To assess the effectiveness of bromocriptine in reducing the size of PRL-secreting macroadenomas with extrasellar extension, we conducted a prospective multicenter trial in patients without prior radiotherapy, applying a standard protocol of treatment and tumor size evaluation. Basal serum PRL levels [1441 +/- 417 (+/- SEM) ng/ml for women; 3451 +/- 1111 ng/ml for men] fell in all patients and to 11% or less of basal values in all patients but 1. Normal PRL levels were reached in 18 of the 27 patients. In 13 patients (46%), tumor size was reduced by greater than 50%, in 5 patients (18%) by about 50%, and in 9 patients (36%) by approximately 10-25%. The extent of tumor size reduction did not correlate with basal PRL, nadir PRL, percent fall in PRL, or whether PRL levels reached normal. However, a reduction in PRL levels always preceded any detectable change in tumor size. In 19 patients, reduction in tumor size was evident by 6 weeks, but in the other 8, such reduction was not noted until the 6 month evaluation. In the 4 patients in whom bromocriptine was discontinued at the end of 1 yr, tumor reexpansion occurred in 3. Visual fields improved in 9 of the 10 patients in whom they were abnormal. Because of the excellent results found in most of the patients in this series, we suggest that therapy with bromocriptine should be considered as initial management for patients with PRL-secreting macroadenomas.

Testosterone (T) levels in the plasma of male laboratory rats and mice were measured by radioimmunoassay. There was a striking individual variation with values ranging from less than 1 ng/ml to over 30 ng/ml in mice of the same age and strain housed under identical conditions. Using chronic indwelling catheters inserted into a jugular vein, blood was collected from adult conscious male rats every 24 hr for 4 or 8 days and every 30 min for 2 l / 2 or 8 hr. Considerable differences in plasma T levels were observed between different animals, and 2-to S-fold fluctuations of T concentrations in the plasma were detected between samples collected from the same animal at different times. These large and irregular changes in plasma levels of T are unlike the fairly stable levels observed in the human but bear certain resemblance to the pulsatile release of T described in bulls and rams and perhaps also to the social dominance related differences in plasma T levels in Rhesus monkeys. {Endocrinology 92: 1223, 1973

A series of experiments were conducted which involved the exogenous administration of progesterone and estrogens to 15 ovariectomized ewes. Plasma LH levels were measured by radioimmunoassay and the occurrence of behavioral estrus was determined by vasectomized rams. Injection of estradiol benzoate (EDB) either at 2 or at 16 days after the end of progesterone priming produced 2 effects. Initially, a depression (0-12 hr post injection) of plasma LH, followed by an LH surge (12-24 hr post injection). EDB (50 tig) injected at 2, 8 and 14 days after the end of progesterone priming resulted in typical LH surges to all 3 injections.However, the behavioral responses decreased with repeated injections of EDB. When progesterone was injected simultaneously with EDB on day 2 after the end of progesterone priming, both estrous behavior and the LH surge were totally inhibited but the initial depression in plasma LH was still apparent. These data indicate that estrogens exert both negative and positive actions on LH release from the hypothalamo-hypophyseal system, and that progesterone exerts a block on only the positive action of estrogen. (Endocrinology 88: 1184(Endocrinology 88: , 1971

An enzyme-linked immunosorbent assay (ELISA) was used to detect ovarian and oocyte antibodies in serum from 45 patients with premature ovarian failure (POF). Control sera were obtained from a similar group of normally cycling women without POF. A specific antibody reaction was found when POF sera were tested against human ovary (47%) or oocytes (47%). A combined total of 69% of the sera were positive for either ovary or oocytes. Fewer sera were positive for antibodies against human thyroid (18%) or human placenta (22%), and virtually no reaction with human liver (4%) was seen. LH antibodies were detected by ELISA against LH in only 3 POF sera that also contained ovarian antibodies. Therefore, gonadotropin antibodies alone do not appear to account for POF. In addition, 2 patients were treated by immunosuppression and became pregnant coincident with a decline in the serum concentration of ovarian antibodies. In summary, the results of this study are consistent with previous immunohistochemical data which indicate that ovarian and oocyte antibodies are common in patients with POF. This supports the concept that some forms of POF are associated with an autoimmune process. Furthermore, detection of ovarian and oocyte antibodies by ELISA may permit routine diagnosis of autoimmune POF and provide a basis for therapy.

Medroxyprogesterone acetate (MPA), a synthetic progesterone, was added to the antiepileptic drug regimen of 14 women who had uncontrolled seizures. Of the 11 women who developed amenorrhea, 7 reported fewer seizures during MPA therapy. Overall reductions in seizure frequency averaged 30% (n = 11), declining from a baseline 8.3 +/- 5.8 seizures per month to 5.1 +/- 4.1 seizures per month (p = 0.02). No serious side effects were encountered, but spotting was common. These preliminary data suggest further evaluation of MPA for catamenial seizures.

These results indicate that HCV core antigen can be identified by routine serological ELISA in specimens from the early antibody-negative phase of HCV infection. A test for HCV core antigen may be a useful test for identifying window phase blood donations from antibody negative donors infected with HCV.

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