Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
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Volume 31, Issue 10
Displaying 1-10 of 10 articles from this issue
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  • Hemodynamic Study of Posterior Circulation Using Hydraulic Vascular Model
    —Critical Stenosis of the Vertebrobasilar Artery and Tolerance to Occlusion Therapy—
    Shiro NAGASAWA, Haruhiko KIKUCHI, Hirokazu OHTSUKI, Shinji NAGAYASU, K ...
    1991 Volume 31 Issue 10 Pages 617-622
    Published: 1991
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.31.617
    JOURNAL FREE ACCESS
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    A hydraulic vascular model with glass and silicone tubes of the intracranial portion of the vertebro-basilar artery was used to determine the critical stenosis causing vertebrobasilar insufficiency, and the minimum diameter of the posterior communicating arteries (PComAs) necessary to tolerate therapeutic vertebrobasilar occlusion for unclippable aneurysms. The critical stenosis of one vertebral artery (VA) or basilar artery (BA) differed greatly depending upon the anatomical variations of the PComA and the posterior cerebral artery (PCA): 1.14 mm diameter when the artery supplies 80 ml/ min to the cerebellum and brainstem only, 1.33 mm when 140 ml/min to these structures and one PCA, and 1.56 mm when 200 ml/min to these structures and both PCAs. The minimum PComA diameter to tolerate therapeutic occlusion depended largely upon the occlusion site: one PComA with 1.54 mm diameter for bilateral VA occlusion and 1.25 mm for BA occlusion distal to the branching of the superior cerebellar arteries. The total volume of collateral flow through both PComAs can be estimated by summing the squares of the diameters. These values cannot be applied rigidly to clinical cases, but are useful standards to evaluate the stenotic lesion or tolerance to occlusion.
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  • Expression of MHC Class II Antigens on Human Glioma Cells Modulated by Transfection with Genes Encoding These Antigens
    Seiichi YOSHIDA, Hiroaki TAKAHASHI, Ryuichi TANAKA
    1991 Volume 31 Issue 10 Pages 623-628
    Published: 1991
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.31.623
    JOURNAL FREE ACCESS
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    Four glioma cell lines not expressing human leukocyte antigen (HLA)-DR or DQ did so after transfection with genes encoding HLA-DR and DQ. The glioma cells had enhanced ability to stimulate allogeneic and autologous responding lymphocytes in the mixed lymphocyte response (MLR). Glioma cells expressing only HLA-DR had weaker MLR enhancement than those expressing both HLA-DR and DQ or only HLA-DQ. Stimulation by transformed glioma cells increased the killing activity of responding lymphocytes against autologous glioma cells 2.0 times. Both HLA-DR and DQ are important in MLR, and the immunogenicity of glioma cells might be increased by transfection with genes encoding these antigens.
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  • The Role of the Paraventricular Nucleus and Pituitary Gland in Morphine Analgesia
    Masaaki HASHIMOTO, Shoichiro OHGAMI, Yukichi YONEMASU
    1991 Volume 31 Issue 10 Pages 629-634
    Published: 1991
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.31.629
    JOURNAL FREE ACCESS
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    The authors investigated the analgesic effects of small morphine doses injected into the paraventricular nucleus (PVN) of normal rats and hypophysectomized (Hx) rats. An injection cannula was stereotactically inserted into the PVN or third ventricle. On the 5-7th postoperative day, morphine (7μg) was injected and the pain threshold (paw lick latency: PLL) was measured using a hot plate analgesia meter (52.0 ± 0.1°C). PVN morphine injection caused significantly longer PLL than the control (physiological saline) in both normal and Hx rats. Ventricular morphine injection did not increase PLL over the control. PVN is a site of morphine action. The analgesia induced by PVN morphine injection was not affected by hypophysectomy, or induced by leaking of morphine into the third ventricle.
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  • Effect of Intracisternal Injection of Endothelin-1 on Regional Cerebral Blood Flow in Cats
    Tadashi MORIMOTO, Tetsu HANAMURA, Tomio SASAKI, Isamu SAITO, Kintomo T ...
    1991 Volume 31 Issue 10 Pages 635-640
    Published: 1991
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.31.635
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    The effect of endothelin-1 on regional cerebral blood flow (rCBF) was investigated in adult mongrel cats. Endothelin-1 was injected into the cisterna magna and rCBF was measured by the hydrogen clearance method before and every 30 minutes for 180 minutes after the injection. Endothelin-1 (10-11 mol and 10-9 mol) induced a significant decrease in rCBF and an increase in arterial pressure. The effects of endothelin-1 on rCBF and arterial pressure were mediated, at least in part, by Ca2+, because pretreatment with intracisternally injected nicardipine prevented the changes. Cerebral angiograms obtained before and after endothelin-1 injection demonstrated severe constriction of the basilar artery, but constriction of the internal carotid and middle cerebral arteries was mild. Since the rCBF measured was in the territory of the middle cerebral artery, the decrease in blood flow was probably not solely due to the artery constriction. Other mechanisms such as arteriole constriction and/or regulation of rCBF by the central nervous system may also occur.
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  • Dynamic Computed Tomography for the Evaluation of Cerebrovascular Disease
    Tomoaki TERADA, Takashi NISHIGUCHI, Genhachi HYOTANI, Kazuki MIYAMOTO, ...
