MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Pituitary' source. Wed, 08 Feb 2012 15:09:02 +0100 http://www.medworm.com/index.php?rid=5667689&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj037633867j25478%2F Abstract  There is a clinical impression that when tumors invade the cavernous sinus, compression of the internal carotid artery is rare with pituitary adenomas and more common with other types of lesions but there are no actual data to support this impression. To confirm the impression that the finding of internal carotid artery compression by tumors invading the cavernous sinus is inconsistent with a diagnosis of a pituitary adenoma, we performed a retrospective analysis of MRI scans performed between 2000 and July 2009. An initial search of the radiology database was performed using the terms “invasive mass cavernous MRI” and subsequent refinement narrowed the evaluation to 141 patients with cavernous sinus invasion by sellar/parasellar tumors for whom there were cli... Pituitary journals http://www.medworm.com/rss/comments.php?id=5667689 Fri, 03 Feb 2012 17:52:53 +0100 5667689 http://www.medworm.com/index.php?rid=5667690&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fem40703751x14j47%2F Abstract  We evaluated the efficacy of Gamma knife stereotactic radiosurgery (GKSR) as an adjunctive management modality for patients with drug resistant or intolerant cavernous sinus invasive prolactinomas. Twenty-two patients with cavernous sinus invasive prolactinoma underwent GKSR between 1994 and 2009. Thirteen patients were dopamine agonist (DA) resistant. Six patients were intolerant to DA. Three patients chose GKSR as their initial treatment modality in hopes they might avoid life long suppression medication. The median tumor volume was 3.0 cm3 (range 0.3–11.6). The marginal tumor dose (median = 15 Gy, range 12–25 Gy) prescribed was based on the dose delivered to the optic apparatus. The median follow-up interval was 36 months (range... Pituitary journals http://www.medworm.com/rss/comments.php?id=5667690 Thu, 02 Feb 2012 18:15:59 +0100 5667690 http://www.medworm.com/index.php?rid=5638931&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe5m2074p54011v16%2F Abstract  Growth hormone (GH) is approved by the US Food and Drug Administration (FDA) for use in pediatric patients with disorders of growth failure or short stature and in adults with growth hormone deficiency (GHD) and HIV/AIDS wasting and cachexia. For pediatric patients, guidelines for the use of GH have been developed by several organizations that have identified specific criteria for initiating GH therapy for each FDA-approved indication. Guidelines for adults have also been developed and include recommendations for transition (adolescent) patients with GHD. These patients are often treated with GH as children but may require continued treatment as young adults to attain full skeletal mineralization and improve cardiovascular risk factors. Adult and pediatric guideli... Pituitary journals http://www.medworm.com/rss/comments.php?id=5638931 Tue, 24 Jan 2012 07:30:11 +0100 5638931 http://www.medworm.com/index.php?rid=5582815&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F781846537781124g%2F Abstract  Previous case reports and retrospective studies suggest that pituitary dysfunction may occur after acute bacterial or viral meningitis. In this prospective study we assessed the pituitary functions, lipid profile and anthropometric measures in adults with acute bacterial or viral meningitis. Moreover, in order to investigate whether autoimmune mechanisms could play a role in the pathogenesis of acute meningitis-induced hypopituitarism we also investigated the anti-pituitary antibodies (APA) and anti-hypothalamus antibodies (AHA) prospectively. Sixteen patients (10 males, 6 females; mean ± SD age 40.9 ± 15.9) with acute infectious meningitis were included and the patients were evaluated in the acute phase, and at 6 and 12 months after the ... Pituitary journals http://www.medworm.com/rss/comments.php?id=5582815 Sat, 07 Jan 2012 16:55:14 +0100 5582815 http://www.medworm.com/index.php?rid=5572575&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn88n636810611380%2F Abstract  Patients with adult GH deficiency (AGHD) have a high cardiovascular risk and probably an alteration of the oxidative balance, although evidence is lacking. To evaluate the presence of endothelial dysfunction and oxidative stress in patients with AGHD. Biochemical parameters of oxidative stress and endothelial dysfunction were compared in 25 patients with previously untreated AGHD and 25 healthy controls matched by age and sex. Multivariate analysis was performed to identify independent predictors of oxidative stress. Vascular function of subcutaneous resistance arteries was also analyzed by means of wire myography in 7 patients with untreated AGHD and in 7 healthy controls with similar characteristics. The values of C-reactive protein, interleukin-6 (IL-6) and tum... Pituitary journals http://www.medworm.com/rss/comments.php?id=5572575 Fri, 06 Jan 2012 16:48:01 +0100 5572575 http://www.medworm.com/index.php?rid=5572576&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk05515q6335h427k%2F Abstract  In prolactin-secreting giant adenomas, cabergoline treatment is the first line approach. Surgery and/or radiotherapy are indicated when the tumour is resistant to medical treatment and continues growing, causing visual field impairment. Data concerning other therapeutic approach are scanty. Although PRL-secreting tumours may express somatostatin receptors type 2, 3 and 5, somatostatin analogs treatment is generally ineffective and peptide receptor radionuclide therapy (PRRT) has never been reported. A 58 year-old woman complaining of severe neurological symptoms caused by a giant prolactinoma, relapsing after surgery and not-responding to dopamine-agonists and octreotide LAR treatment, underwent four cycles of PRRT with 111-Indium-DTPA-octreotide with remarka... Pituitary journals http://www.medworm.com/rss/comments.php?id=5572576 Fri, 06 Jan 2012 06:45:06 +0100 5572576 http://www.medworm.com/index.php?rid=5560742&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7882064642242185%2F This study indicates that SSTR5 and SSTR3 are the most frequently expressed SSTR subtypes in NFPAs and supports a potential role of SSTR subtypes in stabilization of tumor remnant from NFPAs. Content Type Journal ArticlePages 1-8DOI 10.1007/s11102-011-0370-8Authors Alessandra Fusco, Division of Endocrinology, School of Medicine, Catholic University, Largo A. Gemelli 8, 00168 Rome, ItalyAntonella Giampietro, Division of Endocrinology, School of Medicine, Catholic University, Largo A. Gemelli 8, 00168 Rome, ItalyAntonio Bianchi, Division of Endocrinology, School of Medicine, Catholic University, Largo A. Gemelli 8, 00168 Rome, ItalyVincenzo Cimino, Division of Endocrinology, School of Medicine, Catholic University, Largo A. Gemelli 8, 00168 Rome, ItalyFrancesca Lugli, Division of End... Pituitary journals http://www.medworm.com/rss/comments.php?id=5560742 Fri, 30 Dec 2011 07:08:17 +0100 5560742 http://www.medworm.com/index.php?rid=5525510&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq8885u1n17132530%2F Abstract  New criteria that define acromegaly remission are more stringent: normal (age/sex-adjusted) insulin-like growth factor type 1 (IGF-1), growth hormone (GH) random (GHr) <1 μg/L, and a GH nadir (GHn) during oral glucose tolerance test (OGTT) of <0.4 μg/L. Discordance between GH and IGF-1 values is often attributed to somatostatin receptor ligands (SRLs) or radiation. The purpose of this study was to evaluate rates of discordant IGF-1 and GH levels in patients with GH secreting adenomas (after pituitary surgery), who were naïve to any other treatment. We retrospectively analyzed data over a 5 year time period (2006–2010), in post-surgery acromegaly patients who had elevated IGF-1 but normal GH levels (per the new cure criteria). Symptoms of a... Pituitary journals http://www.medworm.com/rss/comments.php?id=5525510 Mon, 19 Dec 2011 16:51:07 +0100 5525510 http://www.medworm.com/index.php?rid=5487647&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy17223k8481p64r0%2F In this report we analyzed the complications in 624 procedures of endonasal transsphenoidal endoscopic surgery in the treatment of 570 patients with pituitary adenomas. The leading author (MB) operated pituitary adenomas via pure endoscopic endonasal transsphenoidal surgery between January 2006 and August 2011 at the Hacettepe University, Department of Neurosurgery in Ankara. Complications were assessed in 624 surgical procedures under five groups; rhinological, CSF leaks, infection, vascular and endocrinologic complications. We observed a total of 76 complications (12.1%). Rhinological complications occurred in 8 patients (1.3%): 4 epistaxis (0.6%) and 4 hyposmia (0.6%). Postoperative CSF leaks occurred in 8 patients (1.3%), and infectious complications occurred in 8 patients: 3 cas... Pituitary journals http://www.medworm.com/rss/comments.php?id=5487647 Wed, 07 Dec 2011 10:51:56 +0100 5487647 http://www.medworm.com/index.php?rid=5458409&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7t6w2472t1w34hm1%2F Abstract  Nonfunctioning pituitary adenomas (NFPA) are typically benign neoplasms that can cause significant morbidity through local mass effects. MIB-1/Ki-67 and p53 immuno-reactivity are used to predict aggressive behavior but have known limitations. No marker to date is widely used to reliably predict tumor progression. Phospho-histone H3 (pHH3) is a protein phosphorylated during chromatin condensation in mitosis, and thus anti-pHH3 immunocytochemistry is able to assess mitotic activity. Study objectives were to determine the relationship among pHH3, MIB-1/Ki-67, and p53 in NFPA, and to evaluate the relationship between these indices and time to progression (TTP). Seventy-six patients with NFPA operated on by a single neurosurgeon at University of Texas M. D. Anderson Ca... Pituitary journals http://www.medworm.com/rss/comments.php?id=5458409 Sat, 26 Nov 2011 16:46:59 +0100 5458409 http://www.medworm.com/index.php?rid=5449947&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F212179884624tn61%2F Abstract  To evaluate the metabolic effects of first-line somatostatin analogues or surgery in acromegaly. Retrospective, comparative, 12-month follow-up. Two hundred and thirty one patients (123 men, age 47.32 ± 14.63 years) with active acromegaly, first line treatments were somatostatin analogues in 151 (65.4%) and surgery in 80 (34.6%). Metabolic syndrome (MS) parameters, glucose, insulin and GH during oral glucose tolerance test, stimulated insulin sensitivity by insulin sensitivity index (ISI Matsuda), early and total insulin-secretion rate by insulinogenic index and AUCINS, visceral adiposity function, expressed by visceral adipose index (VAI). Somatostatin analogues treatment improved all MS parameters and significantly reduced fasting glucose (P ... Pituitary journals http://www.medworm.com/rss/comments.php?id=5449947 Thu, 24 Nov 2011 17:43:41 +0100 5449947 http://www.medworm.com/index.php?rid=5441597&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft743xw7083818312%2F We present a case of profound hyperprolactinemia originating from a pituitary adenoma found in the wall of an ovarian dermoid and give a broad overview of the condition and literature. Ectopic prolactin production should always be considered in symptomatic patients found to have elevated serum levels and no findings on brain imaging. Content Type Journal ArticlePages 1-4DOI 10.1007/s11102-011-0366-4Authors Autumn F. Elms, Department of Obstetrics and Gynecology, Winnie Palmer Hospital, Orlando Regional Healthcare, 105 West Miller St., Orlando, FL 32806, USAS. J. Carlan, Department of Obstetrics and Gynecology, Winnie Palmer Hospital, Orlando Regional Healthcare, 105 West Miller St., Orlando, FL 32806, USAAmy E. Rich, Department of Pathology, Orlando Regional Healthcare, Orlando, F... Pituitary journals http://www.medworm.com/rss/comments.php?id=5441597 Mon, 21 Nov 2011 18:03:34 +0100 5441597 http://www.medworm.com/index.php?rid=5409154&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw8137k4g83k969l2%2F Abstract  Ghrelin, an orexigenic hormone, is known to occur in the normal anterior pituitary where its physiologic role is uncertain but may include promotion of appetite. We sought to investigate anticipated differences in adenohypophysial and neurohypophysial ghrelin immunoexpression between normal subjects and patients with anorexia nervosa who had succumbed to complications of the disease. We hypothesized that the glands of anorexia nervosa patients would show relative diminished action in ghrelin content. The study included 12 autopsy-derived pituitaries of anorexia nervosa and 10 control glands. The streptavidin-biotin-peroxidase complex method and double immunohistochemical staining method were used to determine which cell types expressed both ghrelin and adenohypoph... Pituitary journals http://www.medworm.com/rss/comments.php?id=5409154 Fri, 11 Nov 2011 12:49:25 +0100 5409154 http://www.medworm.com/index.php?rid=5409155&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq716486541576t16%2F Abstract  Pituitary carcinoma occurs in ~0.2% of resected pituitary tumours and carries a poor prognosis (mean survival <4 years), with standard chemotherapy regimens showing limited efficacy. Recent evidence suggests that temozolomide (TMZ), an orally-active alkylating agent used principally in the management of glioblastoma, may also be effective in controlling aggressive/invasive pituitary adenomas/carcinomas. A low level of expression of the DNA-repair enzyme O6-methylguanine-DNA methyltransferase (MGMT) predicts TMZ responsiveness in glioblastomas, and a similar correlation has been observed in the majority of aggressive pituitary adenomas/carcinomas reported to date. Here, we report a case of a silent pituitary corticotroph adenoma, which subsequently re-prese... Pituitary journals http://www.medworm.com/rss/comments.php?id=5409155 Thu, 10 Nov 2011 16:52:57 +0100 5409155 http://www.medworm.com/index.php?rid=5388079&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp2245wm04g04j612%2F Abstract  To describe glucose status changes in patients with acromegaly receiving somatostatin analog lanreotide as primary treatment. This retrospective, single-center study conducted during 1996–2008, included acromegalic patients receiving primary lanreotide treatment. Baseline and last follow-up visit assessments included glucose status (according to American Diabetes Association criteria), growth hormone (GH), and insulin-like growth factor-1 (IGF-1) levels. Glucose control was considered improved when fasting plasma glucose or antidiabetic treatments were reduced, and deteriorated if fasting glucose was the same/higher but with increased antidiabetic treatments. 42 patients (median age 50 years; range 29–75 years) were included. At baseline, 26 (62%) we... Pituitary journals http://www.medworm.com/rss/comments.php?id=5388079 Sat, 05 Nov 2011 17:09:44 +0100 5388079 http://www.medworm.com/index.php?rid=5388081&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd6r88423436j0784%2F Abstract  Traumatic brain injury (TBI) is a very common occurrence in childhood, and can lead to devastating long term consequences. Recent research has focused on the potential endocrine consequences of TBI in adults. The research in children is less robust. This paper reviews current literature regarding TBI and possible hypothalamic and pituitary deficiencies in childhood. Acute endocrine changes are commonly found after TBI in pediatric patients, which can include changes in hypothalamic–pituitary–adrenal axis and antidiuretic hormone production and release. In the long term, both temporary and permanent alterations in pituitary function have been found. About 30% of children have hypopituitarism up to 5 years after injury. Growth hormone deficiency and disturb... Pituitary journals http://www.medworm.com/rss/comments.php?id=5388081 Fri, 04 Nov 2011 16:48:04 +0100 5388081 http://www.medworm.com/index.php?rid=5388080&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm624211x08224761%2F Abstract  ACTH-secreting pituitary adenomas (Cushing’s disease, CD) are the most frequent cause of Cushing’s syndrome. To test whether the size of ACTH-secreting adenomas correlates with the degree of biochemical and clinical features of hypercortisolism, we retrospectively reviewed all newly diagnosed CD patients seen at our institution by two neuro-endocrinologists over a 10-year time period. We documented the number of clinical manifestations and baseline hormonal measurements. There were 37 microadenomas (μAs) and 16 macroadenomas (MAs). We sought to characterize the relationship between tumor size (μA vs. MA) and number of signs and symptoms of hypercortisolism and biochemical assessment of hypercortisolemia. There were no significant differences in mean age, BMI... Pituitary journals http://www.medworm.com/rss/comments.php?id=5388080 Fri, 04 Nov 2011 16:48:04 +0100 5388080 http://www.medworm.com/index.php?rid=5361467&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Flvq0t271mm403464%2F Abstract  Neuro-endocrine deficiencies have been argued to be common sequelae after aneurysmal subarachnoid hemorrhage (aSAH). As this, however, does not resemble our clinical experience, we studied the incidence of neuro-endocrine and neuropsychological deficits after aSAH. Twenty-six patients (20 females) were prospectively screened for neuro-endocrine and neuropsychological deficits 3, 6 and 12 months after aSAH. GH, IGF-1, prolactin, LH, FSH, estradiol, testosterone, ACTH as well as cortisol during ACTH-stimulation were assessed. Neuropsychological analysis covered verbal comprehension, short term and working memory, visuospatial construction, figural memory, psychomotor speed, attention, and concentration. During the study period 5 individuals demonstrated neuro-en... Pituitary journals http://www.medworm.com/rss/comments.php?id=5361467 Sat, 29 Oct 2011 05:41:37 +0100 5361467 http://www.medworm.com/index.php?rid=5361468&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F56212w63586503v2%2F Abstract  The metabolic consequences of thyroxine replacement in patients with central hypothyroidism (CH) need to be evaluated. The aim was to examine the outcome of thyroxine replacement in CH. Adult hypopituitary patients (n = 1595) with and without CH from KIMS (Pfizer International Metabolic Database) were studied