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Biomedical subjects

A Teramoto

Publications and source records attributed to A Teramoto.

At least 199 records · Page 11Linked to original sources
PubMed1986

[A case of growth hormone-producing adenoma presenting as a non-functioning tumor at recurrence].

The authors report a case of recurrent pituitary adenoma, which changed its endocrinological function from GH producing to non-functioning. A 37-year-old woman was admitted to our hospital complaining of headaches, amenorrhea and acromegalic features. Skull X-rays showed marked ballooning of the sella turcica and mild thickening of the calvarium. X-rays of the hands and feet revealed moderate acromegalic changes. On pneumoventriculography, the tumor elevated the floor of the third ventricle. The serum GH level was 29.3 ng/ml, which did not respond to insulin induced hypoglycemia. Radical removal of the tumor was performed through a right frontal craniotomy. Histologically, it was diagnosed as a pituitary eosinophilic adenoma. Immunostains revealed the presence of many GH positive cells in the adenoma. Since the post-operative GH levels were still high (12-16 ng/ml), irradiation to the sellar region was carried out. The serum GH concentration gradually decreased to the normal level in one year after the irradiation. At that time no sellar tumor could be found on CT scans. The patient had been well for six years until she noticed hearing impairment of her right ear. She was re-admitted about seven years after the first admission because of cerebellar ataxia and hearing loss. CT scans revealed a recurrent tumor extending from the sellar region to the right cerebello-pontine angle. Serum GH levels on admission were within normal range (3-4 ng/ml). The tumor was partially removed by suboccipital craniectomy. Pathologically, the tumor was reported as a pituitary chromophobe adenoma. With immunostains, no GH positive cells could be found in the adenoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Acromegaly↗
PubMed1985

Prolactin secretion by mixed ACTH-prolactin pituitary adenoma cells in culture.

To characterize the functional aspect of prolactin (Prl) cells coexisting with corticotroph adenomas, pituitary adenoma cells obtained from a patient with Cushing's disease and a patient with Nelson's syndrome, who were associated with hyperprolactinaemia, were cultured in monolayer and their Prl responses to various secretagogues were compared with those of prolactinoma cells in culture. Immunohistochemistry performed in one of these two adenomas demonstrated the presence of Prl-containing cells in addition to ACTH cells. When ACTH-Prl adenoma cells were exposed to ovine corticotrophin-releasing factor (CRF), a dose-dependent increase in both ACTH and Prl secretion was observed, which was blocked by coincubation with hydrocortisone. In contrast, no stimulatory effect of CRF on Prl release was observed in all of the experiments using prolactinoma cells. Thyrotrophin-releasing hormone, which consistently stimulated Prl secretion in ACTH-Prl adenomas, was effective in triggering Prl release in only 25% of the prolactinomas. Exposure of the cultured cells to lysine vasopressin, growth hormone-releasing factor and vasoactive intestinal peptide resulted in an increase in ACTH and Prl secretion in one ACTH-Prl adenoma, however, none of the prolactinomas responded to these stimuli to secrete Prl. Dopamine and somatostatin, on the other hand, uniformly suppressed Prl secretion from ACTH-Prl adenomas as well as from prolactinoma cells. These results suggest that the mode of Prl secretion by mixed ACTH-Prl pituitary adenomas is not identical to that by pure prolactinomas and is, at least in part, common to that of ACTh secretion.

Adenoma↗
PubMed1985

The efficacy of radiotherapy for craniopharyngioma.

A series of 125 patients who underwent surgery for craniopharyngiomas was evaluated to assess the efficacy of radiation therapy: 45 patients had received radiotherapy and 80 had not. These patients included all operative survivors (excluding cases with total tumor removal) treated during the 30 years from 1950 to 1979. Median survival time of the irradiated group was greater than 10 years, whereas it was 3.12 years for the nonirradiated (or control) group. The 5- and 10-year survival rates were 88.9% and 76.0% for the irradiated group, and 34.9% and 27.1% for the control group, respectively. Overall comparison, using the Lee-Desu statistical method, revealed that there was a very high statistical significance (at the level of p less than 0.0001) in the difference between the survival times of the irradiated and control groups. The influence of the following factors on the effectiveness of radiotherapy was analyzed: age of the patient at the first operation, sex, date of surgery, the extent of tumor removal, the size of the tumor, the composition of the tumor (cystic or solid), whether the tumor was calcified or not, the histological subtype of the tumor, the presence of intracranial hypertension, the grade of visual failure, and the presence or absence of diabetes insipidus, altered mentation, and adiposogenital syndrome. The results indicated that, when total removal of the tumor is impossible, radiotherapy should be administered.

