Performance of a modified three-level classification in stratifying open liver resection procedures in terms of complexity and postoperative morbidity.

BACKGROUND: Traditional classifications for open liver resection are not always associated with surgical complexity and postoperative morbidity. The aim of this study was to test whether a three-level classification for stratifying surgical complexity based on surgical and postoperative outcomes, originally devised for laparoscopic liver resection, is superior to classifications based on a previously reported survey for stratifying surgical complexity of open liver resections, minor/major nomenclature or number of resected segments. METHODS: Patients undergoing a first open liver resection without simultaneous procedures at MD Anderson Cancer Center (Houston cohort) or the University of Tokyo (Tokyo cohort) were studied. Surgical and postoperative outcomes were compared among three grades: I (wedge resection for anterolateral or posterosuperior segment and left lateral sectionectomy); II (anterolateral segmentectomy and left hepatectomy); III (posterosuperior segmentectomy, right posterior sectionectomy, right hepatectomy, central hepatectomy and extended left/right hepatectomy). RESULTS: In both the Houston (1878 patients) and Tokyo (1202) cohorts, duration of operation, estimated blood loss and comprehensive complication index score differed between the three grades (all P < 0·050) and increased in stepwise fashion from grades I to III (all P < 0·001). Left hepatectomy was associated with better surgical and postoperative outcomes than right hepatectomy, extended right hepatectomy and right posterior sectionectomy, although these four procedures were categorized as being of medium complexity in the survey-based classification. Surgical outcomes of minor open liver resections also differed between the three grades (all P < 0·050). For duration of operation and blood loss, the area under the curve was higher for the three-level classification than for the minor/major or segment-based classification. CONCLUSION: The three-level classification may be useful in studies analysing open liver resection at Western and Eastern centres.

ANTECEDENTES: Las clasificaciones tradicionales de la resección hepática abierta (open liver resection, OLR) por número de segmentos resecados, no siempre se asocian con la complejidad quirúrgica y la morbilidad postoperatoria. El objetivo de este estudio fue comprobar si una clasificación de 3 niveles para estratificar la complejidad quirúrgica en función de los resultados quirúrgicos y postoperatorios, ideada originalmente para la resección hepática laparoscópica, es superior a las clasificaciones basadas en una encuesta descrita previamente para estratificar la complejidad quirúrgica de los procedimientos de OLR, nomenclatura menor/mayor, o número de segmentos resecados. MÉTODOS: Se estudiaron pacientes sometidos a una primera OLR sin otros procedimientos quirúrgicos concomitantes en el hospital MD Anderson (cohorte de Houston) o en la Universidad de Tokio (cohorte de Tokio). Se compararon los resultados quirúrgicos y postoperatorios entre 3 grados: I (resección limitada para el segmento anterolateral o posterosuperior y seccionectomía izquierda); II (segmentectomía anterolateral y hepatectomía izquierda); III (segmentectomía posterosuperior, seccionectomía posterior derecha, hepatectomía derecha, hepatectomía central y hepatectomía ampliada izquierda/derecha). RESULTADOS: En ambas cohortes de Houston (n = 1.878) y Tokio (n = 1.202), el tiempo operatorio, las pérdidas estimadas de sangre, y el índice de complejidad integral (comprehensive complication index) variaba en los 3 grados (todos P < 0,05) y aumentaba paso a paso desde los grados I a III (todos P < 0,05). La hepatectomía izquierda se asociaba con mejores resultados quirúrgicos y postoperatorios que la hepatectomía derecha, hepatectomía derecha ampliada, y seccionectomía posterior derecha, aunque estos cuatro procedimientos fueron categorizados como de complejidad intermedia en la clasificación basada en la encuesta. Los resultados quirúrgicos de las OLRs menores también variaron en los 3 grados (todos P < 0,05). Para el tiempo operatorio y la pérdida sanguínea, el área bajo la curva fue mayor para la clasificación de 3 niveles en el estudio actual, que para la clasificación menor/mayor o la clasificación basada en los segmentos. CONCLUSIÓN: La clasificación en 3 niveles puede ser útil en estudios que analizan las resecciones hepáticas abiertas en centros occidentales y orientales.

