Identification of dying cells--in situ staining.
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Animals↗
Biomedical subjects
Y Sherman
Publications and source records attributed to Y Sherman.
Radiologic spectrum of localized Castleman's disease.
We report seven patients with the localized form of Castleman's disease, diagnosed by surgical biopsy; four had the plasma cell type and three the hyaline vascular type. A variety of nonspecific clinical and radiologic findings were identified in these patients. Precise clinical staging is important to separate the widespread from the localized form of Castleman's disease, as the localized form may be successfully treated surgically. Percutaneous core needle biopsy is not helpful in the diagnosis of Castleman's disease. Significant computerized tomography enhancement with intravenous contrast in the hyaline vascular type is indicative of increased vascularity which may cause surgical complications when resection is attempted.
Adolescent↗
Depressive personality disorder.
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Depressive Disorder↗
The effect of estradiol depletion during the luteal phase on endometrial development.
OBJECTIVE: To examine whether luteal E2 is obligatory for obtaining an adequately developed endometrium. DESIGN: Survey of women with premature ovarian failure (POF) in a prospective, controlled, randomized study. SETTING: In vitro fertilization unit in a tertiary care university medical center. PATIENTS: Fourteen amenorrheic women with POF, candidates for oocyte donation, were divided into two distinct groups with seven women in each subgroup. INTERVENTIONS: Endometrial priming with a fixed dose of oral micronized E2, 4 mg/d for 14 days, was similarly performed in the study and the control groups. Progesterone replacement during the luteal phase was also identical in the two groups and was accomplished by IM P in oil, 50 mg/d for another 14 days. Only the control group continued to have the same E2 regimen during the luteal phase. MAIN OUTCOME MEASURES AND RESULTS: Follicular phase mean E2 levels as well as luteal phase mean P levels were similar in both groups. However, luteal E2 levels differed significantly between the study and the control groups (21 +/- 5 and 692 +/- 199 pg/mL, respectively; conversion factor to SI units, 3.671). Nevertheless, histologic evaluation of endometrial biopsies on days 21 and 26 were similar for both groups. Endometrial gland dating, using light microscopy in the study and the control groups, on day 21, was 19.1 +/- 0.8 and 18.4 +/- 0.5, respectively, and on day 26, 25.4 +/- 0.8 and 25.9 +/- 0.5, respectively. Dating of the stroma in the two biopsies was also similar in both groups. Moreover, transmission electron microscopy performed in two patients of the study group showed typical characteristics of a secretory endometrium. CONCLUSIONS: Luteal E2 depletion in the human does not seem to adversely affect the morphological developmental capacity of the endometrium. Our results suggest that E2 secretion by the corpus luteum in the human does not appear to be obligatory for the development of a normal secretory endometrium. The actual receptivity of the endometrium after such preparation needs to be evaluated.
Adult↗
The effect of progesterone administration in the follicular phase of an artificial cycle on endometrial morphology: a model of premature luteinization.
OBJECTIVE: To evaluate the effect of premature P administration on artificially prepared endometrium in women with ovarian failure. DESIGN: To mimic premature luteinization, patients with ovarian failure were treated with continuous estrogen and episodic P during the follicular phase of artificial cycles. SETTING: In vitro fertilization unit at a university hospital. PATIENTS: The study group included 16 patients with ovarian failure who were randomly divided into two groups. Group A (8 patients) was treated by episodic P administration during the artificial follicular phase on days 2 and 7 (12.5 mg of P in oil IM), and in group B (8 patients), P (6.25 mg) was added on days 3, 4, and 5. Another 16 patients (group C), age matched to the study group, were arbitrarily allocated to serve as controls and had standard preparatory cycles without P supplementation in the follicular phase. Serum E2 and P levels and endometrial biopsies were taken on days 14 and 26. RESULTS: Serum E2 levels were comparable between the study group (group A+B) and controls on both days 14 and 26. Although serum P levels did not differ between the groups on day 26, it was higher in the follicular phase of the study group than in the controls (1.9 +/- 4.0 and 0.2 +/- 0.1 ng/mL, respectively). In the study group, 8 of 16 patients demonstrated early secretory changes in the late follicular phase biopsies, and 9 of 16 women developed stromal-glandular discrepancy in the late luteal phase. This differed significantly from the controls in which only one late luteal biopsy was out of phase. CONCLUSIONS: Episodic surges of P during the follicular phase may result in impaired endometrial development that cannot be corrected by P supplementation during the luteal phase. This unique model provides evidence for the potential detrimental effect of premature P secretion in the follicular phase on endometrial function.
Adult↗
Fibrosarcoma of the vocal fold: a late complication of radiotherapy.
The carcinogenic effect of ionizing radiation is a well known phenomenon. However, the induction of malignancies following irradiation for head and neck cancers is quite rare (Steeves and Vataini, 1982). Most reported cases are osteogenic sarcomas with soft tissue sarcomas encountered less often. We report a rare case of fibrosarcoma of the larynx, following radiation therapy for glottic carcinoma.