Adolescent↗
PubMed1984

Hyperprolactinemia in Cushing's disease and Nelson's syndrome.

In an attempt to clarify the pathogenesis of hyperprolactinemia associated with Cushing's disease, PRL secretion was evaluated in 42 patients with hyperadrenocorticism (Cushing's disease, 26; and adrenocortical adenoma, 16) and in 10 patients with Nelson's syndrome. Mild hyperprolactinemia was found in 6 patients with Cushing's disease (23%) and in 5 patients with Nelson's syndrome (50%). In contrast, basal plasma levels of PRL were normal in all of the patients with Cushing's syndrome secondary to adrenocortical adenoma. Injection of TRH unequivocally induced PRL release; however, the responses were blunted in patients with Cushing's disease and in those with Nelson's syndrome who had hyperprolactinemia. Short term administration of dexamethasone, on the other hand, failed to alter PRL secretion in these patients. In 5 patients with Cushing's disease, plasma levels of PRL were reevaluated when they developed a typical clinical picture of Nelson's syndrome after bilateral adrenalectomy. Four patients had a definite increase in PRL levels. Immunohistochemistry of pituitary adenomas surgically removed from 7 patients with Cushing's disease or Nelson's syndrome demonstrated, in 4 of them, the presence of PRL-containing cells as well as ACTH-containing cells. Two of these patients had hyperprolactinemia, which was corrected by the removal of pituitary tumors. These results suggest that hyperprolactinemia is not a fortuitous occurrence in patients with Cushing's disease and could be explained by the concomitant production and secretion of PRL from corticotroph adenomas.

Adenoma↗
PubMed1983

Localization of concanavalin A binding sites in human pituitary adenoma cells as revealed by HRP-labelling method.

Intracellular lectin (Con A)-binding sites of human pituitary adenoma were examined by electron microscopy using the horseradish-peroxidase (HRP)-labelling technique. In this study were used 16 cases of human pituitary adenomas operated on in our clinics between 1977 and 1981: they concluded 4 each of PRL-, GH-, ACTH-producing and hormonal non-functioning adenomas. In parallel with the detection of lectin-binding sites, basal levels of their secreting hormones were determined by the radioimmunoassay technique, and their producing hormones were characterized light microscopically by the immunocytochemical HRP-labelling technique. In the present study, for hormonal functioning adenoma cells, mature or large granules of each specific type of adenoma cells had no definite Con A-binding sites. On the other hand, immature or small secretory granules of RPL- or GH-producing adenoma cells showed a positive reaction with Con A. ACTH-producing adenomas so far examined revealed no definite binding sites. Some variable results were obtained concerning non-functioning adenomas. Lectins have been and will be very useful in the detection of different subtypes of adenomas in each specific group.

Adenoma↗
PubMed1983

[Glioblastoma and fibrosarcoma in the brain with metaplastic bone formation--a case report].

The authors report a case in which left deep temporal fibrosarcoma with calcified area developed about 6 months after radiation therapy for left temporal astrocytoma. A 37 year-old woman was admitted to our clinic because of headache and visual deterioration. CT scan and angiography suggested left deep temporal glioma and on August 5, 1980, partial resection was performed. Histological sections showed astrocytoma G 2. Postoperative course was uneventful and she left the hospital after radiation therapy of 50 Gy. On March, 1981, right hemiparesis was noticed and progressed rapidly. CT scan suggested left temporal tumor recurred. On March 30, 1981, second operation was performed and this time, histological sections showed glioblastoma. After operation, beta-Interferon (IFN) was given intratumorally via Ommaya's reservoir (3 X 10(6) IU, daily). But in spite of IFN therapy, tumor became larger and she died on June 30, 1981. Autopsy revealed coexistence of glioblastoma and fibrosarcoma with metaplastic bone formation. A brief discussion concerning the problem of cerebral mixed tumors follows the description of the case.

