Biomedical subjects

N W Thompson

Publications and source records attributed to N W Thompson.

At least 199 records · Page 11Linked to original sources

PubMed1977

Dilemmas in the early diagnosis and treatment of multiple endocrine adenomatosis, type II.

Fifteen patients with the diagnosis of multiple endocrine adenomatosis, type II, syndrome (MEA II) were reported from a single center to discuss the dilemmas of early detection and treatment of the adrenal medullary, thyroid, and parathyroid gland diseases. Ten patients came from three families. Three of the patients died, none in hypertensive crisis. Bilateral adrenal medullary disease was present in six patients. Five patients with proved pheochromocytoma had hypertension. All had diagnostic urinary catecholamine values. Nine normotensive patients without proved pheochromocytoma but in a high-risk category for adrenal medullary disease, have multiple suspicious urinary cathecholamines suggestive of adrenal medullary hyperplasia. Bilateral adrenalectomy is recommended for proved adrenal medullary disease in the MEA II syndrome. Medullary carcinoma of the thyroid gland was found in 13 patients and is believed to be present in two others. Five of the proved cases were occult, being discovered by elevation of pentagastrin-stimulated serum calcitonin levels, justifying total thyroidectomy. Parathyroid hyperplasia was found in three patients with preoperative hypercalcemia and in four others with preoperative normocalcemia. Conservative treatment of parathyroid gland hyperplasia in the MEA II syndrome is substantiated. Metachronous phenotypic expression of the syndrome components was significant.

Adolescent↗

PubMed1976

Arteriovenous malformations of the gastrointestinal tract.

During an eight-year period, 17 patients ranging in age from 7 months to 81 years were found to have arteriovenous malformations (AVMs) of the gastrointestinal tract complicated by major hemorrhage. After review of these cases, a clinical classification of AVMs was developed, based on angiographic characteristics, localization, age of the patient, and family history. Type 1 AVMs were solitary, localized lesions within the right side of the colon. They occurred in seven patients 55 years of age or older. None were palpable or visible at operation. Type 2 AVMs occurred in seven patients. They were larger and occasionally visible, most commonly in the small intestine, and probably of congenital origin. Symptoms all began before 50 years of age. Type 3 AVMs were punctate angiomas causing gastrointestinal hemorrhage. They occurred in three patients with the classical findings of hereditary hemorrhagic telangiectasia. The diagnosis of most AVMs can be determined preoperatively only by selective angiographic studies.

Adolescent↗

PubMed1976

Ectopic thyroid tissue in the neck. Benign or malignant?

This is a report of ectopic thyroid tissue in the neck, associated with a nodular colloid goiter, which recurred at least three times, beginning at age 24 years, in a woman in 12 years. The ectopic tissue appeared histologically benign and was identical to that found in the thyroid gland. Scintiscans of the neck and thyroid suppression tests showed that the tissue was initially unsuppressible and presumably autonomous in its function. Our conclusion is that the most reasonable explanation for this phenomenon is the intraoperative transmission of thyroid cells, probably benign and autonomous in function, to other sites in the neck.

Adult↗

PubMed1976

Carotid body tumors.

Carotid body tumors are encounterd infrequently. During the past 30 years, 15 patients with 16 carotid body tumors have been treated at our medical center. All patients have been followed for a minimum of 7 years. The major findings relate to the areas of greatest controversy concerning carotid body tumor treatment: the need for excision, the value of preoperative arteriography, the role of radiation therapy, the criteria of malignancy, and the indications for and technique of carotid artery replacement. Discussed at length are our conclusions that (1) arteriography is absolutely diagnostic and therefore mandatory when carotid body tumor is suspected; (2) radiation therapy has little if any value and has increased the difficulty of excision; and (3) all carotid body tumors should be considered to be malignant. The familial tendency of this tumor is explored in relation to this last conclusion, and we report what we believe is the first finding of both a "benign" and "malignant" tumor occurring in the same family. The techniques of subadventitial excision and carotid artery replacement with autogenous saphenous vein, the latter necessary on three occasions, are demonstrated. There were no operative deaths, no serious complications after operation, and no recurrence or metastasis following total excision. However, two patients died as a direct result of tumor growth following biopsy without excision.

Adult↗

PubMed1975

Immobilization hypercalcemia crisis.

Profound hypercalcemia associated with immobilization is rare. Hypercalcemic crisis occurring as a result of immobilization in which there was not a coexisting, contributing medical condition has not, to our knowledge, been reported previously. Failure to consider hypercalcemia as the source of progressive anorexia, nausea, vomiting, and irritability resulted in a respiratory arrest and nearly fatal outcome in the case of a 13-year-old boy one month after a simple femoral fracture. Therapy consisting of the intravenous administration of fluids and corticosteroids was successful in lowering the serum calcium level until mobilization could be accomplished. Review of previously reported cases emphasizes the difficulty in recognition and diagnosis of this unusual condition. Surgeons treating patients with fractures should be aware of this complication and familiar with its appropriate therapy.

Adolescent↗

PubMed1975

Hepatic cell adenomas, spontaneous liver rupture, and oral contraceptives.

During the past decade, an increasing number of hepatic cell adenomas have been reported. Sppntaneous rupture, a life-threatening complication of this rare tumor, has been noted more frequently. Eight patients with hepatic cell adenomas have been treated at our center. Three patients first developed symptoms from hemoperitoneum. Palpable tumors were discovered in three asymptomatic patients during routine examinations. Two patients had upper abdominal pain from intrahepatic hemorrhage. All patients were young women using oral contraceptive agents. Emergent hepatic lobectomy was performed in the three patients with rupture. The other five patients underwent selective angiographic studies, prior to elective liver resections. All survived operation and have done well since. The increased incidence of hepatic cell adenomas may be related to the use of oral contraceptive agents.

Adenoma↗

PubMed1975