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https://www.readbyqxmd.com/read/28087208/-child-langerhans-cell-histiocytosis
#1
Jean Donadieu, Sébastien Héritier
DEFINITION: Langerhans cell histiocytosis (LCH) is defined by the association of a clinical and radiological involvement and a biopsy of a pathological tissue. Extension: it can affect any organ or system of the body but most commonly the bone (80% of cases), the skin (33%) and the pituitary (25%). Other organs are concerned such as liver, spleen, hematopoietic system and the lungs (15% each), lymph nodes (5-10%) and central nervous system (CNS) excluding the pituitary (2-4%). Natural history: the natural history of the disease is very heterogeneous, ranging from auto-regressive lesions to a disease affecting multiple organs with fatal consequences, while some lesions may be responsible for permanent sequels...
January 10, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28079350/transcranial-approach-in-giant-pituitary-adenomas-results-and-outcome-in-a-modern-series
#2
Thomas Graillon, Frédéric Castinetti, Stéphane Fuentes, Regis Gras, Thierry Brue, Henry Dufour
BACKGROUND: Today, transcranial (TC) approach indications are particularly rare in pituitary adenomas (PA), representing 1.1% of all PA surgeries in our experience. In these rare and selected cases, the complications, advantages, and disadvantages of TC approach were also analyzed. METHODS: 19 cases of giant PA (≥40 mm) operated via TC approach alone or combined with transsphenoidal (TS) approach between 2000 and 2016 were selected. RESULTS: The most frequently observed symptom was visual disturbance...
January 12, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28074401/adipsic-diabetes-insipidus-in-adult-patients
#3
REVIEW
Martín Cuesta, Mark J Hannon, Christopher J Thompson
INTRODUCTION: Adipsic diabetes insipidus (ADI) is a very rare disorder, characterized by hypotonic polyuria due to arginine vasopressin (AVP) deficiency and failure to generate the sensation of thirst in response to hypernatraemia. As the sensation of thirst is the key homeostatic mechanism that prevents hypernatraemic dehydration in patients with untreated diabetes insipidus (DI), adipsia leads to failure to respond to aquaresis with appropriate fluid intake. This predisposes to the development of significant hypernatraemia, which is the typical biochemical manifestation of adipsic DI...
January 10, 2017: Pituitary
https://www.readbyqxmd.com/read/28073908/the-neuroendocrine-sequelae-of-paediatric-craniopharyngioma-a-40-year-meta-data-analysis-of-185-cases-from-three-uk-centres
#4
Timothy Shao Ern Tan, Leena Patel, Jaya Sujatha Gopal-Kothandapani, Sarah Ehtisham, Esieza Clare Ikazoboh, Richard Hayward, Kristian Aquilina, Mars Skae, Nicky Thorp, Barry Pizer, Mohammed Didi, Conor Mallucci, Joanne C Blair, Mark N Gaze, Ian Kamaly-Asl, Helen Spoudeas, Peter E Clayton
Objectives The management of paediatric craniopharyngiomas was traditionally complete resection (CR), with better reported tumour control compared to partial resection (PR) or limited surgery (LS). The subsequent shift towards hypothalamic-sparing, conservative surgery with adjuvant radiotherapy (RT) to any residual tumour, aimed at reducing neuroendocrine morbidity, has not been systematically studied. Hence, we reviewed the sequelae of differing management strategies in paediatric craniopharyngioma across three UK tertiary centres over four decades...
January 10, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28073809/diabetes-insipidus-and-the-use-of-desmopressin-in-hospitalised-children
#5
Charlotte J Elder, Paul J Dimitri
No abstract text is available yet for this article.
January 10, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28070828/hypofractionated-stereotactic-radiosurgery-for-pituitary-metastases
#6
Haemin Chon, KyoungJun Yoon, Do Hoon Kwon, Chang Jin Kim, Min-Seon Kim, Young Hyun Cho
Pituitary metastases (PMs) are uncommon, representing only 1% of pituitary lesions. The diagnosis of PMs can be challenging and an optimal management remains to be determined. Here, we present a pilot clinical study on the efficacy and safety of hypofractionated stereotactic radiosurgery (SRS) with an optimized dosimetric plan in treating PMs. Between June 2013 and December 2014, seven consecutive patients (4 men and 3 women; median age 62 years) had been diagnosed with PMs based on their characteristic clinical and radiological features and subsequently treated using hypofractionated SRS...
