BACKGROUND Pituitary gland metastasis is an unusual event,and pituitary metastasis from lung adenocarcinoma is extremely rare and associated with poor prognosis.To date,approximately 15 cases have been reported.CASE S...BACKGROUND Pituitary gland metastasis is an unusual event,and pituitary metastasis from lung adenocarcinoma is extremely rare and associated with poor prognosis.To date,approximately 15 cases have been reported.CASE SUMMARY Here,we present the case of a 64-year-old woman with pituitary metastasis derived from lung adenocarcinoma,which was difficult to distinguish from other sellar tumors.The patient presented to the neurosurgery clinic with blurred vision and intermittent headache.During hospitalization,brain computed tomography(CT)and magnetic resonance imaging revealed a pituitary macroadenoma.Chest CT revealed irregular nodules in the basal segment of the lower lobe of the left lung,which were likely lung cancer.Positron emission tomography-CT revealed a carbohydrate metabolism tumor in the lungs and sellar region,which was considered malignant.Postoperative pathological examination of the sellar tumor revealed lung adenocarcinoma.CONCLUSION Excision of pituitary metastases combined with radiotherapy and chemotherapy should be a priority treatment for patients with pituitary metastasis.展开更多
Dopamine agonists effectively reduce the secretion of prolactin (PRL) in the great majority of prolactinomas and reduce the bulk of the adenomas, as well as have partial therapeutic effect on some patients with acrome...Dopamine agonists effectively reduce the secretion of prolactin (PRL) in the great majority of prolactinomas and reduce the bulk of the adenomas, as well as have partial therapeutic effect on some patients with acromegaly. The inhibitory effect of bromocriptine (BC), a dopamine agonist, on growth hormone (GH) and PRL secretion of dispersed cells from the pituitary adenomas of 16 cases of acromegaly, which secret GH and PRL simultaneously, were evaluated in vitro. The significant inhibitory effects of BC on PRL secretion were found in 12 cases. It was also found that PRL secretion was strongly inhibited when GH was suppressed; on the contrary, when GH secretion was not suppressed, the production of PRL was not or weakly inhibited. The exact mechanism of the effects is nuclear so far. It is necessary to investigate, at molecular level, the etiology of GH-PRL adenomas and its response to therapeutic agents.展开更多
Nowdays the application of immunohistochemical techniques and ultrastructuralanalysis and correlation with clinical and biochemical findings have led to a moredetailed functional classification,in which growth hormone...Nowdays the application of immunohistochemical techniques and ultrastructuralanalysis and correlation with clinical and biochemical findings have led to a moredetailed functional classification,in which growth hormone (GH)-producing andprolactin (PRL)-producing adenomas have been shown to comprise more than halfof pituitary adenomaso.Few immunoelectron microscopic studies on GH and PRLadenomas have been made,however,in limited cases so far,though a numberof authors have described the characteristics of pituitary adenomas by conventionalelectron microscopy.In addition to routine electron microscopy,immuno-.electron microscopical technique using protein A-gold probes was applied in展开更多
Objective： The aim of the study was to explore the bone morphogenetic protein 4 （BMP-4） how to regulate pro- lactin （PRL） secreting, cell proliferation and invasiveness in human prolactinorna. Methods： Ten patie...Objective： The aim of the study was to explore the bone morphogenetic protein 4 （BMP-4） how to regulate pro- lactin （PRL） secreting, cell proliferation and invasiveness in human prolactinorna. Methods： Ten patients who diagnosed as prolactinoma by clinical characteristics and pathology were divided into two groups, one was sensitive to Brornocriptine, the other was insensitive to Brornocriptine. Every case was conducted by primal cell culture then treated by different concentrations of BMP-4. The cell configuration was observed and PRL hormone was measured in different times. The expressions of BMP-4 rnRNA and BMP-4 in 37 cases of prolactinorna and 8 cases of normal pituitary tissues samples were detected by immunohistochemical and in situ hybridization technique, and the results were analyzed by statistic methods. Results： BMP-4 （5 ng/rnL） could accelerate the secreting of PRL in prolactinorna cell, and it could reach the greatest effect in the concentration of 20 ng/mL. BMP-4 could increase prolactinoma cell proliferation, but when the concentration was 50 ng/rnL, the BMP-4 effect of increasing secreting decreased. When 100 ng/mL, the cell began to die. The effects of the BMP-4 in sensitive group and insensitive group had no difference. The BMP-4 was highly expressed in the prolactinornas and was positively related with the invasiveness grades. Conclusion： BMP-4 have positive regulation in prolactinoma secreting, proliferation, invasiveness effects, BMP-4 probably has the important role in prolactinoma pathogenesis.展开更多
