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At least 19 recordsLinked to original sources
PubMed1976

Transsphenoidal neurosurgery of intracranial neoplasm.

Because of the benign, rapid, and nontraumatizing nature of the extracranial transsphenoidal approach to the base of the skull, this procedure is indicated as the method of choice in nearly all cases of surgery for pituitary fossa and parasellar region access. Some of the largest pituitary chromophobe adenomas with voluminous suprasellar expansion have been successfully excised from below, as well as some calcified tumors, craniopharyngiomas, Rathke's pouch cysts, chordomas, chondromas, and meningiomas. At the other extreme, the smallest intrapituitary microadenomas (as little as 3 mm in diameter) were selectively removed under optic magnification with the surgical microscope. This method is now the most appropriate for the treatment of oversecreting pituitary disorders, even with normal-sized sella turcica (acromegaly - Cushing -galactorrhea). Early detection of intrapituitary microadenoma allows achievement of its selective excision with preservation of the normal gland. Thus, the ideal goal can be achieved by immediate biological cure of hyperpituitarism with preservation of other pituitary functions, resulting in normal physiological eupituitarism.

Acromegaly↗
PubMed1976

Volume of sella turcica in normal subjects and in patients with primary hypothyroidism and hyperthyroidism.

In an attempt to assess a possible relationship between pituitary size and TSH secretion, the volume of sella turcica was measured in 570 subjects, 26 primary hypothyroid patients, and 34 thyrotoxic patients. The volume of sella turcica, measured by a 3-dimensional approach, increased progressively with age until 20 years of age and was rather constant thereafter in normal subjects. In thyrotoxic patients, the volume of sella turcica was normal in spite of decreased plasma TSH concentration. In contrast, 81% of primary hypothyroid patients had an abnormal enlargement of the sella turcica. The magnitude of an increase of sella turcica inversely related with a decrease in serum T4 and T3 concentrations. On the other hand, the magnitude of an increase of sella turcica correlated well with an increase of circulating TSH. We suggest that an increase of sella turcica indirectly reflects an increase in pituitary size and TSH-secreting capacity, possibly due to hypertrophy and hyperplasia of TSH cells in primary hypothyroid patients.

Adolescent↗
PubMed1977

The effect of osmotic stimuli on prolactin secretion and renal water excretion in normal man and in chronic hyperprolactinemia.

An osmoregulatory role for prolactin (PRL) in man has been postulated, and PRL secretion has been reported to be influenced by osmotic stimuli. Clinical observation, however, does not support this notion. The effects of water loading, hypertonic saline infusion and nicotine on serum PRL and on renal water metabolism were investigated in 6 normal subjects and in 8 patients with chronic hyperprolactinemia (four with and four without demonstrable pituitary tumors). None of the patients had thyroid, adrenal or vasopressin deficiency. Renal walter handling in these patients was indistinguishable from normal. Likewise, serum PRL was not affected by the stimuli employed in either the normal subjects or the patients. No correlation between degree or duration of hyperprolactinemia and renal water metabolism was found. It is concluded that PRL is not an important osmoregulatory hormone in man.

Adult↗
PubMed1977

Hormonal changes induced by bromocriptine (CB-154) at the early stage of treatment.

Fifteen female patients with amenorrhea and hyperprolactinemia were studied 1 to 3 times daily during the first 4 days of treatment with bromocriptine (2.5 mg b.i.d). Normal PRL levels were reached within one day in 12 while the mean value for the whole group showed no further significant decrease. Estradiol, LH and FSH levels did not vary significantly at this stage even in those 10 patients who subsequently resumed menstruation.

Adult↗
PubMed1992

[ACTH-independent Cushing's syndrome due to bilateral macronodular adrenal hyperplasia with empty sella turcica and anterior panhypopituitarism].

A case is presented of Cushing's syndrome due to macronodular bilateral adrenal hyperplasia which is ACTH-independent as was demonstrated by the undetectable basal and after stimulation with metoprolol ACTH plasma levels. High cortisol levels is associated in this patient with empty sella turcica and anterior panhypopituitarism with confirm the exclusive adrenal origin of the hormone hypersecretion and the lack of treatment success with hypophysis ablation in this process.

Adrenal Glands↗
PubMed1977

Surgery of the pituitary gland.

Increasing diagnostic sophistication among endocrinologists has continually expanded the horizon of surgical treatment of adenohypophyseal problems. This advancement in endocrinology has been paralleled by improvement in the technical sophistication of neurosurgeons which has resulted in an increasingly aggressive approach to these serious disorders. Neurosurgical treatment is clearly able to provide resolution of significant physical disorders with minimal sequelae. The apparent potential for transsphenoidal approaches to the sella turcica as described within this paper has intrigued a number of neurosurgeons throughout this century. Their continuing interest has carried this procedure to a secure position in the management of many of these complex problems. This paper describes the author's experience with 132 consecutive transsphenoidal hypophysectomies.

Acromegaly↗
PubMed1977

Clinical pituitary disorders.

The pituitary gland is really a confederation of several relatively independent endocrine glands gathered together in close relationship to the hypothalamus which exerts considerable governing control. Each of these sub-glands of the pituitary should be considered separately in every case of pituitary disease. While such an approach is mandatory in dealing with laboratory investigation, it also is profitable in considering clinical and therapeutic aspects of each case to ensure that nothing is overlooked.

Adrenocorticotropic Hormone↗