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1.
Neurol Med Chir (Tokyo) ; 54(10): 845-50, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24257489

RESUMO

The authors report a rare case of cerebral hyperperfusion syndrome (HPS) following the excision of a mycotic aneurysm with superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass. A 74-year-old woman with infective endocarditis presented with progressive cerebral infarction and subarachnoid hemorrhage due to a mycotic aneurysm, which was excised with a STA-MCA bypass. Postoperatively, the patient developed HPS that was considered to be exacerbated by a previous ischemic event. Therefore, cerebral hemodynamics should be evaluated before bypass surgery to prevent subsequent hyperperfusion.


Assuntos
Aneurisma Infectado/cirurgia , Encéfalo/irrigação sanguínea , Revascularização Cerebral/métodos , Aneurisma Intracraniano/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Idoso , Angiografia Cerebral , Infarto Cerebral/diagnóstico , Infarto Cerebral/cirurgia , Imagem de Difusão por Ressonância Magnética , Endocardite Bacteriana/complicações , Feminino , Humanos , Infecções Estreptocócicas/complicações , Streptococcus mutans
2.
Brain Res ; 1534: 87-94, 2013 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-23958343

RESUMO

Edaravone (3-methyl-1-phenyl-2-pyrazolin-5-one) is a free radical scavenger used for acute ischemic stroke. However, it is not known whether edaravone works only as a free radical scavenger or possess other pharmacological actions. Therefore, we elucidated the effects of edaravone on human brain microvascular endothelial cells (HBMECs) by 2 dimensional fluorescence difference gel electrophoresis (2D-DIGE). We found 38 protein spots the intensity of which was significantly altered 1.3 fold on average (p< 0.05) by the edaravone treatment and successfully identified 17 proteins of those. Four of those 17 proteins were cytoskeleton proteins or cytoskeleton-regulating proteins. Therefore, we subsequently investigated the change of size and shape of the cells, the actin network, and the tight junction of HBMEC by immunocytochemistry. As a result, most edaravone-treated HBMECs became larger and rounder compared with those that were not treated. Furthermore, edaravone-treated HBMECs formed gathering zona occludens (ZO)-1, a tight junction protein, along the junction of the cells. In addition, we found that edaravone suppressed interleukin (IL)-1ß-induced secretion of monocyte chemoattractant protein-1 (MCP-1), which was reported to increase cell permeability. We found a novel function of edaravone is the promotion of tight junction formations of vascular endothelial cells partly via the down-regulation of MCP-1 secretion. These data provide fundamental and useful information in the clinical use of edaravone in patients with cerebral vascular diseases.


Assuntos
Antipirina/análogos & derivados , Encéfalo/efeitos dos fármacos , Células Endoteliais/efeitos dos fármacos , Endotélio Vascular/efeitos dos fármacos , Proteômica , Antipirina/farmacologia , Encéfalo/irrigação sanguínea , Encéfalo/metabolismo , Células Cultivadas , Edaravone , Células Endoteliais/metabolismo , Endotélio Vascular/metabolismo , Células HeLa , Humanos , Ácido Láctico/metabolismo , Microvasos/efeitos dos fármacos , Junções Íntimas/efeitos dos fármacos , Junções Íntimas/metabolismo
3.
Acta Neurochir Suppl ; 118: 219-21, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23564136

RESUMO

Intracranial pressure (ICP) monitoring has been used widely for patients with intracranial hypertension. However, the data of mean ICP do not reflect various brain conditions correctly. Therefore, we performed ICP -waveform analysis to assess brain compliance. Data for ICP -waveform analysis were obtained by stereotactic intraventricle puncture. ICP waveform is expressed as a three-phase wave. Analyzed differential waveforms in a water intoxication model and continuous infusion models were evaluated respectively. In the water intoxication models, the second wave (P2) known to reflect compliance is elevated. ICP waveform analysis will be valuable for the assessment of the pathological condition of the brain.


