日本内分泌学会雑誌
Online ISSN : 2186-506X
Print ISSN : 0029-0661
ISSN-L : 0029-0661
68 巻, 8 号
選択された号の論文の7件中1~7を表示しています
  • 魚住 徹, 有田 和徳, 栗栖 薫
    1992 年 68 巻 8 号 p. 711-723
    発行日: 1992/08/20
    公開日: 2012/09/24
    ジャーナル フリー
    There has been a dramatic development in the treatment of pituitary adenomas during the last two decades. The main factors which led to this development were the introduction of transsphenoidal surgery, the development of new imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) and the introduction of newer dopaminergic agents. Present status of the treatment of pituitary adenoma is reported here. This report is based on the experiences of 381 cases of pituitary adenomas treated at the Department of Neurosurgery, Hiroshima University School of Medicine within the last 16 years. There are some problems which have to be solved in order to achieve further development in the treatment of pituitary adenomas. Our experience in this field and a need for future development are listed below.
    1) The transsphenoidal adenomectomy gives high cure rates in cases of micro and expansive prolactinomas and growth hormone secreting adenomas.
    2) Results of the transsphenoidal surgery in cases of ACTH secreting adenomas is not satisfactory. In order to get higher cure rate, a more elaborate operative techniques and an introduction of more effective drug therapy are needed.
    3) Further safety and curability in pituitary surgery will be achieved by the exploitation of new imaging modalities such as MRI.
  • 望月 眞人, 丸尾 猛
    1992 年 68 巻 8 号 p. 724-735
    発行日: 1992/08/20
    公開日: 2012/09/24
    ジャーナル フリー
    The trophoblast of human placenta is composed of syncytiotrophoblast (S-cell) and cytotrophoblast (C-cell). C-cell displays proliferative properties, while S-cell displays little potential for proliferation. A close similarity between cytologic localization of myc product and [3H] thymidine labeling suggests that myc expression is linked to trophoblast proliferation. In situ hybridization with cDNA probes revealed that mRNA expression of hCG α and hCG β are initiated before syncytial formation, whereas hPL mRNA is expressed only in fully differentiated S-cell. EGF and EGF receptor (EGF-R) in 4-5 weeks placenta were localized to C-cell, whereas EGF and EGF-R in 6-12 weeks placenta were localized to S-cell. Consistent with these findings, EGF exerted gestational age dependent dual action on early placenta: one was to stimulate trophoblast proliferation in 4-5 weeks placenta and the other was to stimulate differentiated trophoblast function in 6-12 weeks placenta. An optimal dose of thyroid hormone stimulated progesterone, estradiol, hCG and hPL production in early placental tissues. Furthermore, women with unfavorable outcome of threatened abortion had lower T4, T3, free T4 and free T3 levels, as compared to women with favorable outcome. These data imply a role for thyroid hormone in maintaining early pregnancy. On the other hand, progesterone selectively inhibited hCG(α, β) mRNAs expression and decreased hCG secretion in normal placental tissues, whereas choriocarcinoma did not respond to progesterone. This suggests that inhibitory regulation of hCG synthesis in choriocarcinoma is different from normal palcenta. Characterization of choriocarcinoma hCG revealed that there are striking differences in carbohydrate structures between normal hCG and choriocarcinoma hCG. Sialic acid content in choriocarcinoma hCG was extremely lower compared to that in normal hCG. The biochemical detection of the alteration in hCG sugar chains is useful for early diagnosis of choriocarcinoma.
  • 中道 昇, 陶 緒平, 村上 稔, 山田 憲次, 高村 光行, 川村 将弘
    1992 年 68 巻 8 号 p. 736-742
    発行日: 1992/08/20
    公開日: 2012/09/24
    ジャーナル フリー
    We investigated the effect of Ca2+-channel antagonists, Nicardipine (N), Verapamil (V) and Flunarizine (F), on the corticoidogenesis (CG) in primary cultured bovine adrenocortical cells. To examine the effect on receptor operated Ca2+-channel (ROC) and voltage operated Ca2+-channel (VOC), involved in corticoid synthesis, adrenocorticotropic hormone (ACTH) and high-K+ were used respectively. With or without the antagonists, cells were incubated at 37°C for 1h in the presence of ACTH (100pM) or K+ (30mM). Corticoid was measured fluorometrically using cortisol as the standard. N and V inhibited not only ACTH-induced CG, but high K+-induced CG in a concentration-dependent manner. However, F inhibited only high K+-induced CG, and did not affect ACTH-induced CG. These inhibitions were observed at the low micromolar concentrations (below 40μM) of the antagonists. In the regulation of corticoid synthesis, we indicate that F has an inhibitory effect on VOC without ROC; on the other hand, N and V inhibit both ROC and VOC.
