巻号一覧
49 巻, 8 号
選択された号の論文の11件中1～11を表示しています
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Original Articles
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Takashi SHIMIZU, Kanji NAKAI, Yuji MORIMOTO, Miya ISHIHARA, Hidenori O ...2009 年 49 巻 8 号 p. 327-332
発行日: 2009年
公開日: 2009/08/25
ジャーナル オープンアクセスThe present study investigated the appropriate conditions for induction of lesions in the rabbit atherosclerosis model. Four-week-old male Japanese white rabbits (n = 19) were fed the high cholesterol diet (HCD). This group was classified as the early start (ES) group. The animals were divided into three groups: (i) 1% HCD group (n = 8), (ii) 2% HCD group (n = 8), and (iii) normal diet group (control, n = 3). The HCD groups were divided into two subgroups: (a) balloon injury (BI) group (1% HCD, n = 5; 2% HCD, n = 4), and (b) non-BI group (1% HCD, n = 3; 2% HCD, n = 4). Survival period, histological characteristics, area of plaque, and effects of BI and diet cholesterol content were analyzed. Twelve-week-old male Japanese white rabbits (n = 8) were fed the 1% HCD. This group was classified as the late start (LS) group, and underwent BI in the aorta. The histological characteristics and area of plaque were investigated. The plaque satisfied the three requirements of vulnerable plaque: Lipid rich core, accumulation of macrophages, and thin fibrous cap. The plaque area was significantly greater in the ES group compared to the LS group (p = 0.0037). Survival analysis found no statistical correlation with BI or diet cholesterol content. This study indicates that the simplest conditions for inducing the rabbit atherosclerosis model are 1% HCD, non-BI, and early start of HCD. This model is suitable for experiments with new therapeutic devices.
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Tomofumi NISHIKAWA, Tetsuya UEBA, Motohiro KAJIWARA, Naomi MIYAMATSU, ...2009 年 49 巻 8 号 p. 333-339
発行日: 2009年
公開日: 2009/08/25
ジャーナル オープンアクセスThe validity of regular use of antiplatelet agents was retrospectively assessed in 106 patients with intracerebral hemorrhage (ICH) (supratentorial hemorrhage 92, lobar 22 and deep 70; and infratentorial hemorrhage 14) who underwent T2*-weighted gradient-echo magnetic resonance (MR) imaging between January 2005 and December 2006 in Kishiwada City Hospital. The prevalence of cerebral microbleeds was 54.7% (58/106), and the presence was significantly associated with higher age (odds ratio 3.09, p = 0.007), presence of white matter hyperintensity on T2-weighted MR imaging (odds ratio 2.36, p = 0.032), and previous ICH and/or cerebral infarction (odds ratio 4.77, p = 0.020). Previous ICH and/or cerebral infarction was independently associated with the presence of cerebral microbleeds after adjustment for age, white matter hyperintensity, and hypertension (odds ratio 4.07, p = 0.043). Regular use of antiplatelet agents was not associated with the presence of cerebral microbleeds, whether the patients had cerebrovascular diseases or not. Our findings suggest that antiplatelet medication can be justified for patients with cerebral microbleeds.
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—Review of Initial 100 Cases—Satoshi MAESAWA, Masazumi FUJII, Norimoto NAKAHARA, Tadashi WATANABE, ...2009 年 49 巻 8 号 p. 340-350
発行日: 2009年
公開日: 2009/08/25
ジャーナル オープンアクセスInitial experiences are reviewed in an integrated operation theater equipped with an intraoperative high-field (1.5 T) magnetic resonance (MR) imager and neuro-navigation (BrainSUITE®), to evaluate the indications and limitations. One hundred consecutive cases were treated, consisting of 38 gliomas, 49 other tumors, 11 cerebrovascular diseases, and 2 functional diseases. The feasibility and usefulness of the integrated theater were evaluated for individual diseases, focusing on whether intraoperative images (including diffusion tensor imaging) affected the surgical strategy. The extent of resection and outcomes in each histological category of brain tumors were examined. Intraoperative high-field MR imaging frequently affected or modified the surgical strategy in the glioma group (27/38 cases, 71.1%), but less in the other tumor group (13/49 cases, 26.5%). The surgical strategy was not modified in cerebrovascular or functional diseases, but the success of procedures and the absence of complications could be confirmed. In glioma surgery, subtotal or greater resection was achieved in 22 of the 31 patients (71%) excluding biopsies, and intraoperative images revealed tumor remnants resulting in the extension of resection in 21 of the 22 patients (95.4%), the highest rate of extension among all types of pathologies. The integrated neuro-navigation improved workflow. The best indication for intraoperative high-field MR imaging and integrated neuro-navigation is brain tumors, especially gliomas, and is supplementary in assuring quality in surgery for cerebrovascular or functional diseases. Immediate quality assurance is provided in several types of neurosurgical procedures.
