Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
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Volume 30, Issue 4
Displaying 1-10 of 10 articles from this issue
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  • Immunohistochemical Localization of Prostaglandin F2α in Reperfused Gerbil Brain
    Tadayoshi NAKAGOMI, Tomio SASAKI, Hisayuki OGAWA, Makoto NOGUCHI, Isam ...
    1990 Volume 30 Issue 4 Pages 223-228
    Published: 1990
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.30.223
    JOURNAL FREE ACCESS
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    Immunohistochemical localization of prostaglandin (PG) F2α synthesized during recirculation following experimental forebrain ischemia was studied in Mongolian gerbils. The bilateral carotid arteries were clamped for 5 minutes, and the brains were frozen in situ after 5 minutes of recirculation. Shamoperated gerbils not subjected to arterial occlusion served as controls. Cryostat sections containing dorsal hippocampus 10μm in thickness were incubated in rabbit anti-PGF2α serum and stained with avidin-biotin-peroxidase complex after fixation in carbodi-imide and Zamboni's solution. In specimens from control animals, blood vessels were faintly stained with anti-PGF2α serum, while neurons and glial cells were less intensely stained or unstained. Specimens from reperfused gerbils demonstrated strongly positive staining for PGF2α in blood vessels, neurons (especially hippocampal pyramidal neurons), and glial cells. Staining for PGF2α in the reperfused animals was substantially diminished by pretreatment with indomethacin (10 mg/kg, i.p.). The results indicate that recirculation after forebrain ischemia results in an increase in PGF2α in neurons, glial cells, and blood vessels.
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  • Histopathology of Cystic Cavities in the Cerebral White Matter of HTX Rats with Inherited Hydrocephalus
    Yasuji YOSHIDA, Goyo KOYA, Kouki TAMAYAMA, Toshiro KUMANISHI, Satoshi ...
    1990 Volume 30 Issue 4 Pages 229-233
    Published: 1990
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.30.229
    JOURNAL FREE ACCESS
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    To investigate the mechanism of cystic cavity formation in the cerebral white matter of the HTX rat, a strain with inherited hydrocephalus, the authors carried out a histopathological study of the brain in pups from birth to postnatal day (P) 26. Cystic cavities were formed in the cerebral white matter on the lateral side of the basal ganglia of all HTX rats with moderate to severe ventricular dilatation and, additionally, in the white matter beneath the paramedian cortex in advanced cases at P 10-26. In the initial stage of cyst formation, disarrangement of the ependymal cell layer and spongy alteration of the white matter took place in pups between P 1 and P7. The ependymal disarrangement involved disruption and flattening of the ependymal cells, which were often devoid of microvilli, cilia and intercellular junctional complexes. The spongy state was due to expansion of the extracellular space and multiple microcyst formation with fluid accumulation in the early stage, and large cystic cavities in the advanced stage. The cerebrospinal fluid (CSF) in the ventricle communicated with the fluid in the cystic cavities via the disarranged ependymal cell layer. The ependymal damage was more prominent at the lateral wall of the posterior horn than at the anterior horn of the lateral ventricles. These cavities were demarcated by reactive glial cells in the advanced stage. However, the cavities enlarged in accordance with progressive dilatation of the lateral ventricles during postnatal development. These findings indicate that the initial change responsible for cyst formation is induced by infusion of CSF from the ventricle to the developing white matter as interstitial edema via the disarranged ependymal cell laver, subsequently forming large cystic cavities in the white matter.
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  • Spinal and Muscle Motor Evoked Potentials Following Magnetic Stimulation in Cats
    Minoru FUJIKI, Mitsuo ISONO, Shigeaki HORI
    1990 Volume 30 Issue 4 Pages 234-241
    Published: 1990
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.30.234
    JOURNAL FREE ACCESS
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    Motor evoked potentials (MEP) from transcranial magnetic stimulation were successfully recorded from the spinal cord and gastrocnemius muscle in cats. The spinal MEP consisted of four negative peaks, N 1 through N4, and subsequent small, multiphasic waves. The conduction velocity calculated from N1 corresponded to that of the nonpyramidal cerebellar evoked potential. After ablation of the pyramidal tract at various levels, N1 through N3 persisted, whereas N4 disappeared. The muscle MEP showed the same latency as that of MEP obtained by direct cortical electrical stimulation and disappeared after similar ablation. These findings suggest that the first three peaks of the spinal MEP are responses of the nonpyramidal cerebellospinal pathways and that the fourth peak of the spinal MEP and the muscle MEP are pyramidal tract responses. Spinal and muscle MEP from magnetic stimulation may be valuable in the qualitative evaluation of the function of the pyramidal and nonpyramidal pathways.
