Diabetes insípida y virus del Zika / Diabetes insipid us and Zika virus

La diabetes insípida es el resultado de una secreción o acción reducidas de la hormona vasopresina, expresada clínicamente por un cuadro de poliuria-polidipsia. Los arbovirus pueden tener afinidad por el sistema nervioso y se ha demostrado que el Zika desencadena un trastorno autoinmune que ataca a las células nerviosas, lo que puede traer como consecuencia una diabetes insípida central. En la literatura médica nacional e internacional revisada no se reportan casos anteriores donde se vincule la diabetes insípida con el virus del Zika. Se presenta un caso a propósito de esta asociación: paciente femenina de 53 años, diagnosticada con infección por el virus del Zika dos semanas antes de comenzar con los síntomas sugestivos de diabetes insípida. El potencial neurotrópico del virus, así como los resultados en la resonancia magnética nuclear y la determinación de marcadores de autoinmunidad anti-ADNdc positivos, son elementos que apoyan la hipótesis de que la paciente presentó una posible hipofisitis autoinmune, como respuesta inflamatoria post-infección, desarrollando diabetes insípida central transitoria(AU)

Diabetes insipidus is the result of reduced secretion or action of the vasopressin hormone, which is clinically expressed by a polyuria-polydipsia picture. Arboviruses can have a nervous system affinity and Zika has been shown to trigger an autoimmune disorder that attacks nerve cells, which can result in central diabetes insipidus. The reviewed national and international medical literatures does not report previous cases linking diabetes insipidus with Zika virus. It is presented a case about this association: 53-year-old female patient diagnosed with Zika virus infection two weeks before starting symptoms suggestive of diabetes insipidus. The neurotropic potential of the virus, as well as the results in nuclear MRI and the determination of positive anti-ADNdc autoimmunity markers are elements that support the hypothesis that the patient had a possible autoimmune hypophysis, as a post-infection inflammatory response, developing transient central diabetes insipidus(AU)

Serie de Casos Clínicos: Acromegalia, Presentación Clínica y Evolución en los Pacientes del Hospital "Vicente Corral Moscoso". Cuenca - Ecuador, Mayo 2015 - Abril 2017 / Case Series: Acromegaly, Clinical Presentation and Evolution in Patients of Hospital "Vicente Corral Moscoso". Cuenca - Ecuador, May 2015 - April 201

INTRODUCCIÓN:La acromegalia es una enfermedad sistémica caracterizada por la elevada producción de hormona del crecimiento, su etiología más común es el adenoma hipofisiario. En Ecuador existe una prevalencia de 18.7 casos por millón de habitantes y una incidencia de 1.3 casos por millón de individuos cada año. Se considera que existe un retraso de aproximadamente una década entre el inicio de los síntomas y el reconocimiento de los mismos por parte del equipo de salud. CASO CLÍNICO: Se presentan a continuación tres pacientes con acromegalia, atendidos por el servicio de Endocrinología del Hospital Vicente Corral Moscoso desde Mayo del 2015 hasta Abril del 2017. En esta serie, la edad de diagnóstico fue alrededor de los 34 años. Los motivos de consulta fueron molestias visuales, dolores articulares y complicaciones microvasculares. En todos los casos, la etiología fue un adenoma hipofisario productor de hormona del crecimiento en los que era necesaria la corrección quirúrgica; sin embargo, la paciente del caso 3 rechazó este tratamiento. EVOLUCIÓN: Se presentan a continuación tres pacientes con acromegalia, atendidos por el servicio de Endocrinología del Hospital Vicente Corral Moscoso desde Mayo del 2015 hasta Abril del 2017. En esta serie, la edad de diagnóstico fue alrededor de los 34 años. Los motivos de consulta fueron molestias visuales, dolores articulares y complicaciones microvasculares. En todos los casos, la etiología fue un adenoma hipofisario productor de hormona del crecimiento en los que era necesaria la corrección quirúrgica; sin embargo, la paciente del caso 3 rechazó este tratamiento. CONCLUSIÓN: Es importante reconocer la característica insidiosa de la acromegalia y sus variables manifestaciones clínicas, puesto que un diagnóstico oportuno permite mejorar el pronóstico y la calidad de vida. Hay diversas opciones terapéuticas, siendo el tratamiento quirúrgico complementado con terapia farmacológica, el de mayor eficacia. El manejo debe ser multidisciplinario e individualizado(au)

BACKGROUND: Case Series: Acromegaly, Clinical Presentation and Evolution in Patients of Hospital "Vicente Corral Moscoso". Cuenca - Ecuador, May 2015 - April 2017. CASE REPORTS: Three patients with acromegaly are presented, attended by the Endocrinology service of the Hospital Vicente Corral Moscoso from May 2015 to April 2017. In this series, the diagnosis age was around 34 years. Patients consulted because of visual discomfort, joint pain and microvascular complications. In all cases, the etiology was a pituitary adenoma producing growth hormone, in which surgical correction was necessary; however, patient number 3 rejected surgical treatment. EVOLUTION: In the present series, case 1 is undergoing treatment with Octreotide-Cabergoline and hormone replacement therapy, case 2 achieved biochemical remission with postoperative adjuvant treatment based on somatostatin analogues and case 3 has poor expectation of cure due to her medical history and lack of adherence to treatment. CONCLUSIONS: It is important to recognize the insidious characteristic of acromegaly and its varia-ble clinical manifestations, because a timely diagnosis allows a better prognosis and quality of life. There are several therapeutic options, being the surgical treatment supplemented with pharmacological therapy, the most effective. The management must be multidisciplinary and individualize(au)

