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Objective:To summarize the correlation between anterior pituitary function and tumor size in patients with different hormone-secreting pituitary adenomas.Methods:This was a retrospective case series study. The clinical data of 1 946 patients with pituitary adenoma hospitalized in the First Medical Center of Chinese PLA General Hospital from January 1, 2005, to December 31, 2020, were collected. The correlation between tumor size and anterior pituitary hormone levels was analyzed using Spearman rank correlation analysis in different types of pituitary adenomas.Results:The median age of the 1 946 patients was 45.1 years, of which 857 (44.0%) were men. The maximum tumor diameter of the patients [ M ( Q1, Q3)] was 22 (14, 30) mm. Tumor size in nonfunctioning adenomas ( n=1 191) was negatively correlated with adrenocorticotropic hormone (ACTH) ( r=-0.11, P<0.001), growth hormone ( r=-0.13, P<0.001), and luteinizing hormone (men: r=-0.26, P<0.001, women: r=-0.31, all P<0.001). The tumor size of somatotropic adenomas ( n=297) was positively correlated with growth hormone ( r=0.46, P<0.001), but negatively correlated with male testosterone ( r=-0.41, P<0.001). The tumor size of ACTH-secreting pituitary adenomas ( n=155) was positively correlated with the ACTH level at 8∶00 AM ( r=0.25, P<0.001); however, no correlation was found with cortisol at 8∶00 AM ( P>0.05). The tumor size of prolactinomas ( n=303) was positively correlated with the prolactin level (men: r=0.34, P=0.001; women: r=0.13, P=0.070). Conclusions:The correlation between the function of the anterior pituitary and size of the tumor depends on the cellular origin of the pituitary adenoma and specific type of hormone secretion. In somatotroph adenomas, ACTH-secreting pituitary adenomas, and prolactinomas, there is a positive correlation between tumor size and level of hormones secreted by the corresponding tumors. In patients with nonfunctioning adenomas, the tumor size was negatively correlated with the hormone levels of the pituitary-adrenal and pituitary-growth hormone axes.
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Objective:To discusse the value of pituitin in laparoscopic ovarian cyst removal.Methods:From October 2015 to June 2018 in Dalian Medical University Affiliated Dalian Maternity Hospital, useing prospective research methods, 90 patients with unilateral ovarian cyst (except endometriomas) were randomly divided in 3 groups of pituitrin group,control group 1 and control group 2. The pituitrin group: laparoscopic cystectomy with the injection of diluted pituitrin 6 U, the total amount of diluted pituitrin 10 - 20 ml, ovarian hemostasis was achieved by sutura. The control group 1: ordinary laparoscopic cystectomy without injection suture hemostasis. The control group 2: laparoscopic cystectomy with the injection of normal saline 10 - 20 ml, ovarian hemostasis was same to pituitrin group. The operation time and the amount of bleeding were compared among the three groups. The ovarian reserve was compared between before and 3 months after operation by estradiol (E 2), follicle-stimulating hormone (FSH), luteinizing hormone (LH). Results:The amount of bleeding in the pituitrin group was less than that in the control group1: (14.00 ± 5.48) ml vs. (18.33 ± 6.99) ml, P<0.05. The operation time in the pituitrin group and control group 2 was less than that in the control group1: (43.50 ± 7.21) min, (45.00 ± 10.29) min vs. (50.17 ± 8.95) min, P<0.05. The level of FSH after operatiaon in the pituitrin group and control group 2 was less than that in the control group1: (7.20 ± 1.55) U/L, (7.43 ± 1.52) U/L vs. (8.31 ± 0.97) U/L, P<0.05. The level of E 2 3 months after operation in the pituitrin group was higher than that in the control group 1 and control group 2: (54.20 ± 10.90) ng/L vs. (46.63 ± 10.76) ng/L, (43.90 ± 18.23) ng/L, P<0.05. There was no significant difference of LH 3 months after operation among the three groups ( P>0.05). Conclusions:This study shows that diluted pituitrin decreases operation time and the amount of bleeding during operation, at the same time,the pituitrin injection is valued of ovarian reserve.
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Background: It has been reported that retinoids may lead to hormonal alterations. Aim: In this retrospective study, we aimed to study the effect of acitretin on pituitary hormones in psoriasis patients. Methods: Out of 50 patients intended to be studied, blood samples of 43 patients could be tested before and after 3 months of acitretin therapy (0.2 to 0.5 mg/kg/day). Results: Patients mean ± standard deviation ages and female/male ratio were 46 ± 17 years and 19/24, respectively. After treatment with acitretin, gamma-glutamyltransferase, alkaline phosphatase, total cholesterol and triglyceride levels increased significantly (P < 0.05). After treatment, total protein, free thyroxine (T4) levels decreased significantly (P < 0.05). No significant differences were observed between before–after acitretin treatment regarding pituitary hormone levels in psoriasis patients (P > 0.05). Limitations: The retrospective nature of the study, inability to retest blood samples of 7 patients at 3 months post treatment, low dose and short duration of acitretin treatment were limitations of this study. Conclusion: This study showed that pituitary hormones were not affected except free T4 (thyroid hormone) by acitretin treatment. Further experimental and clinical studies are needed to clarify the effect of acitretin on pituitary hormones.