    1991 Volume 31 Issue 10 Pages 641-646
    Published: 1991
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.31.641
    JOURNAL FREE ACCESS
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    Dynamic computed tomography (DCT) was evaluated as a diagnostic indicator for chronic supratentorial ischemia in 50 cases with or without minor neurological deficits. Peak height (PH, the maximum value of the gamma fitted curve), peak time (PT, the time to PH from the start of DCT), transit time (TT, the time between the first and second inflection points of the gamma fitted curve), and their functional maps were analyzed. Cerebral angiography was then performed in all cases to identify stenotic or occlusive vascular lesions in major cerebral arteries. DCT clearly detected 12 of 13 occlusions of the internal carotid artery (ICA) or middle cerebral artery (MCA), although one ICA occlusion was masked by the contralateral MCA occlusion. However, DCT detected only severe ICA or MCA stenosis (more than 90%). Probably, stenotic lesions of less than 90% did not cause detectable hemodynamic compromise. DCT using PH, PT, and TT functional maps is a useful diagnostic method for hemodynamic changes in ischemic cerebrovascular disease, although bilateral lesions and less stenotic lesions (<90%) are difficult to detect.
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  • Local Complications in Transbrachial Cerebral Angiography Using the 4-F Catheter
    Akira UCHINO
    1991 Volume 31 Issue 10 Pages 647-649
    Published: 1991
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.31.647
    JOURNAL FREE ACCESS
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    Local complications of cerebral angiography using the transbrachial technique were assessed. In 333 patients with cerebrovascular disease 342 catheterizations using a sheathless 4-F catheter were attempted, with 337 successes (98.5%). There were two major and five minor complications (2.1%). A massive hematoma and a pulse deficit were overcome without sequelae. The overall complication incidence was significantly higher in females (5.7%) than in males (0.4%). This procedure requires extra care in female patients.
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  • Early MR Abnormality Indicating Functional Recovery from Spontaneous Intracerebral Hemorrhage
    Hiroshi FUMEYA, Hiroshi HIDESHIMA
    1991 Volume 31 Issue 10 Pages 650-653
    Published: 1991
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.31.650
    JOURNAL FREE ACCESS
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    Magnetic resonance (MR) imaging as an indicator of recovery from hemiparesis was evaluated in 60 patients with spontaneous intracerebral hemorrhage. T2-weighted MR images revealed early MR abnormality (EMA) of the corticospinal tract within 1 week of ictus. Most patients without EMA recovered beyond Brunnstrom's Recovery Stage 3 while only a few patients with EMA did so. Patients with EMA cannot regain motor function because EMA is almost always followed by complete tract degeneration. EMA in the brainstem and poor motor function recovery are closely correlated.
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  • Treatment of Malignant Glioma with High Dose Intra-arterial ACNU and Autologous Bone Marrow Transplantation
    —Case Report—
    Takashi FUJIWARA, Junji YOSHIOKA, Takashi OHMOTO
    1991 Volume 31 Issue 10 Pages 654-657
    Published: 1991
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.31.654
    JOURNAL FREE ACCESS
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    A 44-year-old female with malignant astrocytoma received subtotal removal and high dose (200 mg/m2) intra-arterial 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride (ACNU) with autologous bone marrow transplantation. Tumor remission with minimal bone marrow suppression was achieved. However, she developed severe encephalopathy and computed tomographic scans revealed a low-density area at the ACNU delivery site. She received glycerol solution to treat the brain edema and recovered completely from the encephalopathy. Intra-arterial ACNU exceeding 200 mg/m2 possibly causes neurotoxicity.
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  • Revascularization of the Calcarine Artery in Moyamoya Disease: OA-Cortical PCA Anastomosis
    —Case Report—
    Akira IKEDA, Isao YAMAMOTO, Osamu SATO, Nobuhito MOROTA, Tsutomu TSUJI ...
    1991 Volume 31 Issue 10 Pages 658-661
    Published: 1991
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.31.658
    JOURNAL FREE ACCESS
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    A 38-year-old male presented with moyamoya disease. Occlusion of the bilateral proximal posterior cerebral arteries (PCAs) resulted in homonymous 3/4 (right half and left lower quadrant) anopsia and various mental symptoms. To prevent impending cortical blindness, revascularization to the right PCA was performed by occipital artery (OA) to calcarine artery anastomosis. His neurological state was stabilized. OA-cortical PCA (calcarine artery) anastomosis is an alternative to omentum transplantation or occipital burr hole procedures for impending cortical blindness.
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  • Intraventricular Hemangiopericytoma
    —Case Report—
    Zainal MUTTAQIN, Tohru UOZUMI, Satoshi KUWABARA, Katsuzo KIYA, Kazunor ...
    1991 Volume 31 Issue 10 Pages 662-665
    Published: 1991
    Released on J-STAGE: July 19, 2006
    DOIhttps://doi.org/10.2176/nmc.31.662
    JOURNAL FREE ACCESS
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    A very rare large intraventricular hemangiopericytoma occurred in a 41-year-old male with a 2-month history of headache and paresthesia of the right shoulder and arm. The tumor was partially removed, followed by 50 Gy local Linac irradiation given over 6 weeks. Four months later the residual tumor demonstrated a marked decrease in size and vascularity. The residual tumor was totally removed with less operative bleeding than at the initial operation. This is the first reported case of hemangiopericytoma located in the trigone of the lateral ventricle.
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