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British Medical Journal (Clinical... Mar 1985
Topics: Humans; Hypophysectomy; Pituitary Neoplasms; Prolactin
PubMed: 3919855
DOI: 10.1136/bmj.290.6473.1002-a -
Journal of Veterinary Internal Medicine Jan 2022Electrolyte abnormalities, especially hypernatremia, are frequent complications after transsphenoidal hypophysectomy in dogs with pituitary-dependent hypercortisolism.
BACKGROUND
Electrolyte abnormalities, especially hypernatremia, are frequent complications after transsphenoidal hypophysectomy in dogs with pituitary-dependent hypercortisolism.
OBJECTIVES
To describe electrolyte abnormalities after transsphenoidal hypophysectomy and to investigate possible associations between postoperative hypernatremia and clinical and surgical variables as well as with postoperative outcome.
ANIMALS
One hundred and twenty-seven client-owned dogs.
METHODS
Dogs with pituitary corticotroph adenomas that underwent transsphenoidal hypophysectomy were retrospectively included. Plasma sodium and potassium concentrations were measured -2, +2, +8, +24, and +48 hours from hypophysectomy. Clinical (breed, age, body weight, skull type, urinary cortisol/creatinine ratio, percentage of suppression to dexamethasone) and surgical variables (duration of anesthesia and surgery, pituitary dimensions) were compared to the development of hypernatremia.
RESULTS
Postoperative hypernatremia developed in 46.5% (57/127) of dogs and hyponatremia in 6.3% (8/127). Plasma sodium concentration increased after surgery and peaked at 8 hours after surgery, normalizing after 24 to 48 hours. Plasma potassium concentration increased without exceeding the reference limit. No significant associations were found between clinical and surgical variables and hypernatremia, or between hypernatremia and postoperative death, long-term survival or recurrence. Surgery time was significantly longer in dogs that developed persistent diabetes insipidus (P = .02) and persistent diabetes insipidus occurred more frequently in dogs with enlarged pituitary glands (P = .01).
CONCLUSION AND CLINICAL IMPORTANCE
Hypernatremia remains a frequent postoperative complication after transsphenoidal hypophysectomy but did not appear to have an impact on postoperative outcome. No predisposing factor to postoperative hypernatremia was identified. Variations in plasma potassium concentrations do not seem to influence postoperative outcome.
Topics: ACTH-Secreting Pituitary Adenoma; Adenoma; Animals; Dog Diseases; Dogs; Hypophysectomy; Neoplasm Recurrence, Local; Postoperative Complications; Potassium; Retrospective Studies; Sodium
PubMed: 34914137
DOI: 10.1111/jvim.16337 -
Anaesthesia May 1983Transphenoidal ablation of the pituitary gland by the injection of alcohol is used for the relief of wide-spread cancer pain. A technique is described in which a...
Transphenoidal ablation of the pituitary gland by the injection of alcohol is used for the relief of wide-spread cancer pain. A technique is described in which a cryoprobe is passed through a transphenoidal needle and a number of lesions produced within the gland. It is suggested that this method of pituitary ablation may prove to be as effective but accompanied by fewer complications than the injection of alcohol.
Topics: Cryosurgery; Humans; Hypophysectomy; Pain, Intractable
PubMed: 6859482
DOI: 10.1111/j.1365-2044.1983.tb14039.x -
Anaesthesia Oct 1956
Topics: Breast; Breast Neoplasms; Humans; Hypophysectomy; Mastectomy; Pituitary Gland
PubMed: 13362905
DOI: 10.1111/j.1365-2044.1956.tb08000.x -
Journal of Veterinary Internal Medicine Mar 2021Successful treatment of cats with hypersomatotropism by transsphenoidal hypophysectomy is described in small numbers of cats.
BACKGROUND
Successful treatment of cats with hypersomatotropism by transsphenoidal hypophysectomy is described in small numbers of cats.
OBJECTIVES
To describe the endocrine profile, survival, and remission rates of hypersomatotropism and diabetes mellitus in a cohort of cats with hypersomatotropism that underwent hypophysectomy between 2008 and 2020.