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Objective To investigate the effect of pituitrin-water separation on hemoglobin and ovarian func-tion in laparoscopic ovarian chocolate cyst removal.Methods From February 2018 to February 2019,82 patients with ovarian chocolate cyst removed by laparoscopy were selected from the Second Affiliated Hospital of Wenzhou Medical University.They were randomly divided into observation group and control group according to the digital table,with 41 cases in each group.The control group underwent traditional laparoscopic tear-and-tear ovarian cyst removal,while the observation group underwent pituitrin-water separation.The changes of perioperative indicators ,the decrease of hemoglobin (Hb) before and after operation ,the positive rate of normal ovarian tissue on cyst wall and the number of normal follicles attached to cyst wall ,the changes of serum hormone levels before and after operation were compared between the two groups.Results The amount of bleeding during operation in the observation group [(58.97 ±8.74)mL] was less than that in the control group [(118.93 ±24.21)mL],and the operation time in the observation group[(57.46 ±8.27) min] was shorter than that in the control group [(87.38 ±10.19) min] ,the differences were ststistically significant between the two group ( t ＝14.916,14.598,all P ＜0.05 ).There was no statistically significant difference in the time of anal exhaust between the two groups (P＞0.05).The decrease of Hb in the observation group [(0.71 ±0.16)g／L] was lower than that in the control group [(1.27 ±0.35) g／L] ( t＝9.318,P＜0.05).The positive rate of normal ovarian tissue on cyst wall in the observation group (21.95%) was lower than that in the control group (56.10%),the number of normal follicles attached to the cyst wall in the obser-vation group (2.65 ±0.49) was less than that in the control group (4.86 ±1.24) ,the differences were ststistically significant between the two group ( χ2 ＝10.045, t ＝10.613, all P ＜0.05).The serum level of E2 [( 398.21 ± 17.84)pmol／L] in the observation group was higher than that in the control group [(367.83 ±15.21) pmol／L], while FSH [(6.72 ±0.28)mIU／mL] and LH [(5.23 ±0.38)mIU／mL] levels in the observation group were lower than those in the control group [(7.19 ±0.35)mIU／mL and (5.69 ±0.31)mIU／mL],the differences were ststisti-cally significant between the two group (t＝8.298,6.714,6.006,all P＜0.05).Conclusion The method of pitui-trin-water separation is effective in laparoscopic ovarian chocolate cyst removal ,which can reduce the injury during operation,has little effect on hemoglobin and improve the ovarian reserve function of patients .
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Objective@#To investigate the effect of pituitrin-water separation on hemoglobin and ovarian function in laparoscopic ovarian chocolate cyst removal.@*Methods@#From February 2018 to February 2019, 82 patients with ovarian chocolate cyst removed by laparoscopy were selected from the Second Affiliated Hospital of Wenzhou Medical University.They were randomly divided into observation group and control group according to the digital table, with 41 cases in each group.The control group underwent traditional laparoscopic tear-and-tear ovarian cyst removal, while the observation group underwent pituitrin-water separation.The changes of perioperative indicators, the decrease of hemoglobin (Hb) before and after operation, the positive rate of normal ovarian tissue on cyst wall and the number of normal follicles attached to cyst wall, the changes of serum hormone levels before and after operation were compared between the two groups.@*Results@#The amount of bleeding during operation in the observation group [(58.97±8.74)mL] was less than that in the control group [(118.93±24.21)mL], and the operation time in the observation group[(57.46±8.27)min] was shorter than that in the control group [(87.38±10.19)min] , the differences were ststistically significant between the two group(t=14.916, 14.598, all P<0.05). There was no statistically significant difference in the time of anal exhaust between the two groups (P>0.05). The decrease of Hb in the observation group [(0.71±0.16)g/L] was lower than that in the control group [(1.27±0.35)g/L] (t=9.318, P<0.05). The positive rate of normal ovarian tissue on cyst wall in the observation group (21.95%) was lower than that in the control group (56.10%), the number of normal follicles attached to the cyst wall in the observation group (2.65±0.49) was less than that in the control group (4.86±1.24) , the differences were ststistically significant between the two group(χ2=10.045, t=10.613, all P<0.05). The serum level of E2 [(398.21±17.84)pmol/L] in the observation group was higher than that in the control group [(367.83±15.21)pmol/L], while FSH [(6.72±0.28)mIU/mL] and LH [(5.23±0.38)mIU/mL] levels in the observation group were lower than those in the control group [(7.19±0.35)mIU/mL and (5.69±0.31)mIU/mL], the differences were ststistically significant between the two group (t=8.298, 6.714, 6.006, all P<0.05).@*Conclusion@#The method of pituitrin-water separation is effective in laparoscopic ovarian chocolate cyst removal, which can reduce the injury during operation, has little effect on hemoglobin and improve the ovarian reserve function of patients.