BACKGROUND： Manganese （Mn） and iron （Fe） are the primary elements of welding rods. Mn has been shown to increase prolactin （PRL） production by decreasing dopamine （DA） levels in the hypothalamus. However, Fe ...BACKGROUND： Manganese （Mn） and iron （Fe） are the primary elements of welding rods. Mn has been shown to increase prolactin （PRL） production by decreasing dopamine （DA） levels in the hypothalamus. However, Fe increases DA levels and decreases PRL levels. The toxic mechanism of Mn and Fe co-inhalation-induced regulation of the hypothalamic-hypophyseal-pituitary axis remains unclear. OBJECTIVE： To evaluate the effects of co-inhaled Mn and Fe on hypothalamic DA levels and pituitary PRL production, to investigate whether these changes are reversible, and to determine the role of co-inhaled Mn and Fe. DESIGN, TIME AND SETTING： A randomized, controlled, animal experiment based on inhalation toxicity via whole-body exposure was performed. Hypothalamic DA levels, serum PRL, and PRL and PiN mRNA levels were analyzed at the Institute of Environmental and Occupational Medicine, Inje University, Busan, Korea, from August 2007 to May 2009. MATERIALS： MnSO4 and FeSO4 were purchased from Sigma-Aldrich, St. Louis, MO, USA. High-performance liquid chromatography （HPLC） using an electrochemical detector （ECD） was purchased from Waters Corporation, Milford, MA, USA. mRNA Capture Kit and reverse transcription-polymerase chain reaction （RT-PCR） kit were obtained from Roche Molecular Biochemicals, Mannheim, Germany and Perkin-Elmer, Wellesley, MA, USA, respectively. Rat PRL enzyme-linked immunosorbent assay kit was purchased from Biocode Hycel, Liege, Belgium. METHODS： Eighty 15-week-old, male, Fischer 344 rats were assigned to two groups： one group treated with Mn and Fe and a control group. Each group was sub-divided into four groups on the basis of treatment period （0- and 13-week treated groups with both chemicals） and recovery periods （4- and 13-week recovery groups following 13-week exposure to both chemicals）. The treatment condition was 6 hours per day, 5 days per week, for the entire body. Mn and Fe co-inhalation concentrations were 1.5 mg/m3 and 3.0 mg/m3, respectively. MAIN OUTCOME MEASURES： Hypothalamic DA levels were measured using HPLC-ECD analysis mRNA levels of PRL and Pit-1 were analyzed by Northern blot hybridization and RT-PCR, respectively. Serum PRL levels were measured by enzyme-linked immunosorbent assay. RESULTS： HPLC-ECD analysis revealed that following 13-week co-inhalation of Mn and Fe, hypothalamic DA levels significantly deceased, whereas pituitary PRL mRNA, Pit-1 mRNA, and serum PRL levels significantly increased. At 4 weeks of recovery, DA level in the hypothalamic tissue was significantly increased, and PRL and Pit-1 mRNA levels in the pituitary were significantly decreased. After 13 weeks of recovery, DA and PRL levels recovered to normal. The changing pattern of serum PRL levels was in accordance with pituitary PRL mRNA levels. CONCLUSION： Subchronic co-inhalation of Mn and Fe significantly decreased hypothalamic DA levels, but induced pituitary PRL production, both of which were mediated by Pit-1. These results suggested that Mn dominates over Fe in terms of hypothalamic DA levels and pituitary PRL production, and these effects are reversible in a subchronic inhalation condition. Therefore, changes in hypothalamic DA levels and serum PRL production could be used as biomarkers for welders, who are exposed to Mn and Fe.展开更多
Introduction: In the context of pituitary adenoma, bacterial meningitis is a possible complication of surgical or medical treatment. The occurrence of meningitis before any treatment is exceptional, explained by the e...Introduction: In the context of pituitary adenoma, bacterial meningitis is a possible complication of surgical or medical treatment. The occurrence of meningitis before any treatment is exceptional, explained by the existence of an osteomeningeal breach caused by the adenoma whose main symptom is rhinorrhea. Case Report: We report a case of bacterial meningitis complicating a prolactin pituitary macroadenoma. The patient had been referred for jet vomiting in a febrile context preceded by headaches and visual blurring. There was no rhinorrhea. The examination revealed a meningeal syndrome and the diagnosis of acute bacterial meningitis was made. The isolated germ was the pneumococcus. Faced with headaches and visual blurring, a cerebral scan revealed a pituitary macroadenoma and pituitary hormone dosage had shown hyperprolactinemia. The meningitis was sterilized and the prolactinoma was treated with dopaminergic agonists. This allowed the normalization of prolactinemia and the disappearance of symptoms. Conclusion: The pituitary adenoma was complicated by bacterial meningitis without treatment and the presence of a meningeal breach. Hormonal and bacterial treatments have been successful.展开更多
