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Sample records for pituitary tumor shrinkage

  1. Pituitary Tumors

    Science.gov (United States)

    ... Association (ABTA) International RadioSurgery Association National Brain Tumor Society National Institute of Child Health and Human Development ... Definition The pituitary is a small, bean-sized gland ...

  2. Pituitary tumor

    Science.gov (United States)

    ... than normal level of growth hormone in adults) Nipple discharge and irregular or absent menstrual periods in women Decreased sexual function in men Symptoms caused by pressure from a larger pituitary ...

  3. Pituitary Tumors

    Science.gov (United States)

    ... Peer Support Resources Diseases and Conditions Adrenal Disorders Osteoporosis and Bone Health Children and Teen Health Diabetes Heart Health Men's Health Rare Diseases Pituitary Disorders Thyroid Disorders Transgender Health Obesity and Weight Management Women's Health You and Your ...

  4. Pituitary Tumors: Condition Information

    Science.gov (United States)

    ... hormones. They can press on or damage the pituitary gland and prevent it from secreting adequate levels of hormones. National Institute of Neurological Disorders and Stroke. (2010). NINDS pituitary tumors information page . ...

  5. Pituitary tumors containing cholecystokinin

    DEFF Research Database (Denmark)

    Rehfeld, J F; Lindholm, J; Andersen, B N

    1987-01-01

    We found small amounts of cholecystokinin in the normal human adenohypophysis and therefore examined pituitary tumors from 87 patients with acromegaly, Cushing's disease, Nelson's syndrome, prolactinoma, or inactive pituitary adenomas. Five adenomas associated with Nelson's syndrome contained......'s disease and 7 acromegaly with adenomas containing ACTH. The cholecystokinin peptides from the tumors were smaller and less sulfated than cholecystokinin from normal pituitary glands. We conclude that ACTH-producing pituitary cells may also produce an altered form of cholecystokinin....

  6. Pituitary gland tumors

    International Nuclear Information System (INIS)

    Jesser, J.; Schlamp, K.; Bendszus, M.

    2014-01-01

    This article gives an overview of the most common tumors of the pituitary gland and the differential diagnostics with special emphasis on radiological diagnostic criteria. A selective search of the literature in PubMed was carried out. Pituitary adenomas constitute 10-15 % of all intracranial tumors and are the most common tumors of the sellar region. Tumors smaller than 1 cm in diameter are called microadenomas while those larger than 1 cm in diameter are called macroadenomas. Approximately 65 % of pituitary gland adenomas secrete hormones whereby approximately 50 % secrete prolactin, 10 % secrete growth hormone (somatotropin) and 6 % secrete corticotropin. Other tumors located in the sella turcica can also cause endocrinological symptoms, such as an oversecretion of pituitary hormone or pituitary insufficiency by impinging on the pituitary gland or its stalk. When tumors spread into the space cranial to the sella turcica, they can impinge on the optic chiasm and cause visual disorders. A common differential diagnosis of a sellar tumor is a craniopharyngeoma. In children up to 10 % of all intracranial tumors are craniopharyngeomas. Other differential diagnoses for sellar tumors are metastases, meningiomas, epidermoids and in rare cases astrocytomas, germinomas or Rathke cleft cysts As these tumors are located in an anatomically complex region of the skull base and are often very small, a highly focused imaging protocol is required. The currently favored modality is magnetic resonance imaging (MRI) with the administration of a contrast agent. The sellar region should be mapped in thin slices. In cases of suspected microadenoma the imaging protocol should also contain a sequence with dynamic contrast administration in order to assess the specific enhancement characteristics of the tumor and the pituitary gland. (orig.) [de

  7. [Pituitary gland tumors].

    Science.gov (United States)

    Jesser, J; Schlamp, K; Bendszus, M

    2014-10-01

    This article gives an overview of the most common tumors of the pituitary gland and the differential diagnostics with special emphasis on radiological diagnostic criteria. A selective search of the literature in PubMed was carried out. Pituitary adenomas constitute 10-15% of all intracranial tumors and are the most common tumors of the sellar region. Tumors smaller than 1 cm in diameter are called microadenomas while those larger than 1 cm in diameter are called macroadenomas. Approximately 65% of pituitary gland adenomas secrete hormones whereby approximately 50% secrete prolactin, 10% secrete growth hormone (somatotropin) and 6% secrete corticotropin. Other tumors located in the sella turcica can also cause endocrinological symptoms, such as an oversecretion of pituitary hormone or pituitary insufficiency by impinging on the pituitary gland or its stalk. When tumors spread into the space cranial to the sella turcica, they can impinge on the optic chiasm and cause visual disorders. A common differential diagnosis of a sellar tumor is a craniopharyngeoma. In children up to 10% of all intracranial tumors are craniopharyngeomas. Other differential diagnoses for sellar tumors are metastases, meningiomas, epidermoids and in rare cases astrocytomas, germinomas or Rathke cleft cysts As these tumors are located in an anatomically complex region of the skull base and are often very small, a highly focused imaging protocol is required. The currently favored modality is magnetic resonance imaging (MRI) with the administration of a contrast agent. The sellar region should be mapped in thin slices. In cases of suspected microadenoma the imaging protocol should also contain a sequence with dynamic contrast administration in order to assess the specific enhancement characteristics of the tumor and the pituitary gland.

  8. Pituitary gland tumors; Hypophysentumoren

    Energy Technology Data Exchange (ETDEWEB)

    Jesser, J.; Schlamp, K.; Bendszus, M. [Radiologische Klinik, Universitaetsklinikum Heidelberg, Abteilung fuer Neuroradiologie, Heidelberg (Germany)

    2014-10-15

    This article gives an overview of the most common tumors of the pituitary gland and the differential diagnostics with special emphasis on radiological diagnostic criteria. A selective search of the literature in PubMed was carried out. Pituitary adenomas constitute 10-15 % of all intracranial tumors and are the most common tumors of the sellar region. Tumors smaller than 1 cm in diameter are called microadenomas while those larger than 1 cm in diameter are called macroadenomas. Approximately 65 % of pituitary gland adenomas secrete hormones whereby approximately 50 % secrete prolactin, 10 % secrete growth hormone (somatotropin) and 6 % secrete corticotropin. Other tumors located in the sella turcica can also cause endocrinological symptoms, such as an oversecretion of pituitary hormone or pituitary insufficiency by impinging on the pituitary gland or its stalk. When tumors spread into the space cranial to the sella turcica, they can impinge on the optic chiasm and cause visual disorders. A common differential diagnosis of a sellar tumor is a craniopharyngeoma. In children up to 10 % of all intracranial tumors are craniopharyngeomas. Other differential diagnoses for sellar tumors are metastases, meningiomas, epidermoids and in rare cases astrocytomas, germinomas or Rathke cleft cysts As these tumors are located in an anatomically complex region of the skull base and are often very small, a highly focused imaging protocol is required. The currently favored modality is magnetic resonance imaging (MRI) with the administration of a contrast agent. The sellar region should be mapped in thin slices. In cases of suspected microadenoma the imaging protocol should also contain a sequence with dynamic contrast administration in order to assess the specific enhancement characteristics of the tumor and the pituitary gland. (orig.) [German] Diese Arbeit ist eine Uebersicht ueber die haeufigsten Hypophysentumoren und deren Differenzialdiagnosen mit Augenmerk auf die

  9. MRI of cystic pituitary tumors

    Energy Technology Data Exchange (ETDEWEB)

    Tokunaga, Hitoshi; Hoshi, Seiichiro; Sunada, Souichi; Sunami, Kenro [Kawatetsu Chiba Hospital (Japan); Saeki, Naokatsu; Yamaura, Akira

    1998-11-01

    We retrospectively reviewed MRI findings of 17 patients with 3 histologically proven cystic pituitary tumors. They consisted of 10 cystic pituitary adenomas, 4 craniopharyngiomas and 3 Rathke`s cleft cysts. We analyzed the following MRI parameters such as cyst wall appearance, enhancement pattern of cyst wall, location of residual pituitary gland and location of tumor. They were clinically significant parameters for histological differentiation. Even though combinations of such MRI parameters helped for more accurate preoperative diagnosis, the differentiation between craniopharyngioma and Rathke`s cleft cyst was difficult in some cases. (author)

  10. MRI of cystic pituitary tumors

    International Nuclear Information System (INIS)

    Tokunaga, Hitoshi; Hoshi, Seiichiro; Sunada, Souichi; Sunami, Kenro; Saeki, Naokatsu; Yamaura, Akira

    1998-01-01

    We retrospectively reviewed MRI findings of 17 patients with 3 histologically proven cystic pituitary tumors. They consisted of 10 cystic pituitary adenomas, 4 craniopharyngiomas and 3 Rathke's cleft cysts. We analyzed the following MRI parameters such as cyst wall appearance, enhancement pattern of cyst wall, location of residual pituitary gland and location of tumor. They were clinically significant parameters for histological differentiation. Even though combinations of such MRI parameters helped for more accurate preoperative diagnosis, the differentiation between craniopharyngioma and Rathke's cleft cyst was difficult in some cases. (author)

  11. Subarachnoid hemorrhage in pituitary tumor

    Directory of Open Access Journals (Sweden)

    Ashis Patnaik

    2013-01-01

    Full Text Available Subarachnoid hemorrhage (SAH is the bleeding into the subarachnoid space containing cerebrospinal fluid. The most common cause of SAH is trauma. Rupture of aneurysms, vascular anomalies, tumor bleeds and hypertension are other important etiologies. SAH in the setting of pituitary tumor can result from various causes. It can be due to intrinsic tumor related pathology, injury to surrounding the vessel during the operative procedure or due to an associated aneurysm. We discuss the pathological mechanisms and review relevant literature related to this interesting phenomenon. Early and accurate diagnosis of the cause of the SAH in pituitary tumors is important, as this influences the management.

  12. NMR characterization of pituitary tumors

    International Nuclear Information System (INIS)

    Osbakken, M.; Gonzales, J.; Page, R.

    1984-01-01

    Twelve patients (5 male, 7 female, mean age 37.9 +- 20) with pituitary tumors were extensively evaluated with NMR imaging using a 1.5K gauss resistive magnet. Saturation recovery (SR), inversion recovery (IR) and spin echo (SE) pulse sequences were used for qualitative characterization of the lesions. T/sub 1/ calculations were also performed for brain and pituitary. Tumor histology and endocrine status were correlated with NMR data. All tumors were large with suprasellar extension (6 with prolactin secretion, 6 without). Pituitary T/sub 1/'s ranged from .2 to .64, the mean T/sub 1/ being longer than that of brain (Brain = .4 +- .04; Pit = .48 +- .14). 3 patients with histological evidence of homogeneous adenomas had long T/sub 1/'s (0.58 +- .05). 3 patients with evidence of recent or old hemorhage into the pituitary had much shorter T/sub 1/'s (0.29 +- .12). There was no relationship between prolactin secretion and T/sub 1/. Qualitative T/sub 1/ and T/sub 2/ information can be obtained by using a combination of SR, IR, and SE images. Using this method in the patients, homogeneous adenomas had similar T/sub 1/'s and longer T/sub 2/'s compared to the brain, while patients with bleeds had shorter T/sub 1/'s and T/sub 2/'s. Image T/sub 1/ characteristics correlated well with the calculated T/sub 1/ values. The range of T/sub 1/ (and potentially T/sub 2/) values which occur in apparently similar lesions are most likely due to anatomical and pathophysiological variations in these lesions. It may be ultimately possible to separate different types of pathological processes based on NMR image T/sub 1/ and T/sub 2/ characteristics after careful comparative studies of NMR and histological data are completed. The combination of calculated T/sub 1/ and T/sub 2/ with image T/sub 1/ and T/sub 2/ information may also be useful in further characterization of lesions

  13. Pituitary gland shrinkage in bipolar disorder: The role of gender.

    Science.gov (United States)

    Delvecchio, Giuseppe; Mandolini, Gian Mario; Perlini, Cinzia; Barillari, Marco; Marinelli, Veronica; Ruggeri, Mirella; Altamura, A Carlo; Bellani, Marcella; Brambilla, Paolo

    2018-04-01

    Hyperactivity of the Hypothalamic-Pituitary-Adrenal Axis (HPAA) has been consistently reported in mood disorders. However, only few studies investigated the Pituitary gland (PG) in Bipolar Disorder (BD) and the results are so far contrasting. Therefore, the aim of this study is to explore the integrity of the PG as well as the role of gender and the impact of clinical measurements on this structure in a sample of BD patients compared to healthy controls (HC). 34 BD patients and 41 HC underwent a 1.5 T MRI scan. PG volumes were manually traced for all subjects. Psychiatric symptoms were assessed by means of the Brief Psychiatry Rating Scale, the Hamilton Depression Rating Scale and the Bech Rafaelsen Mania Rating Scale. We found decreased PG volumes in BD patients compared to HC (F = 24.9, p < 0.001). Interestingly, after dividing the sample by gender, a significant PG volume decrease was detected only in female BD patients compared to female HC (F = 9.1, p < 0.001), but not in male BD compared to male HC (F = -0.12, p = 0.074). No significant correlations were observed between PG volumes and clinical variables. Our findings suggest that BD patients have decreased PG volumes, probably due to the long-term hyperactivity of the HPAA and to the consequent strengthening of the negative feedback control towards the PG volume itself. This alteration was particularly evident in females, suggesting a role of gender in affecting PG volumes in BD. Finally, the absence of significant correlations between PG volumes and clinical variables further supports that PG disruption is a trait feature of BD, being independent of symptoms severity and duration of treatment. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Exploiting tumor shrinkage through temporal optimization of radiotherapy

    International Nuclear Information System (INIS)

    Unkelbach, Jan; Craft, David; Hong, Theodore; Papp, Dávid; Wolfgang, John; Bortfeld, Thomas; Ramakrishnan, Jagdish; Salari, Ehsan

    2014-01-01

    In multi-stage radiotherapy, a patient is treated in several stages separated by weeks or months. This regimen has been motivated mostly by radiobiological considerations, but also provides an approach to reduce normal tissue dose by exploiting tumor shrinkage. The paper considers the optimal design of multi-stage treatments, motivated by the clinical management of large liver tumors for which normal liver dose constraints prohibit the administration of an ablative radiation dose in a single treatment. We introduce a dynamic tumor model that incorporates three factors: radiation induced cell kill, tumor shrinkage, and tumor cell repopulation. The design of multi-stage radiotherapy is formulated as a mathematical optimization problem in which the total dose to the normal tissue is minimized, subject to delivering the prescribed dose to the tumor. Based on the model, we gain insight into the optimal administration of radiation over time, i.e. the optimal treatment gaps and dose levels. We analyze treatments consisting of two stages in detail. The analysis confirms the intuition that the second stage should be delivered just before the tumor size reaches a minimum and repopulation overcompensates shrinking. Furthermore, it was found that, for a large range of model parameters, approximately one-third of the dose should be delivered in the first stage. The projected benefit of multi-stage treatments in terms of normal tissue sparing depends on model assumptions. However, the model predicts large dose reductions by more than a factor of 2 for plausible model parameters. The analysis of the tumor model suggests that substantial reduction in normal tissue dose can be achieved by exploiting tumor shrinkage via an optimal design of multi-stage treatments. This suggests taking a fresh look at multi-stage radiotherapy for selected disease sites where substantial tumor regression translates into reduced target volumes. (paper)

  15. T3 receptors in human pituitary tumors.

    Science.gov (United States)

    Machiavelli, Gloria A; Pauni, Micaela; Heredia Sereno, Gastón M; Szijan, Irene; Basso, Armando; Burdman, José A

    2009-11-01

    The purpose of this work was to investigate the synthesis of T3 receptors in human tumors of the anterior pituitary gland, its relationship with the hormone synthesized and/or secreted by the tumor and the post-surgical evolution of the patient. Patients were evaluated clinically and by magnetic nuclear resonance to classify the adenoma according to their size. Hormonal concentrations in sera were determined by radioimmunoassay. Immunohistochemistry of the pituitary hormones was performed in the tumors. Tumors were obtained at surgery and immediately frozen in ice, transported to the laboratory and stored at -70 degrees C. Reverse transcription was performed with purified RNA from the tumors. Out of 33 pituitary tumors, 29 had RNA for T3 receptors synthesis (88%). They were present in different histological specimens, the tumors were grades 1-4 according to their size, and there was no relationship between the size of the tumor and the presence of T3 receptor RNAs. The post-surgical evolution of the patient was mostly dependent on the size and not on the presence of T3 receptors. The presence of thyroid hormone receptors in pituitary tumors is in line with two important characteristics of these tumors: they are histologically benign and well differentiated.

  16. Radiation Therapy of Pituitary Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Park, Moon Baik; Hong, Seong Eong [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    1989-12-15

    Radiation treatment results were analyzed in a retrospective analysis of 47 patients with pituitary adenoma treated with radiation alone or combined with surgery from 1974 through 1987 at the Department of Therapeutic Radiology of Kyung Hee University. The 5-year overall survival rates for all patients was 80.4%. Radiation therapy was effective for improving visual symptoms and headache, but could not normalize amenorrhea and galactorrhoea. There was no difference of survival rate between radiation alone and combination with surgery. Prognostic factors such as age, sex, disease type, visual field, headache and surgical treatment were statistically no significant in survival rates of these patients.

  17. Radiation Therapy of Pituitary Tumors

    International Nuclear Information System (INIS)

    Park, Moon Baik; Hong, Seong Eong

    1989-01-01

    Radiation treatment results were analyzed in a retrospective analysis of 47 patients with pituitary adenoma treated with radiation alone or combined with surgery from 1974 through 1987 at the Department of Therapeutic Radiology of Kyung Hee University. The 5-year overall survival rates for all patients was 80.4%. Radiation therapy was effective for improving visual symptoms and headache, but could not normalize amenorrhea and galactorrhoea. There was no difference of survival rate between radiation alone and combination with surgery. Prognostic factors such as age, sex, disease type, visual field, headache and surgical treatment were statistically no significant in survival rates of these patients

  18. Autocrine IL-6 mediates pituitary tumor senescence

    Science.gov (United States)

    Fuertes, Mariana; Ajler, Pablo; Carrizo, Guillermo; Cervio, Andrés; Sevlever, Gustavo; Stalla, Günter K.; Arzt, Eduardo

    2017-01-01

    Cellular senescence is a stable proliferative arrest state. Pituitary adenomas are frequent and mostly benign, but the mechanism for this remains unknown. IL-6 is involved in pituitary tumor progression and is produced by the tumoral cells. In a cell autonomous fashion, IL-6 participates in oncogene-induced senescence in transduced human melanocytes. Here we prove that autocrine IL-6 participates in pituitary tumor senescence. Endogenous IL-6 inhibition in somatotroph MtT/S shRNA stable clones results in decreased SA-β-gal activity and p16INK4a but increased pRb, proliferation and invasion. Nude mice injected with IL-6 silenced clones develop tumors contrary to MtT/S wild type that do not, demonstrating that clones that escape senescence are capable of becoming tumorigenic. When endogenous IL-6 is silenced, cell cultures derived from positive SA-β-gal human tumor samples decrease the expression of the senescence marker. Our results establish that IL-6 contributes to maintain senescence by its autocrine action, providing a natural model of IL-6 mediated benign adenoma senescence. PMID:27902467

  19. Management of incidental pituitary tumors

    Directory of Open Access Journals (Sweden)

    Nicholas F. Marko

    2011-11-01

    Full Text Available Pituitary incidentalomas are common lesions for which neurosurgical referrals may become progressively more frequent, given the increasing application of neuroimaging. The initial evaluation of a patient with radiographic evidence of an incidentaloma should focus on addressing two questions: (1 is the lesion causing neurological symptoms, and (2 is the lesion hormonally active? The answers to these two questions provide a framework for subsequent clinical management. The initial patient assessment should include a detailed history and physical examination, including the bedside assessment of visual fields. High-quality MRI imaging is essential, and formal visual field testing should be obtained in patients where the lesion abuts or compresses the optic apparatus. The initial biochemical workup is intended to assess potential pituitary hypo- or hyperfunction and should include measurement of serum levels of prolactin, insulin-like growth factor type-1, free thyroxine, testosterone, and an assessment of axis hypothalamic–pituitary–adrenal axis function. Additional testing may include serum thyroid-stimulating hormone, follicle-stimulating hormone, and luteinizing hormone levels. Neurologically-asymptomatic patients without endocrine dysfunction can be managed with observation at regular intervals, including MRI imaging at 6 months and 1 year and then annually for a period of 3 years. Follow-up biochemical assessment is not necessary in the absence of clinical symptoms or radiographic enlargement of the lesion. After 3 years the follow-up interval may be prolonged, although closer follow-up may be indicated for patients with lesions C1 cm. Most patients who either present with or who subsequently develop neurologic or endocrinologic symptoms should be considered for surgery as the first-line therapy.

  20. Endoscopic transnasal approach for removing pituitary tumors

    Directory of Open Access Journals (Sweden)

    Mirian Cabral Moreira de Castro

    2014-05-01

    Full Text Available To describe a series of 129 consecutive patients submitted to the resection of pituitary tumors using the endoscopic transsphenoidal approach in a public medical center. Method: Retrospective analysis based on the records of patients submitted to the resection of a pituitary tumor through the endoscopic transsphenoidal approach between 2004 and 2009. Results: One hundred and twenty-nine records were analyzed. The tumor was non-secreting in 96 (74.42% and secreting in 33 patients (22.58%. Out of the secretory tumors, the most prevalent was the growth hormone producer (7.65%, followed by the prolactinoma, (6.98%. Eleven patients developed cerebral spinal fluid (CSF fistulas, and four of them developed meningitis. One patient died due to intracerebral hemorrhage in the postoperative period. Conclusion: The endoscopic transsphenoidal approach to sellar tumors proved to be safe when the majority of the tumors were non-secreting. The most frequent complication was CSF. This technique can be done even in a public hospital with financial limits, since the health professionals are integrated.

  1. Transsphenoidal Surgery for Pituitary Tumors and Other Sellar Masses.

    Science.gov (United States)

    Owen, Tina J; Martin, Linda G; Chen, Annie V

    2018-01-01

    Transsphenoidal surgery is an option for dogs and cats with functional and nonfunctional pituitary masses or other sellar and parasellar masses. An adrenocorticotropic hormone-secreting tumor causing Cushing disease is the most common clinically relevant pituitary tumor in dogs, and the most common pituitary tumor seen in cats is a growth hormone-secreting tumor causing acromegaly. Transsphenoidal surgery can lead to rapid resolution of clinical signs and provide a cure for these patients. Because of the risks associated with this surgery, it should only be attempted by a cohesive pituitary surgery group with a sophisticated medical and surgical team. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Diabetes insipidus following resection of pituitary tumors.

    Science.gov (United States)

    Schreckinger, Matthew; Szerlip, Nicholas; Mittal, Sandeep

    2013-02-01

    Diabetes insipidus (DI) is a common complication following pituitary surgery and can be transient or permanent. Neurogenic DI occurs following injury to the magnocellular neurons in the hypothalamus that produce and transport arginine vasopressin (AVP) and form the hypothalamo-hypophyseal tract. DI is defined by a constellation of signs and symptoms resulting in dilute high-volume urine output and increasing serum osmolality. The body's inability to concentrate urine leaves the patient dehydrated and leads to metabolic abnormalities that can be life threatening if not recognized and treated in a timely manner with an exogenous AVP analog. The reported incidence of postsurgical central DI varies from 1 to 67%. This wide range likely reflects inconsistencies in the working definition of DI across the literature. Factors affecting the rate of DI include pituitary tumor size, adherence to surrounding structures, surgical approach, and histopathology of pituitary lesion. The likelihood of postoperative DI can be reduced by careful preservation of the neurovascular structures of the hypothalamus, infundibulum, and neurohypophysis. Vigilance and meticulous surgical technique are essential to minimize injury to these critical regions that can lead to postsurgical DI. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. Pituitary tumors in patients with MEN1 syndrome

    Directory of Open Access Journals (Sweden)

    Luis V. Syro

    2012-01-01

    Full Text Available We briefly review the characteristics of pituitary tumors associated with multiple endocrine neoplasia type 1. Multiple endocrine neoplasia type 1 is an autosomal-dominant disorder most commonly characterized by tumors of the pituitary, parathyroid, endocrine-gastrointestinal tract, and pancreas. A MEDLINE search for all available publications regarding multiple endocrine neoplasia type 1 and pituitary adenomas was undertaken. The prevalence of pituitary tumors in multiple endocrine neoplasia type 1 may vary from 10% to 60% depending on the studied series, and such tumors may occur as the first clinical manifestation of multiple endocrine neoplasia type 1 in 25% of sporadic and 10% of familial cases. Patients were younger and the time between initial and subsequent multiple endocrine neoplasia type 1 endocrine lesions was significantly longer when pituitary disease was the initial manifestation of multiple endocrine neoplasia type 1. Tumors were larger and more invasive and clinical manifestations related to the size of the pituitary adenoma were significantly more frequent in patients with multiple endocrine neoplasia type 1 than in subjects with non-multiple endocrine neoplasia type 1. Normalization of pituitary hypersecretion was much less frequent in patients with multiple endocrine neoplasia type 1 than in subjects with non-multiple endocrine neoplasia type 1. Pituitary tumors in patients with multiple endocrine neoplasia type 1 syndrome tend to be larger, invasive and more symptomatic, and they tend to occur in younger patients when they are the initial presentation of multiple endocrine neoplasia type 1.

  4. Gamma knife radiosurgery for secreting pituitary tumors

    International Nuclear Information System (INIS)

    Noren, G.; Jackson, I.M.D.; Chougule, P.; Zheng, Z.; Epstein, M.H.

    1998-01-01

    Transsphenoidal surgery usually represents first line treatment for pituitary adenomas with the aim of removing the tumor, decompressing the optic apparatus and, in secreting tumors, eliminating the hypersecretion. Gamma Knife radiosurgery is indicated for tumor remnants or recurrences in or above the sella including those invading the cavernous sinus and also as initial treatment in patients who are unable to tolerate an open surgical procedure and where medication has failed. In this study, the target definition was retrospectively studied and when necessary corrected in 10 acromegalic patients, 8 with Cushing's disease, and 12 with prolactinomas undergoing Gamma Knife radiosurgery. The dose plan was analyzed and the volume of the target covered by a minimum of 15, 20, 25, 30 and 35 Gy was estimated. A dose/volume profile for each treatment was created and correlated to the endocrinological and clinical outcome. Cure, according to strict endocrinological criteria, was seen in 6 of the acromegalic patients, in 2 of the patients with ACTH hypersecretion, and in 2 of the patients with prolactinomas. Analysis of these profiles, also for the patients with partial effect, show that a minimum radiation dose of 20 Gy may be adequate to eliminate the hypersecretion in acromegalic patients whereas a dose of at least 25 Gy may be required in patients with Cushing's disease and prolactinoma. (author)

  5. Recent Progress in the Medical Therapy of Pituitary Tumors

    Directory of Open Access Journals (Sweden)

    Fabienne Langlois

    2017-05-01

    Full Text Available Management of pituitary tumors is multidisciplinary, with medical therapy playing an increasingly important role. With the exception of prolactin-secreting tumors, surgery is still considered the first-line treatment for the majority of pituitary adenomas. However, medical/pharmacological therapy plays an important role in controlling hormone-producing pituitary adenomas, especially for patients with acromegaly and Cushing disease (CD. In the case of non-functioning pituitary adenomas (NFAs, pharmacological therapy plays a minor role, the main objective of which is to reduce tumor growth, but this role requires further studies. For pituitary carcinomas and atypical adenomas, medical therapy, including chemotherapy, acts as an adjuvant to surgery and radiation therapy, which is often required to control these aggressive tumors. In the last decade, knowledge about the pathophysiological mechanisms of various pituitary adenomas has increased, thus novel medical therapies that target specific pathways implicated in tumor synthesis and hormonal over secretion are now available. Advancement in patient selection and determination of prognostic factors has also helped to individualize therapy for patients with pituitary tumors. Improvements in biochemical and “tumor mass” disease control can positively affect patient quality of life, comorbidities and overall survival. In this review, the medical armamentarium for treating CD, acromegaly, prolactinomas, NFA, and carcinomas/aggressive atypical adenomas will be presented. Pharmacological therapies, including doses, mode of administration, efficacy, adverse effects, and use in special circumstances are provided. Medical therapies currently under clinical investigation are also briefly discussed.

  6. Reoxygenation of hypoxic cells by tumor shrinkage during irradiation. A computer simulation

    International Nuclear Information System (INIS)

    Kocher, M.; Treuer, H.

    1995-01-01

    A 3-dimensional computer simulation was developed in order to estimate the impact of tumor shrinkage on reoxygenation of chronic hypoxic tumor cells during a full course of fractionated irradiation. The growth of a small tumor situated in a vascularized stroma with 350 capillary cross-sections/mm 3 which were displaced by the growing tumor was simulated. Tumors contained 10 4 cells when irradiation started, intrinsic radiosensitivity was set to either low (α=0.3 Gy -1 , β=0.03 Gy -2 ) or high (α=0.4 Gy -1 , β=0.04 Gy -2 ) values. Oxygen enhancement ratio was 3.0, potential tumor doubling time T pot =1, 2 or 5 days. A simulated fractionated radiotherapy was carried out with daily fractions of 2.0 Gy, total dose 50 to 70 Gy. The presence or absence of factors preventing tumor cord shrinkage was also included. During the growth phase, all tumors developed a necrotic core with a hypoxic cell fraction of 25% under these conditions. During irradiation, the slower growing tumors (T pot =2 to 5 days) showed complete reoxygenation of the hypoxic cells after 30 to 40 Gy independent from radiosensitivity, undisturbed tumor shrinkage provided. If shrinkage was prevented, the hypoxic fraction rose to 100% after 30 to 50 Gy. Local tumor control, defined as the destruction of all clonogenic and hypoxic tumor cells increased by 20 to 100% due to reoxygenation and 50 Gy were enough in order to sterilize the tumors in these cases. In the fast growing tumors (T pot =1 day), reoxygenation was only observed in the case of high radiosensitivity and undisturbed tumor shrinkage. In these tumors reoxygenation increased the control rates by up to 60%. (orig./MG) [de

  7. Aspergillosis of the sphenoid sinus simulating a pituitary tumor

    Energy Technology Data Exchange (ETDEWEB)

    Larranaga, J.; Fandino, J.; Gomez-Bueno, J.; Botana, C.; Rodriguez, D.; Gonzalez-Carrero, J.

    1989-09-01

    Sphenoidal aspergillosis is an unusual cause of sella turcica enlargement. Pituitary abscess secondary to Aspergillus had been reported. In the present case, a woman with sphenoid sinus aspergillosis mimiced a pituitary tumor. This patient survived her infection with intact pituitary function following a transsphenoidal approach. No postoperative amphotericine-B and 5-fluorocytosine were necessary. CT scan revealed a mass occupying the sphenoid sinus extending to the sella turcica. Factors that should alert the clinican to the presence of a sphenoidal and pituitary abscess in a patient with sella turcica enlargement are prior episodes of sinusitis, meningitis and immunosuppression and, as in the present case, hyperglycemia. (orig.).

  8. Welcoming the new WHO classification of pituitary tumors 2017: revolution in TTF-1-positive posterior pituitary tumors.

    Science.gov (United States)

    Shibuya, Makoto

    2018-04-01

    The fourth edition of the World Health Organization classification of endocrine tumors (EN-WHO2017) was released in 2017. In this new edition, changes in the classification of non-neuroendocrine tumors are proposed particularly in tumors arising in the posterior pituitary. These tumors are a distinct group of low-grade neoplasms of the sellar region that express thyroid transcription factor-1, and include pituicytoma, granular cell tumor of the sellar region, spindle cell oncocytoma, and sellar ependymoma. This short review focuses on the classification of posterior pituitary tumors newly proposed in EN-WHO2017, and controversies in their pathological differential diagnosis are discussed based on recent cases.

  9. Pituitary Tumors in Childhood: an update in their diagnosis, treatment and molecular genetics

    OpenAIRE

    Keil, Margaret F.; Stratakis, Constantine A.

    2008-01-01

    Pituitary tumors are rare in childhood and adolescence, with a reported prevalence of up to 1 per million children. Only 2 - 6% of surgically treated pituitary tumors occur in children. Although pituitary tumors in children are almost never malignant and hormonal secretion is rare, these tumors may result in significant morbidity. Tumors within the pituitary fossa are of two types mainly, craniopharyngiomas and adenomas; craniopharyngiomas cause symptoms by compressing normal pituitary, causi...

  10. Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): A Pituitary Society Statement.

    Science.gov (United States)

    Casanueva, Felipe F; Barkan, Ariel L; Buchfelder, Michael; Klibanski, Anne; Laws, Edward R; Loeffler, Jay S; Melmed, Shlomo; Mortini, Pietro; Wass, John; Giustina, Andrea

    2017-10-01

    With the goal of generate uniform criteria among centers dealing with pituitary tumors and to enhance patient care, the Pituitary Society decided to generate criteria for developing Pituitary Tumors Centers of Excellence (PTCOE). To develop that task, a group of ten experts served as a Task Force and through two years of iterative work an initial draft was elaborated. This draft was discussed, modified and finally approved by the Board of Directors of the Pituitary Society. Such document was presented and debated at a specific session of the Congress of the Pituitary Society, Orlando 2017, and suggestions were incorporated. Finally the document was distributed to a large group of global experts that introduced further modifications with final endorsement. After five years of iterative work a document with the ideal criteria for a PTCOE is presented. Acknowledging that very few centers in the world, if any, likely fulfill the requirements here presented, the document may be a tool to guide improvements of care delivery to patients with pituitary disorders. All these criteria must be accommodated to the regulations and organization of Health of a given country.

  11. TH-E-BRF-01: Exploiting Tumor Shrinkage in Split-Course Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Unkelbach, J; Craft, D; Hong, T; Papp, D; Wolfgang, J; Bortfeld, T [Massachusetts General Hospital, Boston, MA (United States); Ramakrishnan, J [University of Wisconsin, Madison, Wisconsin (United States); Salari, E [Wichita State University, Wichita, KS (United States)

    2014-06-15

    Purpose: In split-course radiotherapy, a patient is treated in several stages separated by weeks or months. This regimen has been motivated by radiobiological considerations. However, using modern image-guidance, it also provides an approach to reduce normal tissue dose by exploiting tumor shrinkage. In this work, we consider the optimal design of split-course treatments, motivated by the clinical management of large liver tumors for which normal liver dose constraints prohibit the administration of an ablative radiation dose in a single treatment. Methods: We introduce a dynamic tumor model that incorporates three factors: radiation induced cell kill, tumor shrinkage, and tumor cell repopulation. The design of splitcourse radiotherapy is formulated as a mathematical optimization problem in which the total dose to the liver is minimized, subject to delivering the prescribed dose to the tumor. Based on the model, we gain insight into the optimal administration of radiation over time, i.e. the optimal treatment gaps and dose levels. Results: We analyze treatments consisting of two stages in detail. The analysis confirms the intuition that the second stage should be delivered just before the tumor size reaches a minimum and repopulation overcompensates shrinking. Furthermore, it was found that, for a large range of model parameters, approximately one third of the dose should be delivered in the first stage. The projected benefit of split-course treatments in terms of liver sparing depends on model assumptions. However, the model predicts large liver dose reductions by more than a factor of two for plausible model parameters. Conclusion: The analysis of the tumor model suggests that substantial reduction in normal tissue dose can be achieved by exploiting tumor shrinkage via an optimal design of multi-stage treatments. This suggests taking a fresh look at split-course radiotherapy for selected disease sites where substantial tumor regression translates into reduced

  12. TH-E-BRF-01: Exploiting Tumor Shrinkage in Split-Course Radiotherapy

    International Nuclear Information System (INIS)

    Unkelbach, J; Craft, D; Hong, T; Papp, D; Wolfgang, J; Bortfeld, T; Ramakrishnan, J; Salari, E

    2014-01-01

    Purpose: In split-course radiotherapy, a patient is treated in several stages separated by weeks or months. This regimen has been motivated by radiobiological considerations. However, using modern image-guidance, it also provides an approach to reduce normal tissue dose by exploiting tumor shrinkage. In this work, we consider the optimal design of split-course treatments, motivated by the clinical management of large liver tumors for which normal liver dose constraints prohibit the administration of an ablative radiation dose in a single treatment. Methods: We introduce a dynamic tumor model that incorporates three factors: radiation induced cell kill, tumor shrinkage, and tumor cell repopulation. The design of splitcourse radiotherapy is formulated as a mathematical optimization problem in which the total dose to the liver is minimized, subject to delivering the prescribed dose to the tumor. Based on the model, we gain insight into the optimal administration of radiation over time, i.e. the optimal treatment gaps and dose levels. Results: We analyze treatments consisting of two stages in detail. The analysis confirms the intuition that the second stage should be delivered just before the tumor size reaches a minimum and repopulation overcompensates shrinking. Furthermore, it was found that, for a large range of model parameters, approximately one third of the dose should be delivered in the first stage. The projected benefit of split-course treatments in terms of liver sparing depends on model assumptions. However, the model predicts large liver dose reductions by more than a factor of two for plausible model parameters. Conclusion: The analysis of the tumor model suggests that substantial reduction in normal tissue dose can be achieved by exploiting tumor shrinkage via an optimal design of multi-stage treatments. This suggests taking a fresh look at split-course radiotherapy for selected disease sites where substantial tumor regression translates into reduced

  13. Temozolomide-Induced Shrinkage of a Pituitary Carcinoma Causing Cushing's Disease — Report of a Case and Literature Review

    Directory of Open Access Journals (Sweden)

    Lorenzo Curtò

    2010-01-01

    Full Text Available Temozolomide (TMZ is an alkylating chemotherapeutic agent that has recently been used in some cases as a new therapeutic tool for pituitary carcinomas and aggressive pituitary adenomas. In this report, we present the case of effective TMZ treatment in a 42-year-old man with ACTH-secreting carcinoma. The tumor grew progressively over 4 years, from 2.2 to 31.1 cm3, despite three surgical approaches and gamma-knife treatment. Ki-67 increased from 2 to 18%. An intradural metastasis at the foramen magnum was detected by MRI after the third operation. Thereafter, four cycles of 5-day TMZ administration (200 mg/m2/day during the first, and 150 mg/m2/day during the following cycles induced dramatic tumor size reduction (>90%. Clinical conditions improved progressively and, after 17 months from the beginning of TMZ administration, the patient is still alive. The treatment was well tolerated except for a transient thrombocytopenia (grade 4 WHO.

  14. Is IGSF1 involved in human pituitary tumor formation?

    Science.gov (United States)

    Faucz, Fabio R; Horvath, Anelia D; Azevedo, Monalisa F; Levy, Isaac; Bak, Beata; Wang, Ying; Xekouki, Paraskevi; Szarek, Eva; Gourgari, Evgenia; Manning, Allison D; de Alexandre, Rodrigo Bertollo; Saloustros, Emmanouil; Trivellin, Giampaolo; Lodish, Maya; Hofman, Paul; Anderson, Yvonne C; Holdaway, Ian; Oldfield, Edward; Chittiboina, Prashant; Nesterova, Maria; Biermasz, Nienke R; Wit, Jan M; Bernard, Daniel J; Stratakis, Constantine A

    2015-02-01

    IGSF1 is a membrane glycoprotein highly expressed in the anterior pituitary. Pathogenic mutations in the IGSF1 gene (on Xq26.2) are associated with X-linked central hypothyroidism and testicular enlargement in males. In this study, we tested the hypothesis that IGSF1 is involved in the development of pituitary tumors, especially those that produce growth hormone (GH). IGSF1 was sequenced in 21 patients with gigantism or acromegaly and 92 healthy individuals. Expression studies with a candidate pathogenic IGSF1 variant were carried out in transfected cells and immunohistochemistry for IGSF1 was performed in the sections of GH-producing adenomas, familial somatomammotroph hyperplasia, and in normal pituitary. We identified the sequence variant p.N604T, which in silico analysis suggested could affect IGSF1 function, in two male patients and one female with somatomammotroph hyperplasia from the same family. Of 60 female controls, two carried the same variant and seven were heterozygous for other variants. Immunohistochemistry showed increased IGSF1 staining in the GH-producing tumor from the patient with the IGSF1 p.N604T variant compared with a GH-producing adenoma from a patient negative for any IGSF1 variants and with normal control pituitary tissue. The IGSF1 gene appears polymorphic in the general population. A potentially pathogenic variant identified in the germline of three patients with gigantism from the same family (segregating with the disease) was also detected in two healthy female controls. Variations in IGSF1 expression in pituitary tissue in patients with or without IGSF1 germline mutations point to the need for further studies of IGSF1 action in pituitary adenoma formation. © 2015 Society for Endocrinology.

  15. The correlation between aldehyde dehydrogenase-1A1 level and tumor shrinkage after preoperative chemoradiation in locally advanced rectal cancer

    Directory of Open Access Journals (Sweden)

    Rhandyka Rafli

    2015-12-01

    Full Text Available This study was performed to determine the correlation between aldehyde dehydrogenase-1A1 (ALDH1A1 level and tumor shrinkage after chemoradiation in locally advanced rectal cancer. This is a retrospective study of 14 locally advanced rectal cancer patients with long course neoadjuvant chemoradiation. ALDH1A1 level was measured using ELISA from paraffin embedded tissue. Tumor shrinkage was measured from computed tomography (CT scan or magnetic resonance imaging (MRI based on Response Evaluation Criteria in Solid Tumor v1.1 (RECIST v1.1. The mean of ALDH1A1 level was 9.014 ± 3.3 pg/mL and the mean of tumor shrinkage was 7.89 ± 35.7%. Partial response proportion was 28.6%, stable disease proportion was 50% and progressive disease proportion was 21.4%. There was a significant strong negative correlation (r = –0.890, plt; 0.001 between ALDH1A1 and tumor shrinkage. In conclusion, tumor shrinkage in locally advanced rectal cancer after preoperative chemoradiation was influenced by ALDH1A1 level. Higher level of ALDH1A1 suggests decreased tumor shrinkage after preoperative chemoradiation.

  16. Quantitative evaluation of indium-111 (In-111) octreotide pituitary activity: Comparison in patient with and without pituitary tumors

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, P.; Waxman, A.; Nguyen, K. [Cedars-Sinai Medical Center, Los Angeles, CA (United States)] [and others

    1995-05-01

    Indium 111 Octreotide is known to detect pituitary tumors. Variable low level pituitary activity has been reported in pts. with no demonstrable pituitary tumors. To our knowledge, there have been no studies which quantitatively categorize pituitary activity with respect to distinguishing normal subject from pts. with pituitary tumors. 13 pts. with proven, treated acromegaly were included, as well as 15 pts. with no history of pituitary disorder. Both groups underwent SPECT In-111 scintigraphy 24 hours post-injection Average count per pixel ratios were obtained for the pituitary/calvarium (P/C) and pituitary/brain (P/B) regions. 10 pts. with acromegaly underwent growth hormone (GH) measurements 2 hours post-glucose load. Statistical correlation between growth hormone levels using P/C and P/B ratios were obtained. P/C ratios, as well as P/B ratios demonstrated high correlation with serum GH levels correlation coefficient(r)= .717 for P/C p<0.05, and correlation coefficient(r) = 0.828 for P/B ratios p<0.005. P/C ratios and P/B ratios for controls correlated closely with the upper level of normal predicted by P/C or P/B ratios as a function of serum growth hormone found in patients with acromegaly. Somatostatin receptor SPECT scintigraphy of the pituitary and appropriate quantitation can predict patients with growth hormone secreting tumors.

  17. The 2017 World Health Organization classification of tumors of the pituitary gland: a summary.

    Science.gov (United States)

    Lopes, M Beatriz S

    2017-10-01

    The 4th edition of the World Health Organization (WHO) classification of endocrine tumors has been recently released. In this new edition, major changes are recommended in several areas of the classification of tumors of the anterior pituitary gland (adenophypophysis). The scope of the present manuscript is to summarize these recommended changes, emphasizing a few significant topics. These changes include the following: (1) a novel approach for classifying pituitary neuroendocrine tumors according to pituitary adenohypophyseal cell lineages; (2) changes to the histological grading of pituitary neuroendocrine tumors with the elimination of the term "atypical adenoma;" and (3) introduction of new entities like the pituitary blastoma and re-definition of old entities like the null-cell adenoma. This new classification is very practical and mostly based on immunohistochemistry for pituitary hormones, pituitary-specific transcription factors, and other immunohistochemical markers commonly used in pathology practice, not requiring routine ultrastructural analysis of the tumors. Evaluation of tumor proliferation potential, by mitotic count and Ki-67 labeling index, and tumor invasion is strongly recommended on individual case basis to identify clinically aggressive adenomas. In addition, the classification offers the treating clinical team information on tumor prognosis by identifying specific variants of adenomas associated with an elevated risk for recurrence. Changes in the classification of non-neuroendocrine tumors are also proposed, in particular those tumors arising in the posterior pituitary including pituicytoma, granular cell tumor of the posterior pituitary, and spindle cell oncocytoma. These changes endorse those previously published in the 2016 WHO classification of CNS tumors. Other tumors arising in the sellar region are also reviewed in detail including craniopharyngiomas, mesenchymal and stromal tumors, germ cell tumors, and hematopoietic tumors. It is

  18. The value of radiation therapy for pituitary tumors

    International Nuclear Information System (INIS)

    Watari, Tsutomu

    1995-01-01

    Following points are discussed in this review. 1) Historical review of our previous therapeutic management. 2) Classification of pituitary adenomas. 3) Clinical analysis of my recent 58 cases. 4) Verification of usefulness of postoperative irradiation which achieved to increase in local control rate. 5) Authoritativeness of radiotherapy. In general, 3 to 4 portal technique or arc therapy were employed. The lateral opposing field technique was avoid to use. The recommended doses using linear accelerator x-ray technique is approximately 5000 cGy in 5 weeks. To prevent radiation hazard; (1) examiner should not use technique of two opposed fields, (2) total doses should not exceed 5000 cGy in 5 to 6 weeks and the use of daily fractions should not exceed 200 cGy. 6) Correlation of hormone secreting tumors and radiation therapy. 7) Problem of radiosurgery and heavy particle. 8) Countermeasure for recurrence cases. 9) Problem of side effects of radiotherapy and its precaution. Complication of radiation for pituitary adenoma found that the significant side effects are negligibly small in recent years. 10) Pituitary tumor are originally slow growing and benign tumor, therefore the response to irradiation takes long time to elapse for final evaluation. For instance, over 80 to 90% of acromegaly patients respond HGH successfully, but this may require from one to several years. 11) Conclusion. (author)

  19. The value of radiation therapy for pituitary tumors

    Energy Technology Data Exchange (ETDEWEB)

    Watari, Tsutomu [Dokkyo Univ., Mibu, Tochigi (Japan). School of Medicine

    1995-09-01

    Following points are discussed in this review. (1) Historical review of our previous therapeutic management. (2) Classification of pituitary adenomas. (3) Clinical analysis of my recent 58 cases. (4) Verification of usefulness of postoperative irradiation which achieved to increase in local control rate. (5) Authoritativeness of radiotherapy. In general, 3 to 4 portal technique or arc therapy were employed. The lateral opposing field technique was avoid to use. The recommended doses using linear accelerator x-ray technique is approximately 5000 cGy in 5 weeks. To prevent radiation hazard; (1) examiner should not use technique of two opposed fields, (2) total doses should not exceed 5000 cGy in 5 to 6 weeks and the use of daily fractions should not exceed 200 cGy. (6) Correlation of hormone secreting tumors and radiation therapy. (7) Problem of radiosurgery and heavy particle. (8) Countermeasure for recurrence cases. (9) Problem of side effects of radiotherapy and its precaution. Complication of radiation for pituitary adenoma found that the significant side effects are negligibly small in recent years. (10) Pituitary tumor are originally slow growing and benign tumor, therefore the response to irradiation takes long time to elapse for final evaluation. For instance, over 80 to 90% of acromegaly patients respond HGH successfully, but this may require from one to several years. (11) Conclusion. (author).

  20. Pituitary Tumors in Childhood: an update in their diagnosis, treatment and molecular genetics

    Science.gov (United States)

    Keil, Margaret F.; Stratakis, Constantine A.

    2009-01-01

    Pituitary tumors are rare in childhood and adolescence, with a reported prevalence of up to 1 per million children. Only 2 - 6% of surgically treated pituitary tumors occur in children. Although pituitary tumors in children are almost never malignant and hormonal secretion is rare, these tumors may result in significant morbidity. Tumors within the pituitary fossa are of two types mainly, craniopharyngiomas and adenomas; craniopharyngiomas cause symptoms by compressing normal pituitary, causing hormonal deficiencies and producing mass effects on surrounding tissues and the brain; adenomas produce a variety of hormonal conditions such as hyperprolactinemia, Cushing disease and acromegaly or gigantism. Little is known about the genetic causes of sporadic lesions, which comprise the majority of pituitary tumors, but in children, more frequently than in adults, pituitary tumors may be a manifestation of genetic conditions such as multiple endocrine neoplasia type 1 (MEN 1), Carney complex, familial isolated pituitary adenoma (FIPA), and McCune-Albright syndrome. The study of pituitary tumorigenesis in the context of these genetic syndromes has advanced our knowledge of the molecular basis of pituitary tumors and may lead to new therapeutic developments. PMID:18416659

  1. Guanine nucleotide regulation of dopamine receptor agonist affinity states in rat estradiol-induced pituitary tumors

    Energy Technology Data Exchange (ETDEWEB)

    Di Paolo, T.; Falardeau, P.

    1987-08-31

    The authors have investigated dopamine (DA) receptor agonist high- and low-affinity states in female rate estradiol-induced prolactin (PRL)-secreting pituitary tumors and intact pituitary tissue. Estradiol treatment increased the anterior pituitary weight 9-fold and plasma prolactin levels 74-fold and these measures are correlated (R = 0.745, n = 73, p < 0.001). Competition for (/sup 3/H)-spiperone binding to the DA receptor by apomorphine was compared in normal and adenomatous pituitary tissue. The inhibition constants (Ki) and the proportions of the two apomorphine sites are unchanged in tumors compared to intact pituitary tissue. Guanosine 5'-(..beta..-..gamma..-imino)triphosphate (Gpp(NH)p) causes complete conversion of the high into low affinity dopaminergic agonist site in normal pituitary and in tumors. These results suggest that rats with primary estradiol-induced pituitary tumors have normal and functional DA receptors. 9 references, 2 tables.

  2. Guanine nucleotide regulation of dopamine receptor agonist affinity states in rat estradiol-induced pituitary tumors

    International Nuclear Information System (INIS)

    Di Paolo, T.; Falardeau, P.

    1987-01-01

    The authors have investigated dopamine (DA) receptor agonist high- and low-affinity states in female rate estradiol-induced prolactin (PRL)-secreting pituitary tumors and intact pituitary tissue. Estradiol treatment increased the anterior pituitary weight 9-fold and plasma prolactin levels 74-fold and these measures are correlated (R = 0.745, n = 73, p 3 H]-spiperone binding to the DA receptor by apomorphine was compared in normal and adenomatous pituitary tissue. The inhibition constants (Ki) and the proportions of the two apomorphine sites are unchanged in tumors compared to intact pituitary tissue. Guanosine 5'-[β-γ-imino]triphosphate (Gpp(NH)p) causes complete conversion of the high into low affinity dopaminergic agonist site in normal pituitary and in tumors. These results suggest that rats with primary estradiol-induced pituitary tumors have normal and functional DA receptors. 9 references, 2 tables

  3. TSH-induced hyperthyroidism caused by a pituitary tumor.

    Science.gov (United States)

    Beck-Peccoz, Paolo; Persani, Luca

    2006-09-01

    A 45-year-old man presented with frontal headache and visual disturbances to our clinic. For the previous 5 years, he had been receiving treatment for long-lasting mild hyperthyroidism with antithyroid therapy, but therapy had not been carefully followed. During the last 2 years he had also complained of erectile dysfunction and loss of libido. On physical examination, he had a small goiter, normal skin, no Graves' ophthalmopathy, normal BMI, and reduced testis volume and pubic hair. Serum levels of free T3 and T4, serum prolactin, testosterone, serum gonadotropins, insulin-like growth factor 1, adrenocorticotropic hormone, and cortisol were measured. MRI scan, TSH-releasing hormone test, and T3 suppression test were carried out. Levels of pituitary glycoprotein hormone alpha-subunit and sex-hormone-binding protein were also measured. Hyperthyroidism caused by a mixed pituitary adenoma that secretes prolactin and TSH. Trans-sphenoidal resection of the pituitary tumor. After surgery, T3 suppression test failed to completely suppress TSH secretion, which suggested a persistence of residual adenomatous cells. Hyperthyroidism and hypogonadism recurred after 5 years, therefore, treatment with lanreotide was initiated, and resulted in complete resolution of signs and symptoms of the disease.

  4. Evaluation of pituitary tumors at Hospital Nacional del Sur Arequipa, EsSalud (ex IPSS). I: Prolactinomas

    International Nuclear Information System (INIS)

    Delgado B, C.; Bellido P, E.; Beltran C, F.

    1999-01-01

    Pituitary adenomas represent 10 to 15% of intracranial tumors, and prolactinomas are the most common type of secretory pituitary adenomas. The clinical features, PRL levels, CT scanning of the pituitary fossa were tested in 101 patients (91 women and 10 men), before and after treatment with bromocriptine and/or hypophysectomy, they presented prolactin-secreting adenomas, and attended the endocrinology and/or neurosurgery services from September 1992 to June 1997. Pretreatment prolactin levels were 106,9 ng/ml (meam) and decreased to 20,0 ng/ml after an average of 23,6 months of medical therapy with bromocriptine. Headache, galactorrhea, menstrual cycle disorders, visual field disturbances, infertility and decreased libido were present in 80,2%; 71,3%; 51,6%; 23,8%; 7,9% and 6,9%; respectively. CT detected 63 microadenomas and 37 macroadenomas, these figures improved after using bromocriptine to 26 and 24, respectively. Approximately 69% of patients responded to bromocriptine in terms of a decrease of serum PRL to normal, tumor shrinkage, cessation of galactorrhea and return of menses, 21% of patients presented no change and the 9% of them continued to enlarge prolactinomas despite a fall, in some, of the serum PRL concentration. (authors)

  5. Image-based modeling of tumor shrinkage in head and neck radiation therapy1

    Science.gov (United States)

    Chao, Ming; Xie, Yaoqin; Moros, Eduardo G.; Le, Quynh-Thu; Xing, Lei

    2010-01-01

    Purpose: Understanding the kinetics of tumor growth∕shrinkage represents a critical step in quantitative assessment of therapeutics and realization of adaptive radiation therapy. This article presents a novel framework for image-based modeling of tumor change and demonstrates its performance with synthetic images and clinical cases. Methods: Due to significant tumor tissue content changes, similarity-based models are not suitable for describing the process of tumor volume changes. Under the hypothesis that tissue features in a tumor volume or at the boundary region are partially preserved, the kinetic change was modeled in two steps: (1) Autodetection of homologous tissue features shared by two input images using the scale invariance feature transformation (SIFT) method; and (2) establishment of a voxel-to-voxel correspondence between the images for the remaining spatial points by interpolation. The correctness of the tissue feature correspondence was assured by a bidirectional association procedure, where SIFT features were mapped from template to target images and reversely. A series of digital phantom experiments and five head and neck clinical cases were used to assess the performance of the proposed technique. Results: The proposed technique can faithfully identify the known changes introduced when constructing the digital phantoms. The subsequent feature-guided thin plate spline calculation reproduced the “ground truth” with accuracy better than 1.5 mm. For the clinical cases, the new algorithm worked reliably for a volume change as large as 30%. Conclusions: An image-based tumor kinetic algorithm was developed to model the tumor response to radiation therapy. The technique provides a practical framework for future application in adaptive radiation therapy. PMID:20527569

  6. Image-based modeling of tumor shrinkage in head and neck radiation therapy

    International Nuclear Information System (INIS)

    Chao Ming; Xie Yaoqin; Moros, Eduardo G.; Le, Quynh-Thu; Xing Lei

    2010-01-01

    Purpose: Understanding the kinetics of tumor growth/shrinkage represents a critical step in quantitative assessment of therapeutics and realization of adaptive radiation therapy. This article presents a novel framework for image-based modeling of tumor change and demonstrates its performance with synthetic images and clinical cases. Methods: Due to significant tumor tissue content changes, similarity-based models are not suitable for describing the process of tumor volume changes. Under the hypothesis that tissue features in a tumor volume or at the boundary region are partially preserved, the kinetic change was modeled in two steps: (1) Autodetection of homologous tissue features shared by two input images using the scale invariance feature transformation (SIFT) method; and (2) establishment of a voxel-to-voxel correspondence between the images for the remaining spatial points by interpolation. The correctness of the tissue feature correspondence was assured by a bidirectional association procedure, where SIFT features were mapped from template to target images and reversely. A series of digital phantom experiments and five head and neck clinical cases were used to assess the performance of the proposed technique. Results: The proposed technique can faithfully identify the known changes introduced when constructing the digital phantoms. The subsequent feature-guided thin plate spline calculation reproduced the ''ground truth'' with accuracy better than 1.5 mm. For the clinical cases, the new algorithm worked reliably for a volume change as large as 30%. Conclusions: An image-based tumor kinetic algorithm was developed to model the tumor response to radiation therapy. The technique provides a practical framework for future application in adaptive radiation therapy.

  7. Image-based modeling of tumor shrinkage in head and neck radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Chao Ming; Xie Yaoqin; Moros, Eduardo G.; Le, Quynh-Thu; Xing Lei [Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, California 94305-5847 and Department of Radiation Oncology, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, Arkansas 72205-1799 (United States); Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, California 94305-5847 (United States); Department of Radiation Oncology, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, Arkansas 72205-1799 (United States); Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, California 94305-5847 (United States)

    2010-05-15

    Purpose: Understanding the kinetics of tumor growth/shrinkage represents a critical step in quantitative assessment of therapeutics and realization of adaptive radiation therapy. This article presents a novel framework for image-based modeling of tumor change and demonstrates its performance with synthetic images and clinical cases. Methods: Due to significant tumor tissue content changes, similarity-based models are not suitable for describing the process of tumor volume changes. Under the hypothesis that tissue features in a tumor volume or at the boundary region are partially preserved, the kinetic change was modeled in two steps: (1) Autodetection of homologous tissue features shared by two input images using the scale invariance feature transformation (SIFT) method; and (2) establishment of a voxel-to-voxel correspondence between the images for the remaining spatial points by interpolation. The correctness of the tissue feature correspondence was assured by a bidirectional association procedure, where SIFT features were mapped from template to target images and reversely. A series of digital phantom experiments and five head and neck clinical cases were used to assess the performance of the proposed technique. Results: The proposed technique can faithfully identify the known changes introduced when constructing the digital phantoms. The subsequent feature-guided thin plate spline calculation reproduced the ''ground truth'' with accuracy better than 1.5 mm. For the clinical cases, the new algorithm worked reliably for a volume change as large as 30%. Conclusions: An image-based tumor kinetic algorithm was developed to model the tumor response to radiation therapy. The technique provides a practical framework for future application in adaptive radiation therapy.

  8. Collision tumors of the sella: coexistence of pituitary adenoma and craniopharyngioma in the sellar region

    Science.gov (United States)

    2013-01-01

    Collision tumors of the sellar region are relatively uncommon and consist mainly of more than one type of pituitary adenoma or a cyst or cystic tumor. The association of a pituitary adenoma and a craniopharyngioma is particularly rare. This study describes a rare occurrence in which a pituitary adenoma and a craniopharyngioma coexisted in the sellar region. The case involves a 47-year-old woman who underwent transsphenoidal surgery with subtotal tumor resection and reoperation using an interhemispheric transcallosal approach for total microsurgical resection of the tumor because the visual acuity in her left eye had re-deteriorated. Histopathological and immunohistochemical examinations of the excised tissue revealed a pituitary adenoma in the first operation and a craniopharyngioma in the second operation. Retrospective analysis found the coexistence of a pituitary adenoma and a craniopharyngioma, known as a collision tumor. Instead of the transsphenoidal approach, a craniotomy should be performed, to explore the suprasellar region. PMID:23919255

  9. Transformation of a Silent Adrencorticotrophic Pituitary Tumor Into Central Nervous System Melanoma

    Directory of Open Access Journals (Sweden)

    Brandon A. Miller MD, PhD

    2013-06-01

    Full Text Available Silent adrenocorticotrophic pituitary adenomas are nonfunctioning pituitary adenomas that express adrenocorticotrophic hormone (ACTH but do not cause the clinical or laboratory features of hypercortisolemia. Primary central nervous system (CNS melanoma is well documented, but rarely originates in the sellar region or pituitary gland. Here we report transformation of an aggressive silent adrenocorticotrophic pituitary adenoma that transformed into CNS melanoma and review other presentations of pituitary melanoma. A 37-year-old woman initially presented with apoplexy and an invasive nonfunctioning pituitary macroadenoma for which she underwent transphenoidal surgery. The patient underwent 3 subsequent surgeries as the tumor continued to progress. Pathology from the first 3 operations showed pituitary adenoma or carcinoma. Pathology from the final surgery showed melanoma and the magnetic resonance imaging characteristics of the tumor had changed to become consistent with CNS melanoma. Dermatologic and ophthalmologic examinations did not identify cutaneous or ocular melanoma. The patient’s disease progressed despite aggressive surgical, medical and radiologic treatment. To our knowledge, this is the first report demonstrating transformation of a primary pituitary tumor into melanoma. The mechanism of tumor transformation is unclear, but it is possible that a mutation in the original ACTH-producing tumor lead to increased cleavage of pro-opiomelanocortin or ACTH into α-melanocyte-stimulating hormone, which in turn stimulated the expression of microopthalmia transcription factor, leading to melanocytic phenotype transformation.

  10. Acromegaly due to a Macroinvasive Plurihormonal Pituitary Adenoma and a Rectal Carcinoid Tumor

    Directory of Open Access Journals (Sweden)

    Sang Ouk Chin

    2015-09-01

    Full Text Available A macroinvasive pituitary adenoma with plurihormonality usually causes acromegaly and hyperprolactinemia, and also accompanies with neurologic symptoms such as visual disturbances. However, its concurrent presentation with a rectal carcinoid tumor is rarely observed. This study reports the history, biochemical, colonoscopic and immunohistochemical results of a 48-year-old female with acromegaly and hyperprolactinemia. Despite the large size and invasive nature of the pituitary adenoma to adjacent anatomical structures, she did not complain of any neurologic symptoms such as visual disturbance or headache. Immunohistochemical staining of the surgical specimen from the pituitary adenoma revealed that the tumor cells were positive for growth hormone (GH, prolactin (PRL, and thyroid stimulating hormone (TSH. Staining for pituitary-specific transcription factor-1 (Pit-1 was shown to be strongly positive, which could have been possibly contributing to the plurihormonality of this adenoma. Colonoscopy found a rectal polyp that was identified to be a carcinoid tumor using immunohistochemical staining. A macroinvasive pituitary adenoma with concomitant rectal carcinoid tumor was secreting GH, PRL, and TSH, which were believed to be in association with over-expression of Pit-1. This is the first case report of double primary tumors comprising a plurihormonal pituitary macroadenoma and rectal carcinoid tumor.

  11. Differential expression of cyclin Dl in human pituitary tumors: relation to MIB-1 and p27/Kipl labeling indices

    International Nuclear Information System (INIS)

    Hewedi, I.H.; Osman, W.M.; El Mahdy, M.M.

    2011-01-01

    Pituitary tumors are a common form of endocrine neoplasia. However few studies assessed the expression of the principal cyclin regulating checkpoint exit, cyclin Dl. Cyclin Dl expression in pituitary tumors and its possible relation to MIB-1 and p27/K.ipl labeling indices (Us) was explored. Design: We studied a total of 199 pituitaries, including normal pituitaries (n = 7), pituitary adenomas (n = 187), and pituitary carcinoma (n = 5). All tissues were tested as cores of archived tissue microarrays that were immuno stained for cyclin Dl, MIB-1 and p27 using a standard technique. Tissue cores were subjected to automated analysis to evaluate the staining LIs, Results: No cyclin Dl positive cells in the normal anterior pituitary gland was found. Sparse nuclear staining was noted in pituitary tumors. Higher expression of cyclin Dl was noted in pituitary carcinomas compared to adenomas (p < 0.001), in non-functioning adenomas compared to functioning ones (p < 0.001) in macroadenomas versus micro adenomas (p — 0.017) and in recurrent non recurrent adenomas (p < 0.001). Cyclin Dl LI and MIB-1 LI were related among adenomas (p < 0.001) and carcinomas (p = 0.041). p27 LI was neither related to pituitary adenoma recurrence nor invasion. Conclusions: Expression of cyclin Dl in pituitary tumors is related to cell proliferation, recurrence, and metastatic potential. Nuclear cyclin Dl expression is a good marker of aggressive behavior in pituitary tumors

  12. Radiotherapy, especially at young age, increases the risk for de novo brain tumors in patients treated for pituitary tumors

    NARCIS (Netherlands)

    Burman, Pia; Van Beek, André P.; Biller, Beverly M.K.; Camacho-Hubner, Cecilia; Mattsson, Anders F.

    Background: Excess mortality due to de novo malignant brain tumors was recently found in a national study of patients with hypopituitarism following treatment of pituitary tumors. Here, we examined a larger multi-national cohort to corroborate and extend this observation. Objective: To investigate

  13. Tumor shrinkage assessed by volumetric MRI in the long-term follow-up after stereotactic radiotherapy of meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    Astner, Sabrina T.; Theodorou, Marilena; Dobrei-Ciuchendea, Mihaela; Kopp, Christine; Molls, Michael [Dept. of Radiotherapy and Radiooncology, Klinikum rechts der Isar, Technical Univ. of Munich (Germany); Auer, Florian [Dept. of Neuroradiology, Klinikum rechts der Isar, Technical Univ. of Munich (Germany); Grosu, Anca-Ligia [Dept. of Radiotherapy, Univ. Hospital Freiburg (Germany)

    2010-08-15

    Purpose: To evaluate tumor volume reduction in the follow-up of meningiomas after fractionated stereotactic radiotherapy (FSRT) or linac radiosurgery (RS) by using magnetic resonance imaging (MRI). Patients and Methods: In 59 patients with skull base meningiomas, gross tumor volume (GTV) was outlined on contrast-en-hanced MRI before and median 50 months (range 11-92 months) after stereotactic radiotherapy. MRI was performed as an axial three-dimensional gradient-echo T1-weighted sequence at 1.6 mm slice thickness without gap (3D-MRI). Results were compared to the reports of diagnostic findings. Results: Mean tumor size of all 59 meningiomas was 13.9 ml (0.8-62.9 ml) before treatment. There was shrinkage of the treated meningiomas in all but one patient. Within a median volumetric follow-up of 50 months (11-95 months), an absolute mean volume reduction of 4 ml (0-18 ml) was seen. The mean relative size reduction compared to the volume before radiotherapy was 27% (0-73%). Shrinkage measured by 3D-MRI was greater at longer time intervals after radiotherapy. The mean size reduction was 17%, 23%, and 30% (at < 24 months, 24-48 months, and 48-72 months). Conclusion: By using 3D-MRI in almost all patients undergoing radiotherapy of a meningioma, tumor shrinkage is detected. The data presented here demonstrate that volumetric assessment from 3D-MRI provides additional information to routinely used radiologic response measurements. After FSRT or RS, a mean size reduction of 25-45% can be expected within 4 years. (orig.)

  14. Growth hormone and prolactin radioimmunoassay in early diagnosis of pituitary tumors

    International Nuclear Information System (INIS)

    Gembicki, M.; Kosowicz, J.

    1978-01-01

    Results of prolactin and HGH determination in basal conditions and following stimulation tests in the group of 68 patients with pituitary or suprasellar tumors are presented. In acromegaly elevated level of HGH in fasting state, lack of supression after glucose loading and parodoxical drop of HGH after L-dopa administration were observed. In pituitary tumors without acromegaly determinations of HGH during insulin induced hypoglycemia revealed lack of HGH response to such stimulation in 25 cases which indicated hypopituitarism. In 10 cases elevated prolactin levels (48 - 1000 ng/ml) were observed, this indicates that some of so-called inactive tumors are in fact hormonally active. (author)

  15. Diagnosis of tumors of the pituitary region by two-plane CT scans

    International Nuclear Information System (INIS)

    Murata, Minoru; Inoue, Hiroshi; Misumi, Shuzo; Shimizu, Tsuneo; Tamura, Masaru

    1981-01-01

    Thirty five cases of tumors in the pituitary region were analysed by two-plane CT (ordinary sections and reverse sections) in order to obtain a more accurate image of the tumor and thus establish an appropriate indication for the subnasal transsphenoidal approach. The tumors of pituitary region were classified into six groups (types I-VI) according to their degree of extension and direction of growth. Small tumors such as types I and II were detected more clearly by the reverse section than by the ordinary section. In cases of large tumors (types III-VI) relation of the tumor to the surrounding structures such as the sphenoid sinus, third ventricle, lateral ventricule, middle fossa and brain stem was accurately demonstrated by the reverse section. In the differential diagnosis of tumors in the pituitary regions, tumors showing mixed density or slightly high density and widening of the anteroposterior diameter of the sella in the precontrast reverse section and homogeneous enhancement by infusion were likely to be pituitary adenomas. One third of the pituitary adenomas showed ring-like high density in the post-contrast reverse section. Calcification was not seen in the pituitary adenomas by CT scans. All craniopharyngiomas belonged to types III-VI. Craniopharyngiomas showed high and/or low density, and various degrees of calcification in plain CT scans. Ring-like high density was seen in two thirds of the craniopharyngiomas. About one third of the craniopharyngiomas showed widening of the antero-posterior diameter of the sella. (J.P.N.)

  16. Serotonin, ATRX, and DAXX Expression in Pituitary Adenomas: Markers in the Differential Diagnosis of Neuroendocrine Tumors of the Sellar Region.

    Science.gov (United States)

    Casar-Borota, Olivera; Botling, Johan; Granberg, Dan; Stigare, Jerker; Wikström, Johan; Boldt, Henning Bünsow; Kristensen, Bjarne Winther; Pontén, Fredrik; Trouillas, Jacqueline

    2017-09-01

    Differential diagnosis based on morphology and immunohistochemistry between a clinically nonfunctioning pituitary neuroendocrine tumor (NET)/pituitary adenoma and a primary or secondary NET of nonpituitary origin in the sellar region may be difficult. Serotonin, a frequently expressed marker in the NETs, has not been systematically evaluated in pituitary NETs. Although mutations in ATRX or DAXX have been reported in a significant proportion of pancreatic NETs, the mutational status of ATRX and DAXX and their possible pathogenetic role in pituitary NETs are unknown. Facing a difficult diagnostic case of an invasive serotonin and adrenocorticotroph hormone immunoreactive NET in the sellar region, we explored the immunohistochemical expression of serotonin, ATRX, and DAXX in a large series of pituitary endocrine tumors of different types from 246 patients and in 2 corticotroph carcinomas. None of the pituitary tumors expressed serotonin, suggesting that serotonin immunoreactive sellar tumors represent primary or secondary NETs of nonpituitary origin. Normal expression of ATRX and DAXX in pituitary tumors suggests that ATRX and DAXX do not play a role in the pathogenesis of pituitary endocrine tumors that remain localized to the sellar and perisellar region. A lack of ATRX or DAXX in a sellar NET suggests a nonpituitary NET, probably of pancreatic origin. One of the 2 examined corticotroph carcinomas, however, demonstrated negative ATRX immunolabeling due to an ATRX gene mutation. Further studies on a larger cohort of pituitary carcinomas are needed to clarify whether ATRX mutations may contribute to the metastatic potential in a subset of pituitary NETs.

  17. Mechanisms of activation of NHE by cell shrinkage and by calyculin A in Ehrlich ascites tumor cells

    DEFF Research Database (Denmark)

    Pedersen, Stine Helene Falsig; Varming, Camilla; Hoffmann, E K

    2002-01-01

    The Na+/H+ exchanger isoforms NHE1, NHE2, and NHE3 were all found to be expressed in Ehrlich ascites tumor cells, as evaluated by Western blotting and confocal microscopy. Under unstimulated conditions, NHE1 was found predominantly in the plasma membrane, NHE3 intracellularly, and NHE2 in both co....... It is concluded that shrinkage-induced NHE activation is dependent on PKC and p38 MAPK, but not on MLCK or ERK1/2. NHE activity under both iso- and hypertonic conditions is increased by inhibition of serine/threonine phosphatases, and this effect appears to be PKC-dependent....

  18. Value of computerized tomography in the diagnosis of primary and recurrent pituitary gland tumors

    International Nuclear Information System (INIS)

    Imhof, H.; Kuester, W.; Eslami-Nejad, S.

    1979-01-01

    The results of cranial computerized tomography (CCT) of 33 patients with questionable space-occupying lesions in the sella-region are compared with clinical, radiological and surgical reports. Five pituitary gland tumors could be detected for the first time. Four of them are verified by surgery. In eight cases recurrent pituitary glant tumors are suspected. Surprisingly these tumors could be found by surgery only in three cases, while in the remaining five cases only scar-tissue was demonstrable. The high accuracy of CCT in the detection of pituitary gland tumors and the possibility to save the patient expensive and high invasive examinations as well, makes CCT in the presence of corresponding clinical signs to a diagnostic 'must'. It is undecided whether in the cases with possible recurrent tumors, there are real recurrent tumors, which could not be detected by surgery, or only scar tissue. In the latter case scar tissue and recurrent pituitary gland tumors are very similar with CCT. (orig.) 891 MG/orig. 892 CKA [de

  19. Radiation-induced ocular motor cranial nerve palsies in patients with pituitary tumor.

    Science.gov (United States)

    Vaphiades, Michael S; Spencer, Sharon A; Riley, Kristen; Francis, Courtney; Deitz, Luke; Kline, Lanning B

    2011-09-01

    Radiation therapy is often used in the treatment of pituitary tumor. Diplopia due to radiation damage to the ocular motor cranial nerves has been infrequently reported as a complication in this clinical setting. Retrospective case series of 6 patients (3 men and 3 women) with pituitary adenoma, all of whom developed diplopia following transsphenoidal resection of pituitary adenoma with subsequent radiation therapy. None had evidence of tumor involvement of the cavernous sinus. Five patients developed sixth nerve palsies, 3 unilateral and 2 bilateral, and in 1 patient, a sixth nerve palsy was preceded by a fourth cranial nerve palsy. One patient developed third nerve palsy. Five of the 6 patients had a growth hormone-secreting pituitary tumor with acromegaly. Following transsphenoidal surgery in all 6 patients (2 had 2 surgeries), 4 had 2 radiation treatments consisting of either radiosurgery (2 patients) or external beam radiation followed by radiosurgery (2 patients). Patients with pituitary tumors treated multiple times with various forms of radiation therapy are at risk to sustain ocular motor cranial nerve injury. The prevalence of acromegalic patients in this study reflects an aggressive attempt to salvage patients with recalcitrant growth hormone elevation and may place the patient at a greater risk for ocular motor cranial nerve damage.

  20. Portal imaging to assess set-up errors, tumor motion and tumor shrinkage during conformal radiotherapy of non-small cell lung cancer

    International Nuclear Information System (INIS)

    Erridge, Sara C.; Seppenwoolde, Yvette; Muller, Sara H.; Herk, Marcel van; Jaeger, Katrien de; Belderbos, Jose S.A.; Boersma, Liesbeth J.; Lebesque, Joos V.