Hepatectomy for hepatocellular carcinoma after perioperative management of portal hypertension.

BACKGROUND: Indications for hepatectomy in patients with hepatocellular carcinoma (HCC) who have portal hypertension (PH) have been controversial. Some studies have concluded that PH is a contraindication to hepatectomy, whereas others have suggested that perioperative prophylactic management (PPM) can help overcome complications after hepatectomy associated with PH. The objective of this retrospective study was to assess the short- and long-term outcomes after hepatectomy for HCC in patients with PH, with or without PPM. METHODS: Records were reviewed of consecutive patients who underwent hepatectomy for HCC, with or without PPM of PH, in a single institution from 1994 to 2015. Patients were divided into three groups: those who received PPM for PH (PPM group), patients who had PH but did not receive PPM (no-PPM group) and those without PH (no-PH group). RESULTS: A total of 1259 patients were enrolled, including 123 in the PPM group, 181 in the no-PPM group and 955 in the no-PH group. Three- and 5-year overall survival rates were 74·3 and 53·1 per cent respectively in the PPM group, 69·2 and 54·9 per cent in the no-PPM group, and 78·1 and 64·2 per cent in the no-PH group (P = 0·520 for PPM versus no PPM, P = 0·027 for PPM versus no PH, and P < 0·001 for no PPM versus no PH). Postoperative morbidity and mortality rates were 26·0 and 0·8 per cent respectively in the PPM group, 29·8 and 1·1 per cent in the no-PPM group, and 20·3 and 0 per cent in the no-PH group. CONCLUSION: The present study has demonstrated acceptable outcomes among patients with HCC who received appropriate management for PH in an Asian population. Enhancement of the safety of hepatic resection through use of PPM may provide a rationale for expansion of indications for hepatectomy in patients with PH.

Use of a Right Lateral Sector Graft in Living Donor Liver Transplantation Is Feasible, but Special Caution Is Needed With Respect to Liver Anatomy.

Right lateral sector (RLS) grafting has been introduced to enlarge the potential donor pool for living donor liver transplantation (LDLT); however, evidence of its feasibility is limited. Data from 437 LDLTs carried out between 2000 and 2013 were analyzed retrospectively. LDLTs using a right liver graft (n = 251) were compared with those using a RLS graft (RLSG; n = 28). No donor mortality occurred, and the major complication rates were similar between the two groups. Postoperative liver function preservation was better in the RLSG donors. Concerning the recipients, the mortality and overall survival rates were similar between the two groups. The complication rate for the recipients was higher when more than two arterial or biliary anastomoses were necessary. A systematic literature search identified four reports on LDLT using RLSGs. Among 66 LDLTs, including the present series, there were no cases of donor death, and the rates of major and minor complications in the donors were 6% and 29%, respectively. The major complication and overall mortality rates in the recipients were 29% and 6%, respectively. LDLT using an RLSG is feasible, with an acceptable survival rate among the recipients.

Sinistral portal hypertension after pancreaticoduodenectomy with splenic vein ligation.

BACKGROUND: Splenic vein ligation may result in sinistral (left-sided) portal hypertension and gastrointestinal haemorrhage. The aim of this study was to analyse the pathogenesis of sinistral portal hypertension following splenic vein ligation in pancreaticoduodenectomy. METHODS: Patients who underwent pancreaticoduodenectomy for pancreatic cancer between January 2005 and December 2012 were included in this retrospective study. The venous flow pattern from the spleen and splenic hypertrophy were examined after surgery. RESULTS: Of 103 patients who underwent pancreaticoduodenectomy with portal vein resection, 43 had splenic vein ligation. There were two predominant venous flow patterns from the spleen. In the varicose route (27 patients), flow from the spleen passed to colonic varices and/or other varicose veins. In the non-varicose route, flow from the spleen passed through a splenocolonic collateral (14 patients) or a spontaneous splenorenal shunt (2 patients). The varicose route was associated with significantly greater splenic hypertrophy than the non-varicose route (median splenic hypertrophy ratio 1·52 versus 0·94; P < 0·001). All patients with the varicose route had colonic varices, and none had a right colic marginal vein at the hepatic flexure. CONCLUSION: Pancreaticoduodenectomy with splenic vein ligation may lead to sinistral portal hypertension. To avoid the development of varices, it is important to preserve the right colic marginal vein. Reconstruction of the splenic vein should be considered if the right colic marginal vein is divided.

