Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
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Volume 39, Issue 3
Displaying 1-11 of 11 articles from this issue
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  • Inhibition of Topoisomerase II α Subunit De Novo Synthesis by Specific Antisense Oligonucleotides Suppresses Human Glioma T98G Cell Growth
    Masaki SHIN, Shoji KIMURA, Seigo NAGAO
    1999 Volume 39 Issue 3 Pages 199-205
    Published: 1999
    Released on J-STAGE: August 17, 2007
    DOIhttps://doi.org/10.2176/nmc.39.199
    JOURNAL FREE ACCESS
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    Deoxyribonucleic acid (DNA) topoisomerases are enzymes which resolve topological problems in eukaryotic DNA, and may be involved in cell proliferation. The involvement of topoisomerase II in cell proliferation was examined in the human glioma cell line T98G. The growth rate of T98G cells was suppressed by treatment with topoisomerase II antisense oligonucleotides dose-dependently, with significant suppression at concentrations greater than of 0.1mM. The growth rate of T98G treated with control oligonucleotide was suppressed at concentrations greater than 3.0mM. The activity of topoisomerase II in T98G cells treated with 0.5mM topoisomerase II antisense oligonucleotide was one fourth of that in cells treated with control oligonucleotide. When topoisomerase II translation was suppressed, the activity of topoisomerase I was increased. These results suggest that de novo synthesis of the topoisomerase II protein is required to maintain a normal growth rate in cultured T98G cells. These topoisomerases may be functionally related, and might provide compensatory mechanisms in the case of compromised function.
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  • Functional Prognosis after Treatment of Spinal Dural Arteriovenous Fistulas
    Satoshi USHIKOSHI, Kazutoshi HIDA, Yoichi KIKUCHI, Kazuo MIYASAKA, Tos ...
    1999 Volume 39 Issue 3 Pages 206-213
    Published: 1999
    Released on J-STAGE: August 17, 2007
    DOIhttps://doi.org/10.2176/nmc.39.206
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    Functional prognosis after treatment for spinal dural arteriovenous fistulas (SDAVFs) was retrospectively analyzed in 13 consecutive patients aged 38 to 73 years (mean 57 years) treated during the last 5 years. The duration of symptoms before diagnosis ranged from 3 to 72 months (mean 23 months). Neurological symptoms were examined before and 6 months after the treatment. Seven patients underwent embolization as the initial treatment. In four of six patients, N-butyl 2-cyanoacrylate (NBCA) embolization achieved complete obliteration of SDAVF. The other two patients with incomplete embolization and one embolized with polyvinyl alcohol particles underwent subsequent surgical treatment. Six patients were treated by direct surgery. Complete disappearance of SDAVF was confirmed in all nine patients treated surgically. Improvement of gait and micturition disturbance after the treatment was noted in six of 10 and three of six patients, respectively. Long duration of symptoms and high grade of neurological symptoms were associated with a poor functional outcome. NBCA embolization and surgery are curative treatments for SDAVF, but the functional prognosis is not always satisfactory. Embolization is the first choice of treatment for SDAVF because it is less invasive and relatively safe. However, when complete obliteration is not achieved, prompt surgery is recommended because a long duration of symptoms will result in a poor functional prognosis.
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  • Retrolabyrinthine Presigmoid Transpetrosal Approach for Selective Subtemporal Amygdalohippocampectomy
    Tomokatsu HORI, Shinji KONDO, Atsumi TAKENOBU, Jun HIRAO, Norimasa KOH ...
    1999 Volume 39 Issue 3 Pages 214-225
    Published: 1999
    Released on J-STAGE: August 17, 2007
    DOIhttps://doi.org/10.2176/nmc.39.214
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    The retrolabyrinthine presigmoid transpetrosal approach is a modification of the subtemporal approach which is suitable for complete amygdalectomy. By drilling away the retrolabyrinthine presigmoid petrosal bone, at least 1cm more space below and 1cm more space medially is obtained than in the subtemporal approach, and temporal retraction pressure is diminished when approaching from below. Operative results according to the Engel′s classification of seizure control, and pre- and postoperative Wechsler Adult Intelligence Scale (WAIS), revised WAIS, and Wechsler Intelligence Scale for Children scores were measured in 16 patients treated by normal or modified subtemporal amygdalohippocampectomy. Postoperative follow-up ranged from 8 to 79 months. There has been no morbidity or mortality among these 16 patients, and postoperative seizure frequency has been diminished to less than 10% of the preoperative level in 15 of the 16. In eight patients, seizures have been eliminated totally. Subtemporal amygdalohippocampectomy achieved significantly increased performance and full scale intelligence quotient within 2 months after surgery, compared to preoperative levels. Subtemporal amygdalohippocampectomy is an alternative to the transsylvian approach, but is less invasive.
