Increased pituitary volume in antipsychotic-free and antipsychotic-treated patients of the Æsop First-Onset Psychosis Study

Subjects at their first psychotic episode show an enlarged volume of the pituitary gland, but whether this is due to hypothalamic–pituitary–adrenal (HPA) axis hyperactivity, or to stimulation of the prolactin-secreting cells by antipsychotic treatment, is unclear. We measured pituitary volume, using 1.5-mm, coronal, 1.5 T, high-resolution MRI images, in 78 patients at the first psychotic episode and 78age- and gender-matched healthy controls. In all, 18 patients were antipsychotic-free (12 of these were antipsychotic-naý¨ve), 26 werereceiving atypical antipsychotics, and 33 were receiving typical antipsychotics. As hypothesized, patients had a larger pituitary volume than controls (+22percent , p=0.001). When divided by antipsychotic treatment, and compared to controls, the pituitary volume was 15 percent larger in antipsychotic-free patients (p¼0.028), 17 percent larger in patients receiving atypicals (p¼0.01), and 30 percent larger in patients receiving typicals (p=0.001). Patients receiving typicals not only had the largest pituitary volume compared to controls but also showed a trend for a larger pituitary volume compared to the other patients grouped together (11 percent, p¼0.08). When divided by diagnosis, and compared to controls, the pituitary volume was 24 percent larger in patients with schizophrenia/schizophreniform disorder (n¼40, p=0.001), 19 percent larger in depressed patients (n¼13, p¼0.022), 16 percent larger in bipolar patients (n¼16, p¼0.037), and 12 percent larger in those with other psychoses (n¼9, p¼0.2). In conclusion, the first-episode of a psychotic disorder is associated with a larger pituitary independently of the presenceof antipsychotic treatment, and this could be due to activation of the HPA axis. Typical antipsychotics exert an additional enlarging effecton pituitary volume, likely to be related to activation of prolactin-secreting cells...

Chronic effects of marihuana extract on thyroid-gonad relationship in rats

Studies were carried out to elucidate the effects of Crude Aqueous Marihauna Extract free of tetrahydrocannabinol and other cannabinoids (CAME) on thyroid-gonad relationship in male rats. Oral indigestion of CAME for 52 days increased (p<0.01) the plasma levels of total circulating thyroxine and triiodothyronine, increased the weight of the adrenal gland (p<0.05), slightly decreased the plasma thyrotrophin level and the weight of the thyroid gland. These changes suggest the presence of hyperthyroidism in rats receiving CAME. Increased plasma thyroxine levels in CAME-treated rats correlated with the total plasma testosterone (r=0.526), indicating a possibility of thyroid-gonad relationship in such rats (AU)

The influence of the sympathoadrenal system on insulin release in protein-energy malnutrition (PEM)

