Vernon W. Armbrustmacher

Grading of oligodendrogliomas

The purpose of this study was to determine the effectiveness of histologic grading of oligodendrogliomas in a retrospective study. 323 cases with adequate clinical information and confirmatory histological material were acquired from the files of the AFIP. A grading system was devised using the following criteria: endothelial proliferation, necrosis, nuclear/cytoplasmic ratio, cell density and pleomorphism. The grading system separated 23% of the cases into grade A, 49% into grade B, 22% into grade C and 6% into grade D. Statistical analysis showed that the grading system significantly correlated with survival (P ⩽ 0.01). Median survival periods for each grade were as follows: grade A, 94 months; grade B, 51 months; grade C, 45 months; grade D, 17 months. Of the five factors comprising grade, only pleomorphism was significantly correlated with survival by itself (P ⩽ 0.01). It is concluded that grading of this form of glioma can be an effective estimate of prognosis. Cancer 52:2107‐2114, 1983.

Spinal metastases. A rare mode of presentation of brain tumors

An analysis of more than 18,000 primary central nervous system (CNS) tumors revealed only 18 cases (0.01%) in which dropped spinal metastases had caused the presenting symptoms. This group included 11 males and 7 females in whom there was no history of surgical intervention or irradiation. Primitive neuroectodermal tumors (PNET, medulloblastoma), comprised the largest group (11 patients) followed by high‐grade astrocytomas (anaplastic astrocytoma and glioblastoma) (5 patients). One case each of germinoma and ependymoma were also identified. The clinicopathologic data of these cases, and a brief review of the literature are presented.

Diffuse meningeal rhabdomyosarcoma.

Pure rhabdomyosarcomas are extremely rare as primary tumors in the cranial vault. In this instance, a 25‐year‐old man had symptoms and signs of chronically increased intracranial pressure. A biopsy of the meninges of his posterior fossa was performed revealing a spindle‐cell sarcoma. Ultrastructural evidence of striated muscle differentiation and cross striations was present. The patient died of pulmonary emboli. Complete autopsy failed to disclose tumor anywhere except the leptomeninges. The presence of this tumor indicates that a rhabdomyosarcoma can arise from the meninges without a preexisting glioma or teratoma.

Traumatic distortions of the primate head and chest: correlation of biomechanical, radiological and pathological data

High speed cinefluorographic studies were performed on anesthetized primates during graded, experimental blunt impacts of the head or chest. Cineframe data were analyzed frame by frame to identify dynamic anatomic movement patterns during each injury. The results indicate that the brain and heart undergo significant displacements within the first few milliseconds (ms) post-impact and these transient interior motions were correlated with physiologic and pathologic changes as well as impact force and deceleration.

The course of alcoholic-nutritional peripheral neuropathy.

63 patients with alcoholic‐nutritional peripheral neuropathy were given neurologic, electrophysiologic and nutritional examinations. 24 of these patients were reexamined later in the course of their disease, after from 2 to 72 months (mean 33).

Myoadenylate deaminase deficiency and malignant hyperthermia susceptibility: Is there a relationship?☆

Muscle biopsies from 35 patients referred for possible malignant hyperthermia were subjected to contracture testing with halothane, caffeine, and the combined agents, histopathological and fiber-type-distribution analysis, and quantitative assay of three major muscle enzymes: adenylate deaminase, adenylate kinase, and creatine kinase. Adenylate kinase and creatine kinase were in the normal range in all biopsies and each averaged 92% of expected normal value when corrected for their fiber-type distribution. Of the 14 cases with a positive halothane test, 2 had primary myoadenylate deaminase deficiency, and 5 others had low levels of this enzyme (less than one-third normal). In contrast, only 3 of 21 cases negative to halothane testing had low adenylate deaminase levels, and none were deficient. This association was significant by several statistical tests, although it would not be highly predictive for an individual case. A positive halothane test also correlated with a high type 2 fiber contribution, but this was probably secondary, since cases with low enzyme levels had significantly higher type 2 fiber areas. Caffeine contractures did not correlate with either low enzyme levels or with fiber-type distribution. Sixty percent of the biopsies were entirely normal histologically, and showed a significant correlation with a negative combined contracture test. Data on the one family included in this study suggest separate inheritance of the trait for myoadenylate deaminase deficiency and the trait for positive contracture tests. The present findings suggest that patients with myoadenylate deaminase deficiency (and the carrier state as well) may be at increased risk of malignant hyperthermia when subjected to anesthesia.

Juvenile pilocytic astrocytoma of the pineal region. Report of a case

We describe the clinical and autopsy findings of a patient with a juvenile pilocytic astrocytoma which replaced the pineal gland and extended to adjacent brain structures.