Relevancia de componentes del eje hipotálamo-hipófisis-gonadal en la fisiopatología de proteinopatías del sistema nervioso / Relevance of components of the hypothalamic-pituitary-gonadal axis in the pathophysiology of proteinopathies of the nervous system

RESUMEN Introducción: Varias proteinopatías del sistema nervioso están asociadas a la ocurrencia de alteraciones en componentes del eje hipotálamo-hipófisis-gonadal. Objetivo: Reflejar la relevancia de componentes del eje hipotálamo-hipófisis-gonadal en la fisiopatología de proteinopatías del sistema nervioso. Material y Métodos: Se realizó una revisión bibliográfica durante los meses de enero de 2018 a diciembre de 2018. Fueron consultadas bases de datos de referencia, con el uso de descriptores y operadores booleanos. La estrategia de búsqueda avanzada para la selección de los artículos fue empleada, teniendo en cuenta la calidad metodológica o validez de los estudios. Desarrollo: Fueron identificaron alteraciones del funcionamiento normal del eje hipotálamo-hipófisis-gonadal en varias proteinopatías del sistema nervioso. Las alteraciones más frecuentemente reportadas fueron el incremento en los niveles de gonadotropinas, principalmente de la hormona luteinizante, en la enfermedad de Alzheimer, y la disminución de los niveles de testosterona en las enfermedades de Alzheimer, Parkinson, Huntington y Esclerosis Lateral Amiotrófica, con el consiguiente agravamiento del fenotipo clínico. Se obtuvieron evidencias de naturaleza preliminar, que fundamentan la posible ocurrencia de disfunción hipotalámica en pacientes con ataxias espinocerebelosas. Conclusiones: Aun cuando existen evidencias que demuestran la existencia de un vínculo entre la fisiopatología de proteinopatías del sistema nervioso y alteraciones en componentes del eje hipotálamo-hipófisis-gonadal, se requerirán estudios más extensos e integrales para confirmar estas asociaciones y para caracterizar los mecanismos moleculares implicados.

ABSTRACT Introduction: Several proteinopathies of the nervous system are associated with disturbances in components of the hypothalamic-pituitary-gonadal axis. Objective: To assess the relevance of components of the hypothalamic-pituitary-gonadal axis in the pathophysiology of proteinopathies of the nervous system. Material and Methods: A literature review was carried out from January to December 2018. Several databases were searched by using descriptors and Boolean operators. Advanced search strategy was used for the selection of articles, taking into account the methodological quality and validity of the studies. Results: Disturbances of the normal function of the hypothalamic-pituitary-gonadal axis were identified in proteinopathies of the nervous system. The most frequently reported disturbances were the increase in gonadotropin levels, mainly in luteinizing hormone in Alzheimer´s disease, and the decrease in testosterone levels in Alzheimer´s, Parkinson´s and Huntington´s diseases, and Amyotrophic Lateral Sclerosis, with the resulting worsening of the clinical phenotype. Preliminary evidence was obtained, which was pointing to a possible hypothalamic dysfunction in Spinocerebellar ataxia patients. Conclusions: Even when evidences were gathered supporting a link between the pathophysiology of proteinopathies of the nervous system and disturbances in components of the hypothalamic-pituitary-gonadal axis, deeper and more comprehensive studies will be needed to confirm these associations and to characterize the underlying molecular mechanisms.

Morphology and ultrastructure of the hypophysis in bactrian camels ( Camelus bactrianus ) / Morfología y ultraestructura de la hipófisis en camellos bactrianos ( Camelus bactrianus )

The morphology of the hypophysis in Bactrian camel has not been described in the literature, despite it being the master of endocrine organs in vertebrates. In the present study, we examined the morphological features of the hypophysis in Bactrian camel by means of gross anatomy, light and electron microscope. Our findings showed that the gland was a protrusion of the bottom of the hypothalamus at the base of the brain with about 1.54 g in weight and 2 cm3 in volume. The hypophysis consists of two major parts: fully developed adenohypophysis and underdeveloped neurohypophysis, the adenohypophysis consists of pars distalis and pars intermedia. Seven type cells of the pars distalis could be distinguished with immunohistochemical techniques and electron micrographs: somatotroph, mammotroph, thyrotroph, corticotroph, gonadotroph, chromophobe and stellate cells which is in accordance with most mammals. Notably, the stellate cells could be obviously distinguished from chromophobe cells in histological oberservation. Moreover, the corpusculum neurosecretorium (Herring bodies) were rare in the external neurohypophysis, and mainly distributed in the internal neurohypophysis, this was different from most mammals. Results from this study would provide a necessary theoretical basis for ongoing investigations for Bactrian camels and their good adaptability in arid and semi-arid circumstances.

