The Effect of Pituitary-Stalk Section on Thyroid Function and Gonadotropic-Hormone Excretion in Women with Mammary Carcinoma

Dugger, Gordon S.; Wyk, Judson J. Van; Newsome, James F.

doi:10.3171/jns.1962.19.7.0589

Cited by 16 publications

(5 citation statements)

References 13 publications

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“…It might be expected, therefore, that stalk section, which deprives the cells of all hypothalamic stimuli, while causing the one type of cell to cease secreting its hormones, would allow the other type to increase its rate of secretion. In support of this suggestion there is some evidence that those acidophilic cells which secrete lactogenic hormones increase their activity after stalk section, for Dugger et al (1958) and Ehni and Eckles (1959) (Cowie et al, 1963). In general, however, the effects of the operation on the various tissues of the body are remarkably similar in the different species.…”

Section: Other Considerationsmentioning

confidence: 86%

“…Hitherto, hypophysectomy, performed either intracranially or transnasally, has been the more widely used of the two operations (Luft andOlivecrona, 1953, 1957;Atkins et al, 1960;Falconer, 1963;Bateman, 1963), but there are a number of reports of beneficial results obtained after stalk section in cases of mammary carcinoma (Ehni and Eckles, 1959;Dugger et al, 1962), diabetic retinopathy (Field et al, 1962), and exophthalmos (McCullagh et al, 1957). It would therefore be of value if a controlled trial were undertaken to determine to what extent the effects of stalk section approximate to those of hypophysectomy and to discover, for example, whether the response of mammary carcinoma to the two operations is sufficiently comparable to encourage the greater use of stalk section as an alternative therapeutic procedure.…”

Section: Other Considerationsmentioning

confidence: 99%

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Some Effects of Transection of the Pituitary Stalk

Adams¹,

Daniel²,

Prichard³

1964

BMJ

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In the first place, the vulnerability of the physician has been the lack of exact knowledge concerning the nature and natural history of disease, and the extent to which the application of therapeutic measures can alter it in the patient's interests. This knowledge is being won. It is being won by advances in chemistry, physics, and biology; by our understanding of the interaction of chemical substances in living and non-living systems; by our understanding of the transmission of information to cells ; by the way in which this can be modified as these cells differentiate; by the way in which this transmission of information can be altered; by the way in which changes in environment, chemical, physical, and microbial, can affect these processes ; by our identifying and defining the various chemical processes that constitute the activity of the cells in the body; and by our understanding of the way in which the activity of the tissues and organs of the body are correlated and co-ordinated in the life of the whole organism. In all these processes the phenomena that can best be seen in the sick contribute to understanding. Moreover, our understanding of disease and our ability to prevent and cure it become daily more extensive.As we look at this whole field, the most challenging, and the least conquered and understood, is that set of phenomena which we associate with the mind. Here is the great challenge to the physician and to the scientist. To the physician because it is particularly in this respect that one individual differs from another, and because the meeting and mutual understanding of minds constitute the essence of the doctor-patient relationship;to the scientist because here is presented an elementary problem of scientific method-namely, that of classifying the facts in such a way that allows numerical values to be assigned to them, and formulation of these in terms of a simple hypothesis. This challenge has been offered before to the scientific method, and I cannot believe that it will, this time, go unanswered.

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Section: Other Considerationsmentioning

confidence: 86%

Section: Other Considerationsmentioning

confidence: 99%

Some Effects of Transection of the Pituitary Stalk

Adams¹,

Daniel²,

Prichard³

1964

BMJ

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“…It might be expected that isolation from the hypothalamus would depress all anterior pituitary function, but there is some evidence that in these circumstances the output of lactogenic hormone may actually be increased. For example, Ehni and Eckles (1959) and Dugger, Van Wyk, and Newsome (1962) found that milk might be secreted by nonpregnant women after stalk section.…”

Section: Discussionmentioning

confidence: 99%

Transection of the pituitary stalk in man: anatomical changes in the pituitary glands of 21 patients

