Cervical epidural hematoma causing hemiparesis.
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Aged↗
Biomedical subjects
Tadao Nose
Publications and source records attributed to Tadao Nose.
Reduction of nitroxides and radioprotective ability in glioblastoma cells.
Electron spin resonance (ESR) analyses were performed to clarify whether glioblastoma cells scavenge hydroxyl radicals (*OH) generated by x-ray irradiation. The rate of bioreduction of nitroxides by three human glioblastoma cells was also evaluated by the same technique and compared with their x-ray sensitivity. Aerated culture media containing 200mM of 5,5-dimethyl-1-pyrroline-N-oxide (DMPO) with or without U87MG cells were irradiated with x-rays at a dose of 20Gy. ESR was measured immediately after each irradiation. Continuous changes of the ESR spectra of 4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl (Tempol) were analyzed in cell suspensions of TK1, U87MG, and A172 at a concentration of 1.0 x 10(7) cells/ml containing 5 microM Tempol. As a result, the signal of DMPO-OH in the U87MG cell suspension decayed faster than that in the control culture media without cells, and the rate of bioreduction of Tempol in each glioblastoma cell suspension was correlated with the x-ray sensitivity defined from the colony-forming assay in those cell lines. It was indicated that the resistance of glioblastoma cells to ionizing radiation could be closely related to their ability to scavenge radical species generated by ionizing radiation.
Cell Line, Tumor↗
The effect of task block arrangement on the detectability of activation in fMRI.
The effect of task block arrangements on the detection of brain activation was investigated. Sessions of functional magnetic resonance imaging (fMRI) including the same number of two different task conditions but with different arrangements were compared. The two task conditions were, A) Ellipse-shaped black and white checkerboard flicker stimulation at 4.2 Hz covering the bilateral visual field, and B) the same flicker stimuli covering only the left visual field. In the rest blocks (0), the subjects looked at a fixation point. Four different task block arrangements were compared, 1) A0 (0A0A0A0) and B0 (0B0B0B0), 2) A0B0 (0A0B0A0B0A0B0), 3) AB0 (0AB0AB0AB0) and 4) AB (0ABABAB). Bilateral V1, V2, V3 and the left V5 were activated by condition A, and the right V1 and V2 by B. The activation in the left visual field by A0 was larger than in the other three conditions. In a differential analysis between conditions A and B, activation in the left V3 and V5 was declined by AB0 or AB. When rest blocks were located in the post-stimulus undershoot phase, the % signal change of the BOLD signal was emphasized, which caused augmented significance in the detection of the activity. It was indicated that the outcome of the activation map was influenced by the arrangement of task blocks, even though the same number of task blocks were repeated within the sessions. In fMRI studies, task conditions should be carefully compared within or across sessions considering the characteristics of hemodynamic response functions.
Adult↗
Persistent primitive otic artery with IC-cavernous aneurysm.
We describe a case of unruptured internal carotid artery aneurysm associated with persistent primitive otic artery variant in a 48 year old woman. The aneurysm was successfully treated by endovascular embolisation. A possible pathogenesis of this rare condition is discussed.
Arterio-Arterial Fistula↗
Anti-vascular endothelial growth factor antibody and nimustine as combined therapy: effects on tumour growth and angiogenesis in human glioblastoma xenografts.
We evaluated the effectiveness of vascular endothelial growth factor (VEGF) blockade alone and in combination with 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2-chloroethyl)-3-nitrosourea (ACNU, nimustine), a cytotoxic agent commonly used in the treatment of malignant gliomas, to eradicate tumors of human glioblastoma cell lines implanted in SCID (severe combined immunodeficiency) mice. ACNU, but not cisplatin and etoposide, elevated VEGF expression in a glioma cell line in vitro. VEGF antibody alone inhibited glioma growth in vivo as a result of angiogenesis inhibition. The combination with ACNU resulted in an additive effect for inhibition of glioma growth. ACNU also induced VEGF up-regulation in glioma tissues, which was decreased with VEGF antibody treatment. One of the mechanisms of the additive effect of the VEGF antibody and ACNU combination is the blockade of VEGF up-regulation induced by ACNU. As such, the combination of antiangiogenic therapy with conventional therapy is promising for glioma treatment in the future.
Animals↗
Cervical spondylotic myelopathy: surgical results and factors affecting outcome with special reference to age differences.
