Clear‐cell ependymoma: A report of intracortical tumor with significant desmoplasia

We report a case of clear‐cell ependymoma in a 20‐month‐old girl who presented with seizures. The tumor had several uncommon features including a solid consistency, a purely intracortical location, and a remarkable degree of desmoplasia. Clinical, radiological, and pathological findings are presented. This case emphasizes the value of ultrastructural studies in pathological work‐up of brain tumors.     

Cervical paraspinal electromyography: normal values in 100 control subjects.

The normal electromyographic values and the significance of spontaneous activity, when examining the cervical paraspinal muscles, has been studied rarely, and there are very few studies concerning this issue.To obtain muscle unit potential (MUP) reference values for cervical paraspinal muscles, we examined 100 volunteers. Spontaneous activity and the analysis of 20 MUPs in every individual were checked by the automated MUP analysis program.In those individuals ages 20 to 40 years, no spontaneous activity was observed, and in the ones ages 40 to 60 years and 60 years or older, fibrillations and/or positive sharp waves were seen in 8% and 92%, respectively. MUP values were found to be close to those of upper limb muscles. Age has no significant effect on MUP values, except for mean amplitude that was increased in individuals ages 60 to 80 years.Our findings suggest that fibrillations and positive sharp waves do not have much electrodiagnostic value in the study of cervical paraspinal muscles of middle-aged and elderly subjects, when it is an isolated finding, and there is a need for an extended electromyographic examination, including other muscles, to exclude radiculopathy. Automated MUP analysis is easily performed, and our results may serve as reference values.     

Effect of extracorporeal piezoelectric lithotripsy shock waves on renal function measured by Tc-99m-DMSA using spect

Extracorporeal shock-wave lithotripsy has altered the therapeutic approach to urinary stone disease. Recently, a method was developed in which shock-wave generation is obtained piezoelectrically. To evaluate the effect of extracorporeal piezoelectric lithotripsy (EPL) on renal function, 20 patients were studied prior to and after EPL of renal calculi. Renal cortical function was evaluated by using a previously described and validated quantitative single photon emission computerized tomography (SPECT) method to measure individual absolute uptake of technetium-99m dimercaptosuccinic acid (Tc-99m-DMSA). Twenty kidneys were treated, and the 19 contralateral kidneys were without stone disease (1 patient had a single kidney). The absolute kidney uptake of Tc-DMSA in the normal kidneys was 21.4% +/- 6.2% before and 22.2% +/- 6.4% after EPL. For the treated kidneys the absolute update was 16.8% +/- 5.3% and 16.8% +/- 4.7% before and after, respectively. There was no statistical significant difference between pre- and post-treatment values. The absolute kidney uptake was significantly lower (p less than 0.01) in the treated than in the normal kidneys. This study indicates that the EPL procedure did not cause any damage to cortical function detectable by the DMSA uptake.     

Resistin serum levels in type 1 diabetes pre- and post-islet transplantation

Resistin is a recently described secretory protein produced in adipocytes that is thought to be involved in insulin resistance, diabetes, and inflammation. While resistin can be detected in mouse and human serum, very little is known about the regulation of serum resistin levels, especially in humans. To test whether resistin levels are affected by type 1 diabetes mellitus (T1DM), we measured serum resistin levels in samples from 5 healthy volunteers and 6 patients with T1DM pre- and 3 months post-islet transplantation using a human resistin enzyme immunoassay (EIA). Interestingly, serum resistin levels were significantly higher in T1DM patients before transplantation compared to normal controls, but decreased to normal levels after islet transplantation. Thus, our results suggest that human resistin may be involved in the pathophysiology of T1DM and thereby reveal a heretofore unappreciated aspect of human resistin biology.     

State of the Art: Islet Transplantation for the Cure of Type 1 Diabetes Mellitus

Reviews in Endocrine and Metabolic Disorders -     

Foodborne hepatitis A: evidence that microwaving reduces risk?

During July 1988, 68 persons in Chattanooga, Tennessee, developed serologically confirmed hepatitis A. Between 15 June and 3 July, 93% of case-patients ate at a specific restaurant compared with only 3% of the local community. An intravenous drug user who worked as a cook was identified as the source. A case-control study was done to identify the vehicle of transmission. Case-patients were more likely than controls to have eaten hamburger buns and pickles, the only foods routinely handled after cooking. Of the restaurant patrons included in the study, 12 microwaved their food before consumption; none developed clinical illness despite eating large amounts of food handled after cooking. Sandwiches that were not microwaved were significantly associated with illness (odds ratio = 9.6; P less than .02). This epidemiologic evidence suggests that microwaves inactivate hepatitis A virus in food.     

Uncemented arthroplasty for metastatic disease of the hip: preliminary clinical experience

Improved longevity among patients with metastatic bone disease led to increasing incidence of pathologic and impending fractures around the hip. Cemented hip arthroplasty is considered to be the standard of care for this condition. The purpose of this study is to evaluate the outcome of uncemented hip arthroplasty in those patients. We performed a retrospective review of clinical and radiologic data of 57 consecutive patients (60 hips) who underwent an uncemented hip arthroplasty due to metastatic hip disease. Mean follow-up was 18.6 months (range, 5-60 months); overall 1-year survival and mortality rates were 58.5% and 38.3%, respectively. Multiple myeloma and metastatic prostate carcinoma patients had better outcome over other metastasis origin. At last follow-up, no prosthesis failure or operation-related major complication has been recorded.     

Selective Computed Tomography-guided Perisciatic Injection as a Diagnostic Tool in Multiple Hereditary Exostoses

Multiple osteochondromas, also known as multiple hereditary exostoses, is an autosomal-dominant disease. Multiple osteochondromas are characterized by the development of cartilage-capped bony tumors, known as osteochondromas. Osteochondromas can cause limb deformities, limb-length discrepancies, angular deformations, bursitis, and impingement of adjacent tendons or neurovascular structures. They have also been reported as a cause of sciatic pain. Sometimes, more than 1 location of neural compression exists, thereby presenting a difficult diagnostic challenge for treating physicians.This article describes a patient with multiple hereditary exostoses and accompanying severe sciatic pain who was referred for a revision decompressive spine surgery. The patient's functional impairment was such that he was unable to sit for a few minutes. A selective computed tomography-guided perisciatic nerve injection was performed to differentiate between lateral spinal stenosis and peripheral nerve compression or impingement by an existing large pelvic osteochondroma. The patient reported substantial relief and regained the ability to sit pain free immediately postoperatively. Excision of a proximal femur osteochondroma was performed based on the results of a selective perisciatic nerve injection, resulting in successful resolution of his sciatic pain and functional impairment.The current case is an example of the diagnostic challenge in treating patients with multiple anatomic lesions that can cause symptoms and demonstrate how selective computed tomography-guided perisciatic nerve injection can aid clinicians in obtaining an accurate diagnosis and choosing the most appropriate surgical management.     

Monkeypox DNA levels correlate with virus infectivity in clinical samples,Israel, 2022

The current monkeypox virus global spread and lack of data regarding clinical specimens’ infectivity call for examining virus infectivity, and whether this correlates with results from PCR, the available diagnostic tool. We show strong correlation between viral DNA amount in clinical specimens and virus infectivity toward BSC-1 cell line. Moreover, we define a PCR threshold value (Cq ≥ 35, ≤ 4,300 DNA copies/mL), corresponding to negative viral cultures, which may assist risk-assessment and decision-making regarding protective-measures and guidelines for patients with monkeypox.