Kleerekoper, Michael

Mellinger, Raymond C.

English

Henry Ford Health System Scholarly Commons

Henry Ford Hospital Medical Journal Volume 35 Number 4 Article 2 12-1987 Aspects of Endocrinology Michael Kleerekoper Raymond C. Mellinger Follow this and additional works at: https://scholarlycommons.henryford.com/hfhmedjournal  Part of the Life Sciences Commons, Medical Specialties Commons, and the Public Health Commons Recommended Citation Kleerekoper, Michael and Mellinger, Raymond C. (1987) "Aspects of Endocrinology," Henry Ford Hospital Medical Journal : Vol. 35 : No. 4 , 180. Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol35/iss4/2 This Article is brought to you for free and open access by Henry Ford Health System Scholarly Commons. It has been accepted for inclusion in Henry Ford Hospital Medical Journal by an authorized editor of Henry Ford Health System Scholarly Commons. Feature Articles Aspects of Endocrinology F or decades Endocrinology was an area of medicine in which the only reliable tools were the skills of the clinician. The available assays were bioassays which had such limited sen-sitivity that several erroneous physiologic and pathophysiologic concepts were allowed to develop. The introduction of radioim-munoassays in the late 1950s and early 1960s opened up new vis-tas as medical scientists were able to understand for the first time the true hormonal basis for many endocrine disturbances. In the last decade or so, amazing breakthroughs in molecular biology have allowed us to begin to understand the molecular basis of many of these diseases. For a few years it seemed that the role of the strong clinical endocrinologist had become superfluous as even the most eso-teric hormone assays became readily available. By simply order-ing enough tests, answers to clinical problems were provided in percentile form as the assay results retumed from the laboratory. This issue of the Journal features a series of articles in which the skills of the clinician have been blended with the excellence of modem science to continue to expand our endocrine hori-zons. At the same time it is clear from several of the articles that many unanswered questions remain. Endocrine deficiency frequently occurs even though the glands are capable of quite normal function. Drs. Wilson and Wisgerhof demonstrated this phenomenon in their patient whose deficient pituitary function was secondary to a central nervous system disorder A. Keith Cryar, MD, also working with Dr Wisgerhof and neurological surgery colleagues, re-ports the classic features of metastatic disease to the pituitary, with endocrine symptoms occurring even before the primary tu-mor had made its presence known. Dr McKenna reports interesting effects of the drug bro-mocriprine in the treatment of pituitary hyperfunction. Pro-longed remission of Cushing's disease, apparently induced by the drug, is a unique observation. His second manuscript describes the successful intermittent use of bromocriptine in a hyperprolactinemic patient. The reports of Dr Jeffrey Jackson and his colleagues at the Scott & White Clinic also concem aspects of pituitary function. Accepting the possibility of a pituitary factor stimulating adre-nal androgen secretion, these investigators studied the effectsof the opioid antagonist naltrexone in virilized patients. The same center reports the features of a patient with the infrequently rec-ognized disorder, thyrotropin-secreting pituitary tumor Two important communications relate to the subtle man-ifestations and associated disorders of hyperparathyroidism. Drs. Kambouris, Ansari, and Talpos discuss the interesting ob-servation that many cancer patients with hypercalcemia also have hyperparathyroidism, which is the actual cause of the met-abolic disorder and requires surgical treatment. Dr Gregory Brown and colleagues report that the neurobehavioral symp-toms associated with the disease are not necessarily improved by surgical cure. Drs. Fachnie and Foreback report the effects that nonphar-macologic measures have on the semm lipid factors of severely obese persons, while Dr Dumler et al discuss the renal changes they have found studying patients with type 2 diabetes mellitus. Dr Wisgerhof evaluated the Henry Ford Hospital experience with hyperaldosteronism in the 1980s and presents his observa-tions on these cases. Dr. Talpos' tribute to Melvin A. Block. MD, former Chairman of the Department of Surgery and a founding member of the American Association of Endocnne Surgeons, is peculiarly fitting for this issue of the Journal Finally, Dr Bmnner has reviewed the latest contribution by Df Sudha Kini to the cytopathologic diagnosis of thyroid disease-Michael Kleerekoper, MD Bone & Mineral Division Henry Ford Hospital Raymond C. Mellinger, MD Division of Endocrinology Henry Ford Hospital ongeni most c ;arly childl < neurologic agnosis (2) may not bei Decompens tom compi aches, visu Approxima presentatio tricular cere the neurolo, Althougl a small sub stenosis ha; senting as j normality h (9-11). Nor fashion. Th lamic-pitui hypothalam (12). Pituita shunt procei We repor nosis whose •al arrest, w demonstrati 'amic dysfii versed the c A 17-year-c Pubertal deve •"evelopment *ownbyad( •ected at age •^^ ightwasma 13, but hi Sfowth. He f ^^^d«inasc '"^ "res, visu; , The patient weighed 4 "P'^  fundi. C 180 Henry Ford Hosp Med J—Vol 35, No 4, 1987 Lditorial-MeMmgc .t Klee^"'*'^ I "^^ord Hosp \ 

Aspects of Endocrinology

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Aspects of Endocrinology

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