OBJECTIVE The current retrospective study aims to evaluate the management of non-functioning the assessment of experience on pituitary macroadenoma through clinical, biochemical, radiological features, and treatment o...OBJECTIVE The current retrospective study aims to evaluate the management of non-functioning the assessment of experience on pituitary macroadenoma through clinical, biochemical, radiological features, and treatment outcome of patients, and to identify prognostic factors affecting progression-free survival （PFS）. METHODS Data of 55 patients macroadenoma presented to the with non-functioning pituitary Clinical Oncology and Nuclear Medicine department between 1998 and 2009 were investigated. RESULTS The most common symptom was visual disturbance （38.2%） followed by headache （27.3%）. The presence of male predominance was observed （1.4：1）. Ten patients received radio-therapy （RT） only. Extrasellar extension was the more common treatment. The overall response rate was 72.8% with completed response at 16.4%. Memory and intellectual sequelae were the most common late complications of treatment （14%）. The ten-year PFS was at 84.6%. PFS was found to be significantly better with higher dose of RT （up to 54 Gy）, treatment by both surgery and RT, absence of visual field defect, and tumor localized to sella, whereas it was not significantly affected by age and sex. CONCLUSION The data confirmed that the prevalence of mass effect and hypopituitarism in patients with non-functioning pituitary macroadenoma is elevated. Conventional external RT up to 54 Gy is safe and effective in controlling non-functioning pituitary macro- adenoma with tolerable and acceptable morbidity.展开更多
I have read with interest the paper by Hart, et al. re- porting that homocysteine （Hey） is an independent risk fac- tor for non-culprit coronary lesions progression after 12 months of follow-up in elderly patients w...I have read with interest the paper by Hart, et al. re- porting that homocysteine （Hey） is an independent risk fac- tor for non-culprit coronary lesions progression after 12 months of follow-up in elderly patients who has undergone percutaneous coronary stenting. Hcy-mediated increased lipid peroxidation and generation of free radicals results in in- flammation and endothelial dysfunction, which triggers atherosclerotic process. Coronary artery disease is also as- sociated with higher levels of Hcy.展开更多
The paper looks at some bridge structures from ancient aqueducts to the most recent viaducts since people have always built structures that help them to cross terrain obstacles such as rivers, ravines and hills. Their...The paper looks at some bridge structures from ancient aqueducts to the most recent viaducts since people have always built structures that help them to cross terrain obstacles such as rivers, ravines and hills. Their primary goal has functionality and efficiency rather than aesthetic considerations and, yet from a time perspective, they still impress with their beauty and perfection. Gradually, architects began to take care of the form of bridges, as in the case of the Rialto Bridge in Venice. Nowadays, the most renowned architects, with Norman Foster in the lead, take up the design of bridge ＂architecture＂. Although technical solutions remain top priority, aesthetic qualities are widely recognized and appreciated.展开更多
Maternal stress during pregnancy is prevailing worldwide, which exposes fetuses to intrauterine hyper glucocorticoids(GC), programming offspring to obesity and metabolic diseases. Despite the importance of brown adipo...Maternal stress during pregnancy is prevailing worldwide, which exposes fetuses to intrauterine hyper glucocorticoids(GC), programming offspring to obesity and metabolic diseases. Despite the importance of brown adipose tissue(BAT) in maintaining long-term metabolic health, impacts of prenatal hyper GC on postnatal BAT thermogenesis and underlying regulations remain poorly defined. Pregnant mice were administrated with synthetic GC dexamethasone(DEX) at levels comparable to fetal GC exposure of stressed mothers. Prenatal GC exposure dose-dependently reduced BAT thermogenic activity, contributing to lower body temperature and higher mortality of neonates;such difference was abolished under thermoneutrality, underscoring BAT deficiency was the major contributor to adverse changes in postnatal thermogenesis due to excessive GC. Prenatal GC exposure highly activated Redd1 expression and reduced Ppargc1 a transcription from the alternative promoter(Ppargc1 a-AP) in neonatal BAT. During brown adipocyte differentiation, ectopic Redd1 expression reduced Ppargc1 a-AP expression and mitochondrial biogenesis;and the inhibitory effects of GC on mitochondrial biogenesis and Ppargc1 a-AP expression were blocked by Redd1 ablation. Redd1 reduced protein kinase A phosphorylation and suppressed cyclic adenosine monophosphate(c AMP)-responsive element-binding protein(CREB) binding to the c AMP regulatory element(CRE) in Ppargc1 a-AP promoter, leading to Ppargc1 a-AP inactivation. In summary, excessive maternal GC exposure during pregnancy dysregulates Redd1-Ppargc1 a-AP axis, which impairs fetal BAT development, hampering postnatal thermogenic adaptation and metabolic health of offspring.展开更多
