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Biomedical subjects

G Mendelsohn

Publications and source records attributed to G Mendelsohn.

At least 73 records · Page 4Linked to original sources
PubMed1980

Hyperinsulin hypoglycemia in the neonate: therapeutic choices.

Lack of elevated serum insulin in 3 patients with nesidioblastosis following 95% pancreatectomy leaves one with the theoretical possibility that the recurrent hypoglycemia is not due to excess insulin secretion, but rather an iatrogenic hypoglucagon state. If this explanation is correct, progression to a "total" pancreatectomy may not be the appropriate form of therapy. It seems to us that further evaluation of other hormones secreted by the endocrine portion of the pancreas must be clarified before continuing extensive or total pancreatic resections for nesidioblastosis in infancy.

Glucagon↗
PubMed1980

Immunoprotein deposition in the cornea.

A 63-year old woman had bilateral, multi-level corneal deposits distributed as fine, discrete crystals and in dense, deep geographic patches. She had a long history of sero-positive rheumatoid arthritis. Autopsy revealed an unsuspected lymphoproliferative disorder and immune-complex disease. Histologic examination of the eyes revealed eosinophilic, PAS-positive, noncollagenous deposits in the cornea at all levels and also in the ciliary processes, pars plana, and choroid. Stains for gold, amyloid, and acid mucopolysaccharides were negative. Immunoperoxidase stains were positive for IgG most strongly, and also for IgA, kappa and lambda light chains. Transmission electron microscopy showed needle-like electron-dense extracellular particles which we presume are immunoglobulins.

Cornea↗
PubMed1980

Carcinoid tumors of the rectum. Silver reactions, fluorescence, and serotonin content of the cytoplasmic granules.

The argyrophil and argentaffin staining reactions of the intracytoplasmic granules of 23 carcinoid tumors of the rectum were studied. The granules were evaluated for the presence of amines by means of formalin-induced fluorescence and an immunoperoxidase method for serotonin. The results indicate that most rectal carcinoids are argyrophil when the more sensitive Grimelius method is employed. Only occasionally are rectal carcinoids argentaffin, a feature that correlates with positive fluorescent reactions and suggests amine content. Of three argentaffin tumors, one stained positively for serotonin, and a second contained clusters of pleomorphic electron-dense granules of the type more typically seen in known amine-containing carcinoid tumors. For practical purposes, the Grimelius argyrophil stain is most useful in confirming a light-microscopic diagnosis of a rectal carcinoid.

Adolescent↗
PubMed1980

Anaplastic variants of medullary thyroid carcinoma: a light-microscopic and immunohistochemical study.

Three unusual cases of anaplastic medullary thyroid crcinoma, two having small cell characteristics and one having the features of an anaplastic giant-cell carcinoma, were encountered during a review of 110 cases of familial and sporadic medullary carcinoma. Immunoperoxidase demonstration of calcitonin within tumor cells in these three cases enabled differentiation of the two small cell variants from lymphoma or other small cell carcinomas, and differentiation of the anaplastic giant-cell variant from other giant cell carcinomas of the thyroid. Although the existence of small cell carcinomas of the thyroid gland has been questioned, this study shows that small cell carcinomas of the thyroid gland do exist and that at least some are variants of medullary carcinoma. Whereas previous immunohistochemical studies have been successfully employed in defining the spectrum of C-cell proliferative disorders and in understanding the evolution of medullary thyroid carcinoma, this study demonstrates the value of these techniques in diagnostic pathology. Immunoperoxidase staining can be successfully used in differentiating unusual variants of medullary carcinoma from other thyroid tumors.

Adult↗
PubMed1980

Hyperinsulinemic hypoglycemia of the neonate associated with persistent fetal histology and function of the pancreas.

Early in development, the fetal pancreas is characterized by the presence of two distinct generations of endocrine cells and a B-Cell mass that is unresponsive to acute changes in circulating glucose levels. Near the end of intrauterine development, the normal pancreas has "matured" and contains a single generation of endocrine cells and B-Cells that are responsive to changes in glucose concentrations. Recent microscopic examination of resected pancreatic tissue from an infant with hyperinsulinemic hypoglycermia revealed a combination of all three of the currently accepted findings in this neonatal condition: hyperplasia, adenomatosis, and nesidioblastosis. These observations prompted the following hypothesis: When compared to the usual histology of the developing pancreas, nesidioblastosis may be interpreted as an abnormal continuation of normal proliferation of endocrine cells; hyperplasia may be a specific overproduction of the Secondary Islands of Langerhans; and adenomatosis may be an abnormal continuation or overgrowth of the Primary Island of Langerhans. Such extrapolation suggests that infants with hyperinsulinemic hypoglycemia may represent a failure in the normal histological and functional maturation of the endocrine portion of the fetal pancreas.

