Phentolamine continuous infusion in a patient with pheochromocytoma.

Purpose: Use of continuous phentolamine infusion therapy for management of serious cardiovascular complications during adrenalectomy for pheochromocytoma is reported.

Summary: In preparation for surgical resection of a pheochromocytoma, a 38-year-old woman received outpatient oral therapy with the α-adrenergic-receptor blocker phenoxybenzamine for 25 days with the goal of reducing cardiovascular risks associated with catecholamine surge during surgery. Due to inappropriate dosage adjustment, however, outpatient phenoxybenzamine therapy did not achieve adequate α-adrenergic-receptor blockade; during the laparoscopic resection procedure, the woman developed severe hypertension, leading to cardiac arrest and discontinuation of the operation.

Thyrotoxicosis due to ectopic lateral thyroid tissue presenting 5 years after total thyroidectomy.

Objective: To describe a patient who, 5 years after total thyroidectomy to treat Graves disease, presented with thyrotoxicosis due to nonmalignant lateral ectopic thyroid tissue.

Method: We describe the laboratory, imaging, and physical findings of the study patient and review the relevant literature.

Results: A 32-year-old white woman with a history of Graves disease presented with recurrent hyperthyroidism 5 years after total thyroidectomy.

An atlas improves interobserver agreement regarding application of the ISCD vertebral body exclusion criteria.

Coexisting conditions such as osteoarthritis and compression fracture may spuriously elevate the dual-energy X-ray absorptiometry (DXA)-measured lumbar spine bone mass. To improve the diagnostic utility of lumbar spine DXA to diagnose osteoporosis, the International Society for Clinical Densitometry (ISCD) suggests excluding vertebrae affected by focal structural anomalies or unusual T-score discrepancies. However, we previously demonstrated only moderate agreement between physicians regarding vertebral body exclusion.

Traumatic fracture in a healthy man: benign or pathologic?

Objective: To describe the challenge of determining the correct diagnosis in a healthy adult male patient with a recent femoral fracture and a history of multiple bone fractures.

Methods: We present clinical, radiologic, laboratory, and histopathologic details in a patient with a history of recurrent fractures associated with minimal trauma. Moreover, the various types of osteopetrosis are reviewed.

Intimal estrogen receptor (ER)beta, but not ERalpha expression, is correlated with coronary calcification and atherosclerosis in pre- and postmenopausal women.

Background: Controversy exists over the association of estrogen and cardiovascular disease. Estrogen receptors (ERs) alpha and beta are expressed in the endothelial cells and vascular smooth muscle cells (VSMCs) of many arteries, but the relative importance of ERalpha or ERbeta in mediating the vascular response to estrogens is not well defined, particularly in humans. We have shown previously that postmenopausal women receiving hormone therapy (HT) had lower mean coronary artery calcium, plaque area, and calcium-to-plaque ratio compared with untreated women.

Correlating androgen and estrogen steroid receptor expression with coronary calcification and atherosclerosis in men without known coronary artery disease.

Background: Accumulating data emphasize the gender specificity of key components of the atherosclerotic process and the importance of gonadal steroids on the human vasculature. Steroid receptors, including the androgen receptor (AR) and estrogen receptors (ERs) alpha and beta are expressed in key vascular tissues, including endothelial cells and vascular smooth muscle cells. However, the relative abundance and importance of these receptors in the coronary artery are not well defined, particularly in men.

Prevalence and predictors of coronary artery calcification in women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS), a common endocrine disorder of reproductive-aged women, is associated with multiple risk factors for coronary heart disease (CHD), such as diabetes mellitus, dyslipidemia, visceral obesity, and hypertension. However, premature coronary atherosclerosis has not been demonstrated in PCOS women. Electron beam computed tomography (EBCT) noninvasively measures coronary artery calcium (CAC), a marker for coronary atherosclerosis.