    2003-01-01

    Purpose: To investigate patient set-up, tumor movement and shrinkage during 3D conformal radiotherapy for non-small cell lung cancer. Materials and methods: In 97 patients, electronic portal images (EPIs) were acquired and corrected for set-up using an off-line correction protocol based on a shrinking action level. For 25 selected patients, the orthogonal EPIs (taken at random points in the breathing cycle) throughout the 6-7 week course of treatment were assessed to establish the tumor position in each image using both an overlay and a delineation technique. The range of movement in each direction was calculated. The position of the tumor in the digitally reconstructed radiograph (DRR) was compared to the average position of the lesion in the EPIs. In addition, tumor shrinkage was assessed. Results: The mean overall set-up errors after correction were 0, 0.6 and 0.2 mm in the x (left-right), y (cranial-caudal) and z (anterior-posterior) directions, respectively. After correction, the standard deviations (SDs) of systematic errors were 1.4, 1.5 and 1.3 mm and the SDs of random errors were 2.9, 3.1 and 2.0 mm in the x-, y- and z-directions, respectively. Without correction, 41% of patients had a set-up error of more than 5 mm vector length, but with the set-up correction protocol this percentage was reduced to 1%. The mean amplitude of tumor motion was 7.3 (SD 2.7), 12.5 (SD 7.3) and 9.4 mm (SD 5.2) in the x-, y- and z-directions, respectively. Tumor motion was greatest in the y-direction and in particular for lower lobe tumors. In 40% of the patients, the projected area of the tumor regressed by more than 20% during treatment in at least one projection. In 16 patients it was possible to define the position of the center of the tumor in the DRR. There was a mean difference of 6 mm vector length between the tumor position in the DRR and the average position in the portal images. Conclusions: The application of the correction protocol resulted in a significant

  1. Pattern of Tumor Shrinkage during Neoadjuvant Chemotherapy Is Associated with Prognosis in Low-Grade Luminal Early Breast Cancer.

    Science.gov (United States)

    Fukada, Ippei; Araki, Kazuhiro; Kobayashi, Kokoro; Shibayama, Tomoko; Takahashi, Shunji; Gomi, Naoya; Kokubu, Yumi; Oikado, Katsunori; Horii, Rie; Akiyama, Futoshi; Iwase, Takuji; Ohno, Shinji; Hatake, Kiyohiko; Sata, Naohiro; Ito, Yoshinori

    2018-01-01

    Purpose To evaluate the association between tumor shrinkage patterns shown with magnetic resonance (MR) imaging during neoadjuvant chemotherapy (NAC) and prognosis in patients with low-grade luminal breast cancer. Materials and Methods This retrospective study was approved by the institutional review board and informed consent was obtained from all subjects. The low-grade luminal breast cancer was defined as hormone receptor-positive and human epidermal growth factor receptor 2-negative with nuclear grades 1 or 2. The patterns of tumor shrinkage as revealed at MR imaging were categorized into two types: concentric shrinkage (CS) and non-CS. Among 854 patients who had received NAC in a single institution from January 2000 to December 2009, 183 patients with low-grade luminal breast cancer were retrospectively evaluated for the development set. Another data set from 292 patients who had received NAC in the same institution between January 2010 and December 2012 was used for the validation set. Among these 292 patients, 121 patients with low-grade luminal breast cancer were retrospectively evaluated. Results In the development set, the median observation period was 67.9 months. Recurrence was observed in 31 patients, and 16 deaths were related to breast cancer. There were statistically significant differences in both the disease-free survival (DFS) and overall survival (OS) rates between patterns of tumor shrinkage (P breast cancer. DFS rate was significantly longer in patients with the CS pattern (72.8 months; 95% confidence interval [CI]: 69.9, 75.6 months) than in those with the non-CS pattern (56.0 months; 95% CI: 49.1, 62.9 months; P ≤ .001). The CS pattern was associated with an excellent prognosis (median OS, 80.6 months; 95% CI: 79.3, 81.8 months vs 65.0 months; 95% CI: 60.1, 69.8 months; P = .004). Multivariate analysis demonstrated that the CS pattern had the only significant independent association with DFS (P = .007) and OS (P = .037) rates. Conclusion

  2. Acute hypopituitarism associated with periorbital swelling and cardiac dysfunction in a patient with pituitary tumor apoplexy: a case report.

    Science.gov (United States)

    Ohara, Nobumasa; Yoneoka, Yuichiro; Seki, Yasuhiro; Akiyama, Katsuhiko; Arita, Masataka; Ohashi, Kazumasa; Suzuki, Kazuo; Takada, Toshinori

    2017-08-24

    Pituitary tumor apoplexy is a rare clinical syndrome caused by acute hemorrhage or infarction in a preexisting pituitary adenoma. It typically manifests as an acute episode of headache, visual disturbance, mental status changes, cranial nerve palsy, and endocrine pituitary dysfunction. However, not all patients present with classical symptoms, so it is pertinent to appreciate the clinical spectrum of pituitary tumor apoplexy presentation. We report an unusual case of a patient with pituitary tumor apoplexy who presented with periorbital edema associated with hypopituitarism. An 83-year-old Japanese man developed acute anterior hypopituitarism; he showed anorexia, fatigue, lethargy, severe bilateral periorbital edema, and mild cardiac dysfunction in the absence of headache, visual disturbance, altered mental status, and cranial nerve palsy. Magnetic resonance imaging showed a 2.5-cm pituitary tumor containing a mixed pattern of solid and liquid components indicating pituitary tumor apoplexy due to hemorrhage in a preexisting pituitary adenoma. Replacement therapy with oral hydrocortisone and levothyroxine relieved his symptoms of central adrenal insufficiency, central hypothyroidism, periorbital edema, and cardiac dysfunction. Common causes of periorbital edema include infections, inflammation, trauma, allergy, kidney or cardiac dysfunction, and endocrine disorders such as primary hypothyroidism. In the present case, the patient's acute central hypothyroidism was probably involved in the development of both periorbital edema and cardiac dysfunction. The present case highlights the need for physicians to consider periorbital edema as an unusual predominant manifestation of pituitary tumor apoplexy.

  3. Complications Following Primary and Revision Transsphenoidal Surgeries for Pituitary Tumors

    Science.gov (United States)

    Krings, James G.; Kallogjeri, Dorina; Wineland, Andre; Nepple, Kenneth G.; Piccirillo, Jay F.; Getz, Anne E.

    2014-01-01

    Objective This study aimed to determine the incidence of major complications following both primary and revision transsphenoidal pituitary surgery. Major complications included endocrinopathic, skull base, orbital, hemorrhagic and thromboembolic complications, respiratory failure, and death. Secondarily, this study aimed to examine factors associated with the occurrence of complications. Study Design Retrospective cohort analysis of California and Florida all-payer databases from 2005-2008. Methods The major complication rate following both primary and revision transsphenoidal pituitary surgery was calculated. Bivariate analyses were performed to investigate the relationship of patient characteristics with complication occurrence, and a multivariate model was constructed to determine risk factors associated with these complications. Results 5,277 primary cases and 192 revision cases met inclusion criteria. There was a non-significant absolute difference of 3.09% (95% CI −11.00 to 16.14) between the rate of complications following primary (n=443; 8.39%) and revision (n=22; 11.46%) surgeries. Multivariate analyses showed that patients with Medicare (OR=1.74; 95% CI 1.17 to 2.61), Medicaid (OR=2.13; 95% CI 1.59 to 2.86), or a malignant neoplasm (OR=3.10; 95% CI 1.62 to 5.93) were more likely to have complications. Conclusions The rate of major complications following transsphenoidal pituitary surgery is lower than earlier retrospective reports. The overall complication rate following revision surgery was not significantly different from primary surgery. Insurance status and a diagnosis of a malignant neoplasm were associated with a higher rate of complications. PMID:25263939

  4. GFAP-Cre-mediated transgenic activation of Bmi1 results in pituitary tumors.

    Directory of Open Access Journals (Sweden)

    Bart A Westerman

    Full Text Available Bmi1 is a member of the polycomb repressive complex 1 and plays different roles during embryonic development, depending on the developmental context. Bmi1 over expression is observed in many types of cancer, including tumors of astroglial and neural origin. Although genetic depletion of Bmi1 has been described to result in tumor inhibitory effects partly through INK4A/Arf mediated senescence and apoptosis and also through INK4A/Arf independent effects, it has not been proven that Bmi1 can be causally involved in the formation of these tumors. To see whether this is the case, we developed two conditional Bmi1 transgenic models that were crossed with GFAP-Cre mice to activate transgenic expression in neural and glial lineages. We show here that these mice generate intermediate and anterior lobe pituitary tumors that are positive for ACTH and beta-endorphin. Combined transgenic expression of Bmi1 together with conditional loss of Rb resulted in pituitary tumors but was insufficient to induce medulloblastoma therefore indicating that the oncogenic function of Bmi1 depends on regulation of p16(INK4A/Rb rather than on regulation of p19(ARF/p53. Human pituitary adenomas show Bmi1 overexpression in over 50% of the cases, which indicates that Bmi1 could be causally involved in formation of these tumors similarly as in our mouse model.

  5. Gamma radiosurgery combined with trans-sphenoidal surgery for pituitary tumor involved to the cavernous sinus

    International Nuclear Information System (INIS)

    Ikeda, Hidetoshi; Yoshimoto, Takashi; Shirokura, Hidefumi.

    1995-01-01

    Ten patients (2 males and 8 females with an average age of 39 years) were treated with combined trans-sphenoidal surgery and gamma radiosurgery for pituitary tumor involved to the cavernous sinus. A Follow-up period ranged from 7 to 29 months, with a mean of 21 months. Therapeutic effects were assessed using magnetic resonance imaging (MRI) every 3 months, endocrine examination, optical examination for visual field, and auditory test. Pituitary tumor after radiosurgery was shown as hypointensity on T1-weighted images and hyperintensity on T2-weighted images. Tumor response could be classified on MRI into (1) a remarkably decreased tumor in size with increased contrast enhancement (n=6), (2) a remarkably decreased tumor in size with unchanged contrast enhancement (n=one), (3) a slightly decreased tumor in size with increased spotted contrast enhancement (n=2), and (4) unchanged tumor in size with decreased contrast enhancement (n=one). Of 6 Type 1 patients, 5 had growth hormone production. Growth hormone production tended to be associated with favorable response to radiosurgery. In 3 patients who showed endocrinologically favorable response (such as increased growth hormone in blood and somatomedin C value), complete regression of tumor was achieved at a 20-month follow-up period. Radiosurgery also seemed to be useful for treating hormone active tumors. (N.K.)

  6. Pituitary tumor with gigantism, acromegaly and preclinical Cushing's disease diagnosed from the 10th row.

    Science.gov (United States)

    Tourtelot, John B; Vesely, David L

    2013-08-01

    A 7'3" basketball player was noted to have 2 to 3 times thicker tissue in his hands than 6'10" players by an endocrinologist sitting 10 rows above the player in a basketball arena. This led to the diagnosis of pituitary gigantism where the history revealed that he was 7'3" at 15 years of age. At age 19 when the acryl enlargement was noted, a diagnostic workup revealed elevated growth hormones and insulin-like growth factor 1 (IGF-1) with a 2 × 1.3 cm pituitary tumor. His history suggested that his epiphyseal plates had closed at age 15, and because he continued to produce IGF-1, he now has acromegaly. His elevated adrenocorticotropic hormone (ACTH) before surgery suggests that he also had preclinical Cushing's disease. After pituitary transsphenoidal surgery, all acryl enlargement in hands and ligaments disappeared. His growth hormone, IGF-1 and ACTH returned to normal 2 weeks after surgery.

  7. Decision Trees Predicting Tumor Shrinkage for Head and Neck Cancer: Implications for Adaptive Radiotherapy.

    Science.gov (United States)

    Surucu, Murat; Shah, Karan K; Mescioglu, Ibrahim; Roeske, John C; Small, William; Choi, Mehee; Emami, Bahman

    2016-02-01

    To develop decision trees predicting for tumor volume reduction in patients with head and neck (H&N) cancer using pretreatment clinical and pathological parameters. Forty-eight patients treated with definitive concurrent chemoradiotherapy for squamous cell carcinoma of the nasopharynx, oropharynx, oral cavity, or hypopharynx were retrospectively analyzed. These patients were rescanned at a median dose of 37.8 Gy and replanned to account for anatomical changes. The percentages of gross tumor volume (GTV) change from initial to rescan computed tomography (CT; %GTVΔ) were calculated. Two decision trees were generated to correlate %GTVΔ in primary and nodal volumes with 14 characteristics including age, gender, Karnofsky performance status (KPS), site, human papilloma virus (HPV) status, tumor grade, primary tumor growth pattern (endophytic/exophytic), tumor/nodal/group stages, chemotherapy regimen, and primary, nodal, and total GTV volumes in the initial CT scan. The C4.5 Decision Tree induction algorithm was implemented. The median %GTVΔ for primary, nodal, and total GTVs was 26.8%, 43.0%, and 31.2%, respectively. Type of chemotherapy, age, primary tumor growth pattern, site, KPS, and HPV status were the most predictive parameters for primary %GTVΔ decision tree, whereas for nodal %GTVΔ, KPS, site, age, primary tumor growth pattern, initial primary GTV, and total GTV volumes were predictive. Both decision trees had an accuracy of 88%. There can be significant changes in primary and nodal tumor volumes during the course of H&N chemoradiotherapy. Considering the proposed decision trees, radiation oncologists can select patients predicted to have high %GTVΔ, who would theoretically gain the most benefit from adaptive radiotherapy, in order to better use limited clinical resources. © The Author(s) 2015.

  8. Tc99m-Tetrofosmin and Thallium-201 SPECT imaging of pituitary tumors: Preliminary results

    International Nuclear Information System (INIS)

    Yarman, S.; Mudun, A.

    2002-01-01

    Aim: It has been reported that pituitary adenomas accumulate Thallium -201(Tl-201), Tc99m-sestamibi and In111-Octreotide. These agents maybe useful in the diagnosis and follow-up of pituitary adenomas. Tc99m-tetrofosmin also has been shown as an tumor seeking agent in various tumors. The aim of this study is to evaluate the accumulation of Tc99m-tetrofosmin in pituitary adenomas and compare the results to Tl-201 SPECT. Methods: We performed Tc99m-Tetrofosmin and Tl-201 SPECT imaging on 5 patients (pts) with pituitary tumors, 3 patients with acromegaly, 1 patient with macro prolactinoma, and 1 patient with nonfunctional tumor (1 female, 4 male, age range: 26-50). SPECT imaging of cranium were obtained 20 min after intravenous injection of 111 MBq Tl-201 and 555 MBq Tc99m-Tetrofosmin on different days with a dual head gamma camera. All but one patient had surgical therapy. One patient had medical treatment. One patient had post surgical imaging with both Tetrofosmin and Tl-201 and 2 pts had only with Thallium. Semiquantitative analysis were performed by calculating tumor to background ratio from the mean counts of the created ROI's. Results: All adenomas showed prominent uptake with both Thallium and Tetrofosmin. The mean tumor to background ratios were 2.3 (range: 1.2-4.29) with Thallium and 3.57 (range: 1.6-6.86) with Tetrofosmin. Post therapy images showed no significant uptake in pituitary region with both agents in 2 patients. Post therapy mean Thallium uptake ratio in 3 pts was 1.64. One patient with acromegaly showed no decrease in thallium uptake, but showed some decrease in tetrofosmin uptake. Conclusion: Although our patient number is limited, these preliminary results indicate that Tc99m-tetrofosmin has also strong affinity for pituitary adenomas as does Thallium, either the adenoma is functioning or non-functioning. It may have a potential value to evaluate the response to therapy

  9. Antiapoptotic factor humanin is expressed in normal and tumoral pituitary cells and protects them from TNF-α-induced apoptosis.

    Directory of Open Access Journals (Sweden)

    María Florencia Gottardo

    Full Text Available Humanin (HN is a 24-amino acid peptide with cytoprotective action in several cell types such as neurons and testicular germ cells. Rattin (HNr, a homologous peptide of HN expressed in several adult rat tissues, also has antiapoptotic action. In the present work, we demonstrated by immunocytochemical analysis and flow cytometry the expression of HNr in the anterior pituitary of female and male adult rats as well as in pituitary tumor GH3 cells. HNr was localized in lactotropes and somatotropes. The expression of HNr was lower in females than in males, and was inhibited by estrogens in pituitary cells from both ovariectomized female and orquidectomized male rats. However, the expression of HNr in pituitary tumor cells was not regulated by estrogens. We also evaluated HN action on the proapoptotic effect of TNF-α in anterior pituitary cells assessed by the TUNEL method. HN (0.5 µM per se did not modify basal apoptosis of anterior pituitary cells but completely blocked the proapoptotic effect of TNF-α in total anterior pituitary cells, lactotropes and somatotropes from both female and male rats [corrected]. Also, HN inhibited the apoptotic effect of TNF-α on pituitary tumor cells. In summary, our results demonstrate that HNr is present in the anterior pituitary gland, its expression showing sexual dimorphism, which suggests that gonadal steroids may be involved in the regulation of HNr expression in this gland. Antiapoptotic action of HN in anterior pituitary cells suggests that this peptide could be involved in the homeostasis of this gland. HNr is present and functional in GH3 cells, but it lacks regulation by estrogens, suggesting that HN could participate in the pathogenesis of pituitary tumors.

  10. Antiapoptotic Factor Humanin Is Expressed in Normal and Tumoral Pituitary Cells and Protects Them from TNF-α-Induced Apoptosis

    Science.gov (United States)

    Magri, María Laura; Zárate, Sandra; Moreno Ayala, Mariela; Ferraris, Jimena; Eijo, Guadalupe; Pisera, Daniel; Candolfi, Marianela; Seilicovich, Adriana

    2014-01-01

    Humanin (HN) is a 24-amino acid peptide with cytoprotective action in several cell types such as neurons and testicular germ cells. Rattin (HNr), a homologous peptide of HN expressed in several adult rat tissues, also has antiapoptotic action. In the present work, we demonstrated by immunocytochemical analysis and flow cytometry the expression of HNr in the anterior pituitary of female and male adult rats as well as in pituitary tumor GH3 cells. HNr was localized in lactotropes and somatotropes. The expression of HNr was lower in females than in males, and was inhibited by estrogens in pituitary cells from both ovariectomized female and orquidectomized male rats. However, the expression of HNr in pituitary tumor cells was not regulated by estrogens. We also evaluated HN action on the proapoptotic effect of TNF-α in anterior pituitary cells assessed by the TUNEL method. HN (5 µM) per se did not modify basal apoptosis of anterior pituitary cells but completely blocked the proapoptotic effect of TNF-α in total anterior pituitary cells, lactotropes and somatotropes from both female and male rats. Also, HN inhibited the apoptotic effect of TNF-α on pituitary tumor cells. In summary, our results demonstrate that HNr is present in the anterior pituitary gland, its expression showing sexual dimorphism, which suggests that gonadal steroids may be involved in the regulation of HNr expression in this gland. Antiapoptotic action of HN in anterior pituitary cells suggests that this peptide could be involved in the homeostasis of this gland. HNr is present and functional in GH3 cells, but it lacks regulation by estrogens, suggesting that HN could participate in the pathogenesis of pituitary tumors. PMID:25360890

  11. Transient Exacerbation of Nasal Symptoms following Endoscopic Transsphenoidal Surgery for Pituitary Tumors: A Prospective Study.

    Science.gov (United States)

    Davies, Benjamin M; Tirr, Erica; Wang, Yi Yuen; Gnanalingham, Kanna K

    2017-06-01

    Object  Endoscopic transsphenoidal surgery is the commonest approach to pituitary tumors. One disadvantage of this approach is the development of early postoperative nasal symptoms. Our aim was to clarify the peak onset of these symptoms and their temporal evolution. Methods  The General Nasal Patient Inventory (GNPI) was administered to 56 patients undergoing endoscopic transsphenoidal surgery for pituitary tumors preoperatively and at 1 day, 3 days, 2 weeks, 3 months, and 6 to 12 months postoperatively. Most patients underwent surgery for pituitary adenomas ( N  = 49; 88%) and through a uninostril approach ( N  = 55; 98%). Total GNPI (0-135) and scores for the 45 individual components were compared. Results  GNPI scores peaked at 1 to 3 days postoperatively, with rapid reduction to baseline by 2 weeks and below baseline by 6 to 12 months postsurgery ( p  surgery ( p  transsphenoidal pituitary surgery is common, but transient, more so in the functioning subgroup. Nasal symptoms improve below baseline by 6 to 12 months, without the need for specific long-term postoperative interventions in the vast majority of patients.

  12. Follow-up of patients with pituitary tumors before and after operation, medical treatment and radiotherapy

    International Nuclear Information System (INIS)

    Gasser, R.W.; Finkenstedt, G.; Skrabal, F.

    1981-01-01

    From 1976 till 1981 56 patients with pituitary tumors were observed. From a total of 51 adenomas 17 prolactinomas (33.3%), 15 acromegalies (29.4%), 4 Cushing-syndromes (7.8%), 1 TSH-producing adenoma (1.9%) and 14 hormone-inactive adenomas (27.4%) were found. In addition, there were 4 craniopharyngeomas and 1 intrasellar meningeoma. For the individual types of adenomas prae- and postoperative hormonal data after transcranial resp. transsphenoidal adenomectomy are listed. Prolactinomas responded well to bromocriptine therapy in some cases, whereas acromegalies showed no remission after bromocriptine. After radiotherapy of 4 recidive-adenomas remission in one case was seen. Problems and objects of long-term-care of patients with pituitary tumors are discussed. (author)

  13. Follow-up of patients with pituitary tumors before and after operation, medical treatment and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Gasser, R.W.; Finkenstedt, G.; Skrabal, F. (Innsbruck Univ. (Austria). Medizinische Klinik)

    1981-01-01

    From 1976 till 1981 56 patients with pituitary tumors were observed. From a total of 51 adenomas 17 prolactinomas (33.3%), 15 acromegalies (29.4%), 4 Cushing-syndromes (7.8%), 1 TSH-producing adenoma (1.9%) and 14 hormone-inactive adenomas (27.4%) were found. In addition, there were 4 craniopharyngeomas and 1 intrasellar meningeoma. For the individual types of adenomas prae- and postoperative hormonal data after transcranial resp. transsphenoidal adenomectomy are listed. Prolactinomas responded well to bromocriptine therapy in some cases, whereas acromegalies showed no remission after bromocriptine. After radiotherapy of 4 recidive-adenomas remission in one case was seen. Problems and objects of long-term-care of patients with pituitary tumors are discussed.

  14. Testosterone Replacement and Bone Mineral Density in Male Pituitary Tumor Patients

    Directory of Open Access Journals (Sweden)

    Min Jeong Lee

    2014-03-01

    Full Text Available BackgroundHypopituitarism is associated with osteoporosis and osteopenia especially when hypogonadotropic hypogonadism is present. Despite hypopituitarism being an important cause of secondary osteoporosis, osteoporosis in patients receiving surgery for pituitary tumors in Korea has not been studied. In this study, we evaluated the effects of testosterone replacement therapy (TRT on bone mineral density (BMD in postoperative hypogonadal patients with pituitary tumors.MethodsTo examine the effect of TRT on BMD, we performed a retrospective observational study in 21 postoperative male patients who underwent pituitary tumor surgery between 2003 and 2012 at the Ajou University Hospital. Testosterone was replaced in postoperative hypogonadal patients by regular intramuscular injection, daily oral medication, or application of transdermal gel. BMD (g/cm2 measurements of central skeletal sites (lumbar spine, femoral neck, and total femur were obtained using dual-energy X-ray absorptiometry (GE Lunar. For lumbar spine BMD, L1 to L4 values were chosen for analysis. Femur neck and total femur were also analyzed.ResultsDuring the follow-up period (mean, 56 months; range, 12 to 99 months serum testosterone levels increased with the administration of TRT (P=0.007. There was significant improvement (4.56%±9.81% in the lumbar spine BMD compared to baseline BMD. There were no significant changes in the femur neck BMD or total femur BMD. We did not find any statistically significant relationships between changes in testosterone levels and BMD using Spearman correlation analysis.ConclusionOur results indicated that TRT used in the postoperative period for hypogonadal pituitary tumor surgery patients may have beneficial effects on the BMD of the spine.

  15. [Changes and significance of peripheral blood platelet count in tumor shrinkage induced by a low dose of CTX in T739 mice].

    Science.gov (United States)

    Li, Mo-lin; Jia, Yu-jie; Jiang, Miao-na; Shu, Xiao-hong; Li, Chuan-gang

    2008-06-01

    To establish a mouse model for BTT739 tumor-bearing mice cured by a low dose of cyclophosphamide (CTX). And then to observe the dynamic changes and significance of peripheral blood counts especially blood platelet count during tumor shrinkage induced by a low dose of CTX in T739 mice. Mouse bladder carcinoma tissues were inoculated subcutaneously into T739 mice. Seven days later, different doses of CTX or the same volume of NS were administered intraperitoneally to treat these tumor-bearing T739 mice. Tumor sizes were observed and recorded subsequently to find out the minimal dose of CTX that could cure most of these tumor-bearing mice. Then another 12 tumor-bearing mice were randomly divided into 15 mg/kg CTX treatment group and control group. Blood samples were obtained from orbital venous sinus on different times after CTX treatment. Complete blood counts were performed and the relationship between peripheral blood platelet counts and tumor shrinkage was analyzed. Within 2 weeks after CTX treatment, the speed of tumor shrinkage had a positive relationship with the dose of CTX used; but the survival rate of the tumor-bearing mice had a negative relationship with the dose of CTX used in 2 months after CTX treatment. 15 mg/kg CTX could cure most of the tumor bearing mice, while it had no remarkably inhibitive effects on peripheral blood cells. The perpherial platelet count increased to (1483.4+/-184.4)x10(9)/L in mice 6 h after CTX treatment. There was significant difference compared with that in mice of control group (1086.6+/-81.0)x10(9)/L (P0.05). CTX 15 mg/kg could cure most of bladder tumor-bearing T739 mice. The transient increase of the peripheral platelet count in 6 h after CTX treatment may relate to the antitumor effects of CTX.

  16. Endoscopic Endonasal Transsphenoidal Approach for Apoplectic Pituitary Tumor: Surgical Outcomes and Complications in 45 Patients.

    Science.gov (United States)

    Zhan, Rucai; Li, Xueen; Li, Xingang

    2016-02-01

    Objective To assess the safety and effectiveness of the endoscopic endonasal transsphenoidal approach (EETA) for apoplectic pituitary adenoma. Design A retrospective study. Setting Qilu Hospital of Shandong University; Brain Science Research Institute, Shandong University. Participants Patients admitted to Qilu Hospital of Shandong University who were diagnosed with an apoplectic pituitary tumor and underwent EETA for resection of the tumor. Main Outcome Measures In total 45 patients were included in a retrospective chart review. Data regarding patient age, sex, presentation, lesion size, surgical procedure, extent of resection, clinical outcome, and surgical complications were obtained from the chart review. Results In total, 38 (92.7%) of 41 patients with loss of vision obtained visual remission postoperatively. In addition, 16 patients reported a secreting adenoma, and postsurgical hormonal levels were normal or decreased in 14 patients. All other symptoms, such as headache and alteration of mental status, recovered rapidly after surgery. Two patients (4.4%) incurred cerebrospinal fluid leakage. Six patients (13.3%) experienced transient diabetes insipidus (DI) postoperatively, but none of these patients developed permanent DI. Five patients (11.1%) developed hypopituitarism and were treated with replacement of hormonal medicine. No cases of meningitis, carotid artery injury, or death related to surgery were reported. Conclusion EETA offers a safe and effective surgical option for apoplectic pituitary tumors and is associated with low morbidity and mortality.

  17. A transseptal approach in transsphenoidal surgery for pituitary (hypophyseal) tumors

    International Nuclear Information System (INIS)

    Gierek, T.; Galuszko-Ignasiak, B.; Krauze, J.; Rudnik, A.

    1994-01-01

    The authors described the direct transseptal approach in transsphenoidal surgery for hypophyseal tumors. This route gives a good insight into the area of the sella. The above mentioned method is also less destructive to nasal structures in the nasal cavity, because preserves the anterior nasal septum. It is uniformity of actually views of rhinological school. 20 patients were operated using this method and none of them noticed the changes of nasal airway and the sense of smell. (author)

  18. Dramatic Tumor Shrinkage of Locally Advanced and Inoperable Adenoid Cystic Carcinoma after Intra-arterial Chemotherapy

    Directory of Open Access Journals (Sweden)

    Fu-Jen Hsueh

    2015-06-01

    Full Text Available Adenoid cystic carcinoma is rare and usually arises in the salivary glands. It grows slowly, but is characterized by easy perineural invasion with local infiltration and distant metastasis. In metastatic setting, the efficacy of intravenous chemotherapy is limited. Herein, we report one male patient who had a advanced, inoperable adenoid cystic carcinoma with lung metastasis, presenting with right buccal unhealed ulcer, pain and poor intake, whose loco-regional tumors responded dramatically after intra-arterial chemotherapy and his symptoms were almost completely relieved. We also make a literature review for treatment of adenoid cystic carcinoma.

  19. Utility of Early Post-operative High Resolution Volumetric MR Imaging after Transsphenoidal Pituitary Tumor Surgery

    Science.gov (United States)

    Patel, Kunal S.; Kazam, Jacob; Tsiouris, Apostolos J.; Anand, Vijay K.; Schwartz, Theodore H.

    2014-01-01

    Objective Controversy exists over the utility of early post-operative magnetic resonance imaging (MRI) after transsphenoidal pituitary surgery for macroadenomas. We investigate whether valuable information can be derived from current higher resolution scans. Methods Volumetric MRI scans were obtained in the early (30 days) post-operative periods in a series of patients undergoing transsphenoidal pituitary surgery. The volume of the residual tumor, resection cavity, and corresponding visual field tests were recorded at each time point. Statistical analyses of changes in tumor volume and cavity size were calculated using the late MRI as the gold standard. Results 40 patients met the inclusion criteria. Pre-operative tumor volume averaged 8.8 cm3. Early postoperative assessment of average residual tumor volume (1.18 cm3) was quite accurate and did not differ statistically from late post-operative volume (1.23 cm3, p=.64), indicating the utility of early scans to measure residual tumor. Early scans were 100% sensitive and 91% specific for predicting ≥ 98% resection (psurgery and a lack of decrease should alert the surgeon to possible persistent compression of the optic apparatus that may warrant re-operation. PMID:25045791

  20. Clinical results of tumor shrinkage and evaluation of quality of life in low rectal carcinoma after preoperative combined treatment

    International Nuclear Information System (INIS)

    Kojima, Osamu; Suganuma, Yasushi; Tamura, Takao; Ohnishi, Kazuyoshi; Nishiue, Takashi; Itoh, Masahiko; Horie, Hiroshi; Sawai, Seiji; Takahashi, Toshio

    1992-01-01

    To improve the surgical rate and the quality of life (QOL) for patients with advanced low rectal carcinoma, we investigated whether preoperative treatments (irradiation and hyperthermia and 5-fluorouracil (5-FU) suppository, irradiation and hyperthermia, irradiation and 5-FU suppository, irradiation alone and 5-FU suppository alone) were useful. The tumor shrinkage rate after preoperative treatments was highest in the irradiation, hyperthermia and 5-FU suppository group. Pathologically complete regression was observed in the 2 of 18 cases (12%). According to our criteria of histological changes, the irradiation, hyperthermia and 5-FU suppository group showed the greatest effectiveness. The 4 year postoperative survival rate and the 4 year local recurrence rate were 100% and 8% in the irradiation, hyperthermia and 5-FU suppository group and the data suggest that these results were the best of the 5 treatments. After the carcinoma was shrunk after irradiation, hyperthermia and 5-FU suppository, the patients could receive curatively a sphincter-saving operation (super-low anterior resection and transanal rectal resection). The fecal continence of 7 patients after sphincter-saving operations was increased as good by manometric study, defecography and clinical evaluation. In conclusion, our data suggest that the preoperative combined treatment of irradiation, hyperthermia and 5-FU suppository prevents local recurrence and increases the possibility of a sphincter-saving operation for advanced rectal carcinoma. (author)

  1. A Case of Acromegaly in which a Pituitary Gland Tumor was Reduced Significantly by Administering Octreotide Long Acting Release (LAR) and Could Be Removed Surgically.

    Science.gov (United States)

    Arao, Tadashi; Okada, Yosuke; Uemura, Fumi; Nishizawa, Shigeru; Tanaka, Yoshiya

    A 54-year-old woman was admitted to our hospital for detailed examination of acromegaly because she noticed bilateral hand and finger swelling at the age of 43 and plantar thickening, facial changes and unclear articulation at the age of 49. She had prominent brow ridges, mandibular protrusion, and enlargement of the hands, feet, nasal wings, lips and tongue. Her growth hormone (GH) level was 39.8 ng/ml, insulin-like growth factor-1 (IGF-1) level was 717 ng/ml, GH level was not suppressed (22.9 ng/ml) during a 75-g oral glucose tolerance test (OGTT). Radiography showed cauliflower-like enlargement of the distal phalanx of the fingers, thickening/enlargement of the plantar soft tissues, and increased antero-posterior diameter of the sella turcica. Magnetic resonance imaging showed a mass (21×17 mm) growing towards the right suprasellar region and invading the cavernous sinus. She was diagnosed with acromegaly based on the characteristic physical findings, GH excess, high IGF-1, lack of GH suppression during the 75-g OGTT, and the presence of a pituitary tumor. She was started on octreotide long acting release (Oct-LAR) 20 mg/4w for tumor shrinkage. After three doses, her GH and IGF-1 levels decreased to 2.19 ng/ml (1.69 during the 75-g OGTT) and 205 ng/ml, respectively, meeting cure criteria for acromegaly. In this case, a decrease in GH and IGF-1 levels, tumor shrinkage, and resolution of cavernous sinus invasion allowed the patient to undergo surgery with curative intent (the first-line treatment for acromegaly) without postoperative complications. Thus, preoperative Oct-LAR administration has the potential to improve treatment outcomes of acromegaly.

  2. Symptom resolution, tumor control, and side effects following postoperative radiotherapy for pituitary macroadenomas

    International Nuclear Information System (INIS)

    Rush, Stephen; Cooper, Paul R.

    1997-01-01

    This study reports the outcome of 70 patients who were treated by a consistent treatment plan of surgery and postoperative radiotherapy (RT) for pituitary macroadenomas in the modern era [computed tomographic scan or magnetic resonance imaging (MRI), dopamine agonist therapy (DA) added as indicated, and immunohistochemical staining]. Sixty-two patients underwent transsphenoidal surgery (vs. transcranial surgery) and 61 received 45-Gy/25 fractions postoperatively (vs. other dose fractionation schemes). Twenty-four patients received DA for prolactin-secreting tumors. With a median follow-up of 8 years (range 2-15), 68 patients have experienced continuous control of their tumors. Most symptoms related to mass effect abated, while physiologic symptoms such as amenorrhea from markedly elevated prolactin levels tended to persist. Treatment-induced hypopituitarism occurred in 42% of the patients at risk. No patients in this series have died as a result of their pituitary tumor. No gross neuropsychologic dysfunction after treatment has been noted. While it is possible at this time with serial MRI to withhold postoperative RT and observe some patients who have had a 'gross total' resection of a macroadenoma, the therapeutic ratio for surgery and adjuvant radiotherapy for patients with nonfunctional tumors as well as select patients with secretory macroadenomas is favorable

  3. Functional heterogeneity among cell types in the normal pituitary gland and in human and rat pituitary tumors.

    NARCIS (Netherlands)

    L.J. Hofland (Leo)

    1989-01-01

    textabstractHormone secretion by the anterior pituitary gland is under control of hypothalamic regulatory factorsjhormones (see chapter I.l) and peripheral hormones. Apart from the direct effects of these hormones on anterior pituitary hormone secretion several fine- regulatory mechanisms

  4. GROWTH HORMONE-, ALPHA-SUBUNIT AND THYROTROPIN-COSECRETING PITUITARY-ADENOMA IN FAMILIAL SETTING OF PITUITARY-TUMOR

    NARCIS (Netherlands)

    LINKS, TP; MONKELBAAN, JF; DULLAART, RPF; VANHAEFTEN, TW

    1993-01-01

    A patient with acromegaly and hyperthyroidism due to a growth hormone-, thyrotrophin- and alpha-subunit-secreting pituitary adenoma is described. His deceased father had suffered from a pituitary tumour, and was likely to have had acromegaly as well. Plasma growth hormone and insulin-like growth

  5. Differential diagnosis among pituitary and juxtasellar tumors on the basis of NMR images

    Energy Technology Data Exchange (ETDEWEB)

    Ueda, Tohru; Asato, Renin; Handa, Hajime

    1984-08-01

    Proton nuclear magnetic resonance (NMR) scans were performed on 18 patients with pituitary and parasellar tumors and compared with X-ray computed tomography (CT) scans. NMR images were also compared with the operative findings and the pathological changes in the tumors. NMR scans lack bone artifacts and are superior to X-ray CT scans in terms of soft-tissue contrasts, including the marked gray-white-matter contrast. Pituitary adenomas exhibited a high-intensity on SRsub(2000/1000) and a low-intensity on IRsub(1400/400). The diverse histological changes in tumor tissue are not reflected in the changes in the NMR images. Meningiomas were seen as high-intensity on SRsub(2000/1000) and as low-intensity on IRsub(1400/400). On IR images, meningiomas exhibited a higher intensity than pituitary adenomas. Rathke's cleft cyst showed a high-intensity on SRsub(2000/1000) and a high-intensity with a peripheral low-intensity on IRsub(1400/400). These findings on the NMR scans may contribute to the differential diagnosis, because tumors in parasellar regions have, in general, longer T/sub 1/ relaxation times than brain tissues. Craniopharyngiomas were demonstrated to have two components, a solid part and a cystic part. Both were shown as high-intensity on SRsub(2000/1000). The solid part was seen as low-intensity on IRsub(1600/600) and IRsub(1400/400). The cystic part was shown to be low-intensity on IRsub(1400/400). Cystic-membrane and intracystic-niveau formation were revealed on IRsub(1600/600). In many cases, the craniopharyngioma contains small or large calcifications. It is a drawback of the NMR scans that such calcifications are not visualized. (J.P.N.).

  6. Differential diagnosis among pituitary and juxtasellar tumors on the basis of NMR images

    International Nuclear Information System (INIS)

    Ueda, Tohru; Asato, Renin; Handa, Hajime

    1984-01-01

    Proton nuclear magnetic resonance (NMR) scans were performed on 18 patients with pituitary and parasellar tumors and compared with X-ray computed tomography (CT) scans. NMR images were also compared with the operative findings and the pathological changes in the tumors. NMR scans lack bone artifacts and are superior to X-ray CT scans in terms of soft-tissue contrasts, including the marked gray-white-matter contrast. Pituitary adenomas exhibited a high-intensity on SRsub(2000/1000) and a low-intensity on IRsub(1400/400). The diverse histological changes in tumor tissue are not reflected in the changes in the NMR images. Meningiomas were seen as high-intensity on SRsub(2000/1000) and as low-intensity on IRsub(1400/400). On IR images, meningiomas exhibited a higher intensity than pituitary adenomas. Rathke's cleft cyst showed a high-intensity on SRsub(2000/1000) and a high-intensity with a peripheral low-intensity on IRsub(1400/400). These findings on the NMR scans may contribute to the differential diagnosis, because tumors in parasellar regions have, in general, longer T 1 relaxation times than brain tissues. Craniopharyngiomas were demonstrated to have two components, a solid part and a cystic part. Both were shown as high-intensity on SRsub(2000/1000). The solid part was seen as low-intensity on IRsub(1600/600) and IRsub(1400/400). The cystic part was shown to be low-intensity on IRsub(1400/400). Cystic-membrane and intracystic-niveau formation were revealed on IRsub(1600/600). In many cases, the craniopharyngioma contains small or large calcifications. It is a drawback of the NMR scans that such calcifications are not visualized. (J.P.N.)

  7. Macro- and microadenoma of thyrotropin secreting pituitary tumors--two clinical cases.

    Science.gov (United States)

    Hubalewska-Hola, Alicja; Fröss, Katarzyna; Kostecka-Matyja, Marta; Sowa-Staszczak, Anna; Szybiński, Zbigniew; Huszno, Bohdan; Ptak, Marzena

    2003-01-01

    Thyrotropin secreting adenoma, thyrotropinoma (TSH-oma), is a rare cause of hyperthyroidism--called secondary hyperthyroidism. The hormonal profile in pituitary hyperthyroidism is characterized by a nonsuppressed TSH in the presence of high levels of free thyroid hormones (fT4, fT3) reflecting an abnormal feedback. The diagnosis of TSH-oma is often made at the stage of macroadenoma because of the aggressive nature of the tumor and due to the fact that patients are mistakenly treated for more common primary hyperthyroidism for a long time. Two cases of TSH-secreting adenoma were detected in Chair and Department of Endocrinology, Collegium Medicum of the Jagiellonian University in Krakow for the last twenty years. Case 1: 49 year old woman was admitted to the Clinic of Endocrinology in 1999 with recurring hyperthyroidism treated with surgical thyroid ablation in 1992 and thyreostatics for the previous nine years. On admission to the Clinic her thyroid panel presented with elevated free hormone levels (mainly fT3-14.8 pmol/l) and not suppressed TSH-0.7 mIU/l suggesting central hyperthyroidism. MRI scan of the pituitary gland revealed microadenoma of 5 mm in diameter. She was qualified to transsphenoidal resection of the tumor. Histopathology revealed acidophilic adenoma with positive TSH staining. Thyroid hormones 8 days after the operation suggested full effectiveness of the surgery. Case 2: 65 year old man treated for one year with L-Thyroxin because of elevated TSH (60 mIU/l) and then with thyreostatics for elevated fT3 and fT4 was admitted to the Clinic of Endocrinology in 2000 with suspected thyrotropinoma. On admission to the Clinic thyroid panel suggested hyperthyroidism with fT4-40 pmol/l, FT3-11.2 pmol/l without suppression of TSH 2.2 mIU/l. MRI scan revealed a pituitary tumor 20 x 18 x 20 mm, compressing the optic chiasm. He was administered octreotide as a preparation for the operation. The patient underwent trans-sphenoidal resection of the adenoma

  8. Central diabetes insipidus in a dog with a pro-opiomelanocortin-producing pituitary tumor not causing hyperadrenocorticism

    International Nuclear Information System (INIS)

    Goossens, M.M.C.; Rijnberk, A.; Mol, J.A.; Wolfswinkel, J.; Voorhout, G.

    1995-01-01

    Central diabetes insipidus was diagnosed by vasopressin measurements during hypertonic stimulation in a 9-year-old male giant Schnauzer with polyuria and polydipsia. The impaired release of vasopressin was believed to be caused by a large pituitary tumor, which was visualized by computed tomography. Studies of the function of the anterior lobe and the pars intermedia of the pituitary gland were conducted, and high concentrations of ACTH and alpha-melanotrophic hormone (alpha-MSH) were found without concomitant hyperadrenocorticism. Studies of the molecular size of the immunoreactive ACTH in plasma by gel filtration revealed that most of the circulating immunoreactivity was not ACTH but its precursor pro-opiomelanocortin (POMC) and low-molecular-weight POMC-derived peptides. The pituitary tumor of this dog probably originated from melanotrophic cells of the pars intermedia. The sensitivity of the pituitary-adrenocortical system for the suppressive effect of dexamethasone was unaffected

  9. Efficacy of sellar opening in the pituitary adenoma resection of transsphenoidal surgery influences the degree of tumor resection.

    Science.gov (United States)

    Wang, Shousen; Qin, Yong; Xiao, Deyong; Wei, Liangfeng

    2017-07-24

    Endonasal transsphenoidal microsurgery is often adopted in the resection of pituitary adenoma, and has showed satisfactory treatment and minor injuries. It is important to accurately localize sellar floor and properly incise the bone and dura matter. Fifty-one patients with pituitary adenoma undergoing endonasal transsphenoidal microsurgery were included in the present study. To identify the scope of sellar floor opening, CT scan of the paranasal sinus and MRI scan of the pituitary gland were performed for each subject. Intraoperatively, internal carotid artery injury, leakage of cerebrospinal fluid, and tumor texture were recorded, and postoperative complications and residual tumors were identified. The relative size of sellar floor opening significantly differed among the pituitary micro-, macro- and giant adenoma groups, and between the total and partial tumor resection groups. The ratio of sellar floor opening area to maximal tumor area was significantly different between the total and partial resection groups. Logistic regression analysis revealed that the ratio of sellar floor opening area to the largest tumor area, tumor texture, tumor invasion and age were independent prognostic factors. The vertical distance between the top point of sellar floor opening and planum sphenoidale significantly differed between the patients with and without leakage of cerebrospinal fluid. These results together indicated that relatively insufficient sellar floor opening is a cause of leading to residual tumor, and the higher position of the opening and closer to the planum sphenoidale are likely to induce the occurrence of leakage of cerebrospinal fluid.

  10. Inherent Tumor Characteristics That Limit Effective and Safe Resection of Giant Nonfunctioning Pituitary Adenomas.

    Science.gov (United States)

    Nishioka, Hiroshi; Hara, Takayuki; Nagata, Yuichi; Fukuhara, Noriaki; Yamaguchi-Okada, Mitsuo; Yamada, Shozo

    2017-10-01

    Surgical treatment of giant pituitary adenomas is sometimes challenging. We present our surgical series of giant nonfunctioning adenomas to shed light on the limitations of effective and safe tumor resection. The preoperative tumor characteristics, surgical approaches, outcome, and histology of giant nonfunctioning adenoma (>40 mm) in 128 consecutive surgical patients are reviewed. The follow-up period ranged from 19 to 113 months (mean 62.2 months). A transsphenoidal approach was used in the treatment of 109 patients and a combined transsphenoidal transcranial approach in 19 patients. A total of 93 patients (72.7%) underwent total resection or subtotal resection apart from the cavernous sinus (CS). The degree of tumor resection, excluding the marked CS invasion, was lower in tumors that were larger (P = 0.0107), showed massive intracranial extension (P = 0.0352), and had an irregular configuration (P = 0.0016). Permanent surgical complications developed in 28 patients (22.0%). Long-term tumor control was achieved in all patients by single surgery, including 43 patients with adjuvant radiotherapy. Most tumors were histologically benign, with a low MIB-1 index (inherent factors that independently limit effective resection. These high-risk tumors require an individualized therapeutic strategy. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Expression pattern of neuronal intermediate filament α-internexin in anterior pituitary gland and related tumors.

    Science.gov (United States)

    Schult, D; Hölsken, A; Buchfelder, M; Schlaffer, S-M; Siegel, S; Kreitschmann-Andermahr, I; Fahlbusch, R; Buslei, R

    2015-08-01

    α-Internexin (INA) is a class IV neuronal intermediate filament protein that maintains the morphogenesis of neurons. It is expressed in developing neuroblasts and represents the major component of the cytoskeleton in cerebellar granule cells of adult central nervous system tissue. Data concerning INA expression in the human frontal pituitary lobe and related adenomas (PA) is missing. Using immunohistochemistry we examined the distribution pattern of INA in a large cohort of 152 PA, 11 atypical PA, 4 pituitary carcinomas and 20 normal pituitaries (overall n = 187). Quantity of INA protein expression was semi-quantitatively evaluated and grouped into five categories (0 = 0%; 1 = >0-5%; 2 = >5-35%; 3 = >35-80%; 4 = >80% of cells). Cellular staining intensity of INA appeared significantly higher in gonadotropinomas (Go, n = 62), null cell adenomas (NC, n = 7) and thyrotropinomas (TSHomas, n = 7) compared to the other tumor subtypes (p ≤ 0.001). Furthermore, Go and NC showed a peculiar pseudorosette-like staining pattern surrounding blood vessels in 85.5% (59/69) of cases. Interestingly, areas exhibiting homogenous INA staining were often associated with oncocytic cell changes and decreased immunohistochemically detectable hormone expression. Only 8.5% (8/94) of other PA showed a comparable INA distribution (p ≤ 0.001). Go, NC as well as TSHomas exhibit high levels of intracellular INA protein indicating neuronal transdifferentiation. A possible impact on pathogenesis and endocrine activity needs further investigation.

  12. Differentiation of pituitary adenomas from other sellar and parasellar tumors by {sup 99m}Tc(V)-DMSA scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yamamura, Koji [Yokohama City Univ. (Japan). Medical Center; Suzuki, Shinichi; Yamamoto, Isao [Yokohama City Univ. (Japan). School of Medicine

    2003-04-01

    Pentavalent technetium-99m dimercaptosuccinic acid [{sup 99m}Tc(V)-DMSA] scintigraphy was evaluated for the differentiation of pituitary adenomas, especially non-functioning adenomas, from other sellar and parasellar lesions. Diffuse {sup 99m}Tc(V)-DMSA accumulation within the tumor was found in seven of seven non-functioning, three of four growth hormone-secreting, and seven of eight prolactin-secreting adenomas, but only partial accumulation in only two of 16 non-pituitary adenomas and normal pituitary glands. There were no significant relationship between tumor-to-background ratios and tumor size or serum hormone level. {sup 99m}Tc(V)-DMSA scintigraphy showed overall sensitivity of 81% (17/21 cases) for detecting pituitary adenomas, in particular 100% for non-functioning adenomas. {sup 99m}Tc(V)-DMSA may be useful for detecting pituitary adenomas, especially non-functioning adenomas, and for the differentiation of non-functioning pituitary adenomas from other sellar and parasellar lesions. (author)

  13. Fatal antiphospholipid syndrome following endoscopic transnasal-transsphenoidal surgery for a pituitary tumor: A case report.

    Science.gov (United States)

    Li, Chiao-Zhu; Li, Chiao-Ching; Hsieh, Chih-Chuan; Lin, Meng-Chi; Hueng, Dueng-Yuan; Liu, Feng-Chen; Chen, Yuan-Hao

    2017-01-01

    The fatal type of antiphospholipid syndrome is a rare but life-threating condition. It may be triggered by surgery or infection. Endoscopic transnasal-transsphenoidal surgery is a common procedure for pituitary tumor. We report a catastrophic case of a young woman died of fatal antiphospholipid syndrome following endoscopic transnasal-transsphenoidal surgery. A 31-year-old woman of a history of stroke received endoscopic transnasal-transsphenoidal surgery for a pituitary tumor. The whole procedure was smooth. However, the patient suffered from acute delirium on postoperative day 4. Then, her consciousness became comatose state rapidly with dilatation of pupils. Urgent magnetic resonance imaging of brain demonstrated multiple acute lacunar infarcts. The positive antiphosphoipid antibody and severe thrombocytopenia were also noted. Fatal antiphospholipid syndrome was diagnosed. Plasma exchange, corticosteroids, anticoagulant agent were prescribed. The hemodynamic condition was gradually stable. However, the consciousness was still in deep coma. The patient died of organ donation 2 months later. If patients have a history of cerebral stroke in their early life, such as a young stroke, the APS and higher risk of developing fatal APS after major surgery should be considered. The optimal management of APS remains controversial. The best treatment strategies are only early diagnosis and aggressive therapies combing of anticoagulant, corticosteroid, and plasma exchange. The intravenous immunoglobulin is prescribed for patients with refractory APS.

  14. Transsphenoidal surgery for pituitary tumors from microsurgery to the endoscopic surgery. Single surgeon's experience

    International Nuclear Information System (INIS)

    Iwai, Yoshiyasu; Yoshimura, Masaki; Terada, Aiko; Yamanaka, Kazuhiro; Koshimo, Naomi

    2011-01-01

    We reviewed results of the surgical outcome of pituitary tumors treated via the transsphenoidal approach between January, 1994 and January, 2010 at our institution. This data included 100 patients (124 procedures) treated through the sublabial transsphenoidal approach and 45 patients (54 procedures) treated through the endoscopic endonasal (bilateral nostrils) transsphenoidal approach performed by a single surgeon. The extent of tumor removal was significantly improved with endoscopic surgery; adjuvant gamma knife radiosurgery was needed for 65% of patients undergoing microsurgery vs. 30% for patients who had endoscopic surgery (p<0.0001). Patients who underwent endoscopic surgery had less intraoperative blood loss (mean volume: 100 mL for microsurgery patients vs. 30 mL for endoscopic surgery patients, p<0.0001), less pain, and less need for postoperative hormone replacement therapy (19% for microsurgery patients vs. 6% for endoscopic surgery patients; p<0.05). Cerebrospinal fluid (CSF) leakage and meningitis were experienced in one microsurgery patient (1%) and one endoscopic surgery patient (2.2%). Endoscopic surgery is a reasonable alternative to microsurgery and our experience supports the concept that an otolaryngologist/neurosurgeon team skilled in endoscopic techniques and pituitary surgery can safely make the transition from microsurgery to endoscopic surgery. (author)

  15. MRI Findings of Causalgia of the Lower Extremity Following Transsphenoidal Resection of Pituitary Tumor

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    D. Ryan Ormond

    2012-01-01

    Full Text Available Background. Causalgia is continuing pain, allodynia, or hyperalgesia after nerve injury with edema, changes in skin blood flow, or abnormal sudomotor activity. Here we report a case of lower extremity causalgia following elective transsphenoidal resection of a pituitary tumor in a young man. Clinical Presentation. A 33-year-old man with acromegaly underwent elective sublabial transsphenoidal resection of his pituitary tumor. During the three-hour surgery, the lower limbs were kept in a supine, neutral position with a pillow under the knees. The right thigh was slightly internally rotated with a tape to expose fascia lata, which was harvested to repair the sella. Postoperatively, he developed causalgia in a distal sciatic and common peroneal nerve distribution. Pain was refractory to several interventions. Finally, phenoxybenzamine improved his pain significantly. Conclusions. Malpositioning in the operating room resulted in causalgia in this young man. Phenoxybenzamine improved, and ultimately resolved, his symptoms. Improvement in his pain symptoms correlated with resolution of imaging changes in the distal sciatic and peroneal nerves on the side of injury.

  16. Pituitary tumor risk in relation to mobile phone use: A case-control study.

    Science.gov (United States)

    Shrestha, Mithila; Raitanen, Jani; Salminen, Tiina; Lahkola, Anna; Auvinen, Anssi

    2015-01-01

    The number of mobile phone users has grown rapidly, which has generated mounting public concern regarding possible health hazards. This study aims to assess pituitary tumor risk, as it has rarely been investigated. A case-control study was conducted with 80 eligible cases identified from all five university hospitals in Finland and frequency-matched 240 controls from the national population register. Controls were matched to cases by age, sex, region of residence and date of interview. A detailed history of mobile phone use was obtained using a structured interview. Several indicators of mobile phone use were assessed using conditional logistic regression. A reduced odds ratio was seen among regular mobile phone users [OR 0.39, 95% confidence interval (CI) 0.21, 0.72] relative to never/non-regular users, possibly reflecting methodological limitations. Pituitary tumor risk was not increased after 10 or more years since first use (OR 0.69, 95% CI 0.25, 1.89). The risk was not increased in relation to duration, cumulative hours of use, or cumulative number of calls. The results were similar for analog and digital phones. We found no excess risk associated with self-reported short- or medium-term use of mobile phones. This is consistent with most of the published studies. However, uncertainties remained for longer duration of use, as a very small proportion of study participants reported use beyond 10 years.

  17. Pituitary Tumors—Health Professional Version

    Science.gov (United States)

    Pituitary tumors represent from 10% to 25% of all intracranial neoplasms. Pituitary tumors can be classified into three groups: benign adenoma, invasive adenoma, and carcinoma. Find evidence-based information on pituitary tumors treatment.

  18. Thyrotropin-secreting pituitary tumor presenting with congestive heart failure and good response to dopaminergic agonist cabergoline

    Directory of Open Access Journals (Sweden)

    Yu-Hsi Kao

    2013-11-01

    Full Text Available Hyperthyroidism is an important inducing factor in patients with atrial fibrillation, and may trigger heart failure. Thyrotropin (thyroid stimulating hormone, TSH-secreting pituitary tumors are rare causes of hyperthyroidism. Here, we report a 66-year-old man with a pituitary TSH-secreting tumor who presented with hyperthyroidism and congestive heart failure. Endonasal trans-sphenoidal pituitary adenomectomy was performed. After the operation, the symptoms of hyperthyroidism and congestive heart failure were relieved, associated with normalization of thyroid function tests. Unfortunately, hand tremor and progressively elevated free T4 and TSH concentrations recurred 5 months after surgery. A dopaminergic agonist, cabergoline was administered and euthyroidism was restored for at least 11 months.

  19. Endoscopic endonasal approach for craniopharyngioma: the importance of the relationship between pituitary stalk and tumor.

    Science.gov (United States)

    Dho, Yun-Sik; Kim, Yong Hwy; Se, Young-Bem; Han, Doo Hee; Kim, Jung Hee; Park, Chul-Kee; Wang, Kyu-Chang; Kim, Dong Gyu

    2017-09-29

    OBJECTIVE The endoscopic endonasal approach (EEA) is commonly used for the treatment of craniopharyngioma; therefore, it is essential to analyze outcomes in order to understand the benefits and drawbacks. The goal of this paper was to evaluate the clinical features and outcomes associated with this treatment approach. METHODS From July 2010 to March 2016, 82 adult craniopharyngioma patients underwent an EEA at the authors' institution. Of these cases, intraoperative records and immediate postoperative MR images were available for 68 patients. The patients underwent systemized endocrinological evaluation. Eighteen of 68 patients who underwent EEA for recurrence or regrowth of residual lesions after previous surgical management were excluded in the analysis of the anatomical tumor classification. The authors retrospectively analyzed preoperative clinical features and previous anatomical classifications, focusing on the relationship of the pituitary stalk and tumor, to determine predictive factors for the clinical outcome, such as the extent of resection, visual function, endocrinological function, recurrence rate, and complications. RESULTS The mean tumor size was 2.5 cm (3.1 cm for primary tumors and 1.9 cm for recurrent lesions). Gross-total resection (GTR) was achieved in 62 (91.1%) patients (48 [96.0%] patients with primary tumors and 14 [77.8%] patients with recurrent tumors). The rate of GTR was higher in the primary group than in the group with recurrence (p = 0.038). The overall pre- and postoperative visual impairment scale (VIS) scores were 40.8 and 22.1, respectively (50.9 and 14.3 in the primary group and 30.7 and 29.9 in patients with recurrence, respectively). The improvement rate in VIS score was higher in the primary group than in the recurrent group (p = 0.001). Endocrinological function was improved in 4 patients (5.9%) and deteriorated in 32 of 68 patients (47.1%). Tumor invasion into the center of the pituitary stalk affected the postoperative

  20. The incidence of cerebrovascular accidents and second brain tumors in patients with pituitary adenoma: a population-based study.

    Science.gov (United States)

    Brown, Paul D; Blanchard, Miran; Jethwa, Krishan; Flemming, Kelly D; Brown, Cerise A; Kline, Robert W; Jacobson, Debra J; St Sauver, Jennifer; Pollock, Bruce E; Garces, Yolanda I; Stafford, Scott L; Link, Michael J; Erickson, Dana; Foote, Robert L; Laack, Nadia N I

    2014-03-01

    To assess the risk of cerebrovascular accidents (CVAs) and second brain tumors (SBTs) in patients with pituitary adenoma after surgery or radiotherapy. A cohort of 143 people from Olmsted County, who were diagnosed with pituitary adenoma between 1933 and 2000, was studied. Only patients from Olmsted County were included because of the unique nature of medical care in Olmsted County, which allows the ascertainment of virtually all cases of pituitary adenoma for this community's residents and comparisons to the general population in the county. Surgical resection was performed in 76 patients, 29 patients underwent radiotherapy (with 21 undergoing both surgery and radiotherapy), 5 patients were reirradiated, and 59 patients were managed conservatively and observed. Median follow-up was 15.5 years. There was no difference in CVA-free survival between treatment groups. On univariate analysis age > 60 years (hazard ratio [HR], 11.93; 95% CI, 6.26-23.03; P 60 years was associated with worse CVA-free survival. Compared with the general population, there was a 4-fold increase in the rate of CVAs in pituitary adenoma patients (HR, 4.2; 95% CI, 2.8-6.1). Two patients developed SBT (an irradiated patient and a surgically managed patient). CVA is a significant risk for patients with pituitary tumors, but treatment does not seem to impact the risk. Even with long-term follow-up, SBTs are a rare event regardless of treatment modality.

  1. Mice lacking pituitary tumor transforming gene show elevated exposure of DGalNAc carbohydrate determinants

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    Lutsyk A. D.

    2012-04-01

    Full Text Available Aim. To investigate the influence of pituitary tumor transforming gene (pttg-1 knockout on glycome of parenchimal organs by means of lectin histochemistry. Methods. DGalNAc, DGlcNAc, NeuNAc carbohydrate determinants were labelled with soybean agglutinin (SBA and wheat germ agglutinin (WGA, conjugated to peroxidase, with subsequent visualization of the lectin-binding sites with diaminobenzidine. The testes and kidneys of murine strain BL6/C57 with the pttg-1 gene knockout (PTTG-KO were compared to the wild type (PTTG-WT animals, both groups 1 month of age. Results. Knockout of the pttg-1 gene was accompanied by enhanced exposure of the DGalNAc sugar residues within the Golgi complex of secondary spermatocytes, in a brush border of renal tubules and on the lumenal surface of collecting ducts. Conclusions. This study suggests that knockout of the pttg-1 gene may lead to the changes in carbohydrate processing in mammalian organism.

  2. Pertussis toxin inhibits somatostatin-induced K+ conductance in human pituitary tumor cells

    International Nuclear Information System (INIS)

    Yamashita, N.; Kojima, I.; Shibuya, N.; Ogata, E.

    1987-01-01

    The effect of pertussis toxin on somatostatin-induced K + current was examined in dissociated human pituitary tumor cells obtained from two acromegalic patients. Somatostatin-induced hyperpolarization or K + current was observed in 20 of 23 cells in adenoma 1 and 10 of 11 cells in adenoma 2. After treatment with pertussis toxin for 24 h, these responses were completely suppressed (0/14 in adenoma, 1, 0/10 in adenoma 2). Spontaneous action potentials, K + , Na + , and Ca 2+ currents were well preserved after pertussis toxin treatment. When crude membrane fraction was incubated with [ 32 P]NAD, a 41K protein was ADP-ribosylated by pertussis toxin. Hormone release was inhibited by somatostatin and this inhibition was blocked by pertussis toxin treatment

  3. Therapy for non-functional pituitary adenoma. Residual tumor and radiotherapy

    International Nuclear Information System (INIS)

    Takahashi, Toshio; Ito, Satoshi; Shimamura, Norihito; Sekiya, Tetsuharu; Tanaka, Masahiko; Suzuki, Shigeharu

    1997-01-01

    Effects and complication of radiotherapy after surgery of non-functional pituitary adenoma were evaluated with consideration on findings in recent literatures. On 44 cases of 64 patients (36 males and 28 females), the mean age of 48.9y, with macroadenoma, a comparison was made on their recurrence and complication between irradiated and non-irradiated groups after surgery. The follow-up period was >1 year (5y4m in a mean). The total radiation dose was in the range of 40-60 (average 47.3) Gy. Recurrence was seen in 1/31 cases in irradiated group, and 5/13 in non-irradiated group. Reduction of visual acuity and hypopituitarism were observed in 1 and 2 cases, respectively, in irradiated group. Radiotherapy for residual tumor was confirmed useful for preventing recurrence. (K.H.)

  4. The pituitary tumor transforming gene 1 (PTTG-1: An immunological target for multiple myeloma

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    Gagliano Nicoletta

    2008-04-01

    Full Text Available Abstract Background Multiple Myeloma is a cancer of B plasma cells, which produce non-specific antibodies and proliferate uncontrolled. Due to the potential relapse and non-specificity of current treatments, immunotherapy promises to be more specific and may induce long-term immunity in patients. The pituitary tumor transforming gene 1 (PTTG-1 has been shown to be a novel oncogene, expressed in the testis, thymus, colon, lung and placenta (undetectable in most other tissues. Furthermore, it is over expressed in many tumors such as the pituitary adenoma, breast, gastrointestinal cancers, leukemia, lymphoma, and lung cancer and it seems to be associated with tumorigenesis, angiogenesis and cancer progression. The purpose was to investigate the presence/rate of expression of PTTG-1 in multiple myeloma patients. Methods We analyzed the PTTG-1 expression at the transcriptional and the protein level, by PCR, immunocytochemical methods, Dot-blot and ELISA performed on patient's sera in 19 multiple myeloma patients, 6 different multiple myeloma cell lines and in normal human tissue. Results We did not find PTTG-1 presence in the normal human tissue panel, but PTTG-1 mRNA was detectable in 12 of the 19 patients, giving evidence of a 63% rate of expression (data confirmed by ELISA. Four of the 6 investigated cell lines (66.6% were positive for PTTG-1. Investigations of protein expression gave evidence of 26.3% cytoplasmic expression and 16% surface expression in the plasma cells of multiple myeloma patients. Protein presence was also confirmed by Dot-blot in both cell lines and patients. Conclusion We established PTTG-1's presence at both the transcriptional and protein levels. These data suggest that PTTG-1 is aberrantly expressed in multiple myeloma plasma cells, is highly immunogenic and is a suitable target for immunotherapy of multiple myeloma.

  5. Cystic tumors of the pituitary infundibulum: seminal autopsy specimens (1899 to 1904) that allowed clinical-pathological craniopharyngioma characterization.

    Science.gov (United States)

    Pascual, José M; Prieto, Ruth; Rosdolsky, Maria; Strauss, Sewan; Castro-Dufourny, Inés; Hofecker, Verena; Winter, Eduard; Carrasco, Rodrigo; Ulrich, Walter

    2018-04-21

    A heterogeneous group of epithelial cystic tumors developed at the infundibulum and the third ventricle disconcerted pathologists at the dawn of the twentieth century. Very little was known at that time about the physiological role played by the pituitary gland, and there was almost complete ignorance regarding the function of the hypothalamus. Acromegaly, or enlargement of acral body parts, described in 1886 by Pierre Marie, was the only disease linked to primary hypertrophies of the pituitary gland, known as "pituitary strumas". A growing number of young patients manifesting an unexplained combination of physical and mental symptoms, including absent or delayed sexual maturation, progressive obesity, abnormal somnolence, and dementia-like changes in behavior were reported to present large solid-cystic tumors which characteristically expanded within the infundibulum and third ventricle, above an anatomically intact pituitary gland. Between 1899 and 1904, five seminal autopsy studies from different countries thoroughly described the anatomical relationships and histological features of this newly recognized type of infundibular tumors. These cases were instrumental in fostering the systematic investigation of similar lesions by the Austrian pathologist Jakob Erdheim (1874-1937), who in 1904 was able to classify these infundibulo-tuberal cysts under the common category of hypophyseal duct tumors. The pioneering American neurosurgeon Harvey Cushing (1869-1939) unsuccessfully attempted to surgically remove one of these cysts, for the first time in history, in 1902. The term "craniopharyngioma", chosen by Cushing in 1929 to designate these lesions, would eventually prevail over Erdheim's more accurate denomination, which linked their origin to squamous cell remnants derived from the embryological structures that give rise to the pituitary gland. This paper presents a comprehensive, renewed account of the five clinical-pathological reports which laid the groundwork for

  6. Quantitative analysis of tumor shrinkage due to chemotherapy and its implication for radiation treatment planning in limited-stage small-cell lung cancer

    International Nuclear Information System (INIS)

    Xia, Bing; Wang, Jia-Zhou; Liu, Qi; Cheng, Jing-Yi; Zhu, Zheng-Fei; Fu, Xiao-Long

    2013-01-01

    The optimal timing of chemoradiotherapy in limited-stage small-cell lung cancer (LS-SCLC) hasn’t been established, although evidence from studies supported that patients can benefit from early radiation therapy. The purpose of this study was to quantify tumor shrinkage in response to induction chemotherapy (IC), evaluate the impact of tumor shrinkage on radiation dosimetric parameters and determine its implication for the timing of radiation therapy for patients with LS-SCLC. Twenty patients with LS-SCLC who were treated with IC followed by concomitant radiation therapy were investigated retrospectively. Ten patients received 1 cycle of IC, and 10 patients received 2 cycles of IC. Pre-IC CT imaging was coregistered with a simulation CT, and virtual radiation plans were created for pre- and post-IC thoracic disease in each case. The changes in the gross target volume (GTV), planning target volume (PTV) and dosimetric factors associated with the lungs, esophagus and heart were analyzed. The mean GTV and PTV for all of the patients decreased by 60.9% and 40.2%, respectively, which resulted in a significant reduction in the radiation exposure to the lungs, esophagus and heart. Changes in the PTV and radiation exposure of normal tissue were not significantly affected by the number of chemotherapy cycles delivered, although patients who received 2 cycles of IC had a greater decrease in GTV than those who received only 1 cycle of IC (69.6% vs. 52.1%, p = 0.273). Our data showed that targeting the tumor post-IC may reduce the radiation dose to normal tissue in patients with LS-SCLC. However, the benefit to the normal tissue was not increased by an additional cycle of IC. These findings suggest that the first cycle of chemotherapy is very important for tumor shrinkage and that initiating thoracic radiation therapy at the second cycle of chemotherapy may be a reasonable strategy for timing of radiation therapy in LS-SCLC treatment

  7. Long-term follow-up results of combination therapy of surgery and gamma knife on pituitary tumor

    International Nuclear Information System (INIS)

    Ikeda, Hidetoshi; Yoshimoto, Takashi; Shirokura, Hideshi

    1997-01-01

    Usefulness of the combination therapy for invasive pituitary tumor with surgery and gamma knife (GK) was evaluated on 17 cases followed for >2 years. Tumors involved ACTH cell adenoma, GH cell adenoma, mixed GH and PRL, purihormonal adenoma, gonadotrophic cell adenoma, GH cell adenoma and null cell adenoma, which were divided into I and II group since adverse effects by GK on the normal pituitary tissues could be evaluated according to tumor growth and abnormal hormone secretion. Irradiation was carried out to make the marginal dose of around 30 (15-35) Gy and center dose of 25-70 Gy on the gland, and marginal dose of <10 Gy on optic nerve. After GK, follow-up was done by pituitary hormone values, tests for sight and visual field and MRI examination. Hypopituitarism was seen in 67% with 100% remission of Cushing's disease. MRI revealed that the adenoma changed to fibrosis (type 1) with increasing Gd-enhancement or to cystic necrosis (type 2) without Gd-enhancement. Values for GH, cortisol and ACTH turned to normal ones. Thus the combination therapy was found useful. (K.H.)

  8. Temozolomide-Induced Shrinkage of Invasive Pituitary Adenoma in Patient with Nelson’s Syndrome: A Case Report and Review of the Literature

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    Maria Kurowska

    2015-01-01

    Full Text Available Introduction. Invasive tumours in Nelson’s syndrome need aggressive therapy. Recent reports have documented the efficacy of temozolomide (TMZ in the treatment of adenomas resistant to conventional management. Objective. The review of the literature concerning TMZ treatment of atypical corticotroph adenomas and a case study of 56-year-old woman who developed Nelson’s syndrome. Treatment Proceeding. The patient with Cushing’s disease underwent transsphenoidal adenomectomy followed by a 27-month-long period of remission. Due to a regrowth of the tumor, she underwent two reoperations followed by stereotactic radiotherapy. Because of treatment failures, bilateral adrenalectomy was performed. Then she developed Nelson’s syndrome. A fourth transsphenoidal adenomectomy was performed, but there was a rapid recurrence. Five months later, she underwent a right frontotemporal craniotomy. Due to a rapid regrowth of the tumour, the patient did not receive gamma-knife therapy and was treated with cabergoline and somatostatin analogue for some time. Only TMZ therapy resulted in marked clinical, biochemical, and radiological improvement. To date, this is the first case of invasive corticotroph adenoma in Nelson’s syndrome treated with temozolomide in Poland. Conclusion. In our opinion, temozolomide can be an effective treatment option of invasive adenomas in Nelson’s syndrome.

  9. Soft-tissue reactions following irradiation of primary brain and pituitary tumors

    International Nuclear Information System (INIS)

    Baglan, R.J.; Marks, J.E.

    1981-01-01

    One hundred and ninety-nine patients who received radiation therapy for a primary brain or pituitary tumor were studied for radiation-induced soft-tissue reactions of the cranium, scalp, ears and jaw. The frequency of these reactions was studied as a function of: the radiation dose 5 mm below the skin surface, dose distribution, field size and fraction size. Forty percent of patients had complete and permanent epilation, while 21% had some other soft-tissue complication, including: scalp swelling-6%, external otitis-6%, otitis media-5%, ear swelling-4%, etc. The frequency of soft-tissue reactions correlates directly with the radiation dose at 5 mm below the skin surface. Patients treated with small portals ( 2 ) had few soft-tissue reactions. The dose to superficial tissues, and hence the frequency of soft-tissue reactions can be reduced by: (1) using high-energy megavoltage beams; (2) using equal loading of beams; and (3) possibly avoiding the use of electron beams

  10. Symptom distress and quality of life after stereotactic radiosurgery in patients with pituitary tumors: a questionnaire survey.

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    Ching-Ju Yang

    Full Text Available BACKGROUND: Stereotactic radiosurgery (SRS is a common treatment for recurrent or residual pituitary adenomas. The persistence of symptoms and treatment related complications may impair the patient's quality of life (QOL. PURPOSE: The purpose of this study was to examine symptom distress, QOL, and the relationship between them among patients with pituitary tumors who had undergone SRS. METHODS: This study used a cross-sectional design and purposive sampling. We enrolled patients diagnosed with pituitary tumors who had undergone SRS. Data were collected at the CyberKnife Center at a medical center in Northern Taiwan in 2012. A questionnaire survey was used for data collection. Our questionnaire consisted of 3 parts the Pituitary Tumor Symptom Distress Questionnaire, the World Health Organization Quality of Life Instrument Short-Form (WHOQOL-BREF, and a demographic questionnaire. RESULTS: Sixty patients were enrolled in the study. The most common symptoms reported by patients after SRS were memory loss, fatigue, blurred vision, headache, sleep problems, and altered libido. The highest and lowest scores for QOL were in the environmental and psychological domains, respectively. Age was positively correlated with general health and the psychological domains. Level of symptom distress was negatively correlated with overall QOL, general health, physical health, and the psychological and social relationships domains. The scores in the psychological and environmental domains were higher in males than in females. Patients with ≤6 symptoms had better overall QOL, general health, physical health, and psychological and social relationships than those with >6 symptoms. CONCLUSION: Symptom distress can affect different aspects of patient QOL. Levels of symptom distress, number of symptoms, age, and gender were variables significantly correlated with patient QOL. These results may be utilized by healthcare personnel to design educational and targeted

  11. Phosphorylation of intracellular proteins related to the multihormonal regulation of prolactin: comparison of normal anterior pituitary cells in culture with the tumor-derived GH cell lines

    International Nuclear Information System (INIS)

    Beretta, L.; Boutterin, M.C.; Sobel, A.

    1988-01-01

    We have previously identified a group of cytoplasmic phosphoproteins (proteins 1-11) whose phosphorylation could be related, on a pharmacological basis, to the multihormonal regulation of PRL synthesis and release in the anterior pituitary tumor-derived GH cell lines. Phosphoproteins with identical migration properties on two-dimensional electrophoresis gels were also detectable in normal rat anterior pituitary cells in culture. We designed appropriate culture and [ 32 P] phosphate-labeling conditions allowing to analyze the regulation of the phosphorylation of these proteins in normal pituitary cells. TRH, 12-O-tetradecanoylphorbol-13-acetate, and vasoactive intestinal peptide induced the same qualitative changes in phosphorylation of proteins 1-11 in normal as in GH cells. Quantitative differences observed are most likely due to the heterogeneity of primary pituitary cultures. Phosphorylation changes affecting proteins 14-16, not previously detected in GH cells, were also observed with normal anterior pituitary cells. GH cell lines have lost the sensitivity of pituitary lactotrophs for dopamine, an important physiological inhibitor of PRL synthesis and release. In normal anterior pituitary cells in culture, dopamine inhibited also the TRH-stimulated phosphorylation of proteins 1-10, thus strengthening the correlation between phosphorylation of these proteins and multihormonal regulation of pituitary cell functions. Our results indicate: 1) that the same phosphoproteins as in GH cells are related to the multihormonal regulation of nontumoral, normal anterior pituitary cells in culture; 2) that dopamine acts by interfering with the phosphorylation of these proteins

  12. Early tumor shrinkage served as a prognostic factor for patients with stage III non-small cell lung cancer treated with concurrent chemoradiotherapy.

    Science.gov (United States)

    Wei, Min; Ye, Qingqing; Wang, Xuan; Wang, Men; Hu, Yan; Yang, Yonghua; Yang, Jiyuan; Cai, Jun

    2018-05-01

    Lung cancer is the most common cause of cancer death. About 80% of patients are diagnosed at stage III in the non-small cell lung cancer (NSCLC). It is extremely important to understand the progression of this disease which has low survival times despite the advancing treatment modalities. We aimed to investigate the relationship between early tumor shrinkage (ETS) after initial concurrent chemoradiotherapy (C-CRT) and survival outcome in patients with stage III (NSCLC). A retrospective review of 103 patients with stage III NSCLC who had received C-CRT from January 2006 to October 2011 was performed. Patients were treated with systemic chemotherapy regimen of Cisplatin/Vp-16 and concurrent thoracic radiotherapy at a median dose of 66 Gy (range 60-70 Gy). All patients received a computed tomography (CT) examination before treatment. Also subsequently, chest CT scans were performed with the same imaging parameters at approximately 5 weeks after the initiation of treatment. ETS is here stratified by a decrease in tumor size ≥30% and cancer-related death (P < .05) in stage IIINSCLC. ETS may be served as a useful prognostic factor to predict the outcome of stage III NSCLC patients treated with CCRT.

