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are found. Left untreated, the natural course of the disease leads to paraplegia and death [1 -9]. Paraplegia results from compression of the spinal cord or cauda equina by the epidural mass or from thrombophlebitis of the spinal epidural veins resulting in venous infarction of the spinal cord. Death is a result of septicemia. The prognosis for survival and prevention of serious neurologic deficit relates to the rapidity with which appropriate decompression and antibiotic therapy are instituted. The neurologic deficit is less likely to be reversible the more severe and the longer it has been present. Thus, many authors have recognized that prompt and early diagnosis is critical to the management of this potentially curable disease [1-13]. We recently encountered four patients with spinal epidural infections (three pyogenic, one tuberculous) in whom MR imaging of the spine led to expeditious treatment and better clinical outcome. Materials and Methods Four patients with spinal epidural infections (three Staphylococcus aureus, one Mycobacterium tuberculosis)were examined with MR imaging. MR was performed on a GE Signa system with a 1.5-T superconducting CT scans of the spine were obtained on a Siemens DR3 Somatom or Picker 1200 SX unit. Radiographs of the spine were available in all cases.

The karyotypes of cells from an untreated medulloblastoma in an 8‐year‐old girl were characterized by multiple minute chromosomes, an abnormal metacentric and extra chromosomes in group 4–5. These abnormalities permitted identification of tumor cells in the marrow and peripheral blood. Chromosomes in group 4–5 did not demonstrate a late labeling pattern although the patient's lymphocytes and marrow were normal in this respect. This is the first demonstration of a difference in labeling pattern between normal and tumor tissue in man. The minute chromosomes and abnormal metacentric may have resulted from a misdivision of the centromere of 17 or 18. An alternative explanation is that the minute chromosomes were ring chromosomes. In the present tumor there was also evidence for significant biologic variation in karyotype between tumor cells.

A variety of spinal pathological processes demonstrated by intraoperative ultrasound is presented. Use of spinal ultrasound proved helpful in viewing alignment, assessing spinal cord pathology, and viewing anterior to the cord in cases of spinal trauma. As an operative adjunct, ultrasound was especially helpful for viewing extradural spinal metastases and cavitary lesions of the spinal cord, such as syrinxes, cystic tumors, and hematomas. In cases of spondylotic myelopathy, intraoperative ultrasound allowed assessment of the adequacy of the decompression, the space ventral to the cord, and the size and configuration of the spinal cord.

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