[Leukoplakia-like epidermal nevus of the mouth mucosa. Case report]. / Leukoplakischer epidermaler Nävus der Mundschleimhaut. Fallbericht.

We report on a nevus of the oral mucosa, which became present in the age of 30 of a male patient. By microscopic examination we did not find any vacuolation of the spinous layer of the epithelium. So this nevus has been considered quite different from the typical white sponge nevus, and we prefer to name it leucoplakial nevus of the oral mucosa.

Intravenous yohimbine. Selective enhancer of norepinephrine and cortisol secretion and systolic blood pressure in humans.

Yohimbine hydrochloride was administered intravenously to nine normal volunteers to assess alpha 2-adrenergic receptor function. Plasma catecholamines, cortisol, and psychophysiological parameters (blood pressure, pulse, somatic symptoms checklist, and visual analogue scales assessing mood) were used as dependent variables. Plasma norepinephrine and plasma cortisol increased significantly after yohimbine administration, while epinephrine remained unchanged. Systolic blood pressure and somatic symptoms were also significantly increased by yohimbine. These findings suggest that low-dose intravenous yohimbine is an effective probe for alpha 2-adrenergic receptors and the hypothalamic-pituitary-adrenal axis.

[Extreme basalioma variants--case reports]. / Extreme Basaliomvarianten--ein kasuistischer Beitrag.

Considering two cases of extremely extended basal cell epitheliomas the histological results are discussed in relation to the clinical aspect.

Anxiogenic effects of caffeine on panic and depressed patients.

Caffeine increases anxiety in people with anxiety disorders. To determine whether caffeine exerts a similar effect in depression, the authors compared retrospective reports of caffeine intake and symptoms produced by caffeine ingestion in patients with panic disorder, patients with major depression, and control subjects. Panic patients consumed less caffeine and reported more symptoms than depressed or control subjects. Although depressed patients did not differ from control subjects in caffeine intake or most symptoms, more depressed patients reported that caffeine induced anxiety. These data support prior reports that panic patients have increased sensitivity to caffeine; some depressed patients may also have increased sensitivity.

Chronic caffeine consumption and the dexamethasone suppression test in depression.

Acute caffeine administration increases cortisol and converts the dexamethasone suppression test (DST) to nonsuppression in normal humans; data concerning chronic administration as well as effects in depressed patients are minimal. To determine whether caffeine intake influenced DST results in depression, we retrospectively studied the relationship between regular daily caffeine consumption and pretreatment DST status in major depressives. Daily intake was not correlated with either post-DST cortisol levels or symptom ratings. These data suggest that chronic caffeine use is unlikely to be a major factor in dysregulation of the hypothalamic-pituitary-adrenal axis in depression, perhaps because of the development of tolerance.

Serial dexamethasone suppression tests in simultaneous panic and depressive disorders.

Recent work suggests that the simultaneous occurrence of major depressive disorder (MDD) and panic disorder (PD) may be of relevance for clinical findings, therapeutic outcome, and prognosis. It is of interest to know whether or not this relevance extends to biological findings. We addressed this question through comparison of serial Dexamethasone Suppression Test (DST) results in patients who had either MDD alone or simultaneous MDD and PD. We were unable to describe differences between the groups.

Age effects in serial hypothalamic-pituitary-adrenal monitoring.

To evaluate age effects on hypothalamic-pituitary-adrenal (HPA) regulation in depressives, we studied 65 patients with major depressive disorder, endogenous subtype. With each patient serving as his or her own control, we compared weekly dexamethasone suppression test (DST) results among three age subgroups (less than 40 years, n = 18; 40-70 years, n = 40; greater than 70 years, n = 7). The oldest patient group had higher mean post-dexamethasone plasma cortisol concentrations both before and after treatment, and more were DST nonsuppressors. Life table analyses revealed that elderly patients who were DST nonsuppressors had significantly slower patterns of normalization during treatment and that fewer elderly patients ever achieved normal suppression. The results indicate that age effects on HPA function may be confounded with other aspects of depression, such as severity, chronicity and number of previous episodes.

Self-reported diurnal mood changes, early morning awakening and the dexamethasone suppression test in endogenous depression.

Several authors have suggested that Dexamethasone Suppression Test (DST) non-suppression is related to circadian alternations of hypothalamic-pituitary-adrenal function. Two clinical manifestations of altered circadian rhythms in depressed patients are early morning awakening and diurnal variation in mood. To observe whether these clinical symptom patterns were associated with an increased frequency of abnormal DSTs, we examined post-DST plasma cortisol concentrations and matched clinical ratings of early morning awakening and diurnal variation in mood in 49 patients with major depressive disorder, endogenous subtype. We found no significant association between these clinical and laboratory variables.

Maternal nutritional status and adolescent pregnancy outcome.

To investigate the determinants of low birth weight of infants born to adolescent mothers, we studied the obstetric population attended at the Maternity Hospital of Lima, Peru. From this population we selected for study a sample of 1256 adolescent mothers ranging in age from 12 to 25 yr. The study included anthropometric and biochemical measurements used to evaluate nutritional status and physiological maturity of the mother and newborn. Findings from the present research indicate that the low birth weight of infants born to adolescent mothers is not due to premature delivery (short gestation) or low gynecological maturity. Furthermore, young adolescent mothers had smaller and thinner newborns than those born to older women who were adjusted for nutritional status during pregnancy and at delivery. That is, despite the similar nutritional status among the young adolescent mothers, the availability of nutrients for the accumulation of calories in the fetus (measured by skinfold thickness) was less than that of older women. Furthermore, the pregnancy weight gain associated with an optimal or average newborn weight is greater for young teenagers than for older women. These findings support the hypothesis that among rapidly growing teenagers the nutritional requirements of pregnancy may be greater than those of older women, and that this increased requirement competes with the growth needs of the fetus.

Elbow breadth as a measure of frame size for US males and females.

Correlation coefficients of weight, bitrochanteric and elbow breadth to the log-transformed skinfold thickness and age were calculated using 16,494 adult Black and white samples derived from the data sets of the US Health and Nutritional Examination Survey I of 1971 to 1974. Among the variables, elbow breadth exhibited the lowest correlation with skinfold thickness and changes little with age. The analysis shows that elbow breadth can be used as an indicator of frame size. Based on sex-, race-, and age-specific percentiles of elbow breadth the subjects were classified into categories of small, medium, and large frame size. It is suggested that these categories be used for the evaluation of weight for height and frame size.

Relative merits of old and new indices of body mass with reference to skinfold thickness.

Correlation coefficients among the various commonly used indices of body mass and measures of skinfold thickness were calculated using 16,459 adult Black of white samples derived from the data sets of the US Health and Nutritional Examination Survey I of 1971 to 1974. Compared to weight and weight-height cube ratio, weight-height square ratio, and weight-heightp ratio exhibit the highest correlation with skinfold thickness. Furthermore, weight-height square ratio and weight-heightp ratio showed the same amount of correlation with skinfolds. Therefore, weight-heightp ratio is not the best indicator of adiposity. It is concluded that weight-height square ratio along with measures of subcutaneous fat such as skinfold thickness would provide adequate information about body size and body fatness. The applicability of weight-heightp is limited to studies concerned with interpopulation comparisons of body mass and where there are differences in height.