  13. The effect of growth hormone replacement in patients with hypopituitarism on pituitary tumor recurrence, secondary cancer, and stroke.

    Science.gov (United States)

    Jasim, Sina; Alahdab, Fares; Ahmed, Ahmed T; Tamhane, Shrikant U; Sharma, Anu; Donegan, Diane; Nippoldt, Todd B; Murad, M Hassan

    2017-05-01

    Growth hormone replacement therapy has benefits for patients with hypopituitarism. The safety profile in regard to tumor recurrence or progression, development of secondary malignancies, or cerebrovascular stroke is still an area of debate. A comprehensive search of multiple databases-MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus was conducted through August 2015. Eligible studies that evaluated long-term adverse events in adult patients with hypopituitarism treated with growth hormone replacement therapy and reported development of pituitary tumor recurrence or progression, secondary malignancies, or cerebrovascular stroke were selected following a predefined protocol. Reviewers, independently and in duplicate, extracted data and assessed the risk of bias. Random-effects meta-analysis was used to pool relative risks and 95 % confidence intervals. We included 15 studies (published 1995-2015) that reported on 46,148 patients. Compared to non-replacement, growth hormone replacement therapy in adults with hypopituitarism was not associated with statistically significant change in pituitary tumor progression or recurrence (relative risk, 0.77; 95 % confidence interval, 0.53-1.13) or development of secondary malignancy (relative risk, 0.99; 95 % confidence interval, 0.70-1.39). In two retrospective studies, there was higher risk of stroke in patients who did not receive replacement (relative risk, 2.07; 95 % confidence interval, 1.51-2.83). The quality of evidence is low due to study limitations and imprecision. This systematic review and meta-analysis supports the overall safety of growth hormone therapeutic use in adults with hypopituitarism with no clear evidence of increased risk of pituitary tumor recurrence, malignancy, or stroke.

  14. Prediction of postoperative diabetes insipidus using morphological hyperintensity patterns in the pituitary stalk on magnetic resonance imaging after transsphenoidal surgery for sellar tumors.

    Science.gov (United States)

    Hayashi, Yasuhiko; Kita, Daisuke; Watanabe, Takuya; Fukui, Issei; Sasagawa, Yasuo; Oishi, Masahiro; Tachibana, Osamu; Ueda, Fumiaki; Nakada, Mitsutoshi

    2016-12-01

    Diabetes insipidus (DI) remains a complication of transsphenoidal surgery (TSS) for sellar and parasellar tumors. Antidiuretic hormone (ADH) appears as hyper intensity (HI) in the pituitary stalk and the posterior lobe of the pituitary gland on T1-weighted magnetic resonance (MR) imaging. Its disappearance from the posterior lobe occurs with DI, indicating a lack of ADH. The appearance of HI in the pituitary stalk indicates disturbances in ADH transport. This retrospective study included 172 patients undergoing TSS for sellar tumors at our institute from 2006 to 2014. Sequential T1-weighted MR images without enhancement were evaluated for HI in the pituitary stalk and the posterior lobe to assess the localization of ADH before and at intervals after TSS. DI was assessed pre- and postoperatively. HI in the pituitary stalk showed the following morphology: (1) ovoid in the distal end of the pituitary stalk (group A), (2) linear in the distal part of the pituitary stalk (group B), (3) linear in the whole pituitary stalk (group C). Preoperative DI occurred in 6 patients (3.5 %) with no HI observed in the posterior lobe. Postoperative DI was transient in 82 patients (47.7 %), and permanent in 11 (6.4 %). One week after surgery, HI was absent in the posterior lobe in 74 patients (43.0 %), and present in the pituitary stalk in 99 patients (57.6 %); both were significantly correlated with postoperative DI (p < 0.001). The absence of HI in the posterior lobe (A, 48.9 %; B, 68.3 %; C, 92.3 %), persistence of DI (A, 3.7 days; B, 45.9 days; C, 20.5 months), and duration until HI recovery in the posterior lobe (A, 3.6 months; B, 6.8 months; C, 22.9 months) were greatest in group C, followed by group B, and then group A. Fourteen group A patients did not have postoperative DI despite having HI in the pituitary stalk and the posterior lobe. Four group C patients developed permanent DI with persistence HI in the pituitary stalk. HI in the pituitary stalk and its

  15. Radiotherapy, Especially at Young Age, Increases the Risk for De Novo Brain Tumors in Patients Treated for Pituitary/Sellar Lesions

    NARCIS (Netherlands)

    Burman, Pia; van Beek, Andre P.; Biller, Beverly M.K.; Camacho-Hubner, Cecilia; Mattsson, Anders F.

    2017-01-01

    Context: De novo brain tumors developing after treatment of pituitary/sellar lesions have been reported, but it is unknown whether this is linked to any of the treatment modalities. Objective: To study the occurrence of malignant brain tumors and meningiomas in a large cohort of patients treated for

  16. Expression of c-myc and c-fos and binding sites for estradiol and progesterone in human pituitary tumors.

    Science.gov (United States)

    Machiavelli, G A; Rivolta, C M; Artese, R; Basso, A; Burdman, J A

    1998-12-01

    We studied the concentration of mRNA from the oncogenes c-myc and c-fos in human pituitary adenomas by Northern blot hybridization (35 somatotrophinomas, 9 prolactinomas, 21 nonsecreting and 3 adrenocorticotrophinomas). The concentration of estrogens and progesterone receptors was also investigated. The levels of c-myc and c-fos mRNA was higher in nonsecreting tumors which were generally the largest and had a higher percentage of recurrence after surgery than the other groups. High concentration of estrogen receptors was observed in tumors derived from cells which are normally the target of this hormone, mainly prolactinomas. They were also present in somatotrophic and nonsecreting adenomas, related to the presence of prolactin or gonadotrophin cells in these tumors. The presence of estrogen receptors indicates that the tumor cells maintain their differentiation and a good prognosis as is the case for prolactinomas. We did not find any relationship between estrogen receptors and the concentration of c-myc and c-fos oncogenes. Larger adenomas (mainly nonsecreting) had higher levels of c-myc and c-fos mRNA than the other tumors and they had an important percentage of recurrence after surgery. It is clear that tumor size is related to the outcome after surgery and that nonsecreting adenomas are usually large because of the late diagnosis. However two large somatotrophinomas with extrasellar expansion also had overexpression of both oncogenes and both relapsed after surgery.

  17. Dependence of the risk of encephalopathy on the radiotherapy volume after combined surgery and radiotherapy of invasive pituitary tumors

    International Nuclear Information System (INIS)

    Rauhut, F.; Stolke, D.; Stuschke, M.; Sack, H.

    2002-01-01

    The effectiveness of radiotherapy in reducing tumor recurrence of pituitary adenomas is well documented. On the other hand, the risk of side effects to the surrounding central nervous system normal tissue should not be underestimated. This retrospective study includes 58 patients with subtotally resected pituitary tumors. Photon from a 5,7 MV linear accelerator of a 60 cobalt unit with a source-isocenter distance of 80 cm were used throughout for treatment. The doses per fraction ranged from 45 Gy to 60 Gy. For a direct comparison of the different fractionation schedules, the biological effective total dose with 2 Gy per fraction was calculated for all the different application schemes with doses per fraction longer or smaller than 2 Gy. To do this, a fractionation sensitivity of the normal cerebral tissue by an □/□ value of 2 Gy was assumed. Encephalopathy developed in 17 cases (28 percentage) after follow-up times of more than 5 years. Pathological CT- or MRI-findings were seen in 13 cases. Two factors were important for the genesis of radiogenic encephalopathy: 1. Multivariate analysis revealed that the risk of encephalopathy was associated with the radiation volume. 2. The location of the upper field border line was the strongest prognostic factor associated with the risk of encephalopathy (p < 0.05). (author)

  18. Occurrence of FSH, inhibin and other hypothalamic-pituitary-intestinal hormones in normal fertility, subfertility, and tumors of human testes.

    Science.gov (United States)

    Mehta, M K; Garde, S V; Sheth, A R

    1995-01-01

    To compare the distribution of peptide hormones in presumably normal human testicular tissues and specimens exhibiting any of five pathologies. Biopsies from patients having testicular malfunctions were prepared as sections and specifically immunohistochemically stained for inhibin, FSH, serotonin, AUP, and oxytocin. Immunocytochemical studies revealed the presence of various hypophysial-pituitary-intestinal hormones, viz., FSH, inhibin, arginine vasopressin (AVP), calcitonin, serotonin, oxytocin, adrenocorticotropin (ACTH), gastrin, secretin, and somatostatin in human testicular biopsies exhibiting normal spermatogenesis, Sertoli-cell-only syndrome, spermatogenic arrest, Leydig cell hyperplasia, Leydig cell tumor, and seminoma. Intensity of immunostaining for all peptides except FSH was stronger in cases of subfertile as compared to normal testis. Intensity of immunostaining with inhibin was maximum in Leydig cell tumor. These regulatory peptides may be involved in the pathophysiology of the testes.

  19. Long-term results of radiotherapy for pituitary adenomas. Evaluation of tumor control and hypopituitarism after radiotherapy

    International Nuclear Information System (INIS)

    Tsuchida, Emiko; Sakai, Kunio; Matsumoto, Yasuo; Sugita, Tadashi; Sasamoto, Ryuta

    1999-01-01

    To evaluate the results of conventional radiotherapy for pituitary adenomas assessed with computed tomography (CT) or magnetic resonance imaging (MRI). Endpoints include tumor control, normalization of hormone levels in functioning adenomas, and hypopituitarism after radiotherapy as an adverse effect. Forty-two patients were treated with radiotherapy from 1982 to 1995 at Niigata University Hospital. Forty patients were irradiated after surgery because of residual adenomas in 33 patients and tumor regrowth in 7 patients. One patient was treated with radiotherapy alone, and the remaining 1 patient was treated with preoperative radiotherapy. Tumor size and extension were evaluated using CT or MRI, and all tumors were macroadenomas. They consisted of 18 non-functioning and 24 functioning adenomas (growth hormone (GH)-secreting: 11, prolactinomas: 7, concomitant GH and prolactin (PRL)-secreting: 5, gonadotropin-secreting: 1). Treatment was given in 200 cGy daily fraction size and a total dose of 50 Gy was given to most patients. Sixteen patients with GH- and/or PRL-secreting adenomas received bromocriptine. Tumor progression was determined by increase in tumor size as shown by CT or MRI. Hypopituitarism after radiotherapy was evaluated using the functions of corticotropin (ACTH), thyrotropin (TSH), and gonadotropin. Median follow-up time from the end of radiotherapy was 103 months. Tumor progression occurred in 2 out of 42 patients and 10-year progression-free rate for all patients was 93.7%. Normalization of GH levels was obtained in 12 of 16 GH-secreting adenomas with a mean time of 27 months after radiotherapy, and 9 of 12 PRL-secreting adenomas achieved normalization of PRL levels with a mean time of 34 months. One gonadotropin-secreting adenoma achieved normalization of gonadotropin level at 21 months after radiotherapy. The incidence of hypopituitarism after radiotherapy increased with time, and cumulative risk of deficiencies of ACTH, TSH, and gonadotropin at 10

  20. Long-term follow-up of patients with pituitary macroadenomas after postoperative radiation therapy. Analysis of tumor control and functional outcome

    Energy Technology Data Exchange (ETDEWEB)

    Langsenlehner, T.; Jakse, G.; Kapp, K.S.; Mayer, R. [Medical Univ. of Graz (Austria). Dept. of Therapeutic Radiology and Oncology; Stiegler, C. [Medical Univ. of Graz (Austria). Div. of Endocrinology and Nuclear Medicine; Quehenberger, F. [Medical Univ. of Graz (Austria). Inst. for Medical Informatics, Statistics and Documentation; Feigl, G.C. [Regensburg Univ. (Germany). Dept. of Neurosurgery; Mokry, M. [Medical Univ. of Graz (Austria). Dept. of Neurosurgery; Langsenlehner, U. [Medical Univ. of Graz (Austria). Div. of Oncology

    2007-05-15

    Purpose: Evaluation of long-term tumor control, normalization of hormonal hypersecretion, including incidence and time course of pituitary dysfunction following postoperative radiotherapy of pituitary macroadenomas. Patients and Methods: In a retrospective study, the data of 87 patients with pituitary macroadenomas (61 non-secreting adenomas, 26 secreting adenomas) treated between 1984 and 1994 were analyzed. All patients underwent surgery and received postoperative external-beam radiotherapy with a mean dose of 50.4 Gy (range 46-54 Gy). Results: After a follow-up of 15 years the local tumor control rate achieved was 93.0% for non-secreting adenomas and 100% for secreting adenomas, respectively. Normalization of endocrine hypersecretion was noted in 24 of 26 patients (92%). Detailed endocrinological follow-up data were analyzed by an experienced endocrinologist in 77 patients. After a median follow-up of 10.54 years (mean 10.22; range 1.39-20.75 years), in 75 of 77 patients (97%) a hypopituitarism was observed (partial hypopituitarism, n = 28 [36%], panhypopituitarism, n = 47 [61%]), and 68 out of 77 patients (88%) showed evidence of radiotherapy-induced pituitary disorders. The somatotropic function was most commonly affected, followed by gonadal, thyroid and adrenal function. The gonadal axis showed to be the first to be disturbed. 67 patients (87%) required a hormone replacement therapy. Conclusion: Radiotherapy after pituitary surgery is highly effective in reducing hormonal hypersecretion and preventing recurrences of pituitary adenomas. However, pituitary insufficiencies are commonly observed after radiotherapy requiring a close follow-up to ensure timely diagnosis of pituitary dysfunction and an early inception of hormone replacement therapy. (orig.)

  1. Long-term follow-up of patients with pituitary macroadenomas after postoperative radiation therapy. Analysis of tumor control and functional outcome

    International Nuclear Information System (INIS)

    Langsenlehner, T.; Jakse, G.; Kapp, K.S.; Mayer, R.; Stiegler, C.; Quehenberger, F.; Feigl, G.C.; Mokry, M.; Langsenlehner, U.

    2007-01-01

    Purpose: Evaluation of long-term tumor control, normalization of hormonal hypersecretion, including incidence and time course of pituitary dysfunction following postoperative radiotherapy of pituitary macroadenomas. Patients and Methods: In a retrospective study, the data of 87 patients with pituitary macroadenomas (61 non-secreting adenomas, 26 secreting adenomas) treated between 1984 and 1994 were analyzed. All patients underwent surgery and received postoperative external-beam radiotherapy with a mean dose of 50.4 Gy (range 46-54 Gy). Results: After a follow-up of 15 years the local tumor control rate achieved was 93.0% for non-secreting adenomas and 100% for secreting adenomas, respectively. Normalization of endocrine hypersecretion was noted in 24 of 26 patients (92%). Detailed endocrinological follow-up data were analyzed by an experienced endocrinologist in 77 patients. After a median follow-up of 10.54 years (mean 10.22; range 1.39-20.75 years), in 75 of 77 patients (97%) a hypopituitarism was observed (partial hypopituitarism, n = 28 [36%], panhypopituitarism, n = 47 [61%]), and 68 out of 77 patients (88%) showed evidence of radiotherapy-induced pituitary disorders. The somatotropic function was most commonly affected, followed by gonadal, thyroid and adrenal function. The gonadal axis showed to be the first to be disturbed. 67 patients (87%) required a hormone replacement therapy. Conclusion: Radiotherapy after pituitary surgery is highly effective in reducing hormonal hypersecretion and preventing recurrences of pituitary adenomas. However, pituitary insufficiencies are commonly observed after radiotherapy requiring a close follow-up to ensure timely diagnosis of pituitary dysfunction and an early inception of hormone replacement therapy. (orig.)

  2. Differential expression of the neural cell adhesion molecule NCAM 140 in human pituitary tumors

    OpenAIRE

    Aletsee-Ufrecht, M. C.; Langley, O. K.; Gratzl, O.; Gratzl, Manfred

    1990-01-01

    We have analyzed the expression of the intracellular marker protein neuron specific enolase (NSE), synaptophysin (SYN) and of the cell surface marker NCAM (neural cell adhesion molecule) in both normal human hypophysis and in pituitary adenomas in order to explore their potential use as diagnostic tools. All adenomas (4 prolactinomas, 3 growth hormone (GH) producing adenomas and 4 inactive adenomas) showed SYN and NSE immunoreactivity on tissue sections and this was confirmed by immunoblots. ...

  3. Methods for measuring shrinkage

    OpenAIRE

    Chapman, Paul; Templar, Simon

    2006-01-01

    This paper presents findings from research amongst European grocery retailers into their methods for measuring shrinkage. The findings indicate that: there is no dominant method for valuing or stating shrinkage; shrinkage in the supply chain is frequently overlooked; data is essential in pinpointing where and when loss occurs and that many retailers collect data at the stock-keeping unit (SKU) level and do so every 6 months. These findings reveal that it is difficult to benc...

  4. Distinct spontaneous shrinkage of a sporadic vestibular schwannoma

    DEFF Research Database (Denmark)

    Huang, Xiaowen; Cayé-Thomasen, Per; Stangerup, Sven-Eric

    2013-01-01

    on "shrinkage" or "negative growth" or "regression" or "involution" of the tumor were selected, and the contents on the rate, extent and mechanism of spontaneous tumor shrinkage were extracted and reviewed. The reported rate of spontaneous shrinkage of vestibular schwannoma is 5-10% of patients managed......We present a case with outspoken spontaneous vestibular schwannoma shrinkage and review the related literature. The patient was initially diagnosed with a left-sided, intrameatal vestibular schwannoma, which subsequently grew into the cerebello-pontine angle (CPA), followed by total shrinkage...... of the CPA component without any intervention over a 12-year observation period. The literature on spontaneous tumor shrinkage was retrieved by searching the subject terms "vestibular schwannoma, conservative management" in PubMed/MEDLINE database, without a time limit. Of the published data, the articles...

  5. Lack of tumor reduction in hyperprolactinemic women with extrasellar macroadenomas treated with bromocriptine

    Energy Technology Data Exchange (ETDEWEB)

    Boulanger, C.M.; Mashchak, C.A.; Chang, R.J.

    1985-10-01

    Three patients with hyperprolactinemia and large extrasellar pituitary macroadenomas were treated with bromocriptine, 10 mg daily, for 8 weeks. In spite of correction of their amenorrhea, galactorrhea, and hyperprolactinemia, radiologic evaluation by CT scan failed to show evidence of tumor shrinkage. After surgical resection, histologic examination revealed that PRL-secreting cells comprised only a small portion of the tumor cell population in two patients and in the third patient were completely absent. These cases illustrate that large nonfunctional pituitary tumors may mimic signs and symptoms of a prolactinoma and stress the importance of adequate radiologic evaluation during medical management. 8 references, 3 figures.

  6. Lack of tumor reduction in hyperprolactinemic women with extrasellar macroadenomas treated with bromocriptine

    International Nuclear Information System (INIS)

    Boulanger, C.M.; Mashchak, C.A.; Chang, R.J.

    1985-01-01

    Three patients with hyperprolactinemia and large extrasellar pituitary macroadenomas were treated with bromocriptine, 10 mg daily, for 8 weeks. In spite of correction of their amenorrhea, galactorrhea, and hyperprolactinemia, radiologic evaluation by CT scan failed to show evidence of tumor shrinkage. After surgical resection, histologic examination revealed that PRL-secreting cells comprised only a small portion of the tumor cell population in two patients and in the third patient were completely absent. These cases illustrate that large nonfunctional pituitary tumors may mimic signs and symptoms of a prolactinoma and stress the importance of adequate radiologic evaluation during medical management. 8 references, 3 figures

  7. Relative potencies of the somatostatin analogs octreotide, BIM-23014, and RC-160 on the inhibition of hormone release by cultured human endocrine tumor cells and normal rat anterior pituitary cells

    NARCIS (Netherlands)

    L.J. Hofland (Leo); P.M. van Koetsveld (Peter); M. Waaijers (Marlijn); J. Zuyderwijk; S.W.J. Lamberts (Steven)

    1994-01-01

    textabstractIn the present study we investigated the effects of the somatostatin (SS) analogs octreotide, RC-160, and BIM-23014 on GH release by cultured cells of human GH-secreting pituitary tumors, in normal rat anterior pituitary cells, and on gastrin release by

  8. Effects of cysteamine on pituitary, MTTW15 tumor, and serum prolactin levels measured by rat lymphoma cell bioassay and radioimmunoassay

    International Nuclear Information System (INIS)

    Parsons, J.A.; Peterson, E.K.; Hartfel, M.A.

    1984-01-01

    Cysteamine (CSH), a sulfhydryl compound, reduces both serum and anterior pituitary (AP) PRL measured by RIA. We have used the Nb2 lymphoma cell bioassay (BIO) for PRL to evaluate possible CSH-related changes in PRL levels in sera and tissues of male and MtTW15 mammosomatotropic tumor-bearing female rats. Experimental animals received a single sc injection of CSH (300 mg/kg), and samples were collected 0.5-24 h later. Since CSH and serum from CSH rats were toxic in BIO, samples were dialyzed before assay. All samples were evaluated for PRL and GH by RIA as well. A significant decrease (P less than 0.05) in BIO serum PRL was evident in male rats 0.5 h after CSH; levels remained low for 24 h. Serum PRL by RIA was significantly depressed at 4 h but not at 0.5 h or 24 h. PRL in AP extracts was decreased (60-90%) at all times by BIO and RIA. Significant decreases of BIO- and RIA-detectable PRL were recorded in serum and tissues (AP and tumors) at 4 h in tumor rats. Sequentially bled (0.5-4 h) CSH-treated tumor-bearing rats showed 50% and 80% reductions in serum PRL at 1 and 4 h by both BIO and RIA. CSH had no effect on GH levels in sera and tissues of any animal studied at any time interval. Our results substantiate earlier reports on CSH-induced decreases in RIA-detectable PRL. They show that such changes cannot be attributed to assay effects alone, as significant decreases in circulating and stored PRL (both AP and tumor) were evident by BIO. Results with tissue extracts were the most dramatic. They suggest an action of CSH or a metabolic intermediate with stored PRL which reduces both extractable PRL and hormone release. Such an effect of CSH on PRL extraction has been suggested by others. Whatever the mechanism, it appears to be relatively specific, since GH cells were not affected

  9. Short-term preoperative octreotide treatment for TSH-secreting pituitary adenoma.

    Science.gov (United States)

    Fukuhara, Noriaki; Horiguchi, Kentaro; Nishioka, Hiroshi; Suzuki, Hisanori; Takeshita, Akira; Takeuchi, Yasuhiro; Inoshita, Naoko; Yamada, Shozo

    2015-01-01

    Preoperative control of hyperthyroidism in patients with TSH-secreting pituitary adenomas (TSHoma) may avoid perioperative thyroid storm. Perioperative administration of octreotide may control hyperthyroidism, as well as shrink tumor size. The effects of preoperative octreotide treatment were assessed in a large number of patients with TSHomas. Of 81 patients who underwent surgery for TSHoma at Toranomon Hospital between January 2001 and May 2013, 44 received preoperative short-term octreotide. After excluding one patient because of side effects, 19 received octreotide as a subcutaneous injection, and 24 as a long-acting release (LAR) injection. Median duration between initiation of octreotide treatment and surgery was 33.5 days. Octreotide normalized free T4 in 36 of 43 patients (84%) and shrank tumors in 23 of 38 (61%). Length of octreotide treatment did not differ significantly in patients with and without hormonal normalization (p=0.09) and with and without tumor shrinkage (p=0.84). Serum TSH and free T4 concentrations, duration of treatment, incidence of growth hormone (GH) co-secretion, results of octreotide loading tests, form of administration (subcutaneous injection or LAR), tumor volume, and tumor consistency did not differ significantly in patients with and without hormonal normalization and with and without tumor shrinkage. Short-term preoperative octreotide administration was highly effective for TSHoma shrinkage and normalization of excess hormone concentrations, with tolerable side effects.

  10. Synergistic Inhibition of Delayed Rectifier K+ and Voltage-Gated Na+ Currents by Artemisinin in Pituitary Tumor (GH3) Cells.

    Science.gov (United States)

    So, Edmund Cheung; Wu, Sheng-Nan; Wu, Ping-Ching; Chen, Hui-Zhen; Yang, Chia-Jung

    2017-01-01

    Artemisinin (ART) is an anti-malarial agent reported to influence endocrine function. Effects of ART on ionic currents and action potentials (APs) in pituitary tumor (GH3) cells were evaluated by patch clamp techniques. ART inhibited the amplitude of delayed-rectifier K+ current (IK(DR)) in response to membrane depolarization and accelerated the process of current inactivation. It exerted an inhibitory effect on IK(DR) with an IC50 value of 11.2 µM and enhanced IK(DR) inactivation with a KD value of 14.7 µM. The steady-state inactivation curve of IK(DR) was shifted to hyperpolarization by 10 mV. Pretreatment of chlorotoxin (1 µM) or iloprost (100 nM) did not alter the magnitude of ART-induced inhibition of IK(DR) in GH3 cells. ART also decreased the peak amplitude of voltage-gated Na+ current (INa) with a concentration-dependent slowing in inactivation rate. Application of KMUP-1, an inhibitor of late INa, was effective at reversing ART-induced prolongation in inactivation time constant of INa. Under current-clamp recordings, ART alone reduced the amplitude of APs and prolonged the duration of APs. Under ART exposure, the inhibitory actions on both IK(DR) and INa could be a potential mechanisms through which this drug influences membrane excitability of endocrine or neuroendocrine cells appearing in vivo. © 2017 The Author(s). Published by S. Karger AG, Basel.

  11. Sellar plasmacytoma presenting with symptoms of anterior pituitary dysfunction

    Directory of Open Access Journals (Sweden)

    Ana G Ferreira

    2017-11-01

    Full Text Available Sellar plasmacytomas are rare and the differential diagnosis with non-functioning pituitary adenomas might be difficult because of clinical and radiological resemblance. They usually present with neurological signs and intact anterior pituitary function. Some may already have or eventually progress to multiple myeloma. We describe a case associated with extensive anterior pituitary involvement, which is a rare form of presentation. A 68-year-old man was referred to our Endocrinology outpatient clinic due to gynecomastia, reduced libido and sexual impotence. Physical examination, breast ultrasound and mammography confirmed bilateral gynecomastia. Blood tests revealed slight hyperprolactinemia, low testosterone levels, low cortisol levels and central hypothyroidism. Sellar MRI showed a heterogeneous sellar mass (56 × 60 × 61 mm, initially suspected as an invasive macroadenoma. After correcting the pituitary deficits with hydrocortisone and levothyroxine, the patient underwent transsphenoidal surgery. Histological examination revealed a plasmacytoma and multiple myeloma was ruled out. The patient was unsuccessfully treated with radiation therapy (no tumor shrinkage. Myeloma ultimately developed, with several other similar lesions in different locations. The patient was started on chemotherapy, had a bone marrow transplant and is now stable (progression free on lenalidomide and dexamethasone. The presenting symptoms and panhypopituitarism persisted, requiring chronic replacement treatment with levothyroxine, hydrocortisone and testosterone.

  12. Contemporary indications for transsphenoidal pituitary surgery.

    Science.gov (United States)

    Miller, Brandon A; Ioachimescu, Adriana G; Oyesiku, Nelson M

    2014-12-01

    To analyze current indications for transsphenoidal pituitary surgery. The current literature regarding transsphenoidal surgery for all subtypes of pituitary adenomas and other sellar lesions was examined. Alternate approaches for pituitary surgery were also reviewed. Transsphenoidal surgery continues to be the mainstay of surgical treatment for pituitary tumors, and has good outcomes in experienced hands. Pre- and postoperative management of pituitary tumors remains an important part of the treatment of patients with pituitary tumors. Even as medical and surgical treatment for pituitary tumors evolves, transsphenoidal surgery remains a mainstay of treatment. Outcomes after transshenoidal surgery have improved over time. Neurosurgeons must be aware of the indications, risks and alternatives to transsphenoidal pituitary surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. SUNCT syndrome associated with pituitary tumor: case report Síndrome SUNCT associada a tumor de hipófise: relato de caso

    Directory of Open Access Journals (Sweden)

    Pedro A.S. Rocha Filho

    2006-06-01

    Full Text Available For twelve years, the subject of this report, a 38-year-old man, presented a clinical condition compatible with the SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing syndrome. He presented a stabbing and intense daily pain located in the left pre-auricular and temporal regions. Each of these intense pain attacks lasted around one minute and presented a frequency of two to eight times per day. The pain was associated with ipsilateral lacrimation, conjunctival injection and rhinorrhea. MRI revealed a pituitary tumor with little suprasellar extent. The subject’s serial assays of prolactin, GH, TSH and ACTH were within normal levels. Following transsphenoidal hypophysectomy, with complete removal of the tumor, the subject no more presented pain. The pathological diagnosis was non-secreting adenoma. Fourteen months after the surgery, he remains symptom-free.O paciente relatado neste artigo apresentou uma condição clínica compatível com síndrome SUNCT (cefaléia de curta duração, unilateral, neuralgiforme com hiperemia conjuntival e lacrimejamento. Ele referia dor diária, intensa, em facada, localizada na região pré-auricular e temporal esquerdas. Cada ataque de dor permanecia por cerca de um minuto, com freqüência de duas a oito vezes por dia. A dor se acompanhava de lacrimejamento ipsolateral, congestão conjuntival e rinorréia. A RM mostrou um tumor de hipófise com pouca extensão suprasselar. Dosagens de prolactina, GH, TSH e ACTH estavam em níveis normais. Foi então submetido a hipofisectomia transesfenoidal com remoção completa do tumor após o que a dor cessou completamente. O diagnóstico anátomo-patológico foi adenoma não secretor. Quatorze meses após a cirurgia, o paciente permanecia livre de dor.

  14. Selective use of peri-operative steroids in pituitary tumor surgery: escape from dogma

    Directory of Open Access Journals (Sweden)

    Jacqueline Marie Regan

    2013-03-01

    Full Text Available Objective: Traditional neurosurgical practice calls for administration of peri-operative stress-dose steroids for sellar-suprasellar masses undergoing operative treatment. This practice is considered critical to prevent peri-operative complications associated with hypoadrenalism, such as hypotension and circulatory collapse. However, stress-dose steroids complicate the management of these patients. It has been our routine practice to use stress steroids during surgery only if the patient has clinical or biochemical evidence of hypocortisolism pre-operatively. We wanted to be certain that this practice was safe.Methods: We present our retrospective analysis from a consecutive series of 114 operations in 109 patients with sellar and/or suprasellar tumors, the majority of whom were managed without empirical stress-dose steroid coverage. Only patients who were hypoadrenal pre-operatively or who had suffered apoplexy were given stress dose coverage during surgery. We screened for biochemical evidence of hypoadrenalism as a result of surgery by measuring immediate post-operative AM serum cortisol levels.Results: There were no adverse events related to the selective use of cortisol replacement in this patient population. Conclusions: Our experience demonstrates that selective use of corticosteroid replacement is safe; it simplifies the management of the patients, and has advantages over empiric dogmatic steroid coverage.

  15. Alteration of Pituitary Tumor Transforming Gene-1 Regulates Trophoblast Invasion via the Integrin/Rho-Family Signaling Pathway.

    Directory of Open Access Journals (Sweden)

    Seung Mook Lim

    Full Text Available Trophoblast invasion ability is an important factor in early implantation and placental development. Recently, pituitary tumor transforming gene 1 (PTTG1 was shown to be involved in invasion and proliferation of cancer. However, the role of PTTG1 in trophoblast invasion remains unknown. Thus, in this study we analyzed PTTG1 expression in trophoblasts and its effect on trophoblast invasion activity and determined the mechanism through which PTTG1 regulates trophoblast invasion. Trophoblast proliferation and invasion abilities, regardless of PTTG1 expression, were analyzed by quantitative real-time polymerase chain reaction, fluorescence-activated cell sorting analysis, invasion assay, western blot, and zymography after treatment with small interfering RNA against PTTG1 (siPTTG1. Additionally, integrin/Rho-family signaling in trophoblasts by PTTG1 alteration was analyzed. Furthermore, the effect of PTTG1 on trophoblast invasion was evaluated by microRNA (miRNA mimic and inhibitor treatment. Trophoblast invasion was significantly reduced through decreased matrix metalloproteinase (MMP-2 and MMP-9 expression when PTTG1 expression was inhibited by siPTTG1 (p < 0.05. Furthermore, knockdown of PTTG1 increased expression of integrin alpha 4 (ITGA4, ITGA5, and integrin beta 1 (ITGB1; otherwise, RhoA expression was significantly decreased (p < 0.05. Treatment of miRNA-186-5p mimic and inhibitor controlled trophoblast invasion ability by altering PTTG1 and MMP expression. PTTG1 can control trophoblast invasion ability via regulation of MMP expression through integrin/Rho-family signaling. In addition, PTTG1 expression and its function were regulated by miRNA-186-5p. These results help in understanding the mechanism through which PTTG1 regulates trophoblast invasion and thereby implantation and placental development.

  16. Diagnosis and treatment of pituitary adenomas.

    Science.gov (United States)

    Chanson, P; Salenave, S

    2004-12-01

    Pituitary tumors cause symptoms by secreting hormones (prolactin, PRL, responsible for amenorrhea-galactorrhea in women and decreased libido in men; growth hormone, GH, responsible for acromegaly; adrenocorticotropic hormone, ACTH, responsible for Cushing's syndrome; thyroid-stimulating hormone, TSH, responsible for hyperthyroidism), depressing the secretion of hormones (hypopituitarism), or by mass-related effects (headaches, visual field abnormalities...). All patients with pituitary tumors should be evaluated for gonadal, thyroid and adrenal function as well as PRL and GH secretion. Specific stimulation and suppression tests for pituitary hormones are performed in selected situations for detecting the type of hypersecretion or the response to treatment. Imaging procedures (mainly magnetic resonance imaging, MRI, nowadays) determine the presence, size and extent of the lesion. The classification of pituitary tumors is based on the staining properties of the cell cytoplasm viewed by light microscopy and immunocytochemistry revealing the secretory pattern of the adenoma. Treatment of pituitary adenomas consists of surgery (performed in more than 99% of cases via a transphenoidal route) and radiotherapy, generally fractionated or, in selected cases, using stereotactic techniques such as gamma-knife. The availability of medical treatment (dopamine, DA, agonists, somatostatin analogs, GH-receptor antagonists...) has profoundly modified the indications of radiotherapy, drugs being now generally used as a second-line treatment, after surgery (or even as first-line treatment). Based on the results of the different treatment modalities for each type of pituitary adenoma, recommendations will be proposed. They may be summarized as follows. For treatment of GH-secreting adenomas, trans-sphenoidal surgery is the first-line therapy except when the macroadenoma is giant or if surgery is contra-indicated; postoperative radiation therapy (fractionated, or by gamma-knife) is

  17. Shrinkage Reducing Admixture for Concrete

    OpenAIRE

    ECT Team, Purdue

    2007-01-01

    Concrete shrinkage cracking is a common problem in all types of concrete structures, especially for structures and environments where the cracks are prevalent and the repercussions are most severe. A liquid shrinkage reducing admixture for concrete, developed by GRACE Construction Products and ARCO Chemical Company, that reduces significantly the shrinkage during concrete drying and potentially reduces overall cracking over time.

  18. Cure shrinkage in casting resins

    Energy Technology Data Exchange (ETDEWEB)

    Spencer, J. Brock [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-02-01

    A method is described whereby the shrinkage of a casting resin can be determined. Values for the shrinkage of several resin systems in frequent use by Sandia have been measured. A discussion of possible methods for determining the stresses generated by cure shrinkage and thermal contraction is also included.

  19. A case of coexistence of TSH/GH-secreting pituitary tumor and papillary thyroid carcinoma: Challenges in pathogenesis and management.

    Science.gov (United States)

    Kiatpanabhikul, Phatharaporn; Shuangshoti, Shanop; Chantra, Kraisri; Navicharern, Patpong; Kingpetch, Kanaungnit; Houngngam, Natnicha; Snabboon, Thiti

    2017-07-01

    Co-existence of thyrotropin/growth hormone-secreting pituitary adenoma with differentiated thyroid carcinoma is exceedingly rare, with less than 15 cases having been reported. Its clinical presentation and treatment strategy are challenging. We report a case of pituitary macroadenoma, with clinical syndromes of acromegaly and hyperthyroidism, and a thyroid nodule, with cytologically confirmed to be a papillary thyroid carcinoma. Clinical implications, focusing on the strategy for proper management, and possible pathogenesis were discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Stages of Pituitary Tumors

    Science.gov (United States)

    ... by surgery using one of the following operations: Transsphenoidal surgery : A type of surgery in which the instruments ... gland lies just above the sphenoid bone. Enlarge Transsphenoidal surgery. An endoscope and a curette are inserted through ...

  1. Pituitary tumor evaluation

    International Nuclear Information System (INIS)

    Albertson, B.; Binney, S.

    1995-01-01

    This paper describes research on the following: the structure of 10 B 10 -ovine corticotropin releasing hormone and 10 B 10 -growth hormone releasing hormone; the BNCT effect on AtT-20 cell 10 B 10 -CRH incubations in vitro; BNCT effects on GH 4 C 1 cell 10 B 10 growth hormone releasing factor incubation in vitro; and competitive inhibition of AtT-20 cell BNCT effect

  2. Dynamics of tissue shrinkage during ablative temperature exposures

    International Nuclear Information System (INIS)

    Rossmann, Christian; Haemmerich, Dieter; Garrett-Mayer, Elizabeth; Rattay, Frank

    2014-01-01

    There is a lack of studies that examine the dynamics of heat-induced shrinkage of organ tissues. Clinical procedures such as radiofrequency ablation, microwave ablation or high-intensity focused ultrasound, use heat to treat diseases such as cancer and cardiac arrhythmia. When heat is applied to tissues, shrinkage occurs due to protein denaturation, dehydration and contraction of collagen at temperatures greater 50 °C. This is particularly relevant for image-guided procedures such as tumor ablation, where pre- and post-treatment images are compared and any changes in dimensions must be considered to avoid misinterpretations of the treatment outcome. We present data from ex vivo, isothermal shrinkage tests in porcine liver tissue, where axial changes in tissue length were recorded during 15 min of heating to temperatures between 60 and 95 °C. A mathematical model was developed to accurately describe the time and temperature-dependent shrinkage behavior. The shrinkage dynamics had the same characteristics independent of temperature; the estimated relative shrinkage, adjusted for time since death, after 15 min heating to temperatures of 60, 65, 75, 85 and 95 °C, was 12.3, 13.8, 16.6, 19.2 and 21.7%, respectively. Our results demonstrate the shrinkage dynamics of organ tissues, and suggest the importance of considering tissue shrinkage for thermal ablative treatments. (paper)

  3. Influência dos níveis de prolactina e tamanho tumoral na função hipofisária pós-operatória em macroadenomas hipofisários clinicamente não-funcionantes Influence of hyperprolactinemia and tumoral size in the postoperative pituitary function in clinically nonfuncioning pituitary macroadenomas

    Directory of Open Access Journals (Sweden)

    Ana Luiza Vidal Fonseca

    2002-09-01

    Full Text Available OBJETIVO: Estudar a influência da hiperprolactinemia e de tamanho tumoral na função hipofisária em macroadenomas hipofisários clinicamente não funcionantes. MÉTODOS: Foram analisados 23 pacientes com macroadenomas hipofisários clinicamente não funcionantes, com exames de imagem (tomografia computadorizada ou ressonância magnética e dosagens hormonais basais; 16 tinham provas de função hipotálamo-hipofisária (megateste pré-operatórios. Todos os tumores tiveram diagnóstico histológico e em 17 foi realizado também estudo imuno-histoquímico para os hormônios adeno-hipofisários. A análise estatística foi feita por meio dos testes t de Student, qui-quadrado, exato de Fisher e de Mc Neman. O nível de significância adotado foi 5% (pOBJECTIVE: To study the influence of hyperprolactinemia and tumoral size in the pituitary function in clinically nonfuncioning pituitary macroadenomas. METHODS: Twenty three patients with clinically nonfuncioning pituitary macroadenomas were evaluated by image studies (computed tomography or magnetic resonance and basal hormonal level; 16 had preoperative hypothalamus-hypophysial function tests (megatests. All tumors had histological diagnosis and in seventeen immunohistochemical study for adenohypophysial hormones was also performed. Student's t test, chi square test, exact test of Fisher and Mc Neman test were used for the statistics analysis . The level of significance adopted was 5% (p<0.05. RESULTS: Tumoral diameter varied of 1.1 to 4.7 cm (average=2.99 cm ± 1.04. In the preoperative, 5 (21.7% patients did not show laboratorial hormonal deficit, 9 (39.1% developed hyperprolactinemia, 13 (56,5% normal levels of prolactin (PRL and 1 (4.3% subnormal; 18 (78.3% patients developed hypopituitarism (4 pan-hypopituitarism. Nineteen patients (82.6% underwent transsfenoidal approach, 3 (13% craniotomy and 1 (4.4% combined access. Only 6 patients had total tumoral resection. Of the 17 immunohistochemical

  4. Multimodal Navigation in Endoscopic Transsphenoidal Resection of Pituitary Tumors Using Image-Based Vascular and Cranial Nerve Segmentation: A Prospective Validation Study.

    Science.gov (United States)

    Dolati, Parviz; Eichberg, Daniel; Golby, Alexandra; Zamani, Amir; Laws, Edward

    2016-11-01

    Transsphenoidal surgery (TSS) is the most common approach for the treatment of pituitary tumors. However, misdirection, vascular damage, intraoperative cerebrospinal fluid leakage, and optic nerve injuries are all well-known complications, and the risk of adverse events is more likely in less-experienced hands. This prospective study was conducted to validate the accuracy of image-based segmentation coupled with neuronavigation in localizing neurovascular structures during TSS. Twenty-five patients with a pituitary tumor underwent preoperative 3-T magnetic resonance imaging (MRI), and MRI images loaded into the navigation platform were used for segmentation and preoperative planning. After patient registration and subsequent surgical exposure, each segmented neural or vascular element was validated by manual placement of the navigation probe or Doppler probe on or as close as possible to the target. Preoperative segmentation of the internal carotid artery and cavernous sinus matched with the intraoperative endoscopic and micro-Doppler findings in all cases. Excellent correspondence between image-based segmentation and the endoscopic view was also evident at the surface of the tumor and at the tumor-normal gland interfaces. Image guidance assisted the surgeons in localizing the optic nerve and chiasm in 64% of cases. The mean accuracy of the measurements was 1.20 ± 0.21 mm. Image-based preoperative vascular and neural element segmentation, especially with 3-dimensional reconstruction, is highly informative preoperatively and potentially could assist less-experienced neurosurgeons in preventing vascular and neural injury during TSS. In addition, the accuracy found in this study is comparable to previously reported neuronavigation measurements. This preliminary study is encouraging for future prospective intraoperative validation with larger numbers of patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Tumorigenic potential of pituitary tumor transforming gene (PTTG in vivo investigated using a transgenic mouse model, and effects of cross breeding with p53 (+/− transgenic mice

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    Fong Miranda Y

    2012-11-01

    Full Text Available Abstract Background Pituitary tumor-transforming gene (PTTG is an oncogene that is overexpressed in variety of tumors and exhibits characteristics of a transforming gene. Previous transgenic mouse models to access the tumorigenic potential in the pituitary and ovary have resulted in dysplasia without formation of visible tumors, possibly due to the insufficient expression of PTTG. PTTG expression level is critical for ovarian tumorigenesis in a xenograft model. Therefore, the tumorigenic function of PTTG in vivo remains unclear. We generated a transgenic mouse that overexpresses PTTG driven by the CMV promoter to determine whether PTTG functions as a transforming oncogene that is capable of initiating tumorigenesis. Methods Transgenic animals were generated by microinjection of PTTG transgene into the male pronucleus of FVB 0.5 day old embryos. Expression levels of PTTG in tissues of transgenic animals were analyzed using an immunohistochemical analysis. H&E staining and immunohistostaining were performed to examine the type of tumor in transgenic and PTTG transgenic/p53+/- animals. Results PTTG transgenic offspring (TgPTTG were monitored for tumor development at various ages. H&E analysis was performed to identify the presence of cancer and hyperplastic conditions verified with the proliferation marker PCNA and the microvessel marker CD31. Immunohistochemistry was performed to determine transgene expression, revealing localization to the epithelium of the fallopian tube, with more generalized expression in the liver, lung, kidney, and spleen. At eight months of age, 2 out of 15 TgPTTG developed ovarian cancer, 2 out of 15 developed benign tumors, 2 out of 15 developed cervical dysplasia, and 3 out of 15 developed adenomyosis of the uterus. At ten months of age, 2 out of 10 TgPTTG developed adenocarcinoma of the ovary, 1 out of 10 developed a papillary serous adenocarcinoma, and 2 out of 10 presented with atypia of ovarian epithelial cells

  6. Regulation of hormone release by cultured cells from a thyrotropin-growth hormone-secreting pituitary tumor. Direct inhibiting effects of 3,5,3'-triiodothyronine and dexamethasone on thyrotropin secretion.

    Science.gov (United States)

    Lamberts, S W; Oosterom, R; Verleun, T; Krenning, E P; Assies, H

    1984-08-01

    The regulation of TSH and GH secretion was investigated in cultured tumor cells prepared from a mixed TSH/GH secreting pituitary tumor. The tumor tissue had been removed transsphenoidally from a patient with hyperthyroidism and inappropriately high serum TSH levels and acromegaly. TSH and GH secretion by cultured cells were stimulated in a parallel way by TRH (300 nM) and LHRH (50 nM), but were unaffected by bromocriptine (10 nM). Exposure of the tumor cells to dexamethasone (0.1 microM) or T3 (50 nM) had differential effects on hormone secretion. GH secretion was greatly stimulated by dexamethasone, but unaffected by T3. TSH secretion was inhibited both by T3 and by dexamethasone. So, T3 and glucocorticoids inhibit TSH release by the human pituitary tumor cells studied at least partly by means of a direct effect.

  7. Multimodal Navigation in Endoscopic Transsphenoidal Resection of Pituitary Tumors using Image-based Vascular and Cranial Nerve Segmentation: A Prospective Validation Study

    Science.gov (United States)

    Dolati, Parviz; Eichberg, Daniel; Golby, Alexandra; Zamani, Amir; Laws, Edward

    2016-01-01

    Introduction Transsphenoidal surgery (TSS) is a well-known approach for the treatment of pituitary tumors. However, lateral misdirection and vascular damage, intraoperative CSF leakage, and optic nerve and vascular injuries are all well-known complications, and the risk of adverse events is more likely in less experienced hands. This prospective study was conducted to validate the accuracy of image-based segmentation in localization of neurovascular structures during TSS. Methods Twenty-five patients with pituitary tumors underwent preoperative 3TMRI, which included thin-sectioned 3D space T2, 3D Time of Flight and MPRAGE sequences. Images were reviewed by an expert independent neuroradiologist. Imaging sequences were loaded in BrainLab iPlanNet (16/25 cases) or Stryker (9/25 cases) image guidance platforms for segmentation and pre-operative planning. After patient registration into the neuronavigation system and subsequent surgical exposure, each segmented neural or vascular element was validated by manual placement of the navigation probe on or as close as possible to the target. The audible pulsations of the bilateral ICA were confirmed using a micro-Doppler probe. Results Pre-operative segmentation of the ICA and cavernous sinus matched with the intra-operative endoscopic and micro-Doppler findings in all cases (Dice Similarity Coefficient =1). This information reassured the surgeons with regard to the lateral extent of bone removal at the sellar floor and the limits of lateral exploration. Excellent correspondence between image-based segmentation and the endoscopic view was also evident at the surface of the tumor and at the tumor-normal gland interfaces. This assisted in preventing unnecessary removal of the normal pituitary gland. Image-guidance assisted the surgeons in localizing the optic nerve and chiasm in 64% of the cases and the diaphragma sella in 52% of cases, which helped to determine the limits of upward exploration and to decrease the risk of CSF

  8. Radiosurgery for pituitary adenomas: evaluation of its efficacy and safety

    International Nuclear Information System (INIS)

    Castro, Douglas G; Cecílio, Soraya AJ; Canteras, Miguel M

    2010-01-01

    To assess the effects of radiosurgery (RS) on the radiological and hormonal control and its toxicity in the treatment of pituitary adenomas. Retrospective analysis of 42 patients out of the first 48 consecutive patients with pituitary adenomas treated with RS between 1999 and 2008 with a 6 months minimum follow-up. RS was delivered with Gamma Knife as a primary or adjuvant treatment. There were 14 patients with non-secretory adenomas and, among functioning adenomas, 9 were prolactinomas, 9 were adrenocorticotropic hormone-secreting and 10 were growth hormone-secreting tumors. Hormonal control was defined as hormonal response (decline of more than 50% from the pre-RS levels) and hormonal normalization. Radiological control was defined as stasis or shrinkage of the tumor. Hypopituitarism and visual deficit were the morbidity outcomes. Hypopituitarism was defined as the initiation of any hormone replacement therapy and visual deficit as loss of visual acuity or visual field after RS. The median follow-up was 42 months (6-109 months). The median dose was 12,5 Gy (9 - 15 Gy) and 20 Gy (12 - 28 Gy) for non-secretory and secretory adenomas, respectively. Tumor growth was controlled in 98% (41 in 42) of the cases and tumor shrinkage ocurred in 10% (4 in 42) of the cases. The 3-year actuarial rate of hormonal control and normalization were 62,4% and 37,6%, respectively, and the 5-year actuarial rate were 81,2% and 55,4%, respectively. The median latency period for hormonal control and normalization was, respectively, 15 and 18 months. On univariate analysis, there were no relationships between median dose or tumoral volume and hormonal control or normalization. There were no patients with visual deficit and 1 patient had hypopituitarism after RS. RS is an effective and safe therapeutic option in the management of selected patients with pituitary adenomas. The short latency of the radiation response, the highly acceptable radiological and hormonal control and absence of

  9. Radiosurgery for pituitary adenomas: evaluation of its efficacy and safety

    Directory of Open Access Journals (Sweden)

    Canteras Miguel M

    2010-11-01

    Full Text Available Abstract Object To assess the effects of radiosurgery (RS on the radiological and hormonal control and its toxicity in the treatment of pituitary adenomas. Methods Retrospective analysis of 42 patients out of the first 48 consecutive patients with pituitary adenomas treated with RS between 1999 and 2008 with a 6 months minimum follow-up. RS was delivered with Gamma Knife as a primary or adjuvant treatment. There were 14 patients with non-secretory adenomas and, among functioning adenomas, 9 were prolactinomas, 9 were adrenocorticotropic hormone-secreting and 10 were growth hormone-secreting tumors. Hormonal control was defined as hormonal response (decline of more than 50% from the pre-RS levels and hormonal normalization. Radiological control was defined as stasis or shrinkage of the tumor. Hypopituitarism and visual deficit were the morbidity outcomes. Hypopituitarism was defined as the initiation of any hormone replacement therapy and visual deficit as loss of visual acuity or visual field after RS. Results The median follow-up was 42 months (6-109 months. The median dose was 12,5 Gy (9 - 15 Gy and 20 Gy (12 - 28 Gy for non-secretory and secretory adenomas, respectively. Tumor growth was controlled in 98% (41 in 42 of the cases and tumor shrinkage ocurred in 10% (4 in 42 of the cases. The 3-year actuarial rate of hormonal control and normalization were 62,4% and 37,6%, respectively, and the 5-year actuarial rate were 81,2% and 55,4%, respectively. The median latency period for hormonal control and normalization was, respectively, 15 and 18 months. On univariate analysis, there were no relationships between median dose or tumoral volume and hormonal control or normalization. There were no patients with visual deficit and 1 patient had hypopituitarism after RS. Conclusions RS is an effective and safe therapeutic option in the management of selected patients with pituitary adenomas. The short latency of the radiation response, the highly

  10. Pituitary hyperplasia secondary to hypothyroidism in an adolescent

    International Nuclear Information System (INIS)

    Capiel, Carlos A. h; Bouzas, Carlos A.; Mondino, Ana

    2003-01-01

    We report a case of a 14 years old patient with growth arrest and laboratory evidence of hypothyroidism. MR revealed pituitary enlargement simulating macro adenoma. Thyroid replacement therapy resulted in regression of the pituitary size. Awareness of MR appearance of pituitary hyperplasia in children and juvenile patients with laboratory evidence of hypothyroidism might avoid misdiagnosis for pituitary tumor. (author)

  11. Regulation of the pituitary tumor transforming gene by insulin-like-growth factor-I and insulin differs between malignant and non-neoplastic astrocytes

    International Nuclear Information System (INIS)

    Chamaon, Kathrin; Kirches, Elmar; Kanakis, Dimitrios; Braeuninger, Stefan; Dietzmann, Knut; Mawrin, Christian

    2005-01-01

    The reasons for overexpression of the oncogene pituitary tumor transforming gene (PTTG) in tumors are still not fully understood. A possible influence of the insulin-like growth factor I (Igf-I) may be of interest, since enhanced Igf-I signalling was reported in various human tumors. We examined the influence of Igf-I and insulin on PTTG expression in human astrocytoma cells in comparison to proliferating non-neoplastic rat embryonal astrocytes. PTTG mRNA expression and protein levels were increased in malignant astrocytes treated with Igf-I or insulin, whereas in rat embryonic astrocytes PTTG expression and protein levels increased only when cells were exposed to Igf-I. Enhanced transcription did not occur after treatment with inhibitors of phosphoinositol-3-kinase (PI3K) and mitogen-activated protein kinase (MAPK), blocking the two basic signalling pathways of Igf-I and insulin. In addition to this transcriptional regulation, both kinases directly bind to PTTG, suggesting a second regulatory route by phosphorylation. However, the interaction of endogenous PTTG with MAPK and PI3K, as well as PTTG phosphorylation were independent from Igf-I or insulin. The latter results were also found in human testis, which contains high PTTG levels as well as in nonneoplastic astrocytes. This suggest, that PI3K and MAPK signalling is involved in PTTG regulation not only in malignant astrocytomas but also in non-tumorous cells

  12. GENERALIZED DOUBLE PARETO SHRINKAGE.

    Science.gov (United States)

    Armagan, Artin; Dunson, David B; Lee, Jaeyong

    2013-01-01

    We propose a generalized double Pareto prior for Bayesian shrinkage estimation and inferences in linear models. The prior can be obtained via a scale mixture of Laplace or normal distributions, forming a bridge between the Laplace and Normal-Jeffreys' priors. While it has a spike at zero like the Laplace density, it also has a Student's t -like tail behavior. Bayesian computation is straightforward via a simple Gibbs sampling algorithm. We investigate the properties of the maximum a posteriori estimator, as sparse estimation plays an important role in many problems, reveal connections with some well-established regularization procedures, and show some asymptotic results. The performance of the prior is tested through simulations and an application.

  13. Shift of the pituitary stalk in intrasellar pituitary adenomas

    International Nuclear Information System (INIS)

    Ito, Jusuke; Tokiguchi, Susumu; Nakamori, Akitoshi; Watanabe, Akira; Yokoyama, Motoharu.

    1982-01-01

    Fifty-one patients from a group of 344 patients undergoing the evaluation of intrasellar or parasellar tumors were diagnosed on CT as having an intrasellar pituitary adenoma. Axial transverse sections were performed at -10 0 to Reid's basal line, using 1.5-mm-thick slices and sagittal and coronal reformation. Of these 51 patients, 17 showed a shift of the pituitary stalk. The area where a tumor was thought to be located within the sella turcica on preoperative CT became defective on CT after transsphenoidal surgery in all cases. Histological verification was obtained in all cases. Also, the shift of the pituitary stalk was normalized or markedly improved after surgery in all cases. In functioning tumors, all cases except two showed an endocrinologically normal state or a marked improvement after transsphenoidal surgery. On the basis of the above-mentioned facts, it was concluded that the shift of the pituitary stalk in intrasellar pituitary adenomas indicated the evidence of a mass and its location in the sella turcica. However, a shift of the pituitary stalk was also observed under other conditions, such as empty sella and tuberculum sellae meningioma, and so it is not a pathognomonic finding in intrasellar pituitary adenomas. (author)

  14. Predictive Value of Early Tumor Shrinkage and Density Reduction of Lung Metastases in Patients With Metastatic Colorectal Cancer Treated With Regorafenib.

    Science.gov (United States)

    Vanwynsberghe, Hannes; Verbeke, Xander; Coolen, Johan; Van Cutsem, Eric

    2017-12-01

    The benefit of regorafenib in colorectal cancer is not very pronounced. At present, there is lack of predictive biological or radiological markers. We studied if density reduction or small changes in size of lung metastases could be a predictive marker. We retrospectively measured density in size of lung metastases of all patients included in the CORRECT and CONSIGN trials at our center. Contrast-enhanced CT scan at baseline and at week 8 were compared. Data of progressive-free survival and overall survival were collected from the CORRECT and CONSIGN trials. A significant difference in progressive-free survival was seen in 3 groups: response or stable disease in size (5.36 vs. 3.96 months), response in density (6.03 vs. 2.72 months), and response in corrected density (6.14 vs. 3.08 months). No difference was seen for response in size versus stable disease or progressive disease in size. For overall survival, a difference was observed in the same 3 groups: response or stable disease in size (9.89 vs. 6.44 months), response in density (9.59 vs. 7.04 months), and response in corrected density (9.09 vs. 7.16 months). No difference was seen for response in size versus stable disease or progressive disease in size. Density reduction in lung metastases might be a good predictive parameter to predict outcome for regorafenib. Early tumor progression might be a negative predictive factor. If further validated, density reduction and early tumor progression might be useful to ameliorate the cost-benefit of regorafenib. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Pituitary gigantism.

    Science.gov (United States)

    Lu, P W; Silink, M; Johnston, I; Cowell, C T; Jimenez, M

    1992-01-01

    A case of pituitary gigantism resulting from a pituitary adenoma which secreted growth hormone is described. The patient was successfully treated by surgery, which led to the normalisation of endogenous growth hormone secretion. An acceptable final height was achieved with high dose intramuscular testosterone treatment. Images Figure 1 PMID:1520009

  16. Pituitary gigantism.

    OpenAIRE

    Lu, P W; Silink, M; Johnston, I; Cowell, C T; Jimenez, M

    1992-01-01

    A case of pituitary gigantism resulting from a pituitary adenoma which secreted growth hormone is described. The patient was successfully treated by surgery, which led to the normalisation of endogenous growth hormone secretion. An acceptable final height was achieved with high dose intramuscular testosterone treatment.

  17. A pediatric case of pituitary macroadenoma presenting with pituitary apoplexy and cranial nerve involvement: case report

    OpenAIRE

    Özçetin, Mustafa; Karacı, Mehmet; Toroslu, Ertuğ; Edebali, Nurullah

    2016-01-01

    Pituitary adenomas usually arise from the anterior lobe of the pituitary gland and are manifested with hormonal disorders or mass effect. Mass effect usually occurs in nonfunctional tumors. Pituitary adenomas may be manifested with visual field defects or rarely in the form of total oculomotor palsy. Visual field defect is most frequently in the form of bitemporal hemianopsia and superior temporal defect. Sudden loss of vision, papilledema and ophthalmoplegia may be observed. Pituitary apople...

  18. HoxD10 gene delivery using adenovirus/adeno-associate hybrid virus inhibits the proliferation and tumorigenicity of GH4 pituitary lactotrope tumor cells

    International Nuclear Information System (INIS)

    Cho, Mi Ae; Yashar, Parham; Kim, Suk Kyoung; Noh, Taewoong; Gillam, Mary P.; Lee, Eun Jig; Jameson, J. Larry

    2008-01-01

    Prolactinoma is one of the most common types of pituitary adenoma. It has been reported that a variety of growth factors and cytokines regulating cell growth and angiogenesis play an important role in the growth of prolactinoma. HoxD10 has been shown to impair endothelial cell migration, block angiogenesis, and maintain a differentiated phenotype of cells. We investigated whether HoxD10 gene delivery could inhibit the growth of prolactinoma. Rat GH4 lactotrope tumor cells were infected with adenovirus/adeno-associated virus (Ad/AAV) hybrid vectors carrying the mouse HoxD10 gene (Hyb-HoxD10) or the β-galactosidase gene (Hyb-Gal). Hyb-HoxD10 expression inhibited GH4 cell proliferation in vitro. The expression of FGF-2 and cyclin D2 was inhibited in GH4 cells infected with Hyb-HoxD10. GH4 cells transduced with Hyb-HoxD10 did not form tumors in nude mice. These results indicate that the delivery of HoxD10 could potentially inhibit the growth of PRL-secreting tumors. This approach may be a useful tool for targeted therapy of prolactinoma and other neoplasms

  19. A Comparison of Dexmedetomidine and Clonidine in Attenuating the Hemodynamic Responses at Various Surgical Stages in Patients Undergoing Elective Transnasal Transsphenoidal Resection of Pituitary Tumors.

    Science.gov (United States)

    Jan, Summaira; Ali, Zulfiqar; Nisar, Yasir; Naqash, Imtiaz Ahmad; Zahoor, Syed Amer; Langoo, Shabir Ahmad; Azhar, Khan

    2017-01-01

    Transsphenoidal approach to pituitary tumors is a commonly performed procedure with the advantage of a rapid midline access to the sella with minimal complications. It may be associated with wide fluctuations in hemodynamic parameters due to intense noxious stimulus at various stages of the surgery. As duration of the surgery is short and the patients have nasal packs, it is prudent to use an anesthestic technique with an early predictable recovery. A total of 60 patients of either sex between 18 and 65 years of age, belonging to the American Society of Anesthesiologists I and II who were undergoing elective transnasal transsphenoidal pituitary surgery were chosen for this study. Patients were randomly allocated into two groups, Group C (clonidine) and Group D (dexmedetomidine), with each group consisting of 30 patients. Patients in Group C received 200 μg tablet of clonidine and those in Group D received a pantoprazole tablet as placebo at the same time. Patients in the Group D received an intravenous infusion of dexmedetomidine diluted in 50 ml saline (200 μg in 50 ml saline) 10 min before induction and patients in Group C received 0.9% normal saline (50 ml) as placebo. The hemodynamic variables (heart rate, mean arterial pressure) were noted at various stages of the surgery. Statistical analysis of the data was performed. A total of 60 patients were recruited. The mean age, sex, weight and duration of surgery among the two groups were comparable ( P > 0.05). Both dexmedetomidine and clonidine failed to blunt the increase in hemodynamic responses (heart rate and blood pressure) during intubation, nasal packing, speculum insertion and extubation. However when the hemodynamic response was compared between the patients receiving dexmedetomidine and clonidine it was seen that patients who received dexmedetomidine had a lesser increase in heart rate and blood pressure ( P < 0.05) when compared to clonidine. A continuous intravenous infusion of dexmedetomidine as

  20. Imaging of pediatric pituitary endocrinopathies

    Science.gov (United States)

    Chaudhary, Vikas; Bano, Shahina

    2012-01-01

    Accurate investigation of the hypothalamic-pituitary area is required in pediatric patients for diagnosis of endocrine-related disorders. These disorders include hypopituitarism, growth failure, diencephalic syndrome, delayed puberty, precocious puberty, diabetes insipidus, syndrome of inappropriate antidiuretic hormone (SIADH) secretion, and hyperpituitarism. Magnetic resonance imaging (MRI) is the modality of choice to visualize hypothalamic-pituitary axis and associated endocrinopathies. Neuroimaging can be normal or disclose abnormalities related to pituitary-hypothalamic axis like (i) congenital and developmental malformations; (ii) tumors; (iii) cystic lesions; and (iv) infectious and inflammatory conditions. Classical midline anomalies like septo-optic dysplasias or corpus callosum agenesis are commonly associated with pituitary endocrinopathies and also need careful evaluation. In this radiological review, we will discuss neuroendocrine disorders related to hypothalamic pituitary-axis. PMID:23087850

  1. Cirurgia da hipófise por via trans-esfenoidal sob controle radiofluoroscópico e microdissecção novo tratamento da retinopatia diabética, tumores selares e neoplasias endocrinodependentes The surgery of the pituitary gland using a transphenoidal approach under radiofluoroscopic control and microdisection: a new treatment for diabetic retinopathy, pituitary tumors and endocrinodependent growths

    Directory of Open Access Journals (Sweden)

    Jules Hardy

    1968-03-01

    Full Text Available É apresentada nova técnica para a ablação total ou seletiva da hipófise utilizando via de acesso trans-esfenoidal, controle radiofluoroscópico e microdissecção, com traumatismo desprezível às estruturas circunvizinhas. Os autores comentam as aplicações do método à prática neurocirúrgica, relatando parte de uma série de mais 140 casos já operados. São discutidos os resultados obtidos no tratamento de 17 casos de retinopatia diabética, em 11 dos quais apenas o lobo anterior da hipófise foi removido, assim como aqueles obtidos na exérese de 20 casos de tumores selares. As indicações da hipofisectomia por via trans-esfenoidal no controle da sintomatologia das neoplasias endòcrinodependentes é estudada à luz dos resultados obtidos em 17 casos, sendo os resultados comparados com casos nos quais foi feita a implantação selar de ítrio90. As complicações operatorias em relação às três entidades nosológicas acima estudadas são também analisadas. Os autores salientam que a técnica descrita constitui, no presente estado das técnicas neurocirúrgicas utilizadas para a produção de uma insuficiência hipofisária duradoura, a intervenção de escolha.A new neurosurgical technique for the partial or total exéresis of the pituitary gland, using a transphenoidal approach under radiofluoroscopic control and microdisection is described. Part of a series of more than 140 cases operated upon by this method is reported. Results obtained in the treatment of diabetic retinopathy in 17 cases, 11 of which had only the pars anterior removed, are discussed. The applications of the transphenoidal route in 20 cases of pituitary fossa tumors are analysed. The indications of this type of operation in the management of endocrinodependent cancer is studied in 17 cases and compared with the results of 36 cases submitted to implant of Yttrium90 in the sella turcica. The operative complications following transphenoidal exéresis of the

  2. Pituitary Imaging.

    Science.gov (United States)

    Pressman, Barry D

    2017-09-01

    Modern pituitary imaging is MRI. However, computed tomography (CT) still has limited usefulness. In addition, because CT offers much better bone detail and calcium detection, there are some cases in which such additional information is necessary. Before the advent of CT, plain radiography, pneumoencephalography, and angiography were used to diagnose pituitary masses. More recently, CT, and then especially MRI, made it possible to primarily delineate lesions within and around the pituitary gland rather than depend on secondary information that could only suggest their presence. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. High prevalence of early hypothalamic-pituitary damage in childhood brain tumor survivors: need for standardized follow-up programs

    NARCIS (Netherlands)

    Clement, Sarah C.; Meeteren, Antoinette Y. N. Schouten-van; Kremer, Leontien C. M.; van Trotsenburg, A. S. Paul; Caron, Huib N.; van Santen, Hanneke M.

    2014-01-01

    Childhood brain tumor survivors (CBTS) are at increased risk to develop endocrine disorders. Alerted by two cases who experienced delay in diagnosis of endocrine deficiencies within the first 5 years after brain tumor diagnosis, our aim was to investigate the current screening strategy and the

  4. Primary pituitary abscess: case report

    Directory of Open Access Journals (Sweden)

    Hanel Ricardo Alexandre

    2002-01-01

    Full Text Available Pituitary abscesses are potentially life-threatening lesions if not appropriately diagnosed and treated. The authors have operated on more than five hundred cases of pituitary tumors and only one represented a case of pituitary abscess. A 35-year-old woman was investigated for chronic frontal headache. CT scan showed a cystic sellar lesion with ring enhancement after contrast injection leading to an initial diagnosis of pituitary adenoma. She underwent a sublabial transsphenoidal approach to the pituitary gland. After dural opening, purulent material was obtained and no tumor or other associated lesion was detected. There was no evidence of current or previous septicemic illness, meningitis, cavernous sinus thrombosis or sinus infection. Cultures were negative. She was put on antibiotics and discharged after 4 weeks. Nowadays, 10 years after treatment, she is doing well, with no anterior pituitary hormone deficit. MRI shows a partially empty sella without residual lesion and the pituitary stalck is in the midline. The early diagnosis and adequate treatment of this life-threatening lesion may result in excellent prognosis.

  5. Gamma knife radiosurgery for benign cavernous sinus tumors. Treatment concept and outcomes in 120 cases

    International Nuclear Information System (INIS)

    Hayashi, Motohiro; Chernov, Mikhail; Tamura, Noriko

    2012-01-01

    Availability of modern computer-aided robotized devices, such as the Automatic Positioning System (APS TM ; Elekta Instruments AB, Stockholm, Sweden) and Perfexion TM (Elekta Instruments AB), allowed us to develop the original concept of robotic gamma knife microradiosurgery, which is based on the very precise irradiation of the lesion with regard to conformity and selectivity; intentional avoidance of the excessive irradiation of functionally-important anatomical structures, particularly cranial nerves, located both within and in the vicinity of the target; and delivery of sufficient irradiation energy to the tumor with the intention to attain lesion shrinkage, while keeping the marginal dose sufficiently low for prevention of possible complications. The results of such treatment strategy were evaluated retrospectively in 120 patients with benign cavernous sinus neoplasms (pituitary adenomas, meningiomas, schwannomas, and hemangiomas), who were followed up from 24 to 78 months (mean 47 months) after radiosurgery. Tumor growth control and shrinkage rates were 98% and 68%, respectively. More than 50% volume reduction was noted in 25% of lesions. The most prominent volumetric tumor response was observed in hemangiomas, followed by schwannomas, pituitary adenomas, and meningiomas. Treatment-related complications were marked in 7% of cases, and were mainly related to transient isolated cranial neuropathy appearing within several months after radiosurgery. Major morbidity was limited to one patient (0.8%). Application of microradiosurgical treatment principles provides effective and safe management of benign cavernous sinus tumors and is associated with high probability of lesion shrinkage and minimal risk of complications. (author)

  6. Hyperthyroidism and acromegaly due to a thyrotropin- and growth hormone-secreting pituitary tumor. Lack of hormonal response to bromocriptine.

    Science.gov (United States)

    Carlson, H E; Linfoot, J A; Braunstein, G D; Kovacs, K; Young, R T

    1983-05-01

    A 47-year-old woman with acromegaly and hyperthyroidism was found to have an inappropriately normal serum thyrotropin level (1.5 to 2.5 microU/ml) that responded poorly to thyrotropin-releasing hormone but showed partial responsiveness to changes in circulating thyroid hormones. Serum alpha-subunit levels were high-normal and showed a normal response to thyrotropin-releasing hormone. Growth hormone and thyrotropin hypersecretion persisted despite radiotherapy and bromocriptine treatment. Selective trans-sphenoidal removal of a pituitary adenoma led to normalization of both growth hormone and thyrotropin levels. Both thyrotropes and somatotropes were demonstrated in the adenoma by the immunoperoxidase technique and electron microscopy.

  7. Thermal Shrinkage for Shoulder Instability

    OpenAIRE

    Toth, Alison P.; Warren, Russell F.; Petrigliano, Frank A.; Doward, David A.; Cordasco, Frank A.; Altchek, David W.; O’Brien, Stephen J.

    2010-01-01

    Thermal capsular shrinkage was popular for the treatment of shoulder instability, despite a paucity of outcomes data in the literature defining the indications for this procedure or supporting its long-term efficacy. The purpose of this study was to perform a clinical evaluation of radiofrequency thermal capsular shrinkage for the treatment of shoulder instability, with a minimum 2-year follow-up. From 1999 to 2001, 101 consecutive patients with mild to moderate shoulder instability underwent...

  8. Profiling of adrenocorticotropic hormone and arginine vasopressin in human pituitary gland and tumor thin tissue sections using droplet-based liquid-microjunction surface-sampling-HPLC-ESI-MS-MS.

    Science.gov (United States)

    Kertesz, Vilmos; Calligaris, David; Feldman, Daniel R; Changelian, Armen; Laws, Edward R; Santagata, Sandro; Agar, Nathalie Y R; Van Berkel, Gary J

    2015-08-01

    Described here are the results from the profiling of the proteins arginine vasopressin (AVP) and adrenocorticotropic hormone (ACTH) from normal human pituitary gland and pituitary adenoma tissue sections, using a fully automated droplet-based liquid-microjunction surface-sampling-HPLC-ESI-MS-MS system for spatially resolved sampling, HPLC separation, and mass spectrometric detection. Excellent correlation was found between the protein distribution data obtained with this method and data obtained with matrix-assisted laser desorption/ionization (MALDI) chemical imaging analyses of serial sections of the same tissue. The protein distributions correlated with the visible anatomic pattern of the pituitary gland. AVP was most abundant in the posterior pituitary gland region (neurohypophysis), and ATCH was dominant in the anterior pituitary gland region (adenohypophysis). The relative amounts of AVP and ACTH sampled from a series of ACTH-secreting and non-secreting pituitary adenomas correlated with histopathological evaluation. ACTH was readily detected at significantly higher levels in regions of ACTH-secreting adenomas and in normal anterior adenohypophysis compared with non-secreting adenoma and neurohypophysis. AVP was mostly detected in normal neurohypophysis, as expected. This work reveals that a fully automated droplet-based liquid-microjunction surface-sampling system coupled to HPLC-ESI-MS-MS can be readily used for spatially resolved sampling, separation, detection, and semi-quantitation of physiologically-relevant peptide and protein hormones, including AVP and ACTH, directly from human tissue. In addition, the relative simplicity, rapidity, and specificity of this method support the potential of this basic technology, with further advancement, for assisting surgical decision-making. Graphical Abstract Mass spectrometry based profiling of hormones in human pituitary gland and tumor thin tissue sections.

  9. Radiosurgery for pituitary adenomas

    International Nuclear Information System (INIS)

    Castro, Douglas Guedes de; Salvajoli, Joao Victor; Canteras, Miguel Montes; Cecilio, Soraya A. Jorge

    2006-01-01

    Pituitary adenomas represent nearly 15% of all intracranial tumors. Multimodal treatment includes microsurgery, medical management and radiotherapy. Microsurgery is the primary recommendation for nonfunctioning and most of functioning adenomas, except for prolactinomas that are usually managed with dopamine agonist drugs. However, about 30% of patients require additional treatment after microsurgery for recurrent or residual tumors. In these cases, fractionated radiation therapy has been the traditional treatment. More recently, radiosurgery has been established as a treatment option. Radiosurgery allows the delivery of prescribed dose with high precision strictly to the target and spares the surrounding tissues. Therefore, the risks of hypopituitarism, visual damage and vasculopathy are significantly lower. Furthermore, the latency of the radiation response after radiosurgery is substantially shorter than that of fractionated radiotherapy. The goal of this review is to define the efficacy, safety and role of radiosurgery for treatment of pituitary adenomas and to present the preliminary results of our institution. (author)

  10. Accounting for PDMS shrinkage when replicating structures

    DEFF Research Database (Denmark)

    Madsen, Morten Hannibal; Feidenhans'l, Nikolaj Agentoft; Hansen, Poul-Erik

    2014-01-01

    are seldom applied to counteract the shrinkage of PDMS. Also, to perform metrological measurements using replica techniques one has to take the shrinkage into account. Thus we report a study of the shrinkage of PDMS with several different mixing ratios and curing temperatures. The shrinkage factor, with its...

  11. Pituitary Apoplexy After Thyrotropin-releasing Hormone Stimulation Test in a Patient with Pituitary Macroadenoma

    Directory of Open Access Journals (Sweden)

    Huei-Fang Wang

    2007-09-01

    Full Text Available Pituitary apoplexy is a rare complication of pituitary tumors. We report a case of a 41-year-old female with acromegaly due to a pituitary macroadenoma, who developed pituitary apoplexy after a thyrotropin-releasing hormone (TRH 200 mg intravenous injection stimulation test. Neither emergency computed tomography (CT scans nor magnetic resonance imaging (MRI, performed 6 hours and 12 hours, respectively, after the active episode, disclosed the evidence of acute hemorrhage or infarction. Two days later, the pituitary mass, removed by transsphenoidal approach, showed ischemic necrosis and acute hemorrhage. The TRH test is generally safe for evaluating pituitary function, but pituitary apoplexy may occur after the procedure. CT and MRI may miss the diagnosis of pituitary apoplexy, especially if performed immediately after the acute episode.

