[Neurofibromatosis type-II: a familial occurrence of three cases].
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Adolescent↗
Biomedical subjects
K Niijima
Publications and source records attributed to K Niijima.
[Spinal microsurgery at the thoracic to sacral level in the "prone-oblique" position].
Until the present time, almost all posterior approaches to the thoracic to sacral region have been made in either the knee-elbow or the prone position. Those positions, however, have potential disadvantages such as respiratory suppression and/or disturbance of venous return due to compression of the anterior chest and belly. In order to avoid the above mentioned disadvantages, the patient was laid on the operating table in a "Prone-Oblique" position, with the body rotating about 40 degrees around the long axis. The authors performed, with successful results, spinal operations via the posterior route in the "Prone-Oblique" position in 30 cases. An illustrative case was presented of a metastatic intramedullary tumor at the T11/12 level from an unresectable mammary cancer. The cancer had infiltrated and bulged out of the left anterior chest wall so severely and extensively that an operation in the conventional position was impossible. The metastatic tumor was totally and successfully removed via the posterior approach in the "Prone-Oblique" position without any complications related to the position. This "Prone-Oblique" position seems to be physiologically suitable, giving rise to no harmful compression of any part of the patient's body and it provides the surgeon a comfortable posture and a good operative view during microsurgery.
Adult↗
[Usefulness of transcranial magnetic stimulation in the objective assessment of therapy for adrenoleukodystrophy].
Adrenoleukodystrophy (ALD) is a hitherto untreatable, X-linked recessive disorder of the central nervous system characterized by the systemic accumulation of very-long-chain fatty acids. Although various treatments have been proposed, objective evidence of their efficacy is insufficient. This is partly due to the absence of an appropriate method for evaluating the functions of the central nervous system (CNS). In this study, we took up the central motor conduction time (CMCT) as an index of the CNS functions, and measured it in two patients with ALD under steroid pulse therapy to know if this parameter is useful in assessing the effects of therapy. The right and the left motor cortex was stimulated separately with a MAGSTIM 200 magnetic stimulator, using a round coil of 9cm mean diameter to stimulate the hand area or a double cone coil to stimulate the leg area. CMCT, the time an impulse takes to travel from the motor cortex to the anterior horn cells in the corresponding region, was measured by a combination of transcranial magnetic stimulation (TMS) and F wave technique. Before treatment, CMCT to the cervical cord was prolonged slightly in both patients; CMCT to the lumbar cord was prolonged slightly in one and moderately in the other. After repeated steroid pulse therapy, a definite improvement, although partial and transient, was observed in either case. TMS thus seems to be useful not only for detecting functional derangement of the pyramidal tract but for evaluating the efficacy of therapy for this disease.
Adrenoleukodystrophy↗
[A case of pituitary apoplexy: remarkable improvement of visual acuity and field by surgical intervention at the subchronic stage].
A case is reported of a pituitary apoplexy which shows remarkable improvement of visual acuity and field by transsphenoidal surgery performed 33 days after hemorrhage. Possible factors contributing to this excellent surgical outcome are speculated about as follows; atrophic brain (wide suprasellar cistern), destruction of the sella floor by the tumor (infrasellar/extracranial decompression), no vasospasm (pure intracapsular hemorrhage), no hypopituitarism, less invasive operation (transsphenoidal surgery), and so on. Transsphenoidal surgery is thought to be worth performing for pituitary apoplexy, even if timing for the operation is later than the acute stage and even if initial visual impairment is severe.
Chronic Disease↗
Symptomatic myopathy associated with interferon therapy for chronic hepatitis C.
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Adult↗
Adrenal chromaffin cells transdifferentiate in response to basic fibroblast growth factor and show directed outgrowth to a nerve growth factor source in vivo.
Chromaffin cells exposed to basic fibroblast growth factor (bFGF) in vitro express characteristics of sympathetic neurons, extend neurites, and become dependent on nerve growth factor (NGF) for survival. We explored whether the growth factor responsiveness of chromaffin cells could be exploited to enhance the transdifferentiation, neurite outgrowth and functional efficacy of chromaffin cells implanted into rats with unilateral 6-hydroxydopamine lesions. Cografts of neonatal chromaffin cells and fibroblasts genetically modified to produce bFGF were placed into the dopamine-depleted striatum of adult rats. Either control-transfected or NGF-producing fibroblasts were then transplanted 1 mm distal to the cograft. Chromaffin cells transdifferentiated under the influence of bFGF, as indicated by the growth of neurites and the expression of neuron-specific proteins. Distal grafts of NGF-producing fibroblasts successfully induced chromaffin neurites to traverse through the host parenchyma to the NGF source. In the absence of NGF fibroblast grafts, neither neurite extension nor good, long-term survival of the chromaffin-derived neurons was observed. Assessments of apomorphine-induced rotational behavior 2- and 4-weeks postgrafting revealed no behavior improvements in any of the groups. These results indicate that localized sources of growth factors are effective in inducing the transdifferentiation of grafted chromaffin cells as well as the extension of chromaffin-derived neurites into the host parenchyma. Such chromaffin cell-derived neurons are, however, functionally ineffective in this rat model of Parkinson's disease. Whether the lack of behavioral improvement reflected the tropic growth of neurites to an inappropriate striatal region or the noradrenergic nature of the chromaffin cell-derived neurons remains to be clarified. Nonetheless, these results caution that promoting transdifferentiation and neurite extension from engrafted chromaffin cells may not be sufficient to achieve desired functional effects of such grafts.