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  • Neurovascular Decompression for Trigeminal Neuralgia in Elderly Patients
    Hiroshi RYU, Seiji YAMAMOTO, Kenji SUGIYAMA, Naoki YOKOTA, Tokutaro TA ...
    1999 Volume 39 Issue 3 Pages 226-230
    Published: 1999
    Released on J-STAGE: August 17, 2007
    DOIhttps://doi.org/10.2176/nmc.39.226
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    The operative findings and outcomes of neurovascular decompression for trigeminal neuralgia were compared between patients aged 75 years and older (elderly group, 17 patients) and patients aged under 75 years (nonelderly group, 115 patients). There were no statistically significant differences in the operative findings or outcomes between the two groups, except in the percentage of patients who had been treated with carbamazepine. Neurovascular decompression for trigeminal neuralgia can be performed in elderly patients with the same operative results as in nonelderly patients. If other treatments (especially carbamazepine treatment) prove ineffective, neurovascular decompression should be considered in elderly patients before they become too old to undergo surgery. However, neurovascular decompression in elderly patients requires great care, as the venous system, including the superior petrosal vein, should be preserved and retraction of the cerebellum should be avoided whenever possible to maintain correct blood circulation in the cerebellum and brainstem.
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  • Heading Injury Precipitating Subdural Hematoma Associated with Arachnoid Cysts
    Two Case Reports
    Akihito KAWANISHI, Masaki NAKAYAMA, Koki KADOTA
    1999 Volume 39 Issue 3 Pages 231-233
    Published: 1999
    Released on J-STAGE: August 17, 2007
    DOIhttps://doi.org/10.2176/nmc.39.231
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    A 14-year-old boy and a 11-year-old boy presented with subdural hematomas as complications of preexisting arachnoid cysts in the middle cranial fossa, manifesting as symptoms of raised intracranial pressure. Both had a history of heading the ball in a soccer game about 7 weeks and 2 days before the symptom occurred. There was no other head trauma, so these cases could be described as “heading injury.” Arachnoid cysts in the middle cranial fossa are often associated with subdural hematomas. We emphasize that mild trauma such as heading of the ball in a soccer game may cause subdural hematomas in patients with arachnoid cysts.
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  • Cervical Epidural Rhabdomyosarcoma with a Leukemia-like Presentation in an Aged Patient
    Case Report
    Toshihiko HAISA, Tatsuya KONDO, Akiyoshi MIWA, Kiyoshi SAITOH
    1999 Volume 39 Issue 3 Pages 234-237
    Published: 1999
    Released on J-STAGE: August 17, 2007
    DOIhttps://doi.org/10.2176/nmc.39.234
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    A 77-year-old female presented with rhabdomyosarcoma manifesting as leukemia-like indications. Neuroimagings detected cervical and paravertebral masses. Immunohistochemical study of the surgically excised mass lesion from the cervical spine established the correct diagnosis. This leukemia-like presentation of rhabdomyosarcoma requires a multidisciplinary approach to establish the correct diagnosis and treatment.
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  • Cerebral Metastasis of a Uterine Leiomyosarcoma
    Case Report
    Ibrahim M. ZIYAL, Murat MUSLUMAN, Ghassan K. BEJJANI, Canan TANIK, Cen ...
    1999 Volume 39 Issue 3 Pages 238-241
    Published: 1999
    Released on J-STAGE: August 17, 2007
    DOIhttps://doi.org/10.2176/nmc.39.238
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    A 38-year-old female presented with sudden neurological deterioration 6 years after an operation and chemotherapy for uterine leiomyosarcoma. An extremely rare metastasis of the uterine leiomyosarcoma to the brain was identified and totally resected. Whole brain irradiation (50 Gy) was given. A recurrence of the metastasis was resected 10 weeks later. She ultimately died of a second recurrence. Aggressive surgical management of cerebral metastasis of uterine leiomyosarcoma may achieve an improved outcome.
