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Biomedical subjects

J N Rutledge

Publications and source records attributed to J N Rutledge.

11 recordsLinked to original sources

MRI, brain iron and experimental Parkinson's disease.

Abnormal levels of brain iron have been reported in parkinsonism, which is characterized principally by degeneration of dopaminergic (DA) nigrostriatal neurons. There are conflicting reports, however, of both increased and decreased iron in parkinsonism. An animal model of parkinsonism was used to clarify the contribution of the loss of nigrostriatal DAergic neurons to abnormal iron accumulations. In rats with 6-hydroxydopamine induced unilateral DA depletion, brain iron deposition and its day-to-day stability was studied in vivo using T2-weighted magnetic resonance imaging (MRI) scans taken on 4 consecutive days beginning 1-2 months post-surgery and post-mortem by Perls'-DAB histochemical stain. Unilateral DA depletion (parkinsonism model) produced large day-to-day fluctuations in T2 relaxation time in the striatum. The T2 relaxation time in Sham control rats was relatively minor. The uptake and transport of iron by intrinsic cells of the striatum may vary, and this variability may have been exaggerated by the destruction of DAergic nigrostriatal neurons, which are known to modulate the activity of the intrinsic cells. Inconsistent reports of increased or decreased iron in parkinsonism may reflect, in part, single time-point measures of widely fluctuating iron.

Animals

Complicated cholesteatomas: CT findings in inner ear complications of middle ear cholesteatomas.

Patients with facial palsy and middle ear disease, which may be chronic but clinically occult, may have a cholesteatoma with extension medially along the facial canal. In two patients, axial computed tomographic (CT) scans demonstrated involvement of the medial petrous bone. Patients with vertigo and chronic middle ear disease may have a cholesteatoma with a "fistula" between the middle and inner ears. Although the fistula usually involves the lateral semicircular canal, the cholesteatoma may pass through the oval window. In two patients, coronal CT scans showed extension to the oval window in one and through it in the other.

Adult

Study of movement disorders and brain iron by MR.

Heavily T2-weighted high-field MR images provide a unique opportunity for the evaluation of the extrapyramidal motor system. The images are affected by the presence of small amounts of naturally occurring paramagnetic substances--principally iron--that delineate the neostriatum (caudate and putamen), globus pallidus, red nucleus, substantia nigra, and dentate nucleus, primarily by a decrease in signal secondary to the T2* effect. Movement disorders are associated with either increased or decreased signal or both in these structures, depending on the pathologic process. In the initial evaluation of 113 patients with a variety of movement disorders, good correlation of imaging abnormalities can be made with a simplified schema of the extrapyramidal pathways and a system of classification of abnormal movements, parkinsonism/tremor, dystonia, chorea, myoclonus, and hemiballismus. Parkinsonisms are characterized by abnormalities of the cortico-ponto-cerebello-dentato-rubro-thalamo-cortico-spinal tract or the nigrostriatal tract. Dystonias are characterized by abnormalities of the neostriatum predominantly affecting the putamen. Choreas are also characterized by abnormalities of the neostriatum but predominantly affecting the caudate nucleus. Hemiballismus is characterized by lesions affecting the subthalamic nucleus or associated pathway.

Adult

Gastric emphysema.

Gastric emphysema is a rare condition in which gas from a nonbacterial source accumulates within the wall of the stomach. Gastric distension and vomiting frequently precede the formation of the intramural air. Pulmonary disease, instrumentation of the stomach, and obstructing lesions of the antrum and pylorus are also common contributing factors. A case report and an extensive review of the literature are presented.

Aged

Intratracheal neurofibroma.

We have described a unique example of intratracheal neurofibroma in a patient with neurofibromatosis. Although tracheal neoplasms are rare, they should be considered in the presence of obstructive respiratory symptoms. Careful scrutiny of plain roentgenograms with special views should be undertaken for optimal evaluation.

Adolescent

Biliary cystadenoma mistaken for an echinococcal cyst.

Because of the incorrect preoperative diagnosis of echinococcal cyst, a 46-year-old female patient did not receive the surgical procedure of choice for biliary cystadenoma. We suggest that this obscure entity be considered in the differential diagnosis of cystic hepatic masses, with or without calcific margins.

Calcinosis