Comparison of three methods for the estimation of pineal gland volume using magnetic resonance imaging.
Department of Anatomy, School of Medicine, Erciyes University Kayseri, Turkey. firstname.lastname@example.org
Pineal gland is a very important neuroendocrine organ with many physiological functions such as regulating circadian rhythm. Radiologically, the pineal gland volume is clinically important because it is usually difficult to distinguish small pineal tumors via magnetic resonance imaging (MRI). Although many studies have estimated the pineal gland volume using different techniques, to the best of our knowledge, there has so far been no stereological work done on this subject. The objective of the current paper was to determine the pineal gland volume using stereological methods and by the region of interest (ROI) on MRI. In this paper, the pineal gland volumes were calculated in a total of 62 subjects (36 females, 26 males) who were free of any pineal lesions or tumors. The mean ± SD pineal gland volumes of the point-counting, planimetry, and ROI groups were 99.55 ± 51.34, 102.69 ± 40.39, and 104.33 ± 40.45 mm(3), respectively. No significant difference was found among the methods of calculating pineal gland volume (P > 0.05). From these results, it can be concluded that each technique is an unbiased, efficient, and reliable method, ideally suitable for in vivo examination of MRI data for pineal gland volume estimation.
Department of Neurological Surgery, University of California, Los Angeles, 695 Charles E Young Drive South, Gonda 3357, Los Angeles, CA 90095-1761, USA.
Pineal cysts (PCs) are benign and often asymptomatic lesions of the pineal region that are typically small and do not change in size over time. PCs appear as small, well circumscribed, unilocular masses that either reside within or completely replace the pineal gland. This article reviews and discusses the characteristic features of PCs-clinical, histological, and identifiable by various imaging modalities-which assist clinicians in narrowing the differential diagnosis for pineal lesions.
Wajd N Al-Holou, Samuel W Terman, Craig Kilburg, Hugh J L Garton, Karin M Muraszko, William F Chandler, Mohannad Ibrahim, Cormac O Maher
Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan 48109-5338, USA.
OBJECT We reviewed our experience with pineal cysts to define the natural history and clinical relevance of this common intracranial finding. METHODS The study population consisted of 48,417 consecutive patients who underwent brain MR imaging at a single institution over a 12-year interval and who were over 18 years of age at the time of imaging. Patient characteristics, including demographic data and other intracranial diagnoses, were collected from cases involving patients with a pineal cyst. We then identified all patients with pineal cysts who had been clinically evaluated at our institution and who had at least 6 months of clinical and imaging follow-up. All inclusion criteria for the natural history analysis were met in 151 patients. RESULTS Pineal cysts measuring 5 mm or larger in greatest dimension were found in 478 patients (1.0%). Of these, 162 patients were male and 316 were female. On follow-up MR imaging of 151 patients with pineal cyst at a mean interval of 3.4 years from the initial study, 124 pineal cysts remained stable, 4 increased in size, and 23 decreased in size. Cysts that were larger at the time of initial diagnosis were more likely to decrease in size over the follow-up interval (p = 0.004). Patient sex, patient age at diagnosis, and the presence of septations within the cyst were not significantly associated with cyst change on follow-up. CONCLUSIONS Follow-up imaging and neurosurgical evaluation are not mandatory for adults with asymptomatic pineal cysts.
Department of Neuroradiology, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. email@example.com
INTRODUCTION Although pineal cysts are found with a frequency of over one third in autopsy series, prevalences reported in standard magnetic resonance imaging (MRI) studies only range between 0.14% and 4.9%. With the advances in scanner technology and more sensitive high-resolution 3D-sequences, pineal cysts with atypical appearance are more frequently encountered as an incidental finding. In order to help the radiologist and the clinician to correctly interpret these incidental findings and to avoid follow-up MRI or even surgical intervention, we analysed the frequency of typical and atypical pineal cysts using standard MRI-sequences and a high-resolution 3D-trueFISP-sequence (true-Fast-Imaging-with-Steady-State-Precession). METHODS In 111 patients undergoing MRI we analysed the prevalence of pineal cysts in relation to gender and age, as well as the frequency of atypical cysts defined by thickened rim, trabeculations, or asymmetric form using three standard MRI-sequences (T1-SE (T1 weighted spin echo), T2-TSE (T2 weighted turbo spin echo), FLAIR (fluid attenuated inversion recovery)) and compared the diagnostic certainty of these standard sequences with the sensitivity of a high-resolution trueFISP MRI sequence. RESULTS Using trueFISP pineal cysts were detected more frequently than in the standard sequences (35.1% vs. 9.0%(T1-SE), 4.5%(T2-TSE) and 9.0%(FLAIR)). Diagnostic uncertainty was least frequent in trueFISP. In trueFISP, 41.0% of the detected cysts showed one or more features of atypical cysts (standard sequences: 21.4%). Highest prevalence of cysts was detected in the group of 20-30-year-old patients and decreased with increasing age. CONCLUSION High-resolution 3D-sequences like trueFISP increase the detection rate of pineal cysts to levels reported in autoptic series while decreasing the diagnostic uncertainty. Atypically configurated pineal cysts are frequently detected as an incidental finding.
