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Biomedical subjects

B Lippe

Publications and source records attributed to B Lippe.

29 records · Page 2Linked to original sources

Airway obstruction in childhood thyroid carcinoma.

Thyroid carcinoma is an uncommon but well described childhood malignancy. Obstructive airway symptoms represent an unusual mode of presentation of this disease in childhood. A 5-year-old child with locally invasive follicular thyroid carcinoma had symptomatic wheezing for one year, thought to be asthma. Extrinsic compressive tumor or transtracheal, intraluminal tumor, while rare, should always be a consideration in atypical or medically refractory 'asthma' during childhood.

Adenocarcinoma↗

Intersex disorders in adolescents and adults.

Inasmuch as disorders of sexual development and differentiation are not all diagnosed during the neonatal period, physicians and surgeons do encounter such problems in adolescent and adult patients. Because phenotype and gender identity are usually already firmly established, complaints are likely to be functional. Current cytogenetic and hormonal techniques may clarify the cause of the abnormalities but will rarely lead to sex reversal. The therapeutic goal is, when feasible, to maintain and enhance existing sexual identity.

Adolescent↗

Chronic vitamin A intoxication. A multisystem disease that could reach epidemic proportions.

Two patients seen in a six-month period had a diffuse, multisystem disorder characterized by edema of the extremities and face, rash, bone pain and tenderness, symptoms of increased intracranial pressure, and hypercalcemia. Both had been receiving extraordinarily high doses of vitamin A for some time. Serum vitamin A concentrations were markedly elevated, and serum vitamin D concentrations were normal. The history of excessive vitamin administration was only elicited following the detection of hypercalcemia. This is a potential complication of the administration of unregulated food supplements, stressing the need for complete dietary histories in the evaluation of multisystem disorders, with or without hypercalcemia.

Bone and Bones↗

Use of growth hormone-gel.

We evaluated the efficacy of a depot preparation of growth hormone (GH) in a 15% gelatin solution (GH-gel) in the treatment of 15 growth hormone-deficient children. The studies were designed to see if prolonging absorption of GH to achieve lower more physiological concentrations of GH in plasma would decrease the frequency of injection, reduce the amount of GH needed for effective therapeutic response, and improve the response to long-term treatment. We found that after a single dose of GH-gel the plasma concentrations of GH were lower than those achieved after the standard aqueous preparation. The preparation was efficacious in promoting growth and our 1st study of 6 patients suggested that GH-gel given twice a week had a growth response equal to that of the three-times a week aqueous schedule. However both schedules resulted in the frequently observed decreased growth rate during the second treatment year. Our 2nd study, attempting to ameliorate this waning effect by using the GH-gel preparation twice a week in a weight-adjusted dose during the entire second year did not resolve the problem. Thus, GH in depot gel results in more physiological plasma concentrations of GH and may be beneficial in reducing the quantity of hormone needed and the injection frequency but it does not offer a solution to the waning response to the long-term administration of GH.

Adolescent↗

Inconsistent expression of both centromeres of a dicentric Y chromosome in a child with ambiguous external genitalia.

A newborn child with ambiguous external genitalia had evidence of internal female development on the left and internal male development on the right. Blood chromosome analysis showed three cell types: 45,X; 46,XY with the Y being submetacentric and about twice the usual size with two 'centromeric' C bands; and 46,X,dic(Y). Chromosome studies from the skin, uterus, and Fallopian tube showed almost exclusively 45,X cells. This represents the second reported patient in whom two centromeres are inconsistently expressed though present as shown by two 'centromeric' C bands.

Azure Stains↗

Experience with reduction clitoroplasty for clitoral hypertrophy.

A technique for reduction clitoroplasty has been devised which provides an excellent cosmetic appearance for female patients with clitoromegaly due to virilizing CAH. Contrary to previous views, total clitorectomy should rarely, if ever, be considered as an initial method of management of children with clitoral hypertrophy. One of the 4 patients who has undergone reduction clitoroplasty using the described technique has achieved sexual gratification on several occasions postoperatively without discomfort.

Adolescent↗