Intracarotid propofol test for speech and memory dominance in man.

OBJECTIVE: To evaluate the usefulness of propofol as an alternative drug to amobarbital for the Wada test. METHODS: The authors analyzed 67 right-handed patients out of 123 patients who were candidates for neurosurgical therapy and thus underwent the Wada test as a preoperative evaluation. Twelve were tested with propofol and 55 were tested with amobarbital. Test conditions of the Wada test, recovery time of muscle power to manual muscle testing (MMT) Grade 3 (T3/5) and Grade 5 (T5/5), onset time of the first verbal response (Tverb) after injection and that of the first nonverbal response (Tnon-verb), were compared between the two groups. Power spectrum analysis of EEG background activity during the Wada test was performed and the time and spatial distribution of polymorphic slow activities were also compared in three cases. RESULTS: With propofol injection, lateralities of language and memory function were identified in 12 and 9 of 12 patients in comparison to amobarbital (52 and 41 of 55 patients detection in language and memory function). No complications with direct intracarotid injection of propofol were observed. T3/5 and T5/5 with propofol injection were shorter while Tverb and Tnon-verb were longer compared to amobarbital. Absolute power of polymorphic slow EEG waves gradually increased and then rapidly decreased with propofol, which was in contrast to amobarbital injection. CONCLUSIONS: With direct intracarotid propofol injection, the Wada test was satisfactorily performed in all 12 patients and 2 more patients with left-handedness or with different injection dose for each side without any complications. Clinical usefulness of propofol as an alternative drug to amobarbital for the Wada test was indicated.

Incorporation and differentiation of hippocampus-derived neural stem cells transplanted in injured adult rat retina.

PURPOSE: In a previous study it has been shown that adult rat hippocampus-derived neural stem cells can be successfully transplanted into neonatal retinas, where they differentiate into neurons and glia, but they cannot be transplanted into adult retinas. In the current study, the effect of mechanical injury to the adult retina on the survival and differentiation of the grafted hippocampal stem cells was determined. METHODS: Mechanical injury was induced in the adult rat retina by a hooked needle. A cell suspension (containing 90,000 neural stem cells) was slowly injected into the vitreous space. The specimens were processed for immunohistochemical studies at 1, 2, and 4 weeks after the transplantation. RESULTS: In the best case, incorporation of grafted stem cells was seen in 50% of the injured retinas. Most of these cells located from the ganglion cell layer through the inner nuclear layer close to the injury site. Immunohistochemically, at 1 week, more than half of the grafted cells expressed nestin. At 4 weeks, some grafted cells showed immunoreactivity for microtubule-associated protein (MAP) 2ab, MAP5, and glial fibrillary acidic protein (GFAP), suggesting progress in differentiation into cells of neuronal and astroglial lineages. However, they showed no immunoreactivity for HPC-1, calbindin, and rhodopsin, which suggests that they did not differentiate into mature retinal neurons. Immunoelectron microscopy revealed the formation of synapse-like structures between graft and host cells. CONCLUSIONS: By the manipulation of mechanical injury, the incorporation and subsequent differentiation of the grafted stem cells into neuronal and glial lineage, including the formation of synapse-like structures, can be achieved, even in the adult rat retina.

Nonconvulsive focal inhibitory seizure: subdural recording from motor cortex.

The authors obtained an ictal electrocorticogram with chronically implanted subdural electrodes from a 30-year-old man with a low grade glioma in the right postcentral gyrus who had a focal inhibitory seizure of the left arm. During the ictal paresis, the authors observed epileptic discharges in the positive arm motor area of the right precentral gyrus and in its rostral area, but not in the negative motor area. The epileptic activity probably inhibited the spinal motoneuron pool without eliciting excitatory activity in the corticospinal pathway.

Expression of heat shock proteins in the developing rat retina.

Expression of three heat shock proteins (HSPs), HSP70, HSP90, and immunoglobulin heavy chain binding protein (Bip) was examined in the developing rat retina using Northern blot analysis. The expression of the inducible form of HSP70 remained uniformly low throughout the perinatal period until P5 and increased rapidly at P7. On the other hand, the constitutive form of HSP70, HSP90, and Bip were expressed constitutively in the rat retina throughout the developmental stage except P3-P5, at which a transient decrease of the expression was observed. The increase of inducible HSP70 mRNA at P7 may correspond to the functional maturation of photoreception in the visual nervous system and may be one of the stress responses to photostimulation. The potential roles of each HSP during development of the rat visual system are discussed.

Ventral spinal subdural hematoma--case report.

