[Dealing with alcoholism--networking of social resources in Kochi prefecture].
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Alcoholism↗
Biomedical subjects
T Takeshima
Publications and source records attributed to T Takeshima.
Platelet ionized magnesium, cyclic AMP, and cyclic GMP levels in migraine and tension-type headache.
Decreased serum and intracellular levels of magnesium have been reported in patients with migraine. It has been suggested that magnesium may play an important role in the attacks and pathogenesis of headaches. We measured ionized magnesium, cyclic AMP (adenosine monophosphate), and cyclic GMP (guanosine monophosphate) in platelets of patients with migraine, in patients with tension-type headache, and in healthy controls. The platelet level of ionized magnesium from patients with tension-type headache was significantly lower than the levels from the other two groups. The platelet level of cyclic AMP from patients with migraine was higher than those from the other groups. We found no significant differences in the platelet cyclic GMP levels among the three groups. It is suggested that reduced platelet ionized magnesium in patients with tension-type headache is related to abnormal platelet function, and that increased platelet cyclic AMP in patients with migraine is related to alteration of neurotransmitters in the platelet.
Adolescent↗
Acrophase amplitude of ambulatory blood pressure decreases in migraineurs.
Ambulatory blood pressure was recorded and analyzed in 13 migraineurs during headache-free periods and in 11 healthy subjects. Systolic blood pressure, mean blood pressure, diastolic blood pressure, pulse pressure, and pulse rate were recorded for 48 hours (three times every hour from 6 AM to mid-night, once an hour at night). Circadian variation of blood pressure was analyzed using single cosinor analysis and group mean cosinor analysis methods. Single cosinor analysis identified significant circadian rhythm of systolic blood pressure in 10 of 11 control subjects (90.9%) and 5 of 13 migraineurs (38.5%, P < 0.02 versus controls, Fisher's exact test). Incidences of significant circadian rhythm of mean blood pressure and diastolic blood pressure were 100% and 100% in controls, 46.2% and 53.8% in the migraineurs (P < 0.01, P < 0.02 versus controls). Incidences of significant rhythm of pulse pressure were 36.3% in controls and 38.5% in the migraine group (difference was not significant). Group mean cosinor analysis identified significant circadian rhythm in both the migraine group and the controls. The MESOR (midline estimating statistic of rhythm) values of systolic, mean, and diastolic blood pressures showed no significant differences between the migraine group and the controls. Acrophase amplitudes of systolic, mean, and diastolic blood pressure were 4.2, 5.2, and 5.9 mm Hg in the migraine group, respectively; and 7.2, 7.3, and 7.5 mm Hg in the controls, respectively. These amplitudes of systolic, mean, and diastolic blood pressures in the migraine group were significantly smaller than those in the controls. These data suggest that some migraineurs lose or alter their circadian blood pressure rhythm. Evaluating migraineurs as a group, significant circadian rhythm of blood pressure can be identified and oscillation amplitudes of blood pressures are decreased. The present results suggest that migraineurs may be subject to dysfunction of the circadian rhythm generator and the autonomic nervous system. Possible involvement of serotonergic projections from the raphe to the suprachiasmatic nuclei of the hypothalamus in migraine is discussed.
Adult↗
Microcirculation after cerebral venous occlusions as assessed by laser Doppler scanning.
Research on cerebral venous circulation disturbances (CVCDs) has been limited partly by the paucity of animal models that produce consistent venous infarction. Occlusion of two adjacent cortical veins in rats by means of a photochemical thrombotic technique provides a minimally invasive, clinically relevant, and reproducible model suited to study the pathophysiology of CVCDs. In this study, the effects of venous occlusion on regional cortical blood flow and the brain damage that ensues were evaluated. Cortical vein occlusion was induced by photoactivation of rose bengal via 100-microm fiberoptic illumination. The cerebral venous flow pattern was examined using fluorescence angiography until 90 minutes after venous occlusion, and regional cerebral blood flow (rCBF) was determined at 48 locations by using laser Doppler scanning. Histological damage was assessed 48 hours after vein occlusion. Occlusion of two cortical veins (Group T; seven animals) was compared with single-vein occlusion and its ensuing brain damage (Group S; five animals) and with sham-operated control (five animals). An rCBF reduction occurred 30 minutes after occlusion in Group T and was more extensive than the decrease in Group S after 60 minutes. Observation frequency histograms based on local CBF data obtained in Group T demonstrated that local CBF at some sites decreased to a level below the ischemic threshold within 90 minutes. Six of the seven rats in Group T had a growing venous thrombus with extravasation of fluorescein. The resulting infarction was significantly larger in Group T (9.8 +/- 4.5% of the hemispheric area) than in Group S (only 3 +/- 1.5% of the hemispheric area). In conclusion, microcirculation perturbations occur early after venous occlusion and result in the formation of a venous thrombus accompanied by local ischemia and severe venous infarction. The extent of vein occlusion determines the resulting brain damage. Based on the results of this study, the authors conclude that CVCDs may be attenuated by prevention of venous thrombus progression together with the use of protective measures against the consequences of ischemia.
