[A study on development of Landau reaction].
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Biomedical subjects
Publications and source records attributed to J Suzuki.
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A long-term result after total removal of a giant intracranial teratoma in early infancy is reported. The patient was a 5-month-old boy with vomiting, convulsion and right hemiparesis occurring acutely and shortly before admission. Plain skull films, In-113m brain scintiscanning and carotid angiography revealed a giant tumor located widely over both frontal lobes. At operation, the tumor, originated from the base of the anterior half of the cranial cavity. A mature teratoma weighing 320 grams was totally removed without sacrificing the adjacent brain and vessels. Both cerebral hemispheres were found severely compressed by the tumor. Postoperative respiratory and convulsive disorders were well controlled. The boy was discharged in the third month after operation. At present, 13 years after operation, he is developing normally for his age. In the junior high school, he studies and plays sports with no handicap. Computed tomography reveals no recurrence of the tumor. EEG shows reactive pattern of activity and small, but rare spikes in the frontal area. And his pituitary function is revealed to be normal.
It is well known that moyamoya disease is sometimes accompanied by cerebral aneurysm. However, a case of moyamoya disease with arterio-venous malformation is not found out on the literature. In this paper, a rare case of moyamoya disease accompanied by arterio-venous malformation is reported. The patient is a 33-year-old male who developed transient left motor weakness and visual disturbance on September 5, 1983. He was admitted to our hospital on October 3, 1983. On admission, there were no abnormal neurological findings. Plain CT scan showed low density area in the left parietooccipital cortex. Enhanced CT scan revealed a ribbon-shaped enhanced area in the right temporooccipital cortex and spotty enhanced area in the right frontal subcortex. Cerebral angiogram was a typical angiogram of moyamoya disease, namely, stenosis of the terminal portions of both internal carotid arteries and basal, ethmoidal and vault moyamoya vessels were seen. On the basis of Suzuki's angiographical classification the patient was diagnosed as being in stage III. Interesting was that a right carotid angiogram revealed an arterio-venous malformation fed by basal moyamoya vessels and drained to Trolard and Sylvian veins in the right frontal lobe. This arterio-venous malformation consisted with feeders, nidus and drainers. The size of arterio-venous malformation was about 8 X 11 X 12 mm on the angiogram. Another interesting fact was that Trolard vein which was one of the draining veins of the arterio-venous malformation flows into the right parietal vault moyamoya vessels as if it was feeding the moyamoya vessels.
After oral administration of [14C]-labelled 3,4-dihydro-8-(2-hydroxy-3-isopropylamino)propoxy-3-nitroxy-2H-1-b enzopyran (nipradilol, NP, K-351) to spontaneously hypertensive rats (SHR) at doses of 3 and 30 mg/kg, the blood levels of radioactivity reached a peak at 1 h (197 and 1972 ng eq. NP/ml, respectively), whereas unchanged NP levels showed a peak at 30 min and Cmax values at both doses indicated a great difference (70-fold) in comparison with the dose ratio. Most of the radioactivity was excreted in urine and feces up to 72 h after administration. Large amounts of unchanged NP were distributed in the heart, aorta and vein which were considered to be target organs of NP. The half-lives of NP in those tissues, as well as in the blood, were short. The level of NP in the liver was low in comparison with the blood level. No significantly different levels of NP and its metabolites between SHR and normotensive rats were seen, except that the free type of 5-OH-DN was higher in the liver and urine in SHR.
A quantitative freeze-fracture study of perivascular astrocytic processes in rat cerebral cortex disclosed rapid disintegration of orthogonal arrays of the intramembrane particles in acute global ischemia. The process apparently preceded the development of astrocytic swelling.
Operative approaches to tumors of the third ventricle, mainly the bifrontal approach through the lamina terminalis, are discussed. The latter approach has several advantages. First, the main arteries can be exposed and the operative field is sufficiently wide to render the operative procedure safe. Second, cortical incision or excision is unnecessary. By cutting the lamina terminalis, which is usually thin and expanded as a result of hydrocephalus, even a large tumor can be removed. In addition, lethal complications are avoided, because this approach has less possibility of damage to the lateral wall of the third ventricle. Seventeen cases of tumor in the third ventricle underwent operation via this approach. The operative technique for the bifrontal approach through the lamina terminalis and three representative cases are reported. This approach can be applied not only to tumors, but to arteriovenous malformations or giant aneurysms adjacent to the third ventricle.
An arteriovenous malformation with a giant aneurysm and an intracerebral hemorrhage in a 3-year-old girl is reported. The malformation, the ruptured giant aneurysm, and the hematoma were totally and successfully removed during an emergency operation with temporary occlusion of the feeding artery and administration of 20% mannitol to prolong the permissive occlusion time of the cerebral arteries.
Using the "canine model of the completely ischemic brain regulated with a perfusion method," the effects on cerebral ischemia of vitamin E, which is known to act as an antioxidant, were investigated. After pretreatment with vitamin E by oral or intravenous administration, cerebral blood flow was reduced to 1/10th the normal state and, 1 hour later, allowed to return to normal. Subsequent changes in electrical activity were observed, and the effects of vitamin E were evaluated. In the control group, no recovery of electrical activity was seen. In the groups given vitamin E, the recovery time was significantly shortened in the dogs given 30 mg/kg of vitamin E intravenously. Furthermore, in the groups treated with vitamin E, distinct recovery of electroencephalographic potentials at 3 hours after recirculation was apparent. These effects were more favorable in the case of intravenous administration than in the case of oral administration. These experimental results indicate that the administration of vitamin E is effective in protecting the brain from cerebral ischemia.
