Copyright © Philip M. Parker, INSEAD. Terms of Use.
Definition: Acromegaly |
AcromegalyNoun1. Enlargement of bones of hands and feet and face; often accompanied by headache and muscle pain and emotional disturbances; caused by overproduction of growth hormone by the anterior pituitary gland (due to a tumor). Source: WordNet 1.7.1 Copyright © 2001 by Princeton University. All rights reserved. |
Etymology: Acromegaly \Ac`ro*meg"a*ly\, noun. [New Latin expression. acromegalia, from the Greek expression 'a`kron point, peak + big.]. (Websters 1913) |
Synonym: AcromegalySynonym: acromegalia (n). (additional references) |
(From Wikipedia, the free Encyclopedia)
Features that result from high level of hGH or expanding tumor include:
There is a marked variation in rates of GH production and the aggressiveness of the tumor. Some adenomas grow slowly and symptoms of GH excess are often not noticed for many years. Other adenomas grow rapidly and invade surrounding brain areas or the sinuses, which are located near the pituitary. In general, younger patients tend to have more aggressive tumors.
Most pituitary tumors arise spontaneously and are not genetically inherited. Many pituitary tumors arise from a genetic alteration in a single pituitary cell which leads to increased cell division and tumor formation. This genetic change, or mutation, is not present at birth, but is acquired during life. The mutation occurs in a gene that regulates the transmission of chemical signals within pituitary cells; it permanently switches on the signal that tells the cell to divide and secrete GH. The events within the cell that cause disordered pituitary cell growth and GH oversecretion currently are the subject of intensive research.
In a few patients, acromegaly is caused not by pituitary tumors but by tumors of the pancreas, lungs, and adrenal glands. These tumors also lead to an excess of GH, either because they produce GH themselves or, more frequently, because they produce GHRH, the hormone that stimulates the pituitary to make GH. In these patients, the excess GHRH can be measured in the blood and establishes that the cause of the acromegaly is not due to a pituitary defect. When these non-pituitary tumors are surgically removed, GH levels fall and the symptoms of acromegaly improve.
In patients with GHRH-producing, non-pituitary tumors, the pituitary still may be enlarged and may be mistaken for a tumor. Therefore, it is important that physicians carefully analyze all "pituitary tumors" removed from patients with acromegaly in order not to overlook the possibility that a tumor elsewhere in the body is causing the disorder.
The goals of treatment are to reduce GH production to normal levels, to
relieve the pressure that the growing pituitary tumor exerts on the
surrounding brain areas, to preserve normal pituitary function, and to
reverse or ameliorate the symptoms of acromegaly. Currently, treatment
options include surgical removal of the tumor, drug therapy, and
radiation therapy of the pituitary.
Surgery is a rapid and effective treatment. The surgeon reaches the
pituitary through an incision in the nose and, with special tools,
removes the tumor tissue in a procedure called transsphenoidal surgery.
This procedure promptly relieves the pressure on the surrounding brain
regions and leads to a lowering of GH levels. If the surgery is
successful, facial appearance and soft tissue swelling improve within a
few days. Surgery is most successful in patients with blood GH levels
below 40 ng/ml before the operation and with pituitary tumors no larger
than 10 mm in diameter. Success depends on the skill and experience of
the surgeon. The success rate also depends on what level of GH is
defined as a cure. The best measure of surgical success is normalization
of GH and IGF-1 levels. Ideally, GH should be less than 2 ng/ml after an
oral glucose load. A review of GH levels in 1,360 patients worldwide
immediately after surgery revealed that 60 percent had random GH levels
below 5 ng/ml. Complications of surgery may include cerebrospinal fluid
leaks, meningitis, or damage to the surrounding normal pituitary tissue,
requiring lifelong pituitary hormone replacement.
Even when surgery is successful and hormone levels return to normal,
patients must be carefully monitored for years for possible recurrence.
