Search PubMed⌕ Search

Biomedical subjects

J L Doppman

Publications and source records attributed to J L Doppman.

At least 325 records · Page 18Linked to original sources
PubMed1980

Familial hypocalciuric hypercalcemia: recognition among patients referred after unsuccessful parathyroid exploration.

Of 67 patients referred after unsuccessful surgery for presumed primary hyperparathyroidism, six were shown to be members of kindreds with familial hypocalciuric hypercalcemia. This diagnosis had not been recognized in any of the six previosuly. Most of the remaining 61 cases had proven or probable typical primary hyperparathyroidism, and a subgroup of four had hypercalcemia with suppression of the parathyroid glands. Urine calcium excretion expressed as the calcium:creatinine clearance ratio provided an easily measurable and effective index to separate the groups with familial hypocalciuric hypercalcemia, typical primary hyperparathyroidism, and suppressed parathyroids. Thus, at least 9% of patients referred after unsuccessful parathyroidectomy had familial hypocalciuric hypercalcemia. The assessment of urine calcium excretion by indices such as the calcium:creatinine clearance ratio should facilitate recognition of this condition, which responds poorly to standard subtotal parathyroidectomy.

Adult↗
PubMed1980

Localization and resection of clinically inapparent medullary carcinoma of the thyroid.

Seven patients who, following thyroidectomy for medullary carcinoma of the thyroid (MCT) had elevated peripheral basal or stimulated plasma calcitonin (CT) levels but no other evidence of disease, were prospectively studied to determine if disease could be localized by selective venous catheterization with pentagastrin stimulation. Disease was correctly localized to a surgically resectable area of the neck in every case and removed with low morbidity rates. Postoperative CT levels decreased in six of seven patients studied, suggesting reduction in tumor burden. One patient had no detectable CT following repeat selective venous catheterization with pentagastrin stimulation. Preoperative and postoperative carcinoembryonic antigen levels changed in a similar manner to CT levels in four of five patients studied. All patients remain alive 6 months to 3 years following the initial operation.

Adult↗
PubMed1979

Radioangiographic measurement of the internal diameters of the uteroplacental arteries in rhesus monkeys.

The internal diameters of successive anatomic segments of the uteroplacental arteries in Macaca mulatta were measured at 100 to 150 dyas' gestation. Although the absolute values vary widely, the proportional relationships between segments are uniform from animal to animal and from one time in gestation to another. We also observed that each of the two uterine arteries supplies a restricted portion of the placenta with little overlap, that there is predominance of one uterine artery over the other in the number of placental lobes supplied, and that two radial arteries occasionally contribute to a single spiral artery, giving rise to an anastomotic loop.

Angiography↗
PubMed1979

Evaluation of computed tomography in the detection of pulmonary metastases: a prospective study.

Conventional linear x-ray tomography is often used to search for pulmonary metastases but tends to underestimate extent of disease when compared with operative findings. In a prospective study, operative findings were correlated with computed axial tomography and conventional linear tomography performed on 25 patients with a history of extrathoracic malignancy and pulmonary nodules. Computed tomography detected 69 nodules of which 31 proved to be metastases. Conventional linear tomography detected 38 nodules of which 25 were metastases. Of the 54 resected nodules measuring greater than 3 mm, computed tomography detected 42; whereas conventional tomography detected 32. Only six of the 31 additional nodules (20%) detected by computed tomography and not by conventional tomography proved to be metastases. These results suggest that computed tomography is more sensitive than conventional tomography in detecting small pulmonary nodules; however, there is diminished specificity in identifying metastatic nodules.

Adenocarcinoma↗
PubMed1979

Calcitonin as a marker for bronchogenic cancer: a prospective study.

A prospective study was done of serum calcitonin (HCT) levels in 61 patients with bronchogenic cancer. Initially, 52% of patients had hypercalcitonemia. Hypercalcitonemia was not confined to patients with any particular histologic type. Seventy-eight percent of those with high calcitonin remained normocalcemic. There was no correlation between high calcitonin levels and osseous metastases. Selective thyroid venous sampling delineated two types of hypercalcitonemia: thyroidal and ectopic. To date, the ectopic type has been associated with the small cell bronchogenic carcinoma. High initial calcitonin levels decreased significantly in 75% of patients on antitumor therapy. In 13 evaluable patients calcitonin levels mirrored clinical status changes 67% of the time. Calcitonin may be a useful marker to assess the results of therapy in patients with bronchogenic cancer.

Bone Neoplasms↗
PubMed1979

Computed tomography in evolution of testicular cancer during intensive chemotherapy.

The evolution of malignant testicular tumor to mature teratoma has been studied in 4 patients. Computed tomography has been helpful in early diagnosis of this biologic phenomenon in these patients receiving intensive chemotherapy for disseminated non-seminomatous testicular cancer. Although the potential significance of this conversion in terms of survival is not known its early recognition by computed tomography has been useful in selecting and monitoring the therapy of these patients.

Adolescent↗
PubMed1979

Meyenburg complexes of the liver and bile cysts as a consequence of hepatic ischemia.