Adenoma↗
PubMed1979

Infective endocarditis during the first decade of life. An autopsy review of 33 cases.

Twenty-six cases of infective endocarditis seen at autopsy during the first decade of life, between 1911 and 1944, are compared with seven fatal cases between 1944 and 1977. The incidence of infective endocarditis at autopsy in this age-group has decreased since 1944 (0.60% to 0.23%). Before 1944, Gram-positive cocci were most frequently responsible. Rheumatic heart disease (31%) more often predisposed to infective endocarditis than did congenital heart disease and left-sided valves were most frequently involved. Peripheral septic foci and penumonia were the most frequent sources of infection. The introduction of penicillin and advances in cardiology and cardiovascular surgery have had considerable impact of the spectrum and evolution of the diseases. Fungi and uncommon opportunistic bacteria are now frequently encountered. Rheumatic heart disease rarely predisposes to infective endocarditis in this age-group, congenital heart disease being the major underlying disease.

Age Factors↗
PubMed1979

Levels of histaminase and L-DOPA decarboxylase activity in the transition from C-cell hyperplasia to familial medullary thyroid carcinoma.

The distribution of calcitonin, L-dopa decarboxylase, and histaminase is studied in sectioned total thyroid glands from patients with different stages of familial medullary thyroid carcinoma. In 5 glands with gross carcinoma and in 3 with early microscopic carcinoma the distribution of all three parameters positively correlates (p less than .01 for each correlation). In contrast, in 6 glands with C-cell hyperplasia only the distribution of calcitonin and L-dopa decarboxylase correlates (r = 0.64, p less than .01) while those for histaminase vs. calcitonin (r = .17, p = N.S.) and histaminase vs. dopa decarboxylase (r = .03, p = N.S.) do not. In the glands with microscopic carcinoma the peak levels of histaminase occur in the areas of disease as defined by immunohistochemical staining of calcitonin; mean histaminase activity is the only one of the three parameters measured that distinguishes between C-cell hyperplasia and microscopic carcinoma (p less than .005). Immunohistochemical staining of histaminase shows positive cells in glands with gross and microscopic carcinoma, but in none of the glands with hyperplasia alone. Histaminase is thus found in high amounts in some malignant C-cells only and may be a useful marker to distinguish between hyperplasia and malignancy in thyroids with early C-cell proliferative disorders.

Amine Oxidase (Copper-Containing)↗
PubMed1979

Distribution of beta-endorphin immunoreactivity in normal human pituitary.

Recent immunohistochemical demonstration of calcitonin in rat pituitary has suggested that calcitonin, in addition to ACTH, endorphins, lipotropins, and melanocyte-stimulating hormones might be derived from a 31,000-dalton glycoprotein percursor molecule. This immunoperoxidase study demonstrates a similar distribution for beta-endorphin and ACTH immunoreactivity in human pituitary; however, the two peptides are not necessarily present in the same cells at all times. Calcitonin could not be demonstrated in human pituitary under conditions suitable for demonstration of the peptide in thyroid C cells. Weakly positive immunostaining could be obtained only with much increase in antiserum concentration and length of incubation, and higher concentrations of calcitonin were needed to abolish staining in preabsorption studies. It thus appears that the immunoreactive calcitonin in human pituitary differs from that in thyroid C cells. Likewise, we could not demonstrate immunoreactive endorphin in any developmental stage of medullary thyroid carcinoma. Our study suggests that caution should be applied in considering a physiologic role for calcitonin in the pituitary and in postulating a common peptide origin for endorphin and calcitonin in humans.

Adrenocorticotropic Hormone↗
PubMed1979

Vasoactive intestinal peptide and its relationship to ganglion cell differentiation in neuroblastic tumors.

