Prolonged mild therapeutic hypothermia versus fever control with tight hemodynamic monitoring and slow rewarming in patients with severe traumatic brain injury: a randomized controlled trial.

Although mild therapeutic hypothermia is an effective neuroprotective strategy for cardiac arrest/resuscitated patients, and asphyxic newborns, recent randomized controlled trials (RCTs) have equally shown good neurological outcome between targeted temperature management at 33 °C versus 36 °C, and have not shown consistent benefits in patients with traumatic brain injury (TBI). We aimed to determine the effect of therapeutic hypothermia, while avoiding some limitations of earlier studies, which included patient selection based on Glasgow coma scale (GCS), delayed initiation of cooling, short duration of cooling, inter-center variation in patient care, and relatively rapid rewarming. We conducted a multicenter RCT in patients with severe TBI (GCS 4-8).

Seizure suppression in amygdala-kindled mice by transplantation of neural stem/progenitor cells derived from mouse embryonic stem cells.

Embryonic stem cells (ES cells) differentiate into multiple cell lineages including neural cells. The present study optimized the method to induce differentiation of gamma-aminobutyric acid-producing neurons (GABAergic neurons) from ES cell-derived neural stem/progenitor cells (NS/PCs), and transplanted these ES cell-derived GABAergic neurons producing neural progenitors into kindled epileptic mice, and analyzed the morphological and functional recovery from epilepsy. The response of kindling was evaluated by the modified Racine scale.

Evaluation of human fetal neural stem/progenitor cells as a source for cell replacement therapy for neurological disorders: properties and tumorigenicity after long-term in vitro maintenance.

It is expected that human neural stem/progenitor cells (hNS/PCs) will some day be used in cell replacement therapies. However, their availability is limited because of ethical issues, so they have to be expanded to obtain sufficient amounts for clinical application. Moreover, in-vitro-maintained hNS/PCs may have a potential for tumorigenicity that could be manifested after transplantation in vivo.

Effect of delayed mild brain hypothermia on edema formation after intracerebral hemorrhage in rats.

Secondary consequences of intracerebral hemorrhage (ICH) including inflammation, edema, and oxidative damage all contribute to cell death after ICH. Brain hypothermia (BH) has been used as an effective neuroprotective treatment in experimental brain ischemia and traumatic brain injury. In this study, we first attempted to evaluate the effect of delayed mild BH (35 degrees C) on brain edema formation 48 hours after ICH.

Targeting optimal biopsy location in basal ganglia germinoma using (11)C-methionine positron emission tomography.

Background: Approximately 5% to 10% of intracranial germinomas arise from the basal ganglia or thalamus. Diagnosis is usually made by stereotactic biopsy, and precise location of the biopsy target is crucial because germinoma in these sites is potentially curable. We herein describe a case with germinoma in the basal ganglia that showed nonspecific clinical and radiological findings.

Preoperative identification of subthalamic nucleus for deep brain stimulation using three-dimensional phase sensitive inversion recovery technique.

Purpose: We assessed the feasibility of utilizing three-dimensional (3D) phase sensitive inversion recovery (IR) images for preoperatively determining deep brain stimulator position.

Methods: We measured geometric distortion with a grid phantom and evaluated images of 3 volunteers to determine optimum imaging parameters for 3D phase sensitive IR.

Results: Geometric distortion measured less than 1.

Metabolic disturbance without brain ischemia in traumatic brain injury: a positron emission tomography study.

Background: Cerebral ischemia is believed to be an important mechanism of secondary neuronal injury in traumatic brain injury (TBI).

Methods: In this study, we performed 15O2 positron emission tomography (PET) studies to measure the cerebral blood flow (CBF) and oxygen metabolism (CMRO2) in the pericontusional region in a total of 15 patients (11 males, 4 females, aged 15-81 years) who sustained TBI with contusional hematoma. PET studies were performed a mean of 13.

Cerebral metabolism monitoring during hypothermia following resuscitation from cardiopulmonary arrest.

Background: The aim of the present study was to evaluate cerebral metabolism monitoring during therapeutic hypothermia for global ischemic brain damage after cardiopulmonary resuscitation (CPR).

Methods: Jugular venous sampling and positron emission tomography (PET) were used. Seven comatose patients with cardiopulmonary arrest underwent hypothermia treatment as soon as possible after CPR.

Hyperbaric oxygen therapy for consciousness disturbance following head injury in subacute phase.

Background: Hyperbaric oxygen (HBO) therapy has been shown to improve outcome after brain injury, however its mechanisms are not understood. The purpose of the present study was to investigate the effect of hyperbaric oxygen (HBO) therapy on the cerebral circulation and metabolism of patients with disturbances in consciousness after head injury in the subacute phase.

Methods: Seven head injury patients underwent HBO treatment after leaving the intensive care unit.

Edaravone attenuates brain edema and neurologic deficits in a rat model of acute intracerebral hemorrhage.

Background And Purpose: Our previous studies have demonstrated that oxidative DNA injury occurs in the brain after intracerebral hemorrhage (ICH). We therefore examined whether edaravone, a free-radical scavenger, could reduce ICH-induced brain injury.

Methods: These experiments used pentobarbital-anesthetized, male Sprague-Dawley rats that received an infusion of either 100 microL autologous whole blood (ICH), FeCl(2), or thrombin into the right basal ganglia.

Prognostic implication of p27 expression in primary central nervous system lymphoma.

To clarify the role of p27/Kip1 (p27) in primary central nervous system lymphomas (PCNSLs), we examined p27 expression by immunohistochemical methods in a series of 22 patients with PCNSL. We attempted to correlate the expression of p27 with proliferation potential and prognosis. Although the MIB-1 labeling index (LI) was lower in tumors with low p27 expression (26.

