Search PubMed⌕ Search

Biomedical subjects

G A Gooding

Publications and source records attributed to G A Gooding.

At least 55 records · Page 3Linked to original sources
PubMed1987

Carcinoids associated with multiple endocrine neoplasia syndromes.

Carcinoids occur in association with MEN types 1 and 2. To determine the relationship between carcinoids and MEN, we reviewed nine patients with carcinoids and other endocrine tumors. Analyzing these 9 patients and 56 other patients previously described in the literature, we found several clinically important relationships. In contrast to the usual midgut and hindgut origin, most carcinoids associated with MEN (69 percent) are of foregut origin (thymus 24 percent, bronchus 27 percent, stomach 3 percent, and duodenum 14 percent). Carcinoids are more commonly associated with MEN type 1 than MEN type 2 (59 patients and 6 patients, respectively). Thymic carcinoids associated with MEN are more common in men (15 versus 2), and most (82 percent) are malignant. Bronchial carcinoids associated with MEN are more common in women (15 versus 4), and most (74 percent) are benign. There is a strong association between thymic carcinoids and parathyroid tumors and between bronchial carcinoids and pituitary tumors. Most patients with carcinoids and hyperparathyroidism (82 percent) have had parathyroid hyperplasia or multiple parathyroid adenomas. Thus, carcinoids may occur in association with both MEN type I and MEN type II. MEN should be suspected in patients with foregut carcinoids. Patients with MEN and ectopic ACTH production should be considered to have bronchial carcinoids if they are female and thymic carcinoid if they are male. The thymus should be routinely removed in patients with MEN type I because of the possible presence of an ectopic parathyroid gland in this tissue and to prevent subsequent development of a carcinoid tumor.

Adolescent↗
PubMed1987

Testicular cysts: US findings.

Testicular cysts have been considered rare. However, of 307 men who underwent high-resolution ultrasonography (10 MHz) of the scrotum, 30 (9.8%) had testicular cysts. Thirty-three testes were involved, 23 with single cysts, eight with clusters of multiple tiny cysts, and two with more than one focus of cyst. One cyst was aspirated intraoperatively, and one cyst of the tunica albuginea was proved at surgery. Eighty cadaveric testes were scanned also, and cysts were found in one. In two cases, the pathologic report, reviewed retrospectively, failed to mention the cyst, but these cysts could have been overlooked. Further work is needed to determine when or if these testicular lesions need follow-up and what significance they have, if any.

Adult↗
PubMed1987

Parathyroid variants: US evaluation.

High-resolution (10-MHz) ultrasonography was performed in 181 patients with primary or secondary hyperparathyroidism during a 4-year period and evaluated retrospectively. Thirty-seven unusual-appearing parathyroid tumors were found among 235 parathyroid glands identified as abnormal. There was pathologic correlation in 36. The typical appearance of parathyroid adenoma was that of an oval hypoechoic or anechoic lesion in the neck, aligned in a craniocaudal direction and often posterior to the thyroid. Morphologic variations from the norm included giant size (n = 11) (4.6%), cystic changes in a solid tumor (n = 9) (3.8%), calcified glands (n = 6[in three patients]) (2.5%), a multilobulated configuration (n = 5) (2.1%), an inhomogeneous pattern (n = 5) (2.1%), and a parathyroid cyst (n = 1) (0.4%). Recognizing the abnormal parathyroid variants can increase the diagnostic accuracy of sonographic examination.

Adenoma↗
PubMed1987

Sonography of the hand and foot in foreign body detection.

To evaluate the possibility that sonography might be effective in the clinical detection of foreign bodies in the soft tissues, we used high-resolution sonography to study 10 patients with suspected foreign bodies in the hand and foot. Using ultrasound, we detected foreign bodies (glass, metal wire) in the sole of the foot of two patients and glass in the hand of another. Seven patients were proved to be free of foreign bodies. In an experimental model to ascertain which types of foreign bodies could be detected by ultrasound, wood, glass, and metallic foreign bodies 2.5 cm in length that had been inserted into the flesh of a chicken breast were immediately identified by high-resolution sonography. Ultrasound also pinpointed the surface beneath which the foreign bodies lay and localized all precisely as to depth from the surface. While detection of a foreign body is important, precise localization is crucial to avoid miscalculation of surgery leading to increased tissue damage, blood loss, and an increased risk of complications. This initial study suggests that high-resolution sonography has applicability in both the detection and the precise localization of foreign bodies in the soft tissues, but the sensitivity and specificity of the procedure remains to be determined.

