Transsphenoidal Hypophysectomy in the Treatment of Metastatic Breast and Prostate Carcinoma

The cases of 70 consecutive patients having a transsphenoidal hypophysectomy for metastatic carcinoma of the breast or prostate are reviewed. In half of the patients with cancer of the breast an objective remission was obtained. In 30 percent of the patients with cancer of the prostate there were objective signs of tumor regression and in 75 percent there was relief of pain. The operative mortality was 1.4 percent and the morbidity of the procedure was gratifyingly small. There is some indication that hypophysectomy may be preferred to adrenalectomy in patients with hormone-responsive metastatic mammary cancer.     

Neurophysin pathways in the normal and hypophysectomized rat

Summary The hypothalamo-extrahypophyseal neurophysin pathways (HEH) and the three hypothalamic nuclei secreting neurophysins, the supraoptic (SON), paraventricular (PVN) and suprachiasmatic (SCN) nuclei, of normal and hypophysectomized rats were studied by application of the immunoperoxidase procedure. Eight well-defined HEH pathways were recognized. Their main sites of projection were: lateral septum and subfornical organ (1 and 2); tractus diagonalis (3); medial nucleus of the amygdala and lateral ventricle (4); nucleus periventricularis thalami, nucleus habenulae lateralis and periaqueductal gray (5); periaqueductal gray, pineal organ, collicular recess and subependymal region of the fourth ventricle (6); dorsomedial nucleus and premammillary area (7); perimammillary region, corpus trapezoideum, ventral surface of medulla oblongata, nucleus tractus solitarii, nucleus commissuralis, substantia gelatinosa and formatio reticularis lateralis of the medulla oblongata and spinal cord (8).Neurophysin fibers of unknown origin were found in the frontal cerebral cortex.It was noted that in pathway 5 the amount of immunostainable material undergoes changes with age.The three neurophysin-secreting nuclei reacted differently following hypophysectomy. Among the HEH pathways the only one that seemed to be affected by hypophysectomy was that innervating the lateral septum.It is suggested that the neurons that survive hypophysectomy either do not project to the neural lobe or, alternatively, display axon collaterals projecting outside the neural lobe. Such a neuronal population could be the origin of the HEH pathways.Supported by Grant RSM-80-13 from the Directión de Investigaciones, Universidad Austral de Chile.The authors wish to acknowledge the valuable help of Mrs. Elizabeth Santibá~nez and Mr. Genaro Alvial.     

Monoamine oxidase and aspartate aminotransferase in cellular fractions of thyroid gland in rats after hypophysectomy and TSH stimulation

Monoamine oxidase (MAO) and aspartate aminotransferase activities in cellular fractions of thyroid gland in rats after hypophysectomy and TSH treatment were investigated. MAO and aspartate aminotransferase activities in thyroid mitochondria were decreased after hypophysectomy and significantly increased after daily injection of TSH during five days to hypophysectomized rats. In microsomes after hypophysectomy a similar decrease of MAO activity was found but TSH was without effect on this activity. In conclusion: it is evident that MAO and aspartate aminotransferase in thyroid mitochondria the enzymes which could be a source for hydrogen peroxide to catalyze thyroid hormone synthesis are under the regulatory influence of TSH.     

Effects of hypophysectomy and immobilization stress on S-adenosylmethionine levels in rat adrenal glands

Rat adrenal S-adenosylmethionine (SAM) levels and phenylethanolamine-N-methyltransferase (PNMT) activity were measured under conditions of hypophysectomy and stress. A new dual-label radioenzymatic assay for SAM is presented which eliminates problems found to exist with previous methods. Strain-specific differences in both PNMT and SAM were found, as well as sex differences in SAM levels. Immobilization stress resulted in an increase in adrenal SAM and PNMT activity, while hypophysectomy decreased both. The distribution of SAM between cortex and medulla did not change with either hypophysectomy or stress. Hypophysectomized Fisher rats were found to be capable of increasing PNMT activity in the absence of increased SAM levels.     

