Biomedical subjects
M B Nashelsky
Publications and source records attributed to M B Nashelsky.
New mesomelic dysplasia with absent fibulae and triangular tibiae.
We report on two unrelated, sporadic cases of a mesomelic dysplasia characterized by absence of fibulae and severely hypoplastic, triangular-shaped tibiae. Moderate mesomelic shortness was present in the upper limbs with proximal widening of the ulnae. There was also axial skeletal involvement in both cases, characterized radiographically by an abnormal pelvis and marked bilateral glenoid hypoplasia. These cases appear to represent a new form of mesomelic dysplasia distinct from those previously delineated.
Cholesterol granulomas of the lungs associated with microangiopathic hemolytic anemia and thrombocytopenia in pulmonary hypertension.
Cholesterol granulomas unrelated to endogenous lipoid pneumonia, pulmonary alveolar proteinosis, or cholesterol pneumonia are a rare finding during pneumectomy or autopsy. They have been occasionally reported in association with pulmonary hypertension. We report a case where these lesions were associated with long-standing pulmonary hypertension and microangiopathic hemolytic anemia and thrombocytopenia. Plexiform lesions were present in the pulmonary vasculature secondary to pulmonary hypertension, causing hemolysis and thrombocytopenia. We suggest that destruction of red blood cells and platelets could provide membrane lipids that are taken up by phagocytic cells, which promotes the formation of these cholesterol deposits.
Bilateral oncocytic cysts of the nasopharynx.
We describe a 59-year-old male patient noted to have bilateral oncocytic cysts of the nasopharynx. These cysts appear to represent retention cysts of peritubal mucoserous glands that have undergone oncocytic metaplasia and would be classified as lateral acquired cysts of the nasopharynx. These cysts are benign but may cause symptoms related to their location in the airway and proximity to the eustachian tube. Endoscopic surgical removal is the treatment of choice.
The time interval between lethal infant shaking and onset of symptoms. A review of the shaken baby syndrome literature.
Many health care professionals believe that there is a very short interval between an act of ultimately lethal infant shaking and the onset of symptoms (altered consciousness, convulsions, respiratory distress, and so on). We reviewed the English-language medical literature on the shaken baby syndrome for case reports or other information that documents the time of onset of symptoms after an act of ultimately lethal infant shaking. The medical literature contains minimal data that substantiate or contradict the contention that is stated here.
Homicide facilitated by inhalation of chloroform.
Three related homicides in which each decedent had significant concentrations of chloroform in blood, fat, brain and/or liver are described. The tissue concentrations of chloroform in one of three decedents were within reported lethal ranges. The concentrations in the remaining two decedents were less than lethal but were well above blood levels in nonoccupationally exposed, healthy subjects. The cause of death in one decedent with sublethal chloroform concentrations was suffocation; the cause of death in the other decedent could not be determined with certainty. The manner of death in each case was homicide. Through a review of the literature the authors discuss the history of chloroform as an inhalation anesthetic and the history of chloroform as an agent of abuse, suicide, assault, and homicide. Blood and/or tissue concentrations of chloroform in nonoccupationally exposed, healthy subjects and victims of suicide or homicide from previous reports are compared and contrasted with the amounts in blood and/or tissue in the three subjects described in this study. The authors conclude that, in addition to a direct lethal effect, chloroform may be used to incapacitate a victim of assault who then dies by another cause.
Cytogenetic abnormalities in B-immunoblastic lymphoma.
We have considered the cytogenetic abnormalities present in 27 unpublished cases of B-immunoblastic lymphoma. Among these 27 patients, the chromosome changes were heterogeneous and complex. The chromosomes most commonly gained were 3 (44% of cases), 18 (44%), 6 (30%) and 11 (30%). The most common structural abnormalities involved band 14q32 (26%), band 18q21 (15%) and bands 6q16-21 (19%). Study of these 27 immunoblastic lymphomas did not allow us to tentatively identify a common primary cytogenetic abnormality unique to B-immunoblastic lymphoma, however, a translocation at 14q32 may be the primary cytogenetic lesion in some of the cases. Rather, we have added to the number of abnormalities reported in immunoblastic lymphoma and in non-Hodgkin's lymphoma in general.
Reactivity of B72.3 with adenocarcinomas. An immunohistochemical study of 476 cases.
BACKGROUND: The monoclonal antibody B72.3 has been shown to react with several common types of adenocarcinoma. However, the distribution of B72.3 reactivity in adenocarcinomas has not been well-enough defined to determine whether B72.3 immunostaining would be helpful in the diagnosis of adenocarcinoma of unknown origin. METHODS: Formaldehyde fixed, paraffin-embedded tissue from 476 adenocarcinomas from a variety of primary sites were studied using B72.3 and an avidin-biotin complex immunohistochemical technique. RESULTS: B72.3 immunoreactivity was seen in 75-100% of the adenocarcinomas from the ovary, endocervix, endometrium, distal esophagus/stomach, colon, lung, breast, prostate, pancreas, and bile ducts. Positive reactions were unusual in thyroid carcinomas (7%) and renal cell carcinomas (11%). B72.3 reactivity was not seen in the 20 hepatocellular carcinomas or 4 adrenal cortical carcinomas studied. CONCLUSIONS: B72.3 reacts with a wide variety of adenocarcinomas. Immunostaining with B72.3 may be helpful in excluding hepatocellular carcinoma in certain clinical settings.