More commonly, hormone levels may improve, but not return completely to
normal. These patients may then require additional treatment, usually
with medications.
Two medications currently are used to treat acromegaly. These drugs
reduce both GH secretion and tumor size. Medical therapy is sometimes
used to shrink large tumors before surgery. Bromocriptine (Parlodel)
in divided doses of about 20 mg daily reduces GH secretion from some
pituitary tumors. Side effects include gastrointestinal upset, nausea,
vomiting, light-headedness when standing, and nasal congestion. These
side effects can be reduced or eliminated if medication is started at a
very low dose at bedtime, taken with food, and gradually increased to
the full therapeutic dose.
Because bromocriptine can be taken orally, it is an attractive choice as
primary drug or in combination with other treatments. However,
bromocriptine lowers GH and IGF-1 levels and reduces tumor size in less
than half of patients with acromegaly. Some patients report improvement
in their symptoms although their GH and IGF-1 levels still are elevated.
The second medication used to treat acromegaly is octreotide
(Sandostatin). Octreotide is a synthetic form of a brain hormone,
somatostatin, that stops GH production. This drug must be injected under
the skin every 8 hours for effective treatment. Most patients with
acromegaly respond to this medication. In many patients, GH levels fall
within one hour and headaches improve within minutes after the
injection. Several studies have shown that octreotide is effective for
long-term treatment. Octreotide also has been used successfully to treat
patients with acromegaly caused by non-pituitary tumors.
Because octreotide inhibits gastrointestinal and pancreatic function,
long-term use causes digestive problems such as loose stools, nausea,
and gas in one third of patients. In addition, approximately 25 percent
of patients develop gallstones, which are usually asymptomatic. In rare
cases, octreotide treatment can cause diabetes. On the other hand,
scientists have found that in some acromegaly patients who already have
diabetes, octreotide can reduce the need for insulin and improve blood
sugar control.
Radiation therapy has been used both as a primary treatment and combined
with surgery or drugs. It is usually reserved for patients who have
tumor remaining after surgery. These patients often also receive
medication to lower GH levels. Radiation therapy is given in divided
doses over four to six weeks. This treatment lowers GH levels by about
50 percent over 2 to 5 years. Patients monitored for more than 5 years
show significant further improvement. Radiation therapy causes a gradual
loss of production of other pituitary hormones with time. Loss of vision
and brain injury, which have been reported, are very rare complications
of radiation treatments.
No single treatment is effective for all patients. Treatment should be
individualized depending on patient characteristics, such as age and
tumor size. If the tumor has not yet invaded surrounding brain tissues,
removal of the pituitary adenoma by an experienced neurosurgeon is
usually the first choice. After surgery, a patient must be monitored for
a long time for increasing GH levels. If surgery does not normalize
hormone levels or a relapse occurs, a doctor will usually begin
additional drug therapy. The first choice should be bromocriptine
because it is easy to administer; octreotide is the second alternative.
With both medications, long-term therapy is necessary because their
withdrawal can lead to rising GH levels and tumor re-expansion.
Radiation therapy is generally used for patients whose tumors are not
completely removed by surgery; for patients who are not good candidates
for surgery because of other health problems; and for patients who do
not respond adequately to surgery and medication.
Largely adopted from http://www.niddk.nih.gov/health/endo/pubs/acro/acro.htmTreatment
Surgery
Drug Therapy
Radiation Therapy
Source: adapted by the editor from Wikipedia, the free encyclopedia under a copyleft GNU Free Documentation License (GFDL) from the article "Acromegaly."