Adams¹,

Daniel²,

Prichard³

1966

Journal of Neurology, Neurosurgery & Psychiatry

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In recent years hypophysectomy (Luft and Olivecrona, 1953) and adrenalectomy (which is nearly always combined with ovariectomy) have been used as methods of treating cases of advanced cancer of the breast (Atkins, Falconer, Hayward, MacLean, and Schurr, 1966) and the results of comparative trials suggest that hypophysectomy is slightly the more effective of these two operations (Atkins, Falconer, Hayward, MacLean, Schurr, and Armitage, 1960). As an alternative to hypophysectomy neurosurgeons have sometimes used the operation of pituitary stalk section for relieving such cases and also for treating patients with cancer of the prostate (see Schurr, 1966). In addition pituitary stalk section has been used for patients with advancing diabetic retinopathy (Field, Schepens, Sweet, and Appels, 1962;Cullen, Harris, Munro, and Duncan, 1965;Fager, Rees, and Bradley, 1966). In assessing the merits of this particular operation as a means of depressing pituitary function, it is important to know the extent to which the structure of the gland is altered and its functions impaired. There are few reports in the literature on the effects of stalk section on the human pituitary (Dandy and Goetsch, 1911;Russell, 1956; Daniel, Prichard, and Schurr, 1958;Le Beau and Foncin, 1960;Nicolaidis, 1962; Adams, Daniel, Prichard, and Schurr, 1963), although much information has now been obtained on the effects of the operation on several species of animal (Harris, 1950;Barrnett and Greep, 1951;Greep and Barrnett, 1951;Benoit and Assenmacher, 1953;Campbell and Harris, 1957;Daniel and Prichard, 1958;Holmes, 1961Holmes, , 1962 Laszlo, David, and Kovics, 1962; Adams, Daniel, and Prichard, 1963a, b, c; 1964a, b, c; 1966a, b; Jacobsohn, 1966). We have now had the opportunity of examining the glands of 21 human patients surviving for various periods of time after stalk section and in this paper we report our findings in these pituitary glands. MATERIAL AND METHODSThe pituitary glands from 21 patients were available for study. In 20 cases the operation was undertaken for the relief of carcinoma of the breast or prostate but in one (case 4 in Table I) the indication was a rapidly advancing diabetic retinopathy. Fourteen of the patients were females and seven were males. The age range was from 36 to 67 years. The pituitary stalk was approached by way of a frontal craniotomy, and in some cases the pituitary stalk was clipped before it was transected at as low a level as was technically possible. In the majority of cases an inert and impermeable barrier or 'plate' (composed usually of dental acrylic resin or tantalum) was placed between the cut ends of the stalk to prevent the re-establishment of the hypothalamo-hypophysial portal circulation.The period of survival after stalk section ranged from 30 hours to 11 months (see Table I). The necropsies on the majority of the cases were undertaken by P.M.D.or J.H.A. but in a few cases the pituitary glands were sent to us, and in these less detailed information is available. At necropsy care was taken to e...

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“…(3) Introduction of radioactive isotopes (a) Transcranial (Rasmussen et al 1953 -90Y; Evans et al 1959 (Bauer 1956 -59"Au) (4) High-energy proton beam (cyclotron) (Tobias et al 1958) et al 1962), w-hile the divided stalk may even reunite to the surviving part of the gland past the edge of the obturator (Le Beau & Foncin 1960, Dugger et al 1962). As surgeons we all feel that, if surgical ablation of an organ is practicable, this is a more certain way to destroy its function than to irradiate it.…”

Section: Mr Murraymentioning

confidence: 99%

Hypophysectomy

Falconer

1963

Proceedings of the Royal Society of Medicine

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The Effect of Pituitary-Stalk Section on Thyroid Function and Gonadotropic-Hormone Excretion in Women with Mammary Carcinoma

Cited by 16 publications

References 13 publications

Some Effects of Transection of the Pituitary Stalk

Some Effects of Transection of the Pituitary Stalk

Transection of the pituitary stalk in man: anatomical changes in the pituitary glands of 21 patients

Hypophysectomy

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