Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 17pt2, Issue 5
Displaying 1-10 of 10 articles from this issue
  • —3 Acute Subdural Hematoma—
    HIROYASU MAKINO, MORIMASA KOHNO, YOSHITAKA NAKADA, YOSHIRO WATANABE
    1977 Volume 17pt2 Issue 5 Pages 375-382
    Published: 1977
    Released on J-STAGE: December 28, 2006
    JOURNAL FREE ACCESS
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  • KAZUO TABUCHI, AKIRA NISHIMOTO, WOLFF M. KIRSCH, JOHN J. VAN BUSKIRK
    1977 Volume 17pt2 Issue 5 Pages 383-390
    Published: 1977
    Released on J-STAGE: December 28, 2006
    JOURNAL FREE ACCESS
    Since 1971 several new papovaviruses have been found and isolated from humans, especially from the brains of patients suffering from progressive multifocal leucoencephalopathy(PML). These human papovaviruses (such as JC, BK, SV40-PML viruses), though antigenically dissimilar to papilloma or polyoma viruses, bear certain physicochemical similarities to simian virus 40 (SV40). The oncogenic potential in hamster of these human papovaviruses (JC, BK) has been reported, raising a suspicion that some human brain tumors may have a viral etiology. As virus-induced animal tumors display virus-specific common antigen(s) irrespective of tumor histology or site, our attention has been directed to the immunocytochemical screening of human brain tumors for the presence or absence of SV40-related T(tumor) antigen, because this protein is known to share common antigenic activity with T antigen(s) induced by human papovaviruses.
    At the time of writing this paper, 39 human brain tumors have been screened for SV40-related T antigen in vivo by immunoperoxidase technique using hamster anti-SV40 T antibody as well as normal hamster serum as a control. Two (one ependymoma, one choroid plexus papilloma) out of 39 cases examined displayed markedly positive staining in the nuclei of tumor cells with anti-SV40 T antiserum, but neither with normal hamster serum nor with anti-SV40 V (nucleocapsid antigen) antibody. An independent complement fixation assay of the nuclear extracts from one of the two positive tumors also confirmed the presence of the antigen which specifically reacted with hamster anti-SV40 T antiserum.
    There have been few systematic searches for papovavirus-related antigens in human neoplasms. However, in 1975 SV40-related T and U antigens have been observed in three cases of human meningioma cells by an immunofluorescence test. Since human cells are semipermissive for papovaviruses, these and our findings strongly suggest a viral etiology for some human brain tumors.
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  • SADAO NAKAJO, MASAO MURAKAMI, HIROSHI FUKAI, SADAAKI OKAMOTO, TERUO SH ...
    1977 Volume 17pt2 Issue 5 Pages 391-397
    Published: 1977
    Released on J-STAGE: December 28, 2006
    JOURNAL FREE ACCESS
    The authors describe a case of a primary brain tumor composed of both gliomatous and sarcomatous elements. Surgical specimen, six months preceding his death, shows anaplastic astrocytoma with moderate endothelial proliferation of the blood vessel. Huge, relatively circumscribed subcortical tumor extending to the epidural space is observed on cross section of the autopsy specimen. Epidural mass is composed of sarcomatous tumor and subcortical one reveals islands of sarcomatous tissue surrounding by gliomatous stroma. In deeper region of the brain, proliferation of astrocytes and vascular hyperplasia are noticed. This tumor may be considered analogous to the gliosarcoma, which is described by Feigin. The histogenesis of the mixed tumor is discussed with special reference to the gliosarcoma.
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  • KENICHIRO SUGITA, TETSURO MIZUTANI, YUICHIRO HAYASHI, YOSHIRO SUZUKI, ...
    1977 Volume 17pt2 Issue 5 Pages 399-404
    Published: 1977
    Released on J-STAGE: December 28, 2006
    JOURNAL FREE ACCESS
    During intracranial vascular surgery neurosurgeons experience that the tone of the vessel changes in relation to the systemic blood pressure through forceps held in their fingers. On the basis of such experiences we have designed forceps with a pair of strain gauges to measure local blood pressure of the intracranial arteries. Blood pressure of arteries larger than 0.8 mm in diameter can be measured by holding them directly with this forceps. This technique was utilized in cases of STA-MCA anastomosis, AVM and aneurysm operations. The degree of success of the vascular anastomosis could be demonstrated quantitatively by the difference in the pressure before and after the anastomosis procedure. In the operation of AVM, the rate of obliteration of the feeding arteries could be discerned by measurement of the pressure of the draining vessels at each step of the procedure. In the aneurysm operation, application of the strain gauge forceps helped detect the stenosis of the parent artery after clipping of ligation of a wide neck aneurysm.
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  • NOBUHITO NONAKA, IKUO KITANO, YASUHIKO MATSUKADO
    1977 Volume 17pt2 Issue 5 Pages 405-414
    Published: 1977
    Released on J-STAGE: December 28, 2006
    JOURNAL FREE ACCESS
    The purpose of this paper is to determine the change of sympathetic nervous functions after subarachnoid hemorrhage. The method used is an assay of dopamine-β-hydroxylase activity in serum, which is proportionally released to norepinephrine from sympathetic nerve end, and it is currently regarded as a parameter of sympathetic nervous function. DBH activity in cerebrospinal fluid was also estimated.
