[A neuron-specific enolase (NSE) positive leiomyosarcoma].

A 40-year-old woman with multiple skin tumors was admitted to our hospital on September 5, 1989. Extensive studies by means of light and electron-microscopic examination and immunohistochemical analysis revealed a neuron-specific enolase (NSE) positive leiomyosarcoma. The level of her elevated serum NSE decreased after receiving her initial chemotherapy, but after the fourth session of chemotherapy, the NSE began to elevate again and she died on December 25, 1989.

[B-chronic lymphocytic leukemia/prolymphocytic leukemia (CLL/PL)--a case report].

A 48-year-old male was admitted to our hospital on April 20, 1989 because of general fatigue and abdominal fullness. Physical examination showed hepatomegaly, massive splenomegaly, and systemic lymphadenopathy. Hematological findings revealed WBC 73,000/microliters, RBC 289 x 10(4)/microliters, Hb 8.

Fluctuation in the concentrations of vanillylmandelic acid and homovanillic acid in mass screening for neuroblastoma.

Fluctuations in the amount of vanillylmandelic acid (VMA) and homovanillic acid (HVA) were studied in random urine samples from 13 infants with neuroblastoma. In patients with a small tumour, many samples contained amounts below the cut off values, suggesting that detection of a patient with neuroblastoma depended on mathematical probability. Using high performance liquid chromatography a patient with a tumour of about 10 g may well be overlooked, whereas a patient whose tumour weighs over 30 g would probably be detected.

[A transitional cell carcinoma of the urinary bladder with a high level of serum CA 19-9--a case report].

Reported is the case of a 72 year-old man who was hospitalized because of abdominal pain and gross hematuria. A subsequent laboratory examinations revealed a high level of serum CA 19-9, and abdominal computed tomography showed a mass lesion behind the urinary bladder and multiple lymphadenopathy. Examination of the digestive organs revealed no abnormality, however cystoscopy showed a submucosal a tumor with a partly ruddy surface.

Improvement in prognosis of neuroblastoma through mass population screening.

Since April 1981, the city of Sapporo, Japan, has conducted a mass screening program to measure urinary vanillylmandelic acid and homovanillylic acid using high-performance liquid chromatography. This program was expanded to the entire island of Hokkaido in October 1987. Mass screening proved beneficial, resulting in an increase in patients diagnosed with neuroblastoma under 1 year of age from 17% to 66%, an increase in stage I cases from 9% to 26%, an increase in stage III cases from 9% to 32%, and an increase in the tumor resectability rate from 15.

Microstimulation for stereotactic neurosurgery.

840 microstimulations were done in 21 patients with movement disorders and chronic pain. Paresthesia was the most common response and occurred in 53.3% of cell responses, since the present study was performed mainly in the nucleus ventrocaudalis (Vc).

[Prolymphocytic leukemia associated with serum hypo IgA].

A 69-year-old man was admitted for the evaluation of leukocytosis with atypical cells. Physical examination revealed marked hepatosplenomegaly. The peripheral blood demonstrated Hb 10.

Effect of midbrain raphe nucleus stimulation on somatosensory evoked potential in cat.

Experiments were carried out to clarify the effect of serotonin [5-hydroxytryptamine (5-HT)] upon the somatosensory evoked potential (SEP) elicited by superficial radial nerve stimulation in cat, and the following results were obtained: (i) in untreated (control) animals, a significant reduction occurred in amplitude of the SEP in response to conditioning stimulation of the dorsal raphe nucleus in the midbrain, within 100 ms of the interval between conditioning and test stimuli; (ii) in 5-HT depleted animals prepared by intraperitoneal injection of p-chlorophenylalanine (PCPA), the amplitude of SEP significantly increased in comparison with that of nontreated animals. Conditioning stimulation of the raphe nucleus in 5-HT depleted animals failed to cause any remarkable change in the SEP; (iii) the diminuation of the SEP by raphe nucleus conditioning reappeared following intraventricular administration of a large dose of 5-HT (200 micrograms) in the PCPA-treated animals. These results have demonstrated that the serotonergic system with its cell bodies located in the raphe nucleus of the midbrain has the function of reducing the amplitude of the SEP, thus suggesting that it acts as a suppressive control on the excitability of the cortex to sensory input.

Evoked potentials from the human thalamus: correlation with microstimulation and single unit recording.

During stereotactic surgery, intrathalamic single unit recordings and summated evoked potentials (Th-SEP), evoked by percutaneous electrical median nerve stimulation and intrathalamic microstimulation, were done using the same microelectrode at the same site. Potentials evoked by natural and electrical stimulation were compared. The format of Th-SEP varied in anteroposterior, mediolateral and dorsoventral directions in the ventrocaudal nucleus (Vc).