Five trained psychiatrists evaluated 330 first-visit patients aged from 12 to 30 at a psychiatric outpatient facility using the DSM-III criteria (Axis-I and Axis-II). Seven cases were diagnosed as definite Borderline Personality Disorder and six cases as definite Schizotypal Personality Disorder. Hence, we had a total of 13 criteria-defined borderline patients (3.9%). Discussions were held on some methodological problems involved in collecting information and making diagnostic judgments.
This study reports the effect of early physiotherapy, using Vojta's method, on children with spastic diplegia. Eight children with spastic diplegia (in spite of early treatment which was started before nine months of age) were compared with 21 children with spastic diplegia in which treatment was started between nine months and three years of age. The average age of starting to walk was eight months earlier in the group treated early, although they had more severe complications. They tended to walk steadily with a gait pattern which was quite different from the classical pattern. All of the early treated patients had confirmed organic brain damage with abnormal CT scan or microcephaly. In conclusion, Vojta's method of treatment is one system which improves the prognosis for walking if performed early.
A new, implantable hearing aid has been developed. An ultraminiature electric microphone placed under the skin of the external ear canal transduces sound waves into electrical impulses that are amplified with battery power. The amplified electrical impulses are fed into a piezoelectric vibrator directly in contact with the stapes. The vibrator transduces the electrical impulses into mechanical vibration with minimal consumption of electrical energy. Direct coupling of the vibrator to the stapes allows a high degree of fidelity in the perception of sound. The developmental process and the structure and function of each component are described together with clinical problems. Preliminary and tentative implantation of this new device during middle ear surgery indicated that it would be beneficial to patients who have suffered hearing loss from middle ear disease and whose condition does not lend itself to surgical correction.
All giant neurons of the medial basal forebrain stained for choline acetyltransferase (ChAT). Cell numbers declined from 400,000 to 475,000 in young controls to approximately 140,000 in elderly controls. Five senile dementia cases had counts ranging from 45,000 to 100,000 cells. ChAT levels in control frontal cortex decreased from 1.2 mumol/hr/100 mg protein at age 40 to 0.5 at age 95. Five senile dementia cases had levels ranging from 0.04 to 0.30. When the cholinergic cell count in the basal forebrain drops below about 100,000 cells, the level of cortical ChAT may be so low that clinical dementia appears.
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Mice were injected with three kinds of interferon, i.e., mouse, human leucocyte and human fibroblast interferon, and the kinetics of their clearance from the blood was compared. After intravenous injection, mouse interferon was cleared very rapidly with an initial half life to two to three minutes, while both types of human interferon were cleared rather slowly with a corresponding value of about 20 minutes. When mouse interferon was injected intramuscularly or intraperitoneally, only very low levels of interferon activity were detected in the serum, and the recovery did not exceed 1% at any time. In contrast, both types of human interferon gave appreciable levels of activity in the serum upon injection by the same routes, and the levels remained stable during the observation period. The recovery of human interferon in the blood was about 10-fold that of mouse interferon. Mouse interferon was not inactivated in vitro by incubation with normal mouse serum. Our results suggest the validity of using homologous interferon for studies on the kinetics of interferon clearance in experimental animals.
Studies were conducted to compare the interferon (IFN) production of four strains of mice when injected with Newcastle disease virus (NDV), polyinosinic-polycytidylic acid (poly I. C), lipopolysaccharide (LPS) or purified protein derivative (PPD). When injected with NDV, C57BL/6 and DDD mice generated higher levels of IFN than BALB/c and C3H/He mice. Upon injection with poly I. C or LPS, C57BL/6 and C3H/He mice produced higher levels of IFN than BALB/c and DDD mice. Differences in IFN production were also observed among BCG-sensitized mice of all four strains upon injection with PPD, C57BL/6 mice engendered the highest levels of IFN, while the C3H/He and DDD mice were intermediate in their response, with the BALB/c mice producing the least amount of IFN.
Forty seven skulls of the crab-eating monkey (Macaca fascicularis) were investigated for their morphological characteristics. Five of them were disintegrated into component bones by the use of the papain. Each cranial and facial bone of this species resembled that of the rhesus monkey (M. mulatta) in its general morphology. Some obvious differences, however, were noticed in the detailed structure of the skulls between these two species. The uncinate process of the ethmoid bone was found in the rhesus monkey but was not found in the crab-eating monkey. The intrajugular process of the temporal and occipital bones was present in the crab-eating monkey but absent in the rhesus monkey. The nasal process of the incisor bone was sutured with frontal bone in the rhesus monkey but was not sutured with that bone in the crab-eating monkey.
To improve the surgical results in patients with acromegaly, rapid radioimmunoassay (RIA) of plasma GH was developed and this method was applied for quick judgement of whether transsphenoidal hypophysectomy was performed successfully or not. The best reaction temperature and the shortest incubation time were proved to be 40 degrees C and 16 min, respectively. The GH values obtained by this method and the usual RIA method were correlated well (r = 0.9, p less than 0.001). Using the rapid RIA it became possible within 35 min just after the termination of the hypophysectomy to report the data to the neurosurgeons. This RIA method was applied for 5 patients with acromegaly undergoing transsphenoidal hypophysectomy. In two cases plasma GH decreased markedly (62.0-71.4% decreases from preoperative value) at the termination of the hypophysectomy, and later fell to normal ranges. The other three cases showed only slight decreases (7.7-17.3%), and the operation was judged as unsuccessful. Therefore, two of these cases were followed by further removal of residual tumors which resulted in steep declines of GH. In the remaining one the further operation was not performed, because surgical removal of the adenoma was believed by the surgeons to be complete. In conclusion, rapid RIA of plasma GH is possible within 16 min and this method is of significant value to improve the surgical results of acromegalic patients.