Labyrinthine artery aneurysm as an internal auditory canal mass.

We present the first case report of a labyrinthine artery aneurysm masquerading as an internal auditory canal tumor. A 72-year-old woman presented with sudden onset right facial paralysis, facial pain, hearing loss, and vertigo. She demonstrated dense right-sided facial paralysis involving all branches of the facial nerve, left beating horizontal nystagmus, and anacusis of the right ear. Magnetic resonance imaging with contrast demonstrated a 6 × 7 mm peripherally enhancing lesion with lack of central uptake filling the right internal auditory canal. The patient elected to proceed with translabyrinthine approach to the internal auditory canal for definitive resection of the mass as well as to decompress the neural structures of the internal auditory canal in an attempt to recover neural function, particularly of the facial nerve. Intraoperatively, the internal auditory canal mass was resected with minimal difficulty, with intraoperative dissection notable for brisk bleeding at the medial base of the tumor just as the tumor was dissected off its medial fibrous attachments. Final pathology of the resected mass revealed a blood vessel with mucinous degeneration of the medial layer of the vessel wall, with immunohistochemical staining confirming the presence and structure of aneurysmal blood vessel

Depression in stroke rehabilitation

Despite recent advances in understanding the pathophysiology of poststroke depression, major questions remain. They include the relative importance of lesion location and size and the confounding effects of time since stroke, age, prior history of depression, and cerebral atrophy. To evaluate these issues, we systematically assessed depressive features, functional status, and brain structure with computer tomography scans in 91 men undergoing stroke rehabilitation. Forty percent met DSM-III criteria for major depressive disorder. Mood disturbance was more severe for patients with right than with left hemisphere lesions, correlated with functional disability and lesion size, and was associated with previous history of depression. Age, time since stroke, and atrophy did not correlate with mood. Depression is common in delayed stroke recovery, regardless of lesion location. Because there are no demographic or anatomic features that predict the absence of depression, depression screening should be part of the assessment of all patients undergoing stroke rehabilitation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30792/1/0000446.pd

Diffusion imaging for evaluation of tumor therapies in preclinical animal models

The increasing development of novel targeted therapies for treating solid tumors has necessitated the development of technology to determine their efficacy in preclinical animal models. One such technology that can non-invasively quantify early changes in tumor cellularity as a result of an efficacious therapy is diffusion MRI. In this overview we present some theories as to the origin of diffusion changes as a result of tumor therapy, a robust methodology for acquisition of apparent diffusion coefficient maps and some applications of determining therapeutic efficacy in a variety therapeutic regimens and animal models.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47951/1/10334_2004_Article_79.pd

A High Density SNP Array for the Domestic Horse and Extant Perissodactyla: Utility for Association Mapping, Genetic Diversity, and Phylogeny Studies

An equine SNP genotyping array was developed and evaluated on a panel of samples representing 14 domestic horse breeds and 18 evolutionarily related species. More than 54,000 polymorphic SNPs provided an average inter-SNP spacing of ∼43 kb. The mean minor allele frequency across domestic horse breeds was 0.23, and the number of polymorphic SNPs within breeds ranged from 43,287 to 52,085. Genome-wide linkage disequilibrium (LD) in most breeds declined rapidly over the first 50–100 kb and reached background levels within 1–2 Mb. The extent of LD and the level of inbreeding were highest in the Thoroughbred and lowest in the Mongolian and Quarter Horse. Multidimensional scaling (MDS) analyses demonstrated the tight grouping of individuals within most breeds, close proximity of related breeds, and less tight grouping in admixed breeds. The close relationship between the Przewalski's Horse and the domestic horse was demonstrated by pair-wise genetic distance and MDS. Genotyping of other Perissodactyla (zebras, asses, tapirs, and rhinoceros) was variably successful, with call rates and the number of polymorphic loci varying across taxa. Parsimony analysis placed the modern horse as sister taxa to Equus przewalski. The utility of the SNP array in genome-wide association was confirmed by mapping the known recessive chestnut coat color locus (MC1R) and defining a conserved haplotype of ∼750 kb across all breeds. These results demonstrate the high quality of this SNP genotyping resource, its usefulness in diverse genome analyses of the horse, and potential use in related species

\u27Not Much Less Necessary than the Atmosphere They Breathed:\u27 Salmon, Indian Treaties, and the Supreme Court - a Centennial Remembrance of United States V. Winans and its Enduring Significance

