Differentiation of hypoglycaemia induced cognitive impairments. An electrophysiological approach.

Effects of hypoglycaemia on distinct cognitive processes were assessed with event-related brain-potential (ERP) measures and reaction times in a hybrid selective-attention/response-choice task. One group of subjects received a euglycaemia-hypoglycaemia-euglycaemia treatment order and a second group a euglycaemia-placebo(euglycaemia)-euglycaemia sequence of treatments. During hypoglycaemia, ERP measures of selective attention (selection negativity), response choice (lateralized readiness potential) and reaction time were delayed compared with baseline performance.

[Hyperthyroidism in TSH-producing hypophyseal adenoma].

History And Clinical Findings: For 5 years a 59-year-old man had been treated with thyrostatic drugs for hyperthyroidism of unknown aetiology. As he had been losing weight, computed tomography had been performed in the search for a malignancy. It revealed a hypophyseal space-occupying lesion.

[Clinical and endocrine diagnosis of pheochromocytoma].

Pheochromocytomas are catecholamine-producing tumors, representing one of the most important causes of secondary hypertension. The classification of these tumors considers both sporadic and familial forms, intra- and extraadrenal localization as well as the dignity. Familial pheochromocytomas are primarily seen under the conditions of multiple endocrine neoplasia, von Hippel-Lindau disease or neurofibromatosis type 1.

[Bilateral laparoscopic transperitoneal adrenalectomy in pheochromocytoma].

Laparoscopic transperitoneal and endoscopic extraperitoneal adrenalectomy are two safe options in minimally invasive surgery associated with a very low morbidity. Comparative studies with the conventional access to the adrenal gland demonstrated the advantages of the endoscopic technique. The anterior transperitoneal approach yields a better exposure of the anatomic structures and allows the surgeon to orient himself more easily, while at the same time he may perform additional laparoscopic maneuvers.

Corticotropin-releasing factor receptors: an overview.

Corticotropin-releasing factor (CRF) is the primary physiological regulator of basal and stress-induced release of ACTH, beta-endorphin and other POMC-derived peptides from the pituitary and plays a major role in the brain and periphery in coordinating endocrine, electrophysiological, autonomic, behavioral and immune responses to stress. In addition, recent clinical data implicate CRF in the etiology and pathophysiology in a variety of endocrine, psychiatric and neurodegenerative disorders. The various effects of CRF are mediated by two distinct CRF receptors expressed at high levels in selected brain areas, but also at different levels in several other non-neuronal tissues.

Octreotide scintigraphy and catecholamine response to an octreotide challenge in malignant phaeochromocytoma.

Objective: Octreotide scintigraphy has been reported to visualize chromaffine tumours. This study in patients with malignant phaeochromocytoma was designed to assess octreotide in comparison with standard m-iodobenzylguanidine (MIBG) scintigraphy and to study functional activity of somatostatin receptors. Finally, two cases of octreotide treatment are reported.

Human corticotropin-releasing hormone and thyrotropin-releasing hormone modulate the hypercapnic ventilatory response in humans.

Human corticotropin-releasing hormone (hCRH) and thyrotropin-releasing hormone (TRH) are known to stimulate ventilation after i.v. administration in humans.

Decreased sympatho-adrenal activity in diabetic patients with autonomic dysfunction following mental stress.

The sympathetic nervous system is of major importance in the regulation of numerous physiological functions. While it is clearly established that there is a decreased noradrenergic status in people with autonomic neuropathy, the epinephrine secretion is much more controversial. Basal and mental stress-stimulated plasma catecholamine levels were measured in 42 diabetic patients with and without pathological cardiovascular function tests and in 13 healthy, non-diabetic control subjects.

Prevalence of dialysis-related amyloidosis in diabetic patients. Diabetes Amyloid Study Group.

It has recently been shown that beta 2-microglobulin isolated from amyloid deposits in dialysis patients is modified by advanced glycation (AGE). In this context it appeared of interest to examine in a cross-sectional multicentre study whether dialysis-related amyloidosis, as evaluated by X-ray assessment of cysts in the metacarpal bones, was different in diabetic patients on maintenance haemodialysis for more than 5 years time compared with matched non-diabetic controls. We evaluated the hand skeleton of 75 diabetic patients (9 type I, 66 type II; 35 male, 40 female; median age 64 years, range 31-86; median duration of dialysis 7 years, range 5-17).

Activation of noradrenergic neurons in the locus coeruleus by corticotropin-releasing factor. A microdialysis study.

In the present study the effects of different doses of corticotropin-releasing factor (CRF) and the CRF antagonist alpha-helical CRF on locus coeruleus (LC) neurons were studied in anesthetized male Wistar rats. To monitor the release of noradrenaline (NA) and its metabolite 3-methoxy-4-hydroxyphenylethylene glycol (MHPG), a microdialysis probe was implanted into the parietal cortex, a major projection area of the LC. Saline, 0.

[Interstitial pneumonia and sepsis due to a Pasteurella multocida infection].

