Endocrine Abstracts

Gross cystic disease of the breast is a condition afflicting 7% of western women and confers an increased risk of developing breast cancer. Biochemical analyses of breast cyst fluid (BCF) have allowed the identification of various components of BCF and the classification of breast cysts into type I and II cysts. Gross cystic disease fluid proteins (GCDFP) are a family of proteins found in BCF and include albumin, apolipoprotein D and prolactin inducible protein (PIP). It is pr...

Transphenoidal hypophysectomy is often carried out to remove ACTH-secreting tumours of the pituitary. A postoperative serum cortisol of <50nmol/l usually indicates cure of the disease but after other audits found persistent cases, 'remission' is thought to be a more appropriate term.Charing Cross Hospital is the tertiary neurosurgical centre for West London where a single, dedicated pituitary surgeon was appointed in 1995. We analysed the success of e...

BACKGROUND: Cell cycle dysregulation is one of the defining features of cancer. Cyclin-dependent kinase 4 (CDK4), together with its regulatory subunit Cyclin D, governs cell cycle progression in G1 phase. CDK4 is in turn regulated by cyclin-dependent kinase inhibitors, including p16INK4A (CDKN2A). Dysregulation of the INK4A/CDK4/cyclin D complex has been established in different a variety of types of human tumours. Dominant mutations affecting codon 24 of the CDK4 gene (replac...

Eliciting an accurate diagnosis of Cushing's disease before transphenoidal hypophysectomy is essential to avoid unnecessary surgery. Localisation of the tumour increases the chance of operative success.In the right hands, Inferior Petrosal Sinus Sampling (IPSS) can provide invaluable information in distinguishing ectopic ACTH from pituitary Cushing's and localising the tumour in patients who are known to have Cushing's syndrome. Due to the invasive natur...

The molecular mechanisms underlying adrenal adenomas have not yet been elucidated. Many groups have sought mutations within the ACTH receptor as well as its downstream signalling pathway, although none have yet been identified. However, mutations in the alpha regulatory subunit of the cAMP dependant Protein Kinase A (PRKAR1A) have recently been described in more than 50% of patients with Carney complex. This syndrome is characterised by nodular adrenocortical hyperplasia as we...

Midnight Cortisol RevisitedD Noimark, MT Barakat, K. Meeran, JF ToddEndocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, LondonBackground: The diagnosis of Cushing's syndrome must be established before any attempt at differential diagnosis. The diagnosis of Cushing's syndrome can be made initially on an outpatient basis with the measurement of 24 hour urinary free cortisol ...

Primary adrenal tumours are responsible for about 10% of cases of Cushing's syndrome. Adrenocortical carcinomas are rare with an incidence of 2 per million per year. Both adrenocortical adenomas and carcinomas occur more commonly in women.A 46 year old previously fit woman presented with a short history of hirsutism, facial plethora, amenorrhoea, acne and progressive weight gain. Hypertension and glucose intolerance had been diagnosed recently. There was...

INTRODUCTIONWe assessed the long-term outcomes of patients managed with intermittent androgen suppression (IAS) following their enrolment in an open, non-randomised feasibility study initiated 10 years ago.PATIENTS AND METHODSAll patients were required to have been managed with androgen suppression for a minimum of 9 months and achieved PSA remissions to levels <4ng/ml. Therapy was stopped and the patients...

Aim: To ascertain the types of treatment, results and correlation between GH and the simultaneous IGF-1. Setting: Endocrine and Neurosurgical Unit. Methods: Endocrine and laboratory database of 17 acromegalic patients (11 male) with mean (SD) age 51(3) years and follow up 11 years. Results: Pituitary surgery 11 patients (3 twice), external radiotherapy 10 (one heavy particle therapy). GH levels have come down from a median value 32.5 mU per litre (Mean plus/minus SEM: 51.9 plu...

Introduction:The genetics of most cases of familial phaechromocytomas is unknown.Up to 50%of paragangliomas arefamilial and increased susceptibility is seen in SDHD and SDHC mutations.We report a family with a mutation in the SDHB gene .Case report: The index case, a 22 year old male was treated at the age of 10 years with extra adrenal phaeochromocytoma. Recently, he was found to have ...

This 65 years old lady, who had undergone neck explorations for parathyroid adenoma in 1972 and 2000, presented with vomiting, lethargy, muscle weakness and polyuria. On admission, her serum Calcium was 2.98 mmol/l (2.18-2.63) with elevated parathyroid hormone of 151 pg/ml (10-70). A Thallium-Technetium parathyroid scan was normal but Octreotide scan showed an area of uptake in the superior mediastinum. A MIBI scan followed, which was unhelpful as were ultrasound scan of the n...

AIM: to study the adequacy of surgery and detect MTC recurrences by means of serum calcitonin.METHODS: 30 patients with MTC were examined and followed-up for 5.5 years in the average. Radio-inmmunological examination, serum CT measurement was performed by means of commercially available kit RIA DCL-1200. Norm is up to 42picograms per ml.RESULTS: as the result of analysis of the surgery types MTC prognosis parameters, such as, tumor...

ER-alpha and ER-beta function as transcription factors to modulate expression of target genes. Both interact with nuclear regulatory proteins to enhance or inhibit transcription. We hypothesized that these co-regulators are expressed in breast cancer tissue and may be differentially regulated by estrogen and tamoxifen.ER-alpha, ER-beta, the co-activator SRC-1, and the co-repressor SMRT were localized within breast tissue by immunohistochemistry, and the ...

Ovarian cancer is the leading cause of death from all gynaecological malignancies. The observation that decreased levels of the natural oestrogen-17beta metabolite, 2-methoxyoestradiol (2-MeOE2) may create a predisposition to oestrogen dependent cancer, has led to considerable interest in the potential use of oestrogen derivatives for the prevention and treatment of hormone dependent cancers. The sulphamoylated oestrone derivative 2-methoxyoestrone-3-O-sulphamate (2-MeO...

Advances in the treatment of acromegaly mean biochemical 'cure ' should be possible in the vast majority of patients. The challenge of the future will be designing treatment algorithms to optimise outcomes for individual patients, to ensure not only life expectancy but also QOL is normalised. QOL data is lacking in acromegaly, as is a disease-specific tool for measuring QOL. ACROQOL is a disease-specific QOL questionnaire compromising 22 questions (scored 1-5, high score good)...

Background: The screening of patients and relatives for the presence of inactivating mutations of the MEN 1 gene, established quite accurately those for prospective detection of neoplasms. Active search for pancreatic lesions has increased the detection of neuroendocrine pancreatic tumours (NEPT) at early ages, most asymptomatic and with no signs of malignancy at diagnosis.Case Report: We describe one kindred where five members were identified as carrier...

Background. The GH/IGF-I axis has been implicated in the pathogenesis of colon and breast cancer. We have recently demonstrated that the local expression of its components correlates with that of tumour-associated genes and angiogenesis. The two predominant isomers of GH in humans are 22kDa and 20kDa isomers. A recent study reported that the two isomers exert opposing effects on breast cancer cells: 22kDa GH promotes proliferation whereas 20kDa GH inhibits proliferation. The l...