Cytophotometric DNA determination was performed on 8 glioblastomas, 4 astrocytomas, 2 oligodendrogliomas, and 4 meningiomas. Tumor cells were separated from a paraffin section and stained for DNA using the acriflavine-Feulgen nuclear reaction. Nonspecific dye-binding was blocked by azocarmin G staining. All the specimens were postirradiated to eliminate primary fluorescence and to stabilize the specific nuclear fluorescence.
There were two major differences between benign and malignant gliomas. There were more cells in the synthetic phase in the malignant series than in the benign tumors, and polyploid cells were frequently seen in the malignant series, but not in the benign series such as the oligodendrogliomas or astrocytomas. All glial tumors, benign or malignant, had stem lines deviating higher than the normal diploid value. On the other hand, meningiomas had a diploid stem line. The deviated stem line in glial tumors may be related to some malignant transformation which occasionally develops in these tumors.

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The prolactin (PRL) production and ultrastructure of two human pituitary adenomas subjected to routine fixation and embedding for transmission electron microscopy were studied by a consecutive semithin-thin section method.The method allowed highly specific immunostaining for PRL on Epon embedded semithin sections and excellent preservation of ultrastructure on the adjacent thin sections.
Immunostaining for PRL by the unlabeled peroxidase-antiperoxidase method on semithin sections after removal of the Epon well delineated the region of immunoreactivity, which corresponded both to the Golgi areas and to the distribution of secretory granules. The cytoplasm of most cells was not diffusely immunostained. Electron microscopy of the adjacent section revealed that the Golgi membranes were highly developed, that scant number of small secretory granules measuring about 160 nm in diameter were scattered in the Golgi areas and along the plasma membrane, and that the so-called misplaced exocytosis (pinching-off of secretory granules to the intercellular space of adenoma cells) existed in most PRL-positive cells. This method confirmed the direct ultrastructural characterization of PRL producing adenoma cells and their difference from non-neoplastic human pituitary PRL cells.

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A brain tumor model was produced by intracerebral inoculation of 10⁴ syngeneic malignant glioma cells induced with 20-methylcholanthrene into the right basal ganglia of C57BL/6 mice. Mean survival days of this model was 22.8 ± 3.1 days. Brain tumors were visible on Day, 12 after tumor inoculation and comprized 37 percent of the brain weight by Day 22.
The results were as follows. (1) Body weight decreased gradually from Day 15 after tumor inoculation. Spleen and thymus weight, and the number of white blood cells and lymphocytes were reduced from Day 17. Mild splenomegaly was observed on Day 12. (2) Lymphocyte proliferative responses to phytohemagglutinin (PHA) of spleen cells from tumor-bearing mice were impaired from Day 12 and suppressed remarkably on Day 22. When serum from tumor-bearing mice was added to lymphocyte culture medium, blastogenesis of normal spleen cells was also impaired from Day 12 and remarkably suppressed on Day 22. (3) Natural cytotoxic activities of spleen cells and brain mononuclear cells from normal mice against malignant glioma cells in a 15 hr ⁵¹Cr release assay were recognized. Cytotoxic activities of spleen cells and brain mononuclear cells from tumor-bearing mice in the same assay were enhanced mildly on Day 12 and recognized by Day 22. (4) Natural cytotoxic cells were observed in the adherent cell fraction of brain mononuclear cells, and in both the adherent and nonadherent cell fractions of spleen cells.
It is suggested that changes of cell-mediated immunity appeared at a relatively early stage in tumorbearing mice, although weight loss of organs, leukopenia, and lymphopenia were observed at the terminal stage. Nonspecific activity of lymphocytes was apparently suppressed with the growth of the tumor, as demonstrated by the appearance of serum blocking factor and lymphopenia. Natural cytotoxicity mediated in part by macrophages was maintained even in the terminal stage.

