A5009444174- Pituitary Gland Disorders and Treatments
- Adrenal Hormones and Disorders
- Growth Hormone and Insulin-like Growth Factors
- Meningioma and schwannoma management
- Traumatic Brain Injury and Neurovascular Disturbances
- Head and Neck Surgical Oncology
- Diabetes and associated disorders
- Pancreatic function and diabetes
- Adrenal and Paraganglionic Tumors
- Glioma Diagnosis and Treatment
- Hormonal and reproductive studies
- Diabetes Management and Research
- Sexual function and dysfunction studies
- Neurological and metabolic disorders
- Cerebrospinal fluid and hydrocephalus
- Traumatic Brain Injury Research
- High Altitude and Hypoxia
- Hormonal Regulation and Hypertension
- Urinary Bladder and Prostate Research
- Teratomas and Epidermoid Cysts
- Electrolyte and hormonal disorders
- Thyroid Disorders and Treatments
- Cancer, Hypoxia, and Metabolism
- Parkinson's Disease and Spinal Disorders
- Neuroendocrine Tumor Research Advances
Pacific Heart Institute
2017-2021
Saint John's Health Center
2008-2019
University of Southern California
2017
Neurosciences Institute
2017
University of California, Los Angeles
2002-2014
University of Santa Monica
2012
Harbor–UCLA Medical Center
2004-2008
UCLA Medical Center
2005-2008
University of California Davis Medical Center
2005-2008
The Lundquist Institute
2005-2008
OBJECTIVE Sodium–glucose cotransporter 2 (SGLT-2) inhibitors are the most recently approved antihyperglycemic medications. We sought to describe their association with euglycemic diabetic ketoacidosis (euDKA) in hopes that it will enhance recognition of this potentially life-threatening complication. RESEARCH DESIGN AND METHODS Cases identified incidentally described. RESULTS 13 episodes SGLT-2 inhibitor–associated euDKA or ketosis nine individuals, seven type 1 diabetes and two diabetes,...
Object. Recognition of pituitary hormonal insufficiencies after head injury and aneurysmal subarachnoid hemorrhage (SAH) may be important, especially given that hypopituitarism-related neurobehavioral problems are typically alleviated by hormone replacement. In this prospective study the authors sought to determine rate risk factors dysfunction SAH in patients at least 3 months insult. Methods. Patients underwent dynamic anterior posterior function testing. Results tests were compared with...
Object. The direct endonasal approach performed with the aid of an operating microscope for removal pituitary tumors has potential advantage over traditional sublabial route minimizing postoperative rhinological complications, yet maintaining a high degree efficacy and safety. To assess effectiveness this procedure, tumor remission rates surgical complications were documented, patients' complaints recorded using questionnaire. Methods. One hundred consecutive patients underwent 109...
The extended transsphenoidal approach, which requires a bone and dural opening through the tuberculum sellae posterior planum sphenoidale, is increasingly used for treatment of nonadenomatous suprasellar tumors. authors present their experiences in using direct endonasal approach patients with tumors.Surgery was performed aid an operating microscope angled endoscopes were to assess completeness resection. Bone defects repaired abdominal fat, collagen sponge, titanium mesh, and, most cases,...
Objective: To determine the prevalence, time course, clinical characteristics, and effect of adrenal insufficiency (AI) after traumatic brain injury (TBI). Design: Prospective intensive care unit–based cohort study. Setting: Three level 1 trauma centers. Patients: A total 80 patients with moderate or severe TBI (Glasgow Coma Scale score, 3–13) 41 without (Injury Severity Score, >15) enrolled between June 2002 November 2003. Measurements: Serum cortisol adrenocorticotropic hormone levels were...
Transsphenoidal adenomectomy carries the possibility of new pituitary failure and recovery. Herein, we present rates determinants postoperative hormonal status.All consecutive patients who underwent endonasal transsphenoidal adenoma removal over an 8-year period were analyzed. Those with previous sellar radiotherapy excluded. Pre- status (at least 3 mo after surgery) determined correlated clinical parameters using a multivariate statistical model.Of 444 (median age 45 years, 75%...
We describe the use of serum cortisol and ACTH levels on postoperative d 1 2 as remission predictors after transsphenoidal surgery for Cushing's disease (CD).Morning were drawn daily surgery; glucocorticoids withheld until evidence hypocortisolemia. Early was defined retrospectively a subnormal morning level [< or =140 nmol/liter (< =5 microg/dl)] sustained subsequent eucortisolemia.Of 40 consecutive adults with CD (mean age 39 yr), 80% achieved early remission. Of patients minimum follow-up...
Adult-onset growth hormone deficiency (GHD) has been associated with reduced quality of life (QOL) and neurobehavioral (NB) deficits. This prospective study tested the hypothesis that traumatic brain injury (TBI) patients GHD or GH insufficiency (GHI) would exhibit greater NB/QOL impairment than without GHD/GHI. Complicated mild, moderate, severe adult TBI (GCS score 3-14) had pituitary function testing performed 6-9 months postinjury. GH-secretory capacity was assessed a GHRH-arginine...
