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Biomedical subjects

G W Geelhoed

Publications and source records attributed to G W Geelhoed.

At least 37 records · Page 2Linked to original sources
PubMed1988

Intraoperative cytologic evaluation of lipid in the diagnosis of parathyroid adenoma.

Analysis of intraoperative air-dried imprints or smears of 20 cases of parathyroid adenoma revealed that the cells of the parathyroid adenomas did not contain extra- or intracellular lipid, but the cytologic material from accompanying normal or atrophic parathyroid glands had large amounts of intracellular lipid and variable amounts of extracellular lipid. Thus, rapid intraoperative cytologic preparation is not only effective in determining whether the specimen is parathyroid or not, but also in specifying the nature of the individual parathyroid glands. These observations again confirm that intraoperative cytologic evaluation of parathyroid tissue is an effective and important pathologic consultation method during parathyroid exploration.

Adenoma↗
PubMed1988

A comparative study of a new skin preparation method for peripheral intravenous lines.

The incidence of peripheral intravenous (IV) catheter infection in relation to skin preparation methods was studied over a 4 month period in 60 patients who had peripheral intravenous infusions in an acute-care setting. Sixty two IV sites were evaluated for redness, inflammation, pain or tenderness, and other signs that might indicate infection or other IV site complications. The hospital protocol for intravenous skin preparation and maintenance was compared with a new method using I.V. Prep. The results indicate a statistically significant difference exists between the two groups when comparing incidence of peripheral IV site complications.

Catheterization↗
PubMed1988

Tracheomalacia from compressing goiter: management after thyroidectomy.

Tracheomalacia may result from prolonged compression by expanding goiter, particularly within the confines of the thoracic inlet. Constriction of the upper airway by the growing goiter may be indication for operation, but the residual problem of tracheomalacia after thyroidectomy is a life-threatening postoperative complication. Examples of postoperative tracheomalacia in patients with neglected goiters endemic in the third world or recurrent goiter with airway compromise in a western medical center referral practice are described for development of management methods. Two patients with lethal postthyroidectomy tracheomalacia led me to anticipate this complication in certain identifiable high-risk patients in my own practice, and the cases of five patients are described for whom several techniques of tracheal support were attempted. One patient, for whom staged tracheoplasty was planned, opted for tracheostomy, whereas four patients have had adequate tracheal airways restored by extrinsic support. One was treated by subtotal thyroidectomy with tracheal suspension; one by staged thyroid reductions; two were treated by creation of extrinsic tracheal neo-rings constructed of surgical wire and vascular prostheses. The patient with the most dramatic airway impairment from the most extensive tracheomalacia experienced very satisfactory airway security. A second patient was also supported by the prosthetic rings but extruded one of them, possibly because of tracheostomy contamination. Until tracheal replacement or better tolerated prosthetic or biologic supports are devised, tracheomalacia will remain a vexing problem complicating thyroidectomy for long-standing or recurrent airway-compressing goiter.

Adult↗
PubMed1988

Acute pseudogout following parathyroidectomy.

Four patients developed acute arthritis following parathyroidectomy over a 3 year period in two general surgical practices. The diagnosis of pseudogout was made by clinical presentation, radiologic findings and demonstration of synovial fluid crystals exhibiting weakly positive birefringence. Rapid resolution of clinical arthritis followed joint aspiration and administration of anti-inflammatory agents in all four patients. Patients with hypercalcemia have a high incidence of calcium pyrophosphate dihydrate crystal deposition into joints. Rapid drops in serum calcium levels can cause shedding of these crystals into synovial fluid which may precipitate acute attacks of pseudogout. Because the relative hypocalcemia following parathyroidectomy provides a good stimulus for crystal shedding, it follows that hypercalcemic patients undergoing parathyroidectomy should experience a high incidence of acute pseudogout. Although this entity has been described before, its occurrence is not widely recognized in clinical practice. It is proposed that these four cases observed over a 3 year period indicate that pseudogout following parathyroidectomy occurs more commonly than previously recognized.

Calcium Pyrophosphate↗
PubMed1987

Mucinous colon carcinoma in a black family.

