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Biomedical subjects

N R Dunnick

Publications and source records attributed to N R Dunnick.

At least 199 records · Page 11Linked to original sources
PubMed1980

Management of intravenous extensions of endocrine tumors and prognosis after surgical treatment.

The capacity of endocrine neoplasms to give rise to intravenous tumor extensions is a feature that is recognized preoperatively by the use of venography employed primarily for tumor localization. A series of adrenocortical tumors, a pheochromocytoma and an extraadrenal chromaffin tumor are reported in which the intravenous tumor component was recognized and the surgical approach was modified to include extirpation of the intravascular tumor. Although intravenous tumor propagation has implied a grave prognosis because of the possibility of blood-borne metastases from the intravascular tumor or physiologic disruption from clot or tumor embolus, resection designed for cure, including distal venous control and tumor thrombectomy, was carried out in each patient. Wider application of preoperative venography enables recognition of these intravenous neoplastic extensions from endocrine tumors; the results of surgical management suggest that this invasive feature should not be a grave prognostic indicator that inhibits attempt at operative eradication of the primary tumor and its intravenous extension.

Adolescent↗
PubMed1980

Computed tomography in primary hepatocellular carcinoma.

Abdominal computed tomography was performed on seven patients with primary hepatocellular carcinoma. The liver appeared normal in one patient, while in the other six patients the tumor was identified as an area of decreased attenuation. In four cases, the tumor was seen better following intravenous administration of a contrast agent, and, in two of these cases, it was not seen on the precontrast scans. In only one case was the hepatoma better seen on the precontrast examination, and it could still be identified following contrast enhancement. Hepatomegaly and an irregular hepatic contour were other findings in these patients.

Adult↗
PubMed1980

Doppler monitoring of arterial punctures.

The authors describe a simple ultrasonic technique for monitoring arterial patency of the limb distal to the site of the arterial catheterization as well as the heart rate. The same system may be used to guide the puncture in obese patients and monitor patency of the artery while applying pressure with a clamp following catheter removal. This technique has been used in 800 patients over a three-year period with no untoward complications.

Angiography↗
PubMed1980

Computed tomographic detection of nonbeta pancreatic islet cell tumors.

Twenty-five patients with nonbeta pancreatic islet cell tumors were examined by computed tomography (CT). In eight patients (32%), the primary pancreatic tumor was identified, and in ten patients (40%), hepatic metastases were seen. Only one of the eight tumors seen on CT was loager tha 10 cm; the other seven ranged from 4 to 9 cm in diameter. Tumors in ectopic locations or possible cellular hyperplasia rather than a discrete tumor may account for the relative insensitivity of CT visualization, particularly among patients with Zollinger-Ellison syndrome.

Adenoma, Islet Cell↗
PubMed1980

False aneurysm formation following arteriographic intimal dissection: serial studies in 2 patients.

Two patients with metastatic islet-cell carcinoma underwent multiple hepatic artery catheterizations for streptozotocin infusion. An intimal flap was raised during one of the initial arteriographic procedures and a false aneurysm developed. The progression of the aneurysm was documented on sequential studies. False aneurysm formation appears to be a relatively unappreciated complication of intimal dissection, and these 2 cases permitted observation of their natural history.

Adenoma, Islet Cell↗
PubMed1980

Percutaneous aspiration of retroperitoneal lymph nodes in ovarian cancer.

Nine percutaneous lymph node aspirations were performed on six patients with ovarian carcinoma. Two aspirations were performed for initial staging, while seven were done as part of the restaging evaluation. Seven of the aspirations were positive for tumor. Two aspirations were negative, one of which was surgically confirmed. In five instances the percutaneous aspiration saved the patient an operative procedure. Percutaneous lymph node aspiration is valuable when tissue is required to confirm metastatic disease during staging evaluation, especially with equivocal or atypical lymphograms. The procedure is also useful in assessing abnormal lymphograms that persist after therapy.

Adenocarcinoma↗
PubMed1980

Intravenous extension of endocrine tumors.

