Evaluation of a portable insulin infusion pump for outpatient management of brittle diabetes.

Three "brittle" diabetic patients were given constant subcutaneous insulin infusion with a portable battery-driven pump, and their plasma glucose and hemoglobin A1 were measured at frequent intervals during inpatient or outpatient periods. Mean plasma glucose decreased significantly in all inhospital patients and remained significantly less than before pump therapy in two of three as outpatients during the 8--12 wk of follow-ups; however, complete normalization of glucose metabolism was not accomplished in any. All three demonstrated a progressive decline in hemoglobin A1 levels to normal or near-normal values.

Etiologic diagnosis of focal pulmonary infection in immunocompromised patients by fluoroscopically guided percutaneous needle aspiration.

Fluoroscopically guided percutaneous needle aspiration of focal pulmonary lesions was performed in 108 presumed infectious episodes in 82 immunocompromised patients in whom prior diagnostic studies, including transtracheal aspiration, were negative to inconclusive. Two-thirds of the lesions were 4 cm or smaller. Single (61/79) or multiple (18/79) organisms were recovered, for a diagnostic yield of 73% (79/108).

Sporadic distal myopathy with early adult onset.

With the exception of the large series of adult-onset hereditary distal myopathy from Sweden, few cases of primary muscle disease with a definite distal predilection have been published. We report 3 sporadic cases of distal myopathy with the following features: (1) early adult onset (26 to 33 years); (2) slowly progressive weakness affecting first the distal leg muscles and later the arms; (3) marked elevation of creatine phosphokinase (more than 10 times the normal value); and (4) electromyographic and histological evidence of myopathy in distal muscles. The differential diagnosis is discussed and other reported cases are reviewed.

Toxic effects of kainic acid on mouse cerebellum in tissue culture.

Cultures of mouse cerebellum were exposed for various intervals after explantation to kainic acid, a glutamic acid analog. Purkinje cells and intracerebellar nucleus neurons were destroyed and cortical laminar formation was inhibited by exposure to kainic acid, while granule cells were relatively spared. Prolonged kainate treatment also reduced the granule cell population.

Multifocal pontine lesions in cancer patients treated with chemotherapy and CNS radiotherapy.

Multifocal pontine lesions were found at postmortem examination in four patients with various types of malignancy. The patients had undergone extensive evaluation and treatment with multiple chemotherapy regimens as well as radiotherapy to the central nervous system. The histologic character and striking anatomic distribution of the pontine lesions are described and their possible pathogenesis discussed.

Posterior fossa subdural hematomas in neonates.

Posterior fossa subdural hematomas in the newborn infant are rare but potentially treatable. The infants are normal after birth, but within days, hydrocephalus hypotonia, and irregular respirations develop. Seizures and third nerve pareses are unusual.

Routine full-lung tomography in the initial staging and treatment planning of patients with Hodgkin's disease and non-Hodgkin's lymphoma.

The yield of additional information from anteroposterior full-lung tomograms that changed stage or treatment, in comparison to that obtained from routine chest radiographs, was prospectively evaluated in 243 previously untreated patients with Hodgkin's disease and non-Hodgkin's lymphoma. Although new information was found in 21.4% of all patients, in only 1.

'Glioblastoma'. Induction of a reproducible autochonous tumor in rats with murine sarcoma virus.

Inoculation of 0.02 ml of high-titer Kirsten strain Murine Sarcoma Virus into the brains of 10-day-old Wistar/Furth rats yields, with 100 percent incidence, a uniform glioblastoma-like tumor within 16 days. Light and electronmicroscopy confirmed the neuroectodermal origin of the parenchymal cells.

Wernicke's encephalopathy: an experimental study in the rhesus monkey.

Experimental Wernicke's encephalopathy, induced in rhesus monkeys with a diet lacking thiamine (vitamin B1), is characterized by cavitary necrosis of the striatum as well as a microvacuolar periventricular lesion of the brain stem such as occurs in man. With high resolution light microscopy and electron microscopy, the primary structural alteration in the brain stem lesion, and probably also in the striatum, appears to be that of widespread "blister" formation due to splitting of myelin at the intraperiod line. Microvascular alterations were minimal, even in the most severely affected regions.