Rats were implanted subcutaneously with silastic capsules containing 10 mg 17-β-estradiol. After 30, 60 and 120 days, their pituitary weights and plasma PRL levels were found to increase significantly. The administra...Rats were implanted subcutaneously with silastic capsules containing 10 mg 17-β-estradiol. After 30, 60 and 120 days, their pituitary weights and plasma PRL levels were found to increase significantly. The administration of β-estradiol also produced a marked rise of PRL mRNA concentrations in the rat total RNA, but the sharper rise of serum PRL levels indicates that estradiol not only promotes transcription of prolactin gene, but also improves the efficiency of translation of the transcription product.展开更多
Objective： To study the correlations between estrogen receptor （ER） and androgen receptor （AR） and the clinical presentations of prolactinoma and investigate the effect of ER and AR expression on the pathogenesis...Objective： To study the correlations between estrogen receptor （ER） and androgen receptor （AR） and the clinical presentations of prolactinoma and investigate the effect of ER and AR expression on the pathogenesis of prolactinoma in sexual difference. Methods： The clinical data of 30 patients who had undergone transsphenoidal operations in Tongji Hospital from December 2000 to December 2001 were reviewed retrospectively. The clinical information included sex, age, serum-prolactin, size, tumor invasiveness, history of use of bromocriptine and frequency of recurrence. In 20 out of the 30 patients, the ER and AR expression was detected by using immunohistochemistry method. With help of Chi-square test, the relationship between ER, AR and the clinical presentations was analyzed. Results： The statistical values revealed that there was no significant correlation between the ER and AR expression levels with the clinical presentations such as sex, age, tumor size or tumor invasiveness among the 20 patients studied （P〉0.05）. Conclusion： The expression of ER or AR is not influenced by the clinical data of prolactinoma such as sex, age, tumor diameter or extent of tumor invasiveness. The tumor is more aggressive in males than in females. In maroadenoma or tumor with hyperprolactineamia （〉200 ng/mL） simple surgical treatment can＇t successfully cure the prolactinoma. Post-operative bromocriptine therapy can＇t be determined by the sex of the patients, but is greatly related to the tumor size and serum-prolactin level before operation.展开更多
Dopamine agonists （DA） are a first-line therapy for prolactinomas （PA）. However, nearly 10% of prolactinomas do not respond to DA therapy. A considerable number of studies have shown that estrogen plays an importa...Dopamine agonists （DA） are a first-line therapy for prolactinomas （PA）. However, nearly 10% of prolactinomas do not respond to DA therapy. A considerable number of studies have shown that estrogen plays an important role in the development of prolactinomas. However, the expression of estrogen receptors （ER） in prolactinomas has not been fully explored. Accordingly, we examined the levels of ESR1 and its subtypes A5-DeI-ESR1 and ESR2 mRNA in prolactinomas. In the present study,展开更多
Objective It has long been reported that prolactinomas treated with bromocriptine increase fibrosis and may affect surgical outcomes.We retrospectively studied 238 consecutive patients with histopathologically confirm...Objective It has long been reported that prolactinomas treated with bromocriptine increase fibrosis and may affect surgical outcomes.We retrospectively studied 238 consecutive patients with histopathologically confirmed prolactinomas undergoing microsurgery in a single neurosurgery department of Tongji Hospital(Wuhan,China) from 2012 to 2015 in order to evaluate tumor consistency changes after bromocriptine pretreatment and surgical outcomes.Methods We divided the patients into four groups;males in the dopamine agonist(DA) group,females in the DA group,males in the no DA group,and females in the no DA group,and we compared the surgery process,specimen Masson staining,and clinical outcomes of the four groups.According to a previously published classification,the operative notes from an experienced neurosurgeon were reviewed to classify the consistency of tumors as "fibrous" or "nonfibrous".Results No differences in tumor consistency were found in male patients with or without DA treatment.However,in female patients with DA treatment,tumors were likely to be harder in texture than the tumors of female patients without DA treatment.Despite tumor consistency differences between sexes,the tumor biological remission rate was similar between groups,as was the rate of tumor resection.Discussion Our study indicates that preoperative DA therapy impacts tumor consistency in female patients but not male patients.Although the surgical and histopathological outcomes are not influenced,these findings may provide useful information for the choice of operative approach and surgery process for pituitary adenoma.展开更多
