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This paper describes mobile robot tactics for recovering a wheeled vehicle that has overturned. If such a vehicle were to tip over backward off its wheels and be unable to recover itself, especially in areas where it is difficult for humans to enter and work, overall work efficiency could decline significantly, not only because the vehicle is not able to perform its job, but because it becomes an obstacle to other work. Herein, the authors propose a robot-based recovery method that can be used to recover such overturned vehicles, and the authors evaluate its effectiveness. The recovery robot, which uses a mounted manipulator and hand to recover the overturned vehicle, is also equipped with a camera and a personal computer (PC). The ARToolKit software package installed on the PC detects AR markers attached to the overturned vehicle and uses the information they provide to orient itself in order to perform recovery operations. A statics analysis indicates the feasibility of the proposed method. To facilitate these operations, it is also necessary to know the distance between the robotic hand and the target position for grasping of vehicle. Therefore, a theoretical analysis is conducted, and a control system based on the results is implemented. The experimental results obtained in this study demonstrate the effectiveness of the proposed system.
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Robótica , HumanosRESUMO
Bovine leukemia virus (BLV) is the causative agent of enzootic bovine leucosis, which results in significant economic losses on many affected farms. BLV infects a wide range of animals as well as cell lines derived from various mammalian species and organs; however, studies show that only some cell lines support sustained production of viral progeny. The differences between cells that produce viral progeny and those that do not are unclear. The aim of this study was to identify the steps of BLV replication that are associated with the capacity of a cell to support a productive infection. Eleven cell lines derived from various species were categorized into two groups, those that produce BLV progeny and those that do not, and the efficiency of viral attachment was compared. In addition, viral entry and reverse transcription were compared for two BLV-producing cell lines and three non-producing cell lines. BLV attached to and entered all of the tested cells. However, synthesis of viral DNA was inhibited in all three non-virus-producing cell lines, suggesting that BLV production was blocked either prior to or at the stage of reverse transcription. These results increase our understanding of the BLV life cycle and should enable better control over the spread of BLV.
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DNA Complementar/genética , Resistência à Doença/genética , Células Epiteliais/virologia , Vírus da Leucemia Bovina/genética , RNA Viral/genética , Replicação Viral/fisiologia , Animais , Gatos , Bovinos , Linhagem Celular , Quirópteros , Chlorocebus aethiops , DNA Complementar/biossíntese , DNA Complementar/imunologia , Cães , Células Epiteliais/classificação , Células Epiteliais/imunologia , Humanos , Vírus da Leucemia Bovina/metabolismo , Camundongos , Especificidade de Órgãos , RNA Viral/metabolismo , Coelhos , Ratos , Transcrição Reversa , Especificidade da Espécie , Ligação Viral , Internalização do VírusRESUMO
PURPOSE: To determine the characteristics of 50 cases of pituitary tumor. METHODS: The medical records of 50 cases of pituitary tumor found in glaucoma patients treated between June 2013 and June 2014 were reviewed. RESULTS: There were 37 women and 13 men whose average age was 55.7 years with a range of 24 to 79 years. The glaucoma was unilateral in 19 and bilateral in 31. The pituitary tumors were classified as Rathke's Cleft Cyst (RCC) in 38 cases (76%), RCC with Cushing disease in 5 (10%), adenoma in 4 (8%), adenoma + growth hormone (GH) producing tumors in 2 (4%), and RCC with adenoma in 1 (2%). Of the 50 patients, 23 were treated by surgery (46%), 2 (4%) by hormone supplement therapy, 2 (4%) rejected therapy, and 23 (46%) were followed without treatment. The visual field defects corresponded with typical pituitary visual field defects in 26 (52%) cases, with that typical of unilateral glaucoma in 6 (23%), and with that typical of bilateral glaucoma in 20 (77%) cases. The major symptom was headaches in 24 (48%), headache with dizziness in 10 (20%), dizziness in only 8 (16%), and no complaints in 8 (16%). CONCLUSIONS: Fifty patients diagnosed with glaucoma had concurrent pituitary tumors. Special attention must be paid to glaucoma patients who complain of headaches with and without dizziness.
