Spatial and temporal disease progression of adult-onset subacute sclerosing panencephalitis.

An adult-onset case of subacute sclerosing panencephalitis with occipitofrontal spread of the infection documented clinically and by MRI is reported. Autopsy revealed numerous intranuclear viral inclusions and widespread demyelination in both frontal lobes. In the occipital lobes where the disease started 5 years previously, inclusions were rare, but degenerative tissue changes were prominent. This case underlines the importance of measles virus migration for the progression of this fatal disorder.

Evaluation of the counterimmunoelectrophoretic (CIE) procedure in a clinical laboratory setting.

The counterimmunoelectrophoretic (CIE) procedure was evaluated under clinical laboratory conditions to determine its validity and comparability with culture methods. The procedure was further evaluated to determine applicability to a variety of clinical samples. An inexpensive set-up was developed to utilize the CIE procedure at bench level. Results indicated the procedure to be sensitive in detecting Haemophilus influenzae, type b, and Neisseria meningitidis (meningococcus), group B. The procedure was more sensitive for detection of H. influenzae, type b, than for meningococcus, group B. The authors have confirmed the usefulness of the CIE procedure in the detection of group B streptococci, pneumococci and teichoic acid antibody to Staphylococcus aureus. Detection of Escherichia coli K 1 antigen was also accomplished by CIE. In the authors' laboratory the CIE procedure was superior to culture methods when used for the detection of H. influenzae, type b, and meningococcus group B.

Sudden progression of a glioblastoma in partial remission?

There are only sparse data on viral CNS infections in patients with malignant glioma. We report a case of fatal herpes encephalitis in a patient with glioblastoma in partial remission and provide a short review of the literature.

[Computerized tomography (CT) and magnetic resonance tomography (MRI) in diseases of the pelvic floor]. / Computertomographie (CT) und Magnetresonanztomographie (MRT) bei Erkrankungen im Beckenbodenbereich.

CT and MRI have become more frequently established in the diagnosis of the pelvis for the last few years. CT and even more MRI are technically essential for the diagnosis of problems of the pelvis like anal carcinoma, anal atresia, anal fistula of the anal canal and rectum. Modern technical equipment allow a scanning time of a few seconds, especially important in patients with bad condition.

[Indications for coagulation in diabetic maculopathy]. / Koagulationsindikation bei der diabetischen Makulopathie.

Macular changes of 333 eyes of 266 diabetic patients were analized regarding number of microaneurysms, area of intraretinal lipids and hermorrhages and the amount of leckage and capillary occlusion in fluorescein angiography. The changes were observed in a central and peripheral area centered around the fovea. The distribution of the changes observed were correlated with the visual acuity of the patients. Only the number of peripheral microaneurysms and the presence of foveal intraretinal edema correlated with a reduction in visual acuity. These parameters are therefore clinical indicators for the severity of diabetic maculopathy. Regarding the visual acuity after a minimal follow up of six months the presence of foveal intraretinal edema was the most important factor with a high risk of short term visual loss. The presence of fovealmacular edema might therefore be the most important indicator for macular photocoagulation treatment.

[Magnetic resonance imaging diagnosis of craniobasal cerebrospinal fluid fistulas by 3D-CISS sequence]. / Die kernspintomographische Darstellung kraniobasaler Liquorfisteln mittels 3D-CISS-Sequenz.

Recently, a Magnetic Resonance Imaging (MRI)-technique has been developed to diagnose the exact anatomical location of fistulas of the cerebrospinal fluid (CSF). This method is called 3D-constructive interference steady state-sequence (CISS) but it is not well known in clinical practice. Aim of the study was the evaluation of specificity and sensitivity of CISS-MRI. 12 patients with rhinoliquorrhea after head injury (n = 7) or skull base tumours (n = 5) were examined by CISS-MRI. The examinations were performed with a 1.5 T whole body MRI scanner in prone position and coronal plane sections. In cases of CSF leckage the sensitivity for detection of a CSF fistula was 100%. In comparison with intraoperative findings, specificity was 100%: in all cases, a dural lesion in anatomical correlation to MRI was detected. Further advantages of this method are its non-invasive character, no need for contrast application, no radiation exposure, and exact localisation of additional anatomical findings (brain herniation, brain contusions).

Tumors of the respiratory tract observed at the German Primate Center, 1978-1994.

Eight spontaneous pulmonary tumors (four bronchiolar tubular adenomas, two bronchiolar adenocarcinomas, two squamous-cell carcinomas) occurred in a total of 54 adult tree shrews (Tupaia belangeri) of the GPC colonies between 1978 and 1994. The adenomas and adenocarcinomas consisted of tubularly or trabecularly arranged cuboidal to cylindrical cells interspersed with some PAS-positive goblet cells, thus resembling the epithelial lining of respiratory bronchioles of tree shrews. The two squamous-cell carcinomas probably originated from the pulmonary alveoles. Three more pulmonary tumors (one small-cell carcinoma, one bronchial adenoma, one squamous-cell carcinoma) developed in 409 adult callitrichids of the GPC colonies during the same period, and one more bronchial adenoma was observed in a common marmoset (Callithrix jacchus) of another colony located in Göttingen. With regard to the adenomas and squamous-cell carcinomas, a similar cellular origin with the three shrews is assumed. The small-cell carcinoma possibly developed from the bronchial epithelium, provided a pathogenesis parallel to that of human small-cell carcinoma is suggested. Four of the tree shrew pulmonary adenomas/adenocarcinomas and the small-cell Ca were macroscopically visible as yellowish-grey nodules of 1 mm x 1 mm to 15 mm x 15 mm diameter, predominantly involving the main lobes (2 x right main lobes, 2 x left main lobes, 1 x all lobes). The pulmonary tumors of the other animals were below macroscopical detectability.

Pulmonary histiocytosis in tree shrews (Tupaia belangeri).

Granulomatous lesions similar to those of pulmonary histiocytosis in rats developed spontaneously in the lungs of captive tree shrews. Incidence peaked in 3-year-old tree shrews. Sex dependency was not observed, and development of the granulomas was unrelated to experimental procedures because the lesions were observed in animals from the breeding stock as well. The granulomas consisted of amorphous material, foam cells, and a few foreign body-type multinuclear giant cells; they also contained acicular clefts, often with some fibrous material. Alveolar septa within and adjacent to the granulomas were thickened in most instances, but did not contain inflammatory cells in appreciable numbers or amyloid. Only traces of cholesterol and calcium were detected in the amorphous material; neutral fat was stored in the foam cells and the amorphous masses. Fibers without birefringency were documented by polarization and scanning electron microscopy in the vicinity of granulomas, which in energy-dispersive X-ray microanalysis consisted mostly of calcium, but lacked silicon.