Low insulin release has been observed in PEM; however, structural damage of the endocrine pancreas is not considered a major causative factor. Although PEM can be considered a stress situation, and catecholamines are known to be inhibitors of insulin release, little work has been done on the role of the sympathoadrenal system on insulin release in PEM. Control rats (132ñ2.6 g) and malnourished rats (53ñ0.55 g) fed on lab chow for 21-28 days after weaning were anaesthethized with 50 mg/kg body weight sodium-pentobarbital intraperitoneally, and blood for insulin radioimmunoassay sampled from the portal vein. Fasting insulin levels in 30 malnourished and 30 control rats were 1.6ñ0.4 uU.ml and 3.93ñ0.26 uU/ml respectively (p<0.001). The two groups of animals showed a significant difference in insulin output in response to glucose load. After collecting fasting blood in malnourished and control rats, an alpha-receptor blocker, phentolamine (0.25 mg/kg body weight), was administered through the inferior vena cava and blood sampled over a period of 2, 5, 10, 20, 30, 45 and 60 minutes. The area under the curves showed no difference in magnitude of insulin release in the two groups. Administering O-methyltyrosine (80 mg/kg body weight) for four days before sacrifice, catecholamine synthesis was blocked in 30 control and 30 malnourished rats. The fasting insulin levels in control and malnourished rats were 9.83ñ0.86 uU/ml and 9.63ñ0.6 uU/ml respectively. The insulin response to intravenous glucose challenge in the control and malnourished rats treated with O-methyl tyrosine for four days before sacrifice was exaggerated during the first phase of release and was of the same magnitude in both groups as compared with rats without drug treatment. Fifteen control and 15 malnourished rats were treated with tranquilizer, diazepam (0.15 mg/kg body weight), over a period of 10-14 days. Fasting insulin levels in the malnourished and control rats were 3.17ñ0.16 uU/ml and 4.61ñ0.11 uU/ml respectively, a significant increase (p<0.001) in the malnourished animals compared with rats without drug treatment. The plasma calcium and potassium levels, which are known to influence insulin release, showed no significant difference between control and malnourished groups. Finally, the histological examination of the islets by light microscopy showed the presence of "normal" B cells in both the malnourished and control rats. These results show that the sympathoadrenal system is one of the factors causing low insulin release in PEM. Although in PEM low insulin output is a form of adaptation to life, high insulin levels are required during treatment. The anabolic effect of insulin might, therefore, be enhanced if PEM patients were subjected to less stress during the period of treatment (AU)

Fetal steroid levels at delivery

The purpose of this study was to investigate cortisol levels in the circulation of neonates following spontaneous onset of labor. There was no significant difference of values between primagravidas and multigravidas, male and female babies, or normal and preeclamptic pregnancies. There was no significant change in mean cord plasma cortisol values with advancing gestational age, after the thirty-third week. It is conceivable that spontaneous labor in humans may be preceded by a release of cortisol into the fetal circulation and when a critical "parturient" level is reached labor becomes established (AU)

Exomphalos-macroglossia-gigantism syndrome in Jamaican infants

The clinical and laboratory findings in six Jamaican infants with the exomphalos-macroglossia-gigantism syndrome are described. The incidence was calculated as 1:13,700 births. There was no family history of similar disease in any case and no evidence of chromosomal abnormality, virus infection, or infantile hypoglycemia. Three infants died, and two showed typical histological features in the kidneys and adrenal glands.(AU)

Adrenal function in malnutrition

Descriptions of the pathology of the adrenal glands of severely malnourished children vary widely and it is equally difficult to draw any firm conclusions from studies of adrenal function in infantile malnutrition. We present here a preliminary report of experiments designed to investigate adrenocortical function in severely malnourished Jamaican children (AU)

The adrenal gland in Jamaican infants

Adrenal glands from 24 relatively well nourished and 44 malnourished Jamaican infants were studied. The average combined adrenal-gland weight was only 1.89 g. as compared with the European average of 5 g. This is almost certainly due to a reduction in the cortical mass and may be a racial difference. The lowest weights were found among the malnourished with an average combined adrenal-gland weight of 1.62 g. as compared with malnourished infants possessed less than 1 g. of adreanal tissue. Adrenal-gland weight was more closely related to body-weight than to height and there was no close correlation between it and the weight of the heart or kidneys. Delayed involution of the foetal cortex, a feature described but not hitherto confirmed in malnourished infants, was presentin only two cases. Other adrenal lesions present in the malnourished group were cortical haemorrhages, ingarctins and necrotic foci. There was evidence of exhaustion of both zones of the adrenal cortex in 3 of the malnourished infants only one showed evidence of exhaustion nad this in only the outer part of the zona fasciculata. (Summary)

Size of the adrenals in Jamaicans

The adrenal glands in Jamaicans are smaller than in Europeans. this reduction in size is probably due to a reduced cortical mass. It is suggested that this reduced cortical mass is concerned in the poor response to shock reported in Jamaicans and others of African descent. It may also play some part in the different pattern of disease encountered in Jamaica.(AU)

The adrenals in Jamaicans (abstract only)

The adrenals in Jamaicans are smaller than in Europeans. (AU)