[Changes of epidural pulse waveform in increased intracranial pressure: an experimental study (author's transl)].
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Biomedical subjects
Publications and source records attributed to H Handa.
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Out of 155 cases of craniopharyngioma seen in the past 47 years, 19 are considered unusual. These 19 cases have been placed under the following headings--1. unusual topography, and 2. associated vascular pathology. Since CT scanning offers important information about extension of craniopharyngiomas, it is very helpful for planning operative approach. However, cerebral angiography is still important for demonstrating vascular pathology.
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Periventricular lucency was evaluated in the computed tomography scans of a large group of patients with hypertensive and normal pressure hydrocephalus as well as cerebral atrophy. It is confirmed that periventricular lucency is most prominent in cases of acute obstructive hydrocephalus in which the periventricular density profile pattern is often linear and steep. This linear profile is due to the disappearance of the ventricular wall as an effective barrier at the level of the superolateral angle of the frontal horn. The features of the periventricular lucency in chronic hydrocephalus (hyper- and normotensive) and cerebral atrophy are presented and discussed in detail.
Twenty cases of infants with computed tomographic low density areas over the frontal lobes that mimicked cortical atrophy are reported. Almost all cases presented with a slight increase in intracranial pressure associated with delayed developmental milestones. Peripheral hypodensity over the frontal lobes disappeared, and the infants' development was essentially normal, in many cases without surgery. The lesion might be called "infantile benign subdural effusion" and should be treated conservatively.
Four cases of histologically verified cerebral cavernous hemangiomas are presented. In one case, computed tomography (CT) showed well demarcated areas of high density, with slight enhancement and no significant mass effect. However, in the other three cases, the CT findings were similar to those encountered in hematomas, low grade gliomas, or meningiomas. Thus, although CT in cerebral cavernomas is informative in most cases, it does not offer specific diagnostic signs.
We examined the synthesis of early and late simian virus 40 (SV40) mRNA's in SV40-infected cells treated with two kinds of protein synthesis inhibitors. SV40 stimulated the synthesis of mRNA's for both large and small tumor antigens in cells pretreated with the drug emetine before the addition of virus. Emetine is a stringent inhibitor of protein synthesis and, thus, protein factors necessary for transcription and processing of these mRNA's probably preexist in the cell. Surprisingly, infection of cells pretreated with the protein synthesis inhibitor cycloheximide stimulated the synthesis of about 10-fold-higher levels of early viral mRNA's than did comparable infections of nontreated cells. This amplification of early viral mRNA steady-state levels is probably not due to inhibition of synthesis of the early A gene product since the same degree of drug-specific amplification was seen in SV40 tsA-infected cells that were cultured at the nonpermissive temperature. However, the most interesting effect of cycloheximide addition on viral mRNA synthesis was its stimulation of the appearance of late mRNA's in the cytoplasm of cells at early periods of infection. The synthesis of late mRNA's does not appear to require the A gene product as late RNAs can be found in the cytoplasm of cells infected with SV40 tsA mutants which have been maintained at 41 degrees C and continuously cultured in the presence of cycloheximide.
28 cases of arteriovenous malformations (AVMs) in children were analyzed and compared with 18 adolescent and 106 adult cases. The findings were: (1) intracerebral hematoma due to rupture of AVMs and focal neurologic deficits were more frequent in children, (2) Operative mortality was higher in children than in adults in cases where total removal was not feasible. (3) Follow-up results suggested that the prognosis in children was less favorable than in adults. (4) When dealing with spontaneous intracerebral hematoma in children care should be taken to search for underlying cryptic AVMs.
The subarachnoid space, the chorioid plexus and the arachnoid villi are microscopically studied in 60 normal human embryos and in 3 abnormal human embryos with rhombencephaloschisis and cervical myeloschisis. The subarachnoid space has been generally considered to be developed by outflow of cerebrospinal fluid (CSF) of the choroid-plexus origin from the IVth ventricle. This generally accepted concept does not meet with our findings: (1) cavity formation in the meninx primitiva is seen before appearance of the choroid plexus; (2) the primitive subarachnoid space is developed earlier in the prepontine region than in the area dorsal to the rhombic roof, and (3) the primitive subarachnoid space is formed in the embryos with dysraphism where the perineural subarachnoid space is separated from the ventricles. Apparently the embryonic pattern of CSF circulation should be much different from the generally believed pattern of adult, since the arachnoid villi are absent in the embryos and the ability of production of CSF in the embryonic choroid plexus is questionable. It is suggested that such embryonic pattern of CSF production and absorption may partly persist in adult human being.
A review of the results of treatment for 155 cases of craniopharyngioma during the past 47 years by the palliative operation was made. Steroid and operative microscope reduced operative mortality and gave more chance of total extirpation, but survival rate was almost unchanged. It is noteworthy that 3 cases who underwent palliative operation more than 30 years ago are still alive and leading useful lives. The quality of survival was somewhat less favorable in pediatric than adult cases. Morbidity frequently encountered in pediatric cases was growth retardaton. Craniopharyngioma is a benign tumor pathohistologically, but it should be considered as malignant because of the region it occurs in. Therefore, no forceful attempt to total extirpation should be made and the operations should, as a rule, be palliative.
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Cerebral aneurysms were induced in rats treated with unilateral ligation of the common carotid artery and hypertension produced by renal infarction with or without beta-aminopropionitrile, one of the lathyrogens. In this experiment, cerebral aneurysms developed more frequently than in the previous experiments in which hypertension induced by deoxycorticosterone and salt had been used. It was demonstrated that deoxycorticosterone was not essential to the development of the lesion. Regardless of its type, hypertension combined with carotid ligation played a primary role in the production of cerebral aneurysms in rats. Sodium chloride enhanced the systolic hypertension and thus increased the incidence of lesions. The role of hypertension in the development of cerebral aneurysms in humans is discussed.
Of 20 female and 14 male patients with chromophobe adenomas, 4 male patients, aged 38 to 47 years, and one female patient, aged 54, showed above normal basal plasma levels of follicle-stimulating hormone (FSH). An in vitro tissue culture study that was performed using chromophobe cells obtained from 3 of the 4 male patients and the 1 female patient showed moderate FSH secretion into the culture media. The secretion of FSH by pituitary chromophobe adenomas might be more frequent than hitherto suspected.
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