• 제목/요약/키워드: pituitary hormone

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Risk factor for pituitary dysfunction in children and adolescents with Rathke's cleft cysts

  • Lim, Han-Hyuk;Yang, Sei-Won
    • Clinical and Experimental Pediatrics
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    • 제53권7호
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    • pp.759-765
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    • 2010
  • Purpose: This study evaluated the clinical manifestations of and risk factors for pituitary insufficiency in children and adolescents with Rathke's cleft cysts. Methods: Forty-four patients with Rathke's cleft cysts younger than 19 years who visited Seoul National University Children's Hospital between January 1995 and September 2009 were enrolled. Rathke's cleft cysts were confirmed histologically through an operation in 15 patients and by brain magnetic resonance imaging (MRI) in 29 patients. The clinical, hormonal, and imaging features were reviewed retrospectively. Results: The clinical presentation of symptomatic patients was as follows: headache (65%), endocrinopathy (61%), and visual disturbance (19%). Endocrinopathy included central precocious puberty (18%), diabetes insipidus (14%), general weakness (11%), and decreased growth velocity (7%). After surgery, hyperprolactinemia resolved in all patients, but growth hormone insufficiency, hypothyroidism, and diabetes insipidus did not improve. Pituitary insufficiency except gonadotropin abnormality correlated significantly with severe headache, visual disturbance, general weakness, and cystic size. Suprasellar extension of cysts and high signals in the T2-weighted image on brain MRI were related to hypothyroidism, hypocortisolism, and diabetes insipidus. Multivariable linear regression analysis showed that only general weakness was a risk factor for pituitary insufficiency ($R^2$=0.549). Conclusion: General weakness is a risk factor for pituitary insufficiency in patients with Rathke's cleft cysts. When a patient with a Rathke's cleft cyst complains of general weakness, the clinician should evaluate pituitary function and consider surgical treatment.

난포자극호르몬과 Pituitary Adenylate Cyclase-activating Polypeptide에 의한 난소의 난포성장 (Control Mechanisms of Ovarian Follicle Development by Follicle Stimulating Hormone and Pituitary Adenylate Cyclase-activating Polypeptide)

  • 이여일;신진옥;김미영;전상영
    • Clinical and Experimental Reproductive Medicine
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    • 제33권1호
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    • pp.15-23
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    • 2006
  • 목 적: 본 연구는 흰쥐 난소를 실험모델로 하여 미성숙 전동 난포의 성장에 대한 pituitary adenylate cyclase-activating polypeptide (PACAP)의 영향을 얄아보고자 하였다. 연구방법: 미성숙 전동 난포를 생후 21일된 흰쥐로부터 분리하여 PACAP을 첨가하거나 첨가하지 않은 무혈청 배양액에서 3일 동안 배양하고, 푸로게스테론 호르몬의 생성, 난포의 성장, 과립막세포의 증식 및 유전자의 동태 등을 관찰하였다. 증식의 정도는 thymidine incorporation 방법으로 검색하고 유전자의 변동은 Northern 분석을 이용하였다. 결 과: PACAP으로 처리한 군은 난포의 직경이 75% 증가한 반면 난포자극호르몬인 FSH로 처리한 군은 65% 증가하였고, PACAP 처리는 과립막 세포의 증식을 강화시켰다. FSH와 PACAP 공히 배양된 흰쥐 난포의 과립막 세포와 FSH에 반응하는 세포주인 GFSHR-17에서의 프로게스테론 생성을 촉진시켰고, PACAP이 FSH의 작용을 증진시켜 SF-1과 아로마타제 유전자 발현을 촉진시켰다. 결 론: 본 연구는 PACAP이 과립막증식과 스테로이드합성을 통하여 전동 난포의 성장을 촉진함을 시사하였고, 또한, SF-1, 아로마타제 등에 대한 FSH의 작용을 도와주는 역할을 PACAP이 담당하므로 PACAP은 초기 난포성장에 필요한 난소국소인자임을 유추할 수 있었다.

Outcome of Endoscopic Transsphenoidal Surgery in Combination with Somatostatin Analogues in Patients with Growth Hormone Producing Pituitary Adenoma

  • Zhou, Tao;Wang, Fuyu;Meng, Xianghui;Ba, Jianmin;Wei, Shaobo;Xu, Bainan
    • Journal of Korean Neurosurgical Society
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    • 제56권5호
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    • pp.405-409
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    • 2014
  • Objective : To determine the efficacy of endoscopic surgery in combination with long-acting somatostatin analogues (SSAs) in treating patients with growth hormone (GH)-secreting pituitary tumor. Methods : We performed retrospective analysis of 133 patients with GH producing pituitary adenoma who underwent pure endoscopic transsphenoidal surgery in our center from January 2007 to July 2012. Patients were followed up for a range of 3-48 months. The radiological remission, biochemical remission and complication were evaluated. Results : A total of 110 (82.7%) patients achieved radiological complete resection, 11 (8.2%) subtotal resection, and 12 (9.0%) partial resection. Eighty-eight (66.2%) patients showed nadir GH level less than 1 ng/mL after oral glucose administration. No mortality or severe disability was observed during follow up. Preoperative long-acting SSA successfully improved left ventricle ejection fraction (LVEF) and blood glucose in three patients who subsequently underwent success operation. Long-acting SSA (20 mg every 30 days) achieved biochemical remission in 19 out 23 (82.6%) patients who showed persistent high GH level after surgery. Conclusion : Endoscopic transsphenoidal surgery can biochemically cure the majority of GH producing pituitary adenoma. Post-operative use of SSA can improve biochemical remission.

