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Biomedical subjects

S Stefanko

Publications and source records attributed to S Stefanko.

At least 19 recordsLinked to original sources

Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: clinicoanatomic correlations.

Fifty-seven of 176 prospectively studied patients with aneurysmal subarachnoid hemorrhage (SAH) developed delayed cerebral ischemia. Clinical features included hemispheric focal signs (13), decrease in level of consciousness (14), or both (30), and mutism (15). Forty-seven patients showed hypodense lesions on CT in one (19) or multiple vascular territories (22), or diffusely in one or both hemispheres (6). Twenty-eight had symmetric decrease in ventricular size. Of 18 autopsied patients, only 1 had a purely univascular lesion. The clinical, CT, and pathologic features suggest that delayed cerebral ischemia after SAH is a multivascular or diffuse process in most patients.

Adult↗

Prenatal diagnosis of X-linked hydrocephaly.

A case of X-linked hydrocephaly is presented. Early second trimester evaluation of the size of the lateral cerebral ventricles resulted in one male fetus continuing further normal development and one male fetus being aborted because of progressive hydrocephaly. The affected fetus was characterized by cerebral ventricular dilation without aqueductal stenosis. This case history shows the feasibility of early monitoring of pregnancies at risk of X-linked hydrocephaly. In some cases, ventricular enlargement rather than aqueductal stenosis may be the primary lesion.

Adult↗

Cadaver nerve allografts in dogs.

Cadaver nerve allografts were studied in major histocompatibility complex-identical beagle donor/recipient combinations. Grafts were removed 3 and 6 hours after the death of the donor, preserved at -70 degrees C and transplanted as 7 cm long grafts at a later date. Graft function and histology was evaluated 9 to 11 months after transplantation by electromyographic examination and histological studies, respectively. Cadaver nerve allografts removed 3 and 6 hours after death show exactly the same excellent regeneration as the freshly removed cryopreserved nerve allografts in major histocompatibility complex identical combinations. This information is of value for future attempts to establish nerve banks of a many as possible different major histocompatibility types. Such banks will be required to accommodate the necessary donor/recipient matching for clinical nerve allografting.

Animals↗

Familial Creutzfeldt-Jakob disease.

A Finnish family is described with 9 cases of presenile dementia in 3 generations. The mean age at onset was 52 years (range 46--62 years). Progressive dementia, upper motor neuron signs, muscular rigidity, and twitching, irregular tremors were consistent features in the 6 clinically investigated patients and were associated with spongiform change in the cerebral cortex of one autopsy and two brain biopsy cases. The EEG showed progressive slowing without the occurrence of repetitive high-voltage complexes at any stage of the disease. The average duration of the disease (21 months, range 11--36 months) was longer than in the sporadic form of CJD. The occurrence of CJD within this family follows a pattern consistent with an autosomal dominant mode of inheritance, suggesting the possibility of vertical transmission of the presumptive causative agent for example by genomic integration or transplacental passage. However, the occurrence of the disease only through the paternal line of relationships and the presence of a discordant twin pair argue strongly against transplacental passage or transmission via mother's milk. Simple contact infection also seems unlikely, as conjugal cases were not found among the 7 married patients. The interval between the death of the last affected member in generation IV and the time of onset of the disease in the first affected member of generation V was 10 years. Thus setting a minimum incubation period if case-to-case transmission were occurring. To evaluate the role of a genetically determined susceptibility to infection studies on the HLA antigens and other genetic markers are in progress.

Creutzfeldt-Jakob Syndrome↗

Role of tissue typing on preserved nerve allografts in dogs.

Histocompatibility seems to play an important role in the regeneration of nerve allografts. Compatible tissue typed nerve allografts behave more like autografts and are, therefore, more readily accepted by the host tissue without producing evident tissue rejection. The influence of histocompatibility difference becomes more marked if the graft is longer than 30-40 mm. Irradiation as a means of reducing the immune reaction of the nerve allografts does not seem to have any beneficial effect along with tissue typing. Preservation of nerve grafts at - 70°C does not have any untoward effect.

Animals↗

Nerve allografts and histocompatibility in dogs.

The histocompatibility requirements for successful frozen nerve allografts were studied in 46 dogs. Major canine histocompatibility (DLA) differences appeared to be of vital importance for nerve regeneration and function, as judged by histological and electromyographic performance 7 to 9 months after grafting. Minor histocompatibility differences did not appear to lead to rejection of the frozen nerve allografts. Graft irradiation did not improve the acceptability of frozen DLA-mismatched grafts. The effect of DLA matching was much more pronounced in allografts 7 cm long than in allografts 4 cm long. The results indicate the need for a bank of frozen human histocompatible (HLA) nerve allografts, and a study of the effect of partial or complete HLA matching on their survival.

Animals↗

A human embryo of 28 mm crown-rump length with cerebral, esophagotracheal and cardiovascular malformations.

The following malformations were observed in a human embryo of 28 mm crown-rump length obtained at operation for tubal rupture in a case of extrauterine pregnancy: 1. Secondary anophthalmia with dysplasia and in part aplasia of the diencephalon. Rudiments of both eyes and eyestalklike proliferations within the diencephalon. No lenses and on the left side only a palpebral fissure. Hypoplasia of the right telencephalic hemisphere and of the right side of diencephalon, mesencephalon and proximal parts of the medulla oblongata. Pseudotumorous proliferations in the diencephalon, in the alar plate of the medulla oblongata (protruding into the fourth ventricle) and in the arachnoid. Hypoplasia of the right internal, middle, and external ear. Dysplasia and in part aplasia of facial osseous elements (cebocephalia). 2. Proximal esophageal atresia with distal tracheoesophageal fistula. 3. A Fallot's tetralogy with right-sided aortic arch and regressive right-sided ductus arteriosus, tricuspid atresia, hypoplasia of the right ventricle with excessive hypertrophy of its wall, and hypoplasia of the pulmonary trunk. Single left superior vena cava and abnormal, semicircular course of the stems of both coronary arteries.

Abnormalities, Multiple↗