Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 33, Issue 4
Displaying 1-10 of 10 articles from this issue
  • Takaharu NAKAMURA, Iwao TAKESHITA, Takanori INAMURA, Takatoshi TASHIMA ...
    1993 Volume 33 Issue 4 Pages 205-211
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    The expression of the B-chain of platelet-derived growth factor (PDGF) was analyzed in 29 human brain tumors (4 astrocytomas, 7 glioblastomas, 3 medulloblastomas, 3 oligodendrogliomas, 7 meningiomas, and others) using monoclonal antibody after digestion with alkaline phosphatase, and compared with proliferative activities measured by in vivo uptake of bromodeoxyuridine. Medulloblastomas contained the highest amounts of PDGF B-chain, some four to eight times more than that in control brain tissue. The most predominant PDGF molecule of the medulloblastoma was 17 kd. Astrocytomas, glioblastomas, oligodendrogliomas, and meningiomas contained predominantly 30 and/or 22-24 kd molecules. Glioblastoma and meningioma proliferative activities correlated closely to PDGF concentrations, with only a few exceptions. Tumors that contained a high level of PDGF B-chain showed high proliferative activity, while tumors with high proliferative activity did not always contain a high level of PDGF B-chain. Tumors that contain many PDGF B-chains may thus indicate malignancy.
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  • Hiroshi TENJIN, Satoshi UEDA, Norihiko MIZUKAWA, Yoshio IMAHORI, Akihi ...
    1993 Volume 33 Issue 4 Pages 212-219
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    Proper treatment of ischemic stroke requires better understanding of cerebral hemodynamic changes. The hemodynamic changes associated with ischemia were measured using positron emission tomography and related to angiographic findings in the subacute and chronic stages of 17 ischemia patients who showed symptoms of main trunk stenosis of the internal carotid artery system. The hemodynamic factors, cerebral blood flow, cerebral blood volume, cerebral metabolic rate for oxygen, oxygen extraction fraction, and flow/volume ratio, were measured in regions of interest determined from the angiographic stenosis (over 50%) and compared in each stage. The cerebral blood flow and flow/volume ratio in the territory downstream of the main trunk stenosis and cerebral metabolic rate for oxygen in the whole cortex were decreased in the subacute stage. In the chronic stage, cerebral blood flow and flow/volume ratio decreased mainly in borderzone areas.
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  • Yutaka HIRASHIMA, Nakamasa HAYASHI, Shunro ENDO, Akira TAKAKU
    1993 Volume 33 Issue 4 Pages 220-224
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    The platelet count in 110 patients with subarachnoid hemorrhage (SAH) was analyzed retrospectively. Changes in the platelet count in 102 patients undergoing intracranial aneurysm surgery showed that the minimum platelet count was similar in patients with and without symptomatic vasospasm, but the minimum occurred later in symptomatic vasospasm patients, regardless of Hunt and Hess grade or operation timing. Sixty-five of 67 non-symptomatic vasospasm patients (97%) showed the minimum platelet count within 4 days of SAH and two (3%) on the 5th day. In contrast, only 10 of 35 symptomatic vasospasm patients (29%) showed a minimum platelet count within 4 days after SAH and 25 (71%) between the 5th and 11th days. Analysis of the eight patients not receiving surgery showed that the minimum platelet count occurred 2 days after SAH in two non-symptomatic vasospasm patients, but after the 5th day in five of six symptomatic vasospasm patients. Therefore, monitoring of the platelet count can provide an indicator of the occurrence of symptomatic vasospasm.
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  • Shiro KASHIWAGI, Yujiro SHIROYAMA, Tetsuaki IWAMOTO, Tetsuo YAMASHITA, ...
    1993 Volume 33 Issue 4 Pages 225-228
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    Sequential changes in plasma fibronectin level in 17 patients with subarachnoid hemorrhage (SAH), with 16 due to ruptured cerebral aneurysms, were compared for patients with good and poor outcomes, and patients with and without vasospasm. Plasma fibronectin concentrations were measured by an immune diffusion method. The clinical outcome was evaluated 3 months after SAH according to the Glasgow Outcome Scale. Plasma fibronectin concentrations were significantly lower on days 3 (p < 0.02) and 9 (p < 0.05) after ictus in patients with poor outcomes (moderately disabled or worse) than in those with good outcomes (good recovery). Patients with vasospasm had lower fibronectin concentrations during the 4 weeks after ictus. Decreased levels of plasma fibronectin were correlated with poor outcomes, most related to vasospasm. Plasma fibronectin levels reflect the overall severity in patients with SAH and are a useful marker for prediction of the final clinical outcome.
