Abstract:
INTRODUCTION: Surgical remission rates for acromegaly vary and are dependent on the tumour morphology, biochemical definition of disease remission and surgical expertise. A previous report from the Manchester region in 1998 reported an overall surgical remission rate of 27% using accepted criteria for biochemical remission at the time. The establishment of the 2010 Consensus guidelines further tightens biochemical criteria for remission. This report aims to assess the impact of establishing a specialist pituitary surgery service in Manchester in 2005, with reduced surgeon numbers on the remission rates for acromegaly surgery. METHODS:Patients with acromegaly undergoing first time endoscopic transsphenoidal surgery between 2005 and 2010 were studied. Surgery was performed by a single surgeon. Review of a prospectively collected acromegaly surgery database was performed with documentation of pre- and postoperative biochemical tests [oral glucose tolerance test (oGTT) and IGF-1], as well as clinical, pathological and radiological data. Definition of disease remission was according to the 2010 Consensus criteria (GH nadir <0·4 μg/l following an oGTT and normalized population matched IGF-1). RESULTS: There were 43 consecutive patients with acromegaly, with 13 (30%) microadenomas and 12 (28%) invasive adenomas. Overall, surgical remission was achieved in 29 (67%) patients. The remission rates were similar between micro (77%), macro (63%) and giant (67%) adenomas. There were nonsignificant trends towards higher remission rates for noninvasive tumours compared with invasive tumours (74%vs 50%) and for patients with a preoperative GH nadir <10 μg/l (73%vs 54%) and IGF-1 standard deviation score <15 (72%vs 54%). CONCLUSIONS: Remission rates for acromegaly surgery have improved following establishment of a specialist surgical service, with a reduction in surgeon numbers. Endoscopic trans-sphenoidal surgery remains an effective first-line treatment for achieving biochemical remission in acromegaly, despite the introduction of the more stringent 2010 consensus guidelines.
journal_name
Clin Endocrinol (Oxf)journal_title
Clinical endocrinologyauthors
Wang YY,Higham C,Kearney T,Davis JR,Trainer P,Gnanalingham KKdoi
10.1111/j.1365-2265.2011.04193.xsubject
Has Abstractpub_date
2012-03-01 00:00:00pages
399-406issue
3eissn
0300-0664issn
1365-2265journal_volume
76pub_type
杂志文章abstract::The effect of surgical stress on the secretions of LH, FSH, testosterone (T) and oestradiol (E2) were studied in twelve male patients. During surgery LH rose significantly; post-operatively, LH fell but remained persistently elevated a week after operation. However, T and E2 fell progressively to a nadir on the second...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1978.tb02208.x
更新日期:1978-09-01 00:00:00
abstract:OBJECTIVE:The distinction between constitutional delay of growth and puberty (CDGP) and isolated hypogonadotropic hypogonadism (IHH) in males with delayed puberty is difficult but important for timely treatment. We assessed the accuracy of the GnRH agonist test (triptorelin 0·1 mg) in comparison with inhibin B alone or...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.12613
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:Hypopituitarism, including severe GH deficiency, is an almost inevitable outcome of craniopharyngioma. However, some GH deficient children with this tumour may grow normally or even have accelerated growth postoperatively. To study this phenomenon we have investigated the endocrine status, including IGF-1 and...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1046/j.1365-2265.1998.00590.x
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:To study the effects of short (6 months) and longer-term (up to 24 months) growth hormone (GH) replacement therapy using a dose titration regimen, on lipid and glucose metabolism in GH-deficient, hypopituitary adults. DESIGN:On-going open study of GH treatment up to 24 months. Measurements were performed at ...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1046/j.1365-2265.2000.01108.x
更新日期:2000-10-01 00:00:00
abstract::A new model has been established for the perfused in situ rat lung. During perfusion with glucose at 4 mmol/l, physiological concentrations of insulin (50 mu/l) caused an initial 1.5 fold increase in lactate production; the increase being sustained at 30% for the 4 h of perfusion. The observation that the lung respond...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1977.tb01313.x
更新日期:1977-09-01 00:00:00
abstract:OBJECTIVE:A recent report showing disappointingly low sensitivity and specificity for the oral high dose dexamethasone test in the differential diagnosis of Cushing's syndrome prompted us to re-evaluate the results obtained in our centre using the continuous 7-hour intravenous dexamethasone suppression test for this pu...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1046/j.1365-2265.1999.00759.x
