and, it agree later to the received data

and, it agree later to the received data, in 87 of the pituitary bodies removed concerning illness , there was a diffusive or nodous hyperplasia whereas tumours have been found in 73 of cases [177]. Similar changes occur in a pituitary body of patients to a syndrome of Nelson; 3 - similarity of symptoms of illness (loss of periodicity of secretion toradol injection both a hydrocortisone and weakening of brake influence of glucocorticoids) with the symptoms observed at primary disturbances in , testifies to a generality of a pathogenesis of both conditions mediated by rising of secretion , and occurrence of similar symptoms at KRF-PRODUCING tumours of lungs confirms this point of view; 4 - researches of the periodic phenomena (secretion both Prolactinum and percent of time occupied with a dream) also specify in primacy of disturbances in . Periodicity of secretion of Prolactinum is lost at illness, but not at syndrome [230], and absence of periodicity of secretion both a hydrocortisone and a shorting of slowly wave dream [231] that meets at patients active illness , disappear after normalisation of level of a hydrocortisone owing to surgical treatment only in some cases; 5 - reactions of some sick of illness on agents, such as a blocker receptors cyproheptadine [232] which, as shown in experiences on animals, influences the central regulation of secretion , convincingly testify in favour of primary role in a disease pathogenesis. The main argument in advantage parentages of illness consists that the selective adenomectomy in the course of transsphenoidal surgical operation leads in the beginning to insufficiency of secretion , and then to function restoration gipotalamo-gipofizarnoj systems [225, 233, 234].
Disturbance of secretion consider as a consequence of suppression AkTg-sekretirujushchej a tumour of function normal like that observe after excision of an adenoma of a cortex of adrenals. Restoration not only hydrocortisone secretion, but also normal daily periodicity and sensitivity to suppression by glucocorticoids testifies in advantage illness parentages. As glucocorticoids can suppress secretion not only at level of central-nervous mechanisms, but also at pituitary body level, sensitivity disturbance to the feedback effects, observed at AkTg-sekretirujushchih tumours, does not contradict opinion about a genesis. The main obstacle for the question decision limitation of number of patients, treated as different methods, and rather small duration observations in most cases serves. So there is to the unknown person a frequency of relapse after to an adenomectomy. It is not excluded also, that there is illness of two types, one of which has a genesis, and another is caused by excessive secretion . The divergence of results of surgical treatment of sick different groups, and also their reactions to pharmacotherapy will be compounded baclofen overdose with representation about a double aetiology of disease. Working out of a sensitive and specific method of definition in blood can give the answer to a question. TREATMENT From all hyperfunctioning tumours of pituitary body AkTg-sekretirujushchie are the most accurate indication for radical treatment as they are accompanied by symptoms of long hyperfunction of a cortex of adrenals. Though in the beginning has shown efficiency of the treatment referred on a pituitary body, but subsequently the basic attention it was given to adrenals. However thanks to successes of transsphenoidal surgical interventions the pituitary body has taken again the central place as object of treatment. Simultaneous improvement of agents of the pharmacotherapy referred both on adrenals, and on , has provided to doctors choice possibility. Before to begin the treatment referred on adrenals, a pituitary body or , it is necessary to carry out careful research for an exception AKTG - or KrF-sekretirujushchih the tumours which excision can lead to treatment of illness . Surgical intervention Until recently more often the bilateral adrenalectomy was an applied technique. Attempts undertaken in the past to leave a part of one adrenal to keep residual function of a cortical layer, have been left because of frequent development of relapses of disease owing to a hyperplasia of the left fragment under the influence of proceeding and amplifying secretion . Like it of attempt to transplant an adrenal tissue in easily accessible sites of a body (for example, in a forearm) though were successful in some cases [235, 236], but or satisfactory function of a graft was established only in some years, or there was a repeated hyperplasia.