巻号一覧
40 巻, 4 号
選択された号の論文の7件中1～7を表示しています
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Ing K Ho, Sue Yu1991 年 40 巻 4 号 p. 183-186
発行日: 1991年
公開日: 2009/03/27
ジャーナル フリーCentral nervous system depressants, e.g. barbiturates, alcohol and benzodiazepines, have a wide spectrum of activity in humans and animals. Evidence accumulated suggests that some of the pharmacological actions exerted by these agents may be mediated through GABA system by mimicking GABAergic transmission. This proceeding briefly summarizes the evidence presented in our previous review (Yu S and Ho Ik: Alcohol 7: 261, 1990) as to how the GABA system plays a part in the barbiturate actions and the development of tolerance to and physical dependence on barbiturates. The comparisons of the effects of alcohol, barbiturates and benzodiazepines at different steps of GABA synapse are also discussed. Furthermore, the results which have been reported in the literature are inconsistent. This may be due to differences in (a) animal models used; (b) brain regions used; (c) protocols (dose, duration, form and route of administration, etc.) used in treating animals and/or (d) techniques (pharmacological, biochemical, physiological, etc.) used.抄録全体を表示PDF形式でダウンロード (331K) -
Laligam N Sekhar, Chandra N Sen, Giuseppe Lanzino, Spiros Pomonis1991 年 40 巻 4 号 p. 187-193
発行日: 1991年
公開日: 2009/03/27
ジャーナル フリーDuring the last 7 years, approximately 170 neoplasms, and 35 vascular lesions involving the cavernous sinus were treated by the first two authors. During the treatment of such lesions, the direct vein graft reconstruction of the internal carotid artery from the petrous to the supraclinoid or infraclinoid ICA was performed in 23 patients. Graft occlusion occurred in 3 patients and in one of these, it was successfully salvaged by placing a long venous graft from the extracranial ICA to the M3 segment of the middle cerebral artery. The latter 3 patients were neurologically normal. One patient with significant athero-sclerotic disease suffered the dissection of the distal internal carotid artery with the graft being patent. The dissection presumably occurred because of the separation of the intima and the media and an improper suturing technique. This patient eventually died. Two patients with severely compromised collateral circulation suffered minor strokes due to the temporary occlssion of the ICA. This has been avoided in the more recent patients by the adoption of brain protection techniques such as moderate hypothermia, induced hypertension, and barbiturate coma. Low dose heparin therapy during grafting and high dose intravenous steroids prior to the grafting also appear to be beneficial. Direct vein graft reconstruction of the intracavernous carotid artery is a valuable tool during the management of cavernous sinus lesions. The advantages and disadvantages of this technique as well as the pros and cons of other revascularization techniques will be discussed. During microsurgical removal of cavernous sinus lesions, the cranial nerves III-VI were reconstructed by direct resuture or by nerve grafting in 16 patients. In the majority of these patients, recovery of cranial nerve function was observed, which was very encouraging. Cranial nerve reconstruction should be attempted whenever the nerves are sacrificed in a patient who has a fair to excellent eye function preoperatively or whenever inadvertent injury to such nerves occurs during cavernous sinus surgery.抄録全体を表示PDF形式でダウンロード (3607K) -
Joseph T Ferrucci1991 年 40 巻 4 号 p. 194-205
発行日: 1991年
公開日: 2009/03/27
ジャーナル フリーWith the increasing availability of curative surgical techniques for primary and secondary hepatic neoplasms, the tasks for clinical imaging of liver cancer suspects have become more exacting. Detection of tumor, differential diagnosis of individual nodules, and mapping the anatomic extensions of malignant disease are now routinely required. Related and unrelated liver substrate abnormalities such as cavernous hemangioma and focal fatty deposits are often discovered in liver cancer suspects and must be differentiated from metastatic deposits. Moreover, modern imaging methods frquently display tiny sub-centimeter nodules which often prove difficult to adequately characterize (micrometastases vs other). The most sensitive imaging techniques are CT after arterial portography and intraoperative ultrasound, but because of their invasiveness, these are reserved exclusively for staging. For primary screening MR imaging is increasingly preferred over CT because of its superiority in discriminating hemangiomas and cysts from metastases without the need for iodinated contrast material.抄録全体を表示PDF形式でダウンロード (17410K) -
Joseph T Ferrucci1991 年 40 巻 4 号 p. 206-214
発行日: 1991年
公開日: 2009/03/27