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:Vascular dysfunction and accelerated atherosclerosis are prominent features of hypothyroidism. The relative roles of thyroid hormone (TH) deficiency and the associated vascular risk conditions are still unclear. We studied the impact of acute and chronic hypothyroidism on vascular reactivity. PATIENTS:We stu...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2009.03609.x
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:Hyperinsulinaemia has a role in the development of hyperandrogenism and polycystic ovary syndrome in women of normal weight. Polycystic ovaries are common in women with bulimia nervosa and this study aimed to determine whether women with bulimia nervosa are insulin resistant and to examine the relation betwee...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1995.tb02617.x
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVES:The aim of the study was to review our long-term use of subcutaneous oestradiol (E2) implant therapy for the treatment of climacteric symptoms in post-menopausal women. On the grounds that the aim is to restore premenopausal serum E2 levels, our declared clinical policy is not to repeat implants even in the ...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1995.tb02660.x
更新日期:1995-05-01 00:00:00
abstract::In an attempt to obtain further information on the aetiology of premenstrual syndrome (PMS), the endocrine changes following enucleation of the corpus luteum in the mid-luteal phase of the cycle were studied in seven patients with PMS, and the results compared to details of seven control patients undergoing hysterecto...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1985.tb00162.x
更新日期:1985-06-01 00:00:00
abstract:OBJECTIVE:Adults with GH deficiency (GHD) exhibit changes in body composition. Studies of the effects of GH substitution on body composition have been short-term or not adequately controlled. The purpose of this study was to evaluate the long-term effects of GH on soft tissue using dual-energy X-ray absorptiometry (DEX...
journal_title:Clinical endocrinology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1365-2265.1995.tb00536.x
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:We recently identified a novel anorexigenic protein, nesfatin-1, which is processed from nesfatin/nucleobindin-2 (NUCB2). However, the clinical importance of this protein has not been determined. OBJECTIVE:To investigate its clinical significance in humans, we have established a new specific enzyme-linked i...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2010.03835.x
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:There is compelling evidence that insulin resistance may play a pivotal role in the development of pregnancy complications including pre-eclampsia and intrauterine growth restriction (IUGR). As dysregulation of visfatin and adiponectin is found in insulin resistance, both adipokines might contribute to pregna...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2007.02751.x
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:We assessed the relationship between serum IGFBP-3 levels with IGF-I and quantitative GH secretory status in poorly growing children. DESIGN:We studied the relationship between 24-hour integrated concentration of GH, peak GH to paired sequential stimulation tests, IGF-I and the IGFBP-3 serum levels. PATIENT...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1993.tb02389.x
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVE:To analyse the effectiveness of age on HbA1c as a criterion for the diagnosis of diabetes in Chinese different age subjects. METHODS:This retrospective study enrolled a total of 1147 outpatients with untreated newly diagnosed diabetes (aged 18-80 years, 42·55% women) from the Fujian Province, China, and 427 ...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.12494
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:Constitutional delay of growth and puberty (CDGP) is a tempo variant with a good prognosis. Healthy late-maturing adolescents grow slower than postulated by age-related references, and therefore, CDGP is frequently confused with growth hormone deficiency (GHD). For differential diagnosis, height velocity refe...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.14358
更新日期:2021-02-01 00:00:00
abstract::An ornithine infusion test was performed in fifty-four children with constitutional short stature. The ornithine infusion induced an elevated level of GH at 45 min (mean value = 873 pmol/l) and a similar rise of cortisol levels (mean value = 544 nmol/l). An important peak of ACTH appeared 15 min before the increase of...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1982.tb01571.x
更新日期:1982-08-01 00:00:00
abstract:INTRODUCTION:Growth hormone deficiency is considered the most important factor determining skeletal fragility in hypopituitary patients. Osteoblasts and chondrocytes express growth hormone (GH) receptor. Two GH receptor isoforms (GHRi) have been identified: they differ for the presence/absence of a protein fragment enc...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.13161
更新日期:2016-11-01 00:00:00