La morfología de la hipófisis en el camello bactriano no ha sido descrita en la literatura, a pesar de ser el maestro de los órganos endocrinos en los vertebrados. En el presente estudio, examinamos las características morfológicas de la hipófisis del camello bactriano por medio de anatomía general, microscocopía de luz y microscopía electrónica. Nuestros hallazgos mostraron que la hipófisis es una protuberancia ubicada en la porción inferior del hipotálamo, en la base del cerebro, con aproximadamente 1,54 g de peso y 2 cm3 de volumen. La hipófisis consta de dos partes principales: adenohipófisis, completamente desarrollada, y neurohipófisis, poco desarrollada; además, la adenohipófisis consta de una pars distalis y una pars intermedia. Con técnicas inmunohistoquímicas y micrografías electrónicas en la pars distalis se pudieron distinguir siete tipos de células: somatotrofas, mamotróficas, tirotrofas, corticotrofas, gonadotrofas, cromófobas y estrelladas, lo que es similar a la mayoría de los mamíferos. En la observación histológica las células estrelladas se pueden distinguir naturalmente de las células cromófobas. Además, es rara la presencia de corpusculum neurosecretorium (Cuerpos de Herring) en la neurohipófisis externa, hallándose distribuidos principalmente en la neurohipófisis interna, esto es diferente a lo encontrado en la mayoría de los mamíferos. Los resultados de este estudio proporcionarían una base teórica necesaria para las investigaciones en curso de los camellos bactrianos y su buena adaptabilidad en circunstancias áridas y semiáridas.

Oncocitoma fusocelular hipofisario / Pituitary spindle cell oncocytoma

El oncocitoma fusocelular es una neoplasia selar primaria no endocrina infrecuente, de curso clínico benigno. Debido a su similitud morfológica con los adenomas hipofisarios, considerar al oncocitoma como diagnóstico diferencial lleva a un abordaje quirúrgico cuidadoso, con el objetivo de evitar el sangrado intraquirúrgico y lograr la resección más completa posible, de la que parecería depender la evolución a largo plazo. Se presenta el caso de un hombre de 60 años que consultó por alteración campimétrica. La evaluación bioquímica evidenció panhipopituitarismo y la resonancia magnética (RM) una lesión selar. Se indicó tratamiento quirúrgico por compromiso visual con diagnóstico presuntivo de macroadenoma hipofisario no funcionante. El diagnóstico anatomopatológico fue compatible con oncocitoma fusocelular. En la RM selar, postquirúrgica (a los 5 meses), se observó remanente tumoral y se decidió realizar radiocirugía, constatándose en las subsiguientes RM disminución tumoral sin evidencia de remanente ni recidiva en 4 años de seguimiento. La comunicación de nuevos casos de esta entidad permitirá aumentar la disponibilidad de evidencia y ayudará a determinar la eficacia de los tratamientos disponibles y el pronóstico.

Spindle cell oncocytoma is an infrequent benign non-endocrine sellar neoplasm. Due to its similar morphology to pituitary adenomas, consideration of this differential diagnosis would conduce to a more careful surgical approach in order to avoid intraoperative bleeding and aiming to a complete resection, on which depends long-term outcomes. We present the case of a 60-year-old male who complained about visual abnormalities, with computerized visual field confirmation. On biochemistry, a panhypopituitarism was detected. The brain magnetic resonance images showed a sellar mass. A non-functioning pituitary macroadenoma was presumptively diagnosed and due to the visual impairment, surgical transesphenoidal treatment was indicated. The histological diagnosis was spindle cell oncocytoma. Five months after surgery, the control image demonstrated a lesion that was considered as remnant tumor, hence radiosurgery was performed. During the follow-up, the tumor reduced its size and four years after initial treatment, the sellar resonance imaging showed disappearance of the residual tumor. Communication of new cases of this rare entity will enlarge the existing evidence and will help to determinate the most effective treatment and prognosis.

Presentación de un adolescente con gigantismo / Presentation of an Adolescent with Gigantism

El gigantismo es una enfermedad hormonal causada por la excesiva secreción de la hormona del crecimiento por parte de la hipófisis anterior antes del cierre la epífisis del hueso, que ocasiona un crecimiento desmesurado de la estatura de todo el cuerpo. Se presentó el caso de un adolescente de 18 años, procedente de una comuna pobre de Haití, con dolor en miembros inferiores y decaimiento, refiere historia previa de crecimiento exagerado en la longitud de su cuerpo, en las manos y pies. En el examen físico se confirmó talla de 2,17 metros y se detectó retardo discreto en el desarrollo sexual. Los síntomas y los exámenes complementarios orientan el diagnóstico clínico de gigantismo, asociado a un hipogonadismo e hipofunción tiroidea discreta; por dificultades económicas se pospuso la detección humoral de la hormona de crecimiento y la realización de la tomografía axial computarizada o una resonancia magnética para el diagnóstico certero.