Assuntos
Encéfalo/fisiopatologia , Pressão Intracraniana/fisiologia , Intoxicação por Água/patologia , Intoxicação por Água/fisiopatologia , Animais , Pressão Sanguínea , Eletrocardiografia , Masculino , Monitorização Fisiológica , Ratos , Ratos Sprague-Dawley , Fatores de Tempo
4.
J Med Case Rep ; 6: 306, 2012 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-22989192

RESUMO

INTRODUCTION: Pituicytoma is a rare neoplasm of the neurohypophysis. To the best of our knowledge there have been no reports of pituicytoma in which long-term magnetic resonance imaging observation was performed. We calculated the doubling time of the tumor volume and described the growth pattern of a pituicytoma. CASE PRESENTATION: A 52-year-old Japanese man with a history of decreased libido was found to have a sellar and suprasellar mass. He underwent transsphenoidal surgery, but only a small specimen was obtained because of intraoperative bleeding. The tentative histological diagnosis was schwannoma. He noticed bitemporal hemianopsia 7 years later. A follow-up magnetic resonance imaging disclosed a tumor volume doubling time of 3830 days. Transcranial gross-total tumor resection was performed. The lesion consisted of elongated and plump tumor cells that were arranged in a fascicular or storiform pattern and were positive for S-100 protein and focally positive for glial fibrillary acidic protein. The final histological diagnosis was pituicytoma. CONCLUSION: Pituicytoma is a slow-growing tumor, but the growth rate may change during follow-up.

5.
Brain Res ; 1460: 73-7, 2012 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-22583857

RESUMO

Diabetes mellitus in neurosurgical patients is known to be a disease with high risks and severe outcomes. However, the mechanism by which diabetes mellitus induces dysfunction of brain tissue is not well known. The hypothesis of this study was that the damage to brain microvasculature in diabetes mellitus results in impaired compliance of the brain. Pathological changes associated with type II diabetes were investigated using a rat model. Pathophysiological changes in diabetic brain tissue were also investigated to confirm cerebral compliance by analyzing intracranial pressure waveforms. Pathologic findings revealed thickening of the basement membrane and fibrous collagen infiltration into the inner basement membrane of the brain microvasculature in diabetes mellitus. Analysis of intracranial pressure waveforms revealed that the P2 portion increased in diabetic rats compared to the control and was increased further with the increase in intracranial pressure. Analysis of the differential pressure curve, with respect to time, demonstrated that intracranial elasticity showed a concomitant increase. Pathologic findings and intracranial pressure waveforms were consistent with changes in brain microvasculature in diabetes mellitus. The increase of elasticity of brain tissue in diabetes mellitus may exacerbate the damage of intracranial disease.


Assuntos
Capilares/patologia , Diabetes Mellitus Tipo 2/fisiopatologia , Angiopatias Diabéticas/fisiopatologia , Pressão Intracraniana/fisiologia , Animais , Capilares/fisiopatologia , Doenças de Pequenos Vasos Cerebrais/patologia , Doenças de Pequenos Vasos Cerebrais/fisiopatologia , Diabetes Mellitus Tipo 2/patologia , Angiopatias Diabéticas/patologia , Elasticidade , Células Endoteliais/patologia , Células Endoteliais/fisiologia , Masculino , Ratos , Ratos Mutantes , Ratos Sprague-Dawley
7.
Neurol Med Chir (Tokyo) ; 52(2): 109-12, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22362296

RESUMO

A 34-year-old man presented with a case of subdural empyema and cerebral abscess that developed 12 years after initial neurosurgical intervention for a traffic accident in 1998. Under a diagnosis of acute subdural hematoma and cerebral contusion, several neurosurgical procedures were performed at another hospital, including hematoma removal by craniotomy, external decompression, duraplasty, and cranioplasty. The patient experienced an epileptic seizure, and was referred to our hospital in March 2010. Magnetic resonance imaging revealed a cerebral abscess extending to the subdural space just under the previous surgical field. Surgical intervention was refused and antimicrobial treatment was initiated, but proved ineffective. Surgical removal of artificial dura and cranium with subdural empyema, and resection of a cerebral abscess were performed on May 12, 2010. No organism was recovered from the surgical samples. Meropenem and vancomycin were selected as perioperative antimicrobial agents. No recurrence of infection has been observed. Postneurosurgical subdural empyema and cerebral abscess are recently emerging problems. Infections of neurosurgical sites containing implanted materials occur in 6% of cases, usually within several months of the surgery. Subdural empyema and cerebral abscess developing 12 years after neurosurgical interventions are extremely rare. The long-term clinical course suggests less pathogenic organisms as a cause of infection, and further investigations to develop appropriate antimicrobial selection and adequate duration of antimicrobial administration for these cases are needed.


