Loren W Greene, M.D.

Differentiating radiation (131I) sialadenitis from autoimmune (Sjogren's syndrome) sialadenitis: Case report
Mandel L.; Greene L.W.
2011 ;21:A59-A60, Thyroid
131-I is actively secreted by the salivary glands,causing obstructive symptomatology and hyposalivation. Low dose 131I rarely causes dry mouth but commonly causes post-meal obstructive swelling. Dry mouth in a patient treated with 131-I was due to existing secondary Sjogren's syndrome (SS) exacerbated by RAI. Scintographic, serologic, microscopic findings confirmed secondary SS. Salivary glands concentrate and secrete Technetium-99m pertechnetate (TPT). TPT time/activity scintiscan examines activity of 4 major salivary glands in real-time, distinguishing salivary symptomatology post-131-I from SS. Ductal wall inflammation and blockage following low dose 131-I; scintiscan shows adequate pickup of TPT, but failure to secrete. In contrast, SS causes lymphocytic replacement of entire parenchyma, interfering with acinar cell pickup; scan shows minimal parotid activity. A thyroid cancer patient treated with 131-I showed no parotid activity, pickup or secretion of TPT, but normal submandibular TPT concentration and secretion. Total parotid parenchymal destruction with hyposalivation is more consistent with SS, rather than 131-I effects. Labial microscopy showed focus score = 1 (Chisholm grade 3) lymphocytic clumped foci, consistent with SS. 131-I sialadenitis (Graph presented) causes diffuse lymphocytic distribution. Schirmer test: normal bilateral tear production. Differentiation of dry mouth of autoimmune from radiation sialadenitis is shown by TPT scan. Usually > 150 mCi is required for hyposalivation, and drying effect is not total. Total parotid parenchymal destruction with hyposalivation is more consistent with SS diagnosis
— id: 140546, year: 2011, vol: 21, page: A59, stat: Journal Article,

Adrenal insufficiency after laparoscopic hysterectomy in a patient with primary antiphospholipid syndrome
Dierking, E; Gogoi, R; Adamcik, S; Greene, L W; Curtin, J P
2008 Feb;111(2 Pt 2):495-498, Obstetrics & gynecology
BACKGROUND: We report a case of bilateral adrenal hemorrhage and subsequent adrenal insufficiency after a laparoscopic hysterectomy in a patient with anticardiolipin antibody syndrome. CASE: A 55-year-old woman with a history of anticardiolipin antibody syndrome presented with nausea and vomiting 1 week after laparoscopic hysterectomy and staging for endometrial adenocarcinoma. Based on a diagnosis of adrenal insufficiency, the patient was started on oral hydrocortisone 20 mg in the morning and 10 mg in the afternoon, and fludrocortisone 0.05 mg twice daily on day 5. Her symptoms resolved completely within 24 hours of beginning steroids. CONCLUSION: The diagnosis of adrenal insufficiency should be entertained in any patient with a history of thrombophilias presenting with general abdominal complaints
— id: 79252, year: 2008, vol: 111, page: 495, stat: Journal Article,

Octreotide therapy for recurrent refractory hypoglycemia due to sulfonylurea in diabetes-related kidney failure
Gonzalez, Rita R; Zweig, Susan; Rao, Jyoti; Block, Romy; Greene, Loren W
2007 Jul-Aug;13(4):417-423, Endocrine practice
OBJECTIVE: To describe a patient with kidney insufficiency from diabetes treated with glyburide, who presented with prolonged and recurrent hypoglycemia unresponsive to large intravenous doses of glucose, which was treated successfully with intravenously administered octreotide, and to review the therapeutic options for hypoglycemia. METHODS: We present a case report of a 66-year-old man with diabetes causing chronic kidney disease, who was treated with orally administered glyburide, 7.5 mg twice a day. He initially presented to another hospital because of hypoglycemia and was treated with intravenously administered glucose and discharged. The next day, his family brought him to our emergency department because of recurring low blood glucose levels and symptoms of sweating, fever, and nightmares. Laboratory tests revealed a blood glucose level of 33 mg/dL and a creatinine concentration of 6.2 mg/dL. RESULTS: The patient was treated with a 5% dextrose and, subsequently, a 10% dextrose infusion without any sustained improvement. The blood glucose level remained low despite the additional administration of 3 ampules of 50% dextrose in water. The patient was given a bolus of octreotide (50 mug subcutaneously) 14 hours after his second presentation. He received another 50-mug dose of octreotide 6 hours later. After this bolus, the hypoglycemia resolved, and he no longer required intravenous administration of glucose to maintain euglycemia. CONCLUSION: Patients with diabetes and kidney disease frequently have persistent and difficult-to-treat hypoglycemia, unresponsive to conventional therapy. Octreotide is an effective and safe treatment for patients with refractory hypoglycemia attributable to sulfonylureas
— id: 73812, year: 2007, vol: 13, page: 417, stat: Journal Article,