Animals↗
Standardized methods to bioassay neurotrophic factors for dopaminergic neurons.
The search for specific neurotrophic factors that will eventually be used to reduce or arrest the rate of degeneration of dopaminergic neurons in Parkinson's disease is being pursued by first testing the ability of putative compounds to increase the survival of dopaminergic neurons in primary cultures of the fetal, ventral mesencephalon. This research has intensified in recent years. The experimental procedures used by different laboratories in these studies differ widely, and meaningful comparisons of the results obtained are accordingly difficult to make. Some important experimental variables include the age of the fetal tissue used; the dissection technique used to isolate the ventral mesencephalon; the percentage of dopaminergic neurons present in the culture initially; handling of the tissue during dissection; the technique used to disperse the cells; the use of serum; the technique of plating the cells; the attachment factors used; detachment and loss of cells during the staining procedure; the age of the cultures at the time of analysis; the uneven distribution of cells at the time of analysis and the use of imaging techniques in the analysis. We show that when the E14 rat embryo is used, it is possible to consistently obtain a culture with 20% of tyrosine hydroxylase-positive neurons. Neither the plating density in the range of 7.8 x 10(3) to 1.25 x 10(5) cells/cm2, nor the percentage of serum in the growth medium affected the percentage of cells that expressed TH initially, at 4 or 12 h after plating. When the cells were plated as 25 microliters droplets, called microislands (area approximately 12.5 mm2), and allowed to attach before additional growth medium was added, cell density remained uniform at the center of the microisland for the duration of the culture. Restriction of the analysis of cell survival to the center of the microisland therefore helped to decrease the variability in counting that could occur when cells are dispersed over a larger area. In contrast, in an 8-well chamber slide or 35 mm petri dish, in which the whole area is plated, cell density was consistently higher at the edge (edge effect), versus the centre, by a factor of about three. The use of microisland cultures also has the additional benefit of increasing by a factor of about five the number of individual cultures that can be set up per liter, and a proportionate reduction in the number of animals used per experiment. When the percentage of serum in the growth medium was 0% always, or 10% for the first 12 h, and 0% thereafter, or 10% always, the number of TH-pos neurons per field (using a x 20 objective, column factor 1.25; area 320 microns2) after 5 days in culture (DIV5) was < 1,3-8 and 14-22, respectively. Under the same experimental conditions, the number of neurons (MAP2-positive) per field was 5-8, 18-30 and 45-65 (N = 10 in all cases), respectively. Serum deprivation therefore has a highly deleterious effect on neuronal survival in culture. We suggest that cultures that were exposed to serum at any stage of the experiment, should not be referred to as "serum-free', since even a brief exposure to serum exerts a protective effect on neurons, and especially on dopaminergic neurons. Instead, the percentage and kind of serum used, the exact usage, and the duration of exposure of the cells to serum should be stated. Finally, it is suggested that where possible, an imaging system with manual count and journaling capabilities be used in the analysis. The methods described are illustrated by dose-response curves of the neurotrophic effects of BDNF, NGF-beta and IL-6 versus percentage survival on dopaminergic neurons, when grown in serum-free medium throughout.
Animals↗
Importance of prevention of intravenous thrombosis and preservation of the venous collateral flow in bridging vein injury during surgery: an experimental study.