  12. RNAi-mediated knockdown of pituitary tumor-transforming gene-1 (PTTG1) suppresses the proliferation and invasive potential of PC3 human prostate cancer cells

    International Nuclear Information System (INIS)

    Huang, S.Q.; Liao, Q.J.; Wang, X.W.; Xin, D.Q.; Chen, S.X.; Wu, Q.J.; Ye, G.

    2012-01-01

    Pituitary tumor-transforming gene-1 (PTTG1) is a proto-oncogene that promotes tumorigenesis and metastasis in numerous cell types and is overexpressed in a variety of human tumors. We have demonstrated that PTTG1 expression was up-regulated in both human prostate cancer specimens and prostate cancer cell lines. For a more direct assessment of the function of PTTG1 in prostate tumorigenesis, RNAi-mediated knockdown was used to selectively decrease PTTG1 expression in PC3 human prostate tumor cells. After three weeks of selection, colonies stably transfected with PTTG1-targeted RNAi (the knockdown PC3 cell line) or empty vector (the control PC3 cell line) were selected and expanded to investigate the role of PTTG1 expression in PC3 cell growth and invasion. Cell proliferation rate was significantly slower (28%) in the PTTG1 knockdown line after 6 days of growth as indicated by an MTT cell viability assay (P < 0.05). Similarly, a soft agar colony formation assay revealed significantly fewer (66.7%) PTTG1 knockdown PC3 cell colonies than control colonies after three weeks of growth. In addition, PTTG1 knockdown resulted in cell cycle arrest at G1 as indicated by fluorescence-activated cell sorting. The PTTG1 knockdown PC3 cell line also exhibited significantly reduced migration through Matrigel in a transwell assay of invasive potential, and down-regulation of PTTG1 could lead to increased sensitivity of these prostate cancer cells to a commonly used anticancer drug, taxol. Thus, PTTG1 expression is crucial for PC3 cell proliferation and invasion, and could be a promising new target for prostate cancer therapy

  13. Mechanisms for pituitary tumorigenesis: the plastic pituitary

    OpenAIRE

    Melmed, Shlomo

    2003-01-01

    The anterior pituitary gland integrates the repertoire of hormonal signals controlling thyroid, adrenal, reproductive, and growth functions. The gland responds to complex central and peripheral signals by trophic hormone secretion and by undergoing reversible plastic changes in cell growth leading to hyperplasia, involution, or benign adenomas arising from functional pituitary cells. Discussed herein are the mechanisms underlying hereditary pituitary hypoplasia, reversible pituitary hyperplas...

  14. Thermal shrinkage for shoulder instability.

    Science.gov (United States)

    Toth, Alison P; Warren, Russell F; Petrigliano, Frank A; Doward, David A; Cordasco, Frank A; Altchek, David W; O'Brien, Stephen J

    2011-07-01

    Thermal capsular shrinkage was popular for the treatment of shoulder instability, despite a paucity of outcomes data in the literature defining the indications for this procedure or supporting its long-term efficacy. The purpose of this study was to perform a clinical evaluation of radiofrequency thermal capsular shrinkage for the treatment of shoulder instability, with a minimum 2-year follow-up. From 1999 to 2001, 101 consecutive patients with mild to moderate shoulder instability underwent shoulder stabilization surgery with thermal capsular shrinkage using a monopolar radiofrequency device. Follow-up included a subjective outcome questionnaire, discussion of pain, instability, and activity level. Mean follow-up was 3.3 years (range 2.0-4.7 years). The thermal capsular shrinkage procedure failed due to instability and/or pain in 31% of shoulders at a mean time of 39 months. In patients with unidirectional anterior instability and those with concomitant labral repair, the procedure proved effective. Patients with multidirectional instability had moderate success. In contrast, four of five patients with isolated posterior instability failed. Thermal capsular shrinkage has been advocated for the treatment of shoulder instability, particularly mild to moderate capsular laxity. The ease of the procedure makes it attractive. However, our retrospective review revealed an overall failure rate of 31% in 80 patients with 2-year minimum follow-up. This mid- to long-term cohort study adds to the literature lacking support for thermal capsulorrhaphy in general, particularly posterior instability. The online version of this article (doi:10.1007/s11420-010-9187-7) contains supplementary material, which is available to authorized users.

  15. Genetics Home Reference: familial isolated pituitary adenoma

    Science.gov (United States)

    ... children or adolescents can lead to increased height (gigantism), because the long bones of their arms and ... Information & Resources MedlinePlus (6 links) Encyclopedia: Acromegaly Encyclopedia: Gigantism Encyclopedia: Pituitary Tumor Encyclopedia: Prolactinoma Health Topic: Endocrine ...

  16. Pituitary Macroprolactinoma with Mildly Elevated Serum Prolactin: Hook Effect

    Directory of Open Access Journals (Sweden)

    Mahnaz Pejman-Sani

    2018-04-01

    Full Text Available A 45-year-old man was admitted in our department with complaints of severe headache for over 6 months period. He also suffered from several problems such as visual field defect, decreased energy and libido, body hair loss, cold intolerance, decreased appetite and dry skin. On physical examination, he was afebrile: BP (blood pressure: 110/70 mm/Hg, PR (pulse rate :65 beat/min, BMI (body mass index: 24. He had no terminal hair on face or chest and subcutaneous adipose tissue mass had been decreased substantially. Laboratory tests revealed; Hb: 12 g/dL (N: 14–17 g/dL, Total testosterone: 1.2 ng/mL (N:–-10 ng/mL, Luteinizing hormone (LH:3.3MIU/mL (N:1–8 MIU/mL, Follicle Stimulating hormone (FSH:1.3 MIU/mL (N:1–7 MIU/mL, T4:3.4 micg/dL (N:4–12 micg/dL, TSH:0.6 MIU/mL (N:0.5–5 MIU/mL, Prolactin:100 ng/mL (2–24 ng/mL, serum cortisol:6 MIU/mL (N:4–21 MIU/mL, IGF1:162 ng/mL (50–245. Pituitary MRI showed macroadenoma (29*16*14 mm in left side of sella turcica which bulged to suprasellar cistern with pressure effect on left optic nerve (Figure 1, 2. Visual field examination revealed mild temporal hemianopia. These findings are consistent with macroadenoma and mild prolactin elevation. We also observed a discrepancy between pituitary tumor size and prolactin level. The correct estimate of serum prolactin was obtained after serial dilutional measurement. Serum prolactin after dilution was 6470 ng/mL. With these findings pituitary macroadenoma was diagnosed and treatment with cabergoline (dopamine agonist 0.5 mg/week was started. After one month follow-up he had no symptoms, visual field defect was improved and pituitary MRI showed significant shrinkage of tumor.

  17. The effects of magnetite (Fe3O4 nanoparticles on electroporation-induced inward currents in pituitary tumor (GH3 cells and in RAW 264.7 macrophages

    Directory of Open Access Journals (Sweden)

    Liu YC

    2012-03-01

    Full Text Available Yen-Chin Liu1, Ping-Ching Wu2, Dar-Bin Shieh2–5, Sheng-Nan Wu3,6,71Department of Anesthesiology, 2Institute of Oral Medicine and Department of Stomatology, 3Department of Physiology, National Cheng Kung University Hospital, College of Medicine, 4Advanced Optoelectronic Technology Center, 5Center for Micro/Nano Science and Technology, National Cheng Kung University, 6Innovation Center for Advanced Medical Device Technology, National Cheng Kung University, 7Department of Anatomy and Cell Biology, National Cheng Kung University Medical College, Tainan, TaiwanAims: Fe3O4 nanoparticles (NPs have been known to provide a distinct image contrast effect for magnetic resonance imaging owing to their super paramagnetic properties on local magnetic fields. However, the possible effects of these NPs on membrane ion currents that concurrently induce local magnetic field perturbation remain unclear.Methods: We evaluated whether amine surface-modified Fe3O4 NPs have any effect on ion currents in pituitary tumor (GH3 cells via voltage clamp methods.Results: The addition of Fe3O4 NPs decreases the amplitude of membrane electroporation-induced currents (IMEP with a half-maximal inhibitory concentration at 45 µg/mL. Fe3O4 NPs at a concentration of 3 mg/mL produced a biphasic response in the amplitude of IMEP, ie, an initial decrease followed by a sustained increase. A similar effect was also noted in RAW 264.7 macrophages.Conclusion: The modulation of magnetic electroporation-induced currents by Fe3O4 NPs constitutes an important approach for cell tracking under various imaging modalities or facilitated drug delivery.Keywords: iron oxide, ion current, free radical

  18. Pertussis toxin modifies the characteristics of both the inhibitory GTP binding proteins and the somatostatin receptor in anterior pituitary tumor cells

    International Nuclear Information System (INIS)

    Mahy, N.; Woolkalis, M.; Thermos, K.; Carlson, K.; Manning, D.; Reisine, T.

    1988-01-01

    The effects of pertussis toxin treatment on the characteristics of somatostatin receptors in the anterior pituitary tumor cell line AtT-20 were examined. Pertussis toxin selectively catalyzed the ADP ribosylation of the alpha subunits of the inhibitory GTP binding proteins in AtT-20 cells. Toxin treatment abolished somatostatin inhibition of forskolin-stimulated adenylyl cyclase activity and somatostatin stimulation of GTPase activity. To examine the effects of pertussis toxin treatment on the characteristics of the somatostatin receptor, the receptor was labeled by the somatostatin analog [125I]CGP 23996. [125I]CGP 23996 binding to AtT-20 cell membranes was saturable and within a limited concentration range was to a single high affinity site. Pertussis toxin treatment reduced the apparent density of the high affinity [125I]CGP 23996 binding sites in AtT-20 cell membranes. Inhibition of [125I]CGP 23996 binding by a wide concentration range of CGP 23996 revealed the presence of two binding sites. GTP predominantly reduced the level of high affinity sites in control membranes. Pertussis toxin treatment also diminished the amount of high affinity sites. GTP did not affect [125I]CGP 23996 binding in the pertussis toxin-treated membranes. The high affinity somatostatin receptors were covalently labeled with [125I] CGP 23996 and the photoactivated crosslinking agent n-hydroxysuccinimidyl-4-azidobenzoate. No high affinity somatostatin receptors, covalently bound to [125I]CGP 23996, were detected in the pertussis toxin-treated membranes. These results are most consistent with pertussis toxin uncoupling the inhibitory G proteins from the somatostatin receptor thereby converting the receptor from a mixed population of high and low affinity sites to only low affinity receptors

  19. Pituitary spindle cell oncocytoma

    Directory of Open Access Journals (Sweden)

    Soledad Sosa

    2018-01-01

    Full Text Available Spindle cell oncocytoma is an infrequent benign non-endocrine sellar neoplasm. Due to its similar morphology to pituitary adenomas, consideration of this differential diagnosis would conduce to a more careful surgical approach in order to avoid intraoperative bleeding and aiming to a complete resection, on which depends long-term outcomes. We present the case of a 60-year-old male who complained about visual abnormalities, with computerized visual field confirmation. On biochemistry, a panhypopituitarism was detected. The brain magnetic resonance images showed a sellar mass. A non-functioning pituitary macroadenoma was presumptively diagnosed and due to the visual impairment, surgical transesphenoidal treatment was indicated. The histological diagnosis was spindle cell oncocytoma. Five months after surgery, the control image demonstrated a lesion that was considered as remnant tumor, hence radiosurgery was performed. During the follow-up, the tumor reduced its size and four years after initial treatment, the sellar resonance imaging showed disappearance of the residual tumor. Communication of new cases of this rare entity will enlarge the existing evidence and will help to determinate the most effective treatment and prognosis.

  20. Radiosurgery of pituitary adenomas

    International Nuclear Information System (INIS)

    Kida, Yoshihisa

    2008-01-01

    The efficacy and role of gamma knife (GK) in the treatment of various pituitary adenomas are described on author's experience and discussed with literature. GK subjects are 328 patients (M 126/F 202, av. age of 47.8 y) in author's hospital, and satisfactory follow-up (32-44 mo) for evaluation has been possible in 253 cases, who had tumors non-functional (129 cases), producing ACTH (23), HGH (70) and PRL (31). Stereotactic GK radiosurgery is done with navigation by Gamma Plan based on enhanced MRI images at various doses, and evaluation in the follow-up period is performed by hormonal levels and MRI which give efficacy of complete response (CR), partial response (PR), MR and standard deviation (SD)/ progressive disease (PD) on the tumor size. The overall tumor control rate is found to be 95-100%. Effectiveness (CR and PR) is found as high as 77.4% in PRL-producing tumor (marginal dose 14-32 Gy), 65% in non-functioning (15-25 Gy), 61% in ACTH (19-30 Gy) and 60% in GH (19-31 Gy), of which tendency is similar to that in literature. Even in ACTH-producing tumor, low ACTH and cortisol levels persisted with tendency of improved obese and hypertensive symptoms. GK radiosurgery has limitations in the tissue size and distance between the tumor and optic nerve/chiasm, but for the enough small tumor, it gives satisfactorily long term efficacy. (R.T.)

  1. Angiogenesis in Pituitary Adenomas: Human Studies and New Mutant Mouse Models

    OpenAIRE

    Cristina, Carolina; Luque, Guillermina María; Demarchi, Gianina; Lopez Vicchi, Felicitas; Zubeldia-Brenner, Lautaro; Perez Millan, Maria Ines; Perrone, Sofia; Ornstein, Ana Maria; Lacau-Mengido, Isabel M.; Berner, Silvia Inés; Becu-Villalobos, Damasia

    2014-01-01

    The role of angiogenesis in pituitary tumor development has been questioned, as pituitary tumors have been usually found to be less vascularized than the normal pituitary tissue. Nevertheless, a significantly higher degree of vasculature has been shown in invasive or macropituitary prolactinomas when compared to noninvasive and microprolactinomas. Many growth factors and their receptors are involved in pituitary tumor development. For example, VEGF, FGF-2, FGFR1, and PTTG, which give a partic...

  2. Astrocytoma of the pituitary gland (pituicytoma): case report

    International Nuclear Information System (INIS)

    Uesaka, T.; Miyazono, M.; Nishio, S.; Iwaki, T.

    2002-01-01

    A 34-year-old man presented with a 4-month history of visual obscuration. Magnetic resonance imaging showed a solid, discrete, contrast-enhancing pituitary mass with suprasellar extension. Surgery, which was performed via a transsphenoidal approach, disclosed the pituitary tumor to be a fibrillary astrocytoma (pituicytoma). This case report contains the clinical and neuroimaging features of this rare tumor of the neurohypophysis, which masqueraded as a pituitary adenoma. (orig.)

  3. Imaging of giant pituitary adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Majos, C.; Coll, S.; Aguilera, C.; Pons, L.C. [Bellvitge Univ., Barcelona (Spain). Inst. de Diagnostice per la Imatge; Acebes, J.J. [Department of Neurosurgery, Ciutat Sanitaria i Universitaria de Bellvitge, L`Hospitalet de Llobregat, Barcelona (Spain)

    1998-10-01

    We present five proven giant pituitary adenomas studied by CT and MRI, and review the clinical and imaging findings. Our aim was to examine the radiologic appearances and to search for criteria useful in distinguishing these tumors from other sellar and suprasellar tumours, mainly craniopharyngioma. The main differences from small adenomas were high prevalence of macrocysts, a more invasive behaviour and a clinical picture dominated by mass effect rather than endocrine disturbance. Factors supporting the diagnosis of pituitary adenoma in a giant intra- and suprasellar mass include: infrasellar extension, absence of calcification and presence of low-signal cysts on T1-weighted images. (orig.) (orig.) With 4 figs., 2 tabs., 9 refs.

  4. The influence of shrinkage reducing admixtures on plastic shrinkage

    Directory of Open Access Journals (Sweden)

    Mora, J.

    2003-12-01

    Full Text Available Shrinkage reducing admixtures (SRAs are viable alternatives for reducing plastic shrinkage cracking in concrete. The objective of the present paper is to study early age plastic shrinkage in restrained concrete elements, where three different SRAs have been used. The influence of the admixture is analyzed through the following measurements: capillary pressure, evaporation, temperature evolution, crack evolution and settlement. The tests for studying the cracking and deformation were made on two different configurations (i.e., restrained prisms with reduced cross-section and restrained panel, in a wind tunnel, with controlled wind temperature and velocity. The conclusions obtained indicate the viability of the use of this type of admixture and the usefulness of the test methods.

    Los aditivos reductores de retracción (SRAs se plantean, hoy en día, como una alternativa viable para reducir la fisuración por retracción plástica. El objetivo del presente artículo es conocer mejor y predecir el comportamiento a primeras edades de la retracción plástica en elementos estructurales coaccionados, a los que se les ha añadido diversos aditivos reductores de retracción (tres tipos diferentes. Esta influencia se analiza a través de las siguientes propiedades: presión capilar, evaporación, evolución de temperaturas, evolución de fisuración, y deformaciones verticales de asentamiento. Los ensayos para estudiar la fisuración y las deformaciones se han realizado sobre diferentes configuraciones (prisma restringido con estrangulamiento y panel restringido, en un túnel de viento, con temperaturas y velocidades de viento controladas. Las conclusiones obtenidas señalan la viabilidad del empleo de este tipo de aditivos y la bondad de los métodos experimentales utilizados.

  5. Study on effects of solar radiation and rain on shrinkage, shrinkage cracking and creep of concrete

    International Nuclear Information System (INIS)

    Asamoto, Shingo; Ohtsuka, Ayumu; Kuwahara, Yuta; Miura, Chikako

    2011-01-01

    In this paper, the effects of actual environmental actions on shrinkage, creep and shrinkage cracking of concrete are studied comprehensively. Prismatic specimens of plain concrete were exposed to three sets of artificial outdoor conditions with or without solar radiation and rain to examine the shrinkage. For the purpose of studying shrinkage cracking behavior, prismatic concrete specimens with reinforcing steel were also subjected to the above conditions at the same time. The shrinkage behavior is described focusing on the effects of solar radiation and rain based on the moisture loss. The significant environment actions to induce shrinkage cracks are investigated from viewpoints of the amount of the shrinkage and the tensile strength. Finally, specific compressive creep behavior according to solar radiation and rainfall is discussed. It is found that rain can greatly inhibit the progresses of concrete shrinkage and creep while solar radiation is likely to promote shrinkage cracking and creep.

  6. A 23-Year-Old Female with a Mixed Germ Cell Tumor of the Pituitary Infundibulum: The Challenge of Differentiating Neoplasm from Lymphocytic Infundibuloneurohypophysitis—A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Sann Yu Mon

    2014-01-01

    Full Text Available The pathologic spectrum of diseases that infiltrate the pituitary infundibulum includes a broad variety of clinical entities. There are significant differences in the prevalence of these etiologies depending on the age of presentation. Lymphocytic infundibuloneurohypophysitis (LINH predominates over other causes of infundibular disease in adults over age 21. Differentiating LINH from other causes of infundibular disease can be difficult because the various etiologies often have similar clinical presentations and radiologic imaging characteristics. We report the first case in an adult of a mixed germ cell tumor comprised of germinoma and embryonal cell carcinoma infiltrating the pituitary infundibulum. In our case, a 23-year-old female was initially misdiagnosed as having LINH. She presented with panhypopituitarism and diabetes insipidus, which is the most common initial presentation in both entities. The two diagnoses are difficult to distinguish based on MRI imaging, CSF findings, and histopathological examination. Our case demonstrates the need for close follow-up of patients with isolated lesions of the pituitary infundibulum and reinforces the need for biopsy of an infundibular lesion when progression of disease is demonstrated. In our case, biopsy with comprehensive immunohistochemical staining was the sole means of making a definitive diagnosis.

  7. Pituitary adenoma with adipose tissue: A new metaplastic variant.

    Science.gov (United States)

    Caporalini, Chiara; Buccoliero, Anna Maria; Pansini, Luigi; Moscardi, Selene; Novelli, Luca; Baroni, Gianna; Bordi, Lorenzo; Ammannati, Franco; Taddei, Gian Luigi

    2017-08-01

    Pituitary adenomas are benign tumors representing approximately 15-20% of intracranial neoplasms. There have been few reports of metaplastic osseous transformation and about 60 cases of neuronal metaplasia in pituitary adenoma but adipose metaplasia has not been previously described in the English literature. Here we report a case of pituitary adenoma with metaplastic adipose tissue in a 58-year-old male patient. Histologically this case fulfilled the criteria of a non-functioning pituitary adenoma, and moreover a central area of adipose tissue, made by mature adipocytes, and many tumor cells, containing fat droplet were evident. Lipomatous transformation of tumor cells in the CNS has been previously observed but, to the best of our knowledge, our case is the first pituitary adenoma with such change. The histogenesis of the adipose element in pituitary adenoma is not well understood, and could be a result of a metaplastic change or divergent differentiation from a common progenitor cell. © 2017 Japanese Society of Neuropathology.

  8. Magnetic resonance imaging of pituitary adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Bonneville, Jean-Francois; Bonneville, Fabrice; Cattin, Francoise [University Hospital, Department of Neuroradiology, Besancon (France)

    2005-03-01

    Today, MR is the only method needed for the morphological investigation of endocrine-active pituitary adenomas. In acromegaly and Cushing's syndrome, the therapeutic attitude is directly dictated by MR data. We present the MR aspect of pituitary adenomas according to size, sex, age, endocrine activity and a few particular conditions such as hemorrhagic pituitary adenomas, pituitary adenomas during pregnancy, cavernous sinus invasion and postsurgical changes. When an intrasellar mass extending out of the sella turcica is detected, the goal of the MR examination is to indicate precisely the origin of the tumor, its extension in relation to the various surrounding structures, its structure and its enhancement in order to help in the differential diagnosis. Demonstration of very small pituitary adenomas remains a challenge. When SE T1- and Turbo SE T2-weighted sequences are non-diagnostic, enhanced imaging becomes mandatory; half-dose gadolinium injection, delayed sequence, dynamic imaging can be of some help. (orig.)

  9. Transsphenoidal surgery for pituitary gigantism and galactorrhea in a 3.5 year old child.

    Science.gov (United States)

    Flitsch, J; Lüdecke, D K; Stahnke, N; Wiebel, J; Saeger, W

    2000-05-01

    The management of pituitary macroadenomas which lead to gigantism may require multiple therapeutical approaches, including medical treatment, surgery, and radiation therapy. Transsphenoidal surgery (TSS) during early childhood that achieves total removal of a growth hormone (GH) secreting tumor is rarely reported. The surgeon is confronted with special problems regarding the infantile anatomy. In this case, a 3.5 year old child, the youngest successfully treated by TSS so far, suffered from a GH- and prolactin (PRL) secreting macroadenoma of the pituitary gland. The girl initially presented with an increasing growth rate, later with breast development, and finally, at the age of 2.8 years, with galactorrhea and secretion of blood from the nipples. Increased levels of GH [122 micrograms/l], insulin-like growth factor (IGF-1) [830 micrograms/l], insulin-like growth factor binding protein 3 (IGFBP-3) [8.6 mg/l] and PRL [590 micrograms/l] were found. MRI scans revealed a macroadenoma of 2.7 cm diameter. An eight-week trial of relatively low dose dopamine agonists led to a reduction of PRL, while the GH- and IGF-1 levels remained unchanged; the tumor showed only little shrinkage. Since there was chiasma compression, we opted for early TSS. A complete tumor removal was achieved despite the difficulties of a narrow approach. After TSS, low levels of GH, IGF-1, and PRL documented a complete tumor removal, but persistent diabetes insipidus and anterior lobe deficits resulted from surgery. In summary, if primary medical therapy alone is unable to adequately reduce hormone hypersecretion and tumor size in early childhood, TSS is recommended. Thus, radiation therapy may be reserved for surgical failure.

  10. Soil shrinkage characteristics in swelling soils

    International Nuclear Information System (INIS)

    Taboada, M.A.

    2004-01-01

    The objectives of this presentation are to understand soil swelling and shrinkage mechanisms, and the development of desiccation cracks, to distinguish between soils having different magnitude of swelling, as well as the consequences on soil structural behaviour, to know methods to characterize soil swell/shrink potential and to construct soil shrinkage curves, and derive shrinkage indices, as well to apply them to assess soil management effects

  11. Treatment Option Overview (Pituitary Tumors)

    Science.gov (United States)

    ... by surgery using one of the following operations: Transsphenoidal surgery : A type of surgery in which the instruments ... gland lies just above the sphenoid bone. Enlarge Transsphenoidal surgery. An endoscope and a curette are inserted through ...

  12. Treatment Options for Pituitary Tumors

    Science.gov (United States)

    ... by surgery using one of the following operations: Transsphenoidal surgery : A type of surgery in which the instruments ... gland lies just above the sphenoid bone. Enlarge Transsphenoidal surgery. An endoscope and a curette are inserted through ...

  13. General Information about Pituitary Tumors

    Science.gov (United States)

    ... by surgery using one of the following operations: Transsphenoidal surgery : A type of surgery in which the instruments ... gland lies just above the sphenoid bone. Enlarge Transsphenoidal surgery. An endoscope and a curette are inserted through ...

  14. Pituitary macroadenomas: reviews of 60 cases

    International Nuclear Information System (INIS)

    Santos, Alair Augusto S.M.D. dos; Fontes, Cristina Asvolinsque P.; Magnago, Marcelo; Moreira, Denise Madeira; Andreiuolo, Pedro Angelo; Oliveira, Fernando Barros de; Teixeira, Ricardo Tostes D.; Correa, Saul Orlando C.

    2000-01-01

    We reviewed 60 cases of patients with pituitary macroadenomas who were submitted to magnetic resonance imaging evaluations at private institutions in Niteroi and Rio de Janeiro, Brazil. The aim of this study was to demonstrate the advantages of magnetic resonance imaging in the diagnosis and follow-up of these patients. Macroprolactinomas were the most prevalent tumors. We also observed four growth-hormone (GH) secreting macroadenomas with clinical signs of acromegaly, and one GH- and prolactin-secreting macroadenoma. Seven patients presented pituitary apoplexy and hyperintense signal on T1-W images before contrast medium (gadolinium) administration suggestive of intratumoral bleeding. The follow-up of 15 cases demonstrated a reduction in the size of the tumor after surgery, clinical treatment or radiotherapy. Magnetic resonance imaging is important for the study of pituitary macroadenomas, particularly before surgery, as it shows the involvement of adjacent structures, specially the cavernous sinus, optic chiasm and pituitary stalk compression. (author)

  15. Malignant tumors of the nasal cavity and paranasal sinuses: long-term outcome and morbidity with emphasis on hypothalamic-pituitary deficiency

    NARCIS (Netherlands)

    Snyers, An; Janssens, Geert O. R. J.; Twickler, Marcel B.; Hermus, Ad R.; Takes, Robert P.; Kappelle, Arnoud C.; Merkx, Matthias A. W.; Dirix, Piet; Kaanders, Johannes H. A. M.

    2009-01-01

    PURPOSE: To evaluate the long-term outcome after surgery and radiotherapy for patients with sinonasal cancer and assess late toxicity, with special emphasis on hypothalamic-pituitary dysfunction. METHODS AND MATERIALS: A retrospective analysis of 168 patients treated for sinonasal cancer in a single

  16. Radiolabelled spiroperidol: Possible pituitary adenoma imaging agent

    International Nuclear Information System (INIS)

    Otto, C.A.; Marshall, J.C.; Lloyd, R.V.; Sherman, P.S.; Wieland, D.M.

    1984-01-01

    Prolactin-secreting pituitary adenomas are the most common type of pituitary tumors. Detection currently depends on physical symptoms, elevated serum prolactin levels and CT scans. An imaging agent which specifically localized in prolactinomas based on some functional characteristic of the tumor would be of considerable clinical value not only for early detection but also for monitoring of therapy. Tritiated spiroperidol ( 3 H-Sp) was selected for evaluation based on 1) the presence of D-2 receptors in normal anterior pituitary and adenoma tissue and 2) the high affinity of spiroperidol for D-2 receptors. Recent data have established that implantation of diethylstilbestrol (DES) in Fischer F344 rats induced prolactin-secreting tumors in the pituitary. 3 HSp was evaluated in pituitary tissue of both control and DES-treated rats. 3 HSp concentration in normal female anterior pituitary tissue was found to be about 0.27% kg dose/g from 5 min to 4hrs. This value was about 10 times levels in cortex, cerebellum and striatum. In DES-treated rats the % kg dose/g values remained approximately the same. A 5-fold increase in serum prolactin was associated with a 6-fold increase in both pituitary weight and % dose/organ. The data suggests that although total pituitary weight has increased due to tumor growth (reflected in increased values for % dose/organ), the relative number of receptors per g of tissue has remained constant. This result is in agreement with observations of others on D-2 receptor concentration in prolactinomas

  17. Identification of metastases in the pituitary stalk

    Energy Technology Data Exchange (ETDEWEB)

    Schubiger, O

    1982-09-01

    Two cases of metastasis in the pituitary stalk are presented. In both cases, presenting with diabetes insipidus, the demonstration of a small (under 1 cm) metastasis in the pituitary stalk was possible using a current generation scanner. Patients with known primary tumors presenting with a diabetes insipidus should be examined by CT before therapy with antidiuretic hormone is initiated. In cases of visible metastasis, a specific therapy together with the hormone-substitution should be discussed.

  18. Addison's Disease and Pituitary Enlargement.

    Science.gov (United States)

    Winters, Stephen J; Vitaz, Todd; Nowacki, Michael R; Craddock, Durrett C; Silverman, Craig

    2015-06-01

    A 60-year-old man with Addison's disease, primary hypothyroidism and type 2 diabetes mellitus who was treated with stable doses of hydrocortisone and fludrocortisone developed increasing skin pigmentation and a bitemporal hemianopia. The plasma ACTH level was 14,464 pg/mL, and an invasive pituitary macroadenoma with suprasellar extension was found on magnetic resonance imaging leading to transnasal-transsphenoidal adenomectomy. The tumor demonstrated features of an eosinophilic adenoma and stained uniformly for ACTH. Residual tumor was treated with stereotactic radiotherapy. This case and the 13 cases published previously indicate that primary adrenal failure may predispose to corticotroph hyperplasia, and in some patients to the development of an invasive corticotroph adenoma. The ACTH level should be measured, and a pituitary magnetic resonance imaging is indicated when skin pigmentation increases in a patient with primary adrenal failure who is receiving customary treatment with glucocorticoids and mineralocorticoids.

  19. Pituitary abscess: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Apostolos K A Karagiannis

    2016-06-01

    Full Text Available Pituitary abscess is a rare life-threating entity that is usually misdiagnosed as a pituitary tumor with a definite diagnosis only made postoperatively. Over the last several decades, advances in healthcare have led to a significant decrease in morbidity and mortality due to pituitary abscess. We report a case of a 34-year-old woman who was admitted to our department for investigation of a pituitary mass and with symptoms of pituitary dysfunction, headaches and impaired vision. During her admission, she developed meningitis-like symptoms and was treated with antibiotics. She eventually underwent transsphenoidal surgery for excision of the pituitary mass. A significant amount of pus was evident intraoperatively; however, no pathogen was isolated. Six months later, the patient was well and had full recovery of the anterior pituitary function. Her menses returned, and she was only on treatment with desmopressin for diabetes insipidus that developed postoperatively.

  20. MRI evaluation of pituitary hyperplasia due to primary hypothyroidism

    International Nuclear Information System (INIS)

    Jiang Chunjing; Shu Jin'er; Li Huimin; Sheng Sanlan; Lu Jinhua

    2010-01-01

    Objective: To analyze the MRI manifestations of the pituitary hyperplasia due to primary hypothyroidism and to improve the differential diagnosis of secondary pituitary hyperplasia and pituitary tumors. Methods: The MRI findings of pituitary hyperplasia in 10 documented primary hypothyroidism patients (male 3, female 7; age range: 9-15 years) were reviewed. The pulse sequences using a 1.0T MR scanner included coronal and sagittal T 1 W, coronal T 2 W and coronal contrast-enhanced T 1 W in all patients. Results: The pituitary gland was markedly enlarged with mean height of 15.5 mm (11-23 mm). Central bulging of pituitary gland was seen in all 10 patients with mild displacement of the infundibulum in 3 and sellar enlargement in 5. All glands had homogeneous MR signal intensities and contrast enhancement. Conclusion: Pituitary hyperplasia due to primary hypothyroidism has characteristic MR features of central bulging with homogeneous signal intensities and contrast enhancement. (authors)

  1. Mitigation strategies for autogenous shrinkage cracking

    DEFF Research Database (Denmark)

    Bentz, Dale P.; Jensen, Ole Mejlhede

    2004-01-01

    As the use of high-performance concrete has increased, problems with early-age cracking have become prominent. The reduction in water-to-cement ratio, the incorporation of silica fume, and the increase in binder content of high-performance concretes all contribute to this problem. In this paper......, the fundamental parameters contributing to the autogenous shrinkage and resultant early-age cracking of concrete are presented. Basic characteristics of the cement paste that contribute to or control the autogenous shrinkage response include the surface tension of the pore solution, the geometry of the pore...... of early-age cracking due to autogenous shrinkage. Mitigation strategies discussed in this paper include: the addition of shrinkage-reducing admixtures more commonly used to control drying shrinkage, control of the cement particle size distribution, modification of the mineralogical composition...

  2. Rapid-onset obesity, hypoventilation, hypothalamic dysfunction, autonomic dysregulation and neuroendocrine tumor syndrome with a homogenous enlargement of the pituitary gland: a case report.

    Science.gov (United States)

    Aljabban, Lama; Kassab, Lina; Bakoura, Nour Alhuda; Alsalka, Mohammad Fayez; Maksoud, Ismaeil

    2016-11-22

    Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation syndrome is a rare pediatric disorder with a variable sequence of clinical presentations, undefined etiology, and high risk of mortality. Our patient presented an unusual course of the disease accompanied by a homogenous mild enlargement of her pituitary gland with an intact pituitary-endocrine axis which, to the best of our knowledge, represents a new finding in rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation syndrome. We present a documented case of a 4 years and 8-month-old Syrian Arabic girl with a distinctive course of signs and symptoms of rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation syndrome accompanied by mature ganglioneuroma in her chest, a homogenous mild enlargement of her pituitary gland, generalized cortical brain atrophy, and seizures. Three months after her first marked symptoms were noted she had a sudden progression of severe respiratory distress that ended with her death. The findings of this case could increase our understanding of the pathogenetic mechanisms of rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation, and place more emphases on pediatricians to consider rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation syndrome whenever early rapid onset of obesity, associated with any malfunction, is observed in children. This knowledge could be lifesaving for children with rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation syndrome.

  3. Trophic and neurotrophic factors in human pituitary adenomas (Review).

    Science.gov (United States)

    Spoletini, Marialuisa; Taurone, Samanta; Tombolini, Mario; Minni, Antonio; Altissimi, Giancarlo; Wierzbicki, Venceslao; Giangaspero, Felice; Parnigotto, Pier Paolo; Artico, Marco; Bardella, Lia; Agostinelli, Enzo; Pastore, Francesco Saverio

    2017-10-01

    The pituitary gland is an organ that functionally connects the hypothalamus with the peripheral organs. The pituitary gland is an important regulator of body homeostasis during development, stress, and other processes. Pituitary adenomas are a group of tumors arising from the pituitary gland: they may be subdivided in functional or non-functional, depending on their hormonal activity. Some trophic and neurotrophic factors seem to play a key role in the development and maintenance of the pituitary function and in the regulation of hypothalamo-pituitary-adrenocortical axis activity. Several lines of evidence suggest that trophic and neurotrophic factors may be involved in pituitary function, thus suggesting a possible role of the trophic and neurotrophic factors in the normal development of pituitary gland and in the progression of pituitary adenomas. Additional studies might be necessary to better explain the biological role of these molecules in the development and progression of this type of tumor. In this review, in light of the available literature, data on the following neurotrophic factors are discussed: ciliary neurotrophic factor (CNTF), transforming growth factors β (TGF‑β), glial cell line-derived neurotrophic factor (GDNF), nerve growth factor (NGF), vascular endothelial growth factor (VEGF), vascular endothelial growth inhibitor (VEGI), fibroblast growth factors (FGFs) and epidermal growth factor (EGF) which influence the proliferation and growth of pituitary adenomas.

  4. MR imaging of the pituitary gland in central precocious puberty

    International Nuclear Information System (INIS)

    Kao, S.C.S.; Cook, J.S.; Hansen, J.R.; Simonson, T.M.

    1992-01-01

    Cranial magnetic resonance imaging was performed in 17 children with central precocious puberty (CPP) and 19 aged-matched controls to compare the appearance of the pituitary gland. Gland size was measured on T1-weighted sagittal and coronal images. The gland was graded according to the concavity or convexity of the upper surface, and the signal intensity of the gland was assessed visually. The mean pituitary volume in 13 CPP children without hypothalamic tumor (292.6 mm 3 ) was significantly greater than that in normal controls (181.35 mm 3 ). The mean volume for the four CPP children with hypothalamic tumor was smaller (145.0 mm 3 ). Compared to controls, the upper pituitary surface in CPP patients appeared convex in a higher proportion. The anterior pituitary was isointense to pons in all patients and controls. Although the posterior pituitary bright spot was present in 14 controls and 11 CPP patients, none with hypothalamic tumor showed it. (orig.)

  5. Thyrotropin secreting pituitary adenoma accompanying a silent somatotropinoma.

    Science.gov (United States)

    Berker, Dilek; Isik, Serhat; Aydin, Yusuf; Tutuncu, Yasemin; Akdemir, Gokhan; Ozcan, Hatice Nursun; Guler, Serdar

    2011-01-01

    Thyroid stimulating hormone (TSH) secreting pituitary adenomas are rare tumors manifested as hyperthyroidism with goiter in the presence of elevated TSH. We present a case with pituitary adenoma secreting both TSH and growth hormone (GH) with the prominent clinical findings of hyperthyroidism but without clinical findings of acromegaly. Pituitary magnetic resonance imaging revealed a macroadenoma. Transsphenoidal surgery was performed twice. The immunohistochemical staining showed that tumor cells were strongly reactive to GH and relatively mildly reactive to TSH. Control pituitary imaging revealed a residual macroadenoma, and long acting octreotide treatment was administered. After two years of the treatment, tumor size remained the same while thyroid function tests and insulin-like growth factor 1 (IGF-I) values returned to normal ranges. In conclusion, we always recommend hormonal examinations for all patients who have pituitary adenoma without signs and symptoms of acromegaly.

  6. External radiotherapy of pituitary adenomas

    International Nuclear Information System (INIS)

    Zierhut, Dietmar; Flentje, Michael; Adolph, Juergen; Erdmann, Johannes; Raue, Friedhelm; Wannenmacher, Michael

    1995-01-01

    Purpose: To evaluate therapeutic outcome and side effects of radiotherapy in pituitary adenomas as sole or combined treatment. Methods and Materials: Retrospective analysis of 138 patients (74 male, 64 female) irradiated for pituitary adenoma from 1972 to 1991 was performed. Mean age was 49.7 years (15-80 years). Regular follow-up (in the mean 6.53 ± 3.99 years) included radiodiagnostical [computed tomography (CT), magnetic resonance imaging (MRI), x-ray], endocrinological, and ophthalmological examinations. Seventy patients suffered from nonfunctional pituitary adenoma, 50 patients suffered from growth-hormone producing adenomas, 11 had prolactinomas, and 7 patients had adrenocorticotropic hormone (ACTH) producing pituitary adenomas. In 99 patients surgery was followed by radiotherapy in case of suspected remaining tumor (invasive growth of the adenoma, assessment of the surgeon, pathologic CT after surgery, persisting hormonal overproduction). Twenty-three patients were treated for recurrence of disease after surgery and 16 patients received radiation as primary treatment. Total doses from 40-60 Gy (mean: 45.5 Gy) were given with single doses of 2 Gy 4 to five times a week. Results: Tumor control was achieved in 131 patients (94.9%). In seven patients, recurrence of disease was diagnosed in the mean 2.9 years (9-98 months) after radiotherapy and salvaged by surgery. A statistically significant dose-response relationship was found in favor of doses ≥ 45 Gy. Ninety percent of the patients with hormonally active pituitary adenomas had a benefit from radiotherapy in means of complete termination (38%) or at least reduction (52%) of hormonal overproduction. Partial or complete hypopituitarism after radiotherapy developed, depending on hormonal axis, in 12 (prolactin) to 27% (follicle-stimulating hormone FSH) of patients who had not already had hypopituitarism prior to radiation. Two out of 138 patients suffered reduction of visual acuity, which was, in part

  7. Thyroid-stimulating hormone pituitary adenomas.

    Science.gov (United States)

    Clarke, Michelle J; Erickson, Dana; Castro, M Regina; Atkinson, John L D

    2008-07-01

    Thyroid-stimulating hormone (TSH)-secreting pituitary adenomas are rare, representing secreting or clinically silent TSH-immunostaining pituitary tumors among all pituitary adenomas followed at their institution between 1987 and 2003. Patient records, including clinical, imaging, and pathological and surgical characteristics were reviewed. Twenty-one patients (6 women and 15 men; mean age 46 years, range 26-73 years) were identified. Of these, 10 patients had a history of clinical hyperthyroidism, of whom 7 had undergone ablative thyroid procedures (thyroid surgery/(131)I ablation) prior to the diagnosis of pituitary adenoma. Ten patients had elevated TSH preoperatively. Seven patients presented with headache, and 8 presented with visual field defects. All patients underwent imaging, of which 19 were available for imaging review. Sixteen patients had macroadenomas. Of the 21 patients, 18 underwent transsphenoidal surgery at the authors' institution, 2 patients underwent transsphenoidal surgery at another facility, and 1 was treated medically. Patients with TSH-secreting tumors were defined as in remission after surgery if they had no residual adenoma on imaging and had biochemical evidence of hypo-or euthyroidism. Patients with TSH-immunostaining tumors were considered in remission if they had no residual tumor. Of these 18 patients, 9 (50%) were in remission following surgery. Seven patients had residual tumor; 2 of these patients underwent further transsphenoidal resection, 1 underwent a craniotomy, and 4 underwent postoperative radiation therapy (2 conventional radiation therapy, 1 Gamma Knife surgery, and 1 had both types of radiation treatment). Two patients had persistently elevated TSH levels despite the lack of evidence of residual tumor. On pathological analysis and immunostaining of the surgical specimen, 17 patients had samples that stained positively for TSH, 8 for alpha-subunit, 10 for growth hormone, 7 for prolactin, 2 for adrenocorticotrophic hormone

  8. Cushing's Syndrome From Pituitary Microadenoma and Pulmonary Nodules.

    Science.gov (United States)

    Tating, Dan Louie Renz P; Montevirgen, Natasha Denise S; Cajucom, Loyda

    2016-03-01

    Cushing's syndrome is a state of cortisol excess, possibly from a tumor in the pituitary gland, the adrenal gland, or an ectopic nonpituitary ACTH-secreting source. The first form, pituitary in origin, was originally described by Harvey Cushing, MD, and was labeled as Cushing's disease. Long-term therapy with glucocorticoids also can lead to iatrogenic Cushing's syndrome.

  9. Long-term consequences of growth hormone replacement and cranial radiation on pituitary function

    NARCIS (Netherlands)

    Appelman-Dijkstra, Natasha Mireille

    2015-01-01

    This thesis covers the consequences of cranial irradiation of non-pituitary tumors, eg nasopharyngeal carcinoma, on pituitary function. In chapter 2 we have performed a meta-analysis of available data reported in literature on pituitary function after cranial radiotherapy for head and neck and

  10. MR imaging of pituitary hyperplasia in a child with growth arrest and primary hypothyroidism

    International Nuclear Information System (INIS)

    Papakonstantinou, O.; Bakantaki, A.; Papadaki, E.; Gourtsoyiannis, N.; Bitsori, M.; Mamoulakis, D.

    2000-01-01

    Magnetic resonance imaging of pituitary hyperplasia has been rarely described in children with primary hypothyroidism. We report a case of pituitary hyperplasia in a child presented with significant growth arrest and laboratory evidence of hypothyroidism. Magnetic resonance imaging revealed symmetrical pituitary enlargement simulating macroadenoma. After thyroid hormone replacement therapy, the child's height increased and pituitary enlargement regressed to normal. Awareness of MRI appearance of pituitary hyperplasia in children with laboratory evidence of hypothyroidism might avoid misdiagnosis for pituitary tumor, which may also manifest as growth disorder, obviating unnecessary surgery. (orig.)

  11. Spontaneous regression of pituitary mass in temporal association with pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, H.; Okudaira, Y.

    1987-09-01

    We have encountered a case of a pituitary mass which emerged and enlarged during pregnancy in a 29-year-old woman. On CT scanning the mass disappeared over the course of four months postpartum and was followed by pituitary hypofunction. The hypofunction was restricted to ACTH, GH, and PRL. The visual field defects, bitemporal hemianopsia, disappeared with disappearance of the pituitary mass on CT scanning, indicating that such deficits during this period were reversible. Based on the clinical course and laboratory data, this case is thought to have been lymphocytic adenohypophysitis. It was concluded that among pituitary tumors developing during pregnancy there are some such cases which do not require surgical therapy.

  12. Volumetric polymerization shrinkage of contemporary composite resins

    Directory of Open Access Journals (Sweden)

    Halim Nagem Filho

    2007-10-01

    Full Text Available The polymerization shrinkage of composite resins may affect negatively the clinical outcome of the restoration. Extensive research has been carried out to develop new formulations of composite resins in order to provide good handling characteristics and some dimensional stability during polymerization. The purpose of this study was to analyze, in vitro, the magnitude of the volumetric polymerization shrinkage of 7 contemporary composite resins (Definite, Suprafill, SureFil, Filtek Z250, Fill Magic, Alert, and Solitaire to determine whether there are differences among these materials. The tests were conducted with precision of 0.1 mg. The volumetric shrinkage was measured by hydrostatic weighing before and after polymerization and calculated by known mathematical equations. One-way ANOVA (a or = 0.05 was used to determine statistically significant differences in volumetric shrinkage among the tested composite resins. Suprafill (1.87±0.01 and Definite (1.89±0.01 shrank significantly less than the other composite resins. SureFil (2.01±0.06, Filtek Z250 (1.99±0.03, and Fill Magic (2.02±0.02 presented intermediate levels of polymerization shrinkage. Alert and Solitaire presented the highest degree of polymerization shrinkage. Knowing the polymerization shrinkage rates of the commercially available composite resins, the dentist would be able to choose between using composite resins with lower polymerization shrinkage rates or adopting technical or operational procedures to minimize the adverse effects deriving from resin contraction during light-activation.

  13. Volumetric polymerization shrinkage of contemporary composite resins

    OpenAIRE

    Nagem Filho, Halim; Nagem, Haline Drumond; Francisconi, Paulo Afonso Silveira; Franco, Eduardo Batista; Mondelli, Rafael Francisco Lia; Coutinho, Kennedy Queiroz

    2007-01-01

    The polymerization shrinkage of composite resins may affect negatively the clinical outcome of the restoration. Extensive research has been carried out to develop new formulations of composite resins in order to provide good handling characteristics and some dimensional stability during polymerization. The purpose of this study was to analyze, in vitro, the magnitude of the volumetric polymerization shrinkage of 7 contemporary composite resins (Definite, Suprafill, SureFil, Filtek Z250, Fill ...

  14. Cushing's disease: pituitary imaging

    International Nuclear Information System (INIS)

    Tripathi, S.; Ammini, A.C.; Bhatia, R.; Gupta, R.; Berry, M.; Sarkar, C.; Mahajan, H.

    1994-01-01

    Fourteen patients with adrenocorticotropic hormone (ACTH)-dependent hypercortisolism underwent pituitary scanning with computed axial tomography (CT) and magnetic resonance imaging (MRI). Computed tomography revealed pituitary macroadenomas in two patients, pituitary hyperplasia in one and suspicion of pituitary microadenoma in one. Thirteen patients underwent MRI. One with a macroadenoma diagnosed on CT did not undergo MRI. The MRI revealed a pituitary macroadenoma in one, microadenoma in three and hyperplasia in two cases. Magnetic resonance imaging following gadolinium diethylene triamine penta acetic acid (Gd-DTPA) enhancement revealed four more pituitary microadenomas. All patients who had pituitary adenomas (micro and macro) and hyperplasia underwent trans-sphenoidal pituitary surgery. One of the two patients, who had an enlarged pituitary on imaging but no demonstrable adenoma, was found to have a microadenoma at surgery. It is concluded that patients with ACTH dependent hypercortisolism should undergo MRI of the pituitary gland to identify/localize corticotroph pituitary ademonas. The study should include Gd-DTPA enhancement in cases where the scan is normal. 2 refs., 3 tabs., 3 figs

  15. Malignant Tumors of the Nasal Cavity and Paranasal Sinuses: Long-Term Outcome and Morbidity With Emphasis on Hypothalamic-Pituitary Deficiency

    International Nuclear Information System (INIS)

    Snyers, An; Janssens, Geert; Twickler, Marcel B.; Hermus, Ad R.; Takes, Robert P.; Kappelle, Arnoud C.; Merkx, Matthias A.W.; Dirix, Piet; Kaanders, Johannes H.A.M.

    2009-01-01

    Purpose: To evaluate the long-term outcome after surgery and radiotherapy for patients with sinonasal cancer and assess late toxicity, with special emphasis on hypothalamic-pituitary dysfunction. Methods and Materials: A retrospective analysis of 168 patients treated for sinonasal cancer in a single institute between 1986 and 2006. A more detailed analysis was performed on a subgroup of 76 patients with adenocarcinoma or squamous cell carcinoma treated with curative intent. Long-term survivors were evaluated for late toxicity by a multidisciplinary team using the late effects of normal tissues (LENT SOMA) scoring system. Additional endocrinologic tests were performed for assessment of hypothalamic-pituitary function. Results: Five-year actuarial local control and overall survival rates were 62% and 35% for all patients and 64% and 42% for the subgroup with squamous cell carcinoma and adenocarcinoma. In multivariate analysis, T stage was the only significant factor predicting local relapse (79% at 5 years for T1-T3 vs. 53% for T4; p = 0.006). Sinonasal mucosal melanomas had the highest rate of regional failure (33% at 5 years). Thirteen of 21 patients (62%) evaluated at the late morbidity clinic had hormonal disturbances, of whom 5 (24%) had definitive evidence of hypopituitarism with multiple hormonal deficiencies. Conclusion: Local failure is the dominant cause of treatment failure for patients with sinonasal cancer, with T4 stage the only independent predictor. Because of a high rate of radiation-induced hypopituitarism, we recommend endocrinologic surveillance for these patients

  16. CASE REPORT Acute pituitary apoplexy complicating a pituitary ...

    African Journals Online (AJOL)

    SA JOURNAL OF RADIOLOGY • December 2010. CASE REPORT. Acute pituitary apoplexy complicating a pituitary macroadenoma. Abstract. Pituitary apoplexy is a rare but potentially life-threatening condition caused by either haemorrhage or infarction of the pituitary gland. In most cases, a pre-existing pituitary ...

  17. Hedgehog signaling activation induces stem cell proliferation and hormone release in the adult pituitary gland

    OpenAIRE

    Joanna Pyczek; Rolf Buslei; David Schult; Annett Hölsken; Michael Buchfelder; Ina Heß; Heidi Hahn; Anja Uhmann

    2016-01-01

    Hedgehog (HH) signaling is known to be essential during the embryonal development of the pituitary gland but the knowledge about its role in the adult pituitary and in associated tumors is sparse. In this report we investigated the effect of excess Hh signaling activation in murine pituitary explants and analyzed the HH signaling status of human adenopituitary lobes and a large cohort of pituitary adenomas. Our data show that excess Hh signaling led to increased proliferation of Sox2(+) and S...

  18. Polymerization shrinkage kinetics and shrinkage-stress in dental resin-composites.

    Science.gov (United States)

    Al Sunbul, Hanan; Silikas, Nick; Watts, David C

    2016-08-01

    To investigate a set of resin-composites and the effect of their composition on polymerization shrinkage strain and strain kinetics, shrinkage stress and the apparent elastic modulus. Eighteen commercially available resin-composites were investigated. Three specimens (n=3) were made per material and light-cured with an LED unit (1200mW/cm(2)) for 20s. The bonded-disk method was used to measure the shrinkage strain and Bioman shrinkage stress instrument was used to measure shrinkage stress. The shrinkage strain kinetics at 23°C was monitored for 60min. Maximum strain and stress was evaluated at 60min. The shrinkage strain rate was calculated using numerical differentiation. The shrinkage strain values ranged from 1.83 (0.09) % for Tetric Evoceram (TEC) to 4.68 (0.04) % for Beautifil flow plus (BFP). The shrinkage strain rate ranged from 0.11 (0.01%s(-1)) for Gaenial posterior (GA-P) to 0.59 (0.07) %s(-1) for BFP. Shrinkage stress values ranged from 3.94 (0.40)MPa for TET to 10.45 (0.41)MPa for BFP. The apparent elastic modulus ranged from 153.56 (18.7)MPa for Ever X posterior (EVX) to 277.34 (25.5) MPa for Grandio SO heavy flow (GSO). The nature of the monomer system determines the amount of the bulk contraction that occurs during polymerization and the resultant stress. Higher values of shrinkage strain and stress were demonstrated by the investigated flowable materials. The bulk-fill materials showed comparable result when compared to the traditional resin-composites. Copyright © 2016 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  19. The various MRI patterns of pituitary apoplexy

    International Nuclear Information System (INIS)

    Piotin, M.; Tampieri, D.; Garant, M.; Melanson, D.; Ruefenacht, D.A.; Delavelle, J.; Mohr, G.; Del Carpio, R.; Robert, F.

    1999-01-01

    The aim of this study was to describe the various MRI features, in correlation to surgical and pathological findings, in patients who presented with pituitary apoplexy (PA). Eleven patients presenting with PA, were evaluated with various MR protocols including spin-echo (SE) T1-weighted sequences in 9 of 11 patients, post gadolinium SE T1-weighted sequences in only 8 of 11 patients, and with T2-weighted SE sequences in 2 of 11 patients. All patients had transsphenoidal pituitary surgery after MR studies. The severity of presenting symptoms ranged from headaches to coma. Ten patients had pituitary macroadenoma; one had a non-hemorrhagic metastatic lesion into a non-adenomatous pituitary gland. Of the 11 patients, one was studied at the acute stage of PA (1 day after onset), 9 at the subacute period (3-15 days after onset), and one at the late stage (5 months after onset). Images compatible with intratumoral hemorrhage were found in all macroadenomas, whereas the metastatic pituitary lesion did not show evidence of bleeding. All gadolinium-enhanced studies showed partial tumoral enhancement. The SE T2-weighted studies demonstrated areas of low and high signal intensities in keeping with the presence of blood degradation contents. Pituitary apoplexy present with different MR features, including hemorrhagic and non-hemorrhagic characteristics on T1-weighted images. Gadolinium-enhanced images do not provide complementary diagnostic information when the presence of blood is assessed on plain images. (orig.)

  20. Mortality in patients with pituitary disease.

    LENUS (Irish Health Repository)

    Sherlock, Mark

    2010-06-01

    Pituitary disease is associated with increased mortality predominantly due to vascular disease. Control of cortisol secretion and GH hypersecretion (and cardiovascular risk factor reduction) is key in the reduction of mortality in patients with Cushing\\'s disease and acromegaly, retrospectively. For patients with acromegaly, the role of IGF-I is less clear-cut. Confounding pituitary hormone deficiencies such as gonadotropins and particularly ACTH deficiency (with higher doses of hydrocortisone replacement) may have a detrimental effect on outcome in patients with pituitary disease. Pituitary radiotherapy is a further factor that has been associated with increased mortality (particularly cerebrovascular). Although standardized mortality ratios in pituitary disease are falling due to improved treatment, mortality for many conditions are still elevated above that of the general population, and therefore further measures are needed. Craniopharyngioma patients have a particularly increased risk of mortality as a result of the tumor itself and treatment to control tumor growth; this is a key area for future research in order to optimize the outcome for these patients.

  1. Application of image guidance in pituitary surgery

    Science.gov (United States)

    de Lara, Danielle; Filho, Leo F. S. Ditzel; Prevedello, Daniel M.; Otto, Bradley A.; Carrau, Ricardo L.

    2012-01-01

    Background: Surgical treatment of pituitary pathologies has evolved along the years, adding safety and decreasing morbidity related to the procedure. Advances in the field of radiology, coupled with stereotactic technology and computer modeling, have culminated in the contemporary and widespread use of image guidance systems, as we know them today. Image guidance navigation has become a frequently used technology that provides continuous three-dimensional information for the accurate performance of neurosurgical procedures. We present a discussion about the application of image guidance in pituitary surgeries. Methods: Major indications for image guidance neuronavigation application in pituitary surgery are presented and demonstrated with illustrative cases. Limitations of this technology are also presented. Results: Patients presenting a history of previous transsphenoidal surgeries, anatomical variances of the sphenoid sinus, tumors with a close relation to the internal carotid arteries, and extrasellar tumors are the most important indications for image guidance in pituitary surgeries. The high cost of the equipment, increased time of surgery due to setup time, and registration and the need of specific training for the operating room personnel could be pointed as limitations of this technology. Conclusion: Intraoperative image guidance systems provide real-time images, increasing surgical accuracy and enabling safe, minimally invasive interventions. However, the use of intraoperative navigation is not a replacement for surgical experience and a systematic knowledge of regional anatomy. It must be recognized as a tool by which the neurosurgeon can reduce the risk associated with surgical approach and treatment of pituitary pathologies. PMID:22826819

  2. Influence of Shrinkage-Reducing Admixtures on the Development of Plastic Shrinkage Cracks

    DEFF Research Database (Denmark)

    Lura, Pietro; Pease, Bradley Justin; Mazzotta, Guy

    2007-01-01

    The term plastic shrinkage cracking is generally used to describe cracks that form between the time when concrete is placed and the time when concrete sets. This paper discusses how the evaporation of water causes concave menisci to form on the surface of fresh concrete. These menisci cause both...... settlement of the concrete and tensile stress development in the surface of the concrete, which increase the potential for development of plastic shrinkage cracks. Specifically, this paper studies the development of plastic shrinkage cracks in mortars containing a commercially available shrinkage-reducing...... admixture (SRA). Mortars containing SRA show fewer and narrower plastic shrinkage cracks than plain mortars when exposed to the same environmental conditions. It is proposed that the lower surface tension of the pore fluid in the mortars containing SRA results in less evaporation, reduced settlement...

  3. Heat shrinkage of electron beam modified EVA

    International Nuclear Information System (INIS)

    Datta, S.K.; Chaki, T.K.; Bhowmick, A.K.

    1997-01-01

    Heat shrinkage of electron beam modified ethylene vinyl acetate copolymer (EVA) has been investigated over a range of times, temperatures, stretching, irradiation doses and trimethylolpropane trimethacrylate (TMPTMA) levels. The irradiated (radiation dose 50 kGy and TMPTMA level 1%) and stretched (100% elongation) sample shrinks to a maximum level when kept at 453K temperature for 60 s. The heat shrinkage of samples irradiated with radiation doses of 20, 50, 100 and 150 kGy increases sharply with increasing stretching in the initial stage. Amnesia rating decreases with increasing radiation dose and TMPTMA level as well as gel content. The high radiation dose and TMPTMA level lower the heat shrinkage due to the chain scission. The effect of temperature at which extension is carried out on heat shrinkage is marginal. The irradiated (radiation dose 50 kGy and TMPTMA level 1%) EVA tubes of different dimensions expanded in a laboratory grade tube expander show similar behaviour at 453K and 60 s. The X-ray and DSC studies reveal that the crystallinity increases on stretching due to orientation of chains and it decreases to a considerable extent on heat shrinking. The theoretical and experimental values of heat shrinkage for tubes and rectangular strips are in good accord, when the radiation dose is 50 kGy and TMPTMA level 1%. (author)

  4. Heat shrinkage of electron beam modified EVA

    Energy Technology Data Exchange (ETDEWEB)

    Datta, S.K.; Chaki, T.K.; Bhowmick, A.K. [Indian Institute of Technology, Kharagpur (India). Rubber Technology Center; Tikku, V.K.; Pradhan, N.K. [NICCO Corporation Ltd., (Cable Div.), Calcutta (India)

    1997-10-01

    Heat shrinkage of electron beam modified ethylene vinyl acetate copolymer (EVA) has been investigated over a range of times, temperatures, stretching, irradiation doses and trimethylolpropane trimethacrylate (TMPTMA) levels. The irradiated (radiation dose 50 kGy and TMPTMA level 1%) and stretched (100% elongation) sample shrinks to a maximum level when kept at 453K temperature for 60 s. The heat shrinkage of samples irradiated with radiation doses of 20, 50, 100 and 150 kGy increases sharply with increasing stretching in the initial stage. Amnesia rating decreases with increasing radiation dose and TMPTMA level as well as gel content. The high radiation dose and TMPTMA level lower the heat shrinkage due to the chain scission. The effect of temperature at which extension is carried out on heat shrinkage is marginal. The irradiated (radiation dose 50 kGy and TMPTMA level 1%) EVA tubes of different dimensions expanded in a laboratory grade tube expander show similar behaviour at 453K and 60 s. The X-ray and DSC studies reveal that the crystallinity increases on stretching due to orientation of chains and it decreases to a considerable extent on heat shrinking. The theoretical and experimental values of heat shrinkage for tubes and rectangular strips are in good accord, when the radiation dose is 50 kGy and TMPTMA level 1%. (author).

  5. Comparison of two heterogeneity correction algorithms in pituitary gland treatments with intensity-modulated radiation therapy; Comparacao de dois algoritmos de correcao de heterogeneidade em tratamentos de tumores de hipofise com radioterapia de intensidade modulada

    Energy Technology Data Exchange (ETDEWEB)

    Albino, Lucas D.; Santos, Gabriela R.; Ribeiro, Victor A.B.; Rodrigues, Laura N., E-mail: lucasdelbem1@gmail.com [Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil). Faculdade de Medicina. Instituto de Radiologia; Weltman, Eduardo; Braga, Henrique F. [Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, SP (Brazil). Servico de Radioterapia

    2013-12-15

    The dose accuracy calculated by a treatment planning system is directly related to the chosen algorithm. Nowadays, several calculation doses algorithms are commercially available and they differ in calculation time and accuracy, especially when individual tissue densities are taken into account. The aim of this study was to compare two different calculation algorithms from iPlan®, BrainLAB, in the treatment of pituitary gland tumor with intensity-modulated radiation therapy (IMRT). These tumors are located in a region with variable electronic density tissues. The deviations from the plan with no heterogeneity correction were evaluated. To initial validation of the data inserted into the planning system, an IMRT plan was simulated in a anthropomorphic phantom and the dose distribution was measured with a radiochromic film. The gamma analysis was performed in the film, comparing it with dose distributions calculated with X-ray Voxel Monte Carlo (XVMC) algorithm and pencil beam convolution (PBC). Next, 33 patients plans, initially calculated by PBC algorithm, were recalculated with XVMC algorithm. The treatment volumes and organs-at-risk dose-volume histograms were compared. No relevant differences were found in dose-volume histograms between XVMC and PBC. However, differences were obtained when comparing each plan with the plan without heterogeneity correction. (author)

  6. Pituitary granulomatosis with polyangiitis

    OpenAIRE

    Slabu, Hannah; Arnason, Terra

    2013-01-01

    Granulomatosis with polyangiitis (GPA) is a small vessel vasculitis that can affect several organs, most commonly the respiratory tract and kidneys. Pituitary involvement is exceptionally rare. Most case reports of GPA of the pituitary gland have been described in middle-aged women who have concomitant ears, nose and throat involvement. The most frequent manifestation is diabetes insipidus due to a preponderance of posterior pituitary infiltration. The majority of cases sustain permanent dama...

  7. Assessment of concrete creep and shrinkage

    International Nuclear Information System (INIS)

    Trivedi, Neha; Singh, R.K.

    2012-01-01

    B-3 model prediction of concrete creep and shrinkage strains on cylindrical specimen and BARC Containment test model (BARCOM) are presented. Experimental shrinkage strain is shown to be in agreement with B-3 model predictions for cylindrical specimen and BARCOM. Creep strain in cylindrical specimen is found to be in agreement with B-3 model. In BARCOM for wall cast in different pores, creep strain is in agreement with B-3 model in hoop direction however in longitudinal direction, observed creep strain in higher than B-3 model. For dome structure cast in a single pour, experimental creep strain shows confirmity with B-3 model both in hoop and longitudinal directions. The study on concrete aging and average longitudinal shrinkage strain is carried out. (author)

  8. Dry shrinkage characteristics of buffer materials

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, H. [ITC, Tokai, Ibaraki (Japan); Fujita, A.

    1999-03-01

    Generation of cracks due to drying of compressed bentonite was observed by changing the initial water content to obtain shrinkage constants such as shrinkage limit and shrinking rate. As a result, generation of practically no cracks was observed when the initial water content of samples was below 13%. The volume change due to drying increased with the water content in the sample, and the shrinkage constants were found to depend on the initial water content. Further, the one-dimensional compression strength after drying was compared with that before drying in order to clarify the effect of cracks generated by drying on the mechanical strength. As a result, the dry sample with cracks proved to have large one-dimensional compression strength or E{sub 50} compared to wet samples, so that the mechanical strength was kept even after drying. (H. Baba)

  9. Cell proliferation and death in the irradiated pituitary gland and its modification by growth stimulants

    International Nuclear Information System (INIS)

    Guo Yaping; Hendry, Jolyon H.; Morris, Ian D.; Davis, Julian R.E.; Beardwell, Colin G.

    1997-01-01

    the hypothalamic-pituitary vasculature. The increasing proportion of GH cells after irradiation indicates that lactotrophs respond more rapidly to irradiation. The stimulation by E 2 + S somehow prevented the radiation-damaged lactotrophs from becoming giant cells. Also, the ratio of apoptotic cells to BrdU-labeled cells was increased by the E 2 + S treatment, indicating that the E 2 + S did enhance radiation-induced cell death relative to cell renewal. However, overall, the E 2 + S stimulus protocol did not promote a dramatic increase in cell death (apoptosis) nor a marked decrease in residual gland weight after irradiation. Hence, its use would probably not be beneficial in the treatment of slow-responding prolactinomas, if malignant lactotrophs respond similarly to the normal pituitary lactotrophs. However, the observation of induced apoptosis after hormone and drug withdrawal suggests that agents which promote tumor shrinkage may be effective by causing rapid apoptosis of tumor cells in vivo

  10. G protein abnormalities in pituitary adenomas.

    Science.gov (United States)

    Spada, A; Lania, A; Ballarè, E

    1998-07-25

    It has been demonstrated that the majority of secreting and nonsecreting adenomas is monoclonal in origin suggesting that these neoplasia arise from the replication of a single mutated cell, in which growth advantage results from either activation of protooncogenes or inactivation of antioncogenes. Although a large number of genes has been screened for mutations, only few genetic abnormalities have been found in pituitary tumors such as allelic deletion of chromosome 11q13 where the MEN-1 gene has been localised, and mutations in the gene encoding the alpha subunit of the stimulatory Gs and Gi2 protein. These mutations constitutively activate the alpha subunit of the Gs and Gi2 protein by inhibiting their intrinsic GTPase activity. Both Gs alpha and Gi2alpha can be considered products of protooncogenes (gsp and gip2, respectively) since gain of function mutations that activate mitogenic signals have been recognized in human tumors. Gsp oncogene is found in 30-40% of GH-secreting adenomas, in a low percentage of nonfunctioning and ACTH-secreting pituitary adenomas, in toxic thyroid adenomas and differentiated thyroid carcinomas. The same mutations, occurred early in embriogenesis, have been also identified in tissues from patients affected with the McCune Albright syndrome. These mutations result in an increased cAMP production and in the subsequent overactivation of specific pathways involved in both cell growth and specific programmes of cell differentiation. By consequence, the endocrine tumors expressing gsp oncogene retain differentiated functions. The gip2 oncogene has been identified in about 10% of nonfunctioning pituitary adenomas, in tumors of the ovary and the adrenal cortex. However, it remains to be established whether Gi proteins activate mitogenic signals in pituitary cells. Since Gi proteins are involved in mediating the effect of inhibitory neurohormones on intracellular effectors, it has been proposed that in pituitary tumors the low expression of

  11. Immediate postoperative complications in transsphenoidal pituitary surgery: A prospective study

    Directory of Open Access Journals (Sweden)

    Tumul Chowdhury

    2014-01-01

    Full Text Available Background: Considering the important role of pituitary gland in regulating various endocrine axes and its unique anatomical location, various postoperative complications can be anticipated resulting from surgery on pituitary tumors. We examined and categorized the immediate postoperative complications according to various tumor pathologies. Materials and Methods: We carried out a prospective study in 152 consecutive patients and noted various postoperative complications during neurosurgical intensive care unit stay (within 48 hrs of hospital stay in patients undergoing transsphenoidal removal of pituitary tumors. Results: In our series, various groups showed different postoperative complications out of which, cerebrospinal fluid leak was the commonest followed by diabetes insipidus, postoperative nausea and vomiting, and hematoma at operation site. Conclusion: Various immediate postoperative complications can be anticipated in transsphenoidal pituitary surgery even though, it is considered to be relatively safe.

  12. MRI of the hypothalamic-pituitary axis in children

    International Nuclear Information System (INIS)

    Argyropoulou, Maria I.; Kiortsis, Dimitrios Nikiforos

    2005-01-01

    In childhood, the MR characteristics of the normal pituitary gland are well established. During the first 2 months of life the adenohypophysis demonstrates high signal. Pituitary gland height (PGH) decreases during the 1st year of life and then increases, reaching a plateau after puberty. The magnetization transfer ratio (MTR) increases in both sexes up to the age of 20 years. On dynamic contrast-enhanced studies, the posterior pituitary lobe enhances simultaneously with the straight sinus, and the adenohypophysis later, but within 30 s. In genetically determined dysfunctional states, the adenohypophysis may be normal, hypoplastic, or enlarged. Pituitary enlargement, observed in Prop 1 gene mutations, is characterized by a mass interposed between the anterior and posterior lobes. An ectopic posterior lobe (EPP), associated with a hypoplastic or absent pituitary stalk, may be observed in patients with hypopituitarism. Tumors of the hypothalamic-pituitary (HP) axis may be the origin of adenohypophyseal deficiencies. A small hypointense adenohypophysis is found in iron overload states and is often associated with hypogonadotrophic hypogonadism. Absence of the posterior lobe bright signal, with or without a thick pituitary stalk or a mass at any site from the median eminence to the posterior pituitary lobe, may be found in diabetes insipidus. Hydrocephalus, suprasellar arachnoid cysts, hypothalamic hamartomas and craniopharyngiomas may result in central precocious puberty (CPP). Increased PGH in girls with idiopathic CPP is useful for its differential diagnosis from premature thelarche (PT). Pituitary adenomas, observed mainly in adolescents, present the same MR characteristics as those in adults. (orig.)

  13. MRI of the hypothalamic-pituitary axis in children

    Energy Technology Data Exchange (ETDEWEB)

    Argyropoulou, Maria I. [University of Ioannina, Department of Radiology, Medical School, Ioannina (Greece); Kiortsis, Dimitrios Nikiforos [University of Ioannina, Department of Physiology, Medical School, Ioannina (Greece)

    2005-11-01

    In childhood, the MR characteristics of the normal pituitary gland are well established. During the first 2 months of life the adenohypophysis demonstrates high signal. Pituitary gland height (PGH) decreases during the 1st year of life and then increases, reaching a plateau after puberty. The magnetization transfer ratio (MTR) increases in both sexes up to the age of 20 years. On dynamic contrast-enhanced studies, the posterior pituitary lobe enhances simultaneously with the straight sinus, and the adenohypophysis later, but within 30 s. In genetically determined dysfunctional states, the adenohypophysis may be normal, hypoplastic, or enlarged. Pituitary enlargement, observed in Prop 1 gene mutations, is characterized by a mass interposed between the anterior and posterior lobes. An ectopic posterior lobe (EPP), associated with a hypoplastic or absent pituitary stalk, may be observed in patients with hypopituitarism. Tumors of the hypothalamic-pituitary (HP) axis may be the origin of adenohypophyseal deficiencies. A small hypointense adenohypophysis is found in iron overload states and is often associated with hypogonadotrophic hypogonadism. Absence of the posterior lobe bright signal, with or without a thick pituitary stalk or a mass at any site from the median eminence to the posterior pituitary lobe, may be found in diabetes insipidus. Hydrocephalus, suprasellar arachnoid cysts, hypothalamic hamartomas and craniopharyngiomas may result in central precocious puberty (CPP). Increased PGH in girls with idiopathic CPP is useful for its differential diagnosis from premature thelarche (PT). Pituitary adenomas, observed mainly in adolescents, present the same MR characteristics as those in adults. (orig.)

  14. Familial Isolated Pituitary Adenomas (FIPA) and the Pituitary Adenoma Predisposition due to Mutations in the Aryl Hydrocarbon Receptor Interacting Protein (AIP) Gene

    Science.gov (United States)

    Aaltonen, Lauri A.; Daly, Adrian F.

    2013-01-01

    Pituitary adenomas are one of the most frequent intracranial tumors and occur with a prevalence of approximately 1:1000 in the developed world. Pituitary adenomas have a serious disease burden, and their management involves neurosurgery, biological therapies, and radiotherapy. Early diagnosis of pituitary tumors while they are smaller may help increase cure rates. Few genetic predictors of pituitary adenoma development exist. Recent years have seen two separate, complimentary advances in inherited pituitary tumor research. The clinical condition of familial isolated pituitary adenomas (FIPA) has been described, which encompasses the familial occurrence of isolated pituitary adenomas outside of the setting of syndromic conditions like multiple endocrine neoplasia type 1 and Carney complex. FIPA families comprise approximately 2% of pituitary adenomas and represent a clinical entity with homogeneous or heterogeneous pituitary adenoma types occurring within the same kindred. The aryl hydrocarbon receptor interacting protein (AIP) gene has been identified as causing a pituitary adenoma predisposition of variable penetrance that accounts for 20% of FIPA families. Germline AIP mutations have been shown to associate with the occurrence of large pituitary adenomas that occur at a young age, predominantly in children/adolescents and young adults. AIP mutations are usually associated with somatotropinomas, but prolactinomas, nonfunctioning pituitary adenomas, Cushing disease, and other infrequent clinical adenoma types can also occur. Gigantism is a particular feature of AIP mutations and occurs in more than one third of affected somatotropinoma patients. Study of pituitary adenoma patients with AIP mutations has demonstrated that these cases raise clinical challenges to successful treatment. Extensive research on the biology of AIP and new advances in mouse Aip knockout models demonstrate multiple pathways by which AIP may contribute to tumorigenesis. This review assesses

  15. Surgical strategy for giant pituitary adenoma based on evaluation of fine feeding system and angioarchitecture

    Directory of Open Access Journals (Sweden)

    Yoshikazu Ogawa, M.D., Ph.D.

    2017-06-01

    Conclusion: Major blood supply was different from the normal supply to the anterior pituitary gland and did not necessarily correspond to tumor shape and extension. Surgical strategy should be established based on the tumor feeding systems and hemodynamics in giant pituitary adenomas.

  16. Pituitary cell differentiation from stem cells and other cells: toward restorative therapy for hypopituitarism?

    Science.gov (United States)

    Willems, Christophe; Vankelecom, Hugo

    2014-01-01

    The pituitary gland, key regulator of our endocrine system, produces multiple hormones that steer essential physiological processes. Hence, deficient pituitary function (hypopituitarism) leads to severe disorders. Hypopituitarism can be caused by defective embryonic development, or by damage through tumor growth/resection and traumatic brain injury. Lifelong hormone replacement is needed but associated with significant side effects. It would be more desirable to restore pituitary tissue and function. Recently, we showed that the adult (mouse) pituitary holds regenerative capacity in which local stem cells are involved. Repair of deficient pituitary may therefore be achieved by activating these resident stem cells. Alternatively, pituitary dysfunction may be mended by cell (replacement) therapy. The hormonal cells to be transplanted could be obtained by (trans-)differentiating various kinds of stem cells or other cells. Here, we summarize the studies on pituitary cell regeneration and on (trans-)differentiation toward hormonal cells, and speculate on restorative therapies for pituitary deficiency.

