Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
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Volume 26, Issue 12
Displaying 1-12 of 12 articles from this issue
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  • Enhancing Effect of Reserpine upon the Cytotoxicity of ACNU on ACNU-resistant Glioma Cells
    Tatsuo YOSHIDA, Keiji SHIMIZU, Yukitaka USHIO, Toru HAYAKAWA, Heitaro ...
    1986 Volume 26 Issue 12 Pages 925-930
    Published: December 15, 1986
    Released on J-STAGE: November 10, 2006
    DOIhttps://doi.org/10.2176/nmc.26.925
    JOURNAL FREE ACCESS
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    Reserpine has enhanced the cytotoxicity of 1 (4-amino-2-methyl-5-pyrimidinyl) methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride (ACNU) in both ACNU-resistant sublines of C6 and 9L glioma cells (C6/ACNU, 9L/ACNU) and could completely overcome ACNU resistance in vitro. When reserpine was added to the culture in the concentration of 10μpM, the concentrations of drug required for 50% inhibition of cell growth of ACNU for C6/ACNU and 9L/ACNU cells decreased to the level of those for C6 and 9L cells, respectively. Intracellular uptake and retention of ACNU in both ACNU-resistant cells increased when 20μM reserpine was added to the culture. It is suggested that the enhanced effect of cytotoxicity of ACNU in ACNU-resistant glioma cells is presumably due to the increase of intracellular concentration of ACNU through the inhibition of the efflux of intracellular ACNU from resistant cells.
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  • Mechanisms of Cellular Resistance to A CNU in Rat Brain Tumor Cell Line
    Toshimitsu AIDA, William J. BODELL
    1986 Volume 26 Issue 12 Pages 931-936
    Published: December 15, 1986
    Released on J-STAGE: November 10, 2006
    DOIhttps://doi.org/10.2176/nmc.26.931
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    9L cells and 9L-2 cells, cell lines derived from the in vivo 9L rat brain tumor model, were treated with 1 (4-amino-2-methyl-5-pyrimidinyl) methyl-3 (2-chloroethyl) -3-nitrosourea hydrochloride (ACNU) and the effect on cell survival, the induction of sister chromatid exchange (SCE), and the formation of DNA interstrand cross-links were compared. Compared to 9L cells, 9L-2 cells were 10-fold more resistant to ACNU and cross-resistant to 1, 3-bis (2-chloroethyl) -1-nitrosourea (BCNU). In contrast to results obtained with chloroethyl nitrosourea, 9L-2 cells were 2-fold more sensitive to nitrogen mustard (HN2) and the amount of cell kill in both 9L and 9L-2 cells treated with cisdiamminedichloroplatinum (II) (cis-Pt) was almost the same. The number of SCEs induced by the treatment of ACNU, BCNU, HN2 and cis-Pt in both cell lines showed a good correlation with cytotoxicity. Compared to 9L cells, 9L-2 cells had 50% fewer DNA interstrand cross-links caused by ACNU and the removals of DNA interstrand cross-links were the same for 9L and 9L-2 cells. These results suggest that DNA interstrand cross-linking may cause cell death, and that it induces the SCEs in cells treated with ACNU and that cellular resistance to chloroethylnitrosoureas, including ACNU, is specific, and that the mechanisms of resistance to ACNU are different from the mechanisms of resistance to other DNA cross-linking agents.
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  • DNA Content and Sensitivity to ACNU of Human Glioma Cell Lines
    Kiyoshi ONDA, Ryuichi TANAKA, Naoto MURAKAMI, Yasuo SUZUKI, Kazunori Y ...
    1986 Volume 26 Issue 12 Pages 937-944
    Published: December 15, 1986
    Released on J-STAGE: November 10, 2006
    DOIhttps://doi.org/10.2176/nmc.26.937
    JOURNAL FREE ACCESS
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    The cytotoxic action of 1-(4-amino-2-methyl-5-pyrimidinyl) methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride (ACNU) is considered to be mainly the result of alkylation of deoxyribonucleic acid (DNA). If ACNU acts chiefly on DNA, sensitivity to ACNU might have a close relation to nuclear DNA content. In this study, the relative DNA content in three established human glioma cell lines, NP-1, NP-2, and NP-3, was investigated by flow cytometry and correlated to their sensitivity to ACNU. For flow cytometric analysis, the cells were fixed in 75% ethanol, treated with ribonuclease and pepsin, and stained with ethidium bromide. Human peripheral mononuclear cells were used as an internal standard for determining the DNA index. Sensitivity to ACNU was evaluated by the cell growth curve and perturbed DNA histograms.
