No abstract

No abstract

Lipid solvent extraction of aldehyde-fixed hepatic tissue of rats caused disappcarancc of all intravascular and hepatoccllular osmiophilic droplets normally present, thus indicating their lipid content. Intramitochondrial dense granules and osmiophilic droplets in lysosomes also disappearcd after this treatment. Lipid solvents extracted 43.8 to 92.6% of the radioactivity from aldehyde-fixed rat liver with cla-labeled lipids. Only 0.7 to 5.8% of the radioactivity was extracted when the hepatic proteins were labeled. When tissue was fixed with OsO4, the lipid solvents extracted only 0.7 to 7.2% of the radioactivity from lipidlabeled liver and only 0 to 0.7 % when proteins were labeled. Thin layer chromatography of the lipid solvents used in extraction of formaldehyde-fixed tissue revealed that triglyceridc, phospholipid, and cholesterol and other lipid classes had been removed. However, acetone extractcd less phospholipids than did ethanol or methanol-chloroform. During fat absorption the number and sizc of osmiophilic droplets increased in the nongranular endoplasmic reticulum. In animals fasted up to 5 days, 250-A osmiophilic particles were still present in the Golgi vesicles, other cytoplasmic vesicles, and in the space of Disse. These were considcrcd possibly to represent lipoprotein being synthesized in the liver cell and sccreted into the blood.

We report a case of cervical teratoma in a term female infant born to a 20-year-old white woman. There are rare tumors in neonates, occurring in approximately 1 in 20,000 to 1 in 40,000 live births. These tumors are accurately defined by ultrasound. Although benign, cervical teratomas cause respiratory compromise. In this case the tumor was removed surgically with no recurrence at the 10-month follow-up.

No abstract

No abstract

No abstract

E ndoscopic third vent r ic u lostomy (ET V ) has become a standard treatment for obstructive hydrocephalus. Clinician investigators from France report their experience with ETVs in 350 patients from July of 1999 to July of 2007. They chose accepted end points for failure of the ETV: death due to hydrocephalus or a performance of a subsequent procedure for cerebrospinal fluid (CSF) management. 1 The investigators contacted 73% of the cohort by telephone to assess clinical endpoints. For the remainder, the endpoints were determined by chart review of their last clinic visit.Within the cohort, there were 165 children younger than 18 years, of whom 22 were younger than 2 years. The most common causes of hydrocephalus were posterior fossa tumors and aqueductal stenosis; however, there were also cases of meningitic, post-hemorrhagic, and idiopathic chronic hydrocephalus. Ten percent of subjects experienced complications.Cox proportional analysis of the data showed that the two most important factors influencing ETV success were patient age and cause of hydrocephalus. Children younger than 6 months had only a 32% chance of having a successful ETV. Causes of hydrocephalus associated with the lowest success rates were post-hemorrhagic hydrocephalus, myelomeningocele, post-meningitic, and chronic idiopathic hydrocephalus. Their greatest success rates occurred in patients with tumors, particularly those located in the tectal and pineal regions. The authors conclude that ETV is a safe and effective therapy for many children and adults with obstructive hydrocephalus.Dr Leonard has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. ETV has begun achieving widespread acceptance for the treatment of obstructive hydrocephalus, yet few outside of pediatric neurosurgery are knowledgeable about the procedure. The procedure begins with cannulation of the lateral ventricle. Guided by an endoscopic camera, the lateral ventricle is traversed to the third ventricle through the Foramen of Monro. In the third ventricle, a hole is made anterior to the mamillary bodies to establish flow of CSF into the subarachnoid space.This large retrospective review of a single institution's experience adds to the literature regarding the utility of ETVs. Multiple studies report the use of ETV in infants with infectious as well as hemorrhagic hydrocephalus. [2][3][4] While pediatric neurosurgeons recognize the utility of ETV, its clinical indications are continually being challenged. The authors tabulated and reported a 10% complication rate. As expected, CSF leak was the most common complication and occurred most frequently in children younger than 1 year. Other authors have reported endocrinologic complications including diabetes insipidus, although in this series none were experienced. 5 While relatively uncommon, the authors did report one post-procedure death related to perforation of the basilar artery, a known complication...