Expression of matrix metalloproteinase-9 in thrombin-induced brain edema formation in rats.

Recent evidence has demonstrated that thrombin plays an important role in the development of brain edema by the blood-brain barrier disruption in intracerebral hemorrhage. Matrix metalloproteinases (MMPs), a family of proteolytic enzymes that degrade the extracellular matrix, are implicated in blood-brain barrier disruption. In this study, we examined whether thrombin injection into the brain parenchyma induces the MMP-9 expression in rats.

FDG-PET findings of the brain in lymphomatoid granulomatosis.

A 44-year-old man with a history of sudden onset short-term disorientation was admitted to our hospital. T2-weighted fast spin-echo MR images of the head showed increased signal intensity in the bilateral frontal and parietal white matter. Gadolinium-enhanced T1-weighted spin-echo images showed multiple areas with punctate and linear enhancement scattered in the bilateral frontal and parietal white matter.

Technetium-99m sestamibi single photon emission computed tomography findings correlated with P-glycoprotein expression in pituitary adenoma.

The aim of this study is to evaluate whether the technetium-99m sestamibi ((99m)Tc-MIBI) single photon emission computed tomography (SPECT) characteristics of pituitary adenomas might be correlated with cavernous sinus invasion, proliferative potential or the multidrug-resistance (MDR-1) gene product P-glycoprotein (Pgp) expression in pituitary adenomas. Fifteen patients with pituitary adenomas, including 10 nonfunctioning adenomas, two prolactinomas, two GH producing adenomas, and one ACTH producing adenomas was investigated for this study. SPECT images with (99m)Tc-MIBI were acquired 15 minutes (early) and 3 hours (delayed) after injection.

Magnetic resonance imaging and positron emission tomography findings in status epilepticus following severe hypoglycemia.

We recently experienced a case with asymmetrical cortical abnormality on MRI with focal status epilepticus following severe hypoglycemia. The cerebral blood flow and metabolisms for oxygen and glucose were determined using positron emission tomography (PET) during focal status epilepticus following severe hypoglycemia and at the follow-up period. Prolonged seizure activity produced profound glucose hypermetabolism and mild hyperemia in the region of the presumed cortical focus of epilepsy and in structures anatomically remote from the focus, corresponding to the areas of abnormal signal intensity on the MRI.

Chiari I malformation accompanied by assimilation of the atlas, Klippel-Feil syndrome, and syringomyelia: case report.

Background: Chiari I malformation, accompanied by superposed bony anomaly of the craniovertebral junction, is comparatively rare. We report a case of Chiari I malformation accompanied by assimilation of the atlas, Klippel-Feil syndrome, and syringomyelia.

Case Description: The patient was a 61-year-old woman demonstrating numbness of the extremities, sensory impairment, muscular weakness, and tendon hyper-reflexia.

Neural stem cells transplantation in cortex in a mouse model of Alzheimer's disease.

Objective: The goal of this study was to elucidate the effect of neurospheres (NS) on dementia in the mouse model of nucleus basalis of Meynert (NBM) lesion.

Methods: Mouse embryonic stem cell (ES) derived neurospheres were transplanted into the frontal association cortex and barrel field of S1 cortex of C57BL/6 mice 4 weeks after including a lesion of NBM by ibotenic acid, while other healthy mice that received ES cells served as control. Behavioral tests by 8-arm radial maze were conducted 8 weeks after transplantation, and double staining of choline acetyltransferase (ChAT), serotonin, amyloid-beta protein (AP) and green fluorescent protein (GFP) 12 weeks after transplantation.

Differences in the neuronal stem cells survival, neuronal differentiation and neurological improvement after transplantation of neural stem cells between mild and severe experimental traumatic brain injury.

We developed a novel protocol for generation and selective amplification of neural progenitor cells regionally specified to the rostral brain but not the spinal cord from mouse embryonic stem cells (ESCs). The neural progenitors could differentiate in vitro and in vivo into many cholinergic and a few GABAergic neurons but rarely into astrocytes. The transplanted neurospheres could survive in the hippocampus (CA3) of animals with mild traumatic brain injury (TBI).

Evaluation of tumor FDG transport and metabolism in primary central nervous system lymphoma using [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) kinetic analysis.

Objective: Although 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been used as a promising tool to diagnose primary central nervous system lymphoma (PCNSL) because the tumor shows very high FDG accumulation, no data exist evaluating the extent of tumor FDG transport and metabolism. The aim of this study was to evaluate the feasibility of FDG-PET kinetic analysis in measurement of uptake parameters of FDG in the lymphoma tissues and in the assessment of treatment effects in patients with PCNSL.

Methods: Dynamic FDG-PET examination was performed in 7 histologically proven PCNSL patients before and after methotrexate-based chemotherapy.

Mechanical thrombolysis for treatment of acute sinus thrombosis--case report.

A 55-year-old woman presented with consciousness disorders. Computed tomography revealed hemorrhage in the left temporoparietal region. The angiographic diagnosis was progressive sinus thrombosis from the superior sagittal sinus to the bilateral transverse sinuses.

Improvement of cerebral arterial stenosis associated with Basedow's disease. Case report.

A 29-year-old female presented with Basedow's disease manifesting as sudden vomiting, diarrhea, fever over 38 degrees C, transient aphasia, and numbness in her extremities. These symptoms were considered due to cerebral ischemia at a local clinic. Magnetic resonance angiography indicated stenosis of the bilateral distal internal carotid arteries and the bilateral proximal anterior cerebral and middle cerebral arteries.