    DNA indices were 1.8 for NP-1 and 1.0 for NP-3. A DNA histogram of NP-2 showed three peaks. Therefore two clonal cell lines, clone A and clone B, were segregated from NP-2; their DNA indices were 1.4 and 2.4, respectively. The growth-inhibitory effect of ACNU was dose-dependent but varied greatly with each cell line. Analysis of the alteration of the DNA histograms after exposure to various doses of ACNU showed common features in all cell lines; the more the cell growth was inhibited by treatment with a higher dosage of ACNU, the more the cells accumulated in S and G2M phases and the less the pattern of the DNA histogram returned to that of the control with the lapse of time. Based on this principle, the histograms of each cell line were compared and the sensitivities were determined together with the result of the growth curve. The sequence was NP-2 clone A, NP-2 clone B, NP-1, NP-3 in the order of high to low sensitivity to ACNU.
    Flow cytometric analysis revealed some interesting characteristics of these cell lines. It was suggested that sensitivity to ACNU of human glioma cells might increase with nuclear DNA content deviating from the normal amount to a higher one. The difference in sensitivity to ACNU between NP-2 clone A and clone B, which were representative of different populations in terms of DNA content, showed the heterogeneity and complexity of human malignant gliomas.
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  • Immunohistochemical Demonstration of Neuron-specific Enolase in Meningiomas and in Normal Meningocytes
    Hidetoshi IKEDA, Ryuichi KATAKURA, Hiroshi NIIZUMA, Shinsuke SUZUKI, M ...
    1986 Volume 26 Issue 12 Pages 945-950
    Published: December 15, 1986
    Released on J-STAGE: November 10, 2006
    DOIhttps://doi.org/10.2176/nmc.26.945
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    An immunohistochemical study by peroxidase-antiperoxidase method for neuron-specific enolase (NSE) was performed on 23 cases of meningioma (meningothelial: 10, transitional: 8, fibroblastic: 5), 3 cases of normal cranial meninx and 2 cases of choroid plexus. Meningocytes were found in the normal arachnoid membranes and choroid plexuses. These meningocytes showed positive immunoperoxidase staining for NSE. On the other hand, dural fibroblasts showed negative staining for NSE. As for meningiomas, strongly positive immunoperoxidase stainings for NSE were seen in the meningothelial type. Immunoperoxidase stainings for NSE were weak in the fibroblastic type. Psammoma bodies were found not only in the meningiomas but also in the normal tissues of the arachnoid membranes and choroid plexuses. These results and consistent with the idea that meningiomas, including meningothelial, transitional and fibroblastic types, are derived from meningocytes and not from dural fibroblasts.
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  • Amyloid Deposits in Pituitary Adenoma
    Immunohistochemical Study
    Tetsuji ORITA, Tadaaki YOKOTA, Fumiya UCHINO, Kunihiko HARADA, Hideo A ...
    1986 Volume 26 Issue 12 Pages 951-955
    Published: December 15, 1986
    Released on J-STAGE: November 10, 2006
    DOIhttps://doi.org/10.2176/nmc.26.951
    JOURNAL FREE ACCESS
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    Amyloid deposits in three functioning human pituitary adenomas (two prolactin (PRL) -secreting and one growth hormone (GH)-secreting) were studied by immunohistochemical techniques. Histological diagnosis was mixed pituitary adenoma in all cases. The amyloid deposits of all cases were negative for GH, AA protein, Aκ, Aλ, and γ-trace, but the amyloid deposits of two cases were strongly positive for PRL. Most cells surrounding amyloid were negative for all antibodies but a few cells were positive for PRL. From these findings, it was strongly suggested that the amyloid in pituitary adenoma is a kind of AE protein and of hormonal origin. Serum hormonal level, radiation, and bromocriptine therapies might not contribute to amyloid deposits.
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  • Anticoagulant Therapy for Symptomatic Cerebral Vasospasm
    Yasuaki YOSHIDA, Tatsuo HAYASHI, Masashi AMO, Asamitsu AHAGON, Koji KU ...
    1986 Volume 26 Issue 12 Pages 956-963
    Published: December 15, 1986
    Released on J-STAGE: November 10, 2006
    DOIhttps://doi.org/10.2176/nmc.26.956
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    Sequential changes in coagulation activity in 45 patients with ruptured intracranial aneurysms, among whom 36 were treated with various kinds of anticoagulant agents, were measured in their acute stages. Parameters employed were prothrombin time (PT), active partial thromboplastin time (APTT), fibrinogen (FBG), platelet count (PLT), antithrombin III (AT III), plasminogen (PLG), factor V, VII, VIII, and modified thromboelastogram (Urokinase resistance test: UKRT). The values of the parameters in the most hypercoagulative stage in each patient exceeded their normal range in the following ratios: PT (longer by 1 sec) in 39 of 45, PLT (less than 12×104/μl) in 16 of 42, factor V (more than 180% or less than 75%) 2 in 12, VII (more than 120% or less than 80%) in 7 of 13, VIII (more than 140% or less than 80%) in 13 of 13, and UKRT (longer than 40 min, or shorter than 20 min) in 27 of 28. The hypercoagulative tendency of 28 patients was estimated using the disseminated intravascular coagulation (DIC) score proposed by the authors. From these estimations, 23 of the 45 patients were found to be in a DIC or pre-DIC state, that is, in DIC tendency in the authors' category.
    The anticoagulant agents used were divided into three groups: 1) gabexate mesilate, chondroitin sulfate, albumin, low molecular dextran, 2) heparin, and 3) aspirin. As a rule, Group 1 agents were administered to the patients with mild symptoms, and to those with severe symptoms heparin was administered besides Group 1 agents. Recently, aspirin has not been used because of the difficulty in controlling its strength of anticoagulant activity. Anticoagulant therapies were given to the non-surgical patients when they were moribund. Of 20 early surgery patients who underwent anticoagulant therapy, no patients died owing to cerebral vasospasm, though 7 of them died of other causes: preoperatively accompanying large hematoma in 3, cardiac dysfunction, troubled operation, hemorrhagic infarction in the cerebellum, and renal dysfunction, in one each. From these results, anticoagulant therapy for symptomatic vasospasm is considered to be effective.
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  • NMR-CT of Cerebrovascular Diseases using Pulse Sequence of Carr-Purcell-Meiboom-Gill Method
    Satoru FUJIWARA, Takashi YOSHIMOTO, Hiroyuki KINOUCHI, Jiro SUZUKI, Sh ...
    1986 Volume 26 Issue 12 Pages 964-972
    Published: December 15, 1986
    Released on J-STAGE: November 10, 2006
    DOIhttps://doi.org/10.2176/nmc.26.964
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    Nuclear magnetic resonance-computed tomography (NMR-CT) findings of 114 cases of cerebrovascular diseases are reported. The NMR-CT used for this study was a product of Bruker Company in West Germany. It has a 0. 15 tesla resistive magnet, using the pulse sequence of the Carr-Purcell-Meiboom-Gill (CPMG) method. Intracerebral hematoma showing iso or low density on X-ray CT could be detected by NMR-CT in the subacute stage and even in the chronic stage. T1 and T2 relaxation times (T1, T2) of hematoma showed prolongation as time passed from about 2 weeks after the onset. NMR-CT detected small or lacunar infarctic lesions at the basal ganglia, the brain stem or the posterior fossa. Prolongations of T1 and T2 in infarctic foci were more marked than in hematomas. In two cases of transient ischemic attack, the responsible lesions were detected by NMR-CT, but no abnormality was found on X-ray CT at the same time. Moreover, as disappearance of the abnormal image and normalization of T1 and T2 in these foci were noted by followup NMR-CT after bypass surgery, it was suggested that these lesions were reversible and might be a critical low perfusion area, the so-called ischemic penumbra. NMR-CT findings in moyamoya disease were the same as those obtained by X-ray CT. However, slightly ischemic lesions might be detected by NMR-CT. Therefore, operative indications and effectiveness for ischemic moyamoya disease might be decided by NMR-CT. For arteriovenous malformations (AVMs), NMR-CT was an excellent diagnostic method because the extent of the lesions was easily recognized, and dilated vessels were depicted as low or no signal intensity areas without using contrast media. Three dimensional observation of brain tissues surrounding the AVM was possible by NMR-CT. These areas were depicted as T1 and T2 prolonged regions on calculated NMR images. This finding may indicate ischemic or necrotic changes due to the blood steal phenomena.