BACKGROUND: Venous infarction (cerebral edema and/or hemorrhage) may occur several hours after sacrifice of the bridging vein during surgery. However, in our experience, severe venous infarction is often produced by prolonged brain retraction in addition to sacrifice of the vein. METHODS: The experiment was carried out using 20 adult cats. In five cats, all bridging veins were coagulated near the superior sagittal sinus and 12 hours later the surgical wound was closed (group A). In five other cats, a round plate weighing 45 g was placed on the center of the Sylvian fissure for 12 hours and then the wound was closed (group B). In the remaining 10 cats, both of these interventions were performed (group C). All 20 animals were sacrificed 12 hours after the wound closure. RESULTS: The degree of Evans-blue dye leakage and brain edema was much more marked in the group C than in groups A and B. The endothelial intactness of the bridging veins studied by staining with a factor VIII-related antigen was much more disturbed in group C than in the other groups. CONCLUSIONS: The endothelium of the cortical veins is damaged much more by the combination of sacrifice of the vein and brain retraction, and this endothelial damage of the cortical vein leads to extensive venous infarction.
Animals↗
Granulocyte colony-stimulating factor administration modulates the surface expression of effector cell molecules on human monocytes.
Granulocyte colony-stimulating factor (G-CSF) has been shown to stimulate human neutrophil functions, both in vitro and in vivo. We examined the effects of G-CSF administration on the surface expression of effector cell molecules on human neutrophils and monocytes. G-CSF (50 micrograms/m2/d) was administered subcutaneously to five healthy volunteers once a day for 7 d. Venous blood was obtained immediately before and after the completion of G-CSF administration and 1 week after the last G-CSF administration. The surface expression of complement receptors (CR), Fc receptors for IgG(FcR) and cellular adhesion molecules on human neutrophils and monocytes were determined by indirect immunofluorescence using flow cytometry and monoclonal antibodies. The expression of CR1, CR3, FcRI and FcRII on neutrophils increased significantly after G-CSF administration and then decreased after the last G-CSF administration. The expression of human leucocyte adhesion molecule-1 (LAM-1) on neutrophils reflected the above expression. On the other hand, the administration of G-CSF increased the expression of CR1, CR3, FcRI and FcRIII on monocytes. The expression of CR1, CR3 and FcRI on monocytes then decreased after the last G-CSF administration, whereas the expression of FcRIII remained at an increased level. These findings indicate that G-CSF administration modulates the expression of effector cell molecules on circulating monocytes as well as on neutrophils, resulting in enhanced defence against selected infections or in potentiation of the tumouricidal capacity of phagocytes in cancer patients.
Adult↗
Spinal tract degeneration confined to the bilateral posterior columns in malnutrition: report of an autopsy.
An autopsy case of malnutrition with spinal tract degeneration confined to the bilateral posterior columns is reported. The patient had schizophrenia in adolescence, and suffered from aplastic anemia in late middle age. Subsequently, he took little food due to delusions for 18 months until his death. He had malnutrition resulting in severe hypoproteinemia. He developed gait disturbance, loss of deep tendon reflexes and paresthesia of limbs. Neuropathological examination disclosed tract degeneration confined to the bilateral spinal posterior columns, in addition to the findings of aplastic anemia and hypoxic encephalopathy in the cerebrum. The myelin and axons were severely affected throughout the spinal cord; status spongiosus with many fatty-laden macrophages was seen in these lesions. Neurons in the posterior column nuclei were intact, while the dorsal roots and their ganglia were moderately affected. The unusual distribution and extension of the degeneration of the bilateral posterior columns in the poor nutritional state is discussed.
Anemia, Aplastic↗
Lactam-conformationally restricted analogs of N alpha-arylsulfonyl arginine amide: design, synthesis and inhibitory activity toward thrombin and related enzymes.
Three new lactam-conformationally restricted arginine derivatives, 1-butyl-3-(6,7-dimethoxy-2-naphthylsulfonyl)-3-(3-guanidinoprop yl)-substituted gamma-, delta-, and epsilon-lactams (2-4), were synthesized on the basis of backbone modification of the lead structure, 6,7-dimethoxy-2-naphthylsulfonylarginine n-butylmethylamide (1). We tested these compounds for inhibitory activity toward thrombin and other trypsin-like enzymes (trypsin, factor Xa, plasmin, and kallikrein). All the compounds synthesized (1-4) potently inhibited thrombin with IC50 values of 0.75, 0.70, 0.92, and 3.2 microM, respectively; they inhibited thrombin over 40-fold more effectively than the other enzymes tested. The gamma-lactam (2) with the most profound inhibitory activity toward thrombin was a reversible inhibitor with a Ki of 0.26 microM. Compound 2 also showed better thrombin selectivity than the lead compound (1). The lactam-conformational restriction of arylsulfonylarginine amides, especially gamma-lactam, has thus proved to be a useful device for the improvement of antithrombotic activity.
