Neurologia medico-chirurgica

Characteristics of an Established Human Glioma Cell Line, KNS-42

Iwao TAKESHITA, Tosuke TAKAKI, Masaharu KURAMITSU, Susumu NAGASAKA, Ta ...

1987 Volume 27 Issue 7 Pages 581-587
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.581

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We established a human glioma cell line derived from a malignant glioma and evaluated it by immunochemical techniques and antibodies to astroglial (glial fibrillary acidic protein: GFAP, S-100 protein), oligodendroglial (myelin basic protein, galactocerebroside), neuronal (neuron-specific enolase: NSE, neurofilament triplet proteins), and mesenchymal (vimentin, fibronectin) antigens. The cell line was epithelial in sparse culture and glial in dense culture. GFAP was expressed by most cells in sparse culture and primarily by overlying cells in dense culture. The amount of GFAP depended on the cell density and ranged from 530 to 990 ng/mg of protein. The cells contained much more vimentin than GFAP. Neurofilament proteins, S-100 protein, myelin basic protein, and galactocerebroside were undetectable. The cells synthesized a small amount of fibronectin and released it into the medium. The amount of NSE was unrelated to cell density, ranged from 13 to 19 ng/mg of protein, and was present in greater quantity in cells cultured in a medium containing 1 μl/ml of sodium lactate.
We conclude that KNS-42 is a permanent astrocytic glioma cell line; it expresses GFAP, NSE, vimentin, and fibronectin, and is morphologically and functionally dependent on its environment.

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Photodynamic Therapy of Experimental 9L Gliosarcoma

—Cytocidal Effect and Pathohistological Analysis—

Yasuhiro OKUDA, Shizuo OI, Satoshi MATSUMOTO

1987 Volume 27 Issue 7 Pages 588-593
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.588

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The effect of photodynamic therapy (PDT) with a hematoporphyrin derivative (HPD) on tumor cell survival was studied in 9L gliosarcoma rat tumor systems, both in vitro and in vivo. In vitro, the cytocidal effect was dependent on HPD concentration and length of exposure to light. The cell death rate was 100% with 30 minutes of light exposure following 6 hours of culturing in a medium containing 50 μg/ml of HPD. Male Fischer 344 rats were inoculated with 9L gliosarcoma cells to produce frontoparietal surface brain tumors. An argon laser with a wave length of 514.5 nm was used as the light source. The rats were divided into several groups and received either no treatment (controls) or one of various combinations of treatment: HPD without light irradiation, placebo plus light irradiation, or HPD plus light irradiation. No degenerative changes were observed histopathologically in the control rats or those not given HPD. Necrotic foci were prominent in the groups given HPD, regardless of whether the light was delivered directly to the tumor surface or to the skin just above the tumor. The necrotic change of the tumor cells comprised nuclear pyknosis, homogenation of chromatin, and vascular collapse associated with extravasation, venous congestion, hyalinization of endothelium, and massive hemorrhage. These results demonstrate the cytocidal effect of PDT on experimental glioma and suggest that this approach will have important clinical application in neurooncology.

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Effects of Thalamic Sensory Relay Nucleus Stimulation on Trigeminal Subnucleus Caudalis Neurons in the Cat

—Nociceptive Activity in Response to Tooth Pulp Stimulation—

Takashi TSUBOKAWA, Yoichi KATAYAMA, Teruyasu HIRAYAMA

1987 Volume 27 Issue 7 Pages 594-600
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.594

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We investigated the effects of electrical stimulation of the thalamic sensory relay nucleus (TSRN) on the nociceptive neural activity within the trigeminal subnucleus caudalis in the cat. We found that the nociceptive activity of the trigeminal subnucleus caudalis neurons in response to tooth pulp or facial skin stimulation was inhibited by both single-pulse and repetitive TSRN stimulation. However, the period of inhibition induced by single-pulse TSRN stimulation was clearly shorter than that induced by periaqueductal gray (PAG) or nucleus raphe magnus (NRM) stimulation. Furthermore, the nociceptive neurons inhibited by PAG stimulation were not always inhibited by TSRN stimulation. The opioid antagonist naloxone (2.0 mg/kg, i.v.) significantly antagonized the inhibition induced by PAG or NRM stimulation but failed to antagonize that produced by TSRN stimulation. These results are discussed in relation to the differences in clinical effects produced by TSRN and PAG stimulation.

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Effects of Thalamic Sensory Relay Nucleus Stimulation on Trigeminal Subnucleus Caudalis Neurons in the Cat

—Abnormal Bursting Hyperactivity after Trigeminal Rhizotomy—

Takashi TSUBOKAWA, Yoichi KATAYAMA, Teruyasu HIRAYAMA

1987 Volume 27 Issue 7 Pages 601-606
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.601

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We studied in the cat the effects of thalamic sensory relay nucleus (TSRN) stimulation on abnormal hyperactivity following trigeminal rhizotomy within the contralateral trigeminal subnucleus caudalis, a trigeminal equivalent of the dorsal horn. The animals were subjected to unilateral retrogasserian rhizotomy 2-6 weeks prior to the experiments. Following the rhizotomy, abnormal bursting and continuous nonbursting hyperactivities were recorded from laminae IV-V of the trigeminal subnucleus caudalis on the rhizotomized side. Some of these neurons responded to peripheral stimuli applied to rostral cervical dermatomes in a manner resembling the nociceptive, wide dynamic range (WDR) neurons of the intact side. However, periaqueductal gray (PAG) stimulation inhibited the hyperactive neurons on the rhizotomized side less frequently than the WDR neurons on the intact side. In contrast to PAG stimulation, TSRN stimulation inhibited the hyperactive neurons on the rhizotomized side as frequently as the WDR neurons on the intact side.
These results are apparently consistent with our clinical observation that neurogenic pain due to deafferentation can be relieved by TSRN stimulation but not by PAG stimulation. This in turn suggests that the pain relief obtained with TSRN stimulation may result at least in part from inhibition of the nociceptive activity or abnormal hyperactivity of dorsal horn neurons.

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Effects of Mannitol on Microcirculation during Temporary Occlusion of the Middle Cerebral Artery in Cats

Akira TANAKA, Masamichi TOMONAGA

1987 Volume 27 Issue 7 Pages 607-612
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.607

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Changes in microcirculation during and after 3 hours of middle cerebral artery (MCA) occlusion in cats were studied with the carbon black perfusion technique. The effect of mannitol on these changes was also studied. The impairment of carbon black filling extended to the entire MCA region when transient hypotension was induced during occlusion. The filling defect was reversed with restoration of blood flow following recirculation, but the animals deteriorated with subsequent elevation of epidural pressure. Preocclusional administration of mannitol protected the microcirculation during occlusion and prevented the development of acute brain swelling associated with reperfusion. On the other hand, postocclusional administration of mannitol had an adverse effect. The pathogenesis of dynamic microcirculatory changes in relation to the development of acute brain swelling and the mechanisms of both the beneficial and adverse effects of mannitol are discussed.

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Epidemiological and Clinical Aspects of Hereditary Cerebral Hemorrhage in Dutch Families

W. LUYENDIJK, G.Th.A.M. BOTS, M.Vegter-vander VLIS, L.N. WENT

1987 Volume 27 Issue 7 Pages 613-616
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.613

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Development of an Optimum Dosage Regimen for Pentobarbital in Patients with Severe Head Injury

Kazuyo NISHIHARA, Yukinao KOHDA, Haruhiko TSUTSUMI, Masaru SASAKI, Toh ...

1987 Volume 27 Issue 7 Pages 617-622
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.617

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We attempted to determine the optimum dosage regimen for pentobarbital (PTB) in patients with head injury by using the pharmacokinetic profile obtained by measuring the serum concentration over time after a single intravenous administration of PTB. The optimum loading dose of PTB (0-10 hours) was calculated at 125.2-250.4 mg/hour and the maintenance dose at 24.3-48.6 mg/hour. Therefore, we used loading and maintenance doses of 200 and 50 mg/hour, respectively. Eight of nine patients were intravenously infused for 10 hours at a constant rate with the loading dose of sodium PTB. They were then given the maintenance dose to sustain the optimal serum PTB concentration (15-30 μg/ml) for about 2 days. The serum PTB concentrations gradually decreased despite the constantrate infusion. In one patient of low body weight, however, the serum PTB concentration was as high as 40-55 μg/ml from 10 to 56 hours after the start of infusion, although the dosage was the same as that of the other patients. The elimination half-life of PTB after cessation of constant-rate infusion was 13.1 ± 2.9 hours, whereas following a single dose it was 39.5 ± 14.9 hours. These results indicate that PTB metabolism is accelerated with long-term infusion and that the dosage regimen we tested is useful for only 2 days in patients weighing 50-75 kg.

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Evaluation of Treatment for Childhood Medulloblastoma, with Special Reference to Combination Therapy with Interferon and Radiation

Kenro SUNAMI, Akimasa UOZUMI, Akio SEMBA, Akira YAMAURA, Hiroyasu MAKI ...

1987 Volume 27 Issue 7 Pages 623-627
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.623

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Thirteen children, aged 6 months to 14 years, underwent surgery for medulloblastoma at Chiba University Hospital from 1971 to 1985. The nine patients treated prior to 1980 received postoperative irradiation therapy with or without chemotherapy. Since 1980, four patients have been treated postoperatively with interferon (IFN) plus radiation therapy. The IFN was administered intramuscularly once or twice a week throughout the period of radiation therapy.
Six of the nine patients not treated with IFN died within 1 year. In this group, the 3 and 5-year survival rates were 33% and 22%, respectively. One of the four patients treated with IFN died within 10 months of surgery, and another is disabled. The remaining two patients are in good condition. The 3and 5-year survival rates in the IFN group were both 75% as of the last follow-up in January of 1986.

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Computed Tomography of Jugular Foramen Neurinomas -

—Report of Four Cases—

Akira UCHINO, Kanehiro HASUO, Masashi FUKUI, Toshio MATSUSHIMA, Shozo ...

1987 Volume 27 Issue 7 Pages 628-632
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.628

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Four jugular foramen neurinomas studied by computed tomography and verified by surgery originated from the glossopharyngeal nerve. Characteristic CT findings were a mixed low and isodense extraaxial mass with ring-like enhancement in the cerebellopontine angle; enlargement of the jugular foramen, with smooth margins and a normal internal auditory canal; and an extracranial soft tissue mass extending through the jugular foramen.

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Cerebrovascular Anomalies associated with Primitive Trigeminal Artery

—Report of Three Cases—

Susumu WAKAI, Yasuichi UEDA, Masakatsu NAGAI

1987 Volume 27 Issue 7 Pages 633-636
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.633

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Three cases of primitive trigeminal artery (PTA), one associated with arteriovenous malformation and two with cerebral aneurysm, are described. All three patients presented with intracranial hemorrhage. One patient had multiple vascular anomalies, including bilateral PTAs, an unpaired pericallosal artery with a large aneurysm on its bifurcation, and a lobar hematoma. The clinical significance of PTA in patients with intracranial hemorrhage is discussed.

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Spontaneous Cerebrospinal Fluid Rhinorrhea Indirectly Caused by Brain Tumor

—Report of Two Cases and Review of the Literature—

Toshihiko KUBOTA, Masahiro KITABAYASHI, Minoru HAYASHI, Tetsumori YAMA ...

1987 Volume 27 Issue 7 Pages 637-642
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.637

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Two cases of nontraumatic cerebrospinal fluid rhinorrhea were presumed to be an indirect manifestation of brain tumor. One patient had a parietal convexity meningioma and the other a cerebellopontine angle neurinoma. Following excision of the tumors these patients spontaneously developed cerebrospinal fluid rhinorrhea, which disappeared after the repair of fistulas at the base of the frontal fossa. In such cases the rhinorrhea may be caused by fragility of certain structures as a consequence of long-standing increased intracranial pressure due to brain tumor.

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Acute Subdural Hematoma of Arterial Origin following Ventriculoperitoneal Shunting

—Report of Two Cases—

Norihiko TAMAKI, Tohru SUYAMA, Takayuki SHIRAKUNI, Satoshi MATSUMOTO

1987 Volume 27 Issue 7 Pages 643-646
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.643

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Two patients developed acute subdural hematomas of arterial origin following ventriculoperitoneal shunting for normal-pressure hydrocephalus. The causative factors appeared to be low intracranial pressure, a consequence of the shunting, and rupture of small arterial branches due to movement of the brain within the intradural cavity. These cases are described and the importance of this rare complication is discussed.