Gigantism, a hormonal disease caused by the excessive secretion of the growth hormone of the anterior pituitary gland, while the epiphysis of the bones is not still closed, it causes an overgrowth body gain height. An 18- year-old male teenager suffering from pain in arms and legs, from his early years presented an overgrowth of all his body, in the physical exam and 2.17 meters of height. He also presented a slow development in his sexual organs. The symptoms found, together with some other test showed a diagnosis of gigantism associated with mild hypogonadism and thyroid hypofuntion. To know the growth hormone, a computer axial tomography and a magnetic resonance were needed in order to determine an exact diagnosis but it was postponed because of for financial reasons.

Effects of Malt Extract on Hypophysis Prolactin Expression and Morphology of Mammary Tissues in Hyperprolactinemia Rats / 医药导报

Objective To observe the effects of malt extract on prolactin expression and morphology of mammary tissue in hyperprolactinemia rats. Methods Metoclopramide hydrochloride was injected subcutaneously to establish hyperprolactinemia model. Sixty rats were divided into normal control group, model control group, bromocriptine group, high-dose, middle-dose and low-dose malt extract groups. Except normal control group, hyperprolactinemia model was established in the other groups. Bromocriptine (0. 389 mg·kg-1 ·d-1 ) was given to bromocriptine group. Malt extract (7. 98, 15. 96 and 31. 92 g·kg-1 ·d-1 ) was administered in low-dose, middle-dose and high-dose malt extract groups. Equal volume of purified water was given to normal control group and model control group. After 30 days of administration, PRL positive cell number of rat hypophysis was counted. RT-PCR was used to measure hypophysis PRL mRNA expression, and morphology of mammary tissues was observed by immunohistochemical method. Results PRL positive cell number was (2. 4±0. 3), (21. 7±0. 8), (3. 8± 0. 5), (4. 5±0. 4), (6. 7±0. 5) and (15. 8±1. 2) in normal control group, model control group, bromocriptine group, high-dose, middle-dose and low-dose malt extract groups. PRL mRNA expression level was (0. 31±0. 02), (1. 58±0. 06), (0. 45± 0. 04), (0. 49±0. 03), (0. 61±0. 04), and (0. 95±0. 09), respectively. As compared with normal control group, hypophysis PRL positive cell number and PRL mRNA expression level of high-dose and middle-dose malt extract group were increased significantly (P<0. 01), and hyperplasia of mammary glands appeared. As compared with model control group, hypophysis PRL positive cell number and PRL mRNA expression level of high-dose and middle-dose malt extract group was decreased significantly (P<0. 01), and hyperplasia of mammary glands was alleviated obviously. Conclusion Malt extract can effectively treat hyperprolactinemia and inhibit hyperplasia of mammary glands through significantly decreasing the expression of hypophysis prolactin in hyperprolactinemia rats.

Different biological expression characteristics of pungent-hot and bitter-cold herbs on Yang-deficiency rats / 中草药

Objective: To initially explore the drug biological characteristics of pungent-hot and bitter-cold herbs on the various functions of hypothalamus-hypophysis-target gland axises in Yang-deficiency rats, according to the pungent-hot herbs, Aconiti Lateralis Radix Praeparata (ALRP), Curculiginis Rhizoma (CR), Cinnamomi Cortex (CC), and bitter-cold Phellodendri Chinensis Cortex (PCC), and Gardeniar Fructus (GF) and to investigate their biological expression characteristic on Yang-deficiency state. Methods: The decoctions of ALPR, CR, CC, PCC, and GF were ig administered to Yang-deficiency rats once daily for 7 d. The indexes of thyroid-stimulating hormone (TSH), triiodothyronine (T3), tetraiodothyronine (T4), 17-hydroxycorticosteroids (17-OHCS), cortisol (COR), testosterone (T), and estradiol (E2) in serum of animals in each group were detected. Results: The T3, 17-OHCS, COR, T, and T/E2 values of Yang-deficiency rats in ALRP, CR, and CC groups were obviously increased, while E2 was decreased. ALRP and CC could significantly increase T4 of Yang-deficiency rats, TSH in Yang-deficient rats was decreased by CC, the COR of Yang-deficiency rats in CC and GF groups was decreased, and E2 in Yang-deficiency rats was decreased by CC. Conclusion: The pungent-hot herbs of ALRP, CR, and CC and bitter-cold herbs of PCC, GF show the different drug property in intervention of Yang-deficiency rats. The pungent-hot herbs have an obvious regulation on hypothalamus-hypophysis-target gland axises, while the bitter-cold herbs have no significant role.

