Effects of Experimental Focal Ischemia of PV- and Calbindin-Immunoreactive Neuron of Rat Neocortex

To understand the changes in expression of calcium binding proteins(CaBP) during the experimental focal ischemia, expression of two kinds of CaBP, paralvumin(PV) and calbindin D-28K(Calbindin), immunocytochemically, and activities of cytochrome oxidase(CO) and acetylcholinesterase(AchE), histochemically, in focal ischemic brain of the rat were investigated. Two groups of focal ischemic infarction were produced in Sprague Dawley rats(200-350 mg):Group I, Clip compression of left middle cerebral artery(MCA) for 5-10 mins and release;Group II, Electric coagulation of left MCA for 2-24 hrs. In the group I, CO activity and PV- and Calbindin-immunoreactivity(IR) were decreased in the left MCA territory, and decreased in number of PV- and Calbindin-IR neurons and degree of IR, but AchE activity was nearly same as that of control cortex. In the group II, decrease of CO and AchE activities, and marked increase of PV- and Calbindin IRs were noted on neuropil in the layers I through VI of ischemic region. Characteristically pyramidal cells, which did not express the both CaBPs in the control cortex, of layer V of ischemic cortex showed PV- and Calbindin Irs in the cell body and apical dendrite. These findings suggest that 1) PV- and Calbindin-IR neurons, mainly non-pyramidal cells, are more vulnerable than pyramidal cell to ischemic injury, 2) CaBP may have some roles in hypoxic neuronal injury, and 3) PV and Calbindin-immunocytochemistry can be used as useful technique in evaluation of experimental ischemia.

An Aneurysmal Dilatation of Cervical Intramedullary Arteriovenous Malformation: Case Report

A 14-year-old girl presenting with sudden onset of headache, neck pain, and quadriparesis was found to have a vascular lesion in the upper cervical cord(C2-C4) by the initial MRI examination. Vertebral angiography revealed a high-flow arteriovenous malformation which opacified rapidly and drained early. It was a direct spinal arteriovenous fistular consisted of a large aneurysmal dilatation 4x2.2x2.2 cm3 at the junction of a feeding artery and a draining vein. Superior anterior spinal artery and a mid-cervical radicular artery formed a common trunk to feed the lesion that drained entirely superiorly to the posterior fossa through a dilated draining vein. The intramedullary lesion was removed completely after surgical ligation of the feeding artery and draining vein through a posterior approach and myelotomy. She improved to the point of being able to walk alone and attended school one year after operation with acceptable posterior column signs. Spinal cord arteriovenous malformations are traditionally classified into three major categories:Type I, II, III. Our case seemed to fit to the new type:Type IV, direct spinal arteriovenous fistula, proposed by Heros(JNS 64:134-139, 1986).

Transcranial Doppler Measurement of Intracraial Arterial Flow Velocity in Subarachnoid Hemorrhage

The velocity of blood flow through the middle cerebral arteries was measured by transcranial Doppler sonography in 18 patients with aneurysmal subarachnoid hemorrhage. The velocity became greater from 4th day after the hemorrhage, reached a plateau on 6th-11th day and declined thereafter. 2) In the cases of laterally localized aneurysms, the velocity through the arteries ipsilateral to the aneurysm was significantly greater than that through the arteries contralateral to the aneurysm. 3) The velocity through the arteries of the patients who showed thick subarachnoid clots on CT scan within 3 days after the hemorrhage was significantly greater than that of the patients who showed thin subarachnoid clots. 4) The maximum mean velocity in the patients with delayed ischemic deficits(DID) was greater than that in the patients without DID. The results suggest that the transcranial Doppler monitering is helpful to detect early vasospasm.

Cranial Metastasis of Hepatocellular Carcinoma: Report of Three Cases

The authors describe three cases of hepatocellular carcinoma presenting with the initial manifestation of an intracranial lesion without primary hepatic symptoms and signs. The only clue of hepatic dysfuntion was mild elevation of the SGOT, SGPT, AIK-Pase and hepatomegaly. The diagnosis could not be made until operation. All three cases of hepatoma had metastasis to cranium. The literauture of hepatoma with cranial metastasis is reviewed.

