The rapid low-dose (1 microgram) cosyntropin test in the immediate postoperative period: results in elderly subjects after major abdominal surgery.

Background: Recently the rapid low-dose (1 microgram) cosyntropin test has been found to be superior to the standard (250 micrograms) rapid cosyntropin test for evaluating the hypothalamic-pituitary-adrenal axis. Because the 1-microgram test has not been studied in postoperative patients, we evaluated the test after major abdominal surgery.

Methods: We performed rapid 1-microgram cosyntropin tests in 20 patients aged 65 years or older immediately and 24 hours after uncomplicated elective abdominal surgery (group A) and in 10 patients who were suspected of having adrenal insufficiency after abdominal surgery (group B).

A Muir-Torre syndrome family.

The Muir-Torre syndrome is a rare autosomal-dominant disease involving sebaceous neoplasms as markers for multiple internal malignancies. Diagnostic criteria include at least one sebaceous gland adenoma, epithelioma, or carcinoma and at least one internal malignancy. The world literature contains 162 cases with 316 internal malignancies.

Management of thyroid cancer of follicular cell origin: Gundersen/Lutheran Medical Center, 1969-1995.

Background: Most reports regarding the treatment of thyroid cancer originate from university referral centers. In this article, we report our experience in managing thyroid cancer of follicular cell origin at a non-university institution over a 26-year period.

Study Design: We reviewed the medical records of all patients treated for thyroid cancer at the Gundersen/Lutheran Medical Center from 1969 to 1995.

Neoplasms in long-term Hartmann's pouches.

A Hartmann's pouch is a blind segment of the rectum created in conjunction with a colon resection in which primary bowel reanastomosis is judged unsafe. Often forgotten, this defunctionalized rectal pouch has a high potential of pathologic lesions, including disuse proctitis, ulcers, bleeding and occasionally neoplasm formation. What are the consequences of Hartmann's pouches left unattended? In this paper, we discuss three patients with neoplasms in a long-term Hartmann's pouch and the pathophysiology of the long-term defunctionalized rectum.