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Gordon S. Dugger, Judson J. Van Wyk and James F. Newsome

system has been less clearly defined in relation to FSH and LH secretion than has been the case with thyrotropin. Furthermore, there is considerable hazard in transferring physiologic data from lower forms to the human since the primate reproductive cycle differs in certain important respects from that in other mammals. As with TSH, however, transplantation of the rat pituitary away from its normal location results in a diminished secretion of both FSH and LH and these effects are reversed when the pituitary is re-implanted under the median eminence. 12, 13, 15

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Donald D. Matson and John F. Crigler Jr.

, urine specific gravities. Thyrotropin—PBI, resin T 3 , cholesterol, thyroidal 131 I uptake, BMR, bone age. ACTH—urinary 17-OH and 17-KS (adoles.) response to metyrapone. Response to water load (20 ml/kg). Gonadotropins (FSH, LH)—urinary or serum (immunological) assays, vaginal smears, testicular biopsies. Growth hormone—serum immunological assay (IRGH) response to induced hypoglycemia or arginine-HCl infusion with simultaneous measurements of blood sugar, plasma free fatty acids and immunoreactive insulin (IRI). BUN, alkaline phosphatase

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Massimo A. Giovanelli, Enrico D. F. Motti, Alessandra Paracchi, Paolo Beck-Peccoz, Bruno Ambrosi and Giovanni Faglia

injection of 200 µg of thyrotropin releasing hormone (TRH). Serum GH response was considered positive when a rise of at least 50% over the baseline, and an absolute increase above 10 ng/ml, were obtained. Serum GH suppressibility was tested by oral glucose load (100 gm) which usually reduces serum GH below 5.0 ng/ml in non-acromegalic subjects. The hypothalamic-pituitary-adrenal function was assessed by means of the following indexes: urinary 17-hydroxycorticosteroids (17-OHCS) 41 in the basal state and after metyrapone administration (750 mg every 4 hours over a 24

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Osami Kubo, Naomi Yamasaki, Yasuo Kamijo, Keiichi Amano, Koichi Kitamura and Reiko Demura

thyrotropin releasing hormone (TRH) test was performed by the intravenous administration of 100 µg of LH-RH mixed with 10 µg/kg of TRH. During the test the patient was not allowed any food intake. Blood samples were drawn before and 30, 60, 90, and 120 minutes after the injection. Basal plasma levels of various hormones before and after surgical excision and radiotherapy of the tumor are shown in Table 1 . The HCG and HCG-β values were markedly high and LH was also measured to be high before treatment but all of them decreased rapidly immediately after treatment. The

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Milam E. Leavens, Naguib A. Samaan, Richard H. Jesse Jr. and Robert M. Byers

. TABLE 3 Serum human growth hormone (HGH) levels in 16 acromegalic patients after thyrotropin-releasing hormone stimulation and glucose tolerance tests (ng/ml) Case No. Thyrotropin-Releasing Hormone Glucose Tolerance Test (50 gm) Before Surgery After Surgery Before Surgery After Surgery Basal Peak Basal Peak Basal Peak Basal Peak 1 83 115 27 90 76 84 25 25 2 61 120 5 7 52 83 0.9 2.0 3 100 125 7 7 10 75 7.0 22 4 24 74 2

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George T. Tindall, C. Scott McLanahan and James H. Christy

for man? Trans Assoc Am Physicians 82: 225–238, 1969 30. Ray BS , Patterson RH Jr : Surgical experience with chromophobe adenomas of the pituitary gland. J Neurosurg 34 : 726 – 729 , 1971 Ray BS, Patterson RH Jr: Surgical experience with chromophobe adenomas of the pituitary gland. J Neurosurg 34: 726–729, 1971 31. Ridgeway EC , Kourides IA , Kliman B , et al : Thyrotropin and prolactin pituitary reserve in the ‘empty sella syndrome.’ J Clin Endocrinol Metab 41 : 968 – 973

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Juji Takeuchi, Hajime Handa and Izumi Nagata

stimulating hormone (FSH), and cortisol were assayed by radioimmunoassay methods. To stimulate these hormones, insulin (0.125 U/kg) was injected intravenously for HGH and cortisol, thyrotropin-releasing hormone (TRH) for TSH, and LH releasing hormone (LRH) for LH and FSH. To assess the pituitary-adrenal functions, lysine-vasopressin and rapid ACTH tests were combined with the insulin test, and plasma cortisol was assayed. Urinary 17-hydroxycorticosteroids (17-OHCS) was also assayed. Details of these hormonal examinations will be published elsewhere. Among these five

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Alan S. Fleischer, Daniel R. Rudman, Nettleton S. Payne and George T. Tindall

AH Jr : A possible role of cyclic AMP in mediating the effects of thyrotropin-releasing hormone on prolactin release and on prolactin and growth hormone synthesis in pituitary cells in culture. Endocrinology 98 : 1147 – 1159 , 1976 Dannies PS, Gautvik KM, Tashjian AH Jr: A possible role of cyclic AMP in mediating the effects of thyrotropin-releasing hormone on prolactin release and on prolactin and growth hormone synthesis in pituitary cells in culture. Endocrinology 98: 1147–1159, 1976 5. Domm BM , Vassallo CL

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Kenneth R. Feingold, Ira D. Goldfine and Philip R. Weinstein

human growth hormone in acromegalic serum: overestimation by immunoassay and systemic differences between antisera. J Clin Endocrinol Metab 39: 257–262, 1974 14. Irie M , Tsushimi T : Increase of serum growth hormone concentration following thyrotropin-releasing hormone injection in patients with acromegaly or gigantism. J Clin Endocrinol Metab 35 : 97 – 100 , 1972 Irie M, Tsushimi T: Increase of serum growth hormone concentration following thyrotropin-releasing hormone injection in patients with acromegaly or gigantism. J

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Neurosurgical management of acromegaly

Results in 82 patients treated between 1972 and 1977

Edward R. Laws Jr., David G. Piepgras, Raymond V. Randall and Charles F. Abboud

analysis of results from any form of treatment for acromegaly. Previously, reported results were judged by criteria such as “clinical improvement,” “regression of acromegalic features,” or percentage decrease in preoperative levels of growth hormone. Absolute preoperative and postoperative growth hormone levels are considerably more valuable, and the best currently available criteria of surgical success are the postoperative responses of growth hormone to dynamic testing (such as insulin-induced hypoglycemia, glucose load, infusion of thyrotropin-releasing hormone, and