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Biomedical subjects

W A Doll

Publications and source records attributed to W A Doll.

5 recordsLinked to original sources
PubMed1983

Hyperinsulinism after removal of a pheochromocytoma.

The finding of hypoglycemia after the surgical removal of a pheochromocytoma in two patients in a previous study led to monitoring of the serum glucose and plasma C-peptide levels in two other patients with a pheochromocytoma and one with unilateral adrenocortical hyperplasia. In the two patients with a pheochromocytoma endogenous insulin secretion, as measured by a C-peptide assay, was suppressed before removal of the tumours and resumed immediately after removal. The serum glucose levels decreased in these patients, but sufficient intravenous administration of glucose prevented postoperative hypoglycemia. In the patient with adrenocortical hyperplasia the plasma C-peptide level was not decreased before tumour removal, nor did it increase abruptly following removal. It therefore seems likely that the rapid fall in the serum glucose level following removal of a pheochromocytoma is caused by prompt resumption of beta-cell activity, with rebound hyperinsulinism.

Adrenal Cortex Diseases↗
PubMed1982

Intravenous nitroglycerin control of blood pressure during resection of phaeochromocytoma.

The majority of patients presenting for resection of phaeochromocytoma require some form of antihypertensive therapy during operation. Phentolamine and sodium nitroprusside have both been used successfully for this purpose, but each has disadvantages. This report describes the use of intravenous nitroglycerin, a rapidly acting venodilator with no appreciable toxicity, as the sole antihypertensive agent in two patients with phaeochromocytoma and partial alpha adrenergic blockade. Hypertensive episodes were quickly and effectively controlled in each case. There were no hypotensive periods and no side effects.

Adrenal Gland Neoplasms↗
PubMed1977

Hypoglycemia following excision of pheochromocytoma.

In two patients hypoglycemia developed in the immediate postoperative period after removal of a pheochromocytoma. In one patient the serum insulin value was elevated when he was hypoglycemic. Preoperative preparation of patients with pheochromocytoma requires use of an alpha-adrenergic blocking agent to decrease blood pressure and allow the plasma volume to expand; in the two patients referred to phenoxybenzamine was given orally. It is difficult to recognize hypoglycemia postoperatively because of the altered consciousness associated with a major operation, analgesics, anesthetic agents and the effects of adrenergic blocking medications; hence the physician must watch closely for this complication.

Adrenal Gland Neoplasms↗