OBJECTIVE: A variety of factors may affect the surgical outcome in patients with cervical spondylotic myelopathy. The aim of this study is to analyze the prognostic factors by comparing younger and elderly patient groups on the basis of preoperative radiological and clinical data. METHODS: To assess the prognostic factors after surgery had been performed, the clinical and radiological data of 64 patients who underwent expansive laminoplasty were reviewed. Patients were classified into two groups, a younger patient group (<65 yr of age; n = 29) and an elderly patient group (>/=65 yr of age; n = 35). The neurological status of the patients was assessed by use of the Japanese Orthopaedic Association scale. Radiological features were examined with computed tomographic myelography and magnetic resonance imaging. The effects of the clinical and radiological findings on neurological outcome were investigated. RESULTS: The preoperative and postoperative mean Japanese Orthopaedic Association scores in elderly patients were significantly lower than those in younger patients. For elderly patients, the transverse area of the spinal cord at the level of maximum compression and symptom duration were the factors that predicted an excellent recovery. In contrast, the transverse area was the only predictor of excellent recovery in younger patients. Age, preoperative Japanese Orthopaedic Association score, canal diameter, and an intensity change on the spinal cord were not predictive in either age range. CONCLUSION: The transverse area of the spinal cord may be a reliable predictor of excellent recovery in both younger and elderly patient groups. Shorter symptom duration was an important factor in the excellent recovery of elderly patients.
Activities of Daily Living↗
Ruptured middle cerebral artery aneurysm with intramural myxoid degeneration in a child.
A 9-year-old girl presented with a subarachnoid hemorrhage. Cerebral angiography showed a saccular aneurysm arising from the horizontal portion of the right middle cerebral artery. The aneurysm was successfully clipped, and the dome of the aneurysm was excised for pathological study. Histological examination of the aneurysm wall showed that the entire thickness of the wall showed an increased myxoid degeneration. No dissection was present. Most intracranial aneurysms in childhood are believed to be of the saccular type similar to that in adults, but the pathogenesis of the aneurysm formation remains controversial. Myxoid degeneration may cause intracranial saccular aneurysm with eventual rupture, even in the absence of dissection. This is the first case reported of a ruptured saccular aneurysm caused by myxoid degeneration in a child. The possible pathophysiology is discussed.
Aneurysm, Ruptured↗
Small unruptured cerebral aneurysms presenting with oculomotor nerve palsy.
OBJECTIVE: Symptomatic unruptured aneurysms have been considered at relatively high risk for future rupture, and the majority of aneurysms that cause symptoms of mass effect are large. Unruptured aneurysms smaller than 1 cm in diameter sometimes cause neurological symptoms, but their clinical aspects remain obscure. In this article, we review our experience with small unruptured aneurysms presenting with oculomotor nerve palsy. METHODS: Sixteen patients with unruptured aneurysms smaller than 1 cm presenting with oculomotor nerve palsy were included in this study. The patients' clinical profiles were reviewed, and factors affecting the recovery of oculomotor function were determined. RESULTS: The mean size of the aneurysms was 5.8 +/- 1.4 mm. Eleven patients (68.8%) had preceding retrobulbar pain. Fifteen patients underwent successful microsurgical clipping or intravascular embolization, but one patient died of aneurysm rupture before surgery. Seven patients (43.8%) had a complete recovery of oculomotor function, six (37.5%) had an incomplete recovery, and two (12.5%) remained unchanged after treatment. The mean interval between the onset of oculomotor nerve palsy and treatment was 4.7 +/- 3.3 days in patients with complete recovery, 24.2 +/- 15.5 days in patients with incomplete recovery, and 41.0 +/- 12.7 days in unchanged patients. Early surgery resulted in more complete recovery of neural function (P < 0.01). CONCLUSION: Unruptured aneurysms smaller than 1 cm can cause neurological symptoms of mass effect. We recommend timely surgery, preferably within 5 days, to avoid not only aneurysm rupture but also functional disability even in patients with unruptured aneurysms smaller than 1 cm.
Adult↗
Multiple intracranial arterial stenoses around the circle of Willis in association with Graves' disease: report of two cases.
OBJECTIVE AND IMPORTANCE: The association of Graves' disease with multiple intracranial arterial stenoses is rare. CLINICAL PRESENTATION: We report on two Japanese women who experienced the concurrence of Graves' disease and cerebral ischemia attributable to multiple intracranial arterial stenoses around the circle of Willis. Clinically, these patients demonstrated hyperthyroidism, goiter, ophthalmopathy, and ensuing ischemic strokes. Cerebral angiography demonstrated multiple intracranial arterial stenoses around the circle of Willis in both cases. These cases did not meet the full diagnostic criteria for moyamoya disease, in that there were no abnormal, net-like, collateral vessels, but the other clinical and angiographic findings were consistent with this condition. INTERVENTION: After normalization of their hormonal conditions, the patients underwent cerebral revascularization procedures. Both patients achieved excellent recoveries and returned to normal daily life after treatment. CONCLUSION: Multiple intracranial arterial stenoses and Graves' disease may occur simultaneously. Such cases may offer new insights into the pathogenesis of these two conditions. It is important to study more patients with this dual condition, to obtain more evidence of the relationship between genetic and immunogenic backgrounds.