Adult↗
PubMed1987

Localizing studies in patients with persistent or recurrent hyperparathyroidism.

Preoperative localizing studies are essential for patients with persistent or recurrent hyperparathyroidism requiring reoperation, because of loss of normal tissue planes and because the hyperfunctioning parathyroid tissue that remains is more likely to be situated in an ectopic position. The value of noninvasive and invasive localizing techniques was evaluated in 59 consecutive patients undergoing reoperation for persistent (40 patients) or recurrent (19 patients) hyperparathyroidism. Magnetic resonance imaging was performed in 17 patients; 11 results (65%) were positive, 3 (18%) were negative, and 3 (18%) were false-positive. Ultrasonography was performed in 52 patients; 29 (56%) were positive, 16 (31%) were negative, and 7 (13%) were false-positive. Computed tomography was performed on 41 patients; 19 (46%) were positive, 16 (39%) were negative, and 6 (15%) were false-positive. Thallium chloride 201-technetium 99m pertechnetate scans were used in 39 patients; 19 (49%) were positive, 11 (28%) were negative, and 9 (13%) were false-positive. One or more of these noninvasive tests was positive in 78% of the cases. Highly selective venous catheterization with measurement of immunoreactive parathyroid hormone concentration localized the abnormal parathyroid gland in 20 of 28 patients (71%) overall and in 8 of the 14 patients (57%) whose tumors were not identified by the noninvasive techniques. Since false-positive results were common, a combination of localizing studies was helpful in identifying the abnormal gland. Fifty-three of the 59 patients (90%) were successfully treated at the initial reoperation and three were successfully treated at a second reoperation. Advances in parathyroid localization have contributed to the improved surgical results in patients with persistent or recurrent hyperparathyroidism.

Adult↗
PubMed1986

Obstruction of the superior vena cava or subclavian veins: sonographic diagnosis.

The normal subclavian vein shows a respiratory rhythmicity on sonograms and responds to a sudden sniff maneuver by collapsing in a rapid, transient manner secondary to the sudden decrease in intrathoracic pressure. Of 11 patients studied using ultrasound (US) for possible superior vena cava (SVC) obstruction, five patients with proved SVC obstruction had no response of the enlarged subclavian veins to respiratory maneuvers. One patient with a partial obstruction had a minimal response on one side. Two patients with isolated subclavian vein obstructions had no response on the affected side and a normal response on the contralateral side. Three patients proved not to have SVC obstruction had normal responses. Sonography of the subclavian veins may be an effective, indirect screening technique for the presence of SVC obstruction and can also be used to evaluate the patency of the subclavian vein, although the sensitivity and specificity of the method remain to be determined from a larger, prospective study.

Constriction, Pathologic↗
PubMed1986

Transducer frequency considerations in intraoperative US of the spine.

To determine the effect of transducer frequency, we used intraoperative spinal ultrasound to study 15 patients. All patients but one had spinal stenosis and/or disk disease affecting the cervical cord (n = 5), the thoracic cord (n = 1), or the lumbosacral area (n = 8). One patient had an arteriovenous malformation of the cervical cord. Both 5-MHz and 10-MHz transducers were used in one patient; a transducer with the option of 3.5, 5, or 7.5 MHz was used in ten; and a 10-MHz transducer was used in four. We found that, intraoperatively, 10-MHz transducers currently produce the most detailed images of the spine.

Female↗
PubMed1986

Parathyroid imaging: comparison of double-tracer (T1-201, Tc-99m) scintigraphy and high-resolution US.

Parathyroid scintigraphy using a double-tracer (T1-201, Tc-99m) subtraction technique depicted 17 of 23 (74%) parathyroid adenomas in patients with and without previous neck operations. High-resolution (10-MHz) ultrasound (US) depicted 18 (78%) of these adenomas. Average tumor size depicted by US was 17 X 10 X 8 mm (excluding a giant adenoma) and 19 X 10 X 9 mm by scintigraphy. Alone, neither modality was particularly sensitive in the depiction of primary hyperplasia of the parathyroid glands, but combined techniques were more effective than the use of a single modality. With both US and T1-201 scintigraphy, only two of 23 cases of parathyroid adenoma in the neck were missed, and none of the eight cases of secondary hyperplasia were missed. In 11 patients who had previously undergone neck surgery, parathyroid tumors were identified in eight by either US or double-tracer scintigraphy. Preoperative parathyroid imaging with double-tracer scintigraphy and high-resolution US is suggested for patients with hyperparathyroidism, particularly in those patients who have had previous parathyroid surgery.

