Diagnosis of unruptured asymptomatic cerebral aneurysms by magnetic resonance angiography.

The purpose of this study was to assess the incidence of unruptured asymptomatic cerebral aneurysms detected by magnetic resonance angiography (MRA). Three thousand patients without major neurological deficit had undergone MRA. MRA was obtained using three-dimensional time-of-flight method.

Comparison of different methods of temporomandibular joint disc reconstruction--an animal model.

The optimum method of temporomandibular joint (TMJ) reconstruction has not been defined despite numerous surgical treatments and several well controlled clinical trials. Animal models offer an experimental method allowing direct comparison of standardized surgical techniques. Advanced osteoarthrosis was induced bilaterally in 12 mature merino sheep.

In vivo proton magnetic resonance spectroscopy for metabolic changes in brain during chronic cerebral vasospasm in primates.

Objective: To study how neuronal cells are affected by development of chronic cerebral vasospasm after subarachnoid hemorrhage (SAH), the changes in neuronal metabolites during development of vasospasm were evaluated by in vivo localized proton magnetic resonance spectroscopy (MRS) in primates.

Methods: SAH was produced by introduction of a blood clot around the right middle cerebral artery and the right side of the circle of Willis. MRS experiments were performed before SAH and on Days 7 and 14 after SAH.

Endoscopy in the diagnosis of small intestinal tumors.

The importance of endoscopy in the diagnosis of small intestinal tumors was evaluated in 15 patients with small intestinal tumors treated in our hospital. Two tumors were benign, and 13 were malignant (carcinoma in 5 patients, malignant lymphoma in 5 and leiomyosarcoma in 3). The presence of lesions could be determined by X-rays before surgery, but definitive diagnoses were difficult.

Association of Helicobacter pylori and diffuse type gastric cancer.

The major purpose of this study was to evaluate the association of Helicobacter pylori and diffuse type gastric cancer (DGC) clinicopathologically (study 1). The second aim was to investigate genetic differences of H. pylori in patients with DGC and intestinal type cancer (IGC) (study 2).

Development of hydrocephalus after cervical laminoplasty for ossification of the posterior longitudinal ligament: case report.

We report a 69-year-old woman who developed serious hydrocephalus after cervical laminoplasty for ossification of the posterior longitudinal ligament. The patient presented with approximately 50% spinal canal compromise pertaining to ossified lesion at C5 and C6 levels and subsequently underwent a C3-C7 open-door laminoplasty, followed by uneventful neurological recovery until 2 weeks postoperatively. Despite a favourable postoperative course, she presented with serious symptoms and signs of intracranial hypertension about 3 weeks after surgery.

The short-term effect of discectomy on the osteoarthrotic temporomandibular joint in sheep.

The short-term effect of discectomy on osteoarthrotic joints was tested experimentally in sheep. Bilateral temporomandibular joint (TMJ) osteoarthrosis was induced, and at 3 months discectomy was performed on one joint, with the other being left as a control. Neither masticatory nor mouth-opening disturbances had been found after discectomy.

Electrical pelvic floor stimulation: a possible alternative treatment for reflex urinary incontinence in patients with spinal cord injury.

The present study demonstrates the clinical experience of pelvic floor stimulation using percutaneous implantable electrodes and implantable electrical stimulator for the treatment of reflex urinary incontinence in patients with spinal cord injury. Pelvic floor stimulation was carried out on six paraplegic patients who had urinary incontinence from an overactive bladder. After the percutaneous implantation of a pair of electrodes, chronic stimulation was carried out by employing an implanted receiver or an external pulse regulator.

NOS-positive preganglionic neurons innervate a subpopulation of postganglionic neurons in superior cervical ganglion in rats.

To determine the postganglionic targets of NOS-containing preganglionic neurons, we studied the association of NADPH-diaphorase positive preganglionic fibers and retrogradely labeled postganglionic neurons in the superior cervical ganglion (SCG) in rats. Wheat germ agglutinin-horseradish peroxidase solution was applied to the anterior chamber of the eye, middle cerebral artery, subcutaneous layer of the facial skin, or submucosal layer of the inside of the lip. Two days after tracer application, the rats were perfused with fixative solution.

[Long-term evaluation of radiographic changes following cervical anterior fusion with hydroxyapatite ceramic spacer].

Cervical anterior fusion with iliac bone crest has become a popular surgical technique for cervical spondylotic disease. Since about 10 years ago, we have substituted hydroxyapatite ceramic spacer for autologous graft because of postoperative painful hip syndrome. Fourteen patients who underwent cervical anterior fusion with ceramic spacer were evaluated by plain radiographs for over eight years postoperatively.

Challenges to clinical deployment of upper limb neuroprostheses.

The technology for functional neuromuscular stimulation (FNS) as a means of providing upper limb function to people with tetraplegia has been under development by three clinical research groups for almost two decades. This paper presents the current status of the clinical trials of three FNS systems: a noninvasive system built into a cosmetic forearm splint, a 30-channel percutaneous system, and an 8-channel implantable system. The complexity of FNS systems and the unique characteristics of the individuals to whom they are applied combine to create many clinical and technical challenges that must be addressed before the devices can be deployed.

Bacteria closely resembling Helicobacter pylori detected immunohistologically and genetically in resected gallbladder mucosa.

A microorganism with close immunohistological and genetic resemblance to Helicobacter pylori was found in the resected gallbladder mucosa of a 41-year-old woman. The woman was admitted to hospital complaining of fever and right hypochondrial pain. Cholecystectomy was carried out under the diagnosis of gallstones and cholecystitis.