Adult↗
ESR spin trapping of hydroxyl radicals in aqueous solution irradiated with high-LET carbon-ion beams.
The aim of this study was to quantify the hydroxyl radicals (*OH) produced when aqueous solutions are decomposed by high-linear energy transfer (LET) 290 MeV/nucleon carbon-ion beams using an electron spin resonance (ESR) spectrometer. Aerated cell culture medium containing 200 mM 5,5-dimethyl-1-pyrroline-N-oxide (DMPO) was irradiated with doses of 0 to 20 Gy with an LET of 20 to 90 keV/ micro m. We were able to obtain ESR spectra 10 min after irradiation, and the formation of *OH and hydrogen atoms was confirmed by radiolysis of deuterium oxide and ethanol containing DMPO. Our results showed that the yield of *OH by carbon-ion radiolysis increased in proportion to the absorbed dose over the range of 0 to 20 Gy. Furthermore, we discovered that the yield of *OH decreased linearity as LET increased logarithmically from 20 to 90 keV/ micro m. The generation of *OH by carbon-ion radiolysis at LETs of 20, 40, 60, 80 and 90 keV/ micro m was 64, 58, 52, 49 and 50%, respectively, of that for low-LET X radiolysis. These unique findings provide a further understanding of the indirect effect of high-LET radiation.
Carbon↗
Characterization of neutron beams for boron neutron capture therapy: in-air radiobiological dosimetry.
The survival curves and the RBE for the dose components generated in boron neutron capture therapy (BNCT) were determined separately in neutron beams at Japan Research Reactor No. 4. The surviving fractions of V79 Chinese hamster cells with or without 10B were obtained using an epithermal neutron beam (ENB), a mixed thermal-epithermal neutron beam (TNB-1), and a thermal (TNB-2) neutron beam; these beams were used or are planned for use in BNCT clinical trials. The cell killing effect of the neutron beam in the presence or absence of 10B was highly dependent on the neutron beam used and depended on the epithermal and fast-neutron content of the beam. The RBEs of the boron capture reaction for ENB, TNB-1 and TNB-2 were 4.07 +/- 0.22, 2.98 +/- 0.16 and 1.42 +/- 0.07, respectively. The RBEs of the high-LET dose components based on the hydrogen recoils and the nitrogen capture reaction were 2.50 +/- 0.32, 2.34 +/- 0.30 and 2.17 +/- 0.28 for ENB, TNB-1 and TNB-2, respectively. The RBEs of the neutron and photon components were 1.22 +/- 0.16, 1.23 +/- 0.16, and 1.21 +/- 0.16 for ENB, TNB-1 and TNB-2, respectively. The approach to the experimental determination of RBEs outlined in this paper allows the RBE-weighted dose calculation for each dose component of the neutron beams and contributes to an accurate inter-beam comparison of the neutron beams at the different facilities employed in ongoing and planned BNCT clinical trials.
Air↗
Aneurysm and fenestration of the azygos anterior cerebral artery--case report.
A 78-year-old female suffered sudden onset of nausea and headache. Computed tomography demonstrated diffuse subarachnoid hemorrhage. Cerebral angiography demonstrated an aneurysm arising from the right A1 segment of the azygos anterior cerebral artery, and the hypoplastic left A1. A right frontotemporal craniotomy was performed to obliterate the aneurysm by neck clipping. Surgical exploration found the fenestration of the right A1 and showed that the aneurysm had originated from the bifurcation of the fenestrated A1 and a small perforating artery arising from the fenestration. This unusual combination of an aneurysm associated with a fenestration of the right A1 and contralateral A1 hypoplasia may have been caused by local hemodynamic stress.
Aged↗
Head and neck extension-fixation with a head frame for exposure of the distal internal carotid artery in carotid endarterectomy--technical note.
Adequate exposure of the distal internal carotid artery (ICA) for carotid endarterectomy may be difficult to achieve because of the position of the mandible and associated soft tissues. A simple yet effective use of a head frame is described to gain several centimeters of exposure of the distal ICA. The patient's head and neck are fixed in an extension position using a radiolucent head frame. Nasotracheal intubation and secure taping of the chin are also employed to keep the mouth closed and to prevent the mandible from spontaneously hanging down. The head frame tightly fixes the patient's neck, so the mandible does not disturb the surgical field throughout the operation. This simple method maximizes exposure of the distal ICA. The radiolucent head frame also enables intraoperative angiography to confirm the patency of the ICA and the absence of flap formation. This simple technique is useful for exposing the distal ICA.