Assuntos
Abscesso Encefálico/etiologia , Abscesso Encefálico/patologia , Craniotomia/efeitos adversos , Hematoma Subdural Agudo/cirurgia , Complicações Pós-Operatórias/patologia , Espaço Subdural/patologia , Doença Aguda , Adulto , Abscesso Encefálico/cirurgia , Lesões Encefálicas/cirurgia , Craniotomia/métodos , Hematoma Subdural Agudo/etiologia , Humanos , Masculino , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/cirurgia , Espaço Subdural/cirurgia , Fatores de Tempo
8.
No Shinkei Geka ; 40(2): 151-7, 2012 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-22281468

RESUMO

We report a case of post-neurosurgical meningitis, subdural empyema, and cerebral abscess caused by multidrug-resistant Acinetobacter baumannii (MRAB) poorly susceptible to colistin. A 49-year-old man was transferred to our hospital after surgical treatment for putaminal hemorrhage in a foreign country hospital. Several examinations revealed surgical site infection (SSI). From cerebro-spinal fluid examination via ventricular drainage, MRAB was recovered. The minimum inhibitory concentration (MIC) of colistin was 2 µg/mL. Intravenous administration of colistin with ceftazidime and rifampicin was started, with intrathecal colistin administration, based on the results of a Break-point Checkerboard examination, and resulted in effective infection control. Nosocomial infection by MRAB has become an emergent problem in many countries. In Japan, several outbreak accidents caused by MRAB have been reported so far. In this case, genetic analysis revealed that the pathogen had originated from a foreign country, and the prevalence of colistin-resistant pathogens has also increased in these countries. Besides adequate isolation precautions, strategies for post-neurosurgical SSI management and establishment of effective treatments are necessary against neurosurgical SSIs caused by colistin-resistant MRAB.


Assuntos
Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii , Abscesso Encefálico/microbiologia , Colistina/farmacologia , Infecção da Ferida Cirúrgica/microbiologia , Acinetobacter baumannii/efeitos dos fármacos , China , Farmacorresistência Bacteriana Múltipla , Humanos , Masculino , Pessoa de Meia-Idade , Viagem
9.
J Infect Chemother ; 18(1): 115-8, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21894453

RESUMO

Surgical site infection (SSI) is an emerging problem in all fields of surgery, as well as in neurosurgery, with numerous strategies against SSI initiated in many countries. In this report, we describe a case of SSI caused by Neisseria subflava a month after ventriculostomy placement for acute hydrocephalus. A 53-year old man was referred to our hospital, and was diagnosed with a thalamic hemorrhage with ventricular rupture. Bilateral ventriculostomies were performed on the day of presentation. After intensive care for the acute stage, an SSI at the left ventriculostomy site was recognized on the 39th hospital day. The installed reservoir and ventricular tube was removed on the 40th hospital day. The CSF cell count was 2064/3, and N. subflava was recovered from the CSF culture. N. subflava is a common inhabitant found in the human upper respiratory tract, and is reported to be a rare cause of meningitis. There is one case report of meningitis caused by N. subflava transmitted during myelography from medical staff who did not wear facemasks during the procedure. Meningitis caused by N. subflava is rare, and transmission via a medical procedure is extremely rare. Although reported to be only rarely pathogenic, we must recognize that N. subflava can indeed be pathogenic, and can in rare cases be the cause of postoperative meningitis.


