)

GRH,CRH,TRH, LHRH, SRIH, PIF

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3,4

PTH

2-


-
- , ,

- ()
(stress..)
-

()

20

GRH,CRH,TRH, LHRH, SRIH, PIF

GH TSH, ACTH, FSH, LH, PRL, ADH

3,4

PTH

2-

LHRH GnRH

GnRH oscillator GnRh pulse
generator

GABA




(-)
(+)
(-)

ENDO
NE
PGL
D

5HT


-- ()

TRH

TSH

T3 T4

PTH

 ...

-
-
- (

GRH,CRH,TRH, LHRH, SRIH, PIF

, ,
,

GH TSH, ACTH, FSH, LH, PRL, ADH

3,4

GH;
PRL;
Insulin;
Glucagon;
LH;

PTH
FSH; TSH

; , ;
,

T3; T4; (
Tyrosine)

2-

'



=
:

1.
2.
3.

=
:

1.
2.
3.

LHRH

GHRH PIF CRH TRH SRIH

2
FSH-LH
GH
TSH
ACTH
PRL

ADH

OXYT



=
:

=
:

 /:
-

- ( )...
( )
- (TRH test ....)


- ( )

, per os,

-

&
- ???

TRH
GHRH
Gn R H
CRH

SRIF
L H R H

LHRH

GHRH PIF CRH TRH SRIH

FSH-LH
GH
TSH
ACTH
PRL

ADH

OXYT

TRH
GHRH
Gn R H
CRH

SRIF
L H R H


Pituita =phlegm
1887: Minkowski
1900 Mutchinson:..
,

.
1921: inj. ->

1927:(1909): (Smith)
1929: TSH (Aron, Loeb, Bassett)
1933: ACTH (Lollip)

PRL (Riddle)

FSH. LH. (Fevold)

1950-1960
1958
1 GH

1962:
1

LHRH GHRH PIF CRH TRH SRIH

ADH

FSH-LH

GH
PRL

GH

191

TSH
ACTH

OXYT

 GH

GH:

-
-
-
-

 GHRH GH

GH

 GH

stress

GHRH
L-DOPA
O-


L-Dopa
GHRH
GH

GHRH

GH

GHRH

-30

30

60 90 min

-30

30

60 90 min

GHRH-GROWTH HORMONE- IGF-1

GROWTH HORMONE- IGF-1

 GH
- GFs ( )
GH
-

GH
IGFs -
-

GH

(. )
(. )
()

( )

Dwarfs Kingdom (China)

-
(. )

- GH
(T 20 30 min)
SC

Max [ ] 2-6h

Max [ ] IGF-I ~ 20 h

( )

Kauy

(6 )

Silver-Russel

Cornelia de Lange

AIDS

? ?

 GH

Kak;h

LHRH

GHRH PIF CRH TRH SRIH

GH

GH

ADH

FSH-LH

GH
PRL

TSH
ACTH

OXYT

LHRH

GHRH PIF CRH TRH SRIH

GH

GH

ADH

FSH-LH

GH
PRL

TSH
ACTH

OXYT

LHRH

GHRH PIF CRH TRH SRIH

FSH-LH

GH ACTHTSH
PRL

ADH

OXYT

(
)

(
)

M

)
(

(15%-50%)

10-20%
50% (/)
50%
- 50% . (30% ??)

(
)

 GH

MRI
XR
(
a GH )

MRI
GH

GH

(
)


GH

:
:
(MRI)

LHRH

GHRH PIF CRH TRH SRIH

FSH-LH
GH
TSH
ACTH
PRL

ADH

OXYT


(Somatotropin Releasing Inhibiting Hormone)S R I H

S R I H 28

S R I H 14

S R I H

S S T R1

SSTR2

SSTR3

SSTR4

SSTR5

S R I H
( 1 2 min )
:

GH
TSH PRL

+
-
-



Rebound GH

SRIH
-
-
-



Rebound GH

SRIH
- GH >
-
-

 = SRIH

()
( SC )
> S R I H

G H
-

octreotide
E
G H

V I P


SRIH ( )

1-3
.

 H
S R I
GH,
...
( GH)
IGF-I



SRIF

TRH
GHRH
GRH
CRH

SRIF
L H R H

Octreoscan

Octreoscan

111In-pentetreotide scintigraphy of a 41 year-old man with ectopic

Cushing' syndrome caused by a neuroendocrine
carcinoma of the mesentery. Radiotracer accumulation in the left thyroid in
10/2003 (arrow). The mesenterial neuroendocrine tumor became clearly visible in 4/2005 (arrow).

Paraganglioma

250g bolus -> 250g /h IV