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Case Reports
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—Case Report—Kazuhito NAKAMURA, Keiji MURATA, Taichiro KAWAKAMI, Yuzo TERAKAWA, Hid ...2009 年 49 巻 8 号 p. 351-353
発行日: 2009年
公開日: 2009/08/25
ジャーナル オープンアクセスA 59-year-old male presented with repeated transient hemianopsia and hemiparesis on the left. Emergency magnetic resonance angiography showed stenosis of the right posterior cerebral artery (PCA). Endovascular recanalization with percutaneous transluminal angioplasty was performed immediately after the diagnosis. Patency of the PCA was successfully restored. The patient was discharged without neurological deficits. Progressive stroke in the PCA territory is rare. However, emergency endovascular recanalization is possible after prompt clinical diagnosis based on repeated diffusion-weighted magnetic resonance imaging and angiography after a 24-hour interval.
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—Two Case Reports—Haruki YAMAKAWA, Shinichi YOSHIMURA, Toru IWAMA2009 年 49 巻 8 号 p. 354-358
発行日: 2009年
公開日: 2009/08/25
ジャーナル オープンアクセスRetrograde flow through the anterior spinal artery (ASA) from the cervical vertebral artery (VA) to the intracranial distal VA due to disrupted perfusion caused by bilateral VA occlusion is rare. We report two cases of hemodynamic vertebrobasilar circulatory insufficiency caused by bilateral VA occlusion. In these patients, the ASA filled in the retrograde direction, and provided collateral support to the ipsilateral posterior inferior cerebellar artery. The patients were treated with drip intravenous infusion of edaravone and/or argatroban. One patient had a good collateral supply from the posterior communicating artery and recovered almost completely within one month, but the other did not and lapsed into a coma, with generalized hyperreflexia, pin-point pupils, and ataxic respiration. Severe calcified lesions on three-dimensional computed tomography angiography at the occlusion site in the second patient indicated direct surgery including right superficial temporal artery to superior cerebellar artery anastomosis, rather than the endovascular approach. Retrograde flow through the ASA may be observed in this type of critical situation, and may be an important source of collateral supply to the posterior fossa territory.
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—Case Report—Jun MASUOKA, Tomihiro WAKAMIYA, Toshihiro MINETA, Yukinori TAKASE, Mas ...2009 年 49 巻 8 号 p. 359-361
発行日: 2009年
公開日: 2009/08/25
ジャーナル オープンアクセスA 77-year-old woman was admitted to a local hospital with a 7-day history of vertigo and nausea, followed by gait disturbance. Magnetic resonance imaging showed extensive brain edema with a hemorrhagic component in the right cerebellum. The lesion was heterogeneously enhanced after administration of contrast medium. The presumptive diagnosis was malignant glioma based on these findings, as well as the presence of mass effect and abnormal enhancement. She was referred to our hospital. However, cerebral angiography did not reveal tumor stain or arterial occlusion, but confirmed corkscrew-like venous collaterals and absence of opacification of the superior petrosal vein (SPV) and superior petrosal sinus. Topography of the brain edema was consistent with the drainage territory of the SPV. These findings suggested that the lesion was vasogenic edema caused by thrombosis of the SPV. The patient was conservatively treated without anticoagulation therapy, and the neurological and imaging abnormalities resolved spontaneously. To avoid unnecessary biopsy, thrombosis of the SPV should be considered in the differential diagnosis of infratentorial lesion mimicking brain tumors. Knowledge of the posterior fossa venous anatomy is essential to achieve the correct diagnosis.
