RADIO-ACTIVE IMPLANTATION OF THE PITUITARY
RADIO-ACTIVE IMPLANTATION OF THE PITUITARY
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DOI：
10.1002/bjs.18004720113
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发表时间：
1959-01-01
影响因子：
9.6
通讯作者：
CARTER, PT
中科院分区：
文献类型：
--
作者：
FORREST, APM;BLAIR, DW;CARTER, PT
方法临床评估。可的松维持治疗（50 mg.每天）通常在放射活性垂体植入后几天开始。甲状腺替代（甲状腺素，0.3 mg。当患者出现粘液水肿的临床体征时，通常在两到三个月内给予。每名患者至少由我们中的两人每月一次就诊，并根据临床和放射学评估他们的状态。只有当所有癌症表现的消退都没有争议的证据时，患者才被认为从治疗中获益。在每次访视时对视觉不适、尿崩症和尿崩症进行具体询问。36名接受氡植入治疗的患者和36名接受氧化钇棒植入治疗的患者在治疗前后进行了详细的视野检查（哈灵顿，1958 a，B）。此后，仅当患者主诉视觉不适时才进行视野检查。破坏的程度Pegasus。放射性植入物对垂体的破坏作用已通过组织学检查进行了评估。尸检时，在切除大脑并分离垂体柄后，从周围切开鞍囊，并切除鞍后壁。在不损伤囊膜的情况下，用钝性分离法将完整的垂体从蝶鞍中取出，并立即固定在10%的生理盐水中。在移除被Ygo加载螺钉刺穿的腺体时尤其需要小心。当公司，腺体分为水平在三到五个网站，这取决于它的深度。将切片置于腐蚀升华物中过夜，处理，并在几个水平上切片。切片常规染色与hzmalum-伊红，磷钨酸苏木精，和高碘酸-希夫技术单独，并通过Pearse的方法。通过对代表性切片的检查，对破坏程度作出了大致估计。破坏被认为是细胞核和轮廓完全丧失的同义词。染色质颗粒可能在细胞死亡后一段时间内染色，尤其是α细胞。可识别的细胞核被认为是可行的，因为它是不确定的，改变外观的细胞不继续产生激素。45例晚期恶性肿瘤患者（36例乳腺起源）接受了1-20 mc植入治疗。氡进入脑垂体窝在前25名患者中，将一根插管穿过右鼻孔，并将2到4根5-mc插管。引入种子;在其它的中插入两个套管，每个套管一个，和一个8-MC。种子被引入窝的每一半。
METHODS Clinical Assessment.-Cortisone maintenance therapy (50 mg. per day) was usually started a few days after radio-active implantation of the pituitary. Thyroid replacement (thyroxine, 0.3 mg. per day) was given when the patient developed clinical signs of myxcedema, usually in two to three months. Each patient was seen by at least two of us at monthly intervals, and their state assessed on clinical and radiological grounds. Patients were regarded as benefiting from treatment only when there was uncontroversial evidence of regression of all manifestations of cancer. Specific inquiry was made at each visit for visual upset, rhinorrhcea, and diabetes insipidus. Thirty-six patients treated by radon implantation and 36 by YsO rod implantation had detailed examination of the visual fields before and after treatment (Harrington, 1958a, b). Thereafter, examination of the fields was carried out only when the patient complained of visual upset. Extent of Destruction of Pituitary.-The destructive effect of the radio-active implant on the pituitary gland has been estimated by histological examination. At autopsy, after removing the brain and dividing the pituitary stalk, the diaphragma sellz was incised peripherally, and the posterior wall of the sella removed. The complete hypophysis was eased out of the sella by gentle blunt dissection without damaging the capsule, and at once fixed in 10 per cent form01 saline. Care was especially necessary in removing glands which had been transfixed by Ygo-loaded screws. When firm, the gland was divided horizontally at three to five sites, depending on its depth. The slices were placed in corrosive-sublimate-form01 overnight, processed, and each sectioned at several levels. Sections were stained routinely with hzmalum-eosin, phosphotungstic acid haemotoxylin, and the periodic acid-Schiff technique alone, and by Pearse’s method. An approximate estimate of the extent of destruction was made on examination of representative sections. Destruction was regarded as being synonymous with total loss of cell nuclei and outlines. Chromatin granules may take up stain for some time after cell death, especially those of the alpha cells. Recognizable cells with nuclei were regarded as being viable since it is not certainly known that cells of altered appearance do not continue to produce hormone.RESULTS Radon Implantation.-Forty-five patients with advanced malignancy (36 of breast origin) were treated by the implantation of 1-20 mc. radon into the pituitary fossa. In the first 25 patients a single cannula was passed through the right nostril and two to four 5-mc. seeds introduced; in the others two cannulas were inserted, one through each nostril, and a single 8-mc. seed introduced into each half of the fossa.