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  • Cerebral Gumma Showing Spontaneous Regression on Magnetic Resonance Imaging Study
    Case Report
    Hideo TAKESHIMA, Takayuki KAKU, Yukitaka USHIO
    1999 Volume 39 Issue 3 Pages 242-245
    Published: 1999
    Released on J-STAGE: August 17, 2007
    DOIhttps://doi.org/10.2176/nmc.39.242
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    A 75-year-old male presented with the complaint of headache. Magnetic resonance (MR) imaging demonstrated a low-signal intensity area on both T1- and T2-weighted images with ring-like enhancement and adhesion of the dura appearing as dural tail sign. Follow-up MR imaging demonstrated spontaneous regression, so the preoperative diagnosis was malignant lymphoma. Histological examination revealed typical granuloma. Treponema pallidum hemagglutination assay tests of serum and cerebrospinal fluid were positive for active syphilis. The enhanced mass totally disappeared after 4 months of erythromycin therapy. The final diagnosis was cerebral gumma. The incidence of syphilis is increasing, so cerebral gumma should be included in the differential diagnosis of hypovascular tumors that involve both the parenchyma and dura even in the presence of spontaneous regression.
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  • Surgical Treatment of Intractable Epilepsy Originating from the Primary Sensory Area of the Hand
    Case Report
    Eishi ASANO, Shuichi ISHIKAWA, Taisuke OTSUKI, Nobukazu NAKASATO, Taka ...
    1999 Volume 39 Issue 3 Pages 246-250
    Published: 1999
    Released on J-STAGE: August 17, 2007
    DOIhttps://doi.org/10.2176/nmc.39.246
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    A 14-year-old right-handed girl presented with intractable epilepsy originating from the primary sensory area of the hand, manifesting as sensory partial seizures in the left hand with secondary generalization. Neurological examination showed no abnormal findings. Magnetic resonance imaging, magnetoencephalography, and cortical stimulation using chronic subdural electrodes demonstrated a lesion located in the primary sensory cortex of the hand, in which the ictal onset zone was identified by 24-hour intracranial electroencephalographic recording. Surgical resection of the lesion and multiple subpial transections of the adjacent cortices were performed. The histological diagnosis was dysembryoplastic neuroepithelial tumor (DNT). She was completely free of seizures without permanent sensory deficits postoperatively. DNT located in the primary sensory hand area may be resectable without causing postoperative sensory deficits, if accurate functional mapping and surgical resection are performed.
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  • Spontaneous Cerebrospinal Fluid Leakage Detected by Magnetic Resonance Cisternography
    Case Report
    Yoshiya NAKAYAMA, Akira TANAKA, Yasushi UENO, Shinya YOSHINAGA
    1999 Volume 39 Issue 3 Pages 251-254
    Published: 1999
    Released on J-STAGE: August 17, 2007
    DOIhttps://doi.org/10.2176/nmc.39.251
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    A 49-year-old male with no history of head trauma suffered cerebrospinal fluid (CSF) discharge from the left nostril for one month. Coronal computed tomography (CT) showed lateral extension of the sphenoid sinus on both sides and CSF collection on the left side. CT cisternography could not identify the site of CSF leakage. Heavily T2-weighted magnetic resonance (MR) imaging (MR cisternography) in the coronal plane clearly delineated a fistulous tract through the sphenoid bone into the sphenoid sinus. Patch graft with muscle fragment completely relieved the CSF rhinorrhea. Postoperative three-dimensional CT showed the two bone defects identified during surgery. Small bony dehiscences in the sphenoid bone and lateral extension of the sphenoid sinus predisposed the present patient to CSF fistula formation. MR cisternography in the coronal and sagittal planes is superior to CT scanning or CT cisternography for detection of the site of active CSF leakage.
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  • Pediatric Brain Tumors
    Naoki KAGEYAMA
    1999 Volume 39 Issue 3 Pages 255-256
    Published: 1999
    Released on J-STAGE: August 17, 2007
    DOIhttps://doi.org/10.2176/nmc.39.255
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