Meyenburg complexes and simple bile cysts are described in a patient having polyarteritis nodosa with involvement of the intrahepatic arterial tree. Similar lesions are found in the liver of monkeys subjected to experimental occlusion of the peripheral hepatic arterial tree. It is proposed that a pathogenetic mechanism conducive to the formation of Meyenburg complexes may be hepatic ischemia.

Animals↗
PubMed1979

Autotransplantation of cryopreserved parathyroid tissue in man.

Human cryopreserved parathyroid autografts have been performed in six patients following reoperative parathyroid surgery. All patients were rendered hypoparathyroid by their most recent reoperation. Parathyroid tissue was successfully autotransplanted after as long as eighteen months of cryopreservation. Viability and expected in vivo function of cryopreserved parathyroid tissue may be predicted by in vitro testing of parathyroid hormone secretion in response to varying ambient calcium concentration. Parathyroid cryopreservation with subsequent autotransplantation is a practical solution to the problem of permanent hypoparathyroidism that may follow multiple surgical procedures for persistent hyperparathyroidism.

Calcium↗
PubMed1979

Development and experimental evaluation of a contrast medium for computed tomographic examination of the liver and spleen.

A lipoid based contrast material containing 53% of ethiodized oil in emulsion form was developed for computed tomography (CT) of the liver and spleen and tested in rabbits and monkeys. An intravenous dose of 0.2 ml/kg selectively opacified the liver and spleen, resulting in an average increase of 23 EMI units (500 scales) in the attenuation of the liver and a higher increase in the attenuation of the spleen. When injected into rhesus monkeys with carcinogen induced hepatomas there was a significant improvement in the visualization of the tumor, and small lesions, undetectable on the preliminary CT scan, became visible. Toxicity studies are in progress.

Animals↗
PubMed1979

Bile duct cysts secondary to liver infarcts: report of a case and experimental production by small vessel hepatic artery occlusion.

Hepatic bile duct cysts were demonstrated on an abdominal CT scan and confirmed at autopsy in a patient with polyarteritis nodosa. The cysts developed in close proximity to hepatic artery aneurysms and occlusions visualized at hepatic arteriography and confirmed postmortem. The development of similar bile duct cysts following hepatic artery occlusion was demonstrated in 13 Rhesus monkeys.

Aneurysm↗
PubMed1979

Angiographic ablation of parathyroid adenomas.

Six mediastinal parathyroid adenomas were stained by infusing contrast agent through a catheter wedged in the feeding artery. Adenomas in the first three cases were stained unintentionally with small volumes of dilute contrast media and hypercalcemia recurred within 3 to 6 months. In the next three patients, adenomas were deliberately stained with larger doses of concentrated contrast media and these patients have remained normocalcemic from 2 to 18 months following staining. The permanency of parathyroid ablation following deliberate staining with contrast media has not been established.

Adenoma↗
PubMed1979

Evaluation of angiography in Zollinger-Ellison syndrome.

Of 20 patients with the Zollinger-Ellison syndrome who underwent visceral angiography, only 3 had unequivocally positive studies for primary pancreatic tumors; another 5 patients had equivocal diagnoses based on adequate studies. Eight patients had no abnormalities of any kind detected by angiography (except for an obstructed splenic vein in one patient). Five patients were shown to have hypervascular liver metastases. These results contrast with most reports of findings in islet cell tumors in general and specifically with the findings in several small series of the Zollinger-Ellison syndrome.

Adenoma, Islet Cell↗
PubMed1979

Differential diagnosis of brown tumor vs. cystic osteitis by arteriography and computed tomography.

An expansile lytic lesion of bone can be either a brown tumor or a cyst when the patient has hyperparathyroidism. If weight-bearing bones are involved, the diagnosis must be made prior to parathyroidectomy in order to avert a possible pathological fracture. In the authors' patient, arteriography and computed tomography both demonstrated that the lesion in question was a brown tumor, which is hypervascular and clearly separable from a fluid-filled cyst; however, CT has the advantage of being a noninvasive procedure.

Adult↗
PubMed1979

The toposcopic catheter: a design for maneuvering through tortuous vessels.

The toposcopic catheter is an everting tube that advances within a vessel without moving over the endothelium. It easily passed through simulated tortuous vessels which other catheters could not negotiate and was also successful in the external carotid, vertebral, hepatic, renal and coronary arteries in dogs. The catheter advances to its full length (30 cm) or until wedged in small peripheral arteries.

Animals↗
PubMed1979

Preoperative diagnosis and localization of aldosteronomas by measurement of corticosteroids in adrenal venous blood.

Adrenal venous aldosterone/cortisol ratios were determined in 14 patients with primary aldosteronism. Of 12 patients diagnosed as having an adrenal adenoma, ten underwent surgery in which an adenoma was found. Bilateral adrenal hyperplasia was thought to have developed in two other patients. Measurement of adrenal vein cortisol and establishment of aldosterone/cortisol ratios were done to correct for catheter placement and dilute adrenal efflux. Determination of steroids after ACTH stimulation was helpful in distinguishing quiescent from suppressed adrenal in two patients and in confirming the diagnosis of the others.

Adenoma↗