Despite the fact that most gastroenteropancreatic neuroendocrine tumors (GEPNETs) are slow-growing, median overall survival (OS) in patients with liver metastases is 2 to 4 years. In metastatic disease, cytoreductive therapeutic options limited. A relatively new therapy peptide receptor radionuclide radiolabeled somatostatin analog [(177)Lu-DOTA(0),Tyr(3)]octreotate. Here we report on toxicity and efficacy of this treatment, performed over 500 patients.Patients were treated up a cumulative...

Objective : Currently, there is no effective medical treatment for patients with pituitary-dependent Cushing’s disease. A novel somatostatin (SS) analogue, named SOM230, high binding affinity to SS receptor subtypes sst 1 , 2 3 and 5 was recently introduced. We compared the in vitro effects of -preferring analogue octreotide (OCT) multi-ligand SOM230 on ACTH release by human mouse corticotroph tumour cells. Methods By quantitative RT-PCR subtype expression level determined adenomas. In...

To evaluate the long-term impact of cured Cushing's disease on subjective well-being, we assessed quality life by validated health-related questionnaires in 58 patients from transsphenoidal surgery (n = 58), some whom received additional radiotherapy 11) and/or bilateral adrenalectomy 3). The mean duration remission was 13.4 +/- 6.7 yr (range 2-25 yr). Patient data were compared with a control group 98 healthy subjects same age and sex distribution age-adjusted reference values available...

Increased mortality in patients with pituitary tumors after surgical treatment has been reported. However, it is unknown to what extent excess caused by and their general previous exposure hormonal overproduction.The aim of the study was compare between treated for Cushing's disease nonfunctioning macroadenomas (NFMAs).This a follow-up study.We included 248 consecutive adenomas transsphenoidal surgery our hospital NFMAs (n = 174) ACTH-producing 74). The mean duration 10.1 +/- 7.2 yr whole...

Chronic exposure to hypercortisolism has significant impact on patient's health and health-related quality of life (HRQoL), as demonstrated with generic questionnaires. We have developed a disease-generated questionnaire evaluate HRQoL in patients Cushing's syndrome (CS; CushingQoL). Objective Validate the CushingQoL CS clinical practice conditions. Design Observational, international, cross-sectional study. Methods A total 125 were recruited by 14 investigators from Spain, France, Germany,...

The objective of the study was to assess whether weekly administration 40 mg pegvisomant (PEG-V) improves quality life (QoL) and metabolic parameters in acromegalic patients with normal age-adjusted IGF-I concentrations during long-acting somatostatin analog (SSA) treatment.This a prospective, investigator-initiated, double blind, placebo-controlled, crossover study. Twenty subjects received either PEG-V or placebo for two consecutive treatment periods 16 wk, separated by washout period 4...

Summary Objective Quality of life (QoL) is impaired in patients treated for pituitary adenomas. However, differences age and gender distributions hamper a proper comparison QoL. Therefore, we compared age‐ gender‐specific standard deviations (SD) scores ( Z ‐scores) QoL parameters Patients methods We determined ‐scores health‐related questionnaires [the Hospital Anxiety Depression Scale (HADS), Multidimensional Fatigue Inventory (MFI)‐20, Nottingham Health Profile (NHP), Short Form Survey...

Obesity is associated with local T-cell abnormalities in adipose tissue. Systemic obesity-related the peripheral blood compartment are not well defined. In this study, we investigated of morbidly obese and lean subjects. We determined all major subpopulations via six-color flow cytometry, including CD8+ CD4+ T cells, T-helper (Th) subpopulations, natural CD4+CD25+FoxP3+ T-regulatory (Treg) cells. Moreover, molecular analyses to assess thymic output, proliferation (T-cell receptor excision...

Background: We previously reported the efficacy of a combined treatment active acromegaly with both long-acting somatostatin analogs (SSA) and pegvisomant (PEG-V).

Dysregulation of the hypothalamic-pituitary-adrenal axis has been suggested as an independent risk factor for ischemic heart disease. The aim our study was to evaluate whether two markers activity, level salivary cortisol and diurnal pattern, are associated with atherosclerosis carotid arteries in elderly population.A total 1866 participants Rotterdam Study, a population-based cohort elderly, provided four samples throughout 1 d, underwent ultrasonography examine presence plaques common,...

