Striato-pallido-dentate calcifications

Striato-pallido-dentate calcifications (SPDC) is a well defined entity, characterized by calcium deposits in the basal ganglia, dentate nuclei and the centrum semiovale. Several metabolic derangements have been associated with this entity, particularly parathyroid disorders. The traditional designation of Fahr's syndrome should be restricted to the idiopathic cases. The authors report a study of seven patients with SPDC. Hypocalcemia was found in three cases, two with pseudohypoparathyroidism and one with hypoparathyroidism. Fahr's syndrome was diagnosed in four patients. Clinical and laboratory features are presented. Neurological manifestations included epilepsy, dementia and parkinsonism. Discussion focuses on the distinction of this entity from the small pallidal calcifications and on the pathophysiology of basal ganglia mineralisation, in view of recent reports.     

Subcutaneous phlebopathic calcifications

A detailed history of 3 cases of subcutaneous calcifications. A review of the present therapeutic alternatives (other than surgery). A discussion of Selye's theory of calciphylaxis. Its application to one clinical case.     

Familial idiopathic cerebral calcifications

Nine members of a family spanning three generations showed bilateral calcifications of the basal ganglia with autosomal dominant inheritance. Two members developed chorea, dementia, and a characteristic speech disturbance (palialalia) in the third or fourth decade. A third member possibly shows the initial stage of a similar syndrome. Six members with calcifications but without neurological signs are younger than 25 years. All nine patients had normal calcium and phosphorus, and no evidence of endocrinological or somatic abnormalities. Thie 'isiopathic' picture must be differentiated from hypoparathyroidism and pseudohypoparathyroidism.     

CT features of calcifications in abdominal malignant fibrous histiocytoma

Driven by the need for a readily available, non-immunological tissue that possesses many of the characteristics of normal human skin, tissue-engineered skin has been developed. For over a decade, laboratory grown or processed skin has been under investigation and, in some cases, available as an alternative to autologous grafts. Apligraf, derived from neonatal foreskin and bovine type I collagen, is the first bi-layered living skin equivalent approved in the US and other countries for use in venous ulcers. Apligraf is effective both in the treatment of refractory venous ulcers and for acute wounds such as surgical excision sites and split thickness donor sites. Apligraf is safe and is not clinically rejected. Its ultimate fate is not known, so it may well work to aid healing in a variety of ways including graft 'take' and as a stimulus for healing.     

Evaluation of regional cerebral blood flow in massive intracerebral calcifications

Fahr's disease is histopathologically characterized by massive bilateral calcifications of the cerebral basal ganglia, the dentate nuclei of the cerebellum and both the cerebral and cerebellar cortices. We report a case of Fahr's disease in which a 99mTc-hexamethyl-propylenamine oxime (99mTc-HMPAO) brain SPECT study was used to evaluate regional cerebral blood flow to the calcified regions. There was markedly decreased perfusion to the basal ganglia bilaterally as well as decreased perfusion to the cerebral cortices that correlated well with the patient's clinical condition.     

Increased densities and calcifications in the finger bones of children

The AA. describe a case of a giant aneurysm 6 centimeters in diameter in a child of 4 years old. The lesion was made evident on the occasion of an hemorrhage that has caused an insular hematoma. The patient has undergone an operation with favourable outcome. The lack of neurologic symtomatology until the moment of the hemorrhage lead the AA. to think that this lesion was of the notables proportions from the moment of birth, so that the cerebral parenchyma was modeled on it. Unlike others cases in litterature recogniset, the wall of the aneurysmatic bag did not present fibrotics thickenings, and besides the blood-clot included in it seemed histologicaly of recent formation.     

An unusual case of chromophobe adenoma with conspicuous calcifications

Abnormal calcification on skull films in the region of the sella turcica is not commonly found with chromophobe adenoma. A patient with such calcification in a verified chromophobe adenoma is presented. From the literature the incidence of calcification in these tumours is reviewed. The importance of considering a chromophobe adenoma in the differential diagnosis of parasellar calcification from the surgical point of view is mentioned.     

Gonadoblastoma: an ovarian tumor with characteristic pelvic calcifications

Typical circumscribed mottled calcifications in the pelvis are a frequent finding in gonadoblastomas. Six patients with this tumor are reviewed. Radiologically visible calcifying gonadoblastomas were found in three cases.     

Stereotactic core biopsy of calcifications highly suggestive of malignancy

PURPOSE: To assess stereotactic core biopsy for evaluation of Breast Imaging Reporting and Data System (BI-RADS) category 5 calcifications (highly suggestive of malignancy). MATERIALS AND METHODS: Retrospective review of mammograms revealed 31 women (aged 34-86 years) with BI-RADS category 5 calcifications who underwent 14-gauge stereotactic core biopsy with an automated gun. Records were reviewed to determine the frequency with which stereotactic core biopsy obviated a surgical procedure. Cost savings were based on Medicare estimates of $472 for stereotactic core biopsy and $1,335 for surgical biopsy. RESULTS: Of 31 patients, stereotactic core biopsy revealed carcinoma in 19 (61%), atypical ductal hyperplasia (ADH) in eight (26%), and benign findings discordant with mammographic results in four (13%). Surgical biopsy was recommended for the 12 patients with ADH or benign but discordant core biopsy diagnoses. Of the 19 patients with carcinoma at stereotactic core biopsy, two chose to undergo a second biopsy surgically, two had small foci of ductal carcinoma in situ (DCIS) that would have been fully excised with surgical biopsy, one with DCIS at stereotactic core biopsy underwent axillary dissection after invasion was found at surgery, and one underwent excision but had tumor at lumpectomy margins. Thirteen (42%) of 31 patients were spared a surgical procedure, saving $100 per patient. CONCLUSION: Stereotactic core biopsy with an automated gun obviated a surgical procedure in 42% of patients with BI-RADS category 5 calcifications, resulting in modest cost savings in this group.     

Rational polypharmacy in schizophrenia

Approximately 10 to 30% of patients with schizophrenia show poor response to neuroleptics alone. An initial evaluative and treatment approach to these patients is outlined, and the literature on adjunctive treatments, which seek to augment neuroleptic effects, is reviewed. The greatest evidence for efficacy has been shown for lithium, benzodiazepines, carbamazepine, reserpine, and electroconvulsive therapy, although individual patients may also respond to propranolol, clonidine, valproic acid, and L-dopa. Antidepressants may also be useful for treating comorbid depression in nonacutely psychotic patients. One general theme is that no one adjunctive treatment benefits all patients; indeed, only a minority of patients responds to any given agent. Therefore, the choice of specific treatments is best guided by the clinical characteristics of the individual patient. These observations raise the possibility that subgroups of schizophrenia exist; delineation of differences in clinical response to biochemically distinct agents may help elucidate such underlying differences between patient groups.     

Self-structure in schizophrenia.

This study used a set-theoretical model to construct self-perception structures and person-perception structures for 10 recently hospitalized schizophrenic patients, 10 nonschizophrenic patients recently hospitalized for depression, and 10 nonpsychiatric subjects. Overall self-perception structures were significantly less elaborated in the schizophrenic patients when compared with either the psychiatric or the nonpsychiatric comparison group. No comparable differences were found for measures taken from the person-perception structures. The degree of elaboration of self in the particular context of self as psychiatric patient was found to be correlated (r?=?.74, p