Neurologia medico-chirurgica

Effects of Trapidil and Suramin on Growth Factor-induced Calcium Response and Tyrosine Phosphorylation in Human Glioma Cells

Kazuhiko BANDO, Seiji KANNUKI, Kazuhito ROKUTAN, Masayuki SHOUNO, Keiz ...

1995 Volume 35 Issue 9 Pages 631-638
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.631

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Platelet-derived growth factor (PDGF) and epidermal growth factor (EGF) induce the proliferation of glioma cells in vitro. Trapidil and suramin inhibit this growth factor-stimulated glioma cell growth, but the mechanisms are not fully understood. The effects of trapidil and suramin on PDGF and EGFinduced early biochemical events in T98G cells were studied. PDGF induced a rapid increase of intracellular free calcium concentration ([Ca²⁺]i) in fura-2/acetoxymethyl ester-loaded single glioma (T98G) cells. This increase was completely inhibited by removal of extracellular Ca²⁺ with ethylene glycol bis(β-aminoethyl ether)-N, N, N, N-tetraacetic acid but not by an L-type calcium channel blocker (nicardipine), suggesting that PDGF may cause calcium influx through voltage-independent calcium channels in T98G cells. Trapidil and suramin blocked the PDGF-induced calcium response and inhibited the PDGF-initiated tyrosine phosphorylation of the PDGF receptor as detected by Western blot analysis using an antibody specific for phosphotyrosine. Trapidil and suramin also inhibited EGF-initiated calcium response in T98G cells, but only partially inhibited EGF-initiated tyrosine phosphorylation at the same concentrations. Our results suggest that trapidil and suramin inhibit PDGF and EGF-initiated early biochemical events, and thus suppress growth factor-induced cell proliferation.

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¹⁹²Ir Induced Radiation Damage in Monkey Brain Assessed with Magnetic Resonance Imaging and Histological Examination

Hisato HIGASHI, Kengo MATSUMOTO, Minoru NAKAGAWA, Tomohisa FURUTA, Tak ...

1995 Volume 35 Issue 9 Pages 639-647
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.639

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The effects of irradiation on a large volume of normal brain tissue as occurs in interstitial brachytherapy were investigated. Double iridium-192 seed assemblies were stereotactically implanted into the right centrum semiovale of eight adult Japanese monkeys (Macaca fuscata). The morphological changes induced in the normal brain tissue were evaluated with magnetic resonance (MR) imaging with and without gadolinium-diethylenetriaminepenta-acetic acid (Gd) enhancement at 2 days and 1, 3, and 6 months after the brachytherapy. After each MR imaging examination, randomly selected experimental animals were sacrificed to analyze the histological changes. The low intensity area seen inside the ring of contrast enhancement on the T₁-weighted image with Gd enhancement was well correlated with histologically defined necrosis. The high intensity area seen outside the area showing contrast enhancement on the T₂-weighted image was well correlated with an area of histological edema and demyelination. The sizes of the lesion and the high intensity area were maximum during the acute stage (2 days) following interstitial irradiation. This monkey model with MR imaging can be used to investigate the development of brain damage induced by interstitial irradiation. We further recommend careful monitoring to detect the development of brain edema during the acute stage after interstitial brachytherapy, especially when large tumors are treated.

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Clinical Application of Diffusion-weighted Magnetic Resonance Imaging to Intracranial Disorders

Kiyoyuki YANAKA, Shizuo SHIRAI, Hiroshi KIMURA, Takao KAMEZAKI, Akira ...

1995 Volume 35 Issue 9 Pages 648-654
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.648

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Diffusion-weighted magnetic resonance imaging was performed to determine the changes in water diffusion and to investigate the detectability of diffusion anisotropy in patients with intracranial disorders. Diffusion maps of the apparent diffusion coefficient (ADC) were created of 19 patients with cerebral infarction, five with intracerebral hematoma, four with glioma, four with meningioma, four with hydrocephalus, and five with subdural hematoma. ADC was increased in chronic cerebral infarction and glioma, and decreased in acute cerebral infarction, meningioma, and the marginal area of glioma compared with the ADC of the normal gray matter. There was a significant difference in ADC between the marginal and internal areas of glioma. Increased ADC may be due to increased vasogenic edema in infarction and a lack of significant restriction of diffusion within glioma. Decreased ADC can be attributed to restricted diffusion caused by cytotoxic edema in infarction and the underlying histological pattern of densely packed tumor cells in glioma. Diffusion anisotropy of the internal capsule was less detectable in pathological than normal hemispheres. Diffusion anisotropy was less detectable in patients with hydrocephalus and subdural hematoma. Intracranial lesions were thought to have influenced the compression of the brain structures and cells, resulting in decreased diffusion. The measurement of ADC by diffusion-weighted magnetic resonance imaging has the potential for greater understanding of the biophysical changes in various intracranial disorders, including correct diagnosis of cerebral infraction, and histological diagnosis of brain tumor.

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Primary Malignant Lymphoma of the Central Nervous System —Report of Four Long-term Survivors—

Toshiki YAMASAKI, Nobuko SHIMA, Hirohiko YAMABE, Saburo NAGAOKA, Kouzo ...

