Gene Expression Signature in Adipose Tissue of Acromegaly Patients.

To study the effect of chronic excess growth hormone on adipose tissue, we performed RNA sequencing in adipose tissue biopsies from patients with acromegaly (n = 7) or non-functioning pituitary adenomas (n = 11). The patients underwent clinical and metabolic profiling including assessment of HOMA-IR. Explants of adipose tissue were assayed ex vivo for lipolysis and ceramide levels. Patients with acromegaly had higher glucose, higher insulin levels and higher HOMA-IR score. We observed several previously reported transcriptional changes (IGF1, IGFBP3, CISH, SOCS2) that are known to be induced by GH/IGF-1 in liver but are also induced in adipose tissue. We also identified several novel transcriptional changes, some of which may be important for GH/IGF responses (PTPN3 and PTPN4) and the effects of acromegaly on growth and proliferation. Several differentially expressed transcripts may be important in GH/IGF-1-induced metabolic changes. Specifically, induction of LPL, ABHD5, and NRIP1 can contribute to enhanced lipolysis and may explain the elevated adipose tissue lipolysis in acromegalic patients. Higher expression of TCF7L2 and the fatty acid desaturases FADS1, FADS2 and SCD could contribute to insulin resistance. Ceramides were not different between the two groups. In summary, we have identified the acromegaly gene expression signature in human adipose tissue. The significance of altered expression of specific transcripts will enhance our understanding of the metabolic and proliferative changes associated with acromegaly

Choroid plexus cyst in the lateral ventricle causing obstructive symptoms in an adult

This case of a rare symptomatic choroid plexus cyst in the lateral ventricle, which presented with papilledema and decreased vision, is the first such lesion found in an adult. Five earlier reported cases, all in children, are discussed, as are the limitations of computerized tomographic (CT) scanning and the need for further radiological studies to establish the diagnosis preoperatively. Metrizamide ventriculography with CT scanning is used to define the lesion and plan an operative approach.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/24465/1/0000740.pd

The application of ultrasound during brain surgery

The use of intraoperative, real-time ultrasound imaging during intracranial neurosurgical procedures is described. This technique has proven to be extremely useful for localization of a wide variety of deep and superficial brain lesions, and for needle biopsy or aspiration of selected lesions. The precise localization provided by ultrasonic imaging shortens the time of surgery and increases the safety for the patient . Every type of primary and metastatic tumor of the brain has imaged well, and low-grade gliomas are often better defined with ultrasound than by computed tomographic scanning. Abscesses can be imaged and aspirated, and hematomas are easily imaged. A variety of vascular lesions including aneurysms and arteriovenous malformations can be localized and characterized. Structural abnormalities such as hydrocephalus and Arnold-Chiari malformation can be well delineated . L'emploi de l'échographie temps réel au cours des interventions neurochirurgicales cérébrales est décrit. Cet examen s'est montré extrêmement utile pour localiser un large éventail de lésions cérébrales superficielles ou profondes ainsi que pur pratiquer une biopsie aspiration de lésions spécifiques. La localisation précise des lésions grâce à l'image échographique diminue la durée de l'intervention et augmente la sécurité de l'acte opératoire. Toutes les lésions tumorales primitives ou métastatiques du cerveau sont bien mises en évidence; le glioma à son début est mieux détecté par l'échographie que par la tomodensitométrie. Les abcès se manifestent par des images particulières et peuvent être évacués par aspiration; les hématomes se traduisent également par des images bien définies. De nombreuses lésions vasculaires: anévrysmes et malformations artério-veineuses peuvent être décelées et localisées. Des anomalies structurales comme L'hydrocéphalie et la malformation d'Arnold-Chiari peuvent être délimitées. Se describe el uso intraoperatorio de ultrasonido de tiempo real en el curso de procedimientos neuroquirúrgicos intracraneanos. Esta técnica ha probado ser extremadamente útil para la localización de una amplia variedad de lesiones cerebrales profundas y superficiales y para la biopsia o aspiración con aguja de lesiones seleccionadas. La precisión en la localización que provee la ultrasonografía acorta el tiempo operatorio e incrementa la seguridad del paciente.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41278/1/268_2005_Article_BF01655829.pd

The use of ultrasound during spinal cord surgery

Intraoperative spinal ultrasonography is now considered an indispensable tool in many operations on the spine and spinal cord. Using ultrasonography, surgeons can now easily find and evaluate lesions within the spinal cord, dural sac, and along the ventral margin of the vertebral column during operations. Syrinxes, intra- and extramedullary tumors, hematomas, bone fragments, bullet fragements, cysts, and discs can be easily located and treated under ultrasonic guidance. In this article, we described the techniques used in peforming this procedure, normal anatomy, and images of various types of pathologic lesions . L'échographie opératoire rachidienne constitue une exploration indispensable au cours de nombreuses opérations effectuées sur le rachis et la moëlle. En employant l'échographie les chirurgiens peuvent facilement évaluer les lésions de la moëlle, du sac dural, de la partie antérieure de la colonne vertébrale au cours des interventions. Les fistules, les tumeurs extra et intra-médullaires, les hématomes, les fragments osseux, les fragments de projectile, les kystes, les disques peuvent être facilement découverts et traités sous la contrôle de l'échographie. Dans cet article sont décrites les techniques employées, l'anatomie normale et les images des diverses lésions. La ultrasonografía intraoperatoria espinal se considera hoy como un instrumento indispensable en numerosas operaciones sobre la columna vertebral y la medula espinal. Con el uso de ultrasonografía los cirujanos pueden fácilmente, en el curso de una operación, ubicar y evaluar lesiones dentro de la medula espinal y la dura y sobre el aspecto ventral de la columna vertebral. Siringos (fístulas), tumores intra- y extramedulares, hematomas, fragmentos óseos, fragmentos de bala, quistes, y discos pueden ser fácilmente localizados y tratados bajo guía de ultrasonido. En este artículo se describen las técnicas utilizadas en la realización del procedimiento, la anatomía normal, y las imágenes de diversos tipos de lesiones patológicas.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41279/1/268_2005_Article_BF01655830.pd

