Outcome of surgical intrasellar growth hormone tumor performed by a pituitary specialist surgeon in a developing country

Background

Acromegaly is an excessive GH secretion, which in most cases, is caused by a pituitary GH-secreting adenoma. Traditional treatment of acromegaly consists of surgery, drug therapy, and eventually radiotherapy. The aim of this retrospective study is to evaluate the results of transsphenoidal endoscopic surgery in a group of patients with intrasellar GH adenoma who were operated by a pituitary specialist surgeon. We shall then argue about the economical advantages, for the NHS of a developing country, between surgical and medical treatment.

Methods

We have analyzed data from 33 patients with intrasellar GH tumor who had been referred to the neuroendocrine department of the HGF, Brazil. The patients underwent a transsphenoidal endoscopic adenomectomy for acromegaly between 2000 and 2005. Their ages were between 20 and 67 years (mean, 44 years) at the moment of surgery. No cavernous sinus invasion was present. Follow-up was a median of 2 years (range, 12 months-6 years).

Results

All 33 patients had intrasellar adenoma, 84.84% of patients achieved remission by surgery. One patient was operated twice and reached hormonal normalization. Five patients still had the disease and refused a second surgery. A treatment with octreotide was started for these 5 patients and resulted in an adequate control of GH and IGF-1 levels. No patients had radiotherapy.

Conclusion

Our patients, with intrasellar GH tumor, operated by a pituitary specialist neurosurgeon had remission rates approaching those obtained by most specialized neurosurgical centers worldwide. For equal results, our study shows that the surgical treatment is the best issue for the patient and for the NHS.     

The effects of olanzapine and fluphenazine on plasma cortisol, prolactin and muscle rigidity in schizophrenic patients: a double blind study

Pharmacotherapy of schizophrenia is associated with the stressful side effects. Muscle rigidity causes distress, discomfort and poor compliance. The aim of the study was to determine the relationship between plasma hormones (cortisol and prolactin/PRL) and muscle rigidity in female schizophrenic patients treated with olanzapine or fluphenazine. In a randomized, double-blind 22-weeks study, 12 patients were treated with olanzapine (5-20 mg/day) and 10 patients received fluphenazine (6-21 mg/day). Treatment with olanzapine moderately decreased, while treatment with fluphenazine significantly increased plasma cortisol levels and muscle rigidity. The marked and moderate increase in plasma PRL levels were found in patients treated with fluphenazine and olanzapine, respectively. The results suggested that olanzapine induced moderate neuroendocrine effects and a reduction in rigidity as compared to fluphenazine treatment.     

PRL-3在乳腺癌组织及细胞系中的表达

目的：研究乳腺浸润性导管癌组织及乳腺癌细胞系中PRL-3的表达,同时在乳腺癌细胞系中应用SOV抑制剂在不同时间点检测PRL-3的表达情况。方法：应用western blotting方法检NYL腺浸润性导管癌及乳腺癌细胞系中PRL-3的表达,且在乳腺癌细胞系中加入不同浓度的SOV抑制剂后在不同时间点检测PRL-3的表达情况。结果：在乳腺浸润性导管癌组织中PRL-3的表达明显高于其癌旁乳腺组织,统计学显示P〈0．01,且有淋巴结转移组的表达也显著高于无淋巴结转移组（P〈0．01）。应用不同终浓度的SOV（0、2、5、10μmol／L）处理BT549细胞24h、48h、96h、120h后,结果显示PRL-3的表达水平随着SOV浓度的增高表达逐渐下降,呈现出明显的时间-剂量效应关系。结论：PRL-3可能将作为乳腺癌的一种诊断和治疗的靶点,而且其表达的增高会加速乳腺癌的转移。     

精浆中催乳素(PRL)时间分辨免疫荧光测定的临床意义

本文采用时间分辨免疫荧光法和精液电子计算机分析,比较79例男性精浆和血清PRL与精液质量的关系,结果显示:精浆中PRL与精子密度、精子活率呈负相关(P<0.05)。此外血清/精浆PRL比值无精子症组差异较明显,该项计算比例具有一定的临床意义。     

Cytokine-like effects of prolactin in human mononuclear and polymorphonuclear leukocytes

Some biochemical events following the binding of prolactin (PRL) to its receptor in normal human leukocytes were investigated. PRL enhanced JAK2 phosphorylation in peripheral blood mononuclear cells (PBMC) but not in granulocytes. PRL also induced phosphorylation of Stat-5 in PBMC and Stat-1 in granulocytes. Subsequent binding of Stat-5- and of Stat-1-like molecules to a GAS responsive element from the β-casein promoter was detected by EMSA. p38 MAPK (but not p42/p44 MAPK) was activated by PRL in both leukocyte populations. PRL induced iNOS and CIS mRNA expression in granulocytes. Increased expression of IRF-1 and SOCS-2 was observed in granulocytes and of SOCS-3 and iNOS in PBMC. Similar effects were obtained with ovine and human PRL. Antiserum to PRL reduced iNOS and IRF-1 expression induced by PRL in granulocytes and reduced iNOS expression in PBMC. Also, pretreatment of granulocytes with a p38 MAPK inhibitor (SB 203580) prevented in part PRL-induced iNOS and IRF-1 expression. In PBMC, the p38 inhibitor decreased PRL-induced iNOS gene expression. These results indicate that PRL-induced gene regulation in leukocytes requires the activation of at least two different pathways: the Stat and the MAP kinase pathways. Moreover, although PRL activates Stat in both leukocyte types, signal transduction is different in granulocytes and in PBMC. Most importantly, PRL modulates the expression of genes crucial to leukocyte function. The present findings reinforce the concept that PRL has “cytokine-like” activity in human leukocytes.     

