Neurologia medico-chirurgica

Proliferating Cell Nuclear Antigen Expression in Rat Glioma Model: Comparison with Bromodeoxyuridine Labeling Index

Satoshi NAKASU, Masayuki NAKAJIMA, Hirofumi NIOKA, Ken-ichi MATSUMURA, ...

1994 Volume 34 Issue 5 Pages 269-273
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.269

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The usefulness of proliferating cell nuclear antigen (PCNA) immunostaining for estimating the growth fraction in glial tumors was evaluated in ethylnitrosourea-induced rat gliomas. The PCNA labeling index was compared with the bromodeoxyuridine (BrdU) labeling index, using alternate serial sections fixed either in 10% formalin or in periodonate-lysine-paraformaldehyde (PLP). The PCNA labeling index was significantly correlated with the BrdU labeling index if cells with only faint PCNA staining were excluded. Differences in PCNA staining were noted between the two fixatives. The number of PCNA-positive cells in PLP-fixed material was greater than in 10% formalin-fixed material, but showed a poorer correlation with BrdU labeling index. Over-fixation in formalin reduced the number of positive cells. Although peritumoral tissue did not exhibit overexpression of PCNA, the ependymal lining was weakly stained even in areas distant from the tumor. PCNA labeling index is a useful method to estimate the growth fraction when the materials are processed in a controlled way. When clinical specimens with uncertain preparation are used, care is required in interpreting the results.

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Antiproliferative Effect of Tumor Necrosis Factor-α on Human Glioblastoma Cells Linked with Cell Cycle Arrest in G₁ Phase

Kang CHENG, Yutaka SAWAMURA, Shirou SAKUMA, Mitsuhiro TADA, Masako SUD ...

1994 Volume 34 Issue 5 Pages 274-278
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.274

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The effects of tumor necrosis factor-α (TNF) on proliferation and cell cycle alterations in human malignant glioma cell lines, SF-188 and LN-382, were investigated by flow cytometry with the bromodeoxyuridine-propidium iodide dual staining technique. Low concentrations of TNF (1-100 U/ml) suppressed the growth of SF-188 assessed by cell count, 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide assay, and thymidine incorporation assay, but not that of LN-382. After TNF treatment, the percentage of SF-188 cells in the G₀/G₁ phase increased, while the percentage of cells in the S phase decreased. LN-382 cells did not show any marked change in cell kinetics. TNF arrests certain human glioma cells in the G₀/G₁ phase resulting in reduction of deoxyribonucleic acid synthesis in the subsequent S phase, suppressing the proliferation pathway.

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Human Monoclonal Antibody-Drug Conjugates in the Experimental Treatment of Malignant Gliomas —Studies In Vitro and In Vivo—

Jianhong ZHU, Hiroshi TAKAHASHI, Shozo NAKAZAWA

1994 Volume 34 Issue 5 Pages 279-285
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.279

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The chemotherapeutic agents doxorubicin (DXR) and 4''-epi-doxorubicin were separately conjugated to the human monoclonal antibody CLNIgG, which binds strongly to human malignant glioma cells. The antibody-drug conjugates were more potent than the free drugs in killing human glioma cells in vitro and in vivo (subcutaneous glioma model). A biodistribution study using [14-¹⁴C]DXR-CLNIgG conjugate indicated that immunoconjugates delivered at least five times more DXR to glioma tissues than free DXR alone in nude mice without increasing the concentration in other tissues. In a nude rat intracerebral glioma model, intracarotid hyperosmolar perfusion to achieve blood-brain barrier (BBB) opening caused a 640% increase in the DXR-CLNIgG concentration in intracerebral tumor tissue. Human monoclonal antibody-drug conjugates in combination with BBB opening is a potential new approach to the treatment of malignant gliomas.

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Incidental White Matter Lesions Identified on Magnetic Resonance Images of Normal Japanese Individuals

—Correlation with Age and Hypertension—

Hirofumi OYAMA, Yoshihisa KIDA, Takayuki TANAKA, Takanori IWAKOSHI, Ma ...

1994 Volume 34 Issue 5 Pages 286-290
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.286

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Incidental white matter high-intensity lesions are frequently seen on T₂-weighted magnetic resonance (MR) images of the brain in older people. The incidence increases with advancing age or hypertension. Brain MR images of 59 normal individuals were examined to analyze this phenomenon. The total number of white matter high-intensity lesions correlated significantly with age (p = 0.004) or systolic blood pressure (p = 0.03). The 60- to 69-year-old group demonstrated a very close correlation of white matter lesions with systolic (p = 0.02) and diastolic blood pressure (p = 0.01), in contrast to the 50- to 59-year-old group. Hypertensive subjects in their 60s are thought to develop more white matter lesions than subjects in their 50s.

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Germinoma of the Medulla Oblongata —Case Report—

Kazuhiko SUGIYAMA, Tohru UOZUMI, Junji GOISHI, Takashi SOGABE, Kazunor ...

1994 Volume 34 Issue 5 Pages 291-294
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.291

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A 32-year-old female presented with medulla oblongata germinoma manifesting as numbness in the extremities. Computed tomography demonstrated a mass in the medulla oblongata expanding into the fourth ventricle. The tumor was partially removed. Immunohistochemical staining of the tumor specimen demonstrated large epithelioid cells positive for placental alkaline phosphatase, and syncytiotrophoblastic cells positive for β subunit of human chorionic gonadotropin. Some epithelioid cells were also positive for cytokeratin. She received 44 Gy of irradiation to the posterior fossa and 20 Gy whole spinal irradiation. No signs of recurrence have occurred for 9 years. Patients with medulla oblongata germ cell tumor are comparatively older than those with other intracranial germ cell tumors and have two X chromosomes. All tumors were diagnosed as germinoma, and caused symptoms of involvement of the lower cranial nerves and the lower brain stem without pyramidal tract signs.

