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Pituitary Ablation for Diabetic Retinopathy: Title and subTitle BreakI. Results of Hypophysectomy (A Ten-Year Evaluation) FREE

Bronson S. Ray, MD; Artemis G. Pazianos, MD; Ernest Greenberg, MD; Walter L. Peretz, MD; John M. McLean, MD
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Reprint requests to 525 E 68th St, New York 10021 (Dr. Ray).


JAMA. 1968;203(2):79-84. doi:10.1001/jama.1968.03140020007002
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During a ten-year period (1956-1966), fifty-six patients underwent surgical hypophysectomy for the treatment of progressive diabetic retinopathy. Of 47 patients who had adequate follow-up study for evaluation of the effects on the course of the retinopathy, 37 (78.7%) were benefited. After the early experience with hypophysectomy in 18 unselected patients resulting in four postoperative deaths, a more rigid selection on the basis of age and cardiovascular and renal function resulted in avoiding postoperative mortality in the next 38 patients. Hypophysectomy appears to be a desirable method of treatment in the carefully selected diabetic patient who is threatened with blindness.

REFERENCES

Houssay, B.A., and Biasotti, A.A.:  Diabetes pancreática de los perros hipofisoprivos , Rev Soc Argent Biol 6:251-269, 1930;.
Long, G.N.H., and Luken, F.D.W.:  Effects of Adrenalectomy and Hypophysectomy Upon Experimental Diabetes in Cat , J Exp Med 63:465-490 ( (April) ) 1936;.
Luft, R., et al:  Hypophysectomy in Man: Further Experiences in Severe Diabetes Mellitus , Brit Med J 2:752-756 ( (Sept) ) 1955;.
Pearson, O.H., et al:  Hypophysectomy for the Treatment of Diabetic Retinopathy , JAMA 188:116-122 ( (April 13) ) 1964;.
Falkheden, T:  Renal Function Following Hypophysectomy in Man , Acta Endocr 42:571-590 ( (April) ) 1963;.
Berkow, J.W.. et al:  A Retrospective Study of Blind Diabetic Patients , JAMA 193:867-870 ( (Sept 13) ) 1965;.
Caird. F.I., and Garrett, C.J.:  Prognosis for Vision in Diabetic Retinopathy , Diabetes 12:389-397 ( (Sept) -Oct) 1963;.
Poulson, J.E.:  Houssay Phenomenon in Man: Recovery From Retinopathy in Case of Diabetes With Simmond's Disease , Diabetes 2:7-12 ( (Jan) -Feb) 1953;.
Pearson, O.H., et al:  Diabetogenic and Hypoglycemic Effects of Human Growth Hormone . Trans Assoc Amer Physicians 73:217-226, 1960;.
Raben, M.S., and Hollenberg, C.H.:  Effect of Growth Hormone on Plasma Fatty Acids , abstracted, J Clin Invest 37:922-923, 1958;.
Goodman, H.M., and Knobil, E.:  The Effects of Fasting and of Growth Hormone Administration on Plasma Fatty Acid Concentration in Normal and Hypophysectomized Rhesus Monkeys , Endocrinology 65:451-458, 1959;.
Roth, J., et al:  Hypoglycemia: A Potent Stimulus to Secretion of Growth Hormone , Science 140:987-988 ( (May 3) ) 1963;.
Kjellberg, R.N., et al:  Hemorrhagic Diabetic Retinopathy: Treatment by Pituitary Stalk Section or by Pituitary Irradiation With Protons at the Bragg Peak , Neurol Medicochir 7:1-3 ( (Nov) ) 1965;.
Fraser, R., et al:  Pituitary Ablation for Diabetic Retinopathy , Quart J Med 34:443-462 ( (Oct) ) 1965;.
Fager, C.A.; Rees, S.B.; and Bradley, R.F.:  Surgical Ablation of the Pituitary in the Treatment of Diabetic Retinopathy , J Neurosurg 24:727-734 ( (April) ) 1966;.
Field, R.A., et al:  Hypophyseal-Stalk Section in Treatment of Advancing Diabetic Retinopathy , New Eng J Med 264:689-698 ( (April 6) ) 1961;.

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Houssay, B.A., and Biasotti, A.A.:  Diabetes pancreática de los perros hipofisoprivos , Rev Soc Argent Biol 6:251-269, 1930;.
Long, G.N.H., and Luken, F.D.W.:  Effects of Adrenalectomy and Hypophysectomy Upon Experimental Diabetes in Cat , J Exp Med 63:465-490 ( (April) ) 1936;.
Luft, R., et al:  Hypophysectomy in Man: Further Experiences in Severe Diabetes Mellitus , Brit Med J 2:752-756 ( (Sept) ) 1955;.
Pearson, O.H., et al:  Hypophysectomy for the Treatment of Diabetic Retinopathy , JAMA 188:116-122 ( (April 13) ) 1964;.
Falkheden, T:  Renal Function Following Hypophysectomy in Man , Acta Endocr 42:571-590 ( (April) ) 1963;.
Berkow, J.W.. et al:  A Retrospective Study of Blind Diabetic Patients , JAMA 193:867-870 ( (Sept 13) ) 1965;.
Caird. F.I., and Garrett, C.J.:  Prognosis for Vision in Diabetic Retinopathy , Diabetes 12:389-397 ( (Sept) -Oct) 1963;.
Poulson, J.E.:  Houssay Phenomenon in Man: Recovery From Retinopathy in Case of Diabetes With Simmond's Disease , Diabetes 2:7-12 ( (Jan) -Feb) 1953;.
Pearson, O.H., et al:  Diabetogenic and Hypoglycemic Effects of Human Growth Hormone . Trans Assoc Amer Physicians 73:217-226, 1960;.
Raben, M.S., and Hollenberg, C.H.:  Effect of Growth Hormone on Plasma Fatty Acids , abstracted, J Clin Invest 37:922-923, 1958;.
Goodman, H.M., and Knobil, E.:  The Effects of Fasting and of Growth Hormone Administration on Plasma Fatty Acid Concentration in Normal and Hypophysectomized Rhesus Monkeys , Endocrinology 65:451-458, 1959;.
Roth, J., et al:  Hypoglycemia: A Potent Stimulus to Secretion of Growth Hormone , Science 140:987-988 ( (May 3) ) 1963;.
Kjellberg, R.N., et al:  Hemorrhagic Diabetic Retinopathy: Treatment by Pituitary Stalk Section or by Pituitary Irradiation With Protons at the Bragg Peak , Neurol Medicochir 7:1-3 ( (Nov) ) 1965;.
Fraser, R., et al:  Pituitary Ablation for Diabetic Retinopathy , Quart J Med 34:443-462 ( (Oct) ) 1965;.
Fager, C.A.; Rees, S.B.; and Bradley, R.F.:  Surgical Ablation of the Pituitary in the Treatment of Diabetic Retinopathy , J Neurosurg 24:727-734 ( (April) ) 1966;.
Field, R.A., et al:  Hypophyseal-Stalk Section in Treatment of Advancing Diabetic Retinopathy , New Eng J Med 264:689-698 ( (April 6) ) 1961;.
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