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Biomedical subjects

Harold E Carlson

Publications and source records attributed to Harold E Carlson.

7 recordsLinked to original sources

Pheochromocytoma in a pregnant woman with a history of intracerebral aneurysms.

Pheochromocytoma in pregnancy is rare; if unrecognized, potentially fatal hypertensive crises may occur. We report a case of a 35-year-old woman with a history of two intracerebral aneurysms who presented at 26 weeks' gestation with tachycardia, hypertension, and pulmonary edema. Laboratory data revealed elevated 24-hour urinary catecholamine and metanephrine levels, and abdominal sonography showed a 10-cm right adrenal mass. After stabilization with phenoxybenzamine and metoprolol, cesarean section was successfully performed at 36 weeks' gestation. Postpartum abdominal computed tomography scanning confirmed a 10-cm right adrenal mass. A benign pheochromocytoma was removed without incident. This case illustrates the importance of early diagnosis and management of pheochromocytoma in pregnancy and is also an example of the rare association of pheochromocytoma with intracerebral aneurysms.

Adrenal Gland Neoplasms↗

Presence of luteinizing hormone/human chorionic gonadotropin receptors in male breast tissues.

Receptors for LH/human chorionic gonadotropin (hCG) have been found in a variety of nongonadal tissues including the female breast. Using in situ hybridization and immunohistochemistry, we demonstrated the presence of LH/hCG receptor mRNA and protein in normal male breast tissue obtained at autopsy (n = 4) and archival samples of benign gynecomastia (n = 14) and male breast carcinoma (n = 5). Although the function of these receptors remains to be determined, the findings suggest the possibility that LH and hCG may play a role in the pathogenesis of male breast disorders.

Adult↗

Gynecomastia: its features, and when and how to treat it.

Gynecomastia is common, being present in 30% to 50% of healthy men. A general medical history and careful physical examination with particular attention to features suggestive of breast cancer often suffice for evaluation in patients without symptoms or those with incidentally discovered breast enlargement. Men with recent-onset gynecomastia or mastodynia need a more detailed evaluation, including selected laboratory tests to search for an underlying cause. Treatment depends on the cause and may include observation, withdrawal of an offending drug, therapy of an underlying disease, giving androgen or antiestrogen drugs, or plastic surgery.

Gynecomastia↗

Effect of combination glipizide GITS/metformin on fibrinolytic and metabolic parameters in poorly controlled type 2 diabetic subjects.

OBJECTIVE: Epidemiological studies have implicated increased plasminogen-activated inhibitor 1 (PAI-1) as a marker or predictor of accelerated coronary atherosclerotic disease in type 2 diabetes. We sought to determine whether metabolic control, independent of its oral mode of implementation, affects PAI-1 in patients with marked hyperglycemia. RESEARCH DESIGN AND METHODS: A total of 91 subjects were screened, subjected to a 4-week drug washout, and randomized to daily treatment with glipizide GITS (maximum 20 mg, n = 46) or metformin (maximum 2,550 mg, n = 45) as monotherapy. After monotherapy, combination therapy was initiated by adding the second agent to the regimen. Plasma glucose (fasting and postprandial), HbA(1c), fructosamine, and PAI-1 were assayed before and after randomization and sequentially thereafter in all subjects; hepatic glucose output (HGO) and abdominal fat distribution were each measured in a subset of subjects. RESULTS: Glycemic control was markedly impaired at baseline (mean HbA(1c) 10.4 +/- 0.2% glipizide GITS; 10.0 +/- 0.2% metformin) but improved comparably with each agent as monotherapy and in combination (P < 0.0001 vs. baseline), as assessed with meal tolerance studies, fructosamine values, and HGO. Body weight and abdominal fat distribution did not change significantly in either group. PAI-1 concentrations were extraordinarily high (5- to 10-fold more than normal) at baseline (202 +/- 12 ng/ml glipizide GITS; 201 +/- 13 ng/ml metformin) but declined comparably, and significantly, after treatment with either agent as monotherapy and decreased further with combination therapy. CONCLUSIONS: When hyperglycemia is profound, increases in PAI-1 are also profound. Control of hyperglycemia with either glipizide GITS, an insulin secretagogue, or metformin as monotherapy comparably ameliorates elevated PAI-1.

Adult↗

IgE antithyroid antibodies in patients with Hashimoto's disease and chronic urticaria.

Although chronic urticaria may be associated with the presence of serum anti-thyroid antibodies, it is not known whether these antibodies play a causal role in the urticaria. We therefore sought to determine whether the anti-thyroid antibodies seen in patients with urticaria were of the IgE class. Using commercial ELISA kits for measuring serum IgG anti-thyroglobulin and anti-thyroid peroxidase antibodies, we modified the procedure to detect IgE antibodies. We examined sera from 20 patients with urticaria who had IgG anti-thyroid antibodies and from 12 patients with IgG antithyroid antibodies who did not have urticaria. Only 2 of 20 patients with urticaria and IgG anti-thyroid antibodies had detectable IgE anti-thyroid antibodies: 1 patient had anti-thyroid peroxidase IgE antibody and 1 patient had anti-thyroglobulin IgE. IgE anti-thyroid antibodies do not appear to play a causal role in urticaria in the majority of patients.

Autoantibodies↗