Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 33, Issue 9
Displaying 1-10 of 10 articles from this issue
  • Jun-ichi MURATA, Yutaka SAWAMURA, Mitsuhiro TADA, Shiro SAKUMA, Masako ...
    1993 Volume 33 Issue 9 Pages 603-609
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    Granulocyte-macrophage colony-stimulating factor (GM-CSF) production and receptor expression by human glioblastomas was studied. Enzyme-linked immunosorbent assay showed four of 10 glioblastoma cell lines spontaneously released GM-CSF (2.9-9.2 pg GM-CSF protein/ml culture medium), which was enhanced by stimulation with tumor necrosis factor-α (TNF) (10 U/ml) up to 410 pg/ ml. TNF also induced secretion of GM-CSF by another cell line. Northern blot analysis identified increasing GM-CSF gene expression by cells following TNF stimulation. However, no GM-CSF protein was detectable in the cerebrospinal fluid of three malignant glioma patients. Intratumoral administration of TNF in the patients also failed to stimulate GM-CSF levels in the cerebrospinal fluid. A binding assay using flow cytometry with biotinylated GM-CSF and Scatchard analysis using 125I-labeled GM-CSF failed to demonstrate GM-CSF receptor expression on the 13 cell lines. Exogenous GM-CSF stimulation had no effect on production of prostaglandin E2, interleukin-6, or interleukin-8 by glioma cells. Human glioblastoma cells secrete GM-CSF without expressing the receptor in vitro, but there was no evidence of GM-CSF production in vivo.
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  • Hiroshi TAKAHASHI, Shozo NAKAZAWA, Dorothee HERLYN
    1993 Volume 33 Issue 9 Pages 610-615
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    131I-labeled F(ab'')2 fragments of murine monoclonal antibody (MAb) 425 specific to the epidermal growth factor receptor expressed on human gliomas were used in experimental human malignant glioma immunotherapy. Two injections of 150 μCi 131I-labeled 425 F(ab'')2 achieved growth inhibition of U-87MG human malignant glioma xenografts in nude mice. This radiolabeled specific MAb F(ab'')2 was significantly superior to radiolabeled fragments of an anti-hepatitis virus control MAb A5C3 in influencing tumor growth. However, similar treatment of established human malignant glioma xenografts did not inhibit progressive tumor growth significantly. No clear tumor inhibition was produced by unlabeled MAb 425 F(ab'')2. These studies suggest that 131I-labeled MAbs have a significant antitumor effect where unmodified antibody is ineffective. Multiple doses of antibody may achieve an increase in labeled MAb concentration in tumors.
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  • Iwao YAMAKAMI, Akira YAMAURA
    1993 Volume 33 Issue 9 Pages 616-620
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    The effect of decompressive craniectomy on regional cerebral blood flow (rCBF) was investigated in five patients with severe head trauma who underwent decompressive craniectomy. Repeated rCBF studies using single photon emission computed tomography with 99mtechnetium-hexamethyl-propyleneamine oxime observed that a hyperperfusion area (focal CBF increase) occurred in the decompressed brain within 24 hours after decompressive craniectomy. The hyperperfusion area in the decompressed brain enlarged and increased in severity by 1 week after surgery. However, it attenuated and disappeared by 1 month after surgery. The chronology of the hyperperfusion area corresponded to the change in the swelling of decompressed brain observed by x-ray computed tomography. Patient consciousness showed a significant and progressive improvement in the postoperative 1 month period. Decompressive craniectomy may cause a focal CBF increase in the decompressed brain related to the beneficial effect in patients with acute severe head trauma.
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  • Hiroyuki NAKASE, Hideyuki OHNISHI, Hajime TOUHO, Susumu MIYAMOTO, Yasu ...
    1993 Volume 33 Issue 9 Pages 621-624
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    Twenty-three patients with epileptic type moyamoya disease are reviewed among 200 moyamoya disease patients. Ten boys and 13 girls aged 5 months to 12 years were followed over 6 months to 17.3 years. Six had generalized seizure and 17 had focal seizure. Operations were performed within 1 year in eight patients, within 1-3 years in five, and more than 3 years after onset in 10. Nineteen patients improved and suffered no seizure without receiving antiepileptic drugs, but four patients developed true epilepsy and three of these suffered cerebral infarction. Multivariate analyses showed that toddlers aged less than 1 year and mild or severe abnormal computed tomographic (CT) findings correlated with a bad outcome. This study showed that epileptic type moyamoya disease has the same clinical features as transient ischemic attack or infarction type. Age under 1 year and CT abnormalities indicate a poor prognosis and necessity for early reconstructive surgery.
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  • Yoshio TAKASATO, Toshinari ARAI, Yoshihisa OHTA, Kazuaki YAMADA
    1993 Volume 33 Issue 9 Pages 625-629
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    Two adult patients with brainstem glioma were successfully treated surgically. A 37-year-old male had a dorsally exophytic pontine glioma developing from the fourth ventricular fundus, and another 27-year-old male an intrinsic nodular mesencephalic glioma. Preoperative magnetic resonance imaging clearly visualized the tumor margin in both cases, and showed the relationship between the tumor and brainstem structure accurately. The tumors were radically excised using intraoperative evoked potential monitoring, ultrasonic surgical aspirator, and microsurgical techniques. Surgery is indicated when the tumor margin in the brainstem and adjacent region is clear, and the approach is possible without affecting the functional prognosis.
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  • Masaaki YAMAMOTO, Shinji HAGIWARA, Yutaka UMEBARA, Noriko TANAKA, Mits ...
    1993 Volume 33 Issue 9 Pages 630-633
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    We report two patients with solitary thalamic abscess, occurring among 91 consecutive patients (2.2%) with computed tomography (CT)-diagnosed and surgically-verified brain abscess experienced in our college during 1975 to 1991. A 9-year-old girl with congenital heart disease experienced frequent vomiting followed by left hemiparesis and deterioration of consciousness. CT demonstrated a right thalamic ring-enhanced lesion. Purulent material was aspirated via a burr hole. She died of heart failure on the 5th postoperative day. Autopsy disclosed diffuse brain swelling and an encapsulated abscess in the right thalamus, which had ruptured into the third ventricle. A 30-year-old female experienced headache, nausea, and vomiting, which progressed to somnolence and right hemiparesis. CT demonstrated a left thalamic ring-enhanced lesion. Purulent material was aspirated by stereotactic procedures. All symptoms had resolved by the end of the 2nd postoperative week.
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  • Shoichiro KAWAGUCHI, Toshisuke SAKAKI, Kitaro KAMADA, Hideaki IWANAGA, ...
    1993 Volume 33 Issue 9 Pages 634-637
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A 29-year-old male presented with a dissecting aneurysm of the left posterior inferior cerebellar artery manifesting as left lateral medullary syndrome due to brainstem ischemia. Extirpation of the aneurysm and anastomosis of the occipital artery to the posterior inferior cerebellar artery were performed simultaneously. The dissecting aneurysm was confirmed by histological examination of the surgical specimen.
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  • Hiroshi SAKAIDA, Makoto SAKAKURA, Hiroshi TOCHIO, Kouji NAKAO, Akira T ...
    1993 Volume 33 Issue 9 Pages 638-642
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A 34-year-old female presented with a rare chronic encapsulated intracerebral hematoma associated with an angiographically occult arteriovenous malformation. A neovascularized fibrous capsule containing various stages of intracerebral hematoma formation was removed. These unusual entities mimic brain tumors or abscesses because of gradual growth and slowly progressive neurological deficits. Repeated bleeding or exudation from the capillaries of the capsule may allow expansion of the chronic encapsulated intracerebral hematoma.
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  • Atsushi MIYAGI, Mitsuyoshi IWASAKI, Tadashi SHIBUYA, Goro KIDO, Hidehi ...
    1993 Volume 33 Issue 9 Pages 643-650
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A rare pituitary adenoma associated with Rathke''s cleft cyst was discovered incidentally in a 44-yearold male admitted after head trauma. Neurological and physiological examination found no abnormalities, except for panhypopituitarism. Computed tomography and magnetic resonance imaging demonstrated a solid mass in the sellar cavity with suprasellar extension, associated with a cystic mass extending into the third ventricle. The tumor was removed subtotally by the transcranial approach. Light microscopy demonstrated that the cyst wall was composed of ciliated columnar cells, cuboidal cells, and goblet cells, and the solid part indicated chromophobe pituitary adenoma. Immunohistochemistry demonstrated that a few adenoma cells were positive for prolactin and the cyst wall cells were positive for cytokeratin and negative for S-100 protein.
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  • Kenta FUJIMOTO, Yuji NIKAIDOH, Takashi YUASA, Kiyoshi NAGATA, Yuhki ID ...
    1993 Volume 33 Issue 9 Pages 651-655
    Published: 1993
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A 7-year-old girl with meningioangiomatosis not associated with von Recklinghausen''s disease is described. The radiological findings were similar to meningioma, but intraoperatively, a thin septum was found between the mass and the dura mater. Microscopically, there was significant proliferation of fibroblastic spindle-shaped cells and collagenous fibers in the subarachnoid space. Proliferated cells had penetrated into the cortical tissue along the irregularly branched blood vessels. Immunohistochemically, these penetrating perivascular cells were negative for glial fibrillary acidic protein and S-100 protein, and positive for vimentin staining. These findings suggest that the histogenesis of the spindle-shaped cells is most probably meningothelial.
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