Reproducción Estacional en el Macho / Seasonal Reproduction in the Male

Hay una sorprendente relación entre el ambiente y adaptaciones de la conducta reproductiva, muy evidente en los reproductores estacionales que pueden reproducirse en días cortos o largos, de acuerdo a factores proximales, especialmente el fotoperiodo luminoso que provoca cambios fotoneuroendocrinos. Estos, involucran fotoreceptores, un reloj biológico y el aparato neuroendocrino. Las gonadotrofinas (GT), el desarrollo gonadal, la retroalimentación negativa de las GT por los esteroides sexuales, la intervención de las fibras retino-hipotalámico y los núcleos supraquiasmáticos así como la secreción de melatonina, intervienen en esta regulación. El pulso generador del hipotálamo (eminencia media) es importante en el control de la adenohipófisis respecto de la secreción de LH y FSH. En el testículo, las endocrinocitos intersticiales (de Leydig) (que secretan testosterona y también estrógenos), establecen un asa de retroalimentación con la adenohipófisis y el hipotálamo en un circuito de asa larga, corta y ultracorta, donde neuronas neuroendocrinas tienen un rol importante. Los sustentocitos (células de Sertoli) (intratubulares) son importantes por su rol mecánico, trófico y metabólico respecto a las células germinales y la secreción de activina e inhibina, que provoca o inhibe la secreción de FSH respectivamente. Los sustentocitos también secretan muchas proteínas específicas entre las cuales se encuentra la proteína que liga andrógenos (ABP), importante porque concentra 100 veces la testosterona en el parénquima testicular. La secreción tónica, por pulsos de GT, especialmente LH, es debida a actividad hipotalámica a través del control de generación de estos pulsos que se inicia en la pubertad. La reproducción en el potro y el toro se presentan como ejemplos.

There is a surprising interrelationship between environments and adaptation of reproductive behaviour, very evident in seasonal breeders; which may reproduce in long or short days, according to proximal factors, mainly the light photoperiod which triggers photoneuroendocrine changes. These involve photoreceptors, a clock and the neuroendocrine apparatus. Gonadotropins (GT), gonadal development, negative feed back of GT done by sexual steroid, the intervention of the retino-hypothalamic fibers, and suprachiasmatics nucleus as well as melatonine secretion, intervene in this regulation. Of importance is the pulse generator of the hypothalamus (medial eminence) and its control of adenohypofisis for the secretion of LH and FSH. In the testis interstitial endocrine cells (Leydig)(secreting testosterone and also estrogens), establish a feed back loop with the adenohypofisis and hypothalamus in a circuit of long, short and ultra short circuit with neuroendocrine neurons playing a key role. Sustentocyte intratubular (Sertoli)are also important for their trophic, mechanic and metabolic relationships with the germ cells, and the secretions of activine and inhibine, which triggers or inhibits FSH secretions respectively. Sustentocyte also secrete many specifics proteins among which ABP (Androgen Binding Protein) is important because it concentrates 100 fold testosterone in the testicular parenchyme. Tonic secretion by pulses of GT, mainly LH, is due to hypothalamic activity with the control generation of these pulses by puberty. Reproduction in the stallion and the bull are presented as examples.

Rendimento e viabilidade da extração de hipófise de jundiá (Rhamdia quelen) / Silver catfish (Rhamdia quelen) pituitary yield and viability

O extrato hipofisário é provavelmente o indutor hormonal para desova e espermiação mais utilizado em piscicultura. A possibilidade de o produtor ter uma nova fonte de renda motivou a execução deste trabalho. O objetivo foi verificar o rendimento da hipófise no jundiá (Rhamdia quelen), em função do peso, e analisar a viabilidade econômica de sua extração. Exemplares (n=116) com pesos entre 158-1.543g foram abatidos para extração da hipófise. O índice gonadossomático (IGS) também foi calculado para verificar sua relação com o peso da hipófise. A hipófise apresentou relação significativa com o peso dos jundiás, mas não com o IGS. A extração da hipófise é mais uma opção de renda para a cadeia produtiva dessa espécie.

The pituitary extract is probably the most used hormonal inducer to spawning and spermiation in fish culture. The possibility of a new income source for the fish farmer was the reason of this study. The aim of the present study was to verify the yield of the pituitary in silver catfish (Rhamdia quelen) as a function of weight and to analyze the economical viability of its extraction. Specimens (n=116) with 158-1543g were sacrificed for pituitary extraction. The gonadosomatic index (GSI) was also calculated to verify its relationship with the pituitary weight. The pituitary showed a significant relationship with silver catfish weight, but not with the GSI. The extraction of the pituitary is another profitable option to silver catfish productive market.

