Different origins of two corpora lutea recovered from a pregnant African elephant (Loxodonta africana).

Elephant ovaries contain multiple corpora lutea (CLs) throughout pregnancy. Two CLs (P-1 and P-2) collected from a pregnant African elephant were used to investigate their origin and physiological state in this study. The mRNA expressions of prolactin receptor, CYP11A and inhibin betaB subunit were higher in P-2 than in P-1, while LHCGR and inhibin betaA subunit mRNA were higher in P-1 than in P-2. Protein expression of cleaved caspase-3 was detected in P-1 but not in P-2. These results suggest different origins for the two CLs in this one pregnant elephant, and we also demonstrated the production of bioactive prolactin by the elephant placenta.

[CT-guided stereotactic operation for cerebellar abscess by the transtentorial hiatus approach: a case report].

We reported a case of cerebellar vermian abscess, well managed by CT-guided stereotactic aspiration and drainage via the transtentorial hiatus route. A 69-year-old man was admitted to our hospital because of acute deterioration of bronchiectasis. About one month later, he complained of headache and gait unsteadiness. CT scan revealed a multilocular abscess in the cerebellar vermis. Although conservative therapy with antibiotics was applied, the symptoms deteriorated and the lesion continued to grow. Aspiration and drainage were therefore performed for the main lesion by CT-guided stereotactic surgery via the transtentorial hiatus route. This was completed without complications. The postoperative course was good and the lesion had disappeared when enhanced CT was carried out about 2 months after the operation. We consider this stereotactic transtentorial hiatus operation to be an effective treatment for patients such as the present one with a superior vermian lesion and who is at risk due to a poor respiratory condition.

[A case of intracranial arteriovenous malformation presenting with intracranial hypertension].

A case of unruptured arteriovenous malformations (AVMs) presenting benign intracranial hypertension is reported. A 14-year-old male suffered from headache and papilledema. Intracranial pressure was 260 mmH2O. Unenhanced CT demonstrated no evidence of hemorrhage or hydrocephalus. Angiogram demonstrated a large AVM in the left temporal lobe supplied by the left posterior cerebral artery and left middle cerebral artery. It drained into the transverse sinus. Surgical excision of the AVM eliminated the headache and papilledema. AVM causes hemorrhage in 50% of cases, seizure in 30%, and other focal neurological deficits in 20%. Benign intracranial hypertension is an uncommon effect of unruptured AVMs. Only 13 cases have been reported in the literature. Benign intracranial hypertension associated with unruptured AVMs occurs in young patients with high flow AVMs that drain into the major sinus. The mechanism of intracranial hypertension associated with unruptured AVM is unknown. However, there are several possible mechanisms of intracranial hypertension associated with unruptured AVMs. The arterial blood shunting into a major sinus impedes venous return from the surrounding brain. That causes the increase of cerebral blood volume and the elevation of sinus pressure. This mechanism would reduce CSF absorption and would increase intracranial pressure. Pharmacological therapy is ineffective in controlling intracranial hypertension. Surgical excision of AVM effectively reduced intracranial hypertension. Thus, surgical excision of AVMs, if it can be done with low risk, is the treatment of choice to decrease intracranial hypertension in patients with unruptured cerebral AVMs.

Hemichorea associated with ipsilateral chronic subdural hematoma--case report.

Left-sided hemichorea developed suddenly in a 73-year-old male. Computed tomography revealed a left subdural hematoma (SDH) and infarction in the right corona radiata and temporo-occipital region. Hemichorea subsided completely after removal of the SDH. Postoperative single photon emission computed tomography with technetium-99m-hexamethyl-propyleneamine oxime revealed a global low-perfusion area in the right cerebral hemisphere. Right carotid angiography demonstrated severe stenosis of the trunk of the right middle cerebral artery. The cerebral blood flow in the right cerebral hemisphere had probably already decreased to nearly the critical level and was reduced further by the left SDH, inducing the left-sided hemichorea due to dysfunction of the right cerebral hemisphere. This case shows that when hemichorea ipsilateral to a SDH is present, it is important to ascertain whether there is a pre-existing ischemic lesion in the contralateral cerebral hemisphere, particularly in the basal ganglia, thalamus, or corona radiata.