| Domain | Title |
References | |
Books |
|
Source: compiled by the editor from various references; see credits. | |
| Subject | Topic | Quote |
Health | Melmed S. Acromegaly. (references) | |
Ezzat S. Living with acromegaly. (references) | ||
Molitch ME. Clinical manifestations of acromegaly. (references) | ||
Source: compiled by the editor from ICON Group International, Inc.; see credits. | ||
| "Acromegaly" is generally used as an adverb (general) -- approximately 93.33% of the time. "Acromegaly" is used about 15 times out of a sample of 100 million words spoken or written in English. Its rank is based on over 700,000 words used in the English language. Some parts-of-speech are not covered due to the samples used by the British National Corpus. (note: percents less than one-hundredth of one percent have been omitted) |
| Parts of Speech | Percent | Usage per 100 Million Words | Rank in English |
| Adverb (general) | 93.33% | 14 | 93,893 |
| Adjective (general or positive) | 6.67% | 1 | 339,140 |
| Total | 100.00% | 15 | N/A |
Source: compiled by the editor from several corpora; see credits.
| The following statistics estimate the number of searches per day across the major English-language search engines as identified by various trade publications. Hyperlinks lead to commercial use of the expression at Amazon.com. |
| Expression | Frequency per Day |
acromegaly | 170 |
acromegaly picture | 17 |
acromegaly photo | 7 |
acromegaly gigantism | 4 |
acromegaly image | 3 |
acromegaly feline | 2 |
acromegaly patient picture | 2 |
| Source: compiled by the editor from various references; see credits. | |
| Language | Translations for "acromegaly"; alternative meanings/domain in parentheses. | ||||||||||||||||||||||
Danish | tidligt indtræffende akromegali (early acromegaly). (various references) | ||||||||||||||||||||||
Dutch | vroegtijdige acromegalie (early acromegaly). (various references) | ||||||||||||||||||||||
French | acromégalie précoce (early acromegaly). (various references) | ||||||||||||||||||||||
German | Frühakromegalie (early acromegaly), bereits in der Kindheit,d.h.vor Abschluß des Längenwachstums auftretende Akromegalie,eventuell mit Minderwuchs (early acromegaly). (various references) | ||||||||||||||||||||||
Greek | πρόωρη μεγαλακρία (early acromegaly), πρόωρος μεγαλακρία (early acromegaly). (various references) | ||||||||||||||||||||||
Italian | acromegalia precoce (early acromegaly). (various references) | ||||||||||||||||||||||
Pig Latin | acromegalyay acromegalia precoce (early acromegaly). (various references) acromegalia (acromegalia). (various references) акромегалія (acromegalia). (various references) | ||||||||||||||||||||||
| Words rhyming with "acromegaly" (pronounced 'Ac`ro*meg"a*ly'): Abandonedly, Abasedly, Abashedly, Abhorrently, Abidingly, Abjectly, Abnormally, Abominably, Aboriginally, Abortively, Abruptly, Absently, Absolutely, Absorbedly, Abstinently, Abstractedly, Abstractively, Abstractly, Abstrusely, Absurdly, Abundantly, Abusively, Abysmally, Academically, Accentually, Acceptably, Acceptedly, Accessarily, Accessibly, Accessorily, Accidentally, Accommodately, Accordantly, Accordingly, Accountably, Accurately, Accusatively, Accusatorially, Accusingly, Accustomably, Accustomarily, Achromatically, Acidly, Acknowledgedly, Acoustically, Acquiescently, Acquisitively, Acridly, Acrimoniously, Acrocephaly, Acronycally, Acrostically, Actionably, Actively, Actually, Acutely, Adaptly, Additionally, Adequately, Adherently, Adhesively, Adjacently, Adjectivally