Paraplegia due to aspergillosis. Successful conservative treatment of two cases

Aspergillus infection of the spine is rare; for it to lead to paraplegia is still more rare. When this does occur it is usually treated by decompression and antifungal agents, but the results have usually been poor. We report two cases of successful conservative treatment of Aspergillus paraplegia in patients with chronic granulomatous disease.     

Urachal carcinoma: CT findings

The computed tomographic (CT) appearance of urachal carcinoma in ten patients was studied and compared with the pathologic findings. Magnetic resonance images were available in one case. All tumors were mucinous adenocarcinomas; four were solid, three were cystic, and three were mixed. The tumor had a characteristic location along the expected midline course of the urachus directly behind the anterior abdominal wall. The main tumor mass was supravesical in eight patients. Seven tumors contained calcification. CT correctly depicted bladder wall involvement and supravesical extent of tumor in all cases. CT provided incorrect information about invasion of the perivesical fat in three patients and about bladder mucosal invasion in two patients.     

Survival rates after enucleation of eyes with malignant melanoma.

We investigated the rates of mortality for several types of malignant melanomas for evidence that surgery accelerates metastasis. Additionally, we reanalyzed uveal melanoma survival rates from the Armed Forces Institute of Pathology. Our computations showed higher death rates in years two to five after diagnosis than in years one or six to ten. The same pattern of a peak mortality in the early years after diagnosis and lower rates six to ten years thereafter was seen in all tumor types studied. Our analysis of survival rates produced no evidence to alter the existing pattern of treatment for malignant melanoma of the uvea.     

Scale for assessing quality of life of children survivors of cranial posterior fossa tumors

Background Evaluation of quality of life of survivors of brain tumors is an important aspect of outcome that must be included in clinical studies.Methods We have developed a new scale for assessing quality of life (QL) of pediatric long-term survivors of posterior fossa tumors based on their physical, psychointellectual, and endocrine/growth status. We have studied 39 patients, with a median follow-up of 9 years. Twenty-five had cerebellar astrocytoma (CA), 6 medulloblastoma (MDB), 5 brain-stem glioma (BSG) and 3 ependymoma of IV ventricle (EPD).Results Sixty-six percent of children showed neurologic and/or visual sequelae. Little or no significant disability (Bloom's levels I–II) were present in 66%. Psychointellectual dysfunction was present in 44%, with an IQ < 90 in 39%. Endocrine and growth disorders were found in 26%, mostly stature anomalies. According to our scale, QL scores were high in 19 patients (49%), intermediate in 8 (20%), and low in the remaining 12 (31%). Unfavourable outcomes were related to age of less than 4 years, tumors other than CA (MDB, BSG, EPD), incomplete tumoral resection, and employment of radiotherapy and chemotherapy.     

AIRWAY OBSTRUCTION IN CHILDREN

Seventeen children presenting with airway obstruction have been studied to highlight the similar clinical features of different etiological conditions, their diagnostic limitations, and the importance of early bronchoscopy. There were 8 patients with foreign body in lower airway, out of which 6 were vegetable foreign bodies. Few rarer conditions like membranous laryngotracheobronchitis, subglottic hemangioma and acyanotic congenital heart disease producing airway obstruction have been highlighted. There were 2 deaths in the study unrelated to endoscopic procedure.KEY WORDS: Airway obstruction, Bronchoscopy     

Pathogenesis of idiopathic macular holes

An improvement in our understanding of the pathogenesis and natural history of idiopathic macular holes over the last 10 years has led to a more optimistic and interventionist approach to the surgical management of this vitreoretinal disorder. This article reviews the theories postulated for the pathogenesis of this condition and looks at recent work that has investigated the role of the vitreous, internal limiting membrane, and posterior vitreous detachment in the natural history of macular holes.