Male patients with prolactinomas usually present with typical hyperprolactinemia symptoms,including sexual dysfunction and infertility.However,clinical factors related to sexual dysfunction and surgical outcomes in th...Male patients with prolactinomas usually present with typical hyperprolactinemia symptoms,including sexual dysfunction and infertility.However,clinical factors related to sexual dysfunction and surgical outcomes in these patients remain unclear.This study aimed to investigate the outcomes of male patients with prolactinomas after transsphenoidal surgery and the risk factors affecting sexual dysfunction.This study was conducted on 58 male patients who underwent transsphenoidal surgery for prolactinomas between May 2014 and December 2020 at the First Affiliated Hospital of Sun Yat-sen University,Guangzhou,China.We evaluated the sexual function of patients before and after surgery through International Index of Erectile Function-5 scores,libido,and frequency of morning erection.Of the 58 patients,48(82.8%)patients had sexual intercourse preoperatively.Among those 48 patients,41(85.4%)patients presented with erectile dysfunction.The preoperative International Index of Erectile Function-5 scores in patients with macroprolactinomas were significantly higher than those in patients with giant prolactinomas(17.63±0.91 vs 13.28±1.43;P=0.01).Postoperatively,the incidence of erectile dysfunction was 47.9%,which was significantly lower than that preoperatively(85.4%;P=0.01).Twenty-eight(68.3%)patients demonstrated an improvement in erectile dysfunction.Tumor size and invasiveness were significantly correlated with the improvement of erectile dysfunction.Preoperative testosterone<2.3 ng ml^(-1)was an independent predictor of improvement in erectile dysfunction.In conclusion,our results indicated that tumor size and invasiveness were important factors affecting the improvement of sexual dysfunction in male patients with prolactinoma.The preoperative testosterone level was an independent predictor related to the improvement of erectile dysfunction.展开更多
Objective： To study the diagnostic and therapeutic features of prolactinoma. Methods： 124 patients with prolactinoma were studied in clinical manifestation, pathologic, endocrinological, radiographic and therapeutic...Objective： To study the diagnostic and therapeutic features of prolactinoma. Methods： 124 patients with prolactinoma were studied in clinical manifestation, pathologic, endocrinological, radiographic and therapeutic features. Results： The average age of the male patients was 41.6 years, 32.3 years of females. The major clinical manifestation in males were sexual and visual disfunction. In females, disfunction of menstruates and galactorrhea. Average serum prolactin was 1875.22 in males, 376.6 ng/mL in females. Average diameter of the tumors was 38.05 mm in males, and 83.3% of the tumors were invasive, in females were 15.25 mm and 49%. After surgery, the average serum prolactin decreased to 385.84 ng/mL （P〈 0.05）, 13 of 15 patients improved in sexual function, 82.6% patients improved in eyesight and visual field. In females prolactin decreased to 23.93 ng/mL （P 〈 0.05）, and 81.25% infertility with microprolactinoma got pregnancy, higher than controls of drug therapy （P 〈 0.05）. Conclusion： In males, the tumors were usually larger and more invasive, and serum prolactin levels were higher. The patients were elder. But in females, much younger than males, most of the tumors were microadenoma, and after operation the prolactin usually decrease to normal level and more chance of pregnancy. Results of a single therapy were with less satisfaction, we advocate integrated therapy around operation.展开更多
Objective： The aim of the study was to explore the bone morphogenetic protein 4 （BMP-4） how to regulate pro- lactin （PRL） secreting, cell proliferation and invasiveness in human prolactinorna. Methods： Ten patie...Objective： The aim of the study was to explore the bone morphogenetic protein 4 （BMP-4） how to regulate pro- lactin （PRL） secreting, cell proliferation and invasiveness in human prolactinorna. Methods： Ten patients who diagnosed as prolactinoma by clinical characteristics and pathology were divided into two groups, one was sensitive to Brornocriptine, the other was insensitive to Brornocriptine. Every case was conducted by primal cell culture then treated by different concentrations of BMP-4. The cell configuration was observed and PRL hormone was measured in different times. The expressions of BMP-4 rnRNA and BMP-4 in 37 cases of prolactinorna and 8 cases of normal pituitary tissues samples were detected by immunohistochemical and in situ hybridization technique, and the results were analyzed by statistic methods. Results： BMP-4 （5 ng/rnL） could accelerate the secreting of PRL in prolactinorna cell, and it could reach the greatest effect in the concentration of 20 ng/mL. BMP-4 could increase prolactinoma cell proliferation, but when the concentration was 50 ng/rnL, the BMP-4 effect of increasing secreting decreased. When 100 ng/mL, the cell began to die. The effects of the BMP-4 in sensitive group and insensitive group had no difference. The BMP-4 was highly expressed in the prolactinornas and was positively related with the invasiveness grades. Conclusion： BMP-4 have positive regulation in prolactinoma secreting, proliferation, invasiveness effects, BMP-4 probably has the important role in prolactinoma pathogenesis.展开更多
