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Sanno N, Matsuno A, Itoh J, Kakimoto K, Teramoto A, Osamura RY. Combined non-isotopic in situ hybridisation and indirect immunohistochemical analysis of hormone production in the rat pituitary gland. Mol Pathol 2010; 49:M57-60. [PMID: 16696047 PMCID: PMC408020 DOI: 10.1136/mp.49.1.m57] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
An understanding of the intracellular relation between hormonal expression (storage) and gene expression (production) is essential for elucidating the functional status of the individual cells in endocrine tissue such as the pituitary gland. To this end, mRNA expression was visualised by using a combined in situ hybridisation and immunohistochemistry method in routinely processed, formalin fixed, paraffin wax embedded rat pituitaries. mRNA was detected by non-isotopic in situ hybridisation (alkaline phosphatase antialkaline phosphatase method, with nitroblue tetrazolium and 5-bromo-4-chloro-3-indolylphosphate as substrates). Sections were then stained by using the immunoperoxidase method to demonstrate pituitary hormone expression. The specificity of the combined staining method was confirmed by staining adjacent sections separately. The antigenicity of rat growth hormone and prolactin was adequately preserved following hybridisation. In conclusion, this method is specific, easy to use and permits the determination of the functional status of individual cells.
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Affiliation(s)
- N Sanno
- Department of Pathology, Tokai University School of Medicine, Boseidai, Isehara-city Kanagawa, Japan
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2
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Kato Y, Mihara C, Matsuyama J, Ochi S, Ono H, Yamaguchi S, Kagawa R, Sanno N, Yanagawa N. Role of Women in Medicine: A Look at the History, the Present Condition and the Future Status of Women in the Surgical Field, Especially Neurosurgery. ACTA ACUST UNITED AC 2004; 47:65-71. [PMID: 15257477 DOI: 10.1055/s-2004-818470] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We have analyzed the historical background of women's progress in medicine in Japan and the role of female neurosurgeons as models for the next generation. Female neurosurgeons were asked to complete a questionnaire regarding their professional life in detail and the problems they are facing while managing their personal life after getting married and having a child. Some feel that there remain some constraints at work for being a female, due to their male colleagues who are not so understanding in nature. The younger generation is not so keen on joining the neurosurgical branch as their life career due to hard work and complete dedication demanded by neurosurgery. It is not easy for all to manage a neurosurgical career along together with a married life and children. Hence it is now time for those successful female neurosurgeons to become role models. Government can play an important role in these social reforms by coming up with programs to give social security to females and initiate programs for child care for married females pursuing such a demanding profession. Certain measures to encourage females to take up surgery are providing more time by arranging care for babies and families, flexibility in working hours, in addition to having a considerate husband and a considerate chief of department and senior staff. Departmental policies need to be completely impartial and should promote everyone based on their skills and knowledge. Women neurosurgeons need to get together and discuss all these issues so that the younger generation will not hesitate to take up this profession and become stalwarts of neurosurgery like their male counterparts.
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Affiliation(s)
- Y Kato
- Department of Neurosurgery, Fujita Health University, Fujita, Japan.
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Sanno N, Tahara S, Kurotani R, Matsuno A, Teramoto A, Osamura RY. Cytochemical and molecular biological aspects of the pituitary and pituitary adenomas--cell differentiation and transcription factors. Prog Histochem Cytochem 2002; 36:263-99. [PMID: 11822191 DOI: 10.1016/s0079-6336(00)80003-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The anterior pituitary is composed of several cell types, each responsible for the production of specific hormones. Each hormone secreting cells is defined by the activation of its respective hormone genes in a temporally and spatially regulated manner. Recent development in cytochemistry and molecular biology have provided various aspects of human pituitary adenomas, i.e., functional differentiation and classification. The molecular factors that determine hormone production have now been identified as transcription factors. Many novel transcription factors that play a role in anterior pituitary development are implicated. In this review, we focus on the transcriptional factors roles on functional differentiation of the pituitary cells and adenomas and the contribution of cytochemistry and recent development in molecular biological techniques.
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Affiliation(s)
- N Sanno
- Department of Neurosurgery, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8603, Japan
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Abstract
We report a rare case of solitary fibrous tumor (SFT) of the meninges of the posterior fossa presenting as an intracerebellar hemorrhage. A 29-year-old woman was admitted with sudden-onset severe headache, nausea, and vomiting. A computed tomographic (CT) scan of the brain revealed an intracerebellar hemorrhage 3.5cm in diameter. Gadolinium-enhanced magnetic resonance imaging (MRI) showed a heterogeneous enhancement mass. A posterior craniotomy found a firm, highly vascular tumor attached to the meninges. Histologically, the tumor showed mostly sclerotic tissues with spindle cells. In few areas, the tumor had a more compact arrangement of spindle-shaped cells with vascular spaces and highly cellular components. Immunohistochemical study revealed strong CD-34 immunopositivity in many tumor cells. The tumor was diagnosed as SFT of the meninges. We report the clinical and histological features of this newly described tumor with a heterogeneous component.
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Affiliation(s)
- N Sanno
- Department of Neurosurgery, Tama Nagayama Hospital, Nippon Medical School, Tokyo, Japan. sanno_naoko/
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Kobayashi Y, Murakami R, Toba M, Ichikawa T, Kanazawa R, Sanno N, Shimura T, Sawada N, Hosone M, Kumazaki T. Chondroblastoma of the temporal bone. Skeletal Radiol 2001; 30:714-8. [PMID: 11810170 DOI: 10.1007/s002560100435] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2001] [Indexed: 02/02/2023]
Abstract
A rare case of chondroblastoma arising from the temporal bone that occurred in a 60-year-old woman is reported. The tumor appeared well demarcated and osteolytic on the radiographs. CT scan clearly depicted marginal and central calcification in the tumor. MR imaging demonstrated two components in the tumor: a solid component with predominantly low signal intensities on both T1- and T2-weighted sequences, and a multilocular cystic component with T1- and T2-elongation and fluid-fluid levels on the T2-weighted images. Postcontrast MR imaging revealed marked enhancement in the solid component and the septa of the cystic component.
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Affiliation(s)
- Y Kobayashi
- Department of Radiology, Tama-Nagayama Hospital, Nippon Medical School, 1-7-1 Nagayama, Tama-shi, Tokyo 206-8512, Japan.
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6
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Umeoka K, Sanno N, Oyama K, Tahara S, Kurotani R, Ikuyama S, Nakashima M, Watanabe T, Osamura RY, Teramoto A. Immunohistochemical analysis of RCAS1 in human pituitary adenomas. Mod Pathol 2001; 14:1232-6. [PMID: 11743045 DOI: 10.1038/modpathol.3880467] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
It has been reported that RCAS1 (receptor-binding cancer antigen expressed on SiSO cells) acts as a ligand for a receptor present on normal peripheral lymphocytes and induces apoptotic cell death. It is expressed in uterine and ovarian carcinomas, especially in invasive cancers. This immunohistochemical study is aimed to elucidate the expression of RCAS1 in human pituitary adenomas in order to clarify its role in their proliferative regulation and invasiveness. Five normal pituitary glands, 50 human pituitary adenomas, and one malignant glioma were subjected to immunohistochemical studies. In normal pituitary glands, immunostaining of RCAS1 and MIB-1 was not found. In malignant glioma, large numbers of cell nuclei were positive for MIB-1 (MIB-1 index: 28%), and RCAS1 was detected both in the cytoplasm and on the membrane of the tumor cells. Expression of RCAS1 was noted in 48% of pituitary adenomas immunohistochemically (60.0% of growth hormone-secreting adenomas, 60.0% of prolactin-secreting adenomas, 42.9% of adrenocorticotrophin-secreting adenomas, 40.0% of thyroid-stimulating hormone-secreting adenomas, 33.3% of nonfunctioning adenomas, and 44.4% of gonadotropin-subunit-positive adenomas). It showed no correlation with tumor type, size, and invasiveness. The statistically significant relationship between RCAS1 and MIB-1 positivity was identified in our study. These results suggest that expression of RCAS1 as well as MIB-1 positivity predict the growth potential of individual pituitary adenomas.
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Affiliation(s)
- K Umeoka
- Department of Neurosurgery, Nippon Medical School, Tokyo, Japan
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7
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Abstract
Thyrotropin (TSH)-secreting pituitary adenomas represent about 1-2% of all pituitary adenomas and cause secondary or central hyperthyroidism. TSH-secreting adenomas are part of the syndrome of 'inappropriate secretion of TSH' (SITSH). The hormonal profile is characterized by nonsuppressed TSH in the presence of high levels of free thyroid hormones (FT3 and FT4). Previous reports have described the surgical cure of TSH adenoma to be more difficult than other functional adenomas because of large and invasive features. However, with the current introduction of ultrasensitive immunometric assays, TSH-secreting adenomas are more often recognized. Early diagnosis of TSH-secreting adenomas leads to a high rate of remission of hyperthyroidism after surgery. However, some of those type of adenomas have clinical heterogeneity, and subsequently cannot be cured by surgery alone. We present our experiences and review reported cases of TSH-secreting adenomas to direct current management.
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Affiliation(s)
- N Sanno
- Department of Neurosurgery, Nippon Medical School, Tokyo, Japan. sanno_naoko/
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Abstract
Neuro D1 is a basic helix-loop-helix transcription factor expressed in the endocrine cells of pancreas and in a subset of neurons as they undergo terminal differentiation. In the adult pituitary gland, Neuro D1 is expressed in corticotroph cells and contributes to the corticotroph-specific pro-opiomelanocortin (POMC) transcription by interacting with Pituitary homeobox 1 (Ptx 1) transcription factor. In the present study, we investigated the expression of Neuro D1 in human normal pituitaries and different types of human pituitary adenomas using the RT-PCR and immunohistochemical techniques. Using RT-PCR, Neuro D1 mRNA was found to be expressed in ACTH-secreting adenomas (n = 3) and 6 of 8 non-functioning adenomas. On the other hand, GH-secreting adenomas (n = 5) and PRL-secreting adenomas (n = 3) were completely negative for Neuro D1 mRNA. Immunohistochemically, Neuro D1 was expressed in all ACTH-secreting adenomas (n = 10), and in 14 of 20 nonfunctioning adenomas. In contrast, 3 of 10 PRL-secreting adenomas and 2 of 10 GH-secreting adenomas showed positive Neuro D1 staining in the nuclei. The above results suggest that Neuro D1 contribute to the functional expression and the differentiation of ACTH-secreting adenomas. It also appears from our study that Neuro D1 might play a role in the differentiation of non-functioning adenomas, the mechanism of which remains to be further investigated. This is the first study on Neuro D1 in case of human pituitary adenomas.
