Aneurysm of the left middle cerebral artery caused by myxoid degeneration of the vessel wall.

Background: Myxoid degeneration of arterial walls may result in dissection and dissecting aneurysms in extracranial and intracranial portions of cerebral arteries. Rarely, saccular aneurysms may also develop on that basis, but thus far these have only been reported in the cervical portions of the carotid arteries. We describe a case of a nondissecting aneurysm of the left middle cerebral artery caused by myxoid degeneration of the media.

Glioblastoma multiforme of the hippocampus in advanced Alzheimer's disease.

An 87-year-old woman suffered from Alzheimer's disease diagnosed 6 years prior to her death. Autopsy showed in addition to far-advanced Alzheimer's disease, a large, partially necrotic glioblastoma occupying her right hippocampus. Occurrence of a glial neoplasm in Alzheimer's disease could well be coincidental, since both entities are fairly common in elderly individuals; it is however, uncommon for gliomas to centre on the hippocampus itself.

Tissue artefacts caused by sponge in embedding cassettes.

Sponges in embedding cassettes may cause disruptive imprints on the tissues being processed and therefore should not be used in processing tissues. Tissue or lens paper is recommended as a substitute to prevent losing small pieces of tissue through the perforations of the cassette.

Pleomorphic xanthoastrocytoma with desmoplastic reaction: angiomatous variant. Report of two cases.

Two cases of cerebral pleomorphic xanthoastrocytomas (PXA-s) with prominent vascularity and desmoplastic changes occurring in young subjects are presented. The tumors displayed the marked pleomorphism characteristic of PXA-s and had variable cellularity. The cytoplasm of many tumor cells contained an abundance of lipid droplets.

Adrenal cortical adenoma in the spinal canal of an 8-year-old girl.

An ectopic adrenal cortical adenoma containing high levels of androstenedione but without clinically detectable virilizing effects was found in the spinal intradural space of an 8-year-old girl. The tumor, which was located at the L2 level, manifested itself clinically by a short history of bilateral leg pain. It was well encapsulated; therefore, total surgical removal was accomplished.

Penetration of neuronal perikarya by capillaries in chronic limbic encephalitis.

In a case of chronic limbic encephalitis in a 57-year-old man many neurons in the pyramidal cell layer of the hippocampus bilaterally were penetrated by ingrowing capillaries. All gradations from slight to moderate indentation of the cell membranes to complete incorporation of the capillaries in the neuronal perikarya were observed. The penetrating capillaries retained their basement membranes.

Prevention and management of surgical complications during repair of abdominal aortic aneurysms.

Abdominal aortic aneurysms can be repaired with a mortality rate of 3 per cent or less under optimal conditions. To achieve these results, every effort must be made to prevent disastrous surgical complications in this elderly population. This review covers some of the more common and serious complications associated with aneurysm repair: their causation, prevention, diagnosis, and treatment.

Abdominal aortic aneurysmorrhaphy combined with biliary or gastrointestinal surgery.

Abdominal aortic aneurysms occur in 2 to 5 per cent of the population over 60 years of age. Statistically, 7 per cent of patients with aneurysms will have associated cholelithiasis. The incidence of other concomitant intra-abdominal disease is much less.

Histopathological features of recurrent pleomorphic xanthoastrocytomas: further corroboration of the glial nature of this neoplasm. A study of 3 cases.

Pleomorphic xanthoastrocytoma (PXA), a tumor most often presenting superficially over the cerebral hemisphere of young subjects, has certain morphological similarities to fibrous histiocytoma (or fibrous xanthoma) of the meninges and brain, namely the occurrence of lipid-laden neoplastic cells and, frequently, a dense reticulin fiber network. The detection of glial fibrillary acidic (GFA) protein in the tumor cells helped to establish its astrocytic derivation, but it has been advanced that, in spite of this agreed observation, the tumor should still be regarded as a fibrous xanthoma of meningeal origin. Although many patients have a long symptom-free postoperative survival, local recurrences at varying intervals after surgery have been noted in some instances.