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Digital fluoroscopic angiography (DFA) is a recently developed non-invasive intravenous angiography which has become possible through real-time digital subtraction of X-ray transmission data from an image intensifier and television fluoroscopic system. Prototype units were developed and installed. The output signal of the image intensifier-television camera system was digitized by an analog-digital converter. The digital information, 512×512 pixels and 9 bits deep, was fed into the image processing assembly after logarithmic amplification, where 2-8 frames were added and subtracted from the mask images for the final digital images. Up to 32 serial digital images could be stored in real time in the frame memories, while additional images were transfered to other recording units as necessary.
Fifty-five examinations were performed on 49 patients with various clinical symptoms referable to the central nervous system. Diagnostic information was obtained in 26 of the 55 examinations (47.3%), which included brain tumors, aneurysms, and atherosclerotic diseases in the neck. Examinations of “fair” quality were obtained 19 times (34.5%), most being intracranial arterial occlusive diseases. No information was obtained in 10 examinations (18.2%), mostly due to technical failures or misregistration artifacts.
Although spatial resolution of DFA is inferior to conventional angiography, this technique will replace it in certain conditions such as: 1) screening and postoperative follow-up of cervical diseases; 2) visualization of carotid arteries in contemplated transsphenoidal hypophysectomy; 3) diagnosis of large tumors or vascular tumors; 4) visualization of faint tumor stains; 5) diagnosis of sinus occlusions; 6) screening of vascular lesions such as subarachnoid hemorrhage and megadolichobasilar artery; and 7) patency of STA-MCA anastomosis.
Future development of DFA should be directed towards improvement of spatial resolution and removal of misregistration artifacts.

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Diagnosis of posttraumatic subdural low density areas in computerized tomography (CT) has been quite controversial. Laboratory and in vivo CT analysis using the ACTA 0200FS were performed on 19 chronic subdural hematomas and five subdural hygromas.
CT densities of the hematomas and of the ventricular CSF were obtained through regions of interest from preoperative plain CT scans. In six hematomas, both the supernatant and precipitant parts were separately sampled and the corresponding regions of interest were placed accordingly on the CT image. In these 25 hematoma samples, red blood cells (RBC), hematocrit, and hemoglobin (Hgb) varied greatly, though, these values correlated well with the CT densities. Plasma protein content was fairly constant with an average of 7.1±0.8 g/dl. Iron content was comparatively high, but still at levels negligible for CT density. There were four hematoma samples with RBC of less than 20×10⁴ μl or Hgb of less than 2.0 g/dl. Their CT values ranged between 18 and 23 H.U., which were considered close to the in vivo serum level CT density. Five hygroma fluid showed no RBC and very little protein content of less than 0.4 g/dl. CT density ranged between -2 and 13 H.U.. One hygroma was so thin that placement of the region of interest was difficult. The edge effect of the skull was experimentally studied using a phantom skull filled with water. This revealed a remarkable overshoot of the CT values within ten pixels from the inner wall of the skull. Visual observation of the original CT pictures revealed four low density hematomas and seven mixed density ones. When compared to the density of the ventricular cavity, all of the low density hematomas and the supernatant part of the mixed density ones were clearly higher in density. All five hygromas appeared CSF dense or lower. Thus, visual observation offered clear distinction between hematoma and hygroma.
In conclusion, because of the edge effect by the skull, thin subdural fluids could not be diagnosed by CT alone. Thick subdural fluids could be differentiated as either hematoma or hygroma by their CT densities. Subdural hematomas had in vivo CT densities of at least serum level or approximately 20 H.U., while subdural hygromas had densities close to CSF. These characteristics were best appreciated by visual observation of the CT scan films.

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The authors developed a balloon catheter system for cerebral endovascular navigation.
The balloon is made from medical-grade silicone. Its outer diameter is 0.85 mm and its length is from 2.5 to 7.5 mm. It has a metal marker, either a silver pellet or a small stainless steel ball, to verify the position of the balloon under fluoroscopic control. There are two types of balloons—detachable and non-detachable. The catheter is made from polyamide with an outer diameter of 0.63 mm and of length from 40 to 50 cm. The introducer system consists of three parts; an introducer sheath of 15 gauge (inner diameter) Teflon tube, a stop cock and an introducer. The introducer is Y shaped, and has a blood reflux blocker and a side port for irrigation. To insert the introducer sheath into an arterial lumen percutaneously, a tip-bent 16 gauge Teflon needle is used coaxially. Release of the detachable balloon is effected by pulling off the catheter. Polymerizing silicone which contains fine silver powder for fluoroscopic recognition of the position and size of the balloon is used to fill the detachable balloon to prevent its deflation after detachment.