  17. Cushing-type ectopic pituitary adenoma with unusual pathologic features

    Directory of Open Access Journals (Sweden)

    Kristopher T. Kimmell, MD

    2014-06-01

    Full Text Available Ectopic pituitary adenomas comprise, by varying reports, approximately 1-2% of all pituitary adenomas. They are often located in the nasopharyngeal region associated with the pharyngeal pituitary. The location and pathologic features of these masses make them atypical when compared with intrasellar pituitary adenomas. A 54-year-old man presented with vertebral compression fracture and physical stigmata of Cushing’s disease. Biochemical testing confirmed hypercortisolemia responsive to high dose dexamethasone suppression. MRI of the head demonstrated an enhancing mass in the posterior aspect of the sphenoid sinus not involving the sella turcica. Endoscopic biopsy followed by resection confirmed this mass to be a pituitary adenoma with unusual pathologic features. Most notably, the tumor cells demonstrated large, eosinophilic, vacuolated cytoplasm. Immunohistochemical profile of the tumor was typical of an ACTH secreting tumor, notably with positivity for ACTH. The patient did well from his surgery. Post-operatively his serum cortisol level normalized and he remains in chemical remission one year after surgery. Ectopic pituitary adenomas are an unusual manifestation of hormonally active pituitary neoplastic disease. Their atypical clinical presentations, location, and pathologic features can make them a diagnostic challenge. Clinicians should be aware of these entities, especially when considering differential diagnosis for a mass in the sphenoid sinus and nasopharyngeal region.

  18. Evaluation of pituitary lesions on magnetic resonance imaging

    International Nuclear Information System (INIS)

    Sakurai, Takashi; Sakamoto, Tatsuo; Sekino, Hiroaki; Inada, Yoichi; Ishikawa, Toru; Sato, Mitsuya

    1994-01-01

    We evaluated the magnetic resonance imaging (MRI) of seventeen patients with pituitary adenomas (10 cases of prolactin secreting ; 2, growth hormone secreting and 5, non-functioning adenomas) and three patients with pituitary enlargement due to hypothyroidism. The volume of the functional adenomas or the enlarged pituitary glands correlated by MRI correlated with the level of serum pituitary hormone. We evaluated the points of differences on the T 1 weighted images of MRI between microadenomas and pituitary enlargements. The microadenomas appeared as the enlarged pituitary gland with isointensity area, but following administration of Gd-DTPA, the adenomas were recognized as a low intensity area (mass) with in an enhanced high intensity area of the normal gland with a shift of the pituitary stalk. On the other hand, the pituitary enlargements appeared as a large iso intensity area on T 1 weighted images, and were homogeneously enhanced as a high intensity area after Gd-DTPA administration, but without a shift of the pituitary stalk. Signal intensity ratios (SIR) and contrast enhancement ratios (CER) of all cases with pituitary adenomas were calculated using MRI. Differences in SIR and CER could not be demonstrated among the hormone-secreting adenomas. Thus, it is difficult to differentiate the various types of adenomas by using the differences in SIR or CER, since there are many, interfering factors, including hemorrhage, cyst, and necrosis. Postoperative permanent diabetes insipidus (DI) appeared in the cases that had no visualization of posterior high signal intensity area and a tumoral mass effect on the hypothalamus on preoperative MRI. The reason for postoperative permanent DI is thought to be the result of a disturbance of blood circulation in the pituitary gland due to a mass effect and surgical burden to the proximal pituitary stalk or the hypothalamus. (author)

  19. Fractionated proton beam irradiation of pituitary adenomas

    International Nuclear Information System (INIS)

    Ronson, Brian B.; Schulte, Reinhard W.; Han, Khanh P.; Loredo, Lilia N.; Slater, James M.; Slater, Jerry D.

    2006-01-01

    Purpose: Various radiation techniques and modalities have been used to treat pituitary adenomas. This report details our experience with proton treatment of these tumors. Methods and Materials: Forty-seven patients with pituitary adenomas treated with protons, who had at least 6 months of follow-up, were included in this analysis. Forty-two patients underwent a prior surgical resection; 5 were treated with primary radiation. Approximately half the tumors were functional. The median dose was 54 cobalt-gray equivalent. Results: Tumor stabilization occurred in all 41 patients available for follow-up imaging; 10 patients had no residual tumor, and 3 had greater than 50% reduction in tumor size. Seventeen patients with functional adenomas had normalized or decreased hormone levels; progression occurred in 3 patients. Six patients have died; 2 deaths were attributed to functional progression. Complications included temporal lobe necrosis in 1 patient, new significant visual deficits in 3 patients, and incident hypopituitarism in 11 patients. Conclusion: Fractionated conformal proton-beam irradiation achieved effective radiologic, endocrinological, and symptomatic control of pituitary adenomas. Significant morbidity was uncommon, with the exception of postradiation hypopituitarism, which we attribute in part to concomitant risk factors for hypopituitarism present in our patient population

  20. Quantitative analyses of shrinkage characteristics of neem ...

    African Journals Online (AJOL)

    Quantitative analyses of shrinkage characteristics of neem (Azadirachta indica A. Juss.) wood were carried out. Forty five wood specimens were prepared from the three ecological zones of north eastern Nigeria, viz: sahel savanna, sudan savanna and guinea savanna for the research. The results indicated that the wood ...

  1. Shrinkage Approach for Gene Expression Data Analysis

    Czech Academy of Sciences Publication Activity Database

    Haman, Jiří; Valenta, Zdeněk

    2013-01-01

    Roč. 9, č. 3 (2013), s. 2-8 ISSN 1801-5603 Grant - others:UK(CZ) SVV-2013-266517 Institutional support: RVO:67985807 Keywords : microarray technology * high dimensional data * mean squared error * James-Stein shrinkage estimator * mutual information Subject RIV: IN - Informatics, Computer Science http://www.ejbi.org/img/ejbi/2013/3/Haman_en.pdf

  2. Shrinkage Approach for Gene Expression Data Analysis

    Czech Academy of Sciences Publication Activity Database

    Haman, Jiří; Valenta, Zdeněk; Kalina, Jan

    2013-01-01

    Roč. 1, č. 1 (2013), s. 65-65 ISSN 1805-8698. [EFMI 2013 Special Topic Conference. 17.04.2013-19.04.2013, Prague] Institutional support: RVO:67985807 Keywords : shrinkage estimation * covariance matrix * high dimensional data * gene expression Subject RIV: IN - Informatics, Computer Science

  3. Predicting difficult laryngoscopy in acromegalic patients undergoing surgery for excision of pituitary tumors: A comparison of extended Mallampati score with modified Mallampati classification

    Directory of Open Access Journals (Sweden)

    Ashish Bindra

    2013-01-01

    Full Text Available Background: There are numerous reports of difficult laryngoscopy and intubation in patients with acromegaly. To date, no study has assessed the application of extended Mallampati score (EMS for predicting difficult intubation in acromegalics. The primary aim of this study was to compare EMS with modified Mallampati classification (MMP in predicting difficult laryngoscopy in acromegalic patients. We hypothesized that since EMS has been reported to be more specific and better predictor than MMP, it may be superior to the MMP to predict difficult laryngoscopy in acromegalic patients. Materials and Methods: For this prospective cohort study with matched controls, acromegalic patients scheduled to undergo pituitary surgery over a period of 3 years (January 2008-December 2010 were enrolled. Preoperative airway assessment was performed by experienced anesthesiologists and involved a MMP and the EMS. Under anesthesia, laryngoscopic view was assessed using Cormack-Lehane (CL grading. MMP and CL grades of I and II were defined "easy" and III and IV as "difficult". EMS grade of I and II were defined "easy" and III as "difficult". Data were used to determine the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MMP and EMS in predicting difficult laryngoscopy. Results: Seventy eight patients participated in the study (39 patients in each group. Both MMP and EMS failed to detect difficult laryngoscopy in seven patients. Only one laryngoscopy was predicted to be difficult by both tests which was in fact, difficult. Conclusion: We found that addition of neck extension did not improve the predictive value of MMP.

  4. Clinical and histological study of pituitary fibrosarcoma following radiotherapy for pituitary adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Kazufumi; Hayashi, Minoru; Kubota, Toshihiko; Kawano, Hirokazu; Handa, Yuji [Fukui Medical School, Matsuoka (Japan); Komai, Toshio

    1990-11-01

    A 49-year old male was admitted with a history of radiotherapy for a pituitary adenoma 9 years earlier. Three weeks prior to admission, he noticed visual loss in the left eye. Computed tomography (CT) scan revealed a sellar tumor. The patient underwent craniotomy and the tumor was partially resected. The histological diagnosis was benign pituitary adenoma. Two months after surgery, he began to complain of headache and left hemiparesis. CT scan at that time showed a large parasellar tumor extending into the right temporal lobe. A second craniotomy was performed and a firm tumor was partially removed. Under light microscopy, the tumor was composed of anaplastic spindle cells showing a fascicular pattern. Ultrastructurally, the tumor cells were spindle-shaped with elongated nuclei. The cytoplasm contained numerous distended rough endoplasmic reticula and free ribosomes, Golgi apparatus as well as glycogen granules. Some desmosome-like intercellular adherents were observed. Collagen fibers were scattered in the extracellular space. There was no apparent formation of a basement membrane. These findings suggested a close morphological similarity between tumor cells and fibroblasts, conforming to ultrastructural diagnostic criteria for fibrosarcoma. In spite of intensive treatment, such as a second radiotherapy and subsequent craniotomy, the patient died 9 months after admission. The clinical course and pathological findings of the post-irradiation pituitary fibrosarcoma are discussed. (author).

  5. Drying shrinkage problems in high PI subgrade soils.

    Science.gov (United States)

    2014-01-01

    The main objective of this study was to investigate the longitudinal cracking in pavements due to drying : shrinkage of high PI subgrade soils. The study involved laboartory soil testing and modeling. The : shrinkage cracks usually occur within the v...

  6. Risk-adapted single or fractionated stereotactic high-precision radiotherapy in a pooled series of nonfunctioning pituitary adenomas. High local control and low toxicity

    International Nuclear Information System (INIS)

    Bostroem, Jan Patrick; Meyer, Almuth; Pintea, Bogdan; Gerlach, Ruediger; Surber, Gunnar; Hamm, Klaus; Lammering, Guido

    2014-01-01

    The purpose of this work was to evaluate a prospectively initiated two-center protocol of risk-adapted single-fraction (SRS) or fractionated radiotherapy (SRT) in patients with nonsecretory pituitary adenomas (NSA). A total of 73 NSA patients (39 men/34 women) with a median age of 62 years were prospectively included in a treatment protocol of SRS [planning target volume (PTV) 2 mm to optic pathways = low risk] or SRT (PTV ≥ 4 ccm, ≤ 2 mm to optic pathways = high risk) in two Novalis registered centers. Mean tumor volume was 7.02 ccm (range 0.58-57.29 ccm). Based on the protocol guidelines, 5 patients were treated with SRS and 68 patients with SRT. Median follow-up (FU) reached 5 years with 5-year overall survival (OS) of 90.4 % (CI 80.2-95 %) and 5-year local control and progression-free survival rates of 100 % (CI 93.3-100 %) and 90.4 % (CI 80.2-95 %), respectively. A post-SRS/SRT new visual disorder occurred in 2 patients (2.7 %), a new oculomotor nerve palsy in one pre-irradiated patient, in 3 patients (4.1 %) a pre-existing visual disorder improved. New complete hypopituitarism occurred in 4 patients (13.8 %) and in 3 patients (25 %) with pre-existing partial hypopituitarism. Pituitary function in 26 % of patients retained normal. Patients with tumor shrinkage (65.75 %) had a significantly longer FU (p = 0.0093). Multivariate analysis confirmed correlation of new hypopituitarism with duration of FU (p = 0.008) and correlation of new hypopituitarism and tumor volume (p = 0.023). No significant influence factors for occurrence of visual disorders were found. Our SRS/SRT protocol proved to be safe and successful in terms of tumor control and protection of the visual system, especially for large tumors located close to optic pathways. (orig.) [de

  7. The Meaning of Using «The Quality of Life Assessment of Growth Hormone Deficiency in Adults» Questionnaire in Patients with Non-Functional Pituitary Adenomas and Various Tumors of Chiasmosellar Area in Pre- and Postoperative Period

    Directory of Open Access Journals (Sweden)

    Yu.M. Urmanova

    2014-10-01

    Full Text Available The authors have examined 136 patients with growth hormone deficiency (GHD of various origins (pituitary tumors and ischemic heart disease — comparison group. The investigation of the quality of life on the basis of GHD questionnaire «Quality of Life Assessment of Growth Hormone Deficiency in Adults» (QoL-AGHDA in 136 patients showed, that in all groups the average score was higher than normal one (normal < 11, and most significantly it was observed in patients of first, third and fourth groups and second subgroup of the fifth group. Reliable correlation between low basal levels of somatotropic hormone (STH, insulin-like growth factor-1 (IGF-1 of blood plasma and average score by GHD questionnaire QoL-AGHDA was found in the first, second, third, and fourth groups of the second subgroup of the fifth group of patients, that confirms high efficacy of using GHD questionnaire QoL-AGHDA in patients with GHD of various origins. 36 patients in 3 months after transnasal hypophysectomy reported reliable increase in the average score by GHD questionnaire on the background of decreased levels of STH and IGF-1. This shows that in the early postoperative period in patients the severity of hypopituitarism increases and the question of the prescription of hormone replacement therapy arises.

  8. Angiogenesis in Pituitary Adenomas: Human Studies and New Mutant Mouse Models

    Directory of Open Access Journals (Sweden)

    Carolina Cristina

    2014-01-01

    Full Text Available The role of angiogenesis in pituitary tumor development has been questioned, as pituitary tumors have been usually found to be less vascularized than the normal pituitary tissue. Nevertheless, a significantly higher degree of vasculature has been shown in invasive or macropituitary prolactinomas when compared to noninvasive and microprolactinomas. Many growth factors and their receptors are involved in pituitary tumor development. For example, VEGF, FGF-2, FGFR1, and PTTG, which give a particular vascular phenotype, are modified in human and experimental pituitary adenomas of different histotypes. In particular, vascular endothelial growth factor, VEGF, the central mediator of angiogenesis in endocrine glands, was encountered in experimental and human pituitary tumors at different levels of expression and, in particular, was higher in dopamine agonist resistant prolactinomas. Furthermore, several anti-VEGF techniques lowered tumor burden in human and experimental pituitary adenomas. Therefore, even though the role of angiogenesis in pituitary adenomas is contentious, VEGF, making permeable pituitary endothelia, might contribute to adequate temporal vascular supply and mechanisms other than endothelial cell proliferation. The study of angiogenic factor expression in aggressive prolactinomas with resistance to dopamine agonists will yield important data in the search of therapeutical alternatives.

  9. Angiogenesis in pituitary adenomas: human studies and new mutant mouse models.

    Science.gov (United States)

    Cristina, Carolina; Luque, Guillermina María; Demarchi, Gianina; Lopez Vicchi, Felicitas; Zubeldia-Brenner, Lautaro; Perez Millan, Maria Ines; Perrone, Sofia; Ornstein, Ana Maria; Lacau-Mengido, Isabel M; Berner, Silvia Inés; Becu-Villalobos, Damasia

    2014-01-01

    The role of angiogenesis in pituitary tumor development has been questioned, as pituitary tumors have been usually found to be less vascularized than the normal pituitary tissue. Nevertheless, a significantly higher degree of vasculature has been shown in invasive or macropituitary prolactinomas when compared to noninvasive and microprolactinomas. Many growth factors and their receptors are involved in pituitary tumor development. For example, VEGF, FGF-2, FGFR1, and PTTG, which give a particular vascular phenotype, are modified in human and experimental pituitary adenomas of different histotypes. In particular, vascular endothelial growth factor, VEGF, the central mediator of angiogenesis in endocrine glands, was encountered in experimental and human pituitary tumors at different levels of expression and, in particular, was higher in dopamine agonist resistant prolactinomas. Furthermore, several anti-VEGF techniques lowered tumor burden in human and experimental pituitary adenomas. Therefore, even though the role of angiogenesis in pituitary adenomas is contentious, VEGF, making permeable pituitary endothelia, might contribute to adequate temporal vascular supply and mechanisms other than endothelial cell proliferation. The study of angiogenic factor expression in aggressive prolactinomas with resistance to dopamine agonists will yield important data in the search of therapeutical alternatives.

  10. Mesoscopic analysis of drying shrinkage damage in a cementitious material

    DEFF Research Database (Denmark)

    Moonen, P.; Pedersen, R.R.; Simone, A.

    2008-01-01

    Concrete and cement-based materials exhibit shrinkage when exposed to drying. Structural effects and inhomogeneity of material properties adverse free shrinkage, hereby inducing stress concentrations and possibly damage. In this contribution, the magnitude of shrinkage- induced damage during...... temperatures are considered: 35 °C and 50 °C. Significantly more micro-damage and higher internal stresses are found for the latter, revealing the importance of drying shrinkage damage, even at laboratory scale....

  11. Hypopituitarism after stereotactic radiosurgery for pituitary adenomas.

    Science.gov (United States)

    Xu, Zhiyuan; Lee Vance, Mary; Schlesinger, David; Sheehan, Jason P

    2013-04-01

    Studies of new-onset Gamma Knife stereotactic radiosurgery (SRS)-induced hypopituitarism in large cohort of pituitary adenoma patients with long-term follow-up are lacking. We investigated the outcomes of SRS for pituitary adenoma patients with regard to newly developed hypopituitarism. This was a retrospective review of patients treated with SRS at the University of Virginia between 1994 and 2006. A total of 262 patients with a pituitary adenoma treated with SRS were reviewed. Thorough endocrine assessment was performed immediately before SRS and in regular follow-ups. Assessment consisted of 24-hour urine free cortisol (patients with Cushing disease), serum adrenocorticotropic hormone, cortisol, follicle-stimulating hormone, luteinizing hormone, insulin-like growth factor-1, growth hormone, testosterone (men), prolactin, thyroid-stimulating hormone, and free T(4). Endocrine remission occurred in 144 of 199 patients with a functioning adenoma. Tumor control rate was 89%. Eighty patients experienced at least 1 axis of new-onset SRS-induced hypopituitarism. The new hypopituitarism rate was 30% based on endocrine follow-up ranging from 6 to 150 months; the actuarial rate of new pituitary hormone deficiency was 31.5% at 5 years after SRS. On univariate and multivariate analyses, variables regarding the increased risk of hypopituitarism included suprasellar extension and higher radiation dose to the tumor margin; there were no correlations among tumor volume, prior transsphenoidal adenomectomy, prior radiation therapy, and age at SRS. SRS provides an effective and safe treatment option for patients with a pituitary adenoma. Higher margin radiation dose to the adenoma and suprasellar extension were 2 independent predictors of SRS-induced hypopituitarism.

  12. The shrinkage of hardening cement paste and mortar

    NARCIS (Netherlands)

    Haas, de G.D.; Kreijger, P.C.; Niël, E.M.M.G.; Slagter, J.C.; Stein, H.N.; Theissing, E.M.; Wallendael, van M.

    1975-01-01

    This paper is an abstract from the report of the commission B10: "The influence of the shrinkage of cement on the shrink-age of concrete", of the Netherlands Committee for Concrete Research. Measurements of pulse velocity, volume shrinkage and heat of hydration on hardening portland cement support

  13. The Importance of Clinical and Diagnostic Markers of Aggression of Non-Functional Pituitary Adenomas

    Directory of Open Access Journals (Sweden)

    Yu.M. Urmanova

    2015-09-01

    Full Text Available Sixty patients with non-functional pituitary adenomas were observed. Most patients had large-cell chromophobe pituitary adenomas (81.6%. Small-cell chromophobe adenomas occurred in 10 % cases. Only 1 patient (3.3 % had giant carcinoma with regrowth and metastasis into the brain. Markers of aggression of non-functional pituitary adenomas are the young age of a patient, expressed first symptoms of disease manifestation, large size of tumor, asymmetry and deformation of pituitary, invasion of tumor to the neighboring tissues/arteries/cavernous sinus, presence of small cell and dark-cell chromophobe adenoma, panhypopituitarism.

  14. Clinical and genetic aspects of familial isolated pituitary adenomas

    Directory of Open Access Journals (Sweden)

    Vladimir Vasilev

    2012-01-01

    Full Text Available Pituitary adenomas represent a group of functionally diverse neoplasms with relatively high prevalence in the general population. Most occur sporadically, but inherited genetic predisposing factors are increasingly recognized. Familial isolated pituitary adenoma is a recently defined clinical entity, and is characterized by hereditary presentation of pituitary adenomas in the absence of clinical and genetic features of syndromic disease such as multiple endocrine neoplasia type 1 and Carney complex. Familial isolated pituitary adenoma is inherited in an autosomal dominant manner and accounted for approximately 2-3% of pituitary tumors in some series. Germline mutations in the aryl-hydrocarbon interacting protein gene are identified in around 25% of familial isolated pituitary adenoma kindreds. Pituitary adenomas with mutations of the aryl-hydrocarbon interacting protein gene are predominantly somatotropinomas and prolactinomas, but non-functioning adenomas, Cushing disease, and thyrotropinoma may also occur. These tumors may present as macroadenomas in young patients and are often relatively difficult to control. Furthermore, recent evidence indicates that aryl-hydrocarbon interacting protein gene mutations occur in >10% of patients with sporadic macroadenomas that occur before 30 years of age, and in >20% of children with macroadenomas. Genetic screening for aryl-hydrocarbon interacting protein gene mutations is warranted in selected high-risk patients who may benefit from early recognition and follow-up.

  15. Effect of Dolomite as Expansive Agent and Shrinkage Reducing Admixture in Self-Compacting Shrinkage – Compensating Concrete

    OpenAIRE

    Qosai Sahib Radi Marshdi; Ahlam Hamid Jasim; Haider Abass Obeed

    2018-01-01

    The principle of using expansive agents has been recommended to manufacture shrinkage compensating concrete provided that an adequate wet curing is carried out. On the other hand, shrinkage-reducing admixture (SRA) in the concrete mixes, has been more recently suggested to reduce the risk of cracking in concrete structures caused by drying shrinkage. This paper is devoted to the study of the influence of complex modifier in the form of superplasticizer, shrinkage reducing admixture and e...

  16. Epistaxis and pituitary apoplexy due to ruptured internal carotid artery aneurysm embedded within pituitary adenoma.

    Science.gov (United States)

    Peng, Zesheng; Tian, Daofeng; Wang, Hongliu; Kong, Derek Kai; Zhang, Shenqi; Liu, Baohui; Deng, Gang; Xu, Zhou; Wu, Liquan; Ji, Baowei; Wang, Long; Cai, Qiang; Li, Mingchang; Wang, Junmin; Zhang, Aimin; Chen, Qianxue

    2015-01-01

    Epistaxis due to ruptured internal carotid artery (ICA) aneurysm embedded within a pituitary adenoma (PA) has seldom been reported in the literature. Here we want to elaborate the incidence, mechanisms, clinical manifestations, and treatment strategy for this condition. The first survived case of a patient with epistaxis and pituitary apoplexy due to ruptured aneurysm embedded within PA was reported and the literature was reviewed. A 53-year-old male patient presented to our institution with sudden onset epistaxis and progressive vision loss. Neurological examination revealed bilateral ptosis and dilated unresponsive pupils. A CT scan showed a large mass in the pituitary fossa with bony erosion. MRI revealed a large pituitary tumor and abnormal signal intensity in the tumor. No aneurysm was noted during the pre-operative MR angiography. Abundant arterial bleeding suddenly occurred during urgent transsphenoidal surgery. Digital subtraction angiography confirmed the presence of a 14 mm unexpected saccular aneurysm of right ICA in the cavernous sinus with the dome protruding into the sella turcica. Balloon test occlusion of the right ICA was undertaken and permanent occlusion was performed. The patient recovered well and received bromocriptine and thyroid hormone replacement therapy during the follow-up period. At 14-month followup, the patient had no neurological deficits, no features of ischaemia relating to the right ICA therapeutic occlusion. Our case indicated that epistaxis and pituitary apoplexy could be due to the rupture of an ICA aneurysm embedded in a PA. Clinical suspicion should remain high when evaluating any case of epistaxis and pituitary apoplexy. Optimal treatment should take into consideration individual features of the tumor, aneurysm, and patient. Making the correct diagnosis as well as identifying an appropriate management strategy is critical in the care of such patients.

  17. Reduction of pituitary-tumour size in patients with prolactinomas and acromegaly treated with bromocriptine with or without radiotherapy

    International Nuclear Information System (INIS)

    Wass, J.A.H.; Moult, P.J.A.; Thorner, M.O.; Dacie, J.E.; Charlesworth, M.; Jones, A.E.; Besser, G.M.

    1979-01-01

    69 patients with prolactin-secreting or growth-hormone-secreting pituitary tumours were treated with bromocriptine with or without pituitary irradiation and followed up for 6 months to 6 1/2 years. Of 26 patients with prolactinomas, 11 had external pituitary irradiation in addition to bromocriptine. There was evidence of shrinkage of the pituitary tumour (either a reduction in fossa size or loss of visual-field defects) in 6 of these patients (23%), 3 of whom had been treated with bromocriptine alone. Of 43 acromegalic patients, 30 received external pituitary irradiation. 8 (19%) showed evidence of shrinkage of the pituitary tumour, including 2 who had received no radiotherapy. 1 patient treated with bromocriptine alone showed striking reduction in the size of his suprasella extension, as assessed by serial computed-tomography scans over 11 months. At the same time his visual-field defects resolved and his deficient corticotrophin and thyrotrophin reserves returned to normal. Bromocriptine can reduce the size of both prolactin-secreting and growth-hormone-secreting pituitary tumours, and this is of potential importance in their management. (author)

  18. Pituitary Gland Disorders Overview

    Science.gov (United States)

    ... Peer Support Resources Diseases and Conditions Adrenal Disorders Osteoporosis and Bone Health Children and Teen Health Diabetes Heart Health Men's Health Rare Diseases Pituitary Disorders Thyroid Disorders Transgender Health Obesity and Weight Management Women's Health You and Your ...

  19. Shrinkage measurement for holographic recording materials

    Science.gov (United States)

    Fernández, R.; Gallego, S.; Márquez, A.; Francés, J.; Navarro Fuster, V.; Neipp, C.; Ortuño, M.; Beléndez, A.; Pascual, I.

    2017-05-01

    There is an increasing demand for new holographic recording materials. One of them are photopolymers, which are becoming a classic media in this field. Their versatility is well known and new possibilities are being created by including new components, such as nanoparticles or dispersed liquid crystal molecules in classical formulations, making them interesting for additional applications in which the thin film preparation and the structural modification have a fundamental importance. Prior to obtaining a wide commercialization of displays based on photopolymers, one of the key aspects is to achieve a complete characterization of them. In this sense, one of the main parameters to estimate and control is the shrinkage of these materials. The volume variations change the angular response of the hologram in two aspects, the angular selectivity and the maximum diffraction efficiency. One criteria for the recording material to be used in a holographic data storage application is the shrinkage, maximum of 0.5%. Along this work, we compare two different methods to measure the holographic recording material shrinkage. The first one is measuring the angle of propagation for both diffracted orders +/-1 when slanted gratings are recorded, so that an accurate value of the grating vector can be calculated. The second one is based on interference measurements at zero spatial frequency limit. We calculate the shrinkage for three different photopolymers: a polyvinyl alcohol acrylamide (PVA/AA) based photopolymer, one of the greenest photopolymers whose patent belongs to the Alicante University called Biophotopol and on the last place a holographic-dispersed liquid crystal photopolymer (H-PDLC).

  20. Shrinkage deformation of cement foam concrete

    Science.gov (United States)

    Kudyakov, A. I.; Steshenko, A. B.

    2015-01-01

    The article presents the results of research of dispersion-reinforced cement foam concrete with chrysotile asbestos fibers. The goal was to study the patterns of influence of chrysotile asbestos fibers on drying shrinkage deformation of cement foam concrete of natural hardening. The chrysotile asbestos fiber contains cylindrical fiber shaped particles with a diameter of 0.55 micron to 8 microns, which are composed of nanostructures of the same form with diameters up to 55 nm and length up to 22 microns. Taking into account the wall thickness, effective reinforcement can be achieved only by microtube foam materials, the so- called carbon nanotubes, the dimensions of which are of power less that the wall pore diameter. The presence of not reinforced foam concrete pores with perforated walls causes a decrease in its strength, decreases the mechanical properties of the investigated material and increases its shrinkage. The microstructure investigation results have shown that introduction of chrysotile asbestos fibers in an amount of 2 % by weight of cement provides the finely porous foam concrete structure with more uniform size closed pores, which are uniformly distributed over the volume. This reduces the shrinkage deformation of foam concrete by 50%.

  1. The clinical pathologic research of invasive pituitary adenomas

    International Nuclear Information System (INIS)

    Guo Lingchuan; Zheng Yushuang; Wang Shouli; Hui Guozhen; Li Xiangdong

    2012-01-01

    Objective: To study the pathological morphologic characteristics of invasive pituitary tumor and the affect of vascularization to the tumor's invasion. Methods: One hundred and thirty cases of pituitary adenoma patients were divided into two groups, including invasive pituitary adenomas and non-invasive pituitary adenomas, and the clinical data of two groups were analysed and compared. Results : The difference was statistically significant between the invasive group and the non-invasive group in the incidence rate of pathological morphologic characteristics such as high nuclear cytoplasmic ratio, cell pleomorphism, nuclear atypia and nucleoli appearance (P<0.05); there were nuclear atypia and nucleolus margination in the invasive group through electron microscopy. And there was statistical significant difference in rate of MVD expression which was higher in the invasive group than that of noninvasive group (P<0.05). Conclusion: The pathological morphologic characteristics of pituitary tumor and the high expression of MVD are significantly reference valuable in tumor aggression diagnosis, which provides valuable indicators for early clinical diagnosis of tumor invasion. (authors)

  2. Clinicopathological characteristics and therapeutic outcomes in thyrotropin-secreting pituitary adenomas: a single-center study of 90 cases.

    Science.gov (United States)

    Yamada, Shozo; Fukuhara, Noriaki; Horiguchi, Kentaro; Yamaguchi-Okada, Mitsuo; Nishioka, Hiroshi; Takeshita, Akira; Takeuchi, Yasuhiro; Ito, Junko; Inoshita, Naoko

    2014-12-01

    The aim of this study was to analyze clinicopathological characteristics and treatment outcomes in a large single-center clinical series of cases of thyrotropin (TSH)-secreting pituitary adenomas. The authors retrospectively reviewed clinical, pathological, and treatment characteristics of 90 consecutive cases of TSH-secreting pituitary adenomas treated with transsphenoidal surgery between December 1991 and May 2013. The patient group included 47 females and 43 males (median age 42 years, range 11-74 years). Sixteen tumors (18%) were microadenomas and 74 (82%) were macroadenomas. Microadenomas were significantly more frequent in the more recent half of our case series (12 of 45 cases) (p = 0.0274). Cavernous sinus invasion was confirmed in 21 patients (23%). In 67 cases (74%), the tumors were firm elastic or hard in consistency. Acromegaly and hyperprolactinemia were observed, respectively, in 14 (16%) and 11 (12%) of the 90 cases. Euthyroidism was achieved in 40 (83%) of 48 patients and tumor shrinkage was found in 24 (55%) of 44 patients following preoperative somatostatin analog treatment. Conventional transsphenoidal surgery, extended transsphenoidal surgery, and a simultaneous combined supra- and infrasellar approach were performed in 85, 2, and 3 patients, respectively. Total removal with endocrinological remission was achieved in 76 (84%) of 90 patients, including all 16 (100%) patients with microadenomas, 60 (81%) of the 74 with macroadenomas, and 8 (38%) of the 21 with cavernous sinus invasion. None of these 76 patients experienced tumor recurrence during a median follow-up period of 2.8 years. Stratifying by Knosp grade, total removal with endocrinological remission was achieved in 34 of 36 patients with Knosp Grade 0 tumors, all 24 of those with Grade 1 tumors, 12 of the 14 with Grade 2 tumors, 6 of the 8 with Grade 3 tumors, and none of the 8 with Grade 4 tumors. Cavernous sinus invasion and tumor size were significant independent predictors of surgical

  3. MR imaging of pituitary dwarfism

    International Nuclear Information System (INIS)

    Kashimada, Akio; Machida, Kikuo; Honda, Norinari; Mamiya, Toshio; Takahashi, Taku; Kamano, Tsuyoshi; Muramatsu, Masayuki; Inoue, Yusuke

    1993-01-01

    Pituitary MR imaging was performed in 32 patients with clinically diagnosed pituitary dwarfism and 12 normal controls. The patients were divided into two groups according to the severity of pituitary dwarfism based on endocrinological data. The two patients with severe dwarfism showed transection of the pituitary stalk, ectopic posterior lobe and atrophy of the anterior lobe on MR imaging, while the 27 patients with mild dwarfism showed no abnormal MR findings of the pituitary gland. The former group corresponds to typical pituitary dwarfism and the latter to partial GH deficiency, which was recently proposed as another type of pituitary dwarfism. In conclusion, pituitary MR imaging may differentiate partial GH deficiency from typical (stalk-transected) pituitary dwarfism. (author)

  4. MR imaging of pituitary dwarfism

    Energy Technology Data Exchange (ETDEWEB)

    Kashimada, Akio; Machida, Kikuo; Honda, Norinari; Mamiya, Toshio; Takahashi, Taku; Kamano, Tsuyoshi; Muramatsu, Masayuki; Inoue, Yusuke (Saitama Medical School, Kawagoe (Japan). Medical Center)

    1993-02-01

    Pituitary MR imaging was performed in 32 patients with clinically diagnosed pituitary dwarfism and 12 normal controls. The patients were divided into two groups according to the severity of pituitary dwarfism based on endocrinological data. The two patients with severe dwarfism showed transection of the pituitary stalk, ectopic posterior lobe and atrophy of the anterior lobe on MR imaging, while the 27 patients with mild dwarfism showed no abnormal MR findings of the pituitary gland. The former group corresponds to typical pituitary dwarfism and the latter to partial GH deficiency, which was recently proposed as another type of pituitary dwarfism. In conclusion, pituitary MR imaging may differentiate partial GH deficiency from typical (stalk-transected) pituitary dwarfism. (author).

  5. Pituitary infiltration by non-Hodgkin's lymphoma: a case report

    Directory of Open Access Journals (Sweden)

    Aral Ferihan

    2009-11-01

    Full Text Available Abstract Introduction Pituitary adenomas represent the most frequently observed type of sellar masses; however, the presence of a rapidly growing sellar tumor, diabetes insipidus, ophthalmoplegia and headaches in an older patient strongly suggests metastasis to the pituitary. Since the anterior pituitary has a great reserve capacity, metastasis to the pituitary and pituitary involvement in lymphoma are usually asymptomatic. Whereas diabetes insipidus is the most frequent symptom, patients can present with headaches, ophthalmoplegia and bilateral hemianopsia. Case presentation A 70-year-old woman with no previous history of malignancy presented with headaches, right oculomotor nerve palsy and diabetes insipidus. As magnetic resonance imaging revealed a sellar mass involving the pituitary gland and infundibular stalk, which also extended into the right cavernous sinus and sphenoid sinus, the patient underwent an immediate transsphenoidal decompression surgery. Her prolactin was 102.4 ng/ml, whereas her gonadotropic hormone levels were low. A low level of urine osmolality after overnight water deprivation, along with normal plasma osmolality suggested diabetes insipidus. Histological examination revealed that the mass had been the infiltration of a high grade B-cell non-Hodgkin's lymphoma involving respiratory system epithelial cells. Paranasal sinus computed tomography scanning and magnetic resonance imaging of the thorax and abdomen were performed. Since magnetic resonance imaging did not reveal any abnormality, after paranasal sinus computed tomography was performed, we concluded that the primary lymphoma originated from the sphenoid sinus and infiltrated the pituitary. Chemotherapy and radiotherapy to the sellar area were planned, but the patient died and her family did not permit an autopsy. Conclusion Lymphoma infiltration to the pituitary is difficult to differentiate from pituitary adenoma, meningioma and other sellar lesions. To plan the

  6. Fractionated stereotactic radiotherapy in the treatment of pituitary adenomas

    International Nuclear Information System (INIS)

    Kopp, C.; Theodorou, M.; Poullos, N.; Astner, S.T.; Geinitz, H.; Molls, M.; Stalla, G.K.; Meyer, B.; Nieder, C.; Tromsoe Univ.; Grosu, A.L

    2013-01-01

    Purpose: The purpose of this work was to evaluate tumor control and side effects associated with fractionated stereotactic radiotherapy (FSRT) in the management of residual or recurrent pituitary adenomas. Patients and methods: We report on 37 consecutive patients with pituitary adenomas treated with FSRT at our department. All patients had previously undergone surgery. Twenty-nine patients had nonfunctioning, 8 had hormone-producing adenoma. The mean total dose delivered by a linear accelerator was 49.4 Gy (range 45-52.2 Gy), 5 x 1.8 Gy weekly. The mean PTV was 22.8 ccm (range 2.0-78.3 ccm). Evaluation included serial imaging tests, endocrinologic and ophthalmologic examination. Results: Tumor control was 91.9 % for a median follow-up time of 57 months (range 2-111 months). Before FSRT partial hypopituitarism was present in 41 % of patients, while 35 % had anterior panhypopituitarism. After FSRT pituitary function remained normal in 22 %, 43 % had partial pituitary dysfunction, and 35 % had anterior panhypopituitarism. Visual acuity was stable in 76 % of patients, improved in 19 %, and deteriorated in 5 %. Visual fields remained stable in 35 patients (95 %), improved in one and worsened in 1 patient (2.7 %). Conclusion: FSRT is an effective and safe treatment for recurrent or residual pituitary adenoma. Good local tumor control and preservation of adjacent structures can be reached, even for large tumors. (orig.)

  7. Fractionated stereotactic radiotherapy in the treatment of pituitary adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Kopp, C.; Theodorou, M.; Poullos, N.; Astner, S.T.; Geinitz, H.; Molls, M. [Technische Univ. Muenchen, Klinikum rechts der Isar (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie; Stalla, G.K. [Max-Planck-Institut fuer Psychiatrie, Muenchen (Germany). Klinische Neuroendokrinologie; Meyer, B. [Technische Univ. Muenchen, Klinikum rechts der Isar (Germany). Neurochirurgische Klinik und Poliklinik; Nieder, C. [Nordland Hospital, Bodoe (Norway). Dept. of Oncology and Palliative Medicine; Tromsoe Univ. (Norway). Inst. of Clinical Medicine; Grosu, A.L [Freiburg Univ. (Germany). Klinik fuer Strahlenheilkunde

    2013-11-15

    Purpose: The purpose of this work was to evaluate tumor control and side effects associated with fractionated stereotactic radiotherapy (FSRT) in the management of residual or recurrent pituitary adenomas. Patients and methods: We report on 37 consecutive patients with pituitary adenomas treated with FSRT at our department. All patients had previously undergone surgery. Twenty-nine patients had nonfunctioning, 8 had hormone-producing adenoma. The mean total dose delivered by a linear accelerator was 49.4 Gy (range 45-52.2 Gy), 5 x 1.8 Gy weekly. The mean PTV was 22.8 ccm (range 2.0-78.3 ccm). Evaluation included serial imaging tests, endocrinologic and ophthalmologic examination. Results: Tumor control was 91.9 % for a median follow-up time of 57 months (range 2-111 months). Before FSRT partial hypopituitarism was present in 41 % of patients, while 35 % had anterior panhypopituitarism. After FSRT pituitary function remained normal in 22 %, 43 % had partial pituitary dysfunction, and 35 % had anterior panhypopituitarism. Visual acuity was stable in 76 % of patients, improved in 19 %, and deteriorated in 5 %. Visual fields remained stable in 35 patients (95 %), improved in one and worsened in 1 patient (2.7 %). Conclusion: FSRT is an effective and safe treatment for recurrent or residual pituitary adenoma. Good local tumor control and preservation of adjacent structures can be reached, even for large tumors. (orig.)

  8. Progression of an Invasive ACTH Pituitary Macroadenoma with Cushing’s Disease to Pituitary Carcinoma

    Directory of Open Access Journals (Sweden)

    Clarissa Groberio Borba

    2015-01-01

    Full Text Available Pituitary carcinomas are very rare tumors that in most cases produce prolactin and adrenocorticotropic hormone (ACTH. It is a challenge to diagnosis of a pituitary carcinoma before disclosed symptomatic metastasis. We report the case of a female patient with Cushing’s disease who underwent three transsphenoidal surgeries, with pathological findings of common ACTH pituitary adenoma including Ki-67 expression <3%. She achieved hypocortisolism after the 3rd surgery although ACTH levels remained slightly elevated. The patient returned some time later with fast worsening of hypercortisolism. Magnetic resonance imaging showed clivus invasion, which led to a fourth surgery and radiation. This time, immunohistochemistry revealed strong Ki-67 (10% to 15% and p53 expression. Liver and lumbar spine metastases were found on workup. The patient died after few months due to lung infection. Pituitary carcinomas are rare, and the transformation of an ACTH-secreting pituitary adenoma into a carcinoma is exceptional. The difficulty of defining markers for the diagnosis of carcinoma, before metastasis diagnosis, in order to change the management of the disease, is a challenge.

  9. Hemorrhagic chondroid chordoma mimicking pituitary apoplexy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, H.J.; Kalnin, A.J.; Holodny, A.I. [Dept. of Radiology, University Hospital, Newark, NJ (United States); Schulder, M.; Grigorian, A. [Dept. of Neurosurgery, University Hospital, Newark, NJ (United States); Sharer, L.R. [Dept. of Pathology, University Hospital, Newark, NJ (United States)

    1998-11-01

    We describe a hemorrhagic chondroid chordoma involving the sella turcica with suprasellar extension. The CT and MRI appearances mimiked a hemorrhagic pituitary adenoma. Chondroid chordoma is a variant composed of elements of both chordoma and cartilaginous tissue. An uncommon bone neoplasm, located almost exclusively in the spheno-occipital region, it is usually not considered in the differential diagnosis of a tumor with acute hemorrhage in the sellar region. We discuss the clinical and radiological characteristics which may allow one to differentiate chondroid chordoma from other tumors of this area. (orig.) With 3 figs., 9 refs.

  10. Reducing Shrinkage in Canned and Frozen Mushrooms

    OpenAIRE

    Gormley, T. R. (Thomas Ronan); Walshe, P.E.

    1982-01-01

    The process involving a preliminary soaking of the mushrooms in water for 20 min followed by a chill storage period followed by a further water soak for 2 hr, and known as the 3S process, gave a considerable reduction in total shrinkage in both brown and white strain canned mushrooms compared with the control samples. Water uptake by the mushrooms in the 3S process was greatest when the soaking water temperature was between 20 and 30°C and had a pH of 8. Citric acid in the blanch water enhanc...

  11. Creep and shrinkage of Mo(Ni)

    International Nuclear Information System (INIS)

    Kaysser, W.A.; Hofmann-Amtenbrink, M.; Petzow, G.

    1984-01-01

    To avoid some of the errors inherent in a quantitative interpretation of shrinkage of powder compacts as Mo-Ni, other experiments were looked for, where the influence of Ni on the material transport properties of Mo could be measured semi-quantitatively during heating up to temperature and subsequent isothermal annealing. The bending of thin Mo foils under small loads was found to be an experimental arrangement, where variations in stress, in Ni-concentration and in intrinsic material properties could be realized. The results of these creep experiments will be compared in a qualitative sense with sintering experiments in Mo-Ni done under similar conditions as the creep experiments

  12. The result of radiotherapy for pituitary adenoma

    International Nuclear Information System (INIS)

    Lee, H. J.; Yang, K. M.; Suh, S. H.

    1997-01-01

    To evaluate the prognostic factors for disease-free survival and long-term results of radiotherapy for pituitary adenoma. The study involved a retrospective review of outcome in a series of 27 patients with pituitary adenoma, between 1984 and 1995 at Paik hospital. The study included 20 patients treated with surgery and postoperative radiotherapy and 7 with radiotherapy alone. The patients were followed for 12-146 months (median: 97 months). Seventeen were men and 10 were women. The numbers of functioning and non-functioning pituitary adenoma were 22 and 5 respectively and those of microadenoma and macroadenoma were 4 and 23 respectively. The radiation doses of 5040-5580cGy(median: 5040cGy) were delivered over 5-7 weeks, using 4MV LINAC. The prognostic factors were analyzed by log-rank test. For radiation therapy alone, the 5 YSR was 100% and progression free survival rate was 85.8%. The tumor was controlled in 6/7 (85.8%). For surgery and postoperative radiotherapy , the 5YSR, progression free survival rate and local control rate were 95%, 84.8%, and 89.5% respectively. The parameters of tumor size, hormone secretion, radiation dose, radiotherapy field size were evaluated in a uni- and multivariate analysis and all the factors were not statistically significant (P>0.05). Eleven of 12 (92%) with visual field defect experienced normalization or improvement, and 5 for 7 evaluable patients with hyperprolactinoma achieved normalization in 4 and decrement in 5 patients. Only 2 patients developed mild degree of panhypopituitarism. The radiotherapy appears to be effective in controlling clinical symptoms and signs resulting from pituitary adenoma. Local control rate with radiotherapy alone or with surgery and postoperative radiotherapy was comparable. There was a trend toward high recurrence rate in patients with nonfunctioning or prolactin secreting tumor and larger radiation field sizes. (author)

  13. The result of radiotherapy for pituitary adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, H. J.; Yang, K. M.; Suh, S. H. [Inje Univ., Seoul (Korea, Republic of). Coll. of Medicine; Cho, H. L.; Shon, S. C. [Pusan Paik Hospital, Pusan (Korea, Republic of)

    1997-12-01

    To evaluate the prognostic factors for disease-free survival and long-term results of radiotherapy for pituitary adenoma. The study involved a retrospective review of outcome in a series of 27 patients with pituitary adenoma, between 1984 and 1995 at Paik hospital. The study included 20 patients treated with surgery and postoperative radiotherapy and 7 with radiotherapy alone. The patients were followed for 12-146 months (median: 97 months). Seventeen were men and 10 were women. The numbers of functioning and non-functioning pituitary adenoma were 22 and 5 respectively and those of microadenoma and macroadenoma were 4 and 23 respectively. The radiation doses of 5040-5580cGy(median: 5040cGy) were delivered over 5-7 weeks, using 4MV LINAC. The prognostic factors were analyzed by log-rank test. For radiation therapy alone, the 5 YSR was 100% and progression free survival rate was 85.8%. The tumor was controlled in 6/7 (85.8%). For surgery and postoperative radiotherapy , the 5YSR, progression free survival rate and local control rate were 95%, 84.8%, and 89.5% respectively. The parameters of tumor size, hormone secretion, radiation dose, radiotherapy field size were evaluated in a uni- and multivariate analysis and all the factors were not statistically significant (P>0.05). Eleven of 12 (92%) with visual field defect experienced normalization or improvement, and 5 for 7 evaluable patients with hyperprolactinoma achieved normalization in 4 and decrement in 5 patients. Only 2 patients developed mild degree of panhypopituitarism. The radiotherapy appears to be effective in controlling clinical symptoms and signs resulting from pituitary adenoma. Local control rate with radiotherapy alone or with surgery and postoperative radiotherapy was comparable. There was a trend toward high recurrence rate in patients with nonfunctioning or prolactin secreting tumor and larger radiation field sizes. (author).

  14. Endoscopic endonasal transsphenoidal surgery: surgical results of 228 pituitary adenomas treated in a pituitary center.

    Science.gov (United States)

    Gondim, Jackson A; Schops, Michele; de Almeida, João Paulo C; de Albuquerque, Lucas Alverne F; Gomes, Erika; Ferraz, Tânia; Barroso, Francisca Andréa C

    2010-01-01

    Pituitary tumors are challenging tumors in the sellar region. Surgical approaches to the pituitary have undergone numerous refinements over the last 100 years. The introduction of the endoscope have revolutionized pituitary surgery. The aim of this study is to report the results of a consecutive series of patients undergoing pituitary surgery using a pure endoscopic endonasal approach and to evaluate the efficacy and safety of this procedure. We reviewed the data of 228 consecutive patients who underwent endonasal transsphenoidal adenoma removal over an 10-year period. Pre- and post-operative hormonal status (at least 3 months after surgery) were analyzed and compared with clinical parameters presented by the patients. Tumor removal rate, endocrinological outcomes, and complications were retrospectively assessed in 228 patients with pituitary adenomas who underwent 251 procedures between December 1998 and December 2007. There were 93 nonfunctioning adenomas, 58 growth hormone-secreting, 41 prolactin-secreting, 28 adrenocorticotropin hormone secreting, 7 FSH-LH secreting and 1 thyroid-stimulating hormone-secreting adenomas. Gross total removal was achieved in 79.3% of the cases after a median follow-up of 61.5 months. The remission results for patients with nonfunctioning adenomas was 83% and for functioning adenomas were 76.3% (70.6% for GH hormone-secreting, 85.3% for prolactin hormone-secreting, 71.4% for ACTH hormone-secreting, 85.7% for FSH-LH hormone-secreting and 100% for TSH hormone-secreting), with no recurrence at the time of the last follow-up. Post-operative complications were present in 35 (13.9%) cases. The most frequent complications were temporary and permanent diabetes insipidus (six and two cases, respectively), syndrome of inappropriate antidiuretic hormone secretion (two cases) and CSF leaks (eight cases). There was no death related to the procedure in this series. The endoscopic endonasal approach for resection of pituitary adenomas, provides

  15. Deregulated E2F activity induces hyperplasia and senescence-like features in the mouse pituitary gland

    DEFF Research Database (Denmark)

    Lazzerini Denchi, Eros; Attwooll, Claire; Pasini, Diego

    2005-01-01

    The retinoblastoma gene, RB1, is one of the most frequently mutated genes in human cancer. Rb heterozygous mice develop pituitary tumors with 100% incidence, and the E2F transcription factors are required for this. To assess whether deregulated E2F activity is sufficient to induce pituitary tumors...

  16. Mortality in patients treated for Cushing's disease is increased, compared with patients treated for nonfunctioning pituitary macroadenoma

    NARCIS (Netherlands)

    Dekkers, O. M.; Biermasz, N. R.; Pereira, A. M.; Roelfsema, F.; van Aken, M. O.; Voormolen, J. H. C.; Romijn, J. A.

    2007-01-01

    Increased mortality in patients with pituitary tumors after surgical treatment has been reported. However, it is unknown to what extent excess mortality is caused by pituitary tumors and their treatment in general and to what extent by previous exposure to hormonal overproduction. The aim of the

  17. Research progress of MRI in preoperative evaluation of pituitary adenoma's consistency

    International Nuclear Information System (INIS)

    Lu Yiping; Yin Bo; Geng Daoying

    2013-01-01

    As the most common primary disease in pituitary fossa, the incidence of pituitary adenoma ranks 3rd in the primary tumors of the brain. To remove those resectable pituitary adenomas, there are 2 surgical approaches, named trans-sphenoidal endoscopic surgery and craniotomy. Which approach should be used depends on the size, invasive extension and the consistency of the tumors. The trans-sphenoidal endoscopic surgery is more suitable for the tumors with soft consistency which are easy to pull out, while the craniotomy is suitable for the hard ones. So, preoperative evaluation of the tumors' consistency can help to find the best surgical approach and treatments. MRI is not only an ideal method to show the structure of brain, but also can be used to evaluate consistency of tumor. This review illustrated the forming mechanism of the different consistency of pituitary adenoma and the research process in evaluating the consistency. (authors)

  18. Valuation of dynamic MR imaging for diagnosis of pituitary microadenomas

    International Nuclear Information System (INIS)

    Lu Wu; Zhou Shengli; Liu Yusheng

    2003-01-01

    Objective: To evaluate the use of keyhole dynamic magnetic resonance (MR) imaging in evaluation of pituitary microadenomas. Methods: Fifty-three patients with pituitary microadenomas proved by operation or clinical findings such as headache, amenorrhea, lactating, fat or acromegaly were retrospectively studied on dynamic MR, conventional contrast enhanced MR, and unenhanced MR. Then the image data were analyzed by two experienced doctors who didn't know the details and three degrees were made as follows: grade 0, no evidence of the tumor; grade I, asymmetry signals in the pituitary; and grade II, nodulated or sheets signals in the pituitary. The grading data were compared with statistical methods. Results: In dynamic MR grading system: grade 0 was revealed in 1 patient, grade I in 29 patients and grade II in 23 patients. In conventional enhanced MR: grade 0 in 26 patients, grade I in 17 patients and grade II in 10 patients. In conventional unenhanced MR: grade 0 in 39 patients, grade I in 10 patients and grade II in 4 patients. The diagnostic rate of dynamic MR, conventional enhanced MR, and unenhanced MR was 98.1%, 51.9%, and 26.4%, respectively. (P < 0.005). Dynamic MR can increase the grade of tumor compared to the other two, which is significant statistically. Conclusion: Keyhole dynamic MR can increase the diagnostic accuracy of pituitary microadenomas while decreasing the uncertainty. So dynamic MR should become a routine examination for pituitary microadenoma when suspected by clinical findings but negative in conventional MR

  19. Monomorphous Plurihormonal Pituitary Adenoma of Pit-1 Lineage in a Giant Adolescent with Central Hyperthyroidism.

    Science.gov (United States)

    Pereira, Bernardo Dias; Raimundo, Luísa; Mete, Ozgur; Oliveira, Ana; Portugal, Jorge; Asa, Sylvia L

    2016-03-01

    Thyrotropin (TSH)-secreting pituitary adenomas are exceedingly rare at the pediatric age and no cases of co-secretion with other pituitary hormones in these tumors have been described in this age range. We present a case of a monomorphous plurihormonal pituitary adenoma that co-secreted TSH and GH in a pediatric patient. A 13-year-old male presented with increasing height velocity (17.75 cm/year, 9.55SD), weight loss, and visual impairment. Initial biochemical evaluations revealed secondary hyperthyroidism. A giant pituitary tumor compressing the surrounding structures was detected by magnetic resonance, and a transsphenoidal surgery was initially performed. Pathological examinations revealed an atypical, monomorphous plurihormonal Pit-1 lineage tumor with mixed features of silent subtype 3 adenoma and acidophil stem cell adenoma. In the postoperative period, secondary hyperthyroidism recurred with high levels of both GH and IGF1. In addition, due to tumor re-growth, a multimodality treatment plan was undertaken including surgery, somatostatin analogs, and radiotherapy. We report the first pediatric case of a plurihormonal TSH- and GH-secreting pituitary adenoma, further expanding the clinical manifestations of pediatric pituitary tumors. Comprehensive pathological evaluation and close follow-up surveillance are crucial to the prompt delivery of the best therapeutic options in the context of this particularly aggressive pituitary tumor.

  20. Simple numerical chromosome aberrations in two pituitary adenomas

    DEFF Research Database (Denmark)

    Dietrich, C U; Pandis, N; Bjerre, P

    1993-01-01

    Cytogenetic analysis of short-term cultures of one non-secreting and one prolactin-producing pituitary adenoma revealed simple clonal numerical abnormalities in both tumors. The karyotype of the non-secreting adenoma was 48,XX, +4, +9[42]/49,XX, +4, +9, +20[2]/46,XX[6]. In the prolactin-secreting......Cytogenetic analysis of short-term cultures of one non-secreting and one prolactin-producing pituitary adenoma revealed simple clonal numerical abnormalities in both tumors. The karyotype of the non-secreting adenoma was 48,XX, +4, +9[42]/49,XX, +4, +9, +20[2]/46,XX[6]. In the prolactin...

  1. Serotonin, ATRX, and DAXX Expression in Pituitary Adenomas

    DEFF Research Database (Denmark)

    Casar-Borota, Olivera; Botling, Johan; Granberg, Dan

    2017-01-01

    that remain localized to the sellar and perisellar region. A lack of ATRX or DAXX in a sellar NET suggests a nonpituitary NET, probably of pancreatic origin. One of the 2 examined corticotroph carcinomas, however, demonstrated negative ATRX immunolabeling due to an ATRX gene mutation. Further studies......Differential diagnosis based on morphology and immunohistochemistry between a clinically nonfunctioning pituitary neuroendocrine tumor (NET)/pituitary adenoma and a primary or secondary NET of nonpituitary origin in the sellar region may be difficult. Serotonin, a frequently expressed marker...... in the NETs, has not been systematically evaluated in pituitary NETs. Although mutations in ATRX or DAXX have been reported in a significant proportion of pancreatic NETs, the mutational status of ATRX and DAXX and their possible pathogenetic role in pituitary NETs are unknown. Facing a difficult diagnostic...

  2. Ultrasonic assessment of shrinkage type discontinuities

    International Nuclear Information System (INIS)

    Hubber, John

    2010-01-01

    This investigation into ultrasonic internal discontinuities is intended to demonstrate typical examples of internal 'shrinkage' type discontinuities and its connection with the casting suitability, integrity and reliability in service. This type of discontinuity can be misinterpreted by ultrasonic technicians and can lead to the rejection of castings unnecessarily, due to the mis-characterization of fine shrinkage - discrete porosity. The samples for this investigation were taken from thirty ton heavy section ductile iron mill flange castings, manufactured by Graham Campbell Ferrum International. The sampled area was of discontinuities that were recorded for sizing on an area due to loss of back wall echo, but had acceptable reflectivity. A comparative sample was taken adjacent to the area of discrete porosity. The discontinuities found by this investigation are of a 'spongy' type, gaseous in appearance and are surrounded by acoustically sound material. All discontinuities discussed in this paper are centrally located in the through thickness of the casting. The porous nature of this type of discontinuity consisting of approximately 80-90% metal has its own residual strength, as indicated by the proof stress results which reveal a residual strength of up to 50-60% of that of the unaffected area of the casting. The affected areas are elliptical in shape and vary in density and through thickness throughout.

  3. Computation of shrinkage stresses in prestressed concrete containments

    International Nuclear Information System (INIS)

    Wu, R.F.; Ouyang, H.

    1989-01-01

    According to a survey, surface cracking on PCRVs and PCCs under the investigations is confined to drying shrinkage and thermal strain effects and no instances of structurally significant cracking was been found. In this paper, the authors use FEM to compute humidity distribution in drying concrete and shrinkage stresses by internal restraint. Since PCC is built segment by segment in several years, a computational model taking into account construction sequence is presented and shrinkage stresses by external restraints are calculated with the model

  4. Creep and shrinkage of concrete according to Eurocode 2

    Directory of Open Access Journals (Sweden)

    Milićević Ivan M.

    2017-01-01

    Full Text Available This paper presents the procedure for calculation of creep coefficient and shrinkage strain according to Eurocode 2 (SRPS EN 1992-1-1:2004. The calculated values of final creep coefficient and shrinkage strain, for the usual design conditions, are given in Annexes. The influence of key parameters on final creep coefficient and shrinkage strain is analyzed and the comparison between their final values calculated according to Eurocode 2 and BAB 87 is presented.

  5. Silorane- and high filled-based"low-shrinkage" resin composites: shrinkage, flexural strength and modulus

    Directory of Open Access Journals (Sweden)

    Cesar Augusto Galvão Arrais

    2013-04-01

    Full Text Available This study compared the volumetric shrinkage (VS, flexural strength (FS and flexural modulus (FM properties of the low-shrinkage resin composite Aelite LS (Bisco to those of Filtek LS (3M ESPE and two regular dimethacrylate-based resin composites, the microfilled Heliomolar (Ivoclar Vivadent and the microhybrid Aelite Universal (Bisco. The composites (n = 5 were placed on the Teflon pedestal of a video-imaging device, and VS was recorded every minute for 5 min after 40 s of light exposure. For the FS and FM tests, resin discs (0.6 mm in thickness and 6.0 mm in diameter were obtained (n = 12 and submitted to a piston-ring biaxial test in a universal testing machine. VS, FS, and FM data were submitted to two-way repeated measures and one-way ANOVA, respectively, followed by Tukey's post-hoc test (a = 5%. Filtek LS showed lower VS than did Aelite LS, which in turn showed lower shrinkage than did the other composites. Aelite Universal and Filtek LS exhibited higher FS than did Heliomolar and Aelite LS, both of which exhibited the highest FM. No significant difference in FM was noted between Filtek LS and Aelite Universal, while Heliomolar exhibited the lowest values. Aelite LS was not as effective as Filtek LS regarding shrinkage, although both low-shrinkage composites showed lower VS than did the other composites. Only Filtek LS exhibited FS and FM comparable to those of the regular microhybrid dimethacrylate-based resin composite.

  6. Abnormal expression of 11 beta-hydroxysteroid dehydrogenase type 2 in human pituitary adenomas: a prereceptor determinant of pituitary cell proliferation.

    Science.gov (United States)

    Rabbitt, E H; Ayuk, J; Boelaert, K; Sheppard, M C; Hewison, M; Stewart, P M; Gittoes, N J L

    2003-03-20

    The physiological effects of glucocorticoids (GCs) are, at least in part, mediated by inhibition of cell proliferation. Two isozymes of 11 beta-hydroxysteroid dehydrogenase (11 beta-HSD) interconvert cortisol (F) and inactive cortisone (E), and are thus able to modulate GC action at an autocrine level. Previously, we have demonstrated absent expression of 11 beta-HSD2 in normal pituitaries; however, in a small number of pituitary tumors analysed, 11 beta-HSD2 was readily demonstrable. Here we have used real-time RT-PCR to quantify expression of mRNA for 11 beta-HSD1 and 2 in 105 human pituitary tumors and have performed enzyme expression and activity studies in primary pituitary cultures. Overall, pituitary tumors expressed lower levels of 11 beta-HSDl mRNA compared with normals (0.2-fold, Pprotein (mean+/-s.d.)) but no detectable 11 beta-HSDl activity. Proliferation assays showed that addition of glycyrrhetinic acid (an 11 beta-HSD2 inhibitor) resulted in a 30.3+/-7.7% inhibition of cell proliferation. In summary, we describe a switch in expression from 11 beta-HSDl to 11 beta-HSD2 in neoplastic pituitary tissue. We propose that abnormal expression of 11 beta-HSD2 acts as a proproliferative prereceptor determinant of pituitary cell growth, and may provide a novel target for future tumor therapy.

  7. Gigantism caused by growth hormone secreting pituitary adenoma.

    Science.gov (United States)

    Rhee, Noorisaem; Jeong, Kumi; Yang, Eun Mi; Kim, Chan Jong

    2014-06-01

    Gigantism indicates excessive secretion of growth hormones (GH) during childhood when open epiphyseal growth plates allow for excessive linear growth. Case one involved a 14.7-year-old boy presented with extreme tall stature. His random serum GH level was 38.4 ng/mL, and failure of GH suppression was noted during an oral glucose tolerance test (OGTT; nadir serum GH, 22.7 ng/mL). Magnetic resonance imaging (MRI) of the brain revealed a 12-mm-sized pituitary adenoma. Transsphenoidal surgery was performed and a pituitary adenoma displaying positive immunohistochemical staining for GH was reported. Pituitary MRI scan was performed 4 months after surgery and showed recurrence/residual tumor. Medical treatment with a long-acting somatostatin analogue for six months was unsuccessful. As a result, secondary surgery was performed. Three months after reoperation, the GH level was 0.2 ng/mL and insulin-like growth factor 1 was 205 ng/mL. Case two involved a 14.9-year-old boy, who was referred to our department for his tall stature. His basal GH level was 9.3 ng/mL, and failure of GH suppression was reported during OGTT (nadir GH, 9.0 ng/mL). Pituitary MRI showed a 6-mm-sized pituitary adenoma. Surgery was done and histopathological examination demonstrated a pituitary adenoma with positive staining for GH. Three months after surgery, the GH level was 0.2 ng/mL and nadir GH during OGTT was less than 0.1 ng/mL. Pituitary MRI scans showed no residual tumor. We present two cases of gigantism caused by a GH-secreting pituitary adenoma with clinical and microscopic findings.

  8. Gigantism caused by growth hormone secreting pituitary adenoma

    Directory of Open Access Journals (Sweden)

    Noorisaem Rhee

    2014-06-01

    Full Text Available Gigantism indicates excessive secretion of growth hormones (GH during childhood when open epiphyseal growth plates allow for excessive linear growth. Case one involved a 14.7-year-old boy presented with extreme tall stature. His random serum GH level was 38.4 ng/mL, and failure of GH suppression was noted during an oral glucose tolerance test (OGTT; nadir serum GH, 22.7 ng/mL. Magnetic resonance imaging (MRI of the brain revealed a 12-mm-sized pituitary adenoma. Transsphenoidal surgery was performed and a pituitary adenoma displaying positive immunohistochemical staining for GH was reported. Pituitary MRI scan was performed 4 months after surgery and showed recurrence/residual tumor. Medical treatment with a long-acting somatostatin analogue for six months was unsuccessful. As a result, secondary surgery was performed. Three months after reoperation, the GH level was 0.2 ng/mL and insulin-like growth factor 1 was 205 ng/mL. Case two involved a 14.9-year-old boy, who was referred to our department for his tall stature. His basal GH level was 9.3 ng/mL, and failure of GH suppression was reported during OGTT (nadir GH, 9.0 ng/mL. Pituitary MRI showed a 6-mm-sized pituitary adenoma. Surgery was done and histopathological examination demonstrated a pituitary adenoma with positive staining for GH. Three months after surgery, the GH level was 0.2 ng/mL and nadir GH during OGTT was less than 0.1 ng/mL. Pituitary MRI scans showed no residual tumor. We present two cases of gigantism caused by a GH-secreting pituitary adenoma with clinical and microscopic findings.

  9. Gigantism caused by growth hormone secreting pituitary adenoma

    Science.gov (United States)

    Rhee, Noorisaem; Jeong, Kumi; Yang, Eun Mi

    2014-01-01

    Gigantism indicates excessive secretion of growth hormones (GH) during childhood when open epiphyseal growth plates allow for excessive linear growth. Case one involved a 14.7-year-old boy presented with extreme tall stature. His random serum GH level was 38.4 ng/mL, and failure of GH suppression was noted during an oral glucose tolerance test (OGTT; nadir serum GH, 22.7 ng/mL). Magnetic resonance imaging (MRI) of the brain revealed a 12-mm-sized pituitary adenoma. Transsphenoidal surgery was performed and a pituitary adenoma displaying positive immunohistochemical staining for GH was reported. Pituitary MRI scan was performed 4 months after surgery and showed recurrence/residual tumor. Medical treatment with a long-acting somatostatin analogue for six months was unsuccessful. As a result, secondary surgery was performed. Three months after reoperation, the GH level was 0.2 ng/mL and insulin-like growth factor 1 was 205 ng/mL. Case two involved a 14.9-year-old boy, who was referred to our department for his tall stature. His basal GH level was 9.3 ng/mL, and failure of GH suppression was reported during OGTT (nadir GH, 9.0 ng/mL). Pituitary MRI showed a 6-mm-sized pituitary adenoma. Surgery was done and histopathological examination demonstrated a pituitary adenoma with positive staining for GH. Three months after surgery, the GH level was 0.2 ng/mL and nadir GH during OGTT was less than 0.1 ng/mL. Pituitary MRI scans showed no residual tumor. We present two cases of gigantism caused by a GH-secreting pituitary adenoma with clinical and microscopic findings. PMID:25077093

  10. MR imaging of the pituitary gland in central precocious puberty

    Energy Technology Data Exchange (ETDEWEB)

    Kao, S.C.S. (Dept. of Radiology, Univ. of Iowa Coll. of Medicine, Iowa City, IA (United States)); Cook, J.S. (Dept. of Pediatrics, Univ. of Iowa Coll. of Medicine, Iowa City, IA (United States)); Hansen, J.R. (Dept. of Pediatrics, Univ. of Iowa Coll. of Medicine, Iowa City, IA (United States)); Simonson, T.M. (Dept. of Radiology, Univ. of Iowa Coll. of Medicine, Iowa City, IA (United States))

    1992-11-01

    Cranial magnetic resonance imaging was performed in 17 children with central precocious puberty (CPP) and 19 aged-matched controls to compare the appearance of the pituitary gland. Gland size was measured on T1-weighted sagittal and coronal images. The gland was graded according to the concavity or convexity of the upper surface, and the signal intensity of the gland was assessed visually. The mean pituitary volume in 13 CPP children without hypothalamic tumor (292.6 mm[sup 3]) was significantly greater than that in normal controls (181.35 mm[sup 3]). The mean volume for the four CPP children with hypothalamic tumor was smaller (145.0 mm[sup 3]). Compared to controls, the upper pituitary surface in CPP patients appeared convex in a higher proportion. The anterior pituitary was isointense to pons in all patients and controls. Although the posterior pituitary bright spot was present in 14 controls and 11 CPP patients, none with hypothalamic tumor showed it. (orig.)

  11. Atypical pituitary macroadenoma; a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Tae Hee; Lee, Seoung Ro; Park, Dong Woo; Hahm, Chang Kok; Park, Choong Ki; Kim, Yong Su; Paik, Seung Sam; Hong, Eun Kyung [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-01-01

    A 34-year-old man who for two months had experienced headaches and blurred vision showed a 6 x 5 x 4 cm-sized sellar and suprasellar mass with mainly cystic and partially solid portions on both brain CT and MRI. Peripheral, rim-like calcification of the cystic mass was clearly visible on non-enhanced CT and pituitary acidophil stem cell adenoma was confirmed. This is an immature neoplasm which is shown by immunohistochemical study and electromicrocopy to be derived from the common progenitor of growth hormone and prolactin cells. We recently encountered one case, involving unusual radiographic findings, in which pituitary macroadenoma mimicked craniopharyngioma, and we report the CT and MR findings of this tumor.

  12. Hedgehog signaling activation induces stem cell proliferation and hormone release in the adult pituitary gland.

    Science.gov (United States)

    Pyczek, Joanna; Buslei, Rolf; Schult, David; Hölsken, Annett; Buchfelder, Michael; Heß, Ina; Hahn, Heidi; Uhmann, Anja

    2016-04-25

    Hedgehog (HH) signaling is known to be essential during the embryonal development of the pituitary gland but the knowledge about its role in the adult pituitary and in associated tumors is sparse. In this report we investigated the effect of excess Hh signaling activation in murine pituitary explants and analyzed the HH signaling status of human adenopituitary lobes and a large cohort of pituitary adenomas. Our data show that excess Hh signaling led to increased proliferation of Sox2(+) and Sox9(+) adult pituitary stem cells and to elevated expression levels of adrenocorticotropic hormone (Acth), growth hormone (Gh) and prolactin (Prl) in the adult gland. Inhibition of the pathway by cyclopamine reversed these effects indicating that active Hh signaling positively regulates proliferative processes of adult pituitary stem cells and hormone production in the anterior pituitary. Since hormone producing cells of the adenohypophysis as well as ACTH-, GH- and PRL-immunopositive adenomas express SHH and its target GLI1, we furthermore propose that excess HH signaling is involved in the development/maintenance of hormone-producing pituitary adenomas. These findings advance the understanding of physiological hormone regulation and may open new treatment options for pituitary tumors.

  13. [A case of GH and TSH secreting pituitary macroadenoma].

    Science.gov (United States)

    Gołkowski, Filip; Buziak-Bereza, Monika; Stefańska, Agnieszka; Trofimiuk, Małgorzata; Pantofliński, Jacek; Huszno, Bohdan; Czepko, Ryszard; Adamek, Dariusz

    2006-01-01

    A case of GH and TSH secreting pituitary macroadenoma is reported. A 45-year-old female presented clinical features of acromegaly (the abnormal growth of the hands and feet, with lower jaw protrusion), diabetes mellitus, hypertension, nodular goiter and hyperthyroidism of unclear origin. NMR pituitary imaging revealed intra and extrasellar tumor. The laboratory examinations showed very high plasma levels of GH and IGF-1 and normal level of TSH coexisting with high plasma levels of free thyroid hormones. Pharmacological pretreatment with somatostatin analogues caused the substantial reduction of GH and TSH plasma levels. Histological and immunohistochemical examination of the tissue obtained at transsphenoidal surgery showed GH and TSH secreting adenoma. The laboratory examinations after surgery showed normal GH and IGF-1 plasma levels and reduced insulin requirement, what indicates radical operation. The very low plasma levels of TSH and free thyroid hormones after surgery and immunohistochemical examination suggest central hyperthyroidism due to TSH secreting pituitary tumor (thyrotropinoma).

  14. Acromegaly with no pituitary adenoma and no evidence of ectopic source

    Directory of Open Access Journals (Sweden)

    Deepak Khandelwal

    2011-01-01

    Full Text Available More than 99% of patients with acromegaly harbor a growth hormone (GH secreting pituitary adenoma. As the time from onset of signs/symptoms to diagnosis of acromegaly is long (symptom onset to diagnosis is often 4-10 years, pituitary adenomas that cause GH excess are often large and are nearly always visible on conventional magnetic resonance imaging (MRI. However, in rare circumstances, acromegalic patients without an ectopic source will not have imaging evidence of a pituitary adenoma. Management of these patients poses special challenge, and once ectopic source of GH/growth-hormone-releasing hormone (GHRH is ruled out, an exploration of pituitary might be useful. We herein report a case of acromegaly with imaging evidence of sellar floor osteoma, but no pituitary adenoma, and negative work up for an ectopic source of GH/GHRH tumor, and on surgical exploration pituitary adenoma could be identified and removed and confirmed on histopathologic examination.

  15. Plastic shrinkage of mortars with shrinkage reducing admixture and lightweight aggregates studied by neutron tomography

    Energy Technology Data Exchange (ETDEWEB)

    Wyrzykowski, Mateusz, E-mail: mateusz.wyrzykowski@empa.ch [Empa, Swiss Federal Laboratories for Materials Science and Technology, Concrete and Construction Chemistry Laboratory, Dübendorf (Switzerland); Lodz University of Technology, Department of Building Physics and Building Materials, Lodz (Poland); Trtik, Pavel [Paul Scherrer Institute, Laboratory for Neutron Scattering and Imaging, Villigen (Switzerland); Empa, Swiss Federal Laboratories for Materials Science and Technology, Concrete and Construction Chemistry Laboratory, Dübendorf (Switzerland); Münch, Beat [Empa, Swiss Federal Laboratories for Materials Science and Technology, Concrete and Construction Chemistry Laboratory, Dübendorf (Switzerland); Weiss, Jason [Purdue University, School of Civil Engineering, West Lafayette (United States); Vontobel, Peter [Paul Scherrer Institute, Laboratory for Neutron Scattering and Imaging, Villigen (Switzerland); Lura, Pietro [Empa, Swiss Federal Laboratories for Materials Science and Technology, Concrete and Construction Chemistry Laboratory, Dübendorf (Switzerland); ETH Zurich, Institute for Building Materials (IfB), Zurich (Switzerland)

    2015-07-15

    Water transport in fresh, highly permeable concrete and rapid water evaporation from the concrete surface during the first few hours after placement are the key parameters influencing plastic shrinkage cracking. In this work, neutron tomography was used to determine both the water loss from the concrete surface due to evaporation and the redistribution of fluid that occurs in fresh mortars exposed to external drying. In addition to the reference mortar with a water to cement ratio (w/c) of 0.30, a mortar with the addition of pre-wetted lightweight aggregates (LWA) and a mortar with a shrinkage reducing admixture (SRA) were tested. The addition of SRA reduced the evaporation rate from the mortar at the initial stages of drying and reduced the total water loss. The pre-wetted LWA released a large part of the absorbed water as a consequence of capillary pressure developing in the fresh mortar due to evaporation.

  16. Plastic shrinkage of mortars with shrinkage reducing admixture and lightweight aggregates studied by neutron tomography

    International Nuclear Information System (INIS)

    Wyrzykowski, Mateusz; Trtik, Pavel; Münch, Beat; Weiss, Jason; Vontobel, Peter; Lura, Pietro

    2015-01-01

    Water transport in fresh, highly permeable concrete and rapid water evaporation from the concrete surface during the first few hours after placement are the key parameters influencing plastic shrinkage cracking. In this work, neutron tomography was used to determine both the water loss from the concrete surface due to evaporation and the redistribution of fluid that occurs in fresh mortars exposed to external drying. In addition to the reference mortar with a water to cement ratio (w/c) of 0.30, a mortar with the addition of pre-wetted lightweight aggregates (LWA) and a mortar with a shrinkage reducing admixture (SRA) were tested. The addition of SRA reduced the evaporation rate from the mortar at the initial stages of drying and reduced the total water loss. The pre-wetted LWA released a large part of the absorbed water as a consequence of capillary pressure developing in the fresh mortar due to evaporation

  17. What Are the Symptoms of Pituitary Tumors?

    Science.gov (United States)

    ... OLPP) Office of Science Policy, Reporting, and Program Analysis (OSPRA) Division of Extramural Research (DER) Extramural Scientific ... men Lower sex drive The flow of breast milk in a woman who is not pregnant or ...