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Affiliation(s)
- K Oyama
- Department of Neurosurgery, Nippon Medical School, Tokyo, Japan
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Umeoka K, Sanno N, Tera moto A, Osamura Y. [Pituitary tumor from molecular-biological aspects]. No To Shinkei 2001; 53:617-22. [PMID: 11517485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- K Umeoka
- Department of Neurosurgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
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Kim K, Arai K, Sanno N, Osamura RY, Teramoto A, Shibasaki T. Ghrelin and growth hormone (GH) secretagogue receptor (GHSR) mRNA expression in human pituitary adenomas. Clin Endocrinol (Oxf) 2001; 54:759-68. [PMID: 11422110 DOI: 10.1046/j.1365-2265.2001.01286.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The level of growth hormone (GH), growth hormone secretogogue (GHS) and GHS receptor (GHSR) messenger ribonucleic acid (mRNA) expression has been reported as being higher in GH-producing pituitary adenomas than in other types of pituitary adenomas. Recently, ghrelin, an endogenous ligand specific for GHSR, was isolated. Therefore, we attempted to clarify whether ghrelin mRNA is expressed in various types of human pituitary adenoma by competitive reverse transcription-polymerase chain reaction (RT-PCR). We also examined the relationship between the levels of ghrelin or GHSR mRNA and hormonal and tumour characteristics in patients with pituitary adenomas. PATIENTS Pituitary adenoma tissue was obtained at surgery from 13 patients with acromegaly, 4 with prolactinomas, 5 with gonadotrophin (Gn)-producing adenomas, 4 with non-functioning adenomas, 2 with ACTH-producing adenomas and 2 with TSH-producing adenomas. METHODS The expression levels of human ghrelin mRNA and GHSR mRNA were quantified using a competitive RT-PCR method. RESULTS Ghrelin mRNA was detected in all pituitary adenoma tissues examined, with the highest mean level detected in non-functioning adenomas, a moderate level in GH-producing adenomas and Gn-producing adenomas, and the lowest level in prolactinomas. The level of ghrelin mRNA expression in GH-producing adenomas correlated negatively with the size of the adenoma (n = 13) (r = - 0.756, P = 0.0028). Furthermore, the mean level of ghrelin mRNA expression in high-grade (III and IV of Hardy classification) GH-producing adenomas was significantly lower than that in low-grade (I and II) GH-producing adenomas (P = 0.0016). GHSR mRNA was also detected in all pituitary adenomas with the highest mean level in GH-producing adenomas, a moderate level in nonfunctioning adenoma, and the lowest level in prolactinoma and Gn-producing adenomas. CONCLUSIONS Ghrelin mRNA, in addition to GHSR mRNA, is expressed in various types of pituitary adenoma with different levels of expression in each type. Our findings suggest that ghrelin produced in pituitary adenoma may play some role in the mechanism underlying the development of adenoma cells through autocrine and/or paracrine pathways.
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Affiliation(s)
- K Kim
- Department of Physiology, Nippon Medical School, Tokyo, Japan.
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11
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Yoshida Y, Sanno N, Teramoto A. Multiple pituitary hormone gradients from cavernous sinus sampling in patients with Cushing's disease. Acta Neurochir (Wien) 2001; 142:1339-44. [PMID: 11214626 DOI: 10.1007/s007010070002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Cavernous sinus sampling in patients with adreno-corticotropic-hormone (ACTH) secreting pituitary adenomas has been used to identify directly ACTH hypersecretion from the pituitary and to predict the lateralization of a microadenoma. In our previous series, cavernous sinus sampling provided a sufficient central/peripheral (c/p) ratio of ACTH and the correct laterality of the pituitary lesion in all microadenomas situated in the lateral wing. To clarify the diagnostic value of other anterior pituitary hormones in relation to ACTH gradients, we evaluated multiple pituitary hormone gradients between a cavernous sinus and a peripheral vein and between both cavernous sinuses in patients with Cushing's disease. METHODS Cavernous sinus sampling was done in 11 patients with clinical and biochemical features of ACTH-dependent Cushing's syndrome. In 9, pituitary adenoma was detected during trans-sphenoidal surgery and histologically confirmed, while 2 others were suspected of having ectopic lesions. Serum ACTH, prolactin (PRL), thyroid stimulating hormone (TSH), growth hormone (GH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) from catheters in both cavernous sinuses and from a peripheral vein were measured. The c/p ratios of each hormone and the intercavernous gradients were evaluated. RESULTS The c/p ratio of ACTH indicated the presense of pituitary lesions in all 9 patients with ACTH-secreting microadenomas. In addition, the intercavernous gradients of ACTH indicated the correct localization of microadenomas in all 6 patients with lateralized lesions. As for other hormones, the c/p ratios of GH, PRL, TSH and LH were significantly high in number 7, 6, 6 and 3 patients, respectively. In contrast, the significant step up of FSH was observed only in one patient. The intercavernous gradients of GH and PRL were significantly high in number 5 and 4 patients, respectively. CONCLUSIONS The intercavernous gradients of GH and PRL tend to indicate the lateralization of a microadenoma. The measurement of GH and PRL during cavernous sinus sampling may provide additional information, in the lateralization of ACTH-secreting microadenomas.
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Affiliation(s)
- Y Yoshida
- Department of Neurosurgery, Nippon Medical School, Tokyo, Japan
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12
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Kim K, Arai K, Sanno N, Teramoto A, Shibasaki T. The expression of thyrotrophin-releasing hormone receptor 1 messenger ribonucleic acid in human pituitary adenomas. Clin Endocrinol (Oxf) 2001; 54:309-16. [PMID: 11298082 DOI: 10.1046/j.1365-2265.2001.01237.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Thyrotrophin-releasing hormone (TRH) paradoxically induces the release of growth hormone (GH) when injected intravenously into acromegalic patients, although the mechanism of this action is unknown at present. Several research groups have reported that the level of TRH receptor-1 (TRHR-1) mRNA expression is variable in pituitary adenomas, and does not correlate with the degree of paradoxical GH response to TRH administration in a limited number of acromegalic patients. We aimed to compare the expression levels of TRHR-1 mRNA among various types of pituitary adenoma and to clarify whether these levels correlate with the degree of pituitary hormone response to TRH. PATIENTS Pituitary adenoma tissue was obtained by surgery from 14 patients with acromegaly, four with prolactinomas, nine with nonfunctioning adenomas and one with a TSH-producing adenoma. METHODS The level of human TRHR-1 mRNA expression in each adenoma was quantified using the competitive reverse transcription polymerase chain reaction (RT-PCR) METHOD: For amplification of a TRHR-1 cDNA fragment, a sense primer was designed according to the sequence in exon 2 and an antisense primer designed according to the sequence located at the region in exon 3 that does not encode for the alternative splicing-generated short form of TRHR-1 mRNA. RESULTS TRHR-1 mRNA was detected in all pituitary adenomas examined and did not correlate with their size. The mean level of TRHR-1 mRNA expression was significantly lower in GH-producing adenomas than in prolactinomas and nonfunctioning adenomas (1.4 +/- 0.4 x 10(-2) attomol/microg total RNA, 10.7 3.4 x 10(-2) attomol/microg total RNA, and 7.2 +/- 3.3 x 10(-2) attomol/g total RNA, respectively). The ratio of plasma peak GH induced by TRH administration to the basal level of plasma GH in the patients with acromegaly correlated positively with the level of TRHR-1 mRNA expression in their GH-producing adenomas (r = 0.620, P = 0.0179). The responsiveness of plasma PRL and gonadotrophin to TRH in the patients with prolactinoma and nonfunctioning pituitary adenoma did not significantly correlate with the levels of TRHR-1 mRNA expression in their pituitary adenomas, respectively. CONCLUSIONS The findings of the present study suggest that the level of TRHR-1 mRNA expression varies among different types of pituitary adenoma. Furthermore, in acromegaly, the responsiveness of plasma GH to TRH administration appears to at least partially depend on the level of TRHR-1 mRNA expression in the GH-producing pituitary adenoma.
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Affiliation(s)
- K Kim
- Department of Physiology, Nippon Medical School, Tokyo, Japan. Kim_Kyongsong/
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Komatsubara K, Tahara S, Umeoka K, Sanno N, Teramoto A, Osamura RY. Immunohistochemical analysis of p27 (Kip1) in human pituitary glands and in various types of pituitary adenomas. Endocr Pathol 2001; 12:181-8. [PMID: 11579684 DOI: 10.1385/ep:12:2:181] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
p27 (Kip1) plays regulatory roles in the cell cycle by inhibiting the activity of cyclin dependent kinases (CDKs). This immunohistochemical study is aimed at elucidating the expression of p27 in human pituitary and in various types of pituitary adenomas in order to clarify its role in the regulation of proliferation. Sixteen normal pituitary glands and 179 human pituitary adenomas were used for immunohistochemical studies. The tissues were fixed in 10% formalin and embedded in paraffin. Indirect peroxidase method was performed after heat-induced antigen retrieval using a monoclonal antibody against p27 protein. p27 protein was expressed in the nuclei of all 16 normal human pituitary glands. p27 protein was also expressed in 128 of 179 cases of pituitary adenomas (71.5%). A marked decrease of p27 expression was noted in ACTH-secreting adenomas, 8/20 (40.0%), compared with other types of pituitary adenomas--GH-secreting adenomas, 35/46 (76.1%); PRL-secreting adenomas, 22/33 (66.7%); TSH-secreting adenomas, 8/11 (72.7%); and nonfunctioning adenomas, 55/69 (79.7%). These results suggest that p27 may play some role in the regulation of proliferation in all types of pituitary adenomas. The lower levels of p27 in ACTH-secreting adenoma is of particular interest with respect to the intermediate lobe-derived pituitary tumor developed in p27 knockout mice.
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Affiliation(s)
- K Komatsubara
- Department of Neurosurgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
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Kanazawa R, Mizutani N, Sanno N, Shimura T, Teramoto A. [A case of urinary retention secondary to aseptic meningitis]. No Shinkei Geka 2000; 28:1029-33. [PMID: 11127589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
A 46-year-old male was admitted to our hospital with headache, high fever and subsequent consciousness disturbance. Spinal fluid examination intimated aseptic meningitis. Not only these symptoms but bladder dysfunction was presented. The patient was treated with conservative therapy and bladder dysfunction was resolved a month and a half later. We report a case of urinary retention secondary to aseptic meningitis and review the clinical presentation and treatment.
