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Biomedical subjects

V R Challa

Publications and source records attributed to V R Challa.

At least 73 records · Page 4Linked to original sources
PubMed1982

Nonbacterial thrombotic endocarditis. A neurologic perspective of clinicopathologic correlations of 99 patients.

Of 13,913 patients examined at autopsy between 1939 and 1980, the diagnosis of nonbacterial thrombotic endocarditis (NBTE) was made in 99 instances. There were 53 males and 46 females ranging in age from 4 to 89 years. Vegetations were found on the aortic valve in 39; the mitral in 37; the tricuspid in nine; and the mitral in 37; the tricuspid in nine; and the pulmonic in two. Two-valve involvement was present in 12 cases. Malignant neoplasms were found in 42 autopsies. Embolism to the brain was found in 33 cases and to other organs in 62. Coagulation abnormalities were documented in 22 cases, and a distinct picture of disseminated intravascular coagulation of thrombophlebitis elsewhere in the body should arouse suspicion of NBTE. The high incidence of multiple emboli and its association with malignant neoplasms and with a variety of cardiovascular, pulmonary, renal, and gastrointestinal disorders should provide clues for recognition of this serious disorder.

Adolescent↗
PubMed1982

Chronic relapsing polyneuropathy associated with immunoblastic lymphadenopathy.

Two episodes of severe, relapsing sensorimotor polyneuropathy closely paralleled the course of systemic illness in a patient with immunoblastic lymphadenopathy. A review of the literature shows three other cases, although none with documented pathologic changes in muscles and nerves. Based on the pathologic findings in this patient, the peripheral neuropathy associated with immunoblastic lymphadenopathy can be classified under the group of relapsing inflammatory polyneuropathies associated with systemic disorders. Whether prednisone therapy helped this condition is uncertain.

Adult↗
PubMed1982

Histochemical diagnosis of Hirschsprung disease.

A histochemical staining technique for detection of acetylcholinesterase (AChE) in rectal suction biopsies was compared with the presence or absence of ganglion cells in full-thickness or suction biopsies for the diagnosis of Hirschsprung disease (HD) in infants and children. Biopsies from 55 of 58 children were adequate for both the AChE assay and routine pathologic examination for ganglion cells. Two patterns of AChE staining were noted. With pattern A, prominent nerve fibers staining for AChE were seen throughout the muscularis mucosa and the lamina propria. With pattern B, similar fibers were seen only in the muscularis mucosa and the areas of lamina propria that were immediately adjacent. No "false-negative" AChE staining reactions were found in patients with HD. No "false-positive" reactions showing pattern A were found. This pattern was diagnostic for HD. Three false-positive reactions were found showing pattern B in patients with conditions other than HD. Among 22 patients with HD, 19 were males and three were females. Pattern A occurred in all age groups and in both sexes. Pattern B in patients with HD was seen exclusively in male infants 1 month of age or less. Experience suggests that the AChE staining of rectal suction biopsies is an excellent screening test for HD in infants and children. If pattern B is encountered, however, the specimen should be examined by routine pathologic techniques for the presence of submucosal ganglion cells.

Acetylcholinesterase↗
PubMed1981

Intraventricular hemorrhage from pituitary apoplexy.

The case of a patient with a massive intraventricular hemorrhage arising from a pituitary chromophobe adenoma is described. This rare and disastrous complication was ascribed to the large suprasellar extension of the tumor and its close proximity to the floor of the third ventricle. Hemorrhage in the tumor extended along the path of least resistance and ruptured into the third ventricle. A partially treated hyperviscosity syndrome and chemotherapy for an unrelated malignancy (multiple myeloma) may have predisposed the patient to the necrosis and hemorrhage in the pituitary tumor.

Adenoma↗
PubMed1981

Cerebellar hemorrhage complicating isovaleric acidemia: a case report.

Isovaleric acidemia (IVA) is an inborn error of leucine metabolism, resulting in an accumulation of isovaleric acid in the body fluids. The neuropathologic findings in an 11-day-old infant with IVA consisted of diffuse cerebral edema, massive cerebellar hemorrhage, upward transtentorial herniation, and focal degeneration of clusters of glial cells in white and gray matter. Although abnormal myelination has been described in different aminoacidopathies, the above findings have not been reported previously in IVA.

