Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 35, Issue 8
Displaying 1-10 of 10 articles from this issue
  • Masaaki UNO, Keizo MATSUMOTO, M. Christopher WALLACE
    1995 Volume 35 Issue 8 Pages 561-566
    Published: 1995
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    Neutral red staining was evaluated as an acute outcome assessment method in rat models of cerebral ischemia by comparison with histological infarction volume. Fischer 344 rats (n = 48) were used in three different models of middle cerebral artery (MCA) occlusion: proximal MCA occlusion (n = 16), distal MCA occlusion followed by ipsilateral common carotid artery (CCA) occlusion (distal MCA/ CCA occlusion, n = 15), and MCA occlusion with an intravascularly introduced 4-0 nylon suture (intravascular MCA occlusion, n = 17). At 1 hour, 2 hours, and 4 hours after MCA occlusion, animals were injected with 2.5 ml of 4% neutral red solution via the femoral vein, and then sacrificed. Proximal MCA occlusion caused a neutral red defect volume in the cortex which correlated well with histological infarction volume at 4 hours (r = 0.88, p < 0.05), and in the caudate which correlated well with infarction volume at 4 hours (r = 0.94, p < 0.01). Distal MCA/CCA occlusion caused a neutral red defect volume in the cortex lager than the histological infarction volume (4 hrs: 88.6 ± 11.8 vs. 74.3 ± 17.4 mm3, p < 0.05) but closely correlated with the infarction volume at 4 hours (r = 0.81, p < 0.05). Intravascular MCA occlusion caused a neutral red defect volume in only two of 17 animals after 1-4 hours, which correlated well with the absence of histological evidence of infarction. Neutral red staining is a simple method for assessing the acute outcome of focal cerebral ischemia as early as 4 hours after the onset, in an appropriate model of cerebral ischemia.
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  • Tsutomu KATO, Yutaka SAWAMURA, Mitsuhiro TADA, Shirou SAKUMA, Masako S ...
    1995 Volume 35 Issue 8 Pages 567-574
    Published: 1995
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    Expression of the two types of tumor necrosis factor (TNF) receptor, p55 and p75, in 12 human glioblastoma cell lines was studied. Reverse-transcription polymerase chain reaction detected messenger ribonucleic acid (mRNA) transcripts of p55 TNF receptor in all 12 cell lines tested, but p75 TNF receptor mRNA in only four cell lines. Flow cytometric analysis with anti-p55 and anti-p75 TNF receptor monoclonal antibodies demonstrated both p55 and p75 proteins in these four cell lines, but the level of expression of p75 molecule was very low. Correlation of p55 and p75 TNF receptor expression with TNF-induced growth suppression and production of bioactive molecules (interleukin-6, interleukin-8, manganase-superoxide dismutase, prostaglandin E2) showed that p55 TNF receptor mediates these TNF actions, but none of the responses were influenced by the presence of the p75 TNF receptor, which apparently has no specific role.
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  • Fumihiro IMAI, Kazuhisa FUJISAWA, Nobuo KIYA, Takashi NINOMIYA, Yuko O ...
    1995 Volume 35 Issue 8 Pages 575-579
    Published: 1995
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    A 68-year-old female presented with Waldenstrom''s macroglobulinemia with infiltration into the cerebral parenchyma manifesting as increased confusion, memory loss, and disorientation. She had a past history of Waldenstrom''s macroglobulinemia treated 3 years before. Magnetic resonance imaging showed a high intensity area on T2-weighted images in the left frontal lobe extending to the corpus callosum which was well enhanced by gadolinium-diethylenetriaminepenta-acetic acid. Direct infiltration of neoplastic cells was confirmed by biopsy. Immunohistochemical examination showed that mature plasmacytoid cells in the cerebral parenchyma were immunoglobulin M and lambda light chain antigen positive, but immature lymphocytes in Virchow-Robin space were negative. Monoclonal proliferation was confirmed by southern blot analysis. She became symptom free and the size of the lesion was dramatically reduced after 40 Gy irradiation. She showed no evidence of recurrence 3 years after irradiation. As no effective chemotherapy regimen for Bing-Neel syndrome has been established, irradiation is worth considering when neuroimaging suggests intracranial infiltration of neoplastic cells.
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  • Takumi ABE, Kiyoshi MATSUMOTO, Yasushi HORICHI, Takaki HAYASHI, Hisato ...
    1995 Volume 35 Issue 8 Pages 580-583
    Published: 1995
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    Magnetic resonance (MR) angiography as a method for the long-term follow-up of cerebral arteriovenous malformations (AVMs) was assessed in 14 patients with cerebral AVMs. These patients were either untreated or treated with transarterial embolization and/or stereotactic radiosurgery (gamma knife). Two-dimensional and three-dimensional (3D)-time-of-flight (TOF) techniques were useful for following AVMs with a small nidus and few feeders and drainers which were either untreated or had been treated only a few months previously. 3D-TOF MR angiography with a contrast agent was more useful for visualizing the vascular structure, including the residual nidus, during long-term follow-up of treated AVMs.
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  • Masanori KABUTO, Toshihiko KUBOTA, Hidenori KOBAYASHI, Takao NAKAGAWA, ...