Características biométricas de la silla turca en telerradiografías laterales de individuos mapuches y no mapuches de la IX Región, Chile / Biometric characteristics of the sella turcica in lateral telerradiographs of individuals Mapuche and non Mapuche of the IX Region, Chile

El cefalograma lateral es una radiografía que se usa rutinariamente en la ortodoncia. Este tipo de radiografía plana es la mejor opción para investigar las características morfométricas de la silla turca, determinando su tamaño y forma y sus eventuales variaciones. Taveras & Wood han descrito un método, para determinar el tamaño de la silla turca en radiografías. Midiendo el mayor diámetro anteroposterior de la silla turca y la profundidad de ella desde el punto más bajo a una línea que conecta la cima del dorso de la silla al tubérculo selar. Esto nos motivó llevar a cabo un estudio de estas características, para lo cual se registraron las correspondientes observaciones en 88 teleradiografias laterales, de las cuales correspondían a 44 individuos adultos jóvenes mapuches y 44 no mapuches, de ambos sexos, todos pertenecientes a la IX Región. El diámetro anteroposterior de la silla turca fue de 12,85 +/- 1,5 mm, con rangos entre 10,05 a 15,95 mm; la profundidad fue de 10,31 +/- 1,3 mm, con rangos de 7,20 a 13,36 mm; en individuos no mapuche el diámetro anteroposterior fue de 12,11 +/- 2,4 mm, con rangos entre 6,72 a 17,06 mm; la profundidad fue de 11,01 +/- 1,4 mm, con rangos de 7,92 a 13,67 mm. El área selar en mapuches fue de 132,4 mm²; y en no mapuches de 133,3 mm². La forma de la fosa fue circular en 36 casos, oval en 30 casos y plana en 22 casos.

The lateral cephalogram is an x-ray routinely used in orthodontics. This type of plane x-ray is the best choice to investigate the morphometric characteristics of the sella turcica, its size and shape, creating a variation. Taveras & Wood described a method to determine the size of the sella in radiography. Measuring the diameter of the anterior sella turcica and the depth of it from the lowest point to a line connecting the top of the back of the sella to the sellar tuber. This led to a study of the present characteristics , which reported observations in 88 lateral teleradiograph takes, of which 44 were young adult Mapuche individuals and 44 non Mapuche of both sexes, all native to the IX Region. The anteroposterior diameter of the sella turcica was 12.85 +/- 1.5mm, ranging from 10.05 to 15.95 mm, the depth was 10.31 +/- 1.3 mm, with ranges of 7.20 to 13.36 mm, in Mapuche individuals anteroposterior diameter was 12.11 +/- 2.4 mm, ranging from 6.72 to 17.06 mm, the depth was 11.01 +/- 1.4 mm, ranging from 7.92 to 13.67mm. Sellar area in Mapuches has been set at 132.4 mm² and non Mapuche of 133.3 mm². The shape of the fossa of the sella turcica was circular in 36 cases, oval in 30 cases and plane in 22 cases.

Diabete insípido central em um cão / Central diabetes insipidus in a dog

Descreve-se um caso de diabete insípido central em um cão, fêmea, nove anos de idade, sem raça definida, com história de poliúria e polidipsia há 18 meses. Com o exame físico, nenhuma alteração sistêmica foi elucidada. Já nos exames laboratoriais complementares, observou-se policitemia e hiperproteinemia, e a densidade específica da urina (1002) encontrava-se abaixo do limiar fisiológico. O animal foi submetido à privação hídrica e se mostrou incapaz de concentrar a urina durante as sete horas observadas, tempo que levou para apresentar 5 por cento de desidratação. Após isso, foi administrado acetato de desmopressina e, 5 horas após, a densidade estava em 1028, confirmando o diabete insípido de origem central. O animal recebeu terapia à base de acetato de desmopressina, apresentando melhora do quadro clínico.

A case of central diabetes insipidus in a nine-year-old female dog is described. The dog presented intermitent polyuria and polydipsia in the past 18 months. In the clinical exam, complete blood count, alanine transaminase, alkaline phosphatase, BUN, creatinine, glucose and calcium dosages were normal. However, the specific urine gravity was low and presented the value 1002. The dog was unable to concentrate the urine during the seven hours of water deprivation test and presented 5 percent of dehydratation. The administration of desmopressin acetate elevated the specific urine gravity to 1028 five hours after the beginning of the treatment, confirming the diagnosis of diabetes insipidus of central origin.

Effect of soy isoflavone on incretion of female rats / 中国基层医药

Objective To observe the effect of soy isoflavones on incretion of female rats. Methods 42 fe-male rots of 12 weeks old were divided into 3 groups at random. Low dose group were perfused with 40mg · kg-1·d-1 into stomach per day;high dose group were perfused with 80mg·kg-1·d-1 into stomach per day;control group were perfused with physiological saline into stomach. After 14 days,collected blood via jugular vein and tested 4 inde-xes-FSH, LH,E2 and P with chemoluminescence method. Results In 3 groups of soy isoflavones low doee group,soy isoflavones high dose group and control group,FSH were (0.13±0.021) mIu/ml, (0.12±0.018) mIu/ml, (0.15 ±0.024) mIu/ml respectively; LH were (0.17±0.032) mIu/ml, (0.15±0.043) mIu/ml, (0.18±0.047) mIu/ml respectively, which has no obvious differences (P > 0.05) ; E2 were (0.09±0.03) nmol/L, (0.03±0.03) nmol/L, (0.12±0.04) nmol/L respectively; P were (1.43±0.27) ng/ml, (2.82±0.37) ng/ml, (0.67±0.56) ng/ml re-spectivdy. Compare those 3 groups, E2 activeness of soy isoflavones group decreased obviously; but P activeness of soy isoflavones group increased obviously. Conclusion Soy isoflavones has no obvious effect on hypophysis hormone of rat, but the soy isoflavones of different dosages may measure the secretion of female rat ovary hormones by estrogen ac-tivity and antiestrogen activity.

