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Biomedical subjects

E G Fischer

Publications and source records attributed to E G Fischer.

At least 55 records · Page 3Linked to original sources

Intrasellar gangliocytoma and syndromes of pituitary hypersecretion. Case report.

Syndromes of hypersecretion of pituitary hormone and sellar enlargement may on occasion be caused by a gangliocytoma instead of a pituitary adenoma. At least some of these rare tumors are apparently independent of and separable from the pituitary gland, its stalk, and the hypothalamus, and are therefore surgically removable without incurring further endocrine deficit. The authors report such a case, with successful removal of the tumor via a frontal craniotomy. The associated hypersecretion of pituitary hormone was corrected without disturbing normal pituitary function.

Acromegaly↗

Cerebral hemangioma with glial neoplasia (angioglioma?). Report of two cases.

Two patients are reported who had intracerebral mass lesions composed of hemangioma and glial neoplasm. After excision, one recurred as an oligodendroglioma, and the remnant of the other remained static over a 5-year period. These lesions may represent a subgroup of cerebral hemangiomas that have the biological potential for future glial neoplastic growth. Reference is made to experimental work with polyoma virus which can induce cavernous hemangiomas in the central nervous system in mice, and which is a papovavirus. Other papovaviruses can induce ependymomas in hamsters.

Adult↗

Cerebral abscess in children.

We reviewed 94 consecutive episodes of pyogenic brain abscess seen at Children's Hospital Medical Center, Boston, between 1945 and 1980. After 1970, the mortality as reduced from 36% to 14%. Predisposing factors included congenital heart disease, otitic and sinus infections, closed head injuries, and cystic fibrosis. There were seven patients younger than 5 months of age. In one patient with Fallot's tetralogy, an abscess recurred at the site of retained thorium dioxide (Thorotrast) after an 11-year interval. The continuing substantial mortality is attributed to the presence of coma at the time of treatment, hemorrhagic complications of tapping abscesses, and the location of abscesses in deep brain structures. The early detection and successful treatment of brain abscesses in children remains a clinical challenge.

Adolescent↗

Chiari I "malformations"--an acquired disorder?

Caudal herniation of the hindbrain, indistinguishable from the Chiari I deformity, may occur after the establishment of spinal subarachnoid shunts and become symptomatic years after the procedure. Examples are presented and others are cited from the literature. It is proposed that the force responsible for the displacement is the difference in pressure between the cranial and spinal compartments. On the basis of these observations and other considerations as well, a similar process, disproportionate absorption of cerebrospinal fluid from the spinal region, might account for the spontaneous form of the Chiari I deformity.

Absorption↗

Spinal epidural abscess in children.

This is a report of three children with spinal epidural abscess. The literature is reviewed and the features of this condition in children are noted. Because of the nonspecificity of presenting symptoms in children, the diagnosis may be delayed, resulting in a worse outcome, especially in children under 1 year of age. The extensive laminectomy advised for the treatment of spinal epidural abscesses in adults is undesirable in children because of the risk of spinal deformity and in most cases is probably not necessary.

Abscess↗

Results of operative treatment of intracranial metastatic tumors.

Survival and quality of survival have been investigated in 79 patients operated for intracranial metastatic tumor during the decade 1967--1977. The 30-day mortality was 10%. Median survival varied between two and 14 months depending upon the type of primary tumor. The one-year survival was 22% and the two-year survival was 10%. Duration of survival depended strongly upon type of primary turmor and little upon preoperative condition, age, or sex. Fifty-three percent of neurologically impaired patients who survived for at least one month were in better condition after surgery and 5% were in worse condition.

Adolescent↗

Brain abscess and cystic fibrosis.

Brain abscess has only recently been considered a complication of cystic fibrosis. Three patients are reported here and a fourth cited from the literature. All of our patients were young adults with advanced pulmonary disease. The bacteria involved were mouth organisms and were found in the sputum culture in only one of the patients. Resistance was present to previously given antibiotics. As patients with cystic fibrosis survive into adulthood, the risk of developing a brain abscess appears to increase.

Adolescent↗

Neurologic complications of cardiac catheterization.

A retrospective survey was made of neurologic complications of cardiac catheterization. Of 10 patients, only one had a diffuse disorder, with seizures of a type associated with reaction to contrast agents. Disorders in the other nine patients appeared to be embolic in nature. Five of these nine involved deficits indicating damage in the vertebrobasilar territories, suggesting local trauma to vessels as a source of the embolic material.

Adolescent↗

Syringomyelia following lumboureteral shunting for communicating hydrocephalus. Report of three cases.

Three patients are described in whom syringomyelia was identified long after the treatment of communicating hydrocephalus by a lumboureteral shunt. The reason for syrinx formation in these cases could not be determined. In two there was either autopsy-proven or presumed evidence for arachnoiditis, and in the third patient the symptoms of syringomyelia were acutely aggravated by temporary obstruction of shunt. The development of a pressure drop from the intracranial compartment to the spinal compartment with crowding at the foramen magnum is also a suggested mechanism.

Adolescent↗

Physiological aspects of visual perception. II. The subcortical visual direction of behavior.

The second part of the Bennett Lecture for 1975 by Denny-Brown examined the subcortical representation of the dissociation of function described by Denny-Brown and Chambers. Complete removal in the macaque monkey of the corticomesencephalic fibers where they pass from pulvinar to colliculus, and of the colliculus, resulted in the same loss of visual object identification, binocular fixation, and visuosocial behavior that followed removal of area 17. Vision for peripheral movement and spatial orientation ("panoramic vision") remained excellent, with release of catatonia. Conversely, unilateral electrolytic lesions of the mesencephalic tegmentum produced visuospatial distortion, asymmetry of optic righting, and directional difficulties in eye movement (Parinaud syndrome and skew deviation). When bilateral, tegmental lesions produced great constriction of visual field with release of convergence and fixation spasm. Suppression of peripheral attention resulted from perceptual rivalry.

Animals↗