    1H-NMR-CT is very useful in diagnosing various cerebrovascular diseases since these pathological states have close relations to water metabolism in the brain. Moreover, the CPMG method may be the most diagnostic pulse sequence for clinical cases in the neurosurgical field.
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  • A Family with von Hippel-Lindau's Disease associated with Multiple Spinal Hemangioblastomas
    Nobuhiko MARUOKA, Keizo YONEDA, Kazuo KINOSHITA, Yosuyoshi MAMIYA
    1986 Volume 26 Issue 12 Pages 973-978
    Published: December 15, 1986
    Released on J-STAGE: November 10, 2006
    DOIhttps://doi.org/10.2176/nmc.26.973
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    A family with von Hippel-Lindau's disease is reported. In this family four members were affected and three of the four had spinal hemangioblastomas. In two of them the spinal hemangioblastomas were multiple. Case 1, 22-year-old man with hemangioblastomas in the medulla oblongata and right cerebellum. Case 2, 45-year-old woman, mother of Case 1 with hemangioblastoma in the spinal cord at the level of Th3-4, retinal hemangioma, and ovarian cyst. Case 3, 26-year-old woman, niece of Case 2 with hemangioblastomas in the cerebellum and spinal cord at the levels of C3-4, Th8, and Th9, retinal hemangioma, liver cyst, and pancreatic cyst. Case 4, 29-year-old man, brother of Case 3 with hemangioblastomas in the medulla oblongata and spinal cord at the levels of Thl, Th2-3, and Th3-4, retinal hemangioma, liver tumor, and epididymis tumor. All medullary and spinal hemangioblastomas but one were totally removed. In Case 4 a hemangioblastoma at the level of Th2-3, which was thought to be in the ventral aspect of the spinal cord, could not be identified during surgery.
    Spinal hemangioblastoma in von Hippel-Lindau's disease is rarely seen. Spinal angiography is useful for diagnosis but may not identify small hemangioblastomas. Removal of hemangioblastomas in the spinal cord can be done under operating microscope.
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  • Ganglioglioma causing Intracerebral Hemorrhage
    Case Report
    Kousaku TERADA, Kouichi UETSUHARA, Tetsuhiko ASAKURA, Tetsurou SHIMOZU ...
    1986 Volume 26 Issue 12 Pages 979-983
    Published: December 15, 1986
    Released on J-STAGE: November 10, 2006
    DOIhttps://doi.org/10.2176/nmc.26.979
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    A rare case of ganglioglioma associated with intracerebral and intraventricular hemorrhage is reported. A 55-year-old male, who suddenly developed headache, nausea, left hemiparesis, and left hemihypesthesia, was admitted. Plain skull X-ray showed a floccular calcification in the right parieto-occipital region. Computed tomography scan disclosed a calcified mass lesion, not enhanced by the contrast medium, in the right parieto-occipital region, and associated with intracerebral and intraventricular hemorrhages. A right carotid angiogram revealed an avascular mass. A right parieto-occipital craniotomy, subtotal removal of the tumor, and evacuation of the hematoma were performed. The calcified area of the tumor was removed piece by piece, and a reddish soft tumor, not calcified, was found, infiltrating the wall of the right lateral ventricle and intraventricular space. Histologically, the tumor was composed of mature ganglion cells and glial cells. In the calcified area of the tumor, thin-walled angiomatous vessels and calcification in the thick wall of the vessels were observed. The postoperative course was uneventful except for left homonymous hemianopsia. The clinical aspects of ganglioglioma and the relation between this tumor and intracerebral hemorrhage are discussed, reviewing the previously reported cases.
