Biomedical subjects

M R Fetell

Publications and source records attributed to M R Fetell.

26 records · Page 2Linked to original sources

PubMed1985

Immunocytochemistry of pineal astrocytes: species differences and functional implications.

Immunohistochemical demonstration of glial fibrillary acidic protein (GFAP) was performed in human, sheep, rat and guinea pig pineal bodies to determine if there were species differences. Specialized "basket-like" arrangements of many GFAP-positive astrocytic processes were shown around sheep pinealocytes. Human pineals contained scattered astrocytic cell bodies and a moderate number of GFAP-positive astrocytic processes which, as in sheep, also surrounded pinealocytes, but without the dense basket-like arrangements. In both species GFAP-positive fibers were concentrated at the periphery of pseudolobules and around blood vessels. Rat and guinea pig pineals contained only rare astrocytic cell bodies and few GFAP-positive fibers throughout the glands, but had a concentration of parallel GFAP-positive fibers at the stalk. GFAP-positive fibers in human and sheep pineals may be derived from both intra- and extraglandular sites, whereas in rodents only rare processes appear to be derived from within the gland. Astrocytes may play a role in modulation of pineal indoleamines and norepinephrine, and the species differences observed suggest that this effect may be important in sheep and human pineals but not in rodents.

Adult↗

PubMed1985

Blind loop syndrome, vitamin E malabsorption, and spinocerebellar degeneration.

A 72-year-old man had severe malabsorption, progressive retinopathy, and spinocerebellar degeneration 32 years after gastric surgery, blind loop formation, and intestinal bacterial overgrowth. Clinical and pathologic features were typical of vitamin E deficiency; vitamin E was nearly undetectable in serum and profoundly low in adipose tissue. Vitamin E blood levels initially improved on treatment with antibiotics; after additional vitamin E supplementation, there was clinical improvement.

Absorption↗

PubMed1985

Therapeutic modalities for pineal region tumors.

Since there is no radiographic test that can definitely predict the histology of a pineal tumor, we believe all patients should be treated first with a surgical approach to the tumor. This usually is accomplished by the supracerebellar-suboccipital route. Hydrocephalus is best treated at the time of surgery with ventricular drainage. Sometimes, surgery can decompress the CSF obstruction, and the need for a shunt can be averted following surgery; if not, the ventricular drain is converted to a shunt several days later. If a pineal tumor is found to be benign and encapsulated, it is removed by surgery, and the patient requires no additional therapy. Meningiomas, cysts, and low grade cystic astrocytomas all fall into this category. Some germ cell tumors are well differentiated and can also be grossly excised, but one must exercise caution in assuming that the entire tumor is benign. Many seemingly well-differentiated teratomas contain admixtures, sometimes microscopic, of more malignant elements. Careful pathological evaluation of the operative specimen and analysis of biological markers (AFP and beta-HCG) can alert the clinician to the presence of malignant tumor. With germinomas, radiation therapy is initially effective, and chemotherapy has a proven role in treating recurrences. Spinal radiotherapy is withheld unless there is a strong suspicion of spinal seeding. Tumors of pineal cell origin are radiosensitive and should be treated with radiation therapy. Because these tumors are rare, there is little data to date to justify one particular form of chemotherapy over another for recurrent pineal cell malignancies. Likewise, whether chemotherapy is preferable to radiation therapy in the initial treatment of nongerminomatous germ cell malignancies is as yet unclear.

Brain Neoplasms↗

PubMed1982

A benign motor neuron disorder: delayed cramps and fasciculation after poliomyelitis or myelitis.

Two patients had a delayed syndrome of benign fasciculation after complete recovery from paralytic poliomyelitis and a third had the syndrome after an attack of purely motor myelitis. Myalgia was prominent in all three, and two had frequent cramps. Denervation hypertrophy occurred in two. The patients were observed for at least three years, and no new weakness was seen. These cases suggest that some chronic diseases of motor neurons may be benign.

Adult↗

PubMedDate not supplied

Infiltrating lipoma: a cause of monomelic hypertrophy.