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Objective To investigate the effect of vasopressin injection technique on ovarian reserve in patients with laparoscopic cystectomy of unilateral ovarian endometrioma .Methods 70 patients with unilateral ovarian endometrioma were randomly allocated into study group (37 cases) and control group(33 cases) according to the digital table .Diluted vasopressin was injected into the space between the normal ovarian cortex and the cyst wall before stripping in the study group , and ordinary laparoscopic cystectomy without injection was adopted in control group.The average contents of anti -mullerian hormone(AMH),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),antral follicle count(AFC) and peak systolic velocity(PSV) were compared in two groups before and after surgery .Results The operative time of the study group was (37.6 ±8.6) min,which was significantly shorter than (42.8 ±9.1)min of the control group(t=2.46,P<0.05).The blood loss of the study group was (23.2 ±12.1)mL,which was significantly less than (31.4 ±17.3)mL of the control group(t=2.32,P<0.05).In the control group,the E2 levels preoperation and postoperative were (201.46 ±7.51)pmol/L,(153.94 ± 8.72)pmol/L,respectively,the difference was statistically significant between preoperation and postoperation (t =23.72,P<0.05).The AMH levels in the control group preoperation and postoperation were (2.31 ±0.79)ng/mL, (1.67 ±0.75)ng/mL,respectively,there was statistically significant difference between preoperation and postoperation (t=3.38,P<0.05).The FSH levels in the control group preoperation and postoperation were (6.58 ±2.70)U/L, (10.24 ±1.21)U/L,respectively,there was statistically significant difference between preoperation and postoperation (t=7.12,P<0.05).The LH levels in the control group preoperation and postoperation were (5.87 ±1.76)U/L, (6.15 ±2.14) U/L,respectively,there was no significant difference between preoperation and postoperation (t =0.58,P>0.05).The F0 levels in the control group preoperation and postoperation were (8.7 ±2.8),(4.6 ±0.7), respectively,there was significant difference between preoperation and postoperation (P<0.05).The PSV levels in the control group preoperation and postoperation were (13.8 ±5.9)cm/s,(7.5 ±2.4)cm/s,respectively,there was significant difference between preoperation and postoperation (P<0.05).The E2 levels in the study group preopera-tion and postoperation were (199.36 ±8.42)pmol/L,(197.12 ±8.33)pmol/L,respectively,there was no significant difference between preoperation and postoperation (t=1.15,P>0.05).The AMH levels in the study group preopera-tion and postoperation were (2.23 ±0.85) ng/mL,(2.19 ±0.83) ng/mL,respectively,there was no statistically significant difference between preoperation and postoperation (t=0.20,P>0.05).The FSH levels in the study group preoperation and postoperation were (6.27 ±2.35)U/L,(6.73 ±2.23)U/L,respectively,there was no statistically significant difference between preoperation and postoperation (t=0.86,P>0.05).The LH levels in the study group preoperation and postoperation were (5.92 ±2.32) U/L,(5.57 ±2.31) U/L,respectively,there was no statistically significantl difference between preoperation and postoperation (t=0.65,P>0.05).The F0 levels in the study group preoperation and postoperation were (9.2 ±2.4),(8.9 ±2.7),respectively,there was no statistically significant difference between preoperation and postoperation (P>0.05).The PSV levels in the study group preoperation and postoperation were (14.7 ±5.4) cm/s,(14.0 ±4.7) cm/s,respectively,there was no statistically significant difference between preoperation and postoperation (P>0.05).Conclusion Vasopressin injection technique used in unilateral ovarian endometrioma laparoscopic cystectomy is safe and effective ,and it can protect the ovarian reserve .
