Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
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Volume 36, Issue 11
Displaying 1-10 of 10 articles from this issue
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  • Regional Cerebral Blood Flow Measured with 99mTc-HMPAO Based on Two-dimensional 133Xe Study in Ischemic Brain
    Shigeki IMAIZUMI, Shoichi ARAI, Yoshiharu SAKURAI, Hiroshi UENOHARA, A ...
    1996 Volume 36 Issue 11 Pages 775-782
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.775
    JOURNAL FREE ACCESS
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    Two-dimensional regional cerebral blood flow (rCBF) was measured using the xenon-133 inhalation method, and used to calibrate the rCBF measured by single photon emission computed tomography (SPECT) in the non-affected middle cerebral artery (MCA) area. The value of the rCBF in the target area could then be measured by SPECT and compared between patients. Technetium-99m-d, l-hexamethyl-propylene-amine-oxime and technetium-99m-diethylenetriaminepenta-acetic acid-human serum albumin D were used to measure rCBF and regional cerebral blood volume (rCBV), respectively, in the ischemic area of 16 patients who underwent surgical revascularization in the chronic stage. No significant increase in rCBF was obtained after the bypass surgery. The ΔrCBF and ΔCBF/ CBV ratio correlated well with the extent of vascularization in the MCA area on postoperative angiograms. Patients with a low CBF/CBV ratio on preoperative SPECT scans tended to show favorable postoperative vascularization and rCBF in the MCA area. Since the angiographic findings and the ΔrCBF or ΔCBF/CBV were correlated well, this simple and non-invasive method could be used for the analysis of rCBF in a group of patients.
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  • Angiographic Analysis of Moyamoya Disease —How Does Moyamoya Disease Progress?—
    Kiyohiro HOUKIN, Tetsuyuki YOSHIMOTO, Satoshi KURODA, Tatsuya ISHIKAWA ...
    1996 Volume 36 Issue 11 Pages 783-788
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.783
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    Differences in the clinical presentation and angiographic stages of moyamoya disease were studied in 69 patients, 35 children (6.3 ± 2.9 years old) and 34 adults (44.6 ± 10.5 years old). The angiographic stage (Suzuki''s stage) was compared between childhood and adulthood, ischemic onset and hemorrhagic onset, and female and male. The distribution of the angiographic stage was not very different, but was significantly shifted from stage III to stage IV in adult cases. The angiographic stage in patients with hemorrhagic onset was not significantly different from those with ischemic onset. There was no significant difference between females and males. Angiographic change is not very remarkable between pediatric and adult moyamoya disease. The angiographic stage does not directly correlate with the distinct clinical presentations between pediatric and adult moyamoya disease. Other factors such as cerebral blood flow demand and arteriosclerotic change seem to cause these differences.
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  • Transforming Growth Factor-β Inhibits Interferon-γ Secretion by Lymph okine-activated Killer Cells Stimulated with Tumor Cells
    Hirofumi NAGANUMA, Atsushi SASAKI, Eiji SATOH, Mitsuyasu NAGASAKA, Shi ...
    1996 Volume 36 Issue 11 Pages 789-795
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.789
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    The effect of transforming growth factor-β(TGF-β) secreted by glioblastoma (T98G) cells on the secretion of interferon-γ(IFN-γ) by lymphokine-activated killer (LAK) cells stimulated with tumor cells was investigated in cocultures of LAK and Daudi cells supplemented with T98G culture supernatant, T98G culture supernatant preincubated with anti-TGF-β1 and anti-TGF-β2 neutralizing antibodies, anti-TGF-β1 and anti-TGF-β2 antibodies, or natural human TGF-β1 or recombinant human TGF-β2. LAK cells were incubated with anti-TGF-β1 and anti-TGF-β2 antibodies, and with T98G cells of which the supernatant contained both active and latent forms of TGF-β1 and TGF-β2, with or without neutralizing antibodies. Addition of the supernatant from T98G cells to LAK/Daudi culture caused inhibition of IFN-γ secretion by LAK cells. The inhibition was abolished by pretreatment of the supernatants with anti-TGF-β antibodies. Addition of TGF-β1 and TGF-β2 to the LAK/Daudi culture inhibited IFN-γ secretion by LAK cells in a dose-dependent manner. Addition of anti-TGF-β antibodies to the LAK culture resulted in increased IFN-γ secretion. T98G cells failed to stimulate LAK cells to secrete more IFN-γ. Addition of anti-TGF-β antibodies to the LAK-T98G culture resulted in increased IFN-γ secretion by LAK cells. These results suggest that most malignant glioma cells which secrete high levels of TGF-β can inhibit IFN-γ secretion by LAK cells even after tumor cell stimulation.
