[Clinical neuroendocrinology]

An overview of research in clinical neuroendocrinology at the 3 Dept. of Internal Medicine, Charles University in Prague is reported. The research was focused on diagnosis and therapy of pituitary adenomas and on pathophysiology of some pituitary hormones. The follow up of changes in patients with acromegaly may be used as a model for possible side-effects of growth hormone therapy or doping. In acromegaly not only growth hormone serum levels but also IGF and its binding protein 3(IGF BP-3) is used when evaluating the activity of the disease. In therapy first experience was obtained with radiosurgery using Leksell gamma knife. Thirteen year experience in using a dopaminergic agonist terguride (of Czech origin) in treatment of prolactinomas was completed. Terguride represents the treatment of first choice in patients with prolactinomas of each size, giant prolactinomas inclusively. In patients with central Cushing's disease microsurgical selective removal of pituitary adenoma is preferred. When not possible, the treatment with Leksell gamma knife is indicated with the condition of normalization of cortisol secretion with medicamentous therapy until the full effects of radiosurgery are present. Growth hormone and prolactin were proved to be immunologicaly active hormones, the effect of growth hormone being mediated by somatomedins. Somatomedins seem to be ubiquitous growth factors. Their presence was demonstrated even in eggs.