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Zang Xu臧旭 Zhang Shu-ying张淑英 Zhang Shu-hua张淑华Lu Ying-jie路英杰 Wang Wei-jun王维钧 Yin Zhao-yan尹昭炎Shi Yi-fan史轶繁 Wang Zhi-zhong王直中Pituitary Adenoma Cooperative Group Capital Hospital Beijing 《中华医学杂志(英文版)》1983,96(9):647-654
Analysis of 60 pituitary adenomas with acro-
megaly iiS made. All 60 surgical specimens are
studied by both light and electron microscopy.
By light microscopy we classified the adenomas
into strong acidophilic cell (16 cases) and weak
acidophilic cell (20 cases), stem cell (2 cases)
and mixed cell type adenomas (22 cases). By
electron micros.copy we classified them into
densely granulated (14 cases) and sparsely granu-
lated growth hormone (GH) cell adenomas (212
cases) in which there are fibrous bodies near
the indented part of the nucleus which are of
diagnostic value, corresponding to the round
lucent area near the indented nucleus seen by
light microscopy. The densely granulated and
sparsely granulated GH cells may coexist within
1 adenoma (4 cases). Some adenomas may con-
tain 2-3 kinds of secretory granules and are
called multiple functional adenomas, in this
series 18 had GH-;-PRL prolactin), 1 GH+ACTH
and l GH+PRL+ACTH. Strong acidophilic cells
correspond to densely granulated GH cells while
weak acidophilic celIs correspond to sparsely
granulated GH cells. The number of strong or
weak acidophilic cells and number of secretory
granules are not directly proportional to the GH
blood level. By electron microscopy GH, PRL
and ACTH secretory granules have characteristic
features which are not absolute. Correct diagnosis
is based upon combining the clinical symptoms
and signs, blood hormone levels and secretory
granule morphology. F'ibrous body diagnostic
value and their genesis and development are dis-
cussed. 相似文献
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Ge Qin-sheng葛秦生 Xu Ling徐苓 Wang Hui-lan王慧兰 Gu Chun-xia谷春霞Lin Shou-qing林守清 Xu Yong-ding徐庸定 Yu Ke-min 于可敏 Xie Yu-zhang解毓章Shi Yi-fan 史轶繁 Zang Xu臧旭 and Yin Zhao-yan尹昭炎PUMC 《中华医学杂志(英文版)》1985,98(8):543-550
Hypperprolactinemia and its relation to galactorrhea,
amenorrhea and pituitary tumor were studied in 355
cases. Hyperprolactinemia was found in 135 cases,
and its incidences in the 3 groups (galactorrhea
with amenorrhea, galactorrhea with menstruation and
amenorrhea without galactorrhea) were 78.2u/o (111/
142), 21.7% (18/83) and 4.6:vo(6/130) respectively, the
differences being statistically significant (p<0.01).
Of the hyperprolactinemia cases 9570 had galactor-
thea, and about half of them were discovered during
examination. Therefore, pressing the breasts for
milk should be a routine procedure during gyno
cologic examination. There were 60 pituitary ma
croadenomas in this series; the incidence of
hyperprolactinemia was 39.3To (53/153) and amenor
thea with galactorrhea was 37.3%(53/'142). There
fore, prolactinoma is the most important cause of
galactorrhea, amenorrhea and hyperprolactinemia.
Some prolactinomas may not be accompanied by
amenorrhea, galactorrhea or hyperprolactinemia. 42
cases of hyperprolactinemia, half with pituitary
tumors, were treated with bromocriptine. Menstrua
tion resumed in 95.2%, biphasic basal body tempera.
ture (BBT) in 90.5%, and 70.6To infertile patients
became pregnant. The present study shows that the
important cause of amenorrhea is functional dis
turbance in the hypothalamic-pituitary-ovarian axis.
Once prolactin level is lowered, functional distur-
bances can be corrected very quickly. 相似文献
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用本法治疗11例柯兴氏病患者,8例摘除成功,3例手术失败,无1例死亡;8例切除标本中7例经电镜证实为垂体ACTH分泌腺瘤;7例缓解,其症状明显改善或消失,24小时UFC恢复正常,1例缓解不全。文中讨论了此病的诊断、手术指征及手术禁忌证。 相似文献
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Wang Weijun王维钧 Yin Zhaoyan尹昭炎and Shao Shifen邵式玢Calyitat Hospital Chinese Academy of Medicat. Sciences Beijing 《中华医学杂志(英文版)》1981,94(7):449-454
73 cases of congenital anomalies of the
atlanto-occipital region are diagnosed and treat-
ed operatively. Clinical appearance, symptoms
and signs of cranial nerves, upper cervica.l cord
and cerebellum, radiologic findings and opera-
tive technic a.re presented. Long term surgical
results are Gra.de I 39 cases, Grade 11 12 cases,
Grade 111 4 cases and Grade IV 3 cases. Dif-
ferential diagnosis, time of s;urgery and opera-
tive complications are discussed. 相似文献
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甲状腺低功所致垂体促甲状腺素、催乳素混合腺癌很罕见。本例的临床及实验室主要特征为:甲状腺低功,闭经,溢乳,视力左0.1,右0.3,双颞侧偏盲,血清T_4、T_3U值下降及PRL升高,甲状腺微粒抗体增加,TRH对TSH刺激试验呈过强反应。术后肿瘤超微结构检查发现瘤细胞内有TSH、PRL分泌颗粒及微小管。术后视功能迅速恢复,1个半月后月经来潮,溢乳停止,血TSH、PRL接近正常。 相似文献
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经额开颅及经鼻显微手术治疗垂体腺瘤的比较 总被引:3,自引:1,他引:2
自1958年到1983年,共手术治疗垂体腺瘤262例,其中经开颅手术切除肿瘤150例,经鼻显微手术112例。近5年开展经鼻垂体显微手术后,平均每年收治病人较前20年增加6.7倍。垂体内分泌激素的各种测定检查,是垂体肿瘤早期诊断的重要手段,可使病人的确诊和治疗大为提前。经鼻显微手术对鞍内垂体微腺瘤的85%可作到全部或次全切除(53%及32%),从而减少了术后放疗和复发率,提高了垂体内分泌功能恢复的水平。 相似文献
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脑垂体微腺瘤经蝶窦显微外科治疗(120例临床分析) 总被引:1,自引:0,他引:1
本文报告经蝶窦显微外科治疗脑垂体微腺瘤120例,其中男20例,女100例,平均年龄31.7岁。视力视野正常,蝶窦大小都正常范围之内,垂体内分泌素测定皆高于正常。CT 扫描有不正常发现者65.4%,阴性者34.6%。肿瘤大小皆在10mm 之内。治愈率包括早年病例为46.6%,近3年已提高到81.2%,其中 ACTH 治愈率较高、GH 其次、PRL 较差,对脑垂体微腺瘤的诊断和疗效问题也加以讨论。 相似文献
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22例蝶骨嵴脑膜瘤手术治疗体会 总被引:10,自引:1,他引:9
报告22例蝶骨嵴脑膜瘤手术治疗资料。根据CT和术中所见,Bonnal氏分类,A组(内1/3)12例,D和E组冲、外1/3)各5例。D和E组全切除率为100%,A组为41.6%。肿瘤切除程度与其类型、大小有密切关系。强调早期诊断和手术切除以提高全切除率,减少复发。术前供血动脉栓塞,术中应用显微外科技术,CUSA和双极电凝等有利于肿瘤全切并减少对周围重要结构的损伤。本文就手术技巧,尤其是内1/3肿瘤的切除技术进行了较详细的讨论。 相似文献