Departments of Neurosurgery, University of Michigan, Ann Arbor, Michigan, 48109-5335, USA.
OBJECT Pineal cysts are a frequent incidental finding on intracranial imaging. In adults, the prevalence of pineal cysts is estimated to be 1.1-4.3%. However, the prevalence is not well established in younger patients. METHODS The authors retrospectively reviewed a consecutive series of 14,516 patients 25 years of age and younger, who underwent brain MR imaging at a single institution over an 11-year period. In patients identified with pineal cysts, the authors analyzed the images according to cyst size, signal characteristics, enhancement pattern, and evidence of local mass effect. Patient characteristics including demographics and other intracranial diagnoses were collected in the pineal cyst population and compared with a randomly selected age- and sex-matched control patient population. The data were evaluated using univariate and multivariate logistic regression, linear regression, and ANOVA. RESULTS The authors identified 288 pineal region cysts (2.0%). The prevalence of pineal cysts was higher in female (2.4%) than in male patients (1.5%; p < 0.001). Pineal cysts were identified in patients of all ages, with an increased prevalence found in older patients (p < 0.001). Pineal cyst size was similar for all age and sex groups. CONCLUSIONS Pineal cysts are common in the pediatric population, with an increased prevalence in girls and in older patients.
Sevgi Sarikaya-Seiwert, Bernd Turowski, Daniel Hänggi, Giesela Janssen, Hans-Jakob Steiger, Walter Stummer
Departments of Neurosurgery.
Pineal cysts are benign and often asymptomatic intracranial entities. Occasionally they can lead to neurological symptoms through growth or due to intracystic hemorrhage. The purpose of the current report is to describe their clinical characteristics and treatment options. In the current study, the authors illustrate the course of disease in 3 patients who developed neurological symptoms due to hemorrhage into a pineal cyst. Two of their patients had additional cerebral disease, and regular MR imaging examinations were conducted. This circumstance allowed documentation of growth and intracystic hemorrhage. After the occurrence of new neurological symptoms with severe headache, MR images showed a fluid-fluid interface due to intracystic hemorrhage. The third patient presented with acute triventricular hydrocephalus and papilledema due to aqueductal stenosis caused by intracystic hemorrhage. In all 3 cases, excision of the pineal cysts via an infratentorial/supracerebellar approach was performed. Histological examination revealed the characteristic structure of pineal cyst in all cases, with hemorrhagic residues in the form of hemosiderin deposits. All patients recovered fully after surgical removal of the cysts. Furthermore, resolution of occlusive hydrocephalus could be demonstrated in those cases with ventricular enlargement. Pineal cysts without neurological symptoms are often discovered as incidental findings on cranial MR images. In contrast, neurological symptoms such as severe headache, diplopia, or Parinaud syndrome, may occur as a result of pineal apoplexy due to intracystic hemorrhage. The authors' cases confirm that MR imaging can identify intracystic hemorrhage by a characteristic fluid-fluid interface. Their experience suggests that microsurgical resection of cysts may be an effective and curative treatment option.
High prevalence of pineal cysts in healthy adults demonstrated by high-resolution, noncontrast brain MR imaging.