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Extra-axial Ependymoma —Case Report—

Ken HAYASHI, Masatoshi TAMURA, Tetsurou SHIMOZURU, Shizuya KASAMO, Kaz ...

1994 Volume 34 Issue 5 Pages 295-299
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.295

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A 13-year-old boy presented with a very unusual ependymoma extending extra-axially. Computed tomography demonstrated a tumor with a cyst and calcification adjacent to the dura and extending over the right occipital and parietal lobes. The cyst wall and solid tumor were enhanced postcontrast. Magnetic resonance imaging revealed that the solid tumor was isointense on T₁-weighted images and a mixed iso- and high-intensity on T₂-weighted images. The solid tumor and tissue surrounding the cyst were enhanced markedly by gadolinium-diethylenetriaminepenta-acetic acid. Sagittal and coronal images demonstrated a multilocular tumor shadow. Cerebral angiography demonstrated a tumor fed by a posterior branch of the right middle meningeal artery but no feeders from the internal carotid and vertebral arteries. The tumor was removed en bloc. The histological diagnosis was clear cell-type ependymoma.

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Dural Arteriovenous Malformation Involving the Inferior Petrosal Sinus —Case Report—

Masaru YAMADA, Yoshio MIYASAKA, Yukio KITAHARA, Kenzo YADA, Shinichi K ...

1994 Volume 34 Issue 5 Pages 300-303
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.300

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A 59-year-old male presented with a dural arteriovenous malformation involving the inferior petrosal sinus manifesting as false-localizing ocular symptoms. Occlusion between the right inferior petrosal sinus and the right jugular bulb caused an unusual retrograde venous outflow from the inferior petrosal sinus to the cavernous sinus, thought to have been responsible for the chemosis, abducens nerve paresis, and orbital bruit. He was treated successfully with transarterial embolization and radiotherapy.

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Concurrent Subarachnoid Hemorrhage Due to Ruptured Aneurysm and Hypertensive Intracerebral Hemorrhage —Case Report—

Kiyoyuki YANAKA, Shizuo SHIRAI, Hiroshi KIMURA, Tadao NOSE

1994 Volume 34 Issue 5 Pages 304-306
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.304

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A 64-year-old female presented with hypertensive thalamic hemorrhage concurrent with subarachnoid hemorrhage (SAH) due to a ruptured aneurysm manifesting as sudden onset of right hemiparesis followed by severe headache. The aneurysm was located in the basilar artery at the origin of the superior cerebellar artery, remote from the thalamic hematoma. The aneurysm was clipped 3 weeks after SAH. She was discharged with slight right hemiparesis. The method and timing of surgery for such patients depend on hematoma size, location of the aneurysm and hematoma, and neurological status. The intracerebral hemorrhage remote from the ruptured aneurysm should be treated initially if necessary, and the aneurysm clipped after the brain swelling has reduced.

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Dissecting Aneurysm in the Proximal Region of the Posterior Inferior Cerebellar Artery Presenting as Wallenberg''s Syndrome —Case Report—

Hidekatsu MIZUSHIMA, Ken SASAKI, Norihiko KUNII, Takeshi NISHINO, Hiro ...

1994 Volume 34 Issue 5 Pages 307-310
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.307

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A 29-year-old female presented with an unusual case of Wallenberg''s syndrome due to a dissecting aneurysm of the posterior inferior cerebellar artery (PICA) manifesting as a sensation of heaviness in the occipital region and vertigo. Magnetic resonance imaging revealed infarction of the lateral aspect of the medulla oblongata. Digital subtraction angiography (DSA) revealed a spindle-shaped dilatation of irregular contour in the proximal portion of the left PICA. Pooling of contrast medium was noted in the venous phase but no double lumen sign. A suboccipital craniectomy confirmed these findings macroscopically. Blood flow meter monitoring before and after proximal clipping of the diseased vessel ensured the safety of the procedure. Follow-up DSA 3 years after surgery revealed no evidence of aneurysm recurrence.

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Giant Thrombosed Vertebral Artery Aneurysm Treated by Extracranial-Intracranial Bypass and Aneurysmectomy —Case Report—

Shiro NAGASAWA, Tomio OHTA, Yoshinaga KAJIMOTO, Hideo TANAKA, Masahiro ...

1994 Volume 34 Issue 5 Pages 311-314
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.311

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A 42-year-old male presented with a giant thrombosed aneurysm of the left vertebral artery. The aneurysm was resected through a combined subtemporal and suboccipital approach after a saphenous vein bypass graft was placed between the right external carotid artery and the posterior cerebral artery. Intraoperative measurements of the blood flow volume and pressure demonstrated good blood flow in the bypass. Postoperatively, uncontrollable hypertension resulted in huge intracerebral hematoma formation and increased intracranial pressure. Control of systemic hypertension is essential in such patients.

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Postoperative Fungal Arteritis Mimicking Vasospasm —Case Report—

Wolfgang Peter PIOTROWSKI, Peter PILZ

1994 Volume 34 Issue 5 Pages 315-318
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.315

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Intracranial arteritis due to fungal infection is an uncommon complication of neurosurgical operations. A 36-year-old female developed arteritis caused by Aspergillus fumigatus at the site of the temporary clip following the clipping of an initially uncomplicated intracranial aneurysm. The inflammatory, slowly progressing vascular occlusion mimicked the vasospasm common in subarachnoid hemorrhage.

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