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  • Functional Analysis of trk Proto-oncogene Product in Medulloblastoma Cells
    Takashi KOKUNAI, Hideki SAWA, Norihiko TAMAKI
    1996 Volume 36 Issue 11 Pages 796-804
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.796
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    MED-L cells with the 75 kd low-affinity nerve growth factor receptor (p75NGFR) and MED-H cells with the proto-oncogene tropomyosin receptor kinase product (p140trk) were isolated selectively from a parent MED-3 cell line derived from cerebellar medulloblastoma by panning, and the interaction of nerve growth factor (NGF) with these cell lines was analyzed. NGF treatment induced neuronal differentiation, growth inhibition, and tyrosine phosphorylation of p140trk in MED-H cells, but not in MED-L cells. Medulloblastoma cells express the functional NGFR, p140trk, which regulates their differentiation and growth.
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  • Transient Monocular Blindness during Manual Carotid Compression for Carotid-cavernous Sinus Fistulas —Two Case Reports—
    Masaki KOMIYAMA, Misao NISHIKAWA, Toshihiro YASUI
    1996 Volume 36 Issue 11 Pages 805-807
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.805
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    Transient monocular blindness occurred during manual carotid compression in two patients with a traumatic direct and a spontaneous dural arteriovenous carotid-cavernous sinus fistula. Ocular complication may occur during diagnostic or therapeutic carotid compression for carotid-cavernous sinus fistulas, so patients should be informed of this possibility. Ocular examination should be repeated during carotid compression to prevent sequelae of ischemic oculopathy.
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  • Fatal Subarachnoid Hemorrhage from an Inflammatory Cavernous Carotid Artery Aneurysm: Failure of Conservative Treatment After Early Diagnosis —Case Report—
    Hiroshi NAWASHIRO, Akira SHIMIZU, Katsuji SHIMA, Hiroo CHIGASAKI, Tats ...
    1996 Volume 36 Issue 11 Pages 808-811
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.808
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    Inflammatory carotid artery aneurysm is a rare complication of acute paranasal sinusitis. A 50-yearold female presented with a ruptured giant carotid artery aneurysm secondary to infection of the sphenoid sinus and cavernous sinus. She had been healthy until 5 days before admission, when she developed orbital phlegmon and meningitis. She received antibiotic therapy for 10 days. Computed tomography (CT) of the brain 2 days after admission showed no abnormality. However, repeat CT on day 6 showed a round isodense mass in the suprasellar cistern suggesting a cerebral aneurysm. Twelve days after admission, she suffered a fatal subarachnoid hemorrhage. Cerebral angiography revealed a giant left cavernous carotid artery aneurysm with a very irregular shape. Autopsy found sphenoid sinusitis and osteomyelitis extending into the cavernous sinuses. Diagnosis of bacterial inflammatory aneurysms before rupture is very important. Appropriate surgical intervention should be considered if there is enlargement of the original aneurysm or appearance of a new aneurysm indicating a potentially dangerous situation.