Prolactinomas are the most common benign pituitary neoplasms and the common cause of hyperprolactinemia. Most of them arise in women of reproductive age. In men, they are often functionally silent, but present with ma...Prolactinomas are the most common benign pituitary neoplasms and the common cause of hyperprolactinemia. Most of them arise in women of reproductive age. In men, they are often functionally silent, but present with manifestations secondary to pressure effects when they become macro adenomas. We present a case of prolactinoma in a 54-year old male patient who presented with pressure effects because of the tumor, as head ache and bi-temporal hemianopsia. MRI Brain scan was done to identify the tumor. The patient underwent trans-sphenoidal resection of the pituitary macro adenoma. Histological examination revealed spheroid amyloid deposits, almost replacing the adenoma. No medical treatment was given but the tumor recurred after 6 months and a repeat surgery was done for total excision.展开更多
Twelve years following hemicolectomy for colon adenocarcinoma, a 75-year-old patient with prostate cancer was treated for 4 weeks with the antiandrogen nilutamide and then with the long-acting GnRH agonist buserelin. ...Twelve years following hemicolectomy for colon adenocarcinoma, a 75-year-old patient with prostate cancer was treated for 4 weeks with the antiandrogen nilutamide and then with the long-acting GnRH agonist buserelin. The serum testosterone and prostate-specific antigen levels had decreased dramatically after 3 months of treatment. After 2 years of buserelin administration, the hormonal state was examined. Serum estradiol, testosterone, DHEA, DHEAS, FSH and LH levels proved to be suppressed, but the serum PRL concentration was extremely high (3 365 mIU/l). The pituitary MRI revealed a macroadenoma. The patient was treated with the dopamine agonist cabergoline, together with buserelin. After 9 months of this combined treatment, the prostate-specific antigen and testosterone levels were very low;the serum estradiol, DHEA, DHEAS, FSH and LH concentrations remained suppressed. The serum PRL level fell dramatically to 6.95 mIU/l, and a significant reduction in tumor size was observed on MRI. In conclusion: Combined buserelin + cabergoline treatment proved a highly successful procedure to cure this patient with prostate carcinoma and subsequent pituitary macroprolactinoma.展开更多
Background Control of hypersecretion of certain hormones is one of the key targets in the treatment of pituitary adenomas. RNA interference has been shown to inhibit protein expression, and thus it may represent a pro...Background Control of hypersecretion of certain hormones is one of the key targets in the treatment of pituitary adenomas. RNA interference has been shown to inhibit protein expression, and thus it may represent a promising method for the treatment of pituitary adenomas. In the present study, transfection efficiency of small interfering RNA （siRNA） was optimized in human prolactinoma cells. Methods First, a method was optimized to extract highly purified human prolactinoma cells in vitro. The extracted cells were verified to retain the physiological features of prolactin （PRL） secretion. Second, three conditions for siRNA transfection were tested by the evaluation of transfectfon efficiency and cell viability. The proper transfection condition was verified for human prolactinoma cells. Third, the siRNA for prolactin was transfected into the human prolactinoma cells, and the suppression of PRL mRNA was evaluated by quantitative real-time reverse transcription-PCR. Results The siRNA of 100 pmol with Lipofectamine 2000 of 5 μl for 1×10^6 cells was proved preferable, with transfection efficiency being 53.3% and cell viability being 69.7%. In the preliminary experiment the siRNA against PRL decreased the mRNA of PRL by 34.0%. Conclusion It is possible to inhibit hormone hypersecretion by RNA interference, that may eventually enable therapeutic siRNA drugs developed.展开更多