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Glaucoma/complicações , Neoplasias Hipofisárias/diagnóstico , Adenoma/complicações , Adenoma/diagnóstico , Adulto , Idoso , Cistos do Sistema Nervoso Central/complicações , Cistos do Sistema Nervoso Central/diagnóstico , Feminino , Hormônio do Crescimento/biossíntese , Humanos , Masculino , Pessoa de Meia-Idade , Hipersecreção Hipofisária de ACTH/complicações , Hipersecreção Hipofisária de ACTH/diagnóstico , Neoplasias Hipofisárias/complicaçõesRESUMO
Porcine parvovirus (PPV) causes reproductive failure in sows and has spread worldwide. Several new types of porcine parvoviruses have recently been identified in pig herds. The prevalence of five porcine parvoviruses in the Chiangmai area of Thailand was studied. The prevalence in 80 pigs was 53% for PPV (PPV-Kr or -NADL2 being the new abbreviations), 83% for PPV2 (CnP-PARV4), 73% for PPV3 (P-PARV4), 44% for PPV4 (PPV4), and 18% for PBo-likeV (PBoV7). Over 60% of the pigs carried more than three of the five porcine parvoviruses and occurrence together of the two pairs of viral genes, PPV1/PPV3 and PPV2/PBo-likeV were observed. Phylogenetic analyses for PPV2 and PPV3 indicated the existence of only two major clades of PPV2 and one major clade of PPV3.
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Infecções por Parvoviridae/veterinária , Parvovirus Suíno/classificação , Parvovirus Suíno/genética , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/virologia , Animais , Análise por Conglomerados , Coinfecção/epidemiologia , Coinfecção/veterinária , Coinfecção/virologia , DNA Viral/química , DNA Viral/genética , Dados de Sequência Molecular , Infecções por Parvoviridae/epidemiologia , Infecções por Parvoviridae/virologia , Parvovirus Suíno/isolamento & purificação , Filogenia , Prevalência , Análise de Sequência de DNA , Suínos , Tailândia/epidemiologiaAssuntos
Adenoma , Tumores Neuroendócrinos , Doenças da Hipófise , Neoplasias Hipofisárias , Humanos , HipófiseRESUMO
The B-Raf proto-oncogene serine/threonine kinase (B-Raf) is a member of the Raf kinase family. The BRAF V600E mutation occurs frequently in certain brain tumors such as pleomorphic xanthoastrocytoma, ganglioglioma, and pilocytic astrocytoma, and less frequently in epithelioid and giant cell glioblastoma. BRAF V600E mutation in these cases has been canonically detected using Sanger sequencing or immunohistochemistry but not with next-generation sequencing (NGS). Moreover, to our knowledge, there is no detailed report of the BRAF V600E mutation in an adult glioblastoma with classical histologic features (c-GBM). Therefore, we performed NGS analysis to determine the mutational status of BRAF of 13 glioblastomas (GBMs) (11 primary and 2 secondary cases) and detected one tumor harboring the BRAF V600E mutation. We report here the detection of the BRAF V600E mutation in a patient with c-GBM and describe the patient's clinical course as well as the results of histopathological analysis.
Assuntos
Biomarcadores Tumorais/genética , Neoplasias Encefálicas/genética , Glioblastoma/genética , Mutação/genética , Proteínas Proto-Oncogênicas B-raf/genética , Adulto , Biomarcadores Tumorais/metabolismo , Neoplasias Encefálicas/patologia , Glioblastoma/patologia , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Técnicas Imunoenzimáticas , Masculino , Pessoa de Meia-Idade , Prognóstico , Proto-Oncogene MasRESUMO
The porcine parvovirus 2 (PPV2) genome was first identified in 2001 in Myanmar. Recently, the PPV2 genome has been found in several other countries. In this study, the prevalence of PPV2 in Japanese domestic pigs was investigated and found to be 58% (69/120) in healthy domestic pigs and 100% (69/69) in sick domestic pigs. Sequencing and phylogenetic analysis of the PCR products of the VP1 gene and an almost full length PPV2 clone indicated that diverged PPV2 strains exist in Japan. Clearly distinct strains of PPV2 were detected in 7 of the 10 pig farms.