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Affiliation(s)
- R Kanazawa
- Department of Neurosurgery, Tamanagayama Hospital, Nippon Medical School, Japan
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15
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Tahara S, Kurotani R, Sanno N, Takumi I, Yoshimura S, Osamura RY, Teramoto A. Expression of pituitary homeo box 1 (Ptx1) in human non-neoplastic pituitaries and pituitary adenomas. Mod Pathol 2000; 13:1097-108. [PMID: 11048804 DOI: 10.1038/modpathol.3880204] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We investigated the localization of pituitary homeo box 1 (Ptx1) protein in five human non-neoplastic pituitaries and 73 of all types of pituitary adenomas using immunohistochemistry, and the expression of Ptx1 messenger RNA (mRNA) in 18 representative pituitary adenomas using the reverse transcriptase polymerase chain reaction (RT-PCR) technique. By immunohistochemical analysis, Ptx1 protein was extensively detected in the nuclei of normal human pituitary cells. Ptx1 was detected in 10/14 (71.4%) of growth hormone (GH)-secreting adenomas, 12/12 (100%) of prolactin (PRL)-secreting adenomas, 18/20 (90%) of adrenocorticotropic hormone (ACTH)-secreting adenomas, 6/7 (85.7%) of thyroid-stimulating hormone (TSH)-secreting adenomas, and 17/20 (85%) of clinically non-functioning adenomas, including 9/10 (90%) of gonadotropin-subunit-positive adenomas. Thus, there was no relationship between Ptx1 expression and a particular type of pituitary adenomas. By RT-PCR analysis, Ptx1 mRNA was expressed in all 18 cases of pituitary adenomas, including two cases negative for Ptx1 protein by immunohistochemistry. These results suggested that Ptx1 may be an universal transcription factor in both neoplastic and non-neoplastic conditions in human pituitaries. The synergistic action with other transcription factors may be speculated to determine the specific production of the anterior pituitary hormones.
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Affiliation(s)
- S Tahara
- Department of Neurosurgery, Nippon Medical School, Tokyo, Japan
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16
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Sanno N, Teramoto A, Sugiyama M, Matsuno A, Takumi I, Tahara S, Osamura RY. Expression of Pit-1 mRNA and activin/inhibin subunits in clinically nonfunctioning pituitary adenomas. In situ hybridization and immunohistochemical analysis. Horm Res 2000; 50:11-7. [PMID: 9691207 DOI: 10.1159/000023194] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The pituitary-specific transcriptional factor Pit-1 is known to play a role in the development and differentiation of pituitary cells. Recent investigations have suggested a role for this transcriptional factor in pituitary adenomas, especially growth hormone (GH)- and prolactin (PRL)-secreting pituitary adenomas. In this study we analyzed the expression of Pit-1 mRNA and its protein in 24 clinically nonfunctioning pituitary adenomas in comparison with normal pituitary glands using in situ hybridization (ISH) and immunohistochemistry (IHC). The interaction between inhibin/activin, a member of the transforming growth factor-beta family, and Pit-1 was also studied. Immunohistochemically, Pit-1 protein was detected in 9 of 24 adenomas (37.5 %), and 8 of these 9 were also positive for the alpha subunit of glycoprotein (alphaSU). The expression of Pit-1 mRNA was detected in 14 of 24 (58.3%) clinically nonfunctioning adenomas, and it was found in all cases which expressed the Pit-1 protein. By the combined ISH and IHC method, Pit-1 mRNA was frequently observed in alphaSU-immunopositive cells in adenomas. The inhibin/activin alpha subunit was detected in all 24 adenomas and the betaA subunit was detected in 13 of 24 adenomas. The inhibin/activin betaA subunit was detected frequently with Pit-1 mRNA. From our observations, the inhibin/activin betaA subunit in nonfunctioning adenomas may have related the expression of Pit- mRNA in these adenomas.
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Affiliation(s)
- N Sanno
- Department of Neurosurgery, Nippon Medical School, Tokyo, Japan
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Abstract
OBJECT Thyrotropin-secreting pituitary adenomas are rare lesions of the endocrinological system. Although introduction of a hypersensitive radioimmunoassay for thyrotropin enables the recognition of inappropriate secretion of this hormone, the aforementioned lesions remain uncommon and unfamiliar to most neurosurgeons. It has been reported previously that surgical cure of thyrotropin-secreting adenomas is more difficult than in other functional adenomas because of the large size and invasive features of the former. However, the long-term outcome after surgery has not been well documented. The authors report on a surgical series of 16 patients with thyrotropin adenoma and the results of long-term follow up. METHODS Sixteen patients ages 23 to 62 years (12 women and four men) underwent transsphenoidal removal of thyrotropin adenomas between 1983 and 1999. These patients had the syndrome of inappropriate thyrotropin secretion (SITS) with pituitary mass lesions. Four of the patients had undergone previous subtotal thyroidectomy and/or radioiodine thyroid ablation, and 11 had been treated with antithyroid medication. Radiological investigations demonstrated macroadenomas in 14 patients, and 10 of those had cavernous sinus invasion. Surgical findings showed unusually fibrous and firm tumors in 13 (81.2%) of 16 patients. Preoperative octreotide administration was revealed to be effective for serum thyrotropin reduction as well as tumor shrinkage. Transsphenoidal surgery was performed with no morbidity resulting. Surgical remission was achieved in 10 (62.5%) of 16 patients, and total remission was achieved in 14 patients (87.5%) with a combination of additional radiation or medical therapy. In the other two patients, SITS persisted because of tumor rests in the cavernous sinus. Therefore, radiation and/or antithyroid therapy was administered. In the mean follow-up period of 7.5 years (range 11 months-15.8 years), no recurrence of tumor was observed on magnetic resonance images, whereas recurrence of SITS was found in two patients with no tumor regrowth. In addition, coexistent primary hyperthyroidism was found in two other patients despite remission of SITS after surgery. CONCLUSIONS Transsphenoidal surgery can achieve a good long-term outcome in patients with thyrotropin-secreting pituitary adenomas if surgery is performed before these become larger, invasive tumors. In the authors' experience, thyrotropin-secreting adenomas are fibrous and firm, which makes it difficult to achieve surgical remission. In addition, even satisfactory resection of the tumor sometimes results in recurrence of SITS or hyperthyroid symptoms due to coexistent primary hyperthyroidism. It is emphasized that a careful follow-up review is necessary after surgery, especially in patients with a long preoperative history of hyperthyroidism.
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Affiliation(s)
- N Sanno
- Department of Neurosurgery, Nippon Medical School, Tama-city, Tokyo, Japan
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18
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Osamura RY, Tahara S, Kurotani R, Sanno N, Matsuno A, Teramoto A. Contributions of immunohistochemistry and in situ hybridization to the functional analysis of pituitary adenomas. J Histochem Cytochem 2000; 48:445-58. [PMID: 10727285 DOI: 10.1177/002215540004800401] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Immunohistochemistry (IHC) and recently in situ hybridization (ISH) have elucidated various aspects of human pituitary adenomas, i.e., functional differentiation and classification, transcription factors and mechanism of hormone production, regulation of hormone secretion, and processing of prohormones. Recently, the use of tyramide (catalyzed signal amplification; TSA or CSA) and RT-PCR has been effective for detection of trivial amount of proteins (peptides) and mRNA, respectively. Immunomolecular histochemistry is expected to further clarify the function and biology of human pituitary adenomas.
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Affiliation(s)
- R Y Osamura
- Department of Pathology, Tokai University School of Medicine, Boseidai Isehara-city, Kanagawa, Japan
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19
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Sanno N, Ishii Y, Sugiyama M, Takagi R, Node Y, Teramoto A. Subarachnoid haemorrhage and vasospasm due to pituitary apoplexy after pituitary function tests. Acta Neurochir (Wien) 1999; 141:1009-10. [PMID: 10526084 DOI: 10.1007/s007010050409] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- N Sanno
- Department of Neurosurgery, Nippon Medical School, Sendagi Bunkyo-ku, Tokyo, Japan
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20
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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 ACTH-secreting 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 ACTH-secreting 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 ACTH-secreting 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.
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Affiliation(s)
- N Sanno
- Department of Neurosurgery and Internal Medicine, Nippon Medical School, Tokyo, Japan
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21
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Kurotani R, Osamura R, Tahara S, Sanno N, Teramoto A, Mellon P, Inoue K, Yoshimura S. Expression of Ptx1 in the adult rat pituitary glands and pituitary cell lines: hormone-secreting cells and folliculo-stellate cells. Cell Tissue Res 1999; 298:55-61. [PMID: 10555539 PMCID: PMC6095709 DOI: 10.1007/pl00008809] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The pituitary homeobox1 gene (Ptx1) was initially identified as encoding a pituitary-restricted transcription factor for the proopiomelanocortin (POMC) gene. In order to elucidate the expression pattern of the Ptx1 protein, we investigated the localization of the protein in adult rat pituitary gland and in various pituitary cell lines. We produced an antibody specific for Ptxl protein, and confirmed its specificity by Western blot analysis. Immunohistochemically, many nuclei in the anterior pituitary cells as well as in the intermediate cells were positive for Ptxl staining with this specific antibody. Immunohistochemical double staining revealed the presence of Ptx1 not only in all types of hormone-secreting cells but also in some folliculo-stellate (FS) cells. Furthermore, the expression of Ptx1 mRNA was confirmed in various pituitary cell lines and in the FS cell line by using the reverse transcriptase-polymerase chain reaction (RT-PCR) method. Our studies indicated that Ptxl may not only play a role as a basic transcriptional factor for production of various hormones, but may also play some important role(s) in FS cells. Possible synergistic actions with other factors remain to be investigated. The novel finding of Ptx1 in FS cells is of particular interest, and may suggest that FS cells and hormone-secreting cells are derived from a common cellular ancestor.
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Affiliation(s)
| | - R.Y. Osamura
- Department of Pathology, Tokai University School of Medicine, Boseidai Isehara City, Kanagawa 259-1193, Japan, ; Tel: +81 463 93 1121; Fax: +81 463 91 1370
| | | | | | - A. Teramoto
- Department of Neurosurgery, Nippon Medical School, Tokyo
| | - P.L. Mellon
- Department of Reproductive Medicine and Neuroscience, School of Medicine, University of California, San Diego, USA
| | - K. Inoue
- Department of Regulation Biology, Faculty of Science, Saitama University, Saitama, Japan
| | - S. Yoshimura
- Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa, Japan
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22
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Abstract
An autosomal-dominant syndrome known as multiple endocrine neoplasia type 1 (MEN1) is characterized by tumors in parathyroid glands, pancreatic endocrine tissues and the anterior pituitary gland. The predisposing gene was identified at 11q13 when germline mutations in the MEN1 gene were detected in affected pedigrees. To investigate a possible role of this gene in tumorigenesis of non-familial pituitary adenomas, we examined 24 sporadic tumors from Japanese patients for loss of heterozygosity (LOH) at the 11q13 region and for somatic mutations in the entire coding region and exon-intron boundaries of MEN1. Although three common sequence variants were detected, none of the tumors exhibited either LOH or somatic mutations of this gene. Our results indicate that inherited and sporadic forms of pituitary adenomas are different in terms of the genetic events that contribute to their development, and that other loci associated with pituitary neoplasia must still be sought.