  18. PLASTIC SHRINKAGE CONTROLLING EFFECT BY POLYPROPYLENE SHORT FIBER WITH HYDROPHILY

    Science.gov (United States)

    Hosoda, Akira; Sadatsuki, Yoshitomo; Oshima, Akihiro; Ishii, Akina; Tsubaki, Tatsuya

    The aim of this research is to clarify the mechanism of controlling plastic shrinkage crack by adding small amout of synthetic short fiber, and to propose optimum polypropylene short fiber to control plastic shrinkage crack. In this research, the effect of the hydrophily of polypropylene fiber was investigated in the amount of plastic shrinkage of mortar, total area of plastic shrinkage crack, and bond properties between fiber and mortar. The plastic shrinkage test of morar was conducted under high temperature, low relative humidity, and constant wind velocity. When polypropylene fiber had hydrophily, the amount of plastic shrinkage of mortar was restrained, which was because cement paste in morar was captured by hydrophilic fiber and then bleeding of mortar was restrained. With hydrophily, plastic shrinkage of mortar was restrained and bridging effect was improved due to better bond, which led to remarkable reduction of plastic shrinkage crack. Based on experimental results, the way of developing optimum polypropylene short fiber for actual construction was proposed. The fiber should have large hydrophily and small diameter, and should be used in as small amount as possible in order not to disturb workability of concrete.

  19. Shrinkage Degree in $L_{2}$ -Rescale Boosting for Regression.

    Science.gov (United States)

    Xu, Lin; Lin, Shaobo; Wang, Yao; Xu, Zongben

    2017-08-01

    L 2 -rescale boosting ( L 2 -RBoosting) is a variant of L 2 -Boosting, which can essentially improve the generalization performance of L 2 -Boosting. The key feature of L 2 -RBoosting lies in introducing a shrinkage degree to rescale the ensemble estimate in each iteration. Thus, the shrinkage degree determines the performance of L 2 -RBoosting. The aim of this paper is to develop a concrete analysis concerning how to determine the shrinkage degree in L 2 -RBoosting. We propose two feasible ways to select the shrinkage degree. The first one is to parameterize the shrinkage degree and the other one is to develop a data-driven approach. After rigorously analyzing the importance of the shrinkage degree in L 2 -RBoosting, we compare the pros and cons of the proposed methods. We find that although these approaches can reach the same learning rates, the structure of the final estimator of the parameterized approach is better, which sometimes yields a better generalization capability when the number of sample is finite. With this, we recommend to parameterize the shrinkage degree of L 2 -RBoosting. We also present an adaptive parameter-selection strategy for shrinkage degree and verify its feasibility through both theoretical analysis and numerical verification. The obtained results enhance the understanding of L 2 -RBoosting and give guidance on how to use it for regression tasks.

  20. Drying Shrinkage Microcracking in Cement-based Materials

    NARCIS (Netherlands)

    Bisschop, J.; Van Mier, J.G.M.

    2002-01-01

    In this paper the nature of drying shrinkage microcracking in a variety of model cementbased materials, as well as in more practical types of concrete is described. The model mixtures were studied to elucidate the mechanisms of drying shrinkage microcracking and the factors that influence these

  1. Endoscopic endonasal surgery for giant pituitary adenomas: advantages and limitations.

    Science.gov (United States)

    Koutourousiou, Maria; Gardner, Paul A; Fernandez-Miranda, Juan C; Paluzzi, Alessandro; Wang, Eric W; Snyderman, Carl H

    2013-03-01

    Giant pituitary adenomas (> 4 cm in maximum diameter) represent a significant surgical challenge. Endoscopic endonasal surgery (EES) has recently been introduced as a treatment option for these tumors. The authors present the results of EES for giant adenomas and analyze the advantages and limitations of this technique. The authors retrospectively reviewed the medical files and imaging studies of 54 patients with giant pituitary adenomas who underwent EES and studied the factors affecting surgical outcome. Preoperative visual impairment was present in 45 patients (83%) and partial or complete pituitary deficiency in 28 cases (52%), and 7 patients (13%) presented with apoplexy. Near-total resection (> 90%) was achieved in 36 patients (66.7%). Vision was improved or normalized in 36 cases (80%) and worsened in 2 cases due to apoplexy of residual tumor. Significant factors that limited the degree of resection were a multilobular configuration of the adenoma (p = 0.002) and extension to the middle fossa (p = 0.045). Cavernous sinus invasion, tumor size, and intraventricular or posterior fossa extension did not influence the surgical outcome. Complications included apoplexy of residual adenoma (3.7%), permanent diabetes insipidus (9.6%), new pituitary insufficiency (16.7%), and CSF leak (16.7%, which was reduced to 7.4% in recent years). Fourteen patients underwent radiation therapy after EES for residual mass or, in a later stage, for recurrence, and 10 with functional pituitary adenomas received medical treatment. During a mean follow-up of 37.9 months (range 1-114 months), 7 patients were reoperated on for tumor recurrence. Three patients were lost to follow-up. Endoscopic endonasal surgery provides effective initial management of giant pituitary adenomas with favorable results compared with traditional microscopic transsphenoidal and transcranial approaches.

  2. Image guidance in trans-sphenoidal surgery for giant pituitary adenomas: Luxury or necessity?

    OpenAIRE

    Deepak Agrawal

    2012-01-01

    Background: In spite of availability of image guidance (neuronavigation) at major centers around the world, most trans-sphenoidal surgeries for pituitary adenomas continue to be done under fluoroscopic control. On the other hand, the high mortality and morbidity for giant pituitary adenomas is mainly due to inadequate tumor removal. Aims and Objectives: The objective of this study was to study to utility of image guidance in trans-sphenoidal surgeries for optimizing tumor removal in giant pit...

  3. Reduction of the Early Autogenous Shrinkage of High Strength Concrete

    Directory of Open Access Journals (Sweden)

    Drago Saje

    2015-01-01

    Full Text Available The results of a laboratory investigation on the early autogenous shrinkage of high strength concrete, and the possibilities of its reduction, are presented. Such concrete demonstrates significant autogenous shrinkage, which should, however, be limited in the early stages of its development in order to prevent the occurrence of cracks and/or drop in the load-carrying capacity of concrete structures. The following possibilities for reducing autogenous shrinkage were investigated: the use of low-heat cement, a shrinkage-reducing admixture, steel fibres, premoistened polypropylene fibres, and presoaked lightweight aggregate. In the case of the use of presoaked natural lightweight aggregate, with a fraction from 2 to 4 mm, the early autogenous shrinkage of one-day-old high strength concrete decreased by about 90%, with no change to the concrete's compressive strength in comparison with that of the reference concrete.

  4. Non-pituitary origin sellar tumours mimicking pituitary macroadenomas

    Energy Technology Data Exchange (ETDEWEB)

    Abele, T.A., E-mail: travaus@gmail.com [University of Texas Southwestern Medical Center at Dallas, Dallas, TX (United States); Yetkin, Z.F.; Raisanen, J.M.; Mickey, B.E.; Mendelsohn, D.B. [University of Texas Southwestern Medical Center at Dallas, Dallas, TX (United States)

    2012-08-15

    Although the large majority of sellar tumours are pituitary adenomas, several other pituitary and non-pituitary origin tumours arise in the sellar and parasellar regions. Given their location, non-adenomatous lesions frequently mimic pituitary macroadenomas and can pose a diagnostic challenge for the radiologist. Distinguishing rare sellar lesions from the common macroadenoma helps to direct the correct surgical approach and reduce the risk of incomplete resection and/or complications such as cerebrospinal fluid leak with the potential for meningitis. The purpose of this article is to review the imaging features of non-pituitary-origin sellar tumours, focusing on characteristics that may distinguish them from pituitary macroadenomas. Lesions include meningioma, metastatic disease, epidermoid cyst, germinoma, chondrosarcoma, giant cell tumour, and giant aneurysm.

  5. MRI of the TSH (thyroid stimulating hormone) -secreting pituitary adenoma

    International Nuclear Information System (INIS)

    Kang, Byung Chul; Kim, Dong Ik; Chung, Tae Sup; Cho, Yong Kook; Lee, Eun Gig; Jung, Joon Keun

    1995-01-01

    To demonstrate and evaluate the value of MRI findings of the TSH(Thyroid-Stimulating Hormone, TSH, Thyrotropin)-secreting pituitary adenoma. The authors reviewed retrospectively the MR images of 4 patients with TSH-secreting pituitary adenoma. Evaluation of the anatomical location, signal characteristics, enhancement patterns, size, shape and circunferential changes were made. No characteristic common MR findings in size, shape, signal intensity, and circumferential changes of TSH-secreting pituitary adenoma waere observed among 4 cases (size; 5 x 7 mm to 10 x 11 mm, shape; ovoid to round signal intensity; high in 1 case on T1 and T2WI, isosignal intensity in the other 3 cases, circumferential change; stalk deviation in 1 case, no stalk deviation in 3 cases). But, the tumors were centrally located at the anterior pituitary gland and showed relatively homogeneous signal intensity on MR images of all 4 patients. We conclude that centrally-located mass at the anterior pituitary gland with homogeneous signal intensity on MR image may be suggestive of the TSH-secreting pituitary adenoma, although the MR findings are not specific for the disease

  6. Progress in the diagnosis and classification of pituitary adenomas

    Directory of Open Access Journals (Sweden)

    Luis V Syro

    2015-06-01

    Full Text Available Pituitary adenomas are common neoplasms. Their classification is based upon size, invasion of adjacent structures, sporadic or familial cases, biochemical activity, clinical manifestations, morphological characteristics, response to treatment and recurrence. Although they are considered benign tumors, some of them are difficult to treat due to their tendency to recur, despite standardized treatment. Functional tumors present other challenges for normalizing their biochemical activity. Novel approaches for early diagnosis as well as different perspectives on classification may help to identify subgroups of patients with similar characteristics, creating opportunities to match each patient with the best personalized treatment option. In this paper we present the progress in the diagnosis and classification of different subgroups of patients with pituitary tumors that may be managed with specific considerations according to their tumor subtype.

  7. Haemorrhagic pituitary tumours

    International Nuclear Information System (INIS)

    Lazaro, C.M.; Philippine General Hospital, Manila; Guo, W.Y.; Sami, M.; Hindmarsch, T.; Ericson, K.; Hulting, A.L.; Wersaell, J.

    1994-01-01

    In a group of 69 patients with pituitary tumours, 12 were found to have evidence of intratumoral haemorrhage on MRI, characterized by high signal intensity on short TR/TE sequences. This was verified in all but 1 patient. The majority of the bleedings occurred in macroadenomas. Five (42%) were prolactinomas and 4 (33%) were non-functioning adenomas. There were 2 GH- and 1 ACTH-secreting tumours. All 5 patients with prolactinomas were on bromocriptine medication. Two of the patients had a clinical picture of pituitary apoplexy. The haemorrhage was not large enough to prompt surgery in any of the patients. However, surgical verification of the diagnosis was obtained in 5 cases, while 6 patients were examined with follow-up MRI. (orig.)

  8. Pituitary stalk craniopharyngioma

    Science.gov (United States)

    Figueiredo, Eberval Gadelha; Welling, Leonardo Christiaan; de Faria, Jose Weber Vieira; Teixeira, Manoel Jacobsen

    2011-01-01

    Craniopharyngiomas are benign but aggressive neoplasms arising along the craniopharyngeal duct. It is frequently located in the suprasellar region. Primarily pituitary stalk craniopharyngioma is unusual and uncommonly early diagnosed, before it enlarges and extends to supra or parasselar region. This unusual location and the small size pose therapeutic dilemmas, since it has the ability to grow larger. Currently, no consensus exists regarding the optimal management. The authors have recommended complete resection. PMID:22715220

  9. Headache in Patients With Pituitary Lesions: A Longitudinal Cohort Study.

    Science.gov (United States)

    Rizzoli, Paul; Iuliano, Sherry; Weizenbaum, Emma; Laws, Edward

    2016-03-01

    Headache is a presenting feature in 37% to 70% of patients with pituitary tumor. Other pituitary lesions may also present with headache, and together these lesions account for about 20% of all primary brain lesions. Although pituitary lesions have been associated with headache, the exact nature of the relationship remains undefined. It is not always clear whether the presenting headache is an unrelated primary headache, a lesion-induced aggravation of a preexisting primary headache, or a separate secondary headache related to the lesion. To characterize headache in patients referred to a multidisciplinary neuroendocrine clinic with suspected pituitary lesions and to assess changes in headache in those who underwent surgery. We used a self-administered survey of headache characteristics completed by patients upon presentation and after any pituitary surgical procedure. One hundred thirty-three participants completed the preoperative questionnaire (response rate of 99%). The overall prevalence of headache was 63%. Compared to patients without headache, the group with headache was more likely to be female (P = .001), younger (P = .001), and to have had a prior headache diagnosis (P headache localized to the anterior region of the head. Fifty-one patients with headache underwent transsphenoidal pituitary surgery. Headache was not associated with increased odds of having surgery (odds ratio, 0.90). At 3 months, 81% of surgically treated patients with headache who completed the postoperative questionnaire (21/26) reported improvement or resolution of headaches. No patient who completed the postoperative questionnaire (44/84) reported new or worsened headache. Frequent, disabling headaches are common in patients with pituitary lesions referred for neuroendocrine consultation, especially in younger females with a preexisting headache disorder. Surgery in this group was associated with headache improvement or resolution in the majority and was not found to cause or worsen

  10. Primary hypothyroidism masquerading pituitary macroadenoma

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2014-03-01

    Full Text Available Diffuse and reactive pituitary gland enlargement secondary to primary hypothyroidism is an uncommon occurrence and that can masquerade many pituitary disorders. In present article, we report a case of 19 year female severe hypothyroidism presenting with diffuse enlargement of pituitary gland and hyperprolactinemia and review the clinical importance of this entity. Knowledge of this entity is very important to avoid unnecessary surgery and irreversible complications in this sub-group of patients.

  11. Primary hypothyroidism masquerading pituitary macroadenoma

    OpenAIRE

    Agrawal Amit; Reddy Amareesh P.; Malleswara Rao G.; Reddy V. Umamaheswara

    2014-01-01

    Diffuse and reactive pituitary gland enlargement secondary to primary hypothyroidism is an uncommon occurrence and that can masquerade many pituitary disorders. In present article, we report a case of 19 year female severe hypothyroidism presenting with diffuse enlargement of pituitary gland and hyperprolactinemia and review the clinical importance of this entity. Knowledge of this entity is very important to avoid unnecessary surgery and irreversible complications in this sub-group of patients.

  12. MR findings in pituitary haemosiderosis

    International Nuclear Information System (INIS)

    Ambrosetto, P.; Zucchini, S.; Cicognani, A.; Cacciari, E.

    1998-01-01

    A girl with Diamond-Blackfan syndrome and hypopituitarism was suspected of having pituitary haemosiderosis because of the clinical picture and the long history of blood transfusions. On T1-weighted MR images the pituitary exhibited a markedly hypointense anterior lobe (mimicking the empty sella), suggesting iron deposition, while on T2W MRI the low signal of the pituitary was surrounded by the high signal of the CSF. MR may be considered the examination of choice for detecting iron overload in the pituitary. (orig.)

  13. Studies on heat shrinkage PVC tubes

    International Nuclear Information System (INIS)

    Pyun, Hyung Chick; Kim, Ki Yup; Nho, Young Chang

    1991-01-01

    Radiation crosslinking of PVC was investigated for the purpose of obtaining a suitable formulation for heat shrinkable tube. PVC was not only compounded with various crosslinking agents and plasticizers to evaluate their effects on the radiation sensitivity, heat shrinkable property and other mechanical properties, but also mixed with NBR, crosslinking agents and plasticizers to obtain efficient crosslinking yield and suitable mechanical properties for heat shrinkable tube. Gel yield of PVC increased with increasing unsaturation levels per molecular weight of crosslinking agents. Among crosslinking agents tested, TMPTMA with three unsaturated groups showed highest gel yield, while PVC containing NBR was more sensitive to crosslinking than PVC itself regardless the types of crosslinking agents and plasticizers. Tensile strength was increased with increasing radiation dose and gel percent, but elongation decreased. It was found that gel percent was increased with increasing radiation dose, heat transformation was decreased with increasing gel percent. When NBR was mixed with PVC, the radiation dosage required for enhancing yield of gel percent and heat transformation were found to be much smaller comparing with the case containing no NBR. Therefore, the addition of NBR to PVC was very effective to increase heat-resisting property of PVC. Heat shrinkage was not much varied with radiation dose, the types of crosslinking agents and plasticizers, but it was increased remarkably with decreasing stretching temperature and increasing annealing temperature. (Author)

  14. Modeling for prediction of restrained shrinkage effect in concrete repair

    International Nuclear Information System (INIS)

    Yuan Yingshu; Li Guo; Cai Yue

    2003-01-01

    A general model of autogenous shrinkage caused by chemical reaction (chemical shrinkage) is developed by means of Arrhenius' law and a degree of chemical reaction. Models of tensile creep and relaxation modulus are built based on a viscoelastic, three-element model. Tests of free shrinkage and tensile creep were carried out to determine some coefficients in the models. Two-dimensional FEM analysis based on the models and other constitutions can predict the development of tensile strength and cracking. Three groups of patch-repaired beams were designed for analysis and testing. The prediction from the analysis shows agreement with the test results. The cracking mechanism after repair is discussed

  15. Pituitary carcinoma diagnosed on fine needle aspiration: Report of a case and review of pathogenesis

    Directory of Open Access Journals (Sweden)

    Yakoushina Tatiana

    2010-01-01

    Full Text Available Pituitary carcinoma (PC is a very rare entity (0.2% of all pituitary tumors, with only about 140 cases reported in English literature. There are no reliable histological, immunohistochemical or ultrastructural features distinguishing pituitary adenoma (PA from PC. By definition, a diagnosis of PC is made after a patient with PA develops non-contiguous central nervous system (CNS or systemic metastases. To date, only three cases of PC have been reportedly diagnosed on fine needle aspiration (FNA. Two of the reported cases were diagnosed on FNA of the cervical lymph nodes and one on FNA of the vertebral bone lesion. Herein, we present a case of PC, diagnosed on FNA of the liver lesion. In this case, we describe cytologic features of PC and compare them to histologic features of the tumor in the pituitary. Clinical behavior of tumor, pathogenesis of metastasis and immunochemical and prognostic markers will also be described.

  16. Pituitary metastasis of hepatocellular carcinoma presenting with panhypopituitarism: a case report.

    Science.gov (United States)

    Tanaka, Tomoko; Hiramatsu, Katsushi; Nosaka, Takuto; Saito, Yasushi; Naito, Tatsushi; Takahashi, Kazuto; Ofuji, Kazuya; Matsuda, Hidetaka; Ohtani, Masahiro; Nemoto, Tomoyuki; Suto, Hiroyuki; Yamamoto, Tatsuya; Kimura, Hirohiko; Nakamoto, Yasunari

    2015-11-06

    Metastasis to the pituitary gland is extremely rare and is often detected incidentally by symptoms associated with endocrine dysfunction. Breast and lung cancer are the most common primary metastasizing to pituitary gland. Metastasis from hepatocellular carcinoma to the pituitary gland is extremely rare, with only 10 cases having been previously reported. We present here the first case of pituitary metastasis of hepatocellular carcinoma presenting with panhypopituitarism diagnosed by magnetic resonance imaging. We report the case of an 80-year-old Japanese woman who presented with the sudden onset of hypotension and bradycardia after having previously been diagnosed with hepatocellular carcinoma. Based on low levels of pituitary hormones, she was diagnosed with panhypopituitarism caused by metastasis of the hepatocellular carcinoma to the pituitary gland. Magnetic resonance imaging with arterial spin-labeling was effective in the differential diagnosis of the intrasellar tumor. The patient died despite hormone replacement therapy because of hypovolemic shock. Metastasis to the pituitary gland causes various non-specific symptoms, so it is difficult to diagnose. The present case emphasizes the importance of diagnostic imaging in identifying these metastases. Clinicians should consider the possibility of pituitary metastasis in patients with malignant tumors who demonstrate hypopituitarism.

  17. Pituitary metastasis of hepatocellular carcinoma presenting with panhypopituitarism: a case report

    International Nuclear Information System (INIS)

    Tanaka, Tomoko; Hiramatsu, Katsushi; Nosaka, Takuto; Saito, Yasushi; Naito, Tatsushi; Takahashi, Kazuto; Ofuji, Kazuya; Matsuda, Hidetaka; Ohtani, Masahiro; Nemoto, Tomoyuki; Suto, Hiroyuki; Yamamoto, Tatsuya; Kimura, Hirohiko; Nakamoto, Yasunari

    2015-01-01

    Metastasis to the pituitary gland is extremely rare and is often detected incidentally by symptoms associated with endocrine dysfunction. Breast and lung cancer are the most common primary metastasizing to pituitary gland. Metastasis from hepatocellular carcinoma to the pituitary gland is extremely rare, with only 10 cases having been previously reported. We present here the first case of pituitary metastasis of hepatocellular carcinoma presenting with panhypopituitarism diagnosed by magnetic resonance imaging. We report the case of an 80-year-old Japanese woman who presented with the sudden onset of hypotension and bradycardia after having previously been diagnosed with hepatocellular carcinoma. Based on low levels of pituitary hormones, she was diagnosed with panhypopituitarism caused by metastasis of the hepatocellular carcinoma to the pituitary gland. Magnetic resonance imaging with arterial spin-labeling was effective in the differential diagnosis of the intrasellar tumor. The patient died despite hormone replacement therapy because of hypovolemic shock. Metastasis to the pituitary gland causes various non-specific symptoms, so it is difficult to diagnose. The present case emphasizes the importance of diagnostic imaging in identifying these metastases. Clinicians should consider the possibility of pituitary metastasis in patients with malignant tumors who demonstrate hypopituitarism

  18. Prothymosin-alpha and Ki-67 expression in pituitary adenomas

    Directory of Open Access Journals (Sweden)

    Iga Wierzbicka-Tutka

    2016-11-01

    Full Text Available Introduction: Prothymosin alpha (PTMA, a nuclear oncoprotein involved in cell cycle regulation, is used as a prognostic marker in many cancers. The histopathology of pituitary carcinomas and locally invasive adenomas is indistinguishable from that of benign tumors. A new marker is needed to differentiate these lesions. We evaluated PTMA in pituitary adenomas to determine its usefulness as a prognostic factor of tumor proliferation.Material/Methods: We conducted a retrospective analysis of a group of 27 patients, including 15 females (56% and 12 males (44% with a mean age of 58.6±12 years, who underwent pituitary tumor surgery between 2003 and 2012. The Ki-67 and PTMA-nuclear (PTMA-n and PTMA-cytoplasmic (PTMA-c indices were determined by immunohistochemical staining. We studied histopathological features, clinical symptoms, and magnetic resonance imaging or computed tomography performed before surgery and one year following surgery to evaluate tumor size and progression.Results: The expression of Ki-67 was revealed in 77.8% of adenomas, PTMA-n in 81.5% and PTMA-c in 92.6%. The mean value of the Ki-67 index was 1.8%, PTMA-n was 1.84%, and PTMA-c was 35.6%. There was a significant positive correlation between Ki-67 and PTMA-n (p=0.009. We did not find any correlation between Ki-67, PTMA-c, and tumor progression. PTMA-n was found to be correlated with tumor size (p=0.045 and was higher in the case of gonadotropinomas (p=0.026.Conclusions: The positive nuclear expression of Ki-67 and PTMA was observed in the majority of pituitary adenomas. Neither the expression of Ki-67 nor that of PTMA-c was related to tumor recurrence or local invasion.

  19. Regulation of pituitary hormones and cell proliferation by components of the extracellular matrix

    Directory of Open Access Journals (Sweden)

    M. Paez-Pereda

    2005-10-01

    Full Text Available The extracellular matrix is a three-dimensional network of proteins, glycosaminoglycans and other macromolecules. It has a structural support function as well as a role in cell adhesion, migration, proliferation, differentiation, and survival. The extracellular matrix conveys signals through membrane receptors called integrins and plays an important role in pituitary physiology and tumorigenesis. There is a differential expression of extracellular matrix components and integrins during the pituitary development in the embryo and during tumorigenesis in the adult. Different extracellular matrix components regulate adrenocorticotropin at the level of the proopiomelanocortin gene transcription. The extracellular matrix also controls the proliferation of adrenocorticotropin-secreting tumor cells. On the other hand, laminin regulates the production of prolactin. Laminin has a dynamic pattern of expression during prolactinoma development with lower levels in the early pituitary hyperplasia and a strong reduction in fully grown prolactinomas. Therefore, the expression of extracellular matrix components plays a role in pituitary tumorigenesis. On the other hand, the remodeling of the extracellular matrix affects pituitary cell proliferation. Matrix metalloproteinase activity is very high in all types of human pituitary adenomas. Matrix metalloproteinase secreted by pituitary cells can release growth factors from the extracellular matrix that, in turn, control pituitary cell proliferation and hormone secretion. In summary, the differential expression of extracellular matrix components, integrins and matrix metalloproteinase contributes to the control of pituitary hormone production and cell proliferation during tumorigenesis.

  20. An unusual case of hypopituitarism and transient thyrotoxicosis following asymptomatic pituitary apoplexy.

    Science.gov (United States)

    Yoshida, Masanori; Murakami, Miho; Ueda, Harumi; Miyata, Misaki; Takahashi, Norio; Oiso, Yutaka

    2014-01-01

    Although pituitary function is often impaired in pituitary apoplexy, the development of thyrotoxicosis is rare. We describe an unusual case of hypopituitarism due to pituitary apoplexy coexisting with transient hyperthyroidism. A 74-year-old woman presented with severe fatigue, palpitation, appetite loss, hypotension, and hyponatremia. Endocrine studies showed hyperthyroidism and anterior pituitary hormone deficiencies. A magnetic resonance imaging suggested recent-onset pituitary apoplexy in a pituitary tumor, although the patient had no apoplectic symptoms such as headache and visual disturbance. Thyrotoxicosis and adrenal insufficiency worsened her general condition. Glucocorticoid supplementation improved her clinical symptoms and hyponatremia. Serum anti-thyrotropin receptor and thyroid-stimulating antibody titers were negative, and her thyroid function was spontaneously normalized without antithyroid medication, suggesting painless thyroiditis. Thereafter, her thyroid function decreased because of central hypothyroidism and 75 µg of levothyroxine was needed to maintain thyroid function at the euthyroid stage. The pituitary mass was surgically removed and an old hematoma was detected in the specimen. Considering that painless thyroiditis develops as a result of an autoimmune process, an immune rebound mechanism due to adrenal insufficiency probably caused painless thyroiditis. Although the most common type of thyroid disorder in pituitary apoplexy is central hypothyroidism, thyrotoxicosis caused by painless thyroiditis should be considered even if the patient has pituitary deficiencies. Because thyrotoxicosis with adrenal insufficiency poses a high risk for a life-threatening adrenal crisis, prompt diagnosis and treatment are critical.

  1. Primary Endoscopic Transnasal Transsphenoidal Surgery for Giant Pituitary Adenoma.

    Science.gov (United States)

    Kuo, Chao-Hung; Yen, Yu-Shu; Wu, Jau-Ching; Chang, Peng-Yuan; Chang, Hsuan-Kan; Tu, Tsung-Hsi; Huang, Wen-Cheng; Cheng, Henrich

    2016-07-01

    Giant pituitary adenoma (>4 cm) remains challenging because the optimal surgical approach is uncertain. Consecutive patients with giant pituitary adenoma who underwent endoscopic transnasal transsphenoidal surgery (ETTS) as the first and primary treatment were retrospectively reviewed. Inclusion criteria were tumor diameter ≥4 cm in at least 1 direction, and tumor volume ≥10 cm(3). Exclusion criteria were follow-ups surgery. Residual and recurrent tumors (n = 30) were managed with 1 of the following: Gamma Knife radiosurgery (GKRS), reoperation (redo ETTS), both GKRS and ETTS, medication, conventional radiotherapy, or none. At last follow-up, most of the patients had favorable outcomes, including 8 (21.1%) who were cured and 29 (76.3%) who had a stable residual condition without progression. Only 1 (2.6%) had late recurrence at 66 months after GKRS. The overall progression-free rate was 97.4%, with few complications. In this series of giant pituitary adenoma, primary (ie, the first) ETTS yielded complete resection and cure in 21.1%. Along with adjuvant therapies, including GKRS, most patients (97.4%) were stable and free of disease progression. Therefore, primary ETTS appeared to be an effective surgical approach for giant pituitary adenoma. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Delayed Onset of Isolated Unilateral Oculomotor Nerve Palsy Caused by Post-Traumatic Pituitary Apoplexy: A Case Report

    Directory of Open Access Journals (Sweden)

    Tomoki Ishigaki

    2017-09-01

    Full Text Available Post-traumatic pituitary apoplexy is uncommon, most of which present with a sudden onset of severe headache and visual impairments associated with a dumbbell-shaped pituitary tumor. We experienced an unusual case of post-traumatic pituitary apoplexy with atypical clinical features. A 66-year-old man presented with mild cerebral contusion and an incidentally diagnosed intrasellar tumor after a fall accident with no loss of consciousness. The patients denied any symptoms before the accident. After 4 days, the left oculomotor nerve palsy developed and deteriorated associated with no severe headache. Repeated neuroimages suggested that pituitary apoplexy had occurred at admission and showed that the tumor compressed the left cavernous sinus. The patient underwent endonasal transsphenoidal surgery at 6 days after head injury, and the mass reduction improved the oculomotor nerve palsy completely within the following 14 days. The pathologic diagnosis was nonfunctioning pituitary adenoma with hemorrhage and necrosis.

  3. Pituitary apoplexy masquerading as meningitis

    African Journals Online (AJOL)

    meningeal irritation is not considered a classic feature of pituitary apoplexy.2,3 The pathophysiology behind this symptom complex involves leakage of blood into the subarachnoid space, which, in conjunction with the necrotic tissue in the pituitary itself, induces a cytokine response, resulting in meningeal irritation and the.

  4. Pituitary gland imaging and outcome.

    Science.gov (United States)

    Di Iorgi, Natascia; Morana, Giovanni; Gallizia, Anna Lisa; Maghnie, Mohamad

    2012-01-01

    Magnetic resonance imaging (MRI) allows a detailed and precise anatomical study of the pituitary gland by differentiating between the anterior and posterior pituitary lobes. The identification of posterior pituitary hyperintensity, now considered a marker of neurohypophyseal functional integrity, has been the most striking advance for the diagnosis and understanding of anterior and posterior pituitary diseases. The advent of MRI has in fact led to a significant improvement in the understanding of the pathogenesis of disorders that affect the hypothalamo-pituitary area. Today, there is convincing evidence to support the hypothesis that marked MRI differences in pituitary morphology indicate a diverse range of disorders which affect the organogenesis and function of the anterior pituitary gland with different prognoses. Furthermore, the association of extrapituitary malformations accurately defined by MRI has supported a better definition of several conditions linked to pituitary hormone deficiencies and midline defects. MRI is a very informative procedure that should be used to support a diagnosis of hypopituitarism. It is useful in clinical management, because it helps endocrinologists determine which patients to target for further molecular studies and genetic counselling, which ones to screen for additional hormone deficits, and which ones may need growth hormone replacement into adult life. Copyright © 2012 S. Karger AG, Basel.

  5. Pituitary diseases and sleep disorders

    NARCIS (Netherlands)

    Romijn, Johannes A.

    2016-01-01

    Patients with pituitary diseases have decreased quality of life. Sleep disorders are prevalent among patients with pituitary diseases and contribute to decreased quality of life. Patients previously treated for compression of the optic chiasm by surgery, and in some cases postoperative radiotherapy,

  6. The ectopic posterior pituitary gland

    African Journals Online (AJOL)

    2013-11-04

    Nov 4, 2013 ... crinology with short stature, delayed bone age and biochemical features suggestive of hypo pituitarism. Magnetic resonance imaging of the brain demonstrated a flattened anterior pituitary gland within the sella, associated with absence of the infundibular stalk and an ectopic posterior pituitary gland (Fig.

  7. Creep and Shrinkage of High Strength Concretes: an Experimental Analysis

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    Berenice Martins Toralles carbonari

    2002-01-01

    Full Text Available The creep and shrinkage behaviour of high strength silica fume concretes is significantly different from that of conventional concretes. In order to represent the proper time-dependent response of the material in structural analysis and design, these aspects should be adequately quantified. This paper discusses an experimental setup that is able to determine the creep and shrinkage of concrete from the time of placing. It also compares different gages that can be used for measuring the strains. The method is applied to five different concretes in the laboratory under controlled environmental conditions. The phenomena that are quantified can be classified as basic shrinkage, drying shrinkage, basic creep and drying creep. The relative importance of these mechanisms in high strength concrete will also be presented.

  8. Comparison of shrinkage related properties of various patch repair materials

    Science.gov (United States)

    Kristiawan, S. A.; Fitrianto, R. S.

    2017-02-01

    A patch repair material has been developed in the form of unsaturated polyester resin (UPR)-mortar. The performance and durability of this material are governed by its compatibility with the concrete being repaired. One of the compatibility issue that should be tackled is the dimensional compatibility as a result of differential shrinkage between the repair material and the concrete substrate. This research aims to evaluate such shrinkage related properties of UPR-mortar and to compare with those of other patch repair materials. The investigation includes the following aspects: free shrinkage, resistance to delamination and cracking. The results indicate that UPR-mortar poses a lower free shrinkage, lower risk of both delamination and cracking tendency in comparison to other repair materials.

  9. Influence of gelatinous fibers on the shrinkage of silver maple

    Science.gov (United States)

    Donals G. Arganbright; Dwight W. Bensend; Floyd G. Manwiller

    1970-01-01

    The degree of lean was found to have a significant influence on the logitudinal and transverse shrinkage of three soft maple trees. This may be accounted for by differences in the cell wall layer thickness and fibril angle.

  10. Shrinkage and durability study of bridge deck concrete.

    Science.gov (United States)

    2010-12-01

    The Mississippi Department of Transportation is incorporating changes to material : specifications and construction procedures for bridge decks in an effort to reduce shrinkage : cracking. These changes are currently being implemented into a limited ...

  11. Transsphenoidal pituitary resection with intraoperative MR guidance: preliminary results

    Science.gov (United States)

    Pergolizzi, Richard S., Jr.; Schwartz, Richard B.; Hsu, Liangge; Wong, Terence Z.; Black, Peter M.; Martin, Claudia; Jolesz, Ferenc A.

    1999-05-01

    The use of intraoperative MR image guidance has the potential to improve the precision, extent and safety of transsphenoidal pituitary resections. At Brigham and Women's Hospital, an open-bore configuration 0.5T MR system (SIGNA SP, GE Medical Systems, Milwaukee, WI) has been used to provide image guidance for nine transsphenoidal pituitary adenoma resections. The intraoperative MR system allowed the radiologist to direct the surgeon toward the sella turcica successfully while avoiding the cavernous sinus, optic chiasm and other sensitive structures. Imaging performed during the surgery monitored the extent of resection and allowed for removal of tumor beyond the surgeon's view in five cases. Dynamic MR imaging was used to distinguish residual tumor from normal gland and postoperative changes permitting more precise tumor localization. A heme-sensitive long TE gradient echo sequence was used to evaluate for the presence of hemorrhagic debris. All patients tolerated the procedure well without significant complications.

  12. Unusual mixed gangliocytoma-pituitary adenoma in sellar region

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    Jie-tian JIN

    2016-10-01

    Full Text Available Background The presence of ganglion cells within an endocrine pituitary adenoma in sellar region is rare, and is usually diagnosed as "mixed gangliocytoma-pituitary adenoma". Due to lack of radiological characteristics, it is very difficult to make an accurate diagnosis preoperatively. Herein we describe one case of unusual mixed gangliocytoma - growth hormone (GH secreting pituitary adenoma in sellar region and review related literatures, so as to summarize the clinicopathological characteristics and improve the diagnosis and differential diagnosis of this tumor. Methods and Results A 28 - year - old female presented with headache and blurred vision for 8 months. She also complained of acromegaly and amenorrhea. Head CT and MRI examinations showed a sellar and suprasellar mass with clear boundary compressing the optic chiasm and buttom of the third ventricle. The mass exhibited isointense signal or mild hypointensity on T1WI and mild hyperintensity on T2WI with heterogeneous enhancement on the contrast MRI. The tumor was removed totally. The histological sections demonstrated two parts of intermixed areas. One part of areas was marked by a proliferation of scattered gangliocyte - like cells arranged in a fibrillary background. Other areas were marked by a sheet - like or locally papillary proliferation of round and oval cells. Immunohistochemically, cytoplasm of gangliocyte-cells were diffusely positive for synaptophysin (Syn, and negative for adenohypophysial hormones; cytoplasm of round and oval cells were diffusely positive for Syn, and almost 30% cells were positive for GH, and negative for other neurohypophysial hormones. A final diagnosis of mixed gangliocytoma-GH secreting pituitary adenoma in sellar region (WHO grade Ⅰ was made. The patient did not receive postoperatively adjuvant therapy and was followed-up for one year, without any neurological deficit or signs of recurrence. Conclusions Mixed gangliocytoma - pituitary

  13. Anaplastic astrocytoma 14 years after radiotherapy for pituitary adenoma

    International Nuclear Information System (INIS)

    Tamura, Masaru; Misumi, Syuuzou; Kurosaki, Syuuhei; Shibasaki, Takashi; Ohye, Chihiro

    1992-01-01

    A case of anaplastic astrocytoma following radiotherapy for growth hormone secreting pituitary adenoma is presented with a review of the literature. A 43 year old female was admitted with signs of acromegaly and hypertension. An eosinophilic pituitary adenoma was subtotally removed by transsphenoidal approach, followed by 60 Gy irradiation using a 2x2 cm lateral field. Fourteen years later at the age of 57, she suffered from headache, recent-memory disturbance and uncinate fits. CT scan and MRI disclosed ring-like enhanced mass lesion in the left temporal lobe, corresponding to the previous irradiated field. 18 F-FDG PET showed hypermetabolism at the lesion. Left frontotemporal craniotomy was performed, and a reddish gray gelatinous tumor containing necrotic center and cyst was partially removed. Histologically, the tumor consisted of hypercellular astrocytic cells with perivascular pseudorosette. Coagulation necrosis at the center of the tumor, and hyalinosis and fibrosis of the blood vessels in and around the tumor, which might have been caused by the antecedent radiotherapy, were recognized. Postoperative radiotherapy and chemotherapy, were given, however, she expired 13 months after the operation. Seven cases, including ours, of malignant glioma following radiotherapy for pituitary adenoma were reported in the literature. A total dose of irradiation varies from 45 to 95 Gy with a mean of 50 Gy. The period of latency before tumor occurrence ranges from 5 to 22 years with a mean of 10 years. The differentiation of radiation-induced gliomas from radionecrosis of the brain is also discussed. (author)

  14. Anaplastic astrocytoma 14 years after radiotherapy for pituitary adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Tamura, Masaru; Misumi, Syuuzou; Kurosaki, Syuuhei; Shibasaki, Takashi; Ohye, Chihiro (Gunma Univ., Maebashi (Japan). School of Medicine)

    1992-04-01

    A case of anaplastic astrocytoma following radiotherapy for growth hormone secreting pituitary adenoma is presented with a review of the literature. A 43 year old female was admitted with signs of acromegaly and hypertension. An eosinophilic pituitary adenoma was subtotally removed by transsphenoidal approach, followed by 60 Gy irradiation using a 2x2 cm lateral field. Fourteen years later at the age of 57, she suffered from headache, recent-memory disturbance and uncinate fits. CT scan and MRI disclosed ring-like enhanced mass lesion in the left temporal lobe, corresponding to the previous irradiated field. {sup 18}F-FDG PET showed hypermetabolism at the lesion. Left frontotemporal craniotomy was performed, and a reddish gray gelatinous tumor containing necrotic center and cyst was partially removed. Histologically, the tumor consisted of hypercellular astrocytic cells with perivascular pseudorosette. Coagulation necrosis at the center of the tumor, and hyalinosis and fibrosis of the blood vessels in and around the tumor, which might have been caused by the antecedent radiotherapy, were recognized. Postoperative radiotherapy and chemotherapy, were given, however, she expired 13 months after the operation. Seven cases, including ours, of malignant glioma following radiotherapy for pituitary adenoma were reported in the literature. A total dose of irradiation varies from 45 to 95 Gy with a mean of 50 Gy. The period of latency before tumor occurrence ranges from 5 to 22 years with a mean of 10 years. The differentiation of radiation-induced gliomas from radionecrosis of the brain is also discussed. (author).

  15. Prevention of shrinkage cracking in tight concrete structures

    International Nuclear Information System (INIS)

    Alvaredo, A.M.; Wittmann, F.H.

    1995-01-01

    It is shown that crack formation and propagation in concrete members subjected to restrained shrinkage can be realistically predicted by means of a comprehensive approach including a diffusion analysis and fracture mechanics considerations. The conditions for stable crack propagation regarding dimensions of the concrete member, degree of restraint to the imposed deformation and material properties are discussed. Guidelines on the prevention of shrinkage cracking of concrete structures are given. (author). 10 refs., 5 figs

  16. Mutation analysis of inhibitory guanine nucleotide binding protein alpha (GNAI) loci in young and familial pituitary adenomas.

    Science.gov (United States)

    Demir, Hande; Donner, Iikki; Kivipelto, Leena; Kuismin, Outi; Schalin-Jäntti, Camilla; De Menis, Ernesto; Karhu, Auli

    2014-01-01

    Pituitary adenomas are neoplasms of the anterior pituitary lobe and account for 15-20% of all intracranial tumors. Although most pituitary tumors are benign they can cause severe symptoms related to tumor size as well as hypopituitarism and/or hypersecretion of one or more pituitary hormones. Most pituitary adenomas are sporadic, but it has been estimated that 5% of patients have a familial background. Germline mutations of the tumor suppressor gene aryl hydrocarbon receptor-interacting protein (AIP) predispose to hereditary pituitary neoplasia. Recently, it has been demonstrated that AIP mutations predispose to pituitary tumorigenesis through defective inhibitory GTP binding protein (Gαi) signaling. This finding prompted us to examine whether germline loss-of-function mutations in inhibitory guanine nucleotide (GTP) binding protein alpha (GNAI) loci are involved in genetic predisposition of pituitary tumors. To our knowledge, this is the first time GNAI genes are sequenced in order to examine the occurrence of inactivating germline mutations. Thus far, only somatic gain-of-function hot-spot mutations have been studied in these loci. Here, we have analyzed the coding regions of GNAI1, GNAI2, and GNAI3 in a set of young sporadic somatotropinoma patients (n = 32; mean age of diagnosis 32 years) and familial index cases (n = 14), thus in patients with a disease phenotype similar to that observed in AIP mutation carriers. In addition, expression of Gαi proteins was studied in human growth hormone (GH), prolactin (PRL), adrenocorticotropic hormone (ACTH)-secreting and non-functional pituitary tumors. No pathogenic germline mutations affecting the Gαi proteins were detected. The result suggests that loss-of-function mutations of GNAI loci are rare or nonexistent in familial pituitary adenomas.

  17. Shrinkage Module of Soil Samples with Different Cement Content

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    Mohannad Sabry

    2017-12-01

    Full Text Available The differences in soil's body mass during shrinkage over time have changes in soil physical properties which provide an important reason to check the design of underground foundations in expansive soils. In this paper, a state-of-art of the soil heat stress-strain relationship prediction methods is checked using soil engineering laboratory experiments and Matlab R2013b numerical modelling. The shrinkage of soils with different cement content of (0%, 2%, 4%, 6% and 8% with the same water content of 20 percent in room temperature for 24 hours, are critically reviewed in terms of their predictive shrinkage along with their strengths and flexural behaviour. The review highlights the prediction methods present to determine the effect of heat stress on the shrinkage of soil samples with different cement content after classifying the soils into clay, silt and sand depending on their particle size using sieve and hydrometer experiments. The results of the soil engineering laboratory experiments showed that as the cement content increases, the shrinkage of soil decreases as a result of increased elasticity in soil. The numerical analysis using finite element method in Matlab R2013b shows that as the cement content increases the displacement in the soil sample decreases and that the soil sample with 8% cement content has more resistance to shrinkage and less displacement than the soil with 6% cement, which has less resistance to heat stresses and more displacement.

  18. Variation of Shrinkage Strain within the Depth of Concrete Beams

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    Jong-Hyun Jeong

    2015-11-01

    Full Text Available The variation of shrinkage strain within beam depth was examined through four series of time-dependent laboratory experiments on unreinforced concrete beam specimens. Two types of beam specimens, horizontally cast and vertically cast, were tested; shrinkage variation was observed in the horizontally cast specimens. This indicated that the shrinkage variation within the beam depth was due to water bleeding and tamping during the placement of the fresh concrete. Shrinkage strains were measured within the beam depth by two types of strain gages, surface-attached and embedded. The shrinkage strain distribution within the beam depth showed a consistent tendency for the two types of gages. The test beams were cut into four sections after completion of the test, and the cutting planes were divided into four equal sub-areas to measure the aggregate concentration for each sub-area of the cutting plane. The aggregate concentration increased towards the bottom of the beam. The shrinkage strain distribution was estimated by Hobbs’ equation, which accounts for the change of aggregate volume concentration.

  19. PET and endocrine tumors

    International Nuclear Information System (INIS)

    Rigo, P.; Belhocine, T.; Hustinx, R.; Foidart-Willems, J.

    2000-01-01

    The authors review the main indications of PET examination, and specifically of 18 FDG, in the assessment of endocrine tumors: of the thyroid, of the parathyroid, of the adrenal and of the pituitary glands. Neuroendocrine tumors, gastro-entero-pancreatic or carcinoid tumors are also under the scope. Usually, the most differentiated tumors show only poor uptake of the FDG as they have a weak metabolic and proliferative activity. In the assessment of endocrine tumors, FDG-PET should be used only after most specific nuclear examinations been performed. (author)

  20. Xanthomatous Hypophysitis Mimicking a Pituitary Adenoma: Case Report and Review of the Literature

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    Laura Aste

    2010-01-01

    Full Text Available Background. Hypophysitis is an inflammatory disease of the pituitary gland that may mimic pituitary tumors clinically and radiologically. Case Description. We report a case of a xanthomatous hypophysitis initially diagnosed as pituitary adenoma. A 31-year-old woman presented with headache, diabetes insipidus, and amenorrhea. A head CT scan showed no intrasellar changes, while an MRI scan showed a sellar cystic mass. An endocrinological work up revealed mild hypocortisolism and diabetes insipidus (DI. Transsphenoidal surgery was performed. The intraoperative histological examination suggested a pituitary adenoma. The removed tissue showed central necrosis surrounded by accumulation of foamy cells and xanthomatous epithelioid cells. The patient made an uneventful postoperative recovery, Nevertheless, DI persisted and the adenohypophysis hypofunction did not recover. Conclusion. We describe an unusual inflammatory lesion of the pituitary gland mimicking an adenoma. A high level of clinical suspicion of inflammatory disorders is necessary for correct diagnosis and optimal management.

  1. Pituitary apoplexy precipitating diabetes insipidus after living donor liver transplantation.

    Science.gov (United States)

    Matsusaki, Takashi; Morimatsu, Hiroshi; Matsumi, Junya; Matsuda, Hiroaki; Sato, Tetsufumi; Sato, Kenji; Mizobuchi, Satoshi; Yagi, Takahito; Morita, Kiyoshi

    2011-02-01

    Pituitary apoplexy occurring after surgery is a rare but life-threatening acute clinical condition that follows extensive hemorrhagenous necrosis within a pituitary adenoma. Pituitary apoplexy has been reported to occur spontaneously in the majority of cases or in association with various inducing factors. Reported is a case of pituitary apoplexy complicated by diabetes insipidus following living donor liver transplantation (LDLT). To the best of our knowledge, this has not been previously reported. A 56-year-old woman with nonalcoholic steatohepatitis underwent LDLT from her daughter. The patient also required dopamine support and transfusions because of massive intraoperative bleeding. Postoperatively, her coagulopathy continued, and she underwent a second laparotomy because of unknown bleeding on postoperative day 7, when she needed transfusions and dopamine support to maintain her vital signs. She complained of severe headache, excessive thirst, frequent urination, and diplopia from postoperative day 10. She also had polyuria greater than 300 ml/h and was diagnosed with pituitary apoplexy precipitating diabetes insipidus on postoperative day 13. She was treated conservatively without surgery because of the hormonally inactive status and slight mass effect of her tumor. It is important for anesthesiologists and critical care personnel in LDLT settings to take into consideration this complication as a differential diagnosis.

  2. The value of 18F-FDG PET/CT in the diagnosis of incidental pituitary macroadenoma

    International Nuclear Information System (INIS)

    Li Jiannan; Xie Jinghui; Du Xuemei; Lu Zhi; Liu Jinghong; Ling Shangkun; Zhang Yanjun

    2013-01-01

    Objective: To study the incidence difference between healthy people and patients with malignant tumor, and to discuss the diagnostic value of whole-body 18 F-FDG PET/CT examination on incidental pituitary macroadenomas. Methods: A review analysis was made about the image data of 1830 consecutive subjects with no history of pituitary tumor, including 600 healthy subjects and 1230 patients with known or suspected malignancy who underwent 18 F-FDG PET/CT examination. The uptake intensity was recorded by maximum standardized uptake value (SUV max ) of those unexpected pituitary tumor (shot diameter greater than 1.0 cm) with high uptake. The final diagnosis was based on pathology and a 3-26 months follow-up. Compared the incidence difference between healthy people and patients with malignant tumor by Fisher exact test (SPSS 16.0). Assessed the diagnostic efficacy of PET/CT examination. Results: Pituitary tumor was accidentally discovered in 15 patients (SUV max varied between 4.2 and 22.2), including 1 metastases SUV max 19.5 and 14 (0.77%) pituitary macroadenomas; the incidence rate 0.17% (only 1 case was confirmed of pituitary macroadenomas) among the healthy subjects is higher than that of 1.06% (13 cases) among the malignant tumor patients. The sensitivity and accuracy of PET/CT in detecting large pituitary adenomas were 100% and 93.33% respectively. Conclusions: The incidence of pituitary macroadenoma is higher in patients with malignant tumor than that in the healthy controls. PET/CT is of practical significance in the diagnosis of the pituitary macroadenomas. (authors)

  3. Time Course of Symptomatic Recovery After Endoscopic Transsphenoidal Surgery for Pituitary Adenoma Apoplexy in the Modern Era.

    Science.gov (United States)

    Zaidi, Hasan A; Cote, David J; Burke, William T; Castlen, Joseph P; Bi, Wenya Linda; Laws, Edward R; Dunn, Ian F

    2016-12-01

    Pituitary tumor apoplexy can result from either hemorrhagic or infarctive expansion of pituitary adenomas, and the related mass effect can result in compression of critical neurovascular structures. The time course of recovery of visual field deficits, headaches, ophthalmoparesis, and pituitary dysfunction after endoscopic transsphenoidal surgery has not been well established. Medical records were retrospectively reviewed for all patients who underwent endoscopic transsphenoidal surgery for pituitary tumor apoplexy from April 2008 to November 2014. Of 578 patients who underwent transsphenoidal surgery, pituitary tumor apoplexy was identified in 44 patients (7.6%). Two patients had prior surgery, leaving 42 patients for final analysis. These included infarction-related apoplexy in 7 (14.4%) patients, and hemorrhagic apoplexy in 35 (85.6%) patients. Hemorrhagic adenomas had a larger axial tumor diameter than patients with infarctive adenomas (4.4 ± 4.1 cm vs. 1.8 ± 0.8 cm; P surgery. Endoscopic transsphenoidal surgery can provide durable resolution of symptoms for patients presenting with pituitary tumor apoplexy. Recovery from headaches, visual, and pituitary dysfunction may be more rapid compared with ophthalmoparesis. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Outcome of visual acuity after surgical removal of pituitary adenomas

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    Grković Desanka

    2013-01-01

    Full Text Available Introduction. Pituitary adenomas with suprasellar extension may produce anterior visual pathway compression, resulting in characteristic visual deficit. Surgical decompression of these structures prevents further visual deterioration and its postop­ erative recovery. Objective. The aim of this study was to investigate pre­ and postoperative visual acuity (VA in patients with pituitary ad­ enomas, and to detect the influence of prognostic factors, such as symptoms duration, degree of visual acuity reduction and tumor size in the assessment of the prognosis of postoperative visual function. Methods. We analyzed 40 consecutive patients who fulfilled three criteria: evidence of preoperative visual dysfunction, transsphenoidal or transfrontal tumor resection and hystologically verified pituitary adenoma. A visual examination was performed under standard conditions, pre and postoperatively (10 days, one month and six months after surgery. A paired t­test was used to assess the differences of pre­ and postoperative characteristics values, and the Chisquare test of independence in the assessment of the influence of prognostic factors. Results. Postoperative improvement of VA was seen in 84.61% patients (68% eyes. Eyes with preoperative mild and moderate degree of VA reduction showed improvement in 89.65% eyes in contrast to 22.60% eyes with preoperative severe reduction of VA, which was all statistically significant. Eyes in patients with tumor smaller than 20 mm had improvement of VA in 91.66% eyes, while eyes with tumor larger than 40 mm had improvement of VA in 61.11% eyes, which was statistically significant. When symptoms duration was below two years the improvement of VA was detected in 65.38% eyes as related to 50% eyes with symptoms duration exceeding two years, which was not statistically significant. Conclusion. Pituitary adenomas commonly cause visual impairment. Postoperatively the majority of patients show a distinct improvement of

  5. Macrophage colony-stimulating factor induces prolactin expression in rat pituitary gland.

    Science.gov (United States)

    Hoshino, Satoya; Kurotani, Reiko; Miyano, Yuki; Sakahara, Satoshi; Koike, Kanako; Maruyama, Minoru; Ishikawa, Fumio; Sakatai, Ichiro; Abe, Hiroyuki; Sakai, Takafumi

    2014-06-01

    We investigated the role of macrophage colony-stimulating factor (M-CSF) in the pituitary gland to understand the effect of M-CSF on pituitary hormones and the relationship between the endocrine and immune systems. When we attempted to establish pituitary cell lines from a thyrotropic pituitary tumor (TtT), a macrophage cell line, TtT/M-87, was established. We evaluated M-CSF-like activity in conditioned media (CM) from seven pituitary cell lines using TtT/M-87 cells. TtT/M-87 proliferation significantly increased in the presence of CM from TtT/GF cells, a pituitary folliculostellate (FS) cell line. M-CSF mRNA was detected in TtT/GF and MtT/E cells by reverse transcriptase-polymerase chain reaction (RT-PCR), and its expression in TtT/GF cells was increased in a lipopolysaccharide (LPS) dose-dependent manner. M-CSF mRNA expression was also increased in rat anterior pituitary glands by LPS. M-CSF receptor (M-CSFR) mRNA was only detected in TtT/ M-87 cells and increased in the LPS-stimulated rat pituitary glands. In rat pituitary glands, M-CSF and M-CSFR were found to be localized in FS cells and prolactin (PRL)-secreting cells, respectively, by immunohistochemistry. The PRL concentration in rat sera was significantly increased at 24 h after M-CSF administration, and mRNA levels significantly increased in primary culture cells of rat anterior pituitary glands. In addition, TNF-α mRNA was increased in the primary culture cells by M-CSF. These results revealed that M-CSF was secreted from FS cells and M-CSF regulated PRL expression in rat pituitary glands.

  6. Opposite effects of dihydrotestosterone and estradiol on apoptosis in the anterior pituitary gland from male rats.

    Science.gov (United States)

    Magri, María Laura; Gottardo, María Florencia; Zárate, Sandra; Eijo, Guadalupe; Ferraris, Jimena; Jaita, Gabriela; Ayala, Mariela Moreno; Candolfi, Marianela; Pisera, Daniel; Seilicovich, Adriana

    2016-03-01

    Hormones locally synthesized in the anterior pituitary gland are involved in regulation of pituitary cell renewal. In the pituitary, testosterone (T) may exert its actions per se or by conversion to dihydrotestosterone (DHT) or 17β-estradiol (E2) by 5α-reductase and aromatase activity, which are expressed in this gland. Previous reports from our laboratory showed that estrogens modulate apoptosis of lactotropes and somatotropes from female rats. Now, we examined the in vitro and in vivo effects of gonadal steroids on apoptosis of anterior pituitary cells from adult male rats. T in vitro did not modify apoptosis in anterior pituitary cells from gonadectomized (GNX) male rats. DHT, a non-aromatizable androgen, exerted direct antiapoptotic action on total anterior pituitary cells and folliculo-stellate cells, but not on lactotropes, somatotropes, or gonadotropes. On the contrary, E2 exerted a rapid apoptotic effect on total cells as well as on lactotropes and somatotropes. Incubation of anterior pituitary cells with T in presence of Finasteride, an inhibitor of 5α-reductase, increased the percentage of TUNEL-positive cells. In vivo administration of DHT to GNX rats reduced apoptosis in the anterior pituitary whereas E2 exerted proapoptotic action and reduced cells in G2/M-phase of the cell cycle. In summary, our results indicate that DHT and E2 have opposite effects on apoptosis in the anterior pituitary gland suggesting that local metabolization of T to these steroids could be involved in pituitary cell turnover in males. Changes in expression and/or activity of 5α-reductase and aromatase may play a role in the development of anterior pituitary tumors.

  7. Volume change of limestone and its effects on drying shrinkage of concrete

    OpenAIRE

    YAGI, Shogo; AQUINO, Carlos; INOUE, Masumi; OKAMOTO, Takahisa

    2010-01-01

    Recently, the cracks of concrete by drying shrinkage become one of the problems in the construction industry in Japan. The drying shrinkage decreases when the concrete is produced with limestone aggregate. However, it is not clear why the drying shrinkage is decreased. The purpose of this study is to clarify the relation between the drying shrinkage of concrete and the limestone aggregate. In this study, the experiments about the strength, elasticity and drying shrinkage of concrete and the p...

  8. Time-Dependent Behavior of Shrinkage Strain for Early Age Concrete Affected by Temperature Variation

    OpenAIRE

    Qin, Yu; Yi, Zhijian; Wang, Weina; Wang, Di

    2017-01-01

    Shrinkage has been proven to be an important property of early age concrete. The shrinkage strain leads to inherent engineering problems, such as cracking and loss of prestress. Atmospheric temperature is an important factor in shrinkage strain. However, current research does not provide much attention to the effect of atmospheric temperature on shrinkage of early age concrete. In this paper, a laboratory study was undertaken to present the time-dependent shrinkage of early age concrete under...

  9. Pituitary macroadenomas: reviews of 60 cases; Revisao de 60 casos de macroadenomas hipofisarios

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Alair Augusto S.M.D. dos; Fontes, Cristina Asvolinsque P.; Magnago, Marcelo [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Inst. de Radiologia; Moreira, Denise Madeira [Universidade Federal, Rio de Janeiro, RJ (Brazil). Inst. de Radiologia; Andreiuolo, Pedro Angelo [Hospital Santa Cruz/Beneficencia Portuguesa, Niteroi, RJ (Brazil). Servico de Radiologia; Oliveira, Fernando Barros de; Teixeira, Ricardo Tostes D.; Correa, Saul Orlando C. [Universidade Federal, Rio de Janeiro, RJ (Brazil). Inst. de Biofisica Carlos Chagas Filho. Curso de Pos-graduacao Medica

    2000-12-01

    We reviewed 60 cases of patients with pituitary macroadenomas who were submitted to magnetic resonance imaging evaluations at private institutions in Niteroi and Rio de Janeiro, Brazil. The aim of this study was to demonstrate the advantages of magnetic resonance imaging in the diagnosis and follow-up of these patients. Macroprolactinomas were the most prevalent tumors. We also observed four growth-hormone (GH) secreting macroadenomas with clinical signs of acromegaly, and one GH- and prolactin-secreting macroadenoma. Seven patients presented pituitary apoplexy and hyperintense signal on T1-W images before contrast medium (gadolinium) administration suggestive of intratumoral bleeding. The follow-up of 15 cases demonstrated a reduction in the size of the tumor after surgery, clinical treatment or radiotherapy. Magnetic resonance imaging is important for the study of pituitary macroadenomas, particularly before surgery, as it shows the involvement of adjacent structures, specially the cavernous sinus, optic chiasm and pituitary stalk compression. (author)

  10. Uneven Distribution of Regional Blood Supply Prompts the Cystic Change of Pituitary Adenoma.

    Science.gov (United States)

    Zhang, Jianhe; Gu, Jianjun; Ma, Yiming; Huang, Yinxing; Wang, Jiaxing; Wu, Zhifeng; Zhong, Qun; Wang, Shousen

    2017-07-01

    Previous studies have suggested that the cystic change of pituitary adenoma might be related to the blood supply and metabolism of the tumor; however, the exact pathologic mechanism underlying the cystic change remains unknown. We aimed to assess the features of regional blood supply of pituitary adenoma and examine its relationship with the cystic change of pituitary adenoma. Patients (N = 79) with pituitary adenoma admitted to our hospital were divided into the parenchyma group (n = 40) or the cystic change group (n = 39). Dynamic contrast-enhanced magnetic resonance imaging of the pituitary adenoma was conducted for the parenchyma group and the steepest slopes (SS max , reflecting regional blood supply) at different areas were calculated. The location of cystic change of the pituitary adenoma was recorded and analyzed for the cystic change group. The parenchyma group showed an upper SS max of 2.52 ± 1.18, a lower SS max of 2.89 ± 1.46, a left SS max of 2.71 ± 1.31, and a right SS max of 2.66 ± 1.29. The difference between the upper and lower SS max was statistically significant (P supply is unevenly distributed in the parenchymal pituitary adenoma, with reduced blood supply in the upper than the lower region. Cystic change mainly occurs in the upper region of pituitary adenoma. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. In1-ghrelin splicing variant is overexpressed in pituitary adenomas and increases their aggressive features

    Science.gov (United States)

    Ibáñez-Costa, Alejandro; Gahete, Manuel D.; Rivero-Cortés, Esther; Rincón-Fernández, David; Nelson, Richard; Beltrán, Manuel; de la Riva, Andrés; Japón, Miguel A.; Venegas-Moreno, Eva; Gálvez, Ma Ángeles; García-Arnés, Juan A.; Soto-Moreno, Alfonso; Morgan, Jennifer; Tsomaia, Natia; Culler, Michael D.; Dieguez, Carlos; Castaño, Justo P.; Luque, Raúl M.

    2015-01-01

    Pituitary adenomas comprise a heterogeneous subset of pathologies causing serious comorbidities, which would benefit from identification of novel, common molecular/cellular biomarkers and therapeutic targets. The ghrelin system has been linked to development of certain endocrine-related cancers. Systematic analysis of the presence and functional implications of some components of the ghrelin system, including native ghrelin, receptors and the recently discovered splicing variant In1-ghrelin, in human normal pituitaries (n = 11) and pituitary adenomas (n = 169) revealed that expression pattern of ghrelin system suffers a clear alteration in pituitary adenomasas comparedwith normal pituitary, where In1-ghrelin is markedly overexpressed. Interestingly, in cultured pituitary adenoma cells In1-ghrelin treatment (acylated peptides at 100 nM; 24–72 h) increased GH and ACTH secretion, Ca2+ and ERK1/2 signaling and cell viability, whereas In1-ghrelin silencing (using a specific siRNA; 100 nM) reduced cell viability. These results indicate that an alteration of the ghrelin system, specially its In1-ghrelin variant, could contribute to pathogenesis of different pituitary adenomas types, and suggest that this variant and its related ghrelin system could provide new tools to identify novel, more general diagnostic, prognostic and potential therapeutic targets in pituitary tumors. PMID:25737012

  12. A FSH-Secreting Pituitary Macroadenoma Causing A Testosterone Deficiency Syndrome

    Directory of Open Access Journals (Sweden)

    Xiong Wang

    2014-03-01

    Full Text Available FSH-secreting pituitary adenomas can affect sexual and reproductive function. In this article, we have reported the case of a 32-year-old male with secondary infertility. The patient had sexual and reproductive disturbances. The test results of the blood samples indicated obviously decreased testosterone (T and estradiol (E2 levels. Based on previous hormonal results, the patient received pituitary stimulation and human chorionic gonadotropin (hCG tests. Both follicle stimulating hormone (FSH and luteinizing hormone (LH showed low response during the pituitary stimulation test. The results of the hCG test indicated that T/E2 could recover to a normal level. In addition, this patient was diagnosed with pituitary macroadenoma, which was supported by the pituitary MRI. The man’s sexual and reproductive functions recovered following surgery. The pathological results confirmed that the tumor tissue was an FSH-secreting pituitary adenoma by immunohistochemical staining. The purpose of this report was to review the relative literature and discuss the influence of FSH-secreting pituitary adenomas on hormones through the hypothalamus-pituitary-testis axis.

  13. Evaluation of pituitary toxicity after radiotherapy for cerebral chondrosarcomas in adult patients

    OpenAIRE

    Laroche , Suzanne,

    2016-01-01

    Pituitary dysfunction is a late-delayed side effect of cranial radiotherapy. The object of this study was to evaluate radiation induced pituitary toxicity of proton beam therapy in a cohort of adult chondrosarcoma patients. The files of 113 patients were reviewed retrospectively. Mean age at the beginning of radiotherapy was 43 years old (18 to 76). Mean dose delivered to the tumor was 67 Gy and mean dose delivered to the pituitary gland was 59 Gy. Mean post radiotherapy follow up time was 7 ...

  14. Geosynthetic clay liners shrinkage under simulated daily thermal cycles.

    Science.gov (United States)

    Sarabadani, Hamid; Rayhani, Mohammad T

    2014-06-01

    Geosynthetic clay liners are used as part of composite liner systems in municipal solid waste landfills and other applications to restrict the escape of contaminants into the surrounding environment. This is attainable provided that the geosynthetic clay liner panels continuously cover the subsoil. Previous case histories, however, have shown that some geosynthetic clay liner panels are prone to significant shrinkage and separation when an overlying geomembrane is exposed to solar radiation. Experimental models were initiated to evaluate the potential shrinkage of different geosynthetic clay liner products placed over sand and clay subsoils, subjected to simulated daily thermal cycles (60°C for 8 hours and 22°C for 16 hours) modelling field conditions in which the liner is exposed to solar radiation. The variation of geosynthetic clay liner shrinkage was evaluated at specified times by a photogrammetry technique. The manufacturing techniques, the initial moisture content, and the aspect ratio (ratio of length to width) of the geosynthetic clay liner were found to considerably affect the shrinkage of geosynthetic clay liners. The particle size distribution of the subsoil and the associated suction at the geosynthetic clay liner-subsoil interface was also found to have significant effects on the shrinkage of the geosynthetic clay liner. © The Author(s) 2014.

  15. Advancing Treatment of Pituitary Adenomas through Targeted Molecular Therapies: The Acromegaly & Cushing Disease Paradigms

    Directory of Open Access Journals (Sweden)

    Michael Anthony Mooney

    2016-07-01

    Full Text Available The current treatment of pituitary adenomas requires a balance of conservative management, surgical resection, and in select tumor types, molecular therapy. Acromegaly treatment is an evolving field where our understanding of molecular targets and drug therapies has improved treatment options for patients with excess growth hormone levels. We highlight the use of molecular therapies in this disease process and advances in this field, which may represent a paradigm shift for the future of pituitary adenoma treatment.

  16. Advancing Treatment of Pituitary Adenomas through Targeted Molecular Therapies: The Acromegaly and Cushing Disease Paradigms.

    Science.gov (United States)

    Mooney, Michael A; Simon, Elias D; Little, Andrew S

    2016-01-01

    The current treatment of pituitary adenomas requires a balance of conservative management, surgical resection, and in select tumor types, molecular therapy. Acromegaly treatment is an evolving field where our understanding of molecular targets and drug therapies has improved treatment options for patients with excess growth hormone levels. We highlight the use of molecular therapies in this disease process and advances in this field, which may represent a paradigm shift for the future of pituitary adenoma treatment.

  17. Anterior Gray Matter Pituicytic Heterotopia with Monomorphic Anterior Pituitary Cells: A Variant of Nonsecretory Pituitary Adenoma Neuronal Choristoma? Report of a Rare Case and Review of the Literature.

    Science.gov (United States)

    Yowtak, June; Sharma, Suash; Forseen, Scott E; Alleyne, Cargill H

    2017-01-01

    Mixed tumors of adenomatous and neuronal cells in the sellar region are an uncommon finding. The origins of these heterogeneous tumors are unknown, and management remains unsettled. We report a very rare case of anterior gray matter pituicytic heterotopia with monomorphic anterior pituitary cells that likely represents a variant of nonsecreting pituitary adenoma neuronal choristoma (PANCH) with no ganglion cells. We also review the current literature for the various clinical presentations of PANCH. A 49-year-old female complaining of headache, blurred vision, and hair loss was found to have a nonsecretory sellar mass with compression of the optic chiasm on magnetic resonance imaging (MRI). The mass was excised via a transsphenoidal procedure. Histological analysis of tissue sections revealed heterotopic gray matter with reactive gliosis without ganglion cells or Herring bodies. Only 1 smear exhibited characteristics of a pituitary adenoma. The overall findings were most consistent with a variant of PANCH. At a postoperative follow-up of 4.5 years, there was resolution of visual symptoms, and the residual sellar mass was stable on MRI. Neuronal choristoma is hypothesized to originate from embryonal pituitary or hypothalamus, or by differentiation from pituitary adenoma cells. Surgery is the cornerstone of management, and the clinical course appears to be similar to that of nonfunctioning pituitary adenoma in reported cases. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Pituitary autoantibodies in endocrine disorders

    OpenAIRE

    Bensing, Sophie

    2005-01-01

    Autoimmune endocrine disorders are characterised by the development of autoantibodies to specific autoantigens in the target organs. Lymphocytic hypophysitis (LyH) is a disease characterised by inflammation of the pituitary gland, often resulting in hypopituitarism. The aetiology of LyH is considered to be autoimmune. However, only a few pituitary autoantigens have so far been identified. Reliable autoantibody markers are requested in the diagnostic procedure of LyH to avoid...

  19. Sellar tumors; Tumoren der Sellaregion

    Energy Technology Data Exchange (ETDEWEB)

    Weber, M.A.; Essig, M. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Abt. Radiologie; Zoubaa, S. [GSF - Forschungszentrum fuer Gesundheit und Umwelt, Neuherberg, Muenchen (Germany). Abt. Neuropathologie; Politi, M.; Grunwald, I. [Universitaetsklinikum Saarland, Homburg (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie

    2007-06-15

    Because of the complex anatomy, examination of the sella turcica and hypophysis needs a dedicated MR sequence protocol. Not every sellar lesion is a pituitary adenoma. Thus, this review article summarizes the most frequently encountered intra-, supra-, and parasellar tumors and lesions. Differential diagnoses comprise besides adenoma among others craniopharyngioma, meningioma, glioma, germinoma, hamartoma, aneurysm, trigeminal schwannoma, pituitary carcinoma, chordoma, metastasis, infection, and empty sella. Characteristic imaging findings are presented and correlated to micro- and macro-pathology. (orig.)

  20. Radiosurgery for pituitary adenomas; Radiocirurgia nos adenomas hipofisarios

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Douglas Guedes de; Salvajoli, Joao Victor; Canteras, Miguel Montes; Cecilio, Soraya A. Jorge [Instituto de Radiocirurgia Neurologica, Sao Paulo, SP (Brazil)]. E-mail: dougguedes@uol.com.br

    2006-12-15

    Pituitary adenomas represent nearly 15% of all intracranial tumors. Multimodal treatment includes microsurgery, medical management and radiotherapy. Microsurgery is the primary recommendation for nonfunctioning and most of functioning adenomas, except for prolactinomas that are usually managed with dopamine agonist drugs. However, about 30% of patients require additional treatment after microsurgery for recurrent or residual tumors. In these cases, fractionated radiation therapy has been the traditional treatment. More recently, radiosurgery has been established as a treatment option. Radiosurgery allows the delivery of prescribed dose with high precision strictly to the target and spares the surrounding tissues. Therefore, the risks of hypopituitarism, visual damage and vasculopathy are significantly lower. Furthermore, the latency of the radiation response after radiosurgery is substantially shorter than that of fractionated radiotherapy. The goal of this review is to define the efficacy, safety and role of radiosurgery for treatment of pituitary adenomas and to present the preliminary results of our institution. (author)

  1. Recurrence of chromophobe pituitary adenomas after operation and postoperative radiotherapy

    International Nuclear Information System (INIS)

    Salmi, J.; Pelkonen, R.; Grahne, B.; Valtonen, S.

    1982-01-01

    The rate of recurrence is reported in a prospective study of 56 patients (28 men, 28 women) with large chromophobe pituitary adenoma (with or without hyperprolactinemia). The surgical approach was transfrontal in 44 and transseptospehnoidal in 12 patients. Cryoapplication was combined with the transsphenoidal operation. All but one patient received postopertive pituitary irradiation. Altogether, 11 (20 %) clinical relapses (10 men) occurred between 0.5 and 6 years after the transfrontal operation. Patients that relapsed had had larger tumors than those remaining in remission. Occurence of the tumors appeared with a deterioration of the visual field defect in 9 patients. There were no differences in the degrees of hypopituitarism in patients who relapsed as compared to patients remaining in remission. (author)

  2. Pituitary adenomas: historical perspective, surgical management and future directions

    Science.gov (United States)

    Theodros, Debebe; Patel, Mira; Ruzevick, Jacob; Lim, Michael; Bettegowda, Chetan

    2016-01-01

    Pituitary adenomas are among the most common central nervous system tumors. They represent a diverse group of neoplasms that may or may not secrete hormones based on their cell of origin. Epidemiologic studies have documented the incidence of pituitary adenomas within the general population to be as high as 16.7%. A growing body of work has helped to elucidate the pathogenesis of these tumors. Each subtype has been shown to demonstrate unique cellular changes potentially leading to tumorigenesis. Surgical advancements over several decades have included microsurgery and the employment of the endoscope for surgical resection. These advancements increase the likelihood of gross-total resection and have resulted in decreased patient morbidity. PMID:26497533

  3. Linear Shrinkage Behaviour of Compacted Loam Masonry Blocks

    Directory of Open Access Journals (Sweden)

    NAWAB ALI LAKHO

    2017-04-01

    Full Text Available Walls of wet loam, used in earthen houses, generally experience more shrinkage which results in cracks and less compressive strength. This paper presents a technique of producing loam masonry blocks that are compacted in drained state during casting process in order to minimize shrinkage. For this purpose, loam masonry blocks were cast and compacted at a pressure of 6 MPa and then dried in shade by covering them in plastic sheet. The results show that linear shrinkage of 2% occurred which is smaller when compared to un-compacted wet loam walls. This implies that the loam masonry blocks compacted in drained state is expected to perform better than un-compacted wet loam walls.

  4. Shrinkage calibration method for μPIM manufactured parts

    DEFF Research Database (Denmark)

    Quagliotti, Danilo; Tosello, Guido; Salaga, J.

    2016-01-01

    Five green and five sintered parts of a micro mechanical component, produced by micro powder injection moulding, were measured using an optical coordinate measuring machine. The aim was to establish a method for quality assurance of the final produced parts. Initially, the so called “green” parts...... were compared with the sintered parts (final products) calculating the percentage of shrinkage after sintering. Successively, the expanded uncertainty of the measured dimensions were evaluated for each single part as well as for the overall parts. Finally, the estimated uncertainty for the shrinkage...... was evaluated propagating the expanded uncertainty previously stated and considering green and sintered parts correlated. Results showed that the proposed method can be effective instating tolerances if it is assumed that the variability on the dimensions induced by the shrinkage equals the propagated expanded...

  5. Surgical management of pituitary adenomas by transsphenoidal approach

    International Nuclear Information System (INIS)

    Liebert, W.; Szyfter, W.; Tokarz, F.; Szmeja, Z.; Paprzycki, W.