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Infecções por Parvoviridae/veterinária , Parvovirus Suíno/genética , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/virologia , Agricultura , Animais , Variação Genética , Genoma Viral , Genótipo , Japão , Fases de Leitura Aberta , Parvovirus Suíno/classificação , Filogenia , Prevalência , Sus scrofa , SuínosRESUMO
The economic consequences of bovine diarrhea are serious. Few long-term epidemiological data are available concerning the causative pathogens of bovine diarrhea in Japan. From 2002 to 2011, surveillance of enteric pathogens was performed in cows of various breed and age from 302 farms in which diarrhea had occurred in Yamagata Prefecture, Japan. Differences between dairy and beef cows in the number of cases of diarrhea and rates of infection by Salmonella spp. and Eimeria spp. were found. Clinical symptoms (duration of epidemic, hematochezia and complications) caused by bovine rotavirus infection were milder than those caused by bovine coronavirus infection.
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Animais Domésticos , Diarreia/epidemiologia , Monitoramento Epidemiológico , Animais , Bactérias/classificação , Bactérias/isolamento & purificação , Bovinos , Coronavirus Bovino , Diarreia/microbiologia , Diarreia/parasitologia , Diarreia/virologia , Eimeria/isolamento & purificação , Japão/epidemiologia , Prevalência , Vírus/classificação , Vírus/isolamento & purificaçãoRESUMO
Human-assistive robots need to perform trajectory making for and control of a robotic hand along the many rotating mechanisms in our living spaces. If such trajectory control can be performed without high-cost sensors, certainly a significant cost reduction in building the robot will be achieved. This paper describes a method of retrieving a file binder by generating a pseudo-curved trajectory for tilting it using a simple system. A simple claw mechanism with a switch sensor to grasp an object was designed and 3D-printed, and it was attached to a 6-DOF foldable robotic hand developed by the authors. A method for generating a pseudo-curved trajectory using the switch sensor was developed, and the robotic hand was successfully moved along this trajectory to tilt and grasp a file binder to retrieve it from a bookshelf. Experiments to clarify the success rate were also conducted, and it was found that the results depend on the rotational speed of manipulator links and the vibration of the claw mechanism link. A rubber sponge was added to give flexibility to the claw mechanism, which significantly improved the success rate. Furthermore, a control system to recover from tilting failure was constructed, and its effectiveness was validated by experiments.
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A mouse-adapted porcine epidemic diarrhea virus, MK-p10, showed higher neurovirulence in suckling mice than a non-adapted MK strain. There was no difference in virus growth, whereas clear differences between these two virus infections existed in the type of target cells infected, the spread of virus and the cytokine levels produced in the brain. In the early phase of infection, neurons, astrocytes and neural progenitor cells were infected by MK-p10, whereas neural progenitor cells were the only target cells infected by MK. On days 4-5 post-inoculation, MK-p10 antigens were distributed in a number of neurons in a wide area of the brain; however, antigens were restricted in MK infection. In moribund mice in both infection groups, viral antigens were found in a wide area of the brain. The wide spectrum of initial target cells following MK-p10 infection, as well as its faster spread in the brain, may be evidence of enhanced virulence in suckling mice.
