciech

    2012-01-01

    Prolactinoma is the most common secreting pituitary adenoma. It is typically diagnosed in women of reproductive age and is common cause of infertility. Currently the treatment of choice is pharmacotherapy with dopamine agonists, whereas surgical treatment is reserved for a selected group of patients. Pituitary-tumor apoplexy is a rare, life-threatening condition associated with significant morbidity and mortality. The authors present the case of a 25-year-old woman with prolactinoma treated with dopamine agonist. In course of such a treatment the patient became pregnant. The bromocriptine was gradually withdrawn. In the 14th week of pregnancy she was admitted for symptoms suggesting pituitary tumor apoplexy. The treatment with bromocriptine was reinitiated. In the 20th week of pregnancy further deterioration of the patient's neurological condition and visual-field abnormalities were observed. The patient was qualified for surgical treatment - selective transsphenoidal adenomectomy. The successful surgery led to improvement of neurological condition. The early postoperative PRL level decreased significantly and hormonal function of the pituitary was preserved. The pregnancy ended in 38th week with a caesarean section. Endocrinological evaluation conducted after the uneventful delivery confirmed normal function of the pituitary. Magnetic resonance imaging (MRI) did not reveal tumor re-growth. The patient is kept under constant medical care. In this case study the authors discussed therapeutic management and reviewed literature regarding gestational pituitary-tumor apoplexy with particular emphasis on surgical treatment.

  3. Endocrinology in pregnancy: management of the pregnant patient with a prolactinoma.

    Science.gov (United States)

    Molitch, Mark E

    2015-05-01

    A woman with a prolactinoma is usually infertile. Dopamine agonists usually restore ovulation and fertility and such treatment generally is preferred over transsphenoidal surgery because of higher efficacy and safety. Cabergoline is usually preferred over bromocriptine because of its better efficacy with fewer adverse effects. Either drug increases the rates of spontaneous abortions, preterm deliveries, multiple births, or congenital malformations over what may be expected. However, the number of pregnancies reporting such experience is about sevenfold greater for bromocriptine. Tumor growth causing significant symptoms and requiring intervention has been reported to occur in 2.4% of those with microadenomas, 21% in those with macroadenomas without prior surgery or irradiation, and 4.7% of those with macroadenomas with prior surgery or irradiation. Visual fields should be assessed periodically during gestation in women with macroadenomas. If significant tumor growth occurs, most patients respond well to reinstitution of the dopamine agonist. Delivery of the baby and placenta can also be considered if the pregnancy is sufficiently advanced. Transsphenoidal debulking of the tumor is rarely necessary.

  4. Secondary resistance to cabergoline therapy in a macroprolactinoma: a case report and literature review.

    LENUS (Irish Health Repository)

    Behan, L A

    2012-02-01

    Primary resistance to dopamine agonists occurs in 10-15% of prolactinomas but secondary resistance following initial biochemical and anti-proliferative response is very rare and has only been hitherto described in four previous cases, two with bromocriptine and two with cabergoline. We describe a case of a 57-year-old woman who presented with a large macroprolactinoma with suprasellar extension. She was initially treated with bromocriptine therapy with a resolution of symptoms, marked reduction in prolactin concentration and complete tumour shrinkage; a response which was subsequently maintained on cabergoline. After 8 years of dopamine agonist therapy, her prolactin concentration began to rise and there was symptomatic recurrence of her tumour despite escalating doses of cabergoline up to 6 mg weekly. Non-compliance was outruled by observed inpatient drug administration. The patient underwent surgical debulking followed by radiotherapy with good response. This case adds to the previous two cases of secondary resistance to cabergoline therapy in prolactinomas a marked initial response. While the mechanism of secondary resistance remains unknown and not possible to predict, close observation of prolactinoma patients on treatment is necessary.

  5. Managing prolactinoma during pregnancy

    Directory of Open Access Journals (Sweden)

    Maziar Azar

    2010-06-01

    Full Text Available Objective:Prolactinomas are the most common pituitary tumors in pregnant women. We conducted this study on pregnant women with prolactinoma to determine their clinical symptoms and signs and eventual necessity to medical therapy.Materials and methods:A descriptive study was performed on 85 pregnant women with prolactinoma.Patients were followed up by physical examination, imaging, and perimetry for diagnosis of visual field defect. If tumor was increased in size perimetry was performedin order to determine eventual visual field defect (VFD. Patients with progressive visual field defect had absolute indication for trans sphenoidal surgery (TSS.In other cases with progressive enlargement of adenoma size but without VFD bromocriptine was administered. Patients without increasing adenoma size were just followed up.Results:In this study 72 patients (84% had microadenomas, 7 patients (8% had macroadenomas without previous medical or surgical therapy and 6 patients (7% had macroadenomas with previous medical therapy with bromocriptine. Totally 20 patients (23 % had tumor enlargement during pregnancy and was symptomatic in 7 patients (8.2%. There was significant difference between 3 groups according to incidence of symptomatic tumor enlargement.(p<0.05Conclusion:Macroprolactinomas are more likely to enlarge during pregnancy than microprolactinomas. In our study conservative management was successfully done in all patients without surgery or medical therapy.

  6. [The effect of oxcarbamazepine on the clinical effectiveness of dopamine agonists in the treatment of prolactinoma].

    Science.gov (United States)

    Krysiak, Robert; Kedzia, Agnieszka; Okopień, Bogusław

    2011-01-01

    The CYP450 enzyme family plays a very important role in the biotransformation of many drugs with a different chemical structure. Therefore, the inhibition or induction of CYP enzymes may be responsible for the development of numerous drug interactions. Moreover, a peculiarity of constitution causes that some persons in particular situations may respond differently to a drug or treatment than do most people. In this article, we show a case of a young woman diagnosed with prolactinoma who was initially successfully treated with bromocriptine. Two years later she developed epilepsy secondary to brain trauma and as a result, she started receiving oxcarbamazepine treatment. Unfortunately, the treatment led to a deterioration of prolactinoma control. To normalize plasma prolactin levels, bromocriptine dose had to be increased and then replaced, initially with cabergoline and later with quinagolide. Only the latter drug effectively reduced plasma prolactin levels and tumor size. This case shows for the first time the existence of a drug interaction between dopamine agonists and any anti-epileptic drug in patients with prolactinoma.

  7. Methods and clinical applications of positron emission tomography in endocrinology. Methodologie et applications cliniques en endocrinologie de la tomographie a emission de positons

    Energy Technology Data Exchange (ETDEWEB)

    Landsheere, C. de; Lamotte, D. (Liege Univ. (BE))

    1990-01-01

    Positron emission tomography (PET) allows to detect in coincidence photons issued from annihilation between positrons and electrons nearby situated. Tomographic detection (plane by plane) and tomographic reconstruction will lead to the quantitation of radioactive distribution per voxel, in the organ of interest. Recent tomographs can acquire simultaneously several transaxial slices, with a high sensitivity and a spatial resolution of 3-5 mm. Commonly used positron emitters have a short half-life: 2, 10, 20 and 110 min for {sup 15}0, {sup 13}N, {sup 11}C and {sup 18}F, respectively. The use of these isotopes requires on line production of radionuclides and synthesis of selected molecules. In endocrinology, PET allows among others to study noninvasively the receptor density of hormonodependent neoplasms such as breast, uterus, prostate tumors and prolactinomas. These last tumors represent a particular entity because of several combined characteristics: high turnover rate of amino acids, high density of dopaminergic receptors and response to bromocriptine (analogue of dopamine inhibiting the secretion of prolactine) in relation to the level of receptors. Because PET permits to evaluate the density of dopaminergic receptors and the metabolism of amino acids, theoretical response of the prolactinoma to bromocriptin can be predicted, the achieved therapeutic efficacy can be estimated and the long-term follow up of tumor growth can be assessed. This example illustrates the clinical value of PET in endocrinology.

  8. Idiopathic hypertrophic pachymeningitis mimicking prolactinoma with recurrent vision loss.

    Science.gov (United States)

    Lok, Julie Y C; Yip, Nelson K F; Chong, Kelvin K L; Li, C L; Young, Alvin L

    2015-08-01

    Idiopathic hypertrophic pachymeningitis is a rare inflammatory condition with diffuse thickening of the dura mater, which may cause a compressive effect or vascular compromise. We report on a 28-year-old Chinese woman with a history of granulomatous mastitis 7 years previously and oligomenorrhoea, headache, blurred vision, and raised prolactin level 2 years previously, that was diagnosed as prolactinoma and treated conservatively with bromocriptine. However, she had recurrent bilateral vision loss when the bromocriptine was stopped. Her symptoms were resolved by high-dose steroid injection but remained steroid-dependent. Serial magnetic resonance imaging scan showed progressive diffuse thickening of the pachymeningitis with disappearance of pituitary apoplexy. Lumbar puncture showed lymphocytosis with no organisms. Open biopsy of the meninges was performed and histology showed features of inflammatory infiltrates and vasculitis. This is an unusual presentation of a rare condition in this age-group, with co-existing granulomatous mastitis and chronic otitis media, and is a diagnostic challenge mimicking pituitary macroadenoma and meningioma in initial magnetic resonance imaging scans.

  9. 垂体泌乳素腺瘤中雌激素、雄激素的表达与临床特点的相关性研究%Correlations between Expression of Estrogen and Androgen Receptors and the Clinical Characteristics of Prolactinoma

    Institute of Scientific and Technical Information of China (English)

    约翰; 王雄伟; 张华楸; 舒凯; 雷霆

    2006-01-01

    Objective: To study the correlations between estrogen receptor (ER) and androgen receptor (AR) and the clinical presentations of prolactinoma and investigate the effect of ER and AR expression on the pathogenesis of prolactinoma in sexual difference. Methods: The clinical data of 30 patients who had undergone transsphenoidal operations in Tongji Hospital from December 2000 to December 2001 were reviewed retrospectively. The clinical information included sex, age, serum-prolactin, size, tumor invasiveness, history of use of bromocriptine and frequency of recurrence. In 20 out of the 30 patients, the ER and AR expression was detected by using immunohistochemistry method. With help of Chi-square test, the relationship between ER, AR and the clinical presentations was analyzed. Results: The statistical values revealed that there was no significant correlation between the ER and AR expression levels with the clinical presentations such as sex, age, tumor size or tumor invasiveness among the 20 patients studied (P>0.05). Conclusion: The expression of ER or AR is not influenced by the clinical data of prolactinoma such as sex, age, tumor diameter or extent of tumor invasiveness. The tumor is more aggressive in males than in females. In maroadenoma or tumor with hyperprolactineamia (>200 ng/mL) simple surgical treatmentcan't successfully cure the prolactinoma. Post-operative bromocriptine therapy can't be determined by the sex of the patients, but is greatly related to the tumor size and serum-prolactin level before operation.

  10. A case of an ectopic prolactinoma.

    Science.gov (United States)

    Simsir, Ilgin Yildirim; Kocabas, Gokcen Unal; Sahin, Serap Baydur; Erdogan, Mehmet; Cetinkalp, Sevki; Saygili, Fusun; Yilmaz, Candeger; Ozgen, Ahmet Gokhan

    2012-02-01

    A 34-year-old female presented to our clinic with a 1.5 year history of secondary amenorrhea and galactorrhea. Prolactin (PRL) level was found to be 151.89 ng/ml. Pituitary imaging was reported to be normal. An examination of the patient revealed that PRL level was still high so the dose of cabergoline was further increased and subsequently, bromocriptine was added to the treatment. There was no reduction in PRL levels in controls. A scanning was performed to look for an ectopic focus. Abdominal computerized tomography revealed a heterogenous mass lesion originating from the uterus. Octreotide scintigraphy was performed and we observed an involvement consistent with the mass in the uterus. The patient underwent abdominal total hysterectomy. PRL dropped to 0.4 ng/ml the next day after the operation. The pathology result was a low-grade malignant mesenchymal tumor. Prolactin was found to be immunohistochemically negative. However, galactorrhea disappeared postoperative and PRL levels are still low. Elevated levels of PRL, resistant to bromocriptine and cabergoline, rapidly returned to normal after hysterectomy, which obviously indicates that hyperprolactinemia was associated with the myoma of the uterus.

  11. Pharmacological Modulation of Dopamine Receptor D2-Mediated Transmission Alters the Metabolic Phenotype of Diet Induced Obese and Diet Resistant C57Bl6 Mice

    Directory of Open Access Journals (Sweden)

    J. E. de Leeuw van Weenen

    2011-01-01

    Full Text Available High fat feeding induces a variety of obese and lean phenotypes in inbred rodents. Compared to Diet Resistant (DR rodents, Diet Induced Obese (DIO rodents are insulin resistant and have a reduced dopamine receptor D2 (DRD2 mediated tone. We hypothesized that this differing dopaminergic tone contributes to the distinct metabolic profiles of these animals. C57Bl6 mice were classified as DIO or DR based on their weight gain during 10 weeks of high fat feeding. Subsequently DIO mice were treated with the DRD2 agonist bromocriptine and DR mice with the DRD2 antagonist haloperidol for 2 weeks. Compared to DR mice, the bodyweight of DIO mice was higher and their insulin sensitivity decreased. Haloperidol treatment reduced the voluntary activity and energy expenditure of DR mice and induced insulin resistance in these mice. Conversely, bromocriptine treatment tended to reduce bodyweight and voluntary activity, and reinforce insulin action in DIO mice. These results show that DRD2 activation partly redirects high fat diet induced metabolic anomalies in obesity-prone mice. Conversely, blocking DRD2 induces an adverse metabolic profile in mice that are inherently resistant to the deleterious effects of high fat food. This suggests that dopaminergic neurotransmission is involved in the control of metabolic phenotype.

  12. Short-term pharmacological suppression of the hyperprolactinemia of infertile hCG-overproducing female mice persistently restores their fertility.

    Science.gov (United States)

    Ratner, Laura D; Gonzalez, Betina; Ahtiainen, Petteri; Di Giorgio, Noelia P; Poutanen, Matti; Calandra, Ricardo S; Huhtaniemi, Ilpo T; Rulli, Susana B

    2012-12-01

    Female infertility is often associated with deregulation of hormonal networks, and hyperprolactinemia is one of the most common endocrine disorders of the hypothalamic-pituitary axis affecting the reproductive functions. We have shown previously that transgenic female mice overexpressing human chorionic gonadotropin β-subunit (hCGβ+ mice), and producing elevated levels of bioactive LH/hCG, exhibit increased production of testosterone and progesterone, are overweight and infertile, and develop hyperprolactinemia associated with pituitary lactotrope adenomas in adult age. In the present study, we analyzed the influence of the hyperprolactinemia of hCGβ+ females on their reproductive phenotype by treating them with the dopamine agonists, bromocriptine and cabergoline. Long-term bromocriptine treatment of adult mice was effective in the control of obesity, pituitary growth, and disturbances in the hormone profile, demonstrating that hyperprolactinemia was the main cause of the hCGβ+ female phenotype. Interestingly, short-term treatment (1 wk) with cabergoline applied on 5-wk-old mice corrected hyperprolactinemia, hyperandrogenism, and hyperprogesteronemia, prevented pituitary overgrowth, normalized gonadal function, and recovered fertility of adult hCGβ+ females after hormone-induced and natural ovulation. The same cabergoline treatment in the short term applied on 3-month-old hCGβ+ females failed to recover their reproductive function. Hence, we demonstrated that the short-term cabergoline treatment applied at a critical early stage of the phenotype progression effectively prevented the hyperprolactinemia-associated reproductive dysfunction of hCG-overproducing females.

  13. Silymarin BIO-C, an extract from Silybum marianum fruits, induces hyperprolactinemia in intact female rats.

    Science.gov (United States)

    Capasso, Raffaele; Aviello, Gabriella; Capasso, Francesco; Savino, Francesco; Izzo, Angelo A; Lembo, Francesca; Borrelli, Francesca

    2009-09-01

    Breastfeeding is widely acknowledged to have important health benefits for infants and mothers. Milk thistle (Silybum marianum fruits) has been recently proposed to be used by nursing mothers for stimulating milk production; however, the mode of action of this herbal drug is still unknown. In this paper, we have evaluated the effect of a micronized standardized extract of S. marianum (Silymarin BIO-C=Piùlatte) on the serum levels of prolactin in female rats. A 14-day treatment with Silymarin BIO-C (25-200mg/kg, given orally) increased, in a dose dependent manner, the serum prolactin levels. Moreover, after a 66-day discontinuation of Silymarin BIO-C treatment, prolactin levels were still significantly elevated although we observed a trend to decrease that was counteracted by a further 7-day treatment with Silymarin BIO-C. Bromocriptine, a dopamine D(2) receptor agonist, (1-10mg/kg, os) significantly and in a dose dependent manner, reduced the serum prolactin levels; bromocriptine, at the dose of 1mg/kg, significantly reduced the high serum prolactin levels induced by Silymarin BIO-C. In conclusion, we have shown that an extract from S. marianum fruits significantly increases circulating prolactin levels in female rats; this effect seems to involve, at least in part, dopamine D(2) receptors.

  14. Prolactin has a pathogenic role in systemic lupus erythematosus.

    Science.gov (United States)

    Jara, Luis J; Medina, Gabriela; Saavedra, Miguel A; Vera-Lastra, Olga; Torres-Aguilar, Honorio; Navarro, Carmen; Vazquez Del Mercado, Monica; Espinoza, Luis R

    2017-01-28

    Prolactin, a 23-kDa peptide hormone, is produced by the anterior pituitary gland and extrapituitary sites including the immune cells. Prolactin (PRL) participates in innate and adaptive immune response. PRL stimulates the immune cells by binding to receptor (PRL-R). Binding of PRL to its receptor activates the Janus kinase-signal transducer (JAK-STAT). Activation of these cascades results in endpoints such as immunoestimulator and immunosupressor action. Prolactin belongs to the network of immune-neuroendocrine interaction. Hyperprolactinemia has been found in patients with systemic lupus erythematosus (SLE), and new evidence has confirmed a significant correlation between serum PRL levels and disease activity. PRL participates in activation of SLE during pregnancy and in pathogenesis of lupus nephritis, neuropsychiatric, serosal, hematologic, articular, and cutaneous involvement. Hyperprolactinemia was associated with increase IgG concentrations, anti-DNA antibodies, immune complex, glomerulonephritis, and accelerated mortality in murine lupus. Bromocriptine, a dopamine analog that suppresses PRL secretion, was associated with decreased lupus activity, prolonged lifespan, and restoration of immune competence in experimental model. In clinical trials, bromocriptine and derivative drugs showed beneficial therapeutic effect in treating human lupus, including pregnancy. Taken together, clinical and experimental results leave little doubt that PRL indeed contributes to the pathogenesis and clinical expression of SLE.

  15. Somatostatin analog treatment of acromegaly: new aspects.

    Science.gov (United States)

    Lamberts, S W; del Pozo, E

    1988-01-01

    Ten acromegalics received daily doses of 200-300 micrograms of a long-acting somatostatin analog, SMS 201-995 (Sandostatin, SMS), for an average of 64 weeks. Basal mean GH values of 44 +/- (SE) 7.8 ng/ml had fallen into the normal range at the end of the observation period (mean 64 weeks). This effect was accompanied by a substantial drop in somatomedin-C values. Reduction of pituitary tumor size could be documented in 3 of 6 patients. Whereas SMS did not affect high plasma PRL in 4 microprolactinoma patients, lactotrophs turned sensitive to this agent in mixed GH/PRL tumors. In a comparative study between SMS and bromocriptine, the former normalized circulating GH in 10 of 17 acromegalics in an acute trial, whereas bromocriptine was effective in only 5. A combination of both substances was effective in 2 of 3 patients who were insensitive to single drug administration. Cultures of GH-secreting tumor cells showed a statistically significant hormone decrease in the medium when exposed to SMS. However, in some instances, a diminution of the GH contents of the tumor cells was also observed, presumably as the basis for intracellular breakdown and clinical tumor shrinkage.

  16. Management of psychotropic-induced hyperprolactinemia.

    Science.gov (United States)

    Marken, P A; Haykal, R F; Fisher, J N

    1992-10-01

    The effects of individual psychotropic medications on serum prolactin concentrations are described, and recommendations for dealing with adverse effects are provided. Hyperprolactinemia can result in galactorrhea, amenorrhea, irregular menses, and anovulation; in men, impotence and azoospermia, with or without lactation and gynecomastia, can occur. Antipsychotics may block dopamine receptors in the pituitary prolactin-secreting cells and prevent dopamine-induced reduction of prolactin release. The magnitude of the increase in prolactin concentration correlates with the amount of antipsychotic drug given. The treatment of choice is reduction of the antipsychotic dosage or discontinuation of therapy. If adjustments to the antipsychotic dosage fail to resolve symptoms, the dopamine agonists bromocriptine and amantadine may be tried. Antidepressants may produce elevated serum prolactin concentrations, especially with long-term administration. However, the frequency of antidepressant-induced hyperprolactinemia is much lower than that seen with antipsychotics, and serious adverse clinical effects are uncommon. Other psychotropic drugs such as lithium, valproic acid, buspirone, carbamazepine, and benzodiazepines either are only rarely associated with symptomatic hyperprolactinemia or do not produce clinically important changes in prolactin concentrations. Antipsychotic drugs are the psychotropic agents most likely to cause symptomatic hyperprolactinemia. Bromocriptine or amantadine may provide symptomatic relief if withdrawal or adjustment of the antipsychotic dosage does not eliminate the symptoms.

  17. Kidnapping of chicks in emperor penguins: a hormonal by-product?

    Science.gov (United States)

    Angelier, Frédéric; Barbraud, Christophe; Lormée, Hervé; Prud'homme, François; Chastel, Olivier

    2006-04-01

    The function and causes of kidnapping juveniles are little understood because individuals sustain some breeding costs to rear an unrelated offspring. Here we focus on the proximal causes of this behaviour in emperor penguins (Aptenodytes forsteri), whose failed breeders often kidnap chicks. We experimentally tested the hypothesis that kidnapping behaviour was the result of high residual levels of prolactin (PRL), a hormone involved in parental behaviour. Penguins with artificially decreased PRL levels by bromocriptine administration kidnapped chicks less often than control penguins. Within the bromocriptine treated group, kidnapping behaviour was not totally suppressed and the probability of kidnapping a chick was positively correlated to PRL levels measured before treatment. During breeding, emperor penguins have to forage in remote ice-free areas. In these birds, PRL secretion is poorly influenced by chick stimuli and has probably evolved to maintain a willingness to return to the colony after a long absence at sea. Therefore, penguins that have lost their chick during a foraging trip still maintain high residual PRL levels and this, combined with colonial breeding, probably facilitates kidnapping. We suggest that kidnapping in non-cooperative systems may result from a hormonal byproduct of a reproductive adaptation to extreme conditions.

  18. Intestinal mucosal changes and upregulated calcium transporter and FGF-23 expression during lactation: Contribution of lactogenic hormone prolactin.

    Science.gov (United States)

    Wongdee, Kannikar; Teerapornpuntakit, Jarinthorn; Sripong, Chanakarn; Longkunan, Asma; Chankamngoen, Wasutorn; Keadsai, Chutiya; Kraidith, Kamonshanok; Krishnamra, Nateetip; Charoenphandhu, Narattaphol

    2016-01-15

    As the principal lactogenic hormone, prolactin (PRL) not only induces lactogenesis but also enhances intestinal calcium absorption to supply calcium for milk production. How the intestinal epithelium res-ponses to PRL is poorly understood, but it is hypothesized to increase mucosal absorptive surface area and calcium transporter expression. Herein, lactating rats were found to have greater duodenal, jejunal and ileal villous heights as well as cecal crypt depths than age-matched nulliparous rats. Morphometric analyses in the duodenum and cecum showed that their mucosal adaptations were diminished by bromocriptine, an inhibitor of pituitary PRL release. PRL also upregulated calcium transporter expression (e.g., TRPV6 and PMCA1b) in the duodenum of lactating rats. Since excessive calcium absorption could be detrimental to lactating rats, local negative regulator of calcium absorption, e.g., fibroblast growth factor (FGF)-23, should be increased. Immunohistochemistry confirmed the upregulation of FGF-23 protein expression in the duodenal and cecal mucosae of lactating rats, consistent with the enhanced FGF-23 mRNA expression in Caco-2 cells. Bromocriptine abolished this lactation-induced FGF-23 expression. Additionally, FGF-23 could negate PRL-stimulated calcium transport across Caco-2 monolayer. In conclusion, PRL was responsible for the lactation-induced mucosal adaptations, which were associated with compensatory increase in FGF-23 expression probably to prevent calcium hyperabsorption.

  19. Severe hyperprolactinemia associated with internal carotid artery aneurysm: differential diagnosis between prolactinoma and hypothalamic-pituitary disconnection.

    Science.gov (United States)

    Duarte, Felipe Henning Gaia; Machado, Marcio Carlos; Lima, Joilma Rodrigues de; Salgado, Luiz Roberto

    2008-10-01

    Sellar and parasellar masses blocking inhibitory hypothalamic dopaminergic tonus can produce hyperprolactinemia. One of these conditions, seldom reported, is internal carotid artery aneurysm causing pituitary stalk compression and hyperprolactinemia, the majority of which is related to small increases in serum prolactin levels. The aim of this study is to report the case of a patient with an internal carotid aneurysm and severe hiperprolactinemia. A 72 years old female patient, on oncology follow-up for clinically controlled cervical carcinoma, was evaluated due to worsening chronic headaches. During the investigation, computed tomography and magnetic resonance imaging (MRI) showed a sellar mass associated with high prolactin level (1.403 microg/L) that initially was considered a macroprolactinoma, and treated with bromocriptine. However, subsequent pituitary MRI suggested an internal carotid aneurysm, which was confirmed by an angioresonance imaging of cerebral vessels. On low bromocriptine dose (1.25 mg/day), there was a prompt normalization of prolactin levels with a great increase (> 600 microg/L) after withdrawal, which was confirmed several times, suggesting HPD. We report a patient with internal carotid artery aneurysm with severe hyperprolactinemia never reported before in patients with HPD, and the need for a differential diagnosis with macroprolactinomas even considering high prolactin levels.

  20. Secondary resistance to cabergoline therapy in a macroprolactinoma: a case report and literature review.

    LENUS (Irish Health Repository)

    Behan, L A

    2009-02-04

    Primary resistance to dopamine agonists occurs in 10-15% of prolactinomas but secondary resistance following initial biochemical and anti-proliferative response is very rare and has only been hitherto described in four previous cases, two with bromocriptine and two with cabergoline. We describe a case of a 57-year-old woman who presented with a large macroprolactinoma with suprasellar extension. She was initially treated with bromocriptine therapy with a resolution of symptoms, marked reduction in prolactin concentration and complete tumour shrinkage; a response which was subsequently maintained on cabergoline. After 8 years of dopamine agonist therapy, her prolactin concentration began to rise and there was symptomatic recurrence of her tumour despite escalating doses of cabergoline up to 6 mg weekly. Non-compliance was outruled by observed inpatient drug administration. The patient underwent surgical debulking followed by radiotherapy with good response. This case adds to the previous two cases of secondary resistance to cabergoline therapy in prolactinomas a marked initial response. While the mechanism of secondary resistance remains unknown and not possible to predict, close observation of prolactinoma patients on treatment is necessary.

  1. ROLE OF CHOLINERGIC SYSTEM ON THE CONSTRUCTION OF MEMORY AND ITS INTERACTION WITH DOPAMINERGIC SYSTEM

    Directory of Open Access Journals (Sweden)

    F. Z. Zangeneh

    2006-07-01

    Full Text Available The central cholinergic system has been associated with cognitive function and memory and acetylcholine plays an important role during the early stages of memory consolidation. In this study, after training mice were tested with one way active avoidance procedure and retention were tested at 4, 8, 12, 16 and 24 hours of training and compared with non-shocked mice, in which it took 24 hours, a suitable time for retention test. Low dose administration of arecoline and physostigmine pre-training, immediate post-training and before retrieval showed that muscarinic agonist arecoline can potentiated memory in post trained and retrieval phases and reversible cholinesterase inhibitor physostigmine potentiated memory only in retrieval phase. Scopolamine disrupted acetylcholine potentiation only in retrieval phase. In the second part of this study, the effect of dopaminergic system was investigated. Low dose of apomorphine and D2 agonist bromocriptine potentiated memory when administered immediately post-training, and D2 antagonist sulpiride impaired memory. When the cholinergic system was blocked by scopolamine immediately post-training, apomorphine and bromocriptine potentiated memory and sulpiride impaired it. In conclusion, these results suggest that, cholinergic system in retrieval phase is very critical and there was no interaction between the two systems in the post-training phase.

  2. [Methods and clinical applications of positron emission tomography in endocrinology].

    Science.gov (United States)

    De Landsheere, C; Lamotte, D

    1990-01-01

    Positron emission tomography (PET) allows to detect in coincidence photons issued from annihilation between positrons and electrons nearby situated. Tomographic detection (plane by plane) and tomographic reconstruction will lead to the quantitation of radioactive distribution per voxel, in the organ of interest. Recent tomographs can acquire simultaneously several transaxial slices, with a high sensitivity and a spatial resolution of 3-5 mm. Commonly used positron emitters have a short half-life: 2, 10, 20 and 110 min for 150, 13N, 11C and 18F, respectively. The use of these isotopes requires on line production of radionuclides and synthesis of selected molecules. In endocrinology, PET allows among others to study noninvasively the receptor density of hormone-dependent neoplasms such as breast, uterus, prostate tumors and prolactinomas. These last tumors represent a particular entity because of several combined characteristics: high turnover rate of amino acids, high density of dopaminergic receptors and response to bromocriptine (analogue of dopamine inhibiting the secretion of prolactin) in relation to the level of receptors. Because PET permits to evaluate the density of dopaminergic receptors and the metabolism of amino acids, theoretical response of the prolactinoma to bromocriptine can be predicted, the achieved therapeutic efficacy can be estimated and the long-term follow up of tumor growth can be assessed. This example illustrates the clinical value of PET in endocrinology.

  3. Diagnosis and management of galactorrhea.

    Science.gov (United States)

    Leung, Alexander K C; Pacaud, Daniele

    2004-08-01

    After infancy, galactorrhea usually is medication-induced. The most common pathologic cause of galactorrhea is a pituitary tumor. Other causes include hypothalamic and pituitary stalk lesions, neurogenic stimulation, thyroid disorders, and chronic renal failure. Patients with the latter conditions may have irregular menses, infertility, and osteopenia or osteoporosis if they have associated hyperprolactinemia. Tests for pregnancy, serum prolactin level and serum thyroid-stimulating hormone level, and magnetic resonance imaging are important diagnostic tools that should be employed when clinically indicated. The underlying cause of galactorrhea should be treated when possible. The decision to treat patients with galactorrhea is based on the serum prolactin level, the severity of galactorrhea, and the patient's fertility desires. Dopamine agonists are the treatment of choice in most patients with hyperprolactinemic disorders. Bromocriptine is the preferred agent for treatment of hyperprolactin-induced anovulatory infertility. Although cabergoline is more effective and better tolerated than bromocriptine, it is more expensive, and treatment must be discontinued one month before conception is attempted. Surgical resection rarely is required for prolactinomas.

  4. The Diagnosis and Treatment of Sexual Dysfunction Males with Idiopathic Hyperprolactinemia%男性特发性高泌乳素血症致性功能障碍的诊治

    Institute of Scientific and Technical Information of China (English)

    余勇军; 祝存海; 邓辉; 叶昶; 马春清; 陈晓春

    2011-01-01

    目的 探讨男性特发性高泌乳素血症致性功能障碍的临床特征和治疗方法,提高男性特发性高泌乳素血症的诊治水平.方法 用甲磺酸溴隐亭治疗特发性高泌乳素血症的男性患者10例:包括性欲低下10例、勃起功能障碍8例、生精障碍2例.结果 所有患者经甲磺酸溴隐亭(1.25~2.50 mg/d)规律治疗1~24个月,10例患者的性欲得到提高,勃起功能改善8例,生精障碍2例得到缓解.其中3例患者治疗后性满意度不高,并且其血清睾酮水平相对较低,加服十一酸睾酮(40 mg/次,1~2次/d)治疗,0.5~2个月后患者的性满意度得到进一步改善.结论 男性特发性高泌乳素血症所致的性功能障碍较为少见,病因不明,甲磺酸溴隐亭治疗效果良好.高泌乳素血症应引起男科医生的高度重视.%Objective To discuss the clinical feature and diagnosis and treatment of sexual dysfunction males with idiopathic hyperprolactinemia. Methods 10 cases of sexual dysfunction males with idiopathic hyperprolactinemia were retrospectively analyzed. After the clinical evaluation,all the patients were treated with bromocriptine mesylate. Results Of all patients, 10 males presented with complaints of sexual dysfunction, 10 with libido loss,8 with erectile dysfunction and 2 with dyszoospermia. After the bromocriptine mesylate treatment, serum prolactin level of all patients declined and returned to the normal range. All patients' sexual function improved. Conclusion Idiopathic hyperprolactinemia occurred uncommonly in sexual dysfunction males. Bromocriptine therapy may benefit the patients. More attention should be paid to that symptom.

  5. Effects of Neonatal Exposure to Estradiol on Prolactin Secretion and Activity of the Tubero-lnfundibular Dopamine System in Young Adulthood: Comparison with Neonatal Prolactin Deficiency*.