OBJECTIVE: A drastic difference is evident in the prevalence of type 2 diabetes among ethnic groups. We examined role beta-cell function and insulin sensitivity this disparity 4 RESEARCH DESIGN AND METHODS: beta-Cell were assessed 77 healthy glucose-tolerant subjects using a hyperglycemic clamp (18 Asian-Americans, 9 African-Americans, 34 Caucasians, 16 Mexican-Americans). RESULTS: wide range variation was clinical features studied subjects. Insulin index second-phase response differed...
Abstract Nearly one-half of all hypercalcemic patients with lymphoma present inappropriately elevated circulating concentrations the active vitamin D metabolite 1,25-dihydroxyvitamin (1,25(OH)2D3). However, cellular source hormone in lymphomas remains unclear. To address this, we report case a 75-year-old man hypercalcemia associated raised 1,25(OH)2D3 and suppressed parathyroid (PTH) levels. Positron emission tomographic (PET) computed (CT) imaging revealed presence large that was confined...
Giant pituitary adenomas (> or =40 mm) pose a major management challenge. We describe the experience of single surgeon and dedicated neuro-endocrine team with multimodality treatment these tumours in three specialized institutions.Retrospective data set analyses.Fifty-one consecutive patients giant adenoma (39 endocrine-inactive, 12 endocrine-active; mean tumour diameter 45 treated over 10 years by an endonasal transsphenoidal approach were included. All had surgical resection followed...
Object Endoscopy as a visual aid (endoscope assisted) or the sole method (fully endoscopic) is increasingly used in pituitary adenoma surgery. Authors of this study assessed value endoscopic visualization for finding and removing residual after initial microscopic removal. Methods Consecutive patients who underwent endoscope-assisted microsurgical removal were included study. The utility endoscope not visualized by microscope was noted intraoperatively. After maximal tumor under...
Hypopituitarism is common after moderate and severe traumatic brain injury (TBI). Herein, we address the association between mild TBI (mTBI) pituitary metabolic function in retired football players. Retirees 30-65 years of age, with one or more National Football League (NFL) play poor quality life (QoL) based on Short Form 36 (SF-36) Mental Component Score (MCS) were prospectively enrolled. Pituitary hormonal syndrome (MetS) testing was performed. Using a glucagon stimulation test, growth...
We have cloned and characterized a 620-bp fragment of DNA that flanks 5′ the prostate-specific antigen (PSA) gene from prostate cancer patient. Using transfection, efficacy this putative promoter in regulating expression was quantitated several nonprostate tissue cell lines. Our results demonstrated 620-dp actively drives LNCaP, PSA-producing tumor line. No activity detected non-PSA-producing lines, DU145 PC-3, nor renal (R11) or breast (MCF-7) Furthermore, could be regulated vitro by...
The aim of this study is to assess whether gender and body mass index (BMI) should be considered in developing thresholds define GH deficiency, using responses GHRH + arginine (ARG) stimulation insulin tolerance test (ITT). Thirty-nine healthy subjects (19 males, 20 females; ages 21–50 yr) underwent ARG, another 27 8 20–49 ITT. Peak response was significantly higher (P = 0.005) after ARG than with ITT, difference could not explained by age, gender, or BMI. negatively correlated BMI both...
Hormonal dysfunction is a known consequence of moderate and severe traumatic brain injury (TBI). In this study we determined the incidence, time course, clinical correlates acute post-TBI gonadotroph somatotroph dysfunction. Patients had daily measurement serum luteinizing hormone (LH), follicle-stimulating (FSH), testosterone, estradiol, growth hormone, insulin-like factor-1 (IGF-1) for up to 10 days post-injury. Values below fifth percentile healthy cohort were considered abnormal, as...
OBJECTIVE As type 2 diabetes results from an imbalance between insulin sensitivity and beta cell function, either or both may worsen with age. However, existing data are controversial on the effect of ageing function. SUBJECTS AND DESIGN We enrolled 149 healthy, glucose tolerant normotensive Caucasians (age 35 ± 1 years, body mass index 26.07 0.44 kg/m , waist‐hip ratio 0.842 0.009 cm/cm, mean standard error). A cross‐sectional study was designed to examine impact age Their function...
OBJECTIVE Despite advances in exogenous insulin therapy, many patients with type 1 diabetes do not achieve acceptable glycemic control and remain at risk for ketosis insulin-induced hypoglycemia. We conducted a randomized controlled trial to determine whether TTP399, novel hepatoselective glucokinase activator, improved people without increasing hypoglycemia or ketosis. RESEARCH DESIGN AND METHODS SimpliciT1 was phase 1b/2 adaptive study. Phase 2 activities were two parts. Part randomly...
Diversion of the portal blood flow from liver in rats by construction end-to-side portacaval shunts increased DNA synthesis hepatocytes, presumably as a response to cell damage. Electron microscopically variability staining and electron density, cytoplasmic vacuoles mitochondrial changes were noted. The damage associated with diversion may account part for some undesirable side effects man.
Abstract OBJECTIVE: In a series of patients with residual endocrine-inactive macroadenomas who underwent repeat surgery, we assess possible reasons for prior subtotal removal, reoperative success, complication rates, and patient impressions. METHODS: All were identified had removal an macroadenoma reoperated on sellar tumor via endonasal approach. RESULTS: Over 6 years, 188 consecutive adenomas, 30 (16%) surgery (age, 15–77 yr; median interval between surgeries, 25 mo; follow-up, 20 mo)....