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[PMID]: 29267504
[Au] Autor:Mendes GA; Haag T; Trott G; Rech CGSL; Ferreira NP; Oliveira MC; Kohek MB; Pereira-Lima JFS
[Ad] Address:Programa de Pós-Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
[Ti] Title:Expression of E-cadherin, Slug and NCAM and its relationship to tumor invasiveness in patients with acromegaly.
[So] Source:Braz J Med Biol Res;51(2):e6808, 2017 Dec 11.
[Is] ISSN:1414-431X
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:Pituitary adenomas account for 10-15% of primary intracranial tumors. Growth hormone (GH)-secreting adenomas account for 13% of all pituitary adenomas and cause acromegaly. These tumors can be aggressive, invade surrounding structures and are highly recurrent. The objective of this study was to evaluate E-cadherin, Slug and neural cell adhesion molecule (NCAM) expression in GH-secreting pituitary adenomas and its relationship to tumor invasiveness. A cross-sectional study of patients who underwent hypophysectomy due to GH-secreting pituitary adenoma from April 2007 to December 2014 was carried out. The medical records were reviewed to collect clinical data. Immediately after surgery, tumor samples were frozen in liquid nitrogen and stored in a biofreezer at -80°C for assessment of E-cadherin 1 (CDH1), SLUG (SNAI2), and NCAM (NCAM1) by real-time PCR. The samples were fixed in formalin and embedded in paraffin for immunohistochemical analysis of E-cadherin and NCAM. Thirty-five patients with acromegaly were included in the study. Of these, 65.7% had invasive tumors. Immunohistochemically, E-cadherin was expressed in 96.7% of patients, and NCAM in 80% of patients. There was no statistically significant relationship between tumor grade or invasiveness and immunohistochemical expression of these markers. Regarding gene expression, 50% of cases expressed CDH1, none expressed SNAI2, and 53.3% expressed NCAM1. There was no statistically significant relationship between tumor grade or invasiveness and gene expression of CDH1, SNAI2, and NCAM1. The absence of Slug overexpression and of E-cadherin and NCAM suppression suggests that expression of these markers is not associated with tumor invasiveness in GH-secreting pituitary adenomas.
[Mh] MeSH terms primary: Acromegaly/pathology
Adenoma/pathology
Cadherins/analysis
Neural Cell Adhesion Molecules/analysis
Pituitary Neoplasms/pathology
Snail Family Transcription Factors/analysis
[Mh] MeSH terms secundary: Acromegaly/genetics
Acromegaly/metabolism
Adenoma/chemistry
Adenoma/genetics
Adolescent
Adult
Aged
Biomarkers, Tumor/analysis
CD56 Antigen/analysis
Cross-Sectional Studies
Female
Gene Expression
Humans
Immunohistochemistry
Male
Middle Aged
Neoplasm Grading
Neoplasm Invasiveness
Pituitary Neoplasms/chemistry
Pituitary Neoplasms/genetics
Real-Time Polymerase Chain Reaction
Statistics, Nonparametric
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Biomarkers, Tumor); 0 (CD56 Antigen); 0 (Cadherins); 0 (NCAM1 protein, human); 0 (Neural Cell Adhesion Molecules); 0 (SNAI1 protein, human); 0 (Snail Family Transcription Factors)
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:171222
[St] Status:MEDLINE

  2 / 10663 MEDLINE  
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[PMID]: 29190687
[Au] Autor:da Silva AA; Hall JE; do Carmo JM
[Ad] Address:Department of Physiology and Biophysics, Mississippi Center for Obesity Research, Cardiovascular-Renal Research Center, University of Mississippi Medical Center, Jackson, Mississippi, United States of America.
[Ti] Title:Leptin reverses hyperglycemia and hyperphagia in insulin deficient diabetic rats by pituitary-independent central nervous system actions.
