[Measurement of left ventricular chamber and myocardial volume in hypertrophic cardiomyopathy patients by ECG-gated myocardial perfusion SPECT: application of a newly developed edge-detection algorithm].

Quantitative gated SPECT (QGS) software has been reported to demonstrate inaccurate edge detection in the left ventricular chamber in hypertrophic cardiomyopathy patients. In this study we developed a method to calculate left ventricular volume (LVV) and left myocardial volume (LMV) from gated SPECT data using a newly developed edge-detection algorithm, and we compared it with the QGS method of calculating LVV and LMV in a phantom study. Our method gave more accurate measurements LVV and LMV whereas the QGS method underestimated LMV.

Ruptured dissecting aneurysm of the vertebral artery associated with occlusive internal carotid artery dissection--case report.

A 64-year-old male presented with subarachnoid hemorrhage. Angiography showed a dissecting aneurysm of the right vertebral artery (VA), and severe stenosis of the right internal carotid artery (ICA). He was treated conservatively in the early stage.

Why do chronic subdural hematomas continue to grow slowly and not coagulate? Role of thrombomodulin in the mechanism.

Object: Thrombomodulin is a thrombin receptor on vascular endothelial cells that is highly expressed when these cells are injured, and it has anticoagulating activity. The authors investigated thrombomodulin expression to clarify why chronic subdural hematomas (CSDHs) continue to grow slowly, like a tumor, and are liquefied.

Methods: Burr hole craniotomy and drainage were performed in all 35 patients with CSDH who were included in the study.

Spontaneous occlusion of ruptured vertebral artery dissection at the extradural fenestration associated with extradural origin of the posterior inferior cerebellar artery--case report.

A 69-year-old female suffered from sudden onset of severe headache. Computed tomography showed subarachnoid hemorrhage primarily located in the posterior fossa. Initial angiography demonstrated a fenestration of the vertebral artery and an extracranial origin of the posterior inferior cerebellar artery.

Late hemorrhage from persistent pseudoaneurysm in vertebral artery dissection presenting with ischemia: case report.

Background: Vertebral artery dissection lesions tend to resolve spontaneously, but abnormal findings such as aneurysmal-dilatation occasionally persist. However, the clinical features and pathological findings in such cases have never been verified.

Case Description: A 62-year-old man presented with left cerebellar infarction.

Probable lymphocytic hypophysitis diagnosed by short-term serial computed tomography and gallium-67 scintigraphy--case report.

A 61-year-old female presented with headache, malaise, and left oculomotor nerve paralysis. Computed tomography (CT) demonstrated a diffuse pituitary mass and enlarged pituitary stalk with homogeneous contrast enhancement. Her symptoms gradually resolved without treatment.

Secondary glioblastoma remarkably reduced by steroid administration after anaplastic transformation from gliomatosis cerebri--case report.

A 45-year-old female presented with gliomatosis cerebri manifesting as hemiballismus-like involuntary movement in the arm, motor weakness in the leg, and hypesthesia in her left side. Computed tomography showed only diffuse swelling of the right cerebral hemisphere, but T2-weighted magnetic resonance imaging revealed a diffuse lesion spreading from the right thalamus to the temporal, parietal, and occipital lobes on the same side. No abnormal enhancement was recognized.

Clinical importance of c-Met protein expression in high grade astrocytic tumors.

The clinical importance of the expression of c-Met protein, the receptor of hepatocyte growth factor/scatter factor, was evaluated in neuroepithelial tissue tumors. c-Met immunohistochemistry was performed using the streptavidin-biotin-peroxidase complex method with anti-c-Met polyclonal antibody. Specimens were classified as c-Met negative (< 30%) or c-Met positive (> or = 30%) according to the proportion of immunopositive cells under microscopic examination.

Hemangiopericytoma arising at the site of a dural graft 13 years after total removal of a benign meningioma--case report.

A 64-year-old female presented with hemangiopericytoma arising from a dural fascia graft placed after a previous operation for the total removal of a benign meningioma. The patient also had multiple pulmonary metastases identified as hemangiopericytoma. The tumor resected at the first operation was benign based on all grading systems for meningiomas.

[A survey of malignant gliomas accompanied with visceral malignancies].

From January 1984 to December 1997, a total of six patients with malignant gliomas accompanied with visceral malignancies were treated in our department. We reviewed their radiological findings and clinical course. They consisted of four patients with glioblastoma and two patients with anaplastic astrocytoma.

Ossification of transverse ligament of the atlas associated with atlanto-axial dislocation--case report.

A 68-year-old male presented with progressive quadriparesis. Twelve years previously he had undergone anterior decompression with bone grafting for cervical ossification of the posterior longitudinal ligament associated with spinal trauma. Radiological examination showed ossification of the transverse ligament of the atlas (TLA) and severe stenosis of the upper cervical canal.

Abducens nerve palsy caused by basilar impression associated with atlanto-occipital assimilation.

A 47-year-old male presented with abducens nerve palsy due to basilar impression associated with atlanto-occipital assimilation manifesting as slowly progressive bilateral trigeminal neuralgia and diplopia in the right lateral gaze. X-ray and computed tomography of the skull confirmed the diagnosis of basilar impression and atlanto-occipital assimilation, and magnetic resonance imaging disclosed tightness of the posterior cranial fossa. Surgical suboccipital decompression resulted in gradual resolution of the patient's complaints, and no additional symptoms were recognized.

Immunohistochemical examination of c-Met protein expression in astrocytic tumors.

Hepatocyte growth factor/scatter factor (HGF/SF), which has various physiological functions, and its receptor c-Met, the human c-met proto-oncogene product, are thought to be determinant in the pathological processes of various malignancies. To investigate the possible role of HGF/SF in the progression of development of astrocytic tumors, we examined the expression of c-Met in these tumors. Immunohistochemistry using the streptavidin-biotin peroxidase complex method and immunofluorescence double staining with anti-c-Met polyclonal and anti-glial fibrillary acidic protein monoclonal antibodies were performed.