    1994-01-01

    In the years 1976-1993 we have performed 90 transsphenoidal approaches for pituitary adenomas. This paper presents a detail report concerning 23 cases, operated in the last 2 years, with CT and NMR documentation. A preoperative visual deficit was very common in this group of patients. In the postoperative period the dramatic improvement of the vision was observed in 86% of cases. In our opinion the transsphenoidal approach is very useful for the operation of the tumors with suprasellar expansion. (author)

  6. Self-compacting fine-grained concretes with compensated shrinkage

    Directory of Open Access Journals (Sweden)

    Alimov Lev

    2017-01-01

    Full Text Available This paper substantiates the efficiency of application of fine-grained concrete for erection of cast-in-place concrete and reinforced concrete structures of different purpose. On the basis of analysis of experimental research results it was established that the introduction of microfillers with expansion effect to composite binder allows not only improving the rheological properties of fine-grained concrete, but also decreasing of value of shrinkage strain and improving of concrete crack resistance and durability. The analysis of the results of industrial use of fine-grained concretes with compensated shrinkage is given.

  7. Hydration of Portoguese cements, measurement and modelling of chemical shrinkage

    DEFF Research Database (Denmark)

    Maia, Lino; Geiker, Mette Rica; Figueiras, Joaquim A.

    2008-01-01

    form of the dispersion model. The development of hydration varied between the investigated cements; based on the measured data the degree of hydration after 24 h hydration at 20 C varied between 40 and 50%. This should be taken into account when comparing properties of concrete made from the different......Development of cement hydration was studied by measuring the chemical shrinkage of pastes. Five types of Portuguese Portland cement were used in cement pastes with . Chemical shrinkage was measured by gravimetry and dilatometry. In gravimeters results were recorded automatically during at least...

  8. Void shrinkage in stainless steel during high energy electron irradiation

    International Nuclear Information System (INIS)

    Singh, B.N.; Foreman, A.J.E.

    1976-03-01

    During irradiation of thin foils of an austenitic stainless steel in a high voltage electron microscope, steadily growing voids have been observed to suddenly shrink and disappear at the irradiation temperature of 650 0 Cthe phenomenon has been observed in specimens both with and withoutimplanted helium. Possible mechanisms for void shrinkage during irradiation are considered. It is suggested that the dislocation-pipe-diffusion of vacancies from or of self-interstitial atoms to the voids can explain the shrinkage behaviour of voids observed during our experiments. (author)

  9. Investigation of the growth patterns of non-functioning pituitary ...

    African Journals Online (AJOL)

    2016-07-28

    Jul 28, 2016 ... Pituitary adenomas are almost always benign (>99.9%), arise from the anterior pituitary and ... Non-functioning pituitary macroadenomas (NFMA) are the most ... pituitary gland, most likely due to alterations in perfusion.

  10. The Complex Biology of the Aryl Hydrocarbon Receptor and Its Role in the Pituitary Gland.

    Science.gov (United States)

    Formosa, Robert; Vassallo, Josanne

    2017-08-01

    The aryl hydrocarbon receptor (AHR) is a ligand-activated transcription factor best known for its ability to mediate the effects of environmental toxins such as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD or dioxin), polycyclic aromatic hydrocarbons (PAHs), benzene, and polychlorinated biphenyls (PCBs) through the initiation of transcription of a number of metabolically active enzymes. Therefore, the AHR has been studied mostly in the context of xenobiotic signaling. However, several studies have shown that the AHR is constitutively active and plays an important role in general cell physiology, independently of its activity as a xenobiotic receptor and in the absence of exogenous ligands. Within the pituitary, activation of the AHR by environmental toxins has been implicated in disruption of gonadal development and fertility. Studies carried out predominantly in mouse models have revealed the detrimental influence of several environmental toxins on specific cell lineages of the pituitary tissue mediated by activation of AHR and its downstream effectors. Activation of AHR during fetal development adversely affected pituitary development while adult models exposed to AHR ligands demonstrated varying degrees of pituitary dysfunction. Such dysfunction may arise as a result of direct effects on pituitary cells or indirect effects on the hypothalamic-pituitary-gonadal axis. This review offers in-depth analysis of all aspects of AHR biology, with a particular focus on its role and activity within the adenohypophysis and specifically in pituitary tumorigenesis. A novel mechanism by which the AHR may play a direct role in pituitary cell proliferation and tumor formation is postulated. This review therefore attempts to cover all aspects of the AHR's role in the pituitary tissue, from fetal development to adult physiology and the pathophysiology underlying endocrine disruption and pituitary tumorigenesis.

  11. Function of the anterior pituitary gland following surgical and radiotherapeutical management for pituitary adenoma

    International Nuclear Information System (INIS)

    Pakisch, B.; Poier, E.; Stuecklschweiger, G.; Hackl, A.; Obermayer-Pietsch, B.; Warnkross, H.; Leb, G.; Mokry, M.; Clarici, G.

    1992-01-01

    Fifty-five adult patients with adenoma of the pituitary gland (20/55 with hyperfunctional tumors, 21/55 with endocrine inactive tumors, and 14/55 with hormonal deficits at the time of diagnosis) were studied retrospectively in terms of their endocrine outcome after surgery and radiotherapy. Twenty-two percent of the patients developed new hormone deficiency after surgery and 33% after radiotherapy. After a median follow-up time of 4.6 years, 44/53 patients had a pituitary dysfunction and 35/44 a gonadotropin deficiency. There seems to be a correlation between the daily single dose given and the development of endocrine dysfunction, as 15/35 (43%) of those patients who received 2.0 Gy per day developed hormonal deficiencies, compared to 6/20 (30%) of those who received 1.8 Gy per day. The median time from radiotherapy to onset of endocrine abnormalities was 19.7 months. Normalization of the prolactin levels occurred in 55% of the cases, and that of hGH levels in 80%. An ongoing hormone replacement was necessary in 69% of the patients. (orig.) [de

  12. Thyrotropin-producing pituitary adenoma simultaneously existing with Graves' disease: a case report.

    Science.gov (United States)

    Arai, Nobuhiko; Inaba, Makoto; Ichijyo, Takamasa; Kagami, Hiroshi; Mine, Yutaka

    2017-01-06

    Thyrotropin-producing pituitary tumor is relatively rare. In particular, concurrent cases associated with Graves' disease are extremely rare and only nine cases have been reported so far. We describe a case of a thyrotropin-producing pituitary adenoma concomitant with Graves' disease, which was successfully treated. A 40-year-old Japanese woman presented with mild signs of hyperthyroidism. She had positive anti-thyroid-stimulating hormone receptor antibody, anti-thyroglobulin antibody, and anti-thyroid peroxidase antibody. Her levels of serum thyroid-stimulating hormone, which ranged from low to normal in the presence of high levels of serum free thyroid hormones, were considered to be close to a state of syndrome of inappropriate secretion of thyroid-stimulating hormone. Magnetic resonance imaging showed a macropituitary tumor. The coexistence of thyrotropin-producing pituitary adenoma and Graves' disease was suspected. Initial therapy included anti-thyroid medication, which was immediately discontinued due to worsening symptoms. Subsequently, surgical therapy for the pituitary tumor was conducted, and her levels of free thyroid hormones, including the thyroid-stimulating hormone, became normal. On postoperative examination, her anti-thyroid-stimulating hormone receptor antibody levels decreased, and the anti-thyroglobulin antibody became negative. The coexistence of thyrotropin-producing pituitary adenoma and Graves' disease is rarely reported. The diagnosis of this condition is complicated, and the appropriate treatment strategy has not been clearly established. This case suggests that physicians should consider the coexistence of thyrotropin-producing pituitary adenoma with Graves' disease in cases in which thyroid-stimulating hormone values range from low to normal in the presence of thyrotoxicosis, and the surgical treatment of thyrotropin-producing pituitary adenoma could be the first-line therapy in patients with both thyrotropin-producing pituitary adenoma

  13. Aggressive pituitary adenomas occurring in young patients in a large Polynesian kindred with a germline R271W mutation in the AIP gene.

    OpenAIRE

    Jennings, J. E.; Georgitsi, M.; Holdaway, I.; Daly, Adrian; Tichomirowa, M.; Beckers, Albert; Aaltonen, Lauri A; Karhu, A.; Cameron, F. J.

    2009-01-01

    OBJECTIVE: Mutations in the aryl hydrocarbon receptor-interacting protein (AIP) were recently shown to confer a pituitary adenoma predisposition in patients with familial isolated pituitary adenomas (FIPA). We report a large Samoan FIPA kindred from Australia/New Zealand with an R271W mutation that was associated with aggressive pituitary tumors. DESIGN AND METHODS: Case series with germline screening of AIP and haplotype analyses among R271W families. RESULTS: This previously unreported kind...

  14. [Staged transcranial and transsphenoidal surgery for giant pituitary adenomas: a retrospective study of 21 cases].

    Science.gov (United States)

    Liao, D Y; Liu, Z Y; Zhang, J; Ren, Q Q; Liu, X Y; Xu, J G

    2018-05-08

    Objective: To investigate the effect of the second-stage transcranial and transsphenoidal approach for giant pituitary tumors. Methods: A retrospective review of 21 patients, who had undergone the transcranial surgery and then transsphenoidal surgery for giant pituitary adenomas from 2012 to 2015 in the neurosurgery department of West China Hospital, was performed. Visual findings, endocrine presentation, complications, and tumor types were collected. All data were based on clinical feature, MRI, and follow-up. Results: Among the 21 cases, gross total resection of tumor was achieved in 7 of all patients, subtotal in 11, and partial in 3. No intracranial hemorrhage or death occurred postoperatively. Postoperative infectionoccurred in one patient and cerebrospinal fluid leakage occurred in 3 patients. Four patients recovered after treatment. Conclusion: According to the clinical feature and MRI, it is safe and effective to choose the transcranial surgery and then transsphenoidal surgery for specific giant pituitary adenomas, which can improve treatment effects and reduce postoperative complications.

  15. Radiotherapy for pituitary adenoma: long-term outcome and sequelae

    International Nuclear Information System (INIS)

    McCord, Mark W.; Buatti, John M.; Fennell, Eileen M.; Mendenhall, William M.; Marcus, Robert B.; Rhoton, Albert L.; Grant, Maria B.; Friedman, William A.

    1997-01-01

    Purpose: To review outcome and treatment sequelae in patients treated with external beam radiotherapy for pituitary adenomas. Methods and Materials: One hundred forty-one patients with pituitary adenomas received radiotherapy at the University of Florida and had 2-year minimum potential follow-up. One hundred twenty-one had newly diagnosed adenomas, and 20 had recurrent tumors. Newly diagnosed tumors were treated with surgery and radiotherapy (n = 98) or radiotherapy alone (n = 23). Patients with recurrent tumors received salvage treatment with surgery and radiotherapy (n = 10) or radiotherapy alone (n = 10). The impact of age, sex, presenting symptoms, tumor extent, surgery type, degree of resection, hormonal activity, primary or salvage therapy, and radiotherapy dose on tumor control was analyzed. Tumor control is defined by the absence of radiographic progression and stable or decreased hormone level (in hormonally active tumors) after treatment. Effect of therapy on vision, hormonal function, neurocognitive function, life satisfaction, and affective symptoms were examined. A Likert categorical scale survey was used for assessment of neurocognitive, life satisfaction, and affective symptom status. Survey results from the radiotherapy patients were compared with a control group treated with transsphenoidal surgery alone. Multivariate analysis used the forward step-wise sequence of chi squares for the log rank test. Results: At 10 years, tumor control for the surgery and radiotherapy group (S + RT) was 95% and not statistically different (p = 0.58) than for patients treated with radiotherapy alone (RT) (90%). Patients with prolactin- and ACTH-secreting tumors had significantly worse tumor control, as did patients treated for recurrent tumors. Multivariate analysis for tumor control revealed that only young age was predictive of worse outcome (p = 0.0354). Visual function was either unaffected or improved in most patients, although four patients developed visual

  16. Measuring method for heat-shrinkage of fuel pellet

    International Nuclear Information System (INIS)

    Komono, Akira; Ishizaki, Jin; Inaki, Kiyohiro.

    1997-01-01

    The present invention concerns a method of determining an amount of heat-shrinkage of UR 2 pellets containing gadolinium oxide (Gd 2 O 2 ) based on the difference of the density thereof before and after heating. In a heat shrinkage test of UO 2 pellets containing from 1.0 to 15.0% by weight of gadolinium oxide, the amount of heat-shrinkage is measured under the condition of heat-retaining temperature: from 1700 to 1750degC, temperature elevation time and lowering time: from 90 to 120mins, heat-retaining time: 24hours, inert gas atmosphere, gas pressure: 0.35kg/cm 2 and gas dew point: from -55 to 40degC without changing O/M. This invention has a feature in the use of the inert gas and the elevation of the dew point of the gas. Then, oxygen dissociation phenomenon from crystal lattices of the fuel pellets is suppressed, and normal densification value is shown. Then, fuel pellets of good quality with less fluctuation of the heat-shrinkage can be obtained. (N.H.)

  17. Fast generation of computer-generated holograms using wavelet shrinkage.

    Science.gov (United States)

    Shimobaba, Tomoyoshi; Ito, Tomoyoshi

    2017-01-09

    Computer-generated holograms (CGHs) are generated by superimposing complex amplitudes emitted from a number of object points. However, this superposition process remains very time-consuming even when using the latest computers. We propose a fast calculation algorithm for CGHs that uses a wavelet shrinkage method, eliminating small wavelet coefficient values to express approximated complex amplitudes using only a few representative wavelet coefficients.

  18. Effect of processing conditions on shrinkage in injection moulding

    NARCIS (Netherlands)

    Jansen, K.M.B.; van Dijk, D.J.; Husselman, M.H.

    1998-01-01

    A systematic study on the effect of processing conditions on mold shrinkage was undertaken for seven common thermoplastic polymers. It turned out that the holding pressure was always the key parameter. The effect of the melt temperature is slightly less important. Injection velocity and mold

  19. Accurate characterisation of post moulding shrinkage of polymer parts

    DEFF Research Database (Denmark)

    Neves, L. C.; De Chiffre, L.; González-Madruga, D.

    2015-01-01

    The work deals with experimental determination of the shrinkage of polymer parts after injection moulding. A fixture for length measurements on 8 parts at the same time was designed and manufactured in Invar, mounted with 8 electronic gauges, and provided with 3 temperature sensors. The fixture w...

  20. Drying and Radial Shrinkage Characteristics and Changes in Color ...

    African Journals Online (AJOL)

    nahimana

    2011-08-12

    Aug 12, 2011 ... A pre-test experiment was carried out following the. Thompson ... energy saving potential and the ability to control drying temperature and air humidity. ..... structural collapse by shrinkage, case hardening, etc. From the slopes of .... Thus, the Nahimana et al. model is proposed as a new model predicting with ...

  1. Shrinkage of Newly Formed Particles in an Urban Environment

    Czech Academy of Sciences Publication Activity Database

    Škrabalová, Lenka; Zíková, Naděžda; Ždímal, Vladimír

    2015-01-01

    Roč. 15, č. 4 (2015), s. 1313-1324 ISSN 1680-8584 R&D Projects: GA ČR GAP209/11/1342 Institutional support: RVO:67985858 Keywords : aerosol dynamics * ultrafine particles * particle shrinkage Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 2.393, year: 2015

  2. Drying and radial shrinkage characteristics and changes in color ...

    African Journals Online (AJOL)

    Drying and radial shrinkage characteristics and changes in color and shape of carrots tissues during air drying were studied. Slices dimensions were obtained by computer vision and the color was quantified by chroma, hue, whitening index and total carotenoids contents. The drying time became shorter of 1 h when ...

  3. Radiation therapy of brain tumor

    International Nuclear Information System (INIS)

    Sung, K. J.; Lee, D. H.; Park, C. Y.

    1980-01-01

    One hundred and six cases of brain tumors were treated at the Yonsei Cancer Center from January 1972 to August 1978 by Co-60 teletherapy unit. We analyses their clinical findings, histopathological findings, treatment and results. In those cases which computerized tomography had been used before and after radiation therapy, changes in tumor size and the presence of edema or necrosis following treatment was evaluated. 1. Among 106 cases, 90 cases were primary brain tumors and 16 cases were metastatic brain tumors. Pituitary tumors (38), glioma (34) and pinealoma (10) composed of most of primary brain tumors. 2. Post treatment follow-up was possible in 38 cases more than 1 years. Four among 11 cases of giloma expired and survivors had considerable neurological symptoms except 2 cases. Sixty five percent (12/20) of pituitary tumors showed improvement of visual symptoms and all cases (7) of pinealoma which post treatment follow-up was possible, showed remarkable good response. 3. Findings of CT scan after radiation treatment were compatible with results of clinical findings and post treatment follow-up. It showed complete regression of tumor mass in one case of pinealoma and medulloblastoma. One case of pituitary tumor showed almost complete regression of tumor mass. It also showed large residual lesion in cases of glioblastoma multiforme and cystic astrocytoma.

  4. Management of CNS tumors

    International Nuclear Information System (INIS)

    Griem, M.L.

    1987-01-01

    The treatment of tumors of the CNS has undergone a number of changes based on the impact of CT. The use of intraoperative US for the establishment of tumor location and tumor histology is demonstrated. MR imaging also is beginning to make an impact on the diagnosis and treatment of tumors of the CNS. Examples of MR images are shown. The authors then discuss the important aspects of tumor histology as it affects management and newer concepts in surgery, radiation, and chemotherapy on tumor treatment. The role of intraoperative placement of radioactive sources, the utilization of heavy particle radiation therapy, and the potential role of other experimental radiation therapy techniques are discussed. The role of hyperfractionated radiation and of neutrons and x-ray in a mixed-beam treatment are discussed in perspective with standard radiation therapy. Current chemotherapy techniques, including intraarterial chemotherapy, are discussed. The complications of radiation therapy alone and in combination with chemotherapy in the management of primary brain tumors, brain metastases, and leukemia are reviewed. A summary of the current management of pituitary tumors, including secreting pituitary adenomas and chromophobe adenomas, are discussed. The treatment with heavy particle radiation, transsphenoidal microsurgical removal, and combined radiotherapeutic and surgical management are considered. Tumor metastasis management of lesions of the brain and spinal cord are considered

  5. Characterisation of tissue shrinkage during microwave thermal ablation.

    Science.gov (United States)

    Farina, Laura; Weiss, Noam; Nissenbaum, Yitzhak; Cavagnaro, Marta; Lopresto, Vanni; Pinto, Rosanna; Tosoratti, Nevio; Amabile, Claudio; Cassarino, Simone; Goldberg, S Nahum

    2014-11-01

    The aim of this study was to characterise changes in tissue volume during image-guided microwave ablation in order to arrive at a more precise determination of the true ablation zone. The effect of power (20-80 W) and time (1-10 min) on microwave-induced tissue contraction was experimentally evaluated in various-sized cubes of ex vivo liver (10-40 mm ± 2 mm) and muscle (20 and 40 mm ± 2 mm) embedded in agar phantoms (N = 119). Post-ablation linear and volumetric dimensions of the tissue cubes were measured and compared with pre-ablation dimensions. Subsequently, the process of tissue contraction was investigated dynamically during the ablation procedure through real-time X-ray CT scanning. Overall, substantial shrinkage of 52-74% of initial tissue volume was noted. The shrinkage was non-uniform over time and space, with observed asymmetry favouring the radial (23-43 % range) over the longitudinal (21-29%) direction. Algorithmic relationships for the shrinkage as a function of time were demonstrated. Furthermore, the smallest cubes showed more substantial and faster contraction (28-40% after 1 min), with more considerable volumetric shrinkage (>10%) in muscle than in liver tissue. Additionally, CT imaging demonstrated initial expansion of the tissue volume, lasting in some cases up to 3 min during the microwave ablation procedure, prior to the contraction phenomenon. In addition to an asymmetric substantial shrinkage of the ablated tissue volume, an initial expansion phenomenon occurs during MW ablation. Thus, complex modifications of the tissue close to a radiating antenna will likely need to be taken into account for future methods of real-time ablation monitoring.

  6. The Shrinkage Cracking Behavior in Reinforced Reactive Powder Concrete Walls

    Directory of Open Access Journals (Sweden)

    Samir A. Al-Mashhadi

    2017-07-01

    Full Text Available In this study, the reduced scale wall models were used (they are believed to resemble as much as possible the field conditions to study the shrinkage behavior of reactive powder concrete (RPC base restrained walls. Six base restrained RPC walls were casted in different length/height ratios of two ratios of steel fiber by volume in Summer. These walls were restrained by reinforced concrete bases to provide the continuous base restraint to the walls. The mechanical properties of reactive powder concrete investigated were; compressive strength between (75.3 – 140.1 MPa, splitting tensile strength between (5.7 – 13.9 MPa, flexural tensile strength (7.7 – 24.5 MPa, and static modulus of elasticity (32.7 – 47.1GPa. Based on the observations of this work, it was found that the cracks did not develop in the reduced scale of the reactive powder concrete (RPC walls restrained from movement at their bases for different L/H ratios (2, 5, and 10 and for two ratio of steel fiber (1% & 2% during 90 days period of drying conditions. Moreover, the shrinkage values increase toward the edges. Based on the results of this work, the increase in the maximum shrinkage values of walls with 1% steel fiber were (29%, 28%, 28% of the maximum shrinkage values of walls with 2% steel fiber of length/height ratios of (2, 5, and 10 respectively. The experimental observation in beam specimens showed that the free shrinkage, tensile strain capacity and elastic tensile strain capacity (at date of cracking of beams with 1% steel fiber were higher than the beams with 2% steel fiber by about (24%, (45% and (42% respectively

  7. Endoscopic endonasal trans-sphenoid surgery of pituitary adenoma

    Directory of Open Access Journals (Sweden)

    Y R Yadav

    2012-01-01

    Full Text Available Endoscopic endonasal trans-sphenoid surgery (EETS is increasingly used for pituitary lesions. Pre-operative CT and MRI scans and peroperative endoscopic visualization can provide useful anatomical information. EETS is indicated in sellar, suprasellar, intraventricular, retro-infundibular, and invasive tumors. Recurrent and residual lesions, pituitary apoplexy and empty sella syndrome can be managed by EETS. Modern neuronavigation techniques, ultrasonic aspirators, ultrasonic bone curette can add to the safety. The binostril approach provides a wider working area. High definition camera is much superior to three-chip camera. Most of the recent reports favor EETS in terms of safety, quality of life and tumor resection, hospital stay, better endocrinological, and visual outcome as compared to the microscopic technique. Nasal symptoms, blood loss, operating time are less in EETS. Various naso-septal flaps and other techniques of CSF leak repair could help reduce complications. Complications can be further reduced after achieving the learning curve, good understanding of limitations with proper patient selection. Use of neuronavigation, proper post-operative care of endocrine function, establishing pituitary center of excellence and more focused residency and endoscopic fellowship training could improve results. The faster and safe transition from microscopic to EETS can be done by the team concept of neurosurgeon/otolaryngologist, attending hands on cadaveric dissection, practice on models, and observation of live surgeries. Conversion to a microscopic or endoscopic-assisted approach may be required in selected patients. Multi-modality treatment could be required in giant and invasive tumors. EETS appears to be a better surgical option in most pituitary adenoma.

  8. Photon spectrum and absorbed dose in brain tumor

    Energy Technology Data Exchange (ETDEWEB)

    Silva S, A. [General Electric Healthcare, Antonio Dovali Jaime 70, Torre A 3er. piso, Col. Santa Fe, 01210 Mexico D. F. (Mexico); Vega C, H. R. [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Cipres No. 10, Fracc. La Penuela, 98068 Zacatecas, Zac. (Mexico); Rivera M, T. [IPN, Centro de Investigacion en Ciencia Aplicada y Tecnologia Avanzada, Av. Legaria No. 694, 11500 Mexico D. F. (Mexico)

    2015-10-15

    Using Monte Carlo methods a BOMAB phantom inside a treatment hall with a brain tumor nearby the pituitary gland was treated with photons produced by a Varian 6 MV linac. The photon spectrum and the absorbed dose were calculated in the tumor, pituitary gland and the head. The treatment beam was collimated to illuminate only the tumor volume; however photons were noticed in the gland. Photon fluence reaching the tumor is 78.1 times larger than the fluence in the pituitary gland, on the other hand the absorbed dose in the tumor is 188 times larger than the dose in the gland because photons that reach the pituitary gland are scattered, by the head and the tumor, through Compton effect. (Author)

  9. Photon spectrum and absorbed dose in brain tumor.

    Science.gov (United States)

    Vega-Carrillo, Hector Rene; Silva-Sanchez, Angeles; Rivera-Montalvo, Teodoro

    2016-11-01

    Using Monte Carlo methods a BOMAB phantom inside a treatment hall with a brain tumor nearby the pituitary gland was treated with photons produced by a Varian 6MV linac. The photon spectrum and the absorbed dose were calculated in the tumor, pituitary gland and the head. The treatment beam was collimated to illuminate only the tumor volume; however photons were noticed in the gland. Photon fluence reaching the tumor is and 15.7 times larger than the fluence in the pituitary gland, on the other hand the absorbed dose in the tumor is 37.1 times larger than the dose in the gland because photons that reach the pituitary gland are scattered, by the head and the tumor, through Compton effect. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Photon spectrum and absorbed dose in brain tumor

    International Nuclear Information System (INIS)

    Silva S, A.; Vega C, H. R.; Rivera M, T.

    2015-10-01

    Using Monte Carlo methods a BOMAB phantom inside a treatment hall with a brain tumor nearby the pituitary gland was treated with photons produced by a Varian 6 MV linac. The photon spectrum and the absorbed dose were calculated in the tumor, pituitary gland and the head. The treatment beam was collimated to illuminate only the tumor volume; however photons were noticed in the gland. Photon fluence reaching the tumor is 78.1 times larger than the fluence in the pituitary gland, on the other hand the absorbed dose in the tumor is 188 times larger than the dose in the gland because photons that reach the pituitary gland are scattered, by the head and the tumor, through Compton effect. (Author)

  11. Radioimmunoassay of pituitary LH in fetal rabbit

    International Nuclear Information System (INIS)

    Veyssiere, Georges; Berger, Michel; Jean-Faucher, Christiane; Turckheim, Marc de; Jean, Claude

    1981-01-01

    LH was measured by radioimmunology from the 18th day of gestation to birth in 318 male and female pituitary glands. LH was first detectable in the pituitary of 19 day old fetuses of both sexes. In both sexes pituitary LH levels increased from the 18th to the 31st day of gestation with a marked acceleration from the 24th day. LH pituitary levels were not sex-dependent [fr

  12. Recovery from diabetes insipidus and preservation of thyroid function after craniopharyngioma removal and pituitary stalk sectioning.

    Science.gov (United States)

    Ogawa, Yoshikazu; Niizuma, Kuniyasu; Tominaga, Teiji

    2017-11-01

    Craniopharyngioma is a slow-growing tumor, but long-term tumor control with maintenance of quality of life is sometimes very difficult to achieve, and hypothalamic disturbance should be strictly avoided in the treatment. However, management of the pituitary gland and/or pituitary stalk varies among surgeons and institutions. This retrospective review identified 44 patients, 24 males and 20 females with craniopharyngiomas who were initially treated by surgery through the extended transsphenoidal approach with pituitary stalk sectioning at a single institute. If the tumor bed involved the posterior lobe of the pituitary gland, pituitary stalk, anterior and/or mid portion of the third ventricle floor, these structures were removed en-bloc together with the tumor. The closest attention was paid to preserve fine arteries running along the surface of optic chiasm and the lateral walls of the third ventricle. Surgical outcome and changes in postoperative endocrinological status were investigated. Gross total removal was achieved in 40 of 44 patients (91%), and all patients could discharge without autonomic and/or thermal disturbances. Tumor remnants were identified with tight adhesion to the perforating arteries in 2 cases, tight adhesion to mammillary bodies in 1, and optic chiasm in 1. Administration of anti-diuretic hormone could be discontinued in 23 of 44 patients (52.3%) with improved diabetes insipidus (DI), although no patient could discontinue glucocorticoid administration. Preservation of thyroid function was achieved in another 23 of 44 patients (52.3%), and recovery from DI was correlated with preservation of thyroid function (p=0.016). Pituitary dysfunction is partially reversible even with pituitary stalk sectioning. Regrowth of tumor in the anterior and/or mid portion of the third ventricle floor including pituitary stalk can possibly be prevented by aggressive tumor removal, and co-achievement of long-term tumor control with maintenance of quality of life

  13. Gamma Knife Radiosurgery for Patients With Nonfunctioning Pituitary Adenomas: Results From a 15-Year Experience

    International Nuclear Information System (INIS)

    Pollock, Bruce E.; Cochran, Joseph; Natt, Neena; Brown, Paul D.; Erickson, Dana; Link, Michael J.; Garces, Yolanda I.; Foote, Robert L.; Stafford, Scott L.; Schomberg, Paula J.

    2008-01-01

    Purpose: To evaluate the efficacy and complications of stereotactic radiosurgery for patients with nonfunctioning pituitary adenomas (NFA). Methods and Materials: This was a retrospective review of 62 patients with NFA undergoing radiosurgery between 1992 and 2004, of whom 59 (95%) underwent prior tumor resection. The median treatment volume was 4.0 cm 3 (range, 0.8-12.9). The median treatment dose to the tumor margin was 16 Gy (range, 11-20). The median maximum point dose to the optic apparatus was 9.5 Gy (range, 5.0-12.6). The median follow-up period after radiosurgery was 64 months (range, 23-161). Results: Tumor size decreased for 37 patients (60%) and remained unchanged for 23 patients (37%). Two patients (3%) had tumor growth outside the prescribed treatment volume and required additional treatment (fractionated radiation therapy, n = 1; repeat radiosurgery, n 1). Tumor growth control was 95% at 3 and 7 years after radiosurgery. Eleven (27%) of 41 patients with normal (n = 30) or partial (n = 11) anterior pituitary function before radiosurgery developed new deficits at a median of 24 months after radiosurgery. The risk of developing new anterior pituitary deficits at 5 years was 32%. The 5-year risk of developing new anterior pituitary deficits was 18% for patients with a tumor volume of ≤4.0 cm 3 compared with 58% for patients with a tumor volume >4.0 cm 3 (risk ratio 4.5; 95% confidence interval = 1.3-14.9, p = 0.02). No patient had a decline in visual function. Conclusions: Stereotactic radiosurgery is effective in the management of patients with residual or recurrent NFA, although longer follow-up is needed to evaluate long-term outcomes. The primary complication is hypopituitarism, and the risk of developing new anterior pituitary deficits correlates with the size of the irradiated tumor

  14. Trace elements in human pituitary

    International Nuclear Information System (INIS)

    Kanabrocki, E.L.; Greco, J.; Graham, L.A.; Kaplan, E.; Rubnitz, M.E.; Oester, Y.T.; Brar, S.; Gustafson, P.S.; Nelson, D.M.; Molinari, F.; Moore, C.E.; Kanabrocki, J.A.

    1976-01-01

    Neutron activation analysis was used to determine several trace elements in human pituitaries from adult subjects aged 42 to 83 years who had died of ischemic heart disease, carcinoma and cirrhosis of the liver. None of these subjects suffered from mental disease. The concentrations of Fe, Zn, Rb, Se, Br, Cr, Hg, Cs and Co in dried tissue showed no correlation with the diseases, and the results may therefore be representative of the general population. These elements may play a very fundamental role in pituitary function. (U.K.)

  15. Stubborn hiccups as a sign of massive apoplexy in a naive acromegaly patient with pituitary macroadenoma

    Directory of Open Access Journals (Sweden)

    Gulay Simsek Bagir

    2017-05-01

    Full Text Available Pituitary apoplexy (PA may very rarely present with hiccups. A 32-year-old man with classical acromegaloid features was admitted with headache, nausea, vomiting and stubborn hiccups. Pituitary magnetic resonance imaging (MRI demonstrated apoplexy of a macroadenoma with suprasellar extension abutting the optic chiasm. Plasma growth hormone (GH levels exhibited suppression (below <1 ng/mL at all time points during GH suppression test with 75 g oral glucose. After treatment with corticosteroid agents, he underwent transsphenoidal pituitary surgery and hiccups disappeared postoperatively. The GH secretion potential of the tumor was clearly demonstrated immunohistochemically. We conclude that stubborn hiccups in a patient with a pituitary macroadenoma may be a sign of massive apoplexy that may result in hormonal remission.

  16. Ependymoma of the pituitary fossa. Case report and review of the literature.

    Science.gov (United States)

    Mukhida, Karim; Asa, Sylvia; Gentili, Fred; Shannon, Patrick

    2006-10-01

    The authors describe a case of pituitary fossa ependymoma and discuss its immunohistochemical and ultrastructural characteristics. A 43-year-old man presented with decreased libido and panhypopituitarism. Magnetic resonance imaging demonstrated a well-demarcated enhancing lesion of the pituitary fossa that was completely resected via a transsphenoidal approach. Ependymomas rarely occur in the pituitary fossa, and have been reported in this location only three times in humans and once in a horse. This is the first study in which investigators examined the appearance of a pituitary ependymoma by using electron microscopy. Theories of the origin and treatment of these rare tumors are discussed as they relate to other articles on intracranial ependymomas.

  17. Effects of Shrinkage Reducing Agent and Expansive Admixture on the Volume Deformation of Ultrahigh Performance Concrete

    OpenAIRE

    Anshuang, Su; Ling, Qin; Shoujie, Zhang; Jiayang, Zhang; Zhaoyu, Li

    2017-01-01

    This paper investigated the influences of shrinkage reducing agent and expansive admixture on autogenous and drying shrinkage of ultrahigh performance concrete (UHPC) containing antifoaming admixture. The shrinkage reducing agent was used at dosage of 0.5%, 1%, and 2% and the expansive admixture was used at dosage of 2% to 4% by mass of cementitious material. The results show that the air content of UHPC increases with the higher addition of shrinkage reducing agent and expansive admixtures. ...

  18. Spatio-Temporal Video Segmentation with Shape Growth or Shrinkage Constraint

    Science.gov (United States)

    Tarabalka, Yuliya; Charpiat, Guillaume; Brucker, Ludovic; Menze, Bjoern H.

    2014-01-01

    We propose a new method for joint segmentation of monotonously growing or shrinking shapes in a time sequence of noisy images. The task of segmenting the image time series is expressed as an optimization problem using the spatio-temporal graph of pixels, in which we are able to impose the constraint of shape growth or of shrinkage by introducing monodirectional infinite links connecting pixels at the same spatial locations in successive image frames. The globally optimal solution is computed with a graph cut. The performance of the proposed method is validated on three applications: segmentation of melting sea ice floes and of growing burned areas from time series of 2D satellite images, and segmentation of a growing brain tumor from sequences of 3D medical scans. In the latter application, we impose an additional intersequences inclusion constraint by adding directed infinite links between pixels of dependent image structures.

  19. Hydration of mineral shrinkage-compensating admixture for concrete : an experimental and numerical study

    NARCIS (Netherlands)

    Chen, Wei; Brouwers, H.J.H.

    2012-01-01

    The use of shrinkage-compensating admixture in concrete has been proven to be an effective way to mitigate the shrinkage of concrete. The hydration of a shrinkage-compensating admixture in cement paste and concrete is investigated in this paper with numerical simulation and experimental study. An

  20. Transnasal stereotactic surgery of pituitary adenomas concomitant with acromegaly.

    Science.gov (United States)

    Metyolkina, L; Peresedov, V

    1995-01-01

    Since 1960 we have performed stereotactic transsphenoidal cryohypophysectomy in 70 patients with pituitary adenomas, 42 women and 28 men, aged 11-59 years. The dominant clinical syndrome was acromegaly in 50 patients, galactorrhea in 9, amenorrhea in 5, adiposogenital dystrophy in 4 and gigantism with mild endocrine symptomatology in 2 patients. In 67 patients the histological structure of the tumor was established by biopsy (50 patients with eosinophil adenoma, 10 with mixed-type adenoma, 4 with chromophobe adenoma and 3 with basophil adenoma). Somatotropic hormone, human growth hormone, prolactin, ACTH and 17-ketosteroid levels indicated active/inactive adenomas. In 42 cases the adenoma was only intrasellar, which was confirmed by contrast X-ray investigations, CT scanning, angiography and ophthalmological investigation. Transnasal stereotactic cryohypophysectomy was performed in all 70 cases using a stereotactic apparatus especially designed for operations on the pituitary. All patients (except 2) tolerated the operation well. No complications occurred. Vision deteriorated after operation in 1 patient. Thrombosis of the left middle cerebral artery developed in another patient. All the other patients noted improvement directly after operation - rapid diminution of signs of acromegaly and rapid restoration of normal values in hormonal tests. Six patients with continuing growth of the tumor underwent a second operation 1.5-6 years after the first operation. We conclude from our own clinical experience and information from the literature that transnasal stereotactic cryodestruction is highly effective and relatively safe in the management of pituitary adenoma.

  1. Effects of Carbenoxolone on the Canine Pituitary-Adrenal Axis.

    Science.gov (United States)

    Teshima, Takahiro; Matsumoto, Hirotaka; Okusa, Tomoko; Nakamura, Yumi; Koyama, Hidekazu

    2015-01-01

    Cushing's disease caused by pituitary corticotroph adenoma is a common endocrine disease in dogs. A characteristic biochemical feature of corticotroph adenomas is their relative resistance to suppressive negative feedback by glucocorticoids. The abnormal expression of 11beta-hydroxysteroid dehydrogenase (11HSD), which is a cortisol metabolic enzyme, is found in human and murine corticotroph adenomas. Our recent studies demonstrated that canine corticotroph adenomas also have abnormal expression of 11HSD. 11HSD has two isoforms in dogs, 11HSD type1 (HSD11B1), which converts cortisone into active cortisol, and 11HSD type2 (HSD11B2), which converts cortisol into inactive cortisone. It has been suggested that glucocorticoid resistance in corticotroph tumors is related to the overexpression of HSD11B2. Therefore it was our aim to investigate the effects of carbenoxolone (CBX), an 11HSD inhibitor, on the healthy dog's pituitary-adrenal axis. Dogs were administered 50 mg/kg of CBX twice each day for 15 days. During CBX administration, no adverse effects were observed in any dogs. The plasma adrenocorticotropic hormone (ACTH), and serum cortisol and cortisone concentrations were significantly lower at day 7 and 15 following corticotropin releasing hormone stimulation. After completion of CBX administration, the HSD11B1 mRNA expression was higher, and HSD11B2 mRNA expression was significantly lower in the pituitaries. Moreover, proopiomelanocortin mRNA expression was lower, and the ratio of ACTH-positive cells in the anterior pituitary was also significantly lower after CBX treatment. In adrenal glands treated with CBX, HSD11B1 and HSD11B2 mRNA expression were both lower compared to normal canine adrenal glands. The results of this study suggested that CBX inhibits ACTH secretion from pituitary due to altered 11HSD expressions, and is potentially useful for the treatment of canine Cushing's disease.

  2. Pituitary gigantism: Causes and clinical characteristics.

    Science.gov (United States)

    Rostomyan, Liliya; Daly, Adrian F; Beckers, Albert

    2015-12-01

    Acromegaly and pituitary gigantism are very rare conditions resulting from excessive secretion of growth hormone (GH), usually by a pituitary adenoma. Pituitary gigantism occurs when GH excess overlaps with the period of rapid linear growth during childhood and adolescence. Until recently, its etiology and clinical characteristics have been poorly understood. Genetic and genomic causes have been identified in recent years that explain about half of cases of pituitary gigantism. We describe these recent discoveries and focus on some important settings in which gigantism can occur, including familial isolated pituitary adenomas (FIPA) and the newly described X-linked acrogigantism (X-LAG) syndrome. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. MRI of congenital pituitary insufficiency

    International Nuclear Information System (INIS)

    Almeida Magalhaes, Alvaro C. de; Uehara, Karla C.; Iezzi, Denise

    1995-01-01

    We compare 1,5 T magnetic resonance (MR) image findings in 193 patients with congenital pituitary congenital insufficiency. One hundred and thirty nine of the MR studies were obtained in patients who had isolated growth hormone deficiency. Other fifth - four patients had multiple pituitary hormone deficiency. On MR images, normal anterior and posterior lobes of the pituitary glands can be clearly differentiated because the posterior lobe has a characteristic high intensity on TI-weighted images. In fifty-four patients, the high- intensity of the posterior lobe was not seen, but a similar high signal intensity was observed at the proximal stump in fifty-one patients. this high- intensity area is the newly formed ectopic posterior lobe, which also secrets anti-diuretic hormone just as the posterior lobe would. MR imaging can demonstrate the transection of the pituitary stalk and the formation of the ectopic lobe, revealing to be a useful diagnostic tool in the definition of the type of alteration in growth defects of endocrine origin. (author)

  4. Computed tomography in pituitary abscess

    Energy Technology Data Exchange (ETDEWEB)

    Appel, W; Scharphuis, T; Distelmaier, P

    1986-06-01

    This is a report on a rare case of a recurring abscess in the pituitary gland. Diagnosis was extremely difficult to establish preoperatively. This is demonstrated via various radiological methods. Anamnesis and clinical disease pattern are important assisting factors in diagnosis.

  5. Pituitary Adenoma Recurrence Suspected on Central Hyperthyroidism Despite Empty Sella and Confirmed by 68Ga-DOTA-TOC PET/CT.

    Science.gov (United States)

    Gauthé, Mathieu; Sarfati, Julie; Bourcigaux, Nathalie; Christin-Maitre, Sophie; Talbot, Jean-Noël; Montravers, Françoise

    2017-06-01

    Thyrotropin-secreting pituitary adenomas are very rare tumors, known to present overexpression of somatostatin receptor subtype 2 and which may consequently demonstrate abnormal uptake on Ga-DOTA-TOC PET/CT. A 67-year-old woman with a history of operated pituitary macroadenoma presented with symptoms of hyperthyroidism including a large goiter. Her serum thyroid hormone levels were in favor of central hyperthyroidism. Pituitary MRI depicted an empty sella but visualized an ambiguous lesion centered on the left sphenoidal sinus. Complementary Ga-DOTA-TOC PET/CT finally demonstrated intense uptake by the sphenoidal lesion, confirming recurrence of the pituitary adenoma.

  6. Long-term outcomes of surgery and radiotherapy for secreting and non-secreting pituitary adenoma

    International Nuclear Information System (INIS)

    Kim, Mi Young; Kim, Jin Hee; Oh, Young Kee; Kim, El

    2016-01-01

    To investigate treatment outcome and long term complication after surgery and radiotherapy (RT) for pituitary adenoma. From 1990 to 2009, 73 patients with surgery and RT for pituitary adenoma were analyzed in this study. Median age was 51 years (range, 25 to 71 years). Median tumor size was 3 cm (range, 1 to 5 cm) with suprasellar (n = 21), cavernous sinus extension (n = 14) or both (n = 5). Hormone secreting tumor was diagnosed in 29 patients; 16 patients with prolactin, 12 patients with growth hormone, and 1 patient with adrenocorticotrophic hormone. Impairment of visual acuity or visual field was presented in 33 patients at first diagnosis. Most patients (n = 64) received RT as postoperative adjuvant setting. Median RT dose was 45 Gy (range, 45 to 59.4 Gy). Median follow-up duration was 8 years (range, 3 to 22 years). In secreting tumors, hormone normalization rate was 55% (16 of 29 patients). For 25 patients with evaluable visual field and visual acuity test, 21 patients (84%) showed improvement of visual disturbance after treatment. The 10-year tumor control rate for non-secreting and secreting adenoma was 100% and 58%, respectively (p < 0.001). Progression free survival rate at 10 years was 98%. Only 1 patient experienced endocrinological recurrence. Following surgery, 60% (n = 44) suffered from pituitary function deficit. Late complication associated with RT was only 1 patient, who developed cataract. Surgery and RT are very effective and safe in hormonal and tumor growth control for secreting and non-secreting pituitary adenoma

  7. Long-term outcomes of surgery and radiotherapy for secreting and non-secreting pituitary adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young; Kim, Jin Hee; Oh, Young Kee; Kim, El [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2016-06-15

    To investigate treatment outcome and long term complication after surgery and radiotherapy (RT) for pituitary adenoma. From 1990 to 2009, 73 patients with surgery and RT for pituitary adenoma were analyzed in this study. Median age was 51 years (range, 25 to 71 years). Median tumor size was 3 cm (range, 1 to 5 cm) with suprasellar (n = 21), cavernous sinus extension (n = 14) or both (n = 5). Hormone secreting tumor was diagnosed in 29 patients; 16 patients with prolactin, 12 patients with growth hormone, and 1 patient with adrenocorticotrophic hormone. Impairment of visual acuity or visual field was presented in 33 patients at first diagnosis. Most patients (n = 64) received RT as postoperative adjuvant setting. Median RT dose was 45 Gy (range, 45 to 59.4 Gy). Median follow-up duration was 8 years (range, 3 to 22 years). In secreting tumors, hormone normalization rate was 55% (16 of 29 patients). For 25 patients with evaluable visual field and visual acuity test, 21 patients (84%) showed improvement of visual disturbance after treatment. The 10-year tumor control rate for non-secreting and secreting adenoma was 100% and 58%, respectively (p < 0.001). Progression free survival rate at 10 years was 98%. Only 1 patient experienced endocrinological recurrence. Following surgery, 60% (n = 44) suffered from pituitary function deficit. Late complication associated with RT was only 1 patient, who developed cataract. Surgery and RT are very effective and safe in hormonal and tumor growth control for secreting and non-secreting pituitary adenoma.

  8. Analysis of Shrinkage on Thick Plate Part using Genetic Algorithm

    Directory of Open Access Journals (Sweden)

    Najihah S.N.

    2016-01-01

    Full Text Available Injection moulding is the most widely used processes in manufacturing plastic products. Since the quality of injection improves plastic parts are mostly influenced by process conditions, the method to determine the optimum process conditions becomes the key to improving the part quality. This paper presents a systematic methodology to analyse the shrinkage of the thick plate part during the injection moulding process. Genetic Algorithm (GA method was proposed to optimise the process parameters that would result in optimal solutions of optimisation goals. Using the GA, the shrinkage of the thick plate part was improved by 39.1% in parallel direction and 17.21% in the normal direction of melt flow.

  9. The incidentaloma of the pituitary gland: Is neurosurgery required

    Energy Technology Data Exchange (ETDEWEB)

    Reincke, M.; Allolio, B.; Saeger, W.; Menzel, J.; Winkelmann, W. (Univ. of Cologne (West Germany))

    1990-05-23

    The authors describe a series of 18 patients with an intrasellar mass incidentally discovered by computed tomography or magnetic resonance imaging. The average size of the mass was 13 mm, with a range from 5 to 25 mm. Initial ophthalmologic examination revealed bitemporal hemianopia in 2 patients. Results of routine endocrine testing showed partial hypopituitarism in 5 patients and growth hormone hypersecretion without signs and symptoms of acromegaly in 1 patient. Four patients underwent neurosurgery. Histologically, one chondroid chordoma and three pituitary adenomas were found. In the remaining 14 patients treated conservatively, repeated computed tomography and magnetic resonance imaging revealed no significant change in tumor size at the time of follow-up. The results suggest that the incidentaloma of the pituitary gland is a benign condition that does not necessarily require neurosurgical intervention.

  10. The incidentaloma of the pituitary gland: Is neurosurgery required?

    International Nuclear Information System (INIS)

    Reincke, M.; Allolio, B.; Saeger, W.; Menzel, J.; Winkelmann, W.

    1990-01-01

    The authors describe a series of 18 patients with an intrasellar mass incidentally discovered by computed tomography or magnetic resonance imaging. The average size of the mass was 13 mm, with a range from 5 to 25 mm. Initial ophthalmologic examination revealed bitemporal hemianopia in 2 patients. Results of routine endocrine testing showed partial hypopituitarism in 5 patients and growth hormone hypersecretion without signs and symptoms of acromegaly in 1 patient. Four patients underwent neurosurgery. Histologically, one chondroid chordoma and three pituitary adenomas were found. In the remaining 14 patients treated conservatively, repeated computed tomography and magnetic resonance imaging revealed no significant change in tumor size at the time of follow-up. The results suggest that the incidentaloma of the pituitary gland is a benign condition that does not necessarily require neurosurgical intervention

  11. Etiology of hypopituitarism in tertiary care institutions in Turkish population: analysis of 773 patients from Pituitary Study Group database.

    Science.gov (United States)

    Tanriverdi, F; Dokmetas, H S; Kebapcı, N; Kilicli, F; Atmaca, H; Yarman, S; Ertorer, M E; Erturk, E; Bayram, F; Tugrul, A; Culha, C; Cakir, M; Mert, M; Aydin, H; Taskale, M; Ersoz, N; Canturk, Z; Anaforoglu, I; Ozkaya, M; Oruk, G; Hekimsoy, Z; Kelestimur, F; Erbas, T

    2014-09-01

    Hypopituitarism in adult life is commonly acquired and the main causes are known as pituitary tumors and/or their treatments. Since there are new insights into the etiology of hypopituitarism and presence of differences in various populations, more studies regarding causes of hypopituitarism are needed to be done in different ethnic groups with sufficient number of patients. Therefore, we performed a multi-center database study in Turkish population investigating the etiology of hypopituitarism in 773 patients in tertiary care institutions. The study was designed and coordinated by the Pituitary Study Group of SEMT (The Society of Endocrinology and Metabolism of Turkey). Nineteen tertiary reference centers (14 university hospitals and 5 training hospitals) from the different regions of Turkey participated in the study. It is a cross-sectional database study, and the data were recorded for 18 months. We mainly classified the causes of hypopituitarism as pituitary tumors (due to direct effects of the pituitary tumors and/or their treatments), extra-pituitary tumors and non-tumoral causes. Mean age of 773 patients (49.8 % male, 50.2 % female) was 43.9 ± 16.1 years (range 16-84 years). The most common etiology of pituitary dysfunction was due to non-tumoral causes (49.2 %) among all patients. However, when we analyze the causes according to gender, the most common etiology in males was pituitary tumors, but the most common etiology in females was non-tumoral causes. According to the subgroup analysis of the causes of hypopituitarism in all patients, the most common four causes of hypopituitarism which have frequencies over 10 % were as follows: non-secretory pituitary adenomas, Sheehan's syndrome, lactotroph adenomas and idiopathic. With regard to the type of hormonal deficiencies; FSH/LH deficiency was the most common hormonal deficit (84.9 % of the patients). In 33.8 % of the patients, 4 anterior pituitary hormone deficiencies (FSH/LH, ACTH, TSH, and GH) were

  12. Heterogeneous genetic background of the association of pheochromocytoma/paraganglioma and pituitary adenoma: results from a large patient cohort.

    Science.gov (United States)

    Dénes, Judit; Swords, Francesca; Rattenberry, Eleanor; Stals, Karen; Owens, Martina; Cranston, Treena; Xekouki, Paraskevi; Moran, Linda; Kumar, Ajith; Wassif, Christopher; Fersht, Naomi; Baldeweg, Stephanie E; Morris, Damian; Lightman, Stafford; Agha, Amar; Rees, Aled; Grieve, Joan; Powell, Michael; Boguszewski, Cesar Luiz; Dutta, Pinaki; Thakker, Rajesh V; Srirangalingam, Umasuthan; Thompson, Chris J; Druce, Maralyn; Higham, Claire; Davis, Julian; Eeles, Rosalind; Stevenson, Mark; O'Sullivan, Brendan; Taniere, Phillipe; Skordilis, Kassiani; Gabrovska, Plamena; Barlier, Anne; Webb, Susan M; Aulinas, Anna; Drake, William M; Bevan, John S; Preda, Cristina; Dalantaeva, Nadezhda; Ribeiro-Oliveira, Antônio; Garcia, Isabel Tena; Yordanova, Galina; Iotova, Violeta; Evanson, Jane; Grossman, Ashley B; Trouillas, Jacqueline; Ellard, Sian; Stratakis, Constantine A; Maher, Eamonn R; Roncaroli, Federico; Korbonits, Márta

    2015-03-01

    Pituitary adenomas and pheochromocytomas/paragangliomas (pheo/PGL) can occur in the same patient or in the same family. Coexistence of the two diseases could be due to either a common pathogenic mechanism or a coincidence. The objective of the investigation was to study the possible coexistence of pituitary adenoma and pheo/PGL. Thirty-nine cases of sporadic or familial pheo/PGL and pituitary adenomas were investigated. Known pheo/PGL genes (SDHA-D, SDHAF2, RET, VHL, TMEM127, MAX, FH) and pituitary adenoma genes (MEN1, AIP, CDKN1B) were sequenced using next generation or Sanger sequencing. Loss of heterozygosity study and pathological studies were performed on the available tumor samples. The study was conducted at university hospitals. Thirty-nine patients with sporadic of familial pituitary adenoma and pheo/PGL participated in the study. Outcomes included genetic screening and clinical characteristics. Eleven germline mutations (five SDHB, one SDHC, one SDHD, two VHL, and two MEN1) and four variants of unknown significance (two SDHA, one SDHB, and one SDHAF2) were identified in the studied genes in our patient cohort. Tumor tissue analysis identified LOH at the SDHB locus in three pituitary adenomas and loss of heterozygosity at the MEN1 locus in two pheochromocytomas. All the pituitary adenomas of patients affected by SDHX alterations have a unique histological feature not previously described in this context. Mutations in the genes known to cause pheo/PGL can rarely be associated with pituitary adenomas, whereas mutation in a gene predisposing to pituitary adenomas (MEN1) can be associated with pheo/PGL. Our findings suggest that genetic testing should be considered in all patients or families with the constellation of pheo/PGL and a pituitary adenoma.

  13. Heterogeneous Genetic Background of the Association of Pheochromocytoma/Paraganglioma and Pituitary Adenoma: Results From a Large Patient Cohort

    Science.gov (United States)

    Dénes, Judit; Swords, Francesca; Rattenberry, Eleanor; Stals, Karen; Owens, Martina; Cranston, Treena; Xekouki, Paraskevi; Moran, Linda; Kumar, Ajith; Wassif, Christopher; Fersht, Naomi; Baldeweg, Stephanie E.; Morris, Damian; Lightman, Stafford; Agha, Amar; Rees, Aled; Grieve, Joan; Powell, Michael; Boguszewski, Cesar Luiz; Dutta, Pinaki; Thakker, Rajesh V.; Srirangalingam, Umasuthan; Thompson, Chris J.; Druce, Maralyn; Higham, Claire; Davis, Julian; Eeles, Rosalind; Stevenson, Mark; O'Sullivan, Brendan; Taniere, Phillipe; Skordilis, Kassiani; Gabrovska, Plamena; Barlier, Anne; Webb, Susan M.; Aulinas, Anna; Drake, William M.; Bevan, John S.; Preda, Cristina; Dalantaeva, Nadezhda; Ribeiro-Oliveira, Antônio; Garcia, Isabel Tena; Yordanova, Galina; Iotova, Violeta; Evanson, Jane; Grossman, Ashley B.; Trouillas, Jacqueline; Ellard, Sian; Stratakis, Constantine A.; Maher, Eamonn R.; Roncaroli, Federico

    2015-01-01

    Context: Pituitary adenomas and pheochromocytomas/paragangliomas (pheo/PGL) can occur in the same patient or in the same family. Coexistence of the two diseases could be due to either a common pathogenic mechanism or a coincidence. Objective: The objective of the investigation was to study the possible coexistence of pituitary adenoma and pheo/PGL. Design: Thirty-nine cases of sporadic or familial pheo/PGL and pituitary adenomas were investigated. Known pheo/PGL genes (SDHA-D, SDHAF2, RET, VHL, TMEM127, MAX, FH) and pituitary adenoma genes (MEN1, AIP, CDKN1B) were sequenced using next generation or Sanger sequencing. Loss of heterozygosity study and pathological studies were performed on the available tumor samples. Setting: The study was conducted at university hospitals. Patients: Thirty-nine patients with sporadic of familial pituitary adenoma and pheo/PGL participated in the study. Outcome: Outcomes included genetic screening and clinical characteristics. Results: Eleven germline mutations (five SDHB, one SDHC, one SDHD, two VHL, and two MEN1) and four variants of unknown significance (two SDHA, one SDHB, and one SDHAF2) were identified in the studied genes in our patient cohort. Tumor tissue analysis identified LOH at the SDHB locus in three pituitary adenomas and loss of heterozygosity at the MEN1 locus in two pheochromocytomas. All the pituitary adenomas of patients affected by SDHX alterations have a unique histological feature not previously described in this context. Conclusions: Mutations in the genes known to cause pheo/PGL can rarely be associated with pituitary adenomas, whereas mutation in a gene predisposing to pituitary adenomas (MEN1) can be associated with pheo/PGL. Our findings suggest that genetic testing should be considered in all patients or families with the constellation of pheo/PGL and a pituitary adenoma. PMID:25494863

  14. The Process of Shrinkage as a Challenge to Urban Governance

    Directory of Open Access Journals (Sweden)

    Stryjakiewicz Tadeusz

    2016-06-01

    Full Text Available For many decades most researchers, planners and local authorities have been focusing almost exclusively on urban growth and its socio-economic and spatial consequences. However, in the current debate concerning the future of cities and regions in Europe the process of their shrinkage starts to attract more attention. In the conditions of a declining population, urban governance is an important challenge for local authorities, being usually much more difficult than during the periods of population growth.

  15. Clay Mineralogy of Brazilian Oxisols with Shrinkage Properties

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    Samara Alves Testoni

    2017-08-01

    Full Text Available ABSTRACT Shrinkage capacity (caráter retrátil in Portuguese is a new diagnostic characteristic recently introduced in the Brazilian System of Soil Classification (SiBCS to indicate shrink and swell properties observed in subtropical soils from highland plateaus in southern Brazil, specifically in Oxisols with brown colors. In soils located in road cuts exposed to drying for some weeks, strong shrinkage of soil volume is observed in these soils, resulting in the formation of pronounced vertical cracks and large and very large prismatic structures, which crumble in blocks when handled. We hypothesize that such properties are related to their clay mineralogy, although there are no conclusive studies about this, the motive for the present study. Samples of the A and B horizons from six Oxisols with expansive capacity from the states of Santa Catarina and Rio Grande do Sul were analyzed. One Rhodic Hapludox, from the state of Paraná, without expansive capacity, was used for comparison. All the soils are very clayey, originated from basalt, and have similar iron oxide content. For identification of clay mineralogy, X-ray diffraction techniques were employed, together with the use of NEWMOD® software to investigate and describe the interstratified minerals. The results showed that most expansive soils have a similar mineralogical composition, with kaolinite, interstratified kaolinite-smectite (K-S, and hydroxy-Al interlayered smectites (HIS, unlike the non-expansive Rhodic Hapludox, which exhibited kaolinite with significant amounts of gibbsite and low amount of interstratified K-S. According to the mineralogical assemblage identified in the expansive soils, we can affirm that the mechanism of smectite expansion and contraction is related to the shrinkage capacity of the soil, considering that the level of hydroxy-Al intercalation is low. In addition, these mechanisms also are related to the presence of quasicrystals and domains that control the

  16. The incidence of cerebrovascular accidents in patients with pituitary adenoma

    International Nuclear Information System (INIS)

    Brada, M.; Burchell, L.; Ashley, S.; Traish, D.

    1999-01-01

    Background and Purpose: Patients with pituitary adenomas are effectively treated with a combination of surgery, radiotherapy, and medical therapy. Nevertheless, long-term studies suggest increased mortality that is independent of tumor control, with cerebrovascular accidents (CVA) as the major contributing cause. The purpose of this study was to define the frequency of CVAs in a cohort of patients with pituitary adenoma and identify potential predisposing factors. Patients and Methods: A cohort of 331 United Kingdom (UK) residents with pituitary adenoma treated at the Royal Marsden Hospital (RMH) between 1962 and 1986 was studied. The frequency of CVA was assessed from RMH and referring hospital records and clinicians, by postal questionnaire of referring hospitals and general practitioners, and by examination of all death certificates. The data were analyzed by actuarial methods, and risk factors were assessed by multivariate analysis. The data were compared to the incidence of CVA in the general population using a published UK population cohort. Results: Sixty-four of 331 patients developed CVA after primary treatment of pituitary adenoma. The actuarial incidence of CVA was 4% (95% CI: 2-7%) at 5 years, 11% (95% CI: 8-14%) at 10 years, and 21% (95% CI: 16-28%) at 20 years measured from the date of radiotherapy. The relative risk of CVA compared to the general population in the UK was 4.1. Age was an independent predictive factor for CVA. However, the relative risk in comparison to the general population was independent of age. The relative risk of developing CVA was higher in women compared to men, in patients undergoing debulking surgery compared to less radical procedures, and in patients diagnosed and treated in the 1980s compared to previous decades. The dose of radiotherapy was an additional independent prognostic factor on multivariate analysis. Conclusion: Patients with pituitary adenoma treated with surgery and radiotherapy have a significantly increased

  17. PREDIKSI SHRINKAGE UNTUK MENGHINDARI CACAT PRODUK PADA PLASTIC INJECTION

    Directory of Open Access Journals (Sweden)

    Agus Dwi Anggono

    2015-05-01

    Full Text Available Plastic injection merupakan proses manufactur untuk membuat produk dengan bahan dasar plastic atau dalam kesempatan ini polypropylene. Pada proses tersebut seringkali terjadi cacat produk seperti pengerutan, retak, dimensi tidak sesuai dan kerusakan saat produk keluar dari mould, sehingga banyak material yang terbuang percuma. Meskipun cacat produk tersebut dipengaruhi banyak factor, tetapi yang paling utama adalah masalah shrinkage, atau penyusutan material setelah terjadi pendinginan. Sangat penting untuk melakukan prediksi lebih awal terjadinya penyusutan setelah pendinginan untuk menghindari cacat produk. Dalam penelitian ini akan dilakukan prediksi shrinkage yang akan digunakan untuk material polypropylene dengan cara perhitungan standar. Pembuatan modeling dalam bentuk 3D (tiga dimensi injection molding baik cavity maupun corenya dengan menggunakan CATIA, kemudian dilakukan analisis dengan software MoldFlow untuk pembuatan mesh dan memberikan batasan panas pada komponen sehingga dapat diketahui mode penyusutannya. Analisis ini akan memberikan gambaran tentang distribusi panas pada mould dan memberikan tentang gambaran aliran fluida. Pada analisis tersebut dapat dilihat gejala terjadinya cacat produk, jika hal itu terjadi maka perlu dilakukan perubahan shrinkage, sampai diperoleh hasil analisis yang baik.

  18. The Shrinkage Model And Expert System Of Plastic Lens Formation

    Science.gov (United States)

    Chang, Rong-Seng

    1988-06-01

    Shrinkage causes both the appearance & dimension defects of the injected plastic lens. We have built up a model of state equations with the help of finite element analysis program to estimate the volume change (shrinkage and swelling) under the combinations of injection variables such as pressure and temperature etc., then the personal computer expert system has been build up to make that knowledge conveniently available to the user in the model design, process planning, process operation and some other work. The domain knowledge is represented by a R-graph (Relationship-graph) model which states the relationships of variables & equations. This model could be compare with other models in the expert system. If the user has better model to solve the shrinkage problem, the program will evaluate it automatically and a learning file will be trigger by the expert system to teach the user to update their knowledge base and modify the old model by this better model. The Rubin's model and Gilmore's model have been input to the expert system. The conflict has been solved both from the user and the deeper knowledge base. A cube prism and the convex lens examples have been shown in this paper. This program is written by MULISP language in IBM PC-AT. The natural language provides English Explaination of know why and know how and the automatic English translation for the equation rules and the production rules.

  19. Experimental Analysis on Shrinkage and Swelling in Ordinary Concrete

    Directory of Open Access Journals (Sweden)

    Barbara Kucharczyková

    2017-01-01

    Full Text Available The paper deals with the experimental determination of shrinkage development during concrete ageing. Three concrete mixtures were made. They differed in the amount of cement in the fresh mixture, 300, 350, and 400 kg/m3. In order to determine the influence of plasticiser on the progress of volume changes, another three concrete mixtures were prepared with plasticiser in the amount of 0.25% by cement mass. Measurements were performed with the goal of observing the influence of cement and plasticiser content on the overall development of volume changes in the concrete. Changes in length and mass losses of the concrete during ageing were measured simultaneously. The continuous measurement of concrete mass losses caused by drying of the specimen’s surface proved useful during the interpretation of results obtained from the concrete shrinkage measurement. During the first 24 hours of ageing, all the concrete mixtures exhibited swelling. Its magnitude and progress were influenced by cement, water, and plasticiser content. However, a loss of mass caused by water evaporation from the surface of the specimens was also recorded in this stage. The measured progress of shrinkage corresponded well to the progress of mass loss.

  20. Modeling Restrained Shrinkage Induced Cracking in Concrete Rings Using the Thick Level Set Approach

    Directory of Open Access Journals (Sweden)

    Rebecca Nakhoul

    2018-03-01

    Full Text Available Modeling restrained shrinkage-induced damage and cracking in concrete is addressed herein. The novel Thick Level Set (TLS damage growth and crack propagation model is used and adapted by introducing shrinkage contribution into the formulation. The TLS capacity to predict damage evolution, crack initiation and growth triggered by restrained shrinkage in absence of external loads is evaluated. A study dealing with shrinkage-induced cracking in elliptical concrete rings is presented herein. Key results such as the effect of rings oblateness on stress distribution and critical shrinkage strain needed to initiate damage are highlighted. In addition, crack positions are compared to those observed in experiments and are found satisfactory.

  1. Pituitary-hormone secretion by thyrotropinomas.

    Science.gov (United States)

    Roelfsema, Ferdinand; Kok, Simon; Kok, Petra; Pereira, Alberto M; Biermasz, Nienke R; Smit, Jan W; Frolich, Marijke; Keenan, Daniel M; Veldhuis, Johannes D; Romijn, Johannes A

    2009-01-01

    Hormone secretion by somatotropinomas, corticotropinomas and prolactinomas exhibits increased pulse frequency, basal and pulsatile secretion, accompanied by greater disorderliness. Increased concentrations of growth hormone (GH) or prolactin (PRL) are observed in about 30% of thyrotropinomas leading to acromegaly or disturbed sexual functions beyond thyrotropin (TSH)-induced hyperthyroidism. Regulation of non-TSH pituitary hormones in this context is not well understood. We there therefore evaluated TSH, GH and PRL secretion in 6 patients with up-to-date analytical and mathematical tools by 24-h blood sampling at 10-min intervals in a clinical research laboratory. The profiles were analyzed with a new deconvolution method, approximate entropy, cross-approximate entropy, cross-correlation and cosinor regression. TSH burst frequency and basal and pulsatile secretion were increased in patients compared with controls. TSH secretion patterns in patients were more irregular, but the diurnal rhythm was preserved at a higher mean with a 2.5 h phase delay. Although only one patient had clinical acromegaly, GH secretion and IGF-I levels were increased in two other patients and all three had a significant cross-correlation between the GH and TSH. PRL secretion was increased in one patient, but all patients had a significant cross-correlation with TSH and showed decreased PRL regularity. Cross-ApEn synchrony between TSH and GH did not differ between patients and controls, but TSH and PRL synchrony was reduced in patients. We conclude that TSH secretion by thyrotropinomas shares many characteristics of other pituitary hormone-secreting adenomas. In addition, abnormalities in GH and PRL secretion exist ranging from decreased (joint) regularity to overt hypersecretion, although not always clinically obvious, suggesting tumoral transformation of thyrotrope lineage cells.

  2. A patient with Cushing disease lateralizing a pituitary adenoma by inferior petrosal sinus sampling using desmopressin: a case report

    Directory of Open Access Journals (Sweden)

    Joo Hee Lim

    2016-03-01

    Full Text Available A 14-year-old girl was referred for evaluation of the etiology of Cushing syndrome. During the previous 2 years, she had experienced weight gain, secondary amenorrhea, growth retardation, and back pain. Random serum cortisol level, 24-hour urinary free cortisol excretion, and overnight and low-dose dexamethasone suppression tests suggested Cushing syndrome. Midnight adrenocorticotropic hormone (ACTH level and high-dose dexamethasone suppression test confirmed Cushing disease. Pituitary magnetic resonance imaging was suspicious for microadenoma. To eliminate ectopic ACTH syndrome, and lateralize the pituitary tumor, inferior petrosal sinus sampling (IPSS was performed by desmopressin use to stimulate ACTH. Finally, the patient was diagnosed with Cushing disease due to ACTH-secreting pituitary microadenoma, lateralized to the left side; subsequently underwent transsphenoidal surgery. Here we report a case of a 14-year-old girl diagnosed with Cushing disease with a pituitary tumor lateralized by IPSS using desmopressin, which is very rare in pediatric Cushing disease.

  3. A patient with Cushing disease lateralizing a pituitary adenoma by inferior petrosal sinus sampling using desmopressin: a case report.

    Science.gov (United States)

    Lim, Joo Hee; Kim, Soo Jung; Jung, Mo Kyung; Kim, Ki Eun; Kwon, Ah Reum; Chae, Hyun Wook; Kim, Duk Hee; Kim, Ho-Seong

    2016-03-01

    A 14-year-old girl was referred for evaluation of the etiology of Cushing syndrome. During the previous 2 years, she had experienced weight gain, secondary amenorrhea, growth retardation, and back pain. Random serum cortisol level, 24-hour urinary free cortisol excretion, and overnight and low-dose dexamethasone suppression tests suggested Cushing syndrome. Midnight adrenocorticotropic hormone (ACTH) level and high-dose dexamethasone suppression test confirmed Cushing disease. Pituitary magnetic resonance imaging was suspicious for microadenoma. To eliminate ectopic ACTH syndrome, and lateralize the pituitary tumor, inferior petrosal sinus sampling (IPSS) was performed by desmopressin use to stimulate ACTH. Finally, the patient was diagnosed with Cushing disease due to ACTH-secreting pituitary microadenoma, lateralized to the left side; subsequently underwent transsphenoidal surgery. Here we report a case of a 14-year-old girl diagnosed with Cushing disease with a pituitary tumor lateralized by IPSS using desmopressin, which is very rare in pediatric Cushing disease.

  4. Mammosomatotroph adenoma of the pituitary associated with gigantism and hyperprolactinemia. A morphological study including immunoelectron microscopy.

    Science.gov (United States)

    Felix, I A; Horvath, E; Kovacs, K; Smyth, H S; Killinger, D W; Vale, J

    1986-01-01

    A 29-year old giantess with growth hormone excess and hyperprolactinemia underwent transsphenoidal surgery to remove her pituitary tumor. Electron microscopy revealed a mammosomatotroph adenoma composed of one cell type. Immunoelectron microscopy, using the immunogold technique, demonstrated predominantly growth hormone or prolactin or a varying mixture of both growth hormone and prolactin in the adenoma cells. The presence of growth hormone and prolactin was found not only in the cytoplasm of the same adenoma cells but also in the same secretory granules. In the nontumorous adenohypophysis, somatotrophs and lactotrophs showed ultrastructural signs of hyperactivity. This finding is in contrast with the presence of suppressed somatotrophs and lactotrophs seen in nontumorous portions of adult pituitaries harboring growth hormone or prolactin-secreting adenomas. Our morphological study reinforces the view that growth hormone-producing pituitary tumors, originating in childhood, are different from those of the adult gland.

  5. Depletion of pituitary prolactin by cysteamine is due to loss of immunological activity

    Energy Technology Data Exchange (ETDEWEB)

    Scammell, J.G.; Dannies, P.S.

    1984-03-01

    The mechanism by which cysteamine reduces the prolactin(PRL) content of pituitary cells was studied in primary cultures of estradiol-induced pituitary tumors in Fischer 344 rats. The PRL content of these cells was effectively decreased by cysteamine, with an IC50 of 0.2 mM. Cells previously labeled with (/sup 3/H)leucine were exposed to cysteamine (0.25 mM), and the intracellular content of (/sup 3/H)PRL was measured by immunological or nonimmunological means, that is by immunoprecipitation and electrophoresis or by electrophoresis alone. The intracellular concentration of immunoreactive (/sup 3/H)PRL was reduced by 53% by cysteamine, whereas (/sup 3/H)PRL quantified by electrophoresis alone was not significantly affected. Our data indicate that cysteamine reduces the PRL content of pituitary tumor cells by causing the loss of its immunoreactivity.

  6. Gamma Knife radiosurgery in pituitary adenomas: Why, who, and how to treat?

    Science.gov (United States)

    Castinetti, Frederic; Brue, Thierry

    2010-08-01

    Pituitary adenomas are benign tumors that can be either secreting (acromegaly, Cushing's disease, prolactinomas) or non-secreting. Transsphenoidal neurosurgery is the gold standard treatment; however, it is not always effective. Gamma Knife radiosurgery is a specific modality of stereotactic radiosurgery, a precise radiation technique. Several studies reported the efficacy and low risk of adverse effects induced by this technique: in secreting pituitary adenomas, hypersecretion is controlled in about 50% of cases and tumor volume is stabilized or decreased in 80-90% of cases, making Gamma Knife a valuable adjunctive or first-line treatment. As hormone levels decrease progressively, the main drawback is the longer time to remission (12-60 months), requiring an additional treatment during this period. Hypopituitarism is the main side effect, observed in 20-40% cases. Gamma Knife is thus useful in the therapeutic algorithms of pituitary adenomas in well-defined indications, mainly low secreting small lesions well identified on magnetic resonance imaging (MRI).

  7. Depletion of pituitary prolactin by cysteamine is due to loss of immunological activity

    International Nuclear Information System (INIS)

    Scammell, J.G.; Dannies, P.S.

    1984-01-01

    The mechanism by which cysteamine reduces the prolactin(PRL) content of pituitary cells was studied in primary cultures of estradiol-induced pituitary tumors in Fischer 344 rats. The PRL content of these cells was effectively decreased by cysteamine, with an IC50 of 0.2 mM. Cells previously labeled with [ 3 H]leucine were exposed to cysteamine (0.25 mM), and the intracellular content of [ 3 H]PRL was measured by immunological or nonimmunological means, that is by immunoprecipitation and electrophoresis or by electrophoresis alone. The intracellular concentration of immunoreactive [ 3 H]PRL was reduced by 53% by cysteamine, whereas [ 3 H]PRL quantified by electrophoresis alone was not significantly affected. Our data indicate that cysteamine reduces the PRL content of pituitary tumor cells by causing the loss of its immunoreactivity

  8. Clinical results of stereotactic hellium-ion radiosurgery of the pituitary gland at Lawrence Berkeley Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Levy, R.P.; Fabrikant, J.I.; Lyman, J.T.; Frankel, K.A.; Phillips, M.H.; Lawrence, J.H.; Tobias, C.A.

    1989-12-01

    The first therapeutic clinical trial using accelerated heavy-charged particles in humans was performed at Lawrence Berkeley Laboratory (LBL) for the treatment of various endocrine and metabolic disorders of the pituitary gland, and as suppressive therapy for adenohypophyseal hormone-responsive carcinomas and diabetic retinopathy. In acromegaly, Cushing's disease, Nelson's syndrome and prolactin-secreting tumors, the therapeutic goal in the 433 patients treated has been to destroy or inhibit the growth of the pituitary tumor and control hormonal hypersecretion, while preserving a functional rim of tissue with normal hormone-secreting capacity, and minimizing neurologic injury. An additional group of 34 patients was treated for nonsecreting chromophobe adenomas. This paper discusses the methods and results of stereotactic helium-ion radiosurgery of the pituitary gland at Lawrence Berkeley Laboratory. 11 refs.

  9. Clinical results of stereotactic helium-ion radiosurgery of the pituitary gland at Lawrence Berkeley Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Levy, R.P.; Fabrikant, J.I.; Lyman, J.T.; Frankel, K.A.; Phillips, M.H.; Lawrence, J.H.; Tobias, C.A.

    1989-12-01

    The first therapeutic clinical trial using accelerated heavy-charged particles in humans was performed for the treatment of various endocrine and metabolic disorders of the pituitary gland, and as suppressive therapy for adenohypophyseal hormone-responsive carcinomas and diabetic retinopathy. Since then, over 800 patients have received stereotactically-directed plateau-beam heavy-charged particle pituitary irradiation at this institution. In acromegaly, Cushing's disease, Nelson's syndrome and prolactin-secreting tumors, the therapeutic goal in the 433 patients treated has been to destroy or inhibit the growth of the pituitary tumor and control hormonal hypersecretion, while preserving a functional rim of tissue with normal hormone-secreting capacity, and minimizing neurologic injury. An additional group of 34 patients was treated for nonsecreting chromophobe adenomas. This paper discusses the methods and results of these treatments. 11 refs.