Contrast-enhanced intraoperative ultrasonography using perfluorobutane microbubbles for the enumeration of colorectal liver metastases.

BACKGROUND: Intraoperative ultrasonography (IOUS) is considered the standard for the identification of liver metastases. Use of lipid-stabilized perfluorobutane microbubbles as an ultrasound contrast agent may improve this. The value of contrast-enhanced IOUS (CE-IOUS) in enumerating colorectal liver metastases was studied here. METHODS: CE-IOUS was performed in consecutive resections for colorectal liver metastases in 2007-2010. All patients underwent preoperative computed tomography. Magnetic resonance imaging was not carried out routinely. Conventional intraoperative examination including IOUS, and CE-IOUS with peripherally injected contrast were performed. The histopathological findings and 6-month follow-up images were used as the reference standard. RESULTS: The study group of 102 patients had a total of 315 lesions identified on preoperative imaging (2·4 lesions per operation; 129 operations). Conventional intraoperative examination including IOUS identified 350 lesions (2·7 per operation). CE-IOUS identified 370 lesions (2·9 per operation). The sensitivity, specificity and accuracy of CE-IOUS were 97·1, 59·1 and 93·2 per cent respectively. The CE-IOUS findings altered the surgical plan in 19 operations (14·7 per cent). CONCLUSION: CE-IOUS provided additional information to that obtained using contemporary preoperative imaging and conventional intraoperative examinations.

Direct inhibitory effect of long term estradiol treatment on dopamine synthesis in tuberoinfundibular dopaminergic neurons: in vitro studies using hypothalamic slices.

The mechanism of the inhibitory effect of long term treatment with estradiol on dopamine synthesis in tuberoinfundibular dopaminergic (TIDA) neurons was studied by using hypothalamic slices from ovariectomized rats. Treatment with 2 mg estradiol valerate (EV) at a 3-week interval increased the weight of the anterior pituitary gland and the concentration of serum PRL. In vivo and in vitro dopamine synthesis in TIDA neurons were estimated in EV-treated animals by 3,4-dihydroxyphenylalanine (DOPA) accumulation in the median eminence after injections of 3-hydroxybenzylhydrazine (NSD 1015), a DOPA decarboxylase inhibitor, and after incubation of hypothalamic slices with NSD 1015, respectively. In vivo DOPA accumulation in the median eminence was less in EV-treated rats than in control rats. The basal rate of in vitro DOPA accumulation in the median eminence of hypothalamic slices from EV-treated rats was lower than that in control rats. Ca2+-dependent DOPA accumulation in the median eminence, determined by incubation in medium containing depolarization agents such as 50 mM K+ and veratridine, was decreased in EV-treated rats. Furthermore, cAMP-dependent DOPA accumulation, determined by incubation with Bu2cAMP or forskolin, was also suppressed in EV-treated rats. The decreased depolarization-induced DOPA accumulation in the median eminence recovered after cessation of EV treatment. Hyperprolactinemia lasting for 6 weeks, achieved by transplantation of anterior pituitaries under the kidney capsule, increased the rate of depolarization-induced DOPA accumulation in the median eminence. On the other hand, EV treatment was effective in inhibiting depolarization-induced DOPA accumulation in hypophysectomized rats regardless of the presence of anterior pituitary transplants. These results suggest that chronically administered estradiol inhibits dopamine synthesis in TIDA neurons via a direct action on the hypothalamus and overcomes the facilitatory action of PRL on dopamine synthesis; and estradiol inhibits all three distinct systems that regulate basal, Ca2+-dependent, and cAMP-dependent dopamine synthesis in TIDA neurons.

Midbrain pathways for the initiation and maintenance of the nocturnal prolactin surge in pseudopregnant rats.

