Japanese Journal of Neurosurgery
Online ISSN : 2187-3100
Print ISSN : 0917-950X
ISSN-L : 0917-950X
Volume 12 , Issue 3
Showing 1-22 articles out of 22 articles from the selected issue
  • Type: Cover
    2003 Volume 12 Issue 3 Pages Cover16-
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Download PDF (239K)
  • Type: Index
    2003 Volume 12 Issue 3 Pages Toc6-
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Download PDF (63K)
  • Type: Appendix
    2003 Volume 12 Issue 3 Pages App10-
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Download PDF (89K)
  • Hiraku Takebe
    Type: Article
    2003 Volume 12 Issue 3 Pages 143-146
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Ethics committees were established in all medical universities and colleges in Japan in the late 1980s. New medical methods, both in basic research as well as in clinical practice, required ethical consideration. A guideline for bioethics in research on the human genome and gene analyses was laid out by the government in 2001. The guideline is contradictory in certain principles with international guidelines such as those established by WHO. The difference might be caused by lack of human genetics in medical education in Japan. Genetic counseling, which is emphasized in the government guideline, is not practiced, mainly due to a lack of well-trained genetic counselors. An urgent program to promote the education of human genetics in medical schools as well as in general education is needed. Gene therapy should be limited to the cure of diseases, not for the "improvement" of non-disease characteristics. Diversity in human genes should be kept intact, as human beings are but one of the nature's species.
    Download PDF (581K)
  • Munehisa Shimamura, Motokuni Aoki, Ryuichi Morishita
    Type: Article
    2003 Volume 12 Issue 3 Pages 147-155
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    There is a limitation in the treatment of neurological diseases, such as neurodegenerative disease, brain tumor, and cerebrovascular disease. Gene therapy is one promising treatment for these diseases. Clinical trials have been studied for brain tumor, Canavan disease, and amyotrophic lateral sclerosis. The efficacy was proved to some extent, but there were some problems such as vector immunoreactivity. However, more effective and safe vectors have been developed recently, and gene therapy might be popular in the field of cerebral diseases in the future.
    Download PDF (1414K)
  • Toshiyuki Miyata
    Type: Article
    2003 Volume 12 Issue 3 Pages 156-160
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Recently, attention has been focused on single nucleotide polymorphisms (SNPs). SNPs are useful not only as markers for human genetic studies because of their high density, but also because they make it easy to perform large-scale genotyping using high-throughput methods. Monitoring SNPs may help gene hunters to trace sequences associated with susceptibility to common diseases. A large number of SNPs are deposited in the public database, dbSNP at the U. S. National Center for Biotechnology Information. We validated 525 candidate SNPs by DNA sequencing of samples from Japanese individuals, and a total of 143 SNPs (27%) were identified. In Japan, the JSNP project is underway and many SNPs have been identified. In the near future, the genotyping of SNPs will identify the susceptible genes of common diseases.
    Download PDF (546K)
  • Katsunobu Takenaka, Noboru Sakai, Akio Koizumi
    Type: Article
    2003 Volume 12 Issue 3 Pages 161-165
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    The role of genetics in cerebrovascular disorders such as subarachnoid hemorrhage, cerebral infarction, moyamoya disease or cerebral hemorrhage, is complex and paradoxical. Although the heritability of these diseases is relatively minor, some genetic varients significantly modify the incidence of these disorders. The molecular genetic factors involved in cerebrovasculr disorders were reviewed.
