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Purpose: Non-functioning pituitary adenomas (NFPAs) are often associated with hyperprolactinemia, which is known as the “stalk effect”. However, the relationships between hyperprolactinemia and the radiographic characteristics of the tumor that affects the pituitary stalk have not been well characterized. We aimed to identify the differences in the clinical and radiographic characteristics of patients with NFPA, with and without hyperprolactinemia. Methods: We enrolled 107 patients with NFPA and allocated them to hyperprolactinemia and non-hyperprolactinemia groups using two different cut-off values: (1) the upper limit of the normal reference range, adjusted for sex and menopausal status, and (2) the upper quartile across the cohort, and compared their clinical and radiographic characteristics. These analyses were conducted to clarify the relationship between the “stalk effect” and the postoperative change in antidiuretic hormone secretion. Results: The specific radiographic characteristics of the patients included the presence of a cystic or hemorrhagic tumor and the presence of pituitary stalk deviation, which were more frequent in the patients with hyperprolactinemia. Interestingly, the incidence of postoperative transient diabetes insipidus was statistically significantly higher in the hyperprolactinemia group (≥40 ng/mL) and in the group with radiologic evidence of stalk deviation, which were shown to be independent risk factors on multivariate analysis. Conclusion: The presence of a “stalk effect” was associated with a higher risk of postoperative transient diabetes insipidus, reflecting perioperative pituitary stalk dysfunction following NFPA surgery, especially in patients with serum prolactin concentrations ≥40 ng/mL and radiologic evidence of stalk deviation.

Coadministering two different classes of antibiotics as empirical therapy can be critical in treating healthcare-associated infections in hospitals. Herein, we report a case of acute kidney injury (AKI) caused by coadministration of vancomycin with high-dose meropenem that manifested as a rapid increase in serum creatinine levels and an associated increase in vancomycin trough concentrations. The patient was diagnosed with meningioma at 50?years and was followed up regularly. The patient underwent surgery and antibiotic treatment between 63 and 66?years for suspected meningitis and pneumonia. Coadministration of vancomycin with high-dose meropenem (6.0?g/day) caused AKI; however, no AKI occurred when vancomycin was administered alone or with a low dose of meropenem (1.5 or 3.0?g/day). To our knowledge, this report is the first to show that administering different dosages of meropenem in combination with vancomycin may contribute to the risk of developing AKI. We suggest that coadministered vancomycin and high-dose meropenem (6.0?g/day) may increase the risk of AKI. Our report adds to the limited literature documenting the coadministration of vancomycin with varying doses of meropenem and its impact on the risk of AKI and highlights the importance of investigating AKI risk in response to varying dosages of meropenem when it is coadministered with vancomycin.

The present study explored the contextual control of running-based taste aversion in rats by giving rats a salty solution in Context A followed by wheel running and the same solution in Context B without running. Experiment 1 demonstrated that the contextual control of saline aversion was greater for Sprague-Dawley (SD) rats than for Wistar rats, and that the superior performance of the SD rats was maintained even after a 16-day break. Experiment 2 replicated the contextual control in a new set of SD rats, with the same type of bottles/spouts employed in both contexts. Experiment 2 also revealed three features of this context discrimination learning: (a) failure to show conditional control in a two-bottle (saline vs. water) choice test, (b) transfer to tap water intake, and (c) maintenance of good performance after exposure to those contexts without the conditioned taste solution. The theoretical implications of these features are discussed.

Running in an activity wheel yields conditioned aversion to a taste solution consumed before the running, but its underlying physiological mechanism is unknown. According to the claim that energy expenditure or general stress caused by physical exercise is a critical factor for this taste-aversion learning, not only running but also other stressful exercises should yield conditioned aversion to the paired taste. This prediction was disconfirmed in two experiments, because stressful conspecific fighting did not work as an effective agent to establish taste aversion in rats.