scholarly journals Outcomes of Transsphenoidal Surgery in Growth Hormone-Secreting Pituitary Adenomas

2021 ◽  
Author(s):  
Oleksandr Voznyak ◽  
Andrii Lytvynenko ◽  
Oleg Maydannyk ◽  
Roman Ilyuk ◽  
Yaroslav Zinkevych ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenomas ◽  
Senior Author ◽  
Oral Glucose ◽  
Surgical Removal ◽  
Metabolic Disturbances ◽  
Systemic Impact ◽  
Oral Glucose Tolerance Tests ◽  
Mortality Ratio ◽  
Glucose Tolerance Tests

AbstractGrowth hormone (GH)-secreting pituitary adenomas (PA) make up 15 to 20% of total amount of hormonally active adenomas. In addition to acromegaly and gigantism, these tumors cause deep metabolic disturbances. Its systemic impact leads to increased mortality ratio of 1.32 compared with general population. Surgical removal remains the priority treatment option in controlling acromegaly and provides endocrinologic remission in up to 72% patients. A total of 92 patients were included in the study. All surgeries were performed via microscopic transsphenoidal approach (TSA) by the senior author in our institution between December 2009 and October 2019. Only patients who were followed-up with 75 g oral glucose tolerance tests (OGTTs), GH, and insulin-like growth factor I (IFG-I) measurements preoperatively, 1 week, and every 6 months postoperatively were analyzed. Based on standard preoperative 1.5-T MR imaging with contrast enhancement, the adenomas were identified and distributed according to the size and KNOSP classification. The efficacy depends on KNOSP grade, which is directly correlated with invasiveness to cavernous sinus (CS). Grades 3 and 4 are unfavorable factors influencing prognosis. Excluding grade 0 adenomas, as the surgery was not difficult with the excellent outcomes, we reached 75% (36 out of 48) remission in grade 1 to 2 groups. In contrast, only 17% (2 out of 12) had successful outcomes after surgery alone. In conclusion, the study demonstrates the efficiency of TS surgery in patients with confirmed GH-secreting PA.

Low carbohydrate intake and oral glucose-tolerance tests

The Lancet ◽  
1998 ◽  
Vol 352 (9135) ◽  
pp. 1223 ◽  
Author(s):  
Keiji Yoshioka ◽  
Sadayoshi Yokoh ◽  
Toshihide Yoshida
Keyword(s):  
Glucose Tolerance ◽  
Carbohydrate Intake ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Low Carbohydrate ◽  
Oral Glucose Tolerance Tests ◽  
Glucose Tolerance Tests

scholarly journals ogttMetrics: Data structures and algorithms for oral glucose tolerance tests

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 684
Author(s):  
Benjamin J. Stubbs ◽  
Keith Frankston ◽  
Marcel Ramos ◽  
Nancy Laranjo ◽  
Frank M. Sacks ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Open Source Software ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Estimation Of Parameters ◽  
Large Clinical Trial ◽  
Oral Glucose Tolerance Tests ◽  
Open Source Software Package ◽  
Glucose Tolerance Tests ◽  
Data Structures And Algorithms

We describe an open source software package, ogttMetrics, to compute diverse measures of glucose metabolism derived from oral glucose tolerance tests (OGTTs). Tools are provided to organize, visualize and compare OGTT data from large cohorts. Numerical difficulties in estimation of parameters of the Bergman minimal model are described, and in one large clinical trial, the simpler closed form index of Matsuda is observed to lead to similar rankings of individuals with respect to insulin sensitivity, and similar inferences concerning effects of modifications to carbohydrate content and glycemic index of experimental diets.

Outcomes after a purely endoscopic transsphenoidal resection of growth hormone–secreting pituitary adenomas

2010 ◽  
Vol 29 (4) ◽  
pp. E5 ◽  
Author(s):  
Peter G. Campbell ◽  
Erin Kenning ◽  
David W. Andrews ◽  
Sanjay Yadla ◽  
Marc Rosen ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenomas ◽  
Remission Rate ◽  
Csf Leak ◽  
Oral Glucose ◽  
Cure Rate ◽  
Cavernous Sinus Invasion ◽  
Remission Criteria ◽  
Biochemical Cure ◽  
Transsphenoidal Resection

Object Using strict biochemical remission criteria, the authors assessed surgical outcomes after endoscopic transsphenoidal resection of growth hormone (GH)–secreting pituitary adenomas and identified preoperative factors that significantly influence the rate of remission. Methods A retrospective review of a prospectively maintained database was performed. The authors reviewed cases in which an endoscopic resection of GH-secreting pituitary adenomas was performed. The cohort consisted of 26 patients who had been followed for 3–60 months (mean 24.5 months). The thresholds of an age-appropriate, normalized insulin-like growth factor–I concentration, a nadir GH level after oral glucose load of less than 1.0 μg/l, and a random GH value of less than 2.5 μg/l were required to establish biochemical cure postoperatively. Results Overall, in 57.7% of patients undergoing a purely endoscopic transsphenoidal pituitary adenectomy for acromegaly, an endocrinological cure was achieved. The mean clinical follow-up duration was 24.5 months. In patients with microadenomas (4 cases) the cure rate was 75%, whereas in patients harboring macroadenomas (22 cases) the cure rate was 54.5%. Cavernous sinus invasion (Knosp Grades 3 and 4) was associated with a significantly lower remission rate (p = 0.0068). Hardy Grade 3 and 4 tumors were also less likely to achieve biochemical cure (p = 0.013). The overall complication rate was 11.5% including 2 incidents of transient diabetes insipidus and 1 postoperative CSF leak, which were treated nonoperatively. Conclusions A purely endoscopic transsphenoidal approach to GH-secreting pituitary adenomas leads to similar outcome for noninvasive macroadenomas compared with traditional microsurgical techniques. Furthermore, this approach may often provide maximal visualization of the tumor, the pituitary gland, and the surrounding neurovascular structures.

Reversibility of endocrine changes produced in guinea pigs by exposure to cold

1965 ◽  
Vol 208 (1) ◽  
pp. 115-117 ◽  
Author(s):  
Harry Sobel ◽  
George C. Haberfelde ◽  
Albert E. Reeves
Keyword(s):  
Glucose Tolerance ◽  
Guinea Pigs ◽  
Room Temperature ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Definite Evidence ◽  
Exposure To Cold ◽  
Thyroid Glands ◽  
Oral Glucose Tolerance Tests ◽  
Glucose Tolerance Tests

Guinea pigs were exposed continuously to a temperature of 2–4 C for 6 months. They were then reacclimatized to room temperature, and after 4–6 months certain tests were carried out. During control collections and following exposure to cold the previously cold-exposed animals exhibited urinary corticoid excretion values which were approximately 10% below those of their controls. Following intraperitoneal injection of ACTH the response was approximately 20% greater. However, these differences were not statistically significant. Oral glucose tolerance tests revealed definite evidence of reduction in tolerance in the previously cold-exposed animals. Six animals exhibited 150-min values which exceeded by more than 20 mg/ 100 ml the highest value observed in the controls. Fourteen others whose values fell within this limit exhibited a statistically significant increase in the 150-min value as compared with the controls. The PBI values were the same in each group. There were no histological residues in the pituitary, adrenal, pancreas, and thyroid glands.

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