Assuntos
Meningites Bacterianas/microbiologia , Neisseria/isolamento & purificação , Infecções por Neisseriaceae/microbiologia , Ventriculostomia/efeitos adversos , Encéfalo/patologia , Humanos , Masculino , Meningites Bacterianas/tratamento farmacológico , Meningites Bacterianas/patologia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Infecções por Neisseriaceae/tratamento farmacológico , Infecções por Neisseriaceae/patologia , Infecção da Ferida Cirúrgica/tratamento farmacológico , Infecção da Ferida Cirúrgica/microbiologia , Infecção da Ferida Cirúrgica/patologia
10.
Br J Neurosurg ; 26(1): 91-3, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21707240

RESUMO

Intracerebral metastasis in osteosarcoma is extremely rare. A 14-year-old girl who had previously been operated upon for osteosarcoma of the femur presented with seizures and left hemiparesis. A right parietal lesion with calcification and brain oedema was found. After resection of the mass, pathology revealed an osteosarcoma metastasis.


Assuntos
Neoplasias Encefálicas/secundário , Neoplasias Femorais , Osteossarcoma/secundário , Adolescente , Neoplasias Encefálicas/cirurgia , Feminino , Neoplasias Femorais/terapia , Humanos , Neoplasias Pulmonares/secundário , Regressão Neoplásica Espontânea , Osteossarcoma/cirurgia
11.
Obes Res Clin Pract ; 6(4): e263-346, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-24331593

RESUMO

BACKGROUND: Insulin resistance (IR) and visceral obesity are often observed in adult growth hormone deficiency patients (AGHDs). However, there is little information regarding the intrahepatic lipid (IHL) or the intramyocellular lipid (IMCL) content and their association with IR in AGHDs. The aim of this study was to directly assess IHL and IMCL in AGHDs by proton magnetic resonance spectroscopy and to evaluate the association of lipid levels with IR. METHODS: Appropriate hormone replacement therapy (RT) other than GH and estrogen was prescribed before evaluation. Ten AGHDs (aged 23-75 years) without diabetes or elevation of aminotransferases were examined the percent body fat, visceral fat area (VFA), IHL, IMCL, adipokines and glucose metabolism. In two AGHDs, changes of these parameters were evaluated after GHRT. RESULTS: Visceral obesity and metabolic syndrome was found in 100% and in 80% of the patients, respectively. IHL was significantly higher than that in non-obese healthy controls (12.5 ± 4.6 vs. 0.69 ± 0.46%, M ± SE, p = 0.0330), while IMCL did not differ between AGHDs and controls (528.8 ± 137.2 vs. 378 ± 51.1 mM, p = 0.2728). Homeostasis model assessment of IR was significantly correlated with IHL (r = 0.896, p = 0.0001) and IMCL (r = 0.749, p = 0.0102), but not with the VFA or percent truncal fat mass. A decrease of IHL and improvement of glucose tolerance were observed in the two patients after 6 M GHRT. CONCLUSION: These results demonstrated that IHL, but not IMCL, may increase in AGHDs, and that IHL may associate with IR. GHRT may decrease IHL along with amelioration of IR.

12.
Neurol Med Chir (Tokyo) ; 51(10): 707-10, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22027246

RESUMO

A 7-year-old boy presented with a longitudinal clival fracture following a traffic accident. The boy presented only with temporary unconsciousness despite suffering a fracture of the clivus. Fractures of the clivus are often caused by severe head trauma, and the mortality rate is high due to coexisting injury of the adjacent vessels, brain stem, and lower cranial nerves. Review of the radiological and clinical findings of longitudinal clival fractures found that all reported pediatric patients with longitudinal clival fracture, including the present case, suffered an occipital impact, whereas the majority of longitudinal clival fractures in adults occur following frontal or axial impact.


Assuntos
Acidentes de Trânsito , Lesões Encefálicas/patologia , Fossa Craniana Posterior/lesões , Fossa Craniana Posterior/patologia , Traumatismos Cranianos Fechados/patologia , Fratura da Base do Crânio/patologia , Lesões Encefálicas/diagnóstico por imagem , Lesões Encefálicas/fisiopatologia , Criança , Fossa Craniana Posterior/diagnóstico por imagem , Escala de Coma de Glasgow , Traumatismos Cranianos Fechados/diagnóstico por imagem , Traumatismos Cranianos Fechados/fisiopatologia , Humanos , Masculino , Radiografia , Recuperação de Função Fisiológica/fisiologia , Fratura da Base do Crânio/diagnóstico por imagem , Fratura da Base do Crânio/fisiopatologia , Hemorragia Subaracnoídea Traumática/diagnóstico por imagem , Hemorragia Subaracnoídea Traumática/patologia
13.
No Shinkei Geka ; 39(6): 607-10, 2011 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-21628741