[Imaging of myocardial perfusion and metabolism with positron emission tomography].

Positron emission tomography (PET) has been providing new information in the diagnosis and the pathophysiological assessment of heart diseases. The PET tracers commonly used in Japan are 13N-ammonia, 18F-fluorodeoxyglucose (FDG) for imaging of myocardial perfusion and metabolism, respectively. Measurement of regional myocardial blood flow by 13N-ammonia dynamic PET scan and a compartment model analysis is applied to the functional estimation of coronary stenotic lesions and the detection of perfusion abnormalities in hypertrophic heart diseases, familial hyperchlesterolemia and other diseases with possible microvascular lesions.

Occlusive cerebrovasculopathy after internal radiation and bleomycin therapy for craniopharyngioma--case report.

A 34-year-old female presented with occlusive cerebrovasculopathy without definite ischemic symptoms and regrowth of a cystic tumor in the third ventricle. She had been treated for a craniopharyngioma 19 years previously by internal irradiation with 198Au colloid combined with intracavitary administration of bleomycin via an Ommaya reservoir. Cerebral angiography demonstrated complete occlusion of the clinoid portion of the left internal carotid artery and stenosis of the left posterior cerebral artery, and numerous transdural anastomoses which had developed after craniotomy.

Successful removal of meningioma of the pineal region after embolization.

A 69-year-old female presented with a meningioma of the pineal region manifesting as gait disturbance and mental dysfunction. Magnetic resonance imaging revealed a homogeneously well-enhanced circumscribed round mass of about 5 cm in diameter in the pineal region. Angiography demonstrated that the tumor was fed mainly by the bilateral middle meningeal arteries (MMAs), and preoperative intravascular embolization was performed through the bilateral MMAs using estrogen-alcohol and polyvinyl acetate.

Prediction of consistency of meningiomas with preoperative magnetic resonance imaging.

Background: The consistency of a meningioma is one of the important factors in determining the surgical outcome. If the surgeon is aware of the consistency of a meningioma preoperatively, the surgical plans will be influenced. A few papers have described the correlation between consistency of meningiomas and their magnetic resonance imaging (MRI) findings.

The outcome of early surgical management of ruptured posterior circulation aneurysms.

Since 1990, early surgery within 3 days following subarachnoid hemorrhage has been performed routinely in our hospital even for ruptured posterior circulation aneurysms. Our experience with early surgical management of 25 patients with posterior circulation aneurysms, including two patients who underwent endovascular surgery, is reported. Fourteen patients had an aneurysm on the basilar, the posterior cerebral or superior cerebellar artery (BA), and 11 patients had an aneurysm on the vertebral or posterior inferior cerebellar artery (VA).

Cerebellar infarction with hydrocephalus caused by spontaneous extracranial vertebral artery dissection--case report.

A 38-year-old male suffered sudden onset of rotational vertigo without headache. Consciousness disturbance developed on the 3rd day after the onset. Computed tomography showed cerebellar infarction with obstructive hydrocephalus.

[Idiopathic intracranial hypotension associated with decreased blood concentration of vitamin A].

We report a case of idiopathic intracranial hypotension, a clinically rare syndrome. A 28-year-old woman was admitted with orthostatic headaches associated with nausea secondary to intracranial hypotension. Lumbar puncture yielded an opening pressure of 4 cmH2O in the lateral recumbent position, and the spinal fluid protein concentration was 56 mg/dl.

[Skull base metastasis from renal cell carcinoma presenting as abducens nerve paresis: report of two cases].

We report two cases of skull base metastasis from renal cell carcinoma. Case 1: A 55-year-old female presented with a skull base tumor located on the clivus. Partial removal of the tumor was performed via the transsphenoidal approach.

Large diffuse arteriovenous malformation affecting the right cerebral and cerebellar hemispheres: case report.

A cerebral vascular malformation was triggered in a 24-year-old man by left hemiparesis resembling transient ischemic attack. Cerebral angiography revealed slight dilation of the right anterior cerebral artery, middle cerebral artery, superior cerebellar artery, and posterior inferior cerebellar artery, as well as marked capillary blush and dilation of medullary veins involving the right cerebral hemisphere, especially the frontal lobe and cerebellar hemispheres. This vascular malformation, a clinical rarity, seemed to be in the same family as diffuse arteriovenous malformation or "medullary venous malformation.

Secondary exposure of medical staff to sarin vapor in the emergency room.

Objective: To clarify the risk of secondary exposure of medical staff to sarin vapor in the emergency room, and to warn emergency room staffs of the hazard.

Design: Retrospective observational survey.

Setting: Emergency department of a university hospital in a metropolitan area of Japan.

Release of ciliary neurotrophic factor from cultured astrocytes and its modulation by cytokines.

CNTF rescues various types of lesioned neurons in vivo, and it needs to be released from astrocytes into the extracellular space to have the effect. However, direct evidence for CNTF release has not been unequivocally demonstrated. We hypothesized that the rapid sequestration by CNTF receptor present on cultured astrocytes might be the cause of the inability to detect CNTF released into astrocyte-conditioned medium (ACM).

Accumulation of nerve growth factor in cerebrospinal fluid and biological activity following neurosurgery.

Perioperative nerve growth factor (NGF) levels in cerebrospinal fluid (CSF) of patients with acoustic neurinoma (14 cases), tentorial meningioma (1 case), or subarachnoid hemorrhage (1 case) were examined. Preoperative NGF levels in CSF were below the level of detection in all patients. However, NGF was found to accumulate transiently in CSF following neurosurgery.