Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 34, Issue 6
Displaying 1-10 of 10 articles from this issue
  • Kyozo KATO, Jun YOSHIDA, Masaaki MIZUNO, Kenichiro SUGITA, Nobuhiko EM ...
    1994 Volume 34 Issue 6 Pages 339-344
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    The thymidine kinase (tk) gene of herpes simplex virus type 1 (HSV-1) was transduced into three glioma cell lines (T98, U251MG, T9) using a retrovirus vector. The supernatants of viral producer cell line PA317/LTRNL was used for infection and three transduced cell lines (T98/LTRNL, U251MG/ LTRNL, T9/LTRNL) were established. The toxicities of the anti-herpetic drugs, acyclovir and gancyclovir, were evaluated in vitro. The cytotoxicities of acyclovir and gancyclovir to the HSV-1 tk genetransduced cells increased 100-1000 fold compared to the non-transduced parental cell lines. The cytotoxic effect of gancyclovir was higher than that of acyclovir, requiring a concentration of less than 0.31 μM to obtain 50% inhibition. Deoxyribonucleic acid analysis of the gancyclovir-treated cells demonstrated fragmentation, suggesting that apoptosis is involved in the mechanism of cell death. The HSV-1 tk gene-transduced cells were co-cultured with parental cells and treated with gancyclovir. More than 95% of cells were killed in a mixture ratio of 1:1, suggesting that the “bystander effect” operated in this system. Selective transduction of HSV-1 tk gene into glioma cells using a retroviral vector and treatment with gancyclovir is a promising therapy for patients with malignant glioma.
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  • Hideto MISHINA, Akihiko YABUKI
    1994 Volume 34 Issue 6 Pages 345-352
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    Acute compression ischemia was induced in 30 cats by progressive inflation of an epidural balloon, followed by rapid decompression. Changes in intracranial pressure, mean arterial blood pressure, cerebral blood flow (CBF), arteriovenous oxygen difference (AVDO2), cerebral metabolic rate of oxygen (CMRO2), and electroencephalography (EEG) were studied in 13 untreated animals and in seven animals receiving barbiturate. Ten cats with cardiovascular or respiratory problems, or intracranial hematoma were excluded from the study. In untreated animals, six (46%) survived with no brain swelling and were classified as the “no swelling group, ” and seven (56%) died from fatal brain swelling and were classified as the “delayed swelling group.” All animals with barbiturate therapy showed no brain swelling. Serial measurement of CBF, AVDO2, and CMRO2 indicated the existence of postischemic delayed hypoperfusion associated with relative hypermetabolism in untreated animals. Good recovery of CBF and CMRO2 was observed in the “no swelling group, ” and poor recovery in the “delayed swelling group.” The time course of the total fast-wave components on EEG was quite similar to that of CMRO2, and the time course of the “CBF index, ” which is % fast-wave component of EEG divided by AVDO2, was similar to that of CBF. Barbiturates reduced CMRO2 and fast-wave component during administration, possibly improving the relatively hypermetabolic state, and reduced the mortality rate to 0%. The maximum effects of barbiturate could be expected by administering the drug at the stage of delayed hypoperfusion with relative hypermetabolism, indicated by rapid recovery of the % fast-wave component, high AVDO2, and low CBF index.
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  • Ichiro NAKAHARA, John PILE-SPELLMAN, Lotfi HACEIN-BEY, Robert M. CROWE ...
    1994 Volume 34 Issue 6 Pages 353-359
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    An endovascular non-detachable balloon technique was used to treat 14 patients with cerebral aneurysms. Eight patients presented with subarachnoid hemorrhage, and six others presented with headache or mass effect. Six aneurysms were located in the anterior circulation and eight in the posterior circulation. Seven aneurysms were giant, three were large, and four were small. All target aneurysms or vessels were occluded successfully. Parent vessel was successfully spared in seven cases. There were no procedural complications related to the non-detachable nature of the balloon used. Follow-up angiography detected refilling of aneurysms in three of 11 patients, two with small ruptured aneurysms that bled again following partial deflation or balloon movement. The other aneurysms tested remained occluded, as demonstrated on follow-up angiograms, for up to 15 months. Outcomes were good to excellent in 10 patients, poor in one, and three died. Non-detachable balloons might be preferred for treatment of certain types of cerebral aneurysms including those where intraaneurysmal maneuvers might be considered dangerous, for example, with recent bleeding or intraluminal fresh clots; where precise placement of the balloon is required, for example, in the vicinity of perforators or collaterals emerging near the neck; and where detachment could be dangerous or difficult in broad neck and fusiform aneurysms or in tortuous parent vessels.
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  • Masaki KOMIYAMA, Toshihiro YASUI, Katsuhiko TAMURA, Yasunori NAGATA, Y ...
    1994 Volume 34 Issue 6 Pages 360-364
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    Five patients with kissing aneurysms (adherent internal carotid-posterior communicating artery and ipsilateral internal carotid-anterior choroidal artery aneurysms) are reported. There was female predominance and the subarachnoid hemorrhage was commonly due to rupture of the proximal posterior communicating artery aneurysm. Despite the demonstration of angiographic cleavage, the two aneurysms adhere to each other, which makes surgical dissection difficult. Meticulous dissection of the aneurysmal necks and preservation of the blood flow in the anterior choroidal artery are of vital importance.