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—Case Report—Hideo HAMADA, Nakamasa HAYASHI, Masanori KURIMOTO, Akiko TAKAIWA, Kuni ...2009 年 49 巻 8 号 p. 362-364
発行日: 2009年
公開日: 2009/08/25
ジャーナル オープンアクセスA 39-year-old woman presented with long-standing overt ventriculomegaly in adults (LOVA) manifesting as gradually worsening headache. Past history included treatment for myeloschisis at birth. Intelligence quotient (IQ) was 115 and preoperative psychological assessment using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) showed normal scores in all domains. However, scores for constructional ability were slightly low. Computed tomography revealed severe ventriculomegaly involving the lateral and third ventricles, and magnetic resonance imaging showed aqueductal stenosis. Endoscopic third ventriculostomy was performed under a diagnosis of LOVA. Postoperatively, the headache resolved and the RBANS showed improvements in memory and constructional ability. Detailed evaluation of cognitive function provides a good indicator in the treatment of hydrocephalus with normal IQ.
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—Case Report—Satoru SAKIHARA, Kazunori KAGEYAMA, Atsufumi MATSUMOTO, Hidetoshi IKED ...2009 年 49 巻 8 号 p. 365-369
発行日: 2009年
公開日: 2009/08/25
ジャーナル オープンアクセスA 47-year-old woman presented with a pituitary microadenoma manifesting as typical Cushing's syndrome. The diagnosis was Cushing's disease based on the endocrinological findings. Plasma adrenocorticotropic hormone (ACTH) levels were greatly increased from 66 pg/ml to 2490 pg/ml (about 38-fold) in response to the administration of 100 μg human growth hormone-releasing peptide (GHRP)-2. GHRP receptor type 1a messenger ribonucleic acid was detected in the tumor. Therefore, GHRP-2 may stimulate ACTH via the GHRP receptor type 1a in pituitary ACTH-producing tumor. The GHRP-2 test, currently clinically available in Japan, may be a useful diagnostic tool for Cushing's disease.
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—Case Report—Eiji ITO, Kiyoshi SAITO, Tetsuya NAGATANI, Masaaki TERANISHI, Yuri AIM ...2009 年 49 巻 8 号 p. 370-373
発行日: 2009年
公開日: 2009/08/25
ジャーナル オープンアクセスA 67-year-old man presented with a rare case of cavernous sinus thrombophlebitis (CST) caused by Porphyromonas gingivalis with abscess formation extending to the orbital cavity. Neuroimaging demonstrated a cystic lesion in the right cavernous sinus that was hyperintense on diffusion-weighted imaging. The patient was successfully treated with surgical drainage and antibiotic administration. CST is rare and often has a fulminant progression with high rates of morbidity and mortality. The differential diagnosis of cavernous sinus lesions should include CST. Early recognition and differentiation from other diseases with aggressive medical and possible surgical intervention are necessary to reduce mortality and long-term sequelae. Diffusion-weighted imaging is useful for the early recognition and differentiation of CST from other diseases.
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—Case Report—Satoshi TSUTSUMI, Yukimasa YASUMOTO, Masanori ITO2009 年 49 巻 8 号 p. 374-376
発行日: 2009年
公開日: 2009/08/25
ジャーナル オープンアクセスA 61-year-old female presented with multiple meningeal cysts arising along the whole craniospinal axis, manifesting as trigeminal neuralgia, truncal ataxia, and gradually aggravating headache persisting for 2 years. The patient had suspected Sjögren syndrome, but no other contributory medical history such as infection, subarachnoid hemorrhage, trauma, malignancies affecting the central nervous system, or habitual drug use. Cerebral magnetic resonance imaging revealed displaced trigeminal root and midbrain, distorted cerebellar hemisphere, and ventriculomegaly, which were relieved by microsurgical resection of the cyst wall. Histological examination confirmed the diagnosis of arachnoid cysts without concomitant meningeal inflammatory reactions. We thought that the multiple meningeal cysts might have originated from undetected meningitis or undetermined underlying mechanism associated with the autoimmune reactions occurring in the arachnoid membrane covering the central nervous system.
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Editorial Committee
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2009 年 49 巻 8 号 p. EC15-EC16
発行日: 2009年
公開日: 2013/03/08
ジャーナル オープンアクセスPDF形式でダウンロード (54K)
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