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Affiliation(s)
- K Fukino
- Department of Molecular Biology, Institute of Gerontology, Nippon Medical School, Kawasaki-shi, Japan
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23
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Matsuno A, Katakami H, Sanno N, Ogino Y, Osamura RY, Matsukura S, Shimizu N, Nagashima T. Pituitary somatotroph adenoma producing growth hormone (GH)-releasing hormone (GHRH) with an elevated plasma GHRH concentration: a model case for autocrine and paracrine regulation of GH secretion by GHRH. J Clin Endocrinol Metab 1999; 84:3241-7. [PMID: 10487694 DOI: 10.1210/jcem.84.9.6008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
An acromegalic patient with a pituitary somatotroph adenoma associated with an extremely elevated plasma GHRH concentration is presented. The preoperatively high concentration of plasma GHRH returned to the normal level after successful removal of the adenoma. GHRH production and GHRH gene expression were confirmed in the adenoma by studies including immunohistochemistry and in situ hybridization. Expression of GHRH receptor messenger ribonucleic acid was verified by in situ hybridization. Immunohistochemical double staining for GH and GHRH revealed their colocalization in single adenoma cells. These findings confirmed the autocrine or paracrine regulation of GH production by endogenous GHRH from the adenoma cells. GHRH synthesis in the pituitary gland has recently been demonstrated, however, there have been no previous reports of a GHRH-producing pituitary somatotroph adenoma associated with an elevated plasma GHRH concentration. The existence of this GHRH-producing adenoma suggests a possible role of locally generated GHRH in the progression of somatotroph adenomas, i.e. the monoclonally established somatotroph adenomas develop further under the influence of locally produced GHRH. The demonstration of GHRH production by this somatotroph adenoma is of importance in clarifying the autocrine or paracrine regulation of GH production and the progression of human somatotroph adenomas.
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Affiliation(s)
- A Matsuno
- Department of Neurosurgery, Teikyo University Ichihara Hospital, Ichihara City, Chiba, Japan
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24
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Tajima A, Osamura RY, Takekoshi S, Itoh Y, Sanno N, Mine T, Fujita T. Distribution of adrenomedullin (AM), proadrenomedullin N-terminal 20 peptide, and AM mRNA in the rat gastric mucosa by immunocytochemistry and in situ hybridization. Histochem Cell Biol 1999; 112:139-46. [PMID: 10460467 DOI: 10.1007/s004180050400] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Adrenomedullin (AM) is a novel vasorelaxant peptide isolated from pheochromocytoma. Proadrenomedullin N-terminal 20 peptide (PAMP) is a hypotensive peptide generated by posttranslational enzymatic processing of a 185-amino acid pro-AM molecule, the same precursor as AM. In this study, we investigated localizations of these peptides by immunocytochemistry and AM mRNA by non-radioisotopic in situ hybridization followed by the streptavidin and biotin complex (ABC) method and catalyzed signal amplification (CSA) in the rat adrenal medulla and gastric mucosa. In the gastric mucosa, both AM- and PAMP-like immunoreactivities were found in the neuroendocrine cells, but PAMP-positive cells were more abundant than AM-positive ones. By immunoelectron microscopy, AM and PAMP were localized exclusively in the secretory granules. The distribution pattern of AM mRNA-positive cells, only a limited portion of which had AM and/or PAMP, was also similar to that of the two peptides. But AM mRNA was detected also in a few epithelial cells as well as neuroendocrine cells. The two peptides might play an important role in the control of local circulation in the rat stomach.
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Affiliation(s)
- A Tajima
- Fourth Department of Internal Medicine, Tokyo University School of Medicine, 3-28-6 Mejirodai, Bunkyo-ku, Tokyo 112-0086, Japan
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25
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Abstract
Pituitary adenoma is a common neoplasm accounting for 10% of all intracranial tumors. Although the molecular mechanisms underlying the formation of these tumors are largely unknown, a small portion of pituitary adenomas occur in patients with the multiple endocrine neoplasia syndrome type 1 (MEN 1). Although two groups in the United States and Canada have recently reported that sporadic pituitary adenomas very rarely harbor a somatic mutation in the MEN1, MEN1 gene mutation analysis in sporadic pituitary adenomas has not yet been carried out in the Japanese population. To elucidate the potential etiological role of the MEN1 gene in the formation of sporadic pituitary adenomas in Japan, we investigated 40 Japanese patients with sporadic pituitary adenomas (16 hormone-secreting and 24 nonsecreting tumors) for MEN1 gene mutation. Polymerase chain reaction-single-stranded DNA conformation polymorphism analysis and sequencing demonstrated a somatic mutation in the MEN1 gene in only one of the 40 tumors, a prolactinoma, which had a 1-bp deletion in the coding sequence of exon 2. The data suggest that somatic mutations in the MEN1 gene do not play a prominent role in the pathogenesis of sporadic pituitary adenomas.
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Affiliation(s)
- C Wenbin
- Department of Neurosurgery, Faculty of Medicine, University of Tokyo, Japan
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26
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Shuto Y, Nakano T, Sanno N, Domoto H, Sugihara H, Wakabayashi I. Reduced growth hormone receptor messenger ribonucleic acid in an aged man with chronic malnutrition and growth hormone resistance. J Clin Endocrinol Metab 1999; 84:2320-3. [PMID: 10404796 DOI: 10.1210/jcem.84.7.5829] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
A severely malnourished 87-yr-old man presented with hypoglycemia. Serum GH levels were elevated, and serum levels of insulin-like growth factor I (IGF-I), IGF-binding protein-3, and GH-binding protein were extremely reduced. The patient's GH was biologically active. Administration of GH for 4 consecutive days resulted in a slight increment in serum IGF-I levels, but no elevation of serum IGF-binding protein-3. The expression of GH receptor messenger ribonucleic acid in the liver was greatly reduced. An autopsy revealed a Rathke's cleft cyst confined to the sella turcica. Immunohistochemical studies for GH showed that there was nothing to suggest a tumor overproducing GH. In addition, TSH levels were elevated in the presence of normal thyroid hormone levels, and there was a cluster of cells showing strong immunohistochemical staining for the TSH beta-subunit in the pituitary. In this patient, the decreased expression of GH receptor messenger ribonucleic acid in the liver may have been responsible for the GH resistance, which was probably caused by malnutrition.
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Affiliation(s)
- Y Shuto
- Department of Medicine, Tokyo Metropolitan Tama Geriatric Hospital, Japan.
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27
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Tahara S, Sanno N, Teramoto A, Osamura RY. Expression of Rab3, a Ras-related GTP-binding protein, in human nontumorous pituitaries and pituitary adenomas. Mod Pathol 1999; 12:627-34. [PMID: 10392640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Rab proteins are low molecular weight GTP-binding proteins. Among these proteins, the Rab3 isoforms are considered to be involved in the exocytosis of synaptic vesicles and secretory granules in the central nervous system and anterior pituitary gland. In recent reports, the expression of Rab3 isoforms in anterior pituitary glands of mammalian species was extensively investigated. In the present study, we investigated the localization of Rab3 protein in 5 human nontumorous pituitaries and 114 human pituitary adenomas using immunohistochemical methods. In five human nontumorous pituitaries, Rab3 protein was expressed in the cytoplasm of anterior pituitary cells. Double staining for anterior pituitary hormones revealed the expression of Rab3 in growth hormone-secreting cells, but rare expression was observed in the other anterior pituitary hormone-secreting cells. Among the pituitary adenomas, 71 (62.3%) of 114 pituitary adenomas were positive for Rab3. Among the different pituitary adenoma types, the incidence of Rab3 immunopositivity was highest in growth hormone-secreting adenomas (100%), followed by adrenocorticotropic hormone-secreting adenomas (71.4%), thyroid-stimulating hormone-secreting adenomas (57.1%), nonfunctioning adenomas (56.0%), and prolactin-secreting adenomas (33.3%). After an embedding immunoelectron microscopic study, Rab3 was localized along the limiting membrane of secretory granules in the Rab3-positive pituitary adenomas. Western blotting showed the molecular weight of Rab3 to be 25 kDa in the pituitary adenomas, which were immunohistochemically positive for Rab3 protein. These results suggested that Rab3 might be involved in regulating the exocytosis of secretory granules of the anterior pituitary cells, especially growth hormone-secreting ones, which are particularly characterized by densely granulated cytologic features.
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Affiliation(s)
- S Tahara
- Department of Neurosurgery, Nippon Medical School, Tokyo, Japan
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28
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Osamura RY, Tahara S, Komatsubara K, Itoh Y, Kajiwara H, Kurotani R, Sanno N, Teramoto A. Pit-1 positive alpha-subunit positive nonfunctioning human pituitary adenomas: a dedifferentiated GH cell lineage? Pituitary 1999; 1:269-71. [PMID: 11081207 DOI: 10.1023/a:1009954409469] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Pit-1 is a transcription factor which has been reported to regulate differentiation toward GH, PRL and TSH in the anterior pituitary glands. In the human pituitary adenomas, Pit-1 is highly expressed in GH secreting and TSH secreting adenomas as it can well be anticipated. Interestingly, human non-functioning pituitary adenomas also express Pit-1, especially it was expressed in all alpha SU positive nonfunctioning adenomas. The human anterior pituitary cells are special in comparison with rodents in a finding that alpha SU is frequently colocalized with GH. As alpha SU is the first hormone appearing during fetal development in the rodent pituitary glands, it may be postulated that alpha SU Pit-1 positive cells undergo differentiation in the GH cell lineage. From this background, this paper proposes that "alpha SU positive Pit-1 Positive" cells are the ones in the GH cell lineage, more specifically a dedifferentiated cell lineage toward alpha SU/GH/Pit-1.
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Affiliation(s)
- R Y Osamura
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan.