    Download PDF (702K)
  • UCAS Japan Study Group
    Type: Article
    2003 Volume 12 Issue 3 Pages 166-172
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    An unruptured cerebral aneurysm study in Japan (UCAS Japan) is being conducted to clarify the natural course and treatment risks of unruptured cerebral aneurysms (UCA), and build national data bank. This is a prospective cohort study and the enrolled patients are cases with newly diagnosed UCA after January. 1, 2001. Data of all patients with UCA, either treated or observed, is stored in the head-quarter computer through internet registration. All cases are scheduled to have a periodic follow-up at 3 months, 12 months and 36 months after the diagnosis. Registered data includes patient's demographics, neurological status, past and family history, and aneurysmal characteristics. During the last 17 months, we had 2,979 new patients (3,667 aneurysms) with UCA registered from 385 institutions. So far, there is a difference in registry status between geographic locations in Japan. Male-female ratio was 1 : 2 and median age of patients was 63-year-old. Size of aneurysm ranged from 3〜45 mm (median 5 mm). The most frequent reason for imaging, which leaded to diagnosis of UCA, were ill-defined symptoms such as headache or dizziness. Multiple aneurysms was found in 18% of cases and 96% of aneurysms were saccular ones. At the first registration, craniotomy was indicated in 35% and endovascular treatment in 4% of cases. A three months follow-up was reported in 2,327 cases and a 12 months report in 579 cases. Treatment was performed in 943 cases with 1,074 aneurysms. Detailed protocol for this study can be reviewed at internet homepage https://endai.umin.ac.jp/islet/ucasj/. We are planning to call for further patient enrollment and conform a reliable data source to direct future management of UCA.
    Download PDF (1259K)
  • Yuichi Murayama, Masaki Ebara, Satoshi Tateshima, Gary R. Duckwiler, F ...
    Type: Article
    2003 Volume 12 Issue 3 Pages 173-178
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    We evaluate our clinical experience of embolization of cerebral aneurysms using Guglielmi detachable coil (GDC) technology and new direction of endovascular aneurysm therapy. Since 1990, 741 patients harboring 835 aneurysms were treated with GDC embolization at UCLA Medical Center. Immediate angiographic complete occlusion rate and long-term recanalization rate were significantly related with size of the dome and neck of the aneurysm. Overall incidence of delayed rupture was 1.4% and the rate was improved in recent 5 years (0.6%). Nine out of 11 delayed ruptures happened to large or giant aneurysms. The clinical outcomes of patients treated with GDC system have improved in the recent 5 years. However, aneurysm recanalization is still a major limitation of current GDC therapy. Utilization of tissue engineering technology and flow dynamic modification may improve current anatomical outcome.
    Download PDF (1505K)
  • Shigeri Fujimoto, Tooru Inoue, Masahiro Kamouchi, Ryu Matsuo, Tsuyoshi ...
    Type: Article
    2003 Volume 12 Issue 3 Pages 179-184
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Purpose : It has been suggested that intracranial aneurysms could be observed using transcranial color-coded duplex sonography (TCDS). We investigated the sensitivity of TCDS studies for detecting unruptured aneurysms both with and without an echo contrast agent. Methods : We studied 39 patients (44 aneurysms) who were diagnosed as having unruptured intracranial aneurysms by cerebral angiography (36 patients) or MRA (3 patients). We performed TCDS both with and without echo contrast agents in all patients. In 7 patients who underwent endovascular treatment for unruptured intracranial aneurysms, enhanced TCDS studies were done both before and after the treatment. Results : Because of an insufficient transtemporal bone window, intracranial cerebral arteries were not visible with TCDS in 3 patients, despite enhancement by echo contrast agents. Among the 36 patients (38 aneurysms) whose intracranial cerebral arteries could be evaluated by TCDS, 13 cerebral aneurysms were detected (34%) without the aid at echo contrast agents. After echo contrast agents were administered, 9 additional aneurysms were observed by TCDS studies and the sensitivity of the test resulted in 58%. The sensitivity of enhanced TCDS for detecting cerebral aneurysms in the internal carotid artery, middle cerebral artery, anterior cerebral artery or anterior communicating artery, and basilar artery was 46%, 80%, 17%, and 67%, respectively. The frequency of anterior communicating artery, and basilar artery was 46%, 80%, 17%, and 67%, respectively. The frequency of larger aneurysms detection (>5mm) was significantly higher (78%) than that of smaller ones (<5mm ; 40%). In all the patients who underwent endovascular treatment, cerebral aneurysms that had been observed by enhanced TCDS were not detected after the treatment. Conclusions : TCDS may be suitable for the detection as well as follow-up study of intracranial aneurysms. The sensitivity of this noninvasive study is drastically improved by contrast agents.
