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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The methodical and instrumental development in urology has led to the fact that nowadays only in 25% of the patients with prostatic adenoma an "open" adenomectoy of the prostate is performed. The cryosurgery is exclusively reserved to high risk patients who at present, however, increasingly also undergo a transurethral resection. The advantages of the transurethral electroresection compared with the cryosurgery of the prostatic adenoma are discussed and confirmed with the help of the own cases. Advanced cerebral sclerosis means contraindication for every operative procedure in adenoma. Nowadays in the high risk patient a transurethral resection should be performed by the best and most experienced urologist.
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PMID:[Value of cryogenic surgery in the therapeutic plan for prostatic adenoma]. 6 71

82% of the male patients with healthy urogenital tract showed an isoelectric line in the simultaneous EMG-derivation of the sphincter of the bladder under conditions of rest; in 18% of the males a moderate activity was present. In voluntary innervation at once an intensive electric activity of a spindle-shaped discontinuous pattern of the action potential developed in 76% of the patients. In the pressing trial in 83% of the cases a slight to moderately strong activity appeared. In contrast to the examined patients with healthy outlet of the vesicle the patients in whom an adenoma of the prostate gland or a carcinoma of the prostate gland, respectively, was present exhibited deviations from the normal pattern of the action potential, in which cases carriers of adenoma and carcinoma differed. Whether and to what extent the electromyography on the m. sphincter vesicae allows the possibility of the differentiation between adenoma of the prostate gland and carcinoma of the prostate gland in the early clinical stage shall be reserved for further examination.
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PMID:[Use of electromyography of the bladder sphincter for the differentiation of prostate adenoma and prostate carcinoma]. 8 50

Seventy tests of stimulation with hypothalamic thyreotrophic hormone liberation factor, and 35 bromocriptine inhibition tests were carried out on a routine basis in patients with latent or frank hyperprolactinaemia. Pathological hyperprolactinaemia does not have a single clinical pattern: frank, it takes the form either of an exteriorised pituitary adenoma (14 cases), or of an amenorrhoea-galactorrhoea syndrome with or without micro-adenoma (12 cases); latent, it takes the form either of isolated amenorrhoea (17 cases) or of dysovulatory sterility (16 cases). Amongst the dynamic tests available, it is worthwhile to make a choice, and in the case of frank hyperprolactinaemia, the authors propose use of the bromocriptine inhibition test in the first instance. The TRH test is reserved for verification of the results of neurosurgery. As far as latent hyperprolactinaemia is concerned, it may be identify only by the TRH test, with the resultant possibility of specific treatment.
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PMID:[Diagnosis of hyperprolactinaemias: respective value of response to THR and to bromocriptine (author's transl)]. 9 29

82% of the male patients with healthy urogenital tract showed an isoelectric line in the stimulataneous EMG-derivation of the sphincter of the bladder under conditions of rest; in 18% of the males a moderate activity was present. In voluntary innervation at once an intensive electric activity of a spinle-shaped discontinuous pattern of the action potential developed in 76% of the patients. In the pressing trial in 83% of the cases a slight to moderately strong activity appeared. In contrast to the examined patients with healthy outlet of the vesicle the patients in whom an adenoma of the prostate gland or a carcinoma of the prostate gland, respectively, was present exhibited deviations from the normal pattern of the action potential, in which cases carriers of adenoma and carcinoma differed. Whether and to what extent the electromyography on the m. sphincter vesicae allows the possibility of the differentiation between adenoma of the prostate gland and carcinomaof the prostate gland in the early clinical stage shall be reserved for further examination.
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PMID:[Evaluation of hydroxyproline excretion in the urine (UHP) in prostate carcinoma]. 46 72

We have reviewed our experience in the radiographic and ophthalmologic evaluation of 1001 patients with symptoms suggesting the presence of a pituitary, prolactin-secreting adenoma. Twenty-seven patients had abnormal or suspicious radiographic examination of the sella turcica. Twenty-two of those had hyperprolactinemia. In only one instance was an abnormality noted on polytomography that was not seen on a conventional four-view study of the skull. Based on these findings, a four-view plain conventional radiographic assessment of the skull suffices as a screening procedure in patients with amenorrhea, galactorrhea, or both. Thin section tomography should be reserved to more thoroughly evaluate those patients with elevated serum prolactin concentrations and/or abnormal conventional radiographs. We found visual field testing to be of little value as an initial screening procedure in these patients.
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PMID:Evaluation of the pituitary. Patients with suspected prolactin-producing tumors. 56 9

Recurrent hyperparathyroidism occurred in 11 of 295 patients from 10 months to 34 years after an initially successful operation. Seven patients with recurrent hyperparathyroidism had either multiple endocrine adenomatosis type I (MEA) or familial hyperparathyroidism (FHP), one patient had parathyroid cancer, and two patients had renal failure at the time of recurrence. Four of these patients ahd their initial operations elsewhere. Recurrence developed in 33% of patients with MEA or FHP but in only 0.4% of 242 patients without MEA or FHP. The presence of MEA or FHP was known before parathyroid exploration in 18 (86%) of the 21 patients. In patients with MEA or FHP, subtotal parathyroidectomy should be performed if there is more than one gland involved. Other patients should be treated by selective removal of an adenoma because recurrence is rare. Subtotal parathyroidectomy should be reserved for patients with diffuse hyperplasia.
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PMID:Recurrent hyperparathyroidism. 101 86

