Biomedical subjects
Publications and source records attributed to N Sueyoshi.
The case of a 64-year-old woman with multiple intracranial aneurysms and abnormal ophthalmic arteries arising from the bifurcation of the internal carotid artery is described. It is believed that this type of anomaly of the ophthalmic artery has not previously been reported. The neuroradiological and operative findings of this case are presented.
To test the feasibility of intrathecal perfusion of ACNU (3-[(4-amino-2-methyl-5-pyrimidinyl)methyl]-1-(2-chloroethyl)-1-nitro sou rea hydrochloride) in the treatment of subarachnoid dissemination of malignant glioma, the neurotoxicity and pharmacokinetics of ACNU were studied in dogs. ACNU [1-2 mg dissolved in 10-20 ml of lactated Ringer's solution or artificial cerebrospinal fluid (CSF)] was administered via the right lateral ventricle by constant drip infusion and CSF was drained by lumbar puncture. The infusion time was from 15 to 71 min. For the control, a bolus injection was given. No neurological and systemic symptoms were noted after perfusion. Histological examination of the brain and spinal cord revealed only mild denudation of ependyma in the wall of the ventricles in a dog treated three times with 2 mg ACNU (perfusion twice, bolus injection once) and in 2 dogs perfused with 1 mg ACNU once a week for 10 weeks. ACNU was not detected in lumbar CSF after bolus injection into the lateral ventricle. When 1 mg of ACNU, dissolved in 10 ml of artificial CSF, was perfused for a duration of 22 to 31 min, it started to appear in the lumbar CSF 10 to 15 min after the start of perfusion, reaching a maximum concentration of 13.88 to 22.31 micrograms/ml. The area under the drug concentration-time curve was 344 to 706 micrograms x min/ml; the half-time was 15.5 to 19.5 min. The distribution volume was 30.6 to 54.1 ml. These findings suggest the feasibility of intrathecal perfusion of ACNU in the treatment of patients with subarachnoid dissemination of glioma.
It has been suggested that peanut agglutinin (PNA)-binding sites in benign and malignant tissues were quite different. To clarify the difference of PNA-binding sites between benign and malignant ependymoma, PNA-binding sites are investigated on the surface membrane of tissues from benign and malignant ependymomas and cultured ependymoma cells. In four of five malignant ependymoma cases, PNA binding occurred in a diffuse cell membrane fashion or granular intracytoplasmic fashion without neuraminidase treatment. On the other hand, PNA binding was observed without neuraminidase treatment in only two of eight benign ependymoma cases. After neuraminidase treatment, all of our benign and malignant ependymoma cases evidenced PNA binding. PNA binding was clearly evident on the cell membrane of ependymoma cells which were able to express organotypic structures, that is, to form ependymal rosettes after neuraminidase treatment. Normal rat ependymal cells showed PNA binding only after neuraminidase treatment. These findings suggest that the masking of PNA-binding sites of ependymoma cells by sialic acid may be correlated with tumor cell differentiation.
This is the second reported case of a malignant fibrous histiocytoma of the heart that metastasized to the brain. A 33-year-old woman developed headache, nausea, and ataxic gait 9 months after removal of the tumor from the left atrium of the heart. Computed tomographic and magnetic resonance imaging scans disclosed multiple metastatic tumors in the brain. Although dramatic improvement in her symptoms and signs followed the removal of the brain tumors, she died of tumor recurrence in the left atrium 3 months after the removal of the metastatic brain tumors.
A 32-year-old female (gravida 2, para 2) was admitted at 15 weeks of gestation with a chief complaint of left homonymous hemianopsia accompanied by frontal headache. Computed tomography scan and cerebral angiography were performed with the lead shield and probe for X-ray exposure placed on the patient's body. Angiography revealed an arteriovenous malformation (AVM) located in the posterior part of the right temporal lobe. Total dose of the diagnostic X-ray radiated to the fetus was measured 2.5 mrem at the most. The AVM and the hematoma were totally removed successfully at 19 weeks of gestation. A male infant weighing 3180 g was delivered at full term by cesarean section without congenital anomalies and he has been growing up without mental deficits. These results suggest that diagnostic X-ray examination during pregnancy has little risk and that surgical treatment should be given to the mother immediately after the rupture of an AVM if she is in good condition and the gestational date is past 12 weeks.
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A 56-year-old male with a 11-month history of late-onset epilepsy was hospitalized because of status epilepticus. The physical examination and laboratory data were normal. Neurological examination revealed weakness of the right leg. Coronal computed tomography showed a mass of slightly high density in the bilateral parietal convexity, with homogeneous enhancement by contrast medium. Magnetic resonance imaging disclosed an en-plaque epidural tumor in the parietal region along the superior sagittal sinus, which was normointense on T1- and T2-weighted images. Conventional and digital subtraction angiography showed an avascular mass between the superior sagittal sinus and the inner table of the skull at the parietal region. The mass was thought to be situated in the parietal epidural space. On surgery, however, the tumor was found to be located mainly in the dura and subdural space. The histological diagnosis was malignant lymphoma of the B cell type. Ga-scintigraphy, physical examination, and bone marrow and peripheral blood examinations disclosed no systemic abnormalities. Therefore, the tumor was interpreted as a primary intracranial malignant lymphoma. Reports of primary intracranial malignant lymphoma have been increasing, but most have been located in the cerebrum. The dural-subdural location in this case is evidently rare.
We studied the feasibility of intrathecal ACNU perfusion therapy against subarachnoid dissemination of malignant glioma. Intrathecal perfusion was performed in adult dogs by constant drip administration of 1 to 2 mg ACNU dissolved in 10 to 20 ml of lactate Ringer solution into the lateral ventricle and cerebrospinal fluid drainage through the lumbar puncture. The perfusion time was changed from 15 to 71 min. A bolus injection of 2 mg ACNU was also tested in one dog. No neurological symptom was noted during and after perfusion, and histological examination reveal only a minimum denudation of ependyma in a small area. Concentration of ACNU in CSF and serum were measured by HPLC (high-performance liquid chromatography). ACNU was detected in lumbar CSF only by perfusion, not by bolus injection, and the maximum concentrations were 6.26 to 25.76 micrograms/ml. The elimination phase of ACNU in lumbar CSF followed linear kinetics and the half-time was 18 min on average. AUCs (area under the drug concentration-time curve) were 346 to 896 micrograms.min/ml and they were the equivalent of in vitro cell kills in excess of 3 logs for rat 9L gliosarcoma and human glioma 126 cells. Serum concentration was 0.10 micrograms/ml in maximum. These findings suggest the feasibility of intrathecal ACNU perfusion therapy against subarachnoid dissemination of malignant glioma and warrant further studies.
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