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29
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Matsuno A, Sanno N, Tahara S, Teramoto A, Osamura RY, Wada H, Murakami M, Tanaka H, Nagashima T. Silent somatotroph adenoma, detected by catalyzed signal amplification and non-radioisotopic in situ hybridization. Endocr J 1999; 46 Suppl:S81-4. [PMID: 12054127 DOI: 10.1507/endocrj.46.suppl_s81] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- A Matsuno
- Department of Neurosurgery, Teikyo University Ichihara Hospital, Chiba, Japan
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30
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Affiliation(s)
- M Sugiyama
- Department of Neurosurgery, Nippon Medical School, Tokyo, Japan
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31
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Teramoto A, Yoshida Y, Sanno N, Nemoto S. Cavernous sinus sampling in patients with adrenocorticotrophic hormone-dependent Cushing's syndrome with emphasis on inter- and intracavernous adrenocorticotrophic hormone gradients. J Neurosurg 1998; 89:762-8. [PMID: 9817414 DOI: 10.3171/jns.1998.89.5.0762] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT As an alternative method to inferior petrosal sinus sampling with administration of corticotropin-releasing hormone (CRH), the authors have developed a method of selective venous sampling directly from the cavernous sinus, which is performed using a superselective catheterization technique. The goal of this study is to assess this method. METHODS Catheterization to the cavernous sinus was performed in 44 patients with clinical and biochemical features of Cushing's syndrome. Forty of these patients in whom there was a definite clinical and/or histological diagnosis were evaluated. In 35 patients, a pituitary microadenoma was detected on magnetic resonance imaging and/or during surgery. Ectopic lesions were suspected in five patients, who later developed nonpituitary tumors. The central/peripheral (C/P) ratios of adrenocorticotrophic hormone (ACTH) without CRH administration ranged from 5.2 to 448.1 (mean+/-standard deviation, 66.7+/-91.2) in cavernous sinuses and from 1.1 to 52 (mean+/-standard deviation, 8.5+/-9.9) in the inferior petrosal sinuses. The petrosal sinus sampling contained false negative results in eight patients (23%) based on a cutoff point of 2. On the contrary, patients with ectopic lesions did not show any increase in ACTH levels in either sampling portion. The intercavernous gradients of ACTH, ranging from 1.2 to 506.4, indicated the correct lateralization of microadenoma in the lateral wing in all 30 patients. The interpetrosal gradients, ranging from 1 to 31.4, did not give a sufficient value (> or = 1.4) in four patients (13%) with a lateral lesion. In five cases of midline tumors, the intercavernous and interpetrosal gradients indicated false laterality in three and four cases, respectively. The intracavernous (posterior-anterior) gradients, ranging from 1.04 to 60.7 (mean 14.9), showed a higher concentration of ACTH in the posterior portion of the sinus in all patients. CONCLUSIONS These results suggest that 1) cavernous sinus sampling without CRH administration can demonstrate hypersecretion of ACTH from the pituitary gland with a high diagnostic accuracy; 2) intercavernous gradients will indicate the correct lateralization in laterally localized microadenomas; and 3) sampling should be performed from the posterior portion of the cavernous sinus.
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Affiliation(s)
- A Teramoto
- Department of Neurosurgery, Nippon Medical School, Tokyo, Japan.
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32
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Sanno N. [Expression of hypothalamic hormone and hypothalamic hormone receptor genes in human pituitary and pituitary adenomas using in situ reverse transcription-polymerase chain reaction]. Nihon Ika Daigaku Zasshi 1998; 65:405-8. [PMID: 9808997 DOI: 10.1272/jnms1923.65.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- N Sanno
- Department of Neurosurgery, Nippon Medical School
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33
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Sanno N, Shimura T, Takumi I, Tahara S, Node Y, Aihara K, Osamura RY, Teramoto A. An adult case of cerebral primitive neuroectodermal tumour. Acta Neurochir (Wien) 1998; 140:445-6. [PMID: 9728243 DOI: 10.1007/s007010050122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- N Sanno
- Department of Neurosurgery, Nippon Medical School, Japan
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34
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Matsuno A, Nagashima T, Takekoshi S, Utsunomiya H, Sanno N, Osamura RY, Watanabe K, Tamura A, Teramoto A. Ultrastructural simultaneous identification of growth hormone and its messenger ribonucleic acid. Endocr J 1998; 45 Suppl:S101-4. [PMID: 9790240 DOI: 10.1507/endocrj.45.suppl_s101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- A Matsuno
- Department of Neurosurgery, Teikyo University Ichihara Hospital, Chiba, Japan
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35
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Takumi I, Steiner DF, Sanno N, Teramoto A, Osamura RY. Localization of prohormone convertases 1/3 and 2 in the human pituitary gland and pituitary adenomas: analysis by immunohistochemistry, immunoelectron microscopy, and laser scanning microscopy. Mod Pathol 1998; 11:232-8. [PMID: 9521468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Prohormone convertase (PC) 1/3 and PC2 are involved in post-translational processing of endocrine tissues, including the pancreatic islets and pituitary glands. Our immunohistochemical studies disclosed the presence of PC1/3 and PC2 in non-neoplastic pituitary glands, especially in corticotrophs, gonadotrophs, and thyrotrophs. Among 58 pituitary adenomas obtained by trans-sphenoidal surgery, adrenocorticotropin (ACTH)-secreting adenomas showed a high incidence of the presence of PC1/3 and PC2, i.e., nine of nine cases were positive for ACTH. Five of nine cases showed consistency between PC2 localization and alpha-melanocyte stimulating hormone immunoreactivity, which suggests the functional correlation between PC2 and the processing of ACTH. In four cases, we observed inconsistency in immunolocalization, which suggested the possibility of inactive PC2 and abnormal processing of alpha-melanocyte stimulating hormone. The high incidence of PC1/3 and PC2 in nonfunctioning adenomas might be related to the processing of chromogranin A.
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Affiliation(s)
- I Takumi
- Department of Neurosurgery, Nippon Medical School, Sendagi, Tokyo, Japan.
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36
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Hirano H, KASAI KI, Kawakami H, Hirano H, AOKI D, SAITOH E, SUSUMU N, UDAGAWA Y, NOZAWA S, TAI T, Irimura T, HIRAOKA Y, Matsuno A, Nagashima T, Osamura R, Watanabe K, KOJI T, NAKANE PK, Sasaki J, Yamamoto H, Nomura T, Matsuura J, Osamura R, Sanno N, Itoh Y, Kajiwara H, Teramoto A, KATOH R, IBATA Y, HASEGAWA S, Suzuki T, OGAWA H, UMESONO K, Terakawa S, Sakurai T, Kudo Y, Morita M, Higashi H, SUEMATSU M, WAKABAYASHI Y, ISHIMURA Y, HIGUCHI T, KUDOH KI, YOKOTA H, KOKUBO M, Dotsu M, Morishita T, Kinoshita H, Kudo A. Abstracts. Acta Histochem Cytochem 1998. [DOI: 10.1267/ahc.31.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Hiroshi Hirano
- Department of Anatomy, Kyorin University School of Medicine
| | | | - H. Kawakami
- Department of Anatomy, Kyorin University School of Medicine
| | - H. Hirano
- Department of Anatomy, Kyorin University School of Medicine
| | - Daisuke AOKI
- Department of Obstetrics and Gynecology. School of Medicine, Keio University
| | - Eiko SAITOH
- Department of Obstetrics and Gynecology. School of Medicine, Keio University
| | - Nobuyuki SUSUMU
- Department of Obstetrics and Gynecology. School of Medicine, Keio University
| | - Yasuhiro UDAGAWA
- Department of Obstetrics and Gynecology. School of Medicine, Keio University
| | - Shiro NOZAWA
- Department of Obstetrics and Gynecology. School of Medicine, Keio University
| | - Tadashi TAI
- Department of Tumor Immunology, The Tokyo Metropolitan Institute of Medical Science
| | - Tatsuro Irimura
- Laboratory of Cancer Biology and Molecular Immunology, Graduate School of Pharmaceutical Sciences, The University of Tokyo
| | | | | | | | | | | | - Takehiko KOJI
- Department of Histology and Cell Biology, Nagasaki University School of Medicine
| | - Paul K. NAKANE
- Department of Histology and Cell Biology, Nagasaki University School of Medicine
| | - Junzo Sasaki
- Department of Anatomy, Okayama University Medical School
| | - Hitoshi Yamamoto
- Department of Oral Anatomy, School of Dentistry, Iwate Medical University
| | - Takako Nomura
- Department of Anatomy, Okayama University Medical School
| | - Junko Matsuura
- Department of Anatomy, Okayama University Medical School
| | - R.Y. Osamura
- Department of Pathology, Tokai University, School of Medicine
| | - N. Sanno
- Department of Neurosurgery, Nippon Medical School
| | - Y. Itoh
- Department of Pathology, Tokai University, School of Medicine
| | - H. Kajiwara
- Department of Pathology, Tokai University, School of Medicine
| | - A. Teramoto
- Department of Neurosurgery, Nippon Medical School
| | - Ryohei KATOH
- Department of Pathology, Yamanashi Medical University
| | - Yasuhiko IBATA
- Department of Anatomy and Neurobiology, Kyoto Prefectural University of Medicine
| | | | - Takeshi Suzuki
- Institute for Molecular and Cellular Regulation, Gunma University
| | | | | | - Susumu Terakawa
- Photon Medical Research Center, Hamamatsu University School of Medicine
| | - Takashi Sakurai
- Photon Medical Research Center, Hamamatsu University School of Medicine
| | | | | | | | - Makoto SUEMATSU
- Department of Biochemistry, School of Medicine, Keio University
| | | | - Yuzuru ISHIMURA
- Department of Biochemistry, School of Medicine, Keio University
| | | | | | | | | | | | | | | | - Akihiko Kudo
- Department of Anatomy, Kyorin University School of Medicine
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37
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Zhou X, Kudo A, Kawakami H, Hirano H, FAYED M, MAKITA T, SUZAKI E, KATAOKA K, Katsumata O, Fujimoto K, Yamashina S, USUDA N, JOHKURA K, SUGANUMA T, SAWAGUCHI A, NAGAIKE R, KAWANO JI, OINUMA T, Izumi SI, Iwamoto M, Shin M, Nakano PK, Ueda T, Ishikawa Y, Kubo E, Miyoshi N, Fukuda M, Akagi Y, Miki H, Nakajima M, Yuge K, Taomoto M, Tsubura A, Shikata N, Senzaki H, MASUDA A, NAGAOKA T, OYAMADA M, TAKAMATSU T, Furuta H, Hata Y, Yokoyama K, Takamatsu T, Itoh J, Takumi I, Kawai K, Serizawa A, Sanno N, Teramoto A, Osamura R, MATSUTA M, MATSUTA M, I N, TAKAHASHI S, KAWABE K, LIEBER MM, JENKINS RB, SASANO HIRONOBU, IINO KAZUMI, SUZUKI TAKASHI, NAGURA HIROSHI, Ge YB, Ohmori J, Tsuyama S, Yang DH, Murata F, JOHKURA K, LIANG Y, MATSUI T, NAKAZAWA A, HIGUCHI S, MATSUSHITA Y, Naritaka H, Kameya T, Sato Y, Inoue H, Otani M, Kawase T, KUROOKA Y, NASU K, KAMEYAMA S, MORIYAMA N, YANO J, TSUJIMOTO G, Matsushita T, Oyamada M, YAMAMOTO H, MATSUURA J, NOMURA T, SASAKI J, NAWA T, KITAZAWA R, KITAZAWA S, KASIMOTO H, MAEDA S, WATANABE J, Mino K, KONDO K, KANAMURA S, Ueki T, Takeuchi T, Nishimatsu H, Kajiwara T, Moriyama N, Kawabe K, Tominaga T, Kobayashi KI, Minei S, Okada Y, Yamanaka Y, Ichinose T, Hachiya T, Hirano D, Ishida H, Okada K, HASEGAWA H, WATANABE K, ITOH J, HASEGAWA H, UMEMURA S, YASUDA M, TAKEKOSHI S, OSAMURA R, WATANABE K, TAKEDA K, HOSHI T, KATO K, OHARA S, KONNO R, ASAKI S, TOYOTA T, TATENO H, NISHIKAWA S, SASAKI F, Ito Y, Matsumoto K, Daikoku E, Otsuki Y, SANO M, UMEZAWA A, ABE H, FUKUMA M, SUZUKI A, ANDO T, HATA JI. Abstracts. Acta Histochem Cytochem 1998. [DOI: 10.1267/ahc.31.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | - M.H. FAYED