Four patients with intravenous extension of endocrine tumors are described. Three had adrenal carcinoma with extension along the adrenal veins into the inferior vena cava. In two of these, the extension into the inferior vena cava was demonstrated by computed tomography. The fourth patient had a glomus jugulare with extension down the jugular vein into the superior vena cava. In ech case preoperative radiologic evaluation demonstrated the tumor and its venous extension.

Adrenal Gland Neoplasms↗
PubMed1980

Localizing insulinomas with combined radiographic methods.

Twenty-one patients with hyperinsulinism were studied to localize the source of the insulin production. Nineteen patients had pancreatic tumors and two patients studied after pancreatectomy had hepatic metastases. Of the 19 pancreatic tumors, 16 were identified by angiography. CT found six tumors in 14 patients studied while sonography correctly localized only three of 12 tumors. Neither CT nor sonography was positive in those patients with a negative arteriogram. Noninvasive imaging methods can localize large tumors and may be useful for detecting hepatic metastases. Angiography, however, remains the most accurate method for detecting smaller lesions.

Adenoma, Islet Cell↗
PubMed1980

Prospective staging evaluation of patients with cutaneous T-cell lymphomas. Demonstration of a high frequency of extracutaneous dissemination.

A prospective pretreatment staging evaluation was done on 49 consecutive patients with mycosis fungoides or the Sézary syndrome to study patterns of disease spread and prognostic factors. Routine staging procedures included complete blood count, blood chemistries, chest roentgenogram, lymphangiogram, radionuclide scans, bone marrow aspiration and biopsy, liver biopsy, and lymph node biopsy. Special evaluations included cytogenetic analysis, electron microscopy, and T-cell cytology. Extracutaneous lymphoma was documented by light microscopy in 51% of patients and by the three special procedures in 88%. Extracutaneous lymphoma was most frequent in blood and lymph nodes; 18% of patients had visceral involvement. Patients with generalized erythroderma had a higher frequency of extracutaneous disease than did patients with cutaneous plaques and tumors by both light microscopy and special studies. Survival was directly related to the type of skin involvement and the presence or absence of extracutaneous disease. Systemic dissemination of cutaneous T-cell lymphoma is frequent, generally asymptomatic, and develops early via the circulation. These findings may explain why cutaneous therapies are associated with a high frequency of relapse.

Adult↗
PubMed1979

Ultrasound evaluation of American Burkitt's lymphoma.

Burkitt's lymphoma is a childhood disease that characteristically produces large, bulky abdominal tumors. Although these are potentially curable, chemotherapy can produce rapid tumor lysis, with subsequent life-threatening metabolic abnormalities, especially in those patients with large tumors or those who have compromised renal function. Twenty-two patients with proven Burkitt's lymphoma were evaluated by ultrasound. Thirteen patients had abdominal masses. These masses tended to be large, solitary, and acoustically homogeneous. Although most of these tumors were found in the pelvis, upper abdominal and retroperitoneal tumors were also encountered. None of the patients had the typical paravertebral mantle of enlarged nodes seen in other types of lymphoma. In 11 patients with abnormal intravenous pyelograms, ultrasound successfully distinguished between renal lymphoma, hydronephrosis, and, by exclusion, metabolic renal disease. The absence of lymph node disease and the presence of bulky homogeneous extranodal tumor are characteristic ultrasound findings in Burkitt's lymphoma. By locating and quantifying tumor mass and distinguishing between renal lymphoma and hydronephrosis, ultrasound proved to be clinically useful in the management of this disease.

Abdominal Neoplasms↗
PubMed1979

Renal angiomyolipoma: diagnosis by combined ultrasound and computerized tomography.

A case is presented of a 2 cm. renal angiomyolipoma. Computerized tomography demonstrated a region of low attenuation coefficient within this tumor, while B-mode ultrasound visualizes the tumor as a cluster of high amplitude echoes. The diagnosis of a renal angiomylipoma may be suspected preoperatively when this combination of findings is present with computerized tomography and ultrasound.

Aged↗
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

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

Lymphography following leg amputation.

Bilateral lower-extremity lymphangiograms were obtained on 2 patients who previously had one leg amputated for unrelated indications. In both cases an underlying malignant tumor was present, and opacification of the lymph nodes draining the amputated limb was clinically important.

Adult↗
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↗