Meningiomas are frequent intracranial, non‐glial tumors of adults. We present the unusual left lateral ventricular localization of meningioma in a 51‐year‐old man. The magnetic resonance (MR) images showed well demarcated, large mass of the atrium of the left lateral ventricle with transependymal extension into the left temporal lobe. MR spectroscopy revealed the presence of “choline only” spectrum, typical for extra axial neoplasms. The mass was completely resected. The diagnosis of transitional type intraventricular meningioma, with psammoma bodies, histologic grade I was made. Progesterone and estrogen receptors were negative.

Asthma is a chronic inflammatory disease of the airways. The global prevalence of asthma ranges from 1% to 18% of the population, so it remains a common problem with enormous medical and economic impacts. In majority of patients, asthma can be well controlled with simple regimens of inhaled anti-inflammatory and bronchodilating medications. However, some patients tend to suffer from poorly controlled disease in terms of chronic symptoms with episodic severe exacerbations. Major factors that may be related to the emergency department visits and hospitalisation include prior severe attacks, nonadherence to therapeutic regimens, inadequate use of inhaled corticosteroids, poor self-management skills, frequent use of inhaled short-acting beta-agonists, cigarette smoking, poor socioeconomic status and age over 40 years. Severe exacerbations of asthma are life-threatening medical emergencies and require careful brief assesment, treatment according to current GINA (Global Initiative for Asthma) guidelines with periodic reassesment of patient's response to therapy usually in an emergency department.

Exacerbations of chronic obstructive pulmonary disease are a common cause of hospital admission. They have a profound effect on the quality of life, disease progression and healthcare costs. The central event is amplified inflammation with many biomarkers who are not in clinical use. Severe dyspnea and large volume of purulent sputum are typical clinical presentation of exacerbation due to viral or bacterial infections. Bronchodilators and corticosteroids are the mainstay of pharmacologic therapy of exacerbation, antibiotics are useful in the presence of purulent sputum and other signs of respiratory infection. Acute respiratory failure in patients with exacerbation of COPD demand controlled oxygen therapy and noninvasive ventilation or conventional mechanical ventilation. Important advances have been made in understanding etiology and pathogenesis of inflammation in exacerbation of COPD. There is a proposal for approach to such patients in emergency departement and a guidelines for pharmacologic therapy and oxygen therapy.

MR examination revealed the presence of metastatic lesion in the right occipital lobe (Figure 1A) in a 23-year-old man with headaches, severe visual problems and right exophthalmus, associated with soft tissue choroidal mass of the right eyeball (Figure 1A and 1B) and T1W hyperintensity within the corpus viterum, compatible with hemorrhage due to retinal ablatia (Figure 1B). Melanomas are the most frequent malignant ocular neoplasms. Melanoma, renal carcinoma, thyroid carcinoma, and choriocarcinoma are however the most frequent hemorrhagic metastases within the brain parenchyma (1). Histologic evaluation revealed metastatic choriocarcinoma. Primary neoplasm of the testis was confirmed after additional examinations.

OBJECTIVE To determine the distribution of 2 intracellular oxygen-carrying molecules, neuroglobin (NGB) and cytoglobin (CYGB), in specific retinal cell types of human retinas. METHODS Specific antibodies against NGB and CYGB were used in immunohistochemical studies to examine their distribution patterns in human retinal sections. Double-labeling studies were performed with the anti-NGB and anti-CYGB antibodies along with antibodies against neuronal (microtubule-associated protein 2, class III beta-tubulin [TUJ1], protein kinase C alpha, calretinin) and glial (vimentin, glial fibrillary acid protein) markers. Confocal microscopy was used to examine the retinal sections. RESULTS Immunohistochemical analysis of human retinal tissue showed NGB and CYGB immunoreactivity in the ganglion cell layer, inner nuclear layer, inner and outer plexiform layers, and retinal pigment epithelium. Neuroglobin immunoreactivity was also present in the outer nuclear layer and photoreceptor inner segments. Neuroglobin and CYGB were coexpressed in the neurons in the ganglion cell layer and inner nuclear layer but not within glial cells. CONCLUSION Neuroglobin and CYGB are colocalized within human retinal neurons and retinal pigment epithelium but not within glial cells. Clinical Relevance Our results suggest that NGB and CYGB may serve a neuroprotective role as scavengers of reactive oxygen species and therefore should be considered when developing therapeutic strategies for treatment of hypoxia-related ocular diseases.