Acidosis↗
PubMed1981

Biological features of meningiomas that determine the production of cerebral edema.

Although meningiomas are known to cause varying degrees of cerebral edema, the relative importance of their location, size, histological subtype, and other histological features in the production of cerebral edema has not been studied adequately. Therefore, we undertook a retrospective analysis of 43 meningiomas excised between 1975 and 1980. The results indicate that histological subtype has no relationship to the production of cerebral edema, with one exception. Meningiomas containing partly or completely a hemangiopericytic component were the only histological subtype associated consistently with cerebral edema. The location of a meningioma per se may not determine the production of cerebral edema. A relationship between size, aggressive histological features, vascular proliferative changes, and the production of cerebral edema was seen. The need for and the nature of further studies required to explain the cerebral edema that may be associated with small meningiomas are discussed.

Brain Edema↗
PubMed1981

Radiofrequency neurolysis in a clinical model. Neuropathological correlation.

Reports differ on which nerve fibers are affected by radiofrequency lesions made in peripheral nerves, some stating that primarily the myelinated delta and unmyelinated C fibers are destroyed, others stating that the destruction affects all sizes of nerve fibers and both myelinated and unmyelinated fibers. This study was designed to confirm one of those two findings, and to study the role that different temperatures might play in determining which fibers are affected. Radiofrequency lesions (85 degrees C for 2 minutes) were made in dogs by placing a temperature-monitored electrode into the lumber intervertebral foramina. The dogs were killed at intervals up to 6 weeks after rhizotomy, and the lesions were studied by light and electron microscopy. In all lesions, there was a total loss of unmyelinated fibers and a nearly total loss of myelinated fibers. In other dogs, 2-minute lesions were made at 45 degrees, 55 degrees, 65 degrees, and 75 degrees C, and the lesions examined 1 week later. Again, all sizes and all types of fibers were destroyed.

Animals↗
PubMed1981

Spongy degeneration of the nervous system associated with propionic acidemia.

The pathologic changes in the brain of a five and a half month old male child who died of propionic acidemia are presented. Although previous pathologic reports of this disorder describe either no involvement of the central nervous system or focal myelin sheath vacuolization, the present case exhibited different pathology, namely, spongy degeneration of the white matter of Van Bogaert and Bertrand's type. Thus this case illustrates that the pathologic changes in the brain in propionic acidemia are variable. In addition, the cerebellum in this patient showed marked diffuse atrophy and early loss of the external granular layer, two changes that have not been emphasized by previous authors.

Amino Acid Metabolism, Inborn Errors↗
PubMed1981

Vasculitis involving muscle associated with Crohn's colitis.

A case of Crohn's colitis is described in a patient who demonstrated multiple extraintestinal complications, including erythema nodosum, pyoderma gangrenosum, and aphthous oral ulcerations. Our patient simultaneously developed an unusual vasculitis in muscle. Small vessels were affected by necrosis, and polymorphonuclear leukocyte infiltration was appreciated. Leukocytoclastic was suggested by these features and the additional finding of small amounts of nuclear debris. A strong immunofluorescence to antihuman C3 was demonstrated in the affected vessel walls. We did not find circulating IgG immune complexes in serum with the Raji cell assay. The implication of the finding of leukocytoclastic vasculitis in muscle, associated with Crohn's colitis, is discussed.

Adult↗
PubMed1980

Pathology of Yersinia enterocolitica meningitis.

Yersinia enterocolitica, a gram negative aerobic non-haemolytic bacillus, has been identified as a cause of meningitis only once before and the neuropathological features of Y. enterocolitica meningitis have not been reported in the literature. We describe the pathological features of a case of acute fatal meningitis caused by Y. enterocolitica, serotype 0:18, in a 47-year-old male alcoholic with cirrhosis. The organism presumably reached the meninges via the blood stream from the abdominal cavity. Intravascular fibrin thrombi, both recent and organising, were associated with multiple foci of necrosis in the brain. In spite of vigorous antibiotic therapy for three weeks the organism was cultured from the brain at autopsy. Among the various infections caused by Y. enterocolitica, meningitis appears to be the most difficult to eradicate.

Anti-Bacterial Agents↗
PubMed1980

The vascular component in meningiomas associated with severe cerebral edema.

