Late onset Epstein-Barr virus-associated lymphoproliferative disease after allogeneic bone marrow transplant presenting as breast masses.

We report a patient who developed breast masses 17 months after a T cell-depleted partially mismatched related donor (PMRD) bone marrow transplant (BMT) for chronic myeloid leukemia. The patient had severe chronic graft-versus-host disease (GVHD) and the masses were due to Epstein-Barr virus (EBV) lymphoproliferative disease (LPD). The patient expired from fungal pneumonia after chemotherapy for the EBV-LPD.

Cortical blindness as a complication of acute glomerulonephritis.

This case documents acquired reversible cortical blindness as a complication of hypertension secondary to acute glomerulonephritis and emphasizes the importance of recognizing this complication in children. The etiology of the cortical blindness is felt to be secondary to ischemia with edema from arterial spasm. Results of a CT scan of the head and lack of clinical sequelae support this assertion.

Correlation of mechanical properties of vertebral trabecular bone with equivalent mineral density as measured by computed tomography.

We tried to determine whether mineral-equivalent measurements that were obtained using computed tomography could be used to predict the mechanical properties of vertebral trabecular bone. Vertebral bodies that had been obtained during routine autopsy were evaluated by computed tomography. The mechanical properties of the vertebral trabecular bone were determined by subjecting cylindrical specimens to simple compression until failure occurred. The ultimate strength and elastic modulus were determined from load time curves, using constant displacement rate loading. Atomic absorption spectrophotometry was used to determine the weight per cent calcium of each specimen, and quantitative light microscopy was used to determine area fraction bone. Significant positive correlations were found between the observed mechanical properties of the trabecular bone and the equivalent mineral density as measured by computed tomography. Compressive strength (r = 0.720), elastic modulus (r = 0.574), trabecular calcium density (r = 0.780), and area fraction bone (r = 0.579) were all correlated with the equivalent mineral density.

Radiation decontamination unit for the community hospital.

"Freestanding" radiation decontamination units including surgical capability can be developed and made operational in small/medium sized community hospitals at relatively small cost and with minimal plant reconstruction. Because of the development of nuclear power plants in relatively remote areas and widespread transportation of radioactive materials it is important for hospitals and physicians to be prepared to handle radiation accident victims. The Radiological Assistance Program of the United States Department of Energy and the Radiation Emergency Assistance Center Training Site of Oak Ridge Associated Universities are ready to support individual hospitals and physicians in this endeavor. Adequate planning rather than luck, should be used in dealing with potential radiation accident victims. The radiation emergency team is headed by a physician on duty in the hospital. It is important that the team leader be knowledgeable in radiation accident management and have personnel trained in radiation accident management as members of this team. The senior administrative person on duty is responsible for intramural and extramural communications. Rapid mobilization of the radiation decontamination unit is important. Periodic drills are necessary for this mobilization and the smooth operation of the unit.

Effects of contrast agents on the blood-brain barrier. An electron microscopic study.

To determine if contrast agents after the blood-brain barrier by opening tight junctions between endothelial cells and by increasing pinocytosis, the distribution of horseradish peroxidase (HRP) was evaluated after intracarotid injections of contrast media. HRP did not cross the endothelium of cerebral blood vessels. Tight junctions remained closed. There was increased endothelial cell pinocytosis and swelling of astrocyte end-feet.

Alterations at the cellular level in the brain following repeated angiography: protective effect of corticosteroids.

Repeated injections of angiographic contrast media disrupt the blood-brain barrier and lead to transient cerebral edema in the normal experimental animal brain. The corticosteroid, dexamethasone, protects against the development of this edema without altering the effect of the contrast media on the tight junctions between adjacent endothelial cells. Indirect evidence is presented to support the theory that the corticosteroids function to maintain the integrity of the endothelial cells.

Histiocytosis-X of the hypothalamus.

Hypothalamic masses associated with histiocytosis-X may be mistaken for neoplasms. As a result radiation therapy will often be administered rather than chemotherapy, which appears to be the treatment of choice for histiocytosis-X of the hypothalamus. Particularly in young people, the possibility of granulomatous disease should be entertained and biopsy should be considered in the presence of a hypothalamic mass.