Muscle biopsy and computerized tomography indicated that unilateral enlargement of the gastrocnemius muscle in a 12-year-old girl was the result of an infiltrating lipoma. This rare condition may cause diagnostic confusion before EMG and muscle biopsy studies are performed, but it can be readily distinguished from other causes of unilateral muscle enlargement using these methods.

Child↗

PubMedDate not supplied

A pituitary adenoma with dilated ventricles.

It is generally accepted that postoperatively radiographic examinations be limited to the area of pathology. The patient presented here complained of visual difficulties two years after transphenoidal removal of a pituitary prolactinoma. His endocrinologist ordered what he believed to be the appropriate computed tomography study and the neuroradiologist did not correctly interpret the new finding of dilated ventricles. Subsequently, a second primary tumor was discovered, a pineal gland sarcoma. The patient had refused radiotherapy after removal of his prolactinoma. Had he not, his second tumor would probably have been attributed to radiation. It is interesting to speculate whether radiation scatter from treatment of the prolactinoma would have prevented the pineal gland sarcoma.

Adenoma↗

PubMedDate not supplied

Enhanced in vitro growth suppression of human glioblastoma cultures treated with the combination of recombinant fibroblast and immune interferons.

In the present study we have evaluated the effect of recombinant human fibroblast, IFN-beta ser, and immune, IFN-gamma, interferon, alone and in combination, on the proliferation of fifteen early passage human glioblastoma cell cultures. Explant cultures were established from glioblastoma tumor tissue obtained at the time of surgery. After sufficient outgrowth, cultures were dispersed with trypsin/versene and maintained as independent cell lines. IFN-beta ser induced a greater than or equal to 50% reduction in the 7 day growth of 6 of the 15 cultures. The majority of cultures, 9 of 15, displayed less than or equal to 50% growth suppression in comparison with control cultures after 7 days exposure to 2000 Units/ml of IFN-beta ser. When treated with 2000 Units/ml of IFN-gamma, only 1 of the 15 glioblastoma cultures exhibited a greater than or equal to 50% reduction in growth. In contrast, when treated with the combination of IFN-beta ser plus IFN-gamma, 1000 Units/ml of each interferon preparation, 12 of 15 cultures were inhibited by greater than or equal to 50% after 7 days growth. The combination of interferons was effective in suppressing glioblastoma growth both in cultures displaying relative sensitivity and those exhibiting innate resistance to either or both types of interferon when employed alone. One glioblastoma culture, G-7, was studied through 45 passages and displayed the same sensitivity at different passages to growth inhibition when exposed to IFN-beta ser, IFN-gamma or both interferons. Based on previous clinical studies indicating that IFN-beta or IFN-gamma when administered alone to patients do not generally alter the clinical progression of malignant gliomas, the present results suggest that the combination of IFN-beta plus IFN-gamma may prove more effective than either agent alone in the clinical treatment of patients with glioblastoma multiforme.

Brain Neoplasms↗

PubMedDate not supplied

Patterns of spinal cord atrophy by metrizamide CT.

Forty patients with cervical myelopathy underwent high-resolution computed tomography (CT) with intrathecal administration of metrizamide for evaluation of cervical spinal cord atrophy. Thirty of them showed evidence of either focal atrophic distortion or generalized accentuation of the anatomic surface features of the spinal cord. Patients with a Chiari malformation or syringomyelia were excluded. The characteristic features in cervical spondylosis and canal deformity include flattening of the ventral surface of the cord, central infolding, beaking of the lateral funiculi, and wasting of the dorsal surface of the cord. Patients with motor neuron disease showed a combination of anterolateral and posterolateral atrophy reflecting underlying degeneration of the anterior horn cells and/or corticospinal tracts, respectively. Those with monomelic motor neuron disease had a striking ipsilateral hemiatrophy of the spinal cord. Among those presenting with spastic paraparesis, seven with clinically definite multiple sclerosis showed diffuse atrophy or focal degeneration due to a localized plaque of demyelination. Two cases of cord neoplasm showed atrophy secondary to ascending or descending degeneration of the long tracts.

Atrophy↗