[So] Source:PLoS One;12(11):e0184805, 2017.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The hypothalamic-pituitary-adrenal (HPA) axis has been postulated to play a major role in mediating the antidiabetic effects of leptin. We tested if the pituitary is essential for the chronic central nervous system mediated actions of leptin on metabolic and cardiovascular function in insulin-dependent diabetic and non-diabetic rats. Male 12-week-old hypophysectomized Sprague-Dawley rats (Hypo, n = 5) were instrumented with telemetry probes for determination of mean arterial pressure (MAP) and heart rate (HR) 24-hrs/day and an intracerebroventricular (ICV) cannula was placed into the brain lateral ventricle for continuous leptin infusion. In additional groups of Hypo and control rats (n = 5/group), diabetes was induced by single injection of streptozotocin (50 mg/kg, IP). Hypo rats were lighter, had lower MAP and HR (83±4 and 317±2 vs 105±4 mmHg and 339±4 bpm), with similar caloric intake per kilogram of body weight and fasting plasma glucose levels (84±4 vs 80±4 mg/dl) compared to controls. Chronic ICV leptin infusion (7 days, 0.62 µg/hr) in non-diabetic rats reduced caloric intake and body weight (-10%) in Hypo and control rats and markedly increased HR in control rats (~25 bpm) while causing only modest HR increases in Hypo rats (8 bpm). In diabetic Hypo and control rats, leptin infusion reduced caloric intake, body weight and glucose levels (323±74 to 99±20 and 374±27 to 108±10 mg/dl), respectively; however, the effects of leptin on HR were abolished in Hypo rats. These results indicate that hypophysectomy attenuates leptin's effect on HR regulation without altering leptin's ability to suppress appetite or normalize glucose levels in diabetes.
[Mh] MeSH terms primary: Central Nervous System/physiopathology
Diabetes Mellitus, Experimental/complications
Hyperglycemia/drug therapy
Hyperphagia/drug therapy
Leptin/therapeutic use
Pituitary Gland/drug effects
[Mh] MeSH terms secundary: Animals
Blood Glucose/metabolism
Blood Pressure
Bradycardia/drug therapy
Bradycardia/etiology
Energy Intake
Heart Rate
Hyperglycemia/complications
Hyperphagia/complications
Hypophysectomy
Infusions, Intraventricular
Insulin/blood
Leptin/administration & dosage
Male
Pituitary Gland/surgery
Rats
Rats, Sprague-Dawley
Streptozocin
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Name of substance:0 (Blood Glucose); 0 (Insulin); 0 (Leptin); 5W494URQ81 (Streptozocin)
[Em] Entry month:1712
[Cu] Class update date: 180130
[Lr] Last revision date:180130
[Js] Journal subset:IM
[Da] Date of entry for processing:171201
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184805

  3 / 10663 MEDLINE  
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[PMID]: 29332900
[Au] Autor:Tujioka K; Yamada T; Yokogoshi H; Akiduki S; Hishida Y; Tsutsui K; Hayase K
[Ad] Address:Faculty of Early Childhood Care and Education, Ohkagakuen University.
[Ti] Title:Changes in Thyroid Hormone Are Not Involved in Regulating Brain Protein Synthesis in Adults Rats Fed Ornithine.
[So] Source:J Nutr Sci Vitaminol (Tokyo);63(6):389-395, 2017.
[Is] ISSN:1881-7742
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:Brain protein synthesis and the plasma concentration of growth hormone (GH) are sensitive to dietary ornithine. However, dietary ornithine does not increase brain protein synthesis in hypophysectomized rats. Because hypophysectomy may decrease the secretion of thyroid stimulated hormone (TSH), we assessed whether the regulation of brain protein synthesis was mediated by changes in the plasma concentrations of thyroid hormone and ghrelin in the 6-propyl-2-thiouracil (PTU, thyroid inhibitor)-treated or control adult rats fed ornithine. The four experimental groups consisted of PTU-treated and control (24-wk-old) male rats given 0% or 0.7% ornithine-HCl added to a 20% casein diet. The plasma concentrations of GH and ghrelin, and the fractional rates of protein synthesis and RNA activity [g protein synthesized/(g RNA•d)] in the brains were significantly increased after treatment with the 20% casein + 0.7% ornithine compared with the 20% casein diet alone in both the PTU-treated and control groups. Ornithine supplementation to the basal diet did not affect the plasma concentration of T . The RNA concentration (mg RNA/g protein) was not related to the fractional rate of protein synthesis in the brain regions. The results suggest that dietary ornithine likely increases the rate of brain protein synthesis in control and PTU-treated rats, and that the ornithine-induced increase in the GH concentration may stimulate mainly brain protein synthesis via ghrelin. RNA activity is at least partly related to the fractional rate of brain protein synthesis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180115
[Lr] Last revision date:180115
[St] Status:In-Process
[do] DOI:10.3177/jnsv.63.389

  4 / 10663 MEDLINE  
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[PMID]: 29056398
[Au] Autor:Owen TJ; Martin LG; Chen AV
[Ad] Address:Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, PO Box 647060, Pullman, WA 99164-7060, USA. Electronic address: tinajoowen@vetmed.wsu.edu.
