A case of mesangial IgM nephropathy with decreased renal function

A case of mesangial IgM nephropathy associated with chronic renal failure is described. The patient did not reveal nephrotic syndrome during the clinical course. Renal biopsy specimens revealed typical features of mesangial IgM nephropathy when studied by light microscopy, electron microscopy and immunofluorescence staining. Mesangial IgM nephropathy is considered to be a heterogenous disorder, because this disorder is clinically characterized by nephrotic syndrome, mild proteinuria and/or hematuria or renal failure.

Duchenne dystrophy: Reduced density of orthogonal array subunit particles in muscle plasma membrane

Using freeze-fracture, we analyzed the density of orthogonal arrays and subunit particles in muscle plasma membrane of six patients with Duchenne muscular dystrophy and six control boys. The group median density of orthogonal arrays per 1 micron2 and the group mean density of orthogonal array subunit particles per one orthogonal array were significantly lower in Duchenne plasma membrane. The results suggested the possible impairment of orthogonal array function in the muscle plasma membrane of Duchenne muscular dystrophy.

[The bone scintigraphy in eosinophilic granuloma (author's transl)]

The significance of bone scintigraphy using 99mTc-polyphosphate or 99mTc-diphosphate in the diagnosis of eosinophilic granuloma was discussed on the basis of our experience with four cases. The summary is following: 1. On diagnostic procedure of eosinophilic granuloma, it was found that abnormal RI accumulation in the bone scintigram was more marked than that in the ordinary brain scintigram. 2. The bone scintigram of eosinophilic granuloma showed more accurately the extent of skull involvement of cellular infiltration than the plain skull X-rays or brain scintigram. Accordingly, the bone scintigram was helpful for neurosurgeon in planning the operative procedure and determining the extent of removal of the involved skull. 3. The plain skull X-rays show the size of skull defect, and the brain scintigram reveals the size of the size of granuloma per se, as well as soft tissue involvements. We can conjecture the stage of the diseases by comparison between the findings of bone scintigram and those of above procedures: plain skull X-rays and brain scintigram. Viz, the bone scintigram showed more extensive areas of RI accumulation including the surrounding cellular infiltration in the acute stage, but the same size of the lesions shown by the ordinary brain scintigram and plain skull X-rays is chronic stage. Furthermore, we discussed the possibility of the differential diagnosis between eosinophilic granuloma and other neoplastic bone diseases, such as intracranial metastatic tumors and multiple myelomas etc., by further experience with the bone scintigram.

Mycotic aneurysms of the internal carotid artery. Case report

The authors report a case with two mycotic aneurysms in the cavernous portion of the internal carotid artery, presumably secondary to a transient bacteremia from pneumonia. The strikingly rapid development of the aneurysms was demonstrated by angiography. Painful total ophthalmoplegia and extophthalmos were the main clinical features.

[The accessory middle cerebral artery (author's transl)]

The accessory middle cerebral artery has rarely been documented. Four cases of the anomalous artery were found in 1240 carotid angiograms, the incidence being estimated to be 0.24 to 0.34%. Ages of the patients were 45, 52, 53, and 56. They were two males and two females. In two patients, the angiography was carried out because of positive neurological signs after head injury, and in the other two, because of cerebrovascular stroke. All the anomalous arteries were found as incidental findings. The angiography was carried out bilaterally in two patients and the anomalous arteries were found only on one side. They arose from the horizontal portion of the anterior cerebral artery and coursed laterally in paralled with the stem of the middle cerebral artery. Two of them gave rise to the perforating arteries into the brain which accompanied those from the middle cerebral artery. These atomalous arteries were identified very easily on an antero-posterior projection of the angiogram. In the most striking patient, the 52-year-old man, a selective angiography for the middle cerebral artery, which did not demonstrate the anterior cerebral artery and its branch, the accessory middle cerebral artery, was carried out and in the light of the findings, the accessory middle cerebral artery could be identified running in elliptic circle just above D1 on the lateral projection of the routine carotid angiogram. All the accessory middle cerebral arteries in our series were not associated with either intracranial aneurysm or anomalies such as agenesis of the corpus callosum and reduplication of the circle of Willis.