- Department of Anatomy, Faculty of Veterinary Medicine Tanta University
- Department of Veterinary Anatomy, Faculty of Agriculture, Yamaguchi University
| | - T. MAKITA
- Department of Veterinary Anatomy, Faculty of Agriculture, Yamaguchi University
| | - Etsuko SUZAKI
- Department of Anatomy, Hiroshima University School of Medicine
| | - Katsuko KATAOKA
- Department of Anatomy, Hiroshima University School of Medicine
| | | | | | | | - Nobuteru USUDA
- Department of Anatomy and Cell Biology, Shinshu University School of Medicine
| | - Kohhei JOHKURA
- Department of Anatomy and Cell Biology, Shinshu University School of Medicine
| | | | | | | | | | | | - Shin-ichi Izumi
- Department of Histology and Coll Biology, Nmgmeaki University School of Medicine
| | | | - Masashi Shin
- Department of Histology and Coll Biology, Nmgmeaki University School of Medicine
| | | | | | | | | | | | | | | | - H. Miki
- Department of Ophthalmology and Pathology, Kansai Medical University
| | - M. Nakajima
- Department of Ophthalmology and Pathology, Kansai Medical University
| | - K. Yuge
- Department of Ophthalmology and Pathology, Kansai Medical University
| | - M. Taomoto
- Department of Ophthalmology and Pathology, Kansai Medical University
| | - A. Tsubura
- Department of Ophthalmology and Pathology, Kansai Medical University
| | - N. Shikata
- Department of Ophthalmology and Pathology, Kansai Medical University
| | - H. Senzaki
- Department of Ophthalmology and Pathology, Kansai Medical University
| | - Atsushi MASUDA
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine
| | - Takanori NAGAOKA
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine
| | - Masahito OYAMADA
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine
| | - Tetsuro TAKAMATSU
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine
| | - Hirokazu Furuta
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine
| | - Yoshinobu Hata
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine
| | - Keiichi Yokoyama
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine
| | - Tetsuro Takamatsu
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine
| | | | | | - K. Kawai
- Div of Diag Pathol Tokai Univ Sch of Med
| | | | | | | | | | | | | | - Nishiya I
- Departments of Obstetrics and Gynecology
| | - Satoru TAKAHASHI
- Department of Urology, Faculty of Medicine, The University of Tokyo
| | - Kazuki KAWABE
- Department of Urology, Faculty of Medicine, The University of Tokyo
| | | | | | - HIRONOBU SASANO
- Department of Pathology, Tohoku University School of Medicine
| | - KAZUMI IINO
- Department of Pathology, Tohoku University School of Medicine
| | - TAKASHI SUZUKI
- Department of Pathology, Tohoku University School of Medicine
| | - HIROSHI NAGURA
- Department of Pathology, Tohoku University School of Medicine
| | - Y-B Ge
- Department of Anatomy, Faculty of Medicine, Kagoshima University
| | - J. Ohmori
- Department of Anatomy, Faculty of Medicine, Kagoshima University
| | - S. Tsuyama
- Department of Anatomy, Faculty of Medicine, Kagoshima University
| | - D-H Yang
- Department of Anatomy, Faculty of Medicine, Kagoshima University
| | - F. Murata
- Department of Anatomy, Faculty of Medicine, Kagoshima University
| | - Kohei JOHKURA
- Department of Anatomy and Cell Biology, Shinshu University School of Medicine
| | - Yan LIANG
- Department of Anatomy and Cell Biology, Shinshu University School of Medicine
| | - Toshifumi MATSUI
- Department of Geriatric Medicine, Tohoku University School of Medicine
| | - Ayami NAKAZAWA
- Department of Anatomy and Cell Biology, Shinshu University School of Medicine
| | - Susumu HIGUCHI
- National Institute of Alcoholism, National Kurihama Hospital
| | | | - Heiji Naritaka
- Department of Pathology, Kitasato University, Department of Neurosurgery, Keio University
| | - Toru Kameya
- Department of Pathology, Kitasato University, Department of Neurosurgery, Keio University
| | - Yuichi Sato
- Department of Pathology, Kitasato University, Department of Neurosurgery, Keio University
| | - Hiroshi Inoue
- Department of Pathology, Kitasato University, Department of Neurosurgery, Keio University
| | - Mitsuhiro Otani
- Department of Pathology, Kitasato University, Department of Neurosurgery, Keio University
| | - Takeshi Kawase
- Department of Pathology, Kitasato University, Department of Neurosurgery, Keio University
| | - Yuji KUROOKA
- Department of Uroloby, Faculty of Medicine, The University of Tokyo
| | - Kimio NASU
- Department of Molecular Biology, Reserch Laboratories, Nippon Shinyaku Co. Ltd
| | - Shuji KAMEYAMA
- Department of Uroloby, Faculty of Medicine, The University of Tokyo
| | - Nobuo MORIYAMA
- Department of Uroloby, Faculty of Medicine, The University of Tokyo
| | - Junichi YANO
- Department of Molecular Biology, Reserch Laboratories, Nippon Shinyaku Co. Ltd
| | - Gozo TSUJIMOTO
- Division of Pediatric Pharmacology, National Children's Medical Reserch Center
| | - Tsutomu Matsushita
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine
| | - Masahito Oyamada
- Department of Pathology and Cell Regulation, Kyoto Prefectural University of Medicine
| | - Hitoshi YAMAMOTO
- Department of Oral Anatomy, School of Dentistry, Iwate Medical University
| | - Junko MATSUURA
- Department of Anatomy, Okayama University Medical School
| | - Takako NOMURA
- Department of Anatomy, Okayama University Medical School
| | - Junzo SASAKI
- Department of Anatomy, Okayama University Medical School
| | - Tokio NAWA
- Department of Oral Anatomy, School of Dentistry, Iwate Medical University
| | | | | | - Hideyoshi KASIMOTO
- Department of Pathology
- Department of Orthopaedic Surgery, Kobe University School of Medicine
| | | | - Jun WATANABE
- Department of Anatomy, Kansai Medical University
| | - Kazuto Mino
- Department of Anatomy, Kansai Medical University
| | | | | | - Tetsuo Ueki
- Department of Urology, Faculty of Medicine, The University of Tokyo Department of Urology, Mitsui Memorial Hospital
| | - Takumi Takeuchi
- Department of Urology, Faculty of Medicine, The University of Tokyo Department of Urology, Mitsui Memorial Hospital
| | - Hiroaki Nishimatsu
- Department of Urology, Faculty of Medicine, The University of Tokyo Department of Urology, Mitsui Memorial Hospital
| | - Takahiro Kajiwara
- Department of Urology, Faculty of Medicine, The University of Tokyo Department of Urology, Mitsui Memorial Hospital
| | - Nobuo Moriyama
- Department of Urology, Faculty of Medicine, The University of Tokyo Department of Urology, Mitsui Memorial Hospital
| | - Kazuki Kawabe
- Department of Urology, Faculty of Medicine, The University of Tokyo Department of Urology, Mitsui Memorial Hospital
| | - Takashi Tominaga
- Department of Urology, Faculty of Medicine, The University of Tokyo Department of Urology, Mitsui Memorial Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - M. YASUDA
- Dept of Pathol Tokai Univ Sch of Med
| | | | | | | | - Kazuo TAKEDA
- Department of Anatomy, Kansai Medical University
| | - Tatsuya HOSHI
- Departments of Pathology, Medicine and Obstetrics and Gynecology, the Tohoku University School of Medicine
| | - Katsuaki KATO
- Departments of Pathology, Medicine and Obstetrics and Gynecology, the Tohoku University School of Medicine
| | - Shuichi OHARA
- Departments of Pathology, Medicine and Obstetrics and Gynecology, the Tohoku University School of Medicine
| | - Ryo KONNO
- Departments of Pathology, Medicine and Obstetrics and Gynecology, the Tohoku University School of Medicine
| | - Shigeru ASAKI
- Departments of Pathology, Medicine and Obstetrics and Gynecology, the Tohoku University School of Medicine
| | - Takayoshi TOYOTA
- Departments of Pathology, Medicine and Obstetrics and Gynecology, the Tohoku University School of Medicine
| | - Hiroo TATENO
- Departments of Pathology, Medicine and Obstetrics and Gynecology, the Tohoku University School of Medicine
| | - Sumio NISHIKAWA
- Department of Biology, Tsurumi University School of Dental Medicine
| | - Fumie SASAKI
- Department of Biology, Tsurumi University School of Dental Medicine
| | - Yuko Ito
- Department of Anatomy and Biology, Osaka Medical College
| | | | - Eriko Daikoku
- Department of Anatomy and Biology, Osaka Medical College
| | | | - Makoto SANO
- Department of Pathology, Keio University School of Medicine
| | | | - Hitoshi ABE
- Department of Pathology, Keio University School of Medicine
| | - Mariko FUKUMA
- Department of Pathology, Keio University School of Medicine
| | - Atsushi SUZUKI
- Department of Pathology, Keio University School of Medicine
| | - Takashi ANDO
- Department of Pathology, Keio University School of Medicine
| | - Jun-ichi HATA
- Department of Pathology, Keio University School of Medicine
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Itoh J, Sanno N, Matsuno A, Itoh Y, Watanabe K, Osamura RY. Application of confocal laser scanning microscopy (CLSM) to visualize prolactin (PRL) and PRL mRNA in the normal and estrogen-treated rat pituitary glands using non-fluorescent probes. Microsc Res Tech 1997; 39:157-67. [PMID: 9361267 DOI: 10.1002/(sici)1097-0029(19971015)39:2<157::aid-jemt7>3.0.co;2-i] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In the present study, we performed concomitant visualization of immunohistochemistry (IHC) and in situ hybridization (ISH) on the materials processed for conventional light microscopic specimens using non-fluorescent Confocal Laser. Scanning Microscopy (CLSM). CLSM was used in the reflection confocal mode using horseradish peroxidase (HRP)-3-3'diaminobenzidine (DAB)-osmium (osmium black) and nitroblue tetrazolium (NBT) as non-fluorescent detection methods (probes). To obtain clearer images of the organelles, images that were built up as electronic signals in CLSM were processed in an image analysis system (IAS). By using the combination of CLSM and IAS, in IHC, immunohistochemical localization of prolactin (PRL) was in well-developed lamellar or whorling rough endoplasmic reticula (RER), Golgi apparatus, and secretory granules. With ISH, the expression and distribution of PRL messenger ribonucleic acid (mRNA) was observed in a fashion suggesting polysome-like structures on RER. These observations were confirmed by immunoelectron microscopy and electron microscopic ISH. The herein-described method is expected to be useful to perform the concomitant observation of IHC and ISH at subcellular levels using the conventional light microscopic specimens.