After stimulation of the uterine cervix of the rat, a nocturnal PRL surge that is responsible for pseudopregnancy is initiated and maintained daily. This study was designed to determine the midbrain pathways for the neural control of the initiation and maintenance of the nocturnal PRL surge in pseudopregnant rats. Cervical stimulation, applied in the evening of proestrus, initiated a nocturnal PRL surge in the early morning of estrus. Neural transections, when placed in the ventromedial or lateral part of the midbrain before cervical stimulation, completely suppressed the nocturnal surge, whereas sham transections or transections in the dorsal part of the midbrain did not eliminate the nocturnal surge. On the other hand, in rats that received sham transections in the evening on day 5 of pseudopregnancy previously induced by cervical stimulation, a nocturnal PRL surge was observed in the early morning on day 6. None of transections in the ventromedial, lateral, or dorsal part of the midbrain placed in the evening on day 5 of pseudopregnancy affected the nocturnal surge on day 6. These results suggest that the initiation of the nocturnal PRL surge by cervical stimulation requires the neural components that are contained in the ventromedial and lateral parts of the midbrain. In contrast, the maintenance of the nocturnal surge possibly occurs independent of neural afferents from the midbrain.

Characterization of in vitro dopamine synthesis in the median eminence of rats with haloperidol-induced hyperprolactinemia and bromocriptine-induced hypoprolactinemia.

In order to investigate the mechanism of PRL action on dopamine synthesis in tuberoinfundibular dopaminergic (TIDA) neurons, in vitro dopamine synthesis in the median eminence of hypothalamic slices was compared between hyperprolactinemic and hypoprolactinemic rats, Hyper- and hypoprolactinemia were induced in ovariectomized rats by repetitive injections of the dopamine antagonist haloperidol (Halo) and the dopamine agonist bromocriptine (Bromo), respectively. In vitro dopamine synthesis in TIDA neurons was estimated by measuring 3,4-dihydroxyphenylalanine (DOPA) accumulated in the median eminence after incubation of hypothalamic slices with a DOPA decarboxylase inhibitor. Treatment with Halo or Bromo produced increases or decreases, respectively, in the concentration of PRL in serum and in in vivo DOPA accumulation in the median eminence, as compared with vehicle treatment. The basal rate of in vitro DOPA accumulation in the median eminence was increased in Halo-treated rats and was decreased in Bromo-treated rats. The increase in basal DOPA accumulation after Halo treatment was inhibited by Ca2+ removal from medium or tetrodotoxin addition. A CA2+ -dependent increase in DOPA accumulation in the median eminence by depolarization was greater in Halo-treated rats than in Bromo-treated rats. This difference in DOPA accumulation was due to the changes in PRL secretion after Halo and Bromo treatments, since hypophysectomy abolished it. Incubation of hypothalamic slices in Na+-free media to increase the intracellular concentration of Ca2+ through inhibition of Na+-Ca2+ exchange caused an increase in DOPA accumulation. The rate of DOPA accumulation in Na+-free media was increased in Halo-treated rats and was decreased in Bromo-treated rats. On the other hand, neither Halo nor Bromo treatment altered the increase in DOPA accumulation induced by (Bu)2cAMP or forskolin. These results support the view that PRL stimulates dopamine synthesis in TIDA neurons by mechanisms which include an increase in the firing rate of TIDA neurons and increased depolarization-induced synthesis due to an enhanced response of the component that regulates dopamine synthesis to intracellular Ca2+.

Identification by the sequential cell immunoblot assay of a subpopulation of rat dopamine-unresponsive lactotrophs.

