ABSTRACT
Intradural convexity chondromas are slow-growing tumors of young adults and children. Their symptoms are due to their size and degree of mass effect. They are extra-axial, avascular masses without peritumoral edema. CT and magnetic resonance resonance imaging of the head and cerebral angiography are helpful in diagnosis. Treatment is surgical resection.
Subject(s)
Brain Neoplasms/diagnosis , Chondroma/diagnosis , Adolescent , Brain/diagnostic imaging , Brain/pathology , Brain Neoplasms/surgery , Cerebral Angiography , Chondroma/surgery , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Intraperitoneal adhesions, obesity, and distorted abdominal anatomy in shunt-dependent hydrocephalic patients are patient characteristics that increase distal ventriculoperitoneal (VP) shunt failure rates. The use of laparoscopic-aided placement of the distal VP catheter as a technique to decrease the failure rate is evaluated in these patients. METHOD: Thirteen hydrocephalus patients considered to either have intra-abdominal adhesions, be obese, or have distorted abdominal anatomy underwent laparoscopic-aided distal VP catheter placement or revision. Two had shunts placed for the first time and eleven had revisions. Eight patients had revisions performed by both the standard minilaparotomy and laparoscopic methods, but at different times. The average surgical times for both techniques were looked at for these eight patients. Case illustrations are presented. RESULTS: In patients who had both types of abdominal approaches, the average surgical time was 81 min for the laparoscopic-aided technique versus 116 min for the minilaparotomy procedure. The only complication related directly to the laparoscopic procedure was one wound infection. CONCLUSION: In patients with intra-abdominal adhesions, obesity, or distorted abdominal anatomy, laparoscopic-aided distal shunt insertion increases the success rate by its direct visual capability and the ability to lyse abdominal adhesions and position the distal end of the catheter in a desired place.
Subject(s)
Hydrocephalus/surgery , Laparoscopy , Ventriculoperitoneal Shunt/methods , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle AgedABSTRACT
Massive osteolysis is a type of idiopathic osteolysis in which there is spontaneous onset of bone resorption. Almost any bone in the body can be affected. The authors present the case of a 62-year-old man diagnosed with massive osteolysis of the occipital bone and the upper two cervical vertebrae. Despite extensive pneumocephalus, no neurological sign or spinal instability was evident. In this case 4000 cGy of radiation in 200-cGy fractions was administered to the diseased area while the patient was kept in a Miami-J collar. At the 2-year follow-up examination, arrest of the disease process and new bone formation was evident on radiographic studies.
Subject(s)
Cervical Vertebrae , Osteolysis , Skull , Humans , Male , Middle Aged , Osteolysis/classification , Osteolysis/diagnosis , Osteolysis/physiopathology , Osteolysis/therapy , PrognosisABSTRACT
In humans, trisomy 21 results in a specific phenotype known as Down syndrome (DS). The mechanism by which an extra copy of normal genes leads to the DS phenotype is unknown. Most studies in DS and other aneuploid organisms have shown that gene dose is proportional to gene expression. To date, most genes examined have encoded either metabolic enzymes or constitutively expressed products. In the trisomy 16 mouse, an animal model of DS, we found marked dysregulation of two developmentally regulated genes, App and Prn-p. Dysregulation varied from tissue to tissue and during development in the same tissue. We conclude that abnormal phenotypes seen in aneuploid conditions may result in part from disordered expression of developmentally regulated genes.