Cerebral edema is usually a complication of the later growth stages of intracranial neoplasms. Three patients with small meningiomas presented with unusually several cerebral edema out of proportion to the size of tumors. All three tumors exhibited benign meningothelial components, the formation of pseudopsammoma bodies, and striking vascular mural proliferation of small dark cells. In two tumors ultrastructural examination of these cells showed features of pericytes. The vascular pericytic component in these tumors may grow more actively than the meningothelial component and thus may cause the production of severe cerebral edema. The clinical, radiological, operative, and light and electron microscopic findings are presented, and the relationship to angioblastic meningiomas is discussed.

Aged↗
PubMed1980

Odontoid compression of the brain stem in a patient with rheumatoid arthritis. Case report.

Cervical spine involvement by rheumatoid arthritis is common; brain-stem compression secondary to vertical subluxation of the odontoid in patients with rheumatoid arthritis is rare. Vertical subluxation results from 1) destruction of the transverse atlantal, apical, and alar ligaments of the atlas and odontoid, and 2) bone resorption in the occipital condyles, lateral masses of the atlas, and basilar processes of the skull. Neurological symptoms result from direct compression of the brain stem or from ischemia secondary to compression of vertebral arteries, anterior spinal arteries, or small perforating arteries of the brain stem and spinal cord. A case is reported in which a slowly progressive neurological deficit developed in a woman with rheumatoid arthritis following a fall from a stretcher. Neruological symptoms represented direct compression of the medulla by the dens, a mechanism confirmed at operation and autopsy. Recognition of progressive neurological deficit is often difficult in patients with rheumatoid arthritis because of their inactivity and their atrophic and immobile joints, but is essential if appropriate decompressive or stabilizing procedures are to be done. In patients with vertical subluxation of the dens, the transoral approach with removal of the odontoid is recommended. Decompression should be extensive, including the fibrous capsule around the odontoid and overlying synovial tissue as well as the odontoid itself.

Arthritis, Rheumatoid↗
PubMed1980

Embolism of cerebral tissue to lungs following gunshot wound to head.

The case history of a 28-year-old man who sustained a gunshot wound to the head and developed multiple pulmonary emboli composed of cerebral tissue is presented. The brain tissue fragments probably entered the severed end of a bridging vein, traveled along the superior sagittal sinus, and gained access to the internal jugular vein and systemic venous return.

Adult↗
PubMed1979

Electron microscopic findings in primitive neuroectodermal tumors of the cerebrum.

The fine structure of 3 primitive neuroectodermal neoplasms of the cerebral hemispheres was studied. The predominant tumor cells were undifferentiated cells with prominent nuclei and scanty cytoplasm containing few organelles. Ultrastructural evidence suggesting differentiation into ependymal, neuronal and possibly astrocytic elements was also present. This study suggests that the cell of origin of this tumor is a primitive multipotential cell of the cerebrum.

Adolescent↗
PubMed1979

Cerebral embolism from septal fibromuscular dysplasia of the common carotid artery.

A rare type of fibromuscular dysplasia of the common carotid artery, in the form of a septum, was observed in a patient suffering from recurrent cerebral infarctions. Angiography demonstrated growth of the lesion and documented the presence of an intraluminal thrombus attached to it. Comparison with reported cases of the more common "string of beads" lesion of fibromuscular dysplasia suggests that the risk for development of ischemic neurological problems is higher for this type of fibromuscular lesion. Surgical correction is recommended, especially for symptomatic patients.

Arterial Occlusive Diseases↗
PubMed1978

Lactic acidosis associated with cerebellar vermal atrophy and cardiomyopathy.

The association of fluctuating neurological signs and congestive cardiomyopathy with chronic lactic acidosis is described in a 5 1/2 year-old-boy who ultimately succumbed to congestive heart failure. The autopsy findings included severe atrophy of the anterior cerebellar vermis and a hypertrophied heart with left sided endocardial fibroelastosis. Skeletal and cardial muscle calcification was prominent and probably due to the effect of intracellular metabolic alterations associated with lactic acidosis. A review of the literature shows that the combination of cardiomyopathy, isolated atrophy of cerebellar vermis and muscle fiber calcification have not been reported in association with idiopathic lactic acidosis previously.

Acidosis↗