Toward optimal health: The experts discuss thyroid disease
Meisler, JG; Greene, LW; Cobin, R
2000 MAY ;9(4):345-350, Journal of women's health & gender-based medicine
— id: 54656, year: 2000, vol: 9, page: 345, stat: Journal Article,

The unofficial guide to living with diabetes
Thomas, Maria; Greene, Loren W.
[S.l.] : John Wiley, 1999,
— id: 743, year: 1999, vol: , page: , stat: ,

Management of menopause without estrogen
Greene LW; Kurland ES
1994 Jan/Feb;:38-42, Diabetes self-management
— id: 36567, year: 1994, vol: , page: 38, stat: Journal Article,

Managing menstruation
Greene LW; Pearlman S
1994 July;:?-?, Diabetes self-management
— id: 36565, year: 1994, vol: , page: ?, stat: Journal Article,

Women and diabetes : what you should know about osteoporosis
Greene LW; Kaufman C
1993 Sept/Oct;:38-42, Diabetes self-management
— id: 36566, year: 1993, vol: , page: 38, stat: Journal Article,

Computerized axial tomography in the diagnosis and management of thyroid and parathyroid disorders
Blum M; Reede DL; Seltzer TF; Burroughs VJ; Greene LW; Roses DF
1984 Jan-Feb;287(1):34-39, American journal of the medical sciences
Computerized axial tomography (CAT) was used to study 39 patients with known thyroid disease and 14 patients with primary hyperparathyroidism. In all, CAT was performed only when information that was required for diagnosis or therapy was not available from other less expensive techniques. The greatest value was found in the evaluation of cryptic symptoms or structures in the neck after surgery for thyroid cancer, the assessment of the extent of thyroid cancer, the localization of aberrant thyroid tissue, the etiology of unexplained recurrent laryngeal nerve paralysis and the identification and delineation of mediastinal goiter. In six of 14 patients undergoing neck exploration for primary hyperparathyroidism CAT correctly localized the site of the enlarged parathyroid glands including one mediastinal parathyroid adenoma and one patient with two parathyroid adenomas
— id: 25107, year: 1984, vol: 287, page: 34, stat: Journal Article,

Adrenal insufficiency as a complication of the acquired immunodeficiency syndrome
Greene LW; Cole W; Greene JB; Levy B; Louie E; Raphael B; Waitkevicz J; Blum M
1984 Oct;101(4):497-498, Annals of internal medicine
— id: 36564, year: 1984, vol: 101, page: 497, stat: Journal Article,

RADIATION-DOSE ESTIMATES TO LARYNGEAL NERVE AS A RESULT OF I-131 TREATMENT FOR HYPERTHYROIDISM
CHANDRA, R; GREENE, L; BLUM, M
1983 ;10(5):732-732, Medical physics
— id: 40615, year: 1983, vol: 10, page: 732, stat: Journal Article,

Alcohol and the hypothalamus
Greene LW; Hollander CS
1981 ;18(4):15-23, Progress in biochemical pharmacology
— id: 29271, year: 1981, vol: 18, page: 15, stat: Journal Article,

Sex and alcohol: the effects of alcohol on the hypothalamic-pituitary-gonadal axis
Greene LW; Hollander CS
1980 Jan;4(1):1-5, Alcoholism: clinical & experimental research
Effects of alcohol on the hypothalamic-pituitary-gonadal axis are complex. Those at the gonadal level are best defined in studies such as those presented in this issue. However, there is an accumulating body of data supporting central effects of alcohol. The precise locus or loci is not certain. Further investigations probably including in vitro methodologies are likely to enhance our knowledge in this area. Our understanding of the effects of alcohol in the human female is especially limited
— id: 29273, year: 1980, vol: 4, page: 1, stat: Journal Article,

RECIPROCAL LOCAL FEEDBACK OF SOMATOSTATIN (SRIF) AND THYROTROPIN RELEASING HORMONE (TRH) IN DISPERSED CELL-CULTURE OF RAT HYPOTHALAMUS
Hollander, CS; Greene, LW; Rosman, L; Yamauchi, K; Richardson, S; Thaw, C; Deletto, R
1980 ;28(2):A479-A479, Clinical research
— id: 28116, year: 1980, vol: 28, page: A479, stat: Journal Article,

Response to thyrotropin-releasing hormone stimulation in young psychotic children: a pilot study
Campbell M; Hollander CS; Ferris S; Greene LW
1978 Apr;3(2):195-201, Psychoneuroendocrinology
— id: 29277, year: 1978, vol: 3, page: 195, stat: Journal Article,