[Ti] Title:Transsphenoidal Surgery for Pituitary Tumors and Other Sellar Masses.
[So] Source:Vet Clin North Am Small Anim Pract;48(1):129-151, 2018 Jan.
[Is] ISSN:1878-1306
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Transsphenoidal surgery is an option for dogs and cats with functional and nonfunctional pituitary masses or other sellar and parasellar masses. An adrenocorticotropic hormone-secreting tumor causing Cushing disease is the most common clinically relevant pituitary tumor in dogs, and the most common pituitary tumor seen in cats is a growth hormone-secreting tumor causing acromegaly. Transsphenoidal surgery can lead to rapid resolution of clinical signs and provide a cure for these patients. Because of the risks associated with this surgery, it should only be attempted by a cohesive pituitary surgery group with a sophisticated medical and surgical team.
[Mh] MeSH terms primary: Adenoma/veterinary
Cat Diseases/surgery
Dog Diseases/surgery
Hypophysectomy/veterinary
Meningioma/veterinary
Pituitary Neoplasms/veterinary
[Mh] MeSH terms secundary: Adenoma/diagnosis
Adenoma/surgery
Animals
Cat Diseases/diagnosis
Cats
Dog Diseases/diagnosis
Dogs
Hypophysectomy/methods
Meningioma/diagnosis
Meningioma/surgery
Pituitary Neoplasms/diagnosis
Pituitary Neoplasms/surgery
Postoperative Complications/veterinary
Prognosis
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 171222
[Lr] Last revision date:171222
[Js] Journal subset:IM
[Da] Date of entry for processing:171024
[St] Status:MEDLINE

  5 / 10663 MEDLINE  
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[PMID]: 29151078
[Au] Autor:Cieszkowski J; Warzecha Z; Ceranowicz P; Ceranowicz D; Kusnierz-Cabala B; Pedziwiatr M; Dembinski M; Ambrozy T; Kaczmarzyk T; Pihut M; Wieckiewicz M; Olszanecki R; Dembinski A
[Ad] Address:Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland.
[Ti] Title:Therapeutic effect of exogenous ghrelin in the healing of gingival ulcers is mediated by the release of endogenous growth hormone and insulin-like growth factor-1.
[So] Source:J Physiol Pharmacol;68(4):609-617, 2017 Aug.