MENINGOENCEPHALITIS AND PNEUMONITIS DUE TO WESTERN EQUINE VIRUS

The dependence of cancer of the breast and prostate gland upon sex hormones has led to an attack on this problem by way of adrenalectomy with castration or by hypophysectomy when hormone treatment has failed. The survival period of patients who have had adrenalectomy or hypophysectomy has been prolonged by use of cortisone. The risk of either operation is reasonable and maintenance of life on cortisone is simple. The results are encouraging, with a tendency in favor of hypophysectomy. It seems justifiable to advise operation at an early stage of the disease.     

HYPOPHYSECTOMY OR ADRENALECTOMY?—Their Use in Management of Advanced Malignant Disease as Observed in Clinics in Europe

The dependence of cancer of the breast and prostate gland upon sex hormones has led to an attack on this problem by way of adrenalectomy with castration or by hypophysectomy when hormone treatment has failed. The survival period of patients who have had adrenalectomy or hypophysectomy has been prolonged by use of cortisone. The risk of either operation is reasonable and maintenance of life on cortisone is simple. The results are encouraging, with a tendency in favor of hypophysectomy. It seems justifiable to advise operation at an early stage of the disease.     

Further characterization of the effects of hypophysectomy, FSH and estrogen on LH stimulation of testosterone production in Leydig cells isolated from immature rats.

Hypophysectomy of immature rats results after 5 days in a loss of LH responsiveness of Leydig cells. LH responsiveness can be partly maintained by treatment with FSH for 5 days. When estradiol benzoate was administered together with FSH to hypophysectomized rats the maintenance of LH responsiveness was not observed. The loss in LH responsiveness after hypophysectomy in terms of testosterone production could not be explained by either a change in the amount of Leydig cells present in the Leydig cell preparation or to a higher conversion of testosterone. The LH-stimulated cAMP production in cells from hypophysectomized rats was very low compared to cells from intact rats. There was no difference between cAMP production of Leydig cells from untreated, FSH-treated or FSH plus estradiol benzoate treated hypophysectomized rats. During the first 2 days after hypophysectomy LH responsiveness in both untreated and FSH-treated rats showed a comparable decrease. From day 2 after hypophysectomy LH responsiveness remained at a constant level in cells from rats treated with FSH, but declined further in cells from untreated rats. A single injection of estradiol benzoate to hypophysectomized rats treated with FSH counteracted the effect of FSH on LH responsiveness, but only when estradiol was administered at that time after hypophysectomy, when the effect of FSH on LH responsiveness was clear.     

The effect of hypophysectomy and subsequent replacement therapy with sheep prolactin or bovine growth hormone on the lactose synthetase activity of rabbit mammary gland

1. The effects of hypophysectomy and replacement therapy with sheep prolactin and bovine growth hormone on the lactose synthetase activity of the mammary glands of lactating rabbits were studied. 2. There was an approximately fourfold decline in the lactose synthetase activity of homogenates calculated on a DNA basis within 6-7 days of hypophysectomy. Prolactin reversed this decline but growth hormone had no effect. 3. Changes in the properties of a particulate fraction isolated from the glands indicated that a decline in the effective concentration of alpha-lactalbumin was one factor contributing to the decreased lactose synthetase activity after hypophysectomy. 4. As the changes in lactose output produced by hypophysectomy and prolactin therapy are much greater than the changes in total lactose synthetase activity it is concluded that the activity of this enzyme is not the main factor controlling lactose output under these conditions.     

