垂体冠状断层的巨微解剖学

目的:为垂体的影像诊断和垂体疾病的外科治疗提供解剖学资料。方法:火棉胶包埋后作脑垂体冠状薄层切片并进行观察和测量。结果:(1)垂体大多呈椭圆形。正常垂体的高度为(4．5±2．0)mm,宽度为(13．9±3．8)mm。垂体的上缘以凹陷型居多,平坦型次之。两侧海绵窦的大小、形态变化较大。鞍底以凹陷型和隆起型为多。(2)断面情况:垂体常出现在交叉前沟后一个层面,消失于鞍背层面,上以鞍膈与鞍上池和视交叉相邻,下邻蝶窦,两侧为海绵窦。在垂体前叶层面可见垂体柄长(8．8±1．7)mm,在视交叉处其横径为(3．1±0．6)mm,插入垂体处的横径为(2．0±0．2)mm。结论:垂体巨微断面可清晰显示垂体周围的重要结构,为影像检查和垂体手术入路提供解剖学资料。     

大鼠垂体前叶腺细胞增龄变化及其与滤泡星形细胞的关系

目的:研究不同月龄大鼠垂体前叶腺细胞的形态学变化及其与滤泡星形细胞(folliculo-stellate cells,FSCs)之间的形态学关系。方法:透射电镜观察2～3月(青年组)、10～12月(中年组)、18～20月(老年组)3组大鼠垂体前叶的超微结构。结果:3组大鼠的FSCs和腺细胞之间均存在连接复合体样结构;在增龄过程中,FSCs的形态变化不明显,而腺细胞及其细胞间质变化明显:细胞排列散乱、细胞间隙增宽、纤维结缔组织增生,以中年组较为显著;脂褐素、髓样体、凋亡细胞增多,老年组比较明显。结论:FSCs可能通过与腺细胞的直接接触对腺细胞发挥作用;垂体前叶腺细胞及其细胞间隙的变化直接反映其增龄变化。     

Morphology of the pituitary gland in ferrets (Mustela putorius furo) with hyperadrenocorticism

Pituitary tumours are the cause of hyperadrenocorticism in a variety of species, but the role of the pituitary gland in hyperadrenocorticism in ferrets is not known. In this species, the disease is mediated by the action of excess gonadotrophins on the adrenal cortex and is characterized by an excessive secretion of sex steroids. In this study, the pituitary gland of four healthy control ferrets, intact or neutered, and 10 neutered ferrets with hyperadrenocorticism was examined histologically following immunohistochemical labelling for adrenocorticotrophic hormone, alpha-melanocyte-stimulating hormone, growth hormone, thyroid-stimulating hormone, luteinizing hormone, follicle-stimulating hormone, and prolactin. Immunohistochemistry revealed that somatotrophs, thyrotrophs and lactotrophs were the most abundant cell types of the pars distalis of the pituitary gland in the healthy ferrets. The distribution of corticotrophs was similar to that in the dog and man. In ferrets, as in dogs, the melanotrophic cell was almost the only cell type of the pars intermedia. Gonadotrophs were found in the pars distalis of neutered, but not intact ferrets. All the ferrets with hyperadrenocorticism had unilateral or bilateral alterations of the adrenal gland. In addition, in the pituitary gland of two of these ferrets a tumour was detected. These tumours were not immunolabelled by antibodies against any of the pituitary hormones, and had characteristics of the clinically non-functional gonadotroph tumours seen in man. In some of the other ferrets low pituitary immunoreactivity for gonadotrophic hormones was detected, which may have been due to the feedback of autonomous steroid secretion by the neoplastic transformation of the adrenal cortex. It is concluded that initially high concentrations of gonadotrophins resulting from castration may initiate hyperactivity of the adrenal cortex. The low incidence of pituitary tumours and the low density of gonadotrophin-positive cells in non-affected pituitary tissue in this study suggest that persistent hyperadrenocorticism is not dependent on persistent gonadotrophic stimulation.     