[Is] ISSN:1899-1505
[Cp] Country of publication:Poland
[La] Language:eng
[Ab] Abstract:Ghrelin, an acylated 28-amino acid polypeptide, was primary isolated from the stomach, and the stomach is a main source of circulating ghrelin. Ghrelin strongly and dose-dependently stimulates release of growth hormone from the anterior pituitary, as well as increases food intake and fat deposition. Previous studies showed that ghrelin exhibits protective and therapeutic effect in different parts of the gastrointestinal system, including the oral cavity. The aim of present study was to examine the role of growth hormone and insulin-like growth factor-1 (IGF-1) in the healing of gingival ulcers. Studies were performed on rats with the intact pituitary gland and hypophysectomized rats. In anesthetized rats, chronic ulcers of the gum were induced by acetic acid. Rats were treated intraperitoneally twice a day with saline or ghrelin (4, 8 or 16 nmol/kg/dose) for six days. In pituitary-intact rats, administration of ghrelin significantly increased serum concentration of growth hormone and IGF-1 and this effect was associated with a significant increase in the healing rate of gingival ulcers. Moreover, treatment with ghrelin increased mucosal blood flow and DNA synthesis in the gum, while a local inflammation was decreased what was observed as a reduction in mucosal concentration of pro-inflammatory interleukin-1ß. Hypophysectomy decreased serum level of growth hormone below a detection limit; whereas serum concentration of IGF-1 was reduced by 90%. On the other hand, removal of the pituitary gland was without any significant effect on the healing rate of gingival ulcers or on the ulcer-induced increase in DNA synthesis and concentration of pro-inflammatory interleukin-1ß in gingival mucosa. Administration of ghrelin failed to affect serum level of growth hormone and IGF-1 in hypophysectomized rats, and was without any effect on the healing rate of gingival ulcers, mucosal blood flow, DNA synthesis or concentration of interleukin-1ß in gingival mucosa. Neither induction of gingival ulcers nor hypophysectomy nor administration of ghrelin significantly affected serum concentration of pro-inflammatory interleukin-1ß. We concluded that endogenous growth hormone and IGF-1 were involved in the therapeutic effect of exogenous ghrelin in the healing of gingival mucosa damage.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171119
[Lr] Last revision date:171119
[St] Status:In-Process

  6 / 10663 MEDLINE  
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[PMID]: 29134170
[Au] Autor:Harker P; Feo-Lee O; Giraldo-Grueso M; Puentes JC
[Ad] Address:Neuroscience Department, Hospital Universitario San Ignacio, Bogotá, Colombia.
[Ti] Title:Effectiveness of Bilateral Inferior Petrosal Sinuses Sampling in Tumor Lateralization: Intraoperative Findings and Postoperative Results.
[So] Source:J Neurol Surg B Skull Base;78(6):506-511, 2017 Dec.
[Is] ISSN:2193-6331
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Diagnosis and treatment of Cushing's disease (CD) is a demanding endeavor. We evaluated the effectiveness of inferior petrosal sinus sampling (IPSS) in preoperative tumor lateralization and surgical outcomes. Fifty-two consecutive patients with CD and normal magnetic resonance imaging (MRI) were enrolled between 2009 and 2015. Selective catheterization of petrosal sinuses for IPSS was performed. All patients underwent microsurgical dissection, and if a lesion was found, underwent lesion resection. Demographic, biochemical, and intraoperative findings were prospectively collected and reviewed 6 and 12 months postoperatively. Forty-five patients (86.4%) had clear lateralization while seven patients had bilateral elevation. Twenty-two patients (42%) were found to have a macroscopic lesion, defined as an abnormal tissue during microsurgical dissection, which was thus resected. No patient had a lesion larger than 4 mm. Eighty-one percent of patients had the lesion where IPSS had been predicted. Hemi-hypophysectomy was performed on twenty-eight patients based on IPSS findings, since no lesion was found. Eighty-six percent of patients with lesion resection had biochemical remission by 12 months. Biochemical remission was documented in 78 and 71% of patients who underwent hemi-hypophysectomy by 6 and 12 months, respectively. With careful microsurgical dissection, a macroscopic lesion could be found in a significant number of patients with normal MRI. When no lesion was found, we recommend performing a hemi-hypophysectomy based on IPSS findings, since prediction accuracy was high and remission rates were significant.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171116
[Lr] Last revision date:171116
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1055/s-0037-1604409

  7 / 10663 MEDLINE  
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[PMID]: 28973682
[Au] Autor:Borius PY; Garnier SR; Baumstarck K; Castinetti F; Donnet A; Guedj E; Cornu P; Blond S; Salas S; Régis J
[Ad] Address:Functional and Stereotaxic Neurosurgery Department, Hopital La Timone, Marseille University Hospital, Marseille, France.
[Ti] Title:An Open-Label, Analgesic Efficacy and Safety of Pituitary Radiosurgery for Patients With Opioid-Refractory Pain: Study Protocol for a Randomized Controlled Trial.
[So] Source:Neurosurgery;, 2017 Aug 02.
