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Gigantism

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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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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Viola Frey at Nancy Hoffman - ceramic figures at Nancy Hoffman Gallery, New York
From Art in America, 6/1/03 by Jonathan Gilmore

Although Viola Frey's ceramic figures are monumental in scale, they don't have a monumental effect. Rather, these people appear beaten-down, passive or impotent. Constructed in several sections, fired separately and then joined, the sculptures evince human vulnerability through their fragile and fragmented clay material. Indeed, the gigantism of these lumbering men and women--their scale is extraordinary among figurative ceramics--amplifies the symbolic frailties with which they have been invested.

Although the figures are unmistakably American in appearance, their titles suggest general existential conditions. Questioning Man (2002), for example, is a nearly 9-foot-tall fellow in a nondescript blue suit and red striped tie who towers over spectators. With an ungainly stance, arms rigidly pinned to his sides and a blank expression, he elicits more pathos than awe. Even when a figure assumes a more commanding identity, strength is simultaneously asserted and undermined: Man Kicking World (2002)--a seated, suited individual about to kick an enormous 5-foot-diameter globe--seems less Master of the Universe than frustrated child. Reflective Woman I (2002) stands about 8 feet tall in a brightly painted but dowdy knee-length dress, her palm outstretched in a gesture of inquiry and resignation. A massive nude such as Seated Woman (2002) is less constrained by social identity than the businessmen, yet her stilted and impassive air suggests not a voluptuary but a studio model. In such works, Frey favors a stiff frontality that alludes to archaic sculpture.

Frey also exhibited two outsized vessels: Amphora (Men in Power Suits), 2001-02, bearing a frieze of interlocking glad-handing businessmen, and Um VF Iconography (2002), a decorative, freely colored compendium of such motifs as classical statuary, puppetlike humans (including nudes) and pastoral landscapes Wide-bodied and two-handled, these amphorae echo Frey's thick-waisted women, much as ancient sculptural vessels refer the human body.

The exhibition's pastel drawings and large glazed-tile wall pictures feature images of figurines, another reference to past forms. These call attention to tie fact that Frey's large sculptures often look like ordinary, blocky statuettes or cheap figurines that have been enlarged to humongous size. This association, seen against the titles' large themes and her grand scale, suggest that Frey's sculptures are a sardonic comment on human ambitions.

COPYRIGHT 2003 Brant Publications, Inc.
COPYRIGHT 2003 Gale Group

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