Human pathology
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An unusual case of bilateral malignant Brenner tumor with liver and omental metastases is reported. The tumor was histologically a transitional cell carcinoma comparable to a grade III bladder carcinoma. A benign component was not identified, but there were a few nests of malignant epithelial cells distributed in a dense stroma, a pattern identical to that seen in a benign Brenner tumor. ⋯ Nevertheless it is suggested that the current histologic criteria for malignant Brenner tumor be modified to exclude the requirement of an intimately associated benign Brenner tumor. Ultrastructurally the malignant Brenner tumor has many features of the benign Brenner tumor. Some features, notably the basal lamina, micropinocytotic vesicles, nd intracytoplasmic microfibrils, are herein described for the first time in a malignant Brenner tumor.
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Case Reports
Fatal spinal cord infarction caused by fibrocartilaginous embolization of the anterior spinal artery.
A fatal case of massive infarction of the cervical cord caused by fibrocartilaginous embolization of the anterior spinal artery in a 22 year old woman is reported. The source of such emboli is believed to be intervertebral disc material, but the pathogenesis of this entity is obscure. ⋯ The cervical cord is the most common site of involvement. The importance of multiple sections from various levels of the spinal cord and the application of special stains in order to determine the cause of spinal cord infarction are emphasized.
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We describe briefly and comment upon the salient strengths and limitations of the major published theories that purport to explain the mechanism of contrecoup cerebrocortical contusions. Through the application of mechanical principles, we then present a modification, clarification, and expansion of selected aspects of several theories. Our final formulation emphasizes the injurious potential of nonuniform compressive stress and the relationship between brain lag and rotationally induced injury. The resulting theory remains faithful to the laws of physics while explaining the location and distribution of cerebrocortical contusions opposite the site of a moving head impact.
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In order to clarify the relationship between stress and sudden death, we reviewed homicidal assaults that occurred in Cuyahoga County, Ohio (metropolitan Cleveland), over the preceding 30 years. Specifically, attention was focused on the autopsy and investigative findings relating to victims who died as a direct result of physical assault without sustaining internal injuries. ⋯ Two victims survived for a time in the hospital, suffered arrhythmias throughout the hospital course, and had the described cardiac lesions at autopsy. We interpret our data as being strongly supportive of the theory of catecholamine mediation of these myocardial changes in man and of the lethal potential of stress through its effect on the heart.