颈内动脉与垂体关系的解剖学研究及影像学意义

目的:为垂体腺瘤(PA)的影像诊断提供解剖学基础。方法:观测15例(30侧)成人头颅标本颈内动脉海绵窦段(ICICA)的位置、行径及与垂体的关系。结果:⑴ICICA分为3型:I型:Z’形,占42.9%;II型:‘S’形,占35.7%;III型:斜‘L’形,占21.4%。⑵ICICA与垂体外侧壁相贴43.3%(13侧),不相贴56.7%(17侧)。⑶海绵窦(CS)下间隙出现率93.3%(28侧),上间隙现率73.3%(22侧),内侧间隙现率56.7%(17侧)。⑷垂体外侧壁在轴位上可等分为上、中、下3个层面:①36.7%(11侧)颈内动脉(ICA)行经垂体外侧壁各部,②16.7%(7侧)ICA行经垂体外侧壁中和下1/3,③33.3%(10侧)ICA行经垂体外侧壁下1/3,④6.7%(2侧)ICA低于垂体行在ICA沟。结论:ICICA走行变异较多,与垂体关系密切,在PA的影像学诊断中应充分考虑。     

Structural malformations of the brain,eye, and pituitary gland in PHACE syndrome

PHACE syndrome is the association of segmental facial hemangiomas with congenital arterial, brain, cardiac, and ocular anomalies. Structural brain malformations affect 41–52% of PHACE patients and can be associated with focal neurologic deficits, developmental delays, and/or intellectual disability. To better characterize the spectrum of structural brain and other intracranial anomalies in PHACE syndrome, MRI scans of the head/neck were retrospectively reviewed in 55 patients from the PHACE Syndrome International Clinical Registry and Genetic Repository. All registry patients with a diagnosis of definite PHACE syndrome who had MRI scans of satisfactory quality were included. Of 55 patients, 34 (62%) demonstrated ≥1 non‐vascular intracranial anomaly; structural brain malformations were present in 19 (35%). There was no difference in the prevalence of brain anomalies between genders. Brain anomalies were more likely in patients with S1 and/or S2 distribution of facial hemangioma. The most common structural brain defects were cerebellar hypoplasia (25%) and fourth ventricle abnormalities (13%). Dandy–Walker complex and malformations of cortical development were present in 9% and 7%, respectively. Extra‐axial findings such as pituitary anomalies (18%) and intracranial hemangiomas (18%) were also observed. Six patients (11%) had anomalies of the globes or optic nerve/chiasm detectable on MRI. Brain malformations comprise a diverse group of structural developmental anomalies that are common in patients with PHACE syndrome. Along with brain malformations, numerous abnormalities of the pituitary, meninges, and globes were observed, highlighting the need for careful radiologic assessment of these structures in the neuroimaging workup for PHACE syndrome.     

6-Hydroxydopamine induces degenerative changes in innervation of the rat pituitary gland

Administration of 6-hydroxydopamine to adult male rats by peripheral injections induces degenerative changes in nerve terminals innervating cells of the pituitary intermediate lobe. Additional animals were treated with 5-hydroxydopamine, which produced images of nerve profiles containing vesicles with electron-dense centers, indicative of uptake of the false catecholamine (CA) neurotransmitter. Endocrine cells showed cytologic evidence of activation of synthetic and secretory compartments. The ultrastructural observations suggest that innervation to opiomelanocortin cells is sensitive to a CA-specific neurotoxin and strengthens the hypothesis that CA-containing fibers play a role in intermediate lobe neuroregulation.     