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Doenças do Sistema Nervoso/virologia , Vírus da Diarreia Epidêmica Suína/patogenicidade , Animais , Animais Recém-Nascidos , Astrócitos/virologia , Encéfalo/patologia , Encéfalo/virologia , Camundongos , Doenças do Sistema Nervoso/patologia , Células-Tronco Neurais/virologia , Neurônios/virologia , VirulênciaRESUMO
The rabbit kidney cell line RK13 has been reported to be contaminated with noncytopathogenic (ncp) bovine viral diarrhea virus (BVDV). Persistent infection was confirmed by demonstrating the stability of virus titers (10(4.6±0.5) TCID50/ml) and BVDV positive cells (71.9 ± 3.12 %), over six successive passages. Based on the "exaltation of Newcastle disease virus" (END) and reverse plaque formation methods, two types of ncp viruses were isolated, END-phenomenon-positive and negative. Isolates, RK13/E(+) and RK13/E(-), demonstrated (1) differing levels of reproducibility in cell cultures, (2) similar antigenicity against BVDV antisera, (3) identical 5'-UTR region nucleotide sequences, (4) four amino acid differences throughout the genomic open reading frame, and (5) better growth ability in primary rabbit cells than other laboratory strains when inoculated in parallel at an MOI of 0.01. Overall, the BVDV population in RK13 cells consists of at least two different END characteristic quasispecies that are adapted to cultures of rabbit origin, giving rise to naturally attenuated BVDV strains that can be used in vaccine development.
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Vírus da Diarreia Viral Bovina/classificação , Vírus da Diarreia Viral Bovina/isolamento & purificação , Rim/citologia , Adaptação Fisiológica , Animais , Bovinos , Técnicas de Cultura de Células , Linhagem Celular , Vírus da Diarreia Viral Bovina/genética , Vírus da Diarreia Viral Bovina/patogenicidade , Regulação Viral da Expressão Gênica/fisiologia , Variação Genética , Filogenia , Coelhos , VirulênciaRESUMO
Although entire exposure of the sigmoid sinus has been recognized as a complicated procedure in presigmoid approaches, we developed a new technique to expose the sigmoid sinus quite safely and simply without tough bone work. This study aims to demonstrate our technique in detail and present the effect of the procedure. Between January 2004 and December 2010, 77 patients underwent operations via presigmoid approaches in our institute. In all cases, the sigmoid sinus was completely exposed with our new surgical technique. The key step to expose the sigmoid sinus in our technique is dissection of the sinus from the overlying inner cortical bone in an antegrade direction from the junction of the transverse-sigmoid sinus to the jugular bulb using a bone dissector, avoiding meticulous bone drilling. We retrospectively examined a surgical video of all cases and determined the operative time required to entirely expose the sigmoid sinus from the transverse-sigmoid junction to the jugular bulb. In all 77 cases, the sigmoid sinuses were safely exposed with our new technique, and there was no episode of sinus injury. The operative time required to expose the sigmoid sinus ranged from 9.4 to 28.2 min (mean, 14.5 min). Standard drilling techniques took 32.3 min (range, 18.4-46.6 min) in last 20 cases before adoption of new technique. The new technique significantly shortened the surgical time to expose the sigmoid sinus (p < 0.01, Welch's t test). Our new technique is very useful for safely and simply exposing the sigmoid sinus, especially for standard neurosurgeons.
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Cavidades Cranianas/anatomia & histologia , Cavidades Cranianas/cirurgia , Procedimentos Neurocirúrgicos/métodos , Craniotomia , Feminino , Humanos , Masculino , Processo Mastoide/anatomia & histologia , Processo Mastoide/cirurgia , Pessoa de Meia-Idade , Posicionamento do Paciente , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Crânio/anatomia & histologia , Crânio/cirurgiaRESUMO
Increasing the number of degrees of freedom for multi-finger robotic hands is necessary to achieve high performance. However, this increases structural complexity and the obtained improvement may be small. Humans change the shape of their hands by extending or bending the fingers to apply force to an object through contact with a wide surface or two or more fingers. In some cases, continuous finger movements are not necessary or some fingers do not make contact with the object. A robotic hand with a small number of degrees of freedom could effectively use its fingers to perform many tasks by properly arranging the fingers, increasing the movable range of joints, and utilizing the back and sides of the fingers. This paper proposes a hand system and conducts a theoretical analysis of the transformation of the hand shape into a scissor-like motion to handle a cylindrical object. It is found that the scissor-like motion is unsuitable for cylindrical objects that exceed a certain size. Experiments show the effectiveness of the proposed hand system. The correlation between the contact position of a finger with an object and the success ratio of pinching is demonstrated. Furthermore, a control system that can switch from pinching to grasping when the robot judges that pinching is difficult is developed and experimentally validated.