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Objective To investigate changes of relative pituitary hormones in adults with traumatic brain injury (TBI) and the related clinical significance.Methods Quantitative analysis and dynamic observation of relative pituitary hormones were performed in 158 TBI patients by electrochemical luminescence method.Measured indices included plasma total cortisol (PTC),free triiodothyronine (lT3),free thyroxine (FT4),thyrotropin (TSH),growth hormone,follicle stimulating hormone (FSH),luteinizing hormone (LH),estradiol,testosterone,and prolactin.Results Prolactin and PTC increased in the acute phase,but gradually reduced three days after trauma.TSH,FT3,and FT4 slightly decreased after trauma,followed by a gradual return.While there were no significant changes in FSH,LH,estradiol,testosterone,and growth hormone after trauma.Changes in relative pituitary hormones were more profound in patients with a lower GCS.Some patients presented different degree of reduced hormones in recovery period and needed hormone replacement therapy.Among the patients with poor activity of daily living (ADL),lvothyroxine replacement therapy was applied in 2 patients (2/6),prednisone acetate in 1 (1/6),and eleven acid testosterone in 2 (2/6).Among patients with mild ADL,levothyroxine replacement therapy was applied in 2 patients (11％),prednisone acetate in 1 (6％),and eleven acid testosterone in 3 (17％).Among patients with good ADL,levothyroxine replacement therapy was applied in 2 patients (4％) and eleven acid testosterone in 3 (6％).Persistent prolactin elevation was found in patients with poor outcome.Conclusions Changes of relative pituitary hormones in adult patients with TBI are associated with severity and duration of trauma.Abnormal prolactin level can affect outcome of the patients.
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Objective To explore the dynamic changes and clinical significance of relative pituitary hormones in children after craniocerebral injury.Methods The quantitative analysis and dynamic observation were performed in 125 children after craniocerebral injury and 20 voluntary healthy children of relative pituitary hormones including serum prolactin(PRL),cortisol(PTC),three free triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH),growth hormone (GH) by applying electrochemical luminescence method.Tbe hormone variational characteristics were analyzed according to posttraumatic time,Glasgow Coma Scale(GCS) scores on admission and Glasgow Outcome Scale (GOS) scores on discharge,and the relationship between hormone variational characteristics of 58 cases was followed up over 2 years and the activities of daily living (ADL) were also investigated.Results The serum PRL was significantly increased on the first,third and fifth day compared with the healthy control group (P =0.000 0,0.000 0,0.006 7),respectively.There was significant difference between mild,moderate and severe groups within 30 days after suffering from craniocerebral injury (P ＜ 0.05).PTC was heavily increased within 3 days,and significant difference existed among mild and moderate groups mild and severe groups (all P ＜ 0.05) ; TSH,FT3,FT4 decreased slightly after injury and gradually rose in later;GH change wasn't significant;and the larger variation of relative pituitary hormones was responsible for lower GCS scores;FT3,FT4,TSH,and GH decreased in different degrees,which were found in parts of children with craniocerebral injury,and the significant difference of serum PRL existed between GOS scores 4-5 and GOS scores 1-3 groups (P =0.000 1).Conclusions The changes of relative pituitary hormones were associated with the posttraumatic time and the severity of craniocerebral injury.The PRL in serum can aid in prediction of outcome for the children with craniocerebral injury.
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PURPOSE: The diagnosis of pituitary stalk lesion has been based on clinical feature, radiologic assessment for its critical location and role. This study aimed to investigate clinical symptoms, endocrine disturbance, magnetic resonance imaging (MRI) findings of pituitary stalk lesions in children and adolescents and to evaluate differences between neoplastic lesions with the others. METHODS: We performed a retrospective review of patients under 18 years old with pituitary stalk lesions diagnosed at the Seoul National University Children's Hospital between 2000 and 2013, by a text search for head MRI reports by using 'pituitary stalk', 'infundibulum', and 'infundibular stalk', as keywords. RESULTS: For the 76 patients, sixteen patients (21.1%) had congenital lesions, and 52 (68.4%) had neoplasms. No inflammatory lesions were found. Diabetes insipidus (DI) was the most common endocrine defect, diagnosed in 38 patients (50%). There was male predominance especially in neoplastic group. Thickened pituitary stalk was, but enhancement of lesion was not, associated with neoplasm. DI was more prevalent in neoplastic stalk lesions. Anterior pituitary dysfunction such as growth hormone and adrenocorticotropic hormone deficiencies were less prevalent in neoplastic lesions of pituitary stalk. CONCLUSION: In conclusion, the etiology of pituitary stalk lesions in children and adolescents is diverse and different from that in adults. Neoplastic pituitary stalk lesions can be differentiated from nonneoplastic lesions by systemic evaluation of clinical, hormonal, radiological findings.
