Brain metastasis from malignant fibrous histiocytoma of the heart: case report

This is the second reported case of a malignant fibrous histiocytoma of the heart that metastasized to the brain. A 33-year-old woman developed headache, nausea, and ataxic gait 9 months after removal of the tumor from the left atrium of the heart. Computed tomographic and magnetic resonance imaging scans disclosed multiple metastatic tumors in the brain. Although dramatic improvement in her symptoms and signs followed the removal of the brain tumors, she died of tumor recurrence in the left atrium 3 months after the removal of the metastatic brain tumors.     

The clinico-statistical characteristics of the testicular generative function in male subfertility following mumps

The paper emphasized the role of mumps complicated by orchitis in the etiology of male subfertility with allowances for a possible development of testicular degeneration in the course of epidemic parotiditis alone, i.e. without clinically evident orchitis. To distinguish the impact of mumps sustained in childhood on the infertility development clinical and laboratory investigations would be advisable in the majority of subfertile males. The results of clinical and statistical study of 865 infertile males aged between 20 and 36 yrs whose marital life varied from 8 mos to 12 yrs were reported. Anamnestic evidence of epidemic parotiditis sustained at the age of 5-13 yrs was found in 174 examinees (20.1 per cent). Spermographic data on subfertile males with a history of mumps were exposed to statistical computation and correlated with the data on 200 subfertile males who avoided the disease and the data on 22 healthy fertile males. The authors noted significantly low (p less than 0.05) contents of ejaculate spermatozoa in subfertile males with a history of mumps and a significantly low number of morphologically normal spermatozoa (p less than 0.001) in comparison to those values in subfertile males without a history of epidemic parotiditis.     

The effectiveness of G. A. Ilizarov's method in treating patients with III- and IV-stage chronic ischemia of the lower extremities

The method of treatment after Ilizarov was used in 28 patients with occlusion of lower extremity arteries, mainly of distal localization, with the III and IV degrees of ischemia. Osteotomy of mainly the tibial bone and distraction of the free osseous split was performed during 31-36 days. Two patients had fractures of the bone during operative interventions, after operation four patients had purulent complications or necrosis of the skin around the wire. The immediate positive result was noted in 20 patients. Their fate was followed-up in remote periods from 2 to 19 months, good results were observed in 18 patients. The use of the Ilizarov method was most justified in patients with the III and IV degrees of ischemia when other methods of treatment failed to give any effect and surgical reconstruction of the vessels is impossible. When treating patients with the IV degree, it is necessary to take into consideration the late appearance of revascularization and possibility of temporary deterioration. The use of the Ilizarov method foresees provision of the joint work of an angiosurgeon and a traumatologist-orthopedist.     

Percutaneous removal of renal and upper ureteral stones: clinical results and complications of 103 cases

We report the results and complications of 103 consecutive patients who underwent percutaneous removal of renal and ureteral stones. The overall clinical success rate was 80.6%. For the recent 33 cases in which UL-arm fluoroscopy was used, however, the success rate was as high as 87.9%, which was considered to be due to easier establishment of percutaneous direct access. The most common complications were bleeding (18.5%), extravasation (15.5%) and fever (9.7%). Four cases with significant bleeding required arteriography, but there were no sign of arteriovenous fistula nor pseudoaneurysms in any cases. To study renal parenchymal damage in the percutaneous procedures, plasma renin activities (PRA) were compared in 54 cases after six months. However, significant elevation of PRA did not occur in any case.     

A case of embryonal carcinoma arising in the basal ganglia of the cerebrum]

The occurrence sites of intracranial primary germ cell tumors are most often the pineal and suprasellar regions. The histological type observed most frequently in these tumors is germinoma. Cases of embryonal carcinoma arising in the basal ganglia are rarely reported. To our knowledge, only 4 such cases have been previously reported in the literature. A case of an embryonal carcinoma arising in the basal ganglia is reported. A 17-year-old boy was admitted to our hospital on July 30, 1988 because of headache and vomiting, and a right hemiparesis. On admission, physical inspection showed no abnormalities and neurological examination revealed obtunded consciousness, a right central facial paresis and a right hemiparesis with Hoffman and Babinski reflexes. Noncontrast CT scan showed a large mass of low-to slightly high-density in the region of the left basal ganglia accompanied with midline shift and ventricular dilatation. Enhancement of the lesion was made by contrast CT scan. It was not homogeneous. Cerebral angiogram displayed a contralateral shift and an unrolling of the anterior cerebral artery, a lateral stretch of middle cerebral artery, a downward stretch of anterior choroidal artery and a tumor stain fed by the Heubner artery. On August 3, left frontotemporal craniotomy was performed. The tumor was totally removed in a piecemeal manner using microsurgical techniques. Histopathological diagnosis was mixed-type of germ cell tumor comprising embryonal carcinoma and teratoma. Postoperative CT scan showed complete disappearance of the tumor. A course of radiation of 4950 rads and two courses of a combination chemotherapy with cis-platinum, vinblastine and bleomycin were given within 3 months after the operation.(ABSTRACT TRUNCATED AT 250 WORDS)     

Simultaneous assay of felbamate plus carbamazepine, phenytoin, and their metabolites by liquid chromatography with mobile phase optimization

Felbamate is an investigational antiepileptic drug (AED) in clinical trials. A high-performance liquid chromatographic method for the simultaneous analysis of felbamate, phenytoin (PHT), 5-(p-hydroxyphenyl)-5-phenylhydantoin, carbamazepine (CBZ), carbamazepine-10,11-epoxide, and carbamazepine-10,11-diol in serum was developed by a mobile phase optimization technique. Capacity factors for the compounds of interest and 12 other AEDs and metabolites were determined with mixtures of methanol, acetonitrile, or tetrahydrofuran and a 0.01 M ammonium phosphate buffer, pH 6.5, on a reversed-phase C8 column. An optimized mobile phase composition was determined that could separate the compounds of interest and three internal standards in less than 15 min. Serum was extracted with CH2Cl2/ethyl acetate (2:1) after addition of three internal standards. The method was validated for within-day and between-day precision and accuracy for the six compounds. Coefficients of variation were generally less than 10% at all concentrations and less than 5% in the typical therapeutic range for each compound. The lower limit of detection was estimated at 0.2 micrograms/ml for CBZ and its metabolites and 0.5 micrograms/ml for felbamate and PHT. For felbamate, the lowest point on the standard curve was 1.88 micrograms/ml with a between-day variability of 10.3%. The assay was used to determine the serum concentrations of PHT and CBZ and its metabolites in a subject before, during, and after felbamate therapy.