Folic acid and mental illness.
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Biomedical subjects
Publications and source records attributed to M Lipton.
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Two patients with phosphofructokinase (PFK) deficiency had exercise intolerance and increased serum activity of creatine kinase; one presented with hemolytic anemia, hyperuricemia, and gouty arthritis. The glycogen concentration in the muscle of these patients was about twice normal. PFK activity was virtually absent in muscle, but antibodies against the M subunits of the normal human PFK showed cross-reacting material in muscle from both patients. The PFK level in red blood cells, studied in one case, was lower than normal in the patient and both parents. Morphologically, there was extensive deposition of normal glycogen underneath the sarcolemma and in the intermyofibrillar space. In addition, 2% to 3% of the myofibers contained hyaline, PAS-positive, diastase-resistant inclusions that had a filamentous fine structure; histochemical reactions suggested an insoluble form of glycogen. Similar inclusions have not been described previously in PFK deficiency. Accumulation of an abnormal polysaccharide in muscle may be due to a second undiscovered enzymatic defect or may be a metabolic consequence of PFK deficiency.
Tumors arising from veins are rare, usually present with nonspecific clinical and imaging findings and almost universally show histology of leiomyosarcoma. This twentieth reported case of primary renal vein leiomyosarcoma demonstrates invasion of the renal vein with endoluminal propagation of tumor into the infrahepatic inferior vena cava (IVC), an unreported manifestation. The combination of CT, ultrasound, and angiographic studies allowed differentiation from renal cell carcinoma by suggesting a tumor arising from the renal vein.
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The problems of the terminally ill are treated frequently in plays and books today. With workers in the United States enjoying greater longevity and with medicine's ability to prolong lives after serious illnesses, human resources people and managers will be confronting this problem, too. In addition to behaving in a socially responsible way, changes in the law make it mandatory to deal with the problems of the handicapped in an innovative way. Also, premature termination of those hopelessly ill may be illegal. In this article, Mark Lipton, who has researched this subject, discusses the personnel rights of the handicapped and terminally ill and sound management practice in this area. Managers may wish to avoid this subject because for many it is unpleasant, but given their responsibilities and changes in applicable laws, they will have no choice.
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