We assessed the value of postoperative plasma cortisol concentrations to predict cure and recurrence Cushing's disease after transsphenoidal surgery (TS). Seventy-eight 80 consecutive patients treated by TS for were evaluated. cured 72% (n = 56) patients. Two weeks surgery, with levels below 138 nmol/liter 50; three macroadenomas) eight (27%) 30 (nine greater than cured. Six (five a macroadenoma) these had values less 50 3 months surgery. Therefore, optimal cut-off predicting remission was...

Treatment with the radiolabelled somatostatin analogue 177Lu-octreotate results in tumour remission 47% of patients gastroenteropancreatic neuroendocrine tumours. Adding capecitabine to 177Lu-octreotate, as a radio-sensitiser, may enhance these anti-tumour effects. We now present short-term toxicity profile this novel combination. Seven were treated 7.4 GBq and (1650 mg/m2 per day) for 2 weeks an intended number four cycles. Toxicity, especially haematological renal parameters, monitored on...

Previous studies have demonstrated the expression of somatostatin receptor subtypes (mainly sst(5)) and dopamine (DA) D(2)) in smaller series human corticotroph adenomas. In line with these findings, sst(5) D(2)-targeting agents already been used clinically patients Cushing's disease (CD) shown promising results subsets patients. To what extent are coexpressed within individual adenomas, is not known however.The aim study was to investigate (co-)expression both sst DA receptors a large...

Receptor radionuclide therapy is a promising treatment modality for patients with neuroendocrine tumors whom alternative treatments are limited. The aim of this study was to investigate the incidence hormonal crises after radiolabeled somatostatin analogue [(177)Lu-DOTA(0),Tyr(3)]octreotate ((177)Lu-octreotate).All (177)Lu-octreotate between January 2000 and 2007 were investigated. Four hundred seventy-six gastroenteropancreatic three metastatic pheochromocytoma included analysis.Four...

and reproducible data generated by reliable genotyping assays are available.The LightCycler assay for the detection of CAPN10 polymorphisms offers a rapid method association studies.We grateful to Dr. Olfert Landt (TIB MOLBIOL, Berlin, Germany) design probes.We thank

<i>Objective:</i> Transsphenoidal surgery (TS) is the primary therapy for Cushing’s disease (CD). The aims of this retrospective study were twofold: (i) investigate early and late results TS CD, (ii) evaluate various postoperative tests in order to predict outcome TS. <i>Methods:</i> We reviewed long-term 79 patients with CD who underwent (median follow-up 84 months, range 6–197). Within 2 weeks after surgery, morning serum cortisol concentrations obtained (n = 78)...

To evaluate possible risk factors for meningitis, we retrospectively reviewed 228 transsphenoidal operations (in which a standard regimen of amoxicillin prophylaxis was used) sellar pathology. The incidence meningitis 3.1% (seven cases). Cultures preoperative specimens from the anterior nasal vestibule in three seven patients yielded Staphylococcus aureus, but none these developed S. aureus meningitis. Two with significant paranasal sinus abnormalities compared only five 225 without (P <...

Objective To investigate the effects of unacylated ghrelin (UAG) and co-administration acylated (AG) UAG in morbid obesity, a condition characterized by insulin resistance low GH levels. Design method Eight morbidly obese non-diabetic subjects were treated with either 200 μg, 100 μg combination AG (Comb) or placebo three episodes 4 consecutive days double-blind randomized crossover design. Study medication was administered as daily single i.v. bolus injections at 0900 h after an overnight...

Adrenal Cushing's syndrome caused by ACTH-independent macronodular adrenocortical hyperplasia (AIMAH) can be accompanied aberrant responses to hormonal stimuli. We investigated the prevalence of reactions these stimuli in a large cohort AIMAH patients, both vivo and vitro.In cortisol were studied 35 patients with bilateral adrenal enlargement (sub-)clinical hypercortisolism. In vitro, effects on secretion steroidogenic enzyme mRNA expression evaluated cultured other cells....