文摘OBJECTIVE The current retrospective study aims to evaluate the management of non-functioning the assessment of experience on pituitary macroadenoma through clinical, biochemical, radiological features, and treatment outcome of patients, and to identify prognostic factors affecting progression-free survival （PFS）. METHODS Data of 55 patients macroadenoma presented to the with non-functioning pituitary Clinical Oncology and Nuclear Medicine department between 1998 and 2009 were investigated. RESULTS The most common symptom was visual disturbance （38.2%） followed by headache （27.3%）. The presence of male predominance was observed （1.4：1）. Ten patients received radio-therapy （RT） only. Extrasellar extension was the more common treatment. The overall response rate was 72.8% with completed response at 16.4%. Memory and intellectual sequelae were the most common late complications of treatment （14%）. The ten-year PFS was at 84.6%. PFS was found to be significantly better with higher dose of RT （up to 54 Gy）, treatment by both surgery and RT, absence of visual field defect, and tumor localized to sella, whereas it was not significantly affected by age and sex. CONCLUSION The data confirmed that the prevalence of mass effect and hypopituitarism in patients with non-functioning pituitary macroadenoma is elevated. Conventional external RT up to 54 Gy is safe and effective in controlling non-functioning pituitary macro- adenoma with tolerable and acceptable morbidity.
文摘I have read with interest the paper by Hart, et al. re- porting that homocysteine （Hey） is an independent risk fac- tor for non-culprit coronary lesions progression after 12 months of follow-up in elderly patients who has undergone percutaneous coronary stenting. Hcy-mediated increased lipid peroxidation and generation of free radicals results in in- flammation and endothelial dysfunction, which triggers atherosclerotic process. Coronary artery disease is also as- sociated with higher levels of Hcy.
文摘The paper looks at some bridge structures from ancient aqueducts to the most recent viaducts since people have always built structures that help them to cross terrain obstacles such as rivers, ravines and hills. Their primary goal has functionality and efficiency rather than aesthetic considerations and, yet from a time perspective, they still impress with their beauty and perfection. Gradually, architects began to take care of the form of bridges, as in the case of the Rialto Bridge in Venice. Nowadays, the most renowned architects, with Norman Foster in the lead, take up the design of bridge ＂architecture＂. Although technical solutions remain top priority, aesthetic qualities are widely recognized and appreciated.
基金This work was supported by the National Institute of Health(NIH R01-HD067449)。
文摘Maternal stress during pregnancy is prevailing worldwide, which exposes fetuses to intrauterine hyper glucocorticoids(GC), programming offspring to obesity and metabolic diseases. Despite the importance of brown adipose tissue(BAT) in maintaining long-term metabolic health, impacts of prenatal hyper GC on postnatal BAT thermogenesis and underlying regulations remain poorly defined. Pregnant mice were administrated with synthetic GC dexamethasone(DEX) at levels comparable to fetal GC exposure of stressed mothers. Prenatal GC exposure dose-dependently reduced BAT thermogenic activity, contributing to lower body temperature and higher mortality of neonates;such difference was abolished under thermoneutrality, underscoring BAT deficiency was the major contributor to adverse changes in postnatal thermogenesis due to excessive GC. Prenatal GC exposure highly activated Redd1 expression and reduced Ppargc1 a transcription from the alternative promoter(Ppargc1 a-AP) in neonatal BAT. During brown adipocyte differentiation, ectopic Redd1 expression reduced Ppargc1 a-AP expression and mitochondrial biogenesis;and the inhibitory effects of GC on mitochondrial biogenesis and Ppargc1 a-AP expression were blocked by Redd1 ablation. Redd1 reduced protein kinase A phosphorylation and suppressed cyclic adenosine monophosphate(c AMP)-responsive element-binding protein(CREB) binding to the c AMP regulatory element(CRE) in Ppargc1 a-AP promoter, leading to Ppargc1 a-AP inactivation. In summary, excessive maternal GC exposure during pregnancy dysregulates Redd1-Ppargc1 a-AP axis, which impairs fetal BAT development, hampering postnatal thermogenic adaptation and metabolic health of offspring.