Functional and morphological effects of hypophysectomy and androgen replacement in the rabbit epididymis

Summary The fertilizing ability of spermatozoa from the distal corpus epididymidis of 55 male rabbits of proven fertility has been determined after artificial insemination 1, 2, 3, 5, 7, and 11 days after hypophysectomy. A significant decrease in fertility was noted 3, 5, and 7 days after hypophysectomy. Testosterone propionate (2 mg/kg/day) given for 7 days to hypophysectomized rabbits maintained the fertilizing ability of spermatozoa from the corpus epididymidis when injections were started from the day of hypophysectomy or delayed by a week. The effect of hypophysectomy on the histological features of the epididymal epithelium were studied with light and electron microscopy. Regressive changes were observed: reduction in size of the stereocilia border and the endoplasmic reticulum 3 days after hypophysectomy followed by a decrease in tubular diameter and cell height, a reduction in size of the Golgi apparatus and an increase in number of lysosome-like figures and a vacuolization of the epithelium.These results are discussed in relation to the physiological requirements for sperm maturation.     

The effect of hypophysectomy and prolactin therapy on water balance of the brown trout Salmo trutta.

A technique for the hypophysectomy of the brown trout is described which might be applicable to other salmonids. Hypophysectomy produced a decrease in water turnover which was corrected by prolactin therapy. Hypophysectomy resulted in a decrease in the next flux of osmotic water. Both osmotic and diffusional water permeabilities were evenly decreased after hypophysectomy, such that the ratio of the osmotic and diffusional permeability coefficients (Pos/Pd) retained a value of approximately unity. The data suggest that calcium and prolactin have opposing actions on water balance and that their modes of action are likely to separate.     

Effects of hypophysectomy on some osmoregulatory parameters of the catfish, Heteropneustes fossilis (Bloch)

The catfish, H. fossilis, survives for long periods after hypophysectomy, although with impaired osmoregulatory mechanisms. Plasma osmolarity and cortisol levels decline significantly within 2 hr after hypophysectomy and attain the lowest values by about 27 hr. Hypophysectomy also results in a marked decrease in urine flow rate principally due to reduced glomerular filtration. The reduction in the ability of the kidney of hypophysectomized catfish to eliminate water results in hyperhydration of blood and muscle. Urine osmolarity and sodium concentration increase due to reduced tubular reabsorption of sodium. There is, however, no net change in the total urinary sodium loss. The catfish survives in fresh water after hypophysectomy presumably because its tissues can tolerate significant dilution of the body fluids.     

Effect of hypophysectomy and growth hormone administration on somatostatin and gastrin content in the stomach of rats

The effect of hypophysectomy and bovine growth hormone (GH) administration on somatostatin (SRIF) content as well as gastrin content in the rat stomach was investigated. SRIF content was determined by a specific radioimmunoassay. The total SRIF content in the stomach had decreased 4 weeks after hypophysectomy but was restored significantly in those rats which were subjected to bovine GH administration for 7 days after hypophysectomy. Furthermore, in control rats, an increase in SRIF content in the stomach was observed after 7 days of GH administration. Similar changes in total content of gastrin were observed after hypophysectomy and bovine GH administration, although these changes were not significant. These results indicate that GH may influence gastric function through changes in SRIF and gastrin content in the stomach.     

Changes in the enzyme pattern of the mammary gland of the lactating rat after hypophysectomy and weaning

1. The enzymes glucose 6-phosphate dehydrogenase, 6-phosphogluconate dehydrogenase, phosphoglucomutase, UDP-glucose pyrophosphorylase, phosphofructokinase, ATP-citrate lyase and acetyl-CoA carboxylase have been assayed in rat mammary glands in various stages of involution after hypophysectomy and weaning. 2. After hypophysectomy all seven enzymes decline in activity over a 12–16hr. period but the extent of the decline varies, with acetyl-CoA carboxylase becoming almost totally inactive, ATP-citrate lyase and phosphofructokinase showing a large decrease, and the remaining enzymes a less marked decline. 3. Within 24hr. of removing the litter a change in the pattern of enzyme activity is found very similar to that after hypophysectomy. 4. The significance of these results is discussed in relation to the endocrine control of mammary gland metabolism and the mechanisms of involution.     

