The weight and histological appearance of the thymus from patients with myasthenia gravis were studied. Nine patients treated with corticosteroids were compared with 10 patients not treated with corticosteroids before thymectomy. The thymuses of corticosteroid-treated patients were found to have significantly increased fat and connective tissue, decreased germinal centers, and poorer corticomedullary differentiation than those of untreated patients. The glandular weight and degree of myoepithelial stroma were the same in both groups. The changes following corticosteroid treatment mimic those following aging or acute stress, with retention of the myoepithelial stroma but depletion of thymic lymphoid elements. In myasthenic patients not undergoing thymectomy, the possibility remains that persistent myoepithelial tissue can adversely affect the prognosis.

Adipose Tissue↗

PubMedDate not supplied

Do public schools have an obligation to serve troubled children and youth?

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Adolescent↗

PubMedDate not supplied

Diagnosis of congenital vascular malformations of the extremities: new perspectives.

Congenital vascular malformation (CVM's) have traditionally been evaluated angiographically. Unfortunately, this approach does not always give definitive information about the various components, particularly microfistulous lesions and venous angiomata, and it provides little physiologic information. Furthermore, it is expensive, invasive, and is not needed to guide therapy in the majority of patients who either do not need or will not benefit from surgery or embolotherapy. We propose a different approach which begins initially with simple noninvasive screening tests, then selectively uses labelled-albumin microspheres to quantify the AV shunt fraction and/or magnetic resonance imaging (MRI) to define the anatomic extent and involvement of adjacent structures. This approach gives sufficient anatomic and physiologic information in the vast majority of cases to allow reasonable prognostication and to guide future therapy. Angiography is then reserved for patients identified as probably having localized lesions or for those with more extensive CVM's whose symptoms ultimately justify therapeutic intervention.

Arteriovenous Fistula↗