Adenoma↗
PubMed1986

Sonography of hemorrhagic cysts with computed tomographic correlation.

Hemorrhagic cysts have a potential for malignancy. The sonographic appearance is not pathognomonic. Three cases of benign hemorrhagic renal cysts defined sonographically demonstrate a varied appearance. Computed tomography, angiography, and aspiration offer additional clarification, but surgery is the procedure of choice for a definitive diagnosis, because aspiration of a septated lesion may fail to define malignant cytology in a separate compartment and, in addition, cytologies can be falsely negative.

Adult↗
PubMed1986

Varied sonographic manifestations of cystitis.

In a retrospective study of 90 cases that had both abdominal ultrasound examinations of the bladder and cystoscopy, four cases of proven cystitis were identified. The sonographic appearance of cystitis is varied, depending on the severity of the process, and several manifestations of involvement detectable by ultrasonography are outlined.

Candidiasis↗
PubMed1986

Quick word slides.

Explore the source record for details and available documents.

Audiovisual Aids↗
PubMed1986

Sonography of the sole of the foot. Evidence for loss of foot pad thickness in diabetes and its relationship to ulceration of the foot.

The hypothesis that loss of tissue mass in the foot contributes to foot ulceration in diabetics has never been quantitated. We developed normal criteria for the thickness of the sole of the foot at the heel, and the five metatarsal heads of both feet, using high-resolution ultrasound (10 MHz). We studied 24 normal patients ranging in weight from 125 to 250 lbs. We examined the soles of the feet of 38 diabetics without foot ulcers and 11 diabetics with foot ulcers or a history of foot ulcers who were in the same weight range as the normals. Of statistical significance, the heel thickness in controls was greater than that of the diabetics, which in turn was greater than that of the diabetics with foot ulcers. The thickness of the sole over the first and second metatarsals was also greater in the controls compared with diabetics. We conclude that high-resolution ultrasound is an effective determinant of the thickness of the sole of the foot and that diabetics have variations from the norm in the heel and at the first and second metatarsal heads.

Adipose Tissue↗
PubMed1985

Value of high resolution real-time ultrasonography in secondary hyperparathyroidism.

Thirty-two patients were treated surgically for symptomatic secondary or tertiary hyperparathyroidism, and 27 of these patients had high resolution (10 mHz) real-time ultrasonography before parathyroidectomy. This preoperative localization study identified one or more enlarged hyperplastic parathyroid glands in all but one patient who had not had a previous parathyroid operation, and in five of six patients who did have previous parathyroid operations. In both of the patients in whom no parathyroid glands were identified by ultrasonography the only abnormal enlarged parathyroid glands were those situated within the superior mediastinum. When large glands are not observed by ultrasonography in patients with severe secondary hyperparathyroidism, the glands are usually situated in the superior mediastinum, behind the trachea or esophagus, or deeply within the neck. The size of the parathyroid glands correlated positively with the serum parathyroid hormone level and with the severity of the secondary hyperparathyroidism. Thus, the preoperative identification of parathyroid glands by ultrasonography not only localizes the site of most hyperplastic parathyroid glands (70 percent of patients), but also detects those patients who have enlarged parathyroid glands, elevated serum parathyroid hormone levels, and severe secondary hyperparathyroidism. These are the patients who are thus unlikely to respond to further medical therapy.

Adenoma↗
PubMed1985

Residual lymphocele.

Uncomplicated lymphoceles can cause lateral extrinsic compression of the sigmoid colon. Ultrasound is the study of choice to define these cystic collections, which may persist many months as a postoperative complication of pelvic lymph node dissection.

Adult↗
PubMed1985

Sonographic evaluation of the normal response of subclavian veins to respiratory maneuvers.

Sonography of the subclavian veins is a new noninvasive, simple technique to evaluate the subclavian veins. The physiologic changes of the subclavian veins consistently respond in a predictable manner to simple respiratory maneuvers. The subclavian veins of 11 normal patients (22 veins) whose ages ranged from 18 to 60 years were studied. The most significant change in subclavian vein anteroposterior diameter during respiratory maneuvers (Valsalva/expiration/inspiration) occurred with inspiration (P less than .005), particularly during a sniff, with a mean decrease in diameter of 61%. This baseline evaluation establishes normal sonographic criteria of the subclavian veins. We suggest that real-time ultrasound using a high resolution transducer offers a rapid, reproducible, objective method of evaluating the subclavian vein directly.

Adolescent↗