ANIMALS
Twenty-five client-owned cats with spontaneous hypersomatotropism.
METHODS
Retrospective study. Diagnosis of hypersomatotropism was based on clinical signs, plasma insulin-like growth factor-1 (IGF-1) concentration, and imaging of the pituitary gland. Growth hormone (GH) and IGF-1 concentrations were measured repeatedly after surgery. Survival times were calculated based on follow-up information from owners and referring veterinarians.
RESULTS
Median postoperative hospital stay was 7 days (range, 3-18 days). One cat died within 4 weeks of surgery. Median plasma GH concentration decreased significantly from 51.0 ng/mL (range, 5.0-101.0 ng/mL) before surgery to 3.8 ng/mL (range, 0.6-13.0 ng/mL) at 5 hours after surgery. Remission of hypersomatotropism, defined as normalization of plasma IGF-1 concentration, occurred in 23/24 cats (median, 34 ng/mL; range, 14-240 ng/mL) and 22/24 cats entered diabetic remission. Median survival time was 1347 days (95% confidence interval, 900-1794 days; range, 11-3180 days) and the overall 1-, 2-, and 3-year all-cause survival rates were 76%, 76%, and 52%, respectively.
CONCLUSIONS AND CLINICAL IMPORTANCE
This study shows the beneficial outcome of hypophysectomy in cats with hypersomatotropism, marked by low death rate and a high percentage of diabetic remission and definitive cure.
Topics: Acromegaly; Animals; Cat Diseases; Cats; Diabetes Mellitus; Growth Hormone; Hypophysectomy; Insulin-Like Growth Factor I; Retrospective Studies
PubMed: 33621385
DOI: 10.1111/jvim.16047 -
Fertility and Sterility Jan 2016MacLeod J, Pazianos A, Ray B. The restoration of human spermatogenesis and of the reproductive tract with urinary gonadotropins following hypophysectomy. Fertil Steril...
MacLeod J, Pazianos A, Ray B. The restoration of human spermatogenesis and of the reproductive tract with urinary gonadotropins following hypophysectomy. Fertil Steril 1966;17(1):7-23. "No precedent was available in the male for the amount of [human menopausal gonadotropin] to be given in order to initiate spermatogenesis, if the latter could be done at all." "In this experiment, the evidence is strongly in favor of FSH activity being exerted first at the level of the spermatogonium, inducing mitosis and proliferation of this cell."
Topics: Chorionic Gonadotropin; Humans; Hypophysectomy; Infertility, Male; Male; Spermatozoa; Urogenital System
PubMed: 26688558
DOI: 10.1016/j.fertnstert.2015.11.023 -
World Neurosurgery Dec 2023Located at the base of the skull, the pituitary gland has a long and controversial history, not only in terms of its anatomy, but especially in the functions it performs... (Review)
Review
Located at the base of the skull, the pituitary gland has a long and controversial history, not only in terms of its anatomy, but especially in the functions it performs and in the attempt to approach it surgically. Considered by Galen of Pergamon to have a role in releasing waste products of the brain, a theory accepted until the 17th century, the pituitary gland became a separate entity once with the anatomical descriptions of the famous Andreas Vesalius. At the beginning of the 18th century, researches of the time began to be more and more interested in this gland, trying to identify its functions, and at the same time correcting the traditional theories that were wrong or incomplete. Later, they turned their attention to experimental animal studies that represented the germinal nucleus for the transcranial and endoscopic pituitary surgery. In this review, an attempt has been made to record the entire history of anatomy, physiology and surgery of the pituitary gland, from antiquity to the current day's surgical techniques.
Topics: Animals; Pituitary Gland; Hypophysectomy; Endoscopy; Skull; Head
PubMed: 37683915
DOI: 10.1016/j.wneu.2023.09.004 -
Journal of Veterinary Internal Medicine Mar 2021Hypersomatotropism (HST) is an increasingly recognized endocrinopathy in cats and is mostly described associated with diabetes mellitus (DM).