Cranial Metastasis of Hepatocellular Carcinoma: Report of Three Cases

The authors describe three cases of hepatocellular carcinoma presenting with the initial manifestation of an intracranial lesion without primary hepatic symptoms and signs. The only clue of hepatic dysfuntion was mild elevation of the SGOT, SGPT, AIK-Pase and hepatomegaly. The diagnosis could not be made until operation. All three cases of hepatoma had metastasis to cranium. The literauture of hepatoma with cranial metastasis is reviewed.

Traumatic Aneurysms Developing During Aneurysm Surgery

We present two cases of traumatic aneurysms developing during aneurysmal surgery. The aneurysms were clipped without difficulty in both anterior communicating aneurysmal cases. To prevent the vasospasm, bypervolemic theraphy was begun and hypertension was induced postoperatively. The postoperative rebleeding occured within two weeks after initial aneurymal clipping in both cases. New aneursms developed near the clipped anterior communicating aneruysms ; A1 in one case, A2 in the other case. Minor arterial injury was considered to be the main cause of theses new aneurysmal formation and the hemodynamic stress induced by hypertension and hypervolemic therapy might contribute to the development of new aneurysms.

Traumatic Aneurysms Developing During Aneurysm Surgery

We present two cases of traumatic aneurysms developing during aneurysmal surgery. The aneurysms were clipped without difficulty in both anterior communicating aneurysmal cases. To prevent the vasospasm, bypervolemic theraphy was begun and hypertension was induced postoperatively. The postoperative rebleeding occured within two weeks after initial aneurymal clipping in both cases. New aneursms developed near the clipped anterior communicating aneruysms ; A1 in one case, A2 in the other case. Minor arterial injury was considered to be the main cause of theses new aneurysmal formation and the hemodynamic stress induced by hypertension and hypervolemic therapy might contribute to the development of new aneurysms.

Common antigenic determinants on human tumors detected by anti-fetal brain and anti-neuroblastoma monoclonal antibodies / 대한면역학회지

No abstract available.

Pressor Effect of Intracerebroventricular Diphenhydramine and Ranitidine in Rabbits

This study was undertaken to observe the effects of centrally administred antihistamines on the blood pressure. Diphenhydramine(DPH), a H1-receptor antagonist, and ranitidine(RAN), a H2-receptor antagonist were administered intracerebroventricularly(icv) on urethane-anesthetized rabbits. 1) Both DPH and RAN administered intraccebroventricularly increased blood pressure, however the intravenous(iv) adminstration of them did not affect blood pressure. The pressor response to icv DPH was dose-dependent, but that to icv RAN was not. 2) The pressor response to icv DPH(1mg) was either markedly attenuated or reversed to depressor response by the pretreatment with icv phentolamine(250,500ug), and iv chlorisondamine(0.1, 1mg/Kg) and iv phenoxybenzamine(1mg/Kg). In cord-sectioned rabbtis, icv RAN) 1mg) did not produce pressor response. 3) The pressor responsr to icv RAN(1mg) was not affected by the pretreatment with icv phentolamine(500ug), iv chlorisondamin(1mg/Kg) and iv phenoxybenzamine(1mg/Kg), and iv phenoxybenzamine(1mg/Kg). RAN also producted pressor response in cordsectioned rabbits. These results suggest that the pressor response to icv DPH is elecited by increasing peripheral sympathetic tone via the stimulation of central alpha-adrenoreceptors and the pressor response to icv RAN is produced by releasing some humoral facotr which can increase blood pressure.

