[Glomus tumor? Aberrant internal carotid artery].
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Biomedical subjects
Publications and source records attributed to B Schuknecht.
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In a CT- and NMR-study, condylar remodeling after conservative treatment of condylar dislocation fractures in growing individuals was evaluated. The regenerated condyles displayed great similarities. Two condylar parts could be differentiated--one with and one without muscular attachment. The medial part represents the former small fragment and the lateral part a bony outgrowth. One of the patients studied demonstrated a bifid condyle. NMR-records were remarkable in that each of the three patients presented a lateral pterygoid muscle with the two heads oriented one above the other rather than side by side. This does not seem to support the observation made in experiments, that the disc remains fixed to the caput in low condylar fractures.
A longitudinal study of the remodelling process in three growing individuals who had suffered low condylar fractures with luxation was made utilizing computerized tomography. The small fragment of the condyle is partially resorbed during the remodeling process, while new bone is formed on the lateral aspect. Below the fracture site in the ascending ramus bone apposition was observed. Each of these remodeling responses was more vigorous in the one child examined than in the two adolescents.
A 72 year old female with cerebral abscess due to Nocardia farcinica is reported. Needle aspiration, antimicrobial therapy using a new combination of imipenem and amikacin, and, finally, surgical excision led to prompt and complete recovery. This is the oldest patient to survive cerebral nocardiosis reported in the literature. This infection, is usually regarded as opportunistic and is encountered with increasing frequency in immunocompromised conditions (organ transplantation, chemotherapy, underlying disabling disorder, acquired immunodeficiency syndrome, etc.). The literature is extensively reviewed for various aspects of this disease including prognostic factors, recent developments in antibiotic therapy (imipenem, amikacin, minocycline etc.) and the essential role of surgery in the treatment strategy.
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Twenty patients with an epidural haematoma of the posterior fossa (EPIPF) among a total number of 359 patients with an epidural haematoma are reported (5.6%). Nine patients obtained a good outcome, four patients had a moderate disability and seven patients died (mortality 35%). Mortality of the acute cases was 50%, of the subacute cases 20%. In general, the clinical features were uncertain. Sixteen cases showed an occipital skull fracture or diastasis of the lambdoid suture respectively. A total number of 127 cases with EPIPF from the literature since 1961 was studied. The mortality in the CT-diagnosed group ran to 21.7% and to 25.9% in the group without CT. None of the patients showing a subacute course died when the diagnosis was made by CT, in the group without CT, however, four patients out of 11 subacute cases died. Head injured patients with an occipital trauma should therefore undergo CT scanning to detect a surgically significant lesion before clinical deterioration occurs.
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Tinnitus is a familiar symptom in diseases of the central nervous system. Its aetiology being of a varied nature, the type of tinnitus is a pointer to the pathoanatomic findings that are responsible for the disease. The causes of tinnitus are often found in the borderline areas between various neighbouring disciplines, such as otology, neurology and neurosurgery, whereas the final identification of the real causes is mainly within the scope of radiological diagnosis, in which computed tomography and superselective angiography play an essential role. In addition to arteriovenous fistulas near the petrous bone and glomus tumours, which are well known, there are a few other aetiologies of pulse-synchronous tinnitus that are being discussed in this paper. In recent years there has been substantial therapeutical progress owing to the introduction of new techniques and the development of improved materials for embolisation in interventional neuroradiology. Their application is discussed in connection with various patient groups.
Tinnitus synchronous with the pulse is usually caused by vascular anomalies. In our own patient group we found the most frequent cause to be highly vascularised tumours related to the pretrous bone, the most common being glomus tumours. Pulsatile tinnitus however also is a main symptom of dural arterio-venous malformations with shunts into the transverse and sigmoid sinus. Finally pulsatile tinnitus may be caused by venous deformities, possibly combined with anomalies of the bulb of the jugular vein. While clinical methods give valuable clues to the type of pathological findings, subtle radiological investigations are necessary for the final diagnosis, such as high resolution computer tomography and super-selective angiography. There has been substantial progress in recent years due to technical developments leading to improved diagnosis and treatment by interventional radiology.
Nitrate analyses were performed on ground water well samples originating from sources throughout Wisconsin. The data ranged from below the analytical detection limit up to 140 mg NO3-N/1. Over nine percent of all wells sampled has nitrate concentrations in excess of 10 mg NO3-N/1. Six individual counties had more than 10 mg NO3-N/1 in at least twenty percent of the wells covered in this survey. However, data reported for over eight thousand new wells driven in 1971-1972 showed only slightly more than two percent with nitrate levels above 10 mg NO3-N/1. This reflected the trend toward drilling deeper wells which are influenced less by nitrate seepage as well as adherence to new and stricter well construction codes.
Proton spectroscopic imaging at short TEs (20-30 ms) in human brain requires volume preselection inside the brain to suppress overwhelming lipid and water signals from surrounding tissue. In this article we discuss limitations of conventional volume preselection using stimulated echoes that lead to spectral contamination from surrounding tissue. Improved volume preselection was obtained by adding a complete outer volume suppression (presaturation). The performance of the method is illustrated on normal volunteers and on clinical cases with brain tumors and multiple sclerosis (MS) plaques. In normal human brain, we detected resonances with short T2 values and complex J-coupling, including rather broad methyl/methylene resonances in the chemical shift range between 0 and 2 ppm. Spectroscopic images obtained on patients with intracranial tumors and on one patient with several MS plaques demonstrate the possibility of detecting regional distributions of increased methyl/methylene resonances between 0 and 2 ppm in brain lesions.
BACKGROUND: Pleomorphic adenoma (PA) arising in the external auditory canal (EAC) is a very rare neoplasm, thought to be derived from ceruminous glands. CASE: A 43-year-old male presented with a slowly growing mass in the right EAC. Clinical and radiologic examinations showed a well-circumscribed tumor limited to the EAC, without a connection to the parotid gland. Fine needle aspiration cytology (FNAC) revealed the typical cytologic findings of PA. The diagnosis was confirmed by histologic examination. CONCLUSION: This case illustrates that together with clinical and radiologic findings, primary PA of the EAC can confidently be diagnosed by FNAC.