The responsiveness to dopamine of PRL secretion from individual lactotrophs of female rats was investigated by the use of a newly developed sequential cell immunoblot assay. In this assay, PRL secretion from the same single lactotrophs that had been cultured on plastic coverslips was quantified before and after dopamine treatment by a combination of direct absorption of PRL secreted on protein-blotting transfer membranes, immunostaining, and microscopic image analysis. The assay was sensitive enough to detect 0.03 fg PRL/pixel and was specific for PRL. The range of PRL secretion from single pituitary cells in culture was 0.03-1.92 pg/cell.h. PRL secretion was increased with time of incubation and reached a maximum by 80-160 min. There was a significant correlation in PRL secretion from the same lactotrophs between the first and second 60-min incubations. When medium used in the second incubation contained no dopamine, amounts of PRL secreted during the second incubation period were 21-204% of those secreted during the first incubation period. Inclusion of 10(-8)-10(-6) M dopamine in the second incubation medium increased in a dose-dependent manner the proportion of lactotrophs whose PRL secretion was suppressed significantly compared with that during the first incubation period. However, PRL secretion from approximately 6% of the total lactotrophs was not suppressed even by dopamine at concentrations over 10(-6) M. The present study demonstrates that the sequential cell immunoblot assay is a useful means to quantify repeatedly hormone secretion from individual endocrine cells in culture. Furthermore, these results suggest that there is a subpopulation of rat PRL-secreting lactotrophs that are unresponsive to dopamine.

Lactotrophs secreting small amounts of prolactin reveal great responsiveness to thyrotropin-releasing hormone: analysis by the sequential cell immunoblot assay.

The effects of TRH on PRL secretion from individual lactotrophs of female rats were investigated by using a sequential cell immunoblot assay. The same pituitary cells cultured on coverslips were first incubated to determine basal secretion of PRL and subsequently challenged by one of various concentrations of TRH. The PRL secreted from the single lactotrophs was absorbed on protein-blotting transfer membranes, immunostained, and quantified by microscopic image analysis. When no TRH was added to the medium used in the second incubation (controls), the amount of PRL secreted from individual lactotrophs was 93% of that secreted in the first incubation. Treatment with 3 x 10(-10)-10(-7) M TRH in the second incubation increased in a dose-dependent manner the proportion of lactotrophs whose PRL secretion was significantly greater than confidence limits for PRL secretion in the controls. However, the percentage of TRH-responsive lactotrophs remained less than 50% even at a maximally effective concentration of TRH. Proportions of the TRH-responsive lactotrophs were significantly greater in cells that secreted small amounts of PRL under basal conditions than in those that secreted large amounts. Furthermore, the small, but not the large, secretors showed a significant increase in mean absolute amounts of PRL secreted by 10(-7) M TRH, which represented no less than 45% of all PRL secreted from the lactotroph population by the TRH treatment. These results indicate that 1) there is a heterogeneity with respect to lactotroph responsiveness to TRH and that 2) a population of lactotrophs that secrete small amounts of PRL under basal conditions contains a much larger proportion of TRH-responsive lactotrophs than does a population of lactotrophs that secrete large amounts of PRL.

Measurement of the secretion of a small peptide at the single cell level by the cell immunoblot assay: thyroidectomy increases the number of substance P-secreting anterior pituitary cells.

The present study developed a technique for quantification of a small peptide secreted by single endocrine cells and investigated the cellular basis for the effects of endocrine environments on their secretion by using this technique. To quantify substance P (SP) secreted by monodispersed rat anterior pituitary cells and to estimate the relative abundance of SP-secreting cells, the cell immunoblot assay was improved by several modifications, including the use of incubation chambers and addition of immunostaining procedures of fixation by paraformaldehyde and elimination of nonspecifically stained blots. Single pituitary cells formed SP-specific blots on protein-blotting transfer membranes that constituted a floor portion of the incubation chamber. A combination of microscopic image analysis and SP standard curve made it possible to quantify the amount of SP stained as blots. SP secretion from single pituitary cells showed a large variation ranging from 0.14-144 fg/cell.h. The mean SP secretion and the number of SP-secreting cells were increased in an incubation time-dependent manner, with plateau levels of 20.3 fg/cell and 30.2 in a chamber area of 8 x 8 mm, respectively, at 3 h. Thyroidectomy significantly increased the number of SP-secreting cells and the total amount of SP secretion but decreased the mean SP secretion from single pituitary cells. This decrease in the mean SP secretion in the thyroidectomized rats was found to be due to a relative abundance of cells that secrete small amounts of SP. The present study demonstrates that the cell immunoblot assay is useful for quantifying peptide secretion at the single cell level and suggests that thyroidectomy-induced increase in SP secretion from anterior pituitary cells is not due to an increase in SP secretion per cell but due to an increase in the number of SP-secreting cells.