January 9, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28057594/significant-improvement-in-chronic-persistent-headaches-caused-by-small-rathke-cleft-cysts-after-transsphenoidal-surgery
#7
Issei Fukui, Yasuhiko Hayashi, Daisuke Kita, Yasuo Sasagawa, Masahiro Oishi, Osamu Tachibana, Mitsutoshi Nakada
PURPOSE: Rathke cleft cysts (RCC) are usually asymptomatic and can be observed using conservative methods. However, some patients with RCCs have severe headaches even if they are small enough to be confined to the sella, and these small RCCs have seldom been discussed. This study presents an investigation into clinical characteristics of small RCCs associated with severe headaches, demonstrating efficacy and safety of endoscopic transsphenoidal surgery (ETSS) to relieve headaches. METHODS: In this study, 13 patients with small RCCs (maximum diameter < 10mm) who presented with headaches and were treated by ETSS at our institute from 2009 to 2014 were recruited...
January 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28052875/liver-x-receptor-%C3%AE-lxr%C3%AE-increases-aqp2-protein-level-via-a-post-transcriptional-mechanism-in-renal-collecting-ducts
#8
Wen Su, Shi-Zheng Huang, Min Gao, Xiao-Mu Kong, Jan-Ake Gustafsson, Su-Juan Xu, Bing Wang, Feng Zheng, Li-Hong Chen, Nan-Ping Wang, You-Fei Guan, Xiao-Yan Zhang
Liver X Receptors (LXRs) including LXRα and LXRβ are nuclear receptor transcription factors and play an important role in lipid and glucose metabolism. It has been previously reported that mice lacking LXRβ but not LXRα develop a severe urine concentrating defect, likely via a central mechanism. Here we provide evidence that LXRβ regulates water homeostasis through increasing aquaporin 2 (AQP2) protein levels in renal collecting ducts. LXRβ-/- mice exhibited a reduced response to dDAVP stimulation, suggesting that the diabetes insipidus phenotype is of both central and nephrogenic origin...
January 4, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28051224/erdheim-chester-disease-and-radiobiphosphonates-bone-scan-from-a-simple-peripheral-form-to-a-rare-axial-location-a-case-report
#9
Salah Oueriagli Nabih
The Erdheim-Chester disease is a rare form of non Langherans histiocytosis. It can be expressed by a multi systemic disease interesting: bone, lung, heart, brain, retro peritoneum, skin and retro-orbital tissue. The diagnosis is established under the radiological aspect, bone scan uptake and immunohistological profile. The bone lesions are almost constant and rather characteristic of bone scintigraphy. We related the case of a young female patient of 26 years old with Erdheim-Chester bone disease. Diagnosis was revealed by diabetes insipidus (nerve damage) and diffuses bones pain...
June 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28049999/overlap-of-post-obstructive-diuresis-and-unmasked-diabetes-insipidus-in-a-case-of-igg4-related-retroperitoneal-fibrosis-and-tuberoinfundibular-hypophysitis-a-case-report-and-review-of-the-literature
#10
Midori Sasaki Yatabe, Kimio Watanabe, Yoshimitsu Hayashi, Junichi Yatabe, Satoshi Morimoto, Atsuhiro Ichihara, Masaaki Nakayama, Tsuyoshi Watanabe
The clinical picture of IgG4-related disease (IgG4-RD) is diverse because various organs can be affected. We describe the case of a 56-year-old man with acute renal failure and tuberoinfundibular hypophysitis due to IgG4-RD. Steroid therapy lowered the serum IgG4 level and ameliorated renal dysfunction, bilateral hydronephrosis and retroperitoneal fibrosis. However, polyuria from post-obstructive diuresis and unmasked central diabetes insipidus ensued. The patient's polyuria continued despite the administration of a therapeutic dose of glucocorticoid; the patient's pituitary swelling and anterior pituitary dysfunction were partially ameliorated...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28044054/pituitary-metastasis-from-renal-cell-carcinoma-description-of-a-case-report
#11
Chloé Wendel, Marco Campitiello, Francesca Plastino, Nada Eid, Laurent Hennequin, Philippe Quétin, Raffaele Longo
BACKGROUND Pituitary metastasis is uncommon, breast and lung cancers being the most frequent primary tumors. Renal cell carcinoma (RCC) is a rare cause of pituitary metastases, with only a few cases described to date. CASE REPORT We report a case of a 61-year-old man who presented with a progressive deterioration of visual acuity and field associated with a bitemporal hemianopsia. Two years ago, he underwent radical right nephrectomy for a clear cell RCC (ccRCC). The biological tests showed pan-hypopituitarism and diabetes insipidus...