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Adolescent , Adulte , Enfant , Humains , Mâle , Hormone corticotrope , Diabète insipide , Diagnostic , Hormone de croissance , Tête , Imagerie par résonance magnétique , Hypophyse , Hormones hypophysaires , Études rétrospectives , SéoulRésumé
Objective To compare pituitrin resuscitation,hypertonic saline resuscitation versus hydroxyethyl starch (HES) resuscitation during the early stage in a dog model of severe uncontrolled hemorrhagic shock (UHS).Methods Adult Chinese rural dogs of both sexes,weighing 10-12 kg,underwent sever UHS by transecting one branch of mesenteric arteries,followed by blood withdrawal via the femoral artery to target mean arterial pressure (MAP) of 50 mm Hg.Twenty-four dogs with severe UHS were randomized into 3 groups according to resuscitation strategies (n =8 each):pituitrin resuscitation group (group P),hypertonic saline resuscitation group (group SA),and resuscitation with HES (group HES).In group P,pituitrin was infused at a rate of 0.04U· kg-1 · min-1 after a loading dose of 0.1 U was given intermittently.A single bolus of 7.5 ％ hypertonic saline 6 ml/kg was injected in group SA.HES 200/0.5 was infused at a rate of 18-38 ml· kg-1· h-1 in group HES.MAP was maintained no lower than 50 mm Hg in each group.The branch of mesenteric arteries was ligated 1 h after resuscitation and all the blood initially shed was returned in each group.The parameters of hemodynamics were recorded before UHS (T0),after successful UHS (T1),at 15,30,45 and 60 min of resuscitation (T2-5),and at 2 h after hemostasis and return of shed blood (T6).Arterial blood samples were taken at T0,T1,T5 and T6 for blood gas analysis.Venous blood samples were collected at T0,T5,T6 and 3 days after extubation for determination of serum TNF-α,IL-10 and adrenocorticotropic hormone (ACTH) concentrations.TNF-α/IL-10 ratio was calculated.The survival rate was measured within 72 h after hemostasis and return of shed blood.The volume of blood loss was recorded during UHS phase and uncontrolled bleeding resuscitation phase.Results Compared with group P,SBP,DBP,CVP,HR,serum TNF-α concentration and TNF-α/IL-10 ratio were significantly increased,and Hct and serum IL-10 concentration were decreased in group SA,and SBP,HR,Lac,TNF-α and ACTH concentrations,and TNF-α/IL-10 ratio were significantly increased,and serum IL-10 concentration was decreased in group HES (P ＜ 0.05).SBP,DBP,CVP,HR and serum IL-10 concentration were significantly lower,and Lac,TNF-α and ACTH concentrations,and TNF-α/IL-10 ratio were higher in group HES than in group SA (P ＜ 0.05 or 0.01).The volume of blood loss recorded during uncontrolled bleeding resuscitation phase was significantly larger in group SA than in P and HES groups (P ＜ 0.05).There was no significant difference between P and HES groups in the volume of blood loss recorded during uncontrolled bleeding resuscitation phase (P ＞ 0.05).There was no significant difference in the survival rate between the three groups (P ＞ 0.05).Conclusion Resuscitation with continuous infusion of a small dose of pituitrin can maintain the blood pressure stable with less blood loss and inhibit stress responses and inflammatory responses,and the efficacy is superior to that of resuscitation with a small dose of hypertonic saline or HES resuscitation.
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Objective To explore of curative effect analysis of mifepristone in treatment of endometriosis and the influence of sex hormone levels isoforms expression.Methods 70 cases of patients with endometriosis were randomly divided into the observation group and the control group with 35 cases in each group.The control group was treated by laparoscopic operation,postoperative unused drug therapy.The observation group was treated with laparoscopic operation,postoperative given mifepristone treatment.Results The complete remission rate of the observation group was 85.71％.It was higher than 62.86％ in the control group(x2 =4.786,P ＜ 0.05).The cumulative recurrence rate was 5.71％ in the observation group and the control group was 20％.It was lower than the control group (x2 =5.062,P ＜ 0.05).The level of estradiol (E2) and progesterone (P) after treatment in the observation group were lower than before treatment (t =5.171,3.632,all P ＜ 0.01).The level of luteinizing hormone (LH) and follicle stimulating hormone (FSH) after treatment were higher than before treatment (t =6.478,4.662,P ＜ 0.01).Conclusion Mifepristone is effective and safe to endometriosis.It can obviously improve sex hormone levels for the endometriosis patients.