before and after 2 years of GH replacement. CH patients (CH, n = 1080) were compared with TSH sufficient patients (TSHsuff n = 515) as one group and divided by thyroxine dose/kg/day into tertiles (CHlow-mid-high). Anthropometry, fasting glucose, glycosylated haemoglobin (HbA1c), blood pressure, lipids, IGF-I SDS, quality of life and morbidity were studied. Analyses were standardized for gender, age, number and types of pituita... Pituitary journals http://www.medworm.com/rss/comments.php?id=5361468 Fri, 28 Oct 2011 16:46:30 +0100 5361468 http://www.medworm.com/index.php?rid=5361470&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu78mt08337hj3608%2F Abstract  Isolated GH deficiency (IGHD) is a rare disorder that occurs as an idiopathic form in most cases. The pathway JAK/STAT promotes cellular growth and it could be implicated in this condition. In order to characterize IGHD in the pediatric population and identify genes differently expressed before and after GH therapy, we performed a quantitative evaluation of 84 genes related to the JAK/STAT pathway which, by promoting cellular growth. RT2 Profiler PCR Array and the other/subsequent evaluations were performed in three children with severe IGHD before and after 6 months of GH therapy and in three matched normal children. Gene profiling was modified by the IGHD status and the GH therapy, with a modulation of GHR and some inflammatory genes such as CRP. We found a ... Pituitary journals http://www.medworm.com/rss/comments.php?id=5361470 Fri, 28 Oct 2011 16:46:28 +0100 5361470 http://www.medworm.com/index.php?rid=5361469&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc759546685550527%2F Abstract  Giant (>4 cm) pituitary macroadenomas often require surgery to decompress the optic nerves. Compared with traditional open or transsphenoidal microscopic methods, the extended endoscopic endonasal transsphenoidal approach offers the potential for aggressive resection via a minimal access corridor. We conducted a systematic review of the literature to further our understanding of the role of endoscopy in the management of these challenging lesions. MEDLINE search of the modern literature (1995–2010) to identify surgical series for pediatric and adult pituitary adenomas >4 cm in maximal diameter. Patient and tumor characteristics, resection, morbidity and visual outcome were compared by approach. Chi-square and Fisher’s exact tests with post-hoc B... Pituitary journals http://www.medworm.com/rss/comments.php?id=5361469 Fri, 28 Oct 2011 16:46:28 +0100 5361469 http://www.medworm.com/index.php?rid=5361472&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F379645712160p873%2F This study also suggests modifications to the instrument, which will serve as key quality of life endpoint in an ongoing multicenter nasal outcomes study. Content Type Journal ArticlePages 1-5DOI 10.1007/s11102-011-0358-4Authors Andrew S. Little, Division of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, 2910 North 3rd Avenue, Phoenix, AZ 85013, USAHeidi Jahnke, Division of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, 2910 North 3rd Avenue, Phoenix, AZ 85013, USAPeter Nakaji, Division of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, 2910 North 3rd Avenue, Phoenix, AZ 85013, USAJohn Milligan, Arizona Otolaryngology Consultants, Phoenix, AZ 85016, USAKristi... Pituitary journals http://www.medworm.com/rss/comments.php?id=5361472 Fri, 28 Oct 2011 16:46:27 +0100 5361472 http://www.medworm.com/index.php?rid=5361471&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F32352wm5p23015n8%2F Abstract  Cushing’s disease is the result of chronic overproduction of ACTH by a pituitary tumor. Although the optimal treatment is surgical removal of the adenoma, medical treatment might be an option in selected cases. A 40-year old woman with Cushing’s disease was treated with cabergoline, a neuromodulatory drug, for a corticotrophic macroadenoma. Treatment was initiated at a weekly dose of 0.5 mg and then, on the basis of the evolution of UFC values, adjusted until it reached 6 mg/week. With cabergoline treatment the patient was asymptomatic, the pituitary adenoma showed a significant shrinkage on MRI and urinary cortisol excretion remained within the normal range during 7 years. We show the effectiveness of cabergoline in maintaining long-term biochem... Pituitary journals http://www.medworm.com/rss/comments.php?id=5361471 Fri, 28 Oct 2011 16:46:27 +0100 5361471 http://www.medworm.com/index.php?rid=5324416&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F572t680k53432015%2F Abstract  Acromegaly is a rare disorder due to an excessive production of growth hormone (GH), typically caused by a GH-secreting pituitary adenoma. Anti-pituitary antibodies (APAs) are often seen in patients with different kinds of pituitary pathologies. Because GH has been proposed as a possible antigen recognized by such antibodies, the prevalence of APAs may be higher in conditions characterized by excessive GH secretion. The primary aim of this study was to compare the prevalence of APAs in patients with acromegaly and in controls with other types of pituitary tumors and healthy subjects. Secondary aim was to characterize the pituitary cells targeted by the APAs. Thirty eight acromegaly patients and 215 controls, including 38 patients with prolactinomas, 64 with non-fu... Pituitary journals http://www.medworm.com/rss/comments.php?id=5324416 Fri, 14 Oct 2011 10:39:54 +0100 5324416 http://www.medworm.com/index.php?rid=5315186&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F44hk814n75535052%2F Abstract  Atherothrombosis is a multifactorial process, governed by an interaction between the vessel wall, hemodynamic factors and systemic atherothrombotic risk factors. Recent in vitro, human ex vivo and animal studies have implicated the hormone prolactin as an atherothrombotic mediator. To address this issue, we evaluated the anatomy and function of various microvascular beds as well as plasma atherothrombosis markers in patients with elevated prolactin levels. In this pilot study, involving 10 prolactinoma patients and 10 control subjects, sidestream dark field (SDF) imaging revealed a marked perturbation of the sublingual microcirculation in prolactinoma patients compared to control subjects, as attested to by significant changes in microvascular flow index (2.74&nbsp... Pituitary journals http://www.medworm.com/rss/comments.php?id=5315186 Wed, 12 Oct 2011 16:06:58 +0100 5315186 http://www.medworm.com/index.php?rid=5315187&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv049u8068m27587n%2F The objective of the current study was to determine a volumetric threshold for lesions with high perioperative morbidity and high rate of subtotal resection following endonasal endoscopic surgery. Thus, we analyzed a prospectively collected database of 71 patients who underwent endoscopic transsphenoidal approaches for macroadenomas (diameter >1 cm). Extend of resection (EOR) was calculated based on volumetric analysis of pre-and post-operative contrast-enhanced MRI. Average EOR was 97.8% and a gross total resection (GTR) was achieved in 76.1% of all patients. GTR was accomplished in 92.0% versus 38.1% of adenomas either without or with CS invasion, respectively. Likewise, GTR was accomplished in 90.2% versus 40.0% of lesions less than or greater then 10 cm3 respectively... Pituitary journals http://www.medworm.com/rss/comments.php?id=5315187 Tue, 11 Oct 2011 05:50:17 +0100 5315187 http://www.medworm.com/index.php?rid=5315188&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F73v0415nj4414502%2F We describe the management of these cases after the correct diagnosis was made and provide insight to preoperative diagnosis of this entity. Preoperative diagnosis may help avoid unnecessary surgical resection of an otherwise radiosensitive tumor. We also report and describe in detail a new case of sellar plasmacytoma that we have recently evaluated. Content Type Journal ArticlePages 1-4DOI 10.1007/s11102-011-0352-xAuthors Rene Joukhadar, Department of Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USAKen Chiu, Department of Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA Journal PituitaryOnline ISSN 1573-7403Print ISSN 1386-3... Pituitary journals http://www.medworm.com/rss/comments.php?id=5315188 Mon, 10 Oct 2011 15:01:52 +0100 5315188 http://www.medworm.com/index.php?rid=5286284&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fvxp22165227r3870%2F In conclusion, discrepant GH and IGF-I levels in the diagnosis and follow-up of patients with acromegaly requires consideration of many factors that influence these parameters. Content Type Journal ArticlePages 1-6DOI 10.1007/s11102-011-0351-yAuthors Laura Boero, Departamento de Neuroendocrinología (Neuroendocrinology Department), Sociedad Argentina de Endocrinología y Metabolismo, Diaz Velez 3889, (1200), Buenos Aires, ArgentinaMarcos Manavela, Departamento de Neuroendocrinología (Neuroendocrinology Department), Sociedad Argentina de Endocrinología y Metabolismo, Diaz Velez 3889, (1200), Buenos Aires, ArgentinaKarina Danilowicz, Departamento de Neuroendocrinología (Neuroendocrinology Department), Sociedad Argentina de Endocrinología y Metabolismo, Diaz Velez 3889, (1200), B... Pituitary journals http://www.medworm.com/rss/comments.php?id=5286284 Fri, 30 Sep 2011 05:54:22 +0100 5286284 http://www.medworm.com/index.php?rid=5286285&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4pv5298t8405337r%2F We describe a 50-year-old female who presented with clinical signs and biochemical evidence of acromegaly. Pituitary MRI demonstrated a 2 mm hypointense lesion on the right side of the pituitary gland. However upon drilling of the upper clival bone to expose the sella during endoscopic transsphenoidal surgery, soft tumor-like tissue was encountered within the clivus. Exploration of the sella, including the area of hypointensity noted on preoperative imaging, did not identify any other abnormality. Immunohistochemical examination of the fully resected tumor demonstrated growth hormone immunoreactivity. Failed preoperative diagnosis of this rare ectopic GH-producing tumor was compounded by the presence of a misleading pituitary abnormality consistent with a microadenoma. The epide... Pituitary journals http://www.medworm.com/rss/comments.php?id=5286285 Fri, 30 Sep 2011 05:54:21 +0100 5286285 http://www.medworm.com/index.php?rid=5274542&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr222247183k38447%2F Abstract  Review the medical and surgical management of patients with prolactinomas and provide an in-depth appraisal of the role of radiotherapy in the treatment of prolactinomas. A thorough review of the pertinent literature was carried out and relevant topics were identified. Topics covered in this comprehensive review include: indications for the use of radiotherapy, choice between conventional radiotherapy and stereotactic radiosurgery, as well as the benefits and potential complications associated with each modality. Due to the excellent response rates with medical management, and rapid symptom relief afforded by resection or debulking surgery in patients who do not respond or tolerate medical therapy, radiotherapy is reserved for patients who do not respond to dopami... Pituitary journals http://www.medworm.com/rss/comments.php?id=5274542 Tue, 27 Sep 2011 05:46:12 +0100 5274542 http://www.medworm.com/index.php?rid=5251232&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj314u355j754q722%2F Abstract  Hypothalamic obesity is a potential sequela of craniopharyngioma, arising from hypothalamic damage inflicted by either the tumor and/or its treatment. The marked weight gain that characterizes this disorder appears to result from impaired sympathoadrenal activation, parasympathetic dysregulation, and other hormonal and hypothalamic disturbances that upset the balance between energy intake and expenditure. Given hypopituitarism is commonly present, careful management of hormonal deficits is important for weight control in these patients. In addition, diet, exercise, and pharmacotherapy aimed at augmenting sympathetic output, controlling hyperinsulinism, and promoting weight loss have been used to treat this disease, but these measures rarely lead to sustained weigh... Pituitary journals http://www.medworm.com/rss/comments.php?id=5251232 Wed, 21 Sep 2011 05:50:30 +0100 5251232 http://www.medworm.com/index.php?rid=5226799&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3p436621333j7502%2F We report four patients with Cushing’s disease harboring ACTH-secreting macroadenomas who presented with pituitary apoplexy. We report the endocrinologic and visual outcomes of these patients after emergent transsphenoidal surgery. A retrospective chart review was performed in 4 patients who presented with pituitary apoplexy from hemorrhage into an ACTH-secreting pituitary adenoma. The patient charts were reviewed for clinical presentation, neuroimaging findings, intraoperative surgical findings, pathologic findings, and postoperative endocrinologic and visual outcomes. All patients presented with acute headaches, nausea, vomiting, and visual loss from optic compression. MR imaging demonstrated a hemorrhagic macroadenoma that was confirmed at surgery. All patients underwent emerge... Pituitary journals http://www.medworm.com/rss/comments.php?id=5226799 Fri, 16 Sep 2011 16:49:48 +0100 5226799 http://www.medworm.com/index.php?rid=5226800&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4ww0n86n3417m605%2F We report the case of a 44-year-old male patient with an aggressive silent corticotroph cell pituitary adenoma, subtype 2. In that it progressed to carcinoma despite temozolomide administration, anti-VEGF therapy was begun. MRI, PET scan and pathologic analysis were undertaken. After 10 months of anti-VEGF (bevacizumab) treatment no progression of the lesion was noted. The tumor was biopsied and morphological analysis showed severe cell injury, vascular abnormalities and fibrosis. Bevacizumab treatment has continued for additional 16 months to present with stabilization of disease as documented on serial MRI and PET scans. This is the first case of a bevacizumab-treated pituitary carcinoma with long-term, now 26 months, control of disease. The present findings are prom... Pituitary journals http://www.medworm.com/rss/comments.php?id=5226800 Thu, 15 Sep 2011 05:49:19 +0100 5226800 http://www.medworm.com/index.php?rid=5226801&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr7j4342613x0j144%2F Abstract  To study the currently available data of recurrence rates of functioning and nonfunctioning pituitary adenomas following surgical cure and to analyze associated predisposing factors, which are not well established. A systematic literature search was conducted using Medline, Embase, Web of Science and the Cochran Library for studies reporting data on recurrence of pituitary adenoma after surgery, in nonfunctioning adenoma (NF), prolactinoma (PRL) acromegaly (ACRO) and Cushing’s disease (CUSH). Of 557 initially retrieved potential relevant studies 143 were selected. Recurrence in NFA was defined as reappearance of tumor on MRI or CT. Increase of hormone levels above normal limits as set by the authors after initial remission was used to indicate recurrence in the ... Pituitary journals http://www.medworm.com/rss/comments.php?id=5226801 Wed, 14 Sep 2011 16:08:12 +0100 5226801 http://www.medworm.com/index.php?rid=5209606&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F6031681286n7v7w4%2F Abstract  The optimal dosing of growth hormone (GH) therapy is challenging due to high inter-individual variability in subcutaneous GH absorption and sensitivity to the drug. Optimal dosing would maximize patient gains in height, body composition, and metabolic outcomes while minimizing GH adverse events. The pulsatile secretion of GH, however, does not allow direct assessment of circulating GH levels as a measure of response to GH therapy. Insulin-like growth factor (IGF-I), a key marker of GH activity, has been shown to be useful in monitoring and adjusting GH dose during treatment of GH deficiency (GHD). Traditionally, monitoring IGF-I levels in response to GH therapy has been recommended for assessment of treatment compliance and safety. More recently, GH treatment guid... Pituitary journals http://www.medworm.com/rss/comments.php?id=5209606 Sat, 10 Sep 2011 15:48:32 +0100 5209606 http://www.medworm.com/index.php?rid=5209607&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F6m8mh262890426gg%2F In this study a substitution strategy of hydrocortisone guided by the postoperative cortisol response to CRH appeared safe and did not result in any case of adrenal crises. However, the early postoperative CRH-test does not reliably predict adrenal function after TS for pituitary adenomas in all patients and retesting is mandatory. Content Type Journal ArticlePages 1-9DOI 10.1007/s11102-011-0344-xAuthors Nieke E. Kokshoorn, Department of Endocrinology and Metabolic Diseases C4-R, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The NetherlandsJohannes A. Romijn, Department of Endocrinology and Metabolic Diseases C4-R, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The NetherlandsFerdinand Roelfsema, Department of Endocrinology and Metabolic Disea... Pituitary journals http://www.medworm.com/rss/comments.php?id=5209607 Fri, 09 Sep 2011 05:45:52 +0100 5209607 http://www.medworm.com/index.php?rid=5162750&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd41g5j444u711301%2F Abstract  Long-acting somatostatin analogs are frequently used as adjuvant treatment of acromegaly patients after noncurative surgery. This sudy aims to compare the efficacy of octreotide long-acting release (OCT) and lanreotide Autogel (LAN) in acromegaly patients. Sixty-eight patients not cured by transsphenoidal endoscopic or microscopic pituitary surgery between 2003 and 2009 were retrospectively analyzed (25 men; 43 women; mean age 41.1 ± 10.9 years [range 18–65 years]). The patients were assigned randomly to OCT (n = 36) and LAN (n = 32) groups. Evaluations included insulin-like growth factor I (IGF-I) and growth hormone (GH) after oral glucose tolerance test (OGTT) 3, 6, 12 and 18 months after starting medical treatment;... Pituitary journals http://www.medworm.com/rss/comments.php?id=5162750 Tue, 23 Aug 2011 15:53:08 +0100 5162750 http://www.medworm.com/index.php?rid=5162751&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4jp001617k151637%2F Abstract  Hypophysitis is a chronic inflammation of the pituitary gland often caused by