RESUMO

A case of brain metastasis from peritoneal serous surface papillary carcinoma (SSPC) was reported. This 68-year-old woman was admitted to our department because of decreased consciousness level for the last few days. Her medical past history revealed breast cancer and SSPC of the peritoneum at the age of 64. On admission she was comatose and irritable. Serum and urine examination revealed the syndrome of inappropriate secretion of antidiuretic hormone that was treated with strict restriction of water intake. MRI of the brain demonstrated a nonspecific mass in the subcortical area of the right superior parietal lobule. The mass was successfully removed in en bloc fashion. Pathological diagnosis was SSPC that was compatible with the previous diagnosis obtained from the peritoneum four years previously. Although the patient received whole brain radiation therapy postoperatively, her condition deteriorated rapidly. She died four months after brain surgery. SSPC of the peritoneum is a rare malignant tumor that is defined as a primary tumor histologically indistinguishable from serous carcinoma of the ovary, diffusely involving the peritoneal surface but sparing or only superficially invading the ovaries. Because of the prolongation of survival resulting from advanced chemotherapy for SSPC of the peritoneum, more patients live long enough to develop brain metastasis. Therefore, SSPC of the peritoneum should be kept in mind in the differential diagnosis of a primary site for brain metastasis.


Assuntos
Neoplasias Encefálicas/secundário , Carcinoma Papilar/patologia , Neoplasias Peritoneais/patologia , Idoso , Neoplasias Encefálicas/diagnóstico , Feminino , Humanos , Imageamento por Ressonância Magnética
14.
Neurol Med Chir (Tokyo) ; 49(5): 193-7; discussion 197, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19465788

RESUMO

The efficacy of intravenous administration of 400 mg carboplatin/m(2) body surface area over 60 minutes combined with hyperbaric oxygenation (HBO) therapy (0.2 MPa for 60 min) was investigated in 6 Japanese patients (aged 36-67 years) with malignant or brainstem gliomas. Plasma ultra-filtrate samples were analyzed by high-performance liquid chromatography to evaluate the relationship between efficacy and pharmacokinetics. Brain tumor response was evaluated by magnetic resonance imaging as a function of maximum plasma concentration, area under the curve, or mean residence time (MRT) for carboplatin. The MRT for carboplatin in the complete or partial response group (mean +/- standard deviation 4.3 +/- 1.7 hrs; 6 courses in 3 patients) was significantly longer (p < 0.05) than that in the progressive disease group (2.4 +/- 0.1 hrs; 3 courses in 3 patients), but maximum plasma concentration and area under the curve showed no differences. These results suggest that HBO therapy prolongs the biological residence time of carboplatin. MRT for carboplatin may be useful for predicting continuation or modification of chemotherapy and/or clinical antitumor effects in patients with malignant gliomas.


Assuntos
Antineoplásicos Alquilantes/uso terapêutico , Neoplasias Encefálicas/terapia , Carboplatina/uso terapêutico , Glioblastoma/terapia , Oxigenoterapia Hiperbárica , Adulto , Idoso , Antineoplásicos Alquilantes/administração & dosagem , Antineoplásicos Alquilantes/farmacocinética , Astrocitoma/tratamento farmacológico , Astrocitoma/radioterapia , Astrocitoma/cirurgia , Astrocitoma/terapia , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/cirurgia , Neoplasias do Tronco Encefálico/tratamento farmacológico , Neoplasias do Tronco Encefálico/radioterapia , Neoplasias do Tronco Encefálico/cirurgia , Neoplasias do Tronco Encefálico/terapia , Carboplatina/administração & dosagem , Carboplatina/farmacocinética , Cromatografia Líquida de Alta Pressão , Terapia Combinada , Irradiação Craniana , Sinergismo Farmacológico , Feminino , Glioblastoma/tratamento farmacológico , Glioblastoma/radioterapia , Glioblastoma/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/terapia , Terapia de Salvação , Resultado do Tratamento
15.
No Shinkei Geka ; 36(11): 1011-6, 2008 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-19048920