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Objective To compare the effects of sedation induced with propofol and midazolam on anterior pituitary hormone in mechanically ventilated patients with traumatic brain injury.Methods Eighty-four patients with acute traumatic brain injury,aged 20-60 yr,weighing 50-70 kg,undergoing mechanical ventilation during sedation induced with propofol or midazolam,were randomly divided into 2 groups ( n =42 each):propofol group (group P) and midasolam group (group M).Ramsay sedation score was maintained at 2-4.In group P,propofol was continuously infused at the initial infusion rate of 1.5-6.0 mg·kg-1 ·h-1 and propofol 50 mg was injected intravenously to increase the depth of sedation when needed.In group M,midazolam was continuously infused at the initial infusion rate of 0.10-0.35 mg· kg-1· h-1 and midazolam 7.5 mg was injected intravenously to increase the depth of sedation when needed.The patients were ventilated for 70-120 h.Glasgow Coma Scale scores were assessed before sedation and Glasgow Outcome Scale scores were assessed 4 weeks after admission to the intensive care unit.Venous blood samples were collected at 24 and 72 h of sedation and 4 weeks after admission to the intensive care unit for determination of the levels of serum cortisol,thyroid-stimulating hormone,prolactin,and growth hormone by ELLSA.Results Compared with group M,the levels of serum cortisol and growth hormone were significantly decreased and the level of thyroid-stimulating hormone was significantly increased at 24 and 72 h of sedation in group P ( P ＜ 0.05 or 0.01 ),and the parameters mentioned above were in the normal range.There was no significant difference in the serum prolactin level and outcome between the two groups (P ＞ 0.05).Conclusion The effects of sedation induced with propofol and midazolam on anterior pituitary hormone are comparable in mechanically ventilated patients with traumatic brain injury.
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ObjectiveTo evaluate the efficacy of different dones of urapidil in preventing pituitrin-induced cardiovascular responses in patients undergoing laparoscopic myomectomy.MethodsSixty ASA Ⅰ or Ⅱ patients,aged 27-41 yr,weighing 55-65 kg,scheduled for elective laparoscopic myomectomy under general anesthesia,were randonly divided into 4 groups (n =15 each):control group (group C) and urapidil 0.3,0.5 and 0.8 mg/kg groups (groups U1-3).Urapidil 0.3,0.5 and 0.8 mg/kg were injected intravenously in U1-3 groups respectively,while normal saline 5 ml was given in group C.The mixture of pituitrin 6 U and normal saline 20 ml was injected into the site of hysteromyoma 5 min later.The operation was then started.BIS value was maintained at 45-55.The occurrence of cardiovascular responses was recorded.ResultsThe incidences of cardiovascular responses were 100％,67％,40％ and 20％ in groups C and U1-3 respectively.The incidence of cardiovascular responses was significantly lower in groups U1-3 than in group C,and in groups U2.3 than in group U1 ( P ＜ 0.01 ).There was no significant difference in the incidence of cordiovascular responses between U2 and U3 groups (P ＞ 0.05).ConclusionUrapidil can prevent pituitrin-induced cardiovascular responses in patients undergoing laparoscopic myomectomy and the optimal dose is 0.5 mg/kg.
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Recent studies have shown that pituitary hormones, including thyroid stimulating hormone (TSH), follicle stimulating hormone(FSH), adrenocorticotropic hormone(ACTH), and oxytocin(OT)may actually bypass their target endocrine organs and affect the skeleton directly. Therefore, a new conception, pituitary-bone axis is proposed. This breakthrough sheds a new light on the function of pituitary hormones and the pathogenesis of osteoporosis associated with hyperthyroidism, menopause or pregnancy, and even osteonecrosis after using glucocorticoids. In addition, it is conducive to give the reference guidance for clinical treatment of metabolic bone diseases and new drug development.
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PURPOSE: The purpose of this study was to evaluate the clinical evolution and endocrine features of idiopathic hypopituitarism. METHODS: We reviewed the medical records of 33 patients with idiopathic hypopituitarism who had been followed up from 1982 to 2008, attained their adult final height, and received appropriate hormonal replacement therapy. RESULTS: 28 of these patients (85%) were male, 26 patients (79%) were delivered by breech presentation, and 18 (55%) were firstborns. The mean age at diagnosis was 10.1 +/- 4.6 years, and bone age was delayed a mean of 4.9 +/- 3.0 years. The mean standard deviation score (SDS) for height at diagnosis was -3.6 +/- 2.9. Deficiencies of pituitary hormones were observed in the following order of frequency: growth hormone (100%), thyroid-stimulating hormone (97.0%), luteinizing hormone/follicle - stimulating hormone (81.8%), adrenocorticotropic hormone (45.5%), and antidiuretic hormone (12.1%). Deficiencies of 4 hormones were observed in 14 (42.4%); 3 hormones, in 11 (33.3%); 2 hormones, in 5 (18.2%); and 5 hormones, in 2 (6.1%). Spontaneous onset of puberty occurred in 6 boys (21.4%), and there were no significant differences in the clinical presentations of pituitary hormone deficiency between these boys and those with gonadotropin-releasing hormone deficiency. CONCLUSION: Idiopathic hypopituitarism should be considered in patients of short stature who are delivered by breech presentation, and their hormone levels should be monitored periodically.