The Potential Role of Nitric Oxide Synthase in Survival and Regeneration of Magnocellular Neurons of Hypothalamo-Neurohypophyseal System

Previous investigations from this laboratory have demonstrated that hypophysectomy induces up-regulation of neuronal nitric oxide synthase (nNOS) in magnocellular neurons of the mammalian hypothalamo-neurohypophyseal system (HNS). Accompanied by this upregulation of nNOS, both neuronal regeneration and degeneration are also observed in this system following hypophysectomy. The specific aim of this study was to determine the potential role of nNOS upregulation in neuronal survival and regeneration after hypophysectomy in the adult Sprague–Dawley (SD) rat by using a competitive nitric oxide synthase blocker, N(G)-nitrol-l-arginine methyl ester (l-NAME). We found that l-NAME treatment effectively blocked the regeneration of magnocellular neurons of the rodent hypothalamus as observed in the lumen of the third cerebral ventricle following hypophysectomy. However, l-NAME had no effect on the survival of magnocellular neurons in the supraoptic (SON) and paraventricular (PVN) nuclei after hypophysectomy. These results suggest that the induced increase of nNOS expression enhance the regenerative ability of magnocellular neurons of the HNS following hypophysectomy.     

Temporal analysis of the role of growth hormone in the initiation and maintenance of limb regeneration in the hypophysectomized newt Notophthalmus viridescens

This study was designed to investigate and determine for how long, after either hypophysectomy or the third (last) growth hormone injection (to previously hypophysectomized newts), the circulating and now declining titers of endogenous or exogenous hormone remained at a sufficient concentration to permit a morphologically normal forelimb regeneration response in the adult newt Notophthalmus viridescens. To examine the declining levels of endogenous hormone (hormone withdrawal series [HW]), left forelimbs were amputated at specific times following hypophysectomy. Right forelimbs were amputated 5 days prior to hypophysectomy. The declining levels of exogenous hormone (hormone replacement series [HR] were examined in newts whose left forelimbs were amputated at specific times following the last of three consecutive alternate-day growth hormone injections that were initiated 5 days post hypophysectomy. Right forelimbs were amputated immediately following the first hormone injection. All experimental animals were sacrificed when their right forelimbs regenerated to an advanced digitiform regenerate. In both series right forelimbs regenerated normally. In the HW series normal regeneration resulted only when forelimbs were amputated within 48 hours post hypophysectomy, whereas in the HR series normal regeneration occurred in only those newts whose forelimbs were amputated within 12 hours of the last hormone injection. The regeneration response of left forelimbs in both series gradually declined with the time interval between either hypophysectomy or hormone injection and forelimb amputation. As the hormone titer declined, fewer limbs initiated a normal response; they became progressively more hypomorphic and eventually failed to undergo typical regeneration.     

Short- and long-term effects of hypophysectomy and unilateral ovariectomy on ovarian follicular populations in sheep

The effects of hypophysectomy and unilateral ovariectomy on the total number of follicles with greater than 3 layers of granulosa cells were determined at 4 and 70 days following treatment. The population of preantral follicles (less than 0.23 min diam.) was found to be under the control of gonadotrophins but such control was only evident on a long-term basis. At 70 days after unilateral ovariectomy there was a large increase in the number of preantral follicles but at 70 days after hypophysectomy there was a large decrease. The population of antral follicles (greater than 0.23 mm diam.) was under the immediate control of gonadotrophins. By 4 days after hypophysectomy all large antral follicles had become atretic and the number of antral follicles was further decreased at 70 days after treatment. At 70 days after unilateral ovariectomy there was an increase in the number of antral follicles. The follicular growth rates at 70 days following treatment were decreased in hypophysectomized ewes but increased in ewes after unilateral ovariectomy.     

Lack of release of ACTH from the denervated rat pars intermedia in vivo.