A century ago, the Supreme Court decided United States v. Winans, which upheld the Indian treaty right to cross private property to access traditional fishing grounds in the Columbia River. The Winans decision, a landmark in Indian treaty interpretation, protected critically important cultural and economic practices from white encroachment, a surprising result in an era committed to Indian assimilation and allotment. This article examines the case, its context, its participants, and its contributions to Indian natural resources law. The dispute took place at Celilo Falls, the most important Indian fishing site in the Columbia Basin, although the government agents and attorneys viewed it as a test case, emblematic of the clash of cultures taking place throughout the Northwest at the end of the 19th century. In fact, the article considers in some depth two predecessor cases involving the same tract of land at issue in Winans and suggests that the Indian agents who pursued the case did so because they saw treaty fishing as an economic lifeline for Indians who had failed at agrarianism on-reservation. The district court issued a confusing array of injunctions and opinions that ultimately culminated in dismissal of the case some eight years after it was filed. A direct appeal to the Supreme Court produced an opinion memorable almost as much for its poetic language as for its result. Justice Joseph McKenna, not otherwise known for his lyricism, wrote that fishing at Celilo Falls was not much less necessary to the Indians than the atmosphere they breathed and proceeded to rule that their treaty rights included the imposition of a servitude, a right in land necessary to access their traditional fishing sites. In response to the lower court\u27s conclusion that the treaty language recognizing a tribal right of taking fish in common with settlers meant only equality of treatment, McKenna averred that such a result was certainly an impotent outcome to negotiations and a convention, which seemed to promise more and give the word of the Nation for more. The decision\u27s lodestar status is not merely due to its language, however. It established the reserved rights doctrine, which holds that Indian treaties are not a grant of rights to the Indians but a grant of rights from them - a reservation of rights not granted. Over the last century, the reserved rights doctrine has been immensely important in recognizing tribal proprietary rights to natural resources and in recognizing tribal sovereignty. Winans also reaffirmed the rule that Indian treaties should be interpreted as the Indians, the weaker party, would have understood, and rejected claims that state ownership of the riverbed foreclosed federally created treaty rights. Both of these principles endure. Finally, the case recognized treaty fishing rights as property rights that would run against not only the federal government but also the state and private parties, a precedent that some recent lower court decisions seem to have overlooked

Labyrinthine artery aneurysm as an internal auditory canal mass.

We present the first case report of a labyrinthine artery aneurysm masquerading as an internal auditory canal tumor. A 72-year-old woman presented with sudden onset right facial paralysis, facial pain, hearing loss, and vertigo. She demonstrated dense right-sided facial paralysis involving all branches of the facial nerve, left beating horizontal nystagmus, and anacusis of the right ear. Magnetic resonance imaging with contrast demonstrated a 6 × 7 mm peripherally enhancing lesion with lack of central uptake filling the right internal auditory canal. The patient elected to proceed with translabyrinthine approach to the internal auditory canal for definitive resection of the mass as well as to decompress the neural structures of the internal auditory canal in an attempt to recover neural function, particularly of the facial nerve. Intraoperatively, the internal auditory canal mass was resected with minimal difficulty, with intraoperative dissection notable for brisk bleeding at the medial base of the tumor just as the tumor was dissected off its medial fibrous attachments. Final pathology of the resected mass revealed a blood vessel with mucinous degeneration of the medial layer of the vessel wall, with immunohistochemical staining confirming the presence and structure of aneurysmal blood vessel

Labyrinthine Artery Aneurysm as an Internal Auditory Canal Mass

We present the first case report of a labyrinthine artery aneurysm masquerading as an internal auditory canal tumor. A 72-year-old woman presented with sudden onset right facial paralysis, facial pain, hearing loss, and vertigo. She demonstrated dense right-sided facial paralysis involving all branches of the facial nerve, left beating horizontal nystagmus, and anacusis of the right ear. Magnetic resonance imaging with contrast demonstrated a 6 × 7 mm peripherally enhancing lesion with lack of central uptake filling the right internal auditory canal. The patient elected to proceed with translabyrinthine approach to the internal auditory canal for definitive resection of the mass as well as to decompress the neural structures of the internal auditory canal in an attempt to recover neural function, particularly of the facial nerve. Intraoperatively, the internal auditory canal mass was resected with minimal difficulty, with intraoperative dissection notable for brisk bleeding at the medial base of the tumor just as the tumor was dissected off its medial fibrous attachments. Final pathology of the resected mass revealed a blood vessel with mucinous degeneration of the medial layer of the vessel wall, with immunohistochemical staining confirming the presence and structure of aneurysmal blood vessel

The use of biopsy in the evaluation of pediatric nasopharyngeal masses

Pediatric nasopharyngeal tumors are rare, and few clinicians possess more than anecdotal experience. The differential diagnosis includes a diverse group of benign and malignant tumors, but can be narrowed further based on the clinical and radiographic appearance of the mass. Nasopharyngeal angiofibroma has such characteristic angiographic and CT imaging that many authors suggest biopsy is not essential in the evaluation of this lesion. We present a case of a pediatric nasopharyngeal neoplasm with angiographic, CT, and clinical findings consistent with angiofibroma. We then discuss the preoperative evaluation of, operative approach to, and postoperative staging and treatment of the biopsy-proven embryonal rhabdomyosarcoma. A review of the literature pertinent to this case is presented, and recommendations made concerning biopsy of lesions resembling juvenile nasopharyngeal angiofibroma. We believe this report reaffirms the use of histologic study whenever possible, in addition to radiographic imaging, in the diagnosis of pediatric nasopharyngeal masses.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28324/1/0000080.pd