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Adolescent , Adulte , Enfant , Femelle , Humains , Mâle , Grossesse , Hormone corticotrope , Présentation du siège , Hormone de libération des gonadotrophines , Hormone de croissance , Hypopituitarisme , Lutéine , Dossiers médicaux , Hormones hypophysaires , Puberté , ThyréostimulineRésumé
PURPOSE: The purpose of this study was to evaluate the clinical evolution and endocrine features of idiopathic hypopituitarism. METHODS: We reviewed the medical records of 33 patients with idiopathic hypopituitarism who had been followed up from 1982 to 2008, attained their adult final height, and received appropriate hormonal replacement therapy. RESULTS: 28 of these patients (85%) were male, 26 patients (79%) were delivered by breech presentation, and 18 (55%) were firstborns. The mean age at diagnosis was 10.1 +/- 4.6 years, and bone age was delayed a mean of 4.9 +/- 3.0 years. The mean standard deviation score (SDS) for height at diagnosis was -3.6 +/- 2.9. Deficiencies of pituitary hormones were observed in the following order of frequency: growth hormone (100%), thyroid-stimulating hormone (97.0%), luteinizing hormone/follicle - stimulating hormone (81.8%), adrenocorticotropic hormone (45.5%), and antidiuretic hormone (12.1%). Deficiencies of 4 hormones were observed in 14 (42.4%); 3 hormones, in 11 (33.3%); 2 hormones, in 5 (18.2%); and 5 hormones, in 2 (6.1%). Spontaneous onset of puberty occurred in 6 boys (21.4%), and there were no significant differences in the clinical presentations of pituitary hormone deficiency between these boys and those with gonadotropin-releasing hormone deficiency. CONCLUSION: Idiopathic hypopituitarism should be considered in patients of short stature who are delivered by breech presentation, and their hormone levels should be monitored periodically.
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Adolescent , Adulte , Enfant , Femelle , Humains , Mâle , Grossesse , Hormone corticotrope , Présentation du siège , Hormone de libération des gonadotrophines , Hormone de croissance , Hypopituitarisme , Lutéine , Dossiers médicaux , Hormones hypophysaires , Puberté , ThyréostimulineRésumé
FUNDAMENTO: Os neuro-hormônios estão envolvidos na fisiopatologia da insuficiência cardíaca, mas pouco se sabe sobre seu comportamento na insuficiência aórtica crônica importante (IAo). OBJETIVO: Analisar o comportamento desses mediadores na IAo. MÉTODOS: Analisamos 89 pacientes com IAo, com média etária de 33,6±11,5 anos, 84,6 por cento do sexo masculino, 60 por cento assintomáticos, todos de etiologia reumática. Após avaliação clínica e ecocardiográfica, realizaram-se dosagens plasmáticas de fator de necrose tumoral (TNF), seus antagonistas receptores solúveis tipos I e II (sTNFRI e sTNFRII), interleucina-6 (IL-6), seu receptor solúvel, endotelina-1 e peptídeo natriurético tipo B (BNP). Doze indivíduos saudáveis serviram como controle. RESULTADOS: O valor médio de diâmetro diastólico (DD) do ventrículo esquerdo (VE) foi de 71,9±8,3 mm, e o do diâmetro sistólico (DS) do VE, de 50,4±9,3 mm. Os níveis de neuro-hormônios estavam elevados nos pacientes com IAo: TNF 92,65±110,24 pg/ml vs. 1,67±1,21 pg/ml nos controles, p<0,001; IL-6 7,17±7,78 pg/ml vs. 0,81±0,38 pg/ml nos controles, p = 0,0001; e TNFRI 894,75±348,87 pg/ml vs. 521,42±395,13 pg/ml, p = 0,007. Com exceção dos níveis de BNP, os pacientes sintomáticos e assintomáticos apresentaram perfil neuro-hormonal semelhante. Houve correlação entre TNFRII e diâmetro diastólico do ventrículo esquerdo (DDVE) (r = -0,329, p = 0,038) e diâmetro sistólico do ventrículo esquerdo (DSVE) (r = -0,352, p = 0,027). Os níveis de BNP estavam significativamente mais altos em pacientes sintomáticos, e apenas nestes foi possível correlação entre BNP e diâmetros ventriculares. CONCLUSÃO: Pacientes com insuficiência aórtica crônica importante apresentam altos níveis neuro-hormônios, sem correlação com o status sintomático. Os níveis de TNFRII e BNP puderam ser correlacionados com diâmetros ventriculares, mas apenas este último com sintomas.
