Antibacterial diterpenoids from Cedrus atlantica.

Four diterpene alcohols were isolated from the neutral hexane extract of the cones of Cedrus atlantica, and their structures were confirmed after comparing their spectral data with literature values. These products exhibited significant antibacterial activity against gram (+/-) bacteria.

Germacranolides from Anvillea radiata.

The aerial parts of Anvillea radiata yielded a new germacranolide, 8alpha,9alpha-epoxyparthenolide (3), together with two known compounds, 9alpha-hydroxyparthenolide (1) and parthenolid-9-one (2). The structures of the compounds were elucidated from IR, HRMS, 1H and 13C-NMR, COSY, HETCOR, HMBC and HOHAHA spectral data. The major component 1 was tested for its cytotoxicity and antibacterial activity.

Choroid plexus cyst and chordoid glioma. Report of two cases.

Several types of mass lesions may occur in the third and lateral ventricles. Typically they arise from the lining of the ventricular cavity or from contiguous structures, by extension into the ventricle. The authors describe two patients, each of whom presented with a different rare lesion of the ventricular system. The first was a 53-year-old woman with a history of hypertension who sustained a blunt traumatic injury to the occipital region and subsequently developed a progressively worsening right-sided headache. Radiological examinations over the next 2 years revealed an enlarged right lateral ventricle and, ultimately, a choroid plexus cyst in its anterior and middle third, near the foramen of Monro, which is a rare location for these lesions. The cyst was removed en bloc, and follow-up examinations showed a significant improvement in her headache and a minimal differences in size between right and left ventricles. The authors also describe a 57-year-old man with hypertension, diabetes mellitus, and an old mycardial infarct, who presented to an outside institution with a progressively worsening headache, generalized malaise, and loss of olfactory sensation. Diagnostic imaging revealed a 1.5-cm oval lesion centered in the lamina terminalis region, an open craniotomy was performed, and evaluation of a biopsy sample demonstrated the mass to be a chordoid glioma of the third ventricle, a recently described glioma subtype. Two days after surgery, he suffered a left parietal stroke and an anterior mycardial infarction. After convalescing, he presented to The University of Texas M. D. Anderson Cancer Center for radiotherapy and follow up; 7 months later he was readmitted complaining of headache, short-term memory loss, and worsening confusion and disorientation. Neuroimaging revealed progression of the tumor (now 2 cm in diameter), which was removed by gross-total resection. His headache resolved immediately, and 2 months later his only complaint was of episodes of confusion. Three weeks later he died of a massive myocardial infarction. These two patients represent the sixth case of an adult with a choroid plexus cyst in the anterior lateral ventricle and the 19th case of an adult with a chordoid glioma of the third ventricle, respectively.

Thoracic vertebral hemangioma with extradural extension and spinal cord compression. Case report.

A 45-year-old man presented with progressive numbness of lower extremities and unsteady gait. Magnetic resonance imaging of the dorsal spine demonstrated multiple hyperintense inactive vertebral hemangiomas on T-1 weighted images. There was an active hemangioma involving D7 vertebral body and neural arch with epidural extension and spinal cord compression. He underwent embolization of the main feeders of the lesion and subsequent surgery. The patient's symptoms resolved after treatment. The clinical, magnetic resonance imaging findings, and treatment of this condition are discussed.

Abscess superimposed on brain tumor: two case reports and review of the literature.

BACKGROUND: An abscess involving an already present brain tumor is a rare occurrence. METHOD: Two cases of an abscess superimposed on a brain tumor are presented and discussed. The medical literature is reviewed, and all reported cases are compared to our own. RESULTS: Only 15 cases of an abscess associated with a brain tumor were found in the literature, to which we add 2 of our own. About 60% were intrasellar or parasellar tumors. The origin of such an abscess at this location is by direct extension of the germs from a contiguous infected sinus. Our 2 additional cases were away from the sinuses. One is an ependymoma of the posterior fossa, and the other, a falcotentorial occipital meningioma, each with a superimposed abscess. CONCLUSIONS: We propose an alternate route for the formation of an abscess in conjunction with a brain tumor.

Vascularized fascial patch for repair of suboccipital dural defect.

Advanced knowledge about cutaneous vascularity has enabled the development of axial flaps such as fasciocutaneous, septocutaneous, and musculocutaneous flaps. It has also laid the foundation for microsurgical free flaps. The newly emerging concept of angiosomes sheds yet more light on the complexity and multiplicity of peripheral blood supply. We describe the use of an extended vertical trapezius flap carrying a segment of latissimus dorsi muscle with the underlying paraspinal fascia to close an infected and irradiated posterior fossa craniectomy and dural defect. This flap illustrates the elevation of an angiosomal block of tissues as an axial flap vascularized by the alternative major blood supply of one of its constituents. The potentials of this "angiosomal flap" are explored. A brief review of dural defect repair is also presented.