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Contralateral Extra-axial Hematoma following Surgery for Head Injury

—Report of Two Cases—

Michio YABUMOTO, Kazuyoshi FUNAHASHI, Ichiro KAMEI, Seiji HAYASHI, Nor ...

1987 Volume 27 Issue 7 Pages 647-650
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.647

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Two patients developed acute, contralateral extra-axial (epidural and subdural) hematomas immediately after surgery for head trauma. One patient deteriorated rapidly following surgery. In the other case, brain swelling was noted intraoperatively following decompression. The specific pre-, intra-, and postoperative features that may indicate the formation of a contralateral hematoma are discussed.

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Acute Subdural Hematoma in Patients with Intractable Epilepsy

—Report of Two Cases—

Nobuhiko AOKI, Hiroshi MIZUTANI

1987 Volume 27 Issue 7 Pages 651-653
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.651

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When trauma occurs secondarily to a generalized seizure in patients with intractable epilepsy, even a simple subdural hematoma may be fatal if there is a delay in diagnosis. We encountered two such patients, both of whom suffered an acute, fatal subdural hematoma without cerebral contusion (simple subdural hematoma) as a result of falling during a generalized convulsion. In some cases, ophthalmoscopic examination is critically important in the early detection of simple subdural hematoma.

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Brain Metastasis of Hepatocellular Carcinoma presenting with Hemorrhage

—Case Report—

Shin-ichi OTSUKA, Taro FUKUMITSU, Toyoshiro YAMAMOTO, Hideshi KOMORI, ...

1987 Volume 27 Issue 7 Pages 654-657
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.654

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Only a few cases of hemorrhage from metastatic foci of hepatocellular carcinoma in the brain parenchyma have been reported in the literature. We encountered a 71-year-old male who presented with intracerebral hemorrhage from a metastatic hepatocellular carcinoma. The patient was admitted with sudden onset of left hemiparesis and died about 6 weeks after hospitalization. Precontrast computed tomography (CT) on admission showed a high-density area suggestive of intracerebral hematoma. Serial CT scans revealed a ring-like enhanced mass with increased brain edema in the same region. Autopsy disclosed intraparenchymal metastasis of hepatocellular carcinoma with intratumoral and intracerebral hematoma.

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Total Removal of an Intramedullary Meningioma of the Medulla Oblongata

—Case Report—

Saburo SAKAKI, Tamotsu OHSUGI, Takahiro CHAKI, Masahiro SHIRAISHI, Ken ...

1987 Volume 27 Issue 7 Pages 658-662
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.658

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A 12-year-old boy had central von Recklinghausen's neurofibromatosis with multiple intracranial meningiomas and bilateral acoustic neurinomas. One of the meningiomas was found in the parenchyma of the medulla oblongata and was successfully removed. To our knowledge, this is the first reported case of surgical removal of an intramedullary meningioma of the medulla oblongata. Details of the clinical, neuroradiological, and operative findings are described.

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Strokes in Systemic Lupus Erythematosus

—Case Report—

Michio YABUMOTO, Kunio NAKAI, Kazuyoshi FUNAHASHI, Norihiko KOMAI, Koh ...

1987 Volume 27 Issue 7 Pages 663-667
Published: 1987
Released on J-STAGE: September 21, 2006

DOIhttps://doi.org/10.2176/nmc.27.663

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A patient with systemic lupus erythematosus (SLE) suffered, in rapid sequence, subarachnoid hemorrhage, intracerebral hemorrhage, and cerebral infarction. Small, irregular-shaped aneurysms were present on the left anterior temporal and anterior choroidal arteries. During angiography, extravasation from the second portion of the left middle cerebral artery was recognized, and a subsequent CT scan showed a massive, hyperdense lesion in the temporal lobe. A fusiform aneurysm in the posterior communicating artery was examined histologically and proved to be affected by vasculitis. The patient died of occlusion of the right internal carotid artery. We present the clinical and pathological aspects of aneurysms in SLE patients and discuss their pathogenesis and clinical management.

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