autoimmunity. Among the autoimmune diseases it is one of the few where the autoantigens remain to be identified. The goal of the paper was to characterize the antigenic profile in a previously reported patient with IgG4-related hypophysitis. Immunofluorescence and immunoblotting were performed to detect antibodies to human pituitary proteins. The proteins recognized by western blotting were then submitted to mass spectrometry for sequencing. The patient’s autoantibodies recognized two unique bands around 40 and 30 kDa on immunoblotting. Sequencing revealed one peptide from proopiomelanocortin in the 40 kDa band and four peptides from growth hormone in the 30 kDa band. Th... Pituitary journals http://www.medworm.com/rss/comments.php?id=5162751 Mon, 22 Aug 2011 16:00:02 +0100 5162751 http://www.medworm.com/index.php?rid=5162752&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk2747nx3km286477%2F We described the tumoral effects of a combination therapy with everolimus (5 mg/day) and octreotide (30 mg/month) and the mTOR signalling expression in a patient with pituitary ACTH carcinoma, compared to 17 other ACTH adenomas. Clinical and biochemical evaluation were performed every month, and imaging after 3 month of treatment. mTOR signaling was assessed by microarray expression analysis of each of the 18 adenoma tissues. Combined therapy failed to control pituitary tumor growth and ACTH secretion. Slight activation of mTOR signaling was found in all ACTH tumors alongside important variations between tumors. Low antitumor efficacy shown by everolimus might be explained by the weak activation of mTOR pathway in ACTH tumors. Everolimus treatment was inefficient at co... Pituitary journals http://www.medworm.com/rss/comments.php?id=5162752 Sat, 20 Aug 2011 15:51:02 +0100 5162752 http://www.medworm.com/index.php?rid=5162753&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh84h4jwv207x4692%2F Abstract  We aimed at the evaluation of MEG3 and GADD45γ expression in sporadic functioning and clinically non-functioning human pituitary adenomas, morphologically characterized by immunohistochemistry analysis and their association with clinical features. Thirty eight patients who had undergone hypophysectomy at São José Hospital of Irmandade Santa Casa de Misericórdia in Porto Alegre, Brazil, were included in this study. We evaluated tumor-type specific MEG3 and GADD45γ expression by qRT-PCR in the pituitary adenomas, and its association with clinical features, as age, gender and tumor size, obtained from medical records. The patients consisted of 21 males and 17 females and the mean age was 47 ± 14 (mean ± SD), ranging from 18 to 73 years-... Pituitary journals http://www.medworm.com/rss/comments.php?id=5162753 Thu, 18 Aug 2011 06:02:56 +0100 5162753 http://www.medworm.com/index.php?rid=5162754&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F850j767021561735%2F In conclusion, patients with prolactinomas treated with either CBG or BRC showed higher prevalence of trace and mild Tri or Mi regurgitation, but these findings were not clinically significant. Content Type Journal ArticlePages 1-6DOI 10.1007/s11102-011-0339-7Authors Cesar Luiz Boguszewski, SEMPR, Serviço de Endocrinologia e Metabologia do Hospital de Clínicas, Department of Internal Medicine, Federal University of Parana, Avenida Agostinho Leao Junior, 285, Curitiba, PR 80030-110, BrazilCarlos Mauricio Correa dos Santos, SEMPR, Serviço de Endocrinologia e Metabologia do Hospital de Clínicas, Department of Internal Medicine, Federal University of Parana, Avenida Agostinho Leao Junior, 285, Curitiba, PR 80030-110, BrazilKelly Suga Sakamoto, SEMPR, Serviço de Endocrinologia e Me... Pituitary journals http://www.medworm.com/rss/comments.php?id=5162754 Wed, 17 Aug 2011 05:55:39 +0100 5162754 http://www.medworm.com/index.php?rid=5126804&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F5353846344144558%2F We present 4 cases of stalk transection syndrome diagnosed by the adult endocrinologist that reflect its pleiotropic manifestations. In all cases, MRI showed pathognomonic findings with small anterior pituitary, diminutive or absent infundibulum and ectopic posterior pituitary at the median eminence. Clinical presentation occurred in childhood or the second decade of life. The hormonal deficits were variable in severity and onset, with adrenal insufficiency diagnosed in the second and forth decade in three patients, and absent in another. Growth hormone deficiency was diagnosed before age 10 in three cases and at age 20 in one case with normal spontaneous linear growth. Hypothyroidism had onset in the first or second decade of life and hypogonadism was diagnosed during work-up for l... Pituitary journals http://www.medworm.com/rss/comments.php?id=5126804 Mon, 08 Aug 2011 19:53:14 +0100 5126804 http://www.medworm.com/index.php?rid=5110248&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft4720ru268626538%2F This report represents an unusual case of MEN 1A with association of insulinomas, gastrinomas glucagonomas and somatostatinomas in the same patient. Content Type Journal ArticlePages 1-5DOI 10.1007/s11102-011-0334-zAuthors Mariela Varsavsky, Bone Metabolic Unit, Endocrinology Department, Hospital Universitario San Cecilio, Av. Dr. Oloriz 16, 18012 Granada, SpainRebeca Reyes-García, Bone Metabolic Unit, Endocrinology Department, Hospital Universitario San Cecilio, Av. Dr. Oloriz 16, 18012 Granada, SpainGuillermo Alonso García, Bone Metabolic Unit, Endocrinology Department, Hospital Universitario San Cecilio, Av. Dr. Oloriz 16, 18012 Granada, SpainManuel Muñoz-Torres, Bone Metabolic Unit, Endocrinology Department, Hospital Universitario San Cecilio, Av. Dr. Oloriz 16, 18012 Granad... Pituitary journals http://www.medworm.com/rss/comments.php?id=5110248 Thu, 04 Aug 2011 15:33:08 +0100 5110248 http://www.medworm.com/index.php?rid=5088988&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq853174743441j68%2F Abstract  Pituitary blastoma, a recently described tumor of the neonatal pituitary, exhibits differentiation to Rathke epithelium and adenohypophysial cells of folliculostellate and secretory type, a reflection of arrested pituitary development and unchecked proliferation (Scheithauer et al. in Acta Neuropathol 116(6):657–666, 2008). Herein, we report the pathologic features of three additional cases, all ACTH-producing. One involved a 9-month-old male presenting with progressive right ophthalmoplegia, MRI findings of a large suprasellar mass with cavernous sinus invasion, and elevated plasma ACTH levels. The second was nonfunctioning and occurred in a 13-month-old female with right third nerve palsy. The third had been previously published as a “pituitary adenoma” in ... Pituitary journals http://www.medworm.com/rss/comments.php?id=5088988 Fri, 29 Jul 2011 16:04:50 +0100 5088988 http://www.medworm.com/index.php?rid=5088989&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0314836r6p602126%2F We report an unusual presentation of primary hypothyroidism with pseudoacromegaly and thyrotroph hyperplasia mimicking a pituitary macroadenoma. The thyrotroph hyperplasia resolved completely with levothyroxine therapy. Content Type Journal ArticlePages 1-4DOI 10.1007/s11102-011-0336-xAuthors K. V. S. Hari Kumar, Department of Endocrinology, Command Hospital, Lucknow, UP 226002, IndiaAltamash Shaikh, Department of Endocrinology, PD Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai, 400016 IndiaIrfan Anwar, Department of Neurosurgery, Command Hospital, Lucknow, UP 226002, IndiaP. Prusty, Department of Endocrinology, Command Hospital, Lucknow, UP 226002, India Journal PituitaryOnline ISSN 1573-7403Print ISSN 1386-341X (Source: Pituitary) Pituitary journals http://www.medworm.com/rss/comments.php?id=5088989 Fri, 29 Jul 2011 16:04:48 +0100 5088989 http://www.medworm.com/index.php?rid=5070465&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe9216931x7tuht4m%2F Abstract  To review the literature regarding the diagnosis and management of acromegaly during pregnancy. A systematic literature search was performed using MEDLINE including hand-searching reference lists from original articles. The diagnosis of acromegaly during pregnancy is made difficult due to the physiologic changes in pituitary GH secretion and IGF-1 production resulting from placental GH secretion and the inability of commercial assays to discriminate between pituitary and placental GH. Most patients with acromegaly during pregnancy do not have an increase in tumor size, metabolic complications are uncommon, and neonatal outcome is largely unaffected. IGF-1 levels tend to be stable in such patients possibly due to the high estrogen levels causing GH resistance. Dopa... Pituitary journals http://www.medworm.com/rss/comments.php?id=5070465 Mon, 25 Jul 2011 15:45:36 +0100 5070465 http://www.medworm.com/index.php?rid=5064099&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj6555l3347716822%2F Abstract  The aim was to evaluate the concentrations of lipid subfractions in relation to adipokines and metabolic parameters in adult growth hormone (GH)-deficient hypopituitary patients on conventional replacement therapy. The study included 21 GH deficient-hypopituitary patients (age: 36.0 ± 15.1 years, male/female: 7/14) on conventional replacement therapy other than GH and 20 comparable controls (age: 37.3 ± 14.0 years, male/female: 6/14). Lipid subfractions (Lipoprint system), serum adipokine (leptin, adiponectin, resistin) concentrations, body composition, a surrogate marker for insulin resistance (HOMA) and conventional lipid profile were evaluated. No statistically significant difference was found with respect to HOMA, adipokine conce... Pituitary journals http://www.medworm.com/rss/comments.php?id=5064099 Thu, 21 Jul 2011 18:06:33 +0100 5064099 http://www.medworm.com/index.php?rid=5064100&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa1u7463207r16814%2F Abstract  Neurosurgery is the most widely used definite treatment for pituitary tumors, while medical treatments are a good option to improve symptoms, which tend to recur when drugs are stopped. The aim of this study was to assess postsurgical morbidity of secreting pituitary adenomas (adrenocorticotropin hormone –ACTH- and growth hormone –GH- secreting) and non-functioning (NF) adenomas, operated between January 2002 and May 2009. We retrospectively reviewed the data of 94 patients who were operated by the same neurosurgeons and compared the immediate (1st month) and delayed (1st year) complications between the three groups of adenomas. Forty had immediate post-operative complications (42% of NF, 37% of GH-secreting and 48% of ACTH-secreting adenomas). The most freque... Pituitary journals http://www.medworm.com/rss/comments.php?id=5064100 Thu, 21 Jul 2011 18:06:32 +0100 5064100 http://www.medworm.com/index.php?rid=5064101&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fhw603m6424k275p2%2F Abstract  This short review summarizes the use of late-night salivary cortisol measurement in the diagnosis of Cushing’s syndrome, in the evaluation of patients with adrenal incidentalomas, and in monitoring of post-operative patients, with a focus on the different assay methodologies currently in common use. The focus is on recent studies identified by literature searches using Ovid Medline and Google Scholar as well as analysis of several recent review articles on the topic. Measurement of late night salivary cortisol (LNSC) has an excellent sensitivity and specificity for the diagnosis of Cushing’s syndrome regardless of the assay methodology used. Immunoassays have the advantage of simplicity, low cost, and small sample volume requirement, while liquid chromatograph... Pituitary journals http://www.medworm.com/rss/comments.php?id=5064101 Thu, 21 Jul 2011 18:06:31 +0100 5064101 http://www.medworm.com/index.php?rid=5031057&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F05488np82j19t04h%2F Abstract  The aim of this study was to investigate association between the frequencies of Growth Hormone receptor (d3GHR) gene polymorphisms and some clinical parameters of acromegalic patients. Total of 35 acromegalic patients were enrolled to study. The d3GHR polymorphism was identified by using polymerase chain reaction from peripheral blood samples. The levels of systolic and diastolic blood pressure, BMI, fasting plasma glucose (FPG), Fasting insulin, HOMA-IR, IGF-I, GH, IGFBP3, triglyceride, HDL and LDL cholesterol concentrations were evaluated. The frequencies of d3GHR genotypes were found as follows; 5 (14.3%) subjects had d3/d3, 11 (31.4%) had d3/fl and 19 (54.3%) had fl/fl in patients. The prevalence of the d3 and fl alleles was 30 and 70%, respectively. Systolic ... Pituitary journals http://www.medworm.com/rss/comments.php?id=5031057 Sun, 10 Jul 2011 05:49:40 +0100 5031057 http://www.medworm.com/index.php?rid=5021461&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fht3711p301gw6527%2F Abstract  A 39-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) presented with acromegaly and a pituitary macroadenoma. There was a family history of this renal disorder. She had undergone surgery for pituitary adenoma 6 years prior. Physical examination disclosed bitemporal hemianopsia and elevation of both basal growth hormone (GH) 106 ng/mL (normal 0–5) and insulin-like growth factor (IGF-1) 811 ng/mL (normal 48–255) blood levels. A magnetic resonance imaging scan disclosed a 3.0 cm sellar and suprasellar mass with both optic chiasm compression and left cavernous sinus invasion. Pathologic, cytogenetic, molecular and in silico analysis was undertaken. Histologic, immunohistochemical and ultrastructural studies of the lesion ... Pituitary journals http://www.medworm.com/rss/comments.php?id=5021461 Sat, 09 Jul 2011 06:18:50 +0100 5021461 http://www.medworm.com/index.php?rid=5021463&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0802871p81324615%2F Abstract  In acromegaly, we reported on increased rates of affective disorders such as dysthymia and depression, as well as structural brain changes. Objective of this study was to determine if cognitive impairments in patients with acromegaly exist and whether such impairments are associated with structural brain alterations defined by magnetic resonance imaging (MRI). In this cross-sectional study, 55 patients with biochemically confirmed acromegaly were enrolled. MRI data were compared with 87 control subjects. Main outcome measures were performance levels in 13 cognitive tests covering the domains of attention, memory and executive function, with performance below the cut-off level of the 16th percentile rated as impaired. In addition, individual global and hippocampal ... Pituitary journals http://www.medworm.com/rss/comments.php?id=5021463 Thu, 07 Jul 2011 05:42:40 +0100 5021463 http://www.medworm.com/index.php?rid=5021462&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq34678784x5871u3%2F The objective of the study was to evaluate arterial morphologic changes of early atherosclerosis and changes in procalcitonin (PCT) levels in patients with acromegaly according to disease activity. Thirty-three active and 20 inactive acromegaly patients followed at Endocrinology-Metabolism out-patient clinic of Cerrahpasa Medical Faculty between 2004 and 2008 were included in the study. Twenty gender and age matched healthy subjects were included as the control group. Intima-media thickness (IMT) of the carotid arteries was measured by ultrasonography. Blood was drawn for biochemical tests and the serum concentrations of C-reactive protein (CRP) and PCT. Intergroup analysis revealed no significant differences between Growth hormone (GH), insulin like growth factor-1 (IGF-1), and IMT ... Pituitary journals http://www.medworm.com/rss/comments.php?id=5021462 Thu, 07 Jul 2011 05:42:40 +0100 5021462 http://www.medworm.com/index.php?rid=4994061&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F54kg72tm03032l41%2F Abstract  In acromegaly, growth hormone (GH) and insulin-like growth factor-1 (IGF-1) excess results in a specific cardiomyopathy characterized by concentric cardiac hypertrophy primarily associated with diastolic dysfunction that can lead to impaired systolic function and eventually heart failure. This review of the literature evaluates the effect of therapeutic intervention on cardiac parameters. Clinical studies investigating the impact of treatments for acromegaly on cardiac function published between January 1980 and January 2009 were identified through electronic searches of Medline. Suppression of GH and IGF-1 following surgery or medical treatment with somatostatin analogue therapy is effective in decreasing left ventricular (LV) hypertrophy, with subsequent improve... Pituitary journals http://www.medworm.com/rss/comments.php?id=4994061 Tue, 28 Jun 2011 15:51:54 +0100 4994061 http://www.medworm.com/index.php?rid=4970913&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn20636l056542786%2F Abstract  Apoplexy of pituitary adenomas with subsequent hypopituitarism is a rare but well recognized complication following cardiac surgery. The nature of cardiac on-pump surgery provides a risk of damage to the pituitary because the vascular supply of the pituitary is not included in the cerebral autoregulation. Thus, pituitary tissue may exhibit an increased susceptibility to hypoperfusion, ischemia or intraoperative embolism. After on-pump procedures, patients often present with physical and psychosocial impairments which resemble symptoms of hypopituitarism. Therefore, we analyzed whether on-pump cardiac surgery may cause pituitary dysfunction also in the absence of pre-existing pituitary disease. Twenty-five patients were examined 3–12 months after on-pump car... Pituitary journals http://www.medworm.com/rss/comments.php?id=4970913 Fri, 24 Jun 2011 16:03:31 +0100 4970913 http://www.medworm.com/index.php?rid=4970914&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F38j3u73175427473%2F Abstract  It has been reported that women with prolactinoma were exposed, early in life, to an environment characterized by an absent or violent father. The present study was designed to evaluate whether paternal absence or violent paternal behavior were more prevalent in patients with pituitary adenomas (prolactinoma, acromegaly, non-secreting adenoma and Cushing’s disease) compared to a control population. We conducted an observational case–control multicenter study. We interviewed 395 patients with prolactinoma (296 females and 99 males), 130 with acromegaly (87 females and 43 males), 237 with non-secreting adenoma (144 females and 93 males) and 68 with