Research Imaging Center, The University of Texas Health Science Center at San Antonio, TX, USA. firstname.lastname@example.org
BACKGROUND AND PURPOSE Although the prevalence of pineal cysts in autopsy series has been reported as being between 25% and 40%, MR studies have documented their frequency to range between 1.5% and 10.8%. The purpose of this high-resolution brain MR imaging study at 1.9T was to determine the prevalence of pineal cysts in healthy adults. MATERIALS AND METHODS Brain MR images of 100 healthy young volunteers were randomly selected from our International Consortium for Brain Mapping project data base. Cysts were detected as circular areas of isointensity relative to CSF on both 3D gradient-echo T1-weighted and 2D fast spin-echo T2-weighted images. The inner diameters of all visualized pineal cysts were measured, and a criterion of 2.0 mm of the largest inner cross-sectional diameter was used to categorize cysts as being either small cystic changes (<2.0-mm diameter) or pineal cysts (>2.0-mm diameter). RESULTS Twenty-three percent (23/100) of the volunteers had pineal cysts with a mean largest inner cross-sectional diameter of 4.3 mm (range, 2-14 mm); 13%(13/100) demonstrated cystic changes involving the pineal gland with the largest inner cross-sectional diameter of less than 2.0 mm. There was a slight female predominance. Two subjects with long-term follow-up scans showed no symptoms or changes in the size of their pineal cysts. CONCLUSION On high-resolution MR imaging, the prevalence of pineal cysts was 23% in our healthy group of adults, which is consistent with previous autopsy studies. Long-term follow-up studies of 2 cases demonstrated the stability of the cysts.
Disturbance and strategies for reactivation of the circadian rhythm system in aging and Alzheimer's disease.
Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands.
Circadian rhythm disturbances, such as sleep disorders, are frequently seen in aging and are even more pronounced in Alzheimer's disease (AD). Alterations in the biological clock, the suprachiasmatic nucleus (SCN), and the pineal gland during aging and AD are considered to be the biological basis for these circadian rhythm disturbances. Recently, our group found that pineal melatonin secretion and pineal clock gene oscillation were disrupted in AD patients, and surprisingly even in non-demented controls with the earliest signs of AD neuropathology (neuropathological Braak stages I-II), in contrast to non-demented controls without AD neuropathology. Furthermore, a functional disruption of the SCN was observed from the earliest AD stages onwards, as shown by decreased vasopressin mRNA, a clock-controlled major output of the SCN. The observed functional disconnection between the SCN and the pineal from the earliest AD stage onwards seems to account for the pineal clock gene and melatonin changes and underlies circadian rhythm disturbances in AD. This paper further discusses potential therapeutic strategies for reactivation of the circadian timing system, including melatonin and bright light therapy. As the presence of melatonin MT1 receptor in the SCN is extremely decreased in late AD patients, supplementary melatonin in the late AD stages may not lead to clear effects on circadian rhythm disorders.
Department of Anatomy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. email@example.com
The pinealocytes of the pineal gland of children and adults were studied at both light and electron microscopic levels. The pinealocytes were classified into light and dark pinealocytes on the basis of their shape, nuclear infolding, cytoplasmic contents and staining density. The light pinealocytes outnumber the dark pinealocytes and both of them have thin processes. The light pinealocytes have round or oval cell bodies and nuclei and have vesicles and ribbons. The dark pinealocytes showed more variations in their shape. The nuclear membrane of the dark cells showed numerous infoldings with deep invagination of parts of the cytoplasm within the nuclear folds, giving the appearance of nuclear pellets. The dark pinealocytes contain pigment in their cytoplasm. In addition to the light and dark pinealocytes a very small cell type with an extremely thin and elongated cell body and nucleus was found. The cells of this type were almost always associated with vacuoles filled with flocculent material and accumulations of presumptive secretion in the extracellular compartment. The findings of this study were discussed in the light of the published data about the pinealocytes of human and non-human species.
Institute of Biochemical Physics of RAS, Chernyakhovskogo, 5-94, Moscow 125319, Russia. firstname.lastname@example.org
According to the redusome hypothesis, the aging of an organism is determined by the shortening of chronomeres (small perichromosomal linear DNA molecules). In this paper, a presumptive role for infradian hormonal rhythms is considered. Endogenous infradian rhythms are supposed to actively interact with those hormonal shifts which are governed by an exogenous infradian gravitational lunar rhythm. As a result of this interaction, the so-called T-rhythm is formed. Peaks of T-rhythms are used as the pacemaker signals to keep the life-long "clockwork" of the brain running. The "ticking" of this clock is realized by the periodically repeated shortening of chronomeres in postmitotic neuroendocrine cells, which occurs just at the maxima of T-rhythms. Shortening of telomeres in mitotic cells in vivo is a witness of the aging of the organism, but not the cause of aging. The primary cause of aging is shortening of chronomeres, the material carriers of a temporal program of development and aging. To recognize exogenous gravitational infradian rhythms, a special physiological system--the "lunasensor" system--evolved. It is assumed that it is a necessity to have a lunasensor as a particular variant of sensors of gravitation.