  • 阪本 勝彦, 益崎 裕章, 藤村 直樹, 巖西 真規, 前川 聡, 小林 正, 繁田 幸男
    1992 年 68 巻 8 号 p. 743-751
    発行日: 1992/08/20
    公開日: 2012/09/24
    ジャーナル フリー
    A forty-one-year-old male who was found to have lung carcinoid tumor showed clinical features of Cushing syndrome. At the age of 38 years during a regular check-up, a chest roentgenogram showed multiple nodular shadows in the bilateral lung, and he was admitted to hospital. By open lung biopsy, he was diagnosed as having malignant carcinoid or small cell carcinoma of the lung. The abnormal lung shadows did not respond to chemotherapy (CDDP+VDS). The clinical course after discharge was uneventful until the age of 41 years, when he was readmitted to our hospital because of brain metastasis. Physical examination revealed moon face and central obesity. Plasma ACTH level was high and dexamethasone suppression test showed no cortisol suppression on 8mg dexamethasone administration. Therefore, it was thought that the patient had ACTH producing ectopic tumor which led to Cushing syndrome. We measured the molecular weight of ACTH by column chromatography and found he had a big ACTH (molecular weight about 22000). Reexamining him clinically and histologically, we concluded that the patient had atypical carcinoid tumor in the lung which might produce ACTH causing Cushing syndrome with metastasis to the brain.
  • 家入 蒼生夫, 黒田 久元, 江本 達志, 正和 信英, 長谷川 薫, 下田 新一
    1992 年 68 巻 8 号 p. 752-764
    発行日: 1992/08/20
    公開日: 2012/09/24
    ジャーナル フリー
    A case of congenital familial goiter with impaired thyroglobulin (Tg) synthesis has been reported. The patient is the fifth in a family of six children, three of whom have a goiter. The parents are cousins. The patient's thyroid function tests showed low T4 (1.0 μg/dl) and free T4 (0.2ng/dl), normal or slightly increased T3 (1.8ng/ml) and free T3 (7.4pg/ml), and high TSH (57μ/ml). Serum Tg was 5.1ng/ml (normal<30). The thyroidal 123I-uptake was 59.8% before and 54.5% after perchlorate test. Gel filtration with Bio-Gel A 5m demonstrated the presence of albumin-like protein probably iodinated as a major protein in the thyroid and very low content of Tg which was smaller than the normal 19S Tg. Histologically microfollicular adenoma and negative Tg immunostaining were the dominant findings. Segregation of Tg alleles in the family was studied by Southern blotting with a probe revealing a diallelic RFLP. The results demonstrated that the affected siblings had received the same alleles from both parents and were homozygous for the RFLP. Northern blotting analysis of the goiter RNA with a Tg probe revealed that, whereas the amount of Tg mRNA was normal, its size seemed slightly reduced. PCR amplification of Tg mRNA as six overlapping cDNA fragments demonstrated that a 200bp fragment was missing from the 5′ region of the goiter mRNA. Subcloning and sequencing of the cDNA fragments, and of the patient's genomic DNA amplified from this region, revealed that this aberrant splicing is due to a cytosine to guanine transversion at position minus 3 in the acceptor splice site of intron 3. The presence in exon 4 of a putative donor tyrosine residue (tyr 130) involved in thyroid hormone formation provides a coherent explanation of the hypothyroid status of the patient. To our knowledge, this is the first identified mutation responsible for congenital familial goiter in humans.
  • 渋谷 雄平, 井上 大輔, 横田 敏彦, 奥田 譲治, 森 徹
    1992 年 68 巻 8 号 p. 765-772
    発行日: 1992/08/20
    公開日: 2012/09/24
    ジャーナル フリー
    A case of metastatic thyroid cancer from sigmoid colon cancer is presented.
    A 52-year-old woman had a sigmoidectomy due to adenocarcinoma of the sigmoid colon in April 1988. Serum carcinoembryonic antigen (CEA) levels gradually rose from July 1990 along with multiple metastatic lesions which appeared in the lung. They were resected in January 1991. Two months later the subject noticed a painless and firm lump on the left anterior neck. She was found to have a solitary mass in the left thyroid lobe. Thyroid function remained within normal range. Cytological findings obtained by fine-needle aspiration biopsy showed tall columnar carcinoma cells with an acinar pattern. Subtotal thyroidectomy was performed, and histological examination revealed metastatic adenocarcinoma from colon cancer. Immunohistochemical staining by anti-CEA was positive but anti-thyroglobulin was negative.
  • 石北 敏一, 飯野 祐一, 石田 常博, 武井 寛幸, 森下 靖雄, 樽谷 修
    1992 年 68 巻 8 号 p. 773-782
    発行日: 1992/08/20
    公開日: 2012/09/24
    ジャーナル フリー
    The chemical and immunological properties of thyroglobulin (Tg) in tissue obtained from a patient co-existed with two types of thyroid tumors, i. e., functioning and non-functioning, and were compared with the properties of Tg that was isolated from adjacent peripheral tissue.
    In the present observations, the Tg content was markedly increased in the non-functioning thyroid tumor. On the other hand, the Tg content in the functioning tumor was at the normal level.
    The iodine content of Tg was significantly lower in the non-functioning tumor than in peripheral tissues. Affinity with Lectins differed among Tg preparations, suggesting that the carbohydrate chain in the Tg was different in each nodule in a single individual.
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