Adult↗
PubMed1983

[Effect of human fibroblast interferon on malignant brain tumors].

Since 1980, phase 1 and 2 clinical trials of Hu-IFN-beta have been done in the field of neurosurgery. In the present study, (1) the results of in vivo experiments of Hu-IFN-beta are reported and (2) the effectiveness of Hu-IFN-beta in patients with malignant brain tumors is also evaluated. (1) The antitumor activities of beta-IFN and poly ICLC in nude mice receiving subcutaneous transplants of human brain tumors (2 strains) were compared with those of conventional anticancer drugs. After 3 weeks of treatment with ACNU, vincristine, bleomycin, mitomycin C, beta-IFN and poly ICLC, tumor reduction rates were evaluated by the method of Battelle. The effectiveness of beta-IFN and poly ICLC was slightly inferior to that of ACNU and vincristine, although tumor reduction rates (treated/control values) of 43% and 39% were respectively obtained with beta-IFN and poly ICLC against one strain of glioblastoma. (2) Clinically, 7 patients with malignant brain tumors were given beta-IFN (4 by intratumor administration and 3 by intravenous injection) in a dose of 3 X 10(6) to 9 X 10(6) IU/day for 2 to 6 months to study the efficiency and side effects of IFN treatment. One of four patients given IFN intratumorally showed a reduction in tumor size (partial response) by CT scan; the three patients injected IFN intravenously were unchanged. There were no noteworthy side effects in the cases treated intratumorally except for fever occurring in one patient. In the patients treated intravenously, however, fever, general malaise, leukopenia and thrombocytopenia were noted.

Adolescent↗
PubMed1983

[Pneumocephalus induced by bromocriptine treatment in male prolactinoma--a case report].

The authors reported a case of pneumocephalus induced by bromocriptine (Bc) treatment for a recurrent invasive prolactinoma. The patient was a 38-year old man, who had been treated for 12 years, with three times of craniotomies and two times of irradiation therapies. CT scan showed the recurrence of the tumor, which extended into bilateral middle fossa, left orbit and left cerebellopontine angle. Serum prolactin levels elevated to 35,200 ng/ml. Then Bc was administered in a dose of 5 mg/day. Serum PRL concentration fell to 2,090 ng/ml one month after the initiation of the treatment, when he complained of headache, nausea and vomiting. Since these symptoms were considered as the side effects of Bc, the dose was reduced to 2.5 mg/day. Three weeks later, plain craniograms showed marked pneumocephalus, while no tumor was found on CT scan. The administration of Bc was stopped and he was prescribed a complete rest for a month. The air was collected again when he began to walk around. Therefore, the transsphenoidal operation was performed in order to pack the sella turcica and sphenoid sinus with muscle pieces. Since the pneumocephalus could not be cured, the muscle, taken from the thigh, was spread throughout the left middle fossa by the front-temporal craniotomy. When Bc reduces the size of the invasive prolactinomas, the intra- and extra-cranial spaces may be communicated. The greatest care should be taken for pneumocephalus, CSF rhinorrhea and/or meningitis during the Bc treatment of prolactinomas.

Adenoma↗
PubMed1982

[Male prolactin producing pituitary microadenoma -a case report (author's transl)].

A 27-year-old man was admitted to the Urological Department of Tokyo University, with complaints of delayed puberty and growth retardation. At the age of 14 years, he found his skeletal growth retarded. Since then he had not shown any development of secondary sex characters, such as change of voice, appearance of public and axillary hair and development of external genital organs. He had not experienced the ejaculation and libido, while the excretion has been maintained. This feminized patient showed poorly developed external genitalia, while there was no evidence of galactorrhea or gynecomastia. Ophthalmologic examinations were normal. Endocrinological studies revealed moderate hyperprolactinemia (185-200 ng/ml) and marked disorder for GH secretion. Gonadotropins were low normal and their responses to LH-RH were moderately disturbed. Serum testosterone level was extremely low and its responses to HCG were insufficient. Under the diagnosis of prolactinoma, he was referred to the Neurological Department. Plain skull film and tomography of the sella showed a deformed and slightly expanded sella, the measurement of which were within normal limits. No supra-sellar extention was demonstrated by pneumoencephalography and CT scan. A diagnosis of PRL producing microadenoma was made, and a radical removal of the tumor was performed through the transsphenoidal route. In most tumor cells the presence of PRL was revealed by immunohistochemical stains. Postoperatively, PRL levels returned to normal, while other hormonal deficiencies remained unchanged. With the administration of testosterone, he gradually became masculine and reportedly gained normal libido and potency.