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The histochemical measurements of the lipid content of the pineal gland in rats suffering from malignancy.
Serum concentration of S-100 protein in assessment of cognitive dysfunction after general anesthesia in different types of surgery.
Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Bergmannsheil, Ruhr-University Bochum, Germany. email@example.com
BACKGROUND S-100 protein serum concentration (S-100) serves as a marker of cerebral ischemia in cardiac surgery, head injury and stroke. In these circumstances S-100 corresponds well with the results of neuropsychological tests. The aim of the present study was to investigate the value of S-100 and neuron specific enolase (NSE) in reflecting postoperative cognitive deficit (POCD) after general surgical procedures. METHODS One hundred and twenty patients undergoing vascular, trauma, urological or abdominal surgery were investigated. Serum values of S-100 and NSE were determined preoperatively and 0.5, 4, 18 and 36 h postoperatively. Neuropsychological tests for detecting POCD were performed preoperatively and on day 1, 3, and 6 after the operation. A decline of more than 10% in neuropsychological test results was regarded as POCD. Furthermore, we retrospectively compared the S-100 in patients with and without POCD in different types of surgery. RESULTS According to our definition, forty-eight patients had POCD (95% confidence interval: 37.5-58.5). These patients showed higher serum concentrations of S-100 (median 024 ng/ml; range 0.01-3.3 ng/ml) compared with those without POCD (n=69; median 0.14 ng/ml; range 0-1.34 ng/ml) 30 min postoperatively (P=0.01). Neuron specific enolase was unchanged during the course of the study. Differences of S-100 in patients with and without POCD were found in abdominal and vascular surgery but not in urological surgery. CONCLUSION When all patients are pooled, S-100 appears to be suitable in the assessment of incidence, course and outcome of cognitive deficits. We suspect that in some surgical procedures, such as urological surgery, S-100 appears to be of limited value in detecting POCD. Neuron specific enolase did not reflect neuropsychological dysfunction after noncardiac surgery.
Northwick Park Hospital, Harrow, Middlesex, UK.
Specific inhibition of phorbol ester-stimulated phospholipase D by Clostridium sordellii lethal toxin and Clostridium difficile toxin B-1470 in HEK-293 cells. Restoration by Ral GTPases.
M Schmidt, M Voss, M Thiel, B Bauer, A Grannass, E Tapp, R H Cool, J de Gunzburg, C von Eichel-Streiber, K H Jakobs
Institut für Pharmakologie, Universitätsklinikum Essen, D-45122 Essen, Germany.
Activation of m3 muscarinic acetylcholine receptor (mAChR), stably expressed in human embryonic kidney (HEK)-293 cells, leads to phospholipase D (PLD) stimulation, a process apparently involving Rho GTPases, as shown by studies with Clostridium botulinum C3 exoenzyme and Clostridium difficile toxin B (TcdB). Direct activation of protein kinase C (PKC) by phorbol esters, such as phorbol 12-myristate 13-acetate (PMA), also induces PLD stimulation, which is additive to the mAChR action and which is only poorly sensitive to inactivation of Rho proteins by TcdB. To study whether Ras-like GTPases are involved in PLD regulation, we studied the effects of the TcdB variant TcdB-1470 and Clostridium sordellii lethal toxin (TcsL), known to inactivate Rac and some members of the Ras protein family, on PLD activities. TcdB-1470 and TcsL did not affect basal PLD activity and PLD stimulation by mAChR or direct G protein activation. In contrast, PMA-induced PLD stimulation was inhibited by TcdB-1470 and TcsL in a time- and concentration-dependent manner, without alteration in immunologically detectable PKC isozyme levels. In membranes of HEK-293 cells pretreated with TcdB-1470 or TcsL, basal and stable GTP analog-stimulated PLD activities measured with exogenous phosphatidylcholine, in the presence or absence of phosphatidylinositol 4,5-bisphosphate, were not altered. In contrast, pretreatment with TcdB-1470 and TcsL, but not TcdB, strongly reduced PMA-stimulated PLD activity. The addition of recombinant Rac1, serving as glucosylation substrate for TcdB, TcsL, and TcdB-1470, did not restore PLD stimulation by PMA. Furthermore, PMA-stimulated PLD activity, suppressed by prior treatment with TcdB-1470 or TcsL, was not rescued by the addition of recombinant Ras (RasG12V) or Rap proteins, acting as glucosylation substrates for TcsL only (Ras) or TcdB-1470 and TcsL (Rap). In contrast, the addition of recombinant Ral proteins (RalA and RalB), glucosylation substrates for TscL and TcdB-1470, but not for TcdB, to membranes of TcdB-1470- or TcsL-treated cells fully restored PLD stimulation by PMA without altering the strict MgATP dependence of PMA-induced PLD stimulation. RalA-mediated restoration of PMA-stimulated PLD activity in membranes of TcsL-treated cells was not enhanced by coaddition of RasG12V. In conclusion, the data presented indicate that TcdB-1470 and TcsL selectively interfere with phorbol ester stimulation of PLD and suggest an essential role of Ral proteins in PKC signaling to PLD in HEK-293 cells.
