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ACTH Secreting Adenoma

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Edward H. Oldfield – One of the best experts on this subject based on the ideXlab platform.

  • Prospective evaluation of the characteristics and incidence of Adenoma-associated dural invasion in Cushing disease.
    Journal of neurosurgery, 2011
    Co-Authors: Russell R. Lonser, Alexander Ksendzovsky, Joshua J. Wind, Alexander O. Vortmeyer, Edward H. Oldfield
    Abstract:

    Object Dural invasion by adrenocorticotropic hormone (ACTH)-Secreting Adenomas is a significant risk factor for incomplete resection and recurrence in Cushing disease (CD). Since ACTH-producing Adenomas are often the smallest of the various types of pituitary tumors at the time of resection, examining their invasion provides the best opportunity to identify the precise sites of early dural invasion by pituitary Adenomas. To characterize the incidence and anatomical distribution of dural invasion by ACTHSecreting Adenomas, the authors prospectively and systematically analyzed features of dural invasion in patients with CD. Methods The authors prospectively studied consecutive patients with CD undergoing the systematic removal of ACTHSecreting Adenoma and histological analysis of the anterior sella dura as well as other sites of dural invasion that were evident at surgery. Clinical, imaging, histological, and operative findings were analyzed. Results Eighty-seven patients with CD (58 females and 29 males)…

  • Pseudotumor Cerebri after Surgical Remission of Cushing’s Disease
    The Journal of clinical endocrinology and metabolism, 2010
    Co-Authors: Erin N. Kiehna, Meg Keil, Maya B. Lodish, Constantine A. Stratakis, Edward H. Oldfield
    Abstract:

    Context: Pseudotumor cerebri has only been described after successful surgery for Cushing’s disease (CD) in case reports. We sought to establish the incidence and timing of its occurrence, identify predisposing factors, characterize the clinical presentations and their severity, and examine the effects of treatment in patients who underwent surgery for CD. Setting: This study was conducted at two tertiary care centers: The University of Virginia and the National Institutes of Health. Patients: We conducted a retrospective review of 941 surgeries for CD (723 adults, 218 children) to identify patients who developed pseudotumor cerebri after surgery for CD and examine the associated clinical features. Results: Seven children (four males, three females; 3%), but no adults, developed pseudotumor cerebri postoperatively. All underwent resection of an ACTHSecreting Adenoma, and postoperative serum cortisol reached a nadir of less than 2 μg/dl. After surgery, all were placed on tapering hydrocortisone replacemen…

Akira Teramoto – One of the best experts on this subject based on the ideXlab platform.

  • Corticotropin-releasing Hormone Excites Adrenocorticotropin-Secreting Human Pituitary Adenoma Cells by Activating a Nonselective Cation Current
    , 2016
    Co-Authors: Clin J. Invest, Koji Takano, Junko Yasufuku-takano, Akira Teramoto, Toshiro Fujita
    Abstract:

    The mechanisms of corticotropin-releasing hormone (CRH)– induced excitation of ACTHSecreting Adenoma cells were investigated using the perforated whole-cell clamp tech-nique and intracellular Ca

  • Ectopic corticotroph Adenoma in the cavernous sinus: case report.
    Neurosurgery, 1999
    Co-Authors: Naoko Sanno, Shigeyuki Tahara, Yoichi Yoshida, Hiroyuki Onose, Ichiji Wakabayashi, Akira Teramoto
    Abstract:

