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Journal Article 2011; 32(1): 64-76 PubMed PMID: 21407163 Citation  Keywords:  Adrenalectomy, Animals, Avoidance Learning:drug effects, Corticosterone:blood, Corticotropin-Releasing Hormone:blood, Hypothalamo-Hypophyseal System:physiology, Male, Maze Learning:drug effects, Memory, Short-Term:drug effects, Pituitary-Adrenal System:ph.   

OBJECTIVES: Stress activates the hypothalamic-pituitary-adrenal (HPA) axis. This activation is executed mainly through the release of corticosteroids from adrenal that subsequently exert negative feedback on corticosterone-releasing hormone (CRH) production. The effects of corticosterone on learning and memory has been studied intensively. Less is known about the effect of CRH on cognitive phenomena.

DESIGN AND SETTING: The present study aimed at studying the separate effects of stress cascade hormones, namely CRH and corticosterone, on learning and memory in a battery of learning tasks.

RESULTS: Long-term administration of CRH led to a transient impairment of spatial performance in the active allothetic place avoidance (AAPA) task requiring cognitive coordination, whilst co-application of CRH and corticosterone resulted in permanent impairment in this task. Corticosterone alone impaired the long-term retention of passive avoidance. CRH alone exerted no effect on the working memory version of the Morris water maze (MWM) and inhibitory avoidance.

CONCLUSIONS: Our results suggest differential effects of stress cascade hormones on various types of behavior....

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Journal Article 2011; 32(1): 96-101 PubMed PMID: 21407161 Citation  Keywords:  Adenoma:metabolism, Adult, Aged, Biopsy, Female, Gonadotropins, Pituitary:metabolism, Humans, Male, Middle Aged, Neoplasm Recurrence, Local:metabolism, Pituitary Neoplasms:metabolism, Receptors, Somatostatin:metabolism,.   

OBJECTIVE: Surgical treatment of pituitary macroadenomas often fails because of tumor recurrence after the operation. The causes of tumor recurrence are complex, but one of them may be the high growth potential of the adenoma. As somatostatin receptors mediate antiproliferative, anti-angiogenic and pro-apoptotic actions, it seemed reasonable to investigate their expression in dependence on the adenoma recurrence.

METHODS: Samples of primary and recurrent gonadotropinomas excised surgically from patients were examined. This type of pituitary adenomas was chosen because of its relatively high recurrence rate. The adenoma phenotype and expression of somatostatin receptor subtypes 1-5 (SSTR 1-5) were investigated by immunohistochemistry, and the level of SSTR expression was semiquantitatively scored.

RESULTS: It was found that the adenomas undergoing the early recurrence have lower expression of SSTR 2A and 3 in comparison to those which did not recur during 5 years lasting observation. On the other hand, the recurrent tumors show higher expression of SSTR 1, 2A, 3 and 5 subtypes than their primary counterparts.

CONCLUSIONS: It is hypothesized that SSTR may, at least in part, counteract adenoma recurrence. On the other hand, it can be also presumed that the recurrent gonadotropinomas may be more sensitive to somatostatin analog treatment than primary ones. These hypotheses need to be confirmed in further studies....

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Comparative Study 2011; 32(1): 82-89 PubMed PMID: 21407156 Citation  Keywords:  Animals, Corticosterone:blood, Eating:physiology, Fasting:physiology, Injections, Intravenous, Injections, Intraventricular, Leptin:blood, Male, Nerve Tissue Proteins:genetics, Pituitary Gland:drug effects, Pituitary Hormones, Anterior:blood, Rats, Rats, .   

OBJECTIVE: CART is involved in the control of food intake and hormonal secretion. We aimed to evaluate the effects of CART on hormonal profile in starved rats.

METHODS: Study group included 100 male rats. Under conditions of food limitation CART (55-102) was given centrally (icv) or peripherally (iv). Non-starved animals underwent identical procedure. Vehicle (aCSF or saline)-injected rats served and as a controls. 60 minutes after CART or vehicle administration blood was collected to assess pituitary hormones (LH, FSH, PRL, GH, ACTH, TSH), corticosterone and leptin concentrations.

RESULTS: Itracerebroventricular CART injection resulted in a significant increase in PRL, GH and corticosterone concentrations in non-starved rats compared with vehicle injected animals. However, in a group of starved animals only leptin levels were decreased in comparison with fasted controls. Peripheral CART administration caused a significant increase in PRL, GH and TSH levels in non-starved rats but no changes in investigated hormone levels were observed in starved animals when compared to saline injected controls.

