DXPLAIN--demonstration and discussion of a diagnostic clinical decision support system.
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Artificial Intelligence↗
Biomedical subjects
B H Forman
Publications and source records attributed to B H Forman.
Percutaneous gastrostomy with gastropexy: experience in 125 patients.
We report our experience with radiologically guided percutaneous tube gastrostomy in 125 patients by using a gastropexy technique in which the anterior gastric wall is nonsurgically sutured to the anterior abdominal wall with percutaneously placed T-fasteners before catheter insertion. Short-term follow-up of up to 2 weeks was available in all patients. In 63 patients, long-term follow-up (greater than 4 weeks; average, 3.5 months; maximum, 1 year) was available. Catheter placement was successful in 124 (99%) of 125 patients, including three patients with anatomic changes after Bilroth II hemigastrectomy and two patients with failed endoscopic attempts. There were no deaths related to the procedure, and no patients required surgical intervention for complications attributable to the gastrostomy procedure. The 30-day mortality rate was 11% (n = 7). These deaths were due to cardiorespiratory arrest and were not attributable to the gastrostomy procedure. Major complications occurred in 1.6% (n = 1) and minor complications in 9.5% (n = 6). These results indicate that percutaneous gastrostomy with gastropexy is a safe and effective technique for placement of catheters in the stomach.
Adult↗
ACTH-secreting pheochromocytoma.
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Adrenal Gland Neoplasms↗
The diagnosis and management of pituitary tumors.
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Humans↗
Steroid profile in a case of adrenal carcinoma with severe hypertension.
The case of a young boy who had Cushing's syndrome and severe hypertension in association with metastatic adrenal carcinoma is described. Marked elevation of the mineralocorticoid 11-deoxycorticosterone was demonstrated in the plasma. 11-Deoxycortisol, 17alpha-hydroxyprogesterone, and urinary tetrahydro-11-deoxycortisol and pregnanetriol were also elevated. Aldosterone excretion was low. The data implicate defective 11beta hydroxylation and suggest that excessive 11-deoxycorticosterone production may have been responsible for the hypertension.
17-Hydroxycorticosteroids↗
Effects of an angiotensin inhibitor on adrenocortical response to angiotensin II, ACTH, and K.
A competitive inhibitor of angiotensin II has been studied in nephrectomized dogs treated with dexamethasone to suppress ACTH secretion. The inhibitor, [1-sarcosine, 8-alanine]angiotensin II (P113), has been shown by previous investigators to inhibit the pressor action of angiotensin II but not the pressor effect of other pressor agents. The present experiments demonstrate that P113 inhibits the stimulation of aldosterone secretion by angiotensin II but not by ACTH or potassium infusions. Therefore, P113 appears to be a specific inhibitor of angiotensin's action on both vascular and adrenocortical tissue. In this dog preparation, P113 has a mild nondose-related agonistic action on the blood pressure and a nonsignificant action on aldosterone secretion, although in some dogs P113 appears to have a definite agonist effect.
Adrenal Cortex↗
Ectopic ACTH syndrome due to pheochromocytoma: case report and review of the literature.
A 51-year-old female was diagnosed preoperatively to have a pheochromocytoma producing ACTH. This diagnosis was based upon her paroxysmal hypertension, hyperpigmentation, and hypokalemia. Elevated levels of serum and urine corticosteroids, plasma ACTH, urinary VMA, and catecholamines fell after a right adrenal pheochromocytoma was removed. Subsequently this tumor was found to have a high content of ACTH. Review of the literature indicates a mortality rate of 57% for this syndrome. Proper preoperative recognition and management can result in total cure.
Adrenal Gland Neoplasms↗