Biomedical subjects
Publications and source records attributed to H R Chung.
We describe a case of Behçet's disease (BD) which showed the ileocecal ulcer and cecocecal fistula. This 38-year-old man had appendectomy six years ago because of colicky pain in the right lower abdomen (RLA). There are some reports on fistula formation in BD. In those, some are related to surgery and others are not. BD with cecocecal fistula, possibly associated with a past operation, has not been reported in the literature.
We examined the potential of increased Ca in the diet to modify the effects of Pb on tissue metal concentrations, blood pressure and the incidence of renal tumours. We randomly assigned 48, 5-wk-old male Wistar rats to one of six treatment groups. They were fed a low (0.2%) or high (4.0%) Ca diet for 31 wk and given 0, 1.0 or 100 micrograms Pb/mL in drinking water. In the low Ca groups, increasing concentrations of Pb produced graded increases in mean blood pressure. Rats receiving 4.0% Ca had higher mean blood pressures than the animals fed the 0.2% Ca diet. The 4.0% Ca diet also caused renal and urinary bladder stones to develop in some rats. The high Ca diet did not prevent dose-dependent increases in tissue Pb accumulation, but it caused significant decreases in kidney Cu, femur Mg and Fe in kidney, liver and testis. Femur Mg and Fe and liver Fe concentrations were lowest in rats receiving 4.0% Ca and 100 micrograms Pb/mL. Precancerous and cancerous renal lesions occurred to the greatest extent in the rats receiving 100 micrograms Pb/mL and the high Ca diet. These results suggest that high dietary Ca does not protect against Pb-induced increases in blood pressure or Pb accumulation in tissues and may often produce nephrocalcinosis. In addition, high dietary Ca in the presence of Pb may increase the incidence of renal tumors.
Cytologic examination of peritoneal fluid showed only malignant squamous cells, without revealing adenocarcinomatous cell components, in a patient who had an endometrioid adenosquamous-cell carcinoma of the ovary. Histologic examination of the ovary demonstrated diffuse squamous-cell carcinoma with rare foci of endometrioid and abortive malignant glands, as well as isolated mucin-positive cells. The cytologic differential diagnosis of malignant squamous cells in peritoneal fluid and the pathogenesis of squamous-cell carcinoma of the ovary are discussed.
Two hundred forty-one outpatients with a DSM-III diagnosis of major depressive disorder participated in a six-week double-blind therapeutic trial of alprazolam, diazepam, imipramine hydrochloride, and placebo. Side effects were given as a major reason for attrition by patients taking the three active compounds and ineffectiveness was the reason given by patients taking placebo. Imipramine-treated patients reported the most and placebo patients the least number of adverse effects. Imipramine and alprazolam, but not diazepam, produced significantly more improvement in depressed symptomatology than did placebo. Mean diazepam scores frequently assumed an intermediate position between those of imipramine or alprazolam and placebo. These treatment differences were found to be independent of initial severity levels of anxiety and depression.
Cimetidine is a histamine H2-receptor antagonist that is used in the treatment of patients with gastric and duodenal ulcers and other hypersecretory conditions. This drug has a structure that suggests that it could act as a chelating agent. To examine its effects on trace metal and mineral metabolism, 38 weanling male Sprague-Dawley rats were assigned to one of five treatment groups. These were a high dose [(HD) 1750 mg/(kg X d)] group, HD pair-fed control (HDPF) group, intermediate dose [(ID) 875 mg/(kg X d)] group, ID pair-fed (IDPF) group and low dose [(LD) 87.5 mg/kg X d)] group. In a separate experiment, 20 female Sprague-Dawley rats were assigned to one of two treatment groups: a high dose cimetidine group [(HDFem) 1750 mg/kg X d)] and a pair-fed control group (PFFem). Cimetidine was administered intragastrically four times per week for 5 wk. Significant differences (P less than 0.05) found among groups for the male rats studied included higher plasma copper in the HD and the ID groups, higher plasma sodium, liver copper, heart calcium and heart zinc in the HD group and a lower percentage of fecal excretion of all the divalent metals studied in the HD and the ID groups than in their pair-fed controls. Pathologic examination of the liver revealed extensive fatty infiltration of liver cells, liver cell necrosis and disrupture of liver lobular architecture in the HD group. Cimetidine-dosed females had higher zinc in heart and plasma, higher copper in heart, kidney, liver, jejunum, ileum and uterus, higher manganese in stomach and ileum, lower iron in kidney and liver, lower kidney calcium and higher stomach calcium and lower liver magnesium compared with their pair-fed controls. Levels of liver and kidney metallothionein in the two groups were comparable. Male and female rats receiving high dose cimetidine experienced significant changes in tissue concentrations of some of the trace metals and minerals studied.