文摘BACKGROUND Pituitary gland metastasis is an unusual event,and pituitary metastasis from lung adenocarcinoma is extremely rare and associated with poor prognosis.To date,approximately 15 cases have been reported.CASE SUMMARY Here,we present the case of a 64-year-old woman with pituitary metastasis derived from lung adenocarcinoma,which was difficult to distinguish from other sellar tumors.The patient presented to the neurosurgery clinic with blurred vision and intermittent headache.During hospitalization,brain computed tomography(CT)and magnetic resonance imaging revealed a pituitary macroadenoma.Chest CT revealed irregular nodules in the basal segment of the lower lobe of the left lung,which were likely lung cancer.Positron emission tomography-CT revealed a carbohydrate metabolism tumor in the lungs and sellar region,which was considered malignant.Postoperative pathological examination of the sellar tumor revealed lung adenocarcinoma.CONCLUSION Excision of pituitary metastases combined with radiotherapy and chemotherapy should be a priority treatment for patients with pituitary metastasis.
文摘Dopamine agonists effectively reduce the secretion of prolactin (PRL) in the great majority of prolactinomas and reduce the bulk of the adenomas, as well as have partial therapeutic effect on some patients with acromegaly. The inhibitory effect of bromocriptine (BC), a dopamine agonist, on growth hormone (GH) and PRL secretion of dispersed cells from the pituitary adenomas of 16 cases of acromegaly, which secret GH and PRL simultaneously, were evaluated in vitro. The significant inhibitory effects of BC on PRL secretion were found in 12 cases. It was also found that PRL secretion was strongly inhibited when GH was suppressed; on the contrary, when GH secretion was not suppressed, the production of PRL was not or weakly inhibited. The exact mechanism of the effects is nuclear so far. It is necessary to investigate, at molecular level, the etiology of GH-PRL adenomas and its response to therapeutic agents.
文摘Nowdays the application of immunohistochemical techniques and ultrastructuralanalysis and correlation with clinical and biochemical findings have led to a moredetailed functional classification,in which growth hormone (GH)-producing andprolactin (PRL)-producing adenomas have been shown to comprise more than halfof pituitary adenomaso.Few immunoelectron microscopic studies on GH and PRLadenomas have been made,however,in limited cases so far,though a numberof authors have described the characteristics of pituitary adenomas by conventionalelectron microscopy.In addition to routine electron microscopy,immuno-.electron microscopical technique using protein A-gold probes was applied in
文摘Objective： The aim of the study was to explore the bone morphogenetic protein 4 （BMP-4） how to regulate pro- lactin （PRL） secreting, cell proliferation and invasiveness in human prolactinorna. Methods： Ten patients who diagnosed as prolactinoma by clinical characteristics and pathology were divided into two groups, one was sensitive to Brornocriptine, the other was insensitive to Brornocriptine. Every case was conducted by primal cell culture then treated by different concentrations of BMP-4. The cell configuration was observed and PRL hormone was measured in different times. The expressions of BMP-4 rnRNA and BMP-4 in 37 cases of prolactinorna and 8 cases of normal pituitary tissues samples were detected by immunohistochemical and in situ hybridization technique, and the results were analyzed by statistic methods. Results： BMP-4 （5 ng/rnL） could accelerate the secreting of PRL in prolactinorna cell, and it could reach the greatest effect in the concentration of 20 ng/mL. BMP-4 could increase prolactinoma cell proliferation, but when the concentration was 50 ng/rnL, the BMP-4 effect of increasing secreting decreased. When 100 ng/mL, the cell began to die. The effects of the BMP-4 in sensitive group and insensitive group had no difference. The BMP-4 was highly expressed in the prolactinornas and was positively related with the invasiveness grades. Conclusion： BMP-4 have positive regulation in prolactinoma secreting, proliferation, invasiveness effects, BMP-4 probably has the important role in prolactinoma pathogenesis.