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  • Shoji MABUCHI, Naoki NAKAYAMA, Toyohiko ISU, Tatsuo HARATA, Toshikazu ...
    1994 Volume 34 Issue 6 Pages 365-370
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    Three-dimensional time-of-flight magnetic resonance (MR) angiography using radiofrequency presaturation pulses was used to evaluate the patency of extracranial-intracranial (EC/IC) bypass in 11 patients. Presaturation causes signal loss in the vascular territory supplied by the presaturated EC/IC bypass graft. In all patients with a patent EC/IC bypass graft confirmed on conventional angiography, disappearance of the signal of the middle cerebral artery receiving blood flow from the bypass graft was clearly observed on MR angiograms with presaturation, indicating patency of the EC/IC bypass graft. MR angiography with presaturation pulses is a noninvasive and repeatable method for evaluation of the function of an EC/IC bypass graft.
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  • Hajime TOUHO, Hideyuki OHNISHI, Makoto SENO, Norihiko FURUOKA, Takeki ...
    1994 Volume 34 Issue 6 Pages 371-374
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 76-year-old female presented with vertebrobasilar insufficiency due to a severe stenosis of the right primitive hypoglossal artery (an unusual carotid-basilar anastomosis) manifesting as recurrent transient ischemic attacks (TIA) associated with quadriparesis and cerebellar ataxia with vertigo, nausea, and vomiting. She had been treated with 100 mg of aspirin per day, but TIA associated with the same symptoms persisted. Cerebral blood flow (CBF) studies disclosed a region of moderately low flow in the posterior fossa. Cerebral angiography demonstrated that the posterior fossa was supplied via the right primitive hypoglossal artery, which was severely stenotic at its origin. Percutaneous transluminal angioplasty using a Stealth catheter, 3.0-mm diameter and 10-mm long, successfully dilated the stenosis. No TIA occurred postoperatively, and a marked increase in CBF was demonstrated in the posterior fossa.
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  • Shigeru TSUNODA, Shinichiro KUROKAWA, Toshisuke SAKAKI, Toru YABUNO, T ...
    1994 Volume 34 Issue 6 Pages 375-378
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    An 11-year-old boy presented with medulloblastoma occurring in the cerebellar vermis. Computed tomography and magnetic resonance imaging revealed numerous cysts and calcifications in the tumor. The tumor was subtotally removed and cellular synchronization radiation therapy given. He was discharged without neurological deficits. Histological examination showed the cysts represented necrotic foci. Macrophages, which appeared around the necrotic foci, were important in the development of the calcifications via proliferation of collagen fibers.
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  • Toshihiko KUROIWA, Keita MORIWAKI, Tomio OHTA, Akira TSUTSUMI, Sadao T ...
    1994 Volume 34 Issue 6 Pages 379-381
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 13-year-old boy presented with a primitive neuroectodermal tumor (PNET) with unusual extracranial extension. Precontrast computed tomography showed the tumor as a ring-shaped high-density area which was enhanced postcontrast, with a low-density center. Magnetic resonance imaging showed the tumor as a low-intensity area on the T1-weighted images with marked enhancement by gadolinium-diethylenetriaminepenta-acetic acid, and high intensity on the T2-weighted images. The central area appeared as high intensity on both images, suggesting free methemoglobin. The tumor was subtotally removed. Histological examination demonstrated PNET. Despite irradiation (20 Gy) to the surgical site, and further tumor removal, he died 6 months later. This case showed PNET can extend extracranially. Diagnosis and treatment of such a tumor located extracranially and intracranially require careful consideration.
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  • Shigeru FUJIWARA, Takato MORIOKA, Hideaki ISHIBASHI, Tosuke TAKAKI, Ma ...
    1994 Volume 34 Issue 6 Pages 382-384
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 52-year-old male presented with acute purulent discitis and epidural abscess of the cervical spine manifesting as neck pain and slight fever, followed by sudden onset of quadriparesis. Magnetic resonance (MR) imaging showed a low-signal-intensity area in the C6/7 disc space and epidural space ventral to the spinal cord with peripheral enhancement. Surgical exploration using an anterior approach revealed local discitis and epidural abscess, but no osteomyelitis of the neighboring vertebral bodies. Six months after the decompressive procedure to treat the purulent disc and epidural abscess, he had achieved almost full recovery. Such lesions are rare in adults, but should be considered especially when painful spinal symptoms are associated with fever. Early and definitive diagnosis can be achieved by MR imaging with enhancement.
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  • Nobuhiko AOKI, Tatsuo SAKAI, Akihiro OIKAWA
    1994 Volume 34 Issue 6 Pages 385-387
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 57-year-old male developed subdural effusion after head trauma, which remained asymptomatic and unchanged in volume during a follow-up period of 3 months. A typical chronic subdural hematoma (CSDH) developed 6 weeks after burr-hole exploration in spite of the absence of hematoma capsule or blood components in the effusion. The CSDH was successfully treated by irrigation and drainage. This case suggests that the presence of blood in subdural effusion may be the trigger for evolution of CSDH. We recommend that asymptomatic subdural effusion should be followed up without surgical intervention.
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