Cushing’s disease (61 females and 7 males) and 365 patients from the same clinics with nodular thyroid disease or... Pituitary journals http://www.medworm.com/rss/comments.php?id=4970914 Thu, 23 Jun 2011 16:27:27 +0100 4970914 http://www.medworm.com/index.php?rid=4970915&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft444110g3552q2mr%2F Content Type Journal ArticlePages 1-1DOI 10.1007/s11102-011-0323-2Authors Gilberto Ka Kit Leung, Division of Neurosurgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, People’s Republic of ChinaMichele Mae Ann Yuen, Division of Endocrinology and Metabolism, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, People’s Republic of ChinaWing Sun Chow, Division of Endocrinology and Metabolism, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, People’s Republic of ChinaPhilip Yat Hang Tse, Division of Neurosurgery, Department of Surgery, Li Ka Shing Faculty of Med... Pituitary journals http://www.medworm.com/rss/comments.php?id=4970915 Thu, 23 Jun 2011 16:27:26 +0100 4970915 http://www.medworm.com/index.php?rid=4938311&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F265288j7v35uq060%2F This study emphasizes a significant clinico-radiological correlation in Asian Indian GHD patients. MRI abnormalities in the hypothalamic pituitary area, especially EPP/PSA are more common in patients with CPHD and severe GHD. Among CPHD, EPP/PSA predicts association with hypothyroidism or hypocortisolism. IGHD with MRI abnormality may evolve into CPHD. Content Type Journal ArticlePages 1-8DOI 10.1007/s11102-011-0321-4Authors Varsha S. Jagtap, Department of Endocrinology, Seth G S Medical College, Parel, Mumbai, Maharashtra 400012, IndiaShrikrishna V. Acharya, Department of Endocrinology, Seth G S Medical College, Parel, Mumbai, Maharashtra 400012, IndiaVijaya Sarathi, Department of Endocrinology, Seth G S Medical College, Parel, Mumbai, Maharashtra 400012, IndiaAnurag R. Lila, De... Pituitary journals http://www.medworm.com/rss/comments.php?id=4938311 Sat, 11 Jun 2011 06:37:34 +0100 4938311 http://www.medworm.com/index.php?rid=4938312&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm37h0m04676j8350%2F Abstract  In this case report we describe a 38 year-old-female with galactorrhea several months after the birth of an anencephalic child. She had hyperpolactemia and imaging of the pituitary gland revealed a midline defect and a nasopharyngeal mass compatible with a meningo-(hypophyso-) encephalocele and possibly an ectopic teratoma or desmoid. She was treated with dopamine agonists for 10 years and after cessation of therapy her prolactin levels remain normal. The nasopharyngeal mass remained unchanged over time and there were no signs of hypopituitarism. The hyperprolactinemia at presentation was probably caused by earlier pregnancy and stalk dysfunction due to traction by the mass. With decline of pituitary size, after starting dopamine agonists, the traction probab... Pituitary journals http://www.medworm.com/rss/comments.php?id=4938312 Fri, 10 Jun 2011 06:34:18 +0100 4938312 http://www.medworm.com/index.php?rid=4904535&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fqq80706714204175%2F We present two patients successfully treated with this approach. Complete tumor removal was achieved and both patients achieved satisfactory functional recovery. Content Type Journal ArticlePages 1-5DOI 10.1007/s11102-011-0319-yAuthors Gilberto Ka Kit Leung, Division of Neurosurgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, People’s Republic of ChinaMichelle Mae Ann Yuen, Division of Endocrinology and Metabolism, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, People’s Republic of ChinaWing Sun Chow, Division of Endocrinology and Metabolism, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of... Pituitary journals http://www.medworm.com/rss/comments.php?id=4904535 Fri, 03 Jun 2011 05:59:46 +0100 4904535 http://www.medworm.com/index.php?rid=4854689&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp61132406616h510%2F Abstract  Although acromegaly is a rare disease, the clinical, economic and health-related quality of life (HRQoL) burden is considerable due to the broad spectrum of comorbidities as well as the need for lifelong management. We performed a comprehensive literature review of the past 12 years (1998–2010) to determine the benefit of disease control (defined as a growth hormone [GH] concentration <2.5 μg/l and insulin-like growth factor [IGF]-1 normal for age) on clinical, HRQoL, and economic outcomes. Increased GH and IGF-1 levels and low frequency of somatostatin analogue use directly predicted increased mortality risk. Clinical outcome measures that may improve with disease control include joint articular cartilage thickness, vertebral fractures, left ventri... Pituitary journals http://www.medworm.com/rss/comments.php?id=4854689 Thu, 19 May 2011 16:34:54 +0100 4854689 http://www.medworm.com/index.php?rid=4854690&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn44k385356565231%2F Abstract  The pituicytoma is an extremely rare and little-studied primary tumour of the adult neurohypophysis. With total resection, the pituicytoma appears to have a good prognosis. However, its highly vascular nature makes total resection difficult and local recurrence after subtotal resection is not uncommon. To date, only 40 cases of pituicytoma have been reported in literature. In addition to our own case of a suprasellar pituicytoma, we are reviewing and discussing these with particular attention paid on the surgical management and outcome of this rare neoplasm. Content Type Journal ArticlePages 1-10DOI 10.1007/s11102-011-0317-0Authors Ariyan Pirayesh Islamian, International Neuroscience Institute, Rudolf Pichlmayr Str. 4, 30625 Hannover, GermanyRolf Buslei, Path... Pituitary journals http://www.medworm.com/rss/comments.php?id=4854690 Thu, 19 May 2011 16:34:52 +0100 4854690 http://www.medworm.com/index.php?rid=4854691&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F6m8768704k761421%2F Abstract  Clinically non-functioning pituitary adenomas account for about one-third of pituitary tumors. The majority of them are pathologically classified as gonadotropinomas or null-cell adenomas without hormonal expression. The rest represent silent corticotroph adenomas and plurihormonal tumors. Conservative therapy with dopamine agonists is effective in some cases only depending on the expression of dopamine 2 receptors (D2R). The aim of this study was to quantitatively estimate D2R expression in clinically non-functioning pituitary adenomas and correlate the results with adenoma type according to pathological classification. Out of the 87 adenomas investigated, 63 expressed gonadotropins, 7 were silent corticotroph adenomas, 7 were plurihormonal tumors, and only 6 did ... Pituitary journals http://www.medworm.com/rss/comments.php?id=4854691 Thu, 19 May 2011 16:34:51 +0100 4854691 http://www.medworm.com/index.php?rid=4822502&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd42v416l278073m4%2F Abstract  Cushing’s syndrome is associated with excessive cortisol secretion by the adrenal gland or ectopic tumours and may result in diabetes, hypertension, and life-threatening infections with high mortality rates especially in the case of surgical resection. Although surgical resection is the treatment of choice, patients may benefit from preceding medical therapy. This may especially be useful as an adjunctive approach in emergency settings, if patients cannot undergo surgery, if surgery or radiotherapy fails, or if the tumour recurs. Medical therapy can be categorized in three different groups—inhibition of steroidogenesis, suppression of adrenocorticotropic hormone, and antagonism of the glucocorticoid receptor. However, the majority of common drugs are not avail... Pituitary journals http://www.medworm.com/rss/comments.php?id=4822502 Tue, 10 May 2011 06:03:19 +0100 4822502 http://www.medworm.com/index.php?rid=4822503&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv64r3w5mu8734516%2F Abstract  A 33-year old male was diagnosed with Cushing’s disease due to a large and invasive ACTH-secreting macroadenoma. After surgical failure ketoconazole therapy was initiated to control cortisol hypersecretion and his symptoms. He was referred to radiotherapy, and fractionated stereotactic radiotherapy in 30 fractions was delivered. After 12 daily fractions of radiotherapy the urinary cortisol release increased abruptly together with clinical deterioration. The daily ketoconazole dose was increased, and 10 days after concluding radiotherapy his urinary cortisol returned to normal values. Hormonal remission was observed less than 1 year following radiotherapy. Content Type Journal ArticlePages 1-5DOI 10.1007/s11102-011-0315-2Authors I. Shimon, Institu... Pituitary journals http://www.medworm.com/rss/comments.php?id=4822503 Tue, 10 May 2011 06:03:17 +0100 4822503 http://www.medworm.com/index.php?rid=4806631&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh55p3j150m612k15%2F The objective of this study is to assess the secretory pattern of GH after Oral Glucose Tolerance Test (OGTT) or day-curve (DC), in relation with IGF-I and to evaluate the influence of therapy on OGTT. A retrospective analysis in 279 OGTTs performed in 93 acromegalic patients in our unit from January 1988 to December 2005, in 77 patients also DC data were retrived. GH concentration was evaluated by 3 different systems (RIA, IRMA and chemiluminescence assays), and IGF-I by two RIAs. About 12% of OGTT samples were discordant with the baseline, while discordance between nadir and 120th minute was much lower (5%), with all discordant values, except one, near the cut-off lines. Correlation between DC and OGTT data was around 0.99 among all values, discordance rate between nadir and minimu... Pituitary journals http://www.medworm.com/rss/comments.php?id=4806631 Wed, 04 May 2011 14:51:45 +0100 4806631 http://www.medworm.com/index.php?rid=4745284&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fbr574k54381qj877%2F Abstract  The clinical and radiological findings of a patient affected by apoplexy of an adenoma located within cavernous sinus and presenting isolated Cranial Nerve (CN) VI palsy are reported. The differential diagnosis with other pathologies is debated, and pathogenesis of isolated abducens nerve palsy is investigated. The pertinent literature of this uncommon case of apoplexy is reviewed. A 59-year-old female presented sudden appearance of CN VI palsy associated to violent headache. Endocrinological assessment did not show pituitary insufficiency; MRI depicted an adenoma located within the left CS. She underwent an endoscopic endonasal procedure with extensive opening of the cavernous sinus, occupied by an ischemic adenoma. Afterward, neurological symptoms promptly resol... Pituitary journals http://www.medworm.com/rss/comments.php?id=4745284 Tue, 19 Apr 2011 07:15:56 +0100 4745284 http://www.medworm.com/index.php?rid=4745283&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk36n327g2j002774%2F In conclusions, polycythemia can be a direct, albeit rare, secondary manifestation of acromegaly, that must be considered during the diagnostic work-up of acromegalic patients presenting with such disorder. Content Type Journal ArticlePages 1-6DOI 10.1007/s11102-011-0311-6Authors Gabriele Zoppoli, Department of Internal Medicine, University of Genoa, Genoa, ItalyFederico Bianchi, Department of Endocrine and Medical Sciences and Center of Excellence for Biomedical Research, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, ItalyAndrea Bruzzone, Department of Internal Medicine, University of Genoa, Genoa, ItalyAlessandro Calvia, Department of Internal Medicine, University of Genoa, Genoa, ItalyCaterina Oneto, Department of Internal Medicine, University of Genoa, Genoa, ItalyCa... Pituitary journals http://www.medworm.com/rss/comments.php?id=4745283 Tue, 19 Apr 2011 07:15:56 +0100 4745283 http://www.medworm.com/index.php?rid=4710633&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw48m84v778v76t7m%2F We report a young woman with sudden and severe retroorbital headache, neck pain, and a large sellar mass extending to the suprasellar cistern. A presumptive diagnosis of non-secreting pituitary macroadenoma undergoing apoplexy was made and transphenoidal surgery performed. Histopathology revealed mononuclear infiltration and marked non-hemorrhagic necrosis of the anterior pituitary consistent with a diagnosis of necrotizing infundibulo-hypophysitis. The possible pathogenesis of this rare variant of hypophysitis is discussed. Content Type Journal ArticlePages 1-7DOI 10.1007/s11102-011-0307-2Authors Angelika Gutenberg, Department of Neurosurgery, University Medical Center, Georg August University, 37099 Göttingen, GermanyPatrizio Caturegli, Department of Pathology and Immunology,... Pituitary journals http://www.medworm.com/rss/comments.php?id=4710633 Sat, 09 Apr 2011 15:48:15 +0100 4710633 http://www.medworm.com/index.php?rid=4698916&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw174n06277h34230%2F Abstract  The importance of achieving tumor control in pituitary adenoma surgery is not entirely established. This manuscript reviews the literature linking residual pituitary tumor and hormonal hypersecretion to increases in long term mortality. When possible, we utilized meta-analysis methods to estimate a pooled standardized mortality ratio (SMR), which relates the risk of mortality for a cohort of patients compared to a similar age and gender matched cohort in the general population, for patients with endocrinologic evidence of residual disease. When this was not possible, we review the existing literature in the results and discussion section of this review. We identified 10 articles regarding acromegaly and three articles regarding Cushing’s disease which presented ... Pituitary journals http://www.medworm.com/rss/comments.php?id=4698916 Thu, 07 Apr 2011 17:08:14 +0100 4698916 http://www.medworm.com/index.php?rid=4698917&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fdm03m724843713p4%2F Abstract  Patients with Cushing’s syndrome (CS) develop osteopenia-osteoporosis. The present study evaluates the recovery of bone mass within 2 years after remission of hypercortisolism and in long term follow up, an issue rarely addressed. Twenty patients (6M, 14F, 3 post-menopausal, 15–64 years old), 15 with Cushing’s disease, 2 with ectopic ACTH syndrome, 3 with ACTH-independent CS were studied. BMD, T and Z scores at lumbar spine and proximal femur were assessed by dual-energy X-ray absorptiometry before and 7–33 months after treatment of hypercortisolism. Five patients were treated with bisphosphonates. Four patients had hypogonadism and 4 GH-deficiency. At baseline all patients showed osteopenia/osteoporosis and the spine appeared more damaged t... Pituitary journals http://www.medworm.com/rss/comments.php?id=4698917 Thu, 07 Apr 2011 17:08:13 +0100 4698917 http://www.medworm.com/index.php?rid=4671983&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp2pv384412087822%2F Abstract  Patients with acromegaly have higher prevalence of colorectal neoplasms. The pathogenetic mechanism is still unclear and may be related to sustained increase in serum GH-IGF1. We aimed to evaluate the proliferative and apoptotic markers in samples of colonic mucosa obtained during screening colonoscopic biopsy from patients with acromegaly and study their relationship to serum IGF-1 and GH levels. The study subjects included 32 patients with acromegaly (4 female), 10 healthy controls (irritable bowel syndrome) and 10 positive controls (non-acromegalic colonic adenocarcinoma). Patients with acromegaly were divided into two groups, active disease (AD) and disease in remission (AR). Two biopsies each were obtained during colonoscopy from the right colon, transverse c... Pituitary journals http://www.medworm.com/rss/comments.php?id=4671983 Wed, 30 Mar 2011 23:52:14 +0100 4671983 http://www.medworm.com/index.php?rid=4645046&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4jw8120x795316p2%2F Abstract  Transsphenoidal pituitary adenoma surgery is related to a low morbidity rate. The complications that can occur are classified as intra- and extracranial. The aim of the study is to discuss one group of these complications involving the sphenoid sinus: mucocele and its possible transformation into pyocele. We evaluate clinical presentation, management strategy and the outcome after long-term follow-up presenting an explicative case and a review of the literature. A patient presented to our outpatient clinic 8 months after transsphenoidal surgery for selective removal of a pituitary adenoma because of an acute onset of frontal headache during an airplane travel, fever and pulsating sensation in left eye and ear. MRI revealed a contrast-enhancing lesion in the l... Pituitary journals http://www.medworm.com/rss/comments.php?id=4645046 Fri, 25 Mar 2011 18:50:46 +0100 4645046 http://www.medworm.com/index.php?rid=4632578&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp20656346468kn58%2F We present the clinical, hormonal, hematological course and response to glucocorticoids in a patient of Sheehan’s syndrome presenting with pancytopenia. Complete recovery of pancytopenia was observed after achieving eucortisolemic state thus concluding that gulcocorticoid replacement is sufficient to reverse pancytopenia in these patients. Content Type Journal ArticlePages 1-4DOI 10.1007/s11102-011-0304-5Authors Bashir Ahmad Laway, Department of Endocrinology, Sher-I- Kashmir Institute of Medical Sciences Soura, Srinagar, Jammu and Kashmir IndiaShahnaz Ahmad Mir, Department of Endocrinology, Sher-I- Kashmir Institute of Medical Sciences Soura, Srinagar, Jammu and Kashmir IndiaJavid Rasool Bhat, Department of Clinical Hematology, Sher-I- Kashmir Institute of Medical Sciences Sour... Pituitary journals http://www.medworm.com/rss/comments.php?id=4632578 Mon, 21 Mar 2011 19:00:51 +0100 4632578 http://www.medworm.com/index.php?rid=4611668&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc3673331133m2671%2F Abstract  Dopamine agonists (DA) are the mainstay of treatment for patients with prolactinomas. To describe the efficacy of treatment and the outcomes of DA withdrawal. Retrospective review of electronic medical records of patients with prolactinomas from 1985 to 2009. Seventy-nine patients (17 men/62 women), aged 35.3 ± 1.6 years at diagnosis were studied. The mean follow-up time was 84.7 ± 9.2 months (range 0–336). The mean initial size of microadenomas was 0.74 ± 0.10 cm (range 2.41 ± 0.39) and