scholarly journals Percent reduction of growth hormone levels correlates closely with percent resected tumor volume in acromegaly

2015 ◽  
Vol 122 (4) ◽  
pp. 798-802 ◽  
Author(s):  
Lucia Schwyzer ◽  
Robert M. Starke ◽  
John A. Jane ◽  
Edward H. Oldfield
Keyword(s):  
Growth Hormone ◽  
Tumor Volume ◽  
Tumor Resection ◽  
Volume Growth ◽  
Residual Tumor ◽  
Close Correlation ◽  
Tumor Removal ◽  
Hormone Levels ◽  
Before And After ◽  
Plasma Gh

OBJECT Correlation between tumor volume and hormone levels in individual patients would permit calculation of the fraction of tumor removed by surgery, by measuring postoperative hormone levels. The goals of this study were to examine the relationship between tumor volume, growth hormone (GH), and insulin-like growth factor–1 (IGF-1) levels, and to assess the correlation between percent tumor removal and the reduction in plasma GH and IGF-1 in patients with acromegaly. METHODS The 3D region of interest–based volumetric method was used to measure tumor volume via MRI before and after surgery in 11 patients with GH-secreting adenomas. The volume of residual tumor as a fraction of preoperative tumor volume was correlated with GH levels before and after surgery. Examination of this potential correlation required selection of patients with acromegaly who 1) had incomplete tumor removal, 2) had precise measurements of initial and residual tumor, and 3) were not on medical therapy. RESULTS Densely granulated tumors produced more peripheral GH per mass of tumor than sparsely granulated tumors (p = 0.04). There was a correlation between GH and IGF-1 levels (p = 0.001). Although there was no close correlation between tumor size and peripheral GH levels, after normalizing each tumor to its own plasma GH level and tumor volume, a comparison of percent tumor resection with percent drop in plasma GH yielded a high correlation coefficient (p = 0.006). CONCLUSIONS Densely granulated somatotropinomas produce more GH per mass of tumor than do sparsely granulated tumors. Each GH-secreting tumor has its own intrinsic level of GH production per mass of tumor, which is homogeneous over the tumor mass, and which varies greatly between tumors. In most patients the fraction of a GH-secreting tumor removed by surgery can be accurately estimated by simply comparing plasma GH levels after surgery to those before surgery.

Management of NF2-associated vestibular schwannomas in children and young adults: influence of surgery and clinical factors on tumor volume and growth rate

2019 ◽  
Vol 24 (5) ◽  
pp. 584-592 ◽  
Author(s):  
Isabel Gugel ◽  
Florian Grimm ◽  
Christian Teuber ◽  
Lan Kluwe ◽  
Victor-Felix Mautner ◽  
...  
Keyword(s):  
Growth Rate ◽  
Young Adults ◽  
Tumor Volume ◽  
Statistical Significance ◽  
Tumor Resection ◽  
Internal Auditory Canal ◽  
Vestibular Schwannomas ◽  
Clinical Factors ◽  
Before And After ◽  
Children And Young Adults

OBJECTIVEThe authors’ aim was to evaluate the tumor volume and growth rate of neurofibromatosis type 2 (NF2)–associated vestibular schwannomas (VSs) and the clinical factors or type of mutations before and after surgery in children and adults younger than 25 years at the time of diagnosis.METHODSA total of 579 volumetric measurements were performed in 46 operated tumors in 28 NF2 patients, using thin-slice (< 3 mm) T1-weighted contrast-enhanced MRI. The follow-up period ranged from 21 to 167 months (mean 75 months). Growth rate was calculated using a multilinear regression model. Mutation analysis of the NF2 gene was performed in 25 patients.RESULTSSurgery significantly (p = 0.013) slowed the VS growth rate from 0.69 ± 1.30 cm3/yr to 0.23 ± 0.42 cm3/yr. Factors significantly associated with a higher growth rate of VSs were increasing patient age (p < 0.0005), tumor volume (p = 0.006), tumor size (p = 0.001), and constitutional truncating mutations in the NF2 gene (p = 0.018). VS growth rates tended to be higher in patients with spinal ependymomas and in right-sided tumors and lower in the presence of peripheral schwannomas; however, no statistical significance was achieved.CONCLUSIONSDecompression of the internal auditory canal with various degrees of tumor resection decreases the postoperative tumor growth rate in children and young adults with NF2-associated VS. Patients with potential risk factors for accelerated growth (e.g., large volume, truncating mutations) and with increasing age should be monitored more closely before and after surgery.

scholarly journals Subjective anxiety ratings before and after stressful neurosurgical virtual reality tumor resection task