January 3, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28034815/transsphenoidal-posterior-pituitary-lobe-biopsy-in-patients-with-neurohypophysial-lesions
#12
Yasuyuki Kinoshita, Fumiyuki Yamasaki, Atsushi Tominaga, Satoshi Usui, Kazunori Arita, Tetsuhiko Sakoguchi, Kazuhiko Sugiyama, Kaoru Kurisu
OBJECTIVE: The differential diagnosis of neurohypophysial lesions is difficult and surgical biopsies are indispensable in the histological diagnosis of some patients. Although pituitary stalk biopsies are uniformly performed, there is a considerable risk that they will result in impaired hormonal secretion. We attempt to clarify the usefulness and safety of posterior pituitary lobe biopsy by transsphenoidal surgery (TSS). METHODS: The cases of 11 consecutive patients who underwent posterior pituitary lobe biopsies by TSS were retrospectively studied...
December 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28009229/transoral-robotic-surgery-for-sellar-tumors-first-clinical-study
#13
Dorian Chauvet, Stéphane Hans, Antoine Missistrano, Celeste Rebours, Wissame El Bakkouri, Guillaume Lot
OBJECTIVE The aim of this study was to confirm the feasibility of an innovative transoral robotic surgery (TORS), using the da Vinci Surgical System, for patients with sellar tumors. This technique was designed to offer a new minimally invasive approach, without soft-palate splitting, that avoids the rhinological side effects of classic endonasal approaches. METHODS The authors performed a prospective study of TORS in patients with symptomatic sellar tumors. Specific anatomical features were required for inclusion in the study and were determined on the basis of preoperative open-mouth CT scans of the brain...
December 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28008629/lower-airway-disease-and-pituitary-surgery-is-there-an-association-with-postoperative-cerebrospinal-fluid-leak
#14
Curtis Hanba, Peter F Svider, Jeffrey T Jacob, Murali Guthikonda, James K Liu, Jean Anderson Eloy, Adam J Folbe
OBJECTIVES/HYPOTHESIS: To explore the relationship between lower airway disease and postoperative cerebrospinal fluid (CSF) rhinorrhea among patients undergoing pituitary surgery STUDY DESIGN: Retrospective review. METHODS: A retrospective review of the Healthcare Cost and Utilization Project's 2013 National Inpatient Sample was conducted to characterize the hospital stay and surgical outcomes of patients undergoing pituitary surgery. Patients with lower airway disease (including chronic obstructive pulmonary disease and asthma) were compared to a disease-free population identifying demographics and complications over-represented in the lower airway group...
December 23, 2016: Laryngoscope
https://www.readbyqxmd.com/read/28008190/central-diabetes-insipidus
#15
REVIEW
Hiroshi Arima, Yoshinori Azuma, Yoshiaki Morishita, Daisuke Hagiwara
Central diabetes insipidus (CDI), characterized by polyuria and polydipsia, is caused by deficiency of arginine vasopressin (AVP), an antidiuretic hormone which acts on V2 receptors in kidney to promote reabsorption of free water. CDI is classified into three subtypes; idiopathic, secondary and familial. A previous study suggests that infundibulo-neurohypophysitis might be an underlying cause of idiopathic CDI. Among secondary CDI, the tumors in the central nervous system such as craniopharyngioma and germ cell tumors are the most frequent causes...
