Search PubMed⌕ Search

Biomedical subjects

M H Brooks

Publications and source records attributed to M H Brooks.

At least 55 records · Page 3Linked to original sources
PubMed1981

Unexpected parathyroid disease discovered at thyroidectomy in irradiated patients.

Eight of 23 patients undergoing total thyroidectomy for radiation-associated nodular thyroid disease were found to have unsuspected parathyroid hyperplasia or adenoma at operation. The total serum calcium level was normal preoperatively in each patient. Serum ionized calcium and parathyroid hormone levels were measured in five patients preoperatively and were normal in each case. These pathologic findings in normocalcemic patients may represent a preclinical form of hyperparathyroidism, which would be further evidence linking radiation to the pathogenesis of hyperparathyroidism. The parathyroid glands should be evaluated both pre-operatively and at operation in all patients who have a history of radiation and require thyroidectomy.

Adenoma↗
PubMed1980

Pregnancy in Sheehan's syndrome. Report of a case and review.

Detailed endocrinological studies were performed during and after the eighth pregnancy of a 38-year-old woman who had eight spontaneous pregnancies after the onset of hypopituitarism secondary to massive postpartum hemorrhage. Hormonal replacement therapy was not provided during seven pregnancies and all terminated in spontaneous abortions. Studies of pituitary function during and after the eighth pregnancy demonstrated that the patient had measurable amounts of growth hormone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyrotropin (TSH), adrenocorticotropin (ACTH), and prolactin in her plasma under basal conditions but that these hormones did not increase approximately in response to pregnancy, stress, and specific stimuli. Evaluation of placental function at 26 weeks gestation by measurement of estradiol, progesterone, human placental lactogen, and chorionic gonadotropin revealed no abnormality. Hormone replacement therapy during the eighth pregnancy was associated with the delivery of normal premature infant at 32 weeks gestation. In addition to these studies, a critical review of the literature was undertaken to more clearly define the clinical and laboratory features of pregnancy in Sheehan's syndrome.

Adult↗
PubMed1980

Free thyroxine concentrations in thyroid storm.

Total serum thyroxine concentrations, the dialyzable fractions of total thyroxine, and absolute free thyroxine concentrations were measured in six patients with thyroid storm, in 15 patients with uncomplicated thyrotoxicosis, and in 19 normal subjects. Total thyroxine concentrations were similar in both thyrotoxic groups. However, the mean dialyzable fraction of thyroxine and the mean free thyroxine concentration was significantly higher in patients with thyroid storm than in patients with uncomplicated thyrotoxicosis (0.060 +/- 0.017% versus 0.026 +/- 0.006% and 10.9 +/- 3.8 ng/dL versus 4.7 +/- 1.4 ng/dL, respectively). These findings suggest that events precipitating thyroid storm may act with thyrotoxicosis to decrease thyroxine binding markedly and result in a sharp increase in free thyroxine concentration. These phenomena may play a role in the pathogenesis of thyroid storm.

Adolescent↗
PubMed1979

Intractable hypoglycemia in a patient with renal failure.

A patient with chronic renal failure developed intractable hypoglycemia after 2 1/2 years of dialysis. Metabolic studies did not suggest that malnutrition, substrate limitation, hormone deficiency, or insulin excess were responsible for the low blood glucose level. Impaired gluconeogenesis may have been an important factor, but studies in this patient suggest that enhanced glucose utilization may also play a role in the pathogenesis of hypoglycemia in renal failure.

Adult↗
PubMed1979

The continued importance of adrenalectomy in the treatment of Cushing's disease.

Eighteen patients with pituitary-dependent Cushing's disease have been treated during a ten-year period. Eleven of these received a total of 14 alternative forms of therapy in an attempt to control the clinical manifestations of Cushing's disease prior to adrenalectomy. However, no substantial improvement was noted in these patients, who included four receiving conventional pituitary irradiation, five receiving cyproheptadine, two receiving mitotane, and one each receiving metyrapone and phenytoin. One patient had an attempted transsphenoidal hypophysectomy that could not be accomplished because of hemorrhage. A complete remission of the signs, symptoms, and laboratory abnormalities of Cushing's disease occurred in all 18 patients following bilateral adrenalectomy. There was no operative mortality and morbidity was minimal. This experience confirms that bilateral adrenalectomy is a rapid, safe, and permanent means of reversing hypercortisolism and that it should remain an integral part of the treatment of Cushing's disease.

Adolescent↗
PubMed1978

Vitamin-D-dependent rickets type II. Resistance of target organs to 1,25-dihydroxyvitamin D.

Studies were done to determine the cause for hypocalcemia, secondary hyperparathyroidism, osteomalacia and osteitis fibrosa cystica in a 22-year-old black woman. The patient had normal serum 25-hydroxyvitamin D (14 ng per milliliter) and markedly elevated serum 1,25-dihydroxyvitamin D (137 pg per milliliter). Vitamin D3, 4000 units per day for four weeks, increased the serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D to as high as 29 and 297 pg per milliliter, respectively, and corrected the hypocalcemia and secondary hyperparathyroidism. The results suggest that the disorder results from impaired end-organ response to 1,25-dihydroxyvitamin D. We propose that the entity be called vitamin-D-dependent rickets Type II.

Adult↗
PubMed1978

Anorexia nervosa.

Explore the source record for details and available documents.

Adolescent↗
PubMed1976

Total thyroidectomy and parathyroid autotransplantation for radiation-associated thyroid cancer.

In seventy patients with nodular thyroids and a history of radiation exposure, total thyroidectomy disclosed a 54% incidence of carcinoma; more than half of them had cervial node metastases; four had distant metastases. Fourteen patients required radical neck dissection. The carcinoma was multicentric (both lobes) in 45%. In four patients the carcinoma was found in the lobe contralateral to the one containing the palpable nodule. These findings support the advocates of total thyroidectomy for patients with a nodular thyroid and a history of radiation exposure, provided this operation can be performed with a low incidence of recurrent nerve palsy and hypoparathyroidism.

Adolescent↗
PubMed1975

Serum triiodothyronine concentration in thyroid storm.

Serum triiodothyronine levels were elevated in 6 patients with thyroid storm (769 plus or minus 181 ng/100 ml) but the values observed were not significantly different from those found in uncomplicated thyrotoxicosis (752 plus or minus 282 ng/100 ml). This observation suggests that the pathogenesis of thyroid storm resides in mechanisms other than a simple increase in serum triiodothyronine concentration.

Adolescent↗