The Status of Central Nervous System Tumors in Chonnam and Chonbuk Provinces

The authors analized statistically 635 cases of pathologically confirmed central nervous system tumors in the Chonnam and Chonbuk provinces from 1987 to 1989. The results were as follows ; 1) Of the 635 cases, 327 cases(51.5%) were male and 308 cases(48.5%) were female. 2) Intracranial tumors were 518 cases(81.6%), spine and intraspinal tumors 94(14.8%), scalp and skull tumors 23(3.6%). 3) Average incidence rate of tumors was 3.5/year/100,000 population, 3.1 for Chonnam province, 4.4 for Chonbuk province. 4) Among the brain tumors, glial tumors were the most common(28.4%), and followed by meningiomas(18%), pituitary tumors(15.2%), metastatic tumors(8.9%), Among the intraspinal tumors, neurinomas and neurofibromas were found most frequently(41.5%), and rests were metastatic tumors(23.4%), meningiomas(9.5%) in order. 5) Sexual predilection of tumors was as follows : male preponderance was noted for oligodendrogliomas(9:1), metastatic tumors(2.3:1), glioblastomas multiforme(GM)(1.8:1) cysticercosis(1.6:1), and female preponderance for meningiomas(1:3.2), pituitary tumors(1:2), paragonimiases(1:1.5). 6) The incidence rate of brain tumors in children below 15 years was 11.8% and that which occured infratentorially was 47.5%. 7) The brain tumors were found mainly in cerebral hemispheres, in which area most of tumors were meningiomas, astrocytomas in order. In sellar, parasellar most of tumors were meningiomas astrocytomas in order. In sellar, parasellar and suprasellar region, the majority of tumors were pituitary tumors and meningiomas. 8) Cysticercosis showed a predilection for the sixth and seventh decades, meningiomas, metastatic tumors, neurinomas for sixth decade, GM and supratentorial astrocytomas for fourth, fifth and sixth decades, oligodendroliomas for fifth decade, infratentorial astrocytomas, medulloblastomas and craniopharyngiomas for first and second decades. 9) In the spinal tumors, the favorable site was thoracic region and majority of them were located intradural extramedullarily and extradurally in similar incidence.

A Clinical Analysis of Pediatric Brain Tumors

The authors analyzed 50 children(below 15 years old) with intracranial tumors which were confirmed by operation during 5.5 years from Jan, 1983 to Jul. 1989 retrospectively. The results were as follows : 1) Incidence of pediatric brain tumors was 13.1% among the all intracranial tumors(383 cases). 2) Pediatric brain tumors were found most frequently between the age of six and thirteen years(74.0%), and the ratio of male to female was 1.6 : 1. 3) In respect of location, supratentorial and infratentorial tumors were seen in each 25 patients, and the tumor of central neural axis(58.0%) was more frequent than that of lateral portion(42.0%). 4) The most common tumor was astrocytoma(32.0%) in the supratentorium, and medulloblastoma(26.0%) in the infratentorium. 5) Headache and vomiting were the most common complaining symptoms and papilledema was the most common sign. 6) Hydrocephalus associated with tumors was 24.0% in supratentorium and 88.0% in infratentorium. 7) Postoperative mortality within 1 month was 12.0%.

Analysis of Upper Cervical Injuries

During the past five years we have treated twenty-seven cases of upper cervical injury among total three hundred and seventeen spine injuries. A follow-up study has done on twenty-one upper cervical injuries and the result is reported. The incidence of upper cervical injury was 8.5% of the total spine injury and 17.5% of the cervical injury. Almost all of the injuries(95.2%) were caused by traffic accidents and falls. The types of injury were odontoid fracture(38.1%), hangman's fracture(28.6%), atlanto-axial instability(19.1%), tear drop fracture of the axis(9.5%), and Jefferson's fracture(4.8%). Chief complaints on admission were motor weakness(57.1%), neck pain with limitted range of motion(42.9%), and sensory disturbance was noted in six cases of the motor weakness group(28.6%). Out of twenty-one cases, operative fixation was performed in eight cases with good result in five(62.5%) and thirteen patients were treated conservatively with eleven cases(84.6%) of good result. In chronic nonunited or malnunited cases, it seems to be safer to fuse the level both by anterior and posterior routes than by either route alone because it is not always stable and needs long period of immobilization.