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Procedimentos Cirúrgicos Robóticos , Robótica , Humanos , Mãos , Dedos , Extremidade Superior , Movimento , Força da MãoRESUMO
Objective The results of CyberKnife treatment in patients with craniopharyngiomas are excellent, but reports of long-term follow-up are rare. Hence, considering the possibility of a long-term follow-up of five years or more, we examined the long-term prognoses of these patients. Materials and Methods Of 33 patients, 12 were males and 21 were females. On postoperative evaluation, three patients experienced recurrence after total resection and were treated using CyberKnife. Twenty-five patients were treated with CyberKnife after partial resection. The mean age at treatment was 47 years, and the follow-up period was 61 to 129 months. Results Of the cases assessed as totally resected in the postoperative evaluation, three recurred after 18 months. CyberKnife treatment was administered immediately in recurrent cases; subsequently, no recurrences were observed for 25 months or more. No recurrences were observed in any patients treated with CyberKnife on the residual site after surgical treatment. Many cases had improved pituitary function, but none had deteriorated. In addition, no case of visual function deterioration was reported. Conclusion Twenty years have passed since the introduction of CyberKnife treatment; however, only a few reports have examined the long-term prognosis of patients with craniopharyngiomas who underwent this treatment. We have been aware of the efficacy of CyberKnife treatment for ten years or more; its long-term results are evident, and the good growth control and low adverse effects are impressive. We are confident that we can maintain good treatment results by combining conservative surgical resection with minimal complications and CyberKnife treatment for new patients in the future.
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OBJECTIVE: To analyze the differences in systemic inflammatory responses (SIRS) during the peri-operative period following pituitary surgery, patients with pituitary adenomas were studied. METHODS: There were three patient groups: group A consisted of 30 patients with GH-secreting adenoma, group B consisted of 20 age-matched patients with Cushing's disease, and group C consisted of 30 patients with other kinds of pituitary adenoma. Levels of white blood cells, C-reactive protein (CRP) and IL-6 in peripheral blood, as well as vital signs, were measured before and after operation. RESULTS: Leucocytosis in peri-operative period was significantly milder in group A patients compared with either group B or C patients. The CRP level was significantly higher in both group B and group C patients than in group A patients. SIRS was observed in 17% of the cases in group A; by contrast, it was found in 55%, and 33% of the cases in group B, and in group C, respectively. CONCLUSION: The inflammatory reaction to surgical trauma is milder in patients with GH-secreting adenomas than in patients with other kinds of pituitary adenoma.
