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  • 1
    Electronic Resource
    Electronic Resource
    Corticotropin releasing hormone in plasma of patients with Cushing's disease (1987)
    Springer
    Journal of molecular medicine 65 (1987), S. 529-529 
    Details
    ISSN: 1432-1440
    Keywords: Corticotropin releasing hormone (CRH) ; Cushing's disease ; remission ; transspenoidal surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01721042
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  • 2
    Electronic Resource
    Electronic Resource
    Inconsistent stimulation of plasma ACTH through corticotropin-releasing factor in a patient with central Cushing's disease due to pituitary adenoma (1985)
    Springer
    Journal of molecular medicine 63 (1985), S. 475-477 
    Details
    ISSN: 1432-1440
    Keywords: Corticotropin-releasing factor (CRF) ; Cushing's disease ; ACTH
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Three uncommon findings were observed in a case of Cushing's disease due to macroadenoma: no suppression of plasma ACTH during an 8-mg dexamethasone test, a negative corticotropin-releasing factor test, and a normal X-ray of the sella turcica. Despite these findings, the diagnosis of pituitary was confirmed Cushing's syndrome by computerized tomography and a transphenoidal operation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01731496
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  • 3
    Electronic Resource
    Electronic Resource
    Combined sellar gangliocytoma and pituitary adenoma in acromegaly or Cushing's disease (1994)
    Springer
    Virchows Archiv 425 (1994), S. 93-99 
    Details
    ISSN: 1432-2307
    Keywords: Pituitary adenoma ; Sellar gangliocytoma ; Immunohistology ; Ultrastructure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Three cases of a composite sellar tumour composed of a gangliocytoma and an adenoma are presented. Two patients who showed acromegaly and hyperprolactinaemia had a gangliocytoma and a growth hormone (GH)-prolactin cell adenoma in close proximity. The gangliocytoma contained growth hormone-releasing hormone (GHRH) by immunohistochemistry. At the electron microscopical level, the gangliocytoma was characterized by numerous synaptic vesicles. The third patient, a child with Cushing's disease, presented a corticotropin-releasing hormone (CRH)-positive gangliocytoma in close contact with an adrenocorticotropic hormone (ACTH) secreting adenoma, the latter a typical densely granulated ACTH cell adenoma. Ultrastructurally, the gangliocytoma revealed synaptic vesicles and sparse secretory granules. The results suggest that gangliocytomas may promote the development of pituitary adenomas by hypersecretion of releasing hormones. Whereas 20 cases of sellar GHRH producing gangliocytomas in acromegaly are reported in the literature, the combination of a CRH-positive gangliocytoma and an ACTH cell adenoma in Cushing's disease is apparently the first case.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00193956
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  • 4
    Electronic Resource
    Electronic Resource
    The anterior pituitary lobe in patients with cystic craniopharyngiomas: Three cases of associated lymphocytic hypophysitis (1994)
    Springer
    Acta neurochirurgica 126 (1994), S. 38-43 
    Details
    ISSN: 0942-0940
    Keywords: Hypophysitis ; craniopharyngioma ; hypopituitarism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Specimens of the anterior pituitary lobe were investigated histologically in 28 craniopharyngioma patients operated on transsphenoidally. The pituitary glands in 3 patients revealed lymphocytic invasion giving a histological appearance typical of lymphocytic hypophysitis (incidence: 11%). At follow-up examination all three patients with associated lymphocytic hypophysitis had complete pituitary insufficiency, whereas only 36% of the craniopharyngioma patients without associated lymphocytic hypophysitis were in this poor postoperative endocrine state. The phenomenon of associated lymphocytic hypophysitis in craniopharyngioma patients has not been reported so far. This might be due to the fact that investigators have failed to systematically examine the anterior pituitary lobe in craniopharyngioma patients. The 60 cases of lymphocytic hypophysitis reported in the literature occurred, for the most part, in women during late pregnancy or shortly after delivery. An auto-immune origin is assumed in this type of inflammation. In contrast to this pathophysiological mechanism, we assume a local induction of inflammation resulting from the craniopharyngioma cyst in our 3 patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01476492