Characteristics of protein-kinase-C- and ADP-ribosylation-factor-stimulated phospholipase D activities in human embryonic kidney cells.
Institut für Pharmakologie, Universitätsklinikum Essen, Germany.
Phospholipase D (PLD) activity in human embryonic kidney (HEK) cells is stimulated by phorbol-ester-activated protein kinase C (PKC) and by membrane receptors, the latter apparently acting via the GTP-binding proteins, ADP-ribosylation factor (ARF) and Rho. In the present study, performed in cell-free preparations, we have characterized and compared the regulation of HEK cell PLD activity by the stable GTP analogue, guanosine 5'-O-[gamma-thio]triphosphate (GTP[S]), and the phorbol ester, phorbol 12-myristate 13-acetate (PMA). In digitonin-permeabilized HEK cells, prelabeled with [3H]oleic acid, GTP[S] and PMA caused an approximately threefold concentration-dependent increase in the formation of [3H]phosphatidylethanol, measured in the presence of ethanol. Neomycin, which is known to complex with the PLD cofactor, phosphatidylinositol 4,5-bisphosphate, decreased basal and GTP[S]- or PMA-stimulated PLD activities with similar sensitivity. GDP and its analogue, guanosine 5'-O-[beta-thio]diphosphate, inhibited the stimulatory effect of GTP[S], whereas the PMA response was prevented by the nonselective PKC inhibitor, staurosporine, but not vice versa. PLD stimulation by GTP[S], but not by PMA, was markedly reduced upon cytosol depletion and reconstituted by purified recombinant ARF1. In HEK cell membranes, addition of purified recombinant ARNO, a guanine-nucleotide-exchange factor for ARF1. potentiated the GTP[S]-stimulated PLD activity. PLD stimulation by PMA in HEK cell membranes required MgATP and was largely prevented by the selective PKC inhibitors Goe 6976 and bisindolylmaleimide I. Immunoblot analysis demonstrated that both conventional PKC (alpha, beta, gamma) and atypical PKC isozymes (zeta, tau) were present in HEK cell membranes. The results indicate that phorbol ester stimulation of PLD activity in HEK cells apparently occurs by a phosphorylation-dependent mechanism involving membrane-associated PKC isozymes but not ARF proteins, the major targets of GTP[S]' action.
Cardioprotective potency of the radical scavenger S-2-(3 aminopropylamino) ethylphosphorothioic acid in the post-ischaemic rat heart.
Research Institute of Molecular Pharmacology, Berlin, Germany.
