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Biomedical subjects

P J Numann

Publications and source records attributed to P J Numann.

28 records · Page 2Linked to original sources

Immunocytochemical localization of insulin- and somatostatin-like material in human breast tumors.

Four types of human breast lesions and C3H mouse mammary adenocarcinomas (type A) were examined for the immunocytochemical localization of cells containing hormone-like substances. Insulin- or somatostatin-like immunoreactive material was observed in scattered single cells and nests of tumor cells in seven of eight infiltrating duct carcinomas, and in the majority of tumor cells from an anaplastic carcinoma. A few somatostatin-immunoreactive cells were observed in only one of seven fibroadenomas studied. No immunoreactive cells were observed in mouse adenocarcinomas or in human breast dysplasias. These results suggest that cells with hormone-like immunoreactivity may be a common feature in two types of malignant human breast tumors.

Adenocarcinoma↗

Needle localization of occult breast lesions.

Excision of mammographically demonstrated breast lesions that are clinically occult remains a surgical challenge. Eighteen lesions were preoperatively localized (all but 1 with the Frank hooked wire technique). Eleven lesions were evaluated with specimen radiography. Three lesions proved to be malignant at biopsy and 15 were benign. We found hooked wire needle placement to be extremely accurate, enabling rapid excision of the suspicious mass with excision of rather small areas of the breast with no significant cosmetic defect. Mean anesthetic time for breast biopsy alone was slightly less than time for biopsy with needle localization, which was less than that when specimen radiography was employed. In the absence of a discrete lesion, specimen radiography is a useful adjunct. Needle localization is simple, accurate, rapid, and requires no special apparatus. Its widespread use should lead to the identification of more breast carcinomas in a potentially curable state.

Adult↗

Neuropsychologic deficits associated with primary hyperparathyroidism.

Although neuropsychologic dysfunction has been recognized as a symptom of primary hyperparathyroidism since the earliest descriptions of the disease, the nature of the memory, learning, and cognition deficits has been poorly defined. To assess the nature and extent of the deficits, 10 patients with hyperparathyroidism without specific neuropsychologic complaints and 10 normocalcemic patients were tested with a battery of psychologic tests before and after operation. Postoperative test scores for the Wechsler Logical Memory and Associate Learning, Wechsler Memory Digit Span, and the Similarities subtest of the Wechsler Adult Intelligence Scales, which test short-term verbal memory and cognition, showed statistically significant improvement for the patients with hyperparathyroidism. The patients with hyperparathyroidism improved on the Wechsler Memory Quotient an average of 17%. Tests measuring conceptual tracking, short-term visual memory, graphic skills, and fine motor coordination were unchanged. The results suggest that dominant hemispheric functions are disrupted by hyperparathyroidism. Improved neuropsychologic function can be expected after parathyroidectomy and, since the deficit is difficult to assess before operation, may be an indication for operation in the patient without symptoms.

Cognition↗

Immunoreactive hormones in human breast tissues.

Samples of breast tissue obtained at biopsy or mastectomy from women with benign breast disease and infiltrating duct or anaplastic carcinoma were maintained for 2 weeks in organ culture synthetic medium 199 without additional serum or hormones. Media were changed every 48 hours. Media withdrawn from the tissues were assayed for insulin, prolactin (Prl), and parathyroid hormone (PTH). In addition, tissue explants were extracted in acid-alcohol and assayed for insulin by standard radioimmunoassay (RIA) procedures. At day 0 portions of breast tissue from patients with malignant or benign disease were fixed in Bouin solution; they were then embedded in paraffin; and serial sections were obtained for histologic and immunocytochemical examination. The dissection media assayed for insulin and PTH by RIA showed that the hormones were present in media from patients with benign as well as malignant disease. However, there was no significant difference between the two groups of women. Only traces of Prl were detected in media. The amount of insulin present in certain tissue explants appeared to increase with time in culture. Immunocytochemical studies showed that insulin-like or PTH-like immunostaining appeared most often in malignant tumor tissue and was observed infrequently or not at all in patients with benign disease. Prl-positive cells were rare. These data suggest that breast tissues contain and may synthesize significant amounts of certain hormones that may influence the growth and proliferation of breast cells.

Adult↗

Chlorpropamide-induced changes in patients with hyperparathyroidism.

Ten patients with primary hyperparathyroidism were placed on a constant 30 mEq of calcium and 120 meq of sodium diet, and alterations in their calcium balance in response to standard oral doses of chlorpropamide were studied over a 4 day control period and a 4 day treatment period. The 10 patients treated with chlorpropamide significantly increased the urinary excretion of calcium and sodium and decreased the excretion of cyclic adenosine monophosphate (AMP). The serum calcium was lowered in six of the patients treated with chlorpropamide, and three of these patients, who had diabetes mellitus and either refused or were too ill for parathyroidectomy, continued to receive chlorpropamide for periods of 9 to 36 months. These three patients experienced prolonged lowering of the serum calcium level and became less confused, lethargic, and fatigued. The interrelationships between the chlorpropamide-induced changes in excretion of calcium, sodium, and cyclic AMP still must be clarified.

Adenosine Monophosphate↗

Details of technique and results of staging laparotomy in the diagnosis of Hodgkin's disease.

The operative procedure for staging laparotomy in Hodgkin's disease is described in detail. Of 18 patients undergoing this procedure, staging laparotomy changed the stage of disease and subsequent therapy in 38%. Complications of the operation were minor, occurring in only two patients. Abnormal lymphangiography and splenomegaly proved unreliable clinical diagnostic findings. Most disturbing was the 100% incidence of amenorrhea in the women receiving pelvic irradiation following oophoropexy.

Adolescent↗

Hypokalemia in a patient with pheochromocytoma.

OBJECTIVE: To report the occurrence of hypokalemia in a patient with pheochromocytoma. METHODS: We present a case report and discuss the possible role of hyperepinephrinemia as a cause of hypokalemia. RESULTS: A patient with pheochromocytoma had hypokalemia associated with vomiting, but hypokalemia recurred after repletion of potassium and cessation of vomiting. She had substantially increased epinephrine concentrations in the plasma and in the subsequently excised pheochromocytoma. Because evidence has shown that infusions of epinephrine induce hypokalemia in normal human subjects, the relationship between serum potassium and plasma epinephrine concentrations in 16 previous patients with pheochromocytoma and 4 patients with primary hyperepinephrinemia was studied. A significant negative correlation was noted. CONCLUSION: The presence of hypokalemia and its potential role in predisposing to arrhythmias in patients with pheochromocytoma merit further study.

Journal Article↗