Reports to the President, 1871 - 1916

For more information about this item, visit https://archivesspace.mit.edu/repositories/2/archival_objects/30888

Pergolide As Primary Therapy for Macroprolactinomas

The objective of this study is to determine whether pergolide therapy is an effective modality for the de novo treatment of patients with macroprolactinomas. Twenty-two consecutive patients with macroprolactinomas were included in the study and followed prospectively. These included 16 men and 6 women in whom pregnancy was not of concern. Pergolide was administered once or twice a day depending on the patient's preference. Ten patients received 0.1 mg daily as a maintenance regimen and in the others the daily dose ranged from 0.05 to 0.5 mg. Eight patients reported minor but tolerable side effects. One patient had to be switched to cabergoline because of intolerable nausea. After a mean of 12 months (range, 3–36), mean PRL levels declined from 3,135 ng/ml (range, 126–31,513) to 50 ng/ml (3–573), representing a mean PRL suppression of 88% (range, 0–99). PRL levels became normal in 15 patients and decreased to 25–40 ng/ml in 3 others. The mean tumor volume shrinkage was 25% or greater in 19 patients (86%), 50% or greater in 17 patients (77%), and 75% or greater in 10 patients (45%). Visual abnormalities were reversible after pergolide therapy in all but 1 of 12 patients with initially abnormal formal visual testing. Two out of 4 premenopausal women did not normalize PRL levels and had persistent oligomenorrhea. Testosterone was low in 14 men at presentation and normalized in 3 with pergolide therapy. We conclude that pergolide is a safe, inexpensive, and generally well-tolerated dopamine agonist for the treatment of macroprolactinomas in men and women in whom pregnancy is not of concern. In these specific populations, pergolide may become the first-line therapy for treatment of macroprolactinomas.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47496/1/11102_2004_Article_382165.pd

Rapid Re-expansion of a Macroprolactinoma After Early Discontinuation of Bromocriptine

Prolactin (PRL)-secreting pituitary adenomas are the most common functioning pituitary tumors. Medical treatment with dopamine agonists is the therapy of choice for macroprolactinomas (≥10 mm). Withdrawal of bromocriptine after weeks or months of uninterrupted therapy has been associated with rapid tumor re-expansion as evidenced by x-ray and CT scanning of the pituitary region. We report a patient with a giant macroprolactinoma who had a dramatic response to bromocriptine (tumor volume shrinkage of 53% within a month) but rapid re-expansion to its original dimensions one week after discontinuation of bromocriptine. To our knowledge, this is the first time that the rapid shrinkage/re-expansion of a macroprolactinoma has been documented with serial MRI scans.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47493/1/11102_2004_Article_324060.pd

Intradural extramedullary ganglioneuroma: Case report and review of the literature

The authors present a unique case of an intradural extramedullary ganglioneuroma in the thoracic spine of an adult. Intraspinal ganglioneuromas are rare, benign tumors of sympathetic nervous tissue origin, but exclusively intradural ganglioneuromas have not been reported.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30177/1/0000562.pd

Spectral Resolution for Five-Element, Filtered, X-Ray Detector (XRD) Arrays Using the Methods of Backus and Gilbert

The generalized method of Backus and Gilbert (BG) is described and applied to the inverse problem of obtaining spectra from a 5-channel, filtered array of x-ray detectors (XRD's). This diagnostic is routinely fielded on the Z facility at Sandia National Laboratories to study soft x-ray photons ({le}2300 eV), emitted by high density Z-pinch plasmas. The BG method defines spectral resolution limits on the system of response functions that are in good agreement with the unfold method currently in use. The resolution so defined is independent of the source spectrum. For noise-free, simulated data the BG approximating function is also in reasonable agreement with the source spectrum (150 eV black-body) and the unfold. This function may be used as an initial trial function for iterative methods or a regularization model

Notes of a Meeting Held in the Diplomatic Reception Room of the Department of State on Monday, March 20, 1911

The document is a carbon transcript of notes from a meeting held in the State Department respecting the necessity of more such meetings, the present organization of the Department, expenditures, and esprit de corps. Present at the meeting were: The Assistant Secretaries, the Solicitor, the Director of the Consular Service, the Chief Clerk and the Chiefs and Assistant Chiefs of the Divisions and Bureaus of the Department.https://digitalcommons.ursinus.edu/fmhw_speeches/1004/thumbnail.jp