Enkephalin inhibits dopamine synthesis in vitro in the median eminence portion of rat hypothalamic slices.

The effect of enkephalin on dopamine synthesis in vitro in tuberoinfundibular dopaminergic (TIDA) neurons was investigated in rat hypothalamic slices. Dopamine synthesis in vitro in TIDA neurons was estimated by 3,4-dihydroxyphenylalanine (DOPA) accumulation in the median eminence after incubation of slices with a DOPA decarboxylase inhibitor. The enkephalin agonist [D-Ala2]Met-enkephalinamide (ENKamide) decreased the rate of basal DOPA accumulation in the median eminence portion of hypothalamic slices from ovariectomized rats at concentrations over 2 microM. The inhibitory action of ENKamide was more pronounced in hypothalamic slices from haloperidol-treated rats in which basal DOPA accumulation in the median eminence was stimulated by increased PRL secretion. In contrast, ENKamide decreased neither the rate of depolarization- induced CA2+-dependent DOPA accumulation nor the rate of (Bu)2cAMP- or forskolin-induced DOPA accumulation in the median eminence of normal or haloperidol-treated rats. The rank order of the potencies of enkephalins and their analogs for inhibition of DOPA accumulation in the median eminence was similar to that of their binding capacities for opioid receptors. ENKamide inhibited basal DOPA accumulation even when hypothalamic slices were incubated in Ca2+-free medium to which tetrodotoxin was added or when the median eminence was incubated alone without the remainder of the hypothalamic slice. These results suggest that enkephalin, by acting directly on axon terminals of TIDA neurons in the median eminence, inhibits basal dopamine synthesis.

Mitogen-activated protein kinase-dependent stimulation of proliferation of rat lactotrophs in culture by 3',5'-cyclic adenosine monophosphate.

Intracellular cAMP regulates cell proliferation as a second messenger of extracellular signals in a number of cell types. We investigated, by pharmacological means, whether an increase in intracellular cAMP levels changes proliferation rates of lactotrophs in primary culture, whether there are interactions between signal transduction pathways of cAMP and the growth factor insulin, and where the dopamine receptor agonist bromocriptine acts in the cAMP pathway to inhibit lactotroph proliferation. Rat anterior pituitary cells, cultured in serum-free medium, were treated with cAMP-increasing agents, followed by 5-bromo-2'-deoxyuridine (BrdU) to label proliferating pituitary cells. BrdU-labeling indices indicative of the proliferation rate of lactotrophs were determined by double immunofluorescence staining for PRL and BrdU. Treatment with forskolin (an adenylate cyclase activator) or (Bu)2cAMP (a membrane-permeable cAMP analog) increased BrdU-labeling indices of lactotrophs in a dose- and incubation time-dependent manner. The cAMP-increasing agents were also effective in increasing BrdU-labeling indices in populations enriched for lactotrophs by differential sedimentation. The stimulatory action of forskolin was observed, regardless of concentrations of insulin that were added in combination with forskolin. Inhibition of the action of endogenous cAMP by H89 or KT5720, a protein kinase A inhibitor, attenuated an increase in BrdU-labeling indices by insulin treatment. On the other hand, the specific mitogen-activated protein kinase inhibitor PD98059, which was effective in blocking the mitogenic action of insulin, markedly suppressed the forskolin-induced increase in BrdU-labeling indices. (Bu)2cAMP antagonized not only inhibition of BrdU labeling indices but also changes in cell shape induced by bromocriptine treatment, although forskolin did not have such an antagonizing effect. These results suggest that: 1) intracellular cAMP plays a stimulatory role in the regulation of lactotroph proliferation; 2) cAMP and insulin/mitogen-activated protein kinase signalings require each other for their mitogenic actions; and 3) the antimitogenic action of bromocriptine is, at least in part, caused by inhibition of cAMP production.

Enhanced dopamine synthesis and release in vitro in the median eminence of rat hypothalamus are associated with involution of estradiol-induced pituitary tumors.