    1995 Volume 35 Issue 8 Pages 584-586
    Published: 1995
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    A 65-year-old male and an 80-year-old female presented with unusual simultaneous bilateral hypertensive intracerebral hemorrhages in the putamina and thalami, respectively. The hematomas were demonstrated by computed tomography performed within a few hours of onset. The patients underwent conservative therapy. The male patient died 4 days after the onset and the female finally became vegetative. The majority of patients with bilateral intracerebral hemorrhages generally have a poor outcome due to the development of severe disturbed consciousness, tetraparesis, and pseudobulbar palsy, even if the hematomas are not so large. The indication of surgery for this type of hemorrhage may be confined to patients with small hematomas who can be expected to have a good functional outcome after removal of the larger hematoma.
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  • Shunichi YOKOYAMA, Koki KADOTA, Tetsuhiko ASAKURA, Kazumasa KAWAZOE
    1995 Volume 35 Issue 8 Pages 587-590
    Published: 1995
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
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  • Yasuo SUGITA, Shigeaki YONEDA, Toshinori WATANABE, Minoru SHIGEMORI
    1995 Volume 35 Issue 8 Pages 591-593
    Published: 1995
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    A 77-year-old female presented with a rare aneurysmal subarachnoid hemorrhage accompanied by a remote hypertensive intracerebral hemorrhage. With a past history of hypertension, she suddenly developed right hemiparesis followed by delayed loss of consciousness. Left carotid angiography demonstrated a left internal carotid-posterior communicating artery aneurysm. The intracerebral hematoma was located in the posterior limb of the internal capsule ipsilateral to the ruptured aneurysm. The aneurysm was clipped with a fenestrated clip 3 weeks after the onset. The rise in blood pressure at the onset of intracerebral hemorrhage probably caused the rupture of the internal carotidposterior communicating artery aneurysm.
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  • Yasuhiro MATSUDA, Tetsuji INAGAWA
    1995 Volume 35 Issue 8 Pages 594-597
    Published: 1995
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    Three patients with large or huge meningiomas of the pineal region presented with headache, vomiting, gait and visual disturbance, apraxia, agnosia, and transient amnestic aphasia. Computed tomographic scans revealed round, high-density areas of 8×7×7 cm, 5×5×4 cm, and 3×3×3 cm in the pineal region. Angiography revealed that the bilateral internal cerebral veins and the great vein of Galen were stretched and significantly displaced upward in one patient, and downwards in the other two. The meningiomas appeared to originate from the verum interpositum and falcotentorial junction, respectively. The tumors were removed subtotally or totally via an occipital interhemispheric transtentorial approach and/or infratentorial supracerebellar approach. The postoperative courses were uneventful, and no neurological deficit was detected postoperatively. Pineal region tumors with a maximum diameter of 5 cm or larger should be operated on via a unilateral or bilateral occipital interhemispheric transtentorial approach, regardless of the angiographic findings, because this permits a wide operative field and can be followed, if necessary, by an infratentorial supracerebellar approach. Selection of the operative approach for a relatively small pineal region tumor should depend on the angiographic findings: downward displacement of the bilateral internal cerebral veins and the great vein of Galen indicates an occipital interhemispheric transtentorial approach, whereas upward displacement indicates an infratentorial supracerebellar approach.
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  • Yasuo IWADATE, Hiroki NAMBA, Kanji SUEYOSHI
    1995 Volume 35 Issue 8 Pages 598-603
    Published: 1995
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    Intra-arterial (IA) chemotherapy has achieved no obvious clinical superiority as a treatment for glioblastoma multiforme despite the many theoretical advantages. The clinical courses of 38 patients who underwent surgery and radiotherapy with IA 1-(4-amino-2-methyl-5-pyrimidinyl)-methyl-3-(2chloroethyl)-3-nitrosourea hydrochloride (ACNU) and cisplatin were reviewed. Tumor regrowth was evaluated by comparison of contrast-enhanced areas on computed tomographic scans. The initial response rate was 19 of 32 patients evaluated, and the median survival time (MST) for all 38 patients was 53 weeks. Local recurrence was observed in 20 patients, and distant recurrence (areas more than 3 cm from the original tumor margin) was observed in 15 patients. The MST was 59 weeks for patients without distant recurrence, and 42 weeks for patients with distant recurrence (statistically not significant). Adjuvant IA ACNU and cisplatin chemotherapy did not improve the survival time. An important clinical feature was the high incidence of distant recurrence, in contrast to experience with other conventional therapy regimens. Distant recurrence, without extended survival, may suggest insufficient control of tumor regrowth.
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  • Shigetaka ANEGAWA, Takashi HAYASHI, Ryuichiro TORIGOE, Katsuhiko HARAD ...
    1995 Volume 35 Issue 8 Pages 604-606
    Published: 1995
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    A method for craniotomy via a transverse linear scalp incision on the forehead wrinkle line with cosmetic reconstruction is described. The method requires minimal knowledge of plastic surgical techniques. Operative scars are inconspicuous and the normal appearance of the forehead can be retained, which is especially valuable for patients with alopecia praematura.
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