Morphological Analysis of the Sylvian Fissure Stem to Guide a Safe Trans-sylvian Fissure Approach.

The sylvian fissure stem and its deep cisternal part (SDCP) consist mainly of the orbital gyrus (OG) and anterior medial portion of the temporal lobe. SDCP's adhesion has been found to make a trans-sylvian approach difficult due to the various patterns of adhesion. Thus, in this study, we aim to clarify the morphological features of the SDCP, and to guide a safe trans-sylvian approach.

Dissection of the Sylvian Fissure in the Trans-sylvian Approach Based on the Morphological Classification of the Superficial Middle Cerebral Vein.

The superficial middle cerebral vein (SMCV) is one of the main factors that can impede a wide opening of the sylvian fissure. To reveal the most efficient SMCV dissection for a wide operative field while preserving the veins in the trans-sylvian approach, we retrospectively investigated the SMCVs through intraoperative video images. We characterized the SMCV as composed of the frontosylvian trunk (FST; receiving frontosylvian veins [FSVs] or parietosylvian veins [PSVs]), the temporosylvian trunk (TST; receiving temporosylvian veins [TSVs]), and the superficial middle cerebral common trunk (SMCCT; receiving both FSV/PSV and TSV), and classified the SMCVs of the 116 patients into 5 types based on the morphological classification of the SMCV.

Depolymerization of sulfated polysaccharides under hydrothermal conditions.

Fucoidan and chondroitin sulfate, which are well known sulfated polysaccharides, were depolymerized under hydrothermal conditions (120-180°C, 5-60min) as a method for the preparation of sulfated polysaccharides with controlled molecular weights. Fucoidan was easily depolymerized, and the change of the molecular weight values depended on the reaction temperature and time. The degree of sulfation and IR spectra of the depolymerized fucoidan did not change compared with those of untreated fucoidan at reaction temperatures below 140°C.

Safety evaluation of excessive ingestion of mozuku fucoidan in human.

Fucoidan is a sulfated polysaccharide in the brown sea algae. This study was conducted in 20 subjects taking excessive fucoidan up to 4.05 g daily for 2 wk.

Effect of fucoidan extracted from mozuku on experimental cartilaginous tissue injury.

We investigated the effect of fucoidan, a sulfated polysaccharide, on acceleration of healing of experimental cartilage injury in a rabbit model. An injured cartilage model was surgically created by introduction of three holes, one in the articular cartilage of the medial trochlea and two in the trochlear sulcus of the distal femur. Rabbits in three experimental groups (F groups) were orally administered fucoidan of seven different molecular weights (8, 50, 146, 239, 330, 400, or 1000 kD) for 3 weeks by screening.

Effects of oral administration of fucoidan extracted from Cladosiphon okamuranus on tumor growth and survival time in a tumor-bearing mouse model.

We evaluated the anti-tumor activities of the oral administration of fucoidan extracted from Cladosiphon okamuranus using a tumor (colon 26)-bearing mouse model. The materials used included low-molecular-weight fucoidan (LMWF: 6.5-40 kDa), intermediate-molecular-weight fucoidan (IMWF: 110-138 kDa) and high-molecular-weight fucoidan (HMWF: 300-330 kDa).

Microbial fucoidan degradation by Luteolibacter algae H18 with deacetylation.

A bacterial strain that assimilates fucoidan from Cladosiphon okamuranus as sole carbon source was isolated as Luteolibacter algae H-18. It was found that it degraded fucoidan by intracellular enzymes, and that the degradation reactions were catalyzed by multiple enzymes. One enzyme, designated fraction B, was established to exhibit the deacetylation reaction of fucoidan.

Isolation and characterization of a novel fucoidan-degrading microorganism.

A bacterium utilizing fucoidan from the brown alga Cladosiphon okamuranus as sole carbon source was isolated and identified as Flavobacterium sp. F-31. The strain produced intracellular enzymes involved in fucoidan degradation and desulfation, but desulfation activity was not detected until the molecular weight of fucoidan fell to less than several tens of thousands due to enzymatic degradation.

