Severe pituitary Cushing's disease of sudden onset after 18 years of unsuccessful treatment for a previously non-functioning chromophobe adenoma is described in a middle-aged woman. Initial presentation with symptoms of optic nerve compression had been preceded by two years of amenorrhoea. Transfrontal resection of a chromophobe adenoma followed by radiotherapy, performed both at this time and again after a recurrence eight years later, failed to eradicate the tumour. Ten more years elapsed before she rapidly developed florid features of Cushing's syndrome. Plasma ACTH levels were markedly elevated and were only partially reduced by further transfrontal surgery, complete removal of the tumour proving impossible. Subsequent bilateral adrenalectomy was performed to control her hypercortisolism and a course of cytotoxic chemotherapy was administered in an attempt to treat the tumour recurrence. Immunocytochemical staining of tumour obtained at surgery demonstrated ACTH immunoreactivity both before and after the development of Cushing's disease. Although silent corticotrophic adenomas of the human pituitary, including chromophobic tumours, have been previously described, this is the first report of such a tumour becoming functional, sufficient to cause clinically evident Cushing's disease.

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Gravid albino rats of the Sprague-Dawley strain received either 25, 50, or 100 r whole-body X-radiation on either day 5, 10, 15, or 20 of gestation. Controls were sham-irradiated. Over 500 surviving offspring were evaluated on measures of motor maturation of the upright and righting responses, motor strength, and locomotor learning during the neonatal period. The results indicate that radiation exposure of 100 r on day 15 of gestation retards motor maturation of the upright and righting responses. Almost all of the radiation groups show a decrease in motor strength as compared to the control group with maximum deficits in the groups receiving 50 or 100 r on day 10 or 15 of gestation. On the locomotor learning measure, the results are not consistent, but the group receiving 100 r on day 15 of gestation is maximally affected. These deficits in motor performance are related to observable motor impairment. It is concluded that low levels of radiation received prenatally can have detrimental effects on the development of motor performances in the rat.

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