Citations

Ghrelin, an orexigenic hormone occurs mainly in stomach, and in several tumor types. We investigated ghrelin immunopositivity using the streptavidin‐biotin‐peroxidase complex method in the full spectrum of pituitary adenoma subtypes. Quantification was undertaken by analyzing both the percentage of tumor cells stained for ghrelin and the staining intensity. Cytoplasmic ghrelin immunopositivity was identified in several adenoma subtypes. Not every cell was immunopositive; the intensity of staining differed among cells within the given lesion and among the various tumors. The highest scores were noted in GH adenomas exposed to somatostatin analogues. In decreasing order, lower scores were encountered in ACTH‐producing, silent subtype 1 and 2 adenomas in Cushing disease, silent subtype 3 adenomas, untreated GH adenomas, dopamine agonist‐treated PRL adenomas, gonadotroph adenomas, and ACTH adenomas in Nelson syndrome. No immunoreactivity was found in TSH, untreated PRL‐producing, and null cell adenomas. The high immunoexpression of ghrelin in GH adenomas exposed to somatostatin analogues, may be due to increased ghrelin synthesis or to suppression of its release.

Previous studies showed that in pregnancy the pituitary enlarges and increases in weight due to lactotroph hyperplasia. We demonstrated that in pituitaries of pregnant women, microvessel density is significantly increased compared to those of age– matched non pregnant women. Vascular endothelial growth factor (VEGF) stimulates new vessel formation in several tissues and neoplasms. The aim of the present study was to reveal whether VEGF is involved in the causation of increased vascularity in the pituitaries of pregnant women. We assessed VEGF immunoexpression in 20 autopsy obtained pituitaries of pregnant women and compared the results with 20 controls. Slides were immunostained for VEGF and pituitary hormones using the streptavidin‐biotin‐peroxidase complex method. VEGF immunoexpression was evaluated in 10 random high‐power fields using an image analyzer and the results compared by chi‐square or Fisher exact tests. Immunoexpression of VEGF was not increased in the adenohypophyses of pregnant women compared with the controls indicating that VEGF plays no major role in the causation of increased vascularity. The cause remains to be investigated.

Pituitary enlargement, development of pregnancy cells and prolactin cell hyperplasia are known to occur in pregnancy. In the present work, we assessed microvessel densities in the 20 pituitaries of pregnant women who passed away. Twenty pituitaries of age matched non‐pregnant women who died from non‐endocrine diseases were used as controls. The autopsy obtained pituitaries were formalin fixed and paraffin embedded. Slides were immunostained for adenohypophysial hormones and for CD‐34, an endothelial cell biomarker using the streptavidin‐biotin‐ peroxidase complex method. Microvessel densities were evaluated quantitatively in 10 random high‐ power fields. For statistical analysis, the chi‐square and Fisher exact tests were applied. The results confirmed that the pituitaries of pregnant women increased in weight and contained more PRL immunopositive cells compared to the controls. The formation of pregnancy cells was also evident. In the pituitaries of pregnant women compared to the control, microvessel densities were significantly higher. The cause of increased vascularity remains to be evaluated. This work was supported by the Jarislowsky and Lloyd Carr‐Harris Foundations.

Objective MGMT expression in brain and pituitary tumors has been correlated with temozolomide treatment. Few medical therapies are available in patients with Nelson Syndrome. The aim of the present study was to assess immunohistochemical expression of MGMT in ACTH‐secreting pituitary adenomas in patients with Nelson Syndrome. Methods Our material consisted of specimens from ACTH‐secreting pituitary adenomas from patients with Nelson Syndrome. Immunohistochemical staining for MGMT was performed using the streptavidin‐biotin‐peroxidase complex method. MGMT immunoreactivity was assessed microscopically and recorded as an estimated percentage of nuclear MGMT immunopositivity. (0=none, 1=<10%, 3=<50%, 4=>50%) Results Male:Female ratio was 3:5, with average patient age being 62 (range 57–66). Five of the eight specimens (65%) exhibited no MGMT immunoreactivity, with two out of eight cases (25%) showing slight MGMT immunopositivity and one out of eight cases (12%) demonstrating moderate MGMT immunopositivity (<25%). Conclusions Temozolomide therapy may be useful in patients with Nelson Syndrome. Absent or low MGMT staining in brain and other neoplasms has been shown to correlate with successful treatment with temozolomide, and recent reports assessing aggressive pituitary adenomas suggest similar outcome.

Significance By evaluating children with a malformed cerebral cortex, we identified an ATPase pump (ATP1A3) with an early role in brain development. The ATP1A3 pump maintains the physiological concentration of sodium and potassium ions in cells, a process critical for osmotic equilibrium and membrane potential across several developing cell populations. We employed single-cell sequencing approaches to identify key enrichments for ATP1A3 expression during human cortex development. Unravelling this early cell-type–specific pathophysiology in the developing brain offers a potential basis for the treatment of ATP1A3 -related diseases affecting prenatal and early childhood development.

PURPOSE: Contemporary breast cancer surgery often requires hospital stays of 1 day or less, presenting challenges to delivery of high-quality care. Without sufficient time for proper education and guidance, patients may delay seeking care, experience anxiety, or seek unnecessary care, leading to poorer outcomes and increased costs. To address this, we evaluated the feasibility of a planning-, outcomes-, and analytics-based mobile health application called Manage My Surgery (MMS) for patients undergoing elective breast cancer surgery. METHODS: Patients undergoing breast cancer surgery at an academic health center were invited to use MMS. Those who used the application received pre- and postoperative surveys, which recorded and reported patient satisfaction and outcomes related to the application. RESULTS: Thirty-three female patients undergoing elective breast cancer surgery used MMS. The median age was 58 years. Nineteen patients underwent lumpectomy, and 14 underwent mastectomy. Users logged on to the application an average of 3.5 times. The median number of questions viewed was 12 (range 2-35). Of 17 patients who completed the feedback survey, 100% said that MMS was helpful during preparation for surgery, 82.3% said that MMS was helpful postoperatively, and 94.1% would recommend MMS to others. Preliminary data on patient-reported outcomes collected by MMS suggest improvements in anxiety and depression over time. CONCLUSION: Implementation of a digital care navigation tool in breast cancer surgery patients is feasible. Patients found the tool helpful in both the pre- and postoperative period. Additional ongoing work will focus on patients' self-management skills, long-term outcomes, and health system costs.