MR imaging of cerebrospinal fluid rhinorrhea following the suboccipital approach to the cerebellopontine angle and the internal auditory canal: report of the two cases.

Background: Cerebrospinal fluid (CSF) otorhinorrhea is one of the most common postoperative complications following the suboccipital approach to the cerebellopontine angle and the internal auditory canal. Accurate preoperative detection of the site of CSF leakage is important because inaccuracy may require a more extensive exploratory surgical procedure in the repair operation. There are few reports on evaluation of magnetic resonance (MR) imaging in diagnosing CSF leakage.

Effect of clot removal on cerebrovascular contraction after subarachnoid hemorrhage in the monkey: pharmacological study.

Clot removal at early surgery has been reported to be clinically effective for the prevention of cerebral vasospasm following subarachnoid hemorrhage (SAH) due to rupture of an intracranial aneurysm. We examined the most efficacious timing of mechanical clot removal on pharmacological responses in a monkey SAH model. Cynomolgus monkeys (Macaca fascicularis) were randomized into five groups: sham-operated, clot removal in which the clot was removed 48, 72, or 96 h after SAH, and clot groups.

Endothelial-cell injury of the basilar artery caused by ethanol infusion in dogs.

This study in mongrel dogs was designed to observe the effects of ethanol on both endothelial cells of the basilar artery and brain function. By use of sterile surgical technique, a super-selective catheter was placed in the proximal portion of the basilar artery in the dogs. Five dogs received 3 ml of 25% ethanol and 5 dogs received 3 ml of 50% of ethanol through the catheter over 2 minutes.

Mutagenicity of soy sauce treated with nitrite in the presence of ethanol or alcoholic beverages.

The mutagenicity induced by soy sauce after reaction with 50 mM nitrite at pH 3, 37 degrees C, for 60 min in the presence of 1.25-10% ethanol was reduced in proportion to the ethanol concentration. The mutagenicity of soy sauce treated with nitrite was also reduced in the presence of commercial alcoholic beverages, Japanese sake, wine, 'shochu', whiskey and brandy, but not beer, in proportion to the concentration.

Fluid attenuated inversion recovery (FLAIR) imaging in acute Wernicke encephalopathy.

We report a case of Wernicke encephalopathy in which the FLAIR sequence could reveal involvement of the mammillary bodies. FLAIR imaging was useful in monitoring the lesions as well as in diagnosing Wernicke encephalopathy.

Pharmacological alterations after clot removal in monkey chronic cerebral vasospasm.

An autologous blood clot was placed bilaterally around cerebral arteries in the basal subarachnoid space to mimic subarachoid haemorrhage (SAH). Cynomolgus monkeys were randomised into five groups: sham operated groups, clot removal group at 48, 72 or 96 h after. SAH and clot group.

Endothelin-1 levels in plasma and cerebrospinal fluidfollowing subarachnoid haemorrhage.

A serial measurement of endothelin-1(ET-1) levels in plasma, cisternal and ventricular cerebrospinal fluid(CSF) was performed in 16 patients with subarachnoid haemorrhage (SAH). The patients were classified as grade III or IV according to the clinical grade of Hunt and Hess, and computerised tomography(CT) was classified as Fisher's CT group 3. Cisternal and ventricular CSF and plasma were obtained from the patients on the day of operation days 0-3, days 5-8 and days 14-18 after SAH.

Effect of mannitol on focal cerebral ischemia evaluated by somatosensory-evoked potentials and magnetic resonance imaging.

Background: Mannitol has been used in routine neurosurgical practice for the control of increased intracranial pressure. The effect of mannitol on focal cerebral ischemia was evaluated by somatosensory-evoked potentials (SEP) and magnetic resonance imaging (MRI).

Methods: The left middle cerebral artery (MCA) was exposed via the superomedial transorbital approach and occluded proximal to the origin of the perforating arteries.

Electromyogram analysis and electrical stimulation control of paralysed wrist and hand.

Restoring paralysed hand functions with functional electrical stimulation (FES) essentially requires control of joint angles in their functional positions as well as control of speed and power for grasping. In this study, standard FES patterns were created from the electromyogram (EMG) analysis of 15 healthy subjects in order to restore hand and wrist joint functions in C4 and C5 quadriplegics. Stimulating the hand muscles with the standard patterns produced both wrist joint fixation in a functional position and grasping movement similar to that of healthy subjects.

Surgical treatment for ossification of the posterior longitudinal ligament of the cervical spine.

The results of surgical management of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine consisting of either anterior or posterior surgical decompression of the spinal cord and/or nerve roots were evaluated in 75 patients. The OPLL was continuous (COPLL) in 37 patients, segmental (SOPLL) in 29, mixed COPLL and SOPLL (MOPLL) in five, and circumscribed disk type (DOPLL) in four. Fourteen of the patients with COPLL, 27 with SOPLL, three with MOPLL, and all four with DOPLL were treated via the anterior approach with vertebrectomy and discectomy with anterior fusion.

Intracranial hemorrhage due to long-term anticoagulant therapy in patients with prosthetic heart valves--four case reports.

Four patients with prosthetic heart valves suffered intracranial hemorrhage (cerebral hemorrhage in one patient, cerebellar hemorrhage in one, and chronic subdural hematoma in two) during long-term oral anticoagulant drug therapy (warfarin). In all patients, warfarin was discontinued and its effect neutralized by vitamin K, then surgery was performed after the thrombotest value exceeded 50%. No uncontrollable bleeding occurred at surgery.