BACKGROUND
Hypersomatotropism (HST) is an increasingly recognized endocrinopathy in cats and is mostly described associated with diabetes mellitus (DM).
OBJECTIVES
To evaluate the efficacy and safety of transsphenoidal hypophysectomy in treating HST and DM in cats.
ANIMALS
Sixty-eight client-owned cats with HST and DM treated by transsphenoidal hypophysectomy.
METHODS
Retrospective cohort study. Medical records were reviewed for glycemic control and serum insulin-like growth factor-1 (IGF-1) concentrations. Postoperative complications, death within 4 weeks, and proportion achieving diabetic remission were recorded. Survival times and DM-free intervals were calculated.
RESULTS
Fifty-eight cats (85.3%) were alive 4 weeks postoperatively with 10 (15%) postoperative deaths. Complications included hypoglycemia (n = 9), electrolyte imbalance (n = 9), and transient congestive heart failure (n = 5). Fifty-five cats (95% of 58 surviving cats [81% of all cats undergoing surgery]) had improved control of diabetes. Diabetic remission occurred in 41 cats (71% of 58 surviving cats [60% of all cats]) with insulin administration discontinued after a median of 9 days (range, 2-120). Postoperative 4-week serum IGF-1 concentration nadir was significantly lower in cats achieving diabetic remission (median 20 ng/mL [15-708] than those that did not (324 ng/mL [15-1955]; P = .03). All cats received long-term levothyroxine and hydrocortisone PO, alongside desmopressin (conjunctival) in 38 of 53 cats (72%). Recurrence of DM occurred in 5 of 41 cats (12%) after a median of 248 days (range, 84-1232). Median survival time of all cats was 853 days (range, 1-1740).
CONCLUSIONS AND CLINICAL IMPORTANCE
Transsphenoidal hypophysectomy is an effective treatment for cats with HST and DM, with a long-term outcome that compares favorably to existing options.
Topics: Acromegaly; Animals; Cat Diseases; Cats; Diabetes Mellitus; Hypophysectomy; Insulin; Retrospective Studies
PubMed: 33624865
DOI: 10.1111/jvim.16080 -
Scientific Reports May 2021For pituitary regenerative medicine, the creation of a hypophyseal model in monkeys is necessary to conduct future preclinical studies; however, previous studies...
For pituitary regenerative medicine, the creation of a hypophyseal model in monkeys is necessary to conduct future preclinical studies; however, previous studies reported that hypophysectomy in monkeys is not always safe or satisfactory. This study aimed to create a hypophyseal dysfunction model in a cynomolgus monkey using a safer surgical technique and establish the protocol of pituitary hormone replacement therapy for this model. Surgical resection of the pituitary gland of a 7.8-year-old healthy adult cynomolgus male monkey weighing 5.45 kg was performed to create a hypophyseal dysfunction model for future regenerative studies. Endoscopic transoral transsphenoidal surgery was used to perform hypophysectomy under navigation support. These procedures were useful for confirming total removal of the pituitary gland without additional bone removal and preventing complications such as cerebrospinal fluid leakage. Total removal was confirmed by pathological examination and computed tomography. Hypopituitarism was verified with endocrinological examinations including stimulation tests. Postoperatively, the monkey's general condition of hypopituitarism was treated with hormone replacement therapy, resulting in long-term survival. The success of a minimally invasive and safe surgical method and long-term survival indicate the creation of a hypophyseal dysfunction model in a cynomolgus monkey; hence, this protocol can be employed in the future.
Topics: Animals; Disease Models, Animal; Hormone Replacement Therapy; Humans; Hypophysectomy; Hypopituitarism; Macaca fascicularis; Male; Minimally Invasive Surgical Procedures; Regenerative Medicine; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 34031474
DOI: 10.1038/s41598-021-90209-3 -
CA: a Cancer Journal For Clinicians 1974
Topics: Humans; Hypophysectomy; Male; Palliative Care; Prostatic Neoplasms
PubMed: 4138838
DOI: 10.3322/canjclin.24.5.282