of macrodenomas 2.41 ± 0.39 cm (range 1.1–8) and serum prolactin (PRL) levels were 112 ± 19 and 263 ± 59 ng/ml, respectively (normal range 0–40). Fifty-one (65%) prolactinoma... Pituitary journals http://www.medworm.com/rss/comments.php?id=4611668 Wed, 16 Mar 2011 12:00:07 +0100 4611668 http://www.medworm.com/index.php?rid=4578627&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa43353331g126800%2F Abstract  Harvey Cushing’s monograph The Pituitary Body and Its Disorders describes Case XXXVIII, H. M. B., a 33 year-old man who presented with acromegaly in 1910. The detailed operative note reports an emergency tracheotomy performed following induction of anesthesia, and immediately prior to a naso-labial approach to a suspected sellar lesion. Cushing’s post-operative notes document a significant increase in temperature prior to the patient’s death. Cushing offered an explanation for the patient’s symptoms immediately pre-mortem, which is largely unsatisfying. Following institutional review board approval, and through the courtesy of the Alan Mason Chesney Archives, the surgical records from the Johns Hopkins Hospital, 1896–1912, were reviewed. A review of ... Pituitary journals http://www.medworm.com/rss/comments.php?id=4578627 Thu, 10 Mar 2011 17:13:27 +0100 4578627 http://www.medworm.com/index.php?rid=4567254&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk2691222r6l23434%2F The objective of this study was to screen for acromegaly by application of a simple questionnaire in patients seen at primary health care units. A total of 17,000 patients of both genders >18 and <70 years seen by general practitioner were interviewed. Patients with known pituitary disease and pregnant women were excluded. A simple questionnaire was applied to the patients: Has your shoe size increased over the last 5 years? Did you have to change your wedding ring or ring over the last 5 years because it became tight? In one patient, the diagnosis of acromegaly was suspected by the physician. Among the remaining patients, 178 (1%) responded positively to one of the items of the questionnaire and were submitted to IGF-1 measurement. Five patients had persistently ... Pituitary journals http://www.medworm.com/rss/comments.php?id=4567254 Mon, 07 Mar 2011 06:35:52 +0100 4567254 http://www.medworm.com/index.php?rid=4541630&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft732456j03508jx3%2F Abstract  Perioperative bacterial meningitis after trans-sphenoidal surgery for pituitary and parasellar lesions is an uncommon but serious complication. Little evidence guides the choice of chemoprophylaxis in this setting. To begin to address this deficiency, we investigated the incidence of perioperative meningitis in 442 patients who underwent trans-sphenoidal surgery and received a short chemoprophylaxis regimen with a single agent and did not require lumbar drainage. In 2005 we instituted a standardized antibiotic prophylaxis protocol for trans-sphenoidal surgery that utilized intravenous cefuroxime, a second-generation cephalosporin with broad coverage and excellent spinal fluid penetration, administered 30 min before surgery and 8 h later. The primary endp... Pituitary journals http://www.medworm.com/rss/comments.php?id=4541630 Wed, 23 Feb 2011 23:35:18 +0100 4541630 http://www.medworm.com/index.php?rid=4513683&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd84w57623u124836%2F Abstract  Ghrelin, an orexigenic hormone, is normally produced mainly in stomach. In addition, it has been demonstrated in gastric carcinoid tumors and less often in other neuroendocrine tumors. We investigated ghrelin expression by immunohistochemistry (streptavidin–biotin-peroxidase complex method) in the full spectrum of resected pituitary adenoma subtypes. Quantification of staining considered both the frequency of ghrelin-reactive tumor cells as well as their staining intensity. Cytoplasmic ghrelin immunopositivity was identified in several adenoma subtypes. Cellular staining varied considerably. In addition, the intensity of cell staining differed within the same tumor and between adenoma subtypes. The highest scores were noted in GH producing adenomas exposed to lon... Pituitary journals http://www.medworm.com/rss/comments.php?id=4513683 Mon, 21 Feb 2011 17:07:07 +0100 4513683 http://www.medworm.com/index.php?rid=4503037&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F688575m10p727h74%2F Abstract  Restless legs syndrome (RLS), a neurological sensory-motor disorder characterized by a compelling urge to move the limbs during the night, is a sleep disturbance that impairs quality of life. Prevalence of RLS and consequences on quality of life were investigated in acromegalic patients. Fifty-six patients (20 men, 55.0 ± 1.6 years), 22 with active acromegaly (group 1) and 34 with controlled disease (group 2), and 95 controls (35 men, 52.9 ± 1.1 years) were evaluated by a structured sleep interview concerning insomnia, circadian sleep disorders and excessive diurnal sleepiness (EDS). The Epworth Sleepiness Scale (ESS) questionnaire was administered to those reporting EDS. Patients were investigated by RLS diagnostic interview and Inte... Pituitary journals http://www.medworm.com/rss/comments.php?id=4503037 Thu, 17 Feb 2011 08:00:55 +0100 4503037 http://www.medworm.com/index.php?rid=4484723&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F50k203123674lv4p%2F Abstract  At present, no effective medical treatment exists for recurrent and aggressive craniopharyngiomas that are resistant to conventional therapies, including surgery and adjuvant radiotherapy. Temozolomide is an alkylating chemotherapeutic agent used routinely in the management of high grade gliomas. The response to temozolomide is suggested to be dependent on the tumoral expression of O-6 methylguanine DNA methyltransferase (MGMT). Evidence supports that low MGMT immunoexpression correlates with positive response to temozolomide. Therefore, we aimed to assess MGMT immunoexpression in adamantinomatous craniopharyngiomas, in an effort to predict the likelihood of response to temozolomide. The MGMT immunostaining was performed on 23 adamantinomatous craniofaryngiomas op... Pituitary journals http://www.medworm.com/rss/comments.php?id=4484723 Fri, 11 Feb 2011 11:52:45 +0100 4484723 http://www.medworm.com/index.php?rid=4461126&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F25u2q61g7x1v6488%2F Abstract  Adipsic diabetes insipidus (ADI) is characterised by impaired thirst and defective AVP secretion. We have assessed the thirst response to graded osmotic stimulation using a visual analog scale (VAS) in patients with a history of ADI following surgery for a craniopharyngioma. The patients were thought to be regaining their thirst response but we wanted to confirm that this was the case objectively before relaxing their strict fluid balance regimen. Three patients with adipisa in the presence of hypernatremia following surgery for a craniopharyngioma are described. Their median age at surgery was 13 years (range 11–15 years). All patients had previously demonstrated no desire to drink despite a serum osmolality in excess of 300 mOsmol/kg. Fluid balan... Pituitary journals http://www.medworm.com/rss/comments.php?id=4461126 Mon, 07 Feb 2011 23:04:00 +0100 4461126 http://www.medworm.com/index.php?rid=4461127&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr11725217p473402%2F Abstract  Hyperprolactinemia may cause bone loss but data on fractures are scanty. The aim of this study was to evaluate the prevalence of vertebral fractures in women with prolactin (PRL)-secreting adenoma. In this cross-sectional study, 78 women (median age 45.5 years, range: 20–81) with PRL-secreting pituitary adenoma (66 with microadenoma and 12 with macroadenoma) and 156 control subjects, with normal PRL values and with comparable age to patients with hyperprolactinemia, were evaluated for vertebral fractures by a morphometric approach and for bone mineral density (BMD) by a dual-energy X-ray absorptiometry at lumbar spine. Vertebral fractures were shown in 25 patients with PRL-secreting adenoma (32.6%) and in 20 controls (12.8%, P < 0.001). Fracture... Pituitary journals http://www.medworm.com/rss/comments.php?id=4461127 Mon, 07 Feb 2011 23:03:59 +0100 4461127 http://www.medworm.com/index.php?rid=4451601&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F20g84jr85483200m%2F Abstract  Rapid assessment of adrenal function is critical following transsphenoidal surgery (TSS) for Cushing’s disease (CD) in order to determine surgical efficacy. We hypothesize that there may be a role for ACTH measurement as a rapid indicator of adrenal function. Following surgery for CD, glucocorticoids were withheld and paired plasma ACTH and serum cortisol levels were measured every 6 h. Post-operative hypocortisolemia was defined as serum cortisol <2 mcg/dl or a serum cortisol <5 mcg/dl with the onset of symptoms of adrenal insufficiency within 72 h. We studied 12 subjects, all female, mean age 44.6 years (range 25–55), including 13 surgeries: nine subjects attained hypocortisolemia. Plasma ACTH levels decreased more in subjects w... Pituitary journals http://www.medworm.com/rss/comments.php?id=4451601 Sat, 05 Feb 2011 16:56:25 +0100 4451601 http://www.medworm.com/index.php?rid=4429965&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd2513v196838022v%2F Abstract  The IL-17 plays a crucial role in the invasion of tumors. However, the effects of IL-17 on the invasion of human pituitary adenomas are still unknown. The current study is designed to investigate the possible involvement of IL-17 in the invasion of adenomas. By collecting invasive and non-invasive pituitary adenomas, the mRNA and protein levels of IL-17, IL-17R and MMP-9 are investigated. The results obtained from IHC showed that the strong positive rate and the total positive rate of IL-17, IL-17R and MMP-9 expression cells in the non-invasive group were 17.1 and 51.43%, 14.3 and 54.3%, 17.1 and 57.1%, respectively. In contrast, the strong positive rate and the total positive rate of the invasive group were significantly higher than that of the non-invasive group... Pituitary journals http://www.medworm.com/rss/comments.php?id=4429965 Sat, 29 Jan 2011 17:20:07 +0100 4429965 http://www.medworm.com/index.php?rid=4429966&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F8132uv4222j80r4x%2F We present a 22-year old male patient previously treated with radiotherapy and surgery at the age of 7 for an undefined suprachiasmatic mass. Following treatment he gradually became morbidly obese and besides subsequent panhypopituitarism he achieved his target height probably due to obesity-induced severe hyperinsulinemia. At the age of 21 Langerhans’ cell histiocytosis was diagnosed at the right mandible and was surgically treated. One year later he developed a further painful osteolytic hip lesion and a single zoledronate infusion eliminated all symptoms. We highlight the importance of obtaining a histological diagnosis before initiating treatment, and the distinctive course of the disease in a patient who continued to growth besides GH deficiency. Content Type Journal Artic... Pituitary journals http://www.medworm.com/rss/comments.php?id=4429966 Fri, 28 Jan 2011 20:43:05 +0100 4429966 http://www.medworm.com/index.php?rid=4327591&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7q221472jg387403%2F We present the case of a 51-year old female patient with acromegaly that was resistant to somatostatin analogs and dopamine agonists. The patient was diagnosed with breast cancer requiring treatment with the anti-estrogen tamoxifen. Prior to initiating the treatment with tamoxifen, the IGF-I level was very high at 415% of the upper limit of normal for the patient’s age and sex. During the tamoxifen treatment, the level of IGF-I dropped spectacularly down to normal levels. This observation highlights the effect of an anti-estrogen treatment in certain female patients with acromegaly. Content Type Journal ArticlePages 1-5DOI 10.1007/s11102-010-0287-7Authors Jean-Christophe Maiza, Department of Endocrinology and Metabolic Diseases, CHU Larrey, 24 Chemin de Pourvouville, TSA 30030... Pituitary journals http://www.medworm.com/rss/comments.php?id=4327591 Fri, 07 Jan 2011 14:51:18 +0100 4327591 http://www.medworm.com/index.php?rid=4327593&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw2j44k475305272q%2F Abstract  Cabergoline and bromocriptine are the most used drugs in the treatment of hyperprolactinemia, they are able to normalize the prolactin levels, restore gonadal function and promote tumor reduction in the majority of patients. We undertake a systematic review and meta-analysis of randomized controlled trials to compare cabergoline versus bromocriptine in the treatment of patients with idiopathic hyperprolactinemia and prolactinomas. The data sources were: Embase, Pubmed, Lilacs and Cochrane Central. The outcome measures were: normalization of prolactin secretion, restoration of gonadal function, reduction of tumoral volume, quality of life and adverse drug effects. Were identified 418 references and after screening by title and abstract, we obtained complete copies ... Pituitary journals http://www.medworm.com/rss/comments.php?id=4327593 Fri, 07 Jan 2011 14:51:16 +0100 4327593 http://www.medworm.com/index.php?rid=4327592&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw7636124w68267ut%2F We present two cases of a 31 and 44 years old male with gigantism and acromegaly that were controlled subsequently by surgery, radiotherapy, SRIF analogs and daily PEG-V treatment. They were converted to combined treatment of monthly SSA and (twice) weekly PEG-V. High dose SSA treatment was added while the PEG-V dose was decreased during carful monitoring of the IGF-I. After switching from PEG-V monotherapy to SRIF analogs plus pegvisomant combination therapy IGF-I remained normal. However, the necessary PEG-V dose, to normalize IGF-I differed significantly between these two patients. One patient needed twice weekly 100 mg, the second needed 60 mg once weekly on top of their monthly lanreotide Autosolution injections of 120 mg. The weekly dose reduction was 80 and... Pituitary journals http://www.medworm.com/rss/comments.php?id=4327592 Fri, 07 Jan 2011 14:51:16 +0100 4327592 http://www.medworm.com/index.php?rid=4325150&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy6572q6050482g76%2F In conclusion, our studies showed that AMPK has a role in regulating somatotroph function in normal rat pituitary and proliferation of pituitary adenomatous cells. Content Type Journal ArticlePages 1-11DOI 10.1007/s11102-010-0288-6Authors Giovanni Tulipano, Department of Biomedical Sciences and Biotechnologies, Unit of Pharmacology, University of Brescia, Viale Europa 11, 25123 Brescia, ItalyMichela Giovannini, Department of Biomedical Sciences and Biotechnologies, Unit of Pharmacology, University of Brescia, Viale Europa 11, 25123 Brescia, ItalyMaurizio Spinello, Novartis Farma SpA, Origgio, ItalyValeria Sibilia, Department of Pharmacology and Chemotherapy, University of Milan, Milan, ItalyAndrea Giustina, Department of Medical and Surgical Sciences, Unit of Endocrinology, Univers... Pituitary journals http://www.medworm.com/rss/comments.php?id=4325150 Thu, 06 Jan 2011 17:56:14 +0100 4325150 http://www.medworm.com/index.php?rid=4301085&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl166w615k868t57t%2F Content Type Journal ArticleDOI 10.1007/s11102-010-0279-7Authors Patricia Fainstein Day, Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinolog´ıa de la Sociedad Argentina de Endocrinolog´ıa y Metabolismo, Buenos Aires), Díaz Velez, 3889, 1200 Buenos Aires, ArgentinaMirtha Guitelman, Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinolog´ıa de la Sociedad Argentina de Endocrinolog´ıa y Metabolismo, Buenos Aires), Díaz Velez, 3889, 1200 Buenos Aires, ArgentinaRosa Artese, Neuroendocrinology Department of the Argentine Society of Endocrinology and Metabolism, Buenos Aires (Departamento de Neuroendocrinolog´ıa de la S... Pituitary journals http://www.medworm.com/rss/comments.php?id=4301085 Tue, 28 Dec 2010 15:37:58 +0100 4301085 http://www.medworm.com/index.php?rid=4301086&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc32n45p385503700%2F We present 2 cases of 1,25 (OH)2 D-dependent hypercalcemia associated with growth hormone excess. Complete resection of tumor produced biochemical remission of acromegaly and normalization of calcium and 1,25 (OH)2 D levels, while incomplete resection was associated with persistent 1,25 (OH)2 D-dependent hypercalcemia. Acromegaly should be considered a cause of 1,25 (OH)2 D-dependent hypercalcemia. Content Type Journal ArticleDOI 10.1007/s11102-010-0286-8Authors Reshma Shah, Division of Endocrinology, Diabetes and Lipids. Department of Medicine, Emory University School of Medicine, 1365 B Clifton Rd NE, Atlanta, GA 30329, USAAngelo Licata, Department of Endocrinology, Diabetes and Metabolism, Cleveland Clinic, Cleveland, OH 44195, USANelson M. Oyesiku, Division of Endocrinology, Di... Pituitary journals http://www.medworm.com/rss/comments.php?id=4301086 Tue, 28 Dec 2010 15:37:56 +0100 4301086 http://www.medworm.com/index.php?rid=4289187&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm21882704206464x%2F Abstract  A large body of in vitro evidence shows that cytokines influence the hypothalamic–pituitary–adrenal axis both in physiological conditions and in Cushing’s disease (CD). In order to study in vivo the role of intrapituitary cytokines in CD, we assayed two cytokines known for their action on the pituitary, i.e. interleukin-1 beta (IL-1β) and interleukin-6 (IL-6), and also soluble interleukin-6 receptor (sIL-6R), important for the neural activities of IL-6, in a carefully selected sample of subjects affected by CD undergoing bilateral inferior petrosal sinus sampling. Similarly to ACTH, all cytokines basally showed a higher concentration in the ipsilateral sinus compared to the controlateral one and to that of peripheral blood; after CRH infusion, both ipsilate... Pituitary journals http://www.medworm.com/rss/comments.php?id=4289187 Wed, 22 Dec 2010 20:21:32 +0100 4289187 http://www.medworm.com/index.php?rid=4289188&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F56w8617572673332%2F Abstract  The authors investigate the complications of transnasal transsphenoidal endoscopic surgery in the treatment of 301 patients with pituitary adenomas. A retrospective analysis of complications in 301 patients submitted to transsphenoidal transnasal endoscopic surgery at the General