We reported a rare case of a dialysis patient coincident pituitary prolactinoma with calcification. A 55-year-old woman who had undergone hemodialysis for 8 years was admitted to the nephrology unit because of headach...We reported a rare case of a dialysis patient coincident pituitary prolactinoma with calcification. A 55-year-old woman who had undergone hemodialysis for 8 years was admitted to the nephrology unit because of headache, blurred vision, and hypotension. Physical examination was normal; endocrinological examination demonstrated elevated serum levels of prolactin （〉4240 mlU/L）, but other hormonal profiles, such as growth hormon, adrenocorticotropic hormone, thyroid stimulating hormone, free triiodothyronine, free thyroxine, follicle-stimulating hormone and luteinizing hormone, were absolutely or relatively lower. A cranial computed tomography （CT） suggested saddle area a high-density screenage with an anteroposterior diameter of 1.0 cm. A cerebral magnetic resonance scan confirmed the pituitary adenoma accompanied with calcification. Contrast-enhanced Tl-weighted images revealed a less enhancing tumor, 14 mm wide round lesion with a high intensity signal. It enlarges the sella turcica, but the optic chiasma is not displaced. We suggest that in the differential diagnosis of any hemodialysis patient with severe headache, hypotension, and visual disturbances, this syndrome should be considered as prompt pituitary adenoma.展开更多
Pituitary adenoma coexisting with cerebrospinal fluid(CSF)rhinorrhea and carotid aneurysm is extremely rare.CSF rhinorrhea may cause pneumocephalus and intracranial infection.Rupture of the aneurysm may cause fatal co...Pituitary adenoma coexisting with cerebrospinal fluid(CSF)rhinorrhea and carotid aneurysm is extremely rare.CSF rhinorrhea may cause pneumocephalus and intracranial infection.Rupture of the aneurysm may cause fatal consequence.The authors report such a rare case to draw more attentions.A 55-year-old man presented with sexual dysfunction for 2 years.The serum prolactin was tested as 1,600 ng/ml(normal range,1.39–24.2).Enhanced cranial MR showed an evident lesion at the sellar area,invading the right cavernous sinus.Prolactinoma was diagnosed.He took bromocriptine for one year and received gamma knife therapy thereafter.Four months after the treatment of gamma knife,he got CSF rhinorrhea and nasal bleeding.The endoscopic transnasalsphenoidal approach was performed to resect the tumor and repair the dura defect.The CSF rhinorrhea stopped after the surgery,however his nasal bleeding continued.The digital subtraction angiography(DSA)showed an aneurysm at the right cavernous internal carotid.The endovascular coil embolization was performed to treat the aneurysm.The patient recovered well.The coexistence of CSF rhinorrhea and pituitary adenoma is a high risk factor for the rupture of cavernous internal carotid aneurysm.When treating patients with pituitary adenoma and CSF rhinorrhea,doctors should exclude the aneurysm.When nasal bleeding occurs,the hemorrhage of internal carotid should be considered,and appropriate measures should be taken immediately.展开更多
文摘Rats were implanted subcutaneously with silastic capsules containing 10 mg 17-β-estradiol. After 30, 60 and 120 days, their pituitary weights and plasma PRL levels were found to increase significantly. The administration of β-estradiol also produced a marked rise of PRL mRNA concentrations in the rat total RNA, but the sharper rise of serum PRL levels indicates that estradiol not only promotes transcription of prolactin gene, but also improves the efficiency of translation of the transcription product.
基金This project was supported by a grant from the National Natural Science Foundation of China (No. 39670736).
文摘Objective： To study the correlations between estrogen receptor （ER） and androgen receptor （AR） and the clinical presentations of prolactinoma and investigate the effect of ER and AR expression on the pathogenesis of prolactinoma in sexual difference. Methods： The clinical data of 30 patients who had undergone transsphenoidal operations in Tongji Hospital from December 2000 to December 2001 were reviewed retrospectively. The clinical information included sex, age, serum-prolactin, size, tumor invasiveness, history of use of bromocriptine and frequency of recurrence. In 20 out of the 30 patients, the ER and AR expression was detected by using immunohistochemistry method. With help of Chi-square test, the relationship between ER, AR and the clinical presentations was analyzed. Results： The statistical values revealed that there was no significant correlation between the ER and AR expression levels with the clinical presentations such as sex, age, tumor size or tumor invasiveness among the 20 patients studied （P〉0.05）. Conclusion： The expression of ER or AR is not influenced by the clinical data of prolactinoma such as sex, age, tumor diameter or extent of tumor invasiveness. The tumor is more aggressive in males than in females. In maroadenoma or tumor with hyperprolactineamia （〉200 ng/mL） simple surgical treatment can＇t successfully cure the prolactinoma. Post-operative bromocriptine therapy can＇t be determined by the sex of the patients, but is greatly related to the tumor size and serum-prolactin level before operation.