abstract::Computed tomography of the pituitary fossa was performed in 12 patients with primary hypothyroidism before and after thyroxine treatment. In three, herniation of the diaphragma sellae precluded accurate measurement of the density of the hypophysis. Eight of the remaining patients showed abnormally increased density of...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1985.tb02997.x
更新日期:1985-05-01 00:00:00
abstract:OBJECTIVE:Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) is characterized by high androgen levels, ambiguous genitalia or premature pubarche, increased height velocity and skeletal maturation. Considering the possibility of changes in the IGF system components depending on the state of c...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2004.02075.x
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:In adults, excessive GH secretion may lead to secondary diabetes mellitus, while prolonged GH treatment may accelerate the onset of type 2 diabetes mellitus in predisposed children. The aim of the study was to evaluate insulin sensitivity (IS) and glucose tolerance (GT) in a group of GH-deficient children tre...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2004.02113.x
更新日期:2004-10-01 00:00:00
abstract::The paradoxical GH response to TRH observed in certain adolescents with constitutional tall stature is associated with a 60% fall in plasma levels of somatostatin. Conversely, those tall subjects who do not show a GH increase after TRH, or during a saline control infusion maintain steady levels of somatostatin in plas...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1984.tb03232.x
更新日期:1984-10-01 00:00:00
abstract:OBJECTIVE:Polymorphisms in the thyroid transcription factor forkhead factor E1 (FOXE1) gene have been implicated in the genetic susceptibility to differentiated thyroid cancer, but little is known about their effect on tumour characteristics. The objective of this study was to determine the contribution of the FOXE1 po...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.13166
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:To define the symptoms, signs and treatment outcomes in a population of older patients with Cushing's disease (CD). METHODS:We analysed the clinical presentation and treatment outcomes in 45 CD patients older than 60 years, in comparison with 90 CD patients younger than 60, and a control group of 45 older p...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.13799
更新日期:2018-10-01 00:00:00
abstract::We have employed a syngeneic system utilizing thyroid cell monolayers initiated following thyroid surgery co-cultured with autologous T cells to demonstrate T cell autosensitization in patients with Graves' disease. Antigen-induced blastogenesis was monitored using 24 h [3H]thymidine uptake. Control experiments with 5...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1985.tb01077.x
更新日期:1985-02-01 00:00:00
abstract::We describe here two patients with hypothyroidism due to pituitary-hypothalamic disease in whom basal thyrotrophin (TSH) levels measured by radioimmunoassay (RIA) were elevated yet when measured by a cytochemical bioassay (CBA) were found to be normal. This finding and the absence of the normal rise of thyroid hormone...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1978.tb02174.x
更新日期:1978-05-01 00:00:00
abstract:CONTEXT:The inconclusive evidence regarding long-term safety of recombinant human growth hormone (rhGH) therapy underlines the need for long-term large-scale cohorts. OBJECTIVE:To assess long-term mortality and cancer incidence among patients treated with rhGH during childhood in Israel. DESIGN:A population-based coh...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.13131
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:Strategies to limit the final height of tall children have centred on the use of high doses of sex steroids to advance skeletal maturation. This limits therapy to the peripubertal years whereas the greatest gain in height is in the prepubertal years. Prepubertal growth is largely GH dependent and previous wor...
journal_title:Clinical endocrinology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1365-2265.1995.tb02670.x
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVE:Centripetal obesity is associated with systemic low-grade inflammation and an increased cardiovascular risk. Patients in long-term remission of Cushing's syndrome (CS) report persisting abdominal fat accumulation. However, this has previously not been adequately objectified. Therefore, we investigated the adi...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.12639
更新日期:2015-02-01 00:00:00
abstract::In recent years the techniques of molecular and cellular biology have made it possible to begin to dissect the origins and behaviour of the ACTH-secreting tumour cell. It is becoming apparent that these tumours represent undifferentiated neuroendocrine cells, and it may be that their peptide-secreting properties may h...
journal_title:Clinical endocrinology
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2265.1993.tb01765.x
更新日期:1993-08-01 00:00:00