ABSTRACT
The metastatic tumor occurs in about 6% to 20% of all cases with central diabetes insipidus. Many kinds of cancers such as breast, lung, colon, prostate, leukemia, and lymphoma can metastasize to the pituitary and its stalk. Primary adenoid cystic carcinoma arising in the bronchus is an uncommon disease. It is histologically and ultrastructurally identical to salivary gland adenoid cystic tumor and is regarded as a slowly growing, low graded-malignancy. This is a case report of a 52-year-old woman with diabetes insipidus caused by a pituitary tumor that might have been associated with adenoid cystic carcinoma arising in the bronchus. The patient was diagnosed by water deprivation test, chest CT scan, bronchoscopic biopsy, and brain MRI scan. The water deprivation test showed the patient had central diabetes insipidus, while chest CT scan revealed a lung mass lesion with distal right intermediate bronchial obstruction. The primary malignancy was confirmed by bronchoscopic biopsy. Finally, we confirmed that the patient had a 7mm-sized mass in the posterior pituitary gland and a thickened stalk by brain MRI scan.
Subject(s)
Female , Humans , Middle Aged , Adenoids , Biopsy , Brain , Breast , Bronchi , Carcinoma, Adenoid Cystic , Colon , Diabetes Insipidus , Diabetes Insipidus, Neurogenic , Leukemia , Lung , Lymphoma , Magnetic Resonance Imaging , Neoplasm Metastasis , Pituitary Gland, Posterior , Pituitary Neoplasms , Prostate , Salivary Glands , Tomography, X-Ray Computed , Water DeprivationABSTRACT
Dear Author, You have used abbreviations that will need to be defined in the main paper, i.e. PIT1, PROP1 and MRI. This is just for your advice. Pituitary agenesis is an uncommon cause of panhypopituitarism. It has been proposed that breech delivery, or birth trauma, is a major factor causing pituitary agenesis. Recent studies have suggested that genetic defects in the PIT1 or PROP1 gene might be involved in the pathogenesis of pituitary agenesis. In this case we report on the diagnosis of a 33-years old female patient with-growth retardation and sexual infantilism. We diagnosed anterior pituitary hormones deficiencies, with the exception of adrenocorticotropic hormone, by a combined pituitary stimulation test. We observed pituitary agenesis using sella MRI. Involvement of the PIT1 or PROP1 genes in this case remains to be determined. Here we report a case of pituitary agenesis found in an adult woman together with a brief review about this disease entity.
Subject(s)
Adult , Female , Humans , Abbreviations , Adrenocorticotropic Hormone , Diagnosis , Hypopituitarism , Magnetic Resonance Imaging , Parturition , Pituitary Hormones, Anterior , Sexual InfantilismABSTRACT
The kidney and balances of fluid and volume are the basic components of bloocl pressure control, and the kidney is the primary site that initiates the hypertensive process and is affected by hypertensive vascular disease. In the kidney, the dopamine is a potent natriuretic and vasodilating agent, participat- ing in renal sodium excretion and maintenance of cardiovascular homeostasis. And the dopamine receptors in central nervous system and peripheral organs were identified by physiological, biochernical and radioligand binding techniques. Rut previous morphological and biochemical studies have been unable to characterize or determine the tissue distribution of the dopamine receptor subtypes because no selective ligands are available yet. Furthermore, the cellular distribution of the dopamine receptor subtypes in the rat kidney is not demonstrated well. In the SHR, the ability of exogenous and endogenous renal dopamine to engender a natriuresis is impaired. Since renal dopamine levels in genetic models of hypertension are not lower than their normotensive controls, the impaired intrarenal paracrine effect of dopamine in these animal models of hypertension appears to be receptor or postreceptor mediated. And renal dopamine derives mainly from renal tubular dopamine production and to a lesser extent from dopaminergic nerves. The present study utilizes imrnunohistochemistry with specific antibodies to characterize the renal distribution of dopamine receptor subtypes and recognize the role of dopamine receptor defect in the pathogenesis of hypertension in 14-week-old WKY (mean HP 108+/-5mmHg) and SHR (mean RP 174+/-7 mmHg) kidneys. Also it utilizes antibody of tyrosine hyclroxylase (TH) to recognize the site of the dopamine production mediated by TH using light microscopic immunohistochemistry. In the immunohistochemistry of the WKY kidney, dopamine D1 receptor protein is localized to glomerulus, proximal tubule, distal tubule, renal vessels, cortical and medullary collecting duct. And in the SHR kidney, dopamine D1 receptor protein is localized to glomerulus, distal tubule, renal vessels, cortical and medullary collecting duct, and juxtaglomerular apparatus (JGA). But there is no demonstrable positive reaction in the proximal tubule and weakly positive reactions in the renal arterioles of SHR compared with WKY kidney. In the immunohisto-chemistry of the WKY kidney, dopamine D1 receptor protein is localized