Abstract：
:To make a diagnosis of insulinoma, one must consider it. Neuroglycopenic symptoms are the most prominent and convincing, and the combination of hypoglycemia and endogenous hyperinsulinemia are diagnostic of insulinoma. A glucose level of approximately 40 mg/dL with a concomitant insulin level of 6 microU/mL, a C-peptide level exceeding 200 pmol/L, and a negative screening for sulfonylurea must be documented to confirm the diagnosis. Although in the author's experience, preoperative ultrasound is the best and often the only test performed in the patient undergoing a first-time operation, arteriography is perhaps the single most effective localization test performed on a nationwide basis. Expertly performed intraoperative ultrasonography assists in tumor localization and in delineating important related anatomy and has become virtually routine in the author's surgical practice. Insulinomas are typically benign, single, and small, and are generally firmer than surrounding normal pancreas. Extensive surgical exposure may be required to identify and safely remove the tumor. Enucleation is preferred by the author, but distal pancreatectomy for tumors in the body or tail is an excellent method as well. Tumors in the head of the pancreas are usually enucleated, and pancreatoduodenectomy is rarely performed. The most troublesome complication is a pancreatic leakage causing pseudocyst, abscess, or fistula. Except in MEN 1 syndrome, in which a more extensive resection is usually indicated, excision of a single benign insulinoma leads to long-term cure of the disease. The successful excision of an insulinoma will profoundly affect a patient's life.
journal_name
Endocrinol Metab Clin North Amjournal_title
Endocrinology and metabolism clinics of North Americaauthors
Grant CSdoi
10.1016/s0889-8529(05)70087-6subject
Has Abstractpub_date
1999-09-01 00:00:00pages
533-54issue
3eissn
0889-8529issn
1558-4410pii
S0889-8529(05)70087-6journal_volume
28pub_type
杂志文章,评审abstract：:Congenital cryptorchidism, that is, undescended testis, is one of the most common urogenital abnormalities observed in newborn boys. In addition to the congenital form, there is also acquired form of cryptorchidism. Fertility potential of patients with cryptorchidism has been evaluated by testicular histology and volu...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2015.07.013
更新日期：2015-12-01 00:00:00
abstract：:This review has highlighted some of the experimental studies in animals and humans that have shown an important link between dietary change and atherosclerosis. This relationship was further supported by population studies showing a key role for saturated fat intake in the determination of serum cholesterol level and ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-06-01 00:00:00
abstract：:Hypertension is an important and modifiable risk factor for the macrovascular and microvascular complications of diabetes. Prior literature outlines the significance of lowering blood pressure and subsequent cardiovascular and microvascular benefits. Blood pressure targets of less than 140/90 mm Hg are recommended in ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2017.10.008
更新日期：2018-03-01 00:00:00
abstract：:All organisms must adapt to changing nutrient availability, with nutrient surplus promoting glucose metabolism and nutrient deficit promoting alternative fuels (in mammals, mainly free fatty acids). A major function of glucose-sensing neurons in the hypothalamus is to regulate blood glucose. When these neurons sense g...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2012.11.007
更新日期：2013-03-01 00:00:00
abstract：:Dyslipidemia now is recognized as a significant potential adverse event in HIV-infected patients who are receiving antiretroviral therapy. HIV-infected persons who have hyperlipidemia should be managed similarly to those without HIV infection in accordance with the National Cholesterol Education Program. Providers mus...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2008.11.009
更新日期：2009-03-01 00:00:00
abstract：:Obesity in adults is associated with excess mortality and excess risk of coronary heart disease, hypertension, hyperlipidemia, diabetes, gallbladder disease, certain cancers, and osteoarthritis. Overweight children often become overweight adults, and overweight in adulthood is a health risk. Although childhood overwei...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(03)00074-4
更新日期：2003-12-01 00:00:00
abstract：:This systematic review highlights the uncertainty about the safety and efficacy of glucocorticoid withdrawal in many chronic diseases, elucidating the need for further research in this area. The problem of glucocorticoid withdrawal seems to be good example for wide variation in physicians' approaches to weaning patien...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(02)00008-7