Pituitary Abscess:MRI Analysis / 实用放射学杂志

Objective To discuss the MRI characteristics of pituitary abscess,so that to improve the diagnosis of it.Methods MR imaging data in 8 cases with pituitary abscess proved by operation and pathology,and antibiosis therapy were retrospectively analyzed in combination with review of literatures.Of 8 cases,3 were male and 5 were female,the mean age was 53.3 years(ranged 36~62 years).Results MRI findings included hypophysis enlargement,isointensity in 6 cases and slight hyperintensity in 2 cases on T1WI;isointensity in 4,hyperintensity in 2 and mixed iso-and hyperintensity in 2 on T2WI;hyperintensity in one on DWI.On contrast-enhanced scan,all pituitary masses showed ring enchancement,6 cases showed thickened walls which were slightly lamellar;7 cases demonstrated pituitary stalk thickening and enchancement.Conclusion Pituitary abscesses are of certain typical MRI characteristics.

Correlación topográfica y anatomopatológica en los tumores de la región selar / Topographic and anatomopathological correlation in the sellar region tumors

La alta prevalencia de los macroadenomas hipofisarios en el mundo motivó la realización de esta investigación, cuyo objetivo fundamental fue demostrar el valor de la tomografía computadorizada en el diagnóstico presuntivo de la variedad histológica de los macroadenomas hipofisarios así como de otros tumores menos frecuentes de la región selar, teniendo en cuenta el cuadro clínico. Para ello se estudiaron 124 pacientes operados con el diagnóstico clínico y tomográfico de macroadenomas hipofisarios y otros tumores de la región selar. Se registró la edad, sexo, clínica, signos tomográficos, resultados anatomopatológicos posquirúrgicos. Se observó mayor incidencia de los adenomas hipofisarios (110), con predominio de los no secretores (41,1 %). El grueso de los pacientes se ubicó en las edades entre 30 y 50 años. El sexo femenino prevaleció en los adenomas adrenocorticotrópicos y los meningiomas, y el masculino en los productores de gonadotropina y prolactina. Dentro de los signos tomográficos, la erosión de las clinoides y el dorso selar, así como la hidrocefalia predominaron en los adenomas no secretores y los tumores no adenohipofisarios. Los adenomas productores de gonadotropina se destacaron en la erosión del piso y en el balonamiento selar al igual que los adrenocorticotrópicos. Las calcificaciones fueron frecuentes en los teratomas y craneofaringiomas, al igual que la captación no homogénea del contraste, la cual fue característica en estos casos como en los quistes de la bolsa de Rathke. La TC demostró ser de gran valor diagnóstico en los macroadenomas hipofisarios y otros tumores de la región selar teniendo en cuenta el cuadro clínico del paciente.

The high prevalence of hypophyseal macroadenomas worlwide motivated us to carry out this research, whose fundamental aim was to demonstrate the value of CT in the presumptive diagnosis of the histological variety of hypophyseal macroadenomas, as well as of other less frequent tumours of the sellar region, considering the clinical picture. To this end, 124 patients operated on with a clinical and tomographic diagnosis of hypophyseal macroadenomas and other tumours were studied. Age, sex, hospital stay, tomographic signs, and postsurgical anatomopathological results were registered. The highest incidence was found in the hypophyseal adenomas (110), with predominance of the non-secreting adenomas (41.1 %). Most of the patients were 30-50. The female sex prevailed in the adrenocorticotropic adenomas and meningiomas, and the male sex in gonadotropin and prolactin-producing adenomas. Within the tomographic signs the erosion of the clinoid and sellar dorsum, and hydrocephalus, predominated in the non-secreting adenomas and in the non-adenohypohyseal tumours. The gonadotropin-producing adenomas stood out in the erosion of the floor and in sellar ballooning as well as the adrenocorticotropic adenomas. The calcifications were more common in teratomas and craniopharyngiomas, as well as and the non-homogenous capture of the contrast agent, which was characteristic in these cases, as in Rathke's pouch cysts. CT showed its great diagnostic value in hypophyseal macroadenomas, and other tumours of the sellar region, taking into account the patient's clinical picture.

Abscesso hipofisário simulando apoplexia / Pituitary abscess simulating apoplexy / Pituitary abscess simulating apoplexy

O abscesso hipofisário representa uma patologia rara, que, contudo, deve ser considerada na avaliação das massas selares, uma vez que o seu prognóstico depende da drenagem cirúrgica e do uso de antibióticos específicos. A principal manifestação clínica é cefaléia crônica e nem sempre está associada à identificação de um foco infeccioso, o que diminui a probabilidade da sua inclusão nas hipóteses diagnósticas. Apresenta-se o caso de um paciente com abscesso de hipófise e história pregressa de adenoma operado, cefaléia de início recente e hipopituitarismo adquirido, cujo diagnóstico inicial foi de apoplexia pituitária.

