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  • 1
    ISSN: 0942-0940
    Keywords: Adrenocorticotropic hormone ; hypersecretion ; plurihormonal primordial stem cell ; Somatotroph adenoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Somatotroph adenomas often secrete prolactin (PRL) besides growth hormone (GH) and are sometimes immunostained for other anterior pituitary hormones or their subunits, such as thyroid-stimulating hormone (TSH) β-subunit and glycoprotein hormone α-subunit (αSU). However, Somatotroph adenomas showing hypersecretion of adrenocorticotropic hormone (ACTH) are extremely rare. There have been, to our knowledge, only five published reports on Somatotroph adenomas accompanied by excessive ACTH secretion. Here we report a case of intracavernously invading Somatotroph macro-adenoma with high serum GH, PRL, and ACTH levels. We examined the case using immunohistochemistry (IHC), in situ hybridization (ISH), and cell culture, and confirmed GH, PRL, and ACTH, as well as αSU, production, and the expression of Pit-1 protein by the adenoma, which is known as a transcriptional factor for GH, PRL, and TSH, not for ACTH. Therefore, the presence of unknown transcriptional factor other than Pit-1, common to GH, PRL, and ACTH, may be speculated to be expressed in this adenoma. In our previous study, we had found plurihormonal mRNA expression, especially for ACTH, the β-subunit of follicle-stimulating hormone and luteinizing hormone in some Somatotroph adenomas, using non-radio-isotopic ISH, and suggested that these adenomas might be derived from plurihormonal primordial stem cells. Our present case is significant from the viewpoint of histogenesis of pituitary adenomas, because it further supports the cell origin of Somatotroph adenomas from plurihormonal primordial stem cells, and moreover it suggests the presence of unknown transcriptional factor other than Pit-1, common to GH, PRL, and ACTH.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 140 (1998), S. 20-25 
    ISSN: 0942-0940
    Keywords: Keywords: Cavernous malformation; multilobule; rapid growth; Valsalva manoeuvre; operation; magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors report two cases of cavernous malformation characterized by a multilobular appearance on magnetic resonance images. At surgery, the malformations consisted of several nests of angiomatous components that were separated by intervening brain tissue and connected with each other by tiny vessels. This basic configuration seems to explain the unexpected postoperative recurrence of cavernous malformations and/or rebleeding from the residual lesions.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 0942-0940
    Keywords: Keywords: Jugular foramen; meningioma; carotid ligation; cerebral revascularisation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Two cases with huge dumbbell type jugular foramen meningioma with extension into the parapharyngeal space are reported. A well co-ordinated surgical strategy for total resection to this high risk tumour with neurosurgeons, otolaryngologists and plastic surgeons is mandatory to minimise operative complications. Both of our patients presented with a cervical mass and lower cranial nerve palsies, and had huge dumbbell type masses extending from the posterior cranial fossa through the jugular foramen to the parapharyngeal space, encasing the cervical internal carotid artery. Gross total resection of the tumours was successfully achieved by basically a 2-stage operation. In the first stage, posterior fossa tumours were removed by the transjugular approach, combined with the petrosal approach in one case. In the second stage, cervical tumours were removed along with the cervical carotid artery by the transcervical and/or transmandibular approach, followed by vascular reconstruction from the ipsilateral carotid artery to the middle cerebral artery using saphenous vein graft. From these experiences, we recommend this 2-stage operation for large dumbbell type meningiomas extending to the infratemporal/parapharyngeal space. The intracranial tumour is removed at the first operation. The extracranial portion is resected at the second, and if necessary, the involved cervical carotid artery is resected and simultaneous revascularisation using saphenous vein graft is performed with a vascularised free muscle graft. This strategy could maximise the functional preservation on the one hand, and minimise the surgical risk, such as postoperative infection, on the other.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 0942-0940
    Keywords: Cerebellopontine angle ; choroid plexus papilloma ; lateral-suboccipital approach ; magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Two cases of primary choroid plexus papilloma originating in the cerebellopontine angle (CPA) are reported. Both papillomas were encapsulated and strongly adhering to a choroid plexus tuft protruding from the foramen of Luschka. Successful removal of the tumour was achieved in each case. Surgical strategy, neuroradiological manifestations, and the differential diagnosis are discussed.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 138 (1996), S. 1307-1310 
    ISSN: 0942-0940
    Keywords: Recurrent trigeminal neuralgia ; prosthesis ; vascular transposition
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We report two cases of recurrent trigeminal neuralgia caused by an inserted prosthesis. Teflon material or polyurethane sponge inserted between the trigeminal nerve and the superior cerebellar artery became hardened and compressed the trigeminal nerve 17 months (Teflon) and 9 years (polyurethane sponge) respectively after the initial surgery. On the basis of these cases, it is suggested that actual decompression of the trigeminal nerve is important in surgery for trigeminal neuralgia, and that the prosthesis should not touch the trigeminal nerve.
    Type of Medium: Electronic Resource
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