2015 ◽  
Vol 42 (S1) ◽  
pp. S42-S42
Author(s):  
A Winkler-Schwartz ◽  
J Fares ◽  
B Khalid ◽  
M Baggiani ◽  
S Christie ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Medical Students ◽  
Tumor Resection ◽  
Tumor Removal ◽  
Surgical Performance ◽  
Surgical Simulators ◽  
Surgical Expertise ◽  
Before And After ◽  
Operative Performance ◽  
Junior Residents

Background: The availability of virtual reality (VR) surgical simulators affords the opportunity to assess the influence of stress on neurosurgical operative performance in a controlled laboratory environment. This study sought to examine the effect of a stressful VR neurosurgical task on the subjective anxiety ratings of participants with varying levels of surgical expertise. Methods: Twenty four participants comprised of six staff neurosurgeons, six senior neurosurgical residents (PGY4-6), six junior neurosurgical residents (PGY1-3), and six senior medical students took part in a bimanual VR tumor removal task with a component of sudden uncontrollable intra-operative bleeding. State Trait Anxiety Inventory (STAI) questionnaires were completed immediately pre and post the stress stimulus. The STAI questionnaire consisted of six items (calm, tense, upset, relaxed, content and worried) measured on a Likert scale. Results: Significant increases in subjective anxiety ratings were noted in junior residents (p=0.005) and medical students (p=0.025) while no significant changes were observed for staff and senior neurosurgical residents. Conclusions: Staff and senior residents more effectively mitigate stress compared to junior colleagues in a VR operative environment. Further physiological correlates are needed to determine whether this increased anxiety is paralleled by physiological arousal and altered surgical performance.

Correlation of Neurosurgical Subspecialization with Outcomes in Children with Malignant Brain Tumors

Neurosurgery ◽  
2000 ◽  
Vol 47 (4) ◽  
pp. 879-887 ◽  
Author(s):  
A. Leland Albright ◽  
Richard Sposto ◽  
Emi Holmes ◽  
Paul M. Zeltzer ◽  
Jonathan L. Finlay ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Malignant Gliomas ◽  
Tumor Resection ◽  
Residual Tumor ◽  
Pediatric Brain Tumors ◽  
Neurological Complications ◽  
Tumor Removal ◽  
Primitive Neuroectodermal Tumors ◽  
Cancer Group ◽  
Neuroectodermal Tumors

Abstract OBJECTIVE This study was performed to evaluate the association between the type of neurosurgeon (general or pediatric) and either the extent of tumor removal or the frequency of complications in children undergoing malignant brain tumor resections. METHODS Data were analyzed from three recent Children's Cancer Group studies: two on medulloblastomas/primitive neuroectodermal tumors and one on malignant gliomas. Neurosurgeons were classified as general neurosurgeons, as designated pediatric neurosurgeons in their institutions, or as members of the American Society of Pediatric Neurosurgeons (ASPN), which requires pediatric neurosurgical experience and practice standards. RESULTS Data forms from 732 children were analyzed; 485 were from children with medulloblastomas/primitive neuroectodermal tumors, and 247 were from children with malignant gliomas. Operations were performed by 269 neurosurgeons, including 213 general neurosurgeons, 29 designated pediatric neurosurgeons, and 27 ASPN members. The mean number of operations per surgeon was 1.8, 4.9, and 7.6 for general neurosurgeons, designated pediatric neurosurgeons, and ASPN members, respectively. There was a significant relationship between the extent of tumor resection or the amount of residual tumor and the type of neurosurgeon. Designated pediatric neurosurgeons and ASPN members were more likely to remove more than 90% of the tumor and to leave less than 1.5 cc of residual tumor than were general neurosurgeons (P &lt; 0.05). In these studies, the probability of extensive tumor removal correlated with the number of operations the neurosurgeon performed (P &lt; 0.01). Neurological complications occurred in the following proportion of cases: general neurosurgeons, 23%; designated pediatric neurosurgeons, 32%; and ASPN members, 18%. CONCLUSION Pediatric neurosurgeons are more likely than general neurosurgeons to extensively remove malignant pediatric brain tumors. In these tumors, extent of removal has been demonstrated to influence survival.

DECREASE OF NON-SUPPRESSIBLE INSULIN-LIKE ACTIVITY AFTER PANCREATECTOMY AND NORMALIZATION BY INSULIN THERAPY

1977 ◽  
Vol 85 (4) ◽  
pp. 818-822 ◽  
Author(s):  
J. E. Eigenmann ◽  
M. Becker ◽  
B. Kammermann ◽  
W. Leemann ◽  
R. Heimann ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Acetic Acid ◽  
Insulin Therapy ◽  
Serum Samples ◽  
Hormone Levels ◽  
Severe Diabetes ◽  
Before And After ◽  
Insulin Like Activity ◽  
Parallel Growth

ABSTRACT Non-suppressible insulin-like activity (NSILA-S) was determined in 5 dogs before and after pancreatectomy and again during insulin therapy. All NSILA-S determinations were carried out on serum samples which were passed over Sephadex G-50 columns equilibrated with 1 m acetic acid. The levels of NSILA-S decreased drastically shortly after pancreatectomy and rose slowly after institution of insulin therapy, to normal levels. During the period of severe diabetes after pancreatectomy the concentration of growth hormone was elevated. These findings indicate that 1) the pancreas cannot be the site of synthesis and release of NSILA-S, 2) NSILA-S levels do not always parallel growth hormone levels and 3) the synthesis and secretion of NSILA-S among other factors is under the control of insulin.