S-2-(3 aminopropylamino) ethylphosphorothioic acid (WR-2721) shown to surpass radical scavenging thiols in their radioprotective efficacy in cancer-type diseases has been tested for its protective potential in the reperfused heart. We investigated the radical scavenger properties of the compound in a radical generating system in vitro as well as in isolated rat hearts subjected to 30 min ischaemia and 30 min reperfusion with the electron-paramagnetic resonance spin trap technique. The action on high-energy phosphates is observed by means of phosphorus-31 nuclear magnetic resonance (NMR) spectroscopy while its influence on left ventricular systolic segmental length change (SSLC) during 60 min reperfusion following 60 min regional ischaemia was assessed with a fibreoptic system in anaesthetized open-chest rats. WR-2721 (0.1 mM) reduced the vascular concentration of radical adduct in isolated hearts by up to 78%(275 +/- 84% of pre-ischaemic baseline values vs 1260 +/- 413%, p < 0.05) between 5 and 12.5 min reperfusion. This was accompanied by a reduction of the left ventricular end diastolic pressure to pre-ischaemic values at 30 min of reperfusion (9 +/- 6 mmHg vs 42 +/- 8 mmHg in the absence of WR-2721, p < 0.02). An accelerated recovery of creatine phosphate levels (78 +/- 5% of pre-ischaemia values vs 41 +/- 5% within 60 min reperfusion: p < 0.05) was observed under similar conditions with NMR-spectroscopy, although the post-ischaemic tissue content of adenosine triphosphate was not affected.(ABSTRACT TRUNCATED AT 250 WORDS)
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Preliminary report on the correlations among pineal concretions, prostatic calculi and age in human adult males.
Department of Oral Anatomy, Showa University School of Dentistry, Tokyo, Japan. firstname.lastname@example.org
By using quantitative image analysis of soft X-ray photographs on the bulk of extracted pineal glands and prostates, we made a preliminary investigation into the correlations among pineal concretions (% by mass), prostatic calculi (% by mass) and age (years) in 40 human adult males, ranging in age from 31 to 95 years (mean (+/-SD) 69.9 +/- 15.2 years), who died and underwent the routine dissection course. The mass concentrations of pineal concretions and prostatic calculi were 17.68 +/- 13.56%(range 0-51.34%) and 0.93 +/- 1.31%(range 0-5.82%), respectively. There was no correlation between the mass concentration of pineal concretions and aging (r = 0.03; P < 1.0). There was no correlation between mass concentration of prostatic calculi and aging (r = 0.28; P < 0.5). No pineal concretions and no prostatic calculi were observed in seven and 10 cases, respectively; in addition, in one case, neither-concretions nor calculi were seen. From such data and from the previously reported suggestion on the counteracting functions between the pineal gland and prostate, a negative correlation between the mass concentrations of pineal concretions and prostatic calculi was expected. This was certainly obtained, but the correlation was low (r =-0.39; P < 0.05). Such a low correlation and no correlations between the concentrations of pineal concretions and aging or between prostatic calculi and aging may have been caused by the examination of relatively older humans. Therefore, further investigations using a number of pair samples collected from males including younger age generations will be necessary.
Department of Human Anatomy, Medical University, ul. Spokojna 1, 20-074 Lublin, Poland.
The aim of the study was to compare the size, weight, volume and density of the pineal gland in several groups divided by age, body weight and height. 80 human pineal glands were included in the study. Obtained data were statistically analysed by means of Statistica by Statsoft to check existing differences. Obtained data show some significant differences between pineal gland morphometry in weight- and height-related groups. However, these differences do not influence pineal volume significantly. Differences between the pineal gland volume in the maximal and in the minimal weight groups may suggest some relationship between the gland's structure and body weight. No age-related changes in the morphometry of the pineal gland were observed.
On pineal calcification and its relation to subjective sleep perception: a hypothesis-driven pilot study.
Department of Psychiatry, Interdisciplinary Sleep Clinic, Freie Universität Berlin, Germany. email@example.com
We classified the degree of pineal calcification (DOC) into seven groups using cranial Computer Tomography (cCT) and then correlated pineal DOC to chronic subjective sleep-related disturbances as measured by a sleep questionnaire in 36 patients. Analysed by logistic regression models, age and sex were not, but higher pineal DOC was significantly associated with the presence of daytime tiredness (OR = 4.15, 95% CI: 1.63, 10.54) and sleep disturbance (OR = 1.74, 95% CI: 1.10, 2.74). This study provides initial confirmation of the hypothesis that the increasing degree of pineal calcification (DOC) might indicate a decrease of melatonin production, which consecutively might lead to a disturbed circadian rhythmicity in the sleep-wake cycle, with the principal symptom being daytime tiredness.