to glomerulus, proxirnal tubule, distal tubule, renal vessels, cortical and rnedullary collecting duct. And in the SHR kidney, dopamine D2 receptor protein is localized to glomerulus, distal tubule, renal vessels, cortical and medullary collecting duct, and JGA. So, there is no demonstrable positive reaction in the proximal tubule of SHR compared with WKY. In the glomerulus of the WKY and SHR kidneys, both dopamine D1 and D2 receptors are localized. In the in situ hybridization of the WKY and SHR kidneys, dopamine D and D receptors are only demonstrated at the renal vessels. The positive reaction to TH immunohistochemistry of the WKY and SHR kidneys is only observed in the renal medulla compared with negative reaction on the renal cortex. Considering the excretion of sodium up to 65-70% with volume expansion may be mediated by dopamine D1-like receptors in the proximal tubule, our immunohistochemistry findings for the dopamine receptors may support the failure of natriuretic response in the SHR due to an abnormal dopamine receptor. Also our results rnay mean that the glornerular filtration rate is mediated by both dopamine D1 and Dz receptors comparing with the previous studies that the glomerular filtration rate was mediated by dopamine D2 receptor. I'here are some differences in the receptors expressing sites on the previous radioligand binding and pharmacologic studies, but our results suggest that at least some of the renal dopamine DA and DAz receptors correspond structurally to the central dopamine D1 and D2 receptors. Finally the result of TH immunohisto-chemistry suggests that the production of dopamine in the proximal tubule is not mediated by TH.
Subject(s)
Animals , Rats , Antibodies , Arterioles , Central Nervous System , Dopamine , Filtration , Glomerular Filtration Rate , Homeostasis , Hypertension , Immunohistochemistry , In Situ Hybridization , Juxtaglomerular Apparatus , Kidney , Ligands , Models, Animal , Models, Genetic , Natriuresis , Rats, Inbred SHR , Receptors, Dopamine , Receptors, Dopamine D1 , Receptors, Dopamine D2 , Sodium , Tissue Distribution , Tyrosine , Vascular DiseasesABSTRACT
Acute thyroid abscess is an uneommon type of neck infection. We experieneed a case of staphylococcal thyroid abscess in 29 year old man, diagnosed by needle aspira~tion and culture of the aspirate. The patient had complained fever and slowly growing anterior neck swelling. Needle aspiration of the cold nodule prior to broad spectrum antibiotics was performed. After Surgical excision combined with antibiotics, he was discharged with elinical improvement. The laboratory diagnosis and clinical course was summarized and is reported with relevent references.
Subject(s)
Humans , Abscess , Anti-Bacterial Agents , Clinical Laboratory Techniques , Fever , Neck , Needles , Staphylococcus aureus , Staphylococcus , Thyroid GlandABSTRACT
In order to observe the changes in left ventricular function during coronary artery occlusion and reperfusion, left anterior descending (LAD) coronary arteries in the anesthetized dogs were occluded for 1 hour and then reperfused for 4 hours. Hemodynamic indexes of global systolic and diastolic function and regional wall thickness changes as a regional contractile index were measured during occlusion and reperfusion. The results were as follows; 1) Indexes of global systolic function (left ventricular peak systolic pressure, peak positive dP/dt) and global diastolic function (peak negative dP/dt, time constant, left ventricular end-diastolic pressure) showed deterioration in early occlusion period (10-30 minutes) but gradually improved even if coronary occlusion persisted. Reperfusion did not induce significant changes except that peak positive dP/dt transiently deteriorated 30 minutes after reperfusion and left ventricular end-diastolic pressure decreased 1.5-2 hours after reperfusion. 2) Indexed of regional function (i.e, end-diastolic thickness and % systolic thickening of anterior left ventricular wall) deteriorated by 10 minutes' occlusion which persisted during the entire occlusion period. Reperfusion induced no significant improvement in regional contractile function compared with occlusion 60 minutes' data, which suggested reperfusion for 4 hours after 1 hour's LAD occlusion may be insufficient for the ischemic region to recover its contractility. 3) Reperfusion arrhythmia (ventricular tachycardia) was noted in most (6/9) of the dogs, one of which deteriorated into ventricular fibrillation and the others spontaneously converted to normal sinus rhythm.
Subject(s)
Animals , Dogs , Arrhythmias, Cardiac , Blood Pressure , Coronary Occlusion , Coronary Vessels , Hemodynamics , Reperfusion , Ventricular Fibrillation , Ventricular Function, LeftABSTRACT
Traumatic tricuspid insufficiency(TI) is a relatively uncommon disorder. We experienced a case in which traumatic TI was suspected by history and the diagnosis was confirmed nonivasively by 2-D echocardiography with Doppler technique. Tricuspid valve in this case showed flail anterior leaflet during systole and Doppler echocardiography demonstrated the presence of tricuspid insufficiency.