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Biomedical subjects

W G Ryan

Publications and source records attributed to W G Ryan.

At least 73 records · Page 4Linked to original sources
PubMed1987

Hypercalcemia of sarcoidosis treated with cellulose sodium phosphate.

A patient with pulmonary sarcoidosis and symptomatic hypercalcemia had elevated serum 1,25-dihydroxyvitamin D and angiotensin-converting enzyme levels, with evidence of deterioration of renal function. Pulmonary function tests were normal and there were no other findings to warrant immediate steroid use. She was treated with cellulose sodium phosphate, in an effort to control the hypercalcemia. Serum calcium declined to normal values within 4 weeks and was associated with symptomatic improvement and normalization of BUN and creatinine, indicating perhaps a direct relationship between serum calcium and renal function in this setting. These observations suggest that the hypercalcemia of sarcoidosis may be successfully treated with cellulose sodium phosphate presumably by reducing intestinal calcium absorption, but further clinical trials will be necessary to establish its effectiveness in the long term.

Blood Urea Nitrogen↗
PubMed1986

Studies in a patient with tumor-induced hypophosphatemic osteomalacia.

A 7-year study of a patient with tumor (hemangiopericytoma)-induced hypophosphatemic osteomalacia (TIO) is presented, and the findings are in keeping with the depressed tubular reabsorption of phosphate and low 1,25(OH)2 vitamin D levels seen in other studies. Despite normalization of 1,25(OH)2 vitamin D levels with pharmacologic doses of vitamin D2, there was no discernible effect on serum phosphorus levels. Also, despite hypercalcemia induced by pharmacologic doses of vitamin D2, serum parathyroid hormone levels were persistently elevated, and gradually returned to subnormal levels after removal of the tumor. Following removal of the tumor, there was a rapid increase of the 1,25(OH)2 vitamin D levels to supraphysiologic levels, prompt appropriate increase in tubular reabsorption of phosphate levels, and symptomatic improvement in the osteomalacia. Speculations on the physiologic and pathophysiologic role of the putative hormone(s) produced by the tumors associated with this syndrome are presented.

Calcitriol↗
PubMed1986

The role of ultrasonography in the evaluation of primary hyperparathyroidism.

Ultrasonography was used preoperatively in 21 patients with primary hyperparathyroidism in an effort to locate enlarged parathyroid glands. It indicated the presence of a solitary mass compatible with a parathyroid adenoma in 14 patients. At operation, adenomas were found at the location indicated by ultrasonography in 13 of the 14 patients (93 per cent). In seven patients, ultrasonography failed to reveal evidence of a mass of the parathyroid gland. At operation, three had diffuse parathyroid hyperplasia and four had a solitary adenoma. Of the four patients with adenomas undetected by ultrasonography, one patient had an adenoma which had undergone infarction and three had coexisting nodular thyroid gland disease. We concluded that ultrasonography is valuable in the preoperative assessment of patients with primary hyperparathyroidism. This is especially so in the absence of coexisting nodular thyroid gland disease. When positive, ultrasonography accurately locates adenomas, and when negative, it strongly suggests the presence of hyperplasia. This may have clinical application in limiting the extent of dissection and, thereby, reducing the morbidity of parathyroid gland exploration.

Adenoma↗
PubMed1983

Pathophysiology and modern management of Paget's disease.

Paget's disease of bone is a slowly progressive and frequently disabling disorder of unknown cause. Recent evidence suggests that it may be associated with a viral infection. Until the late 1960s, no effective treatments were available. Now there are three that are suppressive and useful for symptomatic relief. Recent studies suggest that it may be possible to produce permanent remissions of the disease and thus prevent complications.

Calcitonin↗
PubMed1979

Metabolic control in diabetic patients. Effect of insulin-secretory reserve (measured by plasma C-peptide levels) and circulating insulin antibodies.

We measured circulating hemoglobin A1 (HbA1) and fasting plasma C-peptide concentrations in 100 diabetic patients. Pancreatic insulin reserve showed a negative correlation with HbA1 concentrations in nonobese, insulin-treated patients but not in obese patients, whether they were treated with insulin, oral agent, or diet alone. Patients with fasting C-peptide concentrations above 0.1 pmol/ml had significantly better metabolic control than did those with lower values. Anti-insulin antibodies were measured in 37 patients. There was no correlation between metabolic control and the affinity constants or binding capacities of these antibodies.

Adult↗
PubMed1977

Paget's disease of bone.

Paget's disease affects approximately 3% of the population over age forty. It may be genetically transmitted (autosomal-dominant), but recent evidence suggests a viral etiology. Effective agents for control of the disorder have been developed over the past decade, but all have significant drawbacks. Calcitonin tends to lose its effectiveness in significant numbers of patients over a few months, mithramycin has significant toxicity, and diphosphonates tend to cause osteomalacia.

Adult↗
PubMed1977

Treatment of Paget's disease of bone with mithramycin.

The hypothesis that Paget's disease of bone is a low grade neoplastic process led us to use the cytotoxic antibiotic mithramycin in its treatment. The dramatic effects observed on the serum calcium and alkaline phosphatase, and urinary hydroxyproline are compatible with the concept that mithramycin is primarily toxic to osteoclasts. Subjective and objective clinical effects establish this agent as useful in the treatment of Paget's disease despite its observed toxicity to other organ systems.

Chemical and Drug Induced Liver Injury↗