[Is] ISSN:1524-4040
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Hypophysectomy performed by craniotomy or percutaneous techniques leads to complete pain relief in more than 70% to 80% of cases for opioid refractory cancer pain. Radiosurgery could be an interesting alternative approach to reduce complications. OBJECTIVE: To assess the analgesic efficacy compared with standard of care is the primary goal. The secondary objectives are to assess ophthalmic and endocrine tolerance, drug consumption, quality of life, and mechanisms of analgesic action. METHODS: The trial is multicenter, randomized, prospective, and open-label with 2 parallel groups. This concerns patients in palliative care suffering from nociceptive or mixed cancer pain, refractory to standard opioid therapy. Participants will be randomly assigned to the control group receiving standards of care for pain according to recommendations, or to the experimental group receiving a pituitary GammaKnife (Elekta, Stockholm, Sweden) radiosurgery (160 Gy delivered in pituitary gland) associated with standards of care. Evaluation assessments will be taken at baseline, day0, day4, day7, day14, day28, day45, month3, and month6. EXPECTED OUTCOMES: We could expect pain improvement in 70% to 90% of cases at day4. In addition we will assess the safety of pituitary radiosurgery in a vulnerable population. The secondary endpoints could show decay of opioid consumption, good patient satisfaction, and improvement of the quality of life. DISCUSSION: The design of this study is potentially the most appropriate to demonstrate the efficacy and safety of radiosurgery for this new indication. New recommendations could be obtained in order to improve pain relief and quality of life.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171003
[Lr] Last revision date:171003
[St] Status:Publisher
[do] DOI:10.1093/neuros/nyx363

  8 / 10663 MEDLINE  
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[PMID]: 28963390
[Au] Autor:Pal R; Dutta P; Mukherjee KK; Bhansali A
[Ad] Address:Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
[Ti] Title:Acromegaly with hypophosphataemia: McCune-Albright syndrome.
[So] Source:BMJ Case Rep;2017, 2017 Sep 28.
[Is] ISSN:1757-790X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:A 38-year-old man presented with excessive height gain and progressive enlargement of the extremities since childhood. This was compounded by lower limb deformities over the past 5 years. On examination, his height was 196 cm, he had macroglossia, acral enlargement, seborrhoea, hyperhidrosis-suggesting acrogigantism. He had facial asymmetry, wind-swept deformity of lower limbs and a café-au-lait macule over his trunk. Investigations revealed normal-sized pituitary gland with dysplastic cranial bones. Isotope bone scintigraphy was suggestive of polyostotic fibrous dysplasia. A diagnosis of McCune-Albright syndrome was made and trans-sphenoidal hypophysectomy was undertaken. He had persistent hypophosphataemia. Tubular reabsorption of phosphate adjusted for glomerular filtration rate was low and serum FGF-23 level was high. Ga-DOTATATE scintigraphy showed somatostatin-receptor expression in all the dysplastic lesions. FGF-23 produced by the bony lesions could counteract the phosphate-retaining effect of GH excess resulting in hypophosphataemia, which further worsened following hypophysectomy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 170930
[Lr] Last revision date:170930
[St] Status:In-Process

  9 / 10663 MEDLINE  
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[PMID]: 28838299
[Au] Autor:Boland LA; Barrs VR
[Ad] Address:Valentine Charlton Cat Centre, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia.
[Ti] Title:Peculiarities of feline hyperadrenocorticism: Update on diagnosis and treatment.
[So] Source:J Feline Med Surg;19(9):933-947, 2017 Sep.
[Is] ISSN:1532-2750
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Practical relevance: Hyperadrenocorticism (HAC) is a relatively uncommon endocrinopathy of older cats, with a mean age at diagnosis of 10 years. In addition to pituitary-dependent and adrenal-dependent hypercortisolism, clinical signs of HAC can result from adrenal sex steroid-producing tumours. Clinical challenges: While HAC in cats has many similarities to canine HAC, there are key differences in presentation, diagnosis and response to therapy. Most, but not all, cats with HAC have concurrent diabetes mellitus, which is often insulin resistant. Up to a third of cats with HAC have extreme skin fragility and are at high risk of debilitating iatrogenic skin tears during diagnostic or therapeutic interventions. Infections of the skin and nail beds, and urinary, respiratory and gastrointestinal tract, secondary to cortisol-induced immune suppression, are also common. Cats respond differently to dogs to adrenal function tests including adrenocorticotropic hormone (ACTH) stimulation and dexamethasone suppression tests; a 10-fold higher dose of dexamethasone is recommended in cats to screen for HAC. Curative treatment options include adrenalectomy or transsphenoidal hypophysectomy. Radiation or medical treatment may improve clinical signs. The response to mitotane therapy is poor. While trilostane is the medical treatment of choice based on retrospective studies, investigations into the pharmacokinetics of this drug in cats are lacking. Global importance: Feline HAC occurs worldwide and is not associated with any purebreed predisposition. Although uncommon, adrenal sex steroid-producing tumours have a higher prevalence in cats than in dogs. Evidence base: The information in this review is drawn from over 180 reported cases of feline HAC. Reports investigating clinical presentation, clinicopathological findings and treatment outcomes are observational, retrospective multiple case series (EBM grade III) or single case reports (EBM grade IV). While most endocrine testing studies for diagnosis are cohort controlled analytical studies (EBM grade III), prospective, randomised, placebo-controlled studies have been performed (EBM grade I).
