Characteristics of mixed prolactin and adrenocorticotropin secreting pituitary adenomas and the differences in patients with merely prolactin-secreting adenomas

To evaluate the characteristics of pituitary adenomas that produce both prolactin and adrenocorticotropin. Between 2002 and 2011, we reviewed the data of 336 patients undergoing transsphenoidal surgery at Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China. Patients were divided into 2 subgroups: patients with mixed prolactin and adrenocorticotropin secreting adenomas, and patients with merely prolactin-secreting adenomas. Clinical and endocrinological data, imaging, histopathological reports, and outcomes were reviewed. Differences between the 2 groups were statistically analyzed, and p<0.05 was considered statistically significant. Compared to patients with merely prolactin-secreting adenomas, patients with mixed prolactin and adrenocorticotropin secreting adenomas were younger [p<0.001], had higher incidences of headaches and dizziness [p=0.021], progressive obesity [p<0.001], menstrual disorders [p=0.006], polyuria and polydipsia [p<0.001], hypertension [p=0.001], diabetes mellitus [p=0.001], and had higher rates of postoperative hyponatremia [p<0.001]. Recurrence rates in patients with prolactin-secreting adenomas were 19.1% and patients with mixed prolactin and adrenocorticotropin secreting adenomas were 35.1% [p=0.023]. However, the endocrine normalization rate in mixed prolactin and adrenocorticotropin secreting adenomas was lower [p=0.004]. Careful long-term follow-up is needed for patients with mixed prolactin and adrenocorticotropin secreting adenomas

Surgical treatment of gliomas involving the supplementary motor area in the superior frontal gyrus / 中华外科杂志

<p><b>OBJECTIVE</b>To explore surgical treatment of gliomas involving the supplementary motor area (SMA) in the superior frontal gyrus.</p><p><b>METHODS</b>Clinical data and follow-up outcome of 16 patients with low graded astrocytomas involving the supplementary motor area were analyzed.</p><p><b>RESULTS</b>SMA syndrome was developed in 6 patients in whom the posterior tumor resection line was at a distance of more than 1 cm from the precentral sulcus and resolved after 12 months. Hemiplegia occurred however in 8 patients in whom the resection line was less than 1 cm to precentral sulcus and only resolved in 3 patients during follow period 12 months.</p><p><b>CONCLUSIONS</b>When the resection is performed at a distance of less than 1 cm from the precentral sulcus, surgery for gliomas of involving the supplementary motor area in the superior frontal gyrus may be result in permanent morbidity.</p>

Microsurgical treatment of proximal anterior cerebral artery aneurysms / 中华外科杂志

<p><b>OBJECTIVE</b>To explore clinic characteristics of proximal anterior cerebral artery aneurysms and analyzed operative techniques.</p><p><b>METHODS</b>A review was performed of a total of 362 patients whose aneurysms were surgically treated from June 1995 to December 2003, the morbidity of A(1) aneurysms was 2.2%. To reviewed clinical data of 8 proximal anterior cerebral artery aneurysms patients.</p><p><b>RESULTS</b>All of the aneurysms developed at the takeoff point of perforating arteries, the recurrent artery of Heubner in three cases, the medial proximal lenticulostriate artery in five cases. Six cases aneurysms projected posteriorly, two cases projected inferiorly in the surgical field. The shape of the aneurysms was saccular in all cases and diameter no larger than 5 mm in six cases. Patients were clipped satisfactorily, excellent condition in 7 patient, good condition in one.</p><p><b>CONCLUSION</b>It is important to preserve the perforating arteries and use suitable clip by avoiding cerebral ischemia.</p>

Microsurgical treatment of the clinoid and para-clinoid ICA aneurysms / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the microsurgical treatment of the clinoid and para-clinoid ICA aneurysms we analyzed operative techniques, outcome, and indication.</p><p><b>METHODS</b>Clinical data and follow-up outcome of 10 the clinoid and para-clinoid ICA patients were reviewed. In this study there were 3 patients with clinoid ICA aneurysms, five with ophthalmic aneurysms, two with superior hypophyseal aneurysms and one with posterior ICA wall aneurysm.</p><p><b>RESULTS</b>On follow-up (3 - 14 months, mean 7 months), 7 patients were in an excellent condition and two in a good condition; and one died of stroke postoperatively. Patients were clipped satisfactorily, as confirmed by postoperative angiogram in hospital except that one patient died of stroke.</p><p><b>CONCLUSIONS</b>Clinoid and para-clinoid ICA aneurysms were surgical indications. Further clarifications of aneurysms and their indications can improve outcome.</p>