[Evaluation of the diaphragm in patients with COPD (emphysema dominant type) by abdominal ultrasonography].

Unlabelled: The aim of this study was to clarify whether the diaphragm in patients with COPD (emphysema dominant type) can be evaluated by abdominal ultrasonography. We therefore established a method for diaphragm scanning: The dome of the right hemidiaphragm was detected by epigastric right oblique scan passing through the right edge of the inferior vena cava and the zone of apposition. Diaphragmatic flattening, correlation between the flattening and %FEV1.

Two-step surgical treatment using miniature Ommaya's reservoirs for a neonate with multiple large arachnoid cysts.

Method: We followed a two-step surgical strategy using miniature Ommaya's reservoirs in an early neonate with multiple large arachnoid cysts.

Conclusion: Percutaneous fluid aspiration through the reservoirs placed during the first operation permitted the infant to develop sufficiently to withstand the second, more radical cyst wall excision.

Cloning and sequencing analysis of alginate lyase genes from the marine bacterium Vibrio sp. O2.

We isolated a new marine bacteria, which displayed alginate-depolymerizing activity in plate assays, from seawater in Mihonoseki Harbor, Japan. Analysis of the 16S ribosomal RNA gene sequence of one of the isolates proved that this alginate-depolymerizing bacterium belonged to the genus Vibrio and it was named Vibrio sp. O2.

[New monitoring test for sleep apnea syndrome].

We introduce change in pulse transit time (change in PTT: noninvasive intrathoracic pressure monitoring) as a new monitoring test of sleep apnea syndrome, which is being developed for clinical application. In addition, we report the kinetics of cardiogenic oscillation (CGO: noninvasive upper airway obstruction monitoring), which was published in this journal in 2003, and the response of the upper airway in clinical practice (under an endoscope). We also review diaphragmatic movement by abdominal echography (respiration generator monitoring).

[Intracavernous iatrogenic aneurysm causing subarachnoid hemorrhage after removal of intracranial tumor, treated by coil embolizatioin].

We describe a rare case of subarachnoid hemorrhage due to a ruputured iatrogenic traumatic aneurysm in the cavernous carotid artery, caused by injury during surgery for skull base meningioma that was performed 2 years ago. A 64-year-old woman underwent craniotomy for resection of meningioma of the right sphenoid ridge. During surgery, venous bleeding from the cavernous sinus was easily controlled by packing.

[Cardiogenic oscillation--utility of classifying types of sleep apnea].

Cardiogenic pulse waves that travel along the airway wall are captured as airflow variations synchronized with the electrocardiogram at the airway exit. We have used airflow variations caused by cardiogenic pulse waves (hereinafter referred to as cardiogenic oscillation) to classify types of sleep apnea. Pulse waves do not travel downstream if there is an airway obstruction or choke point (wave speed theory).

[A case with surgical repair for delayed occult cerebrospinal fluid rhinorrhea presented as meningitis fourteen years after blunt head trauma].

We describe a case of a 34-year-old woman in whom delayed occult cerebrospinal fluid rhinorrhea presented as meningitis. Removal of an implanted shunt system and surgical repair of the fistula were required. The cerebrospinal fluid fistula was located in the left frontoethmoidal region.

[Usefulness of diffusion-weighted magnetic resonance imaging in diagnosis and therapeutic strategy of deep cerebral venous thrombosis: a case report].

We present the usefulness of Diffusion-weighted magnetic resonance images (DWI) in diagnosis and therapeutic strategy of deep cerebral venous thrombosis (VT). We report a 37-year-old man who suffered general convulsion and deep coma. Magnetic resonance imaging (MRI) showed high intensity in the right caudate nuclei and bilateral thalamus on T2-weighted images.

Comparison of parathyroid hormone levels from the intact and whole parathyroid hormone assays after parathyroidectomy for primary and secondary hyperparathyroidism.