The results of adrenal scintiscans, venograms and venous aldosterone levels are compared with the histologic findings in 33 patients submitted to operations for primary aldosteronism. Standard and suppression scintiscans were performed 2-14 days following intravenous administration of 2mCi of 131I-19-iodocholesterol. The adrenal lesions were histologically classified into four categories: 25 patients had adenomas, 6 had macronodular hyperplasia, 1 had microscopic hyperplasia and 1 had an adenocarcinoma. Asymmetrical uptake between the two adrenals seen on standard scintiscans did not differentiate between a tumor or asymmetrical hyperplasia, unless the tumor was greater than 2 cm in diameter. During suppression scintiscans, unilateral uptake visible within five days of tracer injection was consistent with adenoma. Patients with nodular hyperplasia demonstrated early uptake in both adrenal glands during suppression scintiscans, while the patient with microscopic hyperplasia did not. The type of adrenal lesion was correctly identified in 20/26 (77%) of patients by suppression scintiscans; 21/28 (75% of patients by venograms and 12/16 (75%) of patients who had adrenal venous aldosterone measurements attempted. The majority of surgically correctible lesions could be identified on suppression adrenal scintiscans. Adrenal vein catheterization can be reserved for those patients in whom the results of suppression scintiscans are inconsistent with the clinical degree of aldosteronism.
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PMID:Adrenal imaging with 131I-19-iodocholesterol in the diagnostic evaluation of patients with aldosteronism. 124 93

Persistent primary hyperparathyroidism due to mediastinal parathyroid adenoma was effectively treated by either angiographic ablation or median sternotomy in this study of 49 patients managed at the National Institutes of Health since 1977. Each patient presented here with symptomatic persistent primary hyperparathyroidism after failed initial surgical procedures done at other institutions. Each patient underwent extensive parathyroid localization procedures, including selective angiography, and most had a parathyroid adenoma localized to the mediastinum. Angiographic ablation, the deliberate injection of large doses of contrast material into the artery that selectively perfuses the adenoma, was initially successful in 22 of 30 procedures (73%) in 27 patients. Long-term control of persistent primary hyperparathyroidism was achieved in 17 of 27 patients (63%) by angiographic ablation. Each unsuccessful ablation could be easily salvaged by surgical resection. Surgical resection of the parathyroid adenoma by median sternotomy achieved immediate success in 24 of 24 procedures (p2 less than 0.02 versus ablation), and long-term cure in 23 of 23 evaluable patients (p2 less than 0.001 versus ablation). However, ablation did have benefits for the patients in whom it was successfully performed. It was associated with a significantly shorter hospital stay (median, 6 days versus 9 days for sternotomy, p2 less than 0.003), much less pain, and easier recuperation. Complications of each procedure were transient and similar in both groups. Operative resection is the most effective single means to eradicate mediastinal parathyroid adenoma; however, angiographic ablation can provide similar long-term control of hyperparathyroidism in 63% of patients with less pain and shorter convalescence than that seen in patients after median sternotomy. Our results suggest that angiographic ablation should be attempted as the initial procedure for patients with persistent primary hyperparathyroidism caused by an angiographically identified mediastinal parathyroid adenoma. Operation can be reserved for those who fail ablation.
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PMID:Results of a multidisciplinary strategy for management of mediastinal parathyroid adenoma as a cause of persistent primary hyperparathyroidism. 154 6

The current concepts of differential diagnosis and therapy of Cushing's disease are reviewed. Our own results in a recent series of 103 patients are compared with patients treated by transsphenoidal microsurgery until 1986. In 97% as compared to 91% of prior series a discrete adenoma was found and selective adenomectomy led to remission in about 90%. The endocrine tests alone proved to be highly reliable to discriminate pituitary-dependent Cushing's disease from other forms of Cushing's syndrome. All our 3 patients without pituitary adenoma had some atypical endocrine tests. From these findings and results of other published series invasive investigations as inferior petrosal venous sampling may be reserved for equivocal cases. Magnetic resonance imaging now reveals two thirds of the micro-adenomas and provides the surgeon with excellent anatomical pictures. Rapid intraoperative measurement of peripituitary venous ACTH gradients may help to identify occult adenomas. In spite of different modes of therapy as pharmacological suppression of the adrenals and more sophisticated forms of radiotherapy, transsphenoidal microadenomectomy in experienced hands remains the most effective and the only immediately definite treatment of Cushing's disease.
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PMID:Transnasal microsurgery of Cushing's disease 1990. Overview including personal experiences with 256 patients. 165 10

Since colorectal adenomas are very probably the precursors of colorectal cancer, their detection and removal should result in a decrease in the incidence and mortality from colorectal cancer. Individuals who harbour an adenoma have a 30-50% probability of having additional adenomas at that time, and a 30% probability of having additional adenomas later. Adenomas are prevalent in countries where colorectal cancer is prevalent, about two-thirds of them being tubular and the rest tubulovillous or villous. The initial management of patients with an adenoma consists in searching by colonoscopy the entire colon and removing all additional polyps. Surgical resection is required wherever there is invasive cancer with adverse histological factors. Follow-up in most patients can be after 2-4 years, earlier follow-up being reserved for patients with numerous polyps or with a polyp that had been removed piecemeal. The results of ongoing trials should provide firm guidelines for follow-up and could also be used in mathematical modelling to examine alternative strategies and to help understand the evolving patterns of appearance of new polyps. Finally, a deeper understanding of the biology and inherited and acquired genetics will help identify individuals at risk for adenomas initially and at follow-up. Nutritional factors may also provide a basis for prevention of adenomas in high-risk countries. Many of these issues are being addressed in current research.
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PMID:Risk and surveillance of individuals with colorectal polyps. Who Collaborating Centre for the Prevention of Colorectal Cancer. 207 16


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