Growth Disorders And Acromegaly

Gigantism and Acromegaly brings together pituitary experts, taking readers from bench research, to genetic analysis, clinical analysis, and new therapeutic approaches. This book serves as a reference for growth hormone over-secretion and its diagnosis and treatment for endocrinologists, pediatricians, internists, and neurosurgeons, and for geneticists. Pharmaceutical companies may use it as a reference for drug development and research. Students, residents and fellows in medicine and endocrinology and genetics will also find it valuable as it provides a single up-to-date review of the molecular biology of gigantism and acromegaly as well as recommended approaches to evaluation and management. Acromegaly is a rare pituitary disorder that slowly changes its adult victim’s appearance over time: larger hands and feet, bigger jaw, forehead, nose, and lips. Generally, a benign pituitary tumor is the cause and symptoms of acromegaly can vary from patient to patient, making a diagnosis difficult and prolonging suffering for years. Early detection is key in the management of acromegaly as the pathologic effects of increased growth hormone (GH) production are progressive and can be life-threatening as the result of associated cardiovascular, cerebrovascular, and respiratory disorders and malignancies. Accessible, up-to-date overview of the characteristics, state-of-the-art diagnostic procedures, and management of acromegaly and gigantism Provides a unique compendium of endocrinology, genetics, clinical diagnosis and therapeutics Contains contributions from internationally known experts who have treated patients with acromegaly and gigantism

The first two years of life represent a transition period when growth changes from predominantly growth hormone (GH) independent to GH dependent. This book, Growth Disorders and Acromegaly, includes two parts. The first part consists of five chapters that illustrate the nature, causes, types, signs, and symptoms of GH deficiency (GHD) and fetal growth restriction. It describes the impact of GH and its deficiency on different biological systems in children and adults. Also, this book assesses the role of human GH (hGH) and insulin-growth factor1 (IGF-1) gene families during pregnancy. This book offers several novel insights of GH in male reproductive health. The second part consists of three chapters that show the pegvisomant, colorectal neoplasms in acromegaly, epidemiology and underlying mechanisms, and the surgical managements of acromegaly. Finally, this book will be of interest to scientists, embryologists, neuroendocrinologists, neurotoxicologists, and physicians who follow recent developments in the field of growth disorders.

Currently, surgical management provides the definitive treatment of choice for most pituitary adenomas, craniopharyngiomas and meningiomas of the sellar region. The elegant minimally invasive transnasal endoscopic approach to the sella turcica and the anterior skull base has added a new dimension of versatility to pituitary surgery and can be adapted to many lesions in the region. In this multi-author book with numerous color illustrations the main aspects of the endonasal endoscopic approach to the skull base are presented, starting with a clear description of the endoscopic anatomy, the panoramic view afforded by the endoscope and the development of effective instruments and adjuncts. After the diagnostic studies, the strictly surgical features are considered in detail. The standard technique is described and particular aspects are treated, including the new extended approaches to the cavernous sinus, spheno-ethmoid planum and clival regions.

It has been known for over 40 years that GH-deficient-children benefit from replacement with the hormone. But GH, essential for longitudinal growth, also plays a role after completion of final height. With the introduction of biosynthetic human GH 20 years ago, the use of GH was no longer restricted to severe growth retardation in hypopituitary children. This book will take the reader behind the myths of GH and into the real world of clinical endocrinology. The contributions stem from recognized clinicians and scientists who have been working in the field for decades. The contents encompass traditional end points of GH therapy such as body composition, bone biology and physical performance. Attention is also devoted to diagnostic aspects and side effects. Additional features range from clinical epidemiology to quality of life, and novel areas such as the impact of traumatic brain injury on pituitary function are also covered. The present volume of Frontiers of Hormone Research is essential reading for health care professionals interested in clinical endocrinology and GH.

The molecular era ushered in the cloning of the growth hormone (GH) gene and the production of unlimited amounts of GH through recombinant technology. The continuing momentum of research from basic science to clinical evaluation has brought unprecedented advances to the understanding of GH biology for the clinical endocrinologist. Growth Hormone Related Diseases and Therapy: A Molecular and Physiological Perspective for the Clinician distills all the new information of relevance to the endocrinologist over the last 20 years by offering five sections: physiology, molecular genetics, GH deficiency, acromegaly and pharmacotherapy. The first section on physiology focuses on GH action. A review on the structure and function of the GH receptor is followed by a perspective on the regulatory role of ghrelin on GH secretion. The second section on genetics covers pituitary function and adenomas, including new and fascinating information on familial pituitary adenomas, their genotype and phenotype. The adult GH deficiency section spans the epidemiology and diagnosis of GH deficiency with a strong reminder for the clinician that the transition period represents a critical time of somatic maturation, which continues for years after cessation of liner growth. The section on acromegaly focuses on management, giving practical guides to the value of GH and IGF-1 measurements, the place of somatostatin analogues and of radiotherapy while reminding the reader as to why evaluating quality of life is an important part of management. Finally, the section on GH pharmacology takes the reader through innovative developments of long-acting GH formulations with some products on the threshold of clinical use. This section provides a balanced evidence based review of the effects of GH supplementation in aging and in sports where recent data indicates an enhancing effect on a selective aspect of performance. Growth Hormone Related Diseases and Therapy: A Molecular and Physiological Perspective for the Clinician integrates a wealth of information and will prove an invaluable reference for pediatric endocrinologists, adult endocrinologists, endocrine scientists and internists interested in the human biology of GH.

The manuscripts in this volume were contributed by the speakers invited to the Acromegaly Centennial Symposium held in San Francisco, California in July 1986. The meeting was organized to commemorate the description of acromegaly by the French physician Pierre Marie, in 1886. The members of the Scientific Committee spent many hours assisting us in ensuring an outstanding meeting. The support of Serono Symposia, USA in all phases of the planning and execution of the meeting was sincerely appreciated and was highly professional. Special recognition roust be extended to Professor Roger Guillemin of the Salk Institute, whosp interest in medical history led him to devote a great deal of time and personal expense in obtaining information about the life of Pierre Marie. Dr. GuilIemin's presentation on the life and times of Marie was an extraordinary overview of the cultural, social, and scientific backgrounds in which Marie came to describe the disease, acromegaly. Dr. Guillemin' s findings, which were presented at the main banquet in a splendid audiovisual presentation, were clearly the highlight of the meeting and will long be remembered by the attendees. We were also honored by the presence of Dr. Martine Pierre Marie Granier, the great-granddaughter of Pierre Harie. In her address at the banquet, Dr. Granier provided several delightful and intimate vignettes concerning Pierre Marie, using old family records and photographs. The Scientific Committee wishes to extend its gratitude to Dr. Granier for adding immeasurably to the historical atmosphere of the meeting.

This groundbreaking study of acromegaly, a rare and debilitating disease caused by overproduction of growth hormone, offers a comprehensive overview of the latest research on diagnosis, treatment, and management of symptoms. With case studies, diagrams, and practical advice, the book is a crucial resource for patients, caregivers, and medical professionals. This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant.