Multiple sclerosis may sometimes present as a mass lesion that is indistinguishable from brain tumor both clinically and radiologically. We describe two cases of multiple sclerosis simulating brain tumor on computed tomography (CT) scans and magnetic resonance (MR) images, one of which was proved and another was suggestive to be demyelinating disease by biopsy. Steroid therapy produced regression of the lesions of MR images and CT scans. Our cases and others in the literature suggest strategies for detecting multiple sclerosis presenting as a mass lesion.

Adult↗

PubMedDate not supplied

Evaluation of large intracranial aneurysm with three-dimensional MRI.

OBJECTIVE: The purpose of this study was to evaluate large intracranial aneurysms by contrast-enhanced 3D MRI. MATERIALS AND METHODS: Eleven patients, nine women and two men, were examined. The aneurysms involved the internal carotid artery in seven patients, the middle cerebral artery in one, the basilar artery in two, and the posterior cerebral artery in one. Contrast-enhanced 3D MR images were obtained using FLASH (fast low angle shot) on a 1.5 T system. We obtained axial images first, then sagittal and coronal images by multiplanar reconstruction. Those images were reviewed for comparison with conventional and MR angiography. RESULTS: We could easily evaluate the true aneurysmal size, the intraaneurysmal constitution (patent lumen and intraluminal thrombus), and the detailed relationship of the aneurysm to the surrounding vascular and neural structures. Except for the cavernous internal carotid artery, we could identify the aneurysmal neck by carefully observing axial, sagittal, and coronal images. In addition, the progression of intraaneurysmal thrombosis and the patency of the parent arterial lumen after the endovascular treatment were well appreciated. CONCLUSION: We consider that 3D MRI appears to be useful for evaluation of the large intracranial aneurysm.

Adult↗

PubMedDate not supplied

MR findings in Tay-Sachs disease.

OBJECTIVE: MR and CT findings in two patients of Tay-Sachs disease are reported. MATERIALS AND METHODS: In two patients of Tay-Sachs disease, MR and CT studies were conducted in the early phase (11 and 10 months of age, respectively) and one was followed-up with MR in the late phase at the age of 5 years and 8 months. Six MR studies on this disease (including 3 other cases documented in the literature) were reviewed and correlated with the pathological phases of this disease. RESULTS: MRI findings drastically changed during the phases of disease process in one case. In the early phase, T2-weighted MR images demonstrated hyperintensity in both basal ganglia and thalamus. MR images obtained in the late phase demonstrated markedly advanced brain atrophy and diffuse white matter lesions, which were hyperintense on the T2-weighted images. T1-weighted images exhibited hyperintensity in the basal ganglia, thalamus, and along the cortical layer of the cerebrum, which appeared to by hypointense on T2-weighted images. CONCLUSION: MR was apparently superior to CT in clearly delineating lesions of this disease. These abnormal signal intensities in the late phase may reflect the pathological findings, marked accumulation of GM2 ganglioside in the basal ganglia and thalamus and along the cerebral gray matter.

Brain↗

PubMedDate not supplied

Calcitonin gene-related peptide antagonizes the protective effect of adrenomedullin on histamine-induced bronchoconstriction.

1. In the present study the possible relationship between adrenomedullin (AM) and calcitonin gene-related peptide (CGRP) in the regulation of airway functions in anaesthetized guinea-pigs was examined in vivo. 2. We found that AM significantly inhibited histamine-induced bronchoconstriction in a dose-dependent manner. CGRP or the CGRP receptor antagonist (CGRP [8-37]) alone did not affect pulmonary resistance and pretreatment with CGRP or CGRP [8-37] did not significantly affect histamine-induced bronchoconstriction. However, AM-induced bronchoprotection was significantly inhibited by pretreatment with CGRP or CGRP [8-37] in a dose-dependent manner. 3. It is therefore possible that CGRP may be competitive, at least in part, with binding sites of AM in the guinea-pig airway. Exogenous AM may be useful for the management of bronchial asthma, not only as a potent bronchodilator, but also as a functional antagonist of CGRP.

Adrenomedullin↗

PubMedDate not supplied

Chemosensitivity testing of primary tumor cells from gastric cancer patients with liver metastasis can identify effective antitumor drugs.

The liver metastasis of gastric carcinoma is resistant to conventionally available treatment. Twenty patients with liver metastasis of gastric cancer were treated by arterial drug infusion using a reservoir and seven cases were treated with systemic chemotherapy. The resected primary gastric cancer specimen was used for chemosensitivity assay with 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl-2H tetrazolium bromide (MTT) endpoint, and the patients were treated without reference to the results of the chemosensitivity assay. The mean survival period was assessed according to the histology of the primary lesion, the grade of liver metastasis and, the presence of peritoneal dissemination. No significant differences were observed in the primary tumor histology and grade of liver metastasis, but the survival period of the patients with liver metastasis and peritoneal dissemination was significantly shorter than that of the patients without peritoneal dissemination. Nine patients were treated with drugs that were effective in the chemosensitivity assay, and their responses included two complete responses and two partial responses; these patients showed a significantly prolonged survival period compared with patients treated with drugs that were not effective in the assay. The chemosensitivity assay is useful for evaluating the effectiveness of antitumor agents against liver metastasis of gastric cancer.

Adult↗

PubMedDate not supplied

CT and MR findings in diastematomyelia, with embryogenetic consideration.

Diastemstomyelia is an extremely rare disorder that is seldom found among the Japanese. This paper presents two Japanese patients, a newborn male and a newborn female, with diastematomyelia. CT demonstrated bony spurs more clearly than plain film, and magnetic resonance images indicated split cords and associated anomalies. Although the embryogenesis of diastematomyelia has not been clearly elucidated, the coincidence of levels of associated anomalies and diastematomyelia in our cases and in the literature supports Bremer's embryogenetic explanation of persistent accessory neurenteric canal.

Female↗

PubMedDate not supplied

Arterial hypoxemia induced by fiberoptic bronchoscopy.

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Arteries↗

PubMedDate not supplied

Treatment-related disseminated necrotizing leukoencephalopathy with characteristic contrast enhancement of the white matter.

This report describes unique contrast enhancement of the white matter on T1-weighted magnetic resonance images of two patients with disseminated necrotizing leukoencephalopathy, which developed from acute lymphoblastic leukemia treated with high-dose methotrexate. In both patients, the enhancement was more pronounced near the base of the brain than at the vertex. Necropsy of the first case revealed loss of myelination and necrosis of the white matter. Possible mechanisms causing such a leukoencephalopathy are discussed.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

Cortical laminar necrosis in a patient with moyamoya disease associated with Down syndrome: MR imaging findings.

We report a case of moyamoya disease associated with Down syndrome and congenital heart malformations. Findings of cranial MR imaging indicated cortical laminar necrosis along with cerebral infarction. To explain the development of these findings, we hypothesized that hypoxic brain damage manifesting cortical laminar necrosis was caused by hypoperfusion of the brain due to occlusive changes to the cerebral vessels in moyamoya disease, in addition to a state of general hypoxemia secondary to congenital heart malformations.

Brain↗