    Science.gov (United States)

    Crowley, W R; Shah, G V; Watanobe, H; Grosvenor, C E

    1990-02-01

    Abstract Previous results from this laboratory indicate that female rats who consume milk deficient in prolactin (PRL) during the neonatal period subsequently display hyperprolactinemia, associated with decreased activity in the tubero-infundibular dopamine (DA) system and decreased lactotrope responsiveness to DA receptor stimulation. The present studies tested whether these neuroendocrine consequences of neonatal PRL deficiency can be mimicked by exposure of neonatal rats to estradiol. Female rats were injected sc with 1 mUg estradiol benzoate or oil vehicle on postpartum Days one to 3, while in other experiments, females were made neonatally deficient in PRL through treatment of their mothers with the DA agonist bromocriptine, a treatment that reduces the levels of PRL in milk. Females treated neonatally with estradiol benzoate, as well as offspring of the bromocriptine-treated mothers, displayed hyperprolactinemia as young adults, as compared to their respective vehicle-matched controls, and in both cases, this was abolished by ovariectomy, indicating dependence upon ovarian secretions. As reported previously in neonatal PRL-deficient females, neonatal estradiol benzoate-treated animals also exhibited reduced steady state levels and decreased turnover rates of DA in the median eminence when 35 days of age. DA levels and turnover rates in this region were still significantly reduced on postpartum Day 60. The DA agonist bromocriptine suppressed PRL release to a similar extent in cultured anterior pituitary cells from neonatal estrogen-treated and control rats, suggesting normal responsiveness of DA receptors on lactotrope cells in both groups. The present results confirm the ability of estradiol treatment or induction of a PRL deficiency during the early neonatal period to induce subsequent hyperprolactinemia in female rats, and further indicate that the hyperprolactinemic conditions resulting from either neonatal manipulation are dependent on the ovary and are

  6. Prolactin regulation of kisspeptin neurones in the mouse brain and its role in the lactation-induced suppression of kisspeptin expression.

    Science.gov (United States)

    Brown, R S E; Herbison, A E; Grattan, D R

    2014-12-01

    Hyperprolactinaemia is a major cause of infertility in both males and females, although the mechanism by which prolactin inhibits the reproductive axis is not clear. The aim of the present study was to test the hypothesis that elevated prolactin causes suppression of kisspeptin expression in the hypothalamus, resulting in reduced release of gonadotrophin-releasing hormone (GnRH) and consequent infertility. In oestrogen-treated ovariectomised mice, chronic prolactin-treatment prevented the rise in luteinising hormone (LH) seen in vehicle-treated mice. Kiss1 mRNA was significantly suppressed in both the rostral periventricular region of the third ventricle (RP3V) and arcuate nucleus after prolactin treatment. Exogenous prolactin treatment induced phosphorylated signal transducer and activator of transcription 5 (pSTAT5) in kisspeptin neurones, and suppression of endogenous prolactin using bromocriptine reduced levels of pSTAT5 in kisspeptin neurones, suggesting that prolactin acts directly on kisspeptin neurones. By contrast, fewer than 1% of GnRH neurones expressed pSTAT5 in either dioestrous or lactating mice. As reported previously, there was significant suppression of kisspeptin mRNA and protein in the RP3V on day 7 of lactation, although not in the arcuate nucleus. Bromocriptine treatment significantly increased Kiss1 mRNA expression in the RP3V, although not to dioestrous levels. Unilateral thelectomy, aiming to eliminate sensory inputs from nipples on one side of the body, failed to alter the reduction in the number of kisspeptin neurones observed in the RP3V. These data demonstrate that chronic prolactin administration suppressed serum LH, and reduced Kiss1 mRNA levels in both the RP3V and arcuate nucleus, consistent with the hypothesis that prolactin-induced suppression of kisspeptin secretion might mediate the inhibitory effects of prolactin on GnRH secretion. During lactation, however, the suppression of Kiss1 mRNA in the RP3V was only partially reversed

  7. Dopamine agents for hepatic encephalopathy

    DEFF Research Database (Denmark)

    Junker, Anders Ellekær; Als-Nielsen, Bodil; Gluud, Christian

    2014-01-01

    BACKGROUND: Patients with hepatic encephalopathy may present with extrapyramidal symptoms and changes in basal ganglia. These changes are similar to those seen in patients with Parkinson's disease. Dopamine agents (such as bromocriptine and levodopa, used for patients with Parkinson's disease) have...... therefore been assessed as a potential treatment for patients with hepatic encephalopathy. OBJECTIVES: To evaluate the beneficial and harmful effects of dopamine agents versus placebo or no intervention for patients with hepatic encephalopathy. SEARCH METHODS: Trials were identified through the Cochrane...... of the trials followed participants after the end of treatment. Only one trial reported adequate bias control; the remaining four trials were considered to have high risk of bias. Random-effects model meta-analyses showed that dopamine agents had no beneficial or detrimental effect on hepatic encephalopathy...

  8. [Neuroleptic malignant syndrome : Rare cause of fever of unknown origin].

    Science.gov (United States)

    Chackupurakal, R; Wild, U; Kamm, M; Wappler, F; Reske, D; Sakka, S G

    2015-07-01

    Neuroleptic malignant syndrome (NMS) is a possible cause of fever of unknown origin (FUO) and is a potentially fatal adverse effect of various drugs, especially of neuroleptics. First generation antipsychotics, such as received by the patient described in this article, are more likely to cause NMS than second generation antipsychotics. The key symptoms are the development of severe muscle rigidity and elevated temperature associated with the use of neuroleptic medication. Malignant catatonia (MC) is an important differential diagnosis of NMS. While neuroleptics can trigger NMS and must be immediately discontinued if NMS occurs, neuroleptic therapy represents the first line treatment for MC. This article describes the case of a patient with schizoaffective disorder where initially the diagnosis of NMS was not clear. Eventually, fever and a markedly elevated serum creatine kinase (CK) led to the correct diagnosis and the appropriate therapy with dantrolene, bromocriptine and amantadine. Furthermore, a thorough review of the currently available literature on NMS is provided.

  9. Drug resistant neuroleptic malignant syndrome and the role of electroconvulsive therapy.

    Science.gov (United States)

    Hashim, Husnain; Zeb-un-Nisa; Alrukn, Suhail Abdulla Mohammad; Al Madani, Abubaker Abdul Rahman Shaffi

    2014-04-01

    Neuroleptic malignant syndrome is considered as a rare but potentially fatal complication of neuroleptic medications e.g.,antipsychotics, sedatives and anti emetics. It is characterized by hyperthermia, muscle rigidity, an elevated creatine kinase level and autonomic instability. The syndrome often develops after the start of antipsychotic or a sudden increase in dosage of the neuroleptic medication or in states of dehydration. Treatment is mainly supportive and includes withdrawal of the neuroleptic medication and, possibly, administration of drugs such as dantrolene and bromocriptine. In rare cases where drugs treatment remains ineffective a trial of electroconvulsive therapy is being given. The case presented is a drug resistant case of Neuroleptic Malignant Syndrome where finally electroconvulsive therapy was effective.

  10. Prevention and treatment of malignant syndrome in Parkinson's disease: a consensus statement of the malignant syndrome research group.

    Science.gov (United States)

    Ikebe, Shin-ichiro; Harada, Toshiaki; Hashimoto, Takao; Kanazawa, Ichiro; Kuno, Sadako; Mizuno, Yoshikuni; Mizuta, Eiji; Murata, Miho; Nagatsu, Toshiharu; Nakamura, Shigenobu; Takubo, Hideki; Yanagisawa, Nobuo; Narabayashi, Hirotaro

    2003-04-01

    We report a consensus statement of the collaborative research group on the prevention and treatment of malignant syndrome (MS) in Parkinson's disease. The syndrome is quite similar to neuroleptic MS. Although sudden withdrawal of levodopa was the most frequent cause, many other precipitating events were found such as intercurrent infections, dehydration, hot weather, discontinuation of other anti-parkinsonian drugs, and "wearing off" phenomenon. Awareness of this syndrome is most important for its early detection and the prompt commencement of treatment. MS should be suspected whenever the body temperature rises above 38 degrees C without an apparent cause. Treatment consists of ample intravenous fluid, cooling the body, anti-parkinsonian drugs (particularly levodopa and bromocriptine), dantrolene sodium, and antibiotics if infection is present. Rhabdomyolysis, disseminated intravascular coagulation, and acute renal failure constitute serious complications.

  11. Neuroleptic malignant syndrome presenting as pulmonary edema and severe bronchorrhea.

    Science.gov (United States)

    Patel, U; Agrawal, M; Krishnan, P; Niranjan, S

    2002-04-01

    Neuroleptic malignant syndrome is a rare (incidence, 0.02%-3.2%) but dangerous complication following the use of neuroleptic drugs. When not promptly recognized, this disease carries a high mortality (10%-20%) and morbidity rate. We report an unusual case of neuroleptic malignant syndrome that presented predominantly with autonomic instability in the form of recurrent episodes of respiratory distress. The respiratory distress was initially caused by pulmonary edema and later was caused by severe bronchorrhea. We propose that aspiration pneumonia resulting in respiratory failure, the leading cause of death in neuroleptic malignant syndrome, may be a result of a combination of altered mental status and bronchorrhea. This has therapeutic implications because early institution of bromocriptine/dantrolene can prevent aspiration pneumonia and, hence, mortality from respiratory failure.

  12. Pharmacological profile of the abeorphine 201-678, a potent orally active and long lasting dopamine agonist

    Energy Technology Data Exchange (ETDEWEB)

    Jaton, A.L.; Giger, R.K.A.; Vigouret, J.M.; Enz, A.; Frick, W.; Closse, A.; Markstein, R.

    1986-01-13

    The central dopaminergic effects of an abeorphine derivative 201-678 were compared to those of apomorphine and bromocriptine in different model systems. After oral administration, this compound induced contralateral turning in rats with 6-hydroxydopamine induced nigral lesions and exhibited strong anti-akinetic properties in rats with 6-hydroxydopamine induced hypothalamic lesions. It decreased dopamine metabolism in striatum and cortex, but did not modify noradrenaline and serotonin metabolism in the rat brain. 201-678 counteracted the in vivo increase of tyrosine hydroxylase activity induced by ..gamma..-butyrolactone. In vitro it stimulated DA-sensitive adenylate cyclase and inhibited acetylcholine release from rat striatal slices. This compound had high affinity for /sup 3/H-dopamine and /sup 3/H-clonidine binding sites. These results indicate that 201-678 is a potent, orally active dopamine agonist with a long duration of action. Furthermore it appears more selective than other dopaminergic drugs. 29 references, 5 figures, 3 tables.

  13. Clinical diagnosis and management of prolactinoma%垂体催乳素瘤的临床诊断和治疗

    Institute of Scientific and Technical Information of China (English)

    汤正义

    2008-01-01

    催乳素瘤是垂体最常见的肿瘤,也是高催乳素血症的病因之一.鉴别诊断有时比较困难,需要胃复安或促甲状腺素释放激素刺激试验结果作参考.垂体催乳素瘤现在首选溴隐亭治疗,在特定情况下,还有其它药物、手术和放射治疗可选择.%Prolactinoma is the most common adenoma of pituitary gland, which causes hyperprolactinemia. Differential diagnosis for hyperprolactinemia may sometimes become difficult. The stimulating test with metoclopramide or thyrotropin-releasing hormone helps. Bromocriptine is the first choice to treat prolactinoma. Other medicaments, surgery and radiation are also of choice under certain particular conditions.

  14. Cavernous sinus residual tumor accompanying the empty sella syndrome after treatment of invasive prolactinomas%侵袭性催乳素腺瘤治疗后海绵窦残留或伴空蝶鞍综合征

    Institute of Scientific and Technical Information of China (English)

    吴哲褒; 苏志鹏; 诸葛启钏; 吴近森; 朱丹化; 郑伟明; 于春江

    2008-01-01

    目的 探讨侵袭性催乳素(PRL)腺瘤经治疗后海绵窦残留伴空蝶鞍综合征的临床特征和治疗策略.方法 18例侵袭性PRL腺瘤(Knosp分级Ⅲ或Ⅳ级)经治疗后出现海绵窦肿瘤持续残留,首选药物治疗者9例,首选手术治疗结合药物和(或)放疗9例.结果 平均随访55个月,8例PRL水平正常,7例视力改善.14例因鞍内肿瘤吸收遗留空蝶鞍,7例PRL仍升高,其中5例有不同程度的视交叉下疝(P<0.05).PRL水平正常、无临床症状的7例患者采用低剂量溴隐亭治疗达到PRL水平和肿瘤体积的长期控制.结论 PRL腺瘤治疗后海绵窦肿瘤残留伴发空蝶鞍,这一现象应该引起高度重视,尤其对伴有视交叉下疝的病例,长期的密切随访是必需的.无内分泌和压迫症状的海绵窦残留病例可以采用低剂量的药物治疗达到长期的肿瘤控制和内分泌控制.%Objective To discuss the clinical characteristics, treatment strategy of the cavernous sinus residual tumor (CSRT) accompanying the empty sella syndrome after treatment of invasive prolactinomas. Method Data from 18 patients with CSRT were retrospectively reviewed. Nine patients initially received bromocriptine as primary treatment; nine patients had initially undergone transcranial or transsphenoidal microsurgery and then received bromocriptine or adjuvant radiotherapy. Results During an average follow-up period of 55 months, serum PRL levels of 8 patients were in normal range and those of 10 patients were above the normal level. Visual symptoms improved in 7 patients while deteriorated in 2 patients. Fourteen patients had a secondary empty sella due to tumor shrinkage. Of those 14 patients, seven still had elevated PRL levels; five had optic ehiasmal herniation by different degrees (P<0.05). Seven of these 18 patients maintain their PRL levels normal with low-dose bromocriptine treatment without significant clinical symptoms. Conclusions After treatment of invasive prolactinomas

  15. Giant, solid, invasive prolactinoma in a prepubescent boy with gynecomastia.

    Science.gov (United States)

    Furtado, Sunil V; Saikiran, Narayanam A; Ghosal, Nandita; Hegde, Alangar S

    2010-01-01

    Pituitary adenomas are extremely rare in prepubescent children. Most of these tumors are functioning adenomas, but can also present with vision disturbances and changes in body morphology. We discuss the presentation, management, and outcome of a giant, solid, invasive prolactinoma in a 7-year-old boy who presented with visual disturbances and gynecomastia. The child demonstrated significant improvement in vision and a reduction in size of the tumor after subtotal tumor decompression and treatment with oral bromocriptine for 4 months. Tumor decompression and oral dopamine agonist therapy comprise the accepted treatment for pediatric prolactinomas. To our knowledge, only two previous reports described a giant prolactinoma in a prepubescent child. The relevant literature on pediatric pituitary tumours and prolactinoma is reviewed.

  16. Coat colour changes associated with cabergoline administration in bitches.

    Science.gov (United States)

    Gobello, C; Castex, G; Broglia, G; Corrada, Y

    2003-08-01

    Cabergoline or bromocriptine were administered orally to 60 bitches at doses of 5 microg/kg and 15 microg/kg daily, respectively, for two to 45 days for the treatment of pseudopregnancy or for oestrus induction. Seven of the dogs which received cabergoline for more than 14 days developed coat colour changes from the second week of administration to the next coat shedding. Of these, fawn-coloured bitches developed a yellowish coat colour while Argentine boar hounds became black spotted, mainly on their extremities. In previous untreated oestrous periods, these bitches had shown no coat colour changes. It is concluded that a colour shift in certain haircoats of particular breeds could be mediated through the inhibition of the secretion of melanocyte-stimulating hormone by the administration of the dopaminergic agonist cabergoline for more than two weeks. Transient coat colour changes should be considered a possible side effect when planning long-term treatment with dopaminergic agonists in dogs.

  17. [Vitex Agnus Castus in the treatment of hyperprolactinemia and menstrual disorders - a case report].

    Science.gov (United States)

    Męczekalski, Błażej; Czyżyk, Adam

    2015-07-01

    We describe a patient with mild hyperprolactinemia and menstrual disorders (oligomenorrhea). She presented relative hypoestrogenism in laboratory tests. Magnetic resonans excluded the presence of pituitary adenoma. Because patient developed a bromocriptine intolerance, the Vitex Agnus Castus (VAC) extract has been introduced. The VAC therapy was effective, with symptoms relief and improvement of hormonal tests. The VAC medicines are indicated for the treatment of premenstrual syndrome (PMS), mastalgia, menstrual disorders and mild hyperprolactinemia. The mechanism of action is not fully understood, but it is related to dopaniergic activity of diterpenes and castacin in VAC. The randomized clinical trials revealed efficacy of VAC extract in the treatmet of hyperprolactinemia, menstrual disorders, PMS and mastalgia. Good tolerability, lack of serious side-effects and drug interactions are the advantages of the VAC preparations.

  18. Hyperprolactinemic breast cancer in radiooncologic care

    Energy Technology Data Exchange (ETDEWEB)

    Schlegel, G.; Luethgens, M.; Schoen, H.D.

    1986-02-01

    Serum prolactin has been determined in 334 patients with breast cancer within the radiooncologic care. In addition 54 healthy female blood donors were analysed as controls. Values above 600 mU/l were called hyperprolactinemic. 15% of the patients showed elevated prolactin levels, 25% of which coincided with recurrent disease. Preoperative evaluation of prolactin in combination with TPA and CEA may be an aid in selecting a special group of patients with poor prognosis. Following 31 patients under therapy it could be demonstrated that any successful treatment modality leads to a normalization of elevated prolactin levels. In refractory cases addition of bromocriptine may be effective. Furthermore, drug induced hyperprolactinemia ought to be treated.

  19. Switch to quetiapine in antipsychotic agent-related hyperprolactinemia.

    Science.gov (United States)

    Keller, R; Mongini, F

    2002-12-01

    Novel antipsychotics (clozapine, risperidone, olanzapine, quetiapine) are effective in treating psychotic symptoms, also in neurological disease. Hyperprolactinemia is a side effect related to antipsychotics that can cause galactorrhea, gynecomastia, amenorrhea, anovulation, impaired spermatogenesis, decreased libido and sexual arousal, impotence, and anorgasmia, consequent to removal of tonic dopaminergic inhibition of prolactin secretion via hypothalamic dopaminergic receptor blockade in the tuberoinfundibolar tract. Hyperprolactinemia occurs more frequently during treatment with risperidone and olanzapine compared with clozapine and quetiapine. The therapeutic algorithm to antipsychotic-relatedhyperprolactinemia is the following: reduction in antipsychotic dose, addition of cabergoline, bromocriptine, amantadine, and/or switch to another antipsychotic. We propose switching to quetiapine in symptomatic hyperprolactinemia related to antipsychotics and describe five cases.

  20. [Erythromelalgia: Diagnosis and therapeutic approach].

    Science.gov (United States)

    Miranda, S; Le Besnerais, M; Langlois, V; Benhamou, Y; Lévesque, H

    2017-03-01

    Erythromelalgia is a rare intermittent vascular acrosyndrome characterized by the combination of recurrent burning pain, warmth and redness of the extremities. It is considered in its primary form as an autosomal dominant neuropathy related to mutations of SCN9A, the encoding gene of a voltage-gated sodium channel subtype Nav1.7. Secondary erythromelalgia is associated with myeloproliferative disorders, drugs (bromocriptine, calcium channel blockers), or clinical conditions such as rheumatic diseases or viral infection. Primary familial erythromelalgia include genetics and sporadic forms associated with small fibers neuropathy. Aspirin is a useful treatment of erythromelagia associated with myeloproliferative disorders. Treatment of primary erythromelalgia is difficult, individualized, with sodium channel blockers such as lidocaine, carbamazepine and mexiletine.

  1. An Exploratory Evaluation of Tyrosine Hydroxylase Inhibition in Planaria as a Model for Parkinsonism

    Directory of Open Access Journals (Sweden)

    David Prokai

    2013-11-01

    Full Text Available Planaria are the simplest organisms with bilateral symmetry and a central nervous system (CNS with cephalization; therefore, they could be useful as model organisms to investigate mechanistic aspects of parkinsonism and to screen potential therapeutic agents. Taking advantage of the organism’s anti-tropism towards light, we measured a significantly reduced locomotor velocity in planaria after exposure to 3-iodo-L-tyrosine, an inhibitor of tyrosine hydroxylase that is an enzyme catalyzing the first and rate-limiting step in the biosynthesis of catecholamines. A simple semi-automatic assay using videotaped experiments and subsequent evaluation by tracking software was also implemented to increase throughput. The dopaminergic regulation of locomotor velocity was confirmed by bromocriptine, a drug whose mechanisms of action to treat Parkinson’s disease is believed to be through the stimulation of nerves that control movement.

  2. Network identification of hormonal regulation.

    Directory of Open Access Journals (Sweden)

    Daniel J Vis

    Full Text Available Relations among hormone serum concentrations are complex and depend on various factors, including gender, age, body mass index, diurnal rhythms and secretion stochastics. Therefore, endocrine deviations from healthy homeostasis are not easily detected or understood. A generic method is presented for detecting regulatory relations between hormones. This is demonstrated with a cohort of obese women, who underwent blood sampling at 10 minute intervals for 24-hours. The cohort was treated with bromocriptine in an attempt to clarify how hormone relations change by treatment. The detected regulatory relations are summarized in a network graph and treatment-induced changes in the relations are determined. The proposed method identifies many relations, including well-known ones. Ultimately, the method provides ways to improve the description and understanding of normal hormonal relations and deviations caused by disease or treatment.

  3. [Peripartum cardiomyopathy].

    Science.gov (United States)

    Mouquet, Frédéric; Bouabdallaoui, Nadia

    2015-01-01

    The peripartum cardiomyopathy is a rare form of dilated cardiomyopathy resulting from alteration of angiogenesis toward the end of pregnancy. The diagnosis is based on the association of clinical heart failure and systolic dysfunction assessed by echocardiography or magnetic resonance imaging. Diagnoses to rule out are myocardial infarction, amniotic liquid embolism, myocarditis, inherited cardiomyopathy, and history of treatment by anthracycline. Risk factors are advance maternal age (>30), multiparity, twin pregnancy, African origin, obesity, preeclampsia, gestational hypertension, and prolonged tocolytic therapy. Treatment of acute phase is identical to usual treatment of acute systolic heart failure. After delivery, VKA treatment should be discussed in case of systolic function <25% because of higher risk of thrombus. A specific treatment by bromocriptine can be initiated on a case-by-case basis. Complete recovery of systolic function is observed in 50% of cases. The mortality risk is low. Subsequent pregnancy should be discouraged, especially if systolic function did not recover.

  4. An update on treatments and outcomes in peripartum cardiomyopathy.

    Science.gov (United States)

    Sheppard, Richard; Rajagopalan, Navin; Safirstein, Jordan; Briller, Joan

    2014-05-01

    Peripartum cardiomyopathy (PPCM) is a well-established complication of pregnancy. Criteria include heart failure that presents with reduced left ventricular function, signs and symptoms of heart failure either late in pregnancy or early in the postpartum period. The incidence varies widely depending geography and ethnicity. The pathophysiology of PPCM is still an area of active investigation, but includes immune and inflammatory mechanisms, which are the subject of several investigations. Therapies for chronic heart failure from PPCM are similar to those patients with nonischemic cardiomyopathy from different etiologies, however novel therapies may include bromocriptine, pentoxifylline or other potential therapies influencing the immune system. The need for implantable defibrillators, left ventricular assist devices and cardiac transplant in women with PPCM is rare, and prognosis is better than other forms of nonischemic cardiomyopathy. Despite this, further information about the epidemiology, prognosis and potential therapies are required to better manage and diagnose PPCM in women with signs and symptoms of heart failure.

  5. Peripartum cardiomyopathy: a review

    Directory of Open Access Journals (Sweden)

    Capriola M

    2012-12-01

    Full Text Available Michael CapriolaThomasville Medical Center, Department of Emergency Medicine, Thomasville Medical Center, Thomasville, NC, USAAbstract: Peripartum cardiomyopathy (PPCM is a form of dilated cardiomyopathy of unclear etiology affecting women without preexisting heart disease during the last month of pregnancy or during the first 5 months postpartum. Its incidence shows marked geographic and ethnic variation, being most common in Africa and among women of African descent. Most women present in the first month postpartum with typical heart failure symptoms such as dyspnea, lower extremity edema, and fatigue. These symptoms are often initially erroneously diagnosed as part of the normal puerperal process. Diagnosis can be aided by the finding of a significantly elevated serum brain natriuretic peptide. The etiology of PPCM is unclear; however, recent research suggests abnormal prolactin metabolism is seminal in its development, and prolactin antagonism with bromocriptine shows promise as a novel treatment for PPCM.Keywords: pregnancy, pregnancy complications, cardiovascular, cardiomyopathy, dilated

  6. Radioimmunoassay of nicergoline in biological material

    Energy Technology Data Exchange (ETDEWEB)

    Bizollon, C.A.; Rocher, J.P.; Chevalier, P.

    1982-07-01

    A method for radioimmunosassay of nicergoline (Sermion) in plasma and urine is described. The antiserum was produced in rabbits by administration of an immunogen obtained by coupling bovine serum albumin to the nicergoline molecule at the indole nitrogen. The resulting antibodies reacted well with nicergoline and the 1-demethyl derivative and did not cross-react with the principal metabolites of the substrances nor with rye ergot derivatives, in particular dihydroergotamine, methysergide and bromocriptine. The tracer was nicergoline labelled with iodine-125. The assay was sensitive because concentrations as low as as 125x10/sup -12/ mol/l nicergoline could be directly determined in plasma and urine without prior extraction. The marked specificity and high sensitivity allowed easy determination of plasma and urine levels of this drug following administration in man.

  7. Stimulatory effect of PGF2α on PRL based on experimental inhibition of each hormone in mares.

    Science.gov (United States)

    Ginther, O J; Pinaffi, F L V; Rodriguez, M B; Duarte, L F; Beg, M A

    2012-12-01

    During the luteolytic period in mares, the peak of 65% of pulses of a PGF2α metabolite (PGFM) and the peak of a pulse of PRL have been reported to occur at the same hour. It is unknown whether the synchrony reflects an effect of PGF2α on PRL or vice versa. Controls, a flunixin meglumine (FM)-treated group (to inhibit PGF2α), and a bromocriptine-treated group (to inhibit PRL), were used at 14 days postovulation in June and in September (n = 6 mares/group/mo). Blood samples were collected hourly from just before treatment (Hour 0) to Hour 10. Concentrations of PGFM in the FM group were lower (P PRL in June were lower (P PRL averaged over groups was lower (P PRL concentrations in mares represents an effect of PGF2α on PRL rather than an effect of PRL on PGF2α.

  8. Pregnancy and treatment outcome in a patient with left ventricular non-compaction.

    Science.gov (United States)

    Sawant, Rahul D; Freeman, Leisa J; Stanley, Katherine P S; McKelvey, Alistair

    2013-05-01

    Left ventricular non-compaction (LVNC) is a rare form of cardiomyopathy. This case reviews a woman with familial LVNC (EF 45%, NYHA class I, evidence of non-sustained ventricular tachycardia pre-pregnancy) who had significant decompensation with heart failure in the third trimester that required early delivery. Deterioration in symptoms and LV function 7 days after delivery required further hospitalization and aggressive treatment. Suppression of lactation with bromocriptine, together with standard heart failure management, has allowed recovery and return to full activities and work. Acknowledged adverse risk factors in LVNC are considered, and pre-pregnancy risk assessment is reviewed. There is no specific treatment for LVNC in pregnancy besides the usual management of dilated cardiomyopathy. This is the ninth case report of LVNC in pregnancy reported in the literature.

  9. Different effects of direct and indirect dopamine receptor agonists on immobility time in reserpine-treated mice.

    Science.gov (United States)

    Zarrindast, M R; Minaian, A

    1991-01-01

    1. The effects of dopamine agonists on the immobility time in mice were examined. 2. Apomorphine (APO), bupropion (BUP), bromocriptine (BRC) and quinpirole but not SKF 38393 elicited anti-immobility effect. The effect of the agonists was decreased by the D-2 antagonist sulpiride but not by the D-1 antagonist SCH 23390. 3. In animals pretreated with reserpine, the anti-immobility effects of APO and quinpirole were potentiated, while the response of BPU was decreased and that of BRC was not changed. 4. It is concluded that D-2 dopamine receptors are involved in the anti-immobility effects of dopaminergic agents, D-2 dopamine receptors may become hypersensitive by reserpine and BUP exerts its response through indirect dopaminergic if mechanism.

  10. Synthesis of some /sup 11/C-labelled alkaloids

    Energy Technology Data Exchange (ETDEWEB)

    Laangstroem, B.; Antoni, G.; Halldin, H.; Svaerd, H.; Bergson, G. (Univ. of Uppsala (Sweden) Inst. of Chemistry)

    1982-01-01

    Using (/sup 11/C)-methyl iodide in N-alkylation reactions in dimethylformamide (DMF), the alkaloids N-(/sup 11/C-methyl)-morphine, N-(/sup 11/C-methyl)-codeine, 6-N(methyl)-9, 10-dihydroergotamine, 6-N-(/sup 11/C-methyl)-bromocriptine and N-(/sup 11/C-methyl)-nicotine have been synthesized in radiochemical yields of 50-95%, within 5-10 min of introducing (/sup 11/C)-methyl iodide into the reaction vial. (/sup 11/C)-Methyl iodide was obtained within 4-7 min from (/sup 11/C)-carbon dioxide prepared by the /sup 14/N(p,..cap alpha..)/sup 11/C reaction.

  11. Neuroleptic Malignant Syndrome in a Patient with Tongue Cancer: A Report of a Rare Case

    Directory of Open Access Journals (Sweden)

    Osamu Baba

    2013-01-01

    Full Text Available Background. Neuroleptic malignant syndrome (NMS is a rare but life-threatening complication of neuroleptic drugs, which are used widely in head and neck cancer (HANC patients who develop delirium. Methods and Results. Postoperative delirium in a 39-year-old man with tongue cancer was treated with haloperidol and chlorpromazine. Three days after the first administration of antipsychotics, the patient exhibited elevated body temperature, autonomic and extrapyramidal symptoms, and impaired consciousness. A definitive diagnosis was made using the research diagnostic criteria for NMS in the DSM-IV, and the antipsychotics were immediately discontinued. The patient was given dantrolene and bromocriptine to treat the NMS. The patient’s hyperthermia, elevated creatinin kinase (CK, and muscle rigidity improved gradually, with all symptoms of NMS resolving completely by 13 days after the diagnosis. Conclusions. HANC surgeons must be alert for early signs of NMS and use antipsychotics conservatively to avoid NMS and its potentially fatal outcome.

  12. Dosage-dependent effect of dopamine D2 receptor activation on motor cortex plasticity in humans.

    Science.gov (United States)

    Fresnoza, Shane; Stiksrud, Elisabeth; Klinker, Florian; Liebetanz, David; Paulus, Walter; Kuo, Min-Fang; Nitsche, Michael A

    2014-08-06

    The neuromodulator dopamine plays an important role in synaptic plasticity. The effects depend on receptor subtypes, affinity, concentration level, and the kind of neuroplasticity induced. In animal experiments, dopamine D2-like receptor stimulation revealed partially antagonistic effects on plasticity, which might be explained by dosage dependency. In humans, D2 receptor block abolishes plasticity, and the D2/D3, but predominantly D3, receptor agonist ropinirol has a dosage-dependent nonlinear affect on plasticity. Here we aimed to determine the specific affect of D2 receptor activation on neuroplasticity in humans, because physiological effects of D2 and D3 receptors might differ. Therefore, we combined application of the selective D2 receptor agonist bromocriptine (2.5, 10, and 20 mg or placebo medication) with anodal and cathodal transcranial direct current stimulation (tDCS), which induces nonfocal plasticity, and with paired associative stimulation (PAS) generating a more focal kind of plasticity in the motor cortex of healthy humans. Plasticity was monitored by transcranial magnetic stimulation-induced motor-evoked potential amplitudes. For facilitatory tDCS, bromocriptine prevented plasticity induction independent from drug dosage. However, its application resulted in an inverted U-shaped dose-response curve on inhibitory tDCS, excitability-diminishing PAS, and to a minor degree on excitability-enhancing PAS. These data support the assumption that modulation of D2-like receptor activity exerts a nonlinear dose-dependent effect on neuroplasticity in the human motor cortex that differs from predominantly D3 receptor activation and that the kind of plasticity-induction procedure is relevant for its specific impact.

  13. Electroconvulsive therapy in drug resistant neuroleptic malignant syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Yousefi A

    2010-02-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Neuroleptic malignant syndrome is an idiosyncratic and potentially fatal reaction to neuroleptic drugs and is characterized by fever, muscular rigidity, altered mental status, autonomic dysfunction, elevated serum CPK and leucocytosis Neuroleptic malignant syndrome is treated with dantrolene, bromocriptin, amantadin and electroconvulsive therapy."n"nCase: A 22 years old, schizophrenic female was refered to the Emergency ward of Roozbeh hospital in Tehran, Iran in December 2008 with aggression, impulsivity, and reduced sleep. After injection of haloperidol, the patient developed a high grade fever, diaphoresis and muscular stiffness. She was diagnosed as neuroleptic malignant syndrome and the treatment with dantrolen, bromocriptin and amantadin initiated. Although fever subsided, other signs continued, therefore we applied electroconvulsive therapy to this case."n"nConclusion: Due to excellent response of the patient to electroconvulsive therapy and the rare reports of electroconvulsive therapy in neuroleptic malignant syndrome in the Iranian population, this case may lead to develop studies for further investigations of this issue.

  14. Decreased prolactin levels reduce parental commitment, egg temperatures, and breeding success of incubating male Adélie penguins.

