The surgical management of medullary thyroid carcinoma.

Medullary carcinoma of the thyroid may occur in three patient groups: multiple endocrine neoplasia, type 2b (MEN2b), MEN2a, and sporadic. The prognosis is best in MEN2a and worst in MEN2b. Multicentric disease occurs in approximately 90% of patients in the MEN groups and in 20% of the patients in the sporadic group.

Cutaneous neuropathology in multiple endocrine neoplasia, type 2b.

Increase in masses of mixed (myelinated and nonmyelinated) nerve are observed in the dermis of clinically normal skin of patients with multiple endocrine neoplasia, type 2b (MEN 2b). Preliminary histochemical studies revealed nucleoside triphosphatase and nonspecific acid esterase. Electron microscopy showed axonal organelles, mild degeneration of axons, and numerous axons unassociated with Schwann cells.

Neoplasms metastatic to the thyroid gland.

In this report, the incidence and pathologic factors of neoplasms metastatic to the thyroid gland in patients seen at the Mayo Clinic are examined. The most frequent primary tumors were renal cell carcinoma and adenocarcinoma of the breast. A review of recent studies of this topic at other institutions is also offered.

Paragangliomatosis with numerous catecholamine-producing tumors.

Catecholamine-producing tumors may be found wherever paraganglion tissue exists, and they may be associated with a variety of conditions (multiple endocrine neoplasia types 1, 2a and 2b). The patient described in this report had 21 paragangliomas removed between the ages of 13 and 17 years, and she has evidence of additional tumors. This is the greatest number of paragangliomas reported, and the tumors involved numerous sites.

Carotid body tumors in humans: genetics and epidemiology.

Genetic factors in the etiology of carotid body tumors (CBT) were sought in a medical record review of 222 histologically diagnosed cases at 12 U.S. medical centers.

Primary mediastinal carcinoid tumors.

A study of 15 cases of carcinoid tumor of the thymus, diagnosed and treated at the Mayo Clinic, revealed histopathologic features of the neoplasm that might cause it to be confused with other mediastinal tumors, both primary and secondary. The tumor was associated with ectopic ACTH production in six patients, of whom five had Cushing's syndrome. Metastasis, which occurred in 11 patients (73%), was delayed for as long as 8 years after initial diagnosis.

Scanning and transmission electron microscopic aspects of the nasal acilia syndrome.

A 3-month-old boy was admitted with failure to thrive and persistent fevers. During a 4 month hospitalization for treatment of suspected sepsis, persistent purulent nasal discharge developed. Biopsies of his nasal mucosa on 3 separate occasions disclosed thinned respiratory epithelium and a complete absence of cilia when examined by electron microscopy (EM).

Effects of caffeine, theophylline and theobromine on scheduled controlled responding in rats.

1 Rats were trained to respond under a variable interval 30 s (VI 30) schedule of food reinforcement. Caffeine (0.32-32 mg/kg), theophylline (1.

Gastric tumors in patients with pulmonary chondroma or extra-adrenal paraganglioma: an ultrastructural study.

The histogenesis of a distinctive metastasizing intramural gastric tumor found in patients with extra-adrenal paragangliomas, pulmonary chondromas, or both, is unknown. By light microscopy, it has appeared to be of smooth-muscle derivation, and it has been interpreted as being epithelioid leiomyosarcoma. For further clues to its nature, we studied three examples by electron microscopy (two obtained from patients with extra-adrenal paragangliomas and one from a patient with pulmonary chondroma).

Relationship between caffeine discrimination and caffeine plasma levels.

Rats, trained to discriminate 32 mg/kg caffeine from saline in a two-lever operant task, were tested for the presence of caffeine-appropriate lever responding at various intervals after the intraperitoneal injection of 32 mg/kg caffeine. Following completion of all behavioral tests, caffeine plasma levels were determined in the same animals at the same intervals after caffeine administration. After injection, both caffeine levels and caffeine-appropriate responding showed rapid increases followed by a differential decline.

Acromegaly and pituitary adenoma with phaeochromocytoma: a variant of multiple endocrine neoplasia.

Two women ahd acromegaly due to a pituitary adenoma associated with phaeochromocytoma. Eight additional patients with this combination of tumours have been described by others. Our first patient had sustained hypertension, mild hypercalcaemia, and elevated basal levels of parathyroid hormone and calcitonin associated with malignant phaeochromocytoma and parathyroid hyperplasia.

Caffeine discrimination in the rat.