Hospital of Fortaleza, Brazil between January 1998 and December 2009. The complications were divided in two groups: anatomical (oronasofacial, sphenoid sinus, intrasellar, suprasellar and parasellar) and endocrinological complications (anterior and posterior pituitary dysfunctions). We observed a total of 81 complications (26.9%) in our series. Anatomical complications occurred in 8.97% (27 cases): 8 CSF postoperative leaks (2.6%), 6 cases (1.9%) of delayed nasal bleeding, 5 cases (1.6%) ... Pituitary journals http://www.medworm.com/rss/comments.php?id=4289188 Wed, 22 Dec 2010 20:21:31 +0100 4289188 http://www.medworm.com/index.php?rid=4273078&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F64r115h7317269um%2F Abstract  Despite the fact that consensus guidelines recommend long-term dopamine agonist (DA) therapy as a first-line approach to the treatment of small prolactinoma, some patients continue to prefer a primary surgical approach. Concerns over potential adverse effects of long-term medical therapy and/or the desire to become pregnant and avoid long-term medication are often mentioned as reasons to pursue surgical removal. In this retrospective study, 34 consecutive patients (30 female, 4 male) preferably underwent primary pituitary surgery without prior DA treatment for small prolactinomas (microprolactinoma 1–10 mm, macroprolactinoma 11–20 mm) at the Department of Neurosurgery, University of Bern, Switzerland. At the time of diagnosis, 31 of 34 patients (91%)... Pituitary journals http://www.medworm.com/rss/comments.php?id=4273078 Fri, 17 Dec 2010 17:41:31 +0100 4273078 http://www.medworm.com/index.php?rid=4273079&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm163g485115x0547%2F The objective of this study was to evaluate the frequency of acromegaly in adults with diabetes mellitus (DM) or glucose intolerance (GI) and to estimate its prevalence in the general population. A total of 2,270 patients with DM or GI and age from 20 to 70 years were studied. Patients with known pituitary disease and pregnant women were excluded. Serum IGF-1 was measured in all subjects and, if elevated, a new measurement was obtained together with the measurement of GH in the oral glucose tolerance test (OGTT). Patients with persistently elevated IGF-1 and inadequate suppression of GH were submitted to magnetic resonance imaging (MRI). Acromegaly was not suspected by the assistant physician in any of the patients. Six patients had persistently elevated IGF-1 and inadequate sup... Pituitary journals http://www.medworm.com/rss/comments.php?id=4273079 Fri, 17 Dec 2010 17:41:29 +0100 4273079 http://www.medworm.com/index.php?rid=4267859&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx3u6252595471524%2F Abstract  To determine the prevalence of diabetes, glucose intolerance and impaired fasting glucose in Mexican patients with acromegaly and establish associations with clinical, anthropometric and biochemical variables. 257 patients with acromegaly were evaluated by a 75 g-oral glucose tolerance test with measurements of both GH and glucose (0, 30, 60, 90 120 min) as well as baseline IGF-1. Normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and diabetes (DM) were defined based on the 2003 ADA criteria. NGT, IFG, IGT and DM were found in 27.6, 8.9, 31.6 and 31.9% of the subjects, respectively; 42 of the DM patients were unaware of the diagnosis. Patients with diabetes were older than subjects in the other 3 categories (... Pituitary journals http://www.medworm.com/rss/comments.php?id=4267859 Wed, 15 Dec 2010 16:01:34 +0100 4267859 http://www.medworm.com/index.php?rid=4267860&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn622840053261603%2F Abstract  Acromegaly is a rare disease with a multifaceted clinical presentation. In 90–95% of patients with acromegaly, the disease is caused by a growth hormone (GH)-secreting pituitary adenoma with elevated GH levels that ultimately induce excessive hepatic secretion of insulin-like growth factor-1 (IGF-1). Somatostatin receptor ligands (SRLs) are considered the standard medical choice for the treatment of acromegaly, and normalization of GH and IGF-1 is attainable with effective therapy. This review aims to summarize the literature relative to SRL dose escalation therapy in patients with acromegaly. A United States National Library of Medicine PubMed search of SRL’s was conducted using the following search terms: ((((LAR) OR ATG) OR octreotide) OR lanreotide Autogel... Pituitary journals http://www.medworm.com/rss/comments.php?id=4267860 Wed, 15 Dec 2010 16:01:33 +0100 4267860 http://www.medworm.com/index.php?rid=4242845&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy8l337175u43r437%2F This study suggests that currently known genetic causes are rare in sporadic adult IPI patients, and that systematic genetic screening is not needed in adult-onset sporadic cases of IPI. Conversely, familial cases are highly suspect for genetic causes. Content Type Journal ArticleDOI 10.1007/s11102-010-0278-8Authors Helena Filipsson Nyström, Department of Endocrinology, Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 41345 Gothenburg, SwedenAlexandru Saveanu, Department of Endocrinology, Centre Hospitalo-Universitaire Timone, Marseille, FranceEdna J. L. Barbosa, Department of Endocrinology, Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 41345 Gothenburg, SwedenAnne Barlier, Department of Endocrinology, Centre Hospitalo-Universitaire Timone, Ma... Pituitary journals http://www.medworm.com/rss/comments.php?id=4242845 Mon, 06 Dec 2010 15:08:38 +0100 4242845 http://www.medworm.com/index.php?rid=4231123&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F129268854t58700r%2F In conclusion, beneficial metabolic changes were seen in prolactinoma patients after treatment with DA agonists, underscoring the importance of an active treatment approach and to consider the metabolic profile in the clinical management of hyperprolactinemia patients. Content Type Journal ArticleDOI 10.1007/s11102-010-0277-9Authors Katarina Berinder, Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, 171 76 Stockholm, SwedenThomas Nyström, Department of Internal Medicine, Karolinska Institutet and South Hospital, Stockholm, SwedenCharlotte Höybye, Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, 171 76 Stockholm, SwedenKerstin Hall, Department of Molecular Medicine and Surgery, Endoc... Pituitary journals http://www.medworm.com/rss/comments.php?id=4231123 Thu, 02 Dec 2010 18:15:55 +0100 4231123 http://www.medworm.com/index.php?rid=4209028&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4663777031814t61%2F In this report, an extremely rare case of pediatric thyrotropin-secreting pituitary macroadenoma (TSHoma) is described. An 8-year-old boy, complaining of unsteady gait, was suspected of endocrinopathy because of emaciation and muscle weakness of the legs. Endocrinological work-up established a diagnosis of hyperthyroidism due to syndrome of inappropriate secretion of TSH. Magnetic resonance imaging showed a pituitary macroadenoma with suprasellar and sphenoidal extension without cavernous sinus invasion. He underwent an endoscopic endonasal transsphenoidal adenomectory due to the diagnosis of TSHoma. The adenoma was soft and it was totally removed. Histopathological staining confirmed diagnosis of TSHoma. Postoperative evaluation revealed a subnormal level of TSH (from 13–21 to 0.0... Pituitary journals http://www.medworm.com/rss/comments.php?id=4209028 Fri, 26 Nov 2010 18:08:40 +0100 4209028 http://www.medworm.com/index.php?rid=4206556&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F5p03vjt5u6640h4q%2F Abstract  The gene mutations of Factor V R506Q (FV-Leiden), prothrombin (FII G20210A), methylene tetrahydrofolate reductase (MTHFR) C677T and A1298C and PAI-1 4G/5G are well-established risk factors for thrombosis. We aimed to investigate the prevalence of these gene mutations and their possible impact on the development of pathogenesis in patients with Sheehan’s syndrome (SS). 40 female patients with SS compared to a control group of 45 healthy women. The presence of FV-Leiden, FII G20210A, MTHFR C677T, MTHFR A1298C and PAI-1 4G/5G gene mutations were assessed by polymerase chain reaction analysis with a light cycler analyzer. An odds ratio of greater than one is considered to increase the risk of SS disease as found in Factor V Leiden, FII G20210A, MTHFR C677T, MTHFR A1... Pituitary journals http://www.medworm.com/rss/comments.php?id=4206556 Wed, 24 Nov 2010 20:21:40 +0100 4206556 http://www.medworm.com/index.php?rid=4206557&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F42u6082g7378n685%2F Abstract  The aim of the study was to evaluate the frequency of occurrence of pituitary failure following neurosurgery and the efficacy of transsphenoidal tumour resection in acromegalic patients. We retrospectively evaluated 85 patients (60 female and 25 male), of mean age 43.9 ± 13.2 years, treated by transsphenoidal neurosurgery. Macroadenoma and microadenoma of pituitary were found in 66 (77.6%) and 19 (22.4%) of these patients, respectively. Criteria of cure following neurosurgery were: basal GH < 2.5 μg/l, GH at 120 min in OGTT < 1.0 μg/l and serum concentration of IGF-1 within normal ranges for age and sex. After surgery 32 patients (37.6%) were cured and 53 patients (62.4%) required somatostatin analogue trea... Pituitary journals http://www.medworm.com/rss/comments.php?id=4206557 Wed, 24 Nov 2010 20:21:39 +0100 4206557 http://www.medworm.com/index.php?rid=4203978&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq706827548811q3w%2F Abstract  Cerebrospinal fluid (CSF) leak following initiation of Dopamine agonist therapy for macroprolactinomas, although uncommon, has been described previously in the literature. Traditional management includes primary repair of the defect using either fat or fascia lata in conjunction with lumbar drain insertion. In this case series we outline two cases of CSF leak secondary to invasive pituitary tumour that were repaired successfully using a nasoseptal flap. We believe that this form of repair is effective and associated with minimal morbidity. Content Type Journal ArticleDOI 10.1007/s11102-010-0274-zAuthors B. Thakur, Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Glossop Road, Sheffield, S10 2JF UKA. R. Jesurasa, ... Pituitary journals http://www.medworm.com/rss/comments.php?id=4203978 Tue, 23 Nov 2010 18:16:12 +0100 4203978 http://www.medworm.com/index.php?rid=4192492&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp78915k18312q411%2F Abstract  The aim of this prospective open trial was to evaluate the efficacy in normalizing IGF-I levels of the addition of cabergoline to the treatment of acromegalic patients partially responsive to Octreotide-LAR (OCT-LAR), a long acting somatotastin analog (SSA). Fifty-two patients who did not achieve hormonal control after longterm therapy (at least, 12 months) with OCT-LAR (30 mg every 28 days intramuscularly) were given cabergoline in addition to the SSA treatment. Normalization of IGF-I levels was achieved in 40.4% of patients by 6 months after the addition of cabergoline (1.0–3.0 mg/week; mean, 2.19 ± 0.64), and these patients were considered responsive. Compared to non-responsive subjects, responsive patients had significantly... Pituitary journals http://www.medworm.com/rss/comments.php?id=4192492 Sat, 20 Nov 2010 17:52:31 +0100 4192492 http://www.medworm.com/index.php?rid=4187430&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F776p524263u70156%2F In conclusion, the significant antisecretive and antiproliferative effect of octreotide in this patient might be related to the high expression of SSTR5, in the presence of SSTR2. After reviewing the literature, indeed, in line with previous observations, we hypothesize that SSTR5/SSTR2 ratio in TSHomas may represent a useful marker in predicting the outcome of therapy with SSAs. The role of D2R should be further explored considering that the presence of D2R can influence SSTRs functionality. Content Type Journal ArticleDOI 10.1007/s11102-010-0271-2Authors Federico Gatto, Department of Endocrine and Medical Sciences (DiSEM) & Center of Excellence for Biomedical Research, University of Genova, Viale Benedetto XV, 6, 16132 Genova, ItalyFederica Barbieri, Laboratory of Pharmacology... Pituitary journals http://www.medworm.com/rss/comments.php?id=4187430 Wed, 17 Nov 2010 21:07:43 +0100 4187430 http://www.medworm.com/index.php?rid=4160434&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv7086w77652364m1%2F Abstract  To determine whether peer-reviewed consensus statements have changed clinical practice, we surveyed acromegaly care in specialist centers across the globe, and determined the degree of adherence to published consensus guidelines on acromegaly management. Sixty-five acromegaly experts who participated in the 7th Acromegaly Consensus Workshop in March 2009 responded. Results indicated that the most common referring sources for acromegaly patients were other endocrinologists (in 26% of centers), neurosurgeons (25%) and primary care physicians (21%). In sixty-nine percent of patients, biochemical diagnoses were made by evaluating results of a combination of growth hormone (GH) nadir/basal GH and elevated insulin like growth factor-I (IGF-I) levels. In both Europe and ... Pituitary journals http://www.medworm.com/rss/comments.php?id=4160434 Wed, 10 Nov 2010 10:54:21 +0100 4160434 http://www.medworm.com/index.php?rid=4156244&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7r2r6wg575313x48%2F Abstract  MicroRNAs (miRs) are small, 16–29 nucleotide long, non-coding RNA molecules which regulate the stability or translational efficiency of targeted mRNAs via RNA interference. MiRs participate in the control of cell proliferation, cell differentiation, signal transduction, cell death, and they play a role in carcinogenesis. The aims of our study were to analyse the expression profile of miRs in sporadic clinically non-functioning pituitary adenomas (NFPA) and in normal pituitary tissues, and to identify biological pathways altered in these pituitary tumors. MiR expression profiles of 12 pituitary tissue specimens (8 NFPA and 4 normal pituitary tissues) were determined using miR array based on quantitative real-time PCR with 678 different primers. Five overexpressed... Pituitary journals http://www.medworm.com/rss/comments.php?id=4156244 Tue, 09 Nov 2010 12:52:24 +0100 4156244 http://www.medworm.com/index.php?rid=4152982&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F135321p5272g4385%2F This study was performed to compare 1 μg ACTH, 250 μg ACTH and glucagon tests in the evaluation of HPA axis. The study was carried out on 55 healthy individuals (28 men, 27 women). 10–12 volunteers were included from every decades between 20 and 70 years. Low dose short synacthen test (1 μg ACTH), standard dose short synacthen test (250 μg ACTH) and glucagon tests were performed consecutively. The mean peak cortisol response to standard dose ACTH stimulation test was found to be significantly higher than the low dose ACTH and glucagon stimulation tests. The mean peak cortisol responses to low dose ACTH and the glucagon stimulation tests were not significantly different. The mean peak cortisol responses did not differ significantly between different age ... Pituitary journals http://www.medworm.com/rss/comments.php?id=4152982 Mon, 08 Nov 2010 19:19:19 +0100 4152982 http://www.medworm.com/index.php?rid=4120619&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh5x11k5212240996%2F In conclusion, hypopituitary males exhibit an increased incidence of carotid artery plaque without differences of carotid IMTs, central obesity and higher total cholesterol level. Lower testosterone levels were associated with central obesity- a strong component of a metabolic syndrome, and unsubstituted testosterone deficiency might be an important cardiovascular risk factor in patients with hypopituitarism. Content Type Journal ArticleDOI 10.1007/s11102-010-0265-0Authors Joo Young Kim, Endocrinology, Internal Medicine, Institute of Endocrine Research, Yonsei University College of Medicine, 250 Seongsanno Seodaemun-Gu, 120-752 Seoul, KoreaJae Won Hong, Endocrinology, Internal Medicine, Institute of Endocrine Research, Yonsei University College of Medicine, 250 Seongsanno Seodaem... Pituitary journals http://www.medworm.com/rss/comments.php?id=4120619 Wed, 27 Oct 2010 16:14:42 +0100 4120619 http://www.medworm.com/index.php?rid=4110550&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx91374r24773t634%2F Abstract  To highlight the potential of temozolomide (TMZ) to induce rapid tumor regression in patients with aggressive corticotroph adenomas (CA) that are refractory to surgery and radiation therapy and to review use of TMZ in other pituitary tumors. We present a case of a 56-year-old male with a 3 cm CA treated with transphenoidal surgery (TSS) and conventional radiotherapy in the same year. His hypercortisolemia recurred 11 years later with rapid tumor growth (to 4.2 × 2.5 cm) and he underwent a second TSS with good resection. The tumor recurred 6 months later with ophthalmoplegia. Over 16 months he underwent an additional three surgeries (two TSS, one craniotomy) and repeated conventional radiotherapy. Ki67 staining index on surgical s... Pituitary journals http://www.medworm.com/rss/comments.php?id=4110550 Sat, 23 Oct 2010 15:48:19 +0100 4110550 http://www.medworm.com/index.php?rid=4090188&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F957224517l115733%2F In conclusion, the results of the present study indicate an improvement of left ventricular diastolic function and a significant improvement of cardiac hypertrophy in patients with inactive acromegaly and normal systolic cardiac function compared to those with active disease. Content Type Journal ArticleDOI 10.1007/s11102-010-0263-2Authors Savvas T. H. Toumanidis, Department of Clinical Therapeutics, Medical School, University of Athens, “Alexandra” Hospital, 80 Vas. Sophias Ave.—Lourou Str., 115 28 Athens, GreeceMaria Eleftheria Evangelopoulos, Department of Clinical Therapeutics, Medical School, University of Athens, “Alexandra” Hospital, 80 Vas. Sophias Ave.