Biomedical subjects
Publications and source records attributed to H S Wisoff.
A 70-year-old woman is reported who had glioblastoma multiforme of the cerebellum 52 years after radiation therapy to a midline cerebellar tumor. Seven similar reported cases are reviewed. Dedifferentiation of astrocytoma to glioblastoma and the role of radiation therapy are discussed.
The association of Streptococcus bovis septicemia with abnominal neoplasms has been well-documented. The case of a man who presented with vertebral osteomyelitis due to S. bovis is reported; he was subsequently found to have bacteremia and colonic polyps. It is recommended that patients who present with localized as well as generalized S. bovis infections undergo yearly colonoscopy.
An experimental transplantable canine brain tumor model with the advantages of rapid tumor growth within 10 days and relative safety for the investigator is presently available. The tumor is produced by intracerebral inoculation of cultured cells derived from a canine brain tumor induced by the Schmidt-Ruppin strain of the Rous-Sarcoma virus (SR-RSV). It has potential use as a model in experiments designed to evaluate the effectiveness of chemotherapy and radiotherapy with serial computerized tomography scans. However, characterization of the induced tumor is essential. Ideally, it should have features attributable to glioma and/or neuroectodermal tumors. Utilizing the technique of intracerebral inoculation of cells cultured from the original dog brain tumor induced by SR-RSV, Salcman et al identified the tumor they induced in brains of mongrel puppies as a glioma by light microscopic criteria (Reference). The purpose of our study was to further characterize this experimental tumor by electron microscopic and immunohistochemical techniques. Tumor was induced in 6 mongrel puppies. Stains of the tumor for immunohistochemical reactivity to glial fibrillary acid protein, S-100 protein and 210K neurofilament protein were all negative. With the electron microscope, the intracerebral tumor cells were mostly undifferentiated. They had a few cell processes, occasional punctate adhesions and some microvilli-like structure. The tumor cell nucleus was usually oval shaped and sometimes had nuclear indentations. The cytoplasm contained abundant free ribosomes, some rough endoplasmic reticulum and mitochondria. Collagen fibers and basal lamina were not observed in the intercellular spaces. The capillaries within the tumor were characterized by proliferation of immature endothelial cells which were non-fenestrated.(ABSTRACT TRUNCATED AT 250 WORDS)
Six elderly patients with fractures through the base of the dens are presented. Early posterior fusion with wire and acrylic is recommended after reduction and maintenance of alignment with skeletal traction and treatment of coexistent injuries and illnesses. Uncommon problems and associated injuries complicating treatment in this group of patients are discussed. Some patients in this age group may best be treated with a collar because of concurrent cardiopulmonary disease.
The predictive values of certain features of computerized tomographic (CT) scans in estimating intracranial pressure (ICP) were investigated in 40 patients following closed head injuries. The various features of CT scans selected for study included ventricular compression, the size of the parenchymal mass lesion, midline shift, and an intraventricular clot. All patients with intraventricular clot exhibited severe elevation of pressure. Ventricular compression correlated well with the level of intracranial pressure. Size of the mass was found to be suggestive of pressure elevation but did not reach statistical significance. Midline shift showed no correlation with the intracranial pressure.
Biochemical analysis of a nonfunctional paraganglioma in the cauda equina region demonstrates that its catecholamine content is predominantly dopamine with small amounts of noradrenaline and adrenaline. Scattered mature large neurons characterize the tumor as gangliocytic paraganglioma. Ultrastructural study shows intracytoplasmic neurosecretory granules in the neoplastic cells.
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Spinal AVM's are not rare, and are diagnosed today with increasing frequency by utilization of moedern neuroradiological techniques. Their relationship to the spinal medulla is related to vascular embryological anatomy, and the only effective treatment is directed at obliteration of the fistula. Males are affected more frequently in the middle years of life. Symptoms may mimic spinal cord tumors and demyelinating disorders. The pathogenesis of symptoms, classification, and methods of diagnosis are reviewed, and the various methods of treatment discussed.
The prominent finding on electron microscopy of an unusual spongy variant of medulloblastoma was the marked distention of a well-developed smooth endoplasmic reticulum of the tumor cells. To the authors' knowledge, this fine structural feature has not been described previously in this tumor.
A case of hemangioblastoma of the spinal cord is described in which the tumor presented in an intradural extramedullary location. The patient did not have von Hippel-Lindau's disease or metastatic seeding. It is assumed that the tumor arose in the pia, and its direction of growth was purely extramedullary.
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A subarachnoid ependymal cyst of the spinal cord is rarely reported. A 44 year old man with a cyst compressing the lower spinal cord and conus medullaris is described. Excellent functional recovery followed excision of the lesion. The cells lining the cyst were histologically indistinguishable from normal ependymal cells, but, unlike the normal ependymal cells which are related to subependymal glial tissue, the cells lining the cyst abutted directly on the connective tissue forming the cyst wall. This is in contrast with ependymal lined cysts occurring within the conus medullaris, and intradural teratomatous cysts which consistently contain intracytoplasmic mucinous material. It is postulated that an ependymal cyst could result from isolation of ependymal cells from either the roof or floor plates during embryogenesis of the neural tube.
Moyamoya disease is a rare but well described entity which has been found in the angiographic investigation of subarachnoid hemorrhage, its most common symptom in adults. We present 4 patients in whom moyamoya disease and an intracranial saccular aneurysm were discovered. In 2 of the 3 patients suffering a hemorrhage, the aneurysm was the source of bleeding. Three of the aneurysms were located at the basilar artery bifurcation. We recommend a careful search for a concomitant aneurysm in all patients with subarachnoid hemorrhage in whom moyamoya disease is found. We believe these patients should be treated as though the aneurysm were the source of bleeding.