Transcraniad surgery for pituitary adenomas Evolution of pituitary surgery 010

Transcraniad surgery for pituitary adenomas Evolution of pituitary surgery 010 water fasting weight loss The first actually recorded  surgical intervention for a pituitary tumor can be traced back to Frank Thomas Paul (1851–1941) in the year 1893. However, Sir Victor Horsley (1857–1916) was probably the first surgeon, who operated on a pituitary adenoma dating back to the year 1889. It is known, that he used a bifrontal craniotomy. In order to reach the sella region he described a technique of ‘‘cerebral dislocation’’. However, he encountered a cystic lesion, that he described as not inoperable [20]. Because of this experience and Horsley‘s former laboratory work on sheeps, Frank Thomas Paul eventually consulted Sir Horsley...

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Mortality / Morbidity 009

 Mortality / Morbidity 009 water fasting weight loss Mortality rate related to pituitary tumors is low. Advances in medical and surgical management of these lesions and the availability of hormonal replacement therapies have contributed to successful management.  Pituitary apoplexy can be a lethal complication.   Morbidity associated with macroadenomas may include permanent visual loss, ophthalmoplegia, and other neurological complications.  Tumor recurrence is also a possibility.  CNS metastases and, rarely, distant metastases occur with pituitary tumors.  Endocrine abnormalities are amenable to correction. However, damage in many organ systems as a result of long-standing uncorrected deficiencies...

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Hormonal overproduction Clinical effects 008

Hormonal overproduction Clinical effects 008 water fasting weight loss Prolactin Hypogonadism, if hyperprolactinemia is sustained. Women Amenorrhea, galactorrhea, and infertility . Men-Decreased libido, impotence, and rarely galactorrhea(46) Growth hormone ·      Children and adolescents - May result in pituitary gigantism ·      Adults - Acromegaly Changes in the size of the hand and feet, coarseness of the face, frontal bossing, and prognathism result. Further changes in the voice, and hirsutism, confirm the diagnosis.  Acromegaly frequently results in glucose intolerance, with 20% of patients progressing to diabetes mellitus.  Respiratory difficulty and sleep...

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Classification of pituitary tumors 007

Classification of pituitary tumors 007 water fasting weight loss Based on size, pituitary tumors can be divided into microadenomas (<1cm diameter) and macroadenomas (>1 cm diameter). They also can be classified on the basis of staining characteristics, as chromophobic and chromophilic tumors. The latter can be further subdivided using hematoxylin and eosin stains (ie, eosinophilic or basophilic). However, this classification has proven to be of no clinical value and now has been replaced by a more functional classification that involves electronmicroscopy and immunohistochemistry. These techniques have identified hormones in many chromophobe adenomas, enabling pathologists to identify that they are produced by eosinophilic tumors....

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Pathophysiology of the Pituitary gland 006

Pathophysiology of the Pituitary gland  water fasting weight loss Pituitary tumors are  common neoplasms, and recognition of their presentation is critical since a favorable therapeutic outcome is dependent on early identification of the lesion. Multiple oncogene abnormalities may be involved in pituitary tumorigenesis. Glycoprotein abnormalities, gene mutations, p53 gene deletions, mutations, and rearrangements, and association of pituitary tumors with the syndrome of multiple endocrine neoplasia have been described and are involved in the development of adenomas in the pituitary gland.  The pituitary  tumor transforming gene-1 (PTTG-1) is a newly discovered oncogene that serves as a marker of malignancy grades...

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SECOND HORMONES OF THE POSTERIOR PITUITARY GLAND 005

SECOND HORMONES OF THE POSTERIOR PITUITARY GLAND water fasting weight loss The posterior pituitary is an extension of the hypothalamus and contains the axon terminals of magnocellular neurons located in the Supraoptic and paraventricular nuclei. These neurons generate and propagate action potentials, producing membrane depolarization and exocytosis of the contents of their secretory granules. The neuropeptides oduced by the magnocellular neurons, and consequently released from posterior pituitary, are oxytocin and arginine vasopressin 1.      Oxytocin : The neuropeptide oxytocin is synthesized by magnocellular neurons in the supraoptic and paraventricular nuclei of the hypothalamus and is released from...

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Growth Hormone and Prolactin Family 004

Growth Hormone and Prolactin Family 004 water fasting weight loss GR, a hormone with structural similarity to prolactin, is released from thes omatotrophs, an abundant (50%) cell type in the anterior pituitary. GR is released in pulsatile bursts, with the majority of secretion occurring hocturnally in association with slow-wave sleep. (40) stimulated release of GH is inhibited by somatostatin, a peptide synthesized in most brain regions, predominantly in the periventricular nucleus, arcuate nucleus, and ventromedial nucleus of the hypothalamus. Somostatin is also produced in peripheral organs, including the endocrine pancreas, where it also plays a role in the inhibition of hormone release. Axons from somatostatin neurons run...

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