Arginine↗
Oligodendrocyte-type-2 astrocyte (O-2A) progenitors increase the survival of rat mesencephalic, dopaminergic neurons from death induced by serum deprivation.
When a primary culture of E16 rat striatal cells was grown in a serum-free medium, treatment with basic fibroblast growth factor (bFGF, 10 ng/ml) caused the generation of the progenitor cell for oligodendrocytes and type-2 astrocytes (O-2A). Immunostaining tests confirmed that > 90% of the cells were positive for A2B5, and < 5% positive for glial fibrillary acidic protein (GFAP). When E14, mesencephalic, dopaminergic neurons were co-cultured with established O-2A progenitor cells in a serum-free growth medium, the survival of tyrosine hydroxylase-positive (TH+) neurons increased 23-fold and 668-fold at the 5th and 10th days, respectively, compared with control cultures plated on poly-D-lysine. Conditioned medium from the O-2A progenitor cultures also decreased the death of TH+ neurons. The mitotic inhibitor, cytosine arabinoside (1.0 microM), did not block the protective effect of the O-2A progenitor cells. O-2A progenitor cells produce a potent, soluble factor, that mediates the increased survival of dopaminergic neurons in vitro.
Animals↗
Astrocyte-dependent and -independent phases of the development and survival of rat embryonic day 14 mesencephalic, dopaminergic neurons in culture.
A primary neuronal culture was prepared from the ventral mesencephalon, centered on the A8, A9 and A10 dopaminergic nuclei of the embryonic day 14 rat, and studied from 12 h to 28 days. At 12 h after plating, and before cell death ensued, 95% of the cells stained positive for neuron specific enolase; 20% for tyrosine hydroxylase; 5% for vimentin and < 0.1% for glial fibrillary acidic protein. In the presence of the mitotic inhibitor cytosine arabinoside (2.0 microM), neuronal growth and survival were surprisingly normal up to the ninth day in culture, but deteriorated rapidly thereafter. In the absence of a mitotic inhibitor, and in the presence of proliferating but non-confluent glia, the tyrosine hydroxylase positive neurons that survived to the 10th day, had retracted neurites and a rounded soma, suggesting an inhibition of cell development. Those tyrosine hydroxylase positive neurons that survived this adverse phase of development tended to produce elaborate neuritic profiles after the 11th day, coincident with confluence of the astrocyte monolayer at the 12th day. By the 21st day in culture, and persisting up to the 28th day, 60% (61 +/- 10, n = 20) of the surviving neurons stained positive for tyrosine hydroxylase. When plated on an established, ventral mesencephalic monolayer of astrocytes, at the seventh day in culture, neuritic growth and branching of the tyrosine hydroxylase positive neurons were greater, compared with similar neurons grown on poly-D-lysine, and the signs of arrested development (retraction of neurites and rounded soma) seen at the 10th day after plating on poly-D-lysine, were not observed. We conclude that in the primary culture studied, and under the experimental conditions used, the survival of dopaminergic neurons was independent of glia during the first nine days, and critically dependent on glia thereafter. The resurgence of growth of dopaminergic neurons after 10 days in vitro, and their subsequent selective survival in culture, suggest that confluent type-1 astrocytes produce factors that act selectively on the dopaminergic neuronal phenotype. The successful identification of these dopaminergic-specific, neurotrophic factors could lead to an increased understanding of the etiology of Parkinson's disease, and suggest new directions for therapeutic intervention.
Animals↗
Increased 11-dehydrothromboxane B2 in migraine: platelet hyperfunction in patients with migraine during headache-free period.
Several disturbances in platelet function have been reported in migraine and tension-type headache (TH). The plasma 11-dehydrothromboxane B2 (11-dTXB2) is free from artifactual increase during blood sampling, and it can be a reliable indicator of thromboxane A2 (TXA2) production in vivo. TXA2 is a very potent proaggregatory and vasoconstrictory metabolite formed in the platelets. We investigated plasma 11-dTXB2 and 5-hydroxytryptamine (5-HT) levels in patients with migraine during headache-free periods and in patients with chronic TH. The mean value of plasma 11-dTXB2 levels in migrainous patients was significantly higher than those in TH patients and healthy controls. The mean value of plasma 5-HT levels in TH patients was significantly lower than those in migrainous patients and healthy controls. There was no correlation between plasma 11-dTXB2 levels and plasma 5-HT levels in any group. The results suggest the existence of continuous platelet activation in migrainous patients.