Adenoma↗
PubMed1982

[Pathological changes of prolactinomas treated with bromocriptine].

In order to investigate the pathological changes of prolactinomas induced by the treatment with bromocriptine, 12 cases of prolactinoma were studied using immunocytology and electronmicroscopy. Eight cases were treated with bromocriptine, 5 mg/day, for a few days before surgery, while 4 cases were given for several months. 1) Cases of the short-term administration All of the adenomas except one appeared to be eosinophilic by H-E stain. Electronmicroscopically, abundant secretory granules, measuring 100-350 nm, were found throughout the cytoplasm, while exocytosis, frequently seen in the common type of prolactinomas, could not be observed. With immunostains, prolactin was diffusely positive in the cytoplasm of most adenoma cells, though the intensity of immunostaining for prolactin was relatively faint compared with that of normal prolactin cells or usual prolactinomas. Immunoreactive prolactin was demonstrated on accumulated secretory granules, while it was negative in the Golgi apparatus and rough endoplasmic reticulum (ER). 2) Cases of the long-term administration The tumors corresponded to chromophobe adenomas and the immunoperoxidase techniques revealed the absence of prolactin in the cytoplasm. Electronmicroscopically, secretory granules, measuring about 100 nm, were infrequent and lined up along the cell membrane. Marked shrinkage of the Golgi apparatus and ER was noted with various stages of degenerative changes in adenoma cells. In conclusion, bromocriptine not only inhibits the release of prolactin, but also suppresses the synthesis of it at the initial phase. With a long-term administration of bromocriptine, the cell organelles related to the hormone production, such as the Golgi apparatus and ER show gradual shrinkage under the prolonged tonic inhibition for prolactin release and synthesis. This might be the mechanism by which bromocriptine leads prolactinomas to the shrinkage.

Adenoma↗
PubMed1981

Pituitary apoplexy: its incidence and clinical significance.

The occurrence of hemorrhage from pituitary adenoma (so-called "pituitary apoplexy") was investigated in a consecutive series of 560 cases operated on during the past 30 years. There were 93 cases (16.6%) in which hemorrhage from pituitary adenomas was confirmed either clinically or surgically. These patients were analyzed in terms of age, sex, symptoms and signs, size of tumor, hormonal function, and histological types of adenomas, and computerized tomography findings. In 90 cases (16.6%), hematoma or old bloody fluid was verified within the tumor tissue at surgery. Three other patients presented with subarachnoid hemorrhage, but there was no detectable intratumor hematoma in any of them. Among these 93 patients, 42 (7.5%) showed no evidence of clinical symptoms related to hemorrhage (asymptomatic hemorrhage). Fifty-one patients (9.1%) had definite histories of an acute episode that suggested sudden bleeding (symptomatic hemorrhage: pituitary apoplexy). Thirty-eight patients (6.8%) had a major attack manifested by disturbances of consciousness, hemiparesis, loss of vision, or ocular palsy. In two acromegalic patients, pituitary apoplexy developed during bromocriptine treatment. There was one case of sudden death due to massive hemorrhage from the tumor 14 months after the completion of postoperative radiation therapy. The other 13 symptomatic patients (2.3%) developed a minor attack which included headache, nausea, vomiting, and vertigo. Bleeding from pituitary adenomas was not statistically correlated with any of the following factors: sex, hormonal function of adenomas, and histological types, but it was correlated with age. The number of asymptomatic cases in the third decade was significantly greater than that of the whole group of pituitary adenoma patients in the same decade. The present investigation revealed that the incidence of pituitary apoplexy was unexpectedly high: a major attack in 6.8% of pituitary adenoma patients, a minor attack in 2.3%, and asymptomatic hemorrhage in 7.5% of the cases. This risk of pituitary apoplexy should be kept in mind in treating pituitary adenomas.

Adenoma↗