, Adjectively, Adjunctively, Adjunctly, Admirably, Admittedly, Adorably, Adoringly, Adorningly, Adroitly, Adulterously, Advantageously, Adventurously, Adverbially, Adversely, Advisably, Advisedly, Aerially, Affably, Affectedly, Affectingly, Affectionately, Affectively, Affirmatively, Afflictively, Affluently, Affrightedly, Affrontedly, Affrontingly, Agamically, Agedly, Aggravatingly, Aggregately, Agilely, Agitatedly, Agonistically, Agonizingly, Agreeably, Agreeingly, Airily, Alacriously, Alarmedly, Alchemically, Alertly, Algebraically, Alimentally, Allenarly, Allodially, Allopathically, Allowably, Allowedly, Allusively, Almightily, Alphabetically, Alterably, Alternately, Alternatively, Amatorially, Amazedly, Ambidextrously, Ambiguously, Ambitiously, Amblingly, Ambrosially, Amenably, Amiably, Amicably, Amorously, Amphibiously, Amphiboly, Amphitheatrically, Amply, Anacamptically, Analogically, Analytically, Anatomically, Ancestorially, Anciently, Angelically, Angerly, Angrily, Angularly, Animally, Animatedly, Anniversarily, Annually, Anomalistically, Anomalously, Anomaly, Anonymously, Answerably, Antecedently, Anteriorly, Antichristianly, Anticly, Antiquely, Antiseptically, Antithetically, Anxiously, Apathetically, Apertly, Aphoristically, Apishly, Apocalyptically, Apocryphally, Apologetically, Apostolically, Apparently, Appearingly, Appellatively, Applicatorily, Appliedly, Appreciatingly, Apprehensively, Appropriately, Approvedly, Approximately, Appulsively, Aptly, Arbitrarily, Archetypally, Archly, Arcuately, Ardently, Arduously, Argutely, Arithmetically, Arrantly, Arrogantly, Artfully, Articularly, Articulately, Artificially, Artlessly, Artly, Asexually, Ashamedly, ASSEMBLY, Assistantly, Assumably, Assumedly, Assuredly, Astatically, Astonishedly, Astringently, Atmospherically, Atomically, Attemperly, Attently, Attributively, Audaciously, Audibly, Augustly, Auricularly, Austerely, Authentically, Authenticly, Authorly, Autogenously, Automatically, Autoptically, Auxiliarly, Avaiably, Aversely, Avidiously, Avisely, Awfully, Awkly, Axially, Axiomatically, Backwardly, Badly, Baggily, Bakingly, Baldly, Balefully, Balkingly, Balmily, Baptismally, Barbarously, Barefacedly, Barely, Barometrically, Barrenly, Barruly, Basely, Bashfully, Bastardly, Bawdily, Bayardly, Beamily, Beamingly, Beastly, Becomingly, Befittingly, Behovely, Bellicosely, Belligerently, Beneficently, Beneficially, Benignly, Beseemly, Besottingly, Bestially, Biblically, Bibulously, Biennially, Bifariously, Bigly, Bigotedly, Billy, Bindingly, Binocularly, Bitingly, Bitterly, Blackguardly, Blackly, Blamelessly, Blandly, Blankly, Blasphemously, Blatantly, Blessedly, Blightingly, Blindly, Blithely, Blolly, Bloodily, Bloomingly, Bluely, Blunderingly, Bluntly, Blushingly, Blusteringly, Boastingly, Bobfly, Boilingly, Boisterously, Boldly, Bonnily, Booly, botchedly, botcherly, Botfly, Bouncingly, Bowingly, Boyishly, Braggingly, Bragly, Brainsickly, Brambly, Bravely, Bravingly, Brawlingly, Brazenly, Breathlessly, Brenningly, Briefly, Brightly, Brilliantly, Briskly, Bristly, Brittlely, Broadly, Brokenly, Brokerly, Brutally, Brutely, Bubbly, Buffoonly, Bunglingly, Burglariously, Burly, Busily, Butcherly, Butterfly, Buzzingly, Cabalistically, Calmly, Camously, Candidly, Cankeredly, Cannibally, Cannily, Canonically, Capaciosly, Capitally, Capitularly, Captiously, Carefully, Carelessly, Caressingly, Carnally, Carousingly, Cartographically, Casually, Catchfly, Catechetically, Categorically, Catholicly, Causatively, Caustically, Causticily, Cautiously, Cavalierly, Cavally, Cavilingly, Celestially, Centennially, Centrally, Ceremonially, Ceremoniously, Certainly, Chanceably, Chandlerly, Changeably, Chaotically, Chargeably, Charily, Charitably, Chastely, Cheaply, Cheerfully, Cheerily, Cheeringly, Chely, Chemically, Chidingly, Chiefly, Childishly, Chimerically, Chirpingly, Chirurgeonly, Chivalrously, Choicely, Cholericly, Chorally, Christly. (additional references) |
