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Biomedical subjects

V M Brown

Publications and source records attributed to V M Brown.

7 recordsLinked to original sources

Aromatase and testosterone fatty acid esters: the search for a cryptic biosynthetic pathway to estradiol esters.

The estradiol fatty acid esters (lipoidal derivatives, LE2) are extremely potent estrogens that accumulate in fat, including fat of menopausal women. These steroidal esters are protected from metabolism and are converted to the free, biologically active steroid through the action of esterases. Previous studies have shown that biosynthetic pathways in the adrenal gland exist in which steroid fatty acid esters are substrates. This led us to determine whether a cryptic aromatase pathway exists in which testosterone esters could be converted directly into LE2. We tested a representative fatty acid ester, testosterone stearate, both as an inhibitor and as a substrate for the aromatase enzyme from human placental microsomes. This ester had neither activity. In addition, we tested [1 beta-3H]testosterone acetate as a substrate for this enzyme complex, measuring the production of 3H2O as evidence of aromatization. Although the rate of reaction was considerably slower than that of testosterone, 3H2O was produced. However, when [2, 4, 6, 7-3H]testosterone acetate was incubated and the steroidal products isolated, we found that hydrolysis of the substrate had occurred. Both [3H]-labeled testosterone and estradiol were found, and very little if any [3H]estradiol acetate was formed. Thus, we conclude that an aromatase pathway involving testosterone esters does not exist and that the sole source of LE2 is through direct esterification of estradiol.

Aromatase

Hidradenitis suppurativa of the anogenital region: response to isotretinoin.

Hidradenitis suppurativa, a chronic relapsing disease of apocrine gland-bearing areas, most frequently occurs in the axillae, groin, perineal, and perianal regions. Hidradenitis of vulva is frequently misdiagnosed and inadequately treated. The case of a 15-year-old nulliparous black female adolescent referred for evaluation of multiple draining fistulas of the anogenital region is presented. Diagnostic studies for granulomatous disease were negative. Results of a barium enema were normal and biopsies were compatible with the diagnosis of hidradenitis suppurativa. She was treated for 22 weeks with isotretinoin, 1 mg/kg daily, with an excellent response. Side effects were minor and included cheilitis, mild xerosis, and a transient elevation of serum alkaline phosphatase levels. Few patients with severe hidradenitis have been responsive to this synthetic vitamin A derivative. A review of the literature indicates that the results of treatment with isotretinoin for hidradenitis have been at best equivocal. Isotretinoin should never be used during pregnancy because of known teratogenic effects. Women of childbearing age must use effective contraception during treatment.

Adolescent

Morpheaform basal cell carcinoma in a young black woman.

Basal cell carcinomas are uncommon in black patients, and morpheaform basal cell carcinomas are an uncommon histologic subtype. This case report describes the rare occurrence of a morpheaform basal cell carcinoma in a relatively young black patient. This patient underwent Mohs micrographic surgery as the primary therapy for this tumor. Some features of morpheaform basal cell carcinomas are reviewed, and basal cell skin cancer in blacks is discussed.

Adult

An unusual new hair shaft abnormality: "bubble hair".

A 16-year-old otherwise healthy girl developed a localized area of brittle, easily broken hairs on the scalp. In addition, the hair appeared to "come out in clumps," and the overall texture of the hair changed from soft and naturally curly to straight and stiff. An unusual hair shaft abnormality was demonstrated by routine light and electron microscopy, for which we can find no report of similar cases. The case and associated findings are presented.

Adolescent

A comprehensive training program for multidisciplinary treatment plans.

A client-oriented treatment plan that will direct and coordinate health care staff, thereby ensuring efficient quality client care, is a worthy goal. After planning, implementing, and evaluating a training program for this purpose, the authors concluded that the key to quality client care and successful implementation of this program lies in proper preparation and administrative support.

Education, Nursing, Continuing