    Science.gov (United States)

    Thierry, Anne-Mathilde; Brajon, Sophie; Massemin, Sylvie; Handrich, Yves; Chastel, Olivier; Raclot, Thierry

    2013-09-01

    Hormones regulate many aspects of an individual's phenotype, including various physiological and behavioral traits. Two hormones have been described as important players in the regulation of parental investment in birds: the glucocorticoid hormone corticosterone and prolactin, a pituitary hormone, widely involved in mediating parental behavior. In comparison with corticosterone, the role of prolactin on parental investment remains poorly documented, and most studies so far have been correlative. In this study, the effects of an experimental decrease of prolactin levels on the incubation behavior of a long-lived seabird species were assessed. Male Adélie penguins were treated with self-degradable bromocriptine pellets, inhibiting prolactin secretion. Filming and subsequent video analysis allowed the determination of a behavioral time budget for birds and their position on the nest, while dummy eggs recorded incubation parameters. Incubation duration and breeding success at hatching were also monitored. As expected, bromocriptine-treatment significantly decreased plasma prolactin levels, but did not affect corticosterone levels. The behavioral time budget of penguins was not affected by the treatment. However, treated birds spent significantly more time in an upright position on the nest. These birds also incubated their eggs at lower temperatures and turned their eggs more frequently than controls, resulting in a lengthened incubation period. Despite this, the treatment was insufficient to trigger nest desertion and eggs of treated birds still hatched, indicating that several endocrine signals are required for the induction of nest abandonment. We suggest that the decreased prolactin levels in treated birds offset their timeline of breeding, so that birds displayed behavior typical of early incubation.

  15. Prolactin increases hepatic Na+/taurocholate co-transport activity and messenger RNA post partum.

    Science.gov (United States)

    Ganguly, T C; Liu, Y; Hyde, J F; Hagenbuch, B; Meier, P J; Vore, M

    1994-01-01

    We have shown that Na+/taurocholate co-transport activity is decreased in pregnancy, but rebounds post partum relative to non-pregnant controls, and that activity can be increased by treatment with ovine prolactin [Ganguly, Hyde and Vore (1993) J. Pharmacol. Exp. Ther. 267, 82-87]. To determine the basis for these effects, Na+/taurocholate co-transport was determined in purified basolateral liver plasma-membrane (bLPM) vesicles and compared with steady-state mRNA levels encoding the Na+/taurocholate-co-transporting polypeptide (Ntcp) in non-pregnant controls, pregnant rats (19-20 days pregnant), rats post partum (48 h post partum) and rats post partum treated with bromocriptine to inhibit prolactin secretion. Na+/taurocholate co-transport activity (nmol/5 s per mg of protein) in bLPM was decreased from 10.4 +/- 1.8 in non-pregnant controls to 7.9 +/- 0.6 in bLPM in pregnant rats, but rebounded to 17.5 +/- 1.3 post partum; treatment of rats post partum with bromocriptine to inhibit prolactin secretion decreased activity to 14.1 +/- 0.9. Northern and slot-blot analyses revealed similar changes in mRNA for Ntcp, so that a positive correlation was observed between Na+/taurocholate co-transport activity and Ntcp mRNA. Furthermore, treatment of ovariectomized rats with ovine prolactin increased Ntcp mRNA 10-fold compared with solvent-treated controls, consistent with the 2-fold increase in Vmax, for Na+/taurocholate co-transport in isolated hepatocytes. These data are the first to demonstrate endogenous physiological regulation by prolactin of Ntcp mRNA in parallel with Na+/taurocholate co-transport activity. Images Figure 2 PMID:7945260

  16. Effect observation of drug treatment for infertility of polycystic ovary syndrome%药物治疗多囊卵巢综合症不孕的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张宝爱

    2015-01-01

    ObjectiveOf infertility caused by polycystic ovary syndrome, by symptomatic treatment. MethodsWill 66 cases caused by polycystic ovarian infertility after treatment of drug Diane-35 in different periods, were given at the same time metformin, bromocriptine fertility treatment.ResultsThe effect of oral Diane -35 combined with metformin, bromocriptine on sex hormone levels. Before and after the treatment, the differences were not statistically significant (P>0.05)ConclusionOf polycystic ovary syndrome (PCOS) application of Diane - 35 for, while giving the compound Xuanju capsule as an adjuvant drug therapy and effect in the treatment of infertility.%目的:探讨多囊卵巢综合症引起的不孕,通过对症药物治疗的方法。方法将66例多囊卵巢引起的不孕症经过药物达英-35不同周期的治疗,同时分别给予二甲双胍、溴隐亭治疗助孕。结果口服达英-35联合二甲双胍、溴隐亭对性激素水平的影响。治疗前后比较差异均无统计学意义(P>0.05)结论多囊卵巢综合症应用达英-35治疗,同时给予复方玄驹胶囊做辅助药物治疗,治疗不孕症的疗效明显。

  17. Dopaminergic drugs in type 2 diabetes and glucose homeostasis.

    Science.gov (United States)

    Lopez Vicchi, Felicitas; Luque, Guillermina Maria; Brie, Belen; Nogueira, Juan Patricio; Garcia Tornadu, Isabel; Becu-Villalobos, Damasia

    2016-07-01

    The importance of dopamine in central nervous system function is well known, but its effects on glucose homeostasis and pancreatic β cell function are beginning to be unraveled. Mutant mice lacking dopamine type 2 receptors (D2R) are glucose intolerant and have abnormal insulin secretion. In humans, administration of neuroleptic drugs, which block dopamine receptors, may cause hyperinsulinemia, increased weight gain and glucose intolerance. Conversely, treatment with the dopamine precursor l-DOPA in patients with Parkinson's disease reduces insulin secretion upon oral glucose tolerance test, and bromocriptine improves glycemic control and glucose tolerance in obese type 2 diabetic patients as well as in non diabetic obese animals and humans. The actions of dopamine on glucose homeostasis and food intake impact both the autonomic nervous system and the endocrine system. Different central actions of the dopamine system may mediate its metabolic effects such as: (i) regulation of hypothalamic noradrenaline output, (ii) participation in appetite control, and (iii) maintenance of the biological clock in the suprachiasmatic nucleus. On the other hand, dopamine inhibits prolactin, which has metabolic functions; and, at the pancreatic beta cell dopamine D2 receptors inhibit insulin secretion. We review the evidence obtained in animal models and clinical studies that posited dopamine receptors as key elements in glucose homeostasis and ultimately led to the FDA approval of bromocriptine in adults with type 2 diabetes to improve glycemic control. Furthermore, we discuss the metabolic consequences of treatment with neuroleptics which target the D2R, that should be monitored in psychiatric patients to prevent the development in diabetes, weight gain, and hypertriglyceridemia.

  18. Gonadotropin-releasing hormone stimulates prolactin release from lactotrophs in photoperiodic species through a gonadotropin-independent mechanism.

    Science.gov (United States)

    Henderson, Helen L; Hodson, David J; Gregory, Susan J; Townsend, Julie; Tortonese, Domingo J

    2008-02-01

    Previous studies have provided evidence for a paracrine interaction between pituitary gonadotrophs and lactotrophs. Here, we show that GnRH is able to stimulate prolactin (PRL) release in ovine primary pituitary cultures. This effect was observed during the breeding season (BS), but not during the nonbreeding season (NBS), and was abolished by the application of bromocriptine, a specific dopamine agonist. Interestingly, GnRH gained the ability to stimulate PRL release in NBS cultures following treatment with bromocriptine. In contrast, thyrotropin-releasing hormone, a potent secretagogue of PRL, stimulated PRL release during both the BS and NBS and significantly enhanced the PRL response to GnRH during the BS. These results provide evidence for a photoperiodically modulated functional interaction between the GnRH/gonadotropic and prolactin axes in the pituitary gland of a short day breeder. Moreover, the stimulation of PRL release by GnRH was shown not to be mediated by the gonadotropins, since immunocytochemical, Western blotting, and PCR studies failed to detect pituitary LH or FSH receptor protein and mRNA expressions. Similarly, no gonadotropin receptor expression was observed in the pituitary gland of the horse, a long day breeder. In contrast, S100 protein, a marker of folliculostellate cells, which are known to participate in paracrine mechanisms within this tissue, was detected throughout the pituitaries of both these seasonal breeders. Therefore, an alternative gonadotroph secretory product, a direct effect of GnRH on the lactotroph, or another cell type, such as the folliculostellate cell, may be involved in the PRL response to GnRH in these species.

  19. Circulating breeding and pre-breeding prolactin and LH are not associated with clutch size in the zebra finch (Taeniopygia guttata).

    Science.gov (United States)

    Ryan, Calen P; Dawson, Alistair; Sharp, Peter J; Meddle, Simone L; Williams, Tony D

    2014-06-01

    Clutch size is a fundamental predictor of avian fitness, widely-studied from evolutionary and ecological perspectives, but surprisingly little is known about the physiological mechanisms regulating clutch size variation. The only formal mechanistic hypothesis for avian clutch-size determination predicts an anti-gonadal effect of circulating prolactin (PRL) via the inhibition of luteinizing hormone (LH), and has become widely-accepted despite little experimental support. Here we investigated the relationship between pre-breeding and breeding plasma PRL and LH and clutch-size in captive-breeding female zebra finches (Taeniopygia guttata). Using a repeated-measures design, we followed individual females from pre-breeding, through multiple breeding attempts, and attempted to decrease PRL using the D2-receptor agonist, bromocriptine. Clutch size was independent of variation in pre-breeding PRL or LH, although pre-breeding LH was negatively correlated with the time between pairing and the onset of laying. Clutch size was independent of variation in plasma PRL on all days of egg-laying. Bromocriptine treatment had no effect on plasma PRL, but in this breeding attempt clutch size was also independent of plasma PRL. Finally, we found no evidence for an inverse relationship between plasma PRL and LH levels, as predicted if PRL had inhibitory effects via LH. Thus, our data fail to provide any support for the involvement of circulating PRL in clutch size determination. These findings suggest that alternative models for hormonal control of avian clutch size need to be considered, perhaps involving downstream regulation of plasma PRL at the level of the ovary, or other hormones that have not been considered to date.

  20. Treatment of hyperprolactinemia: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Wang Amy T

    2012-07-01

    Full Text Available Abstract Background Hyperprolactinemia is a common endocrine disorder that can be associated with significant morbidity. We conducted a systematic review and meta-analyses of outcomes of hyperprolactinemic patients, including microadenomas and macroadenomas, to provide evidence-based recommendations for practitioners. Through this review, we aimed to compare efficacy and adverse effects of medications, surgery and radiotherapy in the treatment of hyperprolactinemia. Methods We searched electronic databases, reviewed bibliographies of included articles, and contacted experts in the field. Eligible studies provided longitudinal follow-up of patients with hyperprolactinemia and evaluated outcomes of interest. We collected descriptive, quality and outcome data (tumor growth, visual field defects, infertility, sexual dysfunction, amenorrhea/oligomenorrhea and prolactin levels. Results After review, 8 randomized and 178 nonrandomized studies (over 3,000 patients met inclusion criteria. Compared to no treatment, dopamine agonists significantly reduced prolactin level (weighted mean difference, -45; 95% confidence interval, -77 to −11 and the likelihood of persistent hyperprolactinemia (relative risk, 0.90; 95% confidence interval, 0.81 to 0.99. Cabergoline was more effective than bromocriptine in reducing persistent hyperprolactinemia, amenorrhea/oligomenorrhea, and galactorrhea. A large body of noncomparative literature showed dopamine agonists improved other patient-important outcomes. Low-to-moderate quality evidence supports improved outcomes with surgery and radiotherapy compared to no treatment in patients who were resistant to or intolerant of dopamine agonists. Conclusion Our results provide evidence to support the use of dopamine agonists in reducing prolactin levels and persistent hyperprolactinemia, with cabergoline proving more efficacious than bromocriptine. Radiotherapy and surgery are useful in patients with resistance or intolerance

  1. Functional potencies of dopamine agonists and antagonists at human dopamine D₂ and D₃ receptors.

    Science.gov (United States)

    Tadori, Yoshihiro; Forbes, Robert A; McQuade, Robert D; Kikuchi, Tetsuro

    2011-09-01

    We measured the functional agonist potencies of dopamine agonists including antiparkinson drugs, and functional antagonist potencies of antipsychotics at human dopamine D(2) and D(3) receptors. In vitro pharmacological assessment included inhibition of forskolin-stimulated cAMP accumulation and the reversal of dopamine-induced inhibition in clonal Chinese hamster ovary cells expressing low and high densities of human dopamine D(2L) and D(2S) receptors (hD(2L)-Low, hD(2L)-High, hD(2S)-Low and hD(2S)-High, respectively) and human dopamine D(3) Ser-9 and D(3) Gly-9 receptors (hD(3)-Ser-9 and hD(3)-Gly-9, respectively). Cabergoline, bromocriptine, pergolide, (±)-7-hydroxy-N,N-di-n-propyl-2-aminotetralin (7-OH-DPAT), talipexole, pramipexole, R-(+)-trans-3,4,4a,10b-tetrahydro-4-propyl-2H,5H-[1]benzopyrano[4,3-b]-1,4-oxazin-9-olhydrochloride (PD128907) and ropinirole behaved as dopamine D(2) and D(3) receptor full agonists and showed higher potencies in hD(2L)-High and hD(2S)-High compared to hD(2L)-Low and hD(2S)-Low. In hD(3)-Ser-9 and hD(3)-Gly-9 compared to hD(2L)-Low and hD(2S)-Low, dopamine, ropinirole, PD128907, and pramipexole potencies were clearly higher; talipexole and 7-OH-DPAT showed slightly higher potencies; pergolide showed slightly lower potency; and, cabergoline and bromocriptine potencies were lower. Aripiprazole acted as an antagonist in hD(2L)-Low; a low intrinsic activity partial agonist in hD(2S)-Low; a moderate partial agonist in hD(3)-Ser-9 and hD(3)-Gly-9; a robust partial agonist in hD(2L)-High; and a full agonist in hD(2S)-High. Amisulpride, sulpiride and perphenazine behaved as preferential antagonists; and chlorpromazine and asenapine behaved as modest preferential antagonists; whereas fluphenazine, haloperidol, and blonanserin behaved as non-preferential antagonists in hD(2S)-Low and hD(2S)-High compared to hD(3)-Ser-9 and hD(3)-Gly-9. These findings may help to elucidate the basis of therapeutic benefit observed with these drugs, with

  2. Phenotyping and outcome on contemporary management in a German cohort of patients with peripartum cardiomyopathy.

    Science.gov (United States)

    Haghikia, A; Podewski, E; Libhaber, E; Labidi, S; Fischer, D; Roentgen, P; Tsikas, D; Jordan, J; Lichtinghagen, R; von Kaisenberg, C S; Struman, I; Bovy, N; Sliwa, K; Bauersachs, J; Hilfiker-Kleiner, Denise

    2013-07-01

    Peripartum cardiomyopathy (PPCM) is a life-threatening heart disease developing towards the end of pregnancy or in the months following delivery in previously healthy women in terms of cardiac disease. Enhanced oxidative stress and the subsequent cleavage of the nursing hormone Prolactin into an anti-angiogenic 16 kDa subfragment emerged as a potential causal factor of the disease. We established a prospective registry with confirmed PPCM present in 115 patients (mean baseline left ventricular ejection fraction, LVEF: 27 ± 9 %). Follow-up data (6 ± 3 months) showed LVEF improvement in 85 % and full recovery in 47 % while 15 % failed to recover with death in 2 % of patients. A positive family history of cardiomyopathy was present in 16.5 %. Pregnancy-associated hypertension was associated with a better outcome while a baseline LVEF ≤ 25 % was associated with a worse outcome. A high recovery rate (96 %) was observed in patients obtaining combination therapy with beta-blocker, angiotensin-converting enzyme (ACE) inhibitors/angiotensin-receptor-blockers (ARBs) and bromocriptine. Increased serum levels of Cathepsin D, the enzyme that generates 16 kDa Prolactin, miR-146a, a direct target of 16 kDa Prolactin, N-terminal-pro-brain-natriuretic peptide (NT-proBNP) and asymmetric dimethylarginine (ADMA) emerged as biomarkers for PPCM. In conclusion, low baseline LVEF is a predictor for poor outcome while pregnancy-induced hypertensive disorders are associated with a better outcome in this European PPCM cohort. The high recovery rate in this collective is associated with a treatment concept using beta-blockers, ACE inhibitors/ARBs and bromocriptine. Increased levels of Cathepsin D activity, miR-146a and ADMA in serum of PPCM patients support the pathophysiological role of 16 kDa Prolactin for PPCM and may be used as a specific diagnostic marker profile.

  3. Antioxidant Effects of Some Drugs on Immobilization Stress Combined with Cold Restraint Stress

    Directory of Open Access Journals (Sweden)

    Svetlana Trivic

    2009-11-01

    Full Text Available The aim of this work was to investigate the effect on antioxidant potential of some commonly used drugs (morphine, tramadol, bromocriptine, haloperidol and azithromycin on immobilization stress (IS combined with cold restraint stress (CRS in the rat. After the drug treatment the animals were kept immobilized in the cold chamber at 4±0.3ºC for 3 hours and then decapitaed and the livers were extracted. The following parameters were determined in the liver homogenate: content of reduced glutathione, activities of catalase, xanthine oxidase, glutathione reductase, glutathione peroxidase, peroxidase, and lipid peroxidation intensity. A battery of biochemical assays was used and the resulting data were statistically analyzed. Combined stress exhibited a prooxidative action (increased catalase activity, lowered content of reduced glutathione. Significantly enhanced catalase activity that was observed in all groups compared to the control indicates that the primary reactive oxygen species (ROS metabolite is hydrogen peroxide, which decomposes very rapidly (very high catalase activity, thus hindering formation of OH radicals as the most toxic ROS. None of the tested drugs showed a protective effect on combined IS and CRS. The intensity of lipid peroxidation did not change either in the combined stress or under additional influence of the drugs. Probably, under our experimental conditions, the time was not sufficiently long to observe damage of lipid membrane by ROS.

  4. Metastatic pituitary carcinoma in a patient with acromegaly: a case report

    Directory of Open Access Journals (Sweden)

    Sreenan Seamus

    2012-09-01

    Full Text Available Abstract Introduction Asymptomatic pituitary abnormalities occur in about 10% of cranial magnetic resonance imaging scans, but metastatic carcinoma of the pituitary gland is rare: 133 cases have been reported. Two thirds secreted either prolactin or adrenocorticotropic hormone, and another 24% were non-secreting. Case presentation A 42-year-old Caucasian man lived for 30 years after the diagnosis of a pituitary tumor whose clinical and biochemical features were those of acromegaly and hypogonadism. Radiotherapy, totaling 7300 rad, was administered to the sella over two courses. Growth hormone levels normalized, but he developed both thyroid and adrenal insufficiency, and replacement therapy was commenced. Fourteen years later, growth hormone levels again became elevated, and bromocriptine was commenced but led to side effects that could not be tolerated. An attempted surgical intervention failed, and octreotide and pergolide were used in succession. Twenty-seven years after the diagnosis, a mass from an excisional biopsy of below the angle of the mandible proved to be metastatic pituitary carcinoma. Immunohistochemical staining was positive for synaptophysin, growth hormone, and prolactin. One year later, an octreotide scan showed uptake at the sella, neck, and spleen. Our patient declined further active oncology treatment. Conclusions Metastatic pituitary carcinoma associated with acromegaly is particularly rare. To the best of our knowledge, this is the eighth such case and is the first report of growth hormone and prolactin present in the metastatic mass.

  5. Effect of a long-acting somatostatin analogue (SMS 201-995 on a growth hormone and thyroid stimulating hormone-producing pituitary tumor.

    Directory of Open Access Journals (Sweden)

    Hirasawa,Ryoto

    1991-04-01

    Full Text Available A 46-year-old woman with acromegaly and hyperthyroidism due to a pituitary adenoma. She had high serum thyroid-stimulating hormone (TSH levels and very high serum growth hormone (GH levels. Transsphenoidal removal of the tumor, post-operative irradiation, frontal craniotomy for removal of residual tumor and large-dose bromocriptine therapy were carried out consecutively. After therapy, serum GH levels gradually decreased, but not to the normal range, and serum TSH levels remained at inappropriately normal levels. Using immunoperoxidase techniques, GH-, TSH- and follicle-stimulating hormone (FSH-containing cells were demonstrated in the adenoma. A long-acting somatostatin analogue (SMS 201-995, 600 micrograms/day suppressed the serum GH level to the normal range with a concomitant suppression of TSH. Furthermore, the paradoxical serum GH responses to TRH and LH-RH were slightly improved. No important subjective side-effects were noted. Therefore, SMS 201-995 appeared to be a very effective drug in this patient with a GH- and TSH-producing pituitary tumor.

  6. Paliperidone Inducing Concomitantly Syndrome of Inappropriate Antidiuretic Hormone, Neuroleptic Malignant Syndrome, and Rhabdomyolysis

    Science.gov (United States)

    Lopez, Ricardo

    2016-01-01

    Paliperidone, an active metabolite of risperidone, is a new atypical antipsychotic agent. Syndrome of inappropriate antidiuretic hormone (SIADH), neuroleptic malignant syndrome (NMS), and rhabdomyolysis are the uncommon side effects of psychotropic drugs. We report a case of 35-year-old male with schizoaffective disorder who was admitted for acute-on-chronic exacerbation of his psychotic disorder for which intramuscular paliperidone 234 mg injection was given. Two days later, the patient developed hyponatremic seizures secondary to SIADH which was treated with hypertonic saline. On the third day, he developed high grade fever and severe muscle rigidity with raised creatine phosphokinase (CPK) and liver enzymes levels. He was treated with dantrolene 100 mg, bromocriptine 2.5 mg, and lorazepam 2 mg. Our patient required management of the three rare conditions following treatment with paliperidone. This case highlights the need for health care providers to be aware of the rare, potentially life threatening but preventable hyponatremia, NMS, and rhabdomyolysis as a possible adverse effect of paliperidone. PMID:27721999

  7. Neuroleptic malignant syndrome or a statin drug reaction? A case report.

    Science.gov (United States)

    Cooper, Joyce M; Jones, Alison L

    2009-01-01

    A 60-year-old woman with a long psychiatric history presented with delirium and mutism. She was febrile, with marked limb rigidity and elevated creatinine kinase (CK) level. Current medications included pericyazine. Current or recent use of dopamine-blocking agents, such as pericyazine, together with a disturbance in conscious state, autonomic dysfunction, and an elevated CK level may be suggestive of neuroleptic malignant syndrome (NMS). The diagnosis was confirmed as NMS, and she was successfully treated with bromocriptine. Eight years later, she represents with symptoms suggesting recurrence of NMS including elevated CK level and myalgia, however, without limb rigidity. Current medications include quetiapine, lithium, simvastatin, and a recent course of clarithromycin. Macrolide antibiotics such as clarithromycin inhibit the metabolic pathway of statins via the cytochrome CYP450 3A4 hepatic enzyme system and may result in elevated CK level, myopathy, or rhabdomyolysis producing symptoms that may be confused with NMS. Simvastatin was ceased with rapid decrease in CK level and resolution of symptoms. This case highlights the importance of considering other diagnoses in any patient presenting with a disturbance in conscious state, autonomic dysfunction, and an elevated CK level. Particularly in a patient with a history of NMS, a thorough medication history is essential to aid diagnosis and avoid confusion with presenting symptoms and medical history.

  8. Paliperidone Inducing Concomitantly Syndrome of Inappropriate Antidiuretic Hormone, Neuroleptic Malignant Syndrome, and Rhabdomyolysis

    Directory of Open Access Journals (Sweden)

    Jaspinder Kaur

    2016-01-01

    Full Text Available Paliperidone, an active metabolite of risperidone, is a new atypical antipsychotic agent. Syndrome of inappropriate antidiuretic hormone (SIADH, neuroleptic malignant syndrome (NMS, and rhabdomyolysis are the uncommon side effects of psychotropic drugs. We report a case of 35-year-old male with schizoaffective disorder who was admitted for acute-on-chronic exacerbation of his psychotic disorder for which intramuscular paliperidone 234 mg injection was given. Two days later, the patient developed hyponatremic seizures secondary to SIADH which was treated with hypertonic saline. On the third day, he developed high grade fever and severe muscle rigidity with raised creatine phosphokinase (CPK and liver enzymes levels. He was treated with dantrolene 100 mg, bromocriptine 2.5 mg, and lorazepam 2 mg. Our patient required management of the three rare conditions following treatment with paliperidone. This case highlights the need for health care providers to be aware of the rare, potentially life threatening but preventable hyponatremia, NMS, and rhabdomyolysis as a possible adverse effect of paliperidone.

  9. [Case of neuroleptic malignant syndrome following open heart surgery for thoracic aortic aneurysm with parkinson's disease].

    Science.gov (United States)

    Shinoda, Maiko; Sakamoto, Mik; Shindo, Yuki; Ando, Yumi; Tateda, Takeshi

    2013-12-01

    An 80-year-old woman with Parkinson's disease was scheduled for open heart surgery to repair thoracic aortic aneurysm. Parkinson's symptoms were normally treated using oral levodopa (200 mg), selegiline-hydrochloride (5 mg), bromocriptine-mesilate (2 mg), and amantadine-hydrochloride (200 mg) daily. On the day before surgery, levodopa 50mg was infused intravenously. Another 25 mg of levodopa was infused immediately after surgery. Twenty hours later, the patient developed tremors, heyperventilation, but no obvious muscle rigidity. Two days after surgery, the patient exhibited high fever, hydropoiesis, elevated creatine kinase, and a rise in blood leukocytes. She was diagnosed with neuroleptic malignant syndrome. She was intubated, and received dantrolene sodium. Symptoms of neuroleptic malignant syndrome disappeared on the fourth postoperative day. The stress of open heart surgery, specifically extracorporeal circulation and concomitant dilution of levodopa, triggered neuroleptic malignant syndrome in this patient. Parkinson's patients require higher doses of levodopa prior to surgery to compensate and prevent neuroleptic malignant syndrome after surgery.

  10. [Acute renal failure in neuroleptic malignant syndrome].

    Science.gov (United States)

    Wagner, G; Rónai, L

    1995-10-01

    The neuroleptic malignant syndrome is characterized by hyperpyrexia, muscle rigidity, extrapyramidal motion disorder, vegetative symptoms and mental disorientation. This group of symptoms develops abruptly and may lead to serious complications. One of these complications is the acute renal failure. Permanent muscle rigidity causes the damage of muscle cells which result in myoglobinaemia, myoglobinuria and elevations in muscle related creatine phosphokinase. The authors report the case of a young man who underwent neuroleptic medication because of hebephrenia. During the medication the following symptoms were developed: extrapyramidal symptoms, restlessness, muscle rigidity, high fever. These symptoms eventually lead to acute renal failure caused by rhabdomyolysis (characteristic urine finding, significant elevations in serum creatine phosphokinase). With regards to the neuroleptic malignant syndrome dantrolenum and bromocriptin treatment were applied with the discontinuation of neuroleptic medication. As a part of the complex therapy a massive volumen-supplementing and alkalizing treatment was used but haemodialysis had also become necessary. During the above mentioned treatment symptoms referring to the neuroleptic malignant syndrome resolved and the acute renal failure was cured. The case report calls attention to a specific group of symptoms and the possibilities for prevention and treatment. The above case report is the first observation in Hungary.

  11. Pituitary injury and persistent hypofunction resulting from a peripartum non-hemorrhagic, vaso-occlusive event

    Science.gov (United States)

    Kuriya, Anita; Morris, David V

    2015-01-01

    Summary Cerebral vascular accidents are caused by vasospasm when induced by preeclampsia or by dopamine agonists. However, six arteries nourish the pituitary and prevent against vasospasm-induced damage, which up until now has not been thought to occur. Bromocriptine was used to arrest lactation in a 31-year-old with secondary amenorrhea following preeclampsia and fetal demise at 28 weeks gestation. Tests and history revealed panhypopituitarism not associated with hemorrhage or mass infarction but instead caused by vasospasm. The present study is the first report of pituitary damage from a non-hemorrhagic, vaso-occlusive event in the literature. In keeping with Sheehan's and Simon's syndromes, we have named pituitary damage resulting from vaso-occlusion as Dahan's syndrome, and a literature review suggests that it may be a common and previously overlooked disorder. Learning points Vasospasm can cause damage to the pituitary gland, although it was not previously believed to do so.Preeclampsia and the use of a dopamine agonist, particularly in the peripartum state, may trigger vasospasm.Vasospasm resulting from dopamine agonists may be a common cause of injury to the pituitary gland, and it may have been overlooked in the past. PMID:26038692

  12. Somatostatin and dopamine receptor regulation of pituitary somatotroph adenomas.

    Science.gov (United States)

    Ben-Shlomo, Anat; Liu, Ning-Ai; Melmed, Shlomo

    2017-02-01

    Somatostatin and dopamine receptors are expressed in normal and tumoral somatotroph cells. Upon receptor stimulation, somatostatin and the somatostatin receptor ligands octreotide, lanreotide, and pasireotide, and to a lesser extent, dopamine and the dopamine analogs bromocriptine and cabergoline, suppress growth hormone (GH) secretion from a GH-secreting pituitary somatotroph adenoma. Somatostatin and dopamine receptors are Gαi-protein coupled that inhibit adenylate cyclase activity and cAMP production and reduce intracellular calcium concentration and calcium flux oscillations. Although their main action on somatotroph cells is acute inhibition of GH secretion, they also may inhibit GH production and possibly somatotroph proliferation. These receptors have been reported to create complexes that exhibit functions distinct from that of receptor monomers. Somatostatin suppression of GH is mediated mainly by somatostatin receptor subtype 2 and to a lesser extent by SST5. Human somatostatin receptor subtype 5 has also been shown to harbor mutations associated with GH levels, somatotroph tumor behavior, and somatostatin receptor ligand (SRL) responsiveness. Reviewing current knowledge of somatostatin and dopamine receptor expression and signaling in normal and tumoral somatotroph cells offers insights into mechanisms underlying SRL and dopamine agonist effectiveness in patients with acromegaly.

  13. Prolonged Paroxysmal Sympathetic Storming Associated with Spontaneous Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Yan Liu

    2013-01-01

    Full Text Available Paroxysmal sympathetic storming (PSS is a rare disorder characterized by acute onset of nonstimulated tachycardia, hypertension, tachypnea, hyperthermia, external posturing, and diaphoresis. It is most frequently associated with severe traumatic brain injuries and has been reported in intracranial tumors, hydrocephalous, severe hypoxic brain injury, and intracerebral hemorrhage. Although excessive release of catecholamine and therefore increased sympathetic activities have been reported in subarachnoid hemorrhage (SAH, there is no descriptive report of PSS primarily caused by spontaneous SAH up to date. Here, we report a case of prolonged PSS in a patient with spontaneous subarachnoid hemorrhage and consequent vasospasm. The sympathetic storming started shortly after patient was rewarmed from hypothermia protocol and symptoms responded to Labetalol, but intermittent recurrence did not resolve until 3 weeks later with treatment involving Midazolam, Fentanyl, Dexmedetomidine, Propofol, Bromocriptine, and minimizing frequency of neurological and vital checks. In conclusion, prolonged sympathetic storming can also be caused by spontaneous SAH. In this case, vasospasm might be a precipitating factor. Paralytics and hypothermia could mask the manifestations of PSS. The treatment of the refractory case will need both timely adjustment of medications and minimization of exogenous stressors or stimuli.

  14. Changes in Plasma Prolactin and Growth Hormone Level and Visual Problem after radiation Therapy(RT) of Pituitary Adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sei Chul; Kwon, Hyung Chul; Oh, Yoon Kyeong; Bahk, Yong Whee; Son, Ho Young; Kang, Joon Ki; Song, Jin Un [Catholic Medical College, Seoul (Korea, Republic of)

    1985-06-15

    Twenty-four cases of pituitary adenoma, 13 males and 11 females with the age ranging from 11 to 65 years, received radiation therapy(RT) on the pituitary area with 6MV linear accelerator during past 25 months at the Division of Radiation Therapy, Kangnam St. Mary Hospital, Catholic Medical College. Of 24 case of RT, 20 were postoperative and 4 primary. To evaluate the effect of RT, we analyzed the alteration of the endocrinological tests, neurologic abnormalities, major clinical symptoms, endocrinological changes and improvement in visual problems after RT. The results were as follows ; 1. Major clinical symptoms were headache, visual defects, diabetes insipidus, hypogonadisms and general weakness in decreasing order of frequency. 2. All but the one with Nelson syndrome showed abnormal neuroradiologic changes in the sella turcica with an invasive tumor mass around supra and para-sellar area. 3. Endocrinological classifications of the patient were 11 prolactinoma, 4 growth hormonesecreting tumors, 3 ACTH-secreting tumors consisting of one Cushing disease and two Nelson syndrome, and 6 nonfunctioning tumors. 4. Eleven of 14 patients, visual problems were improved after treatment but remaining 3 were unchanged. 5. Seven of 11 prolactinomas returned to normal hormonal level after postoperative and primary RT and 3 patients are being treated with bromocriptine (BMCP) but on lost case. 6. Two of 4 growth hormone-secreting tumor returned to normal level after RT but the remaining 2 are being treated with BMCP, as well.

