ABSTRACT
An intradural extramedullary spinal cord hemangioendothelioma at T10, T11 recurred twice and was irradiated after the third resection. This first reported case prompted a review of the neuropathology and natural history of this unusual tumor.
Subject(s)
Hemangioendothelioma/pathology , Neoplasm Recurrence, Local/pathology , Spinal Cord Neoplasms/pathology , Combined Modality Therapy , Hemangioendothelioma/therapy , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/therapy , Spinal Cord Neoplasms/therapyABSTRACT
In patients with Cushing's syndrome or morbid obesity, excessive accumulation of fat in the hips, upper back, abdomen, and mediastinum is well known (1, 3, 7). Excessive deposition of fat in the epidural space is less common, but must be recognized as a potential cause of neurological deficit (1-8). We report a patient with iatrogenic Cushing's syndrome, in whom magnetic resonance imaging (MRI) established the specific diagnosis of spinal cord compression secondary to excess epidural fat.
Subject(s)
Lipomatosis/diagnosis , Spinal Neoplasms/diagnosis , Adult , Cushing Syndrome/complications , Epidural Space , Female , Humans , Lipomatosis/complications , Magnetic Resonance Imaging , Spinal Cord Compression/etiology , Spinal Neoplasms/complicationsABSTRACT
A No. 4 French fiberoptic catheter initially developed as an intravascular pressure sensor was incorporated into a system to be used as an intracranial pressure (ICP) monitor. Initially, a series of acute and chronic animal experiments carried out in the rabbit and pig, respectively, demonstrated the reliability and safety of the device. Subsequently, this new monitor was compared to a concurrently functioning ICP monitor in 15 adult and five pediatric patients. This clinical experience also confirmed the safety, accuracy, and reliability of the device. Since these initial studies, this monitor has been used to routinely measure ICP in a large number of adult and pediatric patients. The monitor has functioned well, and there have been no complications related to its use except for an occasional problem with breakage of the optic fiber as a result of patient movement or nursing maneuvers, which has been easily corrected by replacement of the probe. As nursing personnel and ancillary services have become familiar with this new monitor, breakage has not been a problem. This new device can be placed into the ventricular system, the brain parenchyma, or the subdural space, and appears to offer substantial advantages over other monitors presently in use.
Subject(s)
Fiber Optic Technology/instrumentation , Intracranial Pressure , Monitoring, Physiologic/instrumentation , Adult , Animals , Child , Child, Preschool , Equipment Design , Humans , Rabbits , Swine , Time FactorsABSTRACT
Real-time ultrasonography is being used increasingly to establish the diagnosis of and serially assess intraventricular hemorrhage and hydrocephalus in neonates. The procedure requires an open fontanel because scatter from the bone occurs from direct application of the transducer to the skull and bone density precludes satisfactory imaging. With an adult, under circumstances where a bone flap is left out after intracranial procedures and the patient's clinical status is such that the patient cannot be transferred for computed tomographic scanning, real-time ultrasonography allows a safe, noninvasive, bedside demonstration of ventricular size, degree of shift of midline structures, and intraparenchymal and intraventricular lesions.
Subject(s)
Brain Injuries/diagnosis , Skull/surgery , Ultrasonography , Adult , Brain Injuries/complications , Brain Injuries/surgery , Cerebral Hemorrhage/etiology , Female , Hematoma/etiology , Humans , Respiratory Distress Syndrome/complicationsABSTRACT
High-pressure pulsatile lavage is more effective than conventional irrigation in cleansing recently contaminated wounds. This method of irrigation was applied to postoperative infections in an attempt to lower wound bacterial counts to 10(5) or fewer organisms per gram of tissue, a level predictive of safe primary reclosure. Sequential wound biopsies for quantitative bacterial analysis demonstrated that high-pressure lavage is more effective than conventional irrigation in lowering bacterial counts in postoperative staphylococcal wound infections in guinea pigs. However, reductions were transient and did not lower counts sufficiently to permit safe reclosure. In contrast to results in newly contaminated wounds, pulsatile lavage of postoperative infections did not have therapeutic benefit. Reclosure of wounds with greater than 10(5) organisms per gram of tissue is unsafe even after five days of therapy.
Subject(s)
Surgical Wound Infection/therapy , Therapeutic Irrigation/methods , Animals , Disease Models, Animal , Guinea Pigs , Staphylococcal Infections/therapy , Staphylococcus aureus/isolation & purification , Time Factors , Wound HealingABSTRACT
We developed a two-site immunoradiometric assay for rat serum ferritin that uses antibody immobilized on agarose. Individual serum ferritin values were significantly correlated with iron stores as determined chemically by liver ferritin iron content. This group correlation was not sufficiently great, however, to allow confident prediction of iron stores in a given animal on the basis of serum ferritin alone. Significant differences in mean liver ferritin iron concentration between groups of rats raised on diets of differing iron content were not always reflected by differences in mean serum ferritin values. Data correlating the serum levels of ferritin and a liver-specific transaminase suggested that hepatocellular death may sometimes contribute ferritin to the serum. Strong postitive correlations between serum ferritin and iron stores in the rat were not observed when serum transaminase levels were in the normal range.
