Faculty Bibliography

Spontaneous intramural hematoma of the esophagus (SIHE) is a rare condition usually affecting middle-aged or elderly women. It presents as acute substernal or epigastric pain, typically accompanied by dysphagia or hematemesis. SIHE is not usually associated with vomiting, and is therefore clearly distinguished from emetogenic esophageal disorders, such as the Mallory-Weiss lesion and the Boerhaave syndrome. The diagnosis has traditionally been made by barium esophagram. Therapy is conservative; a favorable prognosis is the rule. The pathogenesis is in dispute. We present a case of SIHE without a discernible mucosal breach, suggesting a primary intramural bleed as the initiating event. We document the utility of computed tomographic scan and magnetic resonance imaging in the diagnosis of SIHE

Gastrointestinal involvement by Kaposi's sarcoma in patients with cutaneous or lymph node involvement is common. Since the advent of the acquired immune deficiency syndrome in 1981, primary gastrointestinal involvement, i.e., without skin or lymph node involvement, has not been adequately documented. We describe a patient with acquired immune deficiency syndrome and primary gastrointestinal involvement by Kaposi's sarcoma

Although systemically administered testosterone can effect the postnatal maturation of elements in the seminiferous tubule in hypophysectomized rats and mice, it does not elicit the same degree of development which occurs in normal control animals. In view of reports of precocious spermatogenesis in androgen secreting Leydig cell tumors, the present study was designed to determine if high local levels of testosterone accelerate development of the seminiferous tubules. Testosterone pellets were inserted under the tunica albuginea of the right testis of 7 day old rats. At 17, 23 and 28 days of age development of the seminiferous tubules, as judged by the formation of tubule lumens, was more extensive in the treated testes than in contralateral and sham operated controls. Tubule diameters were not necessarily correlated with lumen formation. This study demonstrates that high local levels of testosterone accelerate seminiferous tubule development in the rat and indicates that tubule diameter may not be a valid basis for estimating development of the testis. It is suggested that testosterone exerts this effect through its actions on the Sertoli cells