基金supported by the Research Special Fund for Public Welfare Industry of Health(201402008)
文摘Dopamine agonists （DA） are a first-line therapy for prolactinomas （PA）. However, nearly 10% of prolactinomas do not respond to DA therapy. A considerable number of studies have shown that estrogen plays an important role in the development of prolactinomas. However, the expression of estrogen receptors （ER） in prolactinomas has not been fully explored. Accordingly, we examined the levels of ESR1 and its subtypes A5-DeI-ESR1 and ESR2 mRNA in prolactinomas. In the present study,
基金Supported by a grant from the National Natural Sciences Foundation of China(No.81270865)
文摘Objective It has long been reported that prolactinomas treated with bromocriptine increase fibrosis and may affect surgical outcomes.We retrospectively studied 238 consecutive patients with histopathologically confirmed prolactinomas undergoing microsurgery in a single neurosurgery department of Tongji Hospital(Wuhan,China) from 2012 to 2015 in order to evaluate tumor consistency changes after bromocriptine pretreatment and surgical outcomes.Methods We divided the patients into four groups;males in the dopamine agonist(DA) group,females in the DA group,males in the no DA group,and females in the no DA group,and we compared the surgery process,specimen Masson staining,and clinical outcomes of the four groups.According to a previously published classification,the operative notes from an experienced neurosurgeon were reviewed to classify the consistency of tumors as "fibrous" or "nonfibrous".Results No differences in tumor consistency were found in male patients with or without DA treatment.However,in female patients with DA treatment,tumors were likely to be harder in texture than the tumors of female patients without DA treatment.Despite tumor consistency differences between sexes,the tumor biological remission rate was similar between groups,as was the rate of tumor resection.Discussion Our study indicates that preoperative DA therapy impacts tumor consistency in female patients but not male patients.Although the surgical and histopathological outcomes are not influenced,these findings may provide useful information for the choice of operative approach and surgery process for pituitary adenoma.
基金funded by the National Natural Science Foundation of China (No.82073049 and No.81802484)Postdoctoral Research Foundation of China (No.2019TQ0376)+1 种基金Science and Technology Program of Guangzhou City (No.201903010093)Natural Science Foundation of Guangdong Province (No.2018A030313549).
文摘Male patients with prolactinomas usually present with typical hyperprolactinemia symptoms,including sexual dysfunction and infertility.However,clinical factors related to sexual dysfunction and surgical outcomes in these patients remain unclear.This study aimed to investigate the outcomes of male patients with prolactinomas after transsphenoidal surgery and the risk factors affecting sexual dysfunction.This study was conducted on 58 male patients who underwent transsphenoidal surgery for prolactinomas between May 2014 and December 2020 at the First Affiliated Hospital of Sun Yat-sen University,Guangzhou,China.We evaluated the sexual function of patients before and after surgery through International Index of Erectile Function-5 scores,libido,and frequency of morning erection.Of the 58 patients,48(82.8%)patients had sexual intercourse preoperatively.Among those 48 patients,41(85.4%)patients presented with erectile dysfunction.The preoperative International Index of Erectile Function-5 scores in patients with macroprolactinomas were significantly higher than those in patients with giant prolactinomas(17.63±0.91 vs 13.28±1.43;P=0.01).Postoperatively,the incidence of erectile dysfunction was 47.9%,which was significantly lower than that preoperatively(85.4%;P=0.01).Twenty-eight(68.3%)patients demonstrated an improvement in erectile dysfunction.Tumor size and invasiveness were significantly correlated with the improvement of erectile dysfunction.Preoperative testosterone<2.3 ng ml^(-1)was an independent predictor of improvement in erectile dysfunction.In conclusion,our results indicated that tumor size and invasiveness were important factors affecting the improvement of sexual dysfunction in male patients with prolactinoma.The preoperative testosterone level was an independent predictor related to the improvement of erectile dysfunction.
