pituitrin and Astrocytoma

New class of therapies, including bipolar therapies (BPT) and "paradoxical" unipolar therapies (PUT) were firstly proposed in relation to a clinical insight and to some results of biological investigations, then they gave rise to mathematical modeling which brought a justification of these therapies, at least from a theoretical point of view. After recalling the mathematical model for the regulation of agonistic antagonistic couples, and reporting the fundamental types of control simulation by means of it, we point out the validity of therapeutical applications inferred from this model. These therapy modalities, including BPT and PUT, now concern the following diseases: astrocytomas, epilepsia and trials on multiple sclerosis. Even if such attempts are in their early stage, noticeably for the last case where biological changes have mainly been studied, it seems that a large span of treatments is open to BPT and PUT. Improvement of these techniques in the future depends, in our opinion, on a parallel working on the dynamics of the mathematical model and the dynamics, perceived by clinical insight and confirmed by biological investigations, of the body reactions to such strategies. Justification of BPT and PUT was given, by resorting to the notion of "pathological homeostasis" which, too often, intervenes in order to nullify the effects of unilateral (not paradoxical) therapies. This research has elicited some therapies which use two agents with antagonistic effects or only an agent with effects similar to the agent already in excess in the body--in both cases at nearly physiological doses.

Topics: Adaptation, Physiological; Adrenal Cortex Hormones; Animals; Astrocytoma; Brain; Brain Neoplasms; Computer Simulation; Epilepsy; Homeostasis; Humans; Models, Theoretical; Multiple Sclerosis; Vasopressins

The study of renin-angiotensin-aldosterone (RAA) and vasopressin (VP) systems in neurosurgical patients with brain tumors and brain edema (BE) had revealed an excessive activity of these systems with secondary hyperaldosteronism especially with BE that proves the pathogenetic role of these systems. Measurement of Aldosterone (Ald) in CSF may serve as a diagnostic test to help manage the patient's clinical condition. Mechanisms of Ald penetration in CSF assumed to be the result of blood-brain-barrier (BBB) destruction (especially in astrocytomas) and/or the mediation by neuropeptides (for example increasing activity of VP V1-receptors). Results serve as a basis for application of the neuropeptide and hormone antagonists and inhibitors on all stages of cascade reactions taking part in the water and sodium retention.

Topics: Adolescent; Adult; Aged; Aldosterone; Astrocytoma; Blood-Brain Barrier; Brain Edema; Brain Neoplasms; Cerebral Hemorrhage; Child; Child, Preschool; Female; Heart Arrest; Hemodynamics; Humans; Hyperaldosteronism; Hypertension; Male; Middle Aged; Postoperative Complications; Prognosis; Radioimmunoassay; Renin-Angiotensin System; Tachycardia; Vasopressins

Changes in the clinical condition, CT scans and MRIs of patients with recurrent or inoperable astrocytomas and brain metastasis have been observed following treatment with a combination of vasopressin and corticoids. These changes have not been reported with corticoids alone--at least not over the short time reported for this therapy. Ten cases of grade II astrocytomas, seven cases of grade III or IV astrocytomas and six cases of metastasis of bronchial or breast origin were studied. To explain the results, it is proposed that vasopressin delays the 'escape' from the effects of corticoids alone and some facts and theories are recalled to help the reader understand the reasoning behind this explanation.

Topics: Adrenal Cortex Hormones; Adult; Antineoplastic Combined Chemotherapy Protocols; Astrocytoma; Brain Neoplasms; Female; Glioblastoma; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Retrospective Studies; Tomography, X-Ray Computed; Vasopressins

A mathematical model of the adrenal postpituitary system has been used in cases of brain disease in which endocrine disturbances play an aggravating role. A computer simulation has suggested a type of therapy adding vasopressin to corticoids; this association seems to elicit better results than corticoids alone. Posttraumatic disorders of the cerebral hydration, on one hand, and inoperable or recurrent tumors, on the other hand, take advantage of such a systemic, formalized approach.

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Aged; Arginine Vasopressin; Astrocytoma; Brain Diseases; Brain Neoplasms; Computers; Dehydration; Dexamethasone; Drug Therapy, Combination; Humans; Hydrocortisone; Models, Theoretical; Neoplasm Recurrence, Local; Thalamus; Vasopressins

A follow-up study was carried out on 12 children with vasopressin sensitive diabetes insipidus. 1) Nine cases (75%) of 12 were finally diagnosed as having brain tumor in later course. There were 3 cases (25%) who could not be decided as having brain tumor during the follow-up period of more than 6 years. 2) There was one case who developed the overt signs of brain tumor 9 years after the onset of diabetes insipidus. Therefore, it seems necessary to follow-up cases with diabetes insipidus for at least 10 years before determining it as idiopathic type. 3) In cases with diabetes insipidus due to brain tumor, associated growth retardation, autonomic symptoms, behavior disorder, endocrine dysfunction and metabolic dysfunction were frequently observed. In the case where these symptoms become aggravated with lapse of time, these findings should be taken seriously as indicating brain tumor. 4) In the case showing either anterior or posterior focal slow waves in the EEG, if such focal slow waves aggravate with age, the findings should be considered as indicative of brain tumor. 5) We would like to emphasize the significance of brain tumor as the underlying pathology of childhood diabetes insipidus.

Topics: Astrocytoma; Brain Neoplasms; Child; Child, Preschool; Diabetes Insipidus; Diagnosis, Differential; Electroencephalography; Female; Follow-Up Studies; Humans; Infant; Male; Vasopressins

Topics: Adrenocorticotropic Hormone; Adult; Aged; Astrocytoma; Brain Neoplasms; Cerebral Ventriculography; Craniopharyngioma; Echoencephalography; Electroencephalography; Female; Glucocorticoids; Humans; Male; Meningioma; Methylprednisolone; Middle Aged; Neurofibromatosis 1; Vasopressins; Visual Field Tests

Topics: Adrenal Cortex Hormones; Adult; Astrocytoma; Brain Neoplasms; Drug Synergism; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Remission, Spontaneous; Vasopressins

Topics: Astrocytoma; Brain Neoplasms; Child; Diet, Sodium-Restricted; Electromyography; Humans; Hyponatremia; Male; Metyrapone; Neural Conduction; Pituitary Function Tests; Sodium; Vasopressins

Topics: Astrocytoma; Brain Neoplasms; Cysts; Epidermal Cyst; Glioblastoma; Humans; Hypothalamo-Hypophyseal System; Lymphoma, Large B-Cell, Diffuse; Meningioma; Neuroectodermal Tumors, Primitive, Peripheral; Oligodendroglioma; Pituitary Gland, Posterior; Vasopressins

Topics: Adrenocorticotropic Hormone; Adult; Aged; Astrocytoma; Brain Edema; Brain Neoplasms; Cerebral Angiography; Echoencephalography; Electroencephalography; Female; Humans; Male; Middle Aged; Neoplasm Metastasis; Pituitary Gland; Radionuclide Imaging; Vasopressins