Sixty-three outpatients with chronic insomnia were treated for 3 weeks under double-blind conditions with either brotizolam (n = 29) at a dose of 0.25 mg or 0.5 mg or placebo (n = 34). A 3-day placebo period preceded and followed the double-blind treatment phase. Brotizolam consistently produced significantly more sleep improvement than placebo but also more adverse effects. In those patients switched abruptly from brotizolam to placebo, rebound insomnia was observed, being most marked at the first post-brotizolam placebo night.
Thirty-six weanling male Sprague-Dawley rats were randomly assigned to one of four treatment groups: SE rats received 4.0 ppm selenium as sodium selenite in drinking water containing 1% sucrose; 15MO rats received 15 ppm molybdenum as sodium molybdate in the drinking water; 45MO rats received 45 ppm molybdenum in their water; and CON rats received distilled-deionized water containing only 1% sucrose. The esophageal carcinogen methylbenzylnitrosamine (MBN) was administered intragastrically in 10% ethanol twice per week for 5 wk at a dose of 2.5 mg/kg. MBN dosing was followed by a 12-wk period for tumor promotion. After this, heart, lungs, liver, spleen, kidneys, testes, tibia, muscle, brain and esophagus were excised. The esophagus was examined for MBN-induced lesions using dissecting and light microscopes and a portion was analyzed for Se. All other tissues were analyzed for Cu, Zn, Fe and Mn; some were also analyzed for Se and Mo. Most rats had precancerous lesions, and all rats had papillomas. There were no significant differences among the four treatment groups in the incidence and number per rat of precancerous lesions or gross papillomas. The SE group had significantly fewer carcinomas per rat than the other groups. The SE rats exhibited a number of significant differences in tissue trace element concentrations; in particular, they had higher Fe concentrations in heart, kidney and spleen than the other rats. The SE rats also had significantly greater urinary excretion of Mn and Fe, and excretion of the latter elements was significantly correlated with that of selenium.(ABSTRACT TRUNCATED AT 250 WORDS)
Both basal cell carcinomas that arise in blacks and those that metastasize are rare, and development of this tumor is an uncommon, late complication of trauma. We report a case of a 70-year-old black man with a basal cell carcinoma arising in a gunshot wound in a shoulder and metastasizing to axillary lymph nodes. Histologically, the tumor was of the metatypical type.
Previous studies indicate that pretreatment with acetone or isopropanol, fasting, and streptozotocin-induced diabetes enhance hepatic microsomal nitroso-dimethylamine (NDMA) demethylase in rats. This study demonstrates that these same treatments also potentiate the hepatotoxicity of NDMA as indicated by plasma glutamic pyruvate transaminase (GPT) levels and histologic data. Pretreatment with acetone or isopropanol (2.5 ml/kg) and 2 days of fasting caused a 2-fold potentiation of NDMA-induced plasma GPT elevation, whereas streptozotocin-induced diabetes caused a 4.6-fold potentiation. The centrilobular necrosis produced by NDMA was more severe after pretreatment with the inducers. NDMA treatment also decreased hepatic microsomal demethylase activity. These results lend support to the concept that a NDMA demethylase is responsible for the activation of NDMA in vivo to a toxic intermediate, and induction of this enzyme activity potentiates NDMA hepatotoxicity.
Multiple papillomas of the tracheobronchial tree are rare in children and adults. We describe a 42-year-old woman with multiple papillomatous-like tumors involving the trachea and bronchi. The limited tissue samples obtained during fiberoptic bronchoscopy initially lead to a benign histopathologic diagnosis; concurrent cytology studies strongly suggested oat cell carcinoma. The biopsy specimen obtained by rigid bronchoscopy ultimately demonstrated unequivocal oat cell carcinoma. This case illustrates an unusual and previously unreported manifestation of oat cell carcinoma--an endoscopic presentation in a papillary form suggesting benign tracheobronchial papillomatosis. Cytology studies were of increased diagnostic significance in this clinicopathologic setting.
