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Biomedical subjects

M S Gee

Publications and source records attributed to M S Gee.

5 recordsLinked to original sources
PubMed1992

Nucleolar organizer regions in paragangliomas of the head and neck.

The clinical behavior of head-and-neck paragangliomas cannot be accurately predicted using standard histologic criteria. Immunohistochemical profiles have proved to be prognostically helpful; however, other independent indicators of prognosis are needed. Tissue markers of proliferative activity include argyrophilic nucleolar organizer regions (AgNOR), which are proteins specifically associated with loops of transcriptionally active ribosomal DNA. Fifteen paragangliomas of the head and neck were divided into solitary nonrecurrent (n = 8), recurrent or locally invasive (n = 4), and multiple (n = 1), or malignant (n = 2) groups. The mean AgNOR count per cell was statistically different between the solitary nonrecurrent and the combined other poorer prognosis groups, suggesting that it may be useful as an independent indicator of biologic behavior. The wide variation in AgNOR counts within groups and the overlap of counts between groups limit, however, the predictive value of this technique for individual tumors.

Adult↗
PubMed1992

Results of a multidisciplinary strategy for management of mediastinal parathyroid adenoma as a cause of persistent primary hyperparathyroidism.

Persistent primary hyperparathyroidism due to mediastinal parathyroid adenoma was effectively treated by either angiographic ablation or median sternotomy in this study of 49 patients managed at the National Institutes of Health since 1977. Each patient presented here with symptomatic persistent primary hyperparathyroidism after failed initial surgical procedures done at other institutions. Each patient underwent extensive parathyroid localization procedures, including selective angiography, and most had a parathyroid adenoma localized to the mediastinum. Angiographic ablation, the deliberate injection of large doses of contrast material into the artery that selectively perfuses the adenoma, was initially successful in 22 of 30 procedures (73%) in 27 patients. Long-term control of persistent primary hyperparathyroidism was achieved in 17 of 27 patients (63%) by angiographic ablation. Each unsuccessful ablation could be easily salvaged by surgical resection. Surgical resection of the parathyroid adenoma by median sternotomy achieved immediate success in 24 of 24 procedures (p2 less than 0.02 versus ablation), and long-term cure in 23 of 23 evaluable patients (p2 less than 0.001 versus ablation). However, ablation did have benefits for the patients in whom it was successfully performed. It was associated with a significantly shorter hospital stay (median, 6 days versus 9 days for sternotomy, p2 less than 0.003), much less pain, and easier recuperation. Complications of each procedure were transient and similar in both groups. Operative resection is the most effective single means to eradicate mediastinal parathyroid adenoma; however, angiographic ablation can provide similar long-term control of hyperparathyroidism in 63% of patients with less pain and shorter convalescence than that seen in patients after median sternotomy. Our results suggest that angiographic ablation should be attempted as the initial procedure for patients with persistent primary hyperparathyroidism caused by an angiographically identified mediastinal parathyroid adenoma. Operation can be reserved for those who fail ablation.

Adenoma↗