Carotid Stenosis↗
Serial neuroimaging of encapsulated chronic intracerebral hematoma with repeated hemorrhage--case report.
A 69-year-old woman presented with headache and short memory disturbance. Computed tomography (CT) demonstrated a small cystic mass lesion in the left temporal lobe. CT and magnetic resonance imaging showed that this lesion enlarged with repeated hemorrhages, associated with progressive amnesia and headache during 3 years follow up. Surgery demonstrated a well-demarcated hard mass lesion in the medial temporal lobe through a transcortical approach after opening left sylvian fissure. The lesion was located entirely in the brain parenchyma and was removed en-bloc after cutting some capillary-like vessels on the capsule. The histological diagnosis was encapsulated old hematoma. The histological findings suggested that expansion of the lesion was due to multiple bleedings from the sinusoidal vessels in the capsule fed by small feeding arteries. The mass effect due to the expansion of the encapsulated hematoma caused progressive short-term amnesia and headache, which were completely resolved by the surgical removal.
Aged↗
Intraoperative angiographic assessment of graft patency during extracranial-intracranial bypass procedures.
The use of intraoperative angiography to monitor graft patency was retrospectively reviewed in extracranial-intracranial bypass procedures. Forty-two patients underwent 43 extracranial-intracranial bypass procedures with the use of intraoperative angiography. Superficial temporal artery (STA)-middle cerebral artery (MCA) bypass was performed in 41 patients (42 procedures) with ischemic cerebrovascular diseases, and vertebral artery-MCA bypass using radial artery graft for intentional ligation of the common carotid artery in one patient with nasopharyngeal carcinoma. Intraoperative angiography provided high-quality subtraction images in every case. There were no complications due to angiography. Graft occlusion was observed intraoperatively in three cases, but an additional procedure reopened the occluded graft in all three cases. Graft patency rate was 100% after surgery. Outcome was excellent in 40 patients and good in one patient who underwent STA-MCA bypass. Intraoperative angiography provides useful information regarding graft patency during bypass surgery. Intraoperative assessment prior to wound closure allows for the recognition and correction of technical failure and decreases the risk of postoperative complications.
Adult↗
Combined laminoplasty with posterior lateral mass plate for unstable spondylotic cervical canal stenosis--technical note.
A technique of combined expanding laminoplasty using longitudinal interspinous iliac bone graft with posterior lateral mass plate is described for the treatment of cervical canal stenosis associated with spinal instability. A 52-year-old male and a 76-year-old female presented with cervical myelopathy. Imaging studies demonstrated spondylotic cervical canal stenosis associated with spinal instability. Posterior stabilization with lateral mass plate by the Axis Fixation System was performed after expanding laminoplasty using interspinous iliac bone graft. The symptoms improved and instability and malalignment (in the female patient) also improved after surgery. This combined surgical technique allows decompression of the spinal cord, immediate internal fixation by plate fixation, and subsequent long-term stabilization by interspinous bony fusion. This technique is indicated in selected patients with multiple segment spondylotic cervical canal stenosis associated with instability and/or malalignment of the spinal column for which simultaneous decompression and stabilization are required.
Aged↗
Cervical myelopathy caused by hypoplasia of the atlas and ossification of the transverse ligament--case report.
A 79-year-old Japanese female presented with symptomatic cervical myelopathy caused by a hypoplastic posterior arch of the atlas and ossification of the transverse ligament. Neuroradiological examination demonstrated a hypoplastic posterior arch of the atlas and ossification of the transverse ligament. The cervical spinal cord was compressed at the level of the atlas by both the hypoplastic posterior arch of the atlas and the ossification of the transverse ligament. The patient underwent C-1 laminectomy, which arrested the progressive myelopathy and resulted in a good recovery. Atlas hypoplasia with ossification of the transverse ligament may be associated with Asian ethnicity.
Aged↗
Significance of a small bulge on the basilar artery in patients with perimesencephalic nonaneurysmal subarachnoid hemorrhage. Report of two cases.
Perimesencephalic nonaneurysmal subarachnoid hemorrhage (SAH) is a distinct type of hemorrhage with a characteristic bleeding pattern and an excellent clinical outcome. The cause of this benign form of SAH remains unknown. The authors report on two cases of perimesencephalic nonaneurysmal SAH in which a small bulge on the basilar artery (BA) was demonstrated on three-dimensional rotational angiography studies. Based on data from these cases, one may infer that the lesion on the BA is responsible for the SAH. The possible pathogenesis is discussed.
Basilar Artery↗