Normal and simian virus 40-transformed human embryonic lung fibroblasts in culture were exposed to 3.5 microM coformycin (CF). This treatment resulted in almost complete inhibition of adenosine deaminase activity in both cell lines and retarded the progress of the fibroblasts through the cell cycle, as measured by the rate of cell proliferation. There was a marked difference, however, in the effect of CF on the traverse of different segments of the cell cycle. In normal fibroblasts, CF rapidly but transiently inhibited cell entry into visible stages of mitosis and delayed the progress through S and G2. In transformed fibroblasts, the effects of CF on the cell cycle included an early acceleration of the cell entry into visible mitosis and prolongation of this phase of the cell cycle. These results indicate that inhibition of adenosine deaminase can have different effects on the traverse of the critical segments of the cell cycle in normal and transformed cells.
A severe pelvic infection developed in a 17-year-old primigravida after a cesarean section. Multiple antibiotics were administered for presumed mixed aerobic and anaerobic infections, without improvement. Subsequently, total hysterectomy and bilateral salpingo-oophorectomy were performed. Despite negative standard cultures, her condition continued to deteriorate and she required two more exploratory laparotomies for suspected intra-abdominal abscesses. Chlamydia trachomatis and, subsequently, Candida albicans were recovered from cultures of peritoneal fluid obtained after the third operation. Serological tests confirmed the presence of acute chlamydial infection. Marked clinical improvement occurred after doxycycline hyclate administration. Although genitourinary and acute pelvic inflammatory diseases due to chlamydiae have been reported previously, no case of severe pelvic infection due to this agent after cesarean section had been described, to our knowledge. Specimens should be studied specifically for chlamydiae when standard cultures demonstrate no pathogens in women suffering from documented pelvic infection.
File analysis based on 98,970 Pap tests on 58,053 patients from the Martland Medical Center of CMDNJ and its clinics was performed. Discovery rates, period prevalence and incidence rates were calculated for categories of mild to moderate dysplasia through invasive carcinoma. An incidence rate of 27/100,000 for invasive carcinoma was obtained, which is lower than the national average. Period prevalence and incidence rates of dysplasias are both high and similar. This indicates that epidemiologic parameters may need to be studied further. The mean age for the mild to moderate dysplasia was 25.7 years, for moderate to severe dysplasia, 29.29 years and for CIS, 33.25 years. These data may imply that younger women, especially in the urban areas, are at much higher risk than previously expected.
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Presented here is an unusual case of extrinsic biliary obstruction due to a mass caused by xanthogranulomatous pyelonephritis, in itself a rare disease, of the right kidney. This phenomenon has not been described previously in the literature, and it should be brought to the attention of practitioners as another possible cause of biliary disease.
This is a report of a case in which multiple primary malignancies involving the larynx and the lung were initially suspected by means of cytologic examination of sputum specimens and bronchial aspirate. Such multiple cancers, once considered to be highly unusual, are now being reported with increasing frequency. It is emphasized that when two distinct cellular morphologies are present on cytologic smears, the possibility of multiple primary cancer could be considered.
A fifty-seven-year-old man with bronchogenic squamous cell carcinoma is described. There was clinical suspicion of metastatic involvement of the kidneys. Urine sediment cytology revealed neoplastic squamous cells consistent with metastatic squamous cell carcinoma. Subsequent autopsy confirmed the renal involvement. In the right kidney the tumor had invaded and breached the renal pelvic wall. It is suggested that urine sediment cytology should be considered a useful diagnostic procedure in this clinicopathologic setting.
The response of 134 anxious neurotic outpatients to lorazepam, diazepam, and placebo was assessed in a 4-week double-blind trial. Both active drugs produced significantly more symptom reduction than placebo. Lorazepam, however, proved effective primarily in those patients who did not complain of sedation, and produced greatest improvement in initially sicker patients. Sedation was significantly more disturbing to lorazepam-treated patients than to diazepam-treated patients. Present findings suggested that 3 mg/day of lorazepam may be too high a dosage for mildly anxious patients, while 15 mg/day of diazepam seems an appropriate dosage for mildly anxious patients but may be too low a dosage for highly anxious patients.