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Clinical applications of a newly developed balloon catheter system were described.
Twenty-two procedures were performed in 19 patients; ten arteriovenous malformations (AVM), two meningiomas, two traumatic dural arteriovenous fistulas, one traumatic internal carotid-cavernous sinus fistula (TICCSF), one choroid plexus angioma, one cerebral basal ganglionic hemorrhage, and two cases with early venous filling shown by angiography. Their age ranged from 14 to 74 years. Selective or superselective angiography was performed in all of the cases, except in two with narrow and strongly curved carotid siphons. The balloon could be introduced into an artery of 1.5 mm in diameter on angiography. In two cases of AVM (Grade III and IV after Luessenhop), electroencephalography and regional cerebral blood flow were studied during temporary occlusion of the AVM main feeders in order to determine the operability. Based on these studies, the Grade III AVM was totally removed with success. The Grade IV AVM was treated with a detachable balloon alone. One case of TICCSF was successfully treated with a balloon. One complication, rupture of an artery due to overinflation of the balloon, was encountered in this series, but the patient was salvaged by urgent craniotomy.
The balloon catheter technique for cerebral endovascular navigation seems beneficial in neurosurgical and neuroradiological fields.

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Remarkable eosinophilic infiltration of the hematoma membrane, observed not infrequently around sinusoidal vessels, has not been well documented.
Histological analysis of the membrane obtained from 57 patients was performed and the findings were classified into 5 groups according to histological maturity and clinical stage. Eosinophils were most conspicuous in membrane which had attained a certain thickness and had completed the sinusoidal pattern of the vessels. It was considered that eosinophils were closely related to the membrane's histological maturity, indicating healing. Eosinophilic infiltration was found in 30% of male patients, whereas all of the female patients showed marked eosinophilic infiltration of the membrane. Significantly, the number of female patients was much smaller. In male patients, the degree of eosinophilic infiltration was related to the estrogen level.
An experimental work was undertaken to produce hematoma membrane in the subcutaneous tissue of the guinea pig, and eosinophilic infiltration of the membrane was examined in relation to estrogen administration and the animal's sex. The results suggested a significant relationship between the membrane eosinophilia and estrogen level, as well as to the sex. It was postulated that eosinophilic infiltration of the chronic subdural hematoma membrane was a manifestation of healing, as in chronic inflammatory granulation, and that it was closely related to the estrogen level as evidenced by the predominate occurence of chronic subdural hematoma in males.

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Three cases of acute epidural hematoma which developed on the opposite side during decompressive surgery for traumatic intracranial hematomas, such as, acute subdural hematoma, brain contusion or acute epidural hematoma, are presented.
Each case had a skull fracture or a diastasis of the cranial suture contralateral to the decompressive craniotomy, which might have injured the dural artery. During or immediately after decompressive operations, sudden bulging of the brain was unexpectedly encountered. It was suspected that bleeding of the injured dural artery ensued from the abrupt release of the mass effect caused by the intracranial hematoma.
Since deviation and distortion of the brain stem would be more rapid and more intense under such circumstances, operative evacuation of the contralateral epidural hematoma should be urgently carried out.

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Midline, or intraventricular, oligodendroglioma seems to be very rare; one such case was reported. The patient was a 35-year-old male, admitted in April 1982 with complaints of nausea, headache, and double vision. He had no objective neurological deficit. Plain craniogram and craniotomogram showed abnormal calcification around the 3rd ventricle. CT revealed the calcified mass lesion at the foramen of Monro. A cyst formation was recognized in the anterior horns of the lateral ventricles. Operation was performed through the right frontal transventricular approach and the solid tumor mass and the cyst walls were removed. Pathohistological diagnosis was oligodendroglioma accompanied partially by astrocytoma. Biochemical analysis of the cyst contents revealed similar values of compositions to those of astrocytomas. Adjuvant irradiation therapy of 5, 000 rads was performed. The patient had no neurological deficit and is now working 5 months after the operation.
Characteristics of midline and/or intraventricular oligodendroglioma were described, reviewing the literature.

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The patient, a 32-year-old female, had suffered from convulsive seizures since the age of 18. In August 1968 she had a right hemiconvulsion followed by right hemiparesis. Ligation of the left common carotid artery and external decompression were performed at a local hospital. Neurological examination in October 1970 showed right hemiparesis including the face. Cerebral angiography revealed a left parietal AVM which was fed by the left pericallosal, callosomarginal, central, and precentral arteries. No aneurysm was demonstrated. In March 1980, she was admitted because of an episode of unconsciousness and aggravation of right hemiparesis. CT scan showed a left parietal AVM and right parietal porencephalia communicating with the right lateral ventricle. Right cerebral angiography also revealed the left parietal AVM, unchanged since 1970, and an aneurysm at the bifurcation of right internal carotid artery.
Not only the presence of the AVM, but also some hemodynamic alterations caused by interruption of the contralateral carotid flow with consequent increase in ipsilateral cerebral blood flow might have been responsible for the neoformation of the aneurysm in this case. Such an association of porencephalia with AVM and an aneurysm has not yet been reported.

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