A pituitary abscess is a rare pathology, but it must be considered when evaluating sellar masses, since its prognosis depends on surgical drainage and on the use of specific antibiotics. The main clinical manifestation is chronic headache, and it is not always associated with the identification of a site of infection, which diminishes the probability of including it in diagnostic hypotheses. The case is presented of a patient with a pituitary abscess and a previous history of adenoma that had been operated on, recent onset headache and acquired hypopituitarism whose initial diagnosis was pituitary apoplexy.

The diagnose of the hypophysis storm elephant and treat the analysis / 中国基层医药

Objective To explore the evidence of the hypophysis,pituitary gland danger advertises for the elephant and the reasonable treatment measure.Methods The clinical characteristics,misdiagnosis reason of the dangerous evidence in 35 hypophysis were retrospeceively analyzed.Results Only 11 cases were finally diagnosed in one year after onset of illness(31.8%).The misdiagnosis rate amounted to 68.2%.With the alimentary canal symptom the leader hair was 91.4%,32 cases.Do not adjust for the menses the next in order,anemia etc.3 cases had the central myelin sheath in the bridge of tapetum fuses,4 cases had organ dysfunction,4 cases dieds.Conclusion To sufferer who infurs big issue of blood in postpartum history on the appearence of the alimentary canal symptom,low serum natrium,hypoglycemia or hypotensions the evidence of the hypophysis,pituitary gland danger possibility should be watched out,on time proceed the relevant check,treatment as early as possible,can reduce the misdiagnosis rate and death rate.

Imaging Diagnosis of Pituitary Stalk Interruption Syndrome / 实用放射学杂志

Objective To analyze the CT and MRI features of pituitary stalk interruption syndrome, so that to improve the diagnostic knowledge of this disease.Methods The imaging and clinical data of 4 patients with pituitary stalk interruption syndrome were retrospectively analyzed. Results In all of the 4 cases, the pituitary stalk were not shown by CT in 2 and by MRI in 4,the high signal intensity of the posterior lobe disappeared on T1WI,while a small nodule in infundibulum with high signal intensity on T1WI was found. Conclusion MRI is the most valuable imaging modality for the diagnosis of pituitary stalk interruption syndrome.

STUDY OF IMMUNOHISTOCHEMICAL LOCALIZATION OF BRAIN NATRIURETIC PEPTIDE-LIKE IMMUNOREACTIVE SUBSTANCE IN THE RAT BRAIN AND PERIPHERAL TISSUES / 解剖学报

Brain natriuretic peptide(BNP) is a recently discovered novel neuropeptide of 26 amino acid residues, isolated from porcine brain, that is of similar potency to atrial natriuretic factor(ANF) in natriuretic, diuretic, hypotensive and smooth muscle relaxant activities. we used a highly selective antisera against BNP raised in rabbit to observe its distribution and localization in some brain areas and some other peripheral tissues by utili zing high sensitive avidin-biotin-peroxidase complex technique. Positive brain natriuretic peptide immunoreactive (BNPir) fibers and cell bodies were observed in the lateral hypothalamic area, caudate-putamen, hippocampus, amygdala, and supraoptic and paraventricular nuclei. A lot of BNPir granules were also found in rat atria. They were of similar localization to that of ANF. Most of the specific granules were accumulated in cytoplasm at both nuclear poles of atrial myocytes. The BNP immunoreactivity is less intense than that of the ANF. Some of scanty, diffuse and fine BNPir granules could also be observed in ventricular myocytes.The coexistence of both BNP and ANF in the brain and heart indicates that BNP may function as a neuropeptide and circulating hormone, and suggests the possibility that the physiological effects such as diuretic natriuretic, hypotensive and smooth muscle relaxant activities so far thought to be mediated by ANF may be regulated through a dual mechanism involving both BNP and ANF. In addition, some BNPir positive cells were also present in the anterior and intermediate lobes of rat pituitary gland. The significance of BNP in hypophysis would be elucidated in the further studies.

The analgesic effects of electroacupuncture stimulation / 日本温泉気候物理医学会雑誌

For the purpose of estimating the analgesic mechanisums of the electroacupuncture stimulation and relating the adrenocortical function with its analgesic effect, the deviation value of the pain threshold by the stimulation and β-endorphin, Met-enkephalin lebels in the cerebrospinal fluid [CSF] and also cortisol lebel in the blood were observed in experimented dogs.<br>The both lebels of CSF and cortisol lebel in blood were significantly increased by the electroacupuncture analgesia. These result suggest that in this analgesia, the hypophysis-adrenal cortex system was activated simultaneously with the production of an endogeneous opiate. Using a new designed pain meter system [non-contact thermal stimulator] for the small animals, increasing of the pain threshold lebels was observed objectively.