  15. Long-Term Clinical Outcomes of Invasive Giant Prolactinomas after a Mean Ten-Year Followup

    Science.gov (United States)

    Wu, Ze Rui; Zhang, Yong; Lin, Shao Jian; Su, Zhi Peng; Wei, Yong Xu; Shang, Han Bing; Yang, Wen Lei; Zhao, Wei Guo

    2016-01-01

    Objective. The aim of this study is to observe clinical outcomes after more than ten years of followup in a group of patients with invasive giant prolactinomas (IGPs) treated with dopamine agonists (DAs). Methods. Twenty-five patients met the criteria of IGPs, among which 16 patients primarily received bromocriptine (BRC) and the other nine had undergone unsuccessful microsurgery prior to BRC treatment. Results. After a mean follow-up period of 135.5 ± 4.7 months, the clinical symptoms in all patients improved by different degrees. Tumor volume was decreased by a mean of 98.6%, and the tumors of 19 patients had almost completely disappeared. The mean duration of treatment at maximal doses of BRC was 48.5 months. At the last follow-up visit, nineteen patients had normal PRL levels, and 14 of these patients had received the low-dose BRC treatment (at an average of 2.9 ± 0.3 mg/d). Younger patients < 25 years had a significantly higher rate of persistent hyperprolactinemia after long-term BRC treatment (p = 0.043). Conclusion. DAs are a first-line therapy for IGPs because they can effectively achieve long-term control in both shrinking tumor volume and normalizing the PRL level, and majority of patients need low-dose DA maintenance. Younger patients are prone to persistent hyperprolactinemia despite long-term DA treatment. PMID:27999593

  16. Hyperprolactinemia and prolactinoma.

    Science.gov (United States)

    Romijn, Johannes A

    2014-01-01

    Prolactinomas are the most frequent pituitary adenomas. In patients with prolactinomas the primary cause of hyperprolactinemia is excessive and autonomic production of prolactin by lactotroph cells. In other conditions, except in case of macroprolactinemia, hyperprolactinemia is secondary to circumstances that stimulate secretion of prolactin by intrinsically normal lactotroph cells, or, rarely, that are the result of decreased clearance of prolactin. In general, cabergoline is the preferred treatment for micro- and macroprolactinomas, because it is more effective with respect to normalization of prolactin levels and reduction of prolactinoma size and because it has fewer side-effects compared to bromocriptine. Recently, it has been suggested that a standardized, individualized, stepwise, dose-escalating regimen of cabergoline may normalize prolactin levels and reduce prolactinoma size in patients who were otherwise considered to be dopamine agonist resistant. In general, the cardiac adverse effects of dopamine agonists reported in Parkinson's disease are not of clinical concern in the treatment of prolactinomas, which are treated with much lower doses. Nonetheless, there is uncertainty with respect to the dose and duration of cabergoline treatment, which requires echocardiographic follow-up. Although withdrawal of dopamine agonists may be considered in patients with prolactinomas well controlled by dopamine agonists, especially in postmenopausal women, recurrence of signs and symptoms may occur in a considerable portion of patients.

  17. Study Progress of Prolactin%泌乳素的研究进展

    Institute of Scientific and Technical Information of China (English)

    王雄

    2012-01-01

    泌乳素是由垂体泌乳细胞分泌的一种蛋白质类激素,主要受神经内分泌调节,其作用是促使乳腺分泌乳汁,作为神经内分泌因子参与免疫调节,维持女性黄体的功能和促进男性睾酮的合成.泌乳素异常分泌会引起高泌乳素血症,且与乳腺增生、肿瘤和某些自身免疫疾病的发生密切相关.采用手术切除泌乳素瘤、西药溴隐亭、中药复方或针灸方法治疗泌乳素相关疾病,疗效确切.%Prolactin is a kind of protein hormone secreted by lactotroph of pituitary gland,mainly regulated by neuroendocrine. It promotes mammary gland lactating, participates immunological regulation as a neuroendocrine factor, maintains female luteinic function and promotes the synthesis of male testosterone. Abnormal secretion of protein will cause hyperprolactinemia,and is closely correlated with hyperplasia of mammary glands, tumor and several autoimmune diseases. The related diseases induced by abnormal secretion of protein can be cured by cutting down prolactinoma,bromocriptine,traditional Chinese medicine or acupuncture, and the curative effect is affirmative.

  18. [Prolactinoma].

    Science.gov (United States)

    Glezer, Andrea; Bronstein, Marcello D

    2014-03-01

    Prolactinomas are the most common pituitary adenomas that affect young women at fertile age. Hyperprolactinemia causes hypogonadism, menstrual irregularities or amenorrhea in women, low serum testosterone levels in men, and infertility and sexual dysfunction in both men and women. Macroprolactinomas may cause cephalea, visual disturbance, and hypopituitarism. Clinical treatment with dopamine agonists is the gold standard, with cabergoline as the first choice due to its greater efficiency and tolerability. In about 20% of the cases, treatment is partially or completely ineffective, a situation in which surgery, in general by transsphenoidal route, is indicated. Radiotherapy is indicated only in the control of tumor growth in invasive/aggressive cases. In invasive macroprolactinoma, the necessary approach, in general, is the combination of several therapeutic modalities, including debulking and recently-approved drugs, such as temozolamide. As for pregnancy, the drug of choice to induce ovulation still is bromocriptine. In the cases of microprolactinomas and intrasselar macroprolactinomas, the treatment with dopaminergic agonists may be suspended after pregnancy is confirmed. In macroprolactinomas, management should be individualized.

  19. Management of prolactinoma with cabergoline treatment in a pregnant woman during her entire pregnancy

    Directory of Open Access Journals (Sweden)

    Sukhwinder Kaur Bajwa

    2011-01-01

    Full Text Available Management of prolactinoma in pregnancy is a big challenge for the treating obstetrician as prolactin levels are normally raised in pregnancy and this creates a possibility of missing the diagnosis of prolactinoma. Women with micro adenomas and intrasellar macro adenomas do not require serial magnetic resonance imaging (MRI or visual field testing as required in macro adenomas with extrasellar extension. A strict and vigil monitoring during each trimester for any clinical signs and symptoms related to tumor will suffice for the diagnosis of enlarging prolactinoma and for any active intervention required thereof. Dopamine agonists are the first choice of drugs to treat these tumors during pregnancy. Cabergoline is reported to be more effective and better tolerated as compared to traditional bromocriptine, with minimal risk of spontaneous abortion, congenital malformations or menstrual abnormalities. We are reporting a patient with macro prolactinoma who was treated successfully throughout her pregnancy with cabergoline. We achieved a very good control of prolactinoma without any significant alteration of dose and also without any adverse effects. We convey that cabergoline can be a first choice drug to treat macro prolactinomas in pregnancy also.

  20. Progress in Etiology,Diagnosis and Treatment of Hyperprolactinemia%高泌乳素血症的病因及诊疗进展

    Institute of Scientific and Technical Information of China (English)

    王佳宁

    2012-01-01

    高泌乳素血症(HPRL)为常见的内分泌紊乱性疾病,在临床症状上女性主要表现为闭经、溢乳、月经稀发、不孕等,该疾病影响了人们的健康及生活质量.目前治疗仍主要以溴隐亭为主,2011年HPRL诊疗指南中把卡麦角林作为首选用药,还有中药、手术、放射等治疗方法.现就HPRL的病因及诊疗进行综述,为高泌乳血症的治疗提供参考.%llyperprolactinaemia( 11PRL )is a common endocrine disorder characterized by amenorrhea, galactorrhea,anovulation and infertility. 11PRL have great impact on health-related quality of life( HRQoL ). The major treatment is still bromocriptine, while 2011 11PRL diagnosis and treatment guideline suggests cabergoline as the optimal medication, and traditional Chinese medicine, surgery and radiotherapy are also the options. Here is to make a review on the etiology, diagnosis and treatment of 11PRL.

  1. Catatonia, Neuroleptic Malignant Syndrome, and Cotard Syndrome in a 22-Year-Old Woman: A Case Report

    Directory of Open Access Journals (Sweden)

    C. Weiss

    2013-01-01

    Full Text Available The following case study describes a 22-year-old woman with depression and symptoms of psychosis who developed neuroleptic malignant syndrome after using Risperidone, thus requiring life support equipment and Bromocriptine, later recovering after seven days. From a psychiatric and neurological point of view, however, the persistence of catatonic syndrome and Cotard syndrome delusions was observed, based on assertions such as “I do not have a heart,” “my heart is not beating,” “I can not breathe,” “I am breaking apart,” “I have no head” (ideas of negation and statements about the patient being responsible for the “death of the whole world” (ideas of enormity. Brain NMR revealed leukoencephalopathy, interpreted as scar lesions caused by perinatal neurological damage, after discarding other pathologies. The patient responded well to electroconvulsive therapy after 11 sessions. Organic vulnerability to these syndromes, as well as their coexistence and clinical differentiation is discussed in the light of the data observed.

  2. Catatonia in Neurologic and Psychiatric Patients at a Tertiary Neurological Center.

    Science.gov (United States)

    Espinola-Nadurille, Mariana; Ramirez-Bermudez, Jesus; Fricchione, Gregory L; Ojeda-Lopez, M Carmen; Perez-González, Andres F; Aguilar-Venegas, Luis C

    2016-01-01

    This study describes the prevalence, phenomenology, treatment, and outcome of neurological patients and psychiatric patients with catatonia at a tertiary neurological center. Clinical variables included nosological diagnoses and complications. Admission length and days with catatonia were used as outcome measures. Of 2,044 patients who were evaluated prospectively, 68 (3.32%) had catatonia, 42 (61.7%) were neurological patients, 19 (27.9%) were psychiatric patients, and 7 (10.2%) had drug-related diagnoses. Of all patients, the ratio of neurological to psychiatric patients was 3:1. Encephalitis was the most common diagnosis (N=26 [38.2%]), followed by schizophrenia (N=12 [17.6%]). Psychiatric patients exhibited a stuporous type of catatonia (15 [83.3%] versus 14 [33.3%], p>0.001), whereas neurological patients exhibited a mixed form of catatonia (25 [59.5%] versus 1 [5.6], pcatatonia. A total of 56 patients (82.3%) received lorazepam, and 14 patients (20.5%) underwent ECT. Second- and third-line treatments included amantadine, bromocriptine, and levodopa. Catatonia is a prevalent syndrome that can remit with proper and opportune treatment.

  3. [Diazepam-responsive malignant catatonia in a patient with an initial clinical diagnosis of neuroleptic malignant syndrome: a case report].

    Science.gov (United States)

    Mishima, Takayasu; Tsuboi, Yoshio; Higuchi, Masa-Aki; Tsugawa, Jun; Obata, Toyoshi; Yamada, Tatsuo

    2011-05-01

    We report a case of malignant catatonia initially diagnosed as neuroleptic malignant syndrome (NMS) that responded successfully to diazepam administration. A 29-year-old man with mental retardation was admitted to our hospital because of high fever, muscle pain, and consciousness disturbance. Fifteen days before admission, he had developed muscle pain and weakness in his legs. He presented with fever, tachycardia, tachypnea, elevated blood pressure, excessive sweating, and neurological findings of lethargy and severe muscle rigidity in the neck and extremities. Laboratory findings included elevated serum creatine phosphokinase (CPK) level. His clinical features and the laboratory test results fulfilled the diagnostic criteria for NMS. He was treated for NMS with dantrolene sodium and bromocriptine mesylate for 2 weeks; however, there was no improvement. Therefore, treatment was changed to diazepam administration because of suspected malignant catatonia. One week after initiation of diazepam administration, his symptoms gradually improved, and the serum CPK level normalized. The diagnosis of malignant catatonia was confirmed because treatment with diazepam was dramatically effective, whereas the initial treatment for NMS was not beneficial. The clinical presentation of malignant catatonia is similar to that of NMS. Indeed, some authors have described NMS as a variant of malignant catatonia. If treatment is refractory in cases of NMS, malignant catatonia may be suspected, and changing treatment to diazepam administration may be useful.

  4. ECT in the treatment of a patient with catatonia: consent and complications.

    Science.gov (United States)

    Zisselman, Marc H; Jaffe, Richard L

    2010-02-01

    Acute catatonia in an adolescent or young adult can present complex clinical challenges. Prominent issues include those involving diagnosis, timely and effective treatment, and diminished capacity to provide consent. The authors describe a 19-year-old woman presenting initially with manic excitement followed by a lengthy period of mutism, immobility, and food and fluid refusal. Elevated temperature, an elevated creatine phosphokinase level, and autonomic dysfunction led to consideration of a malignant catatonic syndrome. The patient manifested rigidity accompanied by posturing and waxy flexibility. Neurologic, medical, and laboratory evaluations failed to identify an organic cause for the likely catatonia. Treatment with amantadine, bromocriptine, and lorazepam was unsuccessful. ECT was deemed appropriate but required emergency guardianship because of the patient's inability to provide consent. At the initial ECT session, the elicited seizure was followed by an episode of torsade de pointes requiring immediate cardioversion. In reviewing the ECT complication, it appeared that muscle damage due to catatonic immobility led to acute hyperkalemia with the administration of succinylcholine. Discussions were held with the patient's guardian outlining the clinical issues and the risks of additional ECT. The patient responded to eight subsequent ECT sessions administered with rocuronium, a nondepolarizing muscle relaxant. The authors provide a brief review of the diagnosis and treatment of catatonia and address issues surrounding ECT, cardiac effects, use of muscle relaxants, and the consent process.

  5. Divergent effects of various diabetes drugs on cardiovascular prognosis.

    Science.gov (United States)

    Bell, David S H; Patil, Harshal R; O'Keefe, James H

    2013-01-01

    This review discusses the current data on various antidiabetic medications and their effects on major adverse cardiovascular events (MACE). Diabetes mellitus is a potent independent risk factor for MACE, and this risk increases in proportion to the elevation of hemoglobin A1c. Available data suggest that tight glycemic control in patients with diabetes reduces microvascular complications, but has limited effect or may even increase the risk of MACE and other macrovascular complications. For individuals with type 2 diabetes mellitus (T2DM) drugs that reduce postprandial glucose (α-glucosidase inhibitors, incretin mimetics, quick-acting bromocriptine, dipeptidyl peptidase-4 inhibitors, and colesevelam) are associated with a decrease in MACE. Drugs that directly reduce insulin resistance (pioglitazone and metformin) are also associated with lesser but still significant decreases in MACE. Insulin, rosiglitazone (but not pioglitazone), and sulfonylureas (especially with glyburide and particularly the glyburide + metformin combination) are associated with increases in MACE. In summary, drugs that reduce postprandial glucose and improve insulin resistance without predisposing patients to hypoglycemia appear to both control hyperglycemia and improve cardiovascular prognosis. However, many of the traditional agents used for treating T2DM, such as insulin and sulfonylureas, do not improve cardiovascular prognosis despite improving hyperglycemia.

  6. Pioglitazone--do we really need it to manage type 2 diabetes?

    Science.gov (United States)

    Sinha, Binayak; Ghosal, Samit

    2013-01-01

    Over the last few years a number of important drugs like rofecoxib, rosiglitazone, gatifloxacin (in diabetics) have lost their position in disease management. The newest controversy revolves around Pioglitazone, a thiozolidindione, which improves insulin sensitivity and is reputed to have cardioprotective actions, but is riddled with several controversies related to weight gain, distal fractures of long bones, recent reports of bladder cancer and others. There are now new groups of drugs, which have been introduced with stringent FDA approval. These include DPP-4 inhibitors, GLP-1 analogues and bromocriptine (old wine in a new bottle). Early in 2013 we are also looking at the launch of another new agent - SGLT-2 inhibitors. These newer agents are associated with not only a significant glucose lowering effect but also positive extra-glycaemic benefits principally in the areas of hypoglycaemia and weight gain. This raises a very important question - do we really need such a controversial agent when such a plethora of agents are available to us with possibly better metabolic profile than pioglitazone? This review addresses this highly contentious area dissecting the pros and cons as we see it.

  7. Neuroprotective and neurotrophic effects of Apigenin and Luteolin in MPTP induced parkinsonism in mice.

    Science.gov (United States)

    Patil, Sachin P; Jain, Pankaj D; Sancheti, Jayant S; Ghumatkar, Priya J; Tambe, Rufi; Sathaye, Sadhana

    2014-11-01

    In the present study, we aim to investigate the neuroprotective and neurotrophic effects of naturally occurring polyphenols like apigenin and luteolin and also to explore the underlying mechanisms with respect to Parkinson's disease (PD). MPTP (25 mg/kg) along with Probenecid (250 mg/kg) was administrated for five consecutive days to induce parkinsonism in mice. Apigenin (5, 10 and 20 mg/kg), luteolin (10 and 20 mg/kg) and Bromocriptine (10 mg/kg) were administrated orally for 26 days including 5 days of pretreatment. Behavioural analysis and biochemical estimation of oxidative stress biomarkers were conducted. Tyrosine hydroxylase (TH), glial fibrillary acidic protein (GFAP) and brain derived neurotrophic factor (BDNF) were evaluated in substantia nigra (SN) region of the brain by immunostaining. TNF-α was estimated using ELISA technique. Our results demonstrate that apigenin and luteolin treatment improved the locomotor and muscular activities in MPTP treated mice. TH-positive cells decreased up to 7% in MPTP treated mice compared to normal mice (P apigenin (69%) and luteolin (63%) treated mice (P apigenin and luteolin treatment as compared to MPTP mice. BDNF levels were elevated significantly in apigenin and luteolin treatment groups when compared to MPTP treatment mice. In conclusion, apigenin and luteolin protected the dopaminergic neurons probably by reducing oxidative damage, neuroinflammation and microglial activation along with enhanced neurotrophic potential. The above results propose both these flavonoids as promising molecules in the therapeutics of PD.

  8. Dopamine inhibits lipopolysaccharide-induced nitric oxide production through the formation of dopamine quinone in murine microglia BV-2 cells.

    Science.gov (United States)

    Yoshioka, Yasuhiro; Sugino, Yuta; Tozawa, Azusa; Yamamuro, Akiko; Kasai, Atsushi; Ishimaru, Yuki; Maeda, Sadaaki

    2016-02-01

    Dopamine (DA) has been suggested to modulate functions of glial cells including microglial cells. To reveal the regulatory role of DA in microglial function, in the present study, we investigated the effect of DA on lipopolysaccharide (LPS)-induced nitric oxide (NO) production in murine microglial cell line BV-2. Pretreatment with DA for 24 h concentration-dependently attenuated LPS-induced NO production in BV-2 cells. The inhibitory effect of DA on LPS-induced NO production was not inhibited by SCH-23390 and sulpiride, D1-like and D2-like DA receptor antagonists, respectively. In addition, pretreatment with (-)-(6aR,12bR)-4,6,6a,7,8,12b-Hexahydro-7-methylindolo[4,3-a]phenanthridin (CY 208-243) and bromocriptine, D1-like and D2-like DA receptor agonists, respectively, did not affect the LPS-induced NO production. N-Acetylcysteine, which inhibits DA oxidation, completely inhibited the effect of DA. Tyrosinase, which catalyzes the oxidation of DA to DA quionone (DAQ), accelerated the inhibitory effect of DA on LPS-induced NO production. These results suggest that DA attenuates LPS-induced NO production through the formation of DAQ in BV-2 cells.

  9. Long-Term Clinical Outcomes of Invasive Giant Prolactinomas after a Mean Ten-Year Followup

    Directory of Open Access Journals (Sweden)

    Ze Rui Wu

    2016-01-01

    Full Text Available Objective. The aim of this study is to observe clinical outcomes after more than ten years of followup in a group of patients with invasive giant prolactinomas (IGPs treated with dopamine agonists (DAs. Methods. Twenty-five patients met the criteria of IGPs, among which 16 patients primarily received bromocriptine (BRC and the other nine had undergone unsuccessful microsurgery prior to BRC treatment. Results. After a mean follow-up period of 135.5±4.7 months, the clinical symptoms in all patients improved by different degrees. Tumor volume was decreased by a mean of 98.6%, and the tumors of 19 patients had almost completely disappeared. The mean duration of treatment at maximal doses of BRC was 48.5 months. At the last follow-up visit, nineteen patients had normal PRL levels, and 14 of these patients had received the low-dose BRC treatment (at an average of 2.9±0.3 mg/d. Younger patients < 25 years had a significantly higher rate of persistent hyperprolactinemia after long-term BRC treatment (p=0.043. Conclusion. DAs are a first-line therapy for IGPs because they can effectively achieve long-term control in both shrinking tumor volume and normalizing the PRL level, and majority of patients need low-dose DA maintenance. Younger patients are prone to persistent hyperprolactinemia despite long-term DA treatment.

  10. 麦芽提取物对高泌乳素血症大鼠脑垂体泌乳素表达及乳腺组织形态学的影响%Effects of Malt Extract on Hypophysis Prolactin Expression and Morphology of Mammary Tissues in Hyperprolactinemia Rats

    Institute of Scientific and Technical Information of China (English)

    朱梦军; 肖晖; 王雄; 吴金虎

    2015-01-01

    目的:观察麦芽提取物对高泌乳素血症大鼠垂体泌乳素( PRL)表达及乳腺组织形态学的影响。方法大鼠背部皮下注射盐酸甲氧氯普胺制备高泌乳素血症模型。60只大鼠分为正常对照组、模型对照组、溴隐亭组及麦芽提取物大、中和小剂量组。除正常对照组外,其他组进行造模。溴隐亭组给予溴隐亭0.389 mg·kg-1·d-1;麦芽提取物小、中和大剂量组分别给予麦芽提取物7.98,15.96和31.92 g·kg-1·d-1。正常对照组和模型对照组给予等容量纯化水。大鼠在造模成功后,灌胃给予相应的药物进行治疗给药,每次2 mL,每日1次,连续30 d。对大鼠脑垂体PRL阳性细胞进行计数,采用反转录聚合酶链反应( RT-PCR)检测大鼠垂体PRL mRNA的表达水平,以及采用免疫组化法观察乳腺组织形态学的变化。结果正常对照组、模型对照组、溴隐亭组、麦芽提取物大、中和小剂量组的PRL阳性细胞数量分别为(2.4±0.3),(21.7±0.8),(3.8±0.5),(4.5±0.4),(6.7±0.5),(15.8±1.2)个,PRL mRNA表达水平分别为(0.31±0.02),(1.58±0.06),(0.45±0.04),(0.49±0.03),(0.61±0.04),(0.95±0.09)。与正常对照组比较,模型对照组大鼠脑垂体PRL阳性细胞数量和PRL mRNA表达水平显著增加(P<0.01),同时乳腺组织出现增生。与模型对照组比较,麦芽提取物大、中剂量组大鼠脑垂体PRL阳性细胞数量和PRL mRNA表达水平显著减少(P<0.01),而且乳腺增生明显减轻。结论麦芽提取物能有效治疗高泌乳素血症及抑制乳腺组织的增生,作用机制是其显著降低高泌乳素血症大鼠脑垂体PRL的表达。%Objective To observe the effects of malt extract on prolactin expression and morphology of mammary tissue in hyperprolactinemia rats. Methods Metoclopramide hydrochloride was injected subcutaneously to establish hyperprolactinemia model. Sixty rats were divided into normal control group, model control group, bromocriptine group

  11. Studies on the regulatory effect of Peony-Glycyrrhiza Decoction on prolactin hyperactivity and underlying mechanism in hyperprolactinemia rat model.

    Science.gov (United States)

    Wang, Di; Wang, Wei; Zhou, Yulin; Wang, Juan; Jia, Dongxu; Wong, Hei Kiu; Zhang, Zhang-Jin

    2015-10-08

    Clinical trials have demonstrated the beneficial effects of Peony-Glycyrrhiza Decoction (PGD) in alleviating antipsychotic-induced hyperprolactinemia (hyperPRL) in schizophrenic patients. In previous experiment, PGD suppressed prolactin (PRL) level in MMQ cells, involving modulating the expression of D2 receptor (DRD2) and dopamine transporter (DAT). In the present study, hyperPRL female rat model induced by dopamine blocker metoclopramide (MCP) was applied to further confirm the anti-hyperpPRL activity of PGD and underlying mechanism. In MCP-induced hyperPRL rats, the elevated serum PRL level was significantly suppressed by either PGD (2.5-10 g/kg) or bromocriptine (BMT) (0.6 mg/kg) administration for 14 days. However, in MCP-induced rats, only PGD restored the under-expressed serum progesterone (P) to control level. Both PGD and BMT administration restore the under-expression of DRD2, DAT and TH resulted from MCP in pituitary gland and hypothalamus. Compared to untreated group, hyperPRL animals had a marked reduction on DRD2 and DAT expression in the arcuate nucleus. PGD (10 g/kg) and BMT (0.6 mg/kg) treatment significant reversed the expression of DRD2 and DAT. Collectively, the anti-hyperPRL activity of PGD associates with the modulation of dopaminergic neuronal system and the restoration of serum progesterone level. Our finding supports PGD as an effective agent against hyperPRL.

  12. MJA Practice Essentials--Endocrinology. 9: Pituitary disease in adults.

    Science.gov (United States)

    Hurley, David M; Ho, Ken K Y

    2004-04-19

    Pituitary adenomas are found in 10%-25% of unselected autopsy series and are evident in about 10% of asymptomatic individuals by magnetic resonance imaging. Diagnosis of pituitary disorders is often delayed by lack of awareness and the subtlety of symptoms and signs. Hypopituitarism is suspected when peripheral hormone concentrations are low without an elevation in the corresponding pituitary tropic hormone(s). Severe adult-onset growth-hormone deficiency results in reduced muscle mass, increased fat mass and diminished quality of life, which are reversed by growth hormone replacement therapy. While trans-sphenoidal surgery remains first-line treatment for acromegaly, drug treatment has an important role in controlling residual growth-hormone excess and, in some circumstances, as first-line treatment. Dopamine-agonist therapy (cabergoline or bromocriptine) is the treatment of choice for micro- and macroprolactinomas. In patients with suggestive clinical features, elevated 24-hour urine free cortisol level is usually sufficient to diagnose endogenous Cushing's syndrome; careful additional investigation is needed to determine whether the cause is Cushing's disease (pituitary adenoma secreting adrenocorticotropic hormone [ACTH]), ectopic ACTH secretion or adrenal disease. Heightened awareness is needed to detect the sometimes subtle symptoms and signs of pituitary disease

  13. Stimulatory and inhibitory effects of neuropeptide Y on growth hormone secretion in acromegaly in vivo.

    Science.gov (United States)

    Watanobe, H; Tamura, T

    1997-02-01

    It has been reported that neuropeptide Y (NPY) affects growth hormone (GH) secretion in several animal species. With respect to the role of NPY in regulating GH release in humans, one previous study has reported that NPY inhibited GH secretion from cultured GH-secreting pituitary adenoma cells in vitro. However, since it has yet to be explored whether NPY affects GH secretion in acromegaly in vivo, in this study we attempted to examine the effect of intravenous (i.v.) bolus injection of 100 microg of human NPY on plasma GH levels in 15 patients with active acromegaly, trying to find a possible correlation among GH responses to NPY, thyrotropin-releasing hormone (TRH;500 microg, i.v.), luteinizing hormone-releasing hormone (LHRH;100 microg, i.v.), and bromocriptine (Br;2.5 mg, per os). NPY significantly increased GH secretion (more than twice the basal level) in 4 (27%) patients, and all of them were responsive to LHRH and non-responsive to Br. In contrast, 3 (20%) acromegalics showed a significant decrease in GH levels (less than half the baseline) after NPY, and all these patients were responsive to both TRH and Br. From these results, we hypothesize that the NPY-induced increase in GH release may be a feature of somatotroph-like pituitary adenoma causing acromegaly, whereas the NPY-induced decrease in GH secretion may be a feature of lactotroph-like adenoma.

  14. Gender differences in serum GH and IGF-I levels and the GH response to dynamic tests in patients with acromegaly.

    Science.gov (United States)

    Tanaka, Satoshi; Fukuda, Izumi; Hizuka, Naomi; Takano, Kazue

    2010-01-01

    Gender affects the GH secretory pattern both in normal subjects and in patients with acromegaly by an uncertain mechanism. Here, we report the influence of gender on the relationship between serum GH and IGF-I levels and the GH response to dynamic tests in patients with acromegaly. Seventy-four patients with untreated acromegaly (M/F 27/47, age range 22-86 yr.) were studied. The serum GH levels did not differ between male and female (6.1 vs. 8.7 ng/ml; p=0.26), while serum IGF-I levels, IGF-I SDS and the IGF-I/GH ratio were lower in female than those in male (679 vs. 769 ng/ml; p50 yr, serum IGF-I levels and IGF-I/GH ratios were lower in female than those in male in patients 50 yrs (684 vs. 680 ng/ml; p=0.39 and 98.7 vs. 118.4; p=0.40). The GH responses to OGTT, TRH, octreotide, and bromocriptine tests were similar in male and female. In conclusion, IGF-I/GH ratio was significantly lower in female than that in male particularly in younger patients with acromegaly. These data suggest that gender, presumably sex steroids in female, may partially modulate the relationship between circulating IGF-I and GH levels in patients with acromegaly.

  15. New drug treatments for alcohol problems: a critical appraisal.

    Science.gov (United States)

    Moncrieff, J; Drummond, D C

    1997-08-01

    This review considers the novel drug treatments that have been suggested to help prevent relapse or attenuate drinking in people with alcohol problems. The evidence from randomized controlled trials for the efficacy of some of the main candidates: acamprosate, naltrexone, bromocriptine, selective serotonin re-uptake inhibitors and buspirone, was examined. Important methodological problems which may have introduced bias were detected in many of the trials. These included failure to test the integrity of the double blind, excluding or estimating outcome in early withdrawals and the comparison of groups on multiple outcome measures with selective reporting of results. In addition, the generalizability of some studies was limited by the procedures used for sample selection. In view of the potential adverse effects of drug treatment it is concluded that the evidence is not strong enough to support the introduction of any of these substances into routine clinical practice at present. The review also emphasizes the importance of methodological rigour to maximize objectivity in treatment evaluation research.

  16. Pharmacological and signalling properties of a D2-like dopamine receptor (Dop3) in Tribolium castaneum.

    Science.gov (United States)

    Verlinden, Heleen; Vleugels, Rut; Verdonck, Rik; Urlacher, Elodie; Vanden Broeck, Jozef; Mercer, Alison

    2015-01-01

    Dopamine is an important neurotransmitter in the central nervous system of vertebrates and invertebrates. Despite their evolutionary distance, striking parallels exist between deuterostomian and protostomian dopaminergic systems. In both, signalling is achieved via a complement of functionally distinct dopamine receptors. In this study, we investigated the sequence, pharmacology and tissue distribution of a D2-like dopamine receptor from the red flour beetle Tribolium castaneum (TricaDop3) and compared it with related G protein-coupled receptors in other invertebrate species. The TricaDop3 receptor-encoding cDNA shows considerable sequence similarity with members of the Dop3 receptor class. Real time qRT-PCR showed high expression in both the central brain and the optic lobes, consistent with the role of dopamine as neurotransmitter. Activation of TricaDop3 expressed in mammalian cells increased intracellular Ca(2+) signalling and decreased NKH-477 (a forskolin analogue)-stimulated cyclic AMP levels in a dose-dependent manner. We studied the pharmacological profile of the TricaDop3 receptor and demonstrated that the synthetic vertebrate dopamine receptor agonists, 2 - amino- 6,7 - dihydroxy - 1,2,3,4 - tetrahydronaphthalene hydrobromide (6,7-ADTN) and bromocriptine acted as agonists. Methysergide was the most potent of the antagonists tested and showed competitive inhibition in the presence of dopamine. This study offers important information on the Dop3 receptor from Tribolium castaneum that will facilitate functional analyses of dopamine receptors in insects and other invertebrates.

  17. Red Lentil Extract: Neuroprotective Effects on Perphenazine Induced Catatonia in Rats

    Science.gov (United States)

    Tarahomi, Shahram; Arzi, Ardeshir; Goudarzi, Mehdi; Bahadoram, Mohammad; Rashidi-Nooshabadi, Mohammadreza

    2016-01-01

    Introduction Parkinsonism is a neurodegenerative disease that is defined by certain symptoms such as muscle rigidity, impaired movement, catatonia, tremor and disorientation of body. Aim The aim was to investigate the effect of red lentil extract on perphenazine-induced Catatonia in model of rat. Materials and Methods This experimental study was done on 48 male albino rats (weight 180–200g) of the Sprague-Dawley strain. Animals were randomly divided into six groups and were pre-treated with a single dose of red lentil extract (200, 400, 800 and 1000 mg/kg), most effective dose of bromocriptine (30mg/kg) and normal saline (5ml/kg) via intraperitoneal (IP) route. perphenazine (5 mg/kg) was after 30 minutes, administered (IP) to induce catatonia. The scoring method of Morpurgo was used to determine the muscular rigidity of animals. Results The results showed that the 200mg/kg red lentil extract treated group had no significant reduction in catatonic responses after perphenazine administration in comparison with control group while the groups that received 800 and 1000mg/kg of red lentil extract showed significant difference (pCatatonia induced by perphenazine in rats. So this extract may be probably beneficial for catatonia in Parkinsonism. PMID:27504309

  18. Current therapeutic concepts in peripartum cardiomyopathy.

    Science.gov (United States)

    Krejci, Jan; Poloczkova, Hana; Nemec, Petr

    2015-01-01

    Peripartum cardiomyopathy (PPCM) is a relatively rare disease characterized by systolic heart failure occuring towards the end of pregnancy or during the months following birth. It is most often seen in women of African descent, and its incidence seems to be slightly increasing in recent years. Other etiologies of heart failure should be excluded to determine the diagnosis of PPCM. The clinical picture corresponds to systolic heart failure. The rapid onset of the symptoms in relation to pregnancy is striking. The essential diagnostic procedures such as echocardiography, cardiac magnetic resonance imaging and endomyocardial biopsy may be beneficial in certain situations. The etiology of the disease remains unclear. Speculated causes include myocarditis, autoimmune disorders, cardiotropic virus infection, and abnormal responses to hemodynamic and hormonal changes during pregnancy. Particular attention is currently given to the concept of increased oxidative stress inducing production of proapoptotic, angiostatic and proinflammatory mediators. Recovery of left ventricular systolic function occurs in about half of the cases. Mortality has been decreasing in recent years, especially in the United States, but is still between 10-15% in less developed countries where therapeutic possibilities are limited. In addition to standard heart failure therapy, specific treatments (pentoxyfilline, bromocriptine, immunomodulatory therapy) have been tested. Mechanical circulatory support is sometimes needed. Heart transplantation is the therapeutic option for the most severe heart failure and is used in about 10% of the cases. Recurrence in subsequent pregnancy is common and therefore, another pregnancy is not recommended in many cases.