Adolescent↗
Recurrence of ICA-PCoA aneurysms after neck clipping.
Between 1975 and 1992, 2211 patients underwent aneurysmal neck clipping at the Nara Medical University clinic and associated hospitals. The aneurysm in 931 of these patients was situated at the junction of the internal carotid artery (ICA) and posterior communicating artery (PCoA). Seven patients were readmitted 4 to 17 years after the first surgery because of regrowth and rupture of an ICA-PCoA aneurysmal sac that had arisen from the residual neck. On angiograms obtained following aneurysmal neck clipping, a large primitive type of PCoA was demonstrated in six patients and a small PCoA in one. A small residual aneurysm was confirmed in only two patients and angiographically complete neck clipping in five. Recurrent ICA-PCoA aneurysms were separated into two types based on the position of the old clip in relation to the new growth. Type 1 aneurysms regrow from the entire neck and balloon eccentrically. In this type, it is possible to apply the clip at the neck as in conventional clipping for a ruptured aneurysm. Type 2 includes aneurysms in which the proximal portion of a previous clip is situated at the corner of the ICA and aneurysmal neck and the distal portion on the enlarged dome of the aneurysm, because the sac is regrowing from a portion of the residual neck. In this type of aneurysm, a Sugita fenestrated clip can occlude the residual neck, overriding the old clip. Classifying these aneurysms into two groups is very useful from a surgical point of view because it is possible to apply a new clip without removing the old clip, which was found to be adherent to surrounding tissue.
Adult↗
[Ultrastructural morphological changes of cortical microvessels following transient cerebral ischemia--a transmission electron microscopic study].
Post-ischemic hypoperfusion may play a significant role in reperfusion injury. Since there is no established treatment for hypoperfusion, however we decided to explore the morphological cause of post-ischemic hypoperfusion. In this study we used transmission electron microscopy to investigate the capillaries in ischemic/reperfused neocortex induced by 2 hours of middle cerebral artery occlusion followed by either 3 or 24 hours of reperfusion in 14 cats. Post-ischemic hypoperfusion was confirmed by measuring regional blood flow through a cranial window just above the left ectosylvian gyrus, which has poor anastomosis. A greater number of endothelial microvilli and capillary endothelial cell swelling were detected in the ischemic/reperfused neocortex, when compared with contralateral control neocortex. Especially after 24-hour reperfusion, collapse of some capillaries was observed with severe perivascular glial swelling and adhesion of PMN leukocytes to the endothelium. These findings yielded the following statistically significant results. 1) The number of endothelial microvilli in the ischemic/reperfused neocortex (mean +/- SD/1 blood vessel = 6.58 +/- 4.32) was significantly greater than in the control neocortex (3.13 +/- 2.68, p = 0.0001). 2) The ratio of capillary inner diameter (ID) to outer diameter (OD) in the ischemic/reperfused neocortex (ID/OD%, mean +/- SD = 75.4 +/- 16.7) was significantly smaller than in the control neocortex (89.2 +/- 10.8, p = 0.0001), indicating endothelial cell swelling. We concluded that these ultrastructural changes might be the cause of the multifactorial development of post-ischemic hypoperfusion, and that especially the number of endothelial microvilli and the endothelial cell swelling ratio might serve as morphological indicators of therapeutic efficacy for reperfusion injury in experimental studies.
Animals↗
Mesencephalic type 1 astrocytes rescue dopaminergic neurons from death induced by serum deprivation.
