RESUMEN
OBJECTIVE: The aim of the study was to examine the relationship between Kinesiophobia and dynamic balance in patients with patellofemoral pain syndrome (PFPS). PATIENTS AND METHODS: Forty subjects with PFPS [20 Low Kinesiophobia (LK), 20 High Kinesiophobia (HK)], and 20 pain-free subjects (control group) were enrolled in the study. All subjects performed a Y-balance test to measure the dynamic balance. Normalized reach distance and balance parameters were recorded. RESULTS: Our findings indicated that patients with PFPS who have a greater Kinesiophobia showed a poorer dynamic balance. In addition, the HK group showed a significantly lower mean reach distance score in the anterior, posterolateral, and posteromedial directions compared to LK and healthy groups. CONCLUSIONS: Addressing the psychological factors such as Kinesiophobia during examination and treatment of people with PFPS may be important to improve the dynamic balance.
Asunto(s)
Kinesiofobia , Síndrome de Dolor Patelofemoral , Humanos , Síndrome de Dolor Patelofemoral/diagnóstico , Síndrome de Dolor Patelofemoral/psicología , Síndrome de Dolor Patelofemoral/terapiaRESUMEN
OBJECTIVE AND IMPORTANCE: Pituitary adenomas producing primarily FSH and to a lesser extent GH, LH, alpha-subunit, TSH and PRL without clinical or laboratory evidence of increased hormone release have not previously been reported. Our aim was to obtain some insight into the possible cytogenesis of this unusual tumor. CLINICAL PRESENTATION: A 65-year-old woman presented with headaches. Magnetic resonance imaging (MRI) demonstrated a sellar mass. Pituitary hormone assays showed normal blood levels. The tumor was removed by the transsphenoidal approach. RESULT: By light microscopy, the adenoma was chromophobic, weakly PAS-positive, and immunoreactive mainly for FSH (85%) and to a lesser extent for GH (30%), LH (15%), alpha-subunit (3%), TSH (2%), and PRL (1%). Although double immunostaining showed hormone reactivities to be localized largely in separate distinct cells, the tumor was ultrastructurally monomorphous, i.e., consisted of a single-cell type, resembling gonadotrophs. CONCLUSION: The cytogenesis of plurihormonal pituitary adenomas is not fully understood. Further investigations are required to clarify the basis for their plurihormonality despite an ultrastructural gonadotroph phenotype.
Asunto(s)
Adenoma/metabolismo , Adenoma/patología , Gonadotrofos/metabolismo , Gonadotrofos/patología , Neoplasias Hipofisarias/metabolismo , Neoplasias Hipofisarias/patología , Adenoma/fisiopatología , Anciano , Femenino , Hormona Folículo Estimulante/biosíntesis , Hormona del Crecimiento/biosíntesis , Humanos , Inmunohistoquímica , Imagen por Resonancia Magnética , Neoplasias Hipofisarias/fisiopatología , Prolactina/biosíntesis , Tirotropina/biosíntesisRESUMEN
The diagnosis of double adenomas of the pituitary can be very complex and is usually suspected on histological assessment of a specimen and confirmed by immunohistochemical and ultrastructural studies. The most commonly applied technique is currently immunohistochemical staining to localize the six pituitary hormones. Application of this technique may fail to identify double adenomas when hormone immunoreactivity is weak or absent in one or both cell populations. We examined specimens from eight patients diagnosed with double adenomas over a 15-yr period. We tested the ability to detect the difference in the two adenomas in each case using three immunostains for the pituitary transcription factors Pit-1, T-pit, and SF-1. We conclude that immunohistochemical localization of the transcription factors Pit-1, T-pit, and SF-1 accurately detects and classifies the distinct cytodifferentiation of double adenomas of the pituitary.
Asunto(s)
Adenoma/metabolismo , Proteínas de Homeodominio/biosíntesis , Neoplasias Primarias Secundarias/metabolismo , Neoplasias Hipofisarias/metabolismo , Receptores Citoplasmáticos y Nucleares/biosíntesis , Factor de Transcripción Pit-1/biosíntesis , Factores de Transcripción/biosíntesis , Adenoma/patología , Adulto , Anciano , Anciano de 80 o más Años , Diferenciación Celular , Transformación Celular Neoplásica , Femenino , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Neoplasias Primarias Secundarias/diagnóstico , Neoplasias Hipofisarias/patología , Estudios Retrospectivos , Factor Esteroidogénico 1 , Proteínas de Dominio T BoxRESUMEN
We report a case of granulomatous hypophysitis with an unusual pathologic finding of psammoma bodies. This finding has not previously been described in the literature. The diagnostic implications of this finding are complex, and the pathogenesis of psammoma body formation in this idiopathic disorder remains unknown.