  19. Peripartum cardiomyopathy: a review.

    Science.gov (United States)

    Bhattacharyya, Anirban; Basra, Sukhdeep Singh; Sen, Priyanka; Kar, Biswajit

    2012-01-01

    Peripartum cardiomyopathy is idiopathic heart failure occurring in the absence of any determinable heart disease during the last month of pregnancy or the first 5 months postpartum. The incidence varies worldwide but is high in developing nations; the cause of the disease might be a combination of environmental and genetic factors. Diagnostic echocardiographic criteria include left ventricular ejection fraction 2.7 cm/m(2). Electrocardiography, magnetic resonance imaging, endomyocardial biopsy, and cardiac catheterization aid in the diagnosis and management of peripartum cardiomyopathy. Cardiac protein assays can also be useful, as suggested by reports of high levels of NT-proBNP, cardiac troponin, tumor necrosis factor-α, interleukin-6, interferon-γ, and C-reactive protein in peripartum cardiomyopathy. The prevalence of mutations associated with familial dilated-cardiomyopathy genes in patients with peripartum cardiomyopathy suggests an overlap in the clinical spectrum of these 2 diseases.Treatment for peripartum cardiomyopathy includes conventional pharmacologic heart-failure therapies-principally diuretics, angiotensin-converting enzyme inhibitors, vasodilators, digoxin, β-blockers, anticoagulants, and peripartum cardiomyopathy-targeted therapies. Therapeutic decisions are influenced by drug-safety profiles during pregnancy and lactation. Mechanical support and transplantation might be necessary in severe cases. Targeted therapies (such as intravenous immunoglobulin, pentoxifylline, and bromocriptine) have shown promise in small trials but require further evaluation. Fortunately, despite a mortality rate of up to 10% and a high risk of relapse in subsequent pregnancies, many patients with peripartum cardiomyopathy recover within 3 to 6 months of disease onset.

  20. Peripartum cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Rodolfo Citro

    2011-07-01

    Full Text Available Peripartum cardiomyopathy is an uncommon form of congestive heart failure associated with systolic dysfunction of left ventricle. The onset is characterised by symptoms of heart failure occurring between the last month of pregnancy and 5-6 months postpartum. The early diagnosis and the institution of medical treatment for this disease are essential because the inadequate management may affect the patient’s long-term prognosis and can lead to severe complications, including death.Currently its aetiology is not completely understood. Many aetiopathogenetic hypotheses have been formulated: inflammation, viral agents, autoimmune processes. In the last years, evidences aroused for a role of prolactin and its 16 kDa metabolite in reducing cardiomyocite metabolic activity and contraction. In this article we have reviewed the current literature with special emphasis on the role of prolactin and the related current treatment strategies. In particular, bromocriptine appears promising, even if women need to be informed that the drug stops the production of breastmilk. Further researchers, such as large multicenter trials, are needed to decide the best treatment for the women suffering of this disease.

  1. McCune Albright syndrome in association with excessive GH secretion: case report.

    Science.gov (United States)

    Özsu, Elif; Mutlu, Gül Yeşiltepe; Çizmecioğlu, Filiz Mine; Hatun, Şükrü

    2015-06-01

    McCune-Albright Syndrome is a rare syndrome characterized with excessive function of peripheral endocrine organs and activating mutations of the stimulatory G protein alpha subunit are involved in the pathogenesis. The three main findings of the disease include hyperpigmented café au lait spots, fibrous dysplasia and increased endocrine functions and excessive secretion of growth hormone is observed in 21% of the patients. Clinical signs may be missed in these patients because of precocious puberty and craniofacial fibrous dysplasia. Since radiotherapy causes to sarcomatous changes and transsphenoidal surgery may cause to severe thickening in the cranial bones, they are not appropriate treatment options and medical treatment is recommended. Bromocriptine, cabergoline and octreotide or different combinations of these drugs are used in treatment and pegvisomant has also been used in recent years. Here, we present a male patient aged 12 years and 7 months to show gigantism as a rare clinical reflection of McCune-Albright Syndrome with an excessive height (197 cm), café au lait spots, growht hormone levels which could not be supressed with oral glucose tolerance test and increased prolactin levels.

  2. Galactorrea grave tras aumento mamario con implantes Severe galactorrhea after mammary augmentation with implants

    Directory of Open Access Journals (Sweden)

    F.T. Fidalgo Rodríguez

    2012-06-01

    Full Text Available La galactorrea es una complicación poco frecuente después de la cirugía plástica mamaria. Su causa aun es desconocida, aunque lo más probable es que su aparición tenga un origen multifactorial. En el caso que presentamos la paciente desarrolló incremento simétrico del volumen de ambas mamas después de un cirugía de aumento mamario. No se detectaron cambios en los valores de prolactina. El proceso no respondió al tratamiento con bromocriptina. La galactorrea postquirúrgica con frecuencia sigue un curso benigno y autolimitado, culminando con resolución espontánea. Dependiendo de la severidad de los síntomas, su tratamiento puede ser médico y/o quirúrgico, con drenaje o incluso retirada de los implantes mamarios.Galactorrhea is a complication rarely observed after mammary plastic surgery. The cause remains unknown although it's likely to be multifactorial. In the reported case, the patient described symmetric massive engorgement of both breasts after augmentation mammoplasty. No significant change was detected in the postoperative prolactin values. The condition was unresponsive to treatment with bromocriptine. Postsurgical galactorrhea often follows a benign course culminating in spontaneous resolution Depending on symptom severity, treatment may be medical with the prescription of dopaminergic agonists, and/or surgical with drainage or even removal of the mammary implants.

  3. Hypothalamic corticotropin-releasing factor immunoreactivity is reduced during induction of pituitary tumors by chronic estrogen treatment

    Energy Technology Data Exchange (ETDEWEB)

    Haas, D.A.; Borgundvaag, B.; Sturtridge, W.C.; George, S.R.

    1987-11-02

    The role that estrogen plays in the regulation of corticotropin-releasing factor (CRF) is not known. A radioimmunoassay specific for rat CRF was utilized to measure the CRF-like immunoreactivity (CRF-ir) in the hypothalamus of ovariectomized rats treated with estradiol for periods up to 12 weeks. Compared to ovariectomized controls, estradiol treatment resulted in significantly reduced CRF-ir after 3 and 12 weeks, although no significant change was seen after 8 weeks. Anterior pituitary (AP) weight was greatly increased by estradiol treatment at all time points studied. Bromocriptine treatment for the last 3 weeks of the 12-week period, or removal of estradiol for 3 weeks after 9 weeks of treatment did not reverse the changes in CRF-ir even though significant regressions of tumor size was achieved. There was no correlation between AP weight and CRF-ir in individual animals. These data show that chronic treatment with estrogen reduced hypothalamic CRF-ir content. Neither a direct estrogenic effect or an indirect effect mediated through alterations in the adenohypophysis could be ruled out. 21 references, 3 figures.

  4. Effects of cysteamine on the hypothalamic-pituitary axis in the rat

    Energy Technology Data Exchange (ETDEWEB)

    McComb, D.J.; Cairns, P.D.; Kovacs, K.; Szabo, S.

    1985-06-01

    The effects of cysteamine (CSH) on hypothalamic concentrations of neuropeptides were reviewed and correlated with available information on changes in pituitary hormone content and circulating pituitary hormone levels. In our study, we found notable changes in the morphology of lactotropes from female Long-Evans rats treated for 7 days with CSH (300 mg/(kg X day) per os). Forming granules increased in number, and crinophagy, which is the augmented incorporation of these granules into lysosomes, was evident. Storage granules were reduced in number. These changes were not suppressed by simultaneous administration of 17 beta-estradiol (50 micrograms/day s.c.) for 7 days. CSH administration failed to prevent estrogen-induced lactotrope hyperplasia. Serum prolactin levels were unaffected by CSH treatment. The morphological changes in the adenohypophysis did not resemble those observed when rats were treated with bromocriptine. The rough endoplasmic reticulum luminal density was reduced in gonadotropes from intact CSH-treated rats after 1 wk. CSH treatment suppressed the development of castration cells and significantly reduced serum luteinizing hormone levels in ovariectomized rats. The morphological effects of CSH appeared to be confined to lactotropes and gonadotropes.

  5. Morphologic effects of cysteamine on the rat adenohypophysis

    Energy Technology Data Exchange (ETDEWEB)

    Cairns, P.D.; McComb, D.J.; Horvath, E.; Kovacs, K.; Milligan, J.V.; Szabo, S.

    1984-12-01

    In pituitary lactotrophs of female Sprague-Dawley rats given cysteamine (300 mg/kg, per os/day) for 7 days, forming granules were increased in number and contained many separate electron-dense structures suggesting crinophagy. Compared to control values, cysteamine treatment caused no change in blood prolactin (PRL) levels, measured by radioimmunoassay (RIA). 17 beta-Estradiol (50 micrograms, sc/day) for 7 days, induced lactotroph hyperplasia and increased blood PRL levels which were unaffected by simultaneous cysteamine administration. The ultrastructural changes did not reflect those due to bromocriptine suppression of secretory activity, and supported the concept that cysteamine altered lactotroph morphology by an unknown mechanism. In pituitary gonadotrophs following cysteamine treatment, increased electron lucency of luminal contents of dilated rough endoplasmic reticulum was noted; however, blood luteinizing hormone (LH) levels did not differ from those of control values. In ovariectomized rats, cysteamine suppressed castration cell formation and reduced blood LH levels, suggesting an interference with the cell's ability to respond to GnRH stimulation. The morphologic effects of cysteamine appeared to be selective to lactotrophs and gonadotrophs, and were not secondary to vascular impairment, as capillary endothelial cells were undamaged.

  6. Primary radiotherapy of prolactinomas. Eight- to 15-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Mehta, A.E.; Reyes, F.I.; Faiman, C.

    1987-07-01

    Eight women with amenorrhea, galactorrhea, and hyperprolactinemia, of whom six had macroadenomas and two had microadenomas, were treated with conventional (cobalt-60) external radiotherapy, and their progress was monitored for eight to 15 years. Normoprolactinemia was established in five of these patients after two to 13 years (median, nine years). A recurrence was treated surgically in one patient, and stable prolactin values and roentgenographic features have been maintained in two patients. Hypopituitarism has developed in only one patient to date, and no other complications of radiotherapy have been observed. These findings, together with the few previous reports on the long-term effects of radiotherapy on macroprolactinomas, have been compared with the long-term results following surgery or dopamine agonist therapy. The normalization of prolactin values is considerably delayed following radiotherapy compared with the other two therapeutic modalities. However, radiotherapy affords permanent normalization without recurrence in a larger percentage of patients than does surgery and avoids the considerable ongoing cost and inconvenience of daily drug ingestion. The long-term development of hypopituitarism appears to be an acceptably small risk of radiotherapy. Thus, conventional radiotherapy is an attractive treatment option, particularly for macroprolactinomas; adjunctive bromocriptine can be used while awaiting the longer-term benefits of radiotherapy.

  7. Therapie des frühen Morbus Parkinson

    Directory of Open Access Journals (Sweden)

    Gerschlager W

    2004-01-01

    Full Text Available Levodopa ist weiterhin der Goldstandard in der Therapie des M. Parkinson. Allerdings führt eine Langzeittherapie mit Levodopa bei vielen Patienten zu motorischen Komplikationen. Experimentelle Studien haben gezeigt, daß eine pulsatile Stimulation der Dopaminrezeptoren zur Entwicklung von motorischen Komplikationen beiträgt. Eine initiale Monotherapie mit Dopaminagonisten (DA wie Cabergolin, Pergolid, Pramipexol oder Ropinirol führt, bei 2- bis 5jährigen Therapieverläufen, seltener zum Auftreten von motorischen Komplikationen. 10-Jahres-Daten einer unlängst publizierten randomisierten Studie zeigen, daß Patienten, die initial mit Levodopa behandelt wurden, signifikant häufiger motorische Komplikationen entwickeln, als Patienten, die zuerst auf Bromocriptin eingestellt wurden, allerdings treten klinisch relevante mäßige oder starke Dyskinesien in beiden Gruppen gleich häufig auf. Außerdem zeigten alle randomisierten Vergleichsstudien einer frühen Levodopatherapie versus einer Initialtherapie mit einem DA eine bessere symptomatische Wirksamkeit von Levodopa. Weiterhin wird eine initiale Monotherapie mit DA empfohlen. Erst wenn keine befriedigende Kontrolle der motorischen Symptome durch eine Monotherapie mit DA erreicht wird, sollte zusätzlich Levodopa gegeben werden. Bei über siebzigjährigen Patienten ist der Einsatz von DA sorgfältig abzuwägen. Falls keine wesentliche Komorbidität, keine Demenz und keine Anamnese von psychiatrischen Symptomen (z. B. medikamenteninduzierte Psychose vorliegt, kann auch in dieser Subgruppe eine initiale Monotherapie mit DA erfolgen.

  8. A systematic review on clinical management of antipsychotic-induced sexual dysfunction in schizophrenia

    Directory of Open Access Journals (Sweden)

    Anna Maria Niccolai Costa

    Full Text Available INTRODUCTION: Sexual dysfunction frequently occurs in patients with schizophrenia under antipsychotic therapy, and the presence of sexual side effects may affect compliance. The aim of this study was to review and describe clinical findings relating to the appropriate management of such dysfunctions. MATERIAL AND METHODS: The research was carried out through Medline (from 1966 to March 2005, PsycInfo (from 1974 to March 2005, and Cochrane Library (from 1965 to March 2005 and included any kind of study, from case reports to randomized trials. RESULTS: The most common sexual dysfunctions found in the literature were libido decrease, difficulties in achieving and maintaining erection, ejaculatory dysfunction, orgasmic dysfunction, and menstrual irregularities. Thirteen papers were found: eight of them were open-label studies, four were descriptions of cases, and only one was a randomized clinical trial. All of them were short-term and had small sample sizes. The agents used were: bromocriptine, cabergoline, cyproheptadine, amantadine, shakuyaku-kanzo-to, sildenafil and selegiline. DISCUSSION: There was no evidence that those agents had proper efficacy in treating the antipsychotic-induced sexual dysfunction. An algorithm for managing sexual dysfunction induced by antipsychotics is suggested as a support for clinical decisions. Since the outcome from schizophrenia treatment is strongly related to compliance with the antipsychotics, prevention of sexual dysfunction is better than its treatment, since there is a scarcity of data available regarding the efficacy of intervention to deal with these problems.

  9. [Toxicity of sulpiride].

    Science.gov (United States)

    Ciszowski, Krzysztof; Szpak, Dorota; Wilimowska, Jolanta

    2010-01-01

    Sulpiride is a benzamide neuroleptic used in the treatment of some psychiatric and gastroenterological disorders. Its antipsychotic, antiautistic, activizing and antidepressive properties result from antagonistic action to dopaminergic D2, D3 and D4 receptors in the central nervous system (CNS). The oral bioavailability of sulpiride is poor and it does not appear to have an extensive first-pass metabolism, nor is it extensively protein-bound. Elimination of sulpiride appears to depend primarily on the kidneys. The acute sulpiride poisoning includes mainly neuropsychiatric (i.e., agitation, hallucinations, and CNS depression) as well as cardiac effects (i.e., hypotension, dysrhythmias, and sinus tachycardia). The life-threatening conditions with sometimes fatal outcome after sulpiride poisoning are prolongation of QTc interval with consequent torsade de pointes (TdP) and neuroleptic malignant syndrome (NMS). The quantitative methods for the measurement of sulpiride blood concentration are not routinely available and the toxic blood concentration is probably higher than 2 mg/L. Treatment of acute sulpiride poisoning includes standard protocols of gastrointestinal decontamination and further symptomatic and supportive measures, among them TdP (magnesium sulphate, isoproterenol, electrotherapy) and NMS treatment (benzodiazepines, bromocriptine, dantrolene, physical cooling).

  10. Daidzin and daidzein suppress free-choice ethanol intake by Syrian golden hamsters.

    Science.gov (United States)

    Keung, W M; Vallee, B L

    1993-11-01

    Syrian Golden hamsters prefer and consume large and remarkably constant amounts of ethanol in a simple two-bottle free-choice regimen. Ethanol intake is significantly suppressed by zimelidine, bromocriptine, buspirone, and lithium carbonate, pharmacological agents that have been shown to be beneficial in controlling ethanol intake in alcohol-dependent humans. These results suggest that this ethanol-drinking animal model has high "predictive validity" and can be used effectively in the search for and identification of new agents for the treatment of alcohol abuse. The model has enabled us to confirm the putative antidipsotropic effect of Radix puerariae (RP), an herb long used in traditional Chinese medicine for the treatment of patients who abuse alcohol. A crude extract of RP at a dose of 1.5 g.kg-1 x day-1 significantly suppresses (> 50%) the free-choice ethanol intake of Golden hamsters. Moreover, two major constituents of RP, daidzein (4',7-dihydroxyisoflavone) and daidzin (the 7-glucoside of daidzein), were also shown to suppress free-choice ethanol intake. Daidzin and daidzein, at doses of 150 and 230 mg.kg-1 x day-1, respectively, suppress ethanol intake by > 50%. RP, daidzein, and daidzin treatment do not significantly affect the body weight and water or food intake of the hamsters. These findings identify a class of compounds that offer promise as safe and effective therapeutic agents for alcohol abuse.

  11. Dopaminergic drug effects during reversal learning depend on anatomical connections between the orbitofrontal cortex and the amygdala.

    Directory of Open Access Journals (Sweden)

    Marieke E. van der Schaaf

    2013-08-01

    Full Text Available Dopamine in the striatum is known to be important for reversal learning. However, the striatum does not act in isolation and reversal learning is also well accepted to depend on the orbitofrontal cortex (OFC and the amygdala. Here we assessed whether dopaminergic drug effects on human striatal BOLD signalling during reversal learning is associated with anatomical connectivity in an orbitofrontal-limbic-striatal network, as measured with diffusion tensor imaging. By using a fibre-based approach, we demonstrate that dopaminergic drug effects on striatal BOLD signal varied as a function of fractional anisotropy (FA in a pathway connecting the OFC with the amygdala. Moreover, our experimental design allowed us to establish that these white-matter dependent drug effects were mediated via D2 receptors. Thus, white matter dependent effects of the D2 receptor agonist bromocriptine on striatal BOLD signal were abolished by co-administration with the D2 receptor antagonist sulpiride. These data provide fundamental insight into the mechanism of action of dopaminergic drug effects during reversal learning. In addition, they may have important clinical implications by suggesting that white matter integrity can help predict dopaminergic drug effects on brain function, ultimately contributing to individual tailoring of dopaminergic drug treatment strategies in psychiatry.

  12. Interactive effects of morphine and dopaminergic compounds on spatial working memory in rhesus monkeys

    Institute of Scientific and Technical Information of China (English)

    Jian-Hong Wang; Joshua Dominie Rizak; Yan-Mei Chen; Liang Li; Xin-Tian Hu; Yuan-Ye Ma

    2013-01-01

    Opiates and dopamine (DA) play key roles in learning and memory in humans and animals.Although interactions between these neurotransmitters have been found,their functional roles remain to be fully elucidated,and their dysfunction may contribute to human diseases and addiction.Here we investigated the interactions of morphine and dopaminergic neurotransmitter systems with respect to learning and memory in rhesus monkeys by using the Wisconsin General Test Apparatus (WGTA) delayed-response task.Morphine and DA agonists (SKF-38393,apomorphine and bromocriptine) or DA antagonists (SKF-83566,haloperidol and sulpiride) were co-administered to the monkeys 30 min prior to the task.We found that dose-patterned co-administration of morphine with D1 or D2 antagonists or agonists reversed the impaired spatial working memory induced by morphine or the compounds alone.For example,morphine at 0.01 mg/kg impaired spatial working memory,while morphine (0.01 mg/kg) and apomorphine (0.01 or 0.06 mg/kg) co-treatment ameliorated this effect.Our findings suggest that the interactions between morphine and dopaminergic compounds influence spatial working memory in rhesus monkeys.A better understanding of these interactive relationships may provide insights into human addiction.

  13. A well-refined in vitro model derived from human embryonic stem cell for screening phytochemicals with midbrain dopaminergic differentiation-boosting potential for improving Parkinson's disease.

    Science.gov (United States)

    Hsieh, Wen-Ting; Chiang, Been-Huang

    2014-07-09

    Stimulation of endogenous neurogenesis is a potential approach to compensate for loss of dopaminergic neurons of substantia nigra compacta nigra (SNpc) in patients with Parkinson's disease (PD). This objective was to establish an in vitro model by differentiating pluripotent human embryonic stem cells (hESCs) into midbrain dopaminergic (mDA) neurons for screening phytochemicals with mDA neurogenesis-boosting potentials. Consequently, a five-stage differentiation process was developed. The derived cells expressed many mDA markers including tyrosine hydroxylase (TH), β-III tubulin, and dopamine transporter (DAT). The voltage-gated ion channels and dopamine release were also examined for verifying neuron function, and the dopamine receptor agonists bromocriptine and 7-hydroxy-2-(dipropylamino)tetralin (7-OH-DPAT) were used to validate our model. Then, several potential phytochemicals including green tea catechins and ginsenosides were tested using the model. Finally, ginsenoside Rb1 was identified as the most potent phytochemical which is capable of upregulating neurotrophin expression and inducing mDA differentiation.

  14. Luteinizing hormone (LH) and prolactin-releasing pituitary tumor: possible malignant transformation of the LH cell line.

    Science.gov (United States)

    Spertini, F; Deruaz, J P; Perentes, E; Pelet, B; Gomez, F

    1986-05-01

    A pituitary tumor was diagnosed in a prepubertal 13-yr-old girl, who had elevated plasma LH (58 mIU/ml) and PRL (93 ng/ml) levels; decreased GH, ACTH, and FSH secretion; and diabetes insipidus. After surgery, plasma LH and PRL declined, but not to normal levels. Conventional external radiotherapy to the pituitary was immediately followed by a decrease in LH to prepubertal values (0.7 mIU/ml), while PRL levels became normal only after a long course of bromocriptine therapy. The pituitary tumor was composed of two distinct cell types: small polygonal cells, which were PRL positive by immunohistochemistry, and clusters of pleomorphic large frequently mitotic polynucleated cells, which were LH positive, some of them also being positive for the alpha-subunit or beta LH but not for beta FSH. Four years after surgery and radiotherapy, the patient deteriorated neurologically. Computed tomographic scan showed widespread frontal and periventricular tumor, which had the histological features of a poorly differentiated carcinoma. No PRL, LH, or alpha- or beta-subunits were detectable on immunocytochemistry. While the PRL-positive cells of the pituitary tumor displayed the histological and clinical features of PRL adenomas, the morphological characteristics of LH cells and the sharp decline of plasma LH levels after radiotherapy were suggestive of malignant transformation. In this context, the later brain tumor could have been the result of subependymal spread of the pituitary tumor after it lost its hormone-secreting capacity.

  15. Male infertility and the present status of its management by drugs

    Directory of Open Access Journals (Sweden)

    Mathur V

    1979-01-01

    Full Text Available Infertility is a common problem and in about 40% of childless couples the husband may also need treatment, alone or alongwith the wife. ln India, however, not much attention has been paid to problems of male fertility and traditionally it is the wife who is primarily held at faith. A proper evaluation of every individual patient and exclusion of surgical conditions like varicocele or obstruction are necessary before starting any drug treatment. No stereotyped regime can succeed for each and every case. Andro-gens, gonadotropins, vitamins A & E, antibiotics and anti-inflam-matory agents are well established modes of therapy, but the dose-schedule has to be carefully determined. Some newer androgens (mesterolone and fIuoxymesterone can be given orally and are very effective in directly stimulating spermatogenesis. Indigenous drugs (Speman can be of considerable help in properly selected cases. The hypothalamic releasing factors (GH-RH, Bromocrip-tine etc. are still on trial but hold-promise for the future. Thyroid, anti-estrogens (Clomiphen, corticosteroids, arginine and vitamin B 12 are of doubtful value only. Excessive smoking and alcohol ought to be discouraged. Since the beneficial effect of treatment could be only short lived, it is essential that the wife′s fertility is simultaneously assured.

  16. Evaluation and management of galactorrhea.

    Science.gov (United States)

    Huang, Wenyu; Molitch, Mark E

    2012-06-01

    Galactorrhea is commonly caused by hyperprolactinemia, especially when it is associated with amenorrhea. Hyperprolactinemia is most often induced by medication or associated with pituitary adenomas or other sellar or suprasellar lesions. Less common causes of galactorrhea include hypothyroidism, renal insufficiency, pregnancy, and nipple stimulation. After pathologic nipple discharge is ruled out, patients with galactorrhea should be evaluated by measurement of their prolactin level. Those with hyperprolactinemia should have pregnancy ruled out, and thyroid and renal function assessed. Brain magnetic resonance imaging should be performed if no other cause of hyperprolactinemia is found. Patients with prolactinomas are usually treated with dopamine agonists (bromocriptine or cabergoline); surgery or radiation therapy is rarely required. Medications causing hyperprolactinemia should be discontinued or replaced with a medication from a similar class with lower potential for causing hyperprolactinemia. Normoprolactinemic patients with idiopathic, nonbothersome galactorrhea can be reassured and do not need treatment; however, those with bothersome galactorrhea usually respond to a short course of a low-dose dopamine agonist.

  17. Gestational Gigantomastia Complicating Pregnancy: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Shadi Rezai

    2015-01-01

    Full Text Available Background. Gestational gigantomastia is a rare disorder without clear etiology or well-established risk factors. Several pathogenic mechanisms contributing to the disease process have been proposed, all of which can lead to a similar phenotype of breast hypertrophy. Case. A 28-year-old Guinean woman presented at 37 weeks of gestation with bilateral gigantomastia, mastalgia, peau d’orange, and back pain. Prolactin levels were 103.3 μg/L (with a normal reference value for prolactin in pregnancy being 36–372 μg/L. The patient was treated with bromocriptine (2.5 mg twice daily, scheduled for a repeat cesarean, and referred to surgery for bilateral mammoplasty. Conclusion. Gestational gigantomastia is a rare disorder, characterized by enlargement and hypertrophy of breast tissue. Our patient presented with no endocrine or hematological abnormalities, adding to a review of the literature for differential diagnoses, workup, and management of cases of gestational gigantomastia with normal hormone levels.

  18. [Hyperprolactinemia and sexual activity of men--clinical aspect].

    Science.gov (United States)

    Medraś, Marek; Jankowska, Ewa Anita

    2004-03-01

    Hyperprolactinemia, particularly resulting from microprolactinoma, is known to induce erectile dysfunction. Contemporary published data do not allow to ascertain which prolactin (PRL) levels result in this type of sexual dysfunctions. The aim of this study was to evaluate the relationship between the extent of hyperprolactinemia and erectile dysfunction in 9 men with microprolactinoma and 8 patients with hyperprolactinemia as side-effects of sulpiride therapy. In all hyperprolactinemic males plasma PRL, LH, FSH and total testosterone levels were measured. The results showed that all patients with iatrogenic hyperprolactinemia were characterised by satisfactory sexual activity, although in 3 men hypotestosteronemia was revealed and in one patient gynecomastia was found. A range of PRL levels was 35-108 ng/ml. Among men with microprolactinoma the capability to lead a satisfactory sexual activity existed, even though in one patient PRL level was 2177 ng/ml, but in 3 other patients importance was observed when PRL concentrations were 281, 195 and 328 ng/ml. After bromocriptine therapy, when PRL levels diminished until 189, 78.3 and 110 ng/ml, the erectile dysfunction disappeared. Authors presume that sexual dysfunctions are not strictly connected with hyperprolactinemia and/or hypotestosterionemia, but probably are conditioned by other unexplicit factors (for example: a heterogeneous structure of PRL complexes).

  19. 中西医结合治疗高催乳素血症不孕症临床分析%Clinical Analysis of Traditional Chinese and Western Medicine Treatment on Infertility Patients with Hyperprolactinemia

    Institute of Scientific and Technical Information of China (English)

    徐碧红; 李茂清

    2012-01-01

    目的:观察中西医治疗高催乳素血症不孕症患者43例的的临床疗效.方法:将86例高催乳素不孕症患者,随机分为对照组、治疗组两组.对照组43例患者给予溴隐亭治疗,治疗组加服自拟疏肝补肾汤,连服3个月.观察两组患者的临床疗效、性激素[包括催乳素(PRL)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、孕酮(P)、睾酮(T)]水平,临床症状积分及妊娠情况等.结果:治疗组、对照组的临床疗效95.3%、79.1%;治疗后两组均可降低PRL水平,提高E2、P水平(P>0.05);但治疗组在临床症状改善方面明显优于对照组(P<0.05);治疗组妊娠率显著高于对照组(P<0.05).结论:中西医治疗高催乳素血症不孕症具有良好的疗效,可改善患者临床症状,提高妊娠率,减少溴隐亭的不良反应,值得临床推广应用.%Objective: To observe the effect of traditional Chinese and western medicine treatment on 43 infertility patients with hyperprolactinemia. Methods;S6 patients of infertility with high prolaetin were randomly divided into control group and treatment group. 43 patients in the control group were given bromocriptine,the treatment group also took liver -soothing and kidney - nourishing decoction for 3 months. The clinical efficacy, sex hormones (including PRL,LH,FSH, E2, P, T) levels, clinical symptom score and pregnancy rate were observed. Results: The clinical efficacy of treatment group and control group were 95. 3% and 79. 1 % ;after treatment the two groups could reduce PRL levels effectively and improve E2,P levels( P >0. 05 ) ;but in the treatment groups clinical symptoms improvement were better than that in the control group( P <0.05) ;the pregnancy rate of treatment group was significantly higher than that of the control group( P <0.05). Conclusion: Traditional Chinese and western medicine treatment has good curative effect on infertility patients with hyperprolactinemia and can improve clinical

  20. Dopamine, T cells and multiple sclerosis (MS).

    Science.gov (United States)

    Levite, Mia; Marino, Franca; Cosentino, Marco

    2017-03-10

    Dopamine is a key neurotransmitter that induces critical effects in the nervous system and in many peripheral organs, via 5 dopamine receptors (DRs): D1R-D5R. Dopamine also induces many direct and very potent effects on many DR-expressing immune cells, primarily T cells and dendritic cells. In this review, we focus only on dopamine receptors, effects and production in T cells. Dopamine by itself (at an optimal concentration of~0.1 nM) induces multiple function of resting normal human T cells, among them: T cell adhesion, chemotactic migration, homing, cytokine secretion and others. Interestingly, dopamine activates resting effector T cells (Teffs), but suppresses regulatory T cells (Tregs), and both effects lead eventually to Teff activation. Dopamine-induced effects on T cells are dynamic, context-sensitive and determined by the: T cell activation state, T cell type, DR type, and dopamine concentration. Dopamine itself, and also few dopaminergic molecules/ drugs that are in clinical use for cardiac, neurological and other non-immune indications, have direct effects on human T cells (summarized in this review). These dopaminergic drugs include: dopamine = intropin, L-DOPA, bromocriptine, pramipexole, pergolide, haloperidol, pimozide, and amantadine. Other dopaminergic drugs were not yet tested for their direct effects on T cells. Extensive evidence in multiple sclerosis (MS) and experimental autoimmune encephalomyelitis (EAE) show dopaminergic dysregulations in T cells in these diseases: D1-like DRs are decreased in Teffs of MS patients, and dopamine does not affect these cells. In contrast, D1-like DRs are increased in Tregs of MS patients, possibly causing functional Treg impairment in MS. Treatment of MS patients with interferon β (IFN-β) increases D1-like DRs and decreases D2-like DRs in Teffs, decreases D1-like DRs in Tregs, and most important: restores responsiveness of patient's Teffs to dopamine. DR agonists and antagonists confer some benefits in

  1. 利培酮致恶性综合征1例%One Case of Neuroleptic Malignant Syndrome Caused by Risperidone

    Institute of Scientific and Technical Information of China (English)

    孙振晓; 孙宇新; 于相芬

    2016-01-01

    1例66岁女性器质性精神障碍患者应用利培酮0.5 mg,bid,7天后增至3 mg/d,108天后出现发热,意识模糊,肌强直、多汗、心动过速、尿潴留、呼吸加快,血压波动性大,血清肌酸激酶949.4 U/L。经停用利培酮,持续心电监护,吸氧,保持呼吸道通畅,持续导尿,给予营养支持,输液,纠正水、电解质及酸碱平衡,应用抗生素控制感染,并给予多巴胺激动剂溴隐亭治疗,14天后症状缓解。%A 66-year-old female patient with organic mental disorders was treated with risperidone at a dosage of 0 . 5 mg by oral route , twice a day for 7 d while the dosage increased gradually to 3 mg/d . The patient devel-oped fever , unconsciousness , rigidity , sweating , tachycardia , urinary retention , tachypnea , blood pressure variability 108 d after treatment , of whom the blood creatine kinase (CPK)level was 949 . 4 U/L . Risperidone was withdrawn , and the patient was given continuous oxygen inhalation , electrocardiographic monitoring and urinary catheterization , of whom the respiratory tract was kept unobstructed . Supportive treatments such as fluid infusion , correction of water electrolyte and acid base imbalance , and infection prevention were also given . Meanwhile , the patient was treated with dopamine receptor agonist bromocriptine , and the symptoms were relieved 14 d later .

  2. [Equine Cushing syndrome (ECS). Case report, review of its diagnosis and therapy and substantial differences from Cushing syndrome in dogs].