Changes in the functions of tuberoinfundibular dopaminergic (TIDA) neurons were investigated during the period when the involution of estradiol-induced PRL-secreting pituitary tumors was occurring. Dopamine synthesis and release in vitro by TIDA neurons were determined by 3,4-dihydroxyphenylalanine (DOPA) accumulation in the median eminence and endogenous dopamine release from the median eminence, respectively. Three weeks after a single injection of 2 mg estradiol valerate into ovariectomized rats, there was a marked increase in the weight of anterior pituitaries and the concentration of serum PRL, but a decrease in K+-induced DOPA accumulation in vitro in the median eminence. Twelve weeks after estradiol treatment, by which time pituitary weights and PRL concentrations declined considerably, K+-induced DOPA accumulation in the median eminence rose 5-fold compared to that in control animals. This change in DOPA accumulation persisted for 24 weeks. Increases were observed at 12 weeks in K+-induced as well as basal and (Bu)2cAMP-induced DOPA accumulation in the median eminence. The increases in basal and (Bu2cAMP-induced DOPA accumulation were not altered by Ca2+ removal from medium. In parallel to the changes in DOPA accumulation, basal and K+-induced release in vitro of dopamine from the median eminence into the medium were decreased 3 weeks after estradiol treatment, but increased at 12 and, in part, 24 weeks. The increases in basal and K+-induced dopamine release were observed even after Ca2+ removal from medium. These results suggest that basal, extracellular Ca2+-dependent, and cAMP-dependent dopamine synthesis as well as basal and depolarization-induced dopamine release in TIDA neurons are stimulated during the period of involution of pituitary tumors associated with estradiol withdrawal.

Pentobarbital anesthesia during the proestrous afternoon blocks lactotroph proliferation occurring on estrus in female rats.

Estradiol stimulates the synthesis and secretion of PRL and lactotroph proliferation, and its long-term administration induces PRL-secreting pituitary tumors. We examined changes in the number of proliferating lactotrophs throughout the estrous cycle in female rats and the involvement of the brain in the regulation of the lactotroph proliferation by anesthetizing with pentobarbital. Female rats revealing regular 4-day estrous cycles were injected ip with the thymidine analog 5-bromo-2'-deoxyuridine (BrdU) 3 h before decapitation to label DNA-replicating cells. Dispersed anterior pituitary cells obtained from these rats were stained for PRL and BrdU with a double labeling immunofluorescence technique. The rate of lactotroph proliferation was represented by the BrdU-labeling index (BrdU-labeled lactotrophs as a percentage of total lactotrophs counted). Lactotrophs from rats injected with BrdU at 1000 h showed a high BrdU-labeling index of 2.6% on estrus, whereas they showed almost undetectable levels of the BrdU-labeling index during the other stages of the estrous cycle. The anterior pituitary cells other than lactotrophs were scarcely labeled during any stages. The BrdU-labeling index began to rise by the midnight between proestrus and estrus, peaked between 0800 and 1200 h, and returned to undetectable levels by the midnight between estrus and diestrus I. Pentobarbital (35 mg/kg, i.p.) injected at 1345 h on proestrus, which was effective in blocking ovulation on estrus, eliminated completely the increase in the BrdU-labeling index as determined by BrdU injection at 1000 h on estrus. In contrast, the high BrdU-labeling index on estrus was partly suppressed to a level of 1.4% by pentobarbital injection at 0900 or 2100 h on proestrus. The rats injected with pentobarbital at 1345 h on proestrus did not show any increases in the BrdU-labeling index even after BrdU injection was delayed from 1000 to 1400 h on estrus. However, a high BrdU-labeling index of 3.7% was obtained in these animals when BrdU was injected at 1000 h on diestrus I. We conclude that 1) lactotrophs of cycling female rats proliferate selectively on the day of estrus; and 2) the proliferation of lactotrophs on estrus is not due to a direct action on the anterior pituitary of estradiol secreted from the ovaries but triggered by neural events occurring during the proestrous afternoon, which are closely related with the regulation of preovulatory surges of gonadotropin and PRL secretion.

Evidence for alteration in the processing of dopamine in the anterior pituitary gland of aged rats: receptors and intracellular compartmentalization of dopamine.

