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Gigantism or giantism, (from Greek gigas, gigantos "giant") is a condition characterized by excessive height growth. As a medical term, gigantism is rarely used except to refer to the rare condition of pituitary gigantism due to prepubertal growth hormone excess. There is no precise definition of the degree of tallness that qualifies a person to be termed a "giant." The term has been typically applied to those whose height is not just in the upper 1% of the population but several standard deviations above mean for persons of the same sex, age, and ethnic ancestry. more...

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Guillain-Barré syndrome

Typical adult heights of Americans and Europeans to whom the term might be applied are 210 - 240 cm (7 - 8 feet) though it may be possible for a person to grow up to 270 cm (9 feet) or taller. The term is rarely applied to basketball players and those whose heights appear to be the healthy result of normal genetics and nutrition.

Pituitary gigantism

Pituitary gigantism due to growth hormone excess is the single condition that accounts for nearly all cases of pathologic extreme height. The excess growth hormone usually results from oversecretion by a group of somatotrope cells of the anterior pituitary gland (termed a "somatotrope adenoma"). These cells do not respond to normal controls of growth or function. They grow very slowly, so that for many years the only effects of such an adenoma are the effects of excessive growth hormone.

The primary effect of growth hormone excess in childhood is excessive growth, but the tallness is accompanied by a characteristic physique recognizable to an endocrinologist. The typical physique involves heavy, thick bones, with large hands and feet and a heavy jaw. Once puberty is complete and adult height is achieved, continued thickening of the skin and growth of the jaw results in a combination of features referred to as acromegaly. Over decades, such an adenoma may reach a large enough size (2 cm or more in diameter) to cause headaches, impair vision, or damage other pituitary functions. Many years of growth-hormone excess can cause other problems as well.

If pituitary gigantism or acromegaly is suspected by a physician, the simplest diagnostic screening test is measurement of insulin-growth factor 1 in the blood. This is usually quite elevated but levels must be interpreted in relation to age and pubertal status. Additional confirmatory testing may include magnetic resonance imaging (MRI) of the pituitary to look for a visible adenoma, and suppressibility of growth hormone levels by glucose. Treatment depends on the size of the adenoma and may involve removal by a neurosurgeon, drugs such as octreotide or bromocriptine, or radiation. Treatment is discussed in more detail in the acromegaly article.

Childhood pituitary gigantism is a rare condition, and those affected are often unusual enough to attain a degree of celebrity status (e.g., André the Giant) Acromegaly is the term used for the condition of growth hormone excess when it occurs in adults. Acromegaly is a far more common disease in adults than pituitary gigantism is in children.

Other conditions of overgrowth or excessive tallness in childhood

Children who are excessively tall are often referred to pediatric endocrinologists for evaluation. The majority of children who seem excessively tall or large to their parents usually have a combination of simple familial tallness and childhood obesity.


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A red's white elephant: in Ceausescu's palace, gigantism and heartache
From National Review, 6/6/05 by Anthony Daniels

THERE is no building in the world more philosophically instructive than the Palatul Parlamentului--formerly the Casa Poporului--in Bucharest. It is worth going all the way to Romania just to see it, for it has layers of meaning that provide an almost infinite scope for reflection. No one who has not seen it can grasp the full potential of human megalomania.

It is 15 years since the downfall and death of Ceausescu, the man who instigated the construction of this colossal edifice and its surrounding Centru Civic, destroying a wide swathe of old Bucharest in the process; and it is a testimony to the incompetence and venality of the local politicians ever since the revolution that nostalgia for the rule of the Romanian Nebuchadnezzar is by no means uncommon. One of his sons has even been asked to stand for president.

Facts about the Palatul Parlamentului tend to come in several versions, often expressed with unjustified confidence in their truth--for example, that 600, 700, and even 7,000 architects were employed in its construction. When the guide tells you that 20,000 people worked night and day on the palace for five years before Ceausescu's death, though, you believe him; just as you would believe him if he told you that 40,000, or even 80,000 people, had worked to construct it. The scale is such that it bears no relation to anything by which you might judge such information. Besides, the details don't really matter. What does it matter if a chandelier has 5,000 or 7,000 globes in a country in which, at the time of construction, the electricity supply was intermittent at best and the president publicly announced that the ideal room temperature in winter was 50 degrees, while 1,000 calories per day were really all that anyone needed to eat?

The exterior of the building looks like the set of an epic film by D. W. Griffith, which is to say not quite real; its style is Hollywood Babylonian. The upper stories are given over to bureaucratic offices (or so we are told), and many of the glass panes of the windows have been replaced by wood. How were they broken, or did they just fall out? While sabotage by bitter bureaucrats is of course a distinct possibility, the latter seems to me more probable, for when you look closely at the construction you see that the workmanship is of the lowest possible standard. There are cracks everywhere; nothing was a matter of pride for the workers, everything a matter of fulfilling a quota with the least possible effort. The wall around the grounds is as uneven as the ground itself. An earth tremor might bring the whole thing tumbling down into a huge pile of rubble; perhaps it wouldn't even require a tremor.