The purpose of this study was to ascertain whether the pars intermedia of the rat adenohypophysis, isolated from direct innervation via the infundibular stem, could maintain adrenal cortical weight and plasma corticosterone levels. We compared the adrenal cortical response of rats 40 days after either complete hypophysectomy, hypophysectomy with reinsertion of only the pars distalis, or hypophysectomy with reinsertion of only the nervosa-intermedia. Adrenal weight and plasma corticosterone levels were partially maintained in the group with reinserted pars distalis. These parameters were not different from the complete hypophysectomy group in the animals with reinserted nervosa-intermedia. Thus, the pars intermedia, with its nerve supply disrupted, cannot maintain adrenal cortical function.     

Increase in the amount of glutathione transferase 4-4 in the rat adrenal gland after hypophysectomy and down-regulation by subsequent treatment with adrenocorticotrophic hormone.

The effect of hypophysectomy and subsequent treatment with adrenocorticotropic hormone (adrenocorticotropin, ACTH) on the isoenzymes of glutathione transferase in the rat adrenal gland was investigated. A large increase (approx. 11-fold) in the level of transferase subunit 4 was observed in hypophysectomized animals by immunoblotting. When the activity of glutathione transferase 4-4 was measured in adrenal cytosol using trans-stilbene oxide as a selective substrate, a 15-fold increase was noted. Lack of the pituitary hormone ACTH is apparently related to this increase, since treatment of hypophysectomized animals with ACTH for 2 weeks partially down-regulated subunit 4. Glutathione transferase subunits 3 and 8 in the adrenal were also increased in amount by hypophysectomy, but not at all to the same extent. The activity of glutathione transferase 4-4 was elevated also in the liver and ovary (5 and 1.5 times respectively) after hypophysectomy. These elevated enzyme levels were, however, not affected by ACTH treatment. This down-regulation of glutathione transferases in the rat adrenal by ACTH may be related to the fact that, under normal conditions, this organ is highly susceptible to the toxic effects of various polycyclic hydrocarbons, whereas under circumstances where there is no ACTH production, as in hypophysectomized rats, the adrenal is resistant to these same hydrocarbons.     

Effects of hypophysectomy on plastocyst survival, progesterone secretion and nidation in the spotted skunk.

12 female skunks were hypophysectomized during the 7-month preimplantation period. Sham operations were performed on 7 skunks by drilling through the basisphenoid but without exposing the pituitary. 22 skunks remained as controls. Complete hypophysectomy significantly reduced peripheral plasma progesterone levels within 40 days while there was a tendency for values to increase in sham hypophysectomized skunks. The only obvious effect hypophysectomy had on ovarian histology during the preimplantation period was the abolition of all antral follicles; corpora lutea remained unchanged for up to 90 days. Blastocysts from hypophysectomized skunks were undergoing a slow attrition of cells after Day 34, and there was some indication that hypophysectomy may have a deleterious effect as early as Day 22. Hypophysectomy significantly prolonged the preimplantation period in 6 out of 7 skunks. It was concluded that the pituitary is essential for initiation of nidation.     

Hormonal control of glycerolphosphate dehydrogenase in the rat brain

—Following hypophysectomy or adrenalectomy, glycerolphosphate dehydrogenase (GPDH) (EC 1.1.1.8) activity decreased exponentially in the cerebral hemispheres and brain stem of adult male rats. The latter region was more affected than the former. Malate dehydrogenase (EC 1.1.1.40), isocitrate dehydrogenase (EC 1.1.1.42), lactate dehydrogenase (EC 1.1.1.27) and mitochondrial glycerolphosphate dehydrogenase (EC 1.1.95.5) activities remained unchanged. Injection of adrenocorticotrophic hormone or cortisol in hypophysectomized rats or cortisol in adrenalectomized rats restored GPDH activity. Thyroidectomy and gonadectomy had no effect on GPDH activity. Liver GPDH was not decreased by hypophysectomy or adrenalectomy. Muscle GPDH was diminished slightly by adrenalectomy and as much as brain GPDH by hypophysectomy. In young rats GPDH developmental increase in activity was inhibited by hypophysectomy. These results clearly show that brain GPDH activity is specifically regulated by cortisol (and probably closely related corticosteroids).