History And Clinical Findings: A 65-year-old diabetic (requiring insulin during the last year) was admitted as an emergency because of a septic temperature rising to 40 degrees C with rigor, tachycardia (up to 120/min) and dyspnoea. On examination there was local reddening and swelling of the skin over the right thenar eminence and along the lower arm. Two days before admission a bad scratch had been inflicted on his right hand by a cat.

Gynaecomastia in a patient with a hCG producing giant cell carcinoma of the lung. Case report.

Gynaecomastia, or enlargement of the male breast may result from various endocrine dysfunctions and often reflects ectopic production of substances such as hCG and estradiol. We report on the case of a 30 year old man who presented with gynaecomastia and elevated plasma levels of hCG, estradiol and testosterone. As a result of several diagnostic procedures such as selective venous sampling and magnetic resonance tomography (MRT), a hCG producing tumor of the upper lobe of the left lung was found.

Effects of corticotropin-releasing hormone on respiratory parameters during sleep in normal men.

Corticotropin-releasing hormone (CRH) is well-known to be a centrally acting respiratory stimulant after systemic application both in healthy subjects and in patients suffering from respiratory failure. In order to study the effects of CRH on sleep EEG and respiratory parameters during sleep, 14 healthy male volunteers were investigated in a single-blind placebo controlled design. After an adaptation night, polysomnography was performed during two successive nights between 23.

Eosinophilia-myalgia syndrome in Germany: an epidemiologic review.

Objective: To review the epidemiologic features of eosinophilia-myalgia syndrome (EMS) in Germany.

Design: We determined the incidence of EMS in Germany through May 1992 and analyzed the dose of L-tryptophan used, the duration of intake, and the concurrent medications.

Material And Methods: All patients receiving L-tryptophan preparations in Germany were already under medical supervision before the onset of the disease; thus, information on patient history and other potential risk factors was readily available.

Control for carbon dioxide-related changes in flow velocity by transcranial Doppler monitoring.

Transcranial Doppler ultrasonography can monitor changes in intracranial blood flow velocity over time in a variety of experimental and clinical settings with excellent temporal resolution. Alterations in arterial carbon dioxide pressure exert a profound influence on blood flow velocity. Such changes exhibit important individual fluctuation depending on respiratory status.

Intra- and extracerebral blood flow changes and flushing after intravenous injection of human corticotropin-releasing hormone.

To study facial flush after systemic administration of human corticotropin-releasing hormone (hCRH) we injected 100 micrograms hCRH intravenously to ten healthy young men. The increase in facial temperature was measured by infrared camera. A significant increase in facial temperature of 1.

The stress-, but not corticotropin-releasing hormone-induced activation of the pituitary-adrenal axis in man is blocked by alprazolam.

A number of experimental studies clearly suggest that benzodiazepines attenuate the corticotropin-releasing hormone (CRH) secretion possibly through inhibitory GABAergic neurons. There is some evidence that benzodiazepines act to inhibit stress-induced activation of the hypothalamic-pituitary-adrenal axis. A comparison of the effects of a benzodiazepine on the stress- and CRH-induced activation in man has not been undertaken so far.

Corticotropin-releasing hormone (CRH) is a respiratory stimulant in humans: a comparative study of human and ovine CRH.

Previous experimental and clinical studies clearly demonstrated that exogenously administered CRH possesses respiratory properties. Until now, these effects were investigated using human (h) CRH in both healthy volunteers and patients under long-term respiration. We now compared the effects of hCRH with those of ovine (o) CRH in ten healthy young males.

Specific mutations of the RET proto-oncogene are related to disease phenotype in MEN 2A and FMTC.

We have analysed 118 families with inherited medullary thyroid carcinoma (MTC) for mutations of the RET proto-oncogene. These included cases of multiple endocrine neoplasia types 2A (MEN 2A) and 2B (MEN 2B) and familial MTC (FMTC). Mutations at one of 5 cysteines in the extracellular domain were found in 97% of patients with MEN 2A and 86% with FMTC but not in MEN 2B patients or normal controls.

Effects of thyrotropin- and corticotropin-releasing hormone on blood pressure and plasma catecholamines in the anesthetized rat.

The neuropeptides thyrotropin-releasing hormone (TRH) and corticotropin-releasing hormone (CRH) have been found to be potent stimulators of the autonomic nervous system in both experimental animals and humans. We studied the effects of different doses of CRH and TRH given intracerebroventricularly in the urethane-anesthetized rat and a single dose of CRH in the chloral hydrate-anesthetized rat to elucidate the effects of these peptides in the unconscious state. All TRH doses studied enhanced blood pressure and noradrenaline and adrenaline secretion.

Effects of nitrendipine on blood pressure, renin-angiotensin-system and atrial natriuretic peptide in hypertensive type I diabetic patients.

In this study, the effects of a six week treatment with the calcium channel blocking agent nitrendipine were assessed in 20 hypertensive type I diabetic patients who received a single oral dose of 20 mg daily. Plasma concentrations of atrial natriuretic peptide (ANP), plasma renin activity (PRA) and active renin, aldosterone, glycosylated hemoglobin (HbA1) and fructosamines were determined at the beginning and the end of the study. Interactions of these endocrine parameters with blood pressure behaviour were analyzed by a correlation matrix.