Immunohistochemical studies have demonstrated that immunoreactive vasoactive intestinal peptide is present in, and restricted to, the differentiating and mature ganglion cells in a variety of normal and neoplastic neural tissues. In a composite pheochromocytoma-ganglioneuroma (associated with the syndrome of watery diarrhea, hypokalemia, and hypochlorhydria), five ganglioneuroblastomas, five ganglioneuromas (two of which were associated with diarrheal syndromes), an unusual mixed neuroblastoma-ganglioneuroma, and four normal sympathetic ganglia, vasoactive intestinal peptide was present in differentiating and mature ganglion cells. The peptide was also demonstrated in isolated ganglion cells in two pheochromocytomas but was not present in pheochromocytes, Schwann cells, or undifferentiated neuroblastic cells in the neuroblastomas and ganglioneuroblastomas. These studies indicate that the presence and presumably the production of vasoactive intestinal peptide thus reflect a particular line of neuroblastic differentiation and are not merely a reflection of common derivation of these tissues. Our identification of vasoactive intestinal peptide in neurogenic tumors associated with diarrhea supports the contention that the peptide might be an important diarrheogenic factor in these tumors.

Adrenal Gland Neoplasms↗
PubMed1979

Ileal adenomas after colectomy in nine patients with adenomatous polyposis coli/Gardner's syndrome.

Adenomas of the ileal mucosa are an uncommon finding in adenomatous polyposis coli/Gardner's syndrome. We report 9 patients who were found to have ileal adenomas 1 yr 11 mo to 25 yr 11 mo after colectomy. The ileal adenomas occurred proximal to an ileorectal anastomosis in 7 patients, both proximal to a cecoproctostomy and later proximal to an ileostomy in 1 patient, and in an ileostomy in 1 patient. The cases confirm that ileal mucosa is susceptible to adenoma formation in adenomatous polyposis coli/Gardner's syndrome and thus provide additional evidence that adenomas are not confined to the colon in these patients. In addition, the findings in the cases suggest that the ileal adenomas developed after colectomy. Thus, our cases suggest that the small intestine should be studied for the presence of adenomas after colectomy with either ileoproctostomy or ileostomy, as well as before resection. On the other hand, aggressive management does not seem warranted as carcinoma of the jejunum and ileum has been reported only rarely.

Adult↗
PubMed1978

Variable content of histaminase, L-dopa decarboxylase and calcitonin in small-cell carcinoma of the lung. Biologic and clinical implications.

To ascertain whether the content of endocrine markers is constant in small-cell carcinoma of the lung, levels of three markers of medullary thyroid carcinoma were studied in this tumor. Histaminase was increased in six of six primary tumors (three to 14,000 times), L-dopa decarboxylase in four of six (six to 30 times), and calcitonin in one of one (eight times) over levels in adjacent lung. Marker levels in mediastinal metastases reflected those in primary tumors in four of five patients. However, in four of seven, multiple hepatic metastases contained low to absent levels despite simultaneously high values in chest lesions. Immunohistochemical studies of histaminase revealed that within each primary tumor different cells contained different amounts of the enzyme. Since marker content varied between tumor cells, between primary tumors and between metastases in individual patients we conclude that circulating levels of these three markers cannot be expected necessarily to mirror tumor burden in patients with small-cell lung tumors.

APUD Cells↗
PubMed1978

Supravalvular aortic stenosis with parafollicular cell (C-cell) hyperplasia.

Autopsy examination of a patient with well-documented supravalvular aortic stenosis and other characteristic features of the idiopathic infantile hypercalcemia syndrome revealed previously unreported hyperplasia of parafollicular cells (C cells). Immunohistochemical analysis demonstrated up to 30 calcitonin-containing cells per high power field, whereas normal glands contain only 4 to 10 cells per low power field in areas of highest concentration. The parathyroid glands were found to be normal both grossly and microscopically, whereas the bones showed thickened trabeculas, normal Haversian canals and no apparent increase in osteoblast or osteoclast activity, suggesting normal parathyroid hormone, but increased thyrocalcitonin activity. We suggest that C-cell hyperplasia has occurred in response to a persistent, rather than transient, elevation in serum calcium levels and that thyrocalcitonin function is augmented, rather than impaired in this disorder. The primary biochemical defect promoting hypercalcemia remains to be clarified, as well as the role, if any, such a defect plays in producing significant pathology in the central nervous system and in the cardiovascular, renal and skeletal systems.

Adult↗
PubMed1978

Dysgenetic male pseudohermaphroditism.

Dysgenetic male pseudohermaphroditism is a disorder of sexual differentiation in which patients present with bilateral dysgenetic testes, persistent müllerian structures, cryptorchidism and inadequate virilization. There were 10 patients with this syndrome seen at our hospital between 1956 and 1976. In this series, there was a 30 per cent incidence of testicular tumors. Because patients with dysgenetic male pseudohermaphroditism have a high incidence of testicular tumors this disorder, which is actually a variant of mixed gonadal dysgenesis, must be distinguished from the other forms of male pseudohermaphroditism.

Adult↗