Learning Objective #1: Understand the importance of utilizing sustained ceramic drug delivery systems for administering steroids in patients with pituitary adenomas

Learning Objective #2: Understand the effects that various levels of cortisol concentrations have on the RC/4B pituitary adenoma cells

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Pituitary adenomas are benign tumors that arise exclusively within the anterior pituitary. These tumors are generally non-aggressive, non-cancerous and non-metastatic. Many of these tumors can be successfully treated. Treatment for any pituitary hormone-secreting adenoma has three main goals: 1.) remove/shrink any tumor mass that is compressing adjacent structures; 2) remove/inactivate any hypersecreting pituitary tissue in order to restore normal hormone levels, and 3) provide the necessary preoperative and postoperative hormone replacement therapy (HRT)aimed at returning the body to normal hormone production. Surgery generally accomplishes the first two goals; however, HRT regime is the most cumbersome and often leaves the patient at serious risk for peaks and valleys in hormone levels as well as an increase in stress levels. Without the hypothalamic-pituitary-adrenal axis (HPA) the patient's ability to produce an anti-stress effect may be altered. Glucocorticoids (GCs) are vital class of steroid hormones that are secreted by the adrenal cortex and are regulated by ACTH largely under the control of the HPA. The HPA is activated by a variety of stresses, and the resultant increase in adrenal glucocorticoid (GC) hormone mediates the body defense responses by its anti-stress effects. The high GC suppresses the activated immune system, and may also inhibit HPA axis through a negative feedback effect. This activation of the HPA axis appears to be maintained until the inflammation/infection subsides. This suggests a mechanism exists in which GC suppression of neuroendocrine regulation is reduced or abolished during periods of high plasma GC levels. The objective of this study is to evaluate RC/4B/C pituitary adenomas cells after 24, 72, 96 hour incubation periods with low, medium, and high doses of cortisol utilizing conventional and sustained drug delivery. Cell viability, cell number, cellular morphology, and cellular metabolism will be compared for treated and controlled groups.