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MEDICAL MANAGEMENT OF ADRENALECTOMY AND HYPOPHYSECTOMY

MEDICAL MANAGEMENT OF ADRENALECTOMY AND HYPOPHYSECTOMY Abstract Bilateral adrenalectomy or hypophysectomy will induce objective remissions in some patients with metastatic breast cancer. It is the purpose of this report to detail our methods for managing patients subjected to these procedures. These methods are based on clinical experience and physiological studies of over 200 patients submitted to either adrenalectomy or hypophysectomy. We shall attempt to describe the general medical management for both procedures and to suggest specific methods for handling the problems peculiar to patients with metastatic disease. Huggins and Scott,1 in 1945, reported the initial experiences with bilateral adrenalectomy in four patients with advanced prostatic cancer. With the use of desoxycorticosterone and adrenal cortical extract they were unable to maintain life in their patients, although one patient survived almost four months. Subsequently, Green and co-workers2 successfully managed adrenalectomy in a diabetic patient with the use of large amounts of adrenal cortical extracts. With the availability References 1. This is given for the first week after operation at this level or 0.1 gm. q. 6 h. P. O. on the advice of our neurosurgical colleagues. 2. Huggins, C., and Scott, W. W.: Bilateral Adrenalectomy in Prostatic Cancer: Clinical Features and Urinary Excretion of 17-Ketosteroids and Estrogen , Ann. Surg. 122:1031, 1945.Crossref 3. Green, D. M.; Nelson, J. N.; Dodds, G. A., and Smalley, R. E.: Bilateral Adrenalectomy in Malignant Hypertension and Diabetes , J. A. M. A. 144:439, 1950.Crossref 4. Bergenstal, D. M., and Dao, T. L. Y.: Management of Addison's Disease in Adrenalectomized Patients , Bull. New York Acad. Med. 29:295, 1953. 5. Hollander, V. P.; West, C. D.; Whitmore, W. F., Jr.; Randall, H. T., and Pearson, O. H.: Physiological Effects of Bilateral Adrenalectomy in Man , Cancer 5:1019, 1952.Crossref 6. Kupperman, H. S., and Epstein, J. A.: Oral Therapy of Adrenal Cortical Hypo function: Use of Combined Fludrocortisone Acetate and Hydrocortisone , J. A. M. A. 159:1447, 1955.Crossref 7. Maclean, J. P.; Li, M. C.; Lipsett, M. B.; Ray, B., and Pearson, O. H.: The Physiological Role of Adrenal Salt Hormone (Aldosterone) in Man , J. Clin. Invest. 34:951, 1955. 8. Li, M. C.; Rall, J. E.; Maclean, J. P.; Lipsett, M. B.; Ray, B. S., and Pearson, O. H.: Thyroid Function Following Hypophysectomy in Man , J. Clin. Endocrinol. 15:1228, 1955.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Internal Medicine American Medical Association

MEDICAL MANAGEMENT OF ADRENALECTOMY AND HYPOPHYSECTOMY

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References (9)

Publisher
American Medical Association
Copyright
Copyright © 1956 American Medical Association. All Rights Reserved.
ISSN
0888-2479
DOI
10.1001/archinte.1956.00250290094011
Publisher site
See Article on Publisher Site

Abstract

Abstract Bilateral adrenalectomy or hypophysectomy will induce objective remissions in some patients with metastatic breast cancer. It is the purpose of this report to detail our methods for managing patients subjected to these procedures. These methods are based on clinical experience and physiological studies of over 200 patients submitted to either adrenalectomy or hypophysectomy. We shall attempt to describe the general medical management for both procedures and to suggest specific methods for handling the problems peculiar to patients with metastatic disease. Huggins and Scott,1 in 1945, reported the initial experiences with bilateral adrenalectomy in four patients with advanced prostatic cancer. With the use of desoxycorticosterone and adrenal cortical extract they were unable to maintain life in their patients, although one patient survived almost four months. Subsequently, Green and co-workers2 successfully managed adrenalectomy in a diabetic patient with the use of large amounts of adrenal cortical extracts. With the availability References 1. This is given for the first week after operation at this level or 0.1 gm. q. 6 h. P. O. on the advice of our neurosurgical colleagues. 2. Huggins, C., and Scott, W. W.: Bilateral Adrenalectomy in Prostatic Cancer: Clinical Features and Urinary Excretion of 17-Ketosteroids and Estrogen , Ann. Surg. 122:1031, 1945.Crossref 3. Green, D. M.; Nelson, J. N.; Dodds, G. A., and Smalley, R. E.: Bilateral Adrenalectomy in Malignant Hypertension and Diabetes , J. A. M. A. 144:439, 1950.Crossref 4. Bergenstal, D. M., and Dao, T. L. Y.: Management of Addison's Disease in Adrenalectomized Patients , Bull. New York Acad. Med. 29:295, 1953. 5. Hollander, V. P.; West, C. D.; Whitmore, W. F., Jr.; Randall, H. T., and Pearson, O. H.: Physiological Effects of Bilateral Adrenalectomy in Man , Cancer 5:1019, 1952.Crossref 6. Kupperman, H. S., and Epstein, J. A.: Oral Therapy of Adrenal Cortical Hypo function: Use of Combined Fludrocortisone Acetate and Hydrocortisone , J. A. M. A. 159:1447, 1955.Crossref 7. Maclean, J. P.; Li, M. C.; Lipsett, M. B.; Ray, B., and Pearson, O. H.: The Physiological Role of Adrenal Salt Hormone (Aldosterone) in Man , J. Clin. Invest. 34:951, 1955. 8. Li, M. C.; Rall, J. E.; Maclean, J. P.; Lipsett, M. B.; Ray, B. S., and Pearson, O. H.: Thyroid Function Following Hypophysectomy in Man , J. Clin. Endocrinol. 15:1228, 1955.Crossref

Journal

A.M.A. Archives of Internal MedicineAmerican Medical Association

Published: Nov 1, 1956

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