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  • Liposomes as Carriers of Cisplatin into the Central Nervous System
    —Experiments with 9L Gliomas in Rats—
    Shobu SHIBATA, Akira OCHI, Kazuo MORI
    1990 Volume 30 Issue 4 Pages 242-245
    Published: 1990
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.30.242
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    The anticancer agent cis-diamminedichloroplatinum (cisplatin) has several disadvantages, including extreme nephrotoxity, rapid binding to plasma proteins, and poor penetration of the central nervous system. In this study liposomes, which can cross the blood-brain barrier, were investigated for their potential in delivering therapeutic agents to brain tumors. Liposomes prepared from egg phosphatidylcholine and cholesterol in a 3 : 1 molar ratio were divided into 1-ml aliquots and either labeled with 14C or treated with horseradish peroxidase (HRP). The preparations were administered via the carotid artery to rats bearing 9L glioma. Radioactive uptake by brain tumor and normal tissues was measured with a liquid scintillation counter. The presence of HRP-containing liposomes in capillary endothelium and brain tumor cells was demonstrated by light and electron microscopic histochemical techniques. Thirty minutes after injection of 14C-labeled liposomes, radioactive uptake was higher in the spleen than in normal brain, brain tumor, liver, and kidney. Also uptake was greater in brain tumor and lower in kidney than that of cisplatin given alone. Light microscopy showed HRPcontaining liposomes in brain tumor tissue 30 minutes after injection. On electron microscopy, liposomes were found to be regularly distributed in surface invaginations and vesicles of capillary endothelial cells. They were also observed within tumor cells. These results indicate that liposomes can penetrate the blood-brain barrier and hold promise as drug carriers in the treatment of brain tumors with cisplatin.
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  • Magnetic Resonance Imaging of Chiari Malformations
    Masami YAMANAKA, Tohru UOZUMI, Katsuaki SAKODA, Satoshi KUWABARA, Taka ...
    1990 Volume 30 Issue 4 Pages 246-250
    Published: 1990
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.30.246
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    The authors describe the features of magnetic resonance (MR) images of Chiari type I and II malformations and present four illustrative cases. Downward displacement of the posterior fossa was more pronounced with type II than type I. A variety of intracranial anomalies were associated with the Chiari type II malformation, whereas type I was mainly associated with syringomyelia and craniovertebral changes. MR imaging is useful in the diagnosis of intracranial anomalies and those situated at the craniovertebral junction, including Chiari malformations.
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  • The Natural Course of Growth Hormone-secreting Pituitary Adenomas after Surgery Alone
    —Clinical Significance of the Growth Hormone Response to Thyrotropin-releasing Hormone and Luteinizing Hormone-releasing Hormone—
    Kazutoshi MUKADA
    1990 Volume 30 Issue 4 Pages 251-257
    Published: 1990
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.30.251
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    The clinical significance of abnormal growth hormone (GH) secretion in response to thyrotropinreleasing hormone (TRH) and luteinizing hormone-releasing hormone (LHRH) was studied in 52 patients with acromegaly due to GH secreting pituitary adenomas treated by trans-sphenoidal microsurgery. The mean period of postoperative follow-up was 4.1 years. In 27 of the 36 patients who had abnormal GH responses to TRH or LHRH before surgery, basal GH levels normalized and abnormal GH responses disappeared immediately after surgery. Among the remaining nine patients, four had normal basal GH levels with abnormal GH responses and five showed persistently abnormal basal GH levels as well as abnormal GH responses. Recurrence requiring retreatment was not observed during follow-up in any of the 31 patients with normal postoperative basal GH levels, regardless of the GH response to TRH or LHRH. All five patients with abnormal basal GH and abnormal GH responses required additional treatment.
    Among the patients who underwent long-term postoperative TRH and LHRH testing, abnormal GH responses reappeared in three of 19 whose abnormal responses had disappeared immediately after surgery. The abnormal response disappeared spontaneously in two of three patients who had abnormal responses immediately after surgery. In four patients with both abnormal GH responses and abnormal basal GH levels immediately after surgery, abnormal GH responses persisted throughout the follow-up period. In addition, the abnormal GH responses appeared in two of 14 patients who had been nonresponsive before surgery.
    These results indicate that the postoperative GH response to TRH or to LHRH was not significantly related to the outcome. Therefore, additional or prophylactic treatment should not be administered solely on the basis of the persistence of abnormal GH response. The most reliable predictor of longterm outcome appears to be the basal GH level immediately after surgery.
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  • Cauda Equina Neurinoma Associated with Normal Pressure Hydrocephalus
    —Case Report—
    Kenki NISHIDA, Shin UEDA, Keizou MATSUMOTO, Kazumasa KUSAKA, Renichi T ...