眶上锁孔入路治疗垂体瘤的临床解剖学研究

目的 :探讨内窥镜辅助眶上锁孔入路治疗垂体瘤的可行性。方法 :2 1例福尔马林固定尸体头部标本用于鞍区各解剖结构 ,特别是垂体柄、视神经、视交叉及其供血动脉特点的观察 ,总结手术可利用的间隙、应保护的结构 ;在 9例新鲜尸头上模拟进行内窥镜辅助眶上锁孔入路手术 ,进一步验证其可行性及优势。结果 :颈内动脉床突上段长度 (14 .5± 1.3 )mm(8.1～ 18.5mm ) ,发向垂体柄、视神经或视交叉的穿支动脉的支数分别为 :大脑前或前交通动脉 3 .0支 (2～ 6支 ) ,颈内动脉 2 .1支 (1～ 5支 ) ,后交通动脉 3 .2支 (3～ 6支 ) ,基底动脉 1.4支 (1～ 3支 )。视神经颅内段长度为 (11.4± 2 .7)mm (6.1～ 17.6mm ) ,第 1间隙面积为 (4 4 .8± 3 .4)mm2 (7.0～ 10 0 .8mm2 ) ,手术可通过第 1间隙或 /和第 2间隙进行。结论 :通过眶上锁孔入路治疗向鞍上发展的垂体瘤有充足的操作空间 ,具有视神经、视交叉减压充分 ,利于保护其供血动脉的优点。     

经单鼻孔蝶窦入路垂体腺瘤切除45例分析

目的探讨经单鼻孔蝶窦入路显微手术垂体腺瘤切除的方法和效果。方法对45例垂体腺瘤患者采用经单鼻孔蝶窦入路显微手术切除6例微腺瘤及39例大腺瘤,其中泌乳素(PRL)腺瘤18例,生长激素(GH)腺瘤8例,混合性(PRL GH或PRL ACTH)腺瘤12例,无功能性腺瘤7例。结果显微镜下全切除43例,次全切除2例。术后一过性尿崩症28例,经治疗1周左右恢复。无手术死亡、脑脊液鼻漏、术区出血及脑膜炎等并发症。术后平均住院8 d,全组病例术中未输血;随访1~5年,1例复发。结论单鼻孔经蝶窦入路较传统经蝶入路具有安全、简便、微创、术后并发症少、恢复快、效果满意等优点,是鞍内肿瘤切除的良好径路。     

Myelolipoma in adenoma of accessory adrenal gland.

A tumor was incidentally found at autopsy in the vicinity of the right adrenal gland of a 69-year-old man who had died of liver cirrhosis with hepatoma. Microscopic examination disclosed a myelolipoma associated with a cortical adenoma occurring in an accessory adrenal gland. No evidence of hormonal abnormalities was found in the clinical record of the patient. The association of myelolipoma with cortical adenoma occurring in an accessory adrenal gland seems very unusual, and the present case is believed to be the first reported of this type of association.     

Effect of tetrapeptides Lys-Glu-Asp-Gly and Ala-Glu-Asp-Gly on the structure and function of the thyroid gland in neonatally hypophysectomized chickens

Tetrapeptides Lys-Glu-Asp-Gly and Ala-Glu-Asp-Gly were synthesized on the basis of amino acid composition of pituitary cytomedins. Administration of these tetrapeptides to hypophysectomized chickens for 40 days was followed by an increase in the concentrations of thyrotropic hormone and thyroid hormones and recovery of thyroid gland structure. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 145, No. 1, pp. 111–114, January, 2008     

垂体腺瘤中垂体激素与S-100蛋白免疫组化双重染色观察

目的：探讨滤泡星状细胞在垂体腺瘤分类中的意义及滤泡星状细胞与内分泌细胞之间的关系。方法：应用免疫组化双重染色方法,对４２ 例人重体腺瘤的垂体激素与 Ｓ１００ 蛋白表达进行对照观察。结果：垂体腺瘤组织中的滤泡星状细胞有两种情况,一种为腺瘤组织中可见散在分布的滤泡星状细胞,并可见１ 个瘤细胞既有 Ｓ１００ 蛋白表达,又含激素分泌颗粒;另一种为滤泡星状细胞构成了腺瘤的一种主要的细胞成分。结论：滤泡星状细胞与内分泌细胞的功能密切相关,可能在调整内分泌细胞的产生和激素释放方面起一定的作用;滤泡星状细胞腺瘤应作为垂体无功能腺瘤的一个单独类型。     