CONCLUSIONS: Our results indicate that CART is able to modulate hormonal profile in a non-starved rats. However, the modulatory effect depends on the CART administration method. Interestingly, CART administration, both icv and iv, does not have an impact on pituitary hormones and corticosterone levels in a course of food limitation....

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Journal Article 2010; 31(6): 823-828 PubMed PMID: 21196926 Citation  Keywords:  Acromegaly:etiology, Adenoma:complications, Adult, Aged, Biomarkers, Tumor:metabolism, Early Diagnosis, Female, Growth Hormone-Secreting Pituitary Adenoma:complications, Humans, Immunohistochemistry, Ki-67 Antigen:metabolism, Male, Middle Aged, Neoplasm I.   

OBJECTIVE: In many pituitary tumor, immunohistochemical studies have been shown to be correlated with different aspects of tumor behavior.There is no study up to date in which markers of Ki-67, p53, VEGF were evaluated concomitantly in GH-secreting adenomas.This study aims to determine which marker has a major role in tumor behavior and whether these markers have a cut-off value to distinguish invasive adenoma from non-invasive pituitary adenoma.

METHODS: Fourty-seven acromegalic patients operated by the same neurosurgeon were included in this study.Twenty-one patients(5micro/16 macro) had non-invasive adenomas and 26 had invasive macroadenomas.Eight patients(6 invasive macroadenomas, 2 microadenomas) were treated with OCT-LAR until one month prior to surgery with treatment duration range of 3-11 months.These patients were excluded from the study group as the noninvasive and invasive adenomas were compared.A separate analysis was performed in invasive adenomas to compare OCT(+) and OCT(-)patients.

RESULTS: Both Ki-67 and p53 expressions showed no correlation with the invasive character of adenomas, but VEGF expression in invasive adenomas was significantly higher with respect to noninvasive group.Our study has taken intermediate staining (>25 %)for VEGF as a cut off value for invasive adenomas.It was also observed that the decrease in VEGF staining in OCT pretreated invasive adenomas was significantly more than those not treated with OCT.

CONCLUSION: VEGF becomes an independent stimulator of angiogenic growth and progression for GH-secreting adenomas with >25% cytoplasmic immunoreactivity.This cut-off value may be useful in determination of prognosis and appropriate treatment strategy.A short term preoperative OCT treatment may be useful as adjunctive therapy especially for locally invasive GH- secreting adenomas....

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Case Reports 2010; 31(5): 597-601 PubMed PMID: 21173743 Citation  Keywords:  Adult, Anti-Bacterial Agents:therapeutic use, Biopsy, Brain Abscess:drug therapy, Diagnosis, Differential, Female, Headache:etiology, Humans, Magnetic Resonance Imaging, Neurosurgical Procedures, Pituitary Diseases:complications, Sphenoid Bone:surgery, Tr.   

OBJECTIVES: Pituitary abscess is rare disease and the correct diagnosis is difficult because there are non-specific symptoms and it is often radiologically indistinguishable from other pituitary lesions.

CASE PRESENTATION: We present one case of pituitary abscess that constitute 0.15% of all pituitary adenomas operated in our department in the 20 years. A 49-year-old woman presented with a history of 10 months bifrontal headache. The MRI showed cystic intra and suprasellar mass with ring enhancement after contrast injection. During transsphenoidal surgery, copious yellowish pus was found. Antibiotic therapy was performed. Histological study of the cyst wall confirmed the diagnosis of pituitary abscess.

CONCLUSION: Pituitary abscess should be considered in the differential diagnosis of all other cyst mass in patients with diabetes insipidus....

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Comparative Study 2010; 31(5): 700-707 PubMed PMID: 21173742 Citation  Keywords:  Adult, Body Mass Index, Dwarfism, Pituitary:diagnosis, Exercise, Female, Health Status, Human Growth Hormone:deficiency, Humans, Male, Obesity:diagnosis, Quality of Life, Surveys and Questionnaires,.   

OBJECTIVES: A great similarity exists between growth hormone (GH) deficiency and obesity in terms of disturbances of organ morphology and function. The aim of the study was to compare health-related quality of life (HR-QoL) as well as exercise capacity and its subjective assessment in adult patients with GH deficiency and in adult patients with obesity.

METHODS: Ten (10) GH-deficient, thirty (30) obese, and thirty (30) healthy subjects participated in the study. HR-QoL comprised two parameters: QoL measured by using the Quality of Life Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA) questionnaire, and subjective evaluation of general health state by using the Visual Analogue Scale. The exercise capacity was determined in Six Minute Walking Test and it was subjectively assessed by Borg Scale for Rating Perceived Exertion and the modified Medical Research Council scale.