Adrenal Medulla↗
[Neck clipping of an aneurysm at the basilar artery-anterior inferior cerebellar artery via presigmoid-transmastoideal approach].
A 51-year-old man presented severe disturbance of consciousness and massive subarachnoid hemorrhage. Angiography disclosed an aneurysm at the ventral bifurcation of the basilar and anterior inferior cerebellar arteries. Neck clipping and additional wrapping/coating were performed via the presigmoid-transmastoideal approach with successful result. The operative procedure was described and advantages of this approach were discussed.
Basilar Artery↗
Enhanced survival and neuronal differentiation of adrenal chromaffin cells cografted into the striatum with NGF-producing fibroblasts.
Although adrenal medullary chromaffin cells have been used extensively for intracerebral grafting, their survival has generally been poor. Improved survival of the implanted cells has been achieved by exposing the chromaffin cells to NGF in vivo. Culture studies have shown, however, that chromaffin cells are converted into sympathetic neurons when NGF is included in the medium. The degree to which such a transdifferentiation may occur in vivo has not been determined. We assessed the effects of cografting chromaffin cells with primary fibroblasts genetically engineered to express NGF. Chromaffin cells from 10 d old rats were implanted with NGF-producing or beta-galactosidase-producing primary fibroblasts (control fibroblasts) into the striatum of 6-hydroxydopamine treated adult rats of the same strain. Eight weeks postgrafting, chromaffin cells cografted with NGF-producing fibroblasts displayed many of the features of mature sympathetic neurons such as large somata, long processes, transmitter vesicles similar to those found in neurons, and positive immunolabeling for the neuronal markers neurofilament, MAP2 and SCG10. Chromaffin-derived neuron number was also significantly enhanced in the presence of NGF-producing fibroblasts. While control fibroblasts were also found to increase chromaffin cell number above that of chromaffin cells grafted alone, the control fibroblasts did not induce neuronal transdifferentiation. These results demonstrate that chromaffin cells cografted with NGF-producing fibroblasts undergo transdifferentiation in vivo and express many characteristics of mature sympathetic neurons. The consequences of this transdifferentiation on the long term survival and function of the transplanted cells in vivo remain to be clarified.
Adrenal Glands↗
[Clinical experiences with a newly developed bipolar cutting and coagulation system (Malis CMC-III bipolar system)].
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Electrocoagulation↗
Expression of antitumor response. Role of attachment and viability of bacillus Calmette-Guérin to bladder cancer cells.
BACKGROUND: Antitumor effects of Bacillus Calmette-Guérin (BCG) against superficial urinary bladder cancer is known to be strong when BCG is directly infused into the bladder cavity. For expression of that effect, attachment of BCG to tumor cells is reported to be essential as the first step. Our study was conducted to elucidate the significance of attachment of BCG to tumor cells in inducing the antitumor effect. METHODS: BCG, Tokyo 172 strain, in the form of live bacilli, lyophilized bacilli, or autoclaved bacilli was co-cultured with MBT-2, mouse-origin transitional cell cancer cells. Various preparations of BCG were mixed with MBT-2 cells and transplanted to male C3H/He mice to see tumor growth-inhibiting effect. RESULTS: Both live and lyophilized BCG attached strongly to MBT-2 cells. The maximal attachment to the cells with live BCG occurred 24 hours earlier than with lyophilized BCG. When BCG was autoclaved, it lost the ability to attach to the cells. Lyophilized or autoclaved BCG exerted a marked tumor growth-inhibiting effects. This effect was equal to the Tokyo 172 strain and the Armand Frappier Canada strain. Histologically, a high degree of infiltration by macrophages was seen. CONCLUSIONS: The results indicated that coexistence of BCG, even as killed by autoclaving, with tumor cells activates local immunity. Accordingly, the significance of the attachment of BCG to tumor cells in intravesical infusion therapy is surmised to lie in the fact that it results in retention of the BCG at the reaction site. This may provide a clue on how to approach future development of safer and more stable BCG-derived antitumor drugs.
Animals↗
Ossified spinal meningioma en plaque.
Ossified spinal meningiomas alone are uncommon lesions and spinal meningiomas en plaque are even more. A rare case is presented of ossified meningioma en plaque in the midthoracic spine, which was totally removed. Characteristics of this tumor with reference to relatively pathognomonic neuroimagings are discussed. Microsurgical outcome of this type of tumor is expected to be good.
Aged↗
Preventive superficial cervical plexus block for postoperative cervicocephalic pain in neurosurgery.
Eighty-six (54%) of a series of 160 patients who underwent neurosurgery experienced postoperative cervicocephalic pain. We performed a superficial cervical plexus block (SCPB) immediately after operation in the subsequent 240 patients, in which the incidence of postoperative cervicocephalic pain was reduced to 27% (65 patients), and the intensity of pain was apparently milder. SCPB is a worthwhile procedure to prevent postoperative cervicocephalic pain.
