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Bruno Weber, Hans Helge and Hans-Jürgen Quabbe


The effect of iv glucagon injections on growth hormone (GH) secretion has been studied in 45 children. A rapid increase in GH plasma values within 30 min was seen in 15 out of 23 normal, 6 out of 12 obese, and 3 out of 10 diabetic subjects. Maximal individual increments ranged from 4.1 to 16.8 ng/ml in the normal, 2.1 to 6.3 ng/ml in the obese, and 2.1 to 4.2 ng/ml in the diabetic responders, respectively. A lower incidence in the GH response and smaller peaks in the obese, as compared to normal weight subjects, agree with many studies using different stimuli. The hyporesponsiveness of diabetic children to glucagon remains unexplained. Some correlation between GH responses and nausea or sick feeling, which occurred in many children following the glucagon load of 1 mg, seemed to indicate stress-like mechanisms as the major cause of this phenomenon, but the possible relevance of more specific glucagon effects cannot be excluded.

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Wolfgang Saeger, Dieter K Lüdecke, Michael Buchfelder, Rudolf Fahlbusch, Hans-Jürgen Quabbe and Stephan Petersenn

In 1996, the German Registry of Pituitary Tumors was founded by the Pituitary Section of the German Society of Endocrinology as a reference center for collection and consultant pathohistological studies of pituitary tumors. The experiences of the first 10 years of this registry based on 4122 cases will herein be reported. The data supplement former collections of the years 1970–1995 with 3480 surgically removed tumors or lesions of the pituitary region. The cases were studied using histology, immunostainings and in some cases also molecular pathology or electron microscopy. The adenomas were classified according to the current World Health Organization classification in the version of 2004. From 1996 on 3489 adenomas (84.6%), 5 pituitary carcinomas (0.12%), 133 craniophar-yngiomas (3.2%), 39 meningiomas (0.94%), 25 metastases (0.6%), 22 chordomas (0.5%), 115 cystic non-neoplastic lesions (2.8%), and 46 inflammatory lesions (1.1%, 248 other lesions or normal tissue (6.0%)) were collected by us. The adenomas (100%) were classified into densely granulated GH cell adenomas (9.2%), sparsely granulated GH cell adenomas (6.3%), sparsely granulated prolactin (PRL) cell adenomas (8.9%), densely granulated PRL cell adenomas (0.3%), mixed GH/PRL cell adenomas (5.2%), mammosomatotropic adenomas (1.1%), acidophilic stem cell adenomas (0.2%), densely granulated ACTH cell adenomas (7.2%), sparsely granulated ACTH cell adenomas (7.9%), Crooke cell adenomas (0.03%), TSH cell adenomas (1.5%), FSH/LH cell adenomas (24.8%), null cell adenomas (19.3%), null cell adenoma, oncocytic variant (5.8%), and plurihormonal adenomas (1.3%). Following the WHO classification of 2004, the new entity ‘atypical adenoma’ was found in 12 cases in 2005. Various prognostic parameters and clinical implications are discussed.

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Ursula Plöckinger, Michael Bäder, Werner Hopfenmüller, Wolfgang Saeger and Hans-Jürgen Quabbe


The value of somatostatin receptor scintigraphy (SRS) to predict the effect of somatostatin analog therapy on pituitary adenomas is not clear, due to the use of different radiopharmaceuticals (123I-Tyr3-octreotide and 111In-pentetreotide) and the small number of patients in previous studies. We used 111In-pentetreotide scintigraphy in 49 patients in order to (i) correlate SRS results with basal tumor volume as well as volume- and hormone-response to 3 months of octreotide therapy (Oct-Tx), (ii) identify tumor remnants after incomplete surgery and (iii) evaluate any correlation with immunohistology. Twenty-five patients had a GH-secreting adenoma (GH-A, 15 prior to intended surgery, 10 with persistent/recurrent disease after previous therapy). Twenty-four patients had a clinically nonfunctioning adenoma (NF-A). For SRS, planar and single photon emission computer tomographic images (SPECT) were recorded 4 h and 24 h post injection. SRS grading was as follows: GO, no uptake; Gl, uptake comparable to normal pituitary; G2, increased uptake; G3, very intense uptake. G2/3 was seen in 8/25 GH-A and in 12/24 NF-A. Pretreatment tumor volume (magnetic resonance imaging (MRI)) tended to be related to 111In-pentetreotide uptake in GH-A with a tumor visible on MRI (G0/1 (n=10) vs G2/3 (n=8): 3·6±1·9 vs 10·±6·5 cm3 (mean±s.e.), P=0·051), but not in NF-A (g0/1 (n=12) vs G2/3 (n=12): 17·0±10·1 vs 14·3±3·6 cm3). SRS did not identify a tumor remnant in the 7 MRI-negative patients with persistent post-operative acromegaly. Basal GH (6-h profile) and IGF-I in GH-A did not correlate with SRS results (G0/1 (n=17) vs G2/3 (n=8), GH: 32·3±18·2 vs 29·3±7·4 μg/l, IGF-I: 851±80 vs 1038±153 μg/l). During Oct-Tx of GH-A neither tumor shrinkage nor GH suppression was related to SRS results. In 6 NF-A classified as gonadotropinomas (by their plasma glycoprotein hormone or α-subunit concentrations, basally and/or in response to TRH) 111In-pentetreotide uptake was not different from that of the non-gonadotropin/non-secreting adenomas. SRS results were not related to the immunohistological subtype in 22 GH-A (monohormonal, mixed somatotrope/lactotrope, plurihormonal) or in 22 NF-A (null-cell adenomas, gonadotropinomas, silent hormonal adenomas). We conclude that 111In-pentetreotide SRS reflects tumor volume poorly in GH-A and not at all in NF-A. It does not predict the effect of Oct-Tx on the volume of both GH-A and NF-A, nor on the GH concentration in GH-A. 111In-pentetreotide SRS is unable to identify postoperative tumor remnants not visible on MRI.

European Journal of Endocrinology 136 369–376