更新日期：2002-09-01 00:00:00
abstract：:In this article, the cellular and molecular mechanisms of diabetic complications have been reviewed. Hyperglycemia-induced mechanisms that may induce vascular dysfunction in specific sites of diabetic microvascular damage include increased polyol pathway flux, altered cellular redox state, increased formation of diacy...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70324-8
更新日期：1996-06-01 00:00:00
abstract：:This article addresses the role of insulin resistance in the pathogenesis of type 2 diabetes. The major causes of acquired insulin resistance including aging, pregnancy, lack of physical activity, and obesity are discussed briefly. The role of free fatty acids (FFAs) as a link between obesity and insulin resistance/ty...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70216-4
更新日期：2001-12-01 00:00:00
abstract：:Weight gain can be a significant barrier to the treatment of diabetes. Insulin detemir is a basal insulin analog that can help patients move safely toward glycemic targets with less weight gain. This review discusses the potential adverse effects of, and hypothesis for, weight gain resulting from intensive insulin man...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(07)80006-5
更新日期：2007-08-01 00:00:00
abstract：:With modern growth hormone (GH) replacement algorithms, children with a diagnosis of growth hormone deficiency achieve at the end of pediatric GH treatment an adult height that is on the average in the normal range. Recent experience with GH replacement in young adults with childhood-onset growth hormone deficiency, h...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2006.11.002
更新日期：2007-03-01 00:00:00
abstract：:Diuretics and beta-blockers have a strong tendency to affect serum lipids adversely, whereas the peripherally acting alpha-blocking agents consistently result in beneficial effects. Most of the other antihypertensive agents (calcium channel blockers, ACE inhibitors, angiotensin II receptor antagonists, and drugs that ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70033-5
更新日期：1998-09-01 00:00:00
abstract：:Lifestyle modification is the cornerstone treatment of type 2 diabetes in the obese patient, and is highly effective at promoting glucose regulation. However, many individuals struggle over time to maintain optimal glycemic control and/or body weight with lifestyle modification. Therefore, additional therapeutic appro...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2016.04.007
更新日期：2016-09-01 00:00:00
abstract：:Adrenocortical carcinoma (ACC) is a rare and aggressive tumor. ACC may be associated with different syndromes of hormone excess, most frequently Cushing's syndrome with or without hypersecretion of androgens. Recent data suggest that cortisol excess is a negative prognostic factor in advanced and localized ACC. Surger...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2018.02.003
更新日期：2018-06-01 00:00:00
abstract：:Diseases in other organs may impair the male reproductive system. Acute critical conditions such as severe trauma, surgery, myocardial infarction, burns, liver failure, intoxication, or starvation are associated with suppression of gonadotropin secretion and secondary hypogonadism. With chronic illnesses, a primary te...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70043-8
更新日期：1998-12-01 00:00:00
abstract：:Somatostatin receptor ligands (octreotide and lanreotide) are currently first-line pharmacotherapy for patients with acromegaly in whom surgery fails to control the disease or cannot be considered. The efficacy of a new pan somatostatin receptor ligand, pasireotide, has been investigated as a potential treatment of ac...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2014.10.004
更新日期：2015-03-01 00:00:00
abstract：:Thyroid storm represents the extreme manifestation of thyrotoxicosis as a true endocrine emergency. Although Grave's disease is the most common underlying disorder in thyroid storm, there is usually a precipitating event or condition that transform the patient into life-threatening thyrotoxicosis. Treatment of thyroid...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2006.09.008
更新日期：2006-12-01 00:00:00
abstract：:A series of investigations have emphasized the heterogeneous nature of the clinical condition known as PCOS and have delineated several factors that may contribute to the hyperandrogenemia and anovulation in this condition. Currently, it remains unclear whether intrinsic abnormalities of ovarian steroidogenesis, the e...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8529(05)70071-2
更新日期：1999-06-01 00:00:00