Centro Hospitalar Universitário de Bicêtre-Universidade Paris-Sul (CHU Bicêtre). firstname.lastname@example.org
A magnetic resonance imaging (MRI) study of the normal pineal gland and pineal simple cysts was performed in 762 cases. A fine section technique (maximum 3 millimeters) enabled most of the times the identifying of a normal pineal in addition to demonstrating that a pineal without any cyst shows an isointense signal in T1 and T2 which, in turn, is enhanced following gadolinium. The measure of the normal pineal was of about 6.1 millimeters in its diameter length. Pineal simple cysts were observed in a 2.6% frequency in relation to the whole series (762 cases); however reaches 6.1% when only the visualized pineals were considered (329 cases). Also, it was found out that simple cysts were not correlated to age or gender. Simple cysts characteristics are: dimension less or equal to 20 millimeters; absence of expansive effect; similar signal to that of the cerebrospinal fluid; absence of cyst growth.
Department of Human Morphology and Developmental Biology, Semmelweis Medical University, Budapest, Hungary. email@example.com
The pineal organ (pineal gland, epiphysis cerebri) contains several calcified concretions called "brain sand" or acervuli (corpora arenacea). These concretions are conspicuous with imaging techniques and provide a useful landmark for orientation in the diagnosis of intracranial diseases. Predominantly composed of calcium and magnesium salts, corpora arenacea are numerous in old patients. In smaller number they can be present in children as well. The degree of calcification was associated to various diseases. However, the presence of calcified concretions seems not to reflect a specific pathological state. Corpora arenacea occur not only in the actual pineal tissue but also in the leptomeninges, in the habenular commissure and in the choroid plexus. Studies with the potassium pyroantimonate (PPA) method on the ultrastructural localization of free calcium ions in the human pineal, revealed the presence of calcium alongside the cell membranes, a finding that underlines the importance of membrane functions in the production of calcium deposits. Intrapineal corpora arenacea are characterized by a surface with globular structures. Meningeal acervuli that are present in the arachnoid cover of the organ, differ in structure from intrapineal ones and show a prominent concentric lamination of alternating dark and light lines. The electron-lucent lines contain more calcium than the dark ones. There is a correlation between the age of the subject and the number of layers in the largest acervuli. This suggests that the formation of these layers is connected to circannual changes in the calcium level of the organ. The histological organization of the human pineal is basically the same as that of mammalian experimental animals. Pineal concretions present in mammalian animal species are mainly of the meningeal type. Meningeal cells around acervuli contain active cytoplasmic organelles and exhibit alkaline phosphatase reaction in the rat and mink, an indication of a presumable osteoblast-like activity. Using Kossa's method for the staining of calcium deposits, a higher calcium concentration was detected in the rat pineal than in the surrounding brain tissue. Since in parathyroidectomised rats calcified deposits are larger and more numerous than in controls, the regulation of the production of acervuli by the parathyroid gland has also been postulated. In most of submammalian species, the pineal organs (pineal-, parapineal organ, frontal organ, parietal eye) are photoreceptive and organized similarly to the retina. Acervuli were found in the pineal of some birds. The pineal organs of lower vertebrates (fish, amphibians, reptiles) exhibit a high calcium content by ultrastructural calcium histochemistry (PPA-method). However, concrements are not formed. The accumulation of Ca2+ seems to depend on the receptor function of the organ. Comparing pineal and retinal photoreceptors in the frog, the photoreceptor outer segments of pinealocytes as well as retinal cones and rods show a large amount of Capyroantimonate deposits. In dark adapted animals calcium ions are present in both sides of the photoreceptor membranes of the outer segment, whereas calcium is shifted extra-cellularly following light adaptation. Overviewing the data available about the pineal calcification, we can conclude that a multifactorial mechanism may be responsible for the calcification. The pineal of higher vertebrates is not just a simple endocrine gland, rather, its histological organization resembles a folded retina having both hormonal and neural efferentation. Mammalian pinealocytes preserve several characteristics of submammalian receptor cells and accumulate free Ca2+ on their membranes (1). In the thin walled retina and in the similarly organized pineal of submammalian species, the diffusion of extracellular calcium is probably easy and there is a lesser tendency to form concrements.(ABSTRACT TRUNCATED)
Department of Anatomy and Histology, Faculty of Veterinary Medicine, University of Extremadura, Cáceres, Spain.