Early and late immunohistochemical and ultrastructural changes associated with functional impairment of the lachrymal gland following external beam radiation

The aim of this study was to investigate scintigraphic, immunohistological and ultrastructural changes associated with radiation-induced dysfunction of the lachrymal gland in an established experimental animal model. Ten rabbits were randomized into two groups and used for the study; in the control as well as experimental group, the Schirmer-test, lachrymal gland scintigraphy, and immunohistological and ultrastructural investigations were carried out prior to irradiation and 72 h as well as 1 month after single-dose irradiation with 15 Gy. Seventy-two hours after irradiation, secretion reduction evaluated by the Schirmer-test was evident. At this phase, we could observe a decrease in the expression of alpha-SMA and a re-distribution of tenascin-C matrix. Ultrastructural changes of acinar and myoepithelial cells were noticed; simultaneously, disturbance in the primary (99m)TcO(4)- uptake as well as significant reduction of the lachrymal ejection fraction was assessed scintigraphically. These changes were still evident 1 month following irradiation but became less intensive. Single-dose irradiation with 15 Gy implicates a functional impairment of the lachrymal gland, which is associated with early immunohistological and ultrastructural alterations. These changes may represent objective surrogate parameters for radiogenic dysfunction and prerequisites for further investigations on radioprotection of lachrymal glands during radiotherapy of the periorbital region.     

Role of sex hormones in development of pituitary adenoma

Role of sex hormones in the development of pituitary adenomas was investigated by analyzing the content of nuclear estradiol and testosterone receptors in different tumors of the anterior pituitary: prolactinomas, meningiomas, growth hormone-producing adenomas, astrocytomas, neurinomas, and ependymomas. The concentration of nuclear estrogen and androgen receptors in prolactin-secreting pituitary adenomas was much higher than in growth hormone-producing adenomas and other pituitary tumors.     

Immunohistochemical studies on S-100 cells in the anterior pituitary gland of Sprague Dawley rats and spontaneous dwarf rats

The S-100 cells in the pituitary glands of adult male Sprague Dawley rats (SDs) and spontaneous dwarf rats (SDRs) were immunohistochemically examined using anti-S-100 and anti-S-100 monoclonal antibodies. The immunoreactive cells against S-100 protein were divided into three subtypes on the basis of their immunore-activity against subunits of S-100 protein: S-100 dominant type (the -type cell), S-100 dominant type (the \-type cell) and immunoreactive against both S-100 and S-100 (the -type cell). In the SD, -type cells represented 26% of the total S-100 immunoreactive cells (S-100 cells) and were localized in the peripheral area of the ventral region of the pituitary gland. This type of cell was observed forming clusters, with more abundant cytoplasm than the -type cell. The proportion of -type cells was 53%. They were diffusely distributed throughout the gland, and their processes were thicker than those of the -type cell. In the SDR, the proportion of -type cells was 55%, and they were observed throughout the gland. In contrast, -type cells totalled 12% and were localized in small areas of the central and peripheral region of the gland. The proportion of -type cells was 21% in the SD and 33% in the SDR and they were observed forming small clusters in both animal groups. The proportion of -type cells compared with the total of S-100-immunoreactive cells was significantly higher (P < 0.05) in the SDR than in the SD, while the proportion of -type cells was markedly lower (P < 0.05).     

Anatomical bases for the transphenoidal approach to the pituitary gland

Summary The anatomical and surgical problems of the transphenoidal approach to the pituitary gland are described in relation to 116 autopsy studies and more than 300 surgical operations.The variations in bony structure and softer parts were studied at each operation.