—Lourou Str., 115 28 Athens, GreeceIoannis Ilias, Department of Clinical Therapeutics, Medical School, Univers... Pituitary journals http://www.medworm.com/rss/comments.php?id=4090188 Wed, 20 Oct 2010 18:00:13 +0100 4090188 http://www.medworm.com/index.php?rid=4069015&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh22022134827275l%2F Abstract  Pituicytoma is an exceptionally rare low-grade glioma (WHO grade I) of the neurohypophysis and infundibulum. We are reporting the case of a 48-year-old man who presented with severe Cushing′s syndrome. Endocrinological evaluation unequivocally confirmed pituitary-dependent Cushing’s syndrome (=Cushing’s disease). Cranial MR-imaging displayed a conspicuous area in the dorsal and basal pituitary gland and a minimal bulging of the pituitary gland paramedian of the pituitary stalk on the right side. Transsphenoidal inspection revealed a small tumor in the basal and dorsal pituitary gland. Surprisingly, the definite postoperative histopathological diagnosis of the removed tumor was pituicytoma and not pituitary adenoma. Hence, the microadenoma responsible for Cus... Pituitary journals http://www.medworm.com/rss/comments.php?id=4069015 Thu, 14 Oct 2010 06:15:13 +0100 4069015 http://www.medworm.com/index.php?rid=4041857&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3095564q1tlv5508%2F Abstract  Primary Pigmented Nodular Adrenocortical Disease (PPNAD) is a rare form of bilateral adrenocortical hyperplasia that is inherited in an autosomal dominant manner and leads to ACTH-independent Cushing’s syndrome (CS). PPNAD may be isolated or associated with Carney Complex (CNC). For the diagnosis of PPNAD and CNC, in addition to the hormonal and imaging tests, searching for PRKAR1A mutations may be recommended. The aims of the present study are to discuss the clinical and molecular findings of two Brazilian patients with ACTH-independent CS due to PPNAD and to show the diagnostic challenge CS represents in childhood. Description of two patients with CS and the many sequential steps for the diagnosis of PPNAD is provided. Sequencing analysis of all coding exons o... Pituitary journals http://www.medworm.com/rss/comments.php?id=4041857 Tue, 05 Oct 2010 18:08:25 +0100 4041857 http://www.medworm.com/index.php?rid=4037817&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fdk7hnp70753g5w02%2F Abstract  Mammary hyperplasia increases breast cancer risk. Tamoxifen prevents breast cancer in women with atypical hyperplasia, but has serious side effects. As estradiol action requires IGF-I, direct inhibition of IGF-I action theoretically might be an efficacious alternative to tamoxifen. After hypophysectomy and oophorectomy, 21-day-old female rats were treated with GH and E2. After 7 days all terminal end buds (TEBs) and 75% of ducts became hyperplastic. Co-treatment with pasireotide, a somatostatin analog that blocks GH secretion and IGF-I action in the mammary gland, prevented hormone-induced hyperplasia. The number and size of TEBs and moderately or floridly hyperplastic ducts was reduced by pasireotide (P < 0.01). In contrast, the same concentratio... Pituitary journals http://www.medworm.com/rss/comments.php?id=4037817 Sat, 02 Oct 2010 05:55:26 +0100 4037817 http://www.medworm.com/index.php?rid=4005699&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx885168x23x04784%2F Abstract  It has been reported that prolactinomas treated with Bromocriptine (BROM) show fibrosis that may interfere with complete surgical resection. The same has not been reported for Cabergoline (CAB). We retrospectively studied 24 consecutive patients (13 females, mean age 40 years, range 16–60) with histopathologically confirmed prolactinomas undergoing surgical resection at Johns Hopkins Hospital between 1992 and 2009. We compared these prolactinomas to 34 patients (22 females, mean age 42.9 years, range 15–75) with GH-secreting adenoma. The operative notes from 7 different neurosurgeons were reviewed to catalog the tumors as fibrous or not fibrous. Of the 24 prolactinomas, 21 (87.5%) were previously treated with DA. Indication for surgery was: DA resista... Pituitary journals http://www.medworm.com/rss/comments.php?id=4005699 Mon, 27 Sep 2010 16:51:51 +0100 4005699 http://www.medworm.com/index.php?rid=3948240&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fdn5hp356x53425l5%2F We present a case of a patient with pre-existing and clinically unapparent CDI which was unmasked after renal transplantation. A 60 year old woman with end-stage renal failure due to autosomal dominant polycystic kidney disease (ADPKD) underwent renal transplantation. She was noted to be markedly polyuric and polydipsic after the transplant. A fluid deprivation test was unequivocally positive for CDI, and desmopressin treatment resulted in immediate symptom relief. Neuroimaging revealed a midline defect in the region of the hypothalamus. She had a history of an intracerebral aneurysm that had ruptured, requiring extensive neurosurgery many years previously. This case demonstrates a rare instance of pre-existing but clinically unapparent CDI unmasked by renal transplantation. It ... Pituitary journals http://www.medworm.com/rss/comments.php?id=3948240 Wed, 08 Sep 2010 05:26:52 +0100 3948240 http://www.medworm.com/index.php?rid=3948239&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm517g5t382k63410%2F Abstract  A review of Dr. Cushing’s surgical cases at Johns Hopkins Hospital revealed new information about his early operative experience with acromegaly. Although in 1912 Cushing published selective case studies regarding this work, a review of all his operations for acromegaly during his early years has never been reported. We uncovered 37 patients who Cushing treated with surgical intervention directed at the pituitary gland. Of these, nine patients who presented with symptoms of acromegaly, and one with symptoms of gigantism were selected for further review. Two patients underwent transfrontal ‘omega incision’ approaches, and the remaining eight underwent transsphenoidal approaches. Of the 10 patients, 6 were male. The mean age was 38.0 years. The mean hospi... Pituitary journals http://www.medworm.com/rss/comments.php?id=3948239 Wed, 08 Sep 2010 05:26:52 +0100 3948239 http://www.medworm.com/index.php?rid=3930539&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm64g74183k31h8u7%2F In this study, pituitary gland volumes were estimated in a total of 28 subjects (22 females, 6 males,) who were free of any pituitary or neurological symptoms and signs. The mean ± SD pituitary gland volumes for the point counting, planimetry and elliptic formulae groups were 582.14 ± 140.16 mm3, 610.08 ± 133.17 mm3, and 432.82 ± 147.38 mm3, respectively. The mean CE for the pituitary gland volume estimates derived from the point counting technique was 8.07%. No significant difference was found between point counting and planimetric methods for the pituitary gland volume (P > 0.05). In addition, there was a 26.14 and 29.71% underestimation of pituitary volume as measured by the elliptic formula compared to the poin... Pituitary journals http://www.medworm.com/rss/comments.php?id=3930539 Thu, 02 Sep 2010 08:40:19 +0100 3930539 http://www.medworm.com/index.php?rid=3930540&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv458n482112p1744%2F Abstract  Primary hypophysitis (PH) is an unusual disorder characterized by inflammatory infiltration of the pituitary gland with various degree of pituitary dysfunction. Glucocorticoids are the treatment of choice in the majority of patients. Still, in patients with poor response in glucocorticoids or when their administration is accompanied with serious side effects, the use of alternative agents should be considered; up to now, data on other therapeutic approaches remains scant mainly due to the rarity of the disease. Among them, the immunosuppressant azathioprine could represent an effective and safe alternative. In this article, we present our clinical experience of two cases with PH successfully treated with azathioprine following serious side effects after initial tr... Pituitary journals http://www.medworm.com/rss/comments.php?id=3930540 Thu, 02 Sep 2010 08:40:17 +0100 3930540 http://www.medworm.com/index.php?rid=3930541&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl23703575r10n42w%2F Abstract  Pituitary surgery involves operating in the nasal cavity, which is considered a clean-contaminated wound. In the absence of evidence-based guidelines for preventing surgical site infections in trans-sphenoidal surgery, a survey of current opinion on prophylactic antibiotics might help elucidate the current acceptable practices and identify opportunities for prospective clinical trials that could lead to the development of practice guidelines. An on-line, 10-question, multiple-choice survey was distributed by e-mail link to the membership of the International Society of Pituitary Surgeons. Sixty-nine members responded to the survey. Ninety-one percent indicated that there was no strong evidence supporting antibiotic use, but 81% used them to be safe. Ninety percent... Pituitary journals http://www.medworm.com/rss/comments.php?id=3930541 Thu, 02 Sep 2010 08:40:16 +0100 3930541 http://www.medworm.com/index.php?rid=3930542&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4827v21021t804pw%2F Abstract  Incidence estimates for pituitary adenomas vary widely, suggesting the effects of numerous risk factors or varying levels of tumor surveillance. We studied the epidemiology of pituitary adenomas using 2004–2007 data collected by 17 Surveillance, Epidemiology, and End Results Programs in the United States (N = 8,276). We observed that incidence rates generally increased with age and were higher in females in early life and higher in males in later life. Males are diagnosed with larger tumors on average than females. Diagnosis may be delayed for males, giving tumors a chance to grow larger before clinical detection. We also observed that American Blacks have higher incidence rates for pituitary adenomas compared with other ethnic groups. There are several... Pituitary journals http://www.medworm.com/rss/comments.php?id=3930542 Thu, 02 Sep 2010 08:40:15 +0100 3930542 http://www.medworm.com/index.php?rid=3912404&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh4316666lr7r2051%2F Abstract  Anemia and other hematological abnormalities are common in patients with Sheehan’s syndrome. The response of these abnormalities to replacement of thyroxine and glucocorticoids is not clear. The aim of the present study was to document the profile of hematological abnormalities and response to treatment in patients with Sheehan’s syndrome. Forty patients of Sheehan’s syndrome and an equal number of age and parity matched healthy controls were studied for prevalence of hematological abnormalities. Hemoglobin concentration, hematocrit, red cell, white cell and platelet count were significantly decreased in patients with Sheehan’s syndrome compared to controls. Frequency of anemia, leucopenia, thrombocytopenia and pancytopenia was significantly higher in thes... Pituitary journals http://www.medworm.com/rss/comments.php?id=3912404 Thu, 26 Aug 2010 18:16:33 +0100 3912404 http://www.medworm.com/index.php?rid=3912405&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4u132401180x4341%2F Abstract  Recent case reports have documented the efficacy of temozolomide therapy in some aggressive pituitary adenomas and pituitary carcinomas resistant to multimodality therapy. Evidence suggests that low O6-methylguanine-DNA methyltransferase (MGMT) immunoexpression correlates with response to temozolomide chemotherapy. Herein, we aimed to study MGMT immunoexpression in a spectrum of pituitary tumors, indolent, aggressive and malignant. A literature review of the use of temozolomide in pituitary tumors was also performed. Immunohistochemistry for MGMT was performed on 60 pituitary tumors identified in the Mayo Clinic Tissue Registry and the consultation files of one of us (BWS). The group included 30 pituitary carcinomas (15 ACTH, 10 PRL, 1 FSH/LH, 1 TSH, 1 silent subty... Pituitary journals http://www.medworm.com/rss/comments.php?id=3912405 Thu, 26 Aug 2010 08:16:11 +0100 3912405 http://www.medworm.com/index.php?rid=3889819&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fgknx2223643t3176%2F Abstract  Assessed by conventional echocardiography the influence of growth hormone deficiency (GHD) and effects of replacement therapy on left ventricle (LV) function and mass (LVM) have shown inconsistent results. We aimed to evaluate cardiac function before and during replacement therapy employing the gold standard method cardiac magnetic resonance imaging (CMRI) and measurements of circulating levels of B-type natriuretic peptides. Sixteen patients (8 males and 8 females, mean age 49 years (range 18–75)) with severe GHD and 16 matched control subjects were included. CMRI was performed at baseline and after 1 year of GH replacement therapy. IGF-I, B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) were measured after 0, 1, 2, 3, 6 and 12&nbsp... Pituitary journals http://www.medworm.com/rss/comments.php?id=3889819 Fri, 20 Aug 2010 17:03:29 +0100 3889819 http://www.medworm.com/index.php?rid=3878450&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F02x3kpl26t6q3070%2F Abstract  Men with hypogonadism tend to have low hemoglobin (HGB) levels. We have investigated a cohort of 36 consecutive male patients with macroprolactinomas to evaluate HGB during presentation and following treatment with cabergoline to suppress prolactin (PRL). Patients’ mean age at diagnosis was 48 years, the mean adenoma size measured 31 mm. The median PRL at baseline was 1,969 ng/ml; the mean testosterone level was low, 1.5 ng/ml. PRL had been successfully normalized in all but six men by using cabergoline. Mean baseline HGB at diagnosis was 13.1 gr%. Sixteen patients had HGB ≤ 13 gr%, including 4 men with HGB ≤ 11.5 gr%. In the subgroup of 15 men with very low testosterone (≤1 ng/ml), baseline HGB was 12.6&nbs... Pituitary journals http://www.medworm.com/rss/comments.php?id=3878450 Tue, 17 Aug 2010 17:22:02 +0100 3878450 http://www.medworm.com/index.php?rid=3874016&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft468n94tnp240617%2F Abstract  Although researchers have discovered that Minnie G. had nearly 50 years of progression-free survival, the absence of her original surgical records have precluded anything more than speculation as to the etiology of her symptoms or the details of her admission. Following IRB approval, and through the courtesy of the Alan Mason Chesney Archives, the microfilm surgical records from the Johns Hopkins Hospital, 1896–1912 were reviewed. Using the surgical number provided in Cushing’s publications, the record for Minnie G. was recovered for further review. Cushing’s diagnosis relied largely on history and physical findings. Minnie G. presented with stigmata associated with classic Cushings Syndrome: abdominal stria, supraclavicular fat pads, and a rounded face... Pituitary journals http://www.medworm.com/rss/comments.php?id=3874016 Sat, 14 Aug 2010 16:45:55 +0100 3874016 http://www.medworm.com/index.php?rid=3866022&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk4xw18g56923u674%2F Abstract  Describe a case of apoplexy of an ACTH-producing pituitary adenoma which resulted not only in an empty sella with concurrent hypothyroidism, hypoprolactinemia, and hypogonadism but persistent hypercortisolemia from two distinct extrasellar remnants of the original adenoma. Review the literature to identify other similar cases. The patient’s medical history, physical exam, lab data, imaging exams and histopathological results were analyzed and compiled into a case report, and an extensive review of the literature was performed. Endocrinological data revealed hypercortisolism and an elevated ACTH with an otherwise suppressed pituitary axis. A pituitary MRI showed a macroadenoma in the left cavernous sinus in addition to an empty sella. An octreotide scan revealed ... Pituitary journals http://www.medworm.com/rss/comments.php?id=3866022 Wed, 11 Aug 2010 18:54:27 +0100 3866022 http://www.medworm.com/index.php?rid=3866023&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx4u2k2466145225k%2F This study quantified the magnitude of day-to-day GH variability in patients with acromegaly by performing an analysis of previously obtained plasma GH profiles. The analysis was performed at the Michigan Clinical Research Unit at the University of Michigan. A total of nine 48 h Q10 min GH profiles obtained in nine patients with active acromegaly were examined. The study was planned after data collection and analysis was conducted using Altman–Bland methods. Day 1 vs. Day 2 values were examined. 