Receptors for dopamine and the subcellular localization of dopamine in the anterior pituitary gland were studied in young cycling female rats and in aged, constant estrous female rats. Dopamine receptors were quantified in membrane preparations of anterior pituitary tissue using [3H] spiperone as the ligand. On the basis of saturation isotherms, it was calculated that the equilibrium dissociation constant (Kd) and binding capacity for [3H]spiperone binding to pituitary membranes from young rats were 34.2 pM and 82 fmol/mg protein, respectively. The relative binding capacity of membranes from aged rats was 35% greater than that of membranes from young rats. There was no difference in the Kd values in aged and young rats. When the relative binding of [3H]spiperone by anterior pituitary membranes from individual animals was quantified by incubation with a saturating concentration of the ligand, it was found that [3H]spiperone binding in aged rats was significantly greater than that in young rats. When the subcellular localization of dopamine in anterior pituitary tissue was examined by means of density gradient centrifugation, it was found that the subcellular distribution of dopamine in tissue of aged rats was quantitatively different from that in young rats. In young rats, a small amount of dopamine was associated with light particles, whereas a large amount of dopamine was associated with heavy particles, which cosedimented with PRL-containing granules. In aged rats, the amount of dopamine associated with light particles was 5 times that found in young rats, whereas the amount of dopamine associated with heavy particles was the same as that in young rats. We speculate that altered intracellular compartmentalization of dopamine, leading to a marked accumulation of dopamine in the light particles, is related to increased secretion of PRL in aged rats.

Data on the sites of stimulatory feedback action of gonadal steroids indispensable for luteinizing hormone release in the rat.

The sites of the stimulatory feedback action of gonadal steroids on LH release were investigated in estrogen-primed ovariectomized rats. Either estradiol benzoate (E2) or estrone (E1) injections 72 h after E2 priming induced a significant increase in serum LH 30 h later, whereas injections of progesterone (P) did so 6 h later. Horizontal sections placed above the medial preoptic area prevented the increase after E2 injections but not after E1 and P injections. Retrochiasmatic sections or bilateral lesions placed in the medial-basal part of the suprachiasmatic area prevented any increases in serum LH induced by steroid injections. Intracerebral implantations of E2 and P in E2-primed ovariectomized rats induced a similar significant increase in serum LH when E2 was implanted into the bed nucleus of stria terminalis (BST), the lateral septum (l-SEPT) and the preoptic suprachiasmatic area (POSC), and when P was implanted in to the medial amygdala, the diagonal band of Broca (DBB), the POSC, the l-SEPT and the anterior hypothalamic area (AHA). These results suggest that the stimulatory feedback effect of E2 is exerted on the limbic structures, especially the BST and the l-SEPT, while the main sites of the stimulatory feedback action of P are located in the DBB, the POSC, and the AHA.

Data on the sites of the stimulatory feedback action of gonadal steroids indispensable for follicle-stimulating hormone release in the rat.

The sites of the stimulatory feedback action of gonadal steroids on FSH release were examined in estrogen-primed ovariectomized rats. Estradiol benzoate (E2) injected 72 h after E2 priming induced a significant increase in serum FSH 6 and 30 h later. However, injections of estrone failed to induce a similar significant increase. Progesterone (P) injections also increased serum FSH 6 h later. Horizontal sections placed above the medial preoptic area prevented the increase in serum FSH after E2 injections but not after P injections. Furthermore, retrochiasmatic sections or bilateral lesions in the medial basal part of the suprachiasmatic area prevented the increase after E2 injections and P injections. E2, implanted into the bed nucleus of stria terminalis and the anterior hypothalamic area in E2-primed ovariectomized rats, induced a significant increase and decrease in serum FSH, respectively, whereas P implanted into the same areas failed to induce it. On the other hand, P implantations into the diagonal band of Broca and the lateral and the medial septum were effective in increasing and decreasing serum FSH, respectively, whereas E2 implantations into these areas were ineffective. Neither E2 nor P implanted into the medial amygdala, the medial preoptic area, or the hippocampus altered serum FSH levels. These results suggest that the stimulatory feedback actions of E2 and P on FSH release are exerted at different sites in the limbic structures.