Correlation Between the Residual Tumor Volume, Extent of Tumor Resection, and O6-Methylguanine DNA Methyltransferase Status in Patients with Glioblastoma

2018 ◽  
Vol 116 ◽  
pp. e147-e161 ◽  
Author(s):  
Mayur Sharma ◽  
Sushma Bellamkonda ◽  
Suryanarayan Mohapatra ◽  
Antonio Meola ◽  
Xuefei Jia ◽  
...  
Keyword(s):  
Dna Methyltransferase ◽  
Tumor Volume ◽  
Tumor Resection ◽  
Residual Tumor ◽  
Methylguanine Dna Methyltransferase

PROLACTIN AND THE PITUITARY-GONADAL AXIS IN MALE URAEMIC PATIENTS ON REGULAR DIALYSIS

1976 ◽  
Vol 82 (1) ◽  
pp. 29-38 ◽  
Author(s):  
C. Hagen ◽  
K. Ølgaard ◽  
A. S. McNeilly ◽  
R. Fisher
Keyword(s):  
Growth Hormone ◽  
Follicle Stimulating Hormone ◽  
Plasma Concentrations ◽  
Sex Hormone Binding Globulin ◽  
Elevated Plasma ◽  
Hormone Binding ◽  
Hormone Levels ◽  
Significant Difference ◽  
Before And After ◽  
Male Patients

ABSTRACT In 21 consecutive adult male patients with chronic renal failure on regular haemo- or peritoneal dialysis, the plasma levels of prolactin (hPr), growth hormone (HGH), thyrotrophin (TSH), luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T) and sex hormone binding globulin (SHBG) were measured. Elevated levels of hPr were found in 16 of the patients and could not only be explained by the medicamentation. All the patients studied showed an inverse ratio of LH to FSH with higher levels of FSH than LH and 15 of the 21 patients had elevated plasma concentrations of FSH, while only 4 had elevated LH. No significant difference in any of the hormone levels could be demonstrated before and after dialysis, and no significant correlation between the hormone levels and the time of dialysis, the type of dialysis or the age of the patient was found. However, 8 of the 21 patients showed higher levels of HGH before than after dialysis. Impotency was found in 11 of the patients, but was not related to abnormal levels of hPr, LH, FSH, T or SHBG.

Effect of hyperthermia and physical activity on circulating growth hormone

2008 ◽  
Vol 33 (5) ◽  
pp. 880-887 ◽  
Author(s):  
Foued Ftaiti ◽  
Monem Jemni ◽  
Asma Kacem ◽  
Monia Ajina Zaouali ◽  
Zouhair Tabka ◽  
...  
Keyword(s):  
Physical Activity ◽  
Growth Hormone ◽  
Air Temperature ◽  
Heat Exposure ◽  
Tympanic Temperature ◽  
Air Humidity ◽  
Gh Secretion ◽  
Before And After ◽  
Globe Temperature ◽  
Plasma Gh

The aim of this study was to differentiate the effects of hyperthermia and physical activity on circulating growth hormone (GH) secretion. Nine healthy volunteer adults performed two 40 min exercise trials and two 50 min passive standing trials. The exercise was performed in either thermo-neutral (N-Ex: air temperature 18 °C, air humidity 40%, and wet bulb globe temperature (WBGT) 17.7 °C) or hot environmental conditions (H-Ex: air temperature 33 °C, air humidity 30%, and WBGT 34.6 °C). The passive exposure trials were also performed in either a comfortable (N-P: air temperature 18 °C, air humidity 40%, and WBGT 17.7 °C) or a hot climatic chamber (H-P: air temperature 40 °C, air humidity 100%, and WBGT 97.1 °C). Plasma GH, plasma volume (PV), tympanic temperature (Tty), and body mass loss (BML) were measured before and after each trial. The decrease in PV was significantly higher during H-Ex and H-P sessions than during N-Ex and N-P sessions. Comparisons showed significantly lower BML in the N-Ex session (1.5% ± 0.3%) than in the H-Ex and H-P sessions (2.1% ± 0.3% and 1.9% ± 0.2%, respectively) (p < 0.001). The rise in Tty was significantly higher during the H-P session (2.9 ± 0.4 °C) (p < 0.001) when compared with the other sessions. Plasma GH concentration increased significantly during all the trials, particularly during the H-Ex session (45 ± 7 ng·mL–1) (p < 0.01). Both exercise and heat exposure, separately, are sufficient to increase significantly the plasma GH concentration, and their combined effect induced a highly synergistic rise in GH.