    Science.gov (United States)

    Fey, K; Jonigkeit, E; Moritz, A

    1998-02-01

    Equine and canine Cushing's syndrome, both of which are the result of elevated cortisol levels, show some different pathogenetical and clinical features and require different therapeutical approaches. In older horses the equine Cushing's syndrome (ECS) is not uncommon. Nearly all cases result from excessive hormone production in cells of the pars intermedia of the pituitary. Besides elevated levels of adrenocorticotrope hormone (ACTH), high peripheral levels of pro-opiomelanocortin, beta-endorphines and alpha-melanocyte-stimulating hormone can be measured. In middle-aged and geriatric dogs, Cushing's syndrome is the most frequently diagnosed endocrinologic abnormality. 80-85% of cases are pituitary-dependent and 15-20% are caused by cortisol producing tumors of the adrenals. 90% of pituitary lesions can be identified as adenomas, which are localised in most cases in the pars distalis of the gland, but may occur rarely in the pars intermedia, too. Clinical symptoms in both species are characterised by wasting despite good appetite or polyphagia, reduction of muscle mass with altered fat deposition and lethargy. Whereas polydipsia/polyuria is a very common feature in dogs with Cushing's syndrome, in horses it is almost invariably a sign of concurrent secondary diabetes mellitus. A typical symptom in ECS is a continuously growing haircoat (hirsutism), whereas in canine Cushing's syndrome generalised alopecia may bring the owner to consult a veterinarian. The symptoms and diagnostic procedures in a 33-year-old mare are described. Useful diagnostic tests are reviewed with special attention to species differences in reacting to them. The therapeutic approach with dopamine-agonists such as bromocriptine and pergolide as well as cyproheptadine to ECS is reviewed.

  3. Parkinson’s Disease: From Pathogenesis to Pharmacogenomics

    Science.gov (United States)

    Cacabelos, Ramón

    2017-01-01

    Parkinson’s disease (PD) is the second most important age-related neurodegenerative disorder in developed societies, after Alzheimer’s disease, with a prevalence ranging from 41 per 100,000 in the fourth decade of life to over 1900 per 100,000 in people over 80 years of age. As a movement disorder, the PD phenotype is characterized by rigidity, resting tremor, and bradykinesia. Parkinson’s disease -related neurodegeneration is likely to occur several decades before the onset of the motor symptoms. Potential risk factors include environmental toxins, drugs, pesticides, brain microtrauma, focal cerebrovascular damage, and genomic defects. Parkinson’s disease neuropathology is characterized by a selective loss of dopaminergic neurons in the substantia nigra pars compacta, with widespread involvement of other central nervous system (CNS) structures and peripheral tissues. Pathogenic mechanisms associated with genomic, epigenetic and environmental factors lead to conformational changes and deposits of key proteins due to abnormalities in the ubiquitin–proteasome system together with dysregulation of mitochondrial function and oxidative stress. Conventional pharmacological treatments for PD are dopamine precursors (levodopa, l-DOPA, l-3,4 dihidroxifenilalanina), and other symptomatic treatments including dopamine agonists (amantadine, apomorphine, bromocriptine, cabergoline, lisuride, pergolide, pramipexole, ropinirole, rotigotine), monoamine oxidase (MAO) inhibitors (selegiline, rasagiline), and catechol-O-methyltransferase (COMT) inhibitors (entacapone, tolcapone). The chronic administration of antiparkinsonian drugs currently induces the “wearing-off phenomenon”, with additional psychomotor and autonomic complications. In order to minimize these clinical complications, novel compounds have been developed. Novel drugs and bioproducts for the treatment of PD should address dopaminergic neuroprotection to reduce premature neurodegeneration in addition to

  4. Positron emission tomography (PET) study of patients with pituitary adenoma using labeled amino acid

    Energy Technology Data Exchange (ETDEWEB)

    Mineura, Katsuyoshi; Sasajima, Toshio; Sakamoto, Tetsuya; Kowada, Masayoshi (Akita Univ. (Japan). Hospital); Shishido, Fumio; Uemura, Kazuo

    1989-12-01

    Four cases with pituitary adenomas were studied using {sup 11}C-L-methionine (C-11 Met) positron-emission tomography (PET). The C-11 Met was intravenously administered at a dose of 0.6 mCi/kg. The uptake of the tracer for tumors was calculated on the PET images 45 min after the injection; the uptake index was represented as a percentage of the total count in the arterial blood over a period of 45 min. In all cases, the C-11 Met accumulated intensely in the tumor regions; the PET images clearly delineated the extent of the tumor. The C-11 Met uptake index for pituitary adenomas varied widely from 3.94 x 10{sup -2}% to 15.36 x 10{sup -2}%, with a mean of 7.87 x 10{sup -2}%. These indices for the tumors increased markedly in comparison with that of the contralateral left temporal gray matter as a nontumor region (1.89 x 10{sup -2}% to 2.43 x 10{sup -2}% with a mean of 2.06 x 10{sup -2}%). In a case of prolactinoma, repeated PET following bromocriptine treatment showed a decrease in the C-11 Met uptake index; this decrease reflected changes in the serum prolactin value. In another case with ACTH-producing adenoma, the T/NT (tumor/nontumor) ratio fell from 3.44 to 2.40; however, the C-11 Met index remained unchanged. C-11 Met PET images facilitate determining the extent of pituitary adenomas and the monitoring of tumor response to treatment. Further application may give useful knowledge on the amino-acid metabolism of the tumor. (author).

  5. Prolactinoma and pregnancy: From the wish of conception to lactation.

    Science.gov (United States)

    Maiter, Dominique

    2016-06-01

    Prolactinoma is a common cause of infertility in young women and treatment with dopamine agonists (DA) allows restoration of fertility in over 90% of the cases. Both bromocriptine and cabergoline have shown a good safety profile when administered during early pregnancy. In particular, data on exposure of the fetus or embryo to cabergoline during the first weeks of pregnancy have now been reported in more than 900 cases, and do indicate that cabergoline is safe in this context. There is no increase in the frequency of spontaneous miscarriage, premature delivery, multiple births or neonatal malformations, and follow-up studies of the children for up to 12years after fetal exposure to cabergoline did not show any physical or developmental abnormalities. These women should therefore continue DA treatment until pregnancy has been initiated. Treatment discontinuation is recommended at that time in women with microprolactinoma or non-compressive macroprolactinoma. For microprolactinomas, the risk of symptomatic tumour enlargement during pregnancy is very low (2-3%). It is higher for macroprolactinomas (20-30%) and careful follow-up is advised, including MRI without contrast injection if symptoms or visual disturbances develop. If a symptomatic tumour enlargement does occur, reinitiation of the dopamine agonist (BRC or CAB) is indicated rather than surgery. Breast-feeding has no harmful effect on tumour growth and DA treatment, if still needed, may be postponed as long as breast-feeding is desired. Finally, about 40% of women with a microprolactinoma or an intermediate size macroprolactinoma may be in prolonged remission after one or more pregnancies.

  6. Oxytocin and dopamine stimulate ghrelin secretion by the ghrelin-producing cell line, MGN3-1 in vitro.

    Science.gov (United States)

    Iwakura, Hiroshi; Ariyasu, Hiroyuki; Hosoda, Hiroshi; Yamada, Go; Hosoda, Kiminori; Nakao, Kazuwa; Kangawa, Kenji; Akamizu, Takashi

    2011-07-01

    To understand the physiological role of ghrelin, it is crucial to study both the actions of ghrelin and the regulation of ghrelin secretion. Although ghrelin actions have been extensively revealed, the direct factors regulating ghrelin secretion by ghrelin-producing cells (X/A-like cells), however, is not fully understood. In this study, we examined the effects of peptide hormones and neurotransmitters on in vitro ghrelin secretion by the recently developed ghrelin-producing cell line MGN3-1. Oxytocin and vasopressin significantly stimulated ghrelin secretion by MGN3-1 cells. Because MGN3-1 cells express only oxytocin receptor mRNA, not vasopressin receptor mRNA, oxytocin is the likely regulator, with the effect of vasopressin mediated by a cross-reaction. We also discovered that dopamine stimulates ghrelin secretion from MGN3-1 cells in a similar manner to the previously known ghrelin stimulators, epinephrine and norepinephrine. MGN3-1 cells expressed mRNA encoding dopamine receptors D1a and D2. The dopamine receptor D1 agonist fenoldopam stimulated ghrelin secretion, whereas the D2, D3 agonist bromocriptine did not. Furthermore, the D1 receptor antagonist SKF83566 attenuated the stimulatory effect of dopamine. These results indicate that the stimulatory effect of dopamine on ghrelin secretion is mediated by the D1a receptor. In conclusion, we identified two direct regulators of ghrelin, oxytocin and dopamine. These findings will provide new direction for further studies seeking to further understand the regulation of ghrelin secretion, which will in turn lead to greater understanding of the physiological role of ghrelin.

  7. Dopamine D2 receptor-mediated Akt/PKB signalling: initiation by the D2S receptor and role in quinpirole-induced behavioural activation.

    Science.gov (United States)

    Chen, Han-Ting; Ruan, Nan-Yu; Chen, Jin-Chung; Lin, Tzu-Yung

    2012-09-24

    The short and long isoforms of the dopamine D2 receptor (D2S and D2L respectively) are highly expressed in the striatum. Functional D2 receptors activate an intracellular signalling pathway that includes a cAMP-independent route involving Akt/GSK3 (glycogen synthase kinase 3). To investigate the Akt/GSK3 response to the seldom-studied D2S receptor, we established a rat D2S receptor-expressing cell line [HEK (human embryonic kidney)-293/rD2S]. We found that in HEK-293/rD2S cells, the D2/D3 agonists bromocriptine and quinpirole significantly induced Akt and GSK3 phosphorylation, as well as ERK1/2 (extracellular-signal-regulated kinase 1/2) activation. The D2S receptor-induced Akt signals were profoundly inhibited by the internalization blockers monodansyl cadaverine and concanavalin A. Activation of the D2S receptor in HEK-293/rD2S cells appeared to trigger Akt/phospho-Akt translocation to the cell membrane. In addition to our cell culture experiments, we studied D2 receptor-dependent Akt in vivo by systemic administration of the D2/D3 agonist quinpirole. The results show that quinpirole evoked Akt-Ser473 phosphorylation in the ventral striatum. Furthermore, intra-accumbens administration of wortmannin, a PI3K (phosphoinositide 3-kinase) inhibitor, significantly suppressed the quinpirole-evoked behavioural activation. Overall, we demonstrate that activation of the dopamine D2S receptor stimulates Akt/GSK3 signalling. In addition, in vivo Akt activity in the ventral striatum appears to play an important role in systemic D2/D3 agonist-induced behavioural activation.

  8. Dopamine D2 receptor-mediated Akt/PKB signalling: initiation by the D2S receptor and role in quinpirole-induced behavioural activation

    Directory of Open Access Journals (Sweden)

    Jin‑Chung Chen

    2012-09-01

    Full Text Available The short and long isoforms of the dopamine D2 receptor (D2S and D2L respectively are highly expressed in the striatum. Functional D2 receptors activate an intracellular signalling pathway that includes a cAMP-independent route involving Akt/GSK3 (glycogen synthase kinase 3. To investigate the Akt/GSK3 response to the seldom-studied D2S receptor, we established a rat D2S receptor-expressing cell line [HEK (human embryonic kidney-293/rD2S]. We found that in HEK-293/rD2S cells, the D2/D3 agonists bromocriptine and quinpirole significantly induced Akt and GSK3 phosphorylation, as well as ERK1/2 (extracellular-signal-regulated kinase 1/2 activation. The D2S receptor-induced Akt signals were profoundly inhibited by the internalization blockers monodansyl cadaverine and concanavalin A. Activation of the D2S receptor in HEK-293/rD2S cells appeared to trigger Akt/phospho-Akt translocation to the cell membrane. In addition to our cell culture experiments, we studied D2 receptor-dependent Akt in vivo by systemic administration of the D2/D3 agonist quinpirole. The results show that quinpirole evoked Akt-Ser473 phosphorylation in the ventral striatum. Furthermore, intra-accumbens administration of wortmannin, a PI3K (phosphoinositide 3-kinase inhibitor, significantly suppressed the quinpirole-evoked behavioural activation. Overall, we demonstrate that activation of the dopamine D2S receptor stimulates Akt/GSK3 signalling. In addition, in vivo Akt activity in the ventral striatum appears to play an important role in systemic D2/D3 agonist-induced behavioural activation.

  9. A Case Report of Catatonia and Neuroleptic Malignant Syndrome With Multiple Treatment Modalities: Short Communication and Literature Review.

    Science.gov (United States)

    Chiou, Yu-Jie; Lee, Yu; Lin, Chin-Chuen; Huang, Tiao-Lai

    2015-10-01

    We describe a case with complicated clinical presentations who was difficult to treat. We described the possible etiologies and differential diagnosis of neuroleptic malignant syndrome (NMS), catatonia, and infection, in details. This patient was also referred to neuro-intensive care unit for extensive workup and treatments by neurologist guidelines. In addition, we also used lorazepam-diazepam protocol and antipsychotics, but both failed to completely relieve her symptoms. She eventually responded to electroconvulsive therapy (ECT).A 60-year-old female patient with schizophrenia was diagnosed to suspected pneumonia, urinary tract infection, and retarded catatonia at first. The brain computed tomography revealed no significant finding. She developed NMS caused by the administration of low-dose quetiapine (200 mg) after carbamazepine was discontinued. The Francis-Yacoub NMS rating scale (F-Y scale) total score was 90. We utilized lorazepam-diazepam protocol and prescribed bromocriptine and amantadine, but NMS was not improved. Meanwhile, we arranged the brain magnetic resonance imaging to survey the physical problem, which revealed agenesis of septum pellucidum and dilated lateral ventricles. She was then transferred to the neuro-intensive care unit on the 15th hospital day for complete study. The results of cerebrospinal fluid study and electroencephalography were unremarkable. She was transferred back to psychiatric ward on the 21st hospital day with residual catatonic and parkinsonian symptoms of NMS, and the F-Y scale total score was 63. Finally, her residual catatonic condition that followed NMS got improved after 11 sessions of ECT. On the 47th hospital day, the F-Y scale total score was 9.This report underscores that the ECT is an effective treatment for a patient of NMS when other treatments have failed.

  10. [How to manage a patient with chronic arterial hypertension during pregnancy and the postpartum period].

    Science.gov (United States)

    Pourrat, O

    2015-03-01

    The management of chronic arterial hypertension during pregnancy and postpartum requires first to estimate the risk of the pregnancy, linked with the severity of hypertension, with cardiac and renal involvement, with its cause as well as with the background (obesity, diabetes, possible history of placental vascular pathology). On a very practical approach, antihypertensive drug has to be started or increased if systolic pressure reaches or exceeds 160 mmHg or if diastolic pressure reaches or exceeds 105 mmHg. Below this level, there are no evidence-based medicine data, but it seems reasonable to treat if pressure increases over 150/100 mmHg (140/90 mmHg in case of ambulatory monitoring). Excessive pressure figures control must be avoided as much as insufficient ones: in practice, it is necessary to decrease the treatment dose if figures are below 130/80 mmHg. Three antihypertensive drugs are consensually recommended today: alphametyldopa, calcium-channel blockers and labetalol. Monotherapy is most often sufficient; if needed, two of these drugs can easily be associated, and even three if necessary. Converting enzyme inhibitors and angiotensin receptor II antagonists should not be prescribed to pregnant women. Betablockers and diuretics are not recommended. Whatever is the antihypertensive drug used, it is necessary to detect the signs of bad placenta blood circulation with uterine Doppler ultrasound and regular controls of fetal growth, and to check for appearance of proteinuria, defining then over-imposed pre-eclampsia needing immediate admission to the maternity. After delivery, lacatation suppresion with bromocriptin should not be prescribed.

  11. 女性脊髓损伤后高催乳素血症的研究进展%Hyperprolactinemia in Female Patients with Spinal Cord Injury (review)

    Institute of Scientific and Technical Information of China (English)

    英小倩; 张军卫

    2016-01-01

    Some female spinal cord injured patients may present a raise of serum prolactin which is irrelevant with pregnancy, and re-sults in irregular menstruation and galactorrhea. Hyperprolactinemia may even happen in men after spinal cord injury. This kind of hyperpro-lactinemia does not relate with the level or severity of spinal cord injury, and maintains for various time. The hypersensitivity to thyrotro-pin-releasing hormone may relate to the elevatory serum prolactin and amenorrhea. In addition, there are some suspicious factors, such as chest wall injury, pituitary body contusion, enkephalins increasing, the stimulation of spinal neural pathways, stress, and so on. Bromocripti-ne has been tried for it.%部分非妊娠期女性脊髓损伤患者伤后出现与妊娠无关的血浆催乳素水平升高,表现为不同程度的月经异常、溢乳;部分男性脊髓损伤后也会出现.这种高催乳素血症与脊髓损伤的节段及损伤程度无关,且持续时间各不相同.脊髓损伤后催乳素增高及闭经可能与伤后对促甲状腺激素释放激素反应增强有关.另外,胸部损伤、垂体挫伤、脑内啡肽升高、脊髓神经通路的刺激、应激等都是可疑因素.溴隐亭治疗可能有效.

  12. Pharmacological treatment of neurobehavioural sequelae of traumatic brain injury.

    Science.gov (United States)

    Lombardi, F

    2008-01-01

    Neurobehavioural sequelae of traumatic brain injuries require an appropriate/effective pharmacological response in that they represent an important cause of disability. In this field, there is no evidence that reaches the level of a standard: there are guidelines on the use of methylphenidate, donepezil and bromocriptine for the treatment of cognitive disturbances, for the non-use of phenytoin and for the use of beta-blockers for controlling aggressiveness. Resolving a single symptom is not relevant in a rehabilitation project if it is not in the context of a more complex picture of neurobehavioural recovery, in which the positive and negative effects of every therapeutic choice are considered. For example, phenytoin could be used for the positive control of epileptic crises but is not advised since it impedes the recovery of cognitive functions in general. Analogous effects not yet identified may concern benzodiazepine, neuroleptics and other sedatives usually prescribed in cases of cranial trauma. Psychotropic drugs are considered to be able to influence the neuronal plasticity processes. Studies on animals have shown that the administration of D-amphetamine combined with sensorial-motor exercise produces the steady acceleration of motor recovery, which acts as a catalyst to the neurological recovery process. On the other hand, alpha1-NA receptor antagonist drugs produce negative effects; these include clonidine (antihypertension) and haloperidol (neuroleptic). Studies need to be carried out to evaluate the effectiveness of particular drugs. These studies need to focus not only on the disappearance of symptoms but also on the positive and negative effects on overall rehabilitation and on the neurobiological recovery of the patient.

  13. Obesity-resistant S5B rats showed great cocaine conditioned place preference than the obesity-prone OM rats

    Energy Technology Data Exchange (ETDEWEB)

    Thanos, P.K.; Wang, G.; Thanos, P.K..; Kim, R.; Cho, J.; Michaelides, M.; Anderson, B.J.; Primeaux, S.D.; Bray, G.A.; Wang, G.-J.; Robinson, J.K.; Volkow, N.D.

    2010-12-01

    Dopamine (DA) and the DA D2 receptor (D2R) are involved in the rewarding and conditioned responses to food and drug rewards. Osborne-Mendel (OM) rats are genetically prone and S5B/P rats are genetically resistant to obesity when fed a high-fat diet. We hypothesized that the differential sensitivity of these two rat strains to natural rewards may also be reflected in sensitivity to drugs of abuse. Therefore, we tested whether OM and S5B/P rats showed a differential preference to cocaine using conditioned place preference (CPP). To also evaluate whether there is specific involvement of the D2R in this differential conditioning sensitivity, we then tested whether the D2R agonist bromocriptine (BC) would differentially affect the effects of cocaine in the two strains. OM and S5B/P rats were conditioned with cocaine (5 or 10 mg/kg) in one chamber and saline in another for 8 days. Rats were then tested for cocaine preference. The effects of BC (0.5, 1, 5, 10, 20 mg/kg) on cocaine preference were then assessed in subsequent test sessions. OM rats did not show a significant preference for the cocaine-paired chamber on test day. Only the S5B/P rats showed cocaine CPP. Later treatment with only the highest dose of BC resulted in reduced cocaine CPP in S5B/P rats when treated with 5 mg/kg cocaine and in OM rats treated with 10 mg/kg cocaine. Our results indicated that obesity-resistant S5B rats showed greater cocaine CPP than the obesity-prone OM rats. These findings do not support a theory of common vulnerability for reinforcer preferences (food and cocaine). However, they show that BC reduced cocaine conditioning effects supporting at least a partial regulatory role of D2R in conditioned responses to drugs.

  14. "Hyperglutamatergic cortico-striato-thalamo-cortical circuit" breaker drugs alleviate tics in a transgenic circuit model of Tourette׳s syndrome.

    Science.gov (United States)

    Nordstrom, Eric J; Bittner, Katie C; McGrath, Michael J; Parks, Clinton R; Burton, Frank H

    2015-12-10

    The brain circuits underlying tics in Tourette׳s syndrome (TS) are unknown but thought to involve cortico/amygdalo-striato-thalamo-cortical (CSTC) loop hyperactivity. We previously engineered a transgenic mouse "circuit model" of TS by expressing an artificial neuropotentiating transgene (encoding the cAMP-elevating, intracellular A1 subunit of cholera toxin) within a small population of dopamine D1 receptor-expressing somatosensory cortical and limbic neurons that hyperactivate cortico/amygdalostriatal glutamatergic output circuits thought to be hyperactive in TS and comorbid obsessive-compulsive (OC) disorders. As in TS, these D1CT-7 ("Ticcy") transgenic mice׳s tics were alleviated by the TS drugs clonidine and dopamine D2 receptor antagonists; and their chronic glutamate-excited striatal motor output was unbalanced toward hyperactivity of the motoric direct pathway and inactivity of the cataleptic indirect pathway. Here we have examined whether these mice׳s tics are countered by drugs that "break" sequential elements of their hyperactive cortical/amygdalar glutamatergic and efferent striatal circuit: anti-serotonoceptive and anti-noradrenoceptive corticostriatal glutamate output blockers (the serotonin 5-HT2a,c receptor antagonist ritanserin and the NE alpha-1 receptor antagonist prazosin); agmatinergic striatothalamic GABA output blockers (the presynaptic agmatine/imidazoline I1 receptor agonist moxonidine); and nigrostriatal dopamine output blockers (the presynaptic D2 receptor agonist bromocriptine). Each drug class alleviates tics in the Ticcy mice, suggesting a hyperglutamatergic CSTC "tic circuit" could exist in TS wherein cortical/amygdalar pyramidal projection neurons׳ glutamatergic overexcitation of both striatal output neurons and nigrostriatal dopaminergic modulatory neurons unbalances their circuit integration to excite striatothalamic output and create tics, and illuminating new TS drug strategies.

  15. Dopamine inhibits somatolactin gene expression in tilapia pituitary cells through the dopamine D2 receptors.

    Science.gov (United States)

    Jiang, Quan; Lian, Anji; He, Qi

    2016-07-01

    Dopamine (DA) is an important neurotransmitter in the central nervous system of vertebrates and possesses key hypophysiotropic functions. Early studies have shown that DA has a potent inhibitory effect on somatolactin (SL) release in fish. However, the mechanisms responsible for DA inhibition of SL gene expression are largely unknown. To this end, tilapia DA type-1 (D1) and type-2 (D2) receptor transcripts were examined in the neurointermediate lobe (NIL) of the tilapia pituitary by real-time PCR. In tilapia, DA not only was effective in inhibiting SL mRNA levels in vivo and in vitro, but also could abolish pituitary adenylate cyclase-activating polypeptide (PACAP)- and salmon gonadotropin-releasing hormone (sGnRH)-stimulated SL gene expression at the pituitary level. In parallel studies, the specific D2 receptor agonists quinpirole and bromocriptine could mimic the DA-inhibited SL gene expression. Furthermore, the D2 receptor antagonists domperidone and (-)-sulpiride could abolish the SL response to DA or the D2 agonist quinpirole, whereas D1 receptor antagonists SCH23390 and SKF83566 were not effective in this respect. In primary cultures of tilapia NIL cells, D2 agonist quinpirole-inhibited cAMP production could be blocked by co-treatment with the D2 antagonist domperidone and the ability of forskolin to increase cAMP production was also inhibited by quinpirole. Using a pharmacological approach, the AC/cAMP pathway was shown to be involved in quinpirole-inhibited SL mRNA expression. These results provide evidence that DA can directly inhibit SL gene expression at the tilapia pituitary level via D2 receptor through the AC/cAMP-dependent mechanism.

  16. A new mutation in the thyroid hormone receptor gene of a Chinese family with resistance to thyroid hormone

    Institute of Scientific and Technical Information of China (English)

    DONG Qian; GONG Chun-xiu; GU Yi; SU Chang

    2011-01-01

    Background Resistance to thyroid hormone (RTH) is a dominant inherited syndrome of reduced tissue responsiveness to thyroid hormone. It is usually due to mutations located at the ligand-binding domain and adjacent hinge region of the thyroid hormone receptor β(TRβ). We report the clinical and laboratory characteristics and the genetic analysis of a patient with this rare disorder and his family members.Methods The clinical presentations and changes of thyroid function tests (TFTs) including magnetic resonance imaging (MRI) of pituitary and other laboratory tests were analysed. TFTs of his family's members were detected as well. Direct DNA sequencing of the TRβ gene was done for those with abnormal TFTs.Results The RTH child had goiter, irritability, aggressiveness, and sudoresis. His TFTs showed high levels of circulating free thyroid hormones (FT4 and FT3) and normal thyroid-stimulating hormone (TSH) concentrations. He felt worse when treated as hyperthyroidism (Grave disease) with thiamazole and his clinical presentations got improved obviously when treated as RTH with bromocriptine without obvious advert effect. We identified a novel missense mutation, A317D, located in exon 9 of the gene of this boy and his mother. His mother had not any clinical presentation, but having abnormal TFTs results.Conclusions This patient reported here was concordant with the criteria of RTH. The feature is dysfunction of hypothalamus-pituitary-thyroid axis. A novel mutation was found in the TRβ, A317D, of this family. This research verified the phenomena that there is a clinical heterogeneity within the same mutation of different RTH patients.

  17. Lysergic acid diethylamide (LSD) is a partial agonist of D2 dopaminergic receptors and it potentiates dopamine-mediated prolactin secretion in lactotrophs in vitro.

    Science.gov (United States)

    Giacomelli, S; Palmery, M; Romanelli, L; Cheng, C Y; Silvestrini, B

    1998-01-01

    The hallucinogenic effects of lysergic acid diethylamide (LSD) have mainly been attributed to the interaction of this drug with the serotoninergic system, but it seems more likely that they are the result of the complex interactions of the drug with both the serotoninergic and dopaminergic systems. The aim of the present study was to investigate the functional actions of LSD at dopaminergic receptors using prolactin secretion by primary cultures of rat pituitary cells as a model. LSD produced a dose-dependent inhibition of prolactin secretion in vitro with an IC50 at 1.7x10(-9) M. This action was antagonized by spiperone but not by SKF83566 or cyproheptadine, which indicates that LSD has a specific effect on D2 dopaminergic receptors. The maximum inhibition of prolactin secretion achieved by LSD was lower than that by dopamine (60% versus 80%). Moreover, the fact that LSD at 10(-8)-10(-6) M antagonized the inhibitory effect of dopamine (10(-7) M) and bromocriptine (10(-11) M) suggests that LSD acts as a partial agonist at D2 receptors on lactotrophs in vitro. Interestingly, LSD at 10(-13)-10(-10) M, the concentrations which are 10-1000-fold lower than those required to induce direct inhibition on pituitary prolactin secretion, potentiated the dopamine (10(-10)-2.5x10(-9) M)-mediated prolactin secretion by pituitary cells in vitro. These results suggest that LSD not only interacts with dopaminergic receptors but also has a unique capacity for modulating dopaminergic transmission. These findings may offer new insights into the hallucinogenic effect of LSD.

  18. Activation of the dopamine receptor type-2 (DRD2) promoter by 9-cis retinoic acid in a cellular model of Cushing's disease mediates the inhibition of cell proliferation and ACTH secretion without a complete corticotroph-to-melanotroph transdifferentiation.

    Science.gov (United States)

    Occhi, Gianluca; Regazzo, Daniela; Albiger, Nora Maria; Ceccato, Filippo; Ferasin, Sergio; Scanarini, Massimo; Denaro, Luca; Cosma, Chiara; Plebani, Mario; Cassarino, Maria Francesca; Mantovani, Giovanna; Stalla, Günter K; Pecori Giraldi, Francesca; Paez-Pareda, Marcelo; Scaroni, Carla

    2014-09-01

    Cushing's disease (CD) is a rare condition in which hypercortisolemia is secondary to excessive ACTH release from a pituitary corticotroph adenoma. CD is associated with significant morbidity and mortality, and a safe therapy that effectively targets the pituitary tumor is still lacking. Retinoic acid (RA) and dopamine agonists (DAs) have recently been considered as monotherapy in CD patients, and satisfactory results have been reported, albeit in a limited number of patients. Given the permissive role of RA on the dopamine receptor type-2 (DRD2), the aim of the present study was to see whether a combination of 9-cis RA and the DA bromocriptine (Br) might represent a possible treatment for CD. Here we show that 9-cis RA induces a functional DRD2 in the pituitary corticotroph cell line AtT20, and increases cell sensitivity to Br via a mechanism only partially related to corticotroph-to-melanotroph transdifferentiation. In addition, 9-cis RA and Br act synergistically to modulate cell viability, with favorable implications for clinical use. In nearly 45% of corticotropinoma-derived primary cultures, the combined administration of 9-cis RA and Br lowered the steady-state level of the ACTH precursor proopiomelanocortin (POMC) more efficiently than either of the drugs alone. In conclusion, the effects of a combination of 9-cis RA and Br on ACTH synthesis/secretion and cell viability in AtT20, and on POMC transcriptional activity in human corticotropinomas might represent a suitable starting point for assessing the potential of this treatment regimen for ACTH-secreting pituitary adenomas. This study thus has potentially important implications for novel therapeutic approaches to CD.

  19. [Peripartum cardiomyopathy: A multiple entity].

    Science.gov (United States)

    Vanzetto, Gérald; Martin, Alix; Bouvaist, Hélène; Marlière, Stéphanie; Durand, Michel; Chavanon, Olivier

    2012-06-01

    Peripartum cardiomyopathy (PPCMP) is a dilated and hypokinetic cardiomyopathy occurring during pregnancy or after delivery, with an estimated incidence between 1/1000 and 1/4000 births. It has been defined as a new onset of heart failure in the month preceding or following delivery, without demonstrated aetiology nor previously known heart disease, and with echocardiographic evidences of left ventricular (LV) dysfunction (LV ejection fraction<0.45). It's a multifactorial disease, immunologic, hormonal, and possibly viral mechanisms playing a determinant pathophysiological role. The classical clinical presentation is a rapid and unexpected onset of heart failure in a previously healthy woman, echocardiography being the key examination for positive and differential diagnosis, prognostication, therapeutic decision-making, and follow-up. The potential severity of PPCMP, and its unpredictable evolution in the first days following diagnosis, require that patients be referred to a tertiary care centre with a high skill in intensive cardiology care. Therapeutic management of PPCMP does not offer any specificity when compared to other causes of acute or chronic heart failure (from diuretics to extracorporeal life support), except for ACE-inhibitors, that are contraindicated before delivery. The high incidence of thrombo-embolic complications observed in the disease requires however rapid and curative anticoagulation, and immuno-suppressive treatment has been proposed in fulminant and highly inflammatory presentation, but its efficacy remains controversial. Very recently, promising results have been reported with bromocriptin-a prolactin secretion inhibitor-for reducing 6-month morbidity and mortality, but these findings have to be confirmed in larger scale randomised trials. As for the long-term evolution, approximately half of the patients will heal, while half of the women will keep some degree of LV dysfunction, 25% of them developing moderate to severe chronic heart

  20. Peripartum cardiomyopathy: definition, incidence, etiopathogenesis, diagnosis, and management.

    Science.gov (United States)

    Garg, Jalaj; Palaniswamy, Chandrasekar; Lanier, Gregg M

    2015-01-01

    Peripartum cardiomyopathy (PPCM) is a serious pregnancy-associated disorder of unknown etiology. The precise cellular and molecular mechanisms underlying PPCM are unclear. A heightened awareness among health care providers can result in early diagnosis of heart failure in late pregnancy and the early postpartum period. Though the symptoms of dyspnea and fatigue can result from normal physiologic changes during pregnancy, an electrocardiogram and brain natriuretic peptide level should be obtained in these patients, in addition to baseline laboratory tests such as a complete blood count, and basic metabolic and hepatic function panels. If the electrocardiogram and brain natriuretic peptide level are abnormal, an echocardiogram should be obtained. The role of endomyocardial biopsy for the diagnosis of PPCM is controversial. Patients should be started on diuretics if volume overloaded, and beta-blockers (preferably metoprolol) if no contraindications exist; angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy or lactation. There are no standard, universally accepted guidelines for the management of PPCM. Although experimental therapies like bromocriptine, pentoxifylline and immunoglobulins have shown promising results, large double-blind randomized trials are essential to confirm the results of smaller studies. In patients with persistent severe left ventricular (LV) dysfunction, advanced therapies like mechanical circulatory support and heart transplantation should be considered. Owing to recent data demonstrating deterioration of LV systolic function after initial recovery, it is essential to maintain long-term follow up of these patients regardless of initial recovery of LV function. We present a comprehensive review of the literature etiopathogenesis, diagnosis, and management of PPCM.

