Shunt function and complications in different etiologies of childhood hydrocephalus were studied in a series of 306 patients involving 1102 shunt operations. Shunts in patients with hydrocephalus caused by neoplasms proved to be most prone to shunt complications. The patency time for shunts in these patients was significantly shorter than for shunts in other patient categories [Standard number of deviations (SND) 5.9; P less than 0.001, Meyer-Kaplan life table analysis]. When the two main groups of infantile hydrocephalus-congenital obstructive hydrocephalus and hydrocephalus caused by perinatal intracerebral hemorrhage-were compared, the latter group proved to be significantly more prone to shunt infections (P less than 0.01), with an infection rate of 17.8% compared with 8.9% for the former group. The importance of this fact is stressed by the observation that these patients appear to constitute an increasing percentage of hydrocephalic patients. According to the present study, patients with congenital intracranial cysts and hydrocephalus are less prone to shunt complications, i.e., the infection rate is 6.8%, which is significantly less than that of patients with other types of hydrocephalus (P less than 0.01; chi-square test).
Low androgen levels may contribute to sexual dysfunction in women after allogeneic hematopoietic cell transplantation (alloHCT). However, data on serum androgens in women after alloHCT are limited. The aim of this study was to assess androgen levels and their association with chronic GvHD (cGvHD) and glucocorticoid (GC) therapy. Included were 65 allografted women, 33 with cGvHD, and 23 of these were on GC therapy. Controls were 94 healthy, age-matched women. Supportive study groups were women after autologous HCT (autoHCT; n=20) and non-transplanted women on GC therapy (n=26). Compared with controls, free testosterone (free T) and dehydroepiandrosterone sulfate (DHEAS) levels were lower in both the alloHCT group and GC groups; P<0.0001 and P<0.05, respectively. Androgens in the autoHCT group were similar or higher than controls. In the subgroup of alloHCT patients without cGvHD, free T was similar to controls (7.2 vs 8.6 pmol/L; P=0.42), whereas DHEAS levels was lower than controls (1.7 vs 2.5 μmol/L; P=0.008). Compared with controls, cGvHD without GC (n=10) was associated with lower free T and DHEAS; P=0.004 and P=0.0004, respectively). The lowest androgen levels were seen in women with both cGvHD and GC therapy. In conclusion, low serum androgens were associated with cGvHD and GC therapy, prompting for studies assessing a possible association between low androgens and sexual dysfunction and quality of life in allografted women.
SummaryA case of familial dysautonomia with a high level of HVA and a normal level of 5‐HIAA in CSF is described. After probenecid loading test the increase in HVA was only slight, while the increase in 5‐HIAA was normal. These findings suggest an explanation for the pathogenesis of the disease.
Two cases of unilateral hydrocephalus are presented. Both cases had an aplasia of foramen of Monro of unknown cause. The possible mechanisms for the symptoms are discussed in view of the case where the first symptoms occurred at 6 years of age. The diagnostic investigations included pneumoencephalographic, isotope and monoamine metabolite studies.
Key-words: unilateral hydrocephalus -foramen of Monromonoamine metabolites
ZusammenfassungEs wird über zwei Fälle von unilateralem Hydrocephalus berichtet. Beide hatten aus unbekannter Ursache eine Aplasie des Foramen Monroi.Auf Basis des Falles, in dem die ersten Symptome im sechsten Lebensjahr erschienen, wird der denkbare Mechanismus der Symptome diskutiert. Der Diagnostik inkludierte Studien der Pneumoencephalographien, Isotope und der Metaboliten der Monoamine.
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