    1990 Volume 30 Issue 4 Pages 258-262
    Published: 1990
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.30.258
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    A 45-year-old male was hospitalized because of gait disturbance, urinary incontinence, and memory disturbance. A computed tomographic (CT) scan revealed dilatation of the cerebral ventricles, and a metrizamide CT scan showed reflux into all ventricles. Cerebrospinal fluid obtained at the time of metrizamide CT was highly xanthochromic. Myelograms demonstrated a tumor between the inferior portion of the fifth lumbar vertebra and that of the second sacral vertebra. After removal of a spinal tumor involving nerve fibers at the cauda equina, his symptoms disappeared and the spinal fluid protein normalized. Three months after surgery, a CT scan revealed reduction of cerebral ventricular size. There are 10 reported cases of spinal tumors resulting in normal pressure hydrocephalus. All these and present cases involved protein in the spinal fluid, which might have been the cause of the hydrocephalus.
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  • Intracranial Chondrosarcoma
    —Case Report—
    Tadao MIYAMORI, Hidetaka MIZUKOSHI, Kiyotoshi YAMANO, Nobutatsu TAKAYA ...
    1990 Volume 30 Issue 4 Pages 263-267
    Published: 1990
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.30.263
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    The authors report the case of a 54-year-old male who was found to have a large intracranial chondrosarcoma at the site from which chondromas had been partially removed twice, 6 and 10 years previously. On the third admission, the second through tenth and the twelfth cranial nerves on the right side were involved. Computed tomographic scans showed a large mass in the right middle and posterior fossae and the right ethmoid sinus. Angiography demonstrated an extradural mass in the right middle fossa. The tumor in the middle and posterior fossae was subtotally removed, and second, third, and eighth cranial nerve function improved postoperatively. Histological examination of tumor specimens showed active proliferation of poorly differentiated cartilagenous cells, suggestive of sarcomatous transformation of the pre-existing chondroma. It is emphasized that chondromas should be removed as completely as possible and that patients must be followed carefully after surgery.
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  • Coexistence of Intracranial Meningioma and Primary Malignant Lymphoma
    —Case Report—
    Toshihiko KUROIWA, Tomio OHTA, Hitoshi KOBATA, Hiromasa YAMAMOTO, Naos ...
    1990 Volume 30 Issue 4 Pages 268-271
    Published: 1990
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.30.268
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    The authors present a case of multiple primary intracranial tumors of different cell types. A 62-yearold female presented with symptoms suggestive of an intracranial mass lesion. Computed tomographic scans revealed two lesions, one in the right temporal lobe and one in the posterior fossa. Both tumors were approached in one operation. The right temporal tumor was diagnosed as primary malignant lymphoma, and the right posterior fossa tumor as meningioma. Phacomatosis was ruled out as a possible etiology. Multiple primary intracranial tumors of different cell types are rare, and this is the first report of coexistent intracranial meningioma and malignant lymphoma.
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  • Multiple Cerebral and Pulmonary Arteriovenous Malformations in Association with Brain and Subcutaneous Abscesses: A Possible Variant of Hereditary Hemorrhagic Telangiectasia
    —Case Report—
    Tetsuro KAWAGUCHI, Shigekiyo FUJITA, Hiroshi YAMADA, Yoshimitsu NISHID ...
    1990 Volume 30 Issue 4 Pages 272-276
    Published: 1990
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.30.272
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    The authors present a case in which multiple cerebral and pulmonary arteriovenous malformations (AVMs), a brain abscess, and a recurrent subcutaneous abscess were found concurrently in a 52-yearold male. He was admitted to our hospital for evaluation of a subcutaneous abscess in the right nuchal area and a right occipital AVM that had been detected at another hospital. Of his eight siblings, three had died of cerebrovascular disease (one in childhood and two as young adults), one had died of unknown causes in childhood, one had been hemiplegic since infancy, one had recently undergone removal of a pulmonary AVM, one was killed in World War II at the age of 24 years, and the remaining sibling was healthy. He had had surgery for a right occipital brain abscess three years prior to this admission. A general examination revealed no abnormalities other than the painful right nuchal mass. Neurological evaluation disclosed left homonymous hemianopsia, which was probably a result of his previous surgery for the right occipital brain abscess. Cerebral angiography showed AVMs in the right parietal (2 × 2 cm), right occipital (1.5 × 1.5 cm), and right cerebellar areas (1 × 1 cm). Digital subtraction angiography of the lung revealed multiple bilateral AVMs. The cerebral and pulmonary AVMs were removed in a two-stage operation. Although this case did not correspond precisely to the triad of hereditary hemorrhagic telangiectasia (HHT), the authors consider it to be related to HHT, since that syndrome is often complicated by multiple cerebral and pulmonary AVMs.
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