Carcinoma, Squamous Cell↗
Histological comparison of suction capsule and endoscopic small intestinal mucosal biopsies in children.
Small intestinal biopsies are part of the routine evaluation of children with chronic diarrhea and malabsorption, and are commonly performed via suction capsule. Because this technique entails x-ray exposure, longer procedure time, and technical failures, most small intestinal biopsies in adults are currently obtained via endoscopy. Endoscopy is believed to yield morphologically inferior specimens, and, therefore, its use for obtaining small intestinal biopsies in children has remained limited. The histological adequacy of biopsy specimens obtained in 30 children by endoscopy and in 30 children by suction capsule was compared. Biopsies were assessed for quality of orientation, size (length and depth), presence of Brunner's glands and crush artifact, and for the ability to confirm or exclude a mucosal abnormality. Small intestinal biopsies obtained via endoscopy were shown to yield tissue specimens that are histologically comparable to those obtained by suction capsule, and that are equally suitable for interpretation.
Biopsy↗
Malignant melanoma in Turner's syndrome.
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Female↗
[CA15-3 tumor marker in early detection of breast cancer].
CA15-3 is a tumor marker associated with mammary tumors. Increased levels have been observed in patients with breast cancer, while normal low levels are usually found in women with no evidence of disease. The potential clinical uses of this marker include monitoring of patients with breast cancer, prognosis, and early detection of recurrence. Tumor markers are not usually used for diagnosis, as only in a few patients are elevated levels found. But when high levels of tumor markers are detected at an early stage, it may be of diagnostic value. In this study we describe a patient we believe to be the first in whom the CA15-3 tumor marker indicated breast cancer, while physical examination and the initial mammography were without suspicious findings. We also show sections of formalin-fixed, paraffin-embedded tissue stained by the CA15-3 indirect immunoperoxidase method.
Antigens, Tumor-Associated, Carbohydrate↗
Identification of programmed cell death in situ via specific labeling of nuclear DNA fragmentation.
Programmed cell death (PCD) plays a key role in developmental biology and in maintenance of the steady state in continuously renewing tissues. Currently, its existence is inferred mainly from gel electrophoresis of a pooled DNA extract as PCD was shown to be associated with DNA fragmentation. Based on this observation, we describe here the development of a method for the in situ visualization of PCD at the single-cell level, while preserving tissue architecture. Conventional histological sections, pretreated with protease, were nick end labeled with biotinylated poly dU, introduced by terminal deoxy-transferase, and then stained using avidin-conjugated peroxidase. The reaction is specific, only nuclei located at positions where PCD is expected are stained. The initial screening includes: small and large intestine, epidermis, lymphoid tissues, ovary, and other organs. A detailed analysis revealed that the process is initiated at the nuclear periphery, it is relatively short (1-3 h from initiation to cell elimination) and that PCD appears in tissues in clusters. The extent of tissue-PCD revealed by this method is considerably greater than apoptosis detected by nuclear morphology, and thus opens the way for a variety of studies.
Animals↗
Fat necrosis below musculocutaneous flap mimicking carcinoma of breast.
The increasing rate of breast reconstruction after modified radical mastectomy has led to the adoption of several techniques including transverse rectus abdominis musculocutaneous flap. Although the method creates a life-like breast both in texture and appearance, among other complications resulting from this operation, fat necrosis mimicking carcinoma on mammography clearly is common. We focus on the case history of 1 patient and detail our findings.
Breast Neoplasms↗
Superficial actinic porokeratosis and cystic fibrosis.
A 24-year-old woman, presenting with cystic fibrosis, developed superficial actinic porokeratosis. Immunosuppression due to cystic fibrosis may be either the cause of or the exacerbating factor in superficial actinic porokeratosis in our patient.
Adult↗
Effect of injured vessel size on bleeding following hypertonic saline infusion in "uncontrolled" hemorrhagic shock in anesthetized rats.
Hypertonic saline (HTS) infusion in "uncontrolled" hemorrhagic shock (UCHS) leads to increased bleeding from injured vessels, fall in mean arterial pressure (MAP), and early mortality. The effect of injured vessel size on blood loss in response to HTS treatment was studied in Neurolidal Ketalar anesthetized Hebrew University strain rats. The animals were randomly assorted into 4 groups: In group I (n = 8) UCHS was induced by resection of 8% of the terminal portion of the rats' tail and the animals were untreated. In group II (n = 8) UCHS was induced as in group I and the animals were treated with 5 ml/kg NaCl 7.5% (HTS). In group III (n = 9) UCHS was induced by 50% resection of the animal's tail, and the animals were untreated. In group IV (n = 12) UCHS was induced as in group III and the animals were treated with 5 ml/kg HTS Resection of 8% of the animal's tail was followed by bleeding of 2.6 +/- 0.3 ml and fall in MAP from 107 +/- 7 to 80 +/- 10 torr (P less than .005) within 5 min. Resection of 50% of the animal's tail was followed by bleeding of 4.3 +/- 0.4 ml (P less than .01) and fall in MAP to 41 +/- 6 torr (P less than .001) after 5 min. Infusion of HTS in group II was followed by further blood loss of 4.9 +/- 07 ml within 4 hr while in untreated group I, blood loss was only 3.4 +/- 0.4 ml (P less than .05), MAP remained unchanged, and there was no mortality.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Crohn's colitis complicated by superimposed invasive amebic colitis.