Vascular graft selection.

Twenty to thirty per cent of patients with arterial injuries and some patients with venous injuries require interpositional grafting. The first choice of grafting material for both arterial and venous injuries is autogenous vein. Injuries to large vessels such as the aorta and superior vena cava may necessitate synthetic prostheses.

"Chordoid" meningeal tumors in young individuals with peritumoral lymphoplasmacellular infiltrates causing systemic manifestations of the Castleman syndrome. A report of seven cases.

Seven young patients ranging in age from 8 to 19 years had surgically removed meningeal neoplasms with a peculiar myxoid-chordoid pattern. The tumors were surrounded by massive polyclonal lymphoplasmacellular infiltrates with follicles and germinal centers. The patients preoperatively manifested iron-resistant hypochromic microcytic anemia, and one of them had dysgammaglobulinemia and stunted growth.

Immediate effect of irradiation on microvasculature.

The immediate effects of irradiation on microvasculature in muscle in an animal model are described in this paper. By using triple isotopes of 125I, 131I, and 22Na, the transcapillary transfer of albumin from the vascular bed to the extravascular space is determined in terms of mg/g of tissue, after single doses of 2 to 14 Gy. These results reveal an increase in the extravascular albumin immediately after irradiation and suggest an instantaneous compromise in vascular permeability even after 2 Gy.

Multiple sulfatase deficiency: bridge between neuronal storage diseases and leukodystrophies.

A fatal case of multiple sulfatase deficiency in a 10-year-old girl is reported. In this rare disease, which is inherited as an autosomal recessive, features of metachromatic leukodystrophy and of mucopolysaccharidoses occur together. The white matter suffers progressive destruction with sulfatides accumulating in macrophages; these stain metachromatically as golden brown granules with acetic acid thionin stain.

A clinical index to predict survival in acute renal failure patients requiring dialysis.

Recent advances in technology have not substantially changed the relatively low survival rate associated with acute renal failure (ARF). Several clinical prognostic variables and multivariate models have been reported to predict survival in individual patients, but these are either cumbersome to use or restrictive in their application. A straightforward clinical index has been developed to predict survival in ARF based on data obtained for all patients receiving dialysis for ARF at the University of Kansas Medical Center from November 1979 through October 1985.

Spinal compression fractures in osteoporotic women: patterns and relationship to hyperkyphosis.

A prospective study of thoracic and lumbar spinal fracture distribution and its relationship to thoracic kyphosis was performed in 87 women with osteoporosis. Anterior wedge fractures were most commonly seen in the midthoracic spine and about the thoracolumbar junction, whereas central compression fractures were most common from the first to the fourth lumbar levels. Solitary wedge fractures did not occur above the seventh thoracic vertebra, suggesting that a cause other than osteoporosis must be suspected in any patient with an isolated high thoracic fracture.

Cerebellar structure in autism.

Several recent reports suggest cerebellar abnormalities in patients with autism. To further investigate the posterior fossa in vivo, we analyzed axial (transverse) and coronal magnetic resonance imaging (MRI) scans of autistic patients. The MRI scans were measured at life-size by planimetry.

Social judgments of facial deformity.

The purpose of this study was to examine age- and gender-related personality and ability judgments associated with facial deformity. Four age groups (range = 8 to 16 years) were shown either photographically corrected versions of children with congenital facial clefts or uncorrected versions. Subjects' ratings of photographs of children with facial deformity were consistently negative.

Influence of various factors on binding of 67Ga to polymorphonuclear leukocytes.

We have studied in vitro, factors that influence the uptake of 67Ga-citrate by human polymorphonuclear leukocytes. Citrate at 20 mM concentration decreased the uptake to 1% of control values. Uptake increased as a function of increased microCi of 67Ga/10(7) cells added and incubation time from 0 to 120 min.