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  • 5
    Electronic Resource
    Electronic Resource
    Carpal tunnel syndrome and acromegaly (1986)
    Springer
    Acta neurochirurgica 83 (1986), S. 54-55 
    Details
    ISSN: 0942-0940
    Keywords: Carpal tunnel syndrome ; Acromegaly ; electroneurographic findings
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 50 patients with acromegaly and carpal tunnel syndrome have been examined electrophysiologically before and after transnasal operation of the pituitary adenoma. 32 of the 50 patients (64%) had symptoms of carpal tunnel syndrome. 13 of them had neurological deficits. 28 of the examined patients had pathological neurographical findings only. About 1 week post-operatively DL was decreased in 43%; in 10 out of 13 patients with neurological deficits DL decreased. GH was normalized in 80% and reduced to 5–10Μg/1 in a further 10%. The investigation did not show whether the carpal tunnel syndrome only depended on a GH increase or on other factors also such ase.g., on the duration of symptoms or tissue changes. None of the patients had the transversal carpal ligament operated on. The coincidence between acromegaly and carpal tunnel syndrome was 64%. In 3 cases the carpal tunnel syndrome was the leading sign to the diagnosis of acromegaly.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01420508
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  • 6
    Electronic Resource
    Electronic Resource
    Tumour ploidy in DNA histograms of pituitary adenomas (1985)
    Springer
    Acta neurochirurgica 76 (1985), S. 18-22 
    Details
    ISSN: 0942-0940
    Keywords: Flow cytometry ; DNA-histogram ; pituitary adenoma ; tumour ploidy ; mitosis ; recurrences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary DNA analysis was performed by flow cytometry (FCM) in 59 cases of different types of pituitary adenomas who underwent microsurgery and were actively followed over a period of 3–6 years. Aneuploid DNA patterns were detected in 12 (20%) cases. Frequency of aneuploidy was highest in prolactin-secreting (36%) as compared to 17% in GH- and 7% in non-secreting adenomas. Some adenoma parameters valid for tumour growth, such as rate of recurrences and mitotic index, were correlated with aneuploidy of the tumour. FCM studies are, therefore, recommended to gain further parameters for the estimation of proliferative activity of pituitary adenomas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01403824
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  • 7
    Electronic Resource
    Electronic Resource
    The choice of treatment after incomplete adenomectomy in acromegaly: Proton- versus highvoltage radiation (1989)
    Springer
    Acta neurochirurgica 96 (1989), S. 32-38 
    Details
    ISSN: 0942-0940
    Keywords: Acromegaly ; growth hormone ; radiotherapy ; proton irradiation ; transsphenoidal microsurgery ; pituitary function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors report the results of a study designed to compare the effectiveness of two different types of radiation in patients with acromegaly where surgical therapy had failed to normalize growth hormone (GH). Longterm follow-up after conventional high voltage radiation in 17 patients and proton therapy in 13 patients confirmed a similar reduction of GH levels in both groups. After 4.5 years a decrease of about 80% was achieved. After “conventional radiation” GH was normal in 8 (47%) and near normal in 6 (35%) while proton therapy resulted in normalization in 5 and improvement in 5 (38%). The slightly better results of “conventional radiation” must be attributed to lower pretreatment levels of GH. Side effects as additional pituitary deficits and oculomotor palsies were more often seen after proton treatment. Since the results of both radiation methods are similar and proton therapy has a tendency to more serious side effects we recommend “conventional radiation” as secondary treatment of acromegaly.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01403492
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  • 8
    Electronic Resource
    Electronic Resource
    Transsphenoidal Cephaloceles in Adults. A Report of Two Cases and Review of the Literature (2000)
    Springer