Sujets)
Adulte , Femelle , Humains , Mâle , Insuffisance aortique/sang , Défaillance cardiaque/sang , Peptide natriurétique cérébral/sang , Facteur de nécrose tumorale alpha/sang , Marqueurs biologiques/sang , Maladie chronique , /sang , Récepteur au facteur de nécrose tumorale de type I/sang , Remodelage ventriculaire/physiologieRésumé
Objective To evaluate the safety and the feasibility of hypophysin injection for hemostasis during laparoscopic stripping of ovarian endometrioma.Methods Retrospective analysis of 86 cases with ovarian endometrionm.Forty-two patients with prophylactic dilute hypophysin injection into cornua uterus and mesosalpinx(study group),and 44 patients without vasopressin(control group).The operative time,intraoperative blood loss,the highest postoperative temperature,postoperative stay and the rate of recurrence were compared.Results The operative time in the study group and the control group were(51.24±22.58)min and(67.02±25.14)min,the intraoperative blood loss were(42.16±26.10)ml and (68.23±28.21)ml,respectively.There was significantly different between two groups(P＜0.01).The rates of recurrence in the study group and the control group were 4.76% and 11.36%,respectively.But it was no significantly different between two groups(P＞0.05).Both the highest postoperative temperature and postoperative stay was no difference between two groups(P＞0.05).Conclusions Hypophysin can reduce the operative time and intraoperative blood loss during laparoscopic stripping of ovarian endometrioma,and it is possible to reduce the rate of recurrence.It is a safe,feasible,cheapand convenient method,and worth using in clinic.
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Objective To investigate dynamic change of anterior pituitary hormones (APHs), thyroid func-tion (TF) and genital hormones (GnHs) in patients with traumatic brain injury (TBI) and their clinical signifi-cance. Method APHs, TF and GnH were tested in 93 patients with TBI,who were admitted to Zhejiang Provin-cial People's Hopital from March 2006 to June 2007. Patients with primary injury in the hypothalamic and pituitary regions, as detected by CT and/or MR/examination, as well as those with tumors or immune diseases in the CNS,endocrine or urinogenital systems, were excluded. The clinical data were analyzed according to Glasgow coma scores (GCS), type and degree of injury, and whether there was any secondary cerebral injury. Twenty healthy people acted as controls. The data were analyzed by the Hotelling T2 test and t-tests using SAS 11.5. A P value of less than 0.05 indicated statistical significance. Results The levels of adrenocortieotropic hormone (ACTH),luteinizing hormone (LH) and prolactin (PRL) were markedly higher in all 93 TBI patients than controls, while those of thyroid-stimulating hormone (TSH), thyroid hormone T3,T4 and FT3 were significantly lower in TBI pa-tients in the early stage after injury than in those at follow-up and controls (P<0.05). The ACTH and PRL val-ues reached (33.33±6.86) and (31.74±5.51), respectively, and the LH value was (9.48±1.14) in the secondary cerebral injury group.The TSH value (1.26±0.17) in the brain injury group was significantly lower than those in controls (P<0.05). With the exception of TSH, PRL, testosterone (T) and E2, other APHs were markedly lower in TBI patients at following-up than in controls (P<0.05). The incidence of traumatic hypothala-mus-pituitary insufficiency (THPI) associated with low levels of more than three APHs was 3.2%, while 13.8% of THPI patients showed low levels of at least one APH. The ratio of sick euthyroid syndrome (SETS) was 14.0%. Conclusions A low level of a single APH is the prevalent pattern in THPI patients. Secondary cerebral injury, such as acute high intracranial pressure, brain edema and ischemia after TBI, may be the chief causes of THPI. Early hyperprolactinemia is an important indication for presaging THPI. The dynamic levels of neurcen-docrine hormones can serve as an important index for determining the suitability of TBI patients for treatment with hormone therapy.
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Objective To investigate the changes of serum pituitary hormones and thyroid hormones in patients with severe brain injuries during hypothermia therapy. Methods Ninety-eight patients with severe brain injuries were randomly divided into mild hypothermia group (50 cases) and control group (routine therapy group,48 cases). The levels of serum PRL,TSH,FT 3 and FT 4 of patients in the both groups were detected by two-side sandwich immunological autochemoluminescence detection system before and after treatment. The therapeutic effects were observed and compared. Results After treatment,the levels of serum PRL,TSH and FT 4 of patients in hypothermia group were (0.25? 0.02) nmol/L ,(0.7?0.2) mU/L and (15.0?5.3) pmol/L,respectively,which were significantly lower than that in control group,ie,(0.46?0.04) nmol/L,(1.1?0.3) mU/L and (21.2? 6.4) pmol/L ,respectively. The good recovery rate (62%) in hypothermia group was higher than that of control group (35%) but the death rate (22%) in hypothermia group was lower than that of control group (42%). Conclusions Mild hypothermia can inhibit the rise of serum pituitary hormones and thyroid hormones after severe brain injury and improve the therapeutic effects.