ジャーナル フリーSuperparamagnetic iron oxide (SPIO) particles are a potent new class of MR contrast agents affording improved detection of hepatic and splenic neoplasms. In this report we reivew the development of this agent through preclinical studies and early clinical results at Massachusetts General Hospital during a 5 year investigation. SPIO particles are sequestered by normal reticuloendothelial system (RES) phagocytic Kupffer cells but are not retained in tumor tissue. Consequently, there is a five fold increase in T2 relaxation between normal RES tissue and tumor with a comparable advantage in quantitative signal to noise ratio, contrast to noise ratio and lesion detectibility in the liver and spleen at MR imaging. Increased lesion conspicuity can be exploited to decrease threshold size for lesion detection to <3mm. Clinically beneficial effects occur with a variety of mildly T2-weighted spin-echo pulse sequences; gradient-echo techniques show even greater benefit after administration of SPIO. Metabolically, pharmaceutical grade preparations are biodegradable and bioavailable, being rapidly turned over into body iron stores and incorporated into erythrocyte hemoglobin. Early dose escalation clinical trials have identified a probable clinical dose range of 10-20μmol Fe/kg body weight. SPIO compounds evaluated to date are still investi-gational in the United States. Newer commercial formulations currently being evaluated may extend clinical safety margins.抄録全体を表示PDF形式でダウンロード (16274K) -
Ivo P Janecka, Chandra N Sen, Laligam N Sekhar, Daniel W Nuss1991 年 40 巻 4 号 p. 215-220
発行日: 1991年
公開日: 2009/03/27
ジャーナル フリーThe complexity of cranial base surgery is a reflection of skull base anatomy as well as technical demands for maximum visualization, control of essential structures, adequate tumor resection and/or reconstruction. Facial translocation has been developed as a new approach to cranial base. It consists of extensive modular facial disassembly which includes displacement of composite facial soft tissue flap and craniofacial skeleton. It creates surgical field with epicenter in nasopharynx and infratemporal fossa allowing easy expansion into sphenoid bone and cranial fossae as well as craniovertebral junction. Recon-struction is functional and esthetic. Versatility of this approach permits expansion into neighboring craniofacial regions. During a 14-month period (11/88-12/89), this facial translocation approach to cranial base was utilized in 20 patients. The approach provided excellent visualization of the involved cranial base permitting oncological as well as reconstructive procedures. All patients healed primarily. Two patients were reoperated on at 4 and 6 months postoperatively; one for a bone graft infection and the other for tumor recurrence. The facial translocation approach offers favorable exposure of the critical zones of cranial base resulting in increased surgical safety and benefit of cranial base surgery.抄録全体を表示PDF形式でダウンロード (5455K) -
水野 雅文1991 年 40 巻 4 号 p. 221-234
発行日: 1991年
公開日: 2009/03/27
ジャーナル フリーNeuropsychological characteristics of right (non-dominant) hemisphere damage were investigated by attention tests, a concept formation and change test, and a self-evaluation task on a total of 126 brain damaged subjects (66 right hemisphere damaged and 60 left hemisphere damaged). Common response patterns specific to subjects with right hemisphere lesions were studied by three attention tests (audio-motor method, cancellation test, and set dependent activity test). Those with right hemisphere lesions showed a large number of responses (excessive response) and low proportion of correct responses (low hit rate, qualitative deterioration of response), indicating a tendency toward randomness. A concept formation and change test, the new modified Wisconsin Card Sorting Test, was performed to investigate the handling of higher concepts. Only the frequency of difficulty of maintaining set (DMS) was significantly higher in those with right hemisphere lesions. Problems concerning attention and attitude toward the tests, i.e. random attitude were thought to exist in those with right hemisphere damage. Self-evaluation and corrective ability were studied on the self-evaluation task using the audio-motor method. Feedback was less effective in subjects with right hemisphere lesions, and they tended to underestimate their errors. These results were consistent with personality characteristics such as the lack of a serious attitude and poor volition for treatment, which are frequently observed in clinical settings. The above are considered basic, common characteristics of right hemisphere damage. These findings may partially explain the phenomenological characteristics of right hemisphere damage described by various investigators.抄録全体を表示PDF形式でダウンロード (1018K) -
岡島 康友, 千野 直一, 才藤 栄一, 木村 彰男1991 年 40 巻 4 号 p. 235-239
発行日: 1991年
公開日: 2009/03/27
ジャーナル フリーSomatosensory vertex potentials (SVPs), consisting of N1, P1, and N2, are obtained widely on the scalp between 100 and 500 msec of latency. To analyze interactions between SVPs evoked by right and left finger stimulation, the sum of N1-P1 or P1-N2 amplitude values in response to stimulation of independent right and left fingers were compared with those evoked by simultaneous stimulation of both fingers. SVPs were recorded at Cz, C3, and C4 in 12 healthy subjects. Three patterns of finger stimulation, namely, right, left, and both right and left, were randomly chosen until 80 responses had been obtained and averaged for each pattern of stimulation. Simultaneous bilateral responses were larger than either right or left finger SVPs. However, they were consistently smaller than summed SVPs from right and left fingers. These results suggest that the SVP generators be different between right and left. But they may be closely inter-related through occlusive connections.抄録全体を表示PDF形式でダウンロード (361K)
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