By Robert B. Page, Richard J. Santen (auth.), Richard J. Santen M.D., Andrea Manni M.D. (eds.)
Patients with various tumors current to the health care provider as a result of scientific manifestations of hormones secreted in extra. This phenomenon attracted the investigative curiosity of such pioneers as Harvey Cushing who famous that pituitary tumors can cause acromegaly and Charles Mayo who linked hyper pressure with adrenal medullary neoplasms. present int~rest in endocrine-related tumors has intensified as a result of the explosive improvement of more moderen methodol ogy for his or her examine. particular measurements of secretory items, hybridization assays to spot items of genomic translation and quantitative evaluation of tissue hormone receptors have supplied technique of characterizing and accurately following sufferers with endocrine-related tumors. remedies established upon those advances are swiftly proliferating. the present quantity makes an attempt to synthesize a lot of this fresh details with the target of delivering a valid foundation for making scientific decisions concerning analysis and administration. Tumors of endocrine glandular tissues generally confront working towards physi cians with tricky administration difficulties. a number of particular good points of those tumors necessitate collaboration between a number of forte disciplines that allows you to unravel those difficulties and to supply a excessive point of scientific care. for instance, endocrine neoplasms secrete energetic hormones or hormone precursors which produce scientific manifestations such a lot conventional to endocrinologists. definite thera pies equivalent to radioactive iodine for thyroid melanoma reap the benefits of the hormone responsiveness of those tumors to facilitate remedy. those elements require members expert in endocrinology to enforce advanced diagnostic and thera peutic maneuvers.
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145. Wilson CB, Dempsey LC: Transphenoidal microsurgical removal of 250 pituitary adenomas. J Neurosurg 48: 13-22, 1978. 146. Faria MA, Tindall GT: Transsphenoidal microsurgery for prolactin-secreting pituitary adenomas. J Neurosurg 56: 33-43, 1982. 147. Laws ER, Piepgras DG, Randall RV, Abboud CF: Neurosurgical management of acromegaly. Results in 82 patients treated between 1972 and 1977. J Neurosurg 50: 464-461,1979. 148. Arafah BM, Brodkey JS, Kaufman B, Velasco M, Manni A, Pearson OH: Transsphenoidal microsurgery in the treatment of acromegaly and giantism.
The surgical approach to the sella from below was pioneered by Cushing  who modified existing transphenoidal techniques making surgery both simpler and safer. By 1912 he was able to report the results of 38 transphenoidal operations with four operative deaths (mortality rate 10%). These results were achieved before the routine use of endotracheal anesthesia, availability of hormo- 27 nal or blood replacement or utilization of antibiotics. Vision was improved in 25 of these 38 patients (63%).