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Affiliation(s)
- J Itoh
- Laboratories for Structure and Function Research, School of Medicine, Tokai University, Kanagawa, Japan
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39
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Sanno N, Itoh J, Teramoto A, Itoh Y, Hori S, Osamura RY. Immunohistochemical detection of human natural killer cell like immunoreactivity in human pituitary adenomas, using monoclonal antibody NK-1. J Neurooncol 1997; 35:29-38. [PMID: 9266438 DOI: 10.1023/a:1005899717286] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Natural killer (NK) cells are specialized lymphocytes which are characterized as non-T and non-B cells, as they lack classic T and B cell surface markers. Recently, NK like immunoreactivity has been identified in endocrine and neuronal tissues as well as in the tumors derived from the neuroectoderm and neuroendocrine system. We examined the expression of NK-1 like immunoreactivity in 6 normal pituitary glands and in 55 cases of neoplastic pituitaries (16 growth hormone (GH) producing adenomas, 14 prolactin (PRL) producing adenomas, 4 thyrotropin (TSH) producing adenomas, 5 adrenocortocitropin (ACTH) producing adenomas and 16 non-functioning adenomas) immunohistochemically. The expression of the S-100 protein, which is a marker for folliclo-stellate (FS) cells, which have been reported to secrete cytokines as immuno-endocrine modulators, were also examined. In normal pituitary glands, NK-1 was detected in all 6 tissues in the cytoplasm of about 5-10% of the anterior pituitary cells. By serial sectioning and double immunostaining, NK-1 immunopositivity was frequently found to be localized in ACTH cells. The colocalization with other anterior pituitary hormones such as GH. PRL, the beta-subunit of luteinizing hormone (LH beta), follicle stimulating hormone (FSH beta). TSH beta and alpha-subunit of glycoprotein (alpha SU) was not observed. The S-100 immunopositive FS cells, which were scattered among hormone producing cells, were closely associated with NK-1 immunoreactive cells in the normal pituitaries. Among the 55 cases of pituitary adenomas, NK-1 was present in all the types of pituitary tumors, and a total of 33 (60.0%) contained NK-1 positive tumor cells. The frequency of NK-1 immunoreactivity in the individual adenoma types was; 14 of 16 GH producing adenomas (87.5%), 7 of 14 PRL producing adenomas (50%). 3 of 4 TSH producing adenomas (75%), 3 of 5 ACTH producing adenomas (60%), and 5 of 16 nonfunctioning adenomas (31.3%). By double immunostaining, NK-1 was found to be frequently colocalized with ACTH in ACTH producing adenomas, and was colocalized with PRL in PRL producing adenomas, or with GH, PRL or the alpha-subunit in GH producing adenoma cells. NK-1 immunoreactive cells were observed in close association with S-100 immunopositive FS cells in the adenomas. Our results may indicate that NK-1 positive cells may have functions as a paracrine modulators of their neighboring cells, which includes S-100 positive FS cells.
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Affiliation(s)
- N Sanno
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
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Abe T, Matsumoto K, Iida M, Hayashi M, Sanno N, Osamura RY. Malignant carcinoid tumor of the anterior mediastinum metastasis to a prolactin-secreting pituitary adenoma: a case report. Surg Neurol 1997; 48:389-94. [PMID: 9315138 DOI: 10.1016/s0090-3019(97)00002-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Although the pituitary gland is known to harbor metastatic deposits, metastasis from a carcinoid tumor is extremely rare. Metastasis to a pituitary adenoma also is an infrequent occurrence. CASE REPORT A case of malignant carcinoid tumor of the anterior mediastinum with metastasis to a prolactin-secreting pituitary adenoma is presented in this 46-year-old woman. This metastatic pituitary tumor demonstrated a high proliferative potential. CONCLUSION To our knowledge, this case represents the first documentation of metastasis from a malignant carcinoid tumor to a pituitary adenoma.
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Affiliation(s)
- T Abe
- Department of Neurosurgery, Showa University School of Medicine, Tokyo, Japan
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Abstract
Although it has been demonstrated that acromegalic patients have an increased risk of neoplasms, especially colon neoplasms, gastric cancer with acromegaly is very rare--only five cases have been reported to date in Japan. We report here a rare case of gastric cancer with acromegaly in a 58-year-old woman, whose acromegalic change began at age 44. This patient showed typical clinical features of acromegaly, with increased concentrations of blood growth hormone (GH) and insulin-like growth factor I (IGF-I); she had four types of neoplasms; gastric cancer, colon tubular adenoma with moderate atypia, pancreatic mucinous cystadenoma, and subcutaneous lipoma. The gastric cancer was macroscopically 0-IIc type, 3.0 x 2.5 cm in size, and histologically diagnosed as a poorly differentiated adenocarcinoma with limited invasion of the mucosal layer. The previously documented stimulatory effects of GH and/or IGF-I on tumorigenesis and cell proliferation may have been responsible for the development of the multiple neoplasms in our patient.
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Affiliation(s)
- K Asai
- Third Department of Surgery, University of Tokyo, Japan
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42
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Jin L, Qian X, Kulig E, Sanno N, Scheithauer BW, Kovacs K, Young WF, Lloyd RV. Transforming growth factor-beta, transforming growth factor-beta receptor II, and p27Kip1 expression in nontumorous and neoplastic human pituitaries. Am J Pathol 1997; 151:509-19. [PMID: 9250163 PMCID: PMC1858020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Transforming growth factor (TGF)-beta has been implicated in the regulation of normal and neoplastic anterior pituitary cell function. TGF-beta regulates the expression of various proteins, including p27Kip1 (p27), a cell cycle inhibitory protein. We examined TGF-beta, TGF-beta type II receptor (TGF-beta-RII), and p27 expression in normal pituitaries, pituitary adenomas, and carcinomas to analyze the possible roles of these proteins in pituitary tumorigenesis. Normal pituitary, pituitary adenomas, and pituitary carcinomas all expressed TGF-beta and TGF-beta-RII immunoreactivity. Reverse transcription polymerase chain reaction analysis showed TGF-beta 1, -beta 2, and -beta 3 isoforms and TGF-beta-RII in normal pituitaries and pituitary adenomas. Pituitary adenomas cells cultured for 7 days in defined media showed a biphasic response to TGF-beta with significant inhibition of follicle-stimulating hormone secretion at higher concentrations (10(-9) mol/L) and stimulation of follicle-stimulating hormone secretion at lower concentrations (10(-13) mol/L) of TGF-beta 1 in gonadotroph adenomas. Immunohistochemical analysis for p27 protein expression showed the highest levels in nontumorous pituitaries with decreased immunoreactivity in adenomas and carcinomas. When nontumorous pituitaries and various adenomas were analyzed for p27 and specific hormone production, growth hormone, luteinizing hormone, and thyroid-stimulating hormone cells and tumors had the highest percentages of cells expressing p27, whereas adrenocorticotrophic hormone cells and tumors had the lowest percentages. Immunoblotting analysis showed that adrenocorticotrophic hormone adenomas also had the lowest levels of p27 protein. Semiquantitative reverse transcription polymerase chain reaction and Northern hybridization analysis did not show significant differences in p27 mRNA expression in the various types of adenomas or in nontumorous pituitaries. In situ hybridization for p27 mRNA showed similar distributions of the gene product in nontumorous pituitaries, pituitary adenomas, and carcinomas. These results indicate that TGF-beta and TGF-beta-RII are widely expressed in nontumorous pituitaries and in pituitary neoplasms and that TGF-beta 1 regulates pituitary hormone secretion. The levels of the TGF-beta-regulated protein p27 decreases in the progression of normal to neoplastic pituitaries. In contrast, the mRNA levels of p27 remained relatively constant in nontumorous pituitaries, pituitary adenomas, and carcinomas, indicating that p27 protein levels in adenomas and carcinomas are regulated by translational and post-translational mechanisms.
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Affiliation(s)
- L Jin
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA
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Abstract
Retinoid X receptors (RXRs) heterodimerize with 1,25-dihydroxyvitamin D3 (VD) receptor (VDR), and play important roles in VD-regulated transactivation. VD acts on many tissues including kidney for the regulation of calcium homeostasis. In the kidney, the expression of VDR in the tubular cells has been well studied. In contrast, little is known about the localization and the functional significance of RXRs there. In order to elucidate these questions, we first performed immunohistochemical analyses of rat kidney using isoform-specific antimouse RXR antibodies we have previously reported. Interestingly, all RXR isoforms, predominantly RXR alpha, mainly localized to the proximal and the distal tubules, but not to the glomeruli. The serial section staining using anti-VDR antibody showed the colocalization of RXR alpha and VDR in those tubular cells. In order to elucidate the functional significance of endogenous receptors in the tubular cells, we next performed transient transfection studies using the tubular-cell derived Madin-Darby bovine kidney cells, which express both endogenous VDR and RXR. We transfected a reporter plasmid containing direct repeat 3 (DR3) sequence, to which only RXR/VDR heterodimer can bind, and found that VD and 9-cis retinoic acid, as well as VD and RXR selective agonist LG100153, had an additive effect for the DR3 transactivation. Taken together, we speculate that endogenous RXRs co-localize with VDR, and coregulate VD-dependent genes in the tubular cells of the kidney as RXR/VDR heterodimer.
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Affiliation(s)
- A Sugawara
- The 2nd Department of Internal Medicine, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan
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Sanno N, Teramoto A, Osamura RY, Genka S, Katakami H, Jin L, Lloyd RV, Kovacs K. A growth hormone-releasing hormone-producing pancreatic islet cell tumor metastasized to the pituitary is associated with pituitary somatotroph hyperplasia and acromegaly. J Clin Endocrinol Metab 1997; 82:2731-7. [PMID: 9253362 DOI: 10.1210/jcem.82.8.4175] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The functional and morphological changes in the pituitary gland caused by a GHRH-producing pancreatic islet cell tumor that metastasized to the pituitary and caused somatotroph hyperplasia are described. A 52-yr-old woman presented with loss of visual acuity, diabetes insipidus, and acromegaly caused by a GHRH-producing endocrine carcinoma metastasized to the pituitary. The serum GHRH, GH, and insulin-like growth factor I levels of the patient were elevated. Immunohistochemical and in situ hybridization study revealed GHRH immunoreactivity and GHRH messenger RNA (mRNA) in the metastatic tumor cells. The anterior pituitary showed hyperplasia of somatotroph cells with intact acinar structure that did not contain an adenoma, determined by light microscopy using silver impregnation. Electron microscopy revealed hyperplastic characteristics of densely granulated somatotrophs. In situ hybridization documented strong signals for GH mRNA and pituitary-specific transcriptional factor Pit-1 mRNA in the hyperplastic somatotrophs. A weak signal for GHRH receptor mRNA was detected in these somatotrophs. However, using in situ RT-PCR, GHRH receptor mRNA was more conclusively observed in most of the somatotrophs. The excessive production of GHRH by metastatic tumor may have resulted in somatotroph hyperplasia by the synergistic effects of Pit-1 and GHRH receptor. It can be concluded that the pathogenesis of pituitary adenoma formation is primarily mediated by other factors than hypothalamic hormone.