  10. Clinical results of stereotactic hellium-ion radiosurgery of the pituitary gland at Lawrence Berkeley Laboratory

    International Nuclear Information System (INIS)

    Levy, R.P.; Fabrikant, J.I.; Lyman, J.T.; Frankel, K.A.; Phillips, M.H.; Lawrence, J.H.; Tobias, C.A.

    1989-12-01

    The first therapeutic clinical trial using accelerated heavy-charged particles in humans was performed at Lawrence Berkeley Laboratory (LBL) for the treatment of various endocrine and metabolic disorders of the pituitary gland, and as suppressive therapy for adenohypophyseal hormone-responsive carcinomas and diabetic retinopathy. In acromegaly, Cushing's disease, Nelson's syndrome and prolactin-secreting tumors, the therapeutic goal in the 433 patients treated has been to destroy or inhibit the growth of the pituitary tumor and control hormonal hypersecretion, while preserving a functional rim of tissue with normal hormone-secreting capacity, and minimizing neurologic injury. An additional group of 34 patients was treated for nonsecreting chromophobe adenomas. This paper discusses the methods and results of stereotactic helium-ion radiosurgery of the pituitary gland at Lawrence Berkeley Laboratory. 11 refs

  11. Clinical results of stereotactic helium-ion radiosurgery of the pituitary gland at Lawrence Berkeley Laboratory

    International Nuclear Information System (INIS)

    Levy, R.P.; Fabrikant, J.I.; Lyman, J.T.; Frankel, K.A.; Phillips, M.H.; Lawrence, J.H.; Tobias, C.A.

    1989-12-01

    The first therapeutic clinical trial using accelerated heavy-charged particles in humans was performed for the treatment of various endocrine and metabolic disorders of the pituitary gland, and as suppressive therapy for adenohypophyseal hormone-responsive carcinomas and diabetic retinopathy. Since then, over 800 patients have received stereotactically-directed plateau-beam heavy-charged particle pituitary irradiation at this institution. In acromegaly, Cushing's disease, Nelson's syndrome and prolactin-secreting tumors, the therapeutic goal in the 433 patients treated has been to destroy or inhibit the growth of the pituitary tumor and control hormonal hypersecretion, while preserving a functional rim of tissue with normal hormone-secreting capacity, and minimizing neurologic injury. An additional group of 34 patients was treated for nonsecreting chromophobe adenomas. This paper discusses the methods and results of these treatments. 11 refs

  12. A primary sellar neuroblastoma mimicking a pituitary adenoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Gun; Heo, Young Jin; Kim, Eun Kyoung; Baek, Jin Wook; Jeong, Hae Woong; Jung, Hyun Seok [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2016-12-15

    Intracranial neuroblastomas are uncommon malignant tumors that usually arise in the supratentorial parenchymal or paraventricular location. A primary neuroblastoma arising in the sella turcica is extremely rare. We report a case of a 76-year-old man who presented with progressive bitemporal hemianopsia. His pituitary hormone levels were within the normal range, except for slightly increased prolactin. Pituitary magnetic resonance imaging revealed a solitary sellar mass with supra- and parasellar extension that mimicked a non-functioning pituitary adenoma or meningioma. The tumor was excised by transsphenoidal resection. Histopathologic analysis revealed small cells surrounded by a dense fibrillary stroma as well as strong expression of neural markers. Hence, the patient was diagnosed with sellar neuroblastoma. Prolactin levels normalized in the immediate postoperative period, although visual disturbances persisted. Herein, we describe the clinical manifestations, MRI characteristics, and histopathologic findings of this case.

  13. Image guidance in trans-sphenoidal surgery for giant pituitary adenomas: Luxury or necessity?

    Directory of Open Access Journals (Sweden)

    Deepak Agrawal

    2012-01-01

    Full Text Available Background: In spite of availability of image guidance (neuronavigation at major centers around the world, most trans-sphenoidal surgeries for pituitary adenomas continue to be done under fluoroscopic control. On the other hand, the high mortality and morbidity for giant pituitary adenomas is mainly due to inadequate tumor removal. Aims and Objectives: The objective of this study was to study to utility of image guidance in trans-sphenoidal surgeries for optimizing tumor removal in giant pituitary adenomas. Materials and Methods: This was a prospective study carried out over a two years (January 2009-December 2010 in the Department of Neurosurgery, All India Institute of Medical Sciences. Patients with giant pituitary adenomas who underwent trans-sphenoidal surgery by the author were included. All surgeries were done under image-guidance only and no fluoroscopy was employed. Trajectory was defined using the image guidance and bone work done accordingly to optimize tumor removal. All patients had a contrast CT of the head done within 48 h of surgery to see for residual tumor. Observations and Results: Sixteen patients with pituitary adenomas were operated using only image-guidance in the study period. Twelve patients had virgin tumors and four patients had recurrent/residual tumors. In four patients, noncontrast MR images were used in for image guidance and contrast CT images were used in the rest. The mean set up time for image-guidance was 11 min (range 7-15 min. The mean ′′overall accuracy of registration′′ was 1.6 mm (range 1.4-2.1 mm. The mean operating time was 72 min (range 52-96 min. In all cases, midline and the relation of the carotid artery to the sella could be confirmed using the image-guidance. There were no intraoperative complications. Postoperative scans showed residual tumor in nine patients. The residual tumor was 25% in one patient (with a fibrous recurrent/residual tumor. Conclusions: Image guidance markedly improves

  14. Apoplexy of a pituitary macroadenoma with reversible third, fourth and sixth cranial nerve palsies following administration of hypothalamic releasing hormones: MR features

    International Nuclear Information System (INIS)

    Riedl, Michaela; Clodi, Martin; Kotzmann, Harald; Hainfellner, Johann A.; Schima, Wolfgang; Reitner, Andreas; Czech, Thomas; Luger, Anton

    2000-01-01

    Pituitary apoplexy in patients with pituitary macroadenomas can occur either spontaneously or following various interventions. We present a case of a 71-year-old woman who developed third, fourth, and sixth cranial nerve palsies following administration of the four hypothalamic releasing hormones for routine preoperative testing of pituitary function. The MR examination showed interval tumor growth with impression of the floor of the third ventricle. There were also changes in signal intensity characteristics of the mass, suggestive of intratumoral bleeding. A transsphenoidal surgery with subtotal resection of the pituitary adenoma was performed. Microscopical examination revealed large areas of necrosis and blood surrounded by adenomatous tissue. Third, fourth, and sixth cranial nerve palsies completely resolved within 4 months. We conclude that MR imaging is useful in the demonstration of pituitary apoplexy following preoperative stimulation tests, but we suggest that these tests should be abandoned in patients with pituitary macroadenomas

  15. Apoplexy of a pituitary macroadenoma with reversible third, fourth and sixth cranial nerve palsies following administration of hypothalamic releasing hormones: MR features

    Energy Technology Data Exchange (ETDEWEB)

    Riedl, Michaela E-mail: michaela.riedl@akh-wien.ac.at; Clodi, Martin; Kotzmann, Harald; Hainfellner, Johann A.; Schima, Wolfgang; Reitner, Andreas; Czech, Thomas; Luger, Anton

    2000-10-01

    Pituitary apoplexy in patients with pituitary macroadenomas can occur either spontaneously or following various interventions. We present a case of a 71-year-old woman who developed third, fourth, and sixth cranial nerve palsies following administration of the four hypothalamic releasing hormones for routine preoperative testing of pituitary function. The MR examination showed interval tumor growth with impression of the floor of the third ventricle. There were also changes in signal intensity characteristics of the mass, suggestive of intratumoral bleeding. A transsphenoidal surgery with subtotal resection of the pituitary adenoma was performed. Microscopical examination revealed large areas of necrosis and blood surrounded by adenomatous tissue. Third, fourth, and sixth cranial nerve palsies completely resolved within 4 months. We conclude that MR imaging is useful in the demonstration of pituitary apoplexy following preoperative stimulation tests, but we suggest that these tests should be abandoned in patients with pituitary macroadenomas.

  16. Evaluation of shrinkage and cracking in concrete of ring test by acoustic emission method

    Science.gov (United States)

    Watanabe, Takeshi; Hashimoto, Chikanori

    2015-03-01

    Drying shrinkage of concrete is one of the typical problems related to reduce durability and defilation of concrete structures. Lime stone, expansive additive and low-heat Portland cement are used to reduce drying shrinkage in Japan. Drying shrinkage is commonly evaluated by methods of measurement for length change of mortar and concrete. In these methods, there is detected strain due to drying shrinkage of free body, although visible cracking does not occur. In this study, the ring test was employed to detect strain and age cracking of concrete. The acoustic emission (AE) method was adopted to detect micro cracking due to shrinkage. It was recognized that in concrete using lime stone, expansive additive and low-heat Portland cement are effective to decrease drying shrinkage and visible cracking. Micro cracking due to shrinkage of this concrete was detected and evaluated by the AE method.

  17. Influence of length-to-diameter ratio on shrinkage of basalt fiber concrete

    Science.gov (United States)

    Ruijie, MA; Yang, Jiansen; Liu, Yuan; Zheng, Xiaojun

    2017-09-01

    In order to study the shrinkage performance of basalt concrete, using the shrinkage rate as index, the work not only studied the influence of different length-to-diameter ratio (LDR) on plastic shrinkage and drying shrinkage of basalt fiber concrete, but also analyzed the action mechanism. The results show that when the fiber content is 0.1%, the LDR of 800 and 1200 take better effects on reducing plastic shrinkage, however the fiber content is 0.3%, that of LDR 600 is better. To improve drying shrinkage, the fiber of LDR 800 takes best effect. In the concrete structure, the adding basalt fibers form a uniform and chaotic supporting system, optimize the pore and the void structure of concrete, make the material further compacted, reduce the water loss, so as to decrease the shrinkage of concrete effectively.

  18. T cell lymphoblastic lymphoma/leukemia within an adrenocorticotropic hormone and thyroid stimulating hormone positive pituitary adenoma: A cytohistological correlation emphasizing importance of intra-operative squash smear.

    Science.gov (United States)

    Gupta, Rakesh K; Saran, Ravindra K; Srivastava, Arvind K; Jagetia, Anita; Garg, Lalit; Sharma, Mehar C

    2017-08-01

    We present a rare case of primary pituitary T cell lymphoma/leukemia (T-LBL) in association with adrenocorticotropic hormone (ACTH) and thyroid stimulating hormone (TSH) expressing pituitary adenoma in a 55-year-old woman highlighting the importance of intra-operative squash smears examination. The patient presented with complaints of headache, diminution of vision and recent onset altered sensorium. MRI revealed a mass lesion in the sellar-suprasellar region with non-visualization of pituitary gland separately, extending to involve adjacent structures diagnosed as invasive pituitary macroadenoma. Intra-operative tissue was sent for squash smear examination. The cytology showed a tumor comprising of sheets of immature lymphoid cells intermixed with clusters of pituitary acinar cells with many mitoses and tingible body macrophages. A diagnosis of presence of immature lymphoid cells within the pituitary was offered and differentials of infiltration by lymphoma cells from systemic disease versus primary central nervous lymphoma-like lymphoma arising in the pituitary adenoma were considered. Later paraffin section examination and immunohistochemistry corroborated with the squash findings and a final diagnosis of primary pituitary T cell lymphoma/leukemia in association with ACTH and TSH expressing pituitary adenoma was made. To date, only six cases of primary pituitary T cell lymphomas, including three T-LBL cases, have been reported. This is the seventh case and first one additionally describing cytohistological correlation and importance of intra-operative cytology. © 2017 Japanese Society of Neuropathology.

  19. Effect of Preserving the Pituitary Stalk During Resection of Craniopharyngioma in Children on the Diabetes Insipidus and Relapse Rates and Long-Term Outcomes.

    Science.gov (United States)

    Cheng, Jing; Fan, Yanqin; Cen, Bo

    2017-09-01

    The objective of this study was to investigate the effect of preserving an infiltrated pituitary stalk during the resection of craniopharyngioma of pituitary stalk origin on postoperative outcomes and thus provide a theoretical basis for microsurgical treatment and prognosis. We screened the clinical data of all 103 pediatric patients with craniopharyngioma undergoing surgical treatment at our department between January 2006 and January 2013 and conducted a retrospective analysis of 82 patients with craniopharyngioma originating in the pituitary stalk. The patients were followed up from 12 months to 8 years. We analyzed the effect of preserving the pituitary stalk on the early and persistent diabetes insipidus rates, postoperative relapse rate, and mortality. In the total resection group (n = 67), the early and persistent diabetes insipidus rates were significantly lower in the 46 patients (68.7%) with a pituitary stalk than in those whose pituitary stalk was removed (P  0.05). In the subtotal resection group (n = 15), a significant difference was observed in the early and persistent diabetes insipidus rates (P  0.05). For children with craniopharyngioma of pituitary stalk origin, preserving the pituitary stalk has a significant effect on the early and persistent diabetes insipidus rates. When intraoperative exploration showed excessive adhesion between the tumor and pituitary stalk, we opted to preserve the pituitary stalk, which significantly reduced the early and persistent postoperative diabetes insipidus rates, without significantly increasing the relapse or mortality rate.

  20. Pilot Study on Early Postoperative Discharge in Pituitary Adenoma Patients: Effect of Socioeconomic Factors and Benefit of Specialized Pituitary Centers.

    Science.gov (United States)

    Sarkiss, Christopher A; Lee, James; Papin, Joseph A; Geer, Eliza B; Banik, Rudrani; Rucker, Janet C; Oudheusden, Barbara; Govindaraj, Satish; Shrivastava, Raj K

    2015-08-01

    Introduction Pituitary neoplasms are benign entities that require distinct diagnostic and treatment considerations. Recent advances in endoscopic transsphenoidal surgery have resulted in shorter lengths of stay (LOS). We implemented a postoperative day (POD) 1 discharge paradigm involving a multidisciplinary approach and detailed preoperative evaluation and review of both medical and socioeconomic factors. Methods The experience of a single neurosurgeon/ears, nose, throat (ENT) team was reviewed, generating a preliminary retrospective database of the first 30 patients who underwent resection of pituitary lesions under the POD 1 discharge paradigm. We assessed multiple axes from their preoperative, in-house, and postoperative care. Results There were 14 men and 16 women with an average age of 53.8 years (range: 27-76 years). There were 22 nonsecretory and 8 secretory tumors with average size of 2.80 cm (range: 1.3-5.0 cm). All 30 patients underwent preoperative ENT evaluation. Average LOS was 1.5 ± 0.7 days. A total of 18 of 30 patients were discharged on POD 1. The insurance status included 15 with public insurance such as emergency Medicaid and 15 with private insurance. Four patients had transient diabetes insipidus (DI); none had permanent DI. Overall, 28 of 30 patients received postoperative steroids. Factors that contributed to LOS > 1 day included public insurance status, two or more medical comorbidities, diabetes mellitus, transient panhypopituitarism, and DI. Conclusion The implementation of a POD 1 discharge plan for pituitary tumors is feasible and safe for elective patients. This implementation requires the establishment of a dedicated Pituitary Center model with experienced team members. The consistent limitation to early discharge was socioeconomic status. Efforts that incorporate the analysis of social disposition parameters with proper management of clinical sequelae are crucial to the maintenance of ideal LOS and optimal patient

  1. LINAC-radiosurgery for nonsecreting pituitary adenomas. Long-term results

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    Runge, M.J.R.; Maarouf, M.; Hunsche, S.; Ruge, M.I.; El Majdoub, F.; Treuer, H.; Sturm, V. [Koeln Univ. (Germany). Dept. of Stereotaxy and Functional Neurosurgery; Kocher, M.; Mueller, R.P. [Koeln Univ. (Germany). Dept. of Radiation Oncology; Voges, J. [Magdeburg Univ. (Germany). Dept. of Stereotactic Neurosurgery

    2012-04-15

    Stereotactic linear accelerator-based radiosurgery (LINAC-RS) is increasingly used for microsurgically inaccessible or recurrent pituitary adenomas. This single-center study evaluates the long-term follow-up after LINAC-RS of nonsecreting pituitary adenomas (NSA). Patients and methods: Between 1992 and August 2008, 65 patients with NSA were treated. Patient treatment and follow-up were conducted according to a prospective protocol. Indications for LINAC-RS were (1) tumor recurrence or (2) residual tumor. Three patients were treated primarily. For analysis of prognostic factors, patients were grouped according to epidemiological or treatment-associated characteristics. Results: A total of 61 patients with a follow-up {>=} 12 months (median 83 months, range 15-186 months, longest follow-up of published radiosurgery series) were evaluated with regard to their clinical, radiological, and endocrinological course. The median tumor volume was 3.5 ml ({+-} 4.3 ml, range 0.3-17.3 ml) treated with a median surface and maximum dose of 13.0 Gy and 29.7 Gy, respectively. Local tumor control was achieved in 98%. One patient died of unrelated cause after 36 months and 1 patient developed a radiation-induced seizure disorder. Visual complications did not occur. In 37 of 41 patients (90.2%), pituitary function remained stable. Maximum dose to the pituitary {<=} 16 Gy and female gender were positive prognostic factors for the preservation of pituitary function. Conclusion: LINAC-RS is a minimally invasive, safe, and effective treatment for recurrent NSA or microsurgically inaccessible residual tumor. LINAC-RS yielded a high rate of local long-term tumor control with a small number of radiation-induced side effects. (orig.)

  2. LINAC-radiosurgery for nonsecreting pituitary adenomas. Long-term results

    International Nuclear Information System (INIS)

    Runge, M.J.R.; Maarouf, M.; Hunsche, S.; Ruge, M.I.; El Majdoub, F.; Treuer, H.; Sturm, V.; Kocher, M.; Mueller, R.P.; Voges, J.

    2012-01-01

    Stereotactic linear accelerator-based radiosurgery (LINAC-RS) is increasingly used for microsurgically inaccessible or recurrent pituitary adenomas. This single-center study evaluates the long-term follow-up after LINAC-RS of nonsecreting pituitary adenomas (NSA). Patients and methods: Between 1992 and August 2008, 65 patients with NSA were treated. Patient treatment and follow-up were conducted according to a prospective protocol. Indications for LINAC-RS were (1) tumor recurrence or (2) residual tumor. Three patients were treated primarily. For analysis of prognostic factors, patients were grouped according to epidemiological or treatment-associated characteristics. Results: A total of 61 patients with a follow-up ≥ 12 months (median 83 months, range 15-186 months, longest follow-up of published radiosurgery series) were evaluated with regard to their clinical, radiological, and endocrinological course. The median tumor volume was 3.5 ml (± 4.3 ml, range 0.3-17.3 ml) treated with a median surface and maximum dose of 13.0 Gy and 29.7 Gy, respectively. Local tumor control was achieved in 98%. One patient died of unrelated cause after 36 months and 1 patient developed a radiation-induced seizure disorder. Visual complications did not occur. In 37 of 41 patients (90.2%), pituitary function remained stable. Maximum dose to the pituitary ≤ 16 Gy and female gender were positive prognostic factors for the preservation of pituitary function. Conclusion: LINAC-RS is a minimally invasive, safe, and effective treatment for recurrent NSA or microsurgically inaccessible residual tumor. LINAC-RS yielded a high rate of local long-term tumor control with a small number of radiation-induced side effects. (orig.)

  3. Growth hormone-secreting pituitary adenoma:clinical and MR imaging findings

    International Nuclear Information System (INIS)

    Park, Hong Suk; Chang, Kee Hyun; Han, Moon Hee; Sim, Jung Suk; Lee, Sang Hyun; Song, Jae Uoo; Yoo, In Kyu; Jung, Hee Won; Yeon, Kyung Mo

    1996-01-01

    To describe clinical and MRI findings of growth hormone-secreting pituitary adenoma, to determine if there are any characteristic MRI findings different from those of other pituitary adenomas, to evaluate the relationship between tumor size and serum growth hormone level, and to assess the results of immunohi-stochemical study. We retrospectively analysed clinical and MRI findings of 29 patients with growth hormone-secreting pituitary adenoma confirmed by serum growth hormone level and surgery. We also evaluated the relationship between the tumor volume and serum growth hormone level, and the results of immunohistochemical study. Coronal and sagittal T1-weighted MR images in all patients and gadolinium-enhanced T1-weighted MR images in 28 patients were obtained with 2.0 T(24 cases) and 0.5 T(5 cases) MR imagers. The images were analyzed in terms of tumor size, signal intensity, degree of contrast enhancement, extent of tumor growth and the presence or absence of cystic change, hemorrhage and calcification. Clinical manifestations included facial feature change and soft tissue swelling of hands and feet(n=29), headache(n=12), impaired visual acuity(n=9), symptoms of hyperprolactinemia(n=8), visual field defect(n=5), and others(n=6). On MR images, all of the 29 cases were seen to be macroadenomas and the size of the tumors averaged 2.2cm(1-5.2cm). Supra- and infrasellar extensions were seen in 21 and 22 patients, respectively. Cavernous sinus invasion was noted in seven, and in one this was bilateral. Signal intensity was isointense with cortical grey matter in 26 cases(90%). Cystic change or necrosis was seen in eight cases(28%), hemorrhage in four(14%), and calcification in two(7%). After enhancement, most(25/28) of the tumors enhanced less than normal pituitary in degree. There was no correlation between serum growth hormone level and tumor size. Immunohistochemical study showed positive growth hormone-secreting pituitary adenomas were various and included

  4. Growth hormone-secreting pituitary adenoma:clinical and MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hong Suk; Chang, Kee Hyun; Han, Moon Hee; Sim, Jung Suk; Lee, Sang Hyun; Song, Jae Uoo; Yoo, In Kyu; Jung, Hee Won; Yeon, Kyung Mo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-10-01

    To describe clinical and MRI findings of growth hormone-secreting pituitary adenoma, to determine if there are any characteristic MRI findings different from those of other pituitary adenomas, to evaluate the relationship between tumor size and serum growth hormone level, and to assess the results of immunohi-stochemical study. We retrospectively analysed clinical and MRI findings of 29 patients with growth hormone-secreting pituitary adenoma confirmed by serum growth hormone level and surgery. We also evaluated the relationship between the tumor volume and serum growth hormone level, and the results of immunohistochemical study. Coronal and sagittal T1-weighted MR images in all patients and gadolinium-enhanced T1-weighted MR images in 28 patients were obtained with 2.0 T(24 cases) and 0.5 T(5 cases) MR imagers. The images were analyzed in terms of tumor size, signal intensity, degree of contrast enhancement, extent of tumor growth and the presence or absence of cystic change, hemorrhage and calcification. Clinical manifestations included facial feature change and soft tissue swelling of hands and feet(n=29), headache(n=12), impaired visual acuity(n=9), symptoms of hyperprolactinemia(n=8), visual field defect(n=5), and others(n=6). On MR images, all of the 29 cases were seen to be macroadenomas and the size of the tumors averaged 2.2cm(1-5.2cm). Supra- and infrasellar extensions were seen in 21 and 22 patients, respectively. Cavernous sinus invasion was noted in seven, and in one this was bilateral. Signal intensity was isointense with cortical grey matter in 26 cases(90%). Cystic change or necrosis was seen in eight cases(28%), hemorrhage in four(14%), and calcification in two(7%). After enhancement, most(25/28) of the tumors enhanced less than normal pituitary in degree. There was no correlation between serum growth hormone level and tumor size. Immunohistochemical study showed positive growth hormone-secreting pituitary adenomas were various and included

  5. Metastatic Mantle Cell Lymphoma to the Pituitary Gland: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Arthur Wang

    2016-01-01

    Full Text Available We present an unusual case of a metastatic mantle cell lymphoma (MCL to the pituitary gland. The patient had a known history of MCL for which she previously received chemotherapy. She presented with new-onset diplopia and confusion, and reported a history of progressive vision blurriness associated with headache, nausea, and vomiting. MRI of the brain showed an enhancing lesion within the sella turcica involving the cavernous sinuses bilaterally, extending into Meckel's cave on the left, and abutting the optic nerves bilaterally. Following surgical excision, histopathology revealed the tumor to be a MCL. Metastatic pituitary tumors are rare and have been estimated to make up 1% of tumors discovered in the sellar region. The two most common secondary metastatic lesions to the sella are breast and lung carcinoma followed by prostate, renal cell, and gastrointestinal carcinoma. Metastatic lymphoma to the pituitary gland is especially rare and is estimated to constitute 0.5% of all metastatic tumors to the sella turcica. To our knowledge, this is the first reported case of MCL metastasizing to the pituitary gland.

  6. Neurotrophins, their receptors and KI-67 in human GH-secreting pituitary adenomas: an immunohistochemical analysis.

    Science.gov (United States)

    Artico, M; Bianchi, E; Magliulo, G; De Vincentiis, M; De Santis, E; Orlandi, A; Santoro, A; Pastore, F S; Giangaspero, F; Caruso, R; Re, M; Fumagalli, L

    2012-01-01

    Pituitary adenomas are a diverse group of tumors arising from the pituitary gland. Typically, they are small, slow-growing, hormonally inactive lesions that come to light as incidental findings on radiologic or postmortem examinations, although some small, slow-growing lesions with excessive hormonal activity may manifest with a clinical syndrome. The family of neurotrophins plays a key role in the development and maintenance of the pituitary endocrine cell function and in the regulation of hypothalamo-pituitary-adrenocortical axis activity. The objective of our experimental study is to investigate the localization of the neurotrophins, their relative receptors and to detect the expression level of Ki-67 to determine whether all these factors participate in the transformation and development of human pituitary adenomas. A very strong expression of Neurotrophin-3 (NT-3) and its receptor TrKC was observed in the extracellular matrix (ECM) and vessel endothelium, together with a clear/marked presence of Brain-derived neurotrophic factor (BDNF), and its receptor TrKB, thus confirming their direct involvement in the progression of pituitary adenomas. On the contrary, NGF (Nerve growth factor) and its receptor TrKA and p75NTR were weakly expressed in the epithelial gland cells and the ECM.

  7. Assessment of endocrine disorders of the hypothalamic-pituitary axis by nuclear medicine techniques

    International Nuclear Information System (INIS)

    Schmidt, M.; Theissen, P.; Dietlein, M.; Schicha, H.; Jackenhoevel, F.; Krone, W.

    2002-01-01

    The following article reviews nuclear medicine techniques which can be used for assessment of endocrine disorders of the hypothalamic-pituitary axis. For planar and SPECT imaging somatostatin-receptor- and dopamine-D2-receptor-scintigraphy are the most widely distributed techniques. These nuclear medicine techniques may be indicated in selected cases to answer differential diagnostic problems. They can be helpful to search for presence and localization of receptor positive tissue. Furthermore they can detect metastasis in the rare cases of a pituitary carcinoma. Scintigraphy with Gallium-67 is suitable for further diagnostic evaluation in suspected hypophysitis. Other SPECT radiopharmaca do not have relevant clinical significance. F-18-FDG as PET radiopharmacon is not ideal because obvious pituitary adenomas could not be visualized. Other PET radiopharmaca including C-11-methionine, C-11-tyrosine, F-18-fluoroethylspiperone, C-11-methylspiperone, and C-11-raclopride are available in specialized centers only. Overall indications for nuclear medicine in studies for the assessment of endocrine disorders of the hypothalamic-pituitary-axis are rare. Original studies often report only about a small number of patients. According to the authors' opinion the relevance of nuclear medicine in studies of clinically important endocrinologic fields, e. g. localization of small ACTH-producing pituitary adenomas, tumor localization in ectopic ACTH syndrome, localization of recurrent pituitary tissue, assessment of small incidentalomas, can not be definitely given yet. (orig.) [de

  8. The Neuro Imaging Description of Giant Pituitary Adenomas Depending on Mechanical Factor

    Directory of Open Access Journals (Sweden)

    Yu.M. Urmanova

    2016-05-01

    Full Text Available The research aim is to analyze of magnetically-resonance tomography data depending on the mechanical factor of giant pituitary adenomas. Materials and methods. Twenty-two adult patients with giant pituitary adenomas were observed during the period from 2015 to 2016 (men 50 %, aged 48.5 years old. The duration of disease varied from 2 months to 25 years. Results. Patients with endo-suprasellar growth of pituitary tumour had signs of chiasmal syndrome with bitemporal hemianopsia, initial or complete homonym hemianopsia, scotomas and others. Such variant of pituitary tumour growth was observed in 7 cases (31.8 %. 4.5 % patients with retro-sellar growth of pituitary tumour typically had violations caused by the growth of tumour into brainstem, that stipulated both the lesion of craniocerebral nerves and vegetative disorders, and also pyramid symptomatology (pathological reflexes, symptoms of oral automatism. Patients with the endo-laterosellar growth of tumour suffered from decline of sharpness of sight on one eye, one-sided headaches, lesion of oculomotorius. For 4.5 % patients with the endo-infrasellar growth of tumour violations of the nasal breathing and swallowing (odynophagia were typical. Conclusions. The most expressed neuroendocrine, ophthalmology and pillar disorders were observed in patients with the total growth of tumor. The giant pituitary adenomas are often accompanied by an invasion growth into surrounding anatomic structures (69.2 % that is a basic factor limiting radical operative intervention and increasing the number of relapses.

  9. Pituitary gland development: an update.

    Science.gov (United States)

    Bancalari, Rodrigo E; Gregory, Louise C; McCabe, Mark J; Dattani, Mehul T

    2012-01-01

    The embryonic development of the pituitary gland involves a complex and highly spatio-temporally regulated network of integrating signalling molecules and transcription factors. Genetic mutations in any of these factors can lead to congenital hypopituitarism in association with a wide spectrum of craniofacial/midline defects ranging from incompatibility with life to holoprosencephaly (HPE) and cleft palate and septo-optic dysplasia (SOD). Increasing evidence supports a genotypic overlap with hypogonadotrophic hypogonadal disorders such as Kallmann syndrome, which is consistent with the known overlap in phenotypes between these disorders. This chapter reviews the cascade of events leading up to the successful development of the pituitary gland and to highlight key areas where genetic variations can occur thus leading to congenital hypopituitarism and associated defects. Copyright © 2012 S. Karger AG, Basel.

  10. CT scan of pituitary adenomas

    International Nuclear Information System (INIS)

    Sakoda, K.; Mukada, K.; Yonezawa, M.; Matsumura, S.; Yoshimoto, H.; Mori, S.; Uozumi, T.

    1981-01-01

    CT scan is an extremely useful, almost harmless means of diagnosing pituitary adenomas. Growth hormone (GH)-secreting adenomas tend to have higher absorption coefficent in plain CT than the nonfunctioning and prolactin (PRL)-secreting adenomas. The absorption coefficent on contrast-enhanced CT does not identify the specific type of adenoma. Ring-like enhancement was observed in five nonfunctioning and four PRL-secreting adenomas with suprasellar extension, while cystic components were observed in four nonfunctioning and four PRL-secreting adenomas. In three of ten cases of PRL-secreting microadenomas, the site corresponding to the adenoma was not enhanced, whereas the normal pituitary was. A correlation exists between the size of PRL-secreting adenoma and the serum PRL level, but not between the size of GH-secreting adenomas and the serum GH level. (orig.)

  11. Extended endoscopic endonasal surgery using three-dimensional endoscopy in the intra-operative MRI suite for supra-diaphragmatic ectopic pituitary adenoma.

    Science.gov (United States)

    Fuminari, Komatsu; Hideki, Atsumi; Manabu, Osakabe; Mitsunori, Matsumae

    2015-01-01

    We describe a supra-diaphragmatic ectopic pituitary adenoma that was safely removed using the extended endoscopic endonasal approach, and discuss the value of three-dimensional (3D) endoscopy and intra-operative magnetic resonance imaging (MRI) to this type of procedure. A 61-year-old-man with bitemporal hemianopsia was referred to our hospital, where MRI revealed an enhanced suprasellar tumor compressing the optic chiasma. The tumor extended on the planum sphenoidale and partially encased the right internal carotid artery. An endocrinological assessment indicated normal pituitary function. The extended endoscopic endonasal approach was taken using a 3D endoscope in the intraoperative MRI suite. The tumor was located above the diaphragma sellae and separated from the normal pituitary gland. The pathological findings indicated non-functioning pituitary adenoma and thus the tumor was diagnosed as a supra-diaphragmatic ectopic pituitary adenoma. Intra-operative MRI provided useful information to minimize dural opening and the supra-diaphragmatic ectopic pituitary adenoma was removed from the complex neurovascular structure via the extended endoscopic endonasal approach under 3D endoscopic guidance in the intra-operative suite. Safe and effective removal of a supra-diaphragmatic ectopic pituitary adenoma was accomplished via the extended endoscopic endonasal approach with visual information provided by 3D endoscopy and intra-operative MRI.

  12. Treatment of pituitary gigantism with the growth hormone receptor antagonist pegvisomant.

    Science.gov (United States)

    Goldenberg, Naila; Racine, Michael S; Thomas, Pamela; Degnan, Bernard; Chandler, William; Barkan, Ariel

    2008-08-01

    Treatment of pituitary gigantism is complex and the results are usually unsatisfactory. The objective of the study was to describe the results of therapy of three children with pituitary gigantism by a GH receptor antagonist, pegvisomant. This was a descriptive case series of up to 3.5 yr duration. The study was conducted at a university hospital. Patients included three children (one female, two males) with pituitary gigantism whose GH hypersecretion was incompletely controlled by surgery, somatostatin analog, and dopamine agonist. The intervention was administration of pegvisomant. Plasma IGF-I and growth velocity were measured. In all three children, pegvisomant rapidly decreased plasma IGF-I concentrations. Growth velocity declined to subnormal or normal values. Statural growth fell into lower growth percentiles and acromegalic features resolved. Pituitary tumor size did not change in two children but increased in one boy despite concomitant therapy with a somatostatin analog. Pegvisomant may be an effective modality for the therapy of pituitary gigantism in children. Titration of the dose is necessary for optimal efficacy, and regular surveillance of tumor size is mandatory.

  13. Isoliquiritigenin exhibits anti-proliferative properties in the pituitary independent of estrogen receptor function

    International Nuclear Information System (INIS)

    Weis, Karen E.; Raetzman, Lori T.

    2016-01-01

    The plant flavonoid isoliquiritigenin (ISL) is a botanical estrogen widely taken as an herbal supplement to ease the symptoms of menopause. ISL has been also shown to have anti-tumor properties in a number of cancer cell backgrounds. However, the effects of ISL on normal cells are less well known and virtually unstudied in the context of the pituitary gland. We have established a pituitary explant culture model to screen chemical agents for gene expression changes within the pituitary gland during a period of active proliferation and differentiation. Using this whole-organ culture system we found ISL to be weakly estrogenic based on its ability to induce Cckar mRNA expression, an estrogen receptor (ER) mediated gene. Using a range of ISL from 200 nM to 200 μM, we discovered that ISL promoted cell proliferation at a low concentration, yet potently inhibited proliferation at the highest concentration. ICI 182,780 failed to antagonize ISL's repression of pituitary cell proliferation, indicating the effect is independent of ER signaling. Coincident with a decrease in proliferating cells, we observed down-regulation of transcript for cyclin D2 and E2 and a strong induction of mRNA and protein for the cyclin dependent kinase inhibitor Cdkn1a (p21). Importantly, high dose ISL did not alter the balance of progenitor vs. differentiated cell types within the pituitary explants and they seemed otherwise healthy; however, TUNEL staining revealed an increase in apoptotic cell death in ISL treated cultures. Our results merit further examination of ISL as an anti-tumor agent in the pituitary gland. - Highlights: • Isoliquiritigenin possesses weak estrogenic activity based on induction of Cckar. • ISL can be anti-proliferative in pituitary explants without altering cell lineages. • Anti-proliferative behavior of ISL is not estrogen receptor mediated. • ISL induces p21 expression leading to cell cycle arrest and apoptosis.

  14. Isoliquiritigenin exhibits anti-proliferative properties in the pituitary independent of estrogen receptor function

    Energy Technology Data Exchange (ETDEWEB)

    Weis, Karen E.; Raetzman, Lori T., E-mail: raetzman@life.illinois.edu

    2016-12-15

    The plant flavonoid isoliquiritigenin (ISL) is a botanical estrogen widely taken as an herbal supplement to ease the symptoms of menopause. ISL has been also shown to have anti-tumor properties in a number of cancer cell backgrounds. However, the effects of ISL on normal cells are less well known and virtually unstudied in the context of the pituitary gland. We have established a pituitary explant culture model to screen chemical agents for gene expression changes within the pituitary gland during a period of active proliferation and differentiation. Using this whole-organ culture system we found ISL to be weakly estrogenic based on its ability to induce Cckar mRNA expression, an estrogen receptor (ER) mediated gene. Using a range of ISL from 200 nM to 200 μM, we discovered that ISL promoted cell proliferation at a low concentration, yet potently inhibited proliferation at the highest concentration. ICI 182,780 failed to antagonize ISL's repression of pituitary cell proliferation, indicating the effect is independent of ER signaling. Coincident with a decrease in proliferating cells, we observed down-regulation of transcript for cyclin D2 and E2 and a strong induction of mRNA and protein for the cyclin dependent kinase inhibitor Cdkn1a (p21). Importantly, high dose ISL did not alter the balance of progenitor vs. differentiated cell types within the pituitary explants and they seemed otherwise healthy; however, TUNEL staining revealed an increase in apoptotic cell death in ISL treated cultures. Our results merit further examination of ISL as an anti-tumor agent in the pituitary gland. - Highlights: • Isoliquiritigenin possesses weak estrogenic activity based on induction of Cckar. • ISL can be anti-proliferative in pituitary explants without altering cell lineages. • Anti-proliferative behavior of ISL is not estrogen receptor mediated. • ISL induces p21 expression leading to cell cycle arrest and apoptosis.

  15. Light bodies in human pituitary adenomas

    DEFF Research Database (Denmark)

    Holck, S; Wewer, U M; Albrechtsen, R

    1987-01-01

    Light bodies are large cytoplasmic granules originally described in the gonadotrophic cells of the rat pituitary gland. In order to determine whether similar bodies occur in the human anterior pituitary gland, 89 pituitary adenomas and periadenomatous tissue from 20 cases were examined...... cells in periadenomatous tissue from 20 cases. These results show that some human pituitary adenomas may contain light bodies identical to those seen in gonadotrophs of rat pituitary....... by transmission electron microscopy. Double membrane bound bodies with filamentous internal structure identical to rodent light bodies were identified in 10 hormone-producing adenomas: 5 PRL, 1 PRL-GH, 2 GH, and 2 ACTH-producing tumours. No light bodies were found in the remaining 79 tumours nor in the pituitary...

  16. Transsphenoidal Surgery for Mixed Pituitary Gangliocytoma-Adenomas.

    Science.gov (United States)

    Shepard, Matthew J; Elzoghby, Mohamed A; Ghanim, Daffer; Lopes, M Beatriz S; Jane, John A

    2017-12-01

    Most sellar gangliocytomas are discovered with a concurrent pituitary adenoma, also known as a mixed gangliocytoma-adenoma (MGA). MGAs are rare, with fewer than 100 cases reported in the literature to date and only 1 previously documented surgical series. Because MGAs are radiologically indistinguishable from pituitary adenomas, they are often diagnosed after surgery. Combined with the paucity of clinical outcome data for these tumors, this makes their diagnosis and management challenging. Here we describe the clinical presentation and outcomes of 10 individuals who were diagnosed with a MGA at a single institution. This retrospective case series study included patients diagnosed with a combined sellar MGA between 1993 and 2016. This series comprised 10 patients, mean age of 44 years (range, 28-63 years) diagnosed with an MGA. The mean tumor size was 1.6 cm (range, 0.4-2.4 cm). Five patients presented with acromegaly, and 1 patient had recurrent Cushing disease. Transsphenoidal surgery was performed in all cases, and gross total resection was achieved in 7 patients (70%). Histologically, 9 of the 10 MGAs were identified as mixed somatotroph adenoma-gangliocytomas. The median duration of follow-up was 74 months (range, 2-180 months). Following adjuvant treatment (n = 3), all patients with acromegaly (n = 4) achieved biochemical remission, and no patient experienced recurrence of the pituitary tumor with a median radiographic follow-up of 48 months. MGAs are often associated with a hypersecretory adenoma. Transsphenoidal surgery is well tolerated by most patients, and when performed in combination with adjuvant therapy, a low rate of recurrence and reversal of preoperative endocrinopathy can be expected. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Perioperative lumbar drain utilization in transsphenoidal pituitary resection.

    Science.gov (United States)

    Alharbi, Shatha; Harsh, Griffith; Ajlan, Abdulrazag

    2018-01-01

    To evaluate lumbar drain (LD) efficacy in transnasal resection of pituitary macroadenomas in preventing postoperative cerebrospinal fluid (CSF) leak, technique safety, and effect on length of hospital stay. We conducted a retrospective data review of pituitary tumor patients in our institution who underwent surgery between December 2006 and January 2013. All patients were operated on for complete surgical resection of pituitary macroadenoma tumors. Patients were divided into 2 groups: group 1 received a preoperative drain, while LD was not preoperatively inserted in group 2. In cases of tumors with suprasellar extension with anticipation of high-flow leak, LD was inserted after the patient was intubated and in a lateral position. Lumbar drain was used for 48 hours, and the drain was removed if no leak was observed postoperatively. In documented postoperative CSF leak patients with no preoperative drain, the leak was treated by LD trial prior to surgical reconstruction. Cases in which leak occurred 6 months postoperatively were excluded. Our study population consisted of 186 patients, 99 women (53%) and 87 men (47%), with a mean age of 50.3+/-16.1 years. Complications occurred in 7 patients (13.7%) in group 1 versus 21 (15.5%) in group 2 (p=0.72). Postoperative CSF leak was observed in 1 patient (1.9%) in group 1 and 7 (5%) in group 2 (Fisher exact test=0.3). Length of hospital stay was a mean of 4.7+/-1.9 days in group 1 and a mean of 2.7+/-2.4 days in group 2 (pLD insertion is generally considered safe with a low risk of complications, it increases the length of hospitalization. Minor complications include headaches and patient discomfort.

  18. Polymerization shrinkage stress of composite resins and resin cements – What do we need to know?

    Directory of Open Access Journals (Sweden)

    Carlos José SOARES

    2017-08-01

    Full Text Available Abstract Polymerization shrinkage stress of resin-based materials have been related to several unwanted clinical consequences, such as enamel crack propagation, cusp deflection, marginal and internal gaps, and decreased bond strength. Despite the absence of strong evidence relating polymerization shrinkage to secondary caries or fracture of posterior teeth, shrinkage stress has been associated with post-operative sensitivity and marginal stain. The latter is often erroneously used as a criterion for replacement of composite restorations. Therefore, an indirect correlation can emerge between shrinkage stress and the longevity of composite restorations or resin-bonded ceramic restorations. The relationship between shrinkage and stress can be best studied in laboratory experiments and a combination of various methodologies. The objective of this review article is to discuss the concept and consequences of polymerization shrinkage and shrinkage stress of composite resins and resin cements. Literature relating to polymerization shrinkage and shrinkage stress generation, research methodologies, and contributing factors are selected and reviewed. Clinical techniques that could reduce shrinkage stress and new developments on low-shrink dental materials are also discussed.

  19. Polymerization shrinkage stress of composite resins and resin cements - What do we need to know?

    Science.gov (United States)

    Soares, Carlos José; Faria-E-Silva, André Luis; Rodrigues, Monise de Paula; Vilela, Andomar Bruno Fernandes; Pfeifer, Carmem Silvia; Tantbirojn, Daranee; Versluis, Antheunis

    2017-08-28

    Polymerization shrinkage stress of resin-based materials have been related to several unwanted clinical consequences, such as enamel crack propagation, cusp deflection, marginal and internal gaps, and decreased bond strength. Despite the absence of strong evidence relating polymerization shrinkage to secondary caries or fracture of posterior teeth, shrinkage stress has been associated with post-operative sensitivity and marginal stain. The latter is often erroneously used as a criterion for replacement of composite restorations. Therefore, an indirect correlation can emerge between shrinkage stress and the longevity of composite restorations or resin-bonded ceramic restorations. The relationship between shrinkage and stress can be best studied in laboratory experiments and a combination of various methodologies. The objective of this review article is to discuss the concept and consequences of polymerization shrinkage and shrinkage stress of composite resins and resin cements. Literature relating to polymerization shrinkage and shrinkage stress generation, research methodologies, and contributing factors are selected and reviewed. Clinical techniques that could reduce shrinkage stress and new developments on low-shrink dental materials are also discussed.

  20. Silent pituitary macroadenoma co-secreting growth hormone and thyroid stimulating hormone.

    Science.gov (United States)

    Sen, Orhan; Ertorer, M Eda; Aydin, M Volkan; Erdogan, Bulent; Altinors, Nur; Zorludemir, Suzan; Guvener, Nilgun

    2005-04-01

    Silent pituitary adenomas are a group of tumors showing heterogenous morphological features with no hormonal function observed clinically. To date no explanation has been provided as to why these tumors remain "silent". We report a case of a silent macroadenoma with both growth hormone (GH) and thyroid stimulating hormone (TSH) staining and secretion but with no clinical manifestations, in particular, the absence of features of acromegaly or hyperthyroidism. The relevant literature is reviewed.

  1. MR imaging of pituitary macroadenomas before and after transsphenoidal surgery

    International Nuclear Information System (INIS)

    Hald, J.K.; Nakstad, P.H.; Kollevold, T.; Bakke, S.J.; Skalpe, I.O.

    1992-01-01

    MR findings before and after transsphenoidal surgery were evaluated in 6 cases. T1-weighted (TR/TE 600/20) sagittal and coronal images with 2 or 4 acquisitions were obtained, using 3-mm slice thickness and 0.3-mm interslice gaps. Of 18 MR examinations, 13 included coronal i.v. contrast medium enhanced images. Image quality, sinus cavernosus invasion, identification of normal pituitary tissue and tumor size were examined. All MR studied clearly demonstrated the macroadenomas whether 2 or 4 acquisitions were used, and whether i.v. contrast medium was administered or not. Surgically confirmed sinus cavernosus infiltration was seen in 4 patients. The pituitary stalk was identified separate from the tumor in 2 patients, and the gland in one. There was reduction in tumor size over time, indicating that final radiologic assessment after transsphenoidal surgery is best performed 4 to 6 months postoperatively. It should not be necessary to routinely include i.v. contrast medium injection in the postoperative evaluation of macroadenomas. (orig.)

  2. Repeated transsphenoidal surgery for resection of pituitary adenoma.

    Science.gov (United States)

    Wang, Shousen; Xiao, Deyong; Wang, Rumi; Wei, Liangfeng; Hong, Jingfang

    2015-03-01

    To investigate the surgical strategy of repeated microscopic transsphenoidal surgery (TSS) for treatment of pituitary adenoma, surgical techniques and treatment outcomes for 29 patients with pituitary adenoma were reviewed and analyzed. There were 17 patients who underwent TSS 18 times and 12 patients who underwent TSS 13 times. The interval between each TSS ranged from 3 months to 18 years, with a median time of 4 years. The tumor height was 15 to 45 mm on the last surgery. Among the 29 patients, 16 patients underwent total tumor resection, 11 patients underwent subtotal resection, and 2 patients underwent partial resection. Cerebrospinal fluid leak occurred in 10 patients. Among 24 patients who were followed up effectively, 1 patient developed abducens paralysis after surgery, 1 patient had chronic diabetes insipidus, and 1 patient received steroid-dependent alternative treatment. The repeated TSS may present satisfied outcomes in experienced hands. The upper edge of the posterior choanae should be identified to ensure the right orientation. The openings of the anterior wall of the sphenoid sinus and the sellar floor should be appropriately expanded to improve tumor exposure. The artificial materials should be identified and removed carefully. Intraoperative cerebrospinal fluid leakage should be managed well.

  3. CT follow-up after radiation therapy for pituitary adenomas

    International Nuclear Information System (INIS)

    Rush, S.C.; Newall, J.

    1988-01-01

    Between 1973 and 1985, 105 patients received radiation therapy as all or part of their treatment for pituitary tumor at the New York University Medical Center. Of these, 48 patients underwent computed tomography (CT) at a minimum of 2 years following treatment, with detailed reports available for analysis of tumor regression. There were 28 men with a median age of 46 years (range, 18-71 years) and 20 women with a median age of 53 years (range, 28-80 years). Tumors were classified as secretory in 23 patients, nonsecretory in 21, and undetermined in four. Sixteen patients were treated with radiation therapy alone, 23 patients with surgery and radiation therapy, and the other with bromocriptine and radiation therapy, with or without surgery. With a median follow-up of 5 years (range, 2-14 years), 16 patients developed an empty sella, 25 patients had residual sellar mass, and seven patients had persistent extrasellar components or no change in their intrasellar mass. Among patients who did not have hypopituitarism at the inception of radiation therapy, five of 13 with empty sellas and 12 of 22 with residual mass subsequently required therapy. The authors conclude that residual mass is commonly found in long-term follow-up after radiation therapy, that isolated imaging studies revealing such findings after treatment in no way herald a diagnosis of recurrence, and that hypopituitarism following pituitary radiation therapy does not correlate with the ablation or persistence of tissue within the sella

  4. Shedding light on canine pituitary dwarfism

    OpenAIRE

    Voorbij, A.M.W.Y.

    2015-01-01

    Pituitary dwarfism, associated with growth hormone deficiency, is an autosomal, recessively inherited disorder in shepherd dogs. Due to the serious nature of pituitary dwarfism and lack of efficient treatment, it is preferable to prevent dwarfs from being born by applying a correct breeding policy. However, because pituitary dwarfism is a recessively inherited disorder and carriers do not differ phenotypically from non-carriers, genetic testing is required to prevent mating of 2 carriers. But...

  5. Sparse electromagnetic imaging using nonlinear iterative shrinkage thresholding

    KAUST Repository

    Desmal, Abdulla; Bagci, Hakan

    2015-01-01

    A sparse nonlinear electromagnetic imaging scheme is proposed for reconstructing dielectric contrast of investigation domains from measured fields. The proposed approach constructs the optimization problem by introducing the sparsity constraint to the data misfit between the scattered fields expressed as a nonlinear function of the contrast and the measured fields and solves it using the nonlinear iterative shrinkage thresholding algorithm. The thresholding is applied to the result of every nonlinear Landweber iteration to enforce the sparsity constraint. Numerical results demonstrate the accuracy and efficiency of the proposed method in reconstructing sparse dielectric profiles.

  6. Sparse electromagnetic imaging using nonlinear iterative shrinkage thresholding

    KAUST Repository

    Desmal, Abdulla

    2015-04-13

    A sparse nonlinear electromagnetic imaging scheme is proposed for reconstructing dielectric contrast of investigation domains from measured fields. The proposed approach constructs the optimization problem by introducing the sparsity constraint to the data misfit between the scattered fields expressed as a nonlinear function of the contrast and the measured fields and solves it using the nonlinear iterative shrinkage thresholding algorithm. The thresholding is applied to the result of every nonlinear Landweber iteration to enforce the sparsity constraint. Numerical results demonstrate the accuracy and efficiency of the proposed method in reconstructing sparse dielectric profiles.

  7. Significance of post-resection tissue shrinkage on surgical margins of oral squamous cell carcinoma.

    Science.gov (United States)

    El-Fol, Hossam Abdelkader; Noman, Samer Abduljabar; Beheiri, Mohamed Galal; Khalil, Abdalla M; Kamel, Mahmoud Mohamed

    2015-05-01

    Resecting oral squamous cell carcinoma (SCC) with an appropriate margin of uninvolved tissue is critical in preventing local recurrence and in making decisions regarding postoperative radiation therapy. This task can be difficult due to the discrepancy between margins measured intraoperatively and those measured microscopically by the pathologist after specimen processing. A total of 61 patients underwent resective surgery with curative intent for primary oral SCC were included in this study. All patients underwent resection of the tumor with a measured 1-cm margin. Specimens were then submitted for processing and reviewing, and histopathologic margins were measured. The closest histopathologic margin was compared with the in situ margin (1 cm) to determine the percentage discrepancy. The mean discrepancy between the in situ margins and the histopathological margins of all close and positive margins were 47.6% for the buccal mucosa (with a P value corresponding to 0.05 equaling 2.1), which is statistically significant, 4.8% for the floor of mouth, 9.5% for the mandibular alveolus, 4.8% for the retromolar trigon, and 33.3% for the tongue. There is a significant difference among resection margins based on tumor anatomical location. Margins shrinkage after resection and processing should be considered at the time of the initial resection. Tumors located in the buccal mucosa show significantly greater discrepancies than tumors at other sites. These findings suggest that it is critical to consider the oral site when outlining margins to ensure adequacy of resection. Buccal SCC is an aggressive disease, and should be considered as an aggressive subsite within the oral cavity, requiring a radical and aggressive resective approach. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Hereditary pituitary hyperplasia with infantile gigantism.

    Science.gov (United States)

    Gläsker, Sven; Vortmeyer, Alexander O; Lafferty, Antony R A; Hofman, Paul L; Li, Jie; Weil, Robert J; Zhuang, Zhengping; Oldfield, Edward H

    2011-12-01

    We report hereditary pituitary hyperplasia. The objective of the study was to describe the results of the clinical and laboratory analysis of this rare instance of hereditary pituitary hyperplasia. The study is a retrospective analysis of three cases from one family. The study was conducted at the National Institutes of Health, a tertiary referral center. A mother and both her sons had very early-onset gigantism associated with high levels of serum GH and prolactin. The condition was treated by total hypophysectomy. We performed clinical, pathological, and molecular evaluations, including evaluation basal and provocative endocrine testing, neuroradiological assessment, and assessment of the pituitary tissue by microscopic evaluation, immunohistochemistry, and electron microscopy. All three family members had very early onset of gigantism associated with abnormally high serum levels of GH and prolactin. Serum GHRH levels were not elevated in either of the boys. The clinical, radiographic, surgical, and histological findings indicated mammosomatotroph hyperplasia. The pituitary gland of both boys revealed diffuse mammosomatotroph hyperplasia of the entire pituitary gland without evidence of adenoma. Prolactin and GH were secreted by the same cells within the same secretory granules. Western blot and immunohistochemistry demonstrated expression of GHRH in clusters of cells distributed throughout the hyperplastic pituitary of both boys. This hereditary condition seems to be a result of embryonic pituitary maldevelopment with retention and expansion of the mammosomatotrophs. The findings suggest that it is caused by paracrine or autocrine pituitary GHRH secretion during pituitary development.

  9. Genetic disorders of the anterior pituitary gland.

    Science.gov (United States)

    Teller, W M

    1985-01-01

    This survey deals with disorders caused by genetically disturbed function of the anterior pituitary gland. Genetic Dwarfism may be caused by isolated growth hormone deficiency (IGHD) or panpituitary diseases, such as congenital absence of the pituitary or familial panhypopituitarism. Genetic disturbances of isolated pituitary hormone secretion without dwarfism may occur as isolated gonadotropin deficiency (IGD), isolated luteinizing hormone deficiency ("fertile eunuch"), Kallmann syndrome (olfactogenital dysplasia), isolated thyrotropin deficiency (ITD) and isolated corticotropin deficiency (ICD). Pituitary dysfunction may also be associated with other genetic disease entities.

  10. Application of intraoperative magnetic resonance imaging in large invasive pituitary adenoma surgery.

    Science.gov (United States)

    Li, Jie; Cong, Zixiang; Ji, Xueman; Wang, Xiaoliang; Hu, Zhigang; Jia, Yue; Wang, Handong

    2015-07-01

    To investigate the clinical application value of intraoperative magnetic resonance imaging (iMRI) in large invasive pituitary adenoma surgery. A total of 30 patients with large pituitary adenoma underwent microscopic tumor resection under the assistance of an iMRI system; 26 cases received surgery through the nasal-transsphenoidal approach, and the remaining four cases received surgery through the pterion approach. iMRI was performed one or two times depending on the need of the surgeon. If a residual tumor was found, further resection was conducted under iMRI guidance. iMRI revealed residual tumors in 12 cases, among which nine cases received further resection. Of these nine cases, iMRI rescanning confirmed complete resection in six cases, and subtotal resection in the remaining three. Overall, 24 cases of tumor were totally resected, and six cases were subtotally resected. The total resection rate of tumors increased from 60% to 80%. iMRI can effectively determine the resection extent of pituitary adenomas. In addition, it provides an objective basis for real-time judgment of surgical outcome, subsequently improving surgical accuracy and safety, and increasing the total tumor resection rate. Copyright © 2015. Published by Elsevier Taiwan.

  11. Tablets or scalpel: Pituitary hyperplasia due to primary hypothyroidism

    Directory of Open Access Journals (Sweden)

    Ahmed Imran Siddiqi, MBBS, MRCP

    2015-01-01

    Full Text Available We describe a patient with pituitary hyperplasia due to primary hypothyroidism. Pituitary hyperplasia and pituitary masses cannot be reliably differentiated on imaging alone, despite significant improvement in imaging quality in recent years.

  12. Quantitative evaluation of headache severity before and after endoscopic transsphenoidal surgery for pituitary adenoma.

    Science.gov (United States)

    Wolf, Amparo; Goncalves, Sandy; Salehi, Fateme; Bird, Jeff; Cooper, Paul; Van Uum, Stan; Lee, Donald H; Rotenberg, Brian W; Duggal, Neil

    2016-06-01

    OBJECT The relationship between headaches, pituitary adenomas, and surgical treatment of pituitary adenomas remains unclear. The authors assessed the severity and predictors of self-reported headaches in patients referred for surgery of pituitary adenomas and evaluated the impact of endoscopic transsphenoidal surgery on headache severity and quality of life (QOL). METHODS In this prospective study, 79 patients with pituitary adenomas underwent endoscopic transsphenoidal resection and completed the Headache Impact Test (HIT-6) and the 36-Item Short Form Health Survey (SF-36) QOL questionnaire preoperatively and at 6 weeks and 6 months postoperatively. RESULTS Preoperatively, 49.4% of patients had mild headache severity, 13.9% had moderate severity, 13.9% had substantial severity, and 22.8% had intense severity. Younger age and hormone-producing tumors predisposed greater headache severity, while tumor volume, suprasellar extension, chiasmal compression, and cavernous sinus invasion of the pituitary tumors did not. Preoperative headache severity was found to be significantly associated with reduced scores across all SF-36 QOL dimensions and most significantly associated with mental health. By 6 months postoperatively, headache severity was reduced in a significant proportion of patients. Of the 40 patients with headaches causing an impact on daily living (moderate, substantial, or intense headache), 70% had improvement of at least 1 category on HIT-6 by 6 months postoperatively, while headache worsened in 7.6% of patients. The best predictors of headache response to surgery included younger age, poor preoperative SF-36 mental health score, and hormone-producing microadenoma. CONCLUSIONS The results of this study confirm that surgery can significantly improve headaches in patients with pituitary adenomas by 6 months postoperatively, particularly in younger patients whose preoperative QOL is impacted. A larger multicenter study is underway to evaluate the long

  13. Histopathological features of post-mortem pituitaries: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Francisco José Tortosa Vallecillos

    Full Text Available SUMMARY Objective: As a result of the use of neuroimaging techniques, silent pituitary lesions are diagnosed more and more frequently; however, there are few published post-mortem studies about this gland. Incidence data of pituitary lesions are rare and in Portugal they are outdated or even non-existent. The aim of this study is to determine the prevalence of normal patterns and incidental post-mortem pituitary pathology at Centro Hospitalar Lisboa Norte, analyzing the associations with clinical data and assessing the clinical relevance of the findings. Method: We reviewed retrospectively and histologically 167 pituitaries of a consecutive series of autopsies from the Department of Pathology of this centre. They were done between 2012 and 2014, and in all cases medical records were reviewed. The morphological patterns observed, were classified into three major groups: 1 Normal histological patterns and variants; 2 Infectious-inflammatory pathology, metabolic and vascular disorders; 3 Incidental primary proliferation and secondary to systemic diseases. Results: The subjects included in this study were of all age groups (from 1 day to 91 years old, 71 were female and 96 male. Fifty-seven of these glands didn’t show any alteration; 51 showed colloid cysts arising from Rathke cleft; 44 presented hyperplasia in adenohypophysis and we identified 20 adenomas in 19 glands (immunohistochemically, eight PRL-producing and five ACTH-producing tumors, ten of which associated with obesity, 11 to hypertension and six to diabetes mellitus. There were two cases with metastasis. Conclusion: Subclinical pathology in our country is similar to that seen in other parts of the world, but at older ages.

  14. Gamma knife radiosurgery for endocrine-inactive pituitary adenomas

    International Nuclear Information System (INIS)

    Liscak, R.; Vladyka, V.; Simonova, G.; Marek, J.; Vymazal, J.

    2007-01-01

    The goal of nonsecreting pituitary adenoma radiosurgery is to halt tumor growth and to maintain normal performance of the hypophysis and the functionally important structures around the sella. The effectiveness of gamma knife radiosurgery was evaluated. Over a period of 10 years (1993-2003), 140 patients with nonsecreting pituitary adenoma were treated by Leksell gamma knife at our Centre. Seventy-nine of them were followed up for longer than 3 years. Their age range was 24-73 years, with a median of 54 years. Eighty-five percent of them had previous open surgery. Fifteen patients had adenoma contact with the optic tract. Fourteen patients had a normally functioning hypophysis, 48 patients had complete panhypopituitarism, while the rest retained partial functions of the normal hypophysis. Adenoma volumes ranged between 0.1 and 31.3, the median being 3.45 ccm. The marginal dose ranged between 12 and -35 Gy, with a median of 20 Gy. The follow-up ranged from 36 to 122 months, with a median of 60 months. No adenoma growth was detected; 89 % of treated adenomas decreased in size, with a median volume reduction of 61 %. There was no perimeter vision impairment after radiosurgery, while 4 out of 52 patients with abnormal perimeter vision reported improvement. There was no impairment of oculomotor nerve function. Impairment of hypophysis function was observed in 2 patients. Radiosurgery has a reliable antiproliferative effect on nonsecreting pituitary adenomas. It is a safe treatment with a low risk of morbidity. Short contact between a nonsecreting pituitary adenoma and the optic pathway is not an absolute contraindication for Gamma knife radiosurgery. (author)

  15. Expression of Eag1 K+ channel and ErbBs in human pituitary adenomas: cytoskeleton arrangement patterns in cultured cells.

    Science.gov (United States)

    del Pliego, Margarita González; Aguirre-Benítez, Elsa; Paisano-Cerón, Karina; Valdovinos-Ramírez, Irene; Rangel-Morales, Carlos; Rodríguez-Mata, Verónica; Solano-Agama, Carmen; Martín-Tapia, Dolores; de la Vega, María Teresa; Saldoval-Balanzario, Miguel; Camacho, Javier; Mendoza-Garrido, María Eugenia

    2013-01-01

    Pituitary adenomas can invade surrounded tissue, but the mechanism remains elusive. Ether à go-go-1 (Eag1) potassium channel and epidermal growth factor receptors (ErbB1 and ErbB2) have been associated to invasive phenotypes or poor prognosis in cancer patients. However, cells arrange their cytoskeleton in order to acquire a successful migration pattern. We have studied ErbBs and Eag1 expression, and cytoskeleton arrangements in 11 human pituitary adenomas. Eag1, ErbB1 and ErbB2 expression were studied by immunochemistry in tissue and cultured cells. The cytoskeleton arrangement was analyzed in cultured cells by immunofluorescence. Normal pituitary tissue showed ErbB2 expression and Eag1 only in few cells. However, Eag1 and ErbB2 were expressed in all the tumors analyzed. ErbB1 expression was observed variable and did not show specificity for a tumor characteristic. Cultured cells from micro- and macro-adenomas clinically functional organize their cytoskeleton suggesting a mesenchymal pattern, and a round leucocyte/amoeboid pattern from invasive clinically silent adenoma. Pituitary tumors over-express EGF receptors and the ErbB2 repeated expression suggests is a characteristic of adenomas. Eag 1 was express, in different extent, and could be a therapeutic target. The cytoskeleton arrangements observed suggest that pituitary tumor cells acquire different patterns: mesenchymal, and leucocyte/amoeboid, the last observed in the invasive adenomas. Amoeboid migration pattern has been associated with high invasion capacity.

  16. Pituitary disorders and their extra-pituitary implications : observations in patients with nonfunctioning pituitary macroadenoma and the IGSF1 deficiency syndrome

    NARCIS (Netherlands)

    Joustra, S.D.

    2016-01-01

    In this thesis, we explored pituitary functioning and extra-pituitary implications of two pituitary disorders in humans. In part A, we focused on the long-term consequences of the diagnosis and treatment of nonfunctioning pituitary macroadenoma (NFMA) on hypothalamic regulation of circadian

  17. Investigation of Shrinkage Defect in Castings by Quantitative Ishikawa Diagram

    Directory of Open Access Journals (Sweden)

    Chokkalingam B.

    2017-03-01

    Full Text Available Metal casting process involves processes such as pattern making, moulding and melting etc. Casting defects occur due to combination of various processes even though efforts are taken to control them. The first step in the defect analysis is to identify the major casting defect among the many casting defects. Then the analysis is to be made to find the root cause of the particular defect. Moreover, it is especially difficult to identify the root causes of the defect. Therefore, a systematic method is required to identify the root cause of the defect among possible causes, consequently specific remedial measures have to be implemented to control them. This paper presents a systematic procedure to identify the root cause of shrinkage defect in an automobile body casting (SG 500/7 and control it by the application of Pareto chart and Ishikawa diagram. with quantitative Weightage. It was found that the root causes were larger volume section in the cope, insufficient feeding of riser and insufficient poured metal in the riser. The necessary remedial measures were taken and castings were reproduced. The shrinkage defect in the castings was completely eliminated.

  18. Radiotherapy for pituitary adenoma: long-term outcome and sequelae

    International Nuclear Information System (INIS)

    McCord, Mark W.; Buatti, John M.; Fennel, Eileen M.; Mendenhall, William M.; Marcus, Robert B.; Friedman, William A.; Rhoton, Albert L.

    1996-01-01

    Purpose/Objective: To review outcome and treatment sequelae in patients treated with external-beam radiotherapy for pituitary adenomas. Materials and Methods: One hundred forty-one patients with pituitary adenomas received radiotherapy and had 2-year minimum follow-up. One hundred twenty-one patients had newly diagnosed adenomas and 20 patients had recurrent tumors. Newly diagnosed tumors were treated with surgery and radiotherapy (S + RT; n=98) or radiotherapy alone (RT; n=23). Patients with recurrent tumors received salvage treatment with S+RT (n=10) or RT (n=10). The impact of age, sex, presenting symptoms, tumor extent, surgery type, degree of resection, hormonal activity, primary or salvage therapy, and radiotherapy dose on local control and cause-specific survival was analyzed. Effect of therapy on vision, hormonal function, life satisfaction, neurocognitive function, and affective symptoms was examined. A Likert scale survey was used for assessment of life satisfaction, neurocognitive status, and affective symptoms after therapy. Survey results from the RT patients were compared to a control group treated with transsphenoidal surgery alone (S). Survival analysis employed the Kaplan-Meier method. Multivariate analysis used the forward step-wise sequence of chi-squares for the log-rank test. Results: At 10 years, local control for the S+RT group (S + RT) was 95% and not statistically different (p=.58) than for patients in the RT group (90%). Cause-specific survival rates were also similar (p=.88) between the S+RT (97%) and RT (99%) groups. Patients with prolactin- and ACTH-secreting tumors had significantly worse local control, as did patients treated for recurrent tumors. Cause-specific survival was not decreased in any patient group. Multivariate analysis for local control and cause-specific survival revealed only young age to be predictive of worse outcome (p=.0354 and p=.0355 respectively). Visual function was either unaffected or improved in most patients

  19. Pituitary gigantism: a retrospective case series.

    Science.gov (United States)

    Creo, Ana L; Lteif, Aida N

    2016-05-01

    Pituitary gigantism (PG) is a rare pediatric disease with poorly defined long-term outcomes. Our aim is to describe the longitudinal clinical course in PG patients using a single-center, retrospective cohort study. Patients younger than 19 years diagnosed with PG were identified. Thirteen cases were confirmed based on histopathology of a GH secreting adenoma or hyperplasia and a height >2 SD for age and gender. Laboratory studies, initial pathology, and imaging were abstracted. Average age at diagnosis was 13 years with an average initial tumor size of 7.4×3.8 mm. Initial transsphenoidal surgery was curative in 3/12 patients. Four of the nine patients who failed the initial surgery required a repeat procedure. Octreotide successfully normalized GH levels in 1/6 patients with disease refractory to surgery (1/6). Two out of five patients received pegvisomant after failing octreotide but only one patient responded to treatment. Five patients were ultimately treated with radiosurgery or radiation patients were followed for an average of 10 years. PG is difficult to treat. In most patients, the initial transsphenoidal surgery failed to normalize GH levels. If the initial surgery was unsuccessful, repeat surgery was unlikely to control GH secretion. Treatment with octreotide or pegvisomant was successful in less than half the patients failing surgery. Radiosurgery was curative, but is not an optimal treatment for pediatric patients. Despite the small sample, our study suggests that the treatment outcome of pediatric PG may be different than adults.

  20. Chemotherapy-Induced Regression of an Adrenocorticotropin-Secreting Pituitary Carcinoma Accompanied by Secondary Adrenal Insufficiency

    Directory of Open Access Journals (Sweden)

    Robert Frank Cornell

    2013-01-01

    Full Text Available Purpose. Adrenocorticotropin- (ACTH- secreting pituitary carcinomas are rare and require multimodality treatment. The aim of this study was to report the response to various therapies and discuss the potential development of secondary adrenal insufficiency with cytotoxic chemotherapy. Methods. This report describes a man with a large silent corticotroph adenoma progressing to endogenous hypercortisolism and metastatic ACTH-secreting pituitary carcinoma over a period of 14 years. Results. Seven years after initial presentation, progressive tumor enlargement associated with the development of hypercortisolism mandated multiple pituitary tumor debulking procedures and radiotherapy. Testing of the Ki-67 proliferation index was markedly high and he developed a hepatic metastasis. Combination therapy with cisplatin and etoposide resulted in a substantial reduction in tumor size, near-complete regression of his liver metastasis, and dramatic decrease in ACTH secretion. This unexpectedly resulted in symptomatic secondary adrenal insufficiency. Conclusions. This is the first reported case of secondary adrenal insufficiency after use of cytotoxic chemotherapy for metastatic ACTH-secreting pituitary carcinoma. High proliferative indices may be predictive of dramatic responses to chemotherapy. Given the potential for such responses, the development of secondary adrenal insufficiency may occur and patients should be monitored accordingly.

  1. Design changes of device to investigation of alloys linear contraction and shrinkage stresses

    Directory of Open Access Journals (Sweden)

    J. Mutwil

    2009-07-01

    Full Text Available Some design changes in device elaborated by author to examination of linear contraction and shrinkage stresses progress of metals and alloys during– and after solidification have been described. The introduced changes have been focused on design of closing of shrinkage test rod mould. The introduced changes have been allowed to simplify a mounting procedure of thermocouples measuring a temperature of the shrinkage rod casting (in 6 points. Exemplary investigation results of linear contraction and shrinkage stresses development in Al-Si13.5% alloy have been presented.

  2. Topology optimization of reinforced concrete structures considering control of shrinkage and strength failure

    DEFF Research Database (Denmark)

    Luo, Yangjun; Wang, Michael Yu; Zhou, Mingdong

    2015-01-01

    To take into account the shrinkage effect in the early stage of Reinforced Concrete (RC) design, an effective continuum topology optimization method is presented in this paper. Based on the power-law interpolation, shrinkage of concrete is numerically simulated by introducing an additional design......-dependent force. Under multi-axial stress conditions, the concrete failure surface is well fitted by two Drucker-Prager yield functions. The optimization problem aims at minimizing the cost function under yield strength constraints on concrete elements and a structural shrinkage volume constraint. In conjunction...... to ensure the structural safety under the combined action of external loads and shrinkage....

  3. Risks and Benefits of Endoscopic Transsphenoidal Surgery for Nonfunctioning Pituitary Adenomas in Patients of the Ninth Decade.

    Science.gov (United States)

    Chinezu, Rares; Fomekong, Franklin; Lasolle, Héllène; Trouillas, Jacqueline; Vasiljevic, Alexandre; Raverot, Gerald; Jouanneau, Emmanuel

    2017-10-01

    The population older than 80 years of age (very elderly) is increasing, and the management of these patients with pituitary surgery is controversial. To determine the prevalence of pituitary tumors in elderly patients and to determine the safety of endoscopic transsphenoidal pituitary surgery for nonfunctioning pituitary adenomas in patients aged older than 80 years. This retrospective study included elderly (65-75 years old) and very elderly consecutive patients operated between 2007 and 2015 for nonfunctioning pituitary adenomas. Tumor characteristics, comorbidities, pre- and postoperative visual and endocrinologic status, and postoperative complications were compared. Of the total 623 operated patients, 307 had nonfunctioning pituitary adenomas. Twenty-three percent (n = 143) of all patients were aged older than 65 years, whereas 2.56% (n = 16) were aged older than 80 years. Gonadotroph and nonimmunoreactive tumors occurred in 81% of patients aged older than 65 years. The study groups were Group A, comprising 15 patients aged older than 80 years, and Group B, comprising 49 patients aged 65-75 years. No presurgical statistical differences were noted between the 2 groups. Complete tumor resection was achieved in 53.3% of Group A and 73.5% of Group B. Postsurgical visual status improved significantly in Group A than in Group B (P = 0.0012). No deaths occurred, and no group differences were noted in the postoperative complications. Age exceeding 80 years is not by itself a predictor of worse clinical outcome of endoscopic transsphenoidal pituitary surgery for nonfunctioning adenomas. Emphasis should be placed on visual pathway decompression for the quality of life in very old people. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Microsurgical therapy of pituitary adenomas.

    Science.gov (United States)

    Mortini, Pietro; Barzaghi, Lina Raffaella; Albano, Luigi; Panni, Pietro; Losa, Marco

    2018-01-01

    We report the efficacy and safety of transsphenoidal microsurgery in a large and homogeneous cohort of patients with pituitary adenomas (PAs) treated at a single Institute by a single neurosurgeon. A total of 2145 consecutive patients undergoing first surgery for a PA were included: 795 (37.1%) had a nonfunctioning pituitary adenoma (NFPA), 595 (27.7%) acromegaly, 496 (23.1%) Cushing's disease, 208 (9.7%) a PRL-secreting adenoma, and 51 patients (2.4%) a TSH-secreting adenoma. Remission was achieved when strict hormonal and radiological criteria were met. Early surgical remission was achieved in 66% of acromegalic patients, 79.6% of patients with Cushing's disease, 64.4% of prolactinomas, 74.5% of patients with a TSH-secreting adenoma, and 66.9% of NFPAs. The mean (±SE) follow-up was 60.1 ± 1.3 months. The recurrence-free survival at 10 years was 78.2% in acromegalic patients, 68.1% in prolactinomas, 74.3% in Cushing's disease, 70.3% in TSH-secreting adenomas, and 75.3% in NFPAs. Preoperative hypoadrenalism recovered in 35.3%, hypogonadism in 43.3% and hypothyroidism in 37.4% of patients with impaired function before surgery. The mortality rate was 0.2% and major morbidity 2.1%. New onset hypoadrenalism occurred after surgery in 2.5% of patients at risk, hypogonadism in 4.1%, and hypothyroidism in 1.8%. Permanent diabetes insipidus (DI) occurred in 0.9% of patients. In experienced hands, transsphenoidal microsurgery for PAs achieves remission in most patients with a low complication rate. Pituitary function is preserved in most cases and can recover in more than one-third of patients with preoperative hypopituitarism.

  5. Pituitary Gigantism: A Case Report

    Directory of Open Access Journals (Sweden)

    Rana Bhattacharjee

    2012-01-01

    Full Text Available Objective: To present a rare case of gigantism. Case Report: A 25-year-old lady presented with increased statural growth and enlarged body parts noticed since the age of 14 years, primary amenorrhea, and frontal headache for the last 2 years.She has also been suffering from non-inflammatory low back pain with progressive kyphosis and pain in the knees, ankles, and elbows for the last 5 years. There was no history of visual disturbance, vomiting, galactorrhoea, cold intolerance. She had no siblings. Family history was non-contributory.Blood pressure was normal. Height 221 cm, weight 138 kg,body mass index (BMI28. There was coarsening of facial features along with frontal bossing and prognathism, large hands and feet, and