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  • Spontaneous Disappearance of Arteriovenous Malformation during Staged Treatment of Multiple Cerebral Arteriovenous Malformations —Case Report—
    Tetsuyuki YOSHIMOTO, Takeshi KASHIWABA, Kiyohiro HOUKIN, Hiroshi ABE
    1996 Volume 36 Issue 11 Pages 812-814
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.812
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    A 36-year-old male presented with aphasia and right hemiparesis due to the rupture of the larger of two arteriovenous malformations (AVMs) coexisting in the left hemisphere. The two AVMs had completely separate locations and different feeding arteries and draining systems. Two months after resection of the larger AVM and evacuation of the hematoma, carotid angiography showed the residual AVM had spontaneously disappeared. He was discharged without deficits. Change of cerebral hemodynamics after removal of the larger AVM presumably caused the spontaneous regression of the smaller one. Cerebral angiograms should be carefully examined because cerebral hemodynamics may be altered after removal of an AVM.
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  • Arteriovenous Malformation Presenting as Hypertensive Putaminal Hemorrhage in an Elderly Patient —Case Report—
    Taku SHIGENO, Takaki ISHIKAWA
    1996 Volume 36 Issue 11 Pages 815-817
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.815
    JOURNAL FREE ACCESS
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    A hypertensive 72-year-old male presented with a ruptured arteriovenous malformation (AVM) manifesting as hematoma indistinguishable from common putaminal hemorrhage on precontrast computed tomography scan. The AVM was located in the proximal sylvian region fed by branches of the anterior and middle cerebral arteries. The AVM was totally removed. Although bleeding from AVM in the elderly is uncommon, the cause of even common hypertensive hemorrhage should be identified by other imaging techniques such as magnetic resonance imaging and cerebral angiography to allow the optimum treatment.
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  • Double Pituitary Adenoma —Two Case Reports—
    Seiji KANNUKI, Keizo MATSUMOTO, Toshiaki SANO, Yasumi SHINTANI, Hirosh ...
    1996 Volume 36 Issue 11 Pages 818-821
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.818
    JOURNAL FREE ACCESS
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    A 43-year-old male and a 39-year-old male presented with multiple pituitary adenomas with two distinct histological types. The first patient who had multiple endocrine neoplasia type 1 had developed acromegaly due to a growth hormone-releasing hormone (GHRH)-producing pancreatic tumor. Both plasma GHRH and growth hormone (GH) levels decreased to normal after resection of the pancreatic tumor. However, the plasma GH level gradually increased again and magnetic resonance imaging revealed pituitary adenoma formation. Histological examination revealed two different histological types of pituitary adenoma: GH cell adenoma and null cell adenoma. The second patient, with no such genetic condition, had a non-functioning pituitary adenoma. Histological examination revealed two different histological types of silent GH cell adenoma and silent gonadotroph adenoma. Careful histological examination is required to exclude the possibility of multiple pituitary adenomas.
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  • Sphenoethmoidal Mucoceles with Intracranial Extension —Three Case Reports—
    Tatsunori YOKOYAMA, Shin-ichi INOUE, Jun-ichi IMAMURA, Tsutomu NAGAMIT ...
    1996 Volume 36 Issue 11 Pages 822-828
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.822
    JOURNAL FREE ACCESS
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    Three unusual cases of sphenoethmoidal mucoceles with rare intracranial extension are reported. A 64-year-old female presented with a 7-month history of right visual disturbance. Computed tomography (CT) and magnetic resonance (MR) imaging demonstrated a huge mass in the right middle fossa. She underwent right frontotemporal craniotomy. Postoperatively, her proptosis and cranial nerve dysfunction had improved markedly. A 53-year-old female complained of headache, nausea, and dizziness. CT and MR imaging revealed a cystic mass filling the right sphenoid sinus. The cystic lesion was evacuated through the transnasal approach. She was doing well postoperatively and has been asymptomatic. A 39-year-old male complained of headache, vomiting, and right visual disturbance. CT and MR imaging demonstrated a homogeneous mass occupying the sphenoid sinus. Sphenoidotomy exposed the cyst extending superiorly into the anterior cranial fossa. He recovered from the visual disturbances and has been asymptomatic since. MR imaging provides confirmation of the diagnosis of sphenoethmoidal mucocele and is important for preoperative evaluation.
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