Faculty Bibliography

Hippocampal principal neurons, granule and pyramidal cells, are known to express type II glucocorticoid receptors (GR) and it is believed that glucocorticoids (GC) mediate at least some of their effects through GR. Under conditions of severe stress and trauma, these principal cells are vulnerable to damage and this mechanism may be exacerbated by GR. The mossy cell, an excitatory dentate gyrus neuron, is also damaged following trauma, with over 50% reported loss in rats after kainate-induced seizures. However, it has not been determined if GC play any role in protecting or exacerbating damage to this important hippocampal cell type. In the present study, we have undertaken an evaluation of the presence of GR in mossy cells of the rat and mouse utilizing an immunocytochemical double-labeling technique. To identify mossy cells in the rat, we utilized an antibody to the glutamate receptor subunit 2/3 (GluR2/3). In addition to GluR2/3 antibodies, in the mouse, an antibody to the calcium-binding protein, calretinin (CR), to identify mossy cells was also employed. Our results show that GR immunoreactivity (IR) was colocalized with GluR2/3-IR in approximately 90% of the rat and the mouse mossy cells. In addition, GR-IR was identified in the CR-IR mossy cells in the mouse hippocampus, whereas the CR-IR interneurons of rat and mouse were negative for GR-IR. The presence of GR on mossy cells may indicate the ability of GC to mediate cellular activity of these cells.

Case histories of proposed life insurance are presented to introduce the topic of cardiac valvular tumors. Using fibroelastoma as the prototypical cardiac tumor, pathology, diagnosis, echocardiographic findings and clinical course are reviewed, based on available clinical literature. Although the natural history of benign cardiac tumors is uncertain, because of the risk of adverse outcomes, cases must be underwritten on an individual basis until long-term studies become available

Fifty-two heroin addicts were inducted onto buprenorphine under the care of psychiatric residents in a setting modeled on office practice. Subjects were maintained on a protocol of six weeks of 16 mg daily dosing, then tapered to zero dose up to week 16, and maintained on placebo through week 18. Of 44 subjects who continued after the first induction dose, 11 terminated during maintenance, 17 during taper; and 16 while on zero dose. Twice weekly urine toxicologies showed significant successive declines in samples positive for heroin use across these three periods: 70%, 41%, and 20%, respectively. Among historical variables, only prior AA attendance distinguished subjects who achieved zero dose from those who did not. A comparison with recent studies suggests that relatively inexperienced office-based physicians can maintain patients on buprenorphine at a level comparable to that reported for research clinic settings, but with comparable rates of heroin abstinence. These findings are discussed in light of potential options for office-based opioid maintenance

Ofri reviews Sloan-Kettering by Abba Kovner and translated by Eddie Levenston

Torture and ill-treatment are reportedly widespread in Mexico. Little is known, however, about the quality of forensic investigations and documentation of evidence of these human rights violations. To determine the integrity of the documentation and the presence, quality, and frequency of both physical and psychological evaluations, analyses were conducted on 103 medical evaluations identified in 33 cases of alleged torture and/or ill-treatment that the Mexican National Commission for Human Rights (CNDH) investigated between January 2000 and July 2002. Findings suggest that forensic medical evaluations in CNDH cases have been conducted promptly after alleged occurrences of torture and/or ill-treatment, and the results of such evaluations have often been introduced as evidence in legal investigations. Inadequate documentation in most forensic medical evaluations reinforces the need for effective training, monitoring, and accountability strategies.