    OBJECTIVE AND IMPORTANCE: Adrenocorticotropin (ACTH)-Secreting pituitary Adenomas causing Cushing’s disease are often difficult to identify because of their variable locations and their small size. This report presents histological evidence of an ectopic ACTHSecreting Adenoma located entirely within the cavernous sinus. CLINICAL PRESENTATION: A 62-year-old woman presented with central obesity, hypertension, and osteoporosis. Endocrinological evaluation suggested the presence of an ACTHSecreting pituitary Adenoma; however, imaging studies, including dynamic magnetic resonance imaging, did not reveal any visible lesions in the pituitary gland. Bilateral cavernous sinus sampling demonstrated a large central/peripheral ACTH gradient, with a right/left ACTH gradient. The patient was treated as having pituitary-dependent Cushing’s disease, until she died suddenly as a result of acute respiratory failure. INTERVENTION: In a postmortem histological examination, an ACTHSecreting Adenoma was found in the right cavernous sinus, which was completely surrounded by dura mater and had no direct connection with the pituitary gland. CONCLUSION: Although they are rare, such Adenomas located in the cavernous sinus should be recognized as one of the reasons for inaccurate cavernous sinus sampling and the failure of transsphenoidal surgery for patients with ACTH-dependent Cushing’s syndrome.

  • Corticotropin-releasing Hormone Excites Adrenocorticotropin-Secreting Human Pituitary Adenoma Cells by Activating a Nonselective Cation Current
    The Journal of clinical investigation, 1996
    Co-Authors: Koji Takano, Junko Yasufuku-takano, Akira Teramoto, Toshiro Fujita
    Abstract:

    The mechanisms of corticotropin-releasing hormone (CRH) induced excitation of ACTHSecreting Adenoma cells were investigated using the perforated whole-cell clamp technique and intracellular Ca2+ concentration ([Ca2+]i) measurement. CRH depolarized ACTHSecreting Adenoma cells by activating a nonselective cation current that showed slight inward rectification. This channel did not seem to be a member of the Ca(2+)-activated cation currents because it was activated even when the [Ca2+]i was chelated below 50 nM. The activation of the current was induced by protein kinase A-mediated pathways. By [Ca2+]i measurement, CRH increased [Ca2+]i of these cells dependently on voltage-gated Ca2+ current. This CRH-induced [Ca2+]i increase was abolished in Na(+)-free extracellular solution, but was not abolished by the addition of 5 microM tetrodotoxin to the extracellular solution. CRH-induced ACTH secretion from the cultured Adenoma cells was also abolished in Na(+)-free extracellular solution, but not in tetrodotoxin-containing extracellular solution. These data indicate that a Na+ current (maybe the nonselective cation current) other than voltage-gated Na+ current plays an important role in CRH-induced [Ca2+]i increase and ACTH secretion. CRH also activated a nonselective cation current in nonAdenoma human corticotrophs, suggesting that the activation of a nonselective cation current is a physiological mechanism of CRH-induced excitation in human corticotrophs.

Toshihiro Suda – One of the best experts on this subject based on the ideXlab platform.

  • Measurement of cytokines in the cavernous sinus plasma from patients with Cushing’s disease.
    Neuropeptides, 1998
    Co-Authors: Hajime Watanobe, T Tamura, Satoshi Habu, Yoshifumi Kakizaki, Akira Kohsaka, Toshihiro Suda
    Abstract:

    Abstract In order to know more about the in vivo secretion of various cytokines from the human pituitary, this study measured the concentrations of interleukin (IL)-1α, IL-1β, IL-2, IL-6, tumor necrosis factor-α and IL-1 receptor antagonist (ra) in both the peripheral blood and the cavernous sinus (CS) plasma from six patients with Cushing’s disease before and after an intravenous bolus injection of human corticotropin-releasing hormone (CRH, 100 μg). As a routine procedure for the diagnosis of Cushing’s disease, adrenocorticotropin (ACTH) levels were also determined in the same samples. In four of the six patients, unstimulated levels of IL-1 ra in the CS ipsilateral to the ACTHSecreting Adenoma were higher than those in the peripheral blood, with a ratio of ≥ 1.5:1, even though CRH was without effect on the cytokine’s concentration in the CS. In contrast, no consistent data were obtained for any of the remaining five cytokines. These results demonstrate for the first time that the in vivo release of IL-1ra is detectable in at least some corticotroph Adenomas, and also suggest a possible role of the cytokine in physiological and pathophysiological processes occurring in the human pituitary.