ABSTRACT
Small cerebral aneurysms that occur at non-branching sites are generally considered to have extremely weak aneurysm walls or a pseudoaneurysm formed by a thrombus. Since conventional clipping and coil embolization are difficult and high-risk, trapping with bypass has been considered the preferred treatment method. The aim of this study is to investigate a case of trapping with high-flow bypass for a ruptured aneurysm at non-branching sites of the middle cerebral artery (MCA). In this study, the CT results indicated subarachnoid hemorrhage, while the CT angiography (CTA) results showed a small aneurysm at the non-branching site of the MCA M1 segment. Moreover, the intraoperative digital subtraction angiography (DSA) results strongly suggested a pseudoaneurysm. The aneurysm was judged to be a pseudoaneurysm over the rupture site of the true aneurysm sac. Coil embolization was performed, but the treatment was interrupted as the aneurysm completely disappeared during the procedure. However, based on the magnetic resonance angiography findings, the aneurysm reappeared on day five and became enlarged. Thus, trapping with high-flow bypass was performed on day 15 and the patient was cured. Owing to the unusual and noteworthy course of this case, trapping with high-flow bypass was considered to be the safest and most reliable first-choice treatment procedure for pseudoaneurysm at non-branching sites of the MCA.
ABSTRACT
Clear cell meningioma (CCM) is a WHO classification Grade II meningioma. It is a very rare disease, of which only 41 cases of spinal cord CCM in children have been reported to date. CCMs sometimes do not have the "dural attachment" that is usually found in meningiomas, and our understanding of the origin of CCMs is therefore controversial. We hereby present a case of pediatric CCM of the lumbar spine, in which we examined intraoperatively, the detailed anatomical location of the tumor. The case is a 10-year-old boy, who presented to our hospital with a 2-month history of lower back and bilateral lower extremity pain upon waking, which gradually worsened. Lumbar spine CT and MRI revealed an intradural extramedullary tumor at the L3 vertebral level, and surgery was performed to remove it. The tumor was in close contact with the dura mater, and also in contact with the cauda equina via the arachnoid. The tumor was likely located primarily between the dura mater and arachnoid. The pathological diagnosis was CCM, with an MIB-1 index of less than 1%. His back pain and bilateral lower extremity pain improved after surgery, and he was discharged from our hospital. Postoperative radiation therapy was not performed. Based on this case, we suggest that intraoperative examination of the anatomical location of these tumors and accumulation of relevant experience are important to elucidate the embryological mechanisms of this rare disease.
ABSTRACT
Although it is now well known that some diseased areas, such as cancer nests, inflammation loci, and infarction areas, are acidified, little is known about cellular signal transduction, gene expression, and cellular functions under acidic conditions. Our group showed that different signal proteins were activated under acidic conditions compared with those observed in a typical medium of around pH 7.4 that has been used until now. Investigations of gene expression under acidic conditions may be crucial to our understanding of signal transduction in acidic diseased areas. In this study, we investigated gene expression in mesothelioma cells cultured at an acidic pH using a DNA microarray technique. After 24 h culture at pH 6.7, expressions of 379 genes were increased more than twofold compared with those in cells cultured at pH 7.5. Genes encoding receptors, signal proteins including transcription factors, and cytokines including growth factors numbered 35, 32, and 17 among the 379 genes, respectively. Since the functions of 78 genes are unknown, it can be argued that cells may have other genes for signaling under acidic conditions. The expressions of 37 of the 379 genes were observed to increase after as little as 2 h. After 24 h culture at pH 6.7, expressions of 412 genes were repressed more than twofold compared with those in cells cultured at pH 7.5, and the 412 genes contained 35, 76, and 7 genes encoding receptors, signal proteins including transcription factors, and cytokines including growth factors, respectively. These results suggest that the signal pathways in acidic diseased areas are different, at least in part, from those examined with cells cultured at a pH of around 7.4.
ABSTRACT
Sediment and nutrients yields especially from farmlands were studied in a watershed in Ishigaki island, Okinawa, Japan. The transport processes of these materials in rivers, mangrove, lagoon and coastal zones were studied by using various observation methods including stable isotope analysis. They were simulated by using a WEPP model which was modified to be applicable to such small islands by identifying several factors from the observations. The model predicts that a proper combination of civil engineering countermeasure and change of farming method can reduce the sediment yield from the watershed by 74%. Observations of water quality and coral recruitment test in Nagura bay indicate that the water is eutrophicated and the corals cannot grow for a long time. Based on these observations, a quantitative target of the reduction of sediment and nutrients yield in watershed can be decided rationally.