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Affiliation(s)
- N Sanno
- Department of Neurosurgery, Nippon Medical School, Tokyo, Japan
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Matsuno A, Takekoshi S, Sanno N, Utsunomiya H, Ohsugi Y, Saito N, Kanemitsu H, Tamura A, Nagashima T, Osamura RY, Watanabe K. Modulation of protein kinases and microtubule-associated proteins and changes in ultrastructure in female rat pituitary cells: effects of estrogen and bromocriptine. J Histochem Cytochem 1997; 45:805-13. [PMID: 9199666 DOI: 10.1177/002215549704500605] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
This study focused on the intracellular signal transduction system and microtubule-associated proteins (MAPs), such as MAP-2 and Tau protein. The modulation of these proteins and their correlation with ultrastructural changes were investigated in rat pituitary prolactin (PRL) cells. Adult female Wistar rats were treated with estrogen and bromocriptine and their pituitary glands were removed for analysis of the expression of tubulin, MAP-2, Tau protein, protein kinase C (PKC), and calcium calmodulin (CaM) kinase. Western blot analysis showed that estrogen increased and bromocriptine decreased the expression of PKC alpha, beta 1, beta 2, CaM kinase alpha, beta, MAP-2, and Tau protein. MAP-2 and Tau protein, which are cytosolic proteins, being translated on free ribosomes, were associated with the membrane of whirling rough endoplasmic reticulum (RER) in estrogen-treated cells and dissociated with vesiculated RER induced by bromocriptine. These results suggested that the modulation of MAP-2 and Tau protein may reflect changes of PKC and CaM kinase, and that the quantitative changes and intracellular modulation of MAPs induced by estrogen and bromocriptine, i.e., estrogen-induced association and bromocriptine-induced dissociation of MAP-2 and Tau protein with membrane of RER, may reflect the dynamics of microtubules and are associated with structural changes in the RER and changes in the synthesis and intracellular transport of PRL.
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Affiliation(s)
- A Matsuno
- Department of Neurosurgery, Teikyo University Ichihara Hospital, Chiba, Japan
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Sanno N, Jin L, Qian X, Osamura RY, Scheithauer BW, Kovacs K, Lloyd RV. Gonadotropin-releasing hormone and gonadotropin-releasing hormone receptor messenger ribonucleic acids expression in nontumorous and neoplastic pituitaries. J Clin Endocrinol Metab 1997; 82:1974-82. [PMID: 9177416 DOI: 10.1210/jcem.82.6.3976] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In the nontumorous pituitary, GnRH stimulates the release and synthesis of LH and FSH by gonadotroph cells via the GnRH receptor (GnRH-R). Little is known, however, about expression of GnRH and GnRH-R messenger RNAs (mRNAs) in nontumorous pituitary tissue and in adenomas. To learn more about the distribution and regulatory roles of GnRH and its receptor, we investigated the expression of both GnRH and GnRH-R mRNAs in nontumorous human pituitary and in various types of pituitary adenomas using the RT-PCR, in situ hybridization, and in situ hybridization in combination with RT-PCR (in situ RT-PCR). Using RT-PCR, GnRH mRNA was found to be expressed in normal human pituitaries and in all types of adenomas. Similarly, GnRH-R mRNA was expressed in nontumorous human pituitaries and in most, but not all, adenomas. These included 5 gonadotroph adenomas, 6 null cell adenomas, 1 of 2 GH-producing tumors, and 1 of 2 ACTH-producing adenomas, but not in the 2 PRL-producing adenomas examined. In situ hybridization studies showed GnRH and GnRH-R mRNAs in all 3 nontumorous pituitaries and in 12 of 33 (36.4%) and 10 of 33 adenomas (30.3%), respectively. Using an indirect in situ RT-PCR technique to increase the sensitivity of the in situ localization, GnRH and GnRH-R mRNAs were detected in 29 (87.9%) and 25 (75.8%) of 33 adenomas, respectively. This is the first report of the localization of GnRH and GnRH-R mRNAs in individual pituitary adenoma cells using in situ RT-PCR. The frequent expression of GnRH and GnRH-R mRNAs in pituitary cells suggests that GnRH has autocrine/paracrine functions in nontumorous and neoplastic pituitary tissues.
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Affiliation(s)
- N Sanno
- Department of Laboratory Medicine and Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA
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Sanno N, Sugawara A, Teramoto A, Abe Y, Yen PM, Chin WW, Osamura RY. Immunohistochemical expression of retinoid X receptor isoforms in human pituitaries and pituitary adenomas. Neuroendocrinology 1997; 65:299-306. [PMID: 9143002 DOI: 10.1159/000127188] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Retinoid X receptors (RXRs) are transcriptional factors that belong to the steroid/thyroid hormone receptor superfamily. There are 3 RXR isoforms-alpha, beta, gamma-known to bind 9-cis-retinoic acid as their ligand. The expression of RXRs in human pituitary glands and pituitary adenomas has not been extensively investigated. To determine whether specific RXR isoforms may play roles in the state of differentiation of pituitary adenomas, we have investigated the immunohistochemical expression of RXR alpha and RXR gamma in 6 nontumorous pituitaries and in 60 different pituitary adenomas using isoform-specific antibodies. In the nontumorous pituitaries. RXR alpha was expressed in the nuclei of almost all cells, while RXR gamma was only expressed in thyrotropin (TSH) cells and in some cells positive for growth hormone (GH) and glycoprotein alpha-subunit (alpha SU) but not in luteinizing hormone (LH) beta-subunit, follicle-stimulating hormone (FSH) beta-subunit, prolactin (PRL) or adrenocorticotropin (ACTH) cells by double immunostaining. All 60 adenomas were RXR alpha positive, and 39 of 60 adenomas (65%) were positive for RXR gamma. The incidence of RXR gamma immunoreactivity in the different adenoma types was: 13 of 16 GH-producing adenomas (81.3%), 9 of 14 PRL-secreting adenomas (64.3%), 6 of 6 TSH-secreting adenomas (100%), 2 of 5 ACTH-secreting adenomas (40%) and 9 of 19 nonfunctioning adenomas (47.4%) including immunohistochemically gonadotropin-subunit-positive adenomas. The colocalization of RXR gamma with the TSH beta subunit, GH and alpha SU in the same adenoma cells was frequently observed, and sometimes RXR gamma was colocalized with PRL, ACTH, FSH beta or LH beta as shown by double immunostaining. We conclude that RXR alpha is expressed in both human pituitaries and pituitary adenomas. In contrast, RXR gamma is expressed more broadly in pituitary adenomas than in normal pituitaries and thus may play a role in the differentiation-specific cell types in the human pituitary both under physiological and pathological conditions.
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Affiliation(s)
- N Sanno
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
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Abstract
The proliferative potential of 45 pituitary adenomas was compared with their biological behaviour as determined by immunohistochemical studies, radiological findings, and clinical manifestations. The PCI (proliferating cell index) as measured using antibody MIB-1 in this study ranged from 0.05 to 4.80%, with an average PCI of 1.49 +/- 0.19% (mean +/- standard error of the mean). There was no significant correlation between proliferation and hormonal state, maximum size, intra-adenomatous haemorrhage, or invasiveness. However, a PCI > or = 1.5% appeared to correlate with the likelihood of tumour regrowth (regrowth rate: 50%); for PCIs < 1.5%, the rate was 16%. Regrowth adenomas had a higher mean MIB-1 PCI than non-regrowth adenomas [2.34 +/- 0.58% (SE) versus 1.14 +/- 0.16%, p < or = 0.05]. MIB-1 PCIs may provide information that is useful for planning follow-up studies and treatment after surgical resection.
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Affiliation(s)
- T Abe
- Department of Neurosurgery, Showa University School of Medicine, Tokyo, Japan
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Matsuno A, Utsunomiya H, Ohsugi Y, Takekoshi S, Sanno N, Osamura RY, Nagao K, Tamura A, Nagashima T. Simultaneous ultrastructural identification of growth hormone and its messenger ribonucleic acid using combined immunohistochemistry and non-radioisotopic in situ hybridization: a technical note. Histochem J 1996; 28:703-7. [PMID: 8950599 DOI: 10.1007/bf02409007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The present electron microscopical study is concerned with the simultaneous visualization of messenger ribonucleic acid (mRNA) and its encoded protein in the same specimen. Pre-embedding electron microscopical in situ hybridization (EM-ISH) on rat pituitary gland tissue localized growth hormone mRNA in the polysomes of the rough endoplasmic reticulum, and subsequent postembedding immunolabelling using protein A-colloidal gold particles identified growth hormone mainly in the secretory granules. We believe that our report provides the first simultaneous ultrastructural identification of mRNA and its encoded protein using combined pre-embedding EM-ISH and immunohistochemistry. In this method, the signals for mRNA were localized specifically as highly electron dense products on the polysomes of the endoplasmic reticulum, and those for its encoded protein were recognized as gold particles both in the cisternae of the reticulum and in the secretory granules. Our ultrastructural double labelling method for mRNA and protein may provide a tool to find important clues for elucidating the intracellular correlation of mRNA translation and secretion of translated protein, because of its high resolution, good morphological preservation, and the specific localization of the reaction products.
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Affiliation(s)
- A Matsuno
- Department of Neurosurgery, Teikyo University Ichihara Hospital, Chiba, Japan
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Abstract
Somatostatinomas are rare endocrine tumors that are located primarily in the pancreas. Metastases are seen most frequently in the liver and lymph nodes. The authors present the case of a 63-year-old man who had a malignant somatostatinoma of pancreatic tail origin that metastasized to the brain 10 years after diagnosis of the primary tumor. The metastatic brain lesions were totally removed and the patient is alive without tumor recurrence 12.3 years after the initial diagnosis. To our knowledge, this case represents the first documentation of brain metastasis from a malignant somatostatinoma, as well as the longest survival time of a patient with a somatostatinoma.
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Affiliation(s)
- T Abe
- Department of Neurosurgery, Showa University School of Medicine, Tokyo, Japan
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