Carcinoma of the large bowel developed in an autosomal dominant pattern in 13 members of a black-American family. Seven members were affected prior to initial ascertainment of the family in 1976. Thereafter, the remaining six were affected while 0.2 cases were expected (p less than 0.001). Median age at diagnosis of colon cancer was 39 years (range, 22-62 years) in this family, compared with 65 years among black-Americans, in general. Histologic review of surgical specimens from six patients and medical record data for a seventh patient showed mucinous adenocarcinoma of the colon, an uncommon histologic variant. Studies of several family members a decade ago had revealed no biologic markers of cancer susceptibility.

Adenocarcinoma, Mucinous↗
PubMed1986

Benzene-induced inhibition of erythroid colony formation in vitro.

The erythroid colony forming unit assay technique was used to study the inhibitory effect of benzene on mouse bone marrow cell culture in vitro. The ability of vitamin B6 to prevent benzene-induced inhibition of erythroid colony formation was also tested. At concentrations equal to or higher than the lowest inhibitory concentration of benzene, pyridoxine HCl significantly prevented benzene-induced inhibition of erythroid colony formation in vitro. However, when benzene concentration was higher, the added pyridoxine HCl was ineffective in preventing benzene-induced inhibition of erythroid colony formation in vitro, even when it was preincubated with the bone marrow cells for 30 minutes prior to adding benzene. On the basis of this finding, it is proposed that benzene-induced inhibition of erythroid colony formation may involve two different mechanisms, one of which involves interaction with vitamin B6 added as pyridoxine HCl.

Animals↗
PubMed1986

Glucagon: endocrine effects and calcium involvement in cardiovascular actions in dogs.

Although the cardiovascular effects of glucagon are understood, its mechanism(s) of action remains unclear. We studied the effects of increasing doses of glucagon (0.001, 0.01, 0.1 mg/kg) on cardiovascular responses in dogs relative to concurrent measurements of circulating glucagon, cyclic AMP, glucose, norepinephrine, epinephrine, triiodothyronine, thyroxine, and cortisol levels. Glucagon-induced increases in plasma cyclic AMP, glucose, and catecholamine concentrations paralleled the heart rate response to glucagon administration. Further studies were conducted to evaluate the role of beta-adrenergic function as well as calcium in mediating glucagon's actions. The tachycardic effects of glucagon (0.01 mg/kg) were unaltered by prior beta-adrenergic receptor blockade with propranolol (3.5 mg/kg total dose). The calcium antagonist verapamil (0.2 mg/kg bolus then 7.5 micrograms/kg/min/infusion) prevented glucagon-induced increases in heart rate. However, the coadministration of glucagon (0.01 mg/kg) with calcium (1.0, 5.0, 10.0, or 50.0 mg/kg) did not alter glucagon's cardiovascular effects. These data indicate that glucagon is a potent tachycardiac agent that also elevates circulating endocrine-related substances. The antagonism of glucagon's tachycardiac effects by verapamil suggests that glucagon's action may be via glucagon-induced calcium movement through calcium channels, although extracellular calcium changes do not alter glucagon's effect. Furthermore, the persistence of glucagon's cardiovascular actions following beta-adrenergic blockade indicates the potential clinical utility of glucagon in reversing the adverse effects of beta-blocker overdoses, and its potential usefulness in treating circulatory shock in "beta-blocked" patients.

Animals↗
PubMed1986

Somatostatin analog: effects on hypergastrinemia and hypercalcitoninemia.

A somatostatin analog (SMS 201-995) was used to treat symptomatic patients with a residual tumor burden of gastrinoma or medullary thyroid carcinoma and pathologic elevations of circulating marker peptides associated with these neuroendocrine tumors. Possible inhibitory effects of the analog on marker peptides, patients' symptoms, or tumor progression were studied in a dose-response protocol and during several months of self-injection of SMS 201-995. Both patients reported remarkable relief of secretory diarrhea and other symptoms, and serum gastrin was successfully suppressed by increasing doses of the analog. However, no effect was seen in reduction of hypercalcitoninemia. Morphologic imaging of residual tumor showed no progression of medullary thyroid carcinoma during treatment and, in the case of hepatic gastrinoma metastases, remarkable tumor regression was confirmed. No toxicity or glucose intolerance was experienced. Somatostatin analog shows promise for palliative management of endocrinologic symptoms due to neuroendocrine tumors, and an inhibitory effect can be measured in some but not all peptide markers. Further evidence of its negative trophic effect on tumor blood flow may suggest an antineoplastic potential, as well as palliative use of this new treatment.

Adult↗