The present study analyzed the participation of the left and right superior ovarian nerves (SON) in regulating progesterone, testosterone, and estradiol serum levels in unilaterally ovariectomized rats on each day of the estrous cycle. For this purpose, ovarian hormone concentrations in serum were measured in animals with either sham-surgery, unilateral ovariectomy (ULO), unilateral sectioning of the SON, or sectioning of the SON innervation of the in situ ovary in rats with ULO.This investigation results show that the right and left ovaries have different capacities to maintain normal hormone levels, that such capacity varies during the estrous cycle, and that it depends on the integrity of the SON innervation. In rats with only one ovary, the effects of ovarian denervation on hormone levels varied according to which ovary remained in situ, the specific hormone, and the day of the estrous cycle when treatment was performed. Present results support the idea that the ovaries send and receive neural information that is processed in the central nervous system and we propose that this information participates in controlling the secretion of gonadotropins related to the regulation of ovarian functions.

Bilateral ovariectomy or adrenalectomy are experimental tools used to understand the mechanisms regulating the hypothalamus-pituitary-ovarian and the hypothalamus-pituitary-adrenal axis. There is evidence that acute unilateral perforation of the dorsal peritoneum in rats results in significant changes in progesterone, testosterone and estradiol serum concentrations. Because different surgical approaches for unilateral or bilateral ovariectomy or adrenalectomy, sectioning the superior ovarian nerve or the vagus nerve are used, we compare the acute effects on hormone serum concentrations resulting from the unilateral or bilateral dorsal approach to performing bilateral ovariectomy or adrenalectomy with those obtained when an unilateral incision is performed in the ventral abdomen. In general, the progesterone, testosterone and estradiol serum concentrations were higher in animals with ventral approach than in those with dorsal surgery, the effects varying depending on the day of the estrous cycle when surgery was performed. The results suggest that the neural signals arising from different zones of the peritoneum and/or the abdominal wall play different roles in the mechanisms regulating steroid hormones concentrations.

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Overproduction of growth hormone in a young person with open epiphyses results in gigantism. Pituitary gigantism is rare and its cause is most often a pituitary adenoma. We present a 9 y.o. boy followed by his psychiatrist, referred for worsening anxiety and rapid growth. He had a history of mild anxiety in childhood with worsening of symptoms a year prior to the endocrine visit. He also had aggressive behavior, irritable mood and poor concentration. He was started on guanfacine with subsequent addition of escitalopram. He has been rapidly outgrowing his clothes and shoes (men’s size 9) and complains of heat intolerance. He was following along the 97 th percentile for height with significant growth acceleration observed starting at age 7 y.o. Current height is at +2.8 SDS. Weight has increased from the 90 th percentile to the 97th percentile since age 4 y.o. and currently at +2.3 SDS. His BMI was at the 95th percentile. Physical examination showed a prominent jaw, widely-spaced teeth, large hands and feet, Tanner I pubic hair, no axillary hair, testicular volume 3 ml bilateral. Initial bloodwork showed elevated IGF-1 at 925 ng/mL (+13.7 SDS). Random growth hormone level was elevated at 5.66 ng/mL. He had normal male karyotype, free T4 was 1.5 ng/dL, with TSH of 2.13 uIU/mL. Prolactin level was normal. Growth hormone level after an oral glucose load showed a nadir of 2.76 ng/mL. This confirms growth hormone excess. ACTH and cortisol levels were normal. FSH and testosterone levels were prepubertal. Intact PTH, calcium and phosphorus levels were all normal. Skeletal survey did not identify any fibrous dysplasia seen in McCune Albright syndrome. Echocardiogram did not show atrial myxoma associated with Carney complex. MRI of the brain and pituitary gland was obtained which showed 4mm x 5 mm pituitary microadenoma. He underwent transsphenoidal surgery. IGF-I level twelve weeks post-surgery had decreased to 384 ng/mL (+4.3 SDS) showing a good response to transsphenoidal surgery. Repeat growth hormone suppression test showed a nadir level of 0.66 ng/mL. Goal of treatment is to normalize IGF-I level based on age. On subsequent visit with his psychiatrist, behavior issues and anxiety have improved with plans to discontinue psychotropic medications. We report a case of growth-hormone secreting pituitary adenoma presenting with anxiety. Patients with pituitary adenomas show a distinct pattern of increased anxiety-related personality traits compared with the general population, proposed to be due to direct and indirect effects of the pituitary lesion or hormonal disturbance on neural circuits or neurotransmission. Symptoms of anxiety and depression are valuable targets for possible future treatment interventions.

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