[Mh] MeSH terms primary: Adrenocortical Hyperfunction/veterinary
Cat Diseases/diagnosis
Cat Diseases/therapy
[Mh] MeSH terms secundary: Adrenocortical Hyperfunction/diagnosis
Adrenocortical Hyperfunction/therapy
Animals
Cats
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171010
[Lr] Last revision date:171010
[Js] Journal subset:IM
[Da] Date of entry for processing:170826
[St] Status:MEDLINE
[do] DOI:10.1177/1098612X17723245

  10 / 10663 MEDLINE  
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[PMID]: 28693686
[Au] Autor:Zhang X; Yu X; Huang Y
[Ad] Address:Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
[Ti] Title:The Correlation of Indices in r-TEG with Intra-operative Blood Loss in Neurosurgical Patients.
[So] Source:Chin Med Sci J;32(2):69-4, 2017 Jun 10.
[Is] ISSN:1001-9294
[Cp] Country of publication:China
[La] Language:eng
[Ab] Abstract:Objective Intra-operative coagulopathy has a close relationship with blood loss and the prognosis of patients. Rapid-thrombelastography (r-TEG) is a comprehensive assessment of coagulation abnormalities and also an effective way for constructing blood transfusion. This study attempts to investigate the correlation of r-TEG indices with intra-operative hemorrhage.Methods Patients who underwent transphenoidal hypophysectomy and craniotomy from January 15 to April 30, 2013 in Peking Union Medical College hospital were recruited. All patients had pre- and post-operative r-TEG and conventional coagulation tests (CCTs). Patients' information and intra-operative blood loss as a percentage of estimated blood volume were recorded. Spearman's correlation analyses were used for discovering the relationship between indices in r-TEG or CCTs and the intra-operative blood loss. The significant correlated index of r-TEG was further investigated using linear regression analysis. Results A total of 181 patients participated in this study. Intra-operative change of α-angle, which reflects the fibrinogen level and function, was the only r-TEG index that correlated with blood loss significantly (P=0.013, r= -0.184), thus challenging the current empirical cognition of the effects of intra-operative hemorrhage on coagulation. As intra-operative blood loss increased, α-angle decreased, and every 1% loss of estimated blood volume (EBV) led to 0.60 degree decrease of α-angle. As for CCT results, changes of fibrinogen and platelet count were also significantly correlated with blood loss (P=0.015 and P=0.001, respectively).Conclusions Peri-operative change of α-angle, as an index of r-TEG, exhibited a significant negative correlation with intra-operative blood loss. The impact of hemorrhage on fibrinogen, instead of clotting factors, should be scrutinized.
[Mh] MeSH terms primary: Blood Loss, Surgical
Neurosurgical Procedures
Thrombelastography
[Mh] MeSH terms secundary: Adolescent
Adult
Aged
Blood Coagulation Tests
Female
Fibrinogen/analysis
Humans
Male
Middle Aged
Platelet Count
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:9001-32-5 (Fibrinogen)
[Em] Entry month:1710
[Cu] Class update date: 171026
[Lr] Last revision date:171026
[Js] Journal subset:IM
[Da] Date of entry for processing:170712
[St] Status:MEDLINE
[do] DOI:10.24920/J1001-9294.2017.011


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