    Download PDF (1121K)
  • Hiromu Hadeishi, Akifumi Suzuki, Nobuyuki Yasui, Junta Moroi, Toshirou ...
    Type: Article
    2003 Volume 12 Issue 3 Pages 185-190
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Objective : To evaluate the effects of mild hypothermia for patients with poor-grade subarachnoid hemorrhage (SAH). Methods : Sixty-one (31%) of 197 patients had poor-grade SAH (WFNS Grade 4 & 5), and 6 of these patients were treated with mild hypothermia for 48 hours following aneurysm clipping. Results : The prognosis of 6 patients according to Glasgow outcome scale is as follows : moderate disability, 1 ; severe disability, 2 ; vegetative state, 3. Conclusion : Hypothermia is not a safe and effective therapy for poor-grade SAH patients because of the severe neurological condition and cardiac abnormalities associated with SAH.
    Download PDF (1177K)
  • Yoshimasa Mori, Tatsuya Kobayashi, Yoshihisa Kida
    Type: Article
    2003 Volume 12 Issue 3 Pages 191-195
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    A case of cerebral cysticercosis is reported in a 22-year-old female who presented with seizure originating from the right hand. Computed tomography (CT) revealed a ring-enhance lesion with a high-density dot at the center in the left motor cortex. Magnetic resonance images (MRI) also showed ring-enhancement. The location of the motor strip containing the lesion was identified by preoperative functional MRI and intraoperative somatosensory-evoked potential recording. Intraoperative ultrasound study from the surface of the motor strip clearly demonstrated location of the lesion. A round smooth-surface cyst containing a decayed parasite was easily removed through a minimal cortical incision. The specimen disclosed characteristic cysticercus features. Postoperative examinations for screening of other visceral organs including X-rays of the extremities, abdominal CT, and serum immunological assay showed no abnormal findings. MRI taken 1 month after the surgical resection showed a disappearance of the local enhancement. Retrospectively, it was thought that cyst degeneration and inflammatory reaction following the death of the parasite had caused seizures as an initial symptom in this patient.
    Download PDF (1408K)
  • Shun-ichi Yoshikai, Kimiaki Hashiguchi, Nobuhiro Hata
    Type: Article
    2003 Volume 12 Issue 3 Pages 196-198
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    We designed a new device for performing successful ventricular taps through the frontal region, including Kocher's point. We assembled a socket from a socket-wrench and 2 alminium nut revets. These tools are popular, inexpensive and easily obtainable in do-it-yourself shops. This device helps in the insertion of the tap needle perpendicular to the skull surface, aiming at the Foramen of Monroe.
    Download PDF (855K)
  • Type: Appendix
    2003 Volume 12 Issue 3 Pages 199-
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Download PDF (73K)
  • Type: Appendix
    2003 Volume 12 Issue 3 Pages 200-
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Download PDF (404K)
  • Type: Appendix
    2003 Volume 12 Issue 3 Pages 201-
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Download PDF (99K)
  • Type: Appendix
    2003 Volume 12 Issue 3 Pages 202-203
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Download PDF (102K)
  • Type: Appendix
    2003 Volume 12 Issue 3 Pages 204-205
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Download PDF (200K)
  • Type: Appendix
    2003 Volume 12 Issue 3 Pages 206-
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Download PDF (65K)
  • Type: Appendix
    2003 Volume 12 Issue 3 Pages 207-210
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Download PDF (396K)
  • Type: Appendix
    2003 Volume 12 Issue 3 Pages 211-
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Download PDF (118K)
  • Type: Appendix
    2003 Volume 12 Issue 3 Pages 211-
    Published: March 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Download PDF (118K)
feedback
Top