Background: Most commercial intact parathyroid hormone (intact PTH) assays cross-react with non-(1-84) PTH (likely 7-84 PTH). Using a whole-molecule PTH (whole PTH) assay that specifically measured only 1-84 PTH, we compared the kinetics of whole PTH and intact PTH after parathyroidectomy in patients with primary hyperparathyroidism (HPT) and secondary HPT.

Methods: This study comprised 74 patients with primary HPT caused by a single adenoma and 18 patients with secondary HPT who underwent parathyroidectomy.

Large carboxy-terminal parathyroid hormone (PTH) fragment with a relatively longer half-life than 1-84 PTH is secreted directly from the parathyroid gland in humans.

Objective: It was discovered that an immunoreactive large carboxy-terminal parathyroid hormone (PTH) fragment (large C-PTH), likely 7-84 PTH, is present in the circulation. However, very little is known about the production and metabolism of this large C-PTH. Combining a whole molecule PTH (whole PTH) immunoradiometric assay (IRMA) specifically for 1-84 PTH and an intact PTH (iPTH) IRMA for the sum of 1-84 PTH and large C-PTH, we were able to assess the circulating level of this large C-PTH as well as the glandular secretion and metabolism of this large C-PTH in primary hyperparathyroidism (pHPT).

[Effort-independent pulmonary function tests].

Many pulmonary function tests require forced expiration, and the precision of the tests depends on the effort of the subjects. In elderly people, the reproducibility of test results may be inadequate because of insufficiency of the subjects' effort, and the diagnosis of COPD, which is frequently observed in elderly people, is often difficult. To improve the accuracy of the diagnosis, pulmonary function tests that do not require effort are needed.

[Pulmonary function tests].

The spirometry has been most valuable pulmonary function test and it defines pulmonary physiology. But the spirometry has not been widely used by general physicians in Japan. The spirometry is effort-dependent test, so, they seem to keep it at a distance.

[A case of tomato juice-induced oral allergy syndrome in which dyspnea onset occurred during the season of Japanese cedar pollen dispersion].

A 42-year-old-man with a history of Japanese cedar pollinosis repeatedly visited the emergency clinic due to dyspnea during the season of Japanese cedar pollen dispersion. Before each onset of this symptom, he had always drunk tomato juice. Swelling of the oral and nasal mucosa, and congestion of the bulbar conjuctiva was observed.

Acute surgery for ruptured dissecting aneurysm of the M3 portion of the middle cerebral artery.

A 65-year-old woman presented with a ruptured dissecting aneurysm of the M3 portion of the middle cerebral artery (MCA) manifesting as disturbance of consciousness and motor aphasia. Computed tomography revealed subarachnoid hemorrhage. Emergent angiography demonstrated segmental aneurysmal dilatation of the M3 portion of the left MCA.

Subsequent rupture after clip on wrap method for ruptured dissecting aneurysm of the distal middle cerebral artery: a case report and review of the literature.

Dissecting aneurysms rarely occur in the middle cerebral artery (MCA). Furthermore, recurrent subarachnoid hemorrhage from ruptured dissecting aneurysms is rare with no published report of subsequent rupture after treatment by the clip on wrap method. The case reported is a 41-year-old man with subarachnoid hemorrhage.

Role of cyclase activating parathyroid hormone (1-84 PTH) measurements during parathyroid surgery: potential improvement of intraoperative PTH assay.

Summary Background Data: Quick intraoperative parathyroid hormone assays are widely used as a guide to the adequacy of resection during parathyroid surgery. However, some authors have reported a 15% error rate of these assays because of the presence of false-positive and false-negative results. Recently the authors have found that most commercial intact PTH (iPTH) assays cross-react with non-(1-84) PTH (likely 7-84 PTH) and that the proportional levels of non-(1-84) PTH in patients were variable in a much wider range, accounting mostly for 20% to 60% of the immunoreactivity in samples obtained from hyperparathyroid patients.