A 26-year-old male presented with a very rare spinal subdural hematoma which developed 3 days after minor trauma. Magnetic resonance imaging showed the very large hematoma, extending from the C-1 to the T-11 levels, ventral to the spinal cord. An attempt to remove the hematoma via a posterior approach on the next day failed. On the 3rd hospital day, the hematoma was partially removed at the C7-T1 intervertebral level through an anterior approach. Neurological signs of paraplegia, and urinary and bowel disturbances did not improve postoperatively.

Localization of trkB and low-affinity nerve growth factor receptor mRNA in the developing rat retina.

The localization of trkB and low-affinity nerve growth factor receptor (LNGFR) mRNAs in the developing rat retina was examined by in situ hybridization. TrkB mRNA was expressed in the ganglion cell layer (GCL), in the inner border of the neuroblastic layer (NBL), and the inner border of the inner nuclear layer (INL). LNGFR mRNA was expressed in the GCL, in almost full thickness of the NBL, and in the intermediate part of the INL. Although both trkB mRNA and LNGFR mRNA were expressed in the GCL, the expression pattern was different between these mRNAs; trkB mRNA was expressed in almost all cells in the GCL uniformly and the expression of LNGFR mRNA varied greatly from cell to cell. In addition, the expression of both mRNAs, especially LNGFR mRNA seemed to be down-regulated at P7, when programmed cell death of the RGCs was prominent. These observations indicate that LNGFR may modulate the function of trkB and that trkB and LNGFR play important roles in the development and maintenance of the RGCs.

Tuberculous hypertrophic pachymeningitis involving the posterior fossa and high cervical region--case report.

A 44-year-old female presented with a rare tuberculous hypertrophic pachymeningitis involving the posterior fossa and high cervical region manifesting as progressive multiple cranial nerve pareses and myelopathy developing over 6 months. Magnetic resonance imaging demonstrated the thickened dura mater and associated syrinx. Despite decompressive craniectomy and antituberculous treatment, she died of disseminated intravascular coagulation. Hypertrophic pachymeningitis is probably best treated by the most extensive excision of affected dura mater possible, unless medical treatment can be instituted for an identifiable underlying causative disease.

Developmental expression of trkB and low-affinity NGF receptor in the rat retina.

Brain-derived neurotrophic factor (BDNF) promotes the survival of retinal ganglion cells, but these effects are dependent on the developmental stages, and a number of retinal ganglion cells are eliminated during pre- and neonatal stages. We have examined the expression of BDNF receptors, trkB and low-affinity nerve growth factor receptor (LNGFR), in the rat retina during these period using Northern blot analysis. The expression of trkB and LNGFR displayed two peaks during embryonic day 17 (E17) through postnatal day 1 (P1), and during P14-P17, indicating that it may play an important role in neuronal development and neuronal cell death.

Extension of optic nerve fibers on genetically modified cells producing brain-derived neurotrophic factor.

Since brain-derived neurotrophic factor (BDNF) promotes the survival of retinal ganglion cells (RGCs), we transfected a rat BDNF cDNA into rat fibroblasts, and retinal fragments of rat embryos were cultured on cell monolayers of these cells. Retinal fragments showed enhanced neurite extension on BDNF-transfected cells compared with that on control cells. The degree of the neurite extension, however, decreased depending upon the embryonic stages. These results suggest that fibroblasts genetically modified to produce BDNF might be a promoter of neurite extension by RGCs, but this does not apply to the RGCs of late embryonic stages.

Possible activity of acidic fibroblast growth factor as a progression factor rather than a transforming factor.

Acidic and basic fibroblast growth factors (aFGF and bFGF) are mitogens for mesoderm- and neuroectoderm-derived cells. The facts that FGF-related proteins are oncogenic and that FGFs are expressed in a variety of tumor cell lines or tumor tissues suggest the transforming activities of FGFs. To examine such an activity of aFGF, we introduced a human aFGF expression vector into two populations of Rat-1 cells; one was non-transformed (nRat-1), the other was partially-transformed (tRat-1). tRat-1 cells transfected with aFGF cDNA formed larger colonies in soft agar and produced larger and more malignant tumors in nude mice than those of parental cells. In contrast, nRat-1 cells transfected with aFGF cDNA neither formed colonies in soft agar nor produced tumors in nude mice. Our results suggest that high expression of aFGF may enhance a tumorigenic potential of Rat-1 cells rather than confer such a potential de novo.

Intraventricular craniopharyngioma: report of two cases and review of the literature.

Two unusual cases of purely intraventricular craniopharyngioma are presented. Both patients complained of headache as a sign of increasing intracranial pressure, but neither other neurological deficits nor hormonal disorders were present. Magnetic resonance images showed a mass lesion located within the third ventricle. Surgery confirmed that these two tumors were completely confined within the third ventricle, and histologically they proved to be squamous papillary craniopharyngiomas. Review of the literature demonstrates that craniopharyngiomas at this location have many common features and would appear to form a distinct entity.