    Acta neurochirurgica 142 (2000), S. 397-400 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Transsphenoidal cephalocele; surgical approach; adult.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ Transsphenoidal cephalocele rarely occurs in adults. We describe two adult cases with transsphenoidal cephaloceles. The first case was a 53-year-old female who presented with spontaneous cerebrospinal fluid (CSF) rhinorrhea. Magnetic resonance (MR) imaging demonstrated a transsphenoidal meningocele. Surgical repair was attempted via the transsphenoidal route. Rhinorrhea recurred at one month and also two years later. Transsphenoidal surgical repairs were repeated. There has been no evidence of CSF leakage in the four years of follow-up after the last surgery. Transsphenoidal repair seems to be the most suitable approach in this case. The second case was a 26-year-old female with secondary amenorrhea, diabetes insipidus, bitemporal hemianopsia, and see-saw nystagmus. MR imaging demonstrated a transsphenoidal encephalocele with the optic chiasma and infundibular recesses descending into the meningocele and an agenesis of the corpus callosum. The first operation was performed via the transnasal route and the second by sublabial transmaxillary transsphenoidal approach six months later. Postoperative MR imaging revealed reduction of the encephalocele. There was neither worsening nor noticeable improvement in the neurological or endocrinological function. However, in this type, complete repair is often impossible, and non-radical surgery such as transsphenoidal repair may be indicated as most suitable. They should be selected with careful assessment referring to MR findings and clinical symptoms and signs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050448
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  • 9
    Electronic Resource
    Electronic Resource
    The Value of Intraoperative Cytology During Transsphenoidal Surgery for ACTH-Secreting Microadenoma (2000)
    Springer
    Acta neurochirurgica 142 (2000), S. 865-870 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Cytology; pituitary adenoma; minute adenoma; Cushing's disease.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Background. Microsurgical selective adenomectomy is the best established method available for the treatment of Cushing's disease. However, this surgical method warrants still more efforts to improve the results in minute microadenomas. In this paper the authors evaluate a method of intraoperative cytological investigations during transsphenoidal surgery.  Method. Between January 1997 and September 1999, transsphenoidal surgery was performed in 75 patients with the diagnosis of Cushing's disease. Fifty-one cases of proven microadenomas were reviewed.  Findings. Of 51 cases, 33 tumors were 3 mm or less in diameter, here after called minute adenomas. In 49 of 51 (96.1%) microadenomas, adenoma tissue was identified by intraoperative cytological techniques. Postoperatively, only 35 of 51 ACTH-secreting microadenomas (68.6%) were confirmed by immunostaining methods. This lower percentage was most probably due to the small amount of tissue obtained. Therefore, in 14 cases (including 12 minute adenomas) the presence of the adenoma was only proven by cytological preparation and clinical outcome. The sensitivity of cytological preparations in cases of confirmed Cushing's disease was 100%.  Interpretation. The method described here was particularly well suited for the intraoperative discrimination and documentation of minute adenomas. Cytological preparation appears to be effective in improving the adenoma finding rate and the surgical outcome in cases of Cushing's disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010070071
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  • 10
    Electronic Resource
    Electronic Resource
    Aspects of personality in patients with pituitary adenomas (1986)
    Springer
    Acta neurochirurgica 83 (1986), S. 8-11 
    Details
    ISSN: 0942-0940
    Keywords: Pituitary tumours and personality ; pituitary tumours and anxiety ; acromegaly and Cushing's disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 24 patients suffering from pituitary tumours, aspects of personality as covered by the FPI (Freiburger Personality Inventory), the Gie\en test and the STAI (State-Trait-Anxiety Inventory) were investigated in order to find out changes or problems which demand special treatment. The most interesting result concerns state and trait-anxiety scores being increased pre-surgically and normalizing to some extent after treatment. Most of the other explored aspects did not show but tendencies which demand further investigation. Relationships between hormone levels and tumour size could not be shown. As a result of this investigation, special psychological treatment should be considered in acromegaly and Cushing's disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01420501
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