Insulin sensitivity was increased in untreated patients with aldosterone producing adenoma. Enhanced insulin receptor binding may contribute to this increased insulin sensitivity.

The balance of the conversion between DHEA-S and DHEA in the hyperthyroid state favoured DHEA-S. Similar to cortisol, the DHEA response in the CRH test in hyperthyroidism seemed to be insufficiently compensated for by increased ACTH, although the DHEA response to low-dose ACTH was similar in the hyperthyroid and euthyroid states. Increased DHEA-S might play some role in the pathological states in many organs in hyperthyroidism.

Abstract. In an attempt to investigate the clinical significance of anti-pituitary antibodies in patients with hypopituitarism, anti-pituitary antibody in plasma was examined in 10 such patients (7 cases of isolated ACTH deficiency, 1 of partial hypopituitarism, and 2 of Sheehan's syndrome), on two or three occasions with an interval of more than 6 months (longitudinal study). In a total of 16 relatives of these 4 patients (2 cases of Sheehan's syndrome, one in each of partial hypopituitarism and isolated ACTH deficiency) and one patient not involved in the longitudinal study, anti-pituitary antibodies were also examined (family study). Anti-pituitary antibodies reacting with rat pituitary cytoplasmic antigens (pituitary cell antibodies: PCA) and pituitary cell surface antibodies (PCSA) reacting with GH3 cells and/or AtT-20 cells were measured with indirect immunofluorescence. The longitudinal study revealed the disappearance of antibodies in 3 patients, 2 PCA positive and one both PCA and PCSA positive. In 3 patients, altered antibody titers or a newly appearing antibody were found during the follow-up period.

Wereport a male Japanese with corticotropin (ACTH)-independent macronodular adrenocortical hyperplasia (AIMAH)associated with multiple colon adenomas/carcinomas. The plasma cortisol level was elevated with no diurnal rhythm and was not suppressed with dexamethasone. Basal plasma ACTHwas unmeasurable but subnormally increased after administration of metyrapone or corticotropin releasing hormone. Both adrenals were resected and weighed 90g; the histopathologic findings were similar to those ofAIMAHas previously reported. At least 21 colon lesions which were adenomasor carcinomas, were resected endoscopically or surgically. This is the second reported case of the association ofAIMAHwith multiple colon polyps. An APCgene point mutation was detected in the colon cancer tissue by polymerase chain reaction (PCR)-single strand conformation polymorphism(SSCP)/direct sequencing analysis at the putative splice acceptor site consensus sequence. However, no abnormality ofAPCgene was detected in the adrenocortical hyperplastic tissue. The possible etiological coexistence of these two diseases is discussed.

A 46-year-old womanwith incidentally discovered thyrotropin (TSH)-producing pituitary adenoma showed endocrine data which was consistent with TSH-producing pituitary tumor. However,she showed only slight hyperthyroidism and the oversecretion and autonomoussecretion of TSH from the tumor seemed to be limited from the results of several endocrine examinations. Immunohistochemical examination revealed that not only TSH-p and TSH-a but also prolactin and growth hormone synthesizing cells were present in the tumor tissue. Pituitary-transcription activator 1 (Pit-1) immunoreactivity was also detected in the adenoma cell nuclei. It was conceivable that the presented TSH-producing adenoma clinically located close to the nonfunctioning adenoma and Pit-1 may have played an important role in the multidirectional differentiation or development of this tumor.