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Hormônio do Crescimento Humano/metabolismo , Inflamação/metabolismo , Neoplasias Hipofisárias/cirurgia , Síndrome de Resposta Inflamatória Sistêmica/metabolismo , Adulto , Proteína C-Reativa/metabolismo , Feminino , Humanos , Interleucina-6/metabolismo , Leucócitos/metabolismo , Leucocitose/sangue , Masculino , Pessoa de Meia-Idade , Hipófise/metabolismo , Hormônios Hipofisários/sangue , Neoplasias Hipofisárias/metabolismoRESUMO
OBJECT: In this study, the authors evaluate the long-term results after Gamma Knife radiosurgery of cranial base meningiomas. This study is a follow-up to their previously published report on the early results. METHODS: Between January 1994 and December 2001, the authors treated benign cranial base meningiomas in 108 patients using low-dose Gamma Knife radiosurgery. The tumor volumes ranged from 1.7 to 55.3 cm3 (median 8.1 cm3), and the radiosurgery doses ranged from 8 to 12 Gy (median 12 Gy) to the tumor margin. RESULTS: The mean duration of follow-up was 86.1 months (range 20-144 months). Tumor volume decreased in 50 patients (46%), remained stable in 51 patients (47%), and increased (local failure) in 7 patients (6%). Eleven patients experienced tumor recurrence outside the treatment field. Among these patients, marginal failure was seen in 5 and distant recurrence was seen in 6. Seven patients were thought to have malignant transformation based on histological or radiological characteristics of the lesion. The actuarial progression-free survival rate, including malignant transformation and outside recurrence, was 93% at 5 years and 83% at 10 years. Neurological status improved in 16 patients (15%). Permanent radiation injury occurred in 7 patients (6%). CONCLUSIONS: Gamma Knife radiosurgery is a safe and effective treatment for cranial base meningiomas as demonstrated with a long-term follow-up period of > 7 years. Surgeons must be aware of the possibility of treatment failure, defined as local failure, marginal failure, and malignant transformation; however, this may be the natural course of meningiomas and not related to radiosurgery.
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Meningioma/cirurgia , Radiocirurgia/métodos , Neoplasias da Base do Crânio/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Imageamento por Ressonância Magnética , Masculino , Meningioma/patologia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Radiocirurgia/efeitos adversos , Neoplasias da Base do Crânio/patologia , Resultado do Tratamento , Adulto JovemRESUMO
Background and importance Traditionally, it has been believed that the plexal segment of the anterior choroidal artery (AChoA) can be sacrificed safely. Here, we present a case of choroid plexus arteriovenous malformation (AVM) in which the capsulothalamic artery originated from distal plexal segment of the AChoA. Clinical presentation A 45-year-old man was diagnosed with arteriovenous malformation involving the left inferior horn in screening MRI. Preceding stereotactic radiosurgery, transarterial target embolization was performed. In this procedure, 20% n-butyl-2-cyanoacrylate (NBCA) was successfully injected from the lateral plexal branch of the AChoA. After embolization, right homonymous hemianopsia developed due to cerebral infarction on the left optic radiation. This infarction was considered to be within the territory of the capsulothalamic artery. Conclusion This anomalous capsulothalamic artery might be formed by hemodynamic compromise of the brain surrounding AVM in early gestation. We must be aware of this unusual anatomical variation to avoid ischemic complication in embolization of the AChoA.
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Artérias Cerebrais/anormalidades , Plexo Corióideo/anormalidades , Embolização Terapêutica/métodos , Malformações Arteriovenosas Intracranianas/terapia , Radiocirurgia/métodos , Variação Anatômica , Angiografia Cerebral , Artérias Cerebrais/diagnóstico por imagem , Infarto Cerebral/diagnóstico por imagem , Infarto Cerebral/etiologia , Plexo Corióideo/diagnóstico por imagem , Embucrilato/uso terapêutico , Hemianopsia/diagnóstico por imagem , Hemianopsia/etiologia , Humanos , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-IdadeRESUMO
We present familial Moyamoya disease in two European children and emphasize the importance of familial factors in the pathogenesis of this disease and its appearance not only in Asians but in the Western population as well. The first patient, a Greek female infant, also has coagulation disorders. Her mother, also suffering from Moyamoya and other family members, have similar coagulation disorders (Factor V Leiden, Methylene-tetrahydrofolic reductase and Factor II 20210A mutations). The second patient, a Scottish boy, is unique in that familial Moyamoya affects five members of three consecutive generations of his maternal family. Genetic analysis in the Greek family demonstrated no abnormality on chromosome 3p26, as in other cases. However, the mitochondrial DNA and Y chromosomal genotype showed that affected members had the same sequence of the Mitochondrial 3 portion of D-loop with Japanese patients. These findings suggest that the pathogenesis of Moyamoya may vary across races and ethnic groups.