abstract：:Neuroendocrine tumors (NETs) are rare, slow-growing neoplasms characterized by their ability to store and secrete different peptides and neuroamines. Some of these substances cause specific clinical syndromes whereas others are not associated with specific syndromes or symptom complexes. NETs usually have episodic exp...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2010.12.010
更新日期：2011-03-01 00:00:00
abstract：:The incidence, clinical presentation, and types of thyroid cancers presenting in childhood are reviewed. The role of antecedent radiation in papillary and follicular thyroid cancers and genetics of medullary thyroid carcinoma are discussed. Unique aspects of therapy and prognosis for the pediatric patient with thyroid...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-09-01 00:00:00
abstract：:This article summarizes the clinical features and molecular pathogenesis of medullary thyroid cancer (MTC) and focuses on the current use of molecular, biochemical, and imaging disease markers as a basis for selection of appropriate therapy. Clinicians treating patients who have MTC face the following challenges: (1) ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2007.04.001
更新日期：2007-09-01 00:00:00
abstract：:This article covers considerations in the etiologies and therapy of hypercalcemia. The differential diagnosis of hypercalcemia is discussed, with particular emphasis on primary hyperparathyroidism and the hypercalcemia of malignancy. Clinical features of hypercalcemia are also discussed. Therapy of hypercalcemia is co...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-06-01 00:00:00
abstract：:Normal sleep is characterized both by reduced glucose turnover by the brain and other metabolically active tissues, and by changes in glucose tolerance. Sleep duration has decreased over the last several decades; data suggest a link between short sleep duration and type 2 diabetes. Obstructive sleep apnea (OSA) result...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2013.05.001
更新日期：2013-09-01 00:00:00
abstract：:A wide variety of medications, devices, and surgical interventions are available to patients who have ED. These range from first-line oral agents to second-line therapy with injections or vacuum devices to third-line options, such as penile prosthesis implantation. In this article, we cover available treatments for er...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2007.02.001
更新日期：2007-06-01 00:00:00
abstract：:This article links the understanding of developmental physiology of the adrenal cortex to adrenocortical tumor formation. Many molecular mechanisms that lead to formation of adrenocortical tumors have been discovered via next-generation sequencing approaches. The most frequently mutated genes in adrenocortical tumors ...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2017.01.007
更新日期：2017-06-01 00:00:00
abstract：:In this article, new avenues in the understanding of immunologic processes involved in hypothyroidism have been explored. The discovery of a family of TSH-R directed antibodies, including TSI-block, TGI, and TGI-block, has afforded perspectives on the etiology of autoimmune thyroid disorders. Thus, whereas TSI and TSI...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-06-01 00:00:00
abstract：:With apparent failure of SU drug therapy, the management of NIDDM patients becomes even more challenging. The following sequence of actions is recommended. 1. Situational dietary noncompliance (eg, a prolonged vacation or a recent period of family or occupational stress) should be treated first by renewed regular cont...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-06-01 00:00:00
abstract：:Nonneoplastic and neoplastic proliferative lesions of endocrine cells of the gastrointestinal tract are detailed. A multistep continuum from hyperplasia, dysplasia to neoplasia is identified for histamine-producing enterochromaffin-like (ECL) cells of the gastric corpus. Most gastric neuroendocrine tumors (NETs) are s...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ecl.2010.08.009
更新日期：2010-12-01 00:00:00
abstract：:Acute hyperkalemia can be a life-threatening consequence of a variety of pathologic, pharmacologic, and iatrogenic disorders. Recognition and prompt therapy often reverse the electrophysiologic complications within minutes. Therefore, physicians must have a thorough understanding of potassium homeostasis. The causes o...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-09-01 00:00:00
abstract：:Although biotechnology has provided physicians with essentially unlimited supplies of growth hormone (GH), there are currently only a few clear-cut indications for exogenous GH therapy. Data now support the use of GH in the treatment of children with GH deficiency and short girls with Turner syndrome. Tantalizing prel...
journal_title：Endocrinology and metabolism clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