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  • Esthesioneuroblastoma
    Case Report
    Ken-ichiroh HIRAMATSU, Kitaro KAMADA, Shoji INUI, Kazuo OKUCHI, Hiroyu ...
    1986 Volume 26 Issue 12 Pages 984-988
    Published: December 15, 1986
    Released on J-STAGE: November 10, 2006
    DOIhttps://doi.org/10.2176/nmc.26.984
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    A case of esthesioneuroblastoma is reported. A 23-year-old male patient was admitted with a complaint of headache. A computerized tomography scan revealed a large high-density mass in the anterior cranial base, and the cystic component extended into the right frontal lobe. Cerebral angiography showed vascular blushing from the ophthalmic artery. Total removal of the tumor was performed successfully, followed by postoperative radiation therapy of 6, 000 rad. However, 5 months after surgery, it recurred as an intranasal tumor. After another two operations with following radiation therapy, the patient returned to social life with anosmia as the only neurological deficit.
    Esthesioneuroblastoma is a rare tumor that presents usually as a mass in the nasal cavity. Thirteen cases have been recorded so far in which the neoplasm manifested initially as an intracranial mass.
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  • Acoustic Neurinoma with Early Venous Drainage and Caput Medusae-like Vasculature on Angiogram
    Case Report
    Chikashi MARUKI, Masanori ITO, Atsushi TAJIMA, Kiyoshi SATO, Yutaka KU ...
    1986 Volume 26 Issue 12 Pages 989-992
    Published: December 15, 1986
    Released on J-STAGE: November 10, 2006
    DOIhttps://doi.org/10.2176/nmc.26.989
    JOURNAL FREE ACCESS
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    It has been considered that acoustic neurinomas are hypovascular tumors on angiogram. Recent angiographical analysis, however, revealed that some of them showed tumor stain, capsular stain, and even arteriovenous shunt. The problem with operation on the acoustic neurinoma with a peculiar vasculature on angiogram has not been discussed in previous reports. In this paper, the neuroradiological findings of a unique case are described, in conjunction with the operative problem. A case of huge acoustic neurinoma with early venous drainage and caput medusae-like vasculature on angiogram is presented. The patient was a 46-year-old woman suffering from dizziness and gait disturbance. On admission, she had bilateral choked disc, left fifth and seventh nerve palsy, and left cerebellar signs. The audiogram showed scale out on the left, carolic test and auditory brain stem response were nil on the left side. On computed tomography, a huge, heterogeneously enhanced mass was detected in the left cerebellopontine angle. Vertebral angiography revealed that the tumor was supplied by the anterior inferior cerebellar artery and ascending pharyngeal artery. Caput medusae-like vasculature was visualized in arterial and capillary phases, and abnormal draining veins were also opacified in these phases. They were considered to be an arteriovenous fistula. At operation, the abnormal vasculature looked like an arteriovenous malformation on the tumor capsule, which made the surgical procedure of dissecting the tumor from the pons extremely difficult.
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  • Orbital Roof Fracture presenting Exophthalmos and Disorder of Eye Movement
    Report of Two Cases
    Shigetaka ANEGAWA, Ryuichiro TORIGOE, Akihiko TAHARA, Toru SHIROUZU, H ...
    1986 Volume 26 Issue 12 Pages 993-997
    Published: December 15, 1986
    Released on J-STAGE: November 10, 2006
    DOIhttps://doi.org/10.2176/nmc.26.993
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    In two cases admitted with double vision and exophthalmos, computed tomography and skull radiograms revealed fractures of the superior third of the left orbital rim. Bone fragments were noticed in the upper lateral quadrant of the orbit. Reconstructive operations were performed in both cases. Shortly after the operation, the double vision and exophthalmos disappeared.
    Fractures of the orbita are infrequent. Among such fractures, blow out fractures which present enophthalmos are most frequently encountered. However, traumatic exophthalmos due to orbital fracture is quite rare. Its mechanism is the decrease of the orbital capacity secondary to the protrusion of bony fragments into the orbita.
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