Light- and electron-microscopic analyses were used to identify and describe the characteristic features of cells containing pigment in the ovine pineal gland during prenatal development. 72 ovine embryos (36 male, 36 female) ranging in age from 54 to 150 days were used for this study. Cells containing pigment granules were a constant feature in this gland. When samples from the different groups were inspected using the naked eye, the detection of pigment was of 61% in groups I (54 to 67 days of prenatal development) and II (71 to 92 days of prenatal development), 83% in group III (98 to 113 days of prenatal development) and 25% in group IV (118 to 150 days of prenatal development). The morphological features and histochemical properties of the pineal pigment enabled it to be identified as melanin. Several types of pigment granules were ultrastructurally distinguished; these varied in size, shape and location within pineal cell populations. The pigment granules were detected in pinealocytes, interstitial cells and pigmented cells. The largest amount and the widest variety of pigmented granules were found in pigmented cells. The presence of cells containing pigmented granules amongst the cell populations of the developing ovine pineal gland was analysed and compared with that of other mammalian species.
Huntingdon Life Sciences, Department of Pathology, Cambridgeshire, UK.
The survey included 151 rats from several carcinogenicity studies up to 104 weeks and 260 rats from short-term studies up to 52 weeks. All studies were performed during the period 1990-1996. Young rats up to 52 weeks of age showed normal structural appearance, in 134 male rats the incidence of mineralisation was 6.3% and in 126 females the incidence was only slightly less at 5.6%. In ageing rats, 70-104 weeks, 88 males and 63 females showed far higher incidence of mineralisation, 83% and 57% respectively, showing that the incidence of mineralisation in ageing rats was higher in males than females. The focal mineralisation occurred mainly at the margin of the gland in the subcapsular region mostly adjacent to small blood vessels. On occasions these involved the parenchymal cells in the middle part of the gland. The focal mineralisation stained positive with von Kossa indicating presence of calcium and also with PAS (Pariodic Acid-Schiff method), indicating presence of neutral mucopolysaccharide. There was no evidence of positivity with Perl's stain (for ferric salts), Toluidine blue (for protein) or Alcian blue (for acid mucopolysaccharides). With Oil Red O there was evidence of presence of fat or lipid in pinealocytes.
Department of Neurosurgery, Hiroshima University School of Medicine, Japan.
PURPOSE: To use MR imaging in the analysis of the size of the normal pineal gland in infants, children, and adolescents. METHODS: We retrospectively analyzed the size of the pineal gland in 249 patients (129 male and 120 female) aged 2 weeks to 20 years old. The maximum length (L), height (H), and width (W) of the gland were determined from a combination of sagittal, coronal, and axial MR images obtained on a 1.5-T scanner. The volume was calculated by using the formula 1/2 x L x H x W. RESULTS: The size of the pineal gland was significantly smaller in patients younger than 2 years old than in older patients. The size of the pineal gland increased until 2 years of age and remained stationary between the ages of 2 and 20 years. We found a large variation in size among all age groups. No difference in size was noted between males and females. CONCLUSION: This study establishes norms for pineal gland size in infants younger than 2 years old and in children and adolescents 2 to 20 years old as detected with MR imaging. Knowledge of the size of the normal pineal gland is important in the detection of abnormalities of the pineal gland, particularly neoplasms.
Multiple sclerosis: the role of the pineal gland in its timing of onset and risk of psychiatric illness.
NeuroCommunication Research Laboratories, Danbury, CT 06811.
The incidence of multiple sclerosis (MS) is age-dependent being rare prior to age 10, unusual prior to age 15, with a peak in the mid 20s. It has been suggested, therefore, that the clinical manifestation of MS is dependent upon having passed the pubertal period. Since pineal melatonin secretion declines from childhood to puberty and as melatonin is an immunomodulator, we have proposed that the dramatic decline in melatonin secretion just prior to the onset of the physical manifestations of puberty may disrupt immune responses resulting in either reactivation of the infective agent or in an increased susceptibility to post-pubertal infection. The fall in melatonin secretion during pre-puberty may also increase the susceptibility of these patients to affective disorder which is associated with lower melatonin secretion and the presence of a phase-advance of their biological rhythms. We predicted, therefore, a higher incidence of affective disorder in patients with pubertal or post-pubertal onset of MS compared to those in whom the disease manifested later. To test this hypothesis, we studied the incidence of affective disorder in relation to age of onset of first neurological symptoms in 31 MS patients, 6 of whom manifested symptoms of MS prior to age 18 (mean = 16.8 years). All patients with pubertal onset MS and only 48% of the control group had an affective disorder. The pubertal onset patients also had a significantly lower nocturnal melatonin levels and a lower incidence of pineal calcification on CT scan. These findings thus support the hypothesis implicating the pineal gland in the timing of onset of MS and in the risk for the development of affective disorder.