Revalidation of inferior petrosal sinus sampling: the latest results from a single-center experience.

Cushing's disease (CD), which manifests as excess cortisol secretion, is caused by adrenocorticotrophic hormone (ACTH)-secreting pituitary adenomas. Such adenomas are occasionally difficult to identify on magnetic resonance imaging (MRI), and thorough endocrinological examination may be required to detect them. Inferior petrosal sinus (IPS) sampling (IPSS) has been the gold standard test for distinguishing CD from ectopic ACTH syndrome (EAS).

Treatment of an anterior cerebral artery pseudoaneurysm secondary to a transsphenoidal surgery using stent-assisted coiling.

Background: Injury of the internal carotid artery (ICA) during transsphenoidal surgery (TSS) is a rare but critical complication. There are several reports on endovascular treatment of ICA injury during TSS. With the recent flourishing of extended TSS, injuries to the distal arteries such as the anterior cerebral artery (ACA) are more likely to occur.

Very Low Rate of New Brain Lesions After Vulnerable Carotid Artery Stenting Cases Using Only FilterWire EZ as Distal Embolic Protection.

Background: Although carotid artery stenting (CAS) has been widely acknowledged as an effective alternative option for patients at high risk of carotid endarterectomy, embolic stroke is a major complication of CAS. Several reports have emphasized that distal protection filter alone is associated with a high risk of embolic complications of CAS with vulnerable plaque. Thus, relatively complicated protection systems have recently been recommended to prevent distal embolic complications.

Utility of crankshaft clips for middle cerebral artery aneurysms: A single-center experience of 150 cases.

Background: Applying more than one clip for a complicated-shaped aneurysm is an established strategy, particularly for middle cerebral arteries (MCA). However, obliterating the cleft of the internal elastic lamina with a single clip is theoretically possible because the line is usually on a single plane. Crankshaft clips were reformed for that purpose decades ago, but are not widely used and have been described in almost no report ever since.

Rebleeding from clipped aneurysm after 35 years: Report of 2 cases.

Background: A successfully applied clip for a ruptured aneurysm keeps the aneurysm's neck closed, preventing rerupture throughout the patient's life. Unfortunately, rebleeding from a clipped aneurysm does occur, but the likelihood declines with time. Since relatively old people suffer from subarachnoid hemorrhage, they die from diseases other than rebleeding, such as cancer.

Idiopathic carotid and coronary vasospasm: A case treated by carotid artery stenting.

Background: We previously reported a case of cerebral infarction complicated by myocardial infarction. The pathogenesis of both infarctions was thought to be vasospasm; thus, we named this condition 'idiopathic carotid and coronary vasospasm'. Various medical treatments for the prevention of carotid vasospasm have been unsuccessfully tried.

Intraarterial vasodilator therapy immediately rescued pure cortical deafness due to bilateral cerebral vasospasm.

Background: Cortical deafness is a rare symptom that is associated with bilateral lesions of the auditory cortex. To date, cortical deafness has been reported in only three cases of subarachnoid hemorrhage (SAH).

Case Description: This 55-year-old female was admitted to our hospital with SAH caused by a ruptured left internal carotid artery (ICA) paraclinoid aneurysm.

Achievement of three year remission in a case of aggressive glioblastoma using a multidisciplinary treatment strategy: A case report.

Glioblastoma (GB) is the most common type of malignant tumor of the central nervous system and, despite extensive research, its prognosis is poor. Although recent advances have been made in the treatment of GB with aggressive resection combined with radiochemotherapy, more than three-quarters of GB patients succumb to the disease within two years. The current study presents a highly aggressive case of small cell GB as diagnosed by histological features and immunohistochemistry for vimentin, glial fibrillary acidic protein, oligodendrocyte lineage transcription factor 2, isocitrate dehydrogenase 1-R132H and p53.

Anterior callosal section is useful for the removal of large tumors invading the dorsal part of the anterior third ventricle: operative technique and results.

Large tumors invading the dorsal part of the anterior third ventricle are difficult to manage. The anterior transcallosal approach is usually used to manage these tumors. In our clinic, anterior callosal section was combined with the anterior interhemispheric (AIH) translamina terminalis approach for these tumors with excellent results.

Dynamic changes in blood flow of a bypassed superficial temporal artery with unstable internal carotid artery stenosis.

Background: There are limited indications for superficial temporal artery to middle cerebral artery (STA-MCA) bypass in the treatment of cerebral atherosclerotic disease. However, recent reports emphasize that STA-MCA bypass may be beneficial for select patients. In this report, we describe a case in which a flow-dependent STA-MCA bypass was achieved in a patient with unstable internal carotid artery (ICA) stenosis.

Myoarchitectonic spinolaminoplasty: efficacy in reconstituting the cervical musculature and preserving biomechanical function.

Object: Laminoplasty has been used to expand the cervical spinal canal, based on the belief that reconstruction of the laminae preserves musculoskeletal function. The true efficacy of laminoplasty for maintaining spinal alignment, stability, and flexibility, however, remains to be proven. The authors have developed a new method, myoarchitectonic spinolaminoplasty (MSLP), which preserves all of the nuchal muscles and reconstitutes all of the musculoskeletal couplings to the posterior elements of the vertebrae.

Dural arteriovenous fistula and progressive conus medullaris syndrome as complications of lumbar discectomy. Case report.

A case of a dural arteriovenous fistula (DAVF) that developed at the site of nerve root sleeve damage as a result of lumbar disc extrusion is reported. A 60-year-old man who had undergone lumbar discectomy 3 years previously for severe left-sided sciatica and L5-S1 disc herniation presented with progressive gait disturbance. After the initial surgery, the symptoms resolved.