RESULTS: Decreased HR-QoL (both parameters) was observed in both GH-deficient and obese patients, with that effect being much more pronounced in the former group. Both, GH-deficient and obese patients, revealed decreased exercise capacity, which was also subjectively assessed as decreased, especially by GH-deficient patients. Positive relationships between HR-QoL and exercise capacity or its subjective assessment, observed in healthy subjects, partially lost their significance in obese, whereas they completely disappeared in GH-deficient subjects.

CONCLUSION: A decrease in HR-QoL is more pronounced in GH-deficient than in obese patients, whereas exercise capacity is unfavourably affected by both disorder to a similar extent, with the lack of clear relationship between these two parameters especially in GH-deficient patients....

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Journal Article 2010; 31(5): 602-608 PubMed PMID: 21173739 Citation  Keywords:  Animals, Brain:metabolism, Depression:metabolism, Humans, Hypothalamo-Hypophyseal System:metabolism, Neural Pathways:pathology, Neurogenic Inflammation:complications, Neuronal Plasticity, Peripheral Nerves:metabolism, Pituitary-Adrenal System:metabolism, .   

: The etiopathogenesis of depression is a highly complex process characterized by several neurobiological alterations including decreased monoamine neurotransmission in the brain, dysregulated hypothalamic-pituitary-adrenal axis activity, decreased neuronal plasticity, and chronic inflammation in the brain and peripheral tissues. Experimental and clinical studies indicate that the vagus nerve may influence these processes. The importance of the vagus nerve in the etiopathogenesis of depression is further supported by its involvement in the induction of sickness behavior, as well as by clinical studies confirming a beneficial effect of vagus nerve stimulation in depressed patients. The aim of this article is to describe current knowledge of afferent and efferent vagal pathways role in the development and progression of depression....

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Journal Article 2010; 31(4): 553-558 PubMed PMID: 20802455 Citation  Keywords:  Adolescent, Chi-Square Distribution, Child, Child, Preschool, Dwarfism, Pituitary:immunology, Female, Human Growth Hormone:immunology, Humans, Immunoglobulin A:immunology, Immunoglobulin M:immunology, Leukocytes:immunology, Male, Recombinant Proteins:immu.   

OBJECTIVE: This study aims at assessing how recombinant human growth hormone treatment of children and young people suffering from isolated growth hormone deficiency affects some selected parameters of the immune system: a percentage of lymphocytes, granulocytes, monocytes, concentrations of A, G, and M immunoglobulins, a percentage of T lymphocytes divided into subpopulations CD4 and CD8, a percentage of NK and B lymphocytes, and phagocytic activity of granulocytes and monocytes.

MATERIALS AND METHODS: The study comprised 30 children and young people aged 4.2-18 years with isolated growth hormone deficiency both prior to and 6 months after rhGH (recombinant human growth hormone) treatment with a dose of 0.093 IU/kg every 24 hr. The control group comprised 25 healthy children with normal height in the respective age bracket. Labelling was conducted by flow cytometry FACS manufactured by Becton-Dickinson using both labelled antibodies and PHAGOTEST® commercial kit (Orpegen). Concentrations of A, G and M immunoglobulins in blood serum were assessed by means of immunoturbidimetric method using COBAS (manufactured by Roche).

RESULTS: The lowest percentage of active granulocytes in PHAGOTEST® was found in a group examined prior to treatment compared to the control group. The percentage increased after 6 months of rhGH treatment to values comparable with the control group. Although mean concentrations of IgM and IgA after 6 months of treatment with rhGH significantly decreased in comparison with those determined prior to treatment, they still remained within the baseline norm. No significant differences in the phagocytic activity of monocytes, IgG concentration, % of NK lymphocytes, T lymphocytes divided into CD4 and CD8 lymphocytes, B lymphocytes and CD4/CD8 lymphocytic index were found. None of the patients exhibited any clinical symptoms of immune disorders.

CONCLUSION: rhGH treatment of patients with isolated growth hormone deficiency can have positive influence on the phagocytic activity of scavenger cells, mainly granulocytes, which in children with isolated growth hormone deficiency seems to be lower than in their health peers. Growth hormone treatment of children with isolated growth hormone deficiency does not significantly affect the activity of the immune system expressed by the phagocytic activity of monocytes, the percentage of B, T and NK lymphocytes and IgG concentration in blood serum....

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