Prolactin-releasing peptide, a possible modulator of prolactin in the euryhaline silver sea bream (Sparus sarba): A molecular study

PRL and PrRP cDNAs have been isolated from euryhaline silver sea bream (Sparus sarba). The PRL cDNA consists of 1360 bp encoding 212 amino acids whereas the PrRP cDNA contains 631 bp encoding preproPrRP with 122 amino acids. The mature PrRP sequence within the preprohormone is identical to the PrRPs isolated from other fish species. PRL mRNA was uniquely expressed in sea bream pituitary but PrRP mRNA was expressed in a variety of organs and tissues including the intestines, olfactory rosette and various brain regions such as hypothalamus and pituitary. Expression levels of PRL and PrRP mRNA have been examined in sea bream adapted to different salinities (0, 6, 12, 33 and 50 ppt). In the pituitary, both PRL and PrRP mRNA were significantly higher in fish adapted to low salinities (0 and 6 ppt) and the expression profiles of both hormones closely paralleled each other. However, expression of hypothalamic PrRP was significantly higher in fish adapted to iso-osmotic salinity (12 ppt) when pituitary PRL expression was low. The present study demonstrates, for the first time, a synchronized mRNA expression pattern between PRL and PrRP in fish pituitary but a disparity of mRNA expression levels between hypothalamic PrRP and pituitary PRL during salinity adaptation. These data suggest that PrRP may possibly act as a local modulator in pituitary rather than a hypothalamic factor for regulation of pituitary PRL expression in silver sea bream.     

产后复原膏治疗产后缺乳的疗效观察

目的：探讨产后复原膏治疗产后缺乳的临床疗效。方法选自2011年10月至2012年3月、2012年10月至2013年3月期间我院产科门诊产后缺乳患者168例,随机分为两组,每组84例,治疗组给予产后复原膏,7天;对照组给予生乳颗粒,7天;分别观察疗效。结果治疗组优于对照组,两组比较有显著性差异,有统计学意义,P＜0．05。结论产后复原膏治疗产后缺乳具有满意临床效果。产后复原膏可以补气养血、通络下乳,具有改善和促进造血功能,增加泌乳素分泌的作用。     

Dopamine infusion into the third ventricle increases gene expression of hypothalamic vasoactive intestinal peptide and pituitary prolactin and luteinizing hormone beta subunit in the turkey

Turkey prolactin (PRL) secretion is controlled by vasoactive intestinal peptide (VIP) neurons residing in the infundibular nuclear complex (INF) of the hypothalamus. The VIPergic activity is modulated by dopamine (DA) via stimulatory D(1) DA receptors. DA (10 nmol/min for 40 min) was infused into the third ventricle of laying turkey hens to study its effect on circulating PRL, hypothalamic VIP and pituitary PRL and LHbeta subunit mRNA levels. Plasma PRL was significantly elevated after 20 min of DA infusion and remained elevated 30 min after cessation of infusion. Hypothalamic VIP mRNA content was significantly greater in the INF of DA-infused birds than it was in the INF of vehicle-infused control birds. No increase in VIP mRNA due to DA infusion was noted in the preoptic area. Pituitary PRL and LHbeta subunit mRNAs were increased in DA-infused hens as compared to vehicle-infused controls but the rate of increase was more in PRL than LHbeta subunit. This study demonstrates that exogenous DA activates hypothalamic VIP gene expression and this increased expression is limited exclusively to the avian INF. The increased VIP mRNA in the INF is correlated with increased levels of circulating PRL and PRL and LHbeta mRNAs in the anterior pituitary.     

Immunomodulatory Effects of Sex Hormones: Requirements for Pregnancy and Relevance in Melanoma

Similarities between the pathologic progression of cancer and the physiologic process of placentation (eg, proliferation, invasion, and local/systemic tolerance) have been recognized for many years. Sex hormones such as human chorionic gonadotropin, estrogens, progesterone, and others contribute to induction of immunologic tolerance at the beginning of gestation. Sex hormones have been shown to play contributory roles in the growth of cancers such as breast cancer, prostrate cancer, endometrial cancer, and ovarian cancer, but their involvement as putative mediators of the immunologic escape of cancer is still being elucidated. Herein, we compare the emerging mechanism by which sex hormones modulate systemic immunity in pregnancy and their potentially similar role in cancer. To do this, we conducted a PubMed search using combinations of the following keywords: “immune regulation,” “sex hormones,” “pregnancy,” “melanoma,” and “cancer.” We did not limit our search to specific publication dates. Mimicking the maternal immune response to pregnancy, especially in late gestation, might aid in design of better therapies to reconstitute endogenous antitumor immunity and improve survival.