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D L Gordon

Publications and source records attributed to D L Gordon.

At least 109 records · Page 6Linked to original sources
PubMed1979

17 alpha-Hydroxylase deficiency. A combination of hydroxylation defect and reversible blockade in aldosterone biosynthesis.

We have studied the hormonal secretion and excretion patterns in a patient with the XX type of 17 alpha-hydroxylase deficiency. In the untreated state, the patient's urine contained only those steroids which do not require 17-hydroxylation in their biosynthesis. Aldosterone was not produced in the patient and the metabolic product of its immediate precursor, 18-hydroxy-11-dehydro-tetrahydrocorticosterone, was excreted in markedly elevated amounts. This apparent complete block in 18 oxidation was reversible upon long-term ACTH suppression within 27 days. Direct in vitro incubation of the patient's adrenal gland removed at operation demonstrated, 1) the complete lack of 17 alpha-hydroxylase activity, 2) the functional block in the ability to oxidize the hydroxyl group at the 18 methyl side chain. The addition of physiological concentrations of angiotensin to the incubation medium further showed, 3) angiotensin mildly stimulated the entire aldosterone biosynthetic pathway, 4) angiotensin directly stimulated the conversion of 18-hydroxycorticosterone to aldosterone. We propose that in this patient, 17-hydroxylase deficiency produced a decreased plasma concentration of cortisol, followed by stimulation of deoxycorticosterone production by ACTH. The resultant increase in extracellular fluid volume suppressed plasma renin activity. This resulted in a low plasma concentration of angiotensin II which directly suppressed oxidation of 18-hydroxycorticosterone to aldosterone. This defect has been called corticosterone methyl oxidase defect type 2.

18-Hydroxycorticosterone↗
PubMed1979

Rehabilitation of the trauma patient.

Many rehabilitation methods are directed at prevention during the acute management of the trauma patient. Their success is measured by the absence of secondary disabilities. Their cost in relation to health care can be estimated. Figures from 1972 showing cost estimates for treatment of common complications are as follows: Decubitus ulcers $7,000, Urinary tract infection 5,000, Kidney stones 5,000, Thrombophlebitis with pulmonary embolism 4,000, Pneumonia 3,000, Contractual deformities 2,000. Current inflation would revise the above costs at least 25%. It is also important to note that the cost of such complications to the individual is immeasurable in time and energy and quality of life.

Bed Rest↗
PubMed1977

Hypothalamic hypopituitarism after pituitary apoplexy in acromegaly.

Pituitary apoplexy in acromegaly is an uncommon event having been recorded approximately 30 times in the English literature. This report records two additional cases that included growth hormone measurements and an assessment of pituitary function. The apoplectic event developed spontaneously in one, and in the other it developed within two weeks of completing a course of radiotherapy to the pituitary gland. Autocure of the acromegaly was apparent. Basal levels of growth hormone were in the normal range but failed to change with provocative stimuli. Luteinizing hormone and follicle-stimulating hormone titers, although detectable, were inappropriately low for the degree of hypogonadism. Pituitary insufficiency was associated with a significant thyroid-stimulating hormone response to protirelin in one patient tested. It is suggested that these experiments of nature lend credence to the proposal that the hypothalamus may play a critical role in the perpetuation of growth hormone hypersecretion in some patients with acromegaly.

Acromegaly↗
PubMed1975

Parathyroid identification by methylene blue infusion.

The intravenous infusion of methylene blue was investigated as a procedure that would identify parathyroid glands during operation in 17 patients with primary hyperparathyroidism. The dye was found to stain all adenomas, most hyperplastic glands and occasionally normal parathyrodi glands. In addition, the frequency of glandular staining was directly related to the size of the gland, although size and histology may have been independent variables. Methylene blue infusion is a safe effective method of localizing abnormal parathyroid glands.

Adenoma↗
PubMed1969

Galactorrhea.

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Adult↗