Outcomes for Pituitary Adenoma Patients Treated with Linac-Based Stereotactic Radiosurgery and Radiotherapy: a Long Term Experience in Thailand

  • Puataweepong, Putipun;Dhanachai, Mantana;Hansasuta, Ake;Dangprasert, Somjai;Sitathanee, Chomporn;Swangsilpa, Thiti;Vitoonpanich, Patamintita;Yongvithisatid, Pornpan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권13호
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    • pp.5279-5284
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    • 2015
  • Background: The study analyzed the long term clinical outcomes of pituitary adenoma cases treated with the first Thailand installation of a dedicated Linac-based stereotactic radiation machine (X-Knife). Materials and Methods: A retrospective review of 115 consecutive pituitary adenoma patients treated with X-Knife at the Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand from 1997 to 2003 was performed. Stereotactic radiosurgery (SRS) was selected for 21 patients (18%) including those with small tumors (${\leq}3cm$) located ${\geq}5mm$. from the optic apparatus, whereas the remaining 94 patients (82%) were treated with fractionated stereotactic radiotherapy (FSRT). Results: With a median follow-up time of 62 months (range, 21-179), the six-year progression free survival was 95% (93% for SRS and 95% for FSRT). The overall hormone normalization at 3 and 5 years was 20% and 30%, respectively, with average time required for normalization of approximately 16 months for SRS and 20 months for FSRT. The incidence of new hypopituitarism was 10% in the SRS group and 9% in the FSRT group. Four patients (5%) developed optic neuropathy (1 in the SRS group and 3 in the FSRT group). Conclusions: Linac-based SRS and FSRT achieved similar high local control rates with few complications in pituitary adenoma cases. However, further well designed, randomized comparative studies between SRS versus FSRT particularly focusing on hormone normalization rates are required.

Clinical Significance of Radical Surgery in the Treatment of Silent Corticotroph Adenoma

  • Kim, Junhyung;Yoon, Seon Jin;Moon, Ju Hyung;Ku, Cheol Ryong;Kim, Se Hoon;Lee, Eun Jig;Kim, Sun Ho;Kim, Eui Hyun
    • Journal of Korean Neurosurgical Society
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    • 제62권1호
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    • pp.114-122
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    • 2019
  • Objective : Silent corticotroph adenomas (SCA) are endocrine-inactive pituitary adenomas with positive immunohistochemistry staining for adrenocorticotropic hormone (ACTH). We investigated whether SCA-associated clinical profiles were more aggressive than hormonally negative adenomas (HNA). Methods : Among 627 patients with pathologically proven endocrine-inactive pituitary adenomas between 2004 and 2013, positive immunohistochemistry revealed 55 SCAs and 411 HNAs. Surgical outcomes and radiological and endocrinological characteristics were compared. Results : Strong female predominance was observed in the SCA group (p<0.001). Cavernous sinus invasion was identified in 22 (40%) SCA patients and 72 (17.6%) HNA patients (p<0.001). There were no differences in ACTH or cortisol levels between the two groups. The incidence of preoperative hypopituitarism and postoperative hormonal outcome did not differ between two groups. Total resection was achieved in 35 patients (63.7%) with SCA and 332 patients (80.8%) with HNA (p=0.007). When tumors were completely removed, recurrence rates were not statistically different between two groups (p=0.60). When complete resection was not achieved, tumors regrew from these remnants in seven patients (35.0%) with SCA and 12 patients (15.2%) with HNA (p=0.05). Conclusion : Total surgical resection for SCA is often challenging as these tumors frequently invade a cavernous sinus. Early remnant tumor intervention is justified, because untreated residual pituitary tumors regrow when patients were followed up for a long time. Prophylactic radiotherapy is not warranted for completely resected SCAs as tumor recurrence is uncommon.