Scrabble® Enable2K-Verified Anagrams | |
| Words within the letters "a-a-c-e-g-l-m-o-r-y" | |
-2 letters: claymore. | |
-3 letters: acerola, caloyer, cameral, caramel, ceramal, crayola, glomera, gomeral, mayoral. | |
-4 letters: aglare, agleam, agorae, alegar, amoral, areola, argyle, caeoma, calmer, calory, camera, clamor, clergy, coaler, comely, cormel, creamy, galore, galyac, gamely, gaoler, glamor, gleamy, laager, legacy, malgre, marcel, margay, morale, oracle, recoal. | |
-5 letters: agley, agora, alamo, alarm, alary, algae, algor, amole, areal, areca, argal, argle, argol, aroma, cager, cagey, camel, cameo, cargo, carle, carol, carom, celom, ceorl, claro, clary, clear, coala, coaly, comae, comal, comer, coral, coyer, craal, cream, cymae, cymar, cymol, early, galea, gamay, gamer, gamey, gayal, gayer, germy, glace, glare, glary, gleam, gloam, glory, golem, goral, graal, grace, grama, gyral, lacer, lacey, lager, lamer, large, largo, layer, leary, loamy, lycea, macer, macle, macro, malar, marge, marly, mayor, mealy, mercy, molar, morae, moral, moray, morel, ocrea, ogler, omega, realm, regal, regma, relay, royal, yager. | |
| Words containing the letters "a-a-c-e-g-l-m-o-r-y" | |
+5 letters: demographically, mineralogically. | |
| Source: compiled by the editor from various references; see credits. SCRABBLE® is a registered trademark. All intellectual property rights in and to the game are owned in the U.S.A and Canada by Hasbro Inc., and throughout the rest of the world by J.W. Spear & Sons Limited of Maidenhead, Berkshire, England, a subsidiary of Mattel Inc. Mattel and Spear are not affiliated with Hasbro. | |
Hexadecimal (or equivalents, 770AD-1900s) (references)41 63 72 6F 6D 65 67 61 6C 79 |
| Leonardo da Vinci (1452-1519; backwards) (references)
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| American Sign Language (origins from 1620-1817 in Italy and, especially, France) (references)
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| Semaphore (1791, in France) (references)
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| Braille (1829, in France) (references)
|
Morse Code (1836) (references).- -.-. .-. --- -- . --. .- .-.. -.--. |
| Dancing Men (Sir Arthur Conan Doyle, 1903) (references)
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Binary Code (1918-1938, probably earlier) (references)01000001 01100011 01110010 01101111 01101101 01100101 01100111 01100001 01101100 01111001 |
HTML Code (1990) (references)A c r o m e g a l y |
ISO 10646 (1991-1993) (references)0041 0063 0072 006F 006D 0065 0067 0061 006C 0079 |
| British Sign Language (Fingerspelling, BSL; 1992, British Deaf Association Dictionary of British Sign Language) (references)
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Encryption (beginner's substitution cypher): (references)35698481797173677891 |
| 1. Definition 2. Synonyms 3. Usage: Commercial 4. Quotations: Non-fiction | 5. Usage Frequency 6. Expressions: Internet 7. Translations: Modern 8. Rhymes | 9. Anagrams 10. Orthography 11. Bibliography |
Copyright © Philip M. Parker, INSEAD. Terms of Use.
