An autopsy case of hypertrophic pachymeningitis and multiple cranial neuropathies is reported. A 53-year-old woman with paraplegia and various neurological signs which developed over a 2 year period was diagnosed as having an epidural mass with thickened dura mater extending from the lower cervical to the thoracic spinal cord. In addition, bilateral episcleritis, blephaloptosis, and blindness of the right eye with various cranial nerve deficits were found to be caused by the mass lesions involving the paranasal sinuses, orbit, and the cavernous sinus. Perinuclear antineutrophil cytoplasmic antibody (p-ANCA) was positive, but cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) was negative by enzyme-linked immunosorbent assay. The partially removed epidural mass with hypertrophied dura mater and biopsy of the paranasal lesions showed chronic granulomatous inflammation with vasculitis. The remaining lesions resolved with steroid therapy with remarkable neurological improvement. The positive p-ANCA test, paranasal involvement, the report of a similar histopathological case and a review of the literature on granulomatous pachymeningitis suggest the presence of p-ANCA-positive Wegener's granulomatosis with central nervous system involvement characterized by hypertrophic pachymeningitis and/or multiple cranial neuropathies.
Extraction constants of silver and thallium(I) picrates and those of 12-crown-4 (12C4) and benzo-15-crown-5(B15C5) with silver and thallium(I) picrates have been determined between benzene and water at 25 °C. Ionpair complex-formation constants (KMLA,o) of 12C4 and B15C5 with silver and thallium picrates in the benzene solution have been calculated and compared with those of 15-crown-5 (15C5), 18-crown-6 (18C6), dibenzo-18-crown-6 (DB18C6), and dibenzo-24-crown-8 (DB24C8). The KMLA,o sequences of the crown ethers with Ag+ and Tl+ are 15C5, 18C6>DB18C6>B15C5>DB24C8>>12C4 and 18C6>>DB18C6>DB24C8>15C5>B15C5>>12C4, respectively. For both Ag+ and Tl+ systems, the relative sizes of the cation and the crown ether cavity, the number of donor oxygen atoms in the crown ether ring, the basicity of donor oxygen atom, and the flexibility of the crown ether are important factors in determining stabilities of the complexes with these crown ethers in the benzene solution.
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