We have established a primary neuronal culture of the embryonic day 14 rat, ventral mesencephalic region, centered on the A8, A9, and A10 dopaminergic nuclei (approximately 1.0 mm3 of tissue). At 16 hr after plating on a substrate of poly-D-lysine, in a serum-free or serum-supplemented growth medium, using a microisland culturing method, 95% of the cells stained positive for neuron-specific enolase, 20% for tyrosine hydroxylase, and < 5% for vimentin. When the growth medium was supplemented with 10% fetal calf serum, the percentage of tyrosine hydroxylase-positive neurons increased significantly (p < 0.05) at the 7th and 10th days in culture, compared with the percentage present at 16 hr after plating. When cultured in a serum-free growth medium, the percentage of tyrosine hydroxylase-positive neurons decreased to < 5% and to 0% by the 5th and 7th days, respectively, while the percentage of GABA-IR neurons increased. The addition of serum to the serum-free culture rescued dopaminergic neurons from death induced by serum deprivation. The effect of serum was dependent both on the time of addition after plating, and on the percentage added. When the cells were plated in a serum-free medium, on a confluent, type 1 astrocyte monolayer, prepared from the ventral mesencephalon of the embryonic day 16 rat, the survival of dopaminergic neurons increased significantly (p < 0.01) at DIV5, versus survival after plating on poly-D-lysine. Conditioned medium prepared from the same mesencephalic type 1 astrocyte monolayer also rescued dopaminergic neurons from death. The rescue mediated by the astrocyte monolayer or the conditioned medium was not inhibited by the mitotic inhibitor cytosine arabino furanoside (1.0 microM). Type 1 astrocyte monolayers and conditioned media prepared from the striatum and cerebral cortex of the embryonic day 16 rat had weaker trophic effects than those mediated by mesencephalic glia. We conclude that serum deprivation causes the selective death of dopaminergic neurons in a primary culture of the rat E14 ventral mesencephalon. Type 1 astrocytes or the conditioned medium from type 1 astrocytes can rescue dopaminergic neurons from death induced by serum deprivation.(ABSTRACT TRUNCATED AT 400 WORDS)
Animals↗
Identification of the purA gene encoding adenylosuccinate synthetase in Thiobacillus ferrooxidans.
The purA gene of Thiobacillus ferrooxidans encoding adenylosuccinate synthetase [EC 6.3.4.4] was identified in the upstream region of the iro gene encoding Fe(II)-oxidase (J. Biol. Chem 267:11242-11247, 1992). The purA gene consisted of 1290 base-pairs, which translated into a 29-amino-acid protein. The gene is functionally active, because it is able to complement an Escherichia coli purA-deficient strain. The deduced gene product has a high degree (60.9%) of sequence identity with that (432 aa) of E. coli purA gene, and both the products share GDEGKGK-DETG-TKLD sequences which are supposed to be GTP-binding domain. The downstream region of the iro gene contained another open-reading frame (ORF) of 1218 bp, and this showed high homology (56.6% over 249 bp) with E. coli ORF-II, which is found as a second ORF and truncated form in the downstream region of the purA gene. Comparison of the gene organization in the flanking region of purA gene between T. ferrooxidans and E. coli is also described.
Adenylosuccinate Synthase↗
Cryopreservation of mouse spermatozoa from inbred and F1 hybrid strains.
Mouse epididymal spermatozoa from inbred(BALB/c, C3H/He, C57BL/6N, CBA/JN and DBA/2N) and F1 hybrid (B6C3F1, BDF1 and CDF1) strains suspended in cryopreservation solution (18% raffinose and 3% skim milk in distilled water) were frozen and stored at -196 degrees C. After thawing at room temperature, sperm motility and fertilizing ability were examined. Spermatozoa from all of the strains were successfully frozen, although the motility and the fertilization rates of frozen-thawed spermatozoa (the proportions of the fresh oocytes from Jcl:ICR strain which developed to pronuclear oocytes and 2-cell embryos after insemination by frozen-thawed spermatozoa) varied among strains (motility: 23% for C57BL/6N to 62% for DBA/2N; fertilization rates: 26% for C57BL/6N to 89% for DBA/2N). Nearly all 2-cell embryos fertilized by frozen-thawed spermatozoa were transferred to the oviducts of pseudopregnant recipients and 35-62% of 2-cell embryos developed into normal young.
Animals↗
Clinicopathological study on craniopharyngioma with sebaceous differentiation.
We presented 2 cases of craniopharyngioma, which showed sebaceous differentiation. Both cases shared the following features: 1) neuroradiological detection of a cystic tumor accompanied by calcification, 2) clear yellowish fluid detected in the cyst during surgery, 3) histological rating as an adamantinomatous type, 4) the presence of a nest-like distribution of multivacuolated cells in the innermost layer of the cyst.
Child↗