Cervical Plexus↗
[Idiopathic normal pressure hydrocephalus in elderly patients: its pathophysiology and diagnosis].
We described 10 cases of idiopathic normal pressure hydrocephalus (NPH) in elderly patients who had good results after shunting. Retrospective analysis of our cases offers the following results which indicate the pathogenesis and surgical selection of idiopathic NPH. 1) Most of the patients had risk factors of ischemic cerebrovascular disease and had multiple small ischemic lesions such as lacunae. 2) Cerebrospinal fluid (CSF) pressure is below 20mmHg in all cases and its response to acetazolamide loading was suppressed or almost lost in most of cases. 3) The volume of the lateral ventricle was slightly reduced after the effective operation. 4) Some of the patients showed clinical improvement even if they had symptoms for more than 2 years before treatment. Two primary theories exist concerning the cause of NPH. One is extraventricular obstruction to CSF flow at the level of the arachnoid villi or the basal cistern. The other is periventricular white matter ischemic damage which decreases the tensile strength of the ventricular walls and leads to ventricular dilatation. Tangential periventricular shearing force due to ventricular dilatation produces the symptom of NPH. Our results support these descriptions as the causes of idiopathic NPH in elderly patients. We noticed, firstly, involvement of the ischemic risk factor. Other findings implied decreased elasticity or compliance of the brain and the loss of the autoregulatory properties of cerebral circulation which accelerate the ischemic damage to the periventricular white matter. In understanding the etiology, it is important to know the fragility of the aged brain and the mechanical and hemodynamic stress to which it is subjected.(ABSTRACT TRUNCATED AT 250 WORDS)
Aged↗
Differential roles of the caudate nucleus and putamen in motor behavior of the cat as investigated by local injection of GABA antagonists.
In order to reveal a functional difference between the two distinctly separate nuclei of the striatum, i.e. the caudate nucleus (Cd) and the putamen (Put), we studied the effects of local bicuculline (BIC) and picrotoxin (PTX) injection into these nuclei on the motor behavior in the cat. The extent of diffusion of the injected BIC could be approximated by determining the extent of spreading of the dye fast green FCF (FCF) mixed with BIC solution since the extent of diffusion of radioactive [3H]BIC mixed with BIC and FCF solution was almost the same as that of FCF.BIC and PTX are GABA antagonists and are assumed to activate efferent neurons of the Cd and Put by removing the action of GABA-ergic inhibitory synapses on them. A total of 28 BIC and 22 PTX injections was made in 20 adult cats, 22 aimed at the Cd and 28 at the Put. Injection of BIC or PTX to either the head or body of the Cd unilaterally induced locomotor hyperactivity without any postural asymmetry or circling tendency. When BIC or PTX was injected into the Put, dystonic movements (dystonia) towards the contralateral side appeared frequently in the neck and trunk. Even though the injected BIC or PTX often spread to the external segment of the globus pallidus, claustrum, or anterior sylvian gyrus, none of these areas was consistently associated with dystonia. These results demonstrate that the Cd and Put are differentially associated with locomotor and postural functions.
Animals↗
Atraumatic subdural hematoma associated with moyamoya disease.
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Hematoma, Subdural↗
Hematological studies on naturally occurring substances. VI. Effects of an animal crude drug "chan su" (bufonis venenum) on blood coagulation, platelet aggregation, fibrinolysis system and cytotoxicity.
During the screening test of the animal crude drug "Chan su" (Chinese name, toad-cake), the venom of Bufo bufo gargorizans CANTOR (Bufonidae), on blood coagulation, platelet aggregation, fibrinolysis system and cytotoxicity, the ethyl acetate extract showed promotive action on platelet aggregation and remarkable cytotoxic activity on HeLa-S3 cells. Nine kinds of bufadienolides were isolated from the ethyl acetate extract by bioactivity-guided fractionation and were identified by chemical and spectral analysis.
Animals↗
Hangman's fracture vs. hanged-man's fracture.
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Axis, Cervical Vertebra↗
Enhanced survival of cultured dopamine neurons by treatment with soluble extracts from chemically deafferentiated striatum of adult rat brain.
A soluble fraction was extracted from a chemically deafferentiated striatum of adult Wistar rats after unilateral lesioning of the nigrostriatal pathway by 6-hydroxydopamine (6-OHDA) injection. The soluble extract from the lesioned side enhanced the survival of cultured mesencephalic dopamine (DA) neurons of 14-day-old rat embryos as evidenced by quantitative counting of tyrosine hydroxylase-like immunoreactive cells. The neurotrophic activity of this striatal extract for DA neurons was highest 14 days after 6-OHDA injection and became negligible in 28 days. The extract showed no promoting effects on cultured gamma-aminobutyric acid (GABA)-containing mesencephalic neurons. These observations indicate that the striatum of adult rats may initiate de novo synthesis of trophic substance(s) for DA neurons but not for GABA neurons when subjected to nigral dopaminergic deafferentiation.
Afferent Pathways↗