Biomedical subjects
Publications and source records attributed to H M Schipper.
Under normal circumstances, sex steroids interact with diverse neural substrates to modulate a host of activities essential to the preservation of the individual and the species. In addition, sex hormones play an important role in various human neurologic conditions including strokes, migraine, certain movement disorders and peripheral neuropathies, and possibly even the behavior of CNS neoplasms.
These brief reviews of selected neuroendocrine or hypothalamic syndromes reinforce several important concepts. Although the hypothalamus may be relatively inaccessible to the neurologic clinician, it is, paradoxically, the region of the CNS that most closely communicates with virtually all other physiologic systems. This is evident by the fact that hypothalamic dysfunction is frequently associated with "non-neurologic" symptoms such as manifestations of endocrine, gastrointestinal, or gynecologic disease. Traditionally, the hypothalamus has been difficult to study, and progress in understanding hypothalamic disorders has been slow in both neuropathology as well as clinical neurology. Nevertheless, as neurology evolves from a descriptive specialty into one increasingly characterized by therapeutic intervention, the challenge of clinical hypothalamic disease offers many exciting possibilities to the neuropharmacologist, neuroendocrinologist, and all astute bedside clinicians.
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Adenoid cystic carcinoma, or cylindromas, constitute a large and distinct group of neoplasms with characteristic microscopic features recognizable in tissues as varied as the nasal passages, tongue, and bronchi. Cylindromas of the larynx are rare and only 60 cases have been reported in a review of the literature in 1977. In this report, a case of adenoid cystic carcinoma originating in the subglottic area of the larynx is discussed, with emphasis on the clinical and pathologic characteristics. In the past, the histogenesis of cylindroma has been the subject of considerable controversy, but recent light microscopic and ultrastructural studies strongly implicate the seromucinous glands of the respiratory and upper digestive tracts as the tissues from which these neoplasms derive. In general, cylindromas of the upper alimentary and respiratory passages are best treated by wide surgical excision. Some clinicians have combined surgery with postoperative radiation therapy in an attempt to prevent or delay recurrence and metastases. Chemotherapeutic agents have also been employed in the postoperative management of adenoid cystic carcinoma although the longterm results of this treatment modality remain to be determined.
In the aging mammalian hypothalamus, a unique subpopulation of glial cells accumulates peroxidase-positive cytoplasmic inclusions distinct from lipofuscin. In adult rodents, this senescence-dependent glial granulation is accelerated by administration of estradiol valerate. In the present study, brain sections derived from male rats given 3 monthly intramuscular injections of estradiol valerate (0.2 mg or 2.0 mg) were immunostained for heat shock proteins and glial fibrillary acidic protein to determine whether a glial stress response is implicated in estrogen-induced granulation. Our findings indicate that estrogen elicits a heat shock response and subsequent granulation in astrocytes residing in estradiol receptor-rich brain regions including the arcuate nucleus and the wall surrounding the third ventricle but not in estradiol receptor-deficient regions such as the striatum and corpus callosum. The heat shock proteins induced by estrogen, namely, the 27, 72, and 90 kDa stress proteins, are upregulated in astrocytes in response to oxidative challenge supporting our hypothesis that estrogen mediates senescent changes in the rodent hypothalamus through oxidative mechanisms.
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The case of a young woman who presented with nausea, vomiting and diarrhea is outlined; the etiology turned out to be a first attack of multiple sclerosis. Plausible mechanisms are discussed.