文摘BACKGROUND： Manganese （Mn） and iron （Fe） are the primary elements of welding rods. Mn has been shown to increase prolactin （PRL） production by decreasing dopamine （DA） levels in the hypothalamus. However, Fe increases DA levels and decreases PRL levels. The toxic mechanism of Mn and Fe co-inhalation-induced regulation of the hypothalamic-hypophyseal-pituitary axis remains unclear. OBJECTIVE： To evaluate the effects of co-inhaled Mn and Fe on hypothalamic DA levels and pituitary PRL production, to investigate whether these changes are reversible, and to determine the role of co-inhaled Mn and Fe. DESIGN, TIME AND SETTING： A randomized, controlled, animal experiment based on inhalation toxicity via whole-body exposure was performed. Hypothalamic DA levels, serum PRL, and PRL and PiN mRNA levels were analyzed at the Institute of Environmental and Occupational Medicine, Inje University, Busan, Korea, from August 2007 to May 2009. MATERIALS： MnSO4 and FeSO4 were purchased from Sigma-Aldrich, St. Louis, MO, USA. High-performance liquid chromatography （HPLC） using an electrochemical detector （ECD） was purchased from Waters Corporation, Milford, MA, USA. mRNA Capture Kit and reverse transcription-polymerase chain reaction （RT-PCR） kit were obtained from Roche Molecular Biochemicals, Mannheim, Germany and Perkin-Elmer, Wellesley, MA, USA, respectively. Rat PRL enzyme-linked immunosorbent assay kit was purchased from Biocode Hycel, Liege, Belgium. METHODS： Eighty 15-week-old, male, Fischer 344 rats were assigned to two groups： one group treated with Mn and Fe and a control group. Each group was sub-divided into four groups on the basis of treatment period （0- and 13-week treated groups with both chemicals） and recovery periods （4- and 13-week recovery groups following 13-week exposure to both chemicals）. The treatment condition was 6 hours per day, 5 days per week, for the entire body. Mn and Fe co-inhalation concentrations were 1.5 mg/m3 and 3.0 mg/m3, respectively. MAIN OUTCOME MEASURES： Hypothalamic DA levels were measured using HPLC-ECD analysis mRNA levels of PRL and Pit-1 were analyzed by Northern blot hybridization and RT-PCR, respectively. Serum PRL levels were measured by enzyme-linked immunosorbent assay. RESULTS： HPLC-ECD analysis revealed that following 13-week co-inhalation of Mn and Fe, hypothalamic DA levels significantly deceased, whereas pituitary PRL mRNA, Pit-1 mRNA, and serum PRL levels significantly increased. At 4 weeks of recovery, DA level in the hypothalamic tissue was significantly increased, and PRL and Pit-1 mRNA levels in the pituitary were significantly decreased. After 13 weeks of recovery, DA and PRL levels recovered to normal. The changing pattern of serum PRL levels was in accordance with pituitary PRL mRNA levels. CONCLUSION： Subchronic co-inhalation of Mn and Fe significantly decreased hypothalamic DA levels, but induced pituitary PRL production, both of which were mediated by Pit-1. These results suggested that Mn dominates over Fe in terms of hypothalamic DA levels and pituitary PRL production, and these effects are reversible in a subchronic inhalation condition. Therefore, changes in hypothalamic DA levels and serum PRL production could be used as biomarkers for welders, who are exposed to Mn and Fe.
文摘Introduction: In the context of pituitary adenoma, bacterial meningitis is a possible complication of surgical or medical treatment. The occurrence of meningitis before any treatment is exceptional, explained by the existence of an osteomeningeal breach caused by the adenoma whose main symptom is rhinorrhea. Case Report: We report a case of bacterial meningitis complicating a prolactin pituitary macroadenoma. The patient had been referred for jet vomiting in a febrile context preceded by headaches and visual blurring. There was no rhinorrhea. The examination revealed a meningeal syndrome and the diagnosis of acute bacterial meningitis was made. The isolated germ was the pneumococcus. Faced with headaches and visual blurring, a cerebral scan revealed a pituitary macroadenoma and pituitary hormone dosage had shown hyperprolactinemia. The meningitis was sterilized and the prolactinoma was treated with dopaminergic agonists. This allowed the normalization of prolactinemia and the disappearance of symptoms. Conclusion: The pituitary adenoma was complicated by bacterial meningitis without treatment and the presence of a meningeal breach. Hormonal and bacterial treatments have been successful.