Rats were trained to discriminate 32 mg/kg caffeine from saline in a two-lever appetitive task. Across a range of caffeine test doses (1-32 mg/kg) rats showed a dose related generalization to the training cue. At intermediate caffeine dose levels, caffeine appeared to produce a more potent cue on tests following saline-training days than after drug-training days.

Multiple endocrine neoplasia with skeletal manifestations.

There are three types of familial multiple endocrine neoplasia, but type 2b, which is characterized by medullary thyroid carcinoma, pheochromocytoma, and ganglioneuromatosis, is the only one in which patients also have skeletal anomalies. These musculoskeletal abnormalities include marfanoid habitus, pes cavus, talipes equinovarus, slipped capital femoral epiphysis, kyphosis, scoliosis, lordosis, increased joint laxity, and weakness of the proximal muscles of the extremities. Affected patients have several facial abnormalities as well, the most striking being enlargement of the lips.

Stereospecific dextrorphan tolerance in rats.

1 Levorphanol was 20 times more potent than dextrorphan in decreasing food-reinforced fixed ratio 15 responding in male Sprague Dawley rats. 2 Chronic dextrorphan (100 mg/kg, i.p.

Radioassay for cobalamin (vitamin B12) requiring no pretreatment of serum.

We describe a radioassay for cobalamin (vitamin B12) in human serum or plasma that requires no boiling or other pretreatment of the sample. Normal chicken serum covalently coupled to magnetizable particles is used as the binding agent. The assay is performed at pH 12.

The induction of immunologic tolerance in guinea pigs infused with dimethylbenz(a)anthracene.

The infusion of 7,12 dimethylbenz(a)anthracene (DMBA) dissolved in DMSO:glycofurol into adult guinea pigs rendered most recipients unresponsive to the induction of contact sensitization with DMBA, either by injection in adjuvant or topical application. The results were similar when guinea pigs infused with DMBA dissolved in Upjohn fat emulsion, were challenged with DMBA in adjuvant, but studies attempting topical sensitization to demonstrate unresponsiveness were inconclusive. Mammary tumors appeared after a latent period of 8 to 11 mo in 4 guinea pigs infused with DMBA in fat emulsion in which topical sensitization with DMBA was attempted.

Use of adrenal biopsy in diagnosing adrenoleukomyeloneuropathy.

A 22-year-old man was seen with Addison's disease, psychosis, and neurologic abnormalities. A tentative diagnosis of adrenoleukomyeloneuropathy was made. Because of his age, negative family history, and the potentially serious prognosis of this disorder, the diagnosis was verified with an adrenal biopsy.

Campylobacter fetus ss. jejuni: a cause of massive lower gastrointestinal hemorrhage.

A patient is described with Campylobacter enteritis complicated by massive lower gastrointestinal bleeding from multiple mucosal ulcers in the terminal ileum and at the ileocecal valve. Repeated stool cultures and antibiotic therapy may be indicated in certain patients to diminish the morbidity arising from what may seem to be mild disease. In patients who suffer bleeding complications, arteriography before surgery is necessary to demonstrate an otherwise grossly indefinable source of bleeding.

Candida esophagitis and laryngitis in chronic mucocutaneous candidiasis.

Five children (aged 11 to 19 years) with lifelong chronic mucocutaneous candidiasis had 12 episodes of esophageal and/or laryngeal candidiasis documented by endoscopy. Symptoms included hoarseness (8/12), dysphagia (6/12), and hemoptysis (1/12). There was poor correlation between oral lesions and esophageal or laryngeal involvement.

Cell-mediated immune defects and infection. A study of malnourished hospitalized children.

Severe protein calorie malnutrition in children in developing countries has been characterized by noticeable depression of cell-mediated immunity and an increased manifestation of infectious illnesses. We studied 23 hospitalized US children whose admitting diagnoses included severe malnutrition to see if similar findings existed. Children were divided into two groups based on the percentage of E rosettes (T cells) prior to nutritional therapy.

Measles-specific lymphocyte reactivity and serum antibody in subjects with different measles histories.

Measles hemagglutination-inhibiting (HAI) antibody titers and measles-specific lymphocyte reactivity were studied in subjects who had previously received killed measles vaccine and had been recently reimmunized with live vaccine--persons who previously had atypical measles, subjects with multiple immunizations with live vaccine, adults with a history of measles, and persons with primary measles immunization. Twelve to 18 months after revaccination of former recipients of killed vaccine, all 31 subjects had measles HAI antibody titers greater than or equal to 10 and only three had lymphocyte stimulation indices (LSI) greater than 2.8.