Pituitary cytokine and growth factor expression and action.

The complex range of pituitary regulatory mechanisms reviewed here underlies the critical function of the pituitary in sustaining all higher life forms. Thus, the ultimate net secretion of pituitary hormones is determined by signal integration from all three tiers of pituitary control. It is clear from our current knowledge that the trophic hormone cells of the anterior pituitary are uniquely specialized to respond to these signals.

Molecular analysis of the adenomatous polyposis coli gene in sarcomas, hematological malignancies and noncolonic, neoplastic tissues.

Somatic mutations of the adenomatous polyposis coli (APC) gene have been frequently found in sporadic colorectal tumors, and the frequency of such mutations remain constant as tumors progress from benign adenomas to malignant cancers. Thus the mutations of the APC gene may have a major role in the early development of sporadic colorectal tumors. Whether inactivation of the APC gene accounts for other types of primary tumors is still being investigated.

Acromegaly.

Subcellular mechanisms support the notion of an intrinsic pituitary defect in acromegaly, with elevated growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels that affect the cardiovascular and respiratory system, as well as neoplastic cell proliferative activity. Surgery, even with external-beam irradiation adjuvant therapy, is only successful in less than 60% of patients, and there are side effects. Normalization of GH levels may improve survival rates.

Molecular pathogenesis of pituitary tumours.

Human pituitary tumours account for 10% of intracranial neoplasms. These tumours are usually sporadic and benign; malignant change and metastasis are extremely rare events. Autosomal dominant inheritance of MEN 1 accounts for a minority of pituitary tumours.

Continuous versus intermittent subcutaneous infusion of octreotide in the treatment of acromegaly.

This review evaluates the efficacy, tolerability, and safety of continuous subcutaneous infusion (CSI) relative to intermittent subcutaneous injection (ISI) of the somatostatin analog, octreotide in the treatment of acromegaly. Data was extracted from five clinical series using CSI octreotide in acromegaly, six reports comparing CSI to ISI, and three studies comparing pulsatile subcutaneous infusion (PSI) to ISI. Effects of each drug regimen on the control of growth hormone (GH), insulin-like growth factor (IGF-1), clinical symptomatology, pituitary tumor size, and adverse effects were evaluated.