  1. Diagnostic challenges and management of a patient with acromegaly due to ectopic growth hormone-releasing hormone secretion from a bronchial carcinoid tumour

    Directory of Open Access Journals (Sweden)

    Nikolaos Kyriakakis

    2017-01-01

    Full Text Available A male patient presented at the age of 30 with classic clinical features of acromegaly and was found to have elevated growth hormone levels, not suppressing during an oral glucose tolerance test. His acromegaly was originally considered to be of pituitary origin, based on a CT scan, which was interpreted as showing a pituitary macroadenoma. Despite two trans-sphenoidal surgeries, cranial radiotherapy and periods of treatment with bromocriptine and octreotide, his acromegaly remained active clinically and biochemically. A lung mass was discovered incidentally on a chest X-ray performed as part of a routine pre-assessment for spinal surgery 5 years following the initial presentation. This was confirmed to be a bronchial carcinoid tumour, which was strongly positive for growth hormone-releasing hormone (GHRH and somatostatin receptor type 2 by immunohistochemistry. The re-examination of the pituitary specimens asserted the diagnosis of pituitary GH hyperplasia. Complete resolution of the patient’s acromegaly was achieved following right lower and middle lobectomy. Seventeen years following the successful resection of the bronchial carcinoid tumour the patient remains under annual endocrine follow-up for monitoring of the hypopituitarism he developed after the original interventions to his pituitary gland, while there has been no evidence of active acromegaly or recurrence of the carcinoid tumour. Ectopic acromegaly is extremely rare, accounting for <1% of all cases of acromegaly. Our case highlights the diagnostic challenges differentiating between ectopic acromegaly and acromegaly of pituitary origin and emphasises the importance of avoiding unnecessary pituitary surgery and radiotherapy. The role of laboratory investigations, imaging and histology as diagnostic tools is discussed.

  2. Type 2 Diabetes Mellitus: A Review of Current Trends

    Directory of Open Access Journals (Sweden)

    Abdulfatai B. Olokoba

    2012-07-01

    Full Text Available Type 2 diabetes mellitus (DM is a chronic metabolic disorder in which prevalence has been increasing steadily all over the world. As a result of this trend, it is fast becoming an epidemic in some countries of the world with the number of people affected expected to double in the next decade due to increase in ageing population, thereby adding to the already existing burden for healthcare providers, especially in poorly developed countries. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include type 2 diabetes mellitus, prevalence, current diagnosis, and current treatment. Only articles in English were included. Screening and diagnosis is still based on World Health Organization (WHO and American Diabetes Association (ADA criteria which include both clinical and laboratory parameters. No cure has yet been found for the disease; however, treatment modalities include lifestyle modifications, treatment of obesity, oral hypoglycemic agents, and insulin sensitizers like metformin, a biguanide that reduces insulin resistance, is still the recommended first line medication especially for obese patients. Other effective medications include non-sulfonylurea secretagogues, thiazolidinediones, alpha glucosidase inhibitors, and insulin. Recent research into the pathophysiology of type 2 DM has led to the introduction of new medications like glucagon-like peptide 1 analogoues: dipeptidyl peptidase-IV inhibitors, inhibitors of the sodium-glucose cotransporter 2 and 11ß-hydroxysteroid dehydrogenase 1, insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, metabolic inhibitors of hepatic glucose output and quick-release bromocriptine. Inhaled insulin was licensed for use in 2006 but has been withdrawn from the market because of low patronage.

  3. Direct effect of PGF2α pulses on PRL pulses, based on inhibition of PRL or PGF2α secretion in heifers.

    Science.gov (United States)

    Pinaffi, F L V; Pugliesi, G; Hannan, M A; Silva, L A; Beg, M A; Ginther, O J

    2012-08-01

    The relationships between PRL and PGF(2α) and their effect on luteolysis were studied. Heifers were treated with a dopamine-receptor agonist (bromocriptine; Bc) and a Cox-1 and -2 inhibitor (flunixin meglumine [FM]) to inhibit PRL and PGF(2α), respectively. The Bc was given (Hour 0) when ongoing luteolysis was indicated by a 12.5% reduction in CL area (cm(2)) from the area on Day 14 postovulation, and FM was given at Hours 0, 4, and 8. Blood samples were collected every 8-h beginning on Day 14 until Hour 48 and hourly for Hours 0 to 12. Three groups of heifers in ongoing luteolysis were used: control (n = 7), Bc (n = 7), and FM (n = 4). Treatment with Bc decreased (P PRL concentrations averaged over Hours 1 to 12. During the greatest decrease in PRL (Hours 2-6), LH concentrations were increased. Progesterone concentrations averaged over hours were greater (P PRL concentrations were reduced. Concentrations of PGFM were not reduced in the Bc group, despite the reduction in PRL. Results supported the hypothesis that a decrease (12.5%) in CL area (cm(2)) is more efficient in targeting ongoing luteolysis (63%) than using any day from Days 14 to ≥ 19 (efficiency/day, 10-24%). The hypothesis that PRL has a role in luteolysis was supported but was confounded by the known positive effect of LH on progesterone. The hypothesis was supported that the synchrony of PGFM and PRL pulses represents a positive effect of PGF(2α) on PRL, rather than an effect of PRL on PGF(2α).

  4. Are Dopamine Agonists Neuroprotective in Parkinson‘s disease?

    Institute of Scientific and Technical Information of China (English)

    乐卫东; Jank.J

    2002-01-01

    Dopamine(DA) agonists are playing increasingly important role in the treatment of not only advanced Parkinson's disease(PD) and in PD patient with levodopa(L-DO-PA)-induced motor fluctuations,but also in early treatment of the disease.This shift has been largely due to the demonstrated L-DOPA-sparing effect of DA agonists and their putative neuroprotective effect,based largely on experimental in vitro and in vivo studies.In this article we review the evidence of neuroprotection by DA agonists pramipexole,ropinirole,pergolide,bromocriptine and apomorphine in cell cultures and animal models of nigral injury.Most of the studies suggest that DA agonists exert their neuroprotection via directly scavenging free radicals or increasing the activities of radical-scavenging enzymes,and enhancing neurotrophic activity.The finding that pramipexole can normalize mitochondrial membrane potential and inhibit activity of caspase-3 in cytoylasmic hybrid cells made from mitochondrial DNA of nonfamilial Alzheimer's disease patients,however,suggests even a broader implication for the neuroprotective role of DA agonists.Although the clinical evidence for neuroprotection by DA agonists is still limited,the preliminary results from several on-going clinal trials are promising.Several longitudinal studies are currently in progress designed to demonstrate a delay or slowing of progresion of PD using various surrogate markers of neuronal degeneration such as18F-L-DOPA PET and123I β-CIT SPECT.The results of these experimental and clinical studies will improve our understanding of the action of DA agonists and provide critical information needed for planning future therapeutic strategies in PD and related neurodegenerative disorders.

  5. Are Dopamine Agonists Neuroprotective in Parkinson′s Disease?

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Dopamine (DA) agonists are playing increasingly important role in the treatment of not only advanced Parkinson′s disease (PD) and in PD patient with levodopa (L-DOPA)-induced motor fluctuations,but also in early treatment of the disease.This shift has been largely due to the demonstrated L-DOPA-sparing effect of DA agonists and their putative neuroprotective effect,based largely on experimental in vitro and in vivo studies.In this article we review the evidence of neuroprotection by DA agonists pramipexole,ropinirole,pergolide,bromocriptine and apomorphine in cell cultures and animal models of nigral injury.Most of the studies suggest that DA agonists exert their neuroprotection via directly scavenging free radicals or increasing the activities of radical-scavenging enzymes,and enhancing neurotrophic activity.The finding that pramipexole can normalize mitochondrial membrane potential and inhibit activity of caspase-3 in cytoplasmic hybrid cells made from mitochondrial DNA of nonfamilial Alzheimer′s disease patients,however,suggests even a broader implication for the neuroprotective role of DA agonists.Although the clinical evidence for neuroprotection by DA agonists is still limited,the preliminary results from several on-going clinical trials are promising.Several longitudinal studies are currently in progress designed to demonstrate a delay or slowing of progresion of PD using various surrogate markers of neuronal degeneration such as 18 F-L-DOPA PET and 123 I β-CIT SPECT.The results of these experimental and clinical studies will improve our understanding of the action of DA agonists and provide critical information needed for planning future therapeutic strategies in PD and related neurodegenerative disorders.``

  6. Parkinson’s Disease: From Pathogenesis to Pharmacogenomics

    Directory of Open Access Journals (Sweden)

    Ramón Cacabelos

    2017-03-01

    Full Text Available Parkinson’s disease (PD is the second most important age-related neurodegenerative disorder in developed societies, after Alzheimer’s disease, with a prevalence ranging from 41 per 100,000 in the fourth decade of life to over 1900 per 100,000 in people over 80 years of age. As a movement disorder, the PD phenotype is characterized by rigidity, resting tremor, and bradykinesia. Parkinson’s disease -related neurodegeneration is likely to occur several decades before the onset of the motor symptoms. Potential risk factors include environmental toxins, drugs, pesticides, brain microtrauma, focal cerebrovascular damage, and genomic defects. Parkinson’s disease neuropathology is characterized by a selective loss of dopaminergic neurons in the substantia nigra pars compacta, with widespread involvement of other central nervous system (CNS structures and peripheral tissues. Pathogenic mechanisms associated with genomic, epigenetic and environmental factors lead to conformational changes and deposits of key proteins due to abnormalities in the ubiquitin–proteasome system together with dysregulation of mitochondrial function and oxidative stress. Conventional pharmacological treatments for PD are dopamine precursors (levodopa, l-DOPA, l-3,4 dihidroxifenilalanina, and other symptomatic treatments including dopamine agonists (amantadine, apomorphine, bromocriptine, cabergoline, lisuride, pergolide, pramipexole, ropinirole, rotigotine, monoamine oxidase (MAO inhibitors (selegiline, rasagiline, and catechol-O-methyltransferase (COMT inhibitors (entacapone, tolcapone. The chronic administration of antiparkinsonian drugs currently induces the “wearing-off phenomenon”, with additional psychomotor and autonomic complications. In order to minimize these clinical complications, novel compounds have been developed. Novel drugs and bioproducts for the treatment of PD should address dopaminergic neuroprotection to reduce premature neurodegeneration in

  7. Differential behavioral reinforcement effects of dopamine receptor agonists in the rat with bilateral lesion of the posterior ventral tegmental area.

    Science.gov (United States)

    Ouachikh, Omar; Dieb, Wisam; Durif, Franck; Hafidi, Aziz

    2013-09-01

    Dopamine dysregulation syndrome in Parkinson's disease has been attributed to dopamine replacement therapies and/or a lesion of the dopaminergic system. The dopaminergic neuronal loss targets the substantia nigra and the ventral tegmental area (VTA). We hypothesize that dopamine replacement therapy is responsible for the potential reinforcement effect in Parkinson's disease by acting on the neuronal reward circuitry. Therefore this study was designed to explore the potential motivational effect of dopamine replacement therapy in bilateral VTA-lesioned animals. The posterior (p)VTA, which project to the nucleus accumbens (NAc) constitutes the major dopamine neuronal circuitry implicated in addictive disorders. Using the conditioned place preference (CPP) behavioral paradigm, we investigated the motivational effects of dopamine receptor agonists, and cocaine in rat with a 6-OHDA bilateral lesion of the pVTA. Amongst the dopamine receptor agonists used in this study only the D2R and D3R agonists (bromocriptine, PD128907 and pramipexole), induced a significant CPP in pVTA-lesioned animals. Dopamine receptor agonists did not induce behavioral sensitization in sham animals. Moreover, confocal D2R immunostaining analysis showed a significant increase in the number of D2R per cell body in the NAc shell of pVTA lesioned rats compared to sham. This result correlated, for the first time, the dopamine receptor agonists effect with DR2 overexpression in the NAc shell of pVTA-lesioned rats. In addition, cocaine, which is known to increase dopamine release, induced behavioral sensitization in sham group but not in dopamine deprived group. Thus, the later result highlighted the importance of pVTA-NAc dopaminergic pathway in positive reinforcements. Altogether these data suggested that the implication of the dopamine replacement therapy in the appearance of dopamine dysregulation syndrome in Parkinson's disease is probably due to both neuronal degeneration in the posterior VTA and

  8. Pituitary regulation of corpus luteum progesterone secretion in cyclic rats.

    Science.gov (United States)

    Sánchez-Criado, J E; López, F; Aguilar, E

    1986-09-01

    Pituitary LH and PRL secretion during the early postovulatory period of the rat estrous cycle seem to affect the corpus luteum (CL) autonomy to secrete progesterone. Thus, while PRL would act luteotropically, LH would be luteolytic. To further investigate these facts, 4-day cyclic rats, treated with either 1 mg bromocriptine (CB) or 0.25 ml 70% ethanol (ETOH) at 1600 h on estrus, were injected with 0.5 ml of either an anti-LH serum (LHAS) or normal horse serum (NHS) at 0800 h on metestrus. Rats treated at 0800 h on metestrus with both, CB and LHAS, were also used. To verify through a different procedure the effect of LH and/or PRL deprivation in estrous cycle CL progesterone secretion, hypophysectomy (HYPOX) and sham HYPOX (SHAM) were done at 0800 h on metestrus in either CB- or ETOH-injected rats at 1600 h on estrus. Hypophysectomized rats at 1600 h on estrus were also used. Progesterone secretion was prolonged up to 0800 h on diestrus in those rats deprived of LH from 0800 h on metestrus (ETOH/LHAS, -/CB + LHAS, ETOH/HYPOX) compared with controls (ETOH/NHS, ETOH/SHAM). This luteotropic effect was absent in those rats lacking estrous afternoon PRL (CB/LHAS, CB/HYPOX, HYPOX/-). No effect on CL progesterone secretion was detected in those rats exclusively deprived of PRL on the afternoon of estrus (CB/NHS, CB/SHAM). These results suggest that in the absence of the protective effects of PRL secretion on the afternoon of estrus, rat CL become extremely sensitive to the luteolytic effects of early diestrous LH levels, and this results in 4-day estrous cycles.

  9. Differential stimulation pathways of progesterone secretion from newly formed corpora lutea in rats treated with ethylene glycol monomethyl ether, sulpiride, or atrazine.

    Science.gov (United States)

    Taketa, Yoshikazu; Yoshida, Midori; Inoue, Kaoru; Takahashi, Miwa; Sakamoto, Yohei; Watanabe, Gen; Taya, Kazuyoshi; Yamate, Jyoji; Nishikawa, Akiyoshi

    2011-06-01

    Ethylene glycol monomethyl ether (EGME), sulpiride, and atrazine are known ovarian toxicants, which increase progesterone (P4) secretion and induce luteal cell hypertrophy following repeated administration. The aim of this study was to define the pathways by which these compounds exerted their effects on the ovary and hypothalamic-pituitary-gonadal (HPG) axis. In the ovary, changes in the steroidogenic activity of new and old corpora lutea (CL) were addressed. EGME (300 mg/kg), sulpiride (100 mg/kg), or atrazine (300 mg/kg) were orally given daily for four times from proestrus to diestrus in normal cycling rats. Treatment with all chemicals significantly increased serum P4 levels, and EGME as well as sulpiride induced increases in prolactin (PRL) levels. In new CL, at both the gene and the protein levels, all three chemicals upregulated the following steroidogenic factors: scavenger receptor class B type I, steroidogenic acute regulatory protein, P450 cholesterol side-chain cleavage, and 3β-hydroxysteroid dehydrogenase (HSD) and downregulated the luteolytic gene, 20α-HSD. Coadministration of EGME and bromocriptine, a D2 agonist, completely inhibited PRL but not P4 secretion. Additionally, steroidogenic factor expression levels were upregulated, and 20α-HSD level was downregulated in new CL. These results suggest that EGME both directly and indirectly stimulates P4 production in luteal cells, whereas sulpiride elevates P4 through activation of PRL secretion in the pituitary. Atrazine may directly activate new CL by stimulating steroidogenic factor expressions. The present study suggests that multiple pathways mediate the effects of EGME, sulpiride, and atrazine on the HPG axis and luteal P4 production in female rats in vivo.

  10. Hypothalamic, pituitary and thyroid dysfunction after radiotherapy to the head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Samaan, N.A.; Vieto, R.; Schultz, P.N.; Maor, M.; Meoz, R.T.; Sampiere, V.A.; Cangir, A.; Ried, H.L.; Jesse, R.H. Jr.

    1982-11-01

    One hundred-ten patients who had nasopharyngeal cancer and paranasal sinus tumors and were free of the primary disease were studied one to 26 years following radiotherapy. There were 70 males and 40 females ranging in age from 4 to 75 years, with a mean age of 36.5 years. During therapy both the hypothalamus and the anterior pituitary gland were in the field of irradiation. The radiation dose to the hypothalamus and the anterior pituitary gland was estimated to be 400 to 7500 rad with a median dose of 5618 rad to the anterior pituitary gland and a median dose of 5000 rad to the hypothalamus. We found evidence of endocrine deficiencies in 91 of the 110 patients studied. Seventy-six patients showed evidence of one or more hypothalamic lesions and 43 patients showed evidence of primary pituitary deficiency. Forty of the 66 patients who received radiotherapy to the neck for treatment or prevention of lymph node metastasis showed evidence of primary hypothyroidism. The range of the dose to the thyroid area was 3000 to 8800 rad with a median of 5000 rad. One young adult woman who developed galactorrhea and amenorrhea 2 years following radiotherapy showed a high serum prolactin level, but had normal anterior pituitary function and sella turcica. She regained her menses and had a normal pregnancy and delivery following bromocriptine therapy. These results indicate that endocrine deficiencies after radiotherapy for tumors of the head and neck are common and should be detected early and treated. Long-term follow-up of these patients is indicated since complications may appear after the completion of radiotherapy.

  11. Medical management of clomiphene-resistant polycystic ovarian syndrome: an update

    Directory of Open Access Journals (Sweden)

    Sharonjeet Kaur

    2014-02-01

    Full Text Available Clomiphene citrate is the traditional first-line treatment for chronic anovulation that characterizes polycystic ovary syndrome (PCOS. A gold standard therapy has always been Clomiphene Citrate (CC. However, 20%-25% of PCOS women fail to ovulate with incremental doses of CC. A good body of evidence suggest that alternatives for PCOS women with CC-resistant anovulation include insulin sensitizers like metformin and pioglitazone. Insulin sensitizers improves pregnancy outcome and ovulation rate by and acts by ameliorating insulin sensitivity and hyperandrogenemia. Metformin is preferred in obese women. Gonadotropins induce ovulation and maintain optimal follicle growth via controlled administration of follicle stimulation hormone. Two regimens are used which includes high and low dose regimen. Low dose regimen is preferred but is associated adverse effects like ovarian hyperstimulation syndrome (OHSS and increased cost. Extending clomiphene therapy reduces cost and improves pregnancy outcome. Glucocorticoids are preferably used when serum Dehydroepiandrosterone levels are > 200µg/dL. Bromocriptine improves ovulation rate by decreasing prolactin levels. Human Chorionic Gonadotropin restores ovulation but its use is limited during intrauterine insemination. Tamoxifen acts in a similar way as CC but has lesser antiestrogenic effect on the endometrium, cervical mucus, and granulosa cells, hence an added advantage of monofollicular ovulation. Aromatase inhibitors block conversion androstenedione and testosterone to estrogen in ovary and improves ovulation rate. Added advantage includes lesser cost, simple to use, no danger of multiple pregnancies and convenient for patient. Combination of GnRH analogues and Gonadotropins are associated with increased risk of OHSS. D-chiro-inositol, N-Acetylcysteine, melatonin and acarbose are tried with little success. [Int J Basic Clin Pharmacol 2014; 3(1.000: 1-9

  12. 垂体催乳素瘤合并妊娠的临床观察%Clinical observation on pituitary prolactinoma complicating pregnancy

    Institute of Scientific and Technical Information of China (English)

    冯娟娟; 吕敏茹; 白桂芹

    2012-01-01

    -term pregnancy, including 22 undergoing caesarean section and 7 with vaginal spontaneous labor. All of the newborn infants survived without any abnormalities. MRI at late trimester of pregnancy revealed increase in tumor size in 7 cases, decrease in 3 cases and no obvious change in 21 cases. None of the symptoms such as headache, eyesight change or visual impairment occurred in patients. The pregnancy progress and outcomes of 7 cases of macroadenoma were not well. Only one of them underwent cesarean section at full term, and the neonate was survival without abnormality. Headache and visual impairment occurred at second trimester in 2 cases. After treatment with bromocriptine, these symptoms relieved and cesarean section was performed at full term. The neonate was survival without abnormality. Another case, with these symptoms at mid trimester of pregnancy, received operation and radiotherapy after induced abortion when symptoms were not significantly relieved treated with bromocriptine. Early abortion occurred in 2 cases and another one miscarried at 18 gestational weeks. Conclusion The pregnancy outcomes of cases of microadenoma are fine after bromocriptine withdrawl, but the pregnancy progress and outcomes of cases of macroadenoma are not well, which needs attention from clinical physicians.

  13. Dopamine and T cells: dopamine receptors and potent effects on T cells, dopamine production in T cells, and abnormalities in the dopaminergic system in T cells in autoimmune, neurological and psychiatric diseases.

    Science.gov (United States)

    Levite, M

    2016-01-01

    expression and/or responses to dopamine or production of dopamine, (xiii) drugs that affect the dopaminergic system have potent effects on T cells (e.g. dopamine=Intropin, L-dopa, bromocriptine, haloperidol, quinpirole, reserpine, pergolide, ecopipam, pimozide, amantadine, tetrabenazine, nomifensine, butaclamol). Dopamine-induced activation of resting Teffs and suppression of Tregs seem beneficial for health and may also be used for immunotherapy of cancer and infectious diseases. Independently, suppression of DRs in autoimmune and pro-inflammatory T cells, and also in cancerous T cells, may be advantageous. The review is relevant to Immunologists, Neurologists, Neuroimmunologists, Hematologists, Psychiatrists, Psychologists and Pharmacologists.

  14. 非典型恶性综合征1例报告暨文献复习%A Case Report of Atypical Neuroleptic Malignant Syndrome and Review of the Literature

    Institute of Scientific and Technical Information of China (English)

    郭艳娥; 贾建军; 谭纪萍; 时霄冰; 管锦群

    2012-01-01

    Objective: To investigate the etiology, pathogenesis, clinical manifestations and treatment of neuroleptic malignant syndrome (NMS). Methods: All clinical data of one NMS were studied retrospectively. Results: The patient presented with altered levels of consciousness, increased muscular rigidity, tachycardia and hypertension, tremor, and elevation of serum creatine kinase (CK). Antipsychotic drugs was discontinued, and he received oral bromocriptine mesilate and amantadine, the patient was recovered quickly. Conclusion: NMS is a severe complication during treatment with antipsychotic drug. The manifestation can be atypical and various. The patient may came to other department beside neurology and psychiatry, so all the internal medicine doctors should be familiar with the disease. Then the NMS patient can be diagnosed and treated quickly and correctly. The prognosis will be better.%目的:探讨恶性综合征的病因、发病机制、临床表现及治疗.方法:回顾性分析1例非典型恶性综合征患者1例,结合文献进行分析讨论.结果:患者因高龄、全身状况差、长期并联合应用多种抗精神病药物、合并应用多种其他药物而诱发,表现为肌张力增高,心率增快,血压增高,经过停用抗精神病药,给予甲磺酸溴隐亭片、盐酸金刚烷胺片及对症支持治疗,患者病情好转.结论:恶性综合征是抗精神病药物治疗的严重并发症,其临床表现可无发热等典型表现,且可出现各系统症状,可能首诊于多个科室,各科临床医师均应熟悉该病的临床表现,以便及时作出诊断,及时治疗,改善患者预后.

  15. 斜坡异位泌乳素垂体腺瘤 1 例临床分析并文献复习%Clinical analysis of one patient with ectopic prolactinoma in clivus and review of literatures

    Institute of Scientific and Technical Information of China (English)

    穆林森; 张红波; 陈谦学; 桂松柏; 曾小君; 白吉伟; 李储忠; 赵鹏; 孙彦辉

    2016-01-01

    Objective To explore the diagnosis , differential diagnosis and treatment of ectopic prolactinoma in clivus .Methods The clinical data of one patient with ectopic pituitary adenoma ( EPA) in clivus underwent surgery and pathology results was retrospectively analyzed ,and the clinical features with literature review were summarized .Results The cases was diagnosed as hyperprolactinemia ,MRI showed clivus mass and preoperative diagnosis was chordoma .The tumors were totally resected through transendoscopic single nostril transsphenoidal approach .Pathological immunohistochemical test showed prolactin positive , the hyperprolactinemia not returned to normal after surgery , oral bromocriptine treatment to control it , follow-up of 1 year without recurrence . Conclusions Ectopic clivus pituitary adenoma was rarely in clinic and easily be misdiagnosed .We should continue to adopt a comprehensive treatment based on surgery .%目的 探讨斜坡异位泌乳素垂体腺瘤的诊断与鉴别诊断及治疗方法. 方法 回顾性分析1例经手术及术后病理检查确诊的斜坡异位垂体腺瘤患者的临床资料,并结合文献总结其临床特点. 结果 该例患者表现为高泌乳素血症,MRI检查发现斜坡病变,术前诊断为脊索瘤. 采用内镜下单鼻孔经鼻蝶入路显微手术全切除肿瘤. 肿瘤病理免疫组化检查泌乳素阳性,术后未完全降至正常,口服溴隐亭治疗,随访1年无复发. 结论 斜坡异位垂体腺瘤临床罕见,误诊率高;仍应采用以手术为主的综合治疗.

  16. Glycyrrhetinic acid and E.resveratroloside act as potential plant derived compounds against dopamine receptor D3 for Parkinson’s disease: a pharmacoinformatics study

    Directory of Open Access Journals (Sweden)

    Mirza MU

    2014-12-01

    Full Text Available Muhammad Usman Mirza,1 A Hammad Mirza,2 Noor-Ul-Huda Ghori,3 Saba Ferdous4 1Centre for Research in Molecular Medicine, The University of Lahore, Lahore, Pakistan; 2Department of Bioscience, COMSATS Institute of Information Technology, Sahiwal, Pakistan; 3Atta-ur-Rehman School of Applied Biosciences, National University of Science and Technology, Islamabad, Pakistan; 4Institute of Structural and Molecular Biology, University College London, UK Abstract: Parkinson’s disease (PD is caused by loss in nigrostriatal dopaminergic neurons and is ranked as the second most common neurodegenerative disorder. Dopamine receptor D3 is considered as a potential target in drug development against PD because of its lesser side effects and higher degree of neuro-protection. One of the prominent therapies currently available for PD is the use of dopamine agonists which mimic the natural action of dopamine in the brain and stimulate dopamine receptors directly. Unfortunately, use of these pharmacological therapies such as bromocriptine, apomorphine, and ropinirole provides only temporary relief of the disease symptoms and is frequently linked with insomnia, anxiety, depression, and agitation. Thus, there is a need for an alternative treatment that not only hinders neurodegeneration, but also has few or no side effects. Since the past decade, much attention has been given to exploitation of phytochemicals and their use in alternative medicine research. This is because plants are a cheap, indispensable, and never ending resource of active compounds that are beneficial against various diseases. In the current study, 40 active phytochemicals against PD were selected through literature survey. These ligands were docked with dopamine receptor D3 using AutoDock and AutoDockVina. Binding energies were compared to docking results of drugs approved by the US Food and Drug Administration against PD. The compounds were further analyzed for their absorption, distribution

  17. Management von Hypophysen- und Nebennierenerkrankungen in der Schwangerschaft

    Directory of Open Access Journals (Sweden)

    Schirpenbach C

    2012-01-01

    Schwangerschaft sollte die medikamentöse Behandlung beendet werden, außer bei Makroadenomen mit extrasellärem Wachstum. Entsprechend der bisherigen Erfahrung kann eine Behandlung mit Bromocriptin und Cabergolin in der Schwangerschaft als sicher angesehen werden.

  18. Cysteamine-colon and cysteamine-duodenum lesions in rats. Attenuation by gastric pentadecapeptide BPC 157, cimetidine, ranitidine, atropine, omeprazole, sulphasalazine and methylprednisolone.

    Science.gov (United States)

    Sikiric, P; Seiwerth, S; Grabarevic, Z; Balen, I; Aralica, G; Gjurasin, M; Komericki, L; Perovic, D; Ziger, T; Anic, T; Prkacin, I; Separovic, J; Stancic-Rokotov, D; Lovric-Bencic, M; Mikus, D; Staresinic, M; Aralica, J; DiBiaggio, N; Simec, Z; Turkovic, B; Rotkvic, I; Mise, S; Rucman, R; Petek, M; Sebecic, B; Ivasovic, Z; Boban-Blagaic, A; Sjekavica, I

    2001-01-01

    Recently, we showed cysteamine-duodenal lesions without gastric acid, since they were induced also in gastrectomized rats, as in naive rats, and they were inhibited by the novel stomach pentadecapeptide BPC 157 as well as standard antiulcer drugs (i.e. cimetidine, ranitidine, omeprazole, bromocriptine, atropine). Therefore, as an advantage of considering cysteamine as a directly acting cytotoxic agent and mentioned agents as direct cytoprotective agents, the present focus was on the ulcerogenic effect of cysteamine and protective effect of gastroduodenal antiulcer agents outside upper gastrointestinal tract (i.e. in colon). Intrarectal administration of the cysteamine (200 or 400 mg/kg b.w) produced severe colon lesions (i.e. transmural inflammation with serosal involvement) in rats (30 min-72 h-experimental period), apparently distinctive from smaller lesions after non-specific irritant enema [diluted HCl solution, pH 3.8 (adjusted to pH of cysteamine solution (pH 3.8)]. All of the tested antiulcer agents were applied simultaneously with cysteamine enema (8 cm from the anus, in a volume of the 1.0 ml/rat) intraperitoneally (i.p.), intragastrically (i.g.) or intrarectally (i.r.). Pentadecapeptide BPC 157 (10 microg or 10 ng/kg b.w.), given in either regimen, previously shown to have, besides others, a particular beneficial activity just in the intestinal mucosa, inhibited these cysteamine colon lesions (assessed after 30 min, 60 min, 180 min, 24 h, 48 h, 72 h following cysteamine in a dose of either 200 or 400 mg/kg i.r.). Cysteamine-colon lesions were also attenuated by standard antiulcer agents (mg/kg b.w.), given i.p., i.g., or i.r., such as ranitidine (10), cimetidine (50), omeprazole (10), atropine (10), together with methylprednisolone (1), and sulphasalazine (50, i.r.), assessed 30 min following application of 200 mg of cysteamine. Finally, standard cysteamine duodenal lesions (assessed 24 h after a subcutaneous application of 400 mg/kg of cysteamine) were

  19. 围生期心肌病诊断与治疗的最新研究进展%Progress in Research on Diagnosis and Treatment of Peripartum Cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    柴丽娜

    2013-01-01

    围生期心肌病是一种特发性、妊娠相关的心肌病,病因还不清楚.其主要特征是既往健康的孕产期妇女,在妊娠晚期至产后5个月期间发生左心室收缩功能减退和心力衰竭.当妊娠晚期或产后早期出现心力衰竭体征时,要高度怀疑围生期心肌病,并早期开始防治.孕妇应避免使用血管紧张素转换酶抑制剂、血管紧张素受体拮抗剂及华法林,因为这些药有可能致畸.一旦分娩,就应该进行标准的心力衰竭治疗.患过围生期心肌病的妇女再次妊娠复发本病的风险很高.该病因与妊娠相关,在诊断和治疗上具有一定的特殊性,近来有不少小规模的前瞻性研究认为溴隐亭治疗围生期心肌病有良好的疗效.现着重针对围生期心肌病的诊断、药物治疗的最新进展进行综述.%Peripartum cardiomyopathy ( PPCM ) is an idiopathic, pregnancy related disease. PPCM 's pathogenesis has not been clearly identified. The principle characteristic of PPCM is that left ventricular systolic dysfunction and heart failure occur in the last month of pregnancy or within 5-6 months postpartum in a previously healthy woman. PPCM should always be considered when there are signs of heart failure in later pregnancy or early postpartum. Due to the presence of teratogens, pregnant women should avoid using angiotensin-converting enzyme-inhibitors , angiotensin-Ⅱ receptor blockers, and warfarin, however, the standard treatment for heart failure should be given after delivery. The risk of recurring PPCM is high in subsequent pregnancies. PPCM is related to pregnancy, so it has some particularity in its diagnosis and treatment. Recently, many small studies have proposed that the use of bromocriptine for PPCM is effective. This article describes the newest diagnostic tools and therapy for PPCM.

  20. Cerebrospinal fluid fistula as the presenting manifestation of pituitary adenoma: case report with a 4-year follow-up Fístula liquórica como manifestação inicial de macroadenoma hipofisário: relato de caso com 4 anos de seguimento

    Directory of Open Access Journals (Sweden)

    Ricardo Alexandre Hanel

    2001-06-01

    Full Text Available We report the case of a young woman who presented with cerebrospinal fluid (CSF rhinorrhea due to an undiagnosed and untreated pituitary adenoma. The tumor had extended well beyond sella turcica and caused bony erosion. The patient initially refused surgery and was treated with bromocriptine and a radiation therapy. CSF leakage did not improved and she was submitted to surgery by the transsphenoidal approach with removal of a tumor mass located in sphenoid sinus and sellar region. Origin of the leak was localized and repaired with fascia lata and a lumbar subarachnoid drain was left in place for 5 days. After 4 years she has normal serum PRL levels and no rhinorrhea. The management, complications and mechanisms involved in this rare condition are discussed.Relatamos o caso de uma paciente que se apresentou com fístula liquórica devido a macroadenoma de hipófise sem diagnóstico e/ou tratamento prévio. O tumor estendia-se além dos limites da sela túrcica, causando erosão óssea. A paciente inicialmente recusou tratamento cirúrgico e foi então tratada com bromocriptina e radioterapia convencional. O fluxo de liquor da fístula não diminuiu e desta feita a paciente concordou com a realização da cirurgia. Realizou-se acesso transesfenoidal com remoção da massa tumoral do seio esfenoidal e selar. A origem da fístula foi reparada com enxerto autólago de fascia lata. Drenagem liquórica lombar foi utilizada por 5 dias. Atualmente, após 4 anos de seguimento, a paciente se apresenta com níveis normais de prolactina e sem sinais de fístula liquórica. Discutimos o mecanismo fisiopatológico desta rara apresentação dos tumores hipofisários bem como seu manejo e complicações.