1995 Volume 35 Issue 9 Pages 655-662
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.655

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Four of 47 patients treated between 1977 and 1993 for histologically confirmed primary malignant lymphoma of the central nervous system (non-Hodgkin''s type of B-cell origin) achieved long-term survival for more than 5 years with a good quality of life. Three have remained disease-free for 9-12.5 years. The fourth achieved complete remission for more than 5 years before death from tumor recurrence. All four patients were treated with a standard therapeutic regimen, consisting of radiotherapy (50-60 Gy local and 30-40 Gy whole brain irradiation) followed by four to six courses of chemotherapy with cyclophosphamide, vincristine, adriamycin, and prednisolone at 4 to 8-week intervals. No further treatment was performed after remission had been obtained. No specific predictors for long-term survival including sex, age, tumor location, multiplicity of lesions, histology, or treatment modality was identified. All four patients showed an immediate tumor response to radiation. We recommend chemotherapy at increasing intervals as part of the post-therapeutic management of longterm, disease-free patients.

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Clinical Features of Progressive Lacunar Infarction —Retrospective Analysis of Patients with Motor Syndromes—

Chifumi KITANAKA, Akira TERAOKA

1995 Volume 35 Issue 9 Pages 663-666
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.663

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The clinical features of progressive lacunar infarction were analyzed in 20 patients with lacunar infarction. Seven of the 20 patients experienced paresis progression and the remaining 13 patients had a stable course. The mean age of progressive lacunar infarction patients (78.6 ± 4.30 yrs) was significantly higher than that of stable lacunar infarction patients (65.1 ± 7.68 yrs) (p < 0.01). Patients presenting with pure motor stroke were more likely to have progressive stroke (7/13) than those presenting with sensorimotor stroke (0/7) (p < 0.05). Paresis aggravation began on Day 1 and ceased on Day 2 in most patients. Progressive paresis began to improve after reaching the nadir. Hemiparesis was only slightly worse after 1 month compared with that on admission. Older patients are more likely to have a progressive course. Paresis progression in lacunar patients does not preclude the possibility of recovery and is not necessarily associated with a poor prognosis.

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Unusual Location of Intracranial Vagus Neurinoma —Case Report—

Hiroyuki KAMIGUCHI, Takayuki OHIRA, Masahito KOBAYASHI, Masahiro OGINO ...

1995 Volume 35 Issue 9 Pages 667-670
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.667

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A 55-year-old male presented with hearing disturbance and tinnitus in the left ear. Computed tomography (CT) and magnetic resonance imaging demonstrated a well-defined, homogeneously enhanced mass in the left cerebellomedullary cistern without extension close to the jugular foramen. A three-dimensional image reconstructed from thin-slice CT scans demonstrated that the mass was clearly separated from the jugular foramen. The mass lesion was totally removed surgically. At surgery the tumor was found to originate from one rootlet of the vagal nerve just after its exit from the medulla oblongata. The histological diagnosis was neurinoma. Intracranial neurinomas of the glossopharyngeal, vagal, or accessory nerve usually originate within or close to the jugular foramen. This unusual location made it difficult to achieve a correct preoperative diagnosis.

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Ruptured Aneurysm at the Origin of Duplication of the Middle Cerebral Artery —Case Report—

Seigo KOYAMA, Akio KOTANI, Jun SASAKI, Makoto TAZOE, Takashi TSUBOKAWA

1995 Volume 35 Issue 9 Pages 671-673
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.671

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A 28-year-old male presented with a rare case of an aneurysm at the origin of duplication of the middle cerebral artery manifesting as subarachnoid hemorrhage. Preoperative angiography revealed duplication of the right middle cerebral artery and an aneurysm at its origin, which was successfully clipped. He was discharged with no neurological deficits. Congenital factors may be more important in the etiology of aneurysms associated with this anomaly.

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Acute Thrombolytic Therapy and Subsequent Angioplasty for Atherosclerotic Stenosis of the Basilar Artery —Case Report—

Shinichi NAKANO, Kiyotaka YOKOGAMI, Ryuji YAMADA, Tomokazu GOYA, Shini ...

1995 Volume 35 Issue 9 Pages 674-677
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.674

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A 50-year-old male presented with severe atherosclerotic stenosis of the basilar artery at its origin with very poor blood flow distally, manifesting as sudden onset of deterioration of consciousness to semicomatose with decerebrate posture. He regained consciousness dramatically after acute thrombolysis, although right hemiparesis persisted due to left pontine infarction. Follow-up angiography after 3 months of antiplatelet and anticoagulation therapy demonstrated severe residual stenosis of the basilar artery. Percutaneous transluminal angioplasty (PTA) resulted in wide patency of the basilar artery stenosis with excellent blood flow distally. Combination of acute thrombolytic therapy and subsequent PTA is an effective treatment for severe basilar artery occlusive disease.

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Thoracic Intradural Anterior Epidermoid Manifesting as Sudden Onset of Paraplegia —Case Report—

Milind DEOGAONKAR, Atul GOEL, Sunil K. PANDYA

1995 Volume 35 Issue 9 Pages 678-679
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.678

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A 32-year-old female presented with a rare thoracic intradural anterior epidermoid tumor manifesting as acute onset of paraplegia. The tumor was completely removed through a laminectomy. She achieved a full neurological recovery. This is a very unusual presentation for an epidermoid tumor.

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Juvenile Parkinsonism Treated with Bilateral Pallidotomies —Case Report—

Yuichi ANNO, Jun HIRAO, Hisayo OKAMOTO, Shinji KONDO, Takashi WATANABE ...

1995 Volume 35 Issue 9 Pages 680-682
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.680

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A 47-year-old female diagnosed as having juvenile parkinsonism at age 38 years developed progressive motor fluctuation while receiving levodopa medication. She underwent right posteroventral pallidotomy which achieved only a transient effect on the wearing-off. An additional procedure on the left pallidum resulted in long-lasting relief of the parkinsonian symptoms.

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