文摘Objective： To study the diagnostic and therapeutic features of prolactinoma. Methods： 124 patients with prolactinoma were studied in clinical manifestation, pathologic, endocrinological, radiographic and therapeutic features. Results： The average age of the male patients was 41.6 years, 32.3 years of females. The major clinical manifestation in males were sexual and visual disfunction. In females, disfunction of menstruates and galactorrhea. Average serum prolactin was 1875.22 in males, 376.6 ng/mL in females. Average diameter of the tumors was 38.05 mm in males, and 83.3% of the tumors were invasive, in females were 15.25 mm and 49%. After surgery, the average serum prolactin decreased to 385.84 ng/mL （P〈 0.05）, 13 of 15 patients improved in sexual function, 82.6% patients improved in eyesight and visual field. In females prolactin decreased to 23.93 ng/mL （P 〈 0.05）, and 81.25% infertility with microprolactinoma got pregnancy, higher than controls of drug therapy （P 〈 0.05）. Conclusion： In males, the tumors were usually larger and more invasive, and serum prolactin levels were higher. The patients were elder. But in females, much younger than males, most of the tumors were microadenoma, and after operation the prolactin usually decrease to normal level and more chance of pregnancy. Results of a single therapy were with less satisfaction, we advocate integrated therapy around operation.
文摘Objective： The aim of the study was to explore the bone morphogenetic protein 4 （BMP-4） how to regulate pro- lactin （PRL） secreting, cell proliferation and invasiveness in human prolactinorna. Methods： Ten patients who diagnosed as prolactinoma by clinical characteristics and pathology were divided into two groups, one was sensitive to Brornocriptine, the other was insensitive to Brornocriptine. Every case was conducted by primal cell culture then treated by different concentrations of BMP-4. The cell configuration was observed and PRL hormone was measured in different times. The expressions of BMP-4 rnRNA and BMP-4 in 37 cases of prolactinorna and 8 cases of normal pituitary tissues samples were detected by immunohistochemical and in situ hybridization technique, and the results were analyzed by statistic methods. Results： BMP-4 （5 ng/rnL） could accelerate the secreting of PRL in prolactinorna cell, and it could reach the greatest effect in the concentration of 20 ng/mL. BMP-4 could increase prolactinoma cell proliferation, but when the concentration was 50 ng/rnL, the BMP-4 effect of increasing secreting decreased. When 100 ng/mL, the cell began to die. The effects of the BMP-4 in sensitive group and insensitive group had no difference. The BMP-4 was highly expressed in the prolactinornas and was positively related with the invasiveness grades. Conclusion： BMP-4 have positive regulation in prolactinoma secreting, proliferation, invasiveness effects, BMP-4 probably has the important role in prolactinoma pathogenesis.
文摘Prolactinomas are the most common benign pituitary neoplasms and the common cause of hyperprolactinemia. Most of them arise in women of reproductive age. In men, they are often functionally silent, but present with manifestations secondary to pressure effects when they become macro adenomas. We present a case of prolactinoma in a 54-year old male patient who presented with pressure effects because of the tumor, as head ache and bi-temporal hemianopsia. MRI Brain scan was done to identify the tumor. The patient underwent trans-sphenoidal resection of the pituitary macro adenoma. Histological examination revealed spheroid amyloid deposits, almost replacing the adenoma. No medical treatment was given but the tumor recurred after 6 months and a repeat surgery was done for total excision.
文摘Twelve years following hemicolectomy for colon adenocarcinoma, a 75-year-old patient with prostate cancer was treated for 4 weeks with the antiandrogen nilutamide and then with the long-acting GnRH agonist buserelin. The serum testosterone and prostate-specific antigen levels had decreased dramatically after 3 months of treatment. After 2 years of buserelin administration, the hormonal state was examined. Serum estradiol, testosterone, DHEA, DHEAS, FSH and LH levels proved to be suppressed, but the serum PRL concentration was extremely high (3 365 mIU/l). The pituitary MRI revealed a macroadenoma. The patient was treated with the dopamine agonist cabergoline, together with buserelin. After 9 months of this combined treatment, the prostate-specific antigen and testosterone levels were very low;the serum estradiol, DHEA, DHEAS, FSH and LH concentrations remained suppressed. The serum PRL level fell dramatically to 6.95 mIU/l, and a significant reduction in tumor size was observed on MRI. In conclusion: Combined buserelin + cabergoline treatment proved a highly successful procedure to cure this patient with prostate carcinoma and subsequent pituitary macroprolactinoma.