전기경련요법후 뇌하수체 호르몬의 순차적인 분비 반응 (Sequential Pituitary Hormone Responses to Electroconvulsive Therapy)

  • 김도관;김수정;최도선;복혜숙;김승태
    • 생물정신의학
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    • 제3권2호
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    • pp.288-294
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    • 1996
  • 전기경련요법을 시행받은 9명의 정동자애 환자들과 2명의 정신분분열형장애 환자들에서 각각 3분 간격으로 혈액을 채취하여 각 채취하여 AVF, ACTH, PRL, cortisol 등의 호르몬에 대해 기저농도 및 전기경련요법 후의 농도 변화를 측정함으로써 각 호르몬 분비 반응 사이의 시간적인, 그리고 양적인 관계를 비교분석하였다. 또한 경련 지속 시간과 각 호르몬 분비반응들 사이의 상관관계도 검토하였다. 상기 호르몬 모두에서 전기경련요법 대한 의미있는 분비반응이 관찰되었다. 즉, AVP는 1.2pg/ml에서 33.3pg/ml(P<0.001). PRL은 21.8ng/ml에서 102.2ng/ml(P<0.005)로 cortsol은 20.1ug/dl에서 31.1ug/dl(P<0.001)로 각각 중가 되었다. 뇌하수체에서 분비되는 AVP, ACTH, PRL 세가지 호르몬 모두는 전기경련 요법 후 3분내에 분비 반용이 시작되었지만, 최고 농도에 도달하는 시간은 각각 3분, 6분, 12~15분대로 분명히 구별되는 소견을 보였다. cortisol은 6분후부터 증가하기 시작하여 20~30분 사이에 최고 농도를 보였다. 경련 지속 시간과 분비 반응과는 의미있는 상관관계를 보이지 않았다. 이상의 연구결과를 토대로 저자들은 다음과 같은 결론에 도달하였다. 1) 전기경련 요법에 대한 뇌하수체 호르몬의 반응은 동시적이라기 보다는 순차식으로 일어나는 것이다. 2) AVP는 다른 어떤 호르몬 보다도 아주 빠르고 양적으로 많은 반응을 보였다. 3) AVP 반응 후에 뒤따르는 ACTH 반응은 대부분의 과거 연구들에서 보고된 것보다 빠르고 강력했다. 4) 이러한 결과들은 뇌하수체 호르몬이 전기 자극보다는 경련의 결과로 분비된다는 가설을 지지해 주는 소견이다. 5) 시상하부-뇌하수체-부신피질 축 호르몬들의 순차적 반웅 양상은 각 호르몬의 분비 반응에 되먹임 조절 기전이 관여할 수 있음을 추정케 한다.

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중증 배란장애 및 뇌하수체분비호르몬 이상을 보이는 불임 환자의 안면체열분포에 관한 임상적 고찰 (Clinical study on face temperature of infertility women with severe anovulation or oligo-ovulation or hypothalamic-pituitary gland hormone disorders)

  • 조현주;임정한;최은미;강명자
    • 대한한방체열의학회지
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    • 제2권1호
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    • pp.35-42
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    • 2003
  • Objective : This study is to examine the interrelationship between Infertility with hypothalamic-pituitary gland disorders and Face temperature by D.I.T.I. Methods : Sample group is the 50 women who were diagnosed as P.C.O.S. or FSH,LH trouble or hyper-prolactinemia or anovulation or oligo-ovulation. Control group is the 50 women who have not P.C.O.S. & FSH.LH trouble & hyper-prolactinemia & anovulation or oligo-ovulation, who have normal menstural cycle and success in pregnancy after treatment. Both group came at Conmaul Oriental Hospital Infertility Center, Seoul, Korea, from May, 2001 to Jan., 2003. They selected at random. We checked temperature of ${\ulcorner}S17{\lrcorner}\;{\ulcorner}SI18{\lrcorner}\;{\ulcorner}TE17{\lrcorner}\;{\ulcorner}HN-3{\lrcorner}$ and gained differences of Rt. check point and Lt. check point, and then compared mean ${\Delta}T$ of sample group with that of control group. Conclusion : We gained results that mean ${\Delta}T$ of sample group is larger than that of control group at all check points. (p=0.000)

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Central diabetic insipidus associated with suspected pituitary gland tumor in a dog

  • Lee, Kyo-Im;Park, Hee-Myung
    • 대한수의학회지
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    • 제51권4호
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    • pp.319-323
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    • 2011
  • A 12-year-old spayed female Yorkshire terrier dog was presented with two-weeks history of lethargy, mental dullness and polydipsia. Neurologic examination revealed proprioceptive defect of all limbs and loss of swallowing gag reflex. The dog revealed persistent dehydration, hypernatremia, hyperosmolarity and hyposthenuria. On magnetic resornance imaging (MRI), the mass were heterogeneous signality on T1 weighted images, hyperintense signality on T2 weighted image with contrast enhancement on hypothalamohypophyseal lesion. Based on these findings, the dog was suspected as having pituitary gland tumor. Through water deprivation test and response to desmopressin acetate (1-deamino-8-D-arginine, DDAVP), this case was diagnosed by central diabetes insipidus (CDI). This paper reports the clinical sign, MRI, response to the exogenous antidiuretic hormone of CDI due to suspected pituitary tumor in a dog and DDAVP administration was evaluated effective therapy to correct hypernatremia induced by CDI.