Effect of Intracerebroventricular Digitalis on Cardiovascular System of Rabbits

Influences of intracerebroventricular(icv) ouabain on cardiovascular system and on pressor response to raised intracranial pressure(ICP) were investigated in urethane-anesthetized rabbits. Intravenous(iv) 40 microgram/kg ouabain did not affect blood pressure of rabbit. Icv ouabain(5, 10, 20 microgram/kg) and digoxin(6.25, 12.5 microgram/kg) produced dose-dependent pressor responses and marked decrease of heart rate. After bilateral vagotomy, the bradycardiac effect of ouabain disappeared, while the pressor effect was significantly potentiated. The ouabain-induced pressor effect was not affected by iv and icy phentolamine or propranolol, and significantly inhibited by icy infusion of lidocaine(0.1 mg/kg/min) and diazepam(0.025 mg/kg/min). The pressor response to raised ICP was not affected by iv 40 microgram/kg ouabain but disappeared by icy 10 microgram/kg ouabain and 6.25 microgram/kg digoxin. These data suggests that ouabain causes pressor effect through direct interaction with a site(s) in central nervous system and bradycardiac effect by direct activation of vagal center, and ouabain blocks central sympathetic stimulation by increase of ICP in rabbits.

Anterior Interbody Fusion Combined with Anterior Cervical Plate Fixation in Cervical Spine Injury

The anterior interbody fusion combined with internal metal plate fixation was performed from January, 1988 in seven patients with unstable mid and lower cervical spine. The insertion of the metal plate was simple and maintained the block bone graft in satisfactory position. We concluded from this early follow-up that, this alternative method of internal fixation of cervical spine allowed not only effective stabilization for the unstable spine but also early mobilization and short hospital stay.

Clinical Analysis of Traumatic Hemorrhage in Child's Basal Ganglia: Eight Cases

Recently, the detection of traumatic intracerebral hematoma has been greatly expedited by the advent of computed tomography. However, traumatic basal ganglia hemorrhage(TBGH) in child have remained rare. The authors obtained following results with analysis of clinical features and outcome in 8 cases of child's TBGH who had been treated at the department of neurosurgery, chonnam university hospital from January 1984 to December 1986. 1) Age distribution was ranged from 3 to 9 years with an average age 5.1 years and 5 were males and 3 were females. 2) Blow of site of the head were right frontal 3, left frontal 3, right parietal 1 and right temporal 1. However, hematoma in the basal ganglia occurred 6 in the left and 2 in the right. 3) On admission, the consciousness level appeared 2 cases in drowsy state(GCS 13), 3 cases in stuporous state(GCS 8,9) and 3 cases in semicomcatose state(GCS 5,7). 4) CT findings of TBGH were classified into 3 types; Type I; spotty type, Type II; moderate type and Type III : massive type. The number of patients was 4 in type I, 2 in type II and 2 in type III. 5) Neurological examination revealed contralateral hemiparesis to the hematoma in all cases(8), facial nerve palsy in 3 cases, motor aphasia in 4 cases and decerebrate rigidity in 2 cases. 6) Of all cases (8), conservative treatment were done in 5 and surgical treatment in 3. As regards the outcome of all cases (8), showed good recovery in 3, moderate disabilety in 2 and death in 3. It was concluded that the first regimen to be chosen in the management of TBGH in child was medical treatment. The patient of moderately disturbed conseionsness would be successfully managed by conservative treatment. The indication for surgery should be restricted to such cases in which the consciouness status were getting worse in spite of active conservative treatment.

