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Biomedical subjects

K D Post

Publications and source records attributed to K D Post.

69 records · Page 4Linked to original sources
PubMed1982

Surgical cure of prolactinoma reverses abnormal prolactin repsonse to carbidopa/L-dopa.

To determine whether the abnormalities in dopaminergic regulation of PRL secretion in patients with prolactinomas persist after resection of the adenoma, we evaluated PRL inhibitory responses to L-dopa alone and L-dopa given after pretreatment with the dopa decarboxylase inhibitor carbidopa before and after transsphenoidal selective resection of prolactinomas in 23 women. Eighteen women were cured by surgery (normal PRL, menses, no galactorrhea), while 5 women were not cured. Preoperatively, the PRL inhibitory responses to L-dopa cured, 4 .3 +/- 3.8%; uncured, 50.1 +/- 5.5% of baseline) was blunted by pretreatment with the decarboxylase inhibitor carbidopa (cured, 79.1 +/- 4.1%; uncured, 76.8 +/- 9.2%). Postoperatively, this blunting disappeared in the cured patients (L-dopa, 49.1 +/- 3.5%; carbidopa/L-dopa, 56.3 +/- 5.1%), but the blunting persisted in the uncured patients (L-dopa, 49.3 +/- 7.9%; carbidopa/L-dopa, 69.3 +/- 4.2%). The return to normal of the carbidopa/L-dopa test in cured prolactinoma patients after surgery is evidence that in these individuals, preoperative abnormalities of secretion are due to either intrinsic abnormalities of the tumor or alteration of hypothalamic function secondary to tumor secretion. In those patients not cured by surgery, dynamic tests of function remain abnormal, findings attributable to either incomplete tumor resection or the presence, in some patients, of underlying hypothalamic dysregulation.

Adenoma↗
PubMed1980

Galactorrhea, oligo/amenorrhea, and hyperprolactinemia in patients with craniopharyngiomas.

We report three patients with craniopharyngiomas who had galactorrhea, oligo/amenorrhea, and abnormal sellar tomograms, clinically suggesting the presence of a prolactinoma. One patient had an intrasellar craniopharyngioma (Rathke's cleft cyst) diagosed during surgical exploration of the pituitary fossa for removal of a suspected prolactinoma, and two had suprasellar caraniopharyngiomas whose presence was suspected on the basis of computed tomography. This finding emphasizes the importance of computed tomography in the evaluation of patients with the clinical presentation of a prolactinoma. In two patients, PRL levels were elevated before surgery and remained elevated after removal of the craniopharyngioma. In the third case, an initially normal serum PRL level became elevated after removal of the tumor.

Adult↗
PubMed1979

Selective transsphenoidal adenomectomy in women with galactorrhea-amenorrhea.

Thirty women with prolactin (PRL)-secreting adenomas underwent selective adenomectomy via a transsphenoidal route. All had abnormal sella polytomes or visual fields, amenorrhea with low basal serum gonadotropin levels despite decreased serum estradiol concentrations, and elevated basal serum PRL levels with blunted PRL response to neuroendocrine stimulation tests )thyrotropin-releasing hormone, levodopa, chlorpromazine, and hypoglycemia). Of 17 patients with microadenomas, 14 (82.4%) were cured and three (17.6%) improved. None were unchanged or worse. Three (60%) of five patients with larger, but still intrasellar tumors, had normalization of PRL levels, return of menses, and resolution of galactorrhea. The patients with tumors extending out of the sella did not fare as well. Overall, 21 (70%) were cured, six (20%) improved, two (6.7%) were unchanged, and the condition of one (3.3%) became worse. All preoperative neurologic deficits resolved. Postoperative complications were minimal with no neurologic morbidity. When tumors are small, surgical results are excellent with minimal risk.

Adenoma↗
PubMed1979

Intra-operative frozen section technique for pituitary adenomas.

Orange G-hematoxylin stains performed on frozen sections from the sella turcica had a diagnostic accuracy of over 90% when compared to permanent sections on the same tissue. This technique allows the pathologist to make an intra-operative contribution to the establishment of tumor margins in the selective removal of pituitary adenomas.

Adenoma↗
PubMed1979

The value of computed tomography in evaluating patients with prolactinomas.

The use of computed tomography (CT) in 28 patients with surgically proved prolactinomas is described. The authors' experience suggests that in evaluating patients with galactorrhea-amenorrhea syndrome, CT in combination with pluridirectional tomography usually provides sufficient information to make further invasive studies unnecessary. In selected cases with low-density areas within the sella as seen on CT, pneumoencephalography is still advisable to distinguish between the empty sella and the necrotic tumor. Angiography is still necessary to exclude vascular causes for suprasellar and parasellar masses such as aneurysms and meningiomas.

Empty Sella Syndrome↗
PubMed1979

Eosinophilic granuloma mimicking a pituitary tumor.

The authors present the case report of a patient in whom hypopituitarism, diplopia, and visual field defects were due to eosinophilic granuloma. Radiographic studies were suggestive of a pituitary tumor and subsequent histological evaluation showed replacement of the anterior pituitary by histiocytic cells. Eosinophilic granuloma should be included in the differential diagnosis of an intrasellar mass.

Adult↗
PubMed1977

Ruptured intracranial aneurysms. Case morbidity and mortality.

The authors review 100 consecutive cases of ruptured intracranial aneurysms to assess the overall morbidity and mortality. Patients were placed on a regimen of bed rest, sedation, control of blood pressure, anticonvulsants, and antifibrinolytic therapy. Surgery was performed on 86 patients with hypotensive anesthesia and microsurgical techniques. The incidence of early rebleeding while on epsilon aminocaproic acid and control of blood pressure was 11.8%. The overall surgical mortality was 8.1%, and the surgical mortality of patients in Grades 1, 2, and 3 was 6.3%. Of the 100 patients, 60 were able to return to their prior activities, and 25 had moderate neurological deficits that required limitation of their activities. The total case mortality was 15%. The evidence presented indicates that the regimen of active medical treatment before microsurgical intervention has improved the overall case morbidity and mortality, as well as the chance for long-term survival.

Adult↗