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Bases anatomiques de l'abord transphéno ïdal de l'hypophyse

Résumé D'aprés 116 études autopsiques et plus de 300 interventions chirurgicales, les auteurs envisagent les problèmes, anatomiques et chirurgicaux, que pose le cheminement transphénoïdal vers l'hypophyse.Les variations des structures osseuses et des parties molles sont étudiées au cours de chaque temps opératoire.

     

Lipomatous pleomorphic adenoma of the ceruminous gland

A case of lipomatous pleomorphic adenoma in the ceruminous gland is reported. A 69-year-old Japanese woman presented with a mass in the posterior wall of the cartilaginous external auditory canal. Light microscopic examination revealed a well-circumscribed tumor composed of tubular structures with apocrine secretion and ceroid deposition, extensive mature adipocytes, and spindle-shaped myoepithelial cells in the myxoid and fibrous stroma. This case demonstrates the peculiar location of a lipomatous pleomorphic adenoma in the external auditory canal.     

Detection of inhibin α and βA subunits (inhibin A, B, activin A,AB) in the human pituitary gland and in pituitary adenomas by immunohistochemistry and nonradioisotopicin situ hybridization

Inhibin and activin are gonadal hormones produced in human ovaries. They are known to act on anterior pituitary cells to regulate the synthesis and secretion of follicle-stimulating hormone (FSH). The purpose of the present study was to determine the localization of inhibin and activin subunits α and βA as endocrine markers in the human normal pituitary gland and pituitary adenomas, using immunohistochemistry andin situ hybridization (ISH) methods. Pituitary tissues from surgical and autopsy materials were fixed in 10% formalin and embedded in paraffin. Five normal pituitary glands and 79 pituitary adenomas were immunostained with the avidin-biotin peroxidase complex (ABC) method using polyclonal antibodies against inhibin and activin subunits α and βA. The other antibodies against anterior pituitary hormones used in this study were as follows: antigrowth hormone (anti-GH), antiprolactin (anti-PRL), antiadrenocorticotropic hormone (anti-ACTH), anti-FSHβ, antilutenizing hormone (anti-LH) β, antithyroid-stimulating hormone (anti-TSH) β, and antiglycoprotein α-subunit (anti-α-SU). We analyzed gene expressions of subunits α and βA by nonradioisotopic ISH in pituitary adenomas. In the normal human pituitary glands, inhibin and activin subunits α and βA immunoreactivities were found diffusely in the cytoplasm of anterior pituitary cells. The percentage of subunit α-immunopositive cells was 40% of the anterior pituitary cells. Subunit βA immunoreactivities were observed in about 15% of the anterior pituitary cells. By the double-staining method, subunit α immunoreactivity was detected in all types of anterior pituitary cells, and it was colocalized most frequently with GH and α-SU-positive cells. Subunit βA immunoreactivity was colocalized predominantly with PRL, FSH-β, LH-β, and α-SU. Among the 79 adenomas, 75 cases (94.9%) were positive for subunit α, and 50 cases (63.3%) were positive for subunit βA. Subunit βA was positive in tumor cells with the following incidences: GH adenomas, 3 of 14 (21.4%); PRL adenomas, 5 of 8 (62.5%); ACTH adenomas, 6 of 6 (100%); TSH adenomas, 7 of 7 (100%); nonfunctioning adenomas, 29 of 44 (65.9%), including gonadotropin-positive, 16 of 22 (80.0%). The ISH signals for subunits α and βA were strongly expressed in gonadotropin-positive adenomas among the nonfunctioning adenomas. The mRNA signals were low and infrequent in the GH-producing adenomas. Inhibin and activin subunit α localization did not demonstrate cell-type specificity in pituitary adenomas. In contrast, subunit βA demonstrated predominant positivity in the functioning pituitary adenomas (ACTH- and TSH-secreting) and nonfunctioning adenomas (including gonadotropin-positive adenomas). The present results suggest that the functional role of inhibin and activin in the differentiation of cells in normal human pituitary glands and adenomas is present in subunit βA.