Proper management of the rotational vertebral artery occlusion secondary to spondylosis.

A 66-year-old man with cervical spondylosis noticed severe vertigo when turning his head to the right. He underwent subclavian arteriography elsewhere, which showed a block of the contrast medium in the right vertebral artery (VA) at the C5/6 level when the patient turned his head to the right. After referral to our institute, however, postcontrast CT scan revealed an attenuated shadow of the venous plexus around the right VA at the C3/4 level.

Evidence of apoptotic procedure in deafferented striatum after cortical injury in young adult rats.

In denervated striatum after excitotoxic cortical lesion in young adult rats, apoptotic cells, though quite few, were observed by TUNEL 2 weeks after surgery. Also, prominent expressions of p53 were observed at the same time. These data indicate that apoptotic procedure may be involved in the denervation-induced degeneration even in young adults.

The exogenous control of transfected c-fos gene expression and angiogenesis in cells implanted into the rat brain.

Previously, we established a stable transfectant, Nf-1, from normal rat kidney (NRK) fibroblasts transfected with a human metallothionein II A (hMT-IIA) promoter/human genomic c-fos fusion gene to produce c-Fos protein. Since the hMT-IIA promoter can be activated by heavy metals, the level of human c-fos gene expression can be increased by addition of heavy metals to the culture medium of Nf-1 cells and the anchorage-independent growth of Nf-1 in soft agar is markedly enhanced in the presence of transforming growth factor-beta (TGF-beta) and epidermal growth factor (EGF). In this study, we found that the hMT-IIA promoter can be activated by zinc, resulting in the elevation of fused c-fos gene expression in Nf-1 cells.

Functional expression of yeast artificial chromosome-human multidrug resistance genes in mouse cells.

Multidrug resistance (MDR) genes, which are ATP-binding cassette family genes, encode the cell surface glycoprotein, P-glycoprotein, which functions as an energy-dependent drug efflux pump. Two relevant human genes, PGY1 and PGY3, are located on human chromosome 7, and three relevant mouse genes, mdr1a, mdr1b, and mdr2, are located on mouse chromosome 5. An LMD1 cell line was established after the transfer of a 580-kb yeast artificial chromosome (YAC) clone carrying the human MDR locus into mouse L cells; the cell line was shown to have stably integrated YAC DNA in an apparent intact form.

Increased expression of DNA topoisomerase I gene and collateral sensitivity to camptothecin in human cisplatin-resistant bladder cancer cells.

We established three cis-diamminedichloroplatinum(II) (cisplatin)-resistant cell lines, T24/DDP5, T24/DDP7, and T24/DDP10, by the stepwise exposure of T24 human bladder cancer cells to increasing concentrations of cisplatin. The resistance to cisplatin of T24/DDP5, T24/DDP7, and T24/DDP10 cells was 2.2-, 5.

Involvement of a DNA binding protein, MDR-NF1/YB-1, in human MDR1 gene expression by actinomycin D.

The human multidrug resistance 1 (MDR1) gene is an SOS gene that responds to environmental stress including various anticancer agents. The chloramphenicol acetyltransferase (CAT) gene was linked to various lengths of MDR1 promoter, and these constructs were integrated into the genome of human cancer KB cells. Using these cell lines, we previously demonstrated that various environmental stimuli lead to an increased abundance of both CAT enzymatic activity and CAT mRNA in a sequence dependent manner.

Involvement of protein kinase in environmental stress-induced activation of human multidrug resistance 1 (MDR1) gene promoter.

The human MDR1 gene can be induced in response to various environmental stimuli. To examine whether such stress-induced activation of the MDR1 gene can be modulated by protein kinase, we employed a stable human cancer KB cell line which contained the bacterial chloramphenicol acetyltransferase (CAT) gene directed by the MDR1 gene promoter. H-7, a protein kinase C inhibitor, at more than 40 microM inhibited activation of the MDR1 promoter that was induced by ethylmethane sulfonate, 5-fluorouracil or UV irradiation.

Detection of a carcinogen, 2-amino-1-methyl-6-phenylimidazo [4,5-b]pyridine, in airborne particles and diesel-exhaust particles.

A carcinogen, 2-amino-1-methyl-6-phenylimidazo [4,5-b]-pyridine (PhIP), has been measured in airborne particles, diesel-exhaust particles, and incineration ash from garbage-burning plants. PhIP was found in all kinds of samples. In the light of the present results, together with the previous findings that PhIP was present in cooked foods and cigarette smoke, PhIP is likely to be an ubiquitous environmental pollutant.

Occurrence of carcinogenic amino-alpha-carbolines in some environmental samples.

The carcinogenic amino-alpha-carbolines, 2-amino-9H-pyrido[2,3-b]indole and AalphaC, have been measured in airborne particles, rain water, soil and cigarette-smoke-polluted indoor air by high-performance liquid chromatography. These carcinogens were found in all kinds of environmental samples examined, although MeAalphaC was not detected in soil. Considering the present results, together with the previous findings that these carcinogens were present in foodstuffs, cigarette smoke and diesel-exhaust particles, amino-alpha-carbolines are likely to be ubiquitous environmental pollutants.

Detection of carcinogenic amino-alpha-carbolines and amino-gamma-carbolines in diesel-exhaust particles.

Diesel-exhaust particles are known to contain mutagenic and carcinogenic chemicals. The aim of this study was to determine whether carcinogenic amino-alpha-carbolines and amino-gamma-carbolines are present in diesel-exhaust particles. These carcinogens which were originally isolated from pyrolysates of proteins and amino acids have been detected in diesel-exhaust particles obtained from two test vehicles as well as in standard materials of automobile-exhaust particles obtained from National Institute for Environmental studies.