Biomedical subjects
Publications and source records attributed to S Lipper.
Multiple thyroid carcinomas of divergent cellular origin are extremely rare. A case is presented in which two unrelated tumors, a medullary carcinoma and a papillary carcinoma, occurred as a collision tumor.
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Fifty-six inpatients with unipolar depression completed treatment with isocarboxazid. In comparing the differences between responders and nonresponders, it was found that psychomotor retardation, pathological guilt, daily persistence of unremitting symptoms, phobic anxiety, dexamethasone suppression test nonsuppression, and neuroticism were significantly more common among nonresponders. Reactivity of mood, blaming others, and extraversion were more common in responders. Total endogenous depression scores on the Newcastle 1, Newcastle 2, and Michigan scales were also significantly higher in nonresponders. Attained platelet monoamine oxidase inhibition was similar in both groups.
An unusual case is presented of a peripheral ameloblastoma arising on the buccal mucosa, which brings the total number of such cases to three. The occurrence and pathogenesis of peripheral ameloblastomas in general, are reviewed, especially with reference to the basal cell carcinoma.
The dexamethasone suppression test (DST) was administered to 28 male combat veterans with posttraumatic stress disorder. Six subjects (21%) were nonsuppressors. The nonsuppression rates for the subgroups with and without major depressive disorder according to the Research Diagnostic Criteria were 50% and 6%, respectively. The authors conclude that cortisol nonsuppression is rare in posttraumatic stress disorder unless there is concomitant major depression.
The normal adrenal gland contains two types of tissue, the adrenal cortical tissue and the adrenal medullary tissue. The cortex is divided into three portions: the outermost "zona glomerulosa," the central "zona fasciculata," and the innermost "zona recticularis." The adrenal medulla is a developmentally separate organ, derived from neuroectoderm, and is the site of epinephrine and norepinephrine production. Adrenal cortical adenoma is commonly the result of a basophilic tumor of the anterior pituitary that secretes excessive amounts of ACTH. Adrenal medullary hyperplasia (or pheochromocytoma) are clinically hazardous tumors because of their excessive secretion of catecholamines. Combined adrenal cortical adenoma and adrenal medullary hyperplasia of the right adrenal gland has never been described previously.
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Red blood cells from 18 lithium carbonate-treated patients with bipolar affective disorder and 12 normal volunteers were analyzed using 1H-nuclear magnetic resonance (NMR) spectroscopy. The spectra were analyzed for alanine, adenosine triphosphate (ATP), choline, 2,3-diphosphoglycerol, glucose, glutathione, glycine, and lactate. Significant elevations of choline and lactate were found in the lithium-treated patients compared with normal, unmedicated subjects. The elevation of lactate due to anaerobic metabolism in the red blood cells was further investigated via fluorometric analysis and appears to be caused by blood standing at room temperature. The observed increases in red blood cell choline are sufficiently high and statistically significant to warrant additional studies on the dramatic effects of lithium on this red cell metabolite, which might be important for an understanding of its mechanism of action in psychiatric disorders.
Platelet monoamine oxidase (MAO) activity was assessed in 23 patients with posttraumatic stress disorder and 19 age-matched male control subjects. An overall significantly lower MAO activity was observed in the posttraumatic stress disorder group. When the group was divided into those with and those without a history of alcohol abuse, only the former group differed significantly from control subjects. The heuristic importance of these findings is discussed.
Concentric membranous bodies (CMB) are described in the cytoplasm of hepatocytes in a liver biopsy from a patient with systemic lupus erythematosus (SLE). Histologically, the biopsy showed binucleated hepatocytes and rosette formation with lymphocytic infiltrates in portal fields. Hepatocyte cytoplasm showed focal fatty metamorphosis, focal staining for RNA with azure B at pH 4.0 (which was perchloric acid labile), diffuse alloxan-Schiff staining for protein, and PAS-positive, diastase-sensitive glycogen. By electron microscopy one to three CMB were present in 10-15% of hepatocytes. CMB appeared as concentric, "fingerprint" or parallel arrays of particle-studded, membranous profiles. Other membranous configurations included mazelike forms. The space of Disse was dilated. Bile ductular changes included basement membrane thickening and redoubling and luminal bulging of ductular epithelium devoid of microvilli. CMB have been rarely reported in human hepatoma and have not heretofore been observed in non-neoplastic human liver. Their appearance in hepatocytes in a patient with SLE may reflect an increase in protein synthesis during regeneration.
Vaginal glomus tumors are exceptionally rare, and have not been reported in the literature. A case of vaginal glomus tumor is described. Light and electron microscopic views are presented. The differential diagnosis and surgical approach are discussed.
Eighteen years after a Billroth II procedure for a duodenal ulcer, a 65-year-old man presented with a large epigastric mass which was clinically interpreted as a pancreatic carcinoma. Fourteen months later, reevaluation of the enlarging mass led to a diagnosis of a villous tumor of the afferent limb of the gastroenterostomy. Laparotomy revealed an advanced villous adenocarcinoma. We could find only one other similar case in a 50-year literature review.
In an attempt to evaluate the responsiveness of the serotonergic neurotransmitter system in depression, fenfluramine, a serotonin releasing agent, was administered to 18 depressed patients and 10 controls, and placebo was administered to 16 of the depressed patients in a double-blind paradigm. Plasma prolactin levels were measured prior to and for five hours following fenfluramine. Fenfluramine produced a significant increase in prolactin in both patients and controls. However, the prolactin response to fenfluramine whether measured as an absolute increase or percent increase from baseline was significantly less in depressed patients than controls. This difference remained equally statistically significant when age-and-sex-matched pairs of depressed patients and controls were compared. These results suggest that the central serotonergic system is less responsive in depressed patients than controls.
We report a case of paraganglioma of the cauda equina and filum terminale. Diagnosis was established by the histologic organoid pattern, immunohistochemical staining for neuron-specific enolase and ultrastructural dense-core neurosecretory granules. A survey of the literature yielded 16 previously reported cases, five of which were described in 1983. This suggests that heightened awareness of this entity will result in a corresponding increase in the reported incidence.
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