December 2016: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28005257/safety-of-transsphenoidal-microsurgical-approach-in-patients-with-an-acth-secreting-pituitary-adenoma
#16
Carmine Antonio Donofrio, Marco Losa, Marco Gemma, Lodoviga Giudice, Lina Raffaella Barzaghi, Pietro Mortini
PURPOSE: Patients affected by Cushing's disease often have important comorbidities directly linked to hypercortisolism that might enhance the operative risk. We report the safety of transsphenoidal surgery in patients affected by Cushing's disease as compared with patients with nonfunctioning pituitary adenoma. METHODS: We have retrospectively analyzed 142 patients with Cushing's disease and 299 patients with nonfunctioning pituitary adenoma who underwent transsphenoidal surgery performed by a single experienced neurosurgeon between September 2007 and December 2014...
December 22, 2016: Endocrine
https://www.readbyqxmd.com/read/28003172/suprasellar-epidermoid-cyst-with-atypical-imaging-findings
#17
G Lakshmi Prasad, P Pavithra
A 65-year-old female presented with progressive unilateral vision loss leading to blindness and features of central diabetes insipidus (DI) for 3 months' duration. Imaging showed a well-circumscribed, lobulated, rim-enhancing suprasellar lesion with inhomogeneous diffusion restriction. Through a pterional trans-sylvian approach, subtotal resection was performed and histopathology revealed features of an epidermoid cyst. At 5 months' follow-up, she had improvement of her diabetes insipidus but no visual improvement...
December 18, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27993745/clinicoradiological-features-and-surgical-outcomes-of-sellar-xanthogranulomas-a-single-center-10-year-experience
#18
Bao Yang, Chenlong Yang, Jingyi Fang, Guang Li, Jisheng Wang, Guijun Jia, Pinan Liu, Wang Jia, Shuo Wang
BACKGROUND: Xanthogranulomas are uncommon granulomatous entities, and those occurring in the sellar region are extremely rare, with a limited number of cases reported in the literature. The diagnosis, management, and prognosis of sellar xanthogranulomas remain poorly understood. METHODS: We retrospectively reviewed the profiles of 14 patients with histologically proven sellar xanthogranulomas in our institution between Jan 2006 and July 2016. Their clinical manifestations, radiological features, operative records, and follow-up outcomes were analysed...
December 16, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27984823/hydrochlorothiazide-in-intensive-care-unit-acquired-hypernatremia-a-randomized-controlled-trial
#19
Marjolein M C O van IJzendoorn, Hanneke Buter, W Peter Kingma, Matty Koopmans, Gerjan Navis, E Christiaan Boerma
PURPOSE: Thiazides are suggested as a treatment for intensive care unit (ICU)-acquired hypernatremia (IAH). The primary aim of the study was reducing serum sodium concentration (sNa) in patients with IAH with hydrochlorothiazide (HCT) in comparison to placebo. Secondary end points were a difference in urine sodium concentration (uNa) and duration of severe IAH. MATERIALS: A monocentric, double-blind, placebo-controlled trial was conducted in 50 patients with IAH and urine potassium + uNa less than sNa in a spot urine sample...
December 2, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27980741/a-case-of-central-diabetes-insipidus-associated-with-cardiac-dysfunction
#20
Nobumasa Ohara, Masanori Kaneko, Tatsuya Suwabe, Tasuku Yoshie, Hiroyuki Kuwano, Katsuya Ebe, Toshio Fujita, Koichi Fuse, Kenzo Kaneko, Kyuzi Kamoi
Central diabetes insipidus (CDI) results from a deficiency of arginine vasopressin (AVP) secretion. It is treated by replacement therapy with the synthetic AVP analogue desmopressin. To prevent heart failure in patients with CDI accompanied by cardiac dysfunction, controlling sodium and water intake is essential, using the minimum effective dose of desmopressin.
December 2016: Clinical Case Reports
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