文摘Background Control of hypersecretion of certain hormones is one of the key targets in the treatment of pituitary adenomas. RNA interference has been shown to inhibit protein expression, and thus it may represent a promising method for the treatment of pituitary adenomas. In the present study, transfection efficiency of small interfering RNA （siRNA） was optimized in human prolactinoma cells. Methods First, a method was optimized to extract highly purified human prolactinoma cells in vitro. The extracted cells were verified to retain the physiological features of prolactin （PRL） secretion. Second, three conditions for siRNA transfection were tested by the evaluation of transfectfon efficiency and cell viability. The proper transfection condition was verified for human prolactinoma cells. Third, the siRNA for prolactin was transfected into the human prolactinoma cells, and the suppression of PRL mRNA was evaluated by quantitative real-time reverse transcription-PCR. Results The siRNA of 100 pmol with Lipofectamine 2000 of 5 μl for 1×10^6 cells was proved preferable, with transfection efficiency being 53.3% and cell viability being 69.7%. In the preliminary experiment the siRNA against PRL decreased the mRNA of PRL by 34.0%. Conclusion It is possible to inhibit hormone hypersecretion by RNA interference, that may eventually enable therapeutic siRNA drugs developed.
文摘We reported a rare case of a dialysis patient coincident pituitary prolactinoma with calcification. A 55-year-old woman who had undergone hemodialysis for 8 years was admitted to the nephrology unit because of headache, blurred vision, and hypotension. Physical examination was normal; endocrinological examination demonstrated elevated serum levels of prolactin （〉4240 mlU/L）, but other hormonal profiles, such as growth hormon, adrenocorticotropic hormone, thyroid stimulating hormone, free triiodothyronine, free thyroxine, follicle-stimulating hormone and luteinizing hormone, were absolutely or relatively lower. A cranial computed tomography （CT） suggested saddle area a high-density screenage with an anteroposterior diameter of 1.0 cm. A cerebral magnetic resonance scan confirmed the pituitary adenoma accompanied with calcification. Contrast-enhanced Tl-weighted images revealed a less enhancing tumor, 14 mm wide round lesion with a high intensity signal. It enlarges the sella turcica, but the optic chiasma is not displaced. We suggest that in the differential diagnosis of any hemodialysis patient with severe headache, hypotension, and visual disturbances, this syndrome should be considered as prompt pituitary adenoma.
基金Supported by the the National Science&Technology Pillar Program during the 12th Five-year Plan Period(No.2012BAI12B03)Beijing Talents Project(No.2012D003034000032)+2 种基金National Key Technology Research and Development Program of the Ministry of Science and Technology of China(No.2013BAI09B03)Beijing Institute for Brain Disorders project(No.BIBDPXM2013_014226_07_000084)the National Natural Science Funds for Distinguished 302 Young Scholars(No.81502390)
文摘Pituitary adenoma coexisting with cerebrospinal fluid(CSF)rhinorrhea and carotid aneurysm is extremely rare.CSF rhinorrhea may cause pneumocephalus and intracranial infection.Rupture of the aneurysm may cause fatal consequence.The authors report such a rare case to draw more attentions.A 55-year-old man presented with sexual dysfunction for 2 years.The serum prolactin was tested as 1,600 ng/ml(normal range,1.39–24.2).Enhanced cranial MR showed an evident lesion at the sellar area,invading the right cavernous sinus.Prolactinoma was diagnosed.He took bromocriptine for one year and received gamma knife therapy thereafter.Four months after the treatment of gamma knife,he got CSF rhinorrhea and nasal bleeding.The endoscopic transnasalsphenoidal approach was performed to resect the tumor and repair the dura defect.The CSF rhinorrhea stopped after the surgery,however his nasal bleeding continued.The digital subtraction angiography(DSA)showed an aneurysm at the right cavernous internal carotid.The endovascular coil embolization was performed to treat the aneurysm.The patient recovered well.The coexistence of CSF rhinorrhea and pituitary adenoma is a high risk factor for the rupture of cavernous internal carotid aneurysm.When treating patients with pituitary adenoma and CSF rhinorrhea,doctors should exclude the aneurysm.When nasal bleeding occurs,the hemorrhage of internal carotid should be considered,and appropriate measures should be taken immediately.