    The results obtained were as follows;
    1. After subarachnoid hemorrhage due to rupture of intracranial aneurysm, the function of sympathetic nervous system was hyperactive and gradually recovered to the normal level. Few days after operation of intracranial aneurysm the DBH activity increased again transiently, indicating temporary hyperactivity of the sympathetic nervous function.
    2. The patient with severe aggravation of clinical symptoms, which mostly resulted from cerebral angiospasm, showed marked fluctuating increase and decrease of serum DBH activity. The fluctuating change of DBH activity in serum indicates the instability of sympathetic nervous system, coincident with clinical disorders.
    3. DBH activity in cerebrospinal fluid showed no relation to cerebral angiospasm.
    It was suggested that these changes of sympathetic nervous system could result from vascular disturbance of hypothalamus after subarachnoid hemorrhage.
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  • —Possible Candidate and Operative Indication—
    MASAHIRO MIZUKAMI, HIROSHI KIN, MICHIHARU NISHIJIMA, GORO ARAKI, HIROS ...
    1977 Volume 17pt2 Issue 5 Pages 415-423
    Published: 1977
    Released on J-STAGE: December 28, 2006
    JOURNAL FREE ACCESS
    Extra-intracranial arterial anastomosis has been attempted in patients with transient ischemic attacks (TIA) or reversible neurological deficits (RIND) in order to prevent subsequent strokes.
    This study was undertaken to seek appropriate candidates for this procedure from the clinical and angiographic points of view.
    Sixty-four cases with carotid TIA' (s) and/or RIND' (s) were investigated by angiography. Of the sixty-four cases, thirty-four had TIA' (s) only, twenty had RIND' (s) with history of TIA' (s) and ten had RIND' (s) only.
    Severe stenosis (more than 50%) and/or occlusion was found in eleven cases. One case had extracranial carotid occlusion, eight cases had intracranial internal carotid or middle cerebral artery stenosis and two cases had both intracranial and extracranial severe stenosis and/or occlusion. Seven patients out of these eleven cases had experienced frequent TIA's and RIND's.
    Three cases out of fifty-seven cases, excluding seven operated cases developed completed stroke (2 cerebral infarction, 1 stroke) during the follow-up period from five months to three years (average, 19.2 months). Two patients developed cerebral infarction in the above mentioned seven cases, namely those cases that had experienced frequent TIA's and/or RIND's. Consequently, if the patient has frequent TIA's and/or RIND's and has severe lesions in the intracranial or both intra-extracranial arteries, there is high possibility of subsequent cerebral infarction. Thus, these seven cases may be possible candidates for the extra-intracranial arterial anastomosis, which means seven cases out of our sixty-four cases (11%).
    Extra-intracranial arterial anastomosis was performed in two cases out of these seven cases, because etiology was considered to be cerebral vascular insufficiency confirmed by regional blood flow (rCBF) study or suspected by angiography which showed only one stenotic vertebral artery supplying blood to the brain. These two cases are to date free from symptoms following the operation, during follow-up period of five months and one year respectively.
    Our data suggest that extra-intracranial arterial anastomosis may be beneficial in a small group of patients with TIA's or RIND's. As more operated cases and non-operated cases are accumulated, more will be known both about the selection of patients and the value of this operation.
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  • HIDEAKI NUKUI, TAKAO NAGAYA, SOHKICHI TANAKA, MOTOMASA KAWAKAMI, TERUT ...
    1977 Volume 17pt2 Issue 5 Pages 425-433
    Published: 1977
    Released on J-STAGE: December 28, 2006
    JOURNAL FREE ACCESS
    Dural arteriovenous malformation (dural AVM) of the posterior fossa is relatively rare and offers various problems concerning its pathophysiology and treatment. In this paper, these problems were discussed on the basis of our experiences with 5 cases and a review of the literature.
    In our cases, all patients complainted of tinnitus and that all noticed bruit on admission. Angiographically the AVM was fed by multiple arteries in all the cases and the sigmoid sinus was occluded in one case. Cerebral hymodynamics was examined by Greitz's method as well as Xe-133 clearance method and were found normal in each case. Operation was carried out on 2 cases. The feeders from the occipital artery were ligated extracranially and the AVM of the scalp was removed. In follow-up study (ranging from 9 months to 8 years and 5 months), tinnitus and bruit disappeared or decreased postoperatively in 2 cases and remained the same as on admission in the other 3 cases. Further signs or symptoms were not noticed.
    In dural AVM, clinical symptoms may occur as a result of several pathological conditions. Tinnitus and head bruit are caused by arterio-venous shunt itself and more serious neurological deficits are produced by disturbance of cerebral hemodynamics due to massive arteriovenous shunt and accompaning secondary changes such as occlusion of the affected sinus, increase of venous pressure and retrograde flow of the cortical veins. But cerebral hypoxia or ischemia must not be produced by arteriovenous shunt which is usually rather minor in dural AVM.