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Ligação Genética/genética , Doença de Moyamoya/genética , Adulto , Anticonvulsivantes/uso terapêutico , Aspirina/farmacologia , Transtornos Herdados da Coagulação Sanguínea/complicações , Transtornos Herdados da Coagulação Sanguínea/tratamento farmacológico , Transtornos Herdados da Coagulação Sanguínea/genética , Encéfalo/patologia , Infarto Cerebral/diagnóstico , Infarto Cerebral/etiologia , Infarto Cerebral/terapia , Criança , Pré-Escolar , Europa (Continente) , Fator V/genética , Família , Feminino , Grécia , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doença de Moyamoya/complicações , Doença de Moyamoya/tratamento farmacológico , Linhagem , Inibidores da Agregação Plaquetária/farmacologia , EscóciaRESUMO
We describe here a case of a clinically nonfunctioning pituitary adenoma, but with expression of ACTH and PRL. A 42-year-old woman was referred to our department for further evaluation of pituitary tumor. She had no acromegaloid features, and no typical Cushingoid features. She had no galactorrhea, and had regular menses. GH, IGF-I, LH, FSH, TSH, ACTH and cortisol levels in blood were all within the normal ranges, while PRL levels were mildly elevated. Both ACTH and cortisol levels were adequately increased in response to CRH, and both were suppressed by a small dose of dexamethasone. Plasma ACTH and cortisol levels were decreased at night, suggesting the circadian rhythms for plasma ACTH levels were undisturbed. Based on these findings we did not clinically suspect ACTH-producing tumor, however immunohistochemistry revealed ACTH immunoreactivity in the pituitary adenoma. Therefore, the tumor was considered a silent corticotroph adenoma. PRL was co-expressed in a significant subpopulation of ACTH-immunoreactive tumor cells. Ptx1, Neuro D1, and T pit were densely expressed and Pit-1 was sparsely expressed in the nuclei of adenoma cells. It is therefore possible that a tumor originating in an immature or uncommited adenohypophysial stem cell may later differentiate into different cell types due to a combination of certain specific transcriptional factors.
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Adenoma Cromófobo/metabolismo , Hormônio Adrenocorticotrópico/biossíntese , Neoplasias Hipofisárias/metabolismo , Prolactina/biossíntese , Fatores de Transcrição/biossíntese , Adenoma Cromófobo/sangue , Adenoma Cromófobo/patologia , Adulto , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Feminino , Proteínas de Homeodomínio/metabolismo , Hormônio do Crescimento Humano/sangue , Humanos , Imuno-Histoquímica , Neoplasias Hipofisárias/sangue , Neoplasias Hipofisárias/patologia , Proteínas com Domínio T/metabolismo , Tireotropina/sangue , Fator de Transcrição Pit-1/metabolismo , Proteínas de Transporte Vesicular/metabolismoRESUMO
Rathke's cleft cyst becomes symptomatic in a few cases. Increasing experience has identified previously unrecognized clinical effects including pituitary dysfunction. This study retrospectively investigated eight patients with Rathke's cleft cyst manifesting as hyponatremia and treated surgically with histological confirmation to clarify the mechanism of hyponatremia. All patients suffered from physical symptoms caused by the hyponatremia. All patients underwent magnetic resonance (MR) imaging and screening of pituitary hormones in addition to cortisol and thyroid hormones. All patients had cysts of more than 10 mm in diameter and MR imaging frequently showed irregularly thickened cyst wall. Histological examination disclosed various phases of inflammation and significant fibrosis. Endocrinological examination showed low concentrations of both serum cortisol in all eight patients and urinary cortisol in six of six patients examined. The major cause of hyponatremia was hypocortisolemia, induced by damage to the anterior pituitary gland.