The larger understanding regulation

The larger understanding regulation of secretion has caused possibility of application of a number agents for depression of its secretion at the expense of change of the central mechanisms. Use agents (L- and ) leads to reception of indistinct results [243, 244]; at the majority of patients reaction to these preparations or is insignificant, or completely is absent. Considering numerous data about a serotonin role in stimulations of secretion (see chapter 6), for treatment of illness with encouraging results have been applied cyproheptadine - a blocker receptors [232]. At this observation depression of level and a hydrocortisone in plasma, restoration of rate skelaxin 800mg of secretion of a hydrocortisone, overwhelming effect of dexamethasone and daily periodicity. Simultaneously with biochemical disturbances there came remission of clinical semiology. Daily doses made 24-32 mg, and by-effects were reduced to drowsiness and . To eliminate last, especially at children, it can be difficult. The greatest efficiency of treatment reached 50 , and against treatment at some patients relapses developed, and at cancellation of a preparation it was observed in all cases. Now it is impossible to predict, at whom from patients cyproheptadine will appear effective. The positive effect of this preparation was observed at patients with a syndrome of Nelson. Cyproheptadine was applied and as an additional agent at the patients receiving radial therapy, and promoted faster offensive of effect. THE TUMOURS COSECRETING THE HORMONE TtG-sekretirujushchie pituitary body tumours meet rather seldom, and in the literature there are mainly descriptions of separate cases, instead of data about their percent among hyperfunctioning tumours. At histological research they represent usually chromophobic adenomas though by means of immunohistochemical techniques in them it is possible to find out presence . These tumours are taped, as a rule, at inspection of patients with a hyperthyroidism at raised, instead of normal or lowered level in plasma [245, 246]. Clinical implications develop of symptoms of growth of tumoral mass (that can be absent if the tumour is small) and thyrotoxicosis symptoms.
The tumours consisting of various types of cells of a pituitary body which cosecrete not only , but simultaneously and or Prolactinum are described also. At these tumours secretion is not always independent. Though simultaneous rising of level and a thyroxine testifies to loss influences of the last on a pituitary body on the mechanism of a negative feedback, depression of level of a thyroxine by means of Methimazolum is often accompanied by the further rising of secretion [246] that reminds a situation concerning AkTg-sekretirujushchih pituitary body tumours. Reaction on varies, being shown only at some patients [247], and unlike patients with a primary hypothyrosis at which L- suppresses secretion , absence of effect L-dofa in this case is described. At patients with TtG-sekretirujushchimi and "not functioning" tumours observed also the raised level a-subedinitsy hormones [248]. The tumours cosecreting , it is necessary to differentiate from augmentation of a Turkish saddle and rising of level owing to a long hypothyrosis. This group of patients can be distinguished on subnormal level of a thyroxine and reducing action of an exogenous thyroxine on raised level . It is more difficult to distinguish patients with raised maintenance and a hyperthyroidism, but without signs of a tumour of a pituitary body [249, 250]. It is considered, that such patients have not tumour, and resistance robaxin medication of a pituitary body to thyroxine action on a feedback mechanism though possibility of existence small, clinically undetectable, a tumour to exclude it is impossible. At revealing of a tumour treatment should be referred on a pituitary body. However at patients with thyrotoxicosis symptoms important before operation to suppress secretion of a thyroxine by means of pharmacological agents to provide an euthyroid condition. THE TUMOURS OF THE PITUITARY BODY COSECRETING GONADOTROPINUM Some cases FSG - or FSG - and Lg-sekretirujushchih adenomas of a pituitary body [251-254] are described all. Consider, that at some patients the augmentation of a pituitary body and tumour formation proisho - again in relation to is long to an existing hypogonadism whereas at other patients of a tumour of a pituitary body can be primary disease. Reaction to introduction or . Can either remain, or be absent, and Testosteron-Depotum can or reduce not enough level , or not influence at all it. Raised secretion , as a rule, keeps cells , but Testosteron-Depotum level usually decreases, leading to occurrence of symptoms of a hypogonadism and spermatogenesis disturbance