    As for treatment, many kinds of operation have been carried out. The most effective method has been the removal of dural AVM. However, the removal of AVM often presents extreme technical difficulties and may expose the patients to great hazard. Therefore, for aged patinets with only tinnitus or bruit, extracranial ligation of feeders should be tried first.
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  • —Mechanism of the Neural Tube Malformations Induced by Ethylnitrosourea Administration at the Stage of Embryogenesis—
    NORIHIKO TAMAKI, KATSUSHI TAOMOTO, KIYOSHI FUJIWARA, YOSHIYUKI OI, SAT ...
    1977 Volume 17pt2 Issue 5 Pages 435-445
    Published: 1977
    Released on J-STAGE: December 28, 2006
    JOURNAL FREE ACCESS
    The purpose of this paper is to study the mechanism and pathogenesis of neural tube malformations on the basis of experimental investigations by ethylnitrosourea (ENU) administration at various stages of embryogenesis. The method used here consisted of intraperitoneal injection of a single dose of ENU into a number of pregnant SD-JCL rats at various stages of the embryogenesis. Various doses of ENU were used. The dead and resorbed conceptuses were counted and all living features were examined by gross observation and by light and scanning electron microscopic study.
    The following results and conclusions were obtained. Various types of neural tube malformations could be induced by administration of a given dosage of ENU on the 9.5 days of gestation; anencephaly, exencephaly, encephalomeningocele, cranial meningocele, hydrocephalus, aplasia cutis congenita and Chiari malformation. These neural tube malformations were selectively produced when ENU was injected at specific stages of the embryogenesis. There was a stage specific susceptibility in producing neural tube malformations. The stage, when the exposure of ENU permitted selective production of neural tube malformations, was followed by a stage, when embryonal mortality was the highest. As for the matter of dosage of ENU given, smaller dosages permitted normal development, and larger dosages had embryotoxic effects. There was a teratogenic zone of dosage, a specific dosage for producing neural tube malformations.
    Neural tube malformations were induced when ENU was treated at the very early developmental stage of neural tube formation, namely at the embryonic stage of initial appearance and early development of the neural plate and groove. Light and scanning electron microscopic study suggested that the neural tube malformations may result from abnormal process of the matrix layer cells in early neural plate, which will lead to the disturbance of proliferation, migration and differentiation of the matrix layer cells.
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  • TAKASHI FUNAKOSHI, HIROMU YAMADA, NOBORU SAKAI, AKIRA HIROSE, AKIO OKU ...
    1977 Volume 17pt2 Issue 5 Pages 447-455
    Published: 1977
    Released on J-STAGE: December 28, 2006
    JOURNAL FREE ACCESS
    One of the frequent causes of shunt impairment following ventriculoperitoneal (V-P) shunt is known to be obstruction of the peritoneal catheter. Expecting prolonged patency of peritoneal catheter, we devised additional slits in the peritoneal catheter of an Ames-Dow-Corning set and have been applying it clinically for several years. The incidence rate of postoperative abdominal catheter obstructions was 10% in the cases where additional slits were formed and 29% in cases that the original Ames' catheter was used. The usefulness of this additional slit formation technique for the prolongation of postoperative shunt patency was thus evidenced. On the other hand, however, several patients, among those shunted with peritoneal catheters having additional slits, complained of symptoms such as headache, vertigo, nausea, vomiting, ataxic gait, etc., accompanied by marked CSF hypotension. Changes in intraventricular CSF pressure were measured in 18 (mainly adult) post-shunt cases, including those in which complaints of CSF hypotension were seen, in changing body position from recumbency to sitting erect. Intraventricular pressure, as observed 10 minutes after sitting erect, ranged between -140 and -385 (-259 on the average) mmH2O. This marked CSF hypotension was considered to be caused by CSF overdrainage due to the siphon effect (reported by Portnoy et al.) and to a reduced flow resistance in the catheter having additional slits. Clinical symptoms seemed to have appeared only in excessively hypotensive cases. For the purpose of preventing CSF overdrainage due to the siphon effect in the erect body posture, we devised an apparatus, antisiphon ball valve (ABV), to be installed in the abdominal wall. This apparatus was installed in 7 cases in which excessive CSF hypotension was observed after V-P shunt. Postural changes in intraventricular CSF pressure before and after installation of ABV were observed in these cases. In 5 of them, CSF hypotension was improved after ABV installation and in 3 of the 5 cases clinical symptoms also were alleviated or disappeared. In 2 further cases, ABV was installed at the time of primary V-P shunting and, in them, CSF hypotension symptoms did not appear. In the 2 cases in which ABV installation was ineffective, inappropriate placement of ABV was considered to be the probable causative factor. Further improvements in the property of ABV and in the technique of its installation are being sought.
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  • NAKAAKIRA TSUKAHARA
    1977 Volume 17pt2 Issue 5 Pages 457-462
    Published: 1977
    Released on J-STAGE: December 28, 2006
    JOURNAL FREE ACCESS
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