Inside, three stories only are of marble, but the rooms, the staircases, and the corridors are of unparalleled size. The style is classicizing, if not exactly classical. Costa-Gavras, the radical Greco-French filmmaker, used the interior as the set for the Vatican scenes of his film Amen, in which he accused the Vatican of complicity in the Holocaust.

The largest of these rooms is the ballroom, 200 feet high and with a plaster niche at each end to bear colossal portraits of Ceausescu, which fortunately were never painted. How much like dancing anyone would have felt under their gaze is something we shall now never know. Once again the workmanship is poor and crude, despite an apparently unlimited budget. It won't be long before crumbling starts in earnest. The fact is that, even under the direct gaze of the dictator, nothing of any refinement could be produced in a Communist dictatorship. The skills to do so had been lost, because the motive to do so had been lost.

Gimcrack workmanship seems to have been something of a 20th-century tradition in Romania, though, at least as far as public monuments were concerned. In the beginning of her famous trilogy about Romania in the period immediately before the war, Olivia Manning observed of the reconstruction of the Royal Palace: "At either end of the palace workmen had started screwing pieces of pre-fabricated classical facade on to scaffolding. And the first version of Bucharest's triumphal arch had fallen down: It had been built ... by a fraudulent contractor who had used inferior cement. When it fell down, the contractor was put in prison."

There were other parallels with Ceausescu's efforts. King Carol II had wanted to make the square in front of his palace large and regular. He had buildings pulled down to this end: "These buildings had been almost the last of the Biedermeier prettiness bestowed on Bucharest by Austria. The King, who planned a square where, dared he ever venture out so openly, he might review a regiment, had ordered that the demolitions be completed before winter." Describing some of this demolition, Manning wrote, "Nearby could be seen the red wallpaper of a cafe--the famous Cafe Napoleon that had been a meeting-place of artists, musicians, poets, and other natural non-conformists. Guy [a character in the novel] had said that all this destruction had been planned simply to wipe out this one centre of revolt."

Ceausescu built his enormous Centru Civic, including the Casa Poporului, to centralize his administration, the better to keep it under close surveillance. He also had a deep mistrust of individual houses, such as had existed in the area he destroyed to build it. They were much harder to survey, and therefore intrigue was much easier to carry out in them. It was his goal to wipe out all such individualist housing altogether, and place the whole population, including the peasantry, in apartment blocks, where surveillance could be universal and inescapable. He was thus like King Carol, but magnified 10,000-fold; and it is a regrettable fact that royal dictators almost always have better taste and more style than commoner dictators. The grandeur that Ceausescu created was that of a man without aesthetic education, whose pride was wounded early in his life and who wanted to take revenge upon his own early biography. He was a man who had heard of beauty and elegance, but had either never seen any, or could not recognize it when he did.

As you walk through the vast marble halls of the Palatul Parlamentului, a question goes through your mind like a refrain: How could a man whose ideology was egalitarian have indulged in a degree of extravagance that equaled in scope, and more or less in effect, that of Louis XIV? After all, he could have carried out his other purposes without erecting such a monstrous folly. Should we see him merely as a megalomaniac hypocrite, then, whose egalitarianism had been all along but a vehicle for his thirst for personal aggrandizement?

I think the truth is rather more complex, and more flattering to the universal human capacity for rationalization. Ceausescu--who was the only person at his own brief and grossly unjust trial to emerge with a semblance of human dignity--would have said, and believed, that he had had the palace built to glorify not himself, but the Romanian nation. It was the property of the Romanian people, not of himself; and why should palaces belong only to monarchs? Did the Romanian people not merit what only kings had hitherto enjoyed? In a perverted way, no doubt, Ceausescu's extravagance, greater than any capitalist's, was a manifestation of his egalitarianism.

When he was overthrown, he left his successors with a dilemma about what to do with the building, then only half-completed inside. In the first flush of joy and accumulated anger at Ceausescu's downfall, most Romanians wanted it pulled down, but--at least according to one version of events--the cost of demolition was prohibitive, and thus the labor of 100,000 man-years was saved. Japanese and American businessmen offered to complete it and turn it into a casino (Bucharest now has a casino on almost every corner), but this was regarded as too undignified. Romania was left with a problem it could ill afford to solve.

This is an illustration of the way men and nations find themselves with problems inherited from the past. The problem is not solved even now. The building is deteriorating even as 200 people are employed on its upkeep. The grounds around it have turned into a wasteland. The apartment blocks that are an integral part of Ceausescu's design--eerily reminiscent of Speer's Germania--regularly shed stucco, brick, and concrete. It is Ceausescu's revenge.

Mr. Daniels is the author of many books, particularly about the Third World.

COPYRIGHT 2005 National Review, Inc.
COPYRIGHT 2005 Gale Group

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