95% confidence intervals of the D2 vs. D1 ratios were calculated on all individual subject data as well as on a single 0800 h GH sample and composite mean data for 2-, 5-, 9-, and 24-h sampling protocols. Confidence interval range was 0.66–1.50 for the 0800 h sample an... Pituitary journals http://www.medworm.com/rss/comments.php?id=3866023 Mon, 09 Aug 2010 19:39:16 +0100 3866023 http://www.medworm.com/index.php?rid=3866024&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn131282464622804%2F Abstract  Long-term treatment of acromegaly prevents aggravation and reverses associated heart disease. A previous study has shown a temporary increase in serum levels of the N-terminal fraction of pro B-type natriuretic peptide (NT-proBNP) suggesting an initial decline in cardiac function when treatment of acromegaly is initiated. This was a three months prospective study investigating short-term cardiac effects of treatment in acromegalic patients. Cardiac function was evaluated by the gold standard method cardiac magnetic resonance imaging (CMRI) and circulating levels of B-type natriuretic peptides (BNP and NT-proBNP). CMRI was performed at baseline and after 3 months of treatment. Levels of IGF-I, BNP and NT-proBNP were measured after 0, 1, 2 and 3 months. Ei... Pituitary journals http://www.medworm.com/rss/comments.php?id=3866024 Mon, 09 Aug 2010 19:39:15 +0100 3866024 http://www.medworm.com/index.php?rid=3832519&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj40781n802787017%2F Abstract  Paediatric Cushing’s disease (CD) is usually associated with growth retardation, but there are only few published data on skeletal maturation at diagnosis. We analysed factors contributing to skeletal maturation and final height in Asian Indian patients with paediatric CD. We conducted retrospective analysis of 48 patients (29 males; 19 females) with mean age: 14.84 years at diagnosis (range 9–19 years). A single observer using the Greulich Pyle method determined the bone age (BA) of each child. BA delay, i.e. the difference between chronological age (CA) and BA, was compared with clinical and biochemical variables. BA delay was present in 35/48 (73%) patients (mean delay 1.6 years, range 0.5–5 years) and correlated negatively with height ... Pituitary journals http://www.medworm.com/rss/comments.php?id=3832519 Fri, 06 Aug 2010 07:12:56 +0100 3832519 http://www.medworm.com/index.php?rid=3810122&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F08w026232g065851%2F Abstract  The aim of the study is to assess the rate of any potential adverse effects on women who became pregnant under cabergoline (CAB) treatment and to evaluate any effects on the embryo-fetal development and on children who were born from mothers exposed to CAB in early weeks of gestation. Observational, retrospective and multicenter study on 103 pregnancies in 90 women with hyperprolactinemia. All patients were under CAB at conception. Serum prolactin at baseline was between 30 and 1921 ng/ml. Duration of therapy before pregnancy ranged from 1 to 120 months and doses ranged from 0.125 to 5 mg/week. Fetal exposure ranged from 3 to 25 weeks, 96.9% of patients received CAB during the first trimester of pregnancy and the rest until the second one. No s... Pituitary journals http://www.medworm.com/rss/comments.php?id=3810122 Fri, 30 Jul 2010 17:05:52 +0100 3810122 http://www.medworm.com/index.php?rid=3810123&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy02l50k2n54777u2%2F Abstract  A 41-year-old man presented with left optic neuritis (ON) without evidence of other autoimmune disease or hormonal imbalance. MRI showed enlargement of the left optic nerve but no sellar lesion. The patient recovered after steroid therapy but later developed right ON and required treatment again. Follow-up MRI revealed an ill-defined, enlarging sellar lesion with enhancement extending into the right cavernous sinus, and the patient developed symptoms of fatigue and loss of libido. Hormonal studies revealed hypogonadism and hypocortisolism. All laboratory investigation for autoimmune and infectious diseases remained negative. A transsphenoidal biopsy of the lesion revealed lymphocytic hypophysitis. The concomitant development of lymphocytic hypophysitis and optic n... Pituitary journals http://www.medworm.com/rss/comments.php?id=3810123 Fri, 30 Jul 2010 17:05:51 +0100 3810123 http://www.medworm.com/index.php?rid=3785303&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm8x41513h387848t%2F Content Type Journal ArticleDOI 10.1007/s11102-010-0237-4Authors M. Alberiche Ruano, Hospital Universitario Insular de Gran Canaria Endocrinology Deparment Las Palmas de Gran Canaria 35016 Canary Island SpainM. Boronat Cortés, Hospital Universitario Insular de Gran Canaria Endocrinology Deparment Las Palmas de Gran Canaria 35016 Canary Island SpainA. Ojeda Pino, Hospital Universitario Insular de Gran Canaria Endocrinology Deparment Las Palmas de Gran Canaria 35016 Canary Island SpainC. Rodriguez Perez, Hospital Universitario Insular de Gran Canaria Endocrinology Deparment Las Palmas de Gran Canaria 35016 Canary Island SpainM. Gracía Nuñez, Hospital Universitario Insular de Gran Canaria Endocrinology Deparment Las Palmas de Gran Canaria 35016 Canary Island SpainD. Marrero Arencibia, ... Pituitary journals http://www.medworm.com/rss/comments.php?id=3785303 Fri, 23 Jul 2010 11:17:40 +0100 3785303 http://www.medworm.com/index.php?rid=3773928&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp64415w842512873%2F Abstract  Pituitary adenomas are unique in several ways—they are rarely malignant and yet can be invasive of several compartments. Recurrences in tumors with bland histological features that have been radically excised are a reason for frustration faced by endocrinologists and neurosurgeons in treatment of pituitary adenomas. Several attempts have therefore been made to determine the growth potential of pituitary adenomas. The aim of the present study was to define the biological significance of the MIB-1 labelling index (MIB-1 LI) in pituitary adenomas. The study included 159 cases of surgically treated pituitary adenoma seen in a single institution. MIB-1 LI was not found to be related to age or gender. The mean MIB-1 LI for clinically functional adenomas was marginally ... Pituitary journals http://www.medworm.com/rss/comments.php?id=3773928 Fri, 16 Jul 2010 19:46:55 +0100 3773928 http://www.medworm.com/index.php?rid=3773929&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F30n4573584256545%2F Content Type Journal ArticleDOI 10.1007/s11102-010-0241-8Authors Benjamin R. Randall, University of Utah Department of Neurosurgery Salt Lake City UT USAKristin L. Kraus, University of Utah Department of Neurosurgery Salt Lake City UT USAMarie F. Simard, University of Utah Department of Pediatrics, Division of Endocrinology Salt Lake City UT USAWilliam T. Couldwell, University of Utah Department of Neurosurgery Salt Lake City UT USA Journal PituitaryOnline ISSN 1573-7403Print ISSN 1386-341X (Source: Pituitary) Pituitary journals http://www.medworm.com/rss/comments.php?id=3773929 Wed, 14 Jul 2010 23:26:47 +0100 3773929 http://www.medworm.com/index.php?rid=3734989&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F37u5026420k61414%2F Abstract  Harvey Cushing’s monograph The Pituitary Body and Its Disorders describes Case XXXII, a 36-year-old man who presented with gigantism in 1910. The detailed post-mortem exam findings are prefaced with a cryptic statement, describing “inauspicious circumstances” surrounding the autopsy. Although contemporary biographies of Cushing have offered insight into these circumstances, the original surgical file for Case XXXII has not been previously reviewed. The original Johns Hopkins Hospital surgical records were reviewed, and the case of John Turner, who Cushing identified by name in his monograph The Pituitary Body and Its Disorders, was selected for further review. A review of the original surgical file revealed a typewritten note by Dr. Crowe, one of the surgeons... Pituitary journals http://www.medworm.com/rss/comments.php?id=3734989 Wed, 07 Jul 2010 06:00:07 +0100 3734989 http://www.medworm.com/index.php?rid=3727841&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc7431453824w2003%2F Abstract  In thyrotoxicosis GH responses to stimuli are diminished and the hypothalamic–pituitary–adrenal axis is hyperactive. There are no data on ghrelin or GHRP-6-induced GH, ACTH and cortisol release in treated hyperthyroidism. We, therefore, evaluated these responses in 10 thyrotoxic patients before treatment and in 7 of them after treatment. GHRH-induced GH release was also studied. Peak GH (μg/L; mean ± SE) values after ghrelin (22.6 ± 3.9), GHRP-6 (13.8 ± 2.3) and GHRH (4.9 ± 0.9) were lower in hyperthyroidism before treatment compared to controls (ghrelin: 67.6 ± 19.3; GHRP-6: 25.4 ± 2.7; GHRH: 12.2 ± 2.8) and did not change after 6 months of euthyroidism (ghrelin: 32.7 ±&nb... Pituitary journals http://www.medworm.com/rss/comments.php?id=3727841 Sun, 04 Jul 2010 22:49:48 +0100 3727841 http://www.medworm.com/index.php?rid=3677858&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx547707874w83832%2F Abstract  Langerhans cell histiocytosis (LCH) is a rare granulomatous disease of unknown etiology. We retrospectively reviewed data from four patients (3 males and 1 female), mean age 33.5 years old (range: 21–40), with histopathological diagnosis of LCH. All of them presented with symptoms suggestive of endocrine involvement. The main complaint was goiter in two patients and polyuria and polydipsia in three. Before the LCH diagnosis, two patients had unevaluated symptoms of diabetes insipidus (DI) and hypogonadism. The mean time from symptoms onset to diagnosis was 6.25 years (range: 2–13). Histopathological diagnosis was established by total thyroidectomy (TT) biopsy in two patients, skin lesion biopsy in one, and pituitary stalk biopsy in the other. In the ... Pituitary journals http://www.medworm.com/rss/comments.php?id=3677858 Fri, 18 Jun 2010 10:40:54 +0100 3677858 http://www.medworm.com/index.php?rid=3653958&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg4026u6957l1xv78%2F In conclusion, oral estrogen treatment appears to normalize serum IGF-1 concentrations in over 70% of women with acromegaly uncured by surgery irrespective of their sensitivity to octreotide LAR. We suggest that estrogens may be a temporary cost-effective and safe treatment for women with postoperative persistent acromegaly. Content Type Journal ArticleDOI 10.1007/s11102-010-0236-5Authors Sophie Vallette, Université de Montréal Department of Endocrinology, Centre Hospitalier de l’Université de Montréal, Notre-Dame Hospital 1560 Sherbrooke East Montreal QC CanadaOmar Serri, Université de Montréal Department of Endocrinology, Centre Hospitalier de l’Université de Montréal, Notre-Dame Hospital 1560 Sherbrooke East Montreal QC Canada Journal PituitaryOnline ISSN 15... Pituitary journals http://www.medworm.com/rss/comments.php?id=3653958 Wed, 09 Jun 2010 20:12:52 +0100 3653958 http://www.medworm.com/index.php?rid=3642392&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F92527qj4420463l7%2F Abstract  Aim of this review is to highlight how and when Traumatic Brain Injury (TBI) as well as Subarachnoid Haemorrhage (SAH) and primary Brain Tumours (pBT) of the Central Nervous System (CNS) can induce hypopituitarism, an under-diagnosed clinical problem. Moreover, this review aims to clarify, on the basis of the recent evidences, how these patients have to be tested for pituitary-function. Both retrospective and prospective studies recommended that patients with more severe form of Brain Injuries (BI) and in particular, those with fractures of the base of the skull or early diabetes insipidus, have to be closely monitored for signs and symptoms of endocrine dysfunction. Further studies will be crucial to raise awareness and remind physicians on the prevalence of hypop... Pituitary journals http://www.medworm.com/rss/comments.php?id=3642392 Fri, 04 Jun 2010 16:54:00 +0100 3642392 http://www.medworm.com/index.php?rid=3601081&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw7708257558156u2%2F Abstract  Tubercular meningitis (TBM) is the most dreaded form of extra pulmonary tuberculosis associated with high morbidity and mortality. Various hypothalamic pituitary hormonal abnormalities have been reported to occur years after recovery from disease but there are no systematic studies in the literature to evaluate the pituitary hypothalamic dysfunction in patients with TBM at the time of presentation. Therefore, the present study was designed to evaluate hypothalamic pituitary abnormalities in newly diagnosed patients with TBM. Patient case series. This prospective study included 75 untreated adult patients with TBM diagnosed as “definite”, “highly probable” and “probable” TBM by Ahuja’s criteria and in clinical stage 1, 2 or 3 at the time of presentatio... Pituitary journals http://www.medworm.com/rss/comments.php?id=3601081 Fri, 21 May 2010 21:15:47 +0100 3601081 http://www.medworm.com/index.php?rid=3544098&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F5133k6g2v0263wg2%2F Content Type Journal ArticleDOI 10.1007/s11102-010-0225-8Authors Ivan S. Login, University of Virginia Health System Department of Neurology Box 800394 Charlottesville VA 22908 USAJessica Login, Washington Elementary School 825 Taylor Avenue Alameda CA 95401 USAJason C. Bennett, University of Virginia Health Sciences Library Digital Media Consultant Box 800722 Charlottesville VA 22908 USA Journal PituitaryOnline ISSN 1573-7403Print ISSN 1386-341X (Source: Pituitary) Pituitary journals http://www.medworm.com/rss/comments.php?id=3544098 Thu, 06 May 2010 08:02:29 +0100 3544098 http://www.medworm.com/index.php?rid=3502207&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1v70l415prt332h8%2F This study also emphasizes the need of growth hormone statues assessment and timely intervention. Content Type Journal ArticleDOI 10.1007/s11102-010-0231-xAuthors Shrikrishna V. Acharya, Seth G S Medical College and KEM Hospital Department of Endocrinology Mumbai 12 Maharashtra IndiaRaju A. Gopal, Seth G S Medical College and KEM Hospital Department of Endocrinology Mumbai 12 Maharashtra IndiaJoe Goerge, Seth G S Medical College and KEM Hospital Department of Endocrinology Mumbai 12 Maharashtra IndiaPadma S. Menon, Seth G S Medical College and KEM Hospital Department of Endocrinology Mumbai 12 Maharashtra IndiaTushar R. Bandgar, Seth G S Medical College and KEM Hospital Department of Endocrinology Mumbai 12 Maharashtra IndiaNalini S. Shah, Seth G S Medical College and KEM Hospital D... Pituitary journals http://www.medworm.com/rss/comments.php?id=3502207 Thu, 22 Apr 2010 09:15:30 +0100 3502207 http://www.medworm.com/index.php?rid=3495603&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F07364qt217810626%2F Abstract  It has been suggested that treatment with adequate dose titration of pegvisomant, a GH antagonist, up to a maximum of 40 mg daily, can achieve IGF-1 normalisation in virtually all patients with acromegaly. On the other hand, temozolomide (TMZ), an alkylating cytostatic agent, has been reported to reduce pituitary tumour size and hormone hypersecretion in a small number of aggressive pituitary macroadenomas. In this paper we report the case of a patient resistant to very high doses of pegvisomant used in combination with somatostatin analogs (SSA) and to TMZ therapy. The patient, initially a 22 year-old man with an invasive GH-secreting pituitary macroadenoma (IGF-1, 371% upper limit of normal), had active acromegaly despite a repeat transsphenoidal surge... Pituitary journals http://www.medworm.com/rss/comments.php?id=3495603 Wed, 21 Apr 2010 09:22:29 +0100 3495603 http://www.medworm.com/index.php?rid=3491989&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F26g2r23g21l171xm%2F We present a case report of a patient recently treated at our institution for an isolated non-small cell lung cancer metastatic lesion to the sella, report the lack of involvement of the pituitary gland in a large single-institution series of treated intracranial parenchymal metastases, and review the pertinent literature. We reviewed cranial imaging studies (CT and MRI) for 935 metastases in 155 patients treated at our institution over the previous 3 years for intracranial metastatic disease. Special attention was paid to the skull base to document the presence of any metastatic disease involving the pituitary gland, infundibular stalk, sella turcica (including anterior and posterior clinoids), or diaphragm sellae. We found no other involvement of the pituitary gland or other s... Pituitary journals http://www.medworm.com/rss/comments.php?id=3491989 Tue, 20 Apr 2010 11:18:10 +0100 3491989 http://www.medworm.com/index.php?rid=3491990&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fax2u733471234375%2F We report the case of a 63 year-old woman with disseminated Rosai-Dorfman disease involving the neurohypophysis and associated with adenohypophysial PRL cell hyperplasia. Content Type Journal ArticleDOI 10.1007/s11102-010-0228-5Authors Fabio Rotondo, St. Michael’s Hospital, University of Toronto Department of Laboratory Medicine, Division of Pathology 30 Bond Street Toronto ON M5B 1W8 CanadaDavid G. Munoz, St. Michael’s Hospital, University of Toronto Department of Laboratory Medicine, Division of Pathology 30 Bond Street Toronto ON M5B 1W8 CanadaRichard G. Hegele, St. Michael’s Hospital, University of Toronto Department of Laboratory Medicine, Division of Pathology 30 Bond Street Toronto ON M5B 1W8 CanadaBruce Gray, St. Michael’s Hospital, University of Toronto Depart... Pituitary journals http://www.medworm.com/rss/comments.php?id=3491990 Tue, 20 Apr 2010 11:18:09 +0100 3491990 http://www.medworm.com/index.php?rid=3484291&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fnv84428121qw3241%2F Abstract  A 3-year 5-month-old boy was seen for second opinion regarding polydipsia and polyuria. Previously, a diagnosis of primary polydipsia was made after normal urine concentration after overnight water deprivation testing. The boy’s father, paternal grandfather, and paternal aunt had diabetes insipidus treated with desmopressin acetate. Based on this young boy’s symptoms, ability to concentrate urine after informal overnight water deprivation, and family history of diabetes insipidus, we performed AVP gene mutation testing. Analysis of the AVP gene revealed a novel mutation G54E that changes a normal glycine to glutamic acid, caused by a guanine to adenine change at nucleotide g.1537 (exon 2) of the AVP gene. Commonly, patients with familial neurohypophyseal diabet... Pituitary journals http://www.medworm.com/rss/comments.php?id=3484291 Sat, 17 Apr 2010 16:50:39 +0100 3484291 http://www.medworm.com/index.php?rid=3469378&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3krv8445n637m851%2F We present a case of acromegaly secondary to proven GHRH-secretion by a bronchial carcinoid tumor in a type 1 diabetic subject and document the clinical course pre- and post-resection of the tumor and of subsequent octreotide therapy. A 54-year-old Caucasian man was referred for evaluation of acromegalic symptoms and significantly increased insulin requirements. He had a history of left lung surgery 20 years prior for hemoptysis. Initial laboratory results indicated acromegaly. Fasting serum growth hormone (GH): 26.1 ng/mL (0–5 ng/mL), insulin-like growth factor 1 (IGF-1): 635 ng/mL (87–283 ng/mL), GH at 60 min post-ingestion of 75 grams of oral glucose during a glucose tolerance test: 8.3 ng/mL (normal <1 ng/mL). Pituitary magnetic reso... Pituitary journals http://www.medworm.com/rss/comments.php?id=3469378 Thu, 08 Apr 2010 18:02:46 +0100 3469378 http://www.medworm.com/index.php?rid=3409534&cid=s_33309_15_f&fid=33309&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe087143g1w261617%2F Abstract  Accurate assessment of the hypothalamic–pituitary–adrenal (HPA) axis is critical for the appropriate management of patients with pituitary adenoma after transsphenoidal surgery. We examine the role of immediate postoperative cortisol levels to assess hypothalamic–pituitary–adrenal axis (HPA) axis function post-operatively. We performed preoperative cortrosyn stimulation test (CST) and measured immediate postoperative serum cortisol levels in 100 patients undergoing 104 transsphenoidal surgeries. These results were compared to those of the CST at 4–6 weeks postoperatively, which served as a measure of HPA axis function. The ability of immediate postoperative, day of surgery (DOS) cortisol levels to predict normal HPA axis function was determined usin... Pituitary journals http://www.medworm.com/rss/comments.php?id=3409534 Thu, 25 Mar 2010 19:07:49 +0100 3409534