Effect of Lidocaine on Experimental Intracranial Hypertension in Rabbits

Effect of infusion and bolus injection of lidocaine on the pressure response to the increased intracranial pressure(ICP) was investigated in urethane-anesthetized rabbits. 1) Arterial blood pressure(BP) and ICP were significantly raised by infusing saline(0.05ml/min) into an epidural balloon. 2) Infusing of lidocaine(0.5mg/kg/min) into an ear vein minutely inhibited the elevation of BP and ICP when infusing saline into an epidural balloon. However, infusion of lidocaine(1.5mg/kg/min) markedly inhibited the elevation of BP and ICP. 3) Repeating the infusion of saline into the epidural balloon with intervals, the duration reached to the level of 80-10 mmHg ICP was gradually shortened. Each depressor response to the first, second and third injection of lidocaine(3 mg/kg) was similar. The first injection transiently reduced the elevated ICP, but the second and third injection reduced that significantly and the reducing effect was gradually prolonged according to repeating the lidocaine injection. These results show that lidocaine could delay the elevation of ICP and reduce the previously increased ICP by infusing saline into an epidural balloon.

Traumatic Epidural Hematomas of the Posterior Fossa

The authors represented an analysis on 10 patients with traumatic epidural hematomas of the posterior fossa who had treated successfully from January 1984 to October 1985. The result were summarized as follows ; 1) Age incidence comprised ranging from 4 to 62 years and 6 were males and 4 were females. 2) Site of hematoma was related with fracture site closely and bleeding source confirmed during operation was transverse sinus in 4 cases, occipital sinus in 1 case, fracture site in 3 cases and unknown in 2 cases and it had close relationship between fracture site and large venous sinus. 3) Outcome was good in most cases except death in 1 and moderate disability in 1 case. Factors contributing to outcome were early detection and adequate treatment and also associated supratentorial injury.

A Case of Subependymal Giant Cell Astrocytoma associated with Tuberous Sclerosis(Case Report)

Subependymal giant cell astrocytoma is a very rare cerebral glioma and is known to be usually associated with tuberous sclerosis. We experienced a case of this tumor occurred at the wall of both lateral ventricles near the foramen of Monro in a patient of tuberous sclerosis who had symtoms and signs of hydrocephalus and other complex manifestations of facial adenoma sebaceum, huge fibroma on occipital scalp and hamartoma on the right retina. The masses were removed completely through transcallosal approach with microsurgical technique. The literatures are also reviewed.

Imterhemispheric Subdural Hematoma

Subdural hematoma in the interhemispheric space is a rare entity. The authors present a case of subdural hematoma in the left interhemispheric space caused by head injury with the characteristic presenting symptom of right hemiparesis, worse in the lower than the upper extremity. Computerized tomography (CT) is the preferred diagnostic procedure and thevcoronal section delineates the extent of hematoma more clearly. It is best treated by osteoplastic craniotomy. Anatomical considerations, clinical features, value of CT scanning, recommended surgical technique, and review of the literature are presented.

Influence of Kallikrein on the Cerebral Blood Flow in Rabbits

It is known that in animals with increased intracranial pressure the cerebral perfusion is curtailed, but whether it is caused by deranged responsiveness of the cerebral vessel is not known. Thus, it was attempted in this study to find out the changes of cerebrovascular response to Kallikrein in the rabbits with increased ICP(20mmHg) under urethane-anesthesia. 1) intracarotid arterial kallikrein elicited increases in cerebral blood flow and decreases in blood pressure and arterial resistance. 2) Cerebral blood flow was significantly decreased in rabbits with increased ICP in comparison with the control rabbits. 3) Intraarterial kallikrein caused dose-depent increases of cerebral blood flow in both groups, but responses were significantly reduced in ICP-elevated group. 4) Kallikrein produced dose-dependent hypotensive effect in both groups with no significant difference between both groups. 5) Cerebrovascular resistance was greater in rabbits with elevated ICP(20 mmHg), but kallikrein induced decreases of cerebrovascular resistance in both groups to the same degree, 6) Above results suggested that increased ICP reduces the cerebral blood flow by increasing cerebrovascular resistance, but it does not modify the reponsiveness of cerebral vessel to kallikrein.