The clinical characteristics and endoscopic appearance of inflammatory bowel disease (IBD) may be very similar to those of amebic colitis. Physicians, especially in areas in which amebiasis is endemic, are familiar with this difficulty. Moreover, in individual cases, it may even be impossible to distinguish between the two conditions, since stool specimens, bowel biopsies, and serological studies may be negative for Entamoeba histolytica, even in the presence of invasive amebic colitis. Invasive amebiasis may rarely be superimposed on IBD, which further complicates the issue. We report here a young patient with a 7-yr history of Crohn's colitis proven histologically who developed invasive amebic colitis during steroid and 6-mercaptopurine treatment for active disease. Stool specimens, mucosal biopsies, and serological studies were negative for E. histolytica, and the diagnosis was established on pathological examination of a surgically resected bowel. Anti-amebic therapy should be considered in endemic areas in cases of persistent IBD.
Adult↗
"Rubral" tremor following radiation of a pineal region vascular hamartoma.
Tumours of the pineal region have historically been difficult to remove safely. Only recently have large series of successful pineal area operations been reported, and there are many advocates for surgical reticence with these tumours. We report a case of a 20-year-ol women whose pineal region tumour was irradiated, whereupon a unilateral low-frequency resting and intention tremor developed. Following resection of the lesion, a vascular hamartoma, the tremor virtually disappeared. We believe the tremor was secondary to radiation induced tumour shrinkage and distortion of the mesencephalon. This case is demonstration of the importance of exploration and histological verification of pineal region tumours.
Adult↗
Cystic duct carcinoma mimicking empyema of the gallbladder.
An 80-year-old woman underwent cholecystectomy because of a clinical and ultrasonic diagnosis of gallbladder empyema. Primary carcinoma of the cystic duct, which was completely removed, was incidentally found during pathologic examination. Although the prognosis following complete removal of this carcinoma is considered to be good, the patient died of the disease 7 months after the operation.
Adenoma, Bile Duct↗
T-2 toxin effect on rat aorta: cellular changes in vivo and growth of smooth muscle cells in vitro.
Rats were injected intraperitoneally with T-2 toxin and their aortas were studied by light and electron microscopy. The growth of smooth muscle cell explants taken from the tunica media of aortas of similarly treated animals was observed. A single large dose (2 mg/kg) or four injections of 0.3 mg/kg T-2 toxin caused damage and occasional necrosis of endothelial cells, accumulation of basement membrane-like material in the intima, and swelling and activation of smooth muscle cells in the tunica media. Three or more weeks after the last injection of 0.3 mg/kg T-2 toxin the endothelial cells were normal but an excess of fragmented intimal basement membrane-like material persisted and smooth muscle cells were still activated. Outgrowths from explants of aortic tunica media taken within 1 week of the last dose of T-2 toxin showed marked inhibition of smooth muscle cell growth. Three or more weeks after the toxin, the explants showed significantly increased outgrowths. These findings suggest that T-2 toxin causes early endothelial and smooth muscle cell injury accompanied by inhibition of smooth muscle cell growth in culture. This is followed by stimulation of the proliferative capacity of smooth muscle cells in vitro. If a similar mechanism is operative in vivo, it could explain the chronic vascular changes observed after limited exposure to T-2 toxin.
Animals↗
Elevated concentrations of elements and abnormalities of neuromuscular junctions in tongue muscles of Down's syndrome.
X-ray spectrometry was used to measure the concentrations of calcium, iron, copper and zinc in tongue muscles from patients with Down's syndrome (DS) undergoing partial glossectomy. Similar measurements on samples from autopsies served as controls. Electron microscopy was used to examine neuromuscular junctions. The calcium and copper were significantly elevated and correlated in DS while the iron and zinc showed little change. The copper increase is probably connected with the known high level of Zn-Cu superoxide dismutase (SOD), coded for by chromosome 21. (In DS there is a trisomy 21). The excess of SOD may interfere with free radicals needed for excitation-contraction coupling and may be instrumental in damaging junctional membranes. The high calcium may result from such membrane damage. It is suggested that neuromuscular junction pathology, either genetic or free radical induced, may cause the tongue weakness in DS.
Adolescent↗