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  • Nobuyuki TAKAI, Isamu EZUKA, Takatoshi SORIMACHI, Takashi KUMAGAI
    1993 Volume 33 Issue 4 Pages 229-233
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    We report three patients with subarachnoid hemorrhage in which no causative lesion was detected angiographically. Surgical intervention revealed a ruptured aneurysm in all three cases, which were clipped successfully. Although the prognosis for a patient with subarachnoid hemorrhage of unknown cause is good, there still remain long-lasting unpleasant complaints probably arising from psychogenic factors. We especially recommend exploratory craniotomy when subarachnoid hemorrhage is located anterior to the circle of Willis, accompanied by thick and obviously lateralizing subarachnoid clots on computed tomography and/or rebleeding in the same anatomical location, even if no causative lesions can be found angiographically.
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  • Masaki KOMIYAMA, Yoshihiko FU, Hisatsugu YAGURA, Toshihiro YASUI, Vire ...
    1993 Volume 33 Issue 4 Pages 234-237
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    Three patients with pontine hemorrhages presenting clinically as trigeminal neuropathy are described. No patient was hypertensive and angiograms were normal. Magnetic resonance (MR) imaging showed heterogeneous lesions, suggesting cavernous malformation, in one patient, but no definite diagnosis could be made in the other two patients. Such cases are rare and should be evaluated using serial MR imaging to differentiate angiographically occult vascular malformation from spontaneous hemorrhage.
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  • Masanori KABUTO, Toshihiko KUBOTA, Hidenori KOBAYASHI, Takao NAKAGAWA
    1993 Volume 33 Issue 4 Pages 238-241
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A mammosomatotroph cell was identified in two consecutive semithin sections of conventional epoxyembedded tissue for light microscopy and an adjacent ultrathin section for electron microscopy cut from a mixed growth hormone (GH)- and prolactin (PRL)- secreting human pituitary adenoma in a 51-year-old female. The same mammosomatotroph cell demonstrated immunostaining for both GH and PRL simultaneously by light microscopy, and was morphologically evaluated by electron microscopy. The ultrastructural features of this cell resembled densely granulated GH-secreting adenoma cells, but also contained characteristics of PRL-secreting adenoma cells.
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  • Yasuhiro KOJIMA, Nobumasa KUWANA
    1993 Volume 33 Issue 4 Pages 242-245
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A rare diffuse arteriovenous malformation (AVM) occurred in an 11-year-old boy with a 4-year history of transient ischemic attacks and weakness of the left extremities. Postcontrast computed tomography (CT) showed cord-like enhancement in the corpus callosum and pineal region. Magnetic resonance (MR) imaging demonstrated atrophy of the right hemisphere and multiple signal voids in the sulci. Cerebral angiography showed a diffuse AVM fed by the bilateral anterior cerebral and right middle cerebral arteries. The AVM nidus consisted of scattered nidi. Several draining veins appeared as multiple signal voids on MR images. No surgery was possible because of the scattered nidi. Left hemiparesis and mental retardation worsened, with progressive atrophy of the right hemisphere on serial MR images. Follow-up radiological examinations showed that the number of nidi increased, the draining vein enlarged, and the gyri calcified. The gyriform calcification on CT scans strongly resembled that seen in Sturge-Weber syndrome.
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  • Hisanori YOSHIMOTO, Osamu YUKAWA, Hideyuki AOYAMA, Hitoshi MAEDA, Tohr ...
    1993 Volume 33 Issue 4 Pages 246-250
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A 66-year-old male presented with a left frontal intracerebral arteriovenous malformation (AVM) fed by the anterior ethmoidal artery. The nidus was located intracerebrally, although the feeder was a dural artery, and was drained by the ascending frontal vein which showed varicose dilatation. The AVM was associated with an unruptured right anterior choroidal artery aneurysm. The AVM was removed and the aneurysm was clipped in a two-stage operation. The etiology of AVMs fed by the ethmoidal artery is still uncertain, but is probably due to a disturbance in normal embryonic development. The association with aneurysm seemed to be incidental.
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  • Takashi TASHIRO, Jun YOSHIDA, Toshihiko WAKABAYASHI, Kenichiro SUGITA, ...
    1993 Volume 33 Issue 4 Pages 251-254
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A 30-year-old female presented with intracranial germinoma involving both the medulla oblongata and suprasellar region. Such involvement of medulla oblongata with initial clinical symptoms similar to brainstem glioma has not been previously reported. Combination chemotherapy using cisplatin and etoposide achieved disappearance of the suprasellar tumor, and decreased size of the medulla oblongata tumor. Relapse occurred 6 months after first treatment, when combination chemotherapy with etoposide and carboplatin achieved reduction in tumor size again.
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