[A case of hypercalcemia with ovarian carcinoma].

A 45-year-old female manifested lower abdominal fullness and symptoms of hypercalcemia with nausea, vomiting, and thirst. Physical examination showed a right ovarian mass and laboratory data demonstrated hypercalcemia (14.6 mg/dl).

Influence of the ipsilateral hemisphere upon somatosensory evoked potential in cats.

Somatosensory evoked potentials (SEPs) were recorded on the skull corresponding to the (left) SI area by (right) superficial radial nerve stimulation. Amongst the various components of the SEP, special attention was directed to the negative component (N15) with a latency of approximately 15 ms. Changes in this potential followed by conditioning stimulation of the ipsilateral (right) hemisphere were observed and the following results were obtained: (i) when conditioning stimuli were applied to the contralateral (left) superficial radial nerve, the ipsilateral (right) thalamic VPL nucleus and the ipsilateral (right) sensory cortex, the amplitude of N15 decreased to 65-80% of the control level at C-T intervals less than 100 ms and (ii) following functional elimination of the unilateral sensory cortex by KCl application, the amplitude of N15 recorded at the opposite side significantly increased.

Methods for microstimulation and recording of single neurons and evoked potentials in the human central nervous system.

An apparatus and technique are described for microstimulation and recording of both slow wave and single neuron (single unit) activities during functional stereotaxic procedures. This method facilitates microstimulation and evoked potential and single unit analysis which, in combination, provide optimum definition of stereotaxic targets in the treatment of functional disorders of the human central nervous system.

[Cerebral aspergillosis as a cerebral vascular accident].

Cerebral aspergillosis is one of the most common mycotic infections in the central nervous system causing different clinical features such as brain abscess, granuloma, meningitis, and encephalitis. Cerebral aspergillosis, however, may lead to a cerebral vascular accident such as intracranial hemorrhage or cerebral infarction. In this report, we present two patients with cerebral aspergillosis accompanied by intracranial hemorrhage.

Single-unit analysis of the human ventral thalamic nuclear group: somatosensory responses.

1. We have studied the functional and somatotopic properties of 531 single mechanoreceptive thalamic neurons in humans undergoing stereotactic surgery for the control of movement disorders and pain. The majority of these somatosensory cells had small receptive fields (RFs) and were activated in a reproducible manner by mechanical stimuli applied to the skin or deep tissues.

[An autopsy case of a gastric cancer associated with elevated AFP, CEA and CA19-9].

A 48-year-old male developed gastric cancer (Borrmann III) with lung and liver metastases. Laboratory examination revealed a markedly elevated AFP (24, 241 ng/ml), CEA (9739.8 ng/ml), and CA-19-9 (726U/ml).

Thalamotomy in generalized dystonia.

A prospective long-term semiquantitative evaluation of the results of ventral intermediate-posterior ventral oral nucleus thalamotomy on the different aspects of dystonia was made in 29 patients with secondary disease, 12 with nonfamilial, eight with (non-Jewish) familial, and seven with atypical DMD. The effect of disease progression, even in secondary patients, on surgical outcome was reviewed. Thalamotomy resulted in a long-term improvement in limb function of more than 25% to 50% in 23% of the patients, over 50% in 34% of patients, but midline features responded poorly.

Origin of short latency somatosensory evoked potential in cats: especially potentials derived from thalamus and cortex.

Short latency somatosensory evoked potential (SSEP) was recorded in cats to identify the potentials originating from the cortex and the thalamus, and the following results were obtained. When SSEP was elicited on the bregma by stimulation of the contralateral superficial radial nerve, P2, P4, P4.5, P5.

[A case report of malignant schwannoma originating from the bone].

While malignant schwannoma is encountered frequently as soft tissue sarcomas, it rarely is found to originate in the bone. We have had a case of malignant schwannoma originating from the tibia of a 47-year-old man. He died from uremia, that resulted from lung, spinal vertebral body, and lymph nodes metastases, despite surgical treatment and chemotherapy.

[A case of metastatic malignant melanoma mimicking pancreatic pseudocyst].

A 74-year-old male was admitted to our hospital complaining of an abdominal mass. Abdominal US and ERCP disclosed a cyst in the pancreas, communicating with a crater in the stomach. Spontaneous rupture of a pancreatic pseudocyst into the stomach was considered.

Microelectrode techniques in localization of stereotactic targets.

Although physiological corroboration of the target is essential in functional stereotactic surgery, the collected data can also be used for the offline study of normal and abnormal brain function. Such studies have the advantage of being made in actual clinical states with the unique opportunity of communicating with the patient. Correlations were made between microelectrode recordings and microstimulation at the same thalamic site with the same microelectrode in 'normal' patients, in those with tremor and in those with central and deafferentation pain.