This study provides a detailed description of immunolocalization of two oxygen-binding proteins, neuroglobin (Ngb) and cytoglobin (Cygb), in the anterior segment of healthy human and canine eyes. Specific antibodies against Ngb and Cygb were used to examine their distribution patterns in anterior segment structures including the cornea, iris, trabecular meshwork, canal of Schlemm, ciliary body, and lens. Patterns of immunoreactivity (IR) were imaged with confocal scanning laser and conventional microscopy. Analysis of sectioned human and canine eyes showed Ngb and Cygb IR in the corneal epithelium and endothelium. In the iris, Ngb and Cygb IR was localized to the anterior border and the stroma, iridal sphincter, and dilator muscle. In the iridocorneal angle, Ngb and Cygb were detected in endothelial cells of the trabecular meshwork and canal of Schlemm in human. In the ciliary body, Ngb and Cygb IR was localized to the non-pigmented ciliary epithelium of the pars plana and pars plicata and in ciliary body musculature. Ngb and Cygb distribution was similar and colocalized within the same structures of healthy human and canine anterior eye segments. Based on their immunolocalization and previously reported biochemical features, we hypothesize that Ngb and Cygb may function as scavengers of reactive oxygen species. This manuscript contains online supplemental material at http://www.jhc.org. Please visit this article online to view these materials.

The primary source of malignant intracerebral nerve sheath tumors is still unclear We report the imaging and MR spectroscopic findings in a 39-year-old man with a very rare brain stem tumor MR examination revealed the presence of intraaxial brain stem tumor with a partial exophytic growth. On pathological examination, the neoplasm appeared to be an intrapontine nerve sheath tumor originating most likely from the intrapontine segment of one of the cranial nerve fibres. The tumor showed exophytic growth, with consequent spread to adjacent subaracnoid space. MR spectroscopy revealed the presence of very high concentration of choline, associated with no creatine and N-acetyl aspartate resonance, suggesting non-glial origin of the intraaxial neoplastic infiltration. MR spectroscopy seems to be a helpful diagnostic modality not only in the estimation of the grade of astrocytomas that has been already confirmed in literature, but also in the diferentiation between glial and non-glial origin of primary intracranial neoplasms when MR imaging is not conclusive.

MR spectroscopy (MRS) of hormonally active pituitary adenomas has not been published in literature. We report MR imaging and spectroscopy findings in a 41-year-old man with extrapituitary growth hormone-secreting adenoma. Application of the single voxel proton MRS, SE 135 technique, with voxel size 11x11x11 mm, revealed the elevated choline peak (resonance at 3.2 ppm) in the paramedial aspect of the tumor, while no metabolic activity in the mentioned region was noted using the same method 11 months after Lanreotide treatment. Elevation of choline peak in functional pituitary adenomas could represent an active marker of cellular proliferation, compatible with increased hormonal activity.

Capillary telangiectasia is a cluster of dilated vessels without smooth muscle or elastic fibers. These vessels are separated by normal brain parenchyma and usually measure less than 30 microns in diameter. Capillary telangiectasia is almost always an asymptomatic entity causing no clinical complications, like bleeding or seizures, compared to other neurovascular malformations [1–4]. However, this benign vascular abnormality may, due to misinterpretation, create serious potential consequences. We herein report three case examples. The first patient was an 11-year-old boy with a history of somnolence and confusion three weeks after head trauma. On a magnetic resonance (MR) examination performed elsewhere, a small hypointense lesion was noted in the pons on the T2-weighted (T2W) sequence, and confirmed by the gradient-echo T2W sequence (TR = 800 ms, TE = 26 ms, and flip angle = 20 degrees) in this institution on a 1.5-Tesla MR imaging unit (Siemens Magnetom SP63 4000), and was inter-