  1. Metastatic prolactinoma: case report with immunohistochemical assessment for p53 and Ki-67 antigens Prolactinoma metastático: relato de caso com avaliação imuno-histoquímica para os antígenos p53 e Ki-67

    Directory of Open Access Journals (Sweden)

    Paulo S. Crusius

    2005-09-01

    Full Text Available Pituitary carcinomas are rare neoplasms characterized by craniospinal and/or systemic metastases originated from the pituitary. Their histopathology is frequently indistinguishable from that of benign adenomas. The development of markers that better reflect their behavior is desirable. We present the case of a 47 year-old man with a prolactin-secreting macroadenoma who was submitted to surgeries, cranial radiation therapy, and bromocriptine treatment, but evolved to a fatal outcome after the disclosure of intracranial metastases. Tumor samples underwent p53 and Ki-67 immunohistochemical assessment. p53 was absent in all samples, a rare finding among pituitary carcinomas. Ki-67 proliferative index was 2.80% in the original tumor, 4.40% in the relapse, and 4.45% in the metastasis. The figure in the relapse is higher than the expected for a noninvasive adenoma. In conclusion, p53 staining is not positive in all pituitary carcinomas. A high Ki-67 proliferative index in a pituitary adenoma might indicate a more aggressive behavior.Carcinomas pituitários são neoplasias raras caracterizadas pela presença de metástases cranio-espinhais e/ou sistêmicas originadas da hipófise. Sua histopatologia é freqüentemente indistinguível daquela dos adenomas benignos. O desenvolvimento de marcadores que melhor reflitam o seu comportamento é desejável. Apresentamos o caso de um homem de 47 anos com um macroadenoma secretor de prolactina que foi submetido a procedimentos cirúrgicos, radioterapia e tratamento com bromocriptina, mas que evoluiu para o óbito após o descobrimento de metástases intracranianas. Amostras do tumor foram submetidas à análise imuno-histoquímica para os antígenos p53 e Ki-67. A coloração para p53 foi negativa em todas as amostras, um achado raro entre os carcinomas pituitários. O índice proliferativo Ki-67 foi 2,80% no tumor original, 4,40% na recidiva e 4,45% na metástase. O valor obtido na recidiva é maior que o

  2. Long-term results of radiotherapy for pituitary adenomas. Evaluation of tumor control and hypopituitarism after radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchida, Emiko; Sakai, Kunio; Matsumoto, Yasuo; Sugita, Tadashi; Sasamoto, Ryuta [Niigata Univ. (Japan). School of Medicine

    1999-09-01

    To evaluate the results of conventional radiotherapy for pituitary adenomas assessed with computed tomography (CT) or magnetic resonance imaging (MRI). Endpoints include tumor control, normalization of hormone levels in functioning adenomas, and hypopituitarism after radiotherapy as an adverse effect. Forty-two patients were treated with radiotherapy from 1982 to 1995 at Niigata University Hospital. Forty patients were irradiated after surgery because of residual adenomas in 33 patients and tumor regrowth in 7 patients. One patient was treated with radiotherapy alone, and the remaining 1 patient was treated with preoperative radiotherapy. Tumor size and extension were evaluated using CT or MRI, and all tumors were macroadenomas. They consisted of 18 non-functioning and 24 functioning adenomas (growth hormone (GH)-secreting: 11, prolactinomas: 7, concomitant GH and prolactin (PRL)-secreting: 5, gonadotropin-secreting: 1). Treatment was given in 200 cGy daily fraction size and a total dose of 50 Gy was given to most patients. Sixteen patients with GH- and/or PRL-secreting adenomas received bromocriptine. Tumor progression was determined by increase in tumor size as shown by CT or MRI. Hypopituitarism after radiotherapy was evaluated using the functions of corticotropin (ACTH), thyrotropin (TSH), and gonadotropin. Median follow-up time from the end of radiotherapy was 103 months. Tumor progression occurred in 2 out of 42 patients and 10-year progression-free rate for all patients was 93.7%. Normalization of GH levels was obtained in 12 of 16 GH-secreting adenomas with a mean time of 27 months after radiotherapy, and 9 of 12 PRL-secreting adenomas achieved normalization of PRL levels with a mean time of 34 months. One gonadotropin-secreting adenoma achieved normalization of gonadotropin level at 21 months after radiotherapy. The incidence of hypopituitarism after radiotherapy increased with time, and cumulative risk of deficiencies of ACTH, TSH, and gonadotropin at 10

  3. Diagnostic challenges and management of a patient with acromegaly due to ectopic growth hormone-releasing hormone secretion from a bronchial carcinoid tumour

    Science.gov (United States)

    Kyriakakis, Nikolaos; Trouillas, Jacqueline; Dang, Mary N; Lynch, Julie; Belchetz, Paul; Korbonits, Márta

    2017-01-01

    Summary A male patient presented at the age of 30 with classic clinical features of acromegaly and was found to have elevated growth hormone levels, not suppressing during an oral glucose tolerance test. His acromegaly was originally considered to be of pituitary origin, based on a CT scan, which was interpreted as showing a pituitary macroadenoma. Despite two trans-sphenoidal surgeries, cranial radiotherapy and periods of treatment with bromocriptine and octreotide, his acromegaly remained active clinically and biochemically. A lung mass was discovered incidentally on a chest X-ray performed as part of a routine pre-assessment for spinal surgery 5 years following the initial presentation. This was confirmed to be a bronchial carcinoid tumour, which was strongly positive for growth hormone-releasing hormone (GHRH) and somatostatin receptor type 2 by immunohistochemistry. The re-examination of the pituitary specimens asserted the diagnosis of pituitary GH hyperplasia. Complete resolution of the patient’s acromegaly was achieved following right lower and middle lobectomy. Seventeen years following the successful resection of the bronchial carcinoid tumour the patient remains under annual endocrine follow-up for monitoring of the hypopituitarism he developed after the original interventions to his pituitary gland, while there has been no evidence of active acromegaly or recurrence of the carcinoid tumour. Ectopic acromegaly is extremely rare, accounting for <1% of all cases of acromegaly. Our case highlights the diagnostic challenges differentiating between ectopic acromegaly and acromegaly of pituitary origin and emphasises the importance of avoiding unnecessary pituitary surgery and radiotherapy. The role of laboratory investigations, imaging and histology as diagnostic tools is discussed. Learning points: Ectopic acromegaly is rare, accounting for less than 1% of all cases of acromegaly. Ectopic acromegaly is almost always due to extra-pituitary GHRH secretion

  4. Pseudocapsule-based transsphenoidal microsurgery for pituitary microprolactinoma%假性包膜在垂体催乳素微腺瘤经蝶窦手术中的意义

    Institute of Scientific and Technical Information of China (English)

    陈娟; 淦超; 李朝曦; 孙炜; 李然; 李家庆; 李晓鹏; 徐钰; 雷霆

    2014-01-01

    Objective To study the clinical significance of pseudocapsule in the transsphenoidal microsurgery for pituitary microprolactinoma.Methods From March 2012 to May 2013,61 patients with microprolactinoma were prospectively grouped and treated with pseudocapsule-based extracapsular transsphenoidal microsurgery,and the clinical and follow-up data were retrospectively analyzed.Results All the patients were followedup for 10 months in average.59 cases (96 %) regained regular menstruation,33 (94%) with galactorrhea had relieved,15 experienced postoperative pregnancy.The preoperative mean value of serum prolactin was 7.66 nmol/L and the postoperative was 0.42 nmol/L.According to the comprehensive evaluation of symptomatic,endocrinological and radiological indexes,the early total remission rate achieved to 96%.There was no severe complication.Conclusions The outcome of pseudocapusle-based extracapsular microsurgery for pituitary microprolactinoma was significant,and the complication was rare.Transshpenoidal microsurgery was the first line treatment for microprolactinoma with poor response or intolerance to bromocriptine.%目的 探讨假性包膜在垂体催乳素(PRL)微腺瘤经蝶窦显微手术中的临床意义.方法 前瞻性的对2012年3月至2013年5月61例催乳素微腺瘤患者采用基于假性包膜为边界的包膜外切除法经蝶窦显微手术治疗,随访收集资料并进行回顾性分析.结果 平均随访10个月;术后3个月内月经恢复规律的患者59例(96%),泌乳症状完全消失33例(94%),术后半年内成功受孕15例;术后3个月血清PRL平均为0.42 nmol/L;术后近期治愈率为96%,并发症发生率为0%.结论 基于假性包膜的经蝶窦显微手术治疗催乳素微腺瘤,近期疗效显著,手术并发症罕见.经蝶窦显微手术治疗是不能耐受药物治疗或药物短期治疗无效的催乳素微腺瘤的首选治疗方法.

  5. 控制性超促排卵中溢乳症的临床处理分析%Analysis of different clinical treatments on galactorrhea syndrome in controlled ovarian hyperstimulation

    Institute of Scientific and Technical Information of China (English)

    戴芳芳; 张丽晓; 郑波; 郑晓红; 程书清; 许晓立; 王春梅

    2014-01-01

    目的:探讨不同临床处理对体外授精-胚胎移植( in vitro fertilization and embryo transfer, IVF-ET)中伴溢乳症的不孕症患者妊娠结局的影响。方法选择在邢台不孕不育专科医院生殖中心接受IVF-ET的不孕症患者358例,其中伴溢乳症296例,无溢乳症及基础血清催乳素( prolactin,PRL)正常的62例。按有无溢乳症、高PRL血症及其处理方法分为5组,A组为溢乳症不伴有高PRL血症,应用甲磺酸溴隐亭治疗;B组为溢乳症伴有高PRL血症,应用甲磺酸溴隐亭治疗;C组为溢乳症不伴有高PRL血症,应用中药治疗;D组为溢乳症不伴有高PRL血症,未给予药物治疗;E组为无溢乳症及基础血清PRL正常。比较5组不孕症患者外源性促性腺激素( gonadotropin,Gn )启动日 PRL 水平、注射绒毛膜促性腺激素( chorionic gonadotrophin,HCG)日PRL水平、获卵数、可用胚胎数、临床妊娠率。结果5组不孕症患者比较,A组临床妊娠率最低(P<0.05);在Gn启动日和注射HCG日,A组PRL水平低于其他4组(P<0.05)。结论不孕症患者无高PRL血症的溢乳症状无需进行治疗,为改善症状,中药治疗可作为很好的尝试。%Objective To investigate the impact of different clinical treatments on pregnant results in infertility patients underWent vitro fertilization embryo transfer( IVF-ET)accompanying With galactorrhea syndrome. Methods 358 cases of infertility patients Who underWent IVF-ET in The Repraduction Center of Xingtai Infertility Specialized Hospital Were selected,of Whom 296 cases Were With galactorrhea syndrome,62 cases Were of normal serum prolactin( PRL)Without galactorrhea syndrome. The patients Were divided into 5 groups,Group A:patients of normal PRL With galactorrhea syndrome under treatment of bromocriptine mesilate,Group B:patients With hyperprolactinemia and galactorrhea syndrome under treatment of bromocriptine mesilate,Group C

  6. Prolaktin und HyperprolaktinämiebrStellungnahme der Deutschen Gesellschaft für Gynäkologische Endokrinologie und Fortpflanzungsmedizin (DGGEF e.V.

    Directory of Open Access Journals (Sweden)

    Rabe T

    2013-01-01

    -bildenden Tumors der Hypophyse (Prolaktinom zu. Die meisten Prolaktinome treten zwischen dem 20. und 40. Lebensjahr auf. Hypophysentumoren, meist Adenome, machen etwa 10–15 % aller intrakraniellen Tumoren aus. Bei den Prolaktinomen wird je nach Größe im MRT zwischen Mikro- ( 10 mm und Makroprolaktinomen ( 10 mm unterschieden. Je nach Größe, Lokalisation, Verdrängungssymptomen (z. B. Chiasma opticum, Lebensalter, Kinderwunsch stehen medikamentöse, neurochirurgische und radiologische Therapieoptionen zur Verfügung. Eine medikamentöse Therapie mit Dopamin-Agonisten ist die Therapie der ersten Wahl für die meisten Patienten mit Prolaktinomen, während eine Operation bei Resistenz gegenüber einer medikamentösen Therapie zusammen mit speziellen Indikationen in Betracht kommt. Die pharmakologischen Wirkungen, Nebenwirkungen und das pharmakologische Profil der Dopamin-Agonisten Bromocriptin, Dopergin, Quinagolid und Cabergolin wird besprochen. Bei Cabergolin kann es unter Langzeittherapie zu einer Fibrose und zu Herzklappenveränderungen kommen, allerdings nur bei hohen Dosierungen ( 2 mg im Rahmen der Parkinsontherapie. Neurochirurgische Eingriffe werden als First-line-Therapie nur bei Kinderwunschpatientinnen mit Akromegalie, Cushing-Syndrom oder speziellen Formen von Makroprolaktinomen indiziert. Die Differentialdiagnostik sowie das Management bei Mikro- und Makro-Prolaktinomen bei Patientinnen mit und ohne Kinderwunsch werden besprochen. Das wichtigste Therapieziel bei der Behandlung einer Hyperprolaktinämie und Prolaktinomen besteht in der Normalisierung des Prolaktinspiegels, um Nebenwirkungen einer Hyperprolaktinämie (z. B. Östrogenmangelsymptome zu verhindern, und bei Prolaktinomen ein Schrumpfen des Tumors zur erreichen – ebenfalls vor dem Hintergrund der Vermeidung ernsthafter klinischer Nebenwirkungen bei weiterem Tumorwachstum. International relevant sind Leitlinien der Endocrine Society (USA zur Diagnostik und Therapie der Hyperprolaktinämie.

  7. 自拟柴郁寄生汤治疗肝郁肾虚型高泌乳素血症月经后期临床研究%Research on the clinical effect of Chaiyujisheng decoction in dealing with hyperprolactinemia with late menstruation

    Institute of Scientific and Technical Information of China (English)

    张芸娜; 金哲; 睢丛璐; 佟庆; 徐翠; 徐彩; 林彤

    2014-01-01

    Objective To observe the effect of Chaiyujisheng decoction week therapy with soothing the liver and in-vigorating the kidney in the treatment of liver and kidney deficiency type hyperprolactinemia menstruation , and to explore its mechanism of action .Methods 60 cases of hyperprolactinemia late menstruation patients , randomly divided into treatment group (Chaiyujisheng decoction) and control group (bromocriptine) with 30 cases in each group.To observe the clinical cur-ative effect before and after treatment , TCM symptoms, blood prolactin ( PRL) and the association between hormone ( E2 , LH) , and compare the effects of the two therapy .Results Compared with before treatment , index scores of the 2 groups after treatment were improved, the difference was statistically significant ( P 0 .05 ) .The 2 group total effectiveness have statistics signifi-cance (86.7%vs.73.3%, P <0.05).Conclusion It demonstrated that the Chaiyujisheng decoction week therapy with soothing the liver and invigorating the kidney in treatment of hyperprolactinemia is safe , effective .%目的:观察自拟柴郁寄生汤疏肝补肾调周疗法治疗肝郁肾虚型高泌乳素血症月经后期的临床疗效,并探讨其作用机制。方法将60例高泌乳素血症月经后期患者,随机分为治疗组(柴郁寄生汤)和对照组(溴隐亭)各30例。观察临床综合疗效、治疗前后中医证候改善情况、血中泌乳素( PRL)和相关性激素( E2、LH)水平,并进行疗效比较。结果与治疗前比较,2组治疗后各项积分均有改善,差异有统计学意义( P <0^.05);治疗组在改善月经周期及腰膝酸软、乳房胀痛、经行少腹胀痛等症状方面疗效明显优于对照组( P <0.05),治疗组总证候积分指数为81.0%,对照组为33.0%。与治疗前比较,2组治疗后PRL、P、LH、E2水平均降低( P <0.05),且治疗组在改善E2水平疗效明显优于对照组( P <0

  8. Medical management of levodopa-associated motor complications in patients with Parkinson's disease.

    Science.gov (United States)

    Jankovic, Joseph; Stacy, Mark

    2007-01-01

    monitoring for hepatotoxicity. Amantadine is a noncompetitive NMDA receptor antagonist shown to lower dyskinesia scores and improve motor complications in patients with Parkinson's disease when given adjunctively with levodopa. Dopamine agonists, also used as initial and adjunctive therapy in Parkinson's disease, improve motor response and decrease 'off' time purportedly through direct stimulation of dopamine receptors. Current dopamine agonists include bromocriptine, pergolide, cabergoline, lisuride, apomorphine, pramipexole, ropinirole and rotigotine. Although effective, this class of medications can be associated with cardiovascular and psychiatric adverse effects that can limit their utility. All medications used to manage levodopa-associated motor complications in patients with Parkinson's disease have had differing degrees of success. Although head-to-head comparisons of drugs within classes are rare, some differences have emerged related to effects on motor fluctuations, dyskinesias and on/off times, as well as to adverse effects. When choosing a drug to treat levodopa-induced complications, it is important to consider the risks and benefits of the different classes and of the specific agents within each class, given the different efficacy and safety profiles of each.

  9. NEUROTRANSMITTERS AND IMMUNITY: 1. DOPAMINE

    Directory of Open Access Journals (Sweden)

    Lucian Hritcu

    2007-08-01

    role for dopamine in modulating, mainly suppressing immune functions (Qui et al., 1994. Animals treated with bromocriptine, a dopamine agonist, also showed suppression of antibody production to SRBC and LPS (Besedovsky and del Ray, 1996 and suppressed activities of lymphocytes in mixed lymphocyte culture (Hiestand et al., 1986. Moreover, the interest regarding the role of dopamine on immune system becomes more relevant when some of important neurological disease like Parkinson’s disease and schizophrenia with hypo- and hyperactivity (Birtwistle et al., 1988 of central dopamine system are well-correlated with severe abnormalities of immune functions (Muller et al., 1993. Therefore, in the present review, we have evaluated information from our laboratory as well as from others regarding the role of dopamine on immune function in both human and experimental animals in order to understand the current status of dopamine-mediated control of the immunological surveillance system.

  10. Pituitary prolactinoma with severe erectile dysfunction as the initial symptom:Diagnosis and treatment of 4 cases%以重度ED为首发症状的垂体泌乳素瘤4例报告

    Institute of Scientific and Technical Information of China (English)

    姜涛; 郑磊; 苏晓明; 彭进强; 孙冬晨; 李泉林; 张志伟; 王法鹏; 姜辉

    2013-01-01

    目的:以重度ED为首发症状的垂体泌乳素瘤易误诊,分析该病所致重度ED的特点,以提高诊治水平. 方法:回顾4例以重度ED(IIEF-5评分5~7分)为首发临床症状、经MRI检查确诊的垂体泌乳素瘤,结合文献诊治特点进行分析. 结果:4例因垂体泌乳素瘤引起的重度ED误诊时间长达2年,血清泌乳素(PRL)均为正常高值的10倍以上,开始应用PDE5抑制剂无效,3例行单鼻孔-蝶窦-垂体瘤全切除术,术后24个月随访:1例PRL正常,IIEF-5 19分,2例PRL分别降至600和768 IU/L,IIEF-5均为15分,此时再服用PDE5抑制剂获得满意效果;1例口服溴隐亭保守治疗,12个月后随访PRL正常,IIEF-5> 21分. 结论:检测血PRL和脑MRI检查可以确诊以重度ED为首发临床症状的垂体泌乳素瘤,在PRL极高的情况下,单纯应用PDE5抑制剂无效,通过手术或药物降低PRL后,ED症状可改善,若改善不明显,此时再应用PDE5抑制剂将会收到满意的效果.%Objective: Pituitary prolactinoma with severe erectile dysfunction (ED) as the initial symptom is often misdiag-nosed. This article explores the diagnosis and treatment of severe ED caused by pituitary prolactinoma. Methods; We retrospectively analyzed the diagnosis and treatment of 4 cases of pituitary prolactinoma with severe ED (IIEF-5 score 5 - 7) as the initial clinical symptom confirmed by MRI. Results: The 4 cases of pituitary prolactinoma-induced severe ED, with serum prolactin 10 times above the maximum normal level, were misdiagnosed for 2 years. AH failed to respond to the PDE5 inhibitor therapy, and then 3 of them underwent transnasal hypophysiectomy. Twenty-four months of follow-up found the level of prolactin restored to normal in 1 case (IIEF-5 = 19), and reduced to 600 and 768 IU/L respectively (IIEF-5 = 15) in the other 2. Then administration of the PDE5 inhibitor was followed, which produced satisfactory efficacy. One case was treated with oral bromocriptine, which restored the

  11. McCune-Albright syndrome combined with gigantism: clinical characteristics and long-term follow-up%McCune-Albright综合征伴巨人症临床特点及长期随访研究

    Institute of Scientific and Technical Information of China (English)

    许岭翎; 朱惠娟; 李梅; 王鸥; 姜艳; 张化冰; 柴晓峰; 冯凯; 李乃适

    2014-01-01

    Objective To investigate the clinical characteristics,causes of disease and responses to treatment in McCuneAlbright syndrome patients combined with gigantism.Methods Long-term follow-up were performed on two cases of McCune-Albright syndrome combined with gigantism,and in combination with literatures the clinical characteristics were analyzed and discussed.Results Both patients underwent neuronavigator assisted transsphenoidal resection of pituitary tumor.After operation,the levels of GH and IGF-1 were significantly decreased.In case 2,GH and IGF-1 levels returned to normal without recurrence during 3-year follow-up.In case 1,treatment of bromocriptine and long-acting somatostatin were performed;growth was notably inhibited and the levels of GH and IGF-1 were significantly decreased.Both patients received bisphosphonate therapy,and bone lesion progression was effectively controlled.Both patients were diagnosed with hypogonadism at the follow-up.Conclusion Treatment of this disease is a long procedure.Clinician should select individualized and comprehensive treatment measures according to the characteristics of patients.Neuronavigation in transsphenoidal resection of pituitary adenoma operation,long-acting somatostatin and bisphosphonate therapy are important measures to control the disease.%目的 探讨伴有巨人症的McCune-Albright综合征患者的临床特点、病程以及对治疗的反应.方法 长期随访北京协和医院收治的2例伴有巨人症的McCune-Albright综合征患者的临床治疗及实验室检查情况.结果 2例患者均接受了神经导航下经蝶入路垂体瘤切除手术,术后生长激素(GH)、胰岛素样生长因子-1(IGF-1)均明显下降,其中例2完全降至正常,随诊3年未见垂体瘤复发迹象;例1术后接受了溴隐亭和长效生长抑素的治疗,生长速度明显降低,GH和IGF-1下降.2例患者均接受了双膦酸盐治疗,骨骼病变进展均得到了有效控制.2例患者均在病程中出现

  12. Guías para el diagnóstico y tratamiento de acromegalia, prolactinomas y enfermedad de Cushing

    Directory of Open Access Journals (Sweden)

    Chen-Ku Chih Hao

    2004-10-01

    (acromegaly and ACTH (Cushing’s disease. There are different opinions about the diagnosis and treatment of these diseases. We present here the guidelines for diagnosis and treatment of these tumors made by the Costa Rican Association of Endocrinology, Diabetes and Nutrition. The main cause of acromegaly is a pituitary tumor that produces growth hormone. The diagnosis is usually made several years after the disease has started because the physical changes occur very slowly. The initial treatment should be surgery and when it fails, medical therapy with octreotide is the main choice. Radiotherapy can be used although it is limited by the long time it takes to start its effect. If there is hyperprolactinemia, other causes of prolactin elevation should be ruled out. If a prolactinoma is identified, the treatment almost always will be with dopamine agonists. Surgery should be performed only in macroprolactinomas with visual field changes that do not shrink with medical treatment. The first choice for medical treatment will be bromocriptine although there are other agents like cabergoline and quinagolide. In Cushing´s disease, there are different tests for screening for hypercortisolism, after which a confirmatory test should be performed. Initial treatment should be surgery followed by radiotherapy. In these cases, medical treatment is less effective than in other pituitary tumors.

  13. 儿童青少年垂体催乳素瘤的临床特点与治疗%Clincal characteristics and treatment of pituitary prolactinoma in children and adolescents

    Institute of Scientific and Technical Information of China (English)

    朱惠娟; 任祖渊; 苏长保; 马文斌; 史轶蘩; 顾锋; 金自孟; 潘慧; 李乃适; 伍学炎; 岳欣; 吴勤勇; 王任直

    2009-01-01

    Objective To study the clinical characteristics and treatment of pituitary prolactinoma in children and adolescents. Method The clinical data of 31 prolactinoma patients treated from 2002 to 2007 in PUMC hospital were reviewed retrospectively. Results The group of patients consisted of(21±67.7)% girls and(10±32.3)% boys.The average age at diagnosis was 16.9±2.7 years old. The onset age was 15.0±2.7 years. The main symptoms were abnormal menstruation in girls and headache and visual disorders in boys. 81% patients had macroadenomas. The baseline level of serum prolactin was positively correlated with the size of tumor.13% patients had secondary hypothyroidism and 24% patients with lower levels of cortisol and ACTH.29% patients were treated with transsphenoidal surgery.The level of PRL maintained normal in 29% patients 2 to 18 months later after operation and in 64% patients treated with bromocriptine.Conclusion Compared with adults,the percentage of male is higher in children and adolescents prolactinoma patients and there are more macroadenomas. Dopamine agonist is effective and safe for these patients.%目的 分析儿童青少年垂体催乳素(PRL)瘤的临床特点和治疗情况.方法 回顾性总结31例儿童青少年垂体PRL瘤患者的临床特点,包括患者性别、年龄、临床表现、影像学特点、激素水平以及治疗情况.结果 本组男女比例1:2,诊断年龄(16.9±2.7)岁,发病年龄(15.0±2.7)岁.女性患者以月经异常,男性以头痛和视力障碍为主要临床表现.其中81%为大腺瘤,血PRL水平与腺瘤长径正相关(r=0.5252,p=0.0145).29%接受手术治疗的患者和64%的药物治疗患者随访2-18个月,PRL水平正常.结论 儿童青少年垂体PRL瘤与成人相比男性患者比例显著升高,大多数为垂体大肿瘤,多于青春发育后起病,多巴胺激动剂治疗安全有效.

  14. Central nervous mechanism of bruxism%磨牙症的中枢神经机制

    Institute of Scientific and Technical Information of China (English)

    黄黄; 刘伟才

    2014-01-01

    The causes of bruxism are divided into peripheral factors and central factors, occlusal factors are known to only play a minor role. Bruxism is associated with sleep micro-arousal and appears to be modulated by various neurotransmitters in the central nervous system. These neurotransmitters may be disturbed the balance between the direct and indirect pathways of the basal ganglia which are involved in the coordination of movements of masticatory muscle in bruxers. L-dopa, bromocriptine and propranolol can inhibit bruxism activity, botulinum toxin injections can reduce the frequency of bruxism events and decrease bruxism-induced pain levels, clonidine can inhibits the rapid eye movement(REM) of bruxism patients and the levels of catecholamines are higher in bruxers. Some authors think that bruxism patients with lower sleep efficiency, but some think that bruxism patients have normal sleep structure and quality; some people think that bruxism occurred more frequently in stage 2 and REM, some think bruxism episodes are equally distributed between non-rapid eye movement(NREM) and REM sleep, but some also think bruxism are mainly occurred in light sleep and seldom occurred in REM, moreover some think that bruxism is a abnormal oral activities that secondary to sleep micro-arousal. Psychological factors like personality and anxiety are also frequently mentioned in relation to bruxism. Bruxism patients have higher life stress and anxiety, the person that severe bruxism, their work and life pressure is more heavier. In this paper, A central factors of bruxism is reviewed in detail concerning their pathophysiological and psychosocial aspects.%磨牙症的病因分为外周神经因素和中枢神经因素,(牙合)因素在磨牙症中只起一小部分作用。磨牙症与睡眠觉醒有关并受多种中枢神经化学递质的影响。中枢神经化学递质可能打乱了基底神经节的直接和间接输出通道的平衡,从而打乱咀嚼肌协调运动,引

  15. 儿童和青少年垂体瘤的临床诊治分析%Clinical analysis of children and adolescents patients with pituitary adenomas

    Institute of Scientific and Technical Information of China (English)

    韩冲; 潘源; 陈高明; 丁学华; 刘志民

    2012-01-01

    14 male and 10 female adenomas were invasive. In the prolactinomas, there were 9 male and 34 female. The most common presenting features were endocrinopathy and visual disturbances. All the patients treated with microsurgery, only 9 patients (12.2%) were received dopamine agonists treatment before operation; some patients proceeded postoperative bromocriptine or radiotherapy. Forty-seven cases were followed up, 6 relapsed patients were received surgery again. Twenty-nine patients in 32 recovered or improved from visual disturbances. Conclusion Children and adolescents patients with pituitary adenoma used to appear in postpubertal age, the ratio between male and female was different in various types of pituitary adenoma. Dopamine agonists using in treating prolactinomas should be further recommended in children and adolescents. The combination of dopamine agonists and surgery, as well as radiotherapy when indicated, can achieve good efficacy in the management of pituitary neoplasm.

  16. 溴隐亭治疗垂体腺瘤后超微结构改变和相关基因表达的研究%Medical management of pituitary adenomas: a study of ultrastructural changes and receptor expressions

    Institute of Scientific and Technical Information of China (English)

    吴哲褒; 诸葛启钏; 张亚卓; 孙异临; 陈勇; 王成德; 苏志鹏; 吕庆平; 吴近森; 郑伟明

    2011-01-01

    目的 从多巴胺2型受体表达水平和服药后细胞超微结构改变来阐明垂体腺瘤溴隐亭治疗的作用机制.方法 4例垂体无功能腺瘤和9例催乳素(PRL)腺瘤患者术前接受溴隐亭治疗,术后观察肿瘤细胞的超微结构改变.肿瘤标本送QRT-PCR检测细胞表面D2R和ER亚型的相对表达水平.结果 PRL腺瘤和临床无功能腺瘤细胞的D2S、D2L、ERα基因在mRNA水平存在差异表达(分别为P<0.01,P<0.01,P=0.019),PRL腺瘤的表达水平明显较高.除1例颗粒密集型PRL腺瘤外,颗粒稀疏型PRL腺瘤服用溴隐亭后肿瘤细胞体积缩小,染色质异常凝集,胞质空泡变性,细胞器减少,可见裸核细胞、暗细胞和不同程度的细胞坏死崩解.垂体无功能腺瘤与PRL腺瘤比较,细胞大小、形态改变较少,胞质内细胞器未见明显减少,少见染色质边聚、胞质空泡变性和裸核细胞.结论 垂体无功能腺瘤和PRL腺瘤在D2R和ER受体水平存在差异表达.垂体无功能腺瘤中D2R表达水平高者也存在溴隐亭治疗后细胞的超微结构改变.溴隐亭治疗后垂体肿瘤细胞超微结构改变和D2R表达水平存在一定的相关性.%Objective The aim of this study is to analyze the ultrastructural changes and dopamine 2 receptor(D2R) expression levels of pituitary adenomas to clarify the mechanism of medical management.Method 9patients with prolactinomas and 4 with nonfunctioning pituitary adenomas( NFPAs)were treated with bromocriptine preoperatively.Ultrastructure changes of tumor cells were observed through electron microscopy.Tumor tissue samples were examined for the expression of both ER mRNA and D2R mRNA isoforms by means of QRT- PCR analysis.Results Expressions of D2S mRNA、 D2L mRNA、 ERα mRNA were significant difference between prolactinomas and NFPAs( P <0.01, P <0.01, P =0.019,respectively),in which was higher in prolac tinomas as compared to NFPAs.Except for 1 patient with densely granulated lact

  17. Hiperprolactinemia en niños y adolescentes, conceptos e interrogantes actuales Hyperprolactinemia in children and adolescents, current questions and concepts

    Directory of Open Access Journals (Sweden)

    H. Fideleff

    2007-06-01

    , dopaminergic agonists are the initial therapy of choice in pediatric age patients. Bromocriptine and cabergoline have been used with similar results to those obtained in adults. The new concepts gained and the better insight into the physiology and pathophysiology of hyperprolactinemic conditions in children and adolescents have brought about a change in diagnostic and therapeutic alternatives.

  18. Diagnosis and treatment of male sexual dysfunction caused by hyperprolactinemia%血高催乳素血症导致男性性功能障碍的诊治分析

    Institute of Scientific and Technical Information of China (English)

    杨雪峰; 杨土生; 郭善媚

    2014-01-01

    and after treatment.Results:1 )There were 23 cases (71.88%)of idiopathic hyperprolactinemia,4 cases (12.50%)of micro adenoma and 5 cases (15.63%)of pitu-itary adenoma among the 32 patients.There were 29 cases (90.63%) of erectile dysfunction,32 cases (100.00%)of decreased libido and 7 cases (21.88%)of orgasmic disorder among the 32 patients.2)The serum prolactin levels of 32 patients after treatment were significantly lower than that before the treatment,with statistically significant difference (P<0.01);The levels of luteinizing hormone,follicle-stimulating hormone and testosterone of 32 patients after treatment were significantly higher than those before the treatment,with statistically significant difference (P<0.01).3)After treatment,the erectile dysfunction,decreased libido,orgasmic dysfunction and other symptoms of 32 patients were improved.Conclusion:Male sexual dysfunction caused by hyperprolactinemia can be confirmed through history taking,clinical characteristics,erectile function index determination,physical ex-amination,hormonal measurement and imaging of pituitary.The efficacy of Bromocriptine Mesylate and testosterone undecanoate is better and worthy of promotion.