ABSTRACT
Pilomyxoid astrocytomas are a more aggressive variant of pilocytic astrocytoma. Over the last 14 years, there has been increasing evidence to suggest that these tumours are distinct pathological entities to pilocytic astrocytomas. Radiological features of these tumours are slowly emerging in the neuroradiological literature. We report a unique radiological appearance of a multicystic, disseminated astrocytoma with pilomyxoid characteristics presenting in a 4-year-old boy and highlight the importance of considering this diagnosis with similar imaging.
Subject(s)
Astrocytoma/diagnosis , Hypothalamic Neoplasms/diagnosis , Antigens, CD/metabolism , Antigens, Differentiation, Myelomonocytic/metabolism , Astrocytoma/complications , Child, Preschool , Humans , Hydrocephalus/etiology , Hypothalamic Neoplasms/complications , Ki-67 Antigen/metabolism , Magnetic Resonance Imaging , Male , Nerve Tissue Proteins , Spinal Cord/pathology , Third Ventricle/pathology , Tomography, X-Ray Computed , Tumor Suppressor Protein p53/metabolismABSTRACT
AIMS & OBJECTIVES: The aim of the study was to look at the infection rate in adults undergoing craniotomies without hair removal and compare the results with the usual practice of pre-operative shaving/clipping. MATERIALS & METHODS: One-hundred consecutive adult patients who had elective supra-tentorial craniotomy for tumour were studied prospectively. A uniform policy of performing surgery without hair removal was adopted. Patients were followed up prospectively to look for surgical site infection. The rate of infection was determined and the results were compared with the published data on similar procedures where hair removal was carried out before surgery. RESULTS: A total of three patients developed surgical-site infection. One infection occurred in the glioma and two in the meningioma subgroup. The rate of infection is comparable to the published figures where pre-operative hair removal was performed routinely. CONCLUSIONS: Cranial surgery with hair left in place does not pre-dispose to an increased infection risk for adults undergoing tumour surgery.
Subject(s)
Brain Neoplasms/surgery , Craniotomy/methods , Hair Removal , Surgical Wound Infection/etiology , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Prospective Studies , Young AdultABSTRACT
The decision to biopsy diffuse pontine gliomas in children remains controversial. There have been many publications over the last 30 years aiming to address this issue. The prognosis for these patients remains extremely poor regardless of treatment and many authors advocate that biopsy carries significant risk for little or no clinical benefit. However, with an increasing knowledge of tumour biology and genetics there is the potential for specific treatments tailored for individual tumours based on their biological or genetic characteristics. The progress of such science in the first instance requires histological diagnosis as part of well conducted clinical trials, then, when treatments have been developed, biopsy samples will be needed to identify the tumours that may respond to such treatments. The authors believe that there is an increasing need for performing a biopsy of these lesions.
Subject(s)
Biopsy , Brain Stem Neoplasms/pathology , Brain Stem/pathology , Glioma/pathology , Biopsy/ethics , Brain Stem Neoplasms/mortality , Brain Stem Neoplasms/therapy , Child , Diagnostic Imaging/methods , Disease Progression , Family/psychology , Female , Glioma/mortality , Glioma/therapy , Humans , Male , Prognosis , Social ResponsibilityABSTRACT
UNLABELLED: Sacral agenesis is an uncommon condition characterised by total or partial absence of the sacrum. The association of this condition with craniocervical junction abnormalities is extremely rare. CASE REPORT: We describe a 3-year-old girl who, at the age of 8 months, while being investigated for short stature, was found to have significant craniocervical instability associated with anomalies of the odontoid peg. In addition to this she had partial sacral agenesis but genetic tests showed a normal karyotype. Due to the inherent difficulty of surgical fixation and immobilisation in an infant of her age, she was managed conservatively in a soft cervical orthosis. At the age of three years, surgery for decompression and stabilisation was deemed necessary due to the onset of neurological morbidity. CONCLUSION: The authors describe this extremely rare association and discuss the difficulties faced while deciding the optimum surgical strategy for managing such young children with craniocervical instability.
Subject(s)
Abnormalities, Multiple/surgery , Atlanto-Axial Joint/abnormalities , Cervical Vertebrae/abnormalities , Joint Dislocations/congenital , Joint Instability/congenital , Nervous System Malformations/surgery , Odontoid Process/abnormalities , Sacrum/abnormalities , Spinal Fusion , Abnormalities, Multiple/diagnostic imaging , Atlanto-Axial Joint/pathology , Atlanto-Axial Joint/surgery , Bone Transplantation , Cervical Vertebrae/pathology , Cervical Vertebrae/surgery , Child, Preschool , Craniofacial Abnormalities/diagnosis , Decompression, Surgical , Female , Follow-Up Studies , Humans , Image Processing, Computer-Assisted , Infant , Joint Dislocations/diagnosis , Joint Dislocations/surgery , Joint Instability/diagnosis , Joint Instability/surgery , Magnetic Resonance Imaging , Nervous System Malformations/diagnosis , Occipital Bone/pathology , Occipital Bone/surgery , Odontoid Process/pathology , Odontoid Process/surgery , Sacrum/pathology , Spinal Cord Compression/diagnosis , Spinal Cord Compression/surgery , Tomography, X-Ray ComputedABSTRACT
Antipolymorphonuclear leucocyte IgG (APS IgG) was prepared from crude horse antipolymorphonuclear leucocyte antiserum (APS). The APS IgG was less toxic than the crude APS and had a powerful and specific effect on rabbit polymorphs in vivo and in vitro. In rabbits infected with Klebsiella pneumoniae it suppressed the normal polymorph response and greatly reduced resistance to infection. Anti-Klebsiella pneumoniae antibody greatly enhanced protection in normal rabbits, but had much less effect on APS/IgG-treated rabbits. It was concluded that the principal cellular defence against K. pneumoniae was the polymorph and that macrophages made only a relatively small contribution to resistance.
Subject(s)
Immunoglobulin G/immunology , Immunosuppression Therapy , Klebsiella Infections/immunology , Neutrophils/immunology , Animals , Antibodies, Bacterial , Immunity, Maternally-Acquired , In Vitro Techniques , Klebsiella pneumoniae/immunology , Leukocyte Count , Rabbits , Sepsis/immunologyABSTRACT
The design and construction of an anaerobic CO(2) cabinet are described. Air is displaced by a stream of oxygen-free CO(2), and anerobic conditions are produced in 3 hr. The equipment is simple and cheap to operate and has been found to be satisfactory for the isolation of strict anaerobes from the mouse intestine.