scholarly journals Persistence of somatostatinergic tone in acromegaly

1995 ◽  
Vol 132 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Roberto Attanasio ◽  
Renato Cozzi ◽  
Giuseppe Oppizzi ◽  
Daniela Dallabonzana ◽  
Iacopo Chiodini ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Inverse Correlation ◽  
Feedback Mechanisms ◽  
Cholinergic Pathways ◽  
Factor I ◽  
Pathway Activation ◽  
Cholinergic Pathway ◽  
Before And After ◽  
Physiological Feedback ◽  
Plasma Gh

Attanasio R, Cozzi R, Oppizzi G, Dallabonzana D, Chiodini I, Benini Z, Orlandi P, Liuzzi A, Chiodini PG. Persistence of somatostatinergic tone in acromegaly. Eur J Endocrinol 1995;132:27–31. ISSN 0804–4643 It is a matter of debate whether hypothalamic somatostatin (SRIH) secretion in acromegaly is preserved and still regulated by the physiological feedback mechanisms of growth hormone (GH) and insulin-like growth factor I. To gather further information on this, the reproducibility of plasma GH changes induced by growth hormone-releasing hormone (GHRH) administration was evaluated in 15 acromegalic patients. There was a highly significant correlation between the peak/basal ratio (P/B) GH response in the 15 patients administered GHRH on two separate occasions (r = 0.99, p <0.001). The test was performed also before and after the administration of drugs able to inhibit or stimulate hypothalamic SRIH release, by activating (pyridostigmine) or inhibiting (pirenzepine) cholinergic pathways, respectively. The GHRH-induced GH response (P/B = 2, range 1.1–26.1) was increased significantly by pyridostigmine pretreatment in 30 patients (P/B = 2.6, range 1.3–34.8; p = 0.0045). In nine out of 30 patients an increase of greater than 2sd of within-subject GHRH variability was observed in response to GHRH plus pyridostigmine when compared to GHRH alone. An inverse correlation (r = −0.37, p <0.05) was observed between GH response to GHRH alone and after pyridostigmine pretreatment. On the contrary, no change of GHRH-induced GH response was observed in 12 patients after pirenzepine pretreatment (P/B =1.9, range 1.1–5 and P/B = 2, range 1.3–6 without and after pirenzepine pretreatment, respectively). These data suggest that in acromegaly the somatostatinergic tone does not seem to fluctuate, and that it can be inhibited often by cholinergic pathway activation but not increased further by cholinergic suppression. Roberto Attanasio, Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, 1-20162 Milano, Italy

scholarly journals COT-30 Effect of tumor resection in 11C methionine accumulation area on survival in patients with glioblastoma

2021 ◽  
Vol 3 (Supplement_6) ◽  
pp. vi31-vi31
Author(s):  
Kazufumi Ohmura ◽  
Etsuko Ohwashi ◽  
Yuka Ikegame ◽  
Hiroaki Takei ◽  
Kazuhiro Miwa ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Tumor Resection ◽  
Residual Tumor ◽  
Extent Of Resection ◽  
Area Reduction ◽  
Positron Emission ◽  
Before And After ◽  
The Relationship ◽  
Ratio Reduction ◽  
Met Pet

Abstract Aim: The amount of tumor excised in an area enhanced by contrast medium on magnetic resonance imaging strongly affects the survival time of patients with glioblastoma. We investigated the effect of the amount of tumor removal in the 11C methionine (MET) accumulation site on overall survival(OS). Methods: Twenty-six patients (15 male; mean age, 68.9 years) with a diagnosis of glioblastoma who underwent tumor resection at Kizawa Memorial Hospital between June 1, 2015 and August 30, 2021 underwent MET-positron emission tomography (MET-PET) before and after the operation. In a comparison of MET-PET before and after tumor resection, the tumor-to-normal (T/N) ratio reduction (ΔT/N), MET accumulation area reduction (MET-extent of resection [EOR]), and the residual MET accumulation volume (MET-residual tumor volume [RTV]) were calculated. The relationship between these MET-related parameters associated with tumor resection and OS was investigated via univariable analysis. Results: Univariate analysis revealed that ΔT/N was significantly associated with OS (hazard ratio [HR]: 0.98; 95% confidence interval [CI]: 0.97–0.99; p=0.02). MET-RTV was also significantly associated with OS (HR: 1.01; 95% CI: 0.98–1.02; p=0.73) Conversely, MET-EOR (HR: 0.99; 95% CI: 0.97–1.01; p=0.06) was not significantly associated with OS. Conclusions: Aggressive surgical resection of the MET accumulation site significantly prolongs survival in patients with glioblastoma.

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