RESUMO

BACKGROUND: Nocardia brain abscess is rare and has uncertain clinical features. Radiological differential diagnosis based on the metabolic feature of Nocardia is discussed. CASE DESCRIPTION: A 73-year-old man presented with a history of otitis media and was treated with antibiotics for 2 weeks. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated an irregular ring-enhancement mass in the left cerebellar hemisphere. This lesion presented as a homogeneous high-intensity area in diffusion-weighted MRI. We also found decreased N-acetyl-aspartate (NAA) peak and increased choline and lipid peaks in proton MR spectroscopy (1H-MRS). We performed an aspiration. Nocardia asiatica in the mass lesion was found by genetic analysis. The patient was treated with a sulfamethoxazole/trimethoprim (ST) mixture and minocycline (MINO) intravenously for 6 months. There has been no recurrence for 2 years. CONCLUSIONS: To our knowledge, this case is the first case of Nocardia asiatica brain abscess in Japan. We considered these MRS findings to be compatible with Nocardia brain abscess as mainly observed in aerobic metabolism. But we also detected a lactate peak in the abscess. Further research is required.


Assuntos
Abscesso Encefálico/diagnóstico , Nocardiose/diagnóstico , Idoso , Neoplasias Encefálicas/diagnóstico , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X
16.
Surg Neurol ; 68(2): 159-63, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17662349

RESUMO

BACKGROUND: Magnetic resonance-guided PLDD has been performed for patients with single-level contained focal disk herniation. We investigated the clinical results of our PLDD practice in reference to the site of the needle tip. METHODS: Thirty-two patients (24 male patients and 8 female patients; mean age, 35 years) who presented with low back pain and signs of monoradiculopathy underwent MR-guided PLDD. The final location of the needle tip was plotted on a T(1)-weighted axial plane of the targeted disk. An axial image of the targeted disk was divided into 4 quadrants in a cruciform fashion and into 3 zones in a concentric circle. The clinical results as evaluated by MacNab's criteria 6 months after PLDD were investigated in each subdivided area where the needle tip was located. RESULTS: The overall success rate of our PLDD practice was 68.8%. The success rate in the 27 patients who had the needle tip in the DL quadrant of the targeted disk was 70.4%. Among them, 14 patients who had the needle tip in the middle zone showed a favorable outcome (77.8%). CONCLUSIONS: The final location of the needle tip was demonstrated in all cases. Although our MR imaging study was not sufficient to determine the exact position of the needle tip because of MR image distortion, such error seems to be acceptable in the results of our study obtained from the relative positioning of the needle tip in the disk space. This study suggests that the middle zone in the DL quadrant of the targeted disk space seems to be a favorable target to obtain better clinical outcomes.


Assuntos
Descompressão Cirúrgica/métodos , Discotomia Percutânea/métodos , Deslocamento do Disco Intervertebral/cirurgia , Terapia a Laser/métodos , Vértebras Lombares , Cirurgia Assistida por Computador , Adolescente , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Deslocamento do Disco Intervertebral/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
17.
Drug Metab Pharmacokinet ; 21(5): 429-31, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17072097

RESUMO

A specific, sensitive and reproducible high-performance liquid chromatographic procedure was developed for the quantitative analysis of carboplatin in human plasma. Plasma was ultrafiltered with an Amicon Centrifree system and then injected onto an analytical NH2 column. Carboplatin was monitored at 230 nm and eluted by 10 min using acetonitrile/methanol/5 mM sodium perchlorate buffer (pH 2.4) (75:15:10, v/v) as a mobile phase. The method yielded intra-day and inter-day precision and accuracy of <6% with a linearly from 0.1 to 80 microg/mL and a recovery of >98%. Plasma concentrations of intravenously administered carboplatin in three patients could be determined by this system. Slightly higher plasma concentrations of carboplatin were detected even 30 min after hyperbaric oxygenation therapy for 60 min than expected. The results suggest that this method could be applicable for measurement of carboplatin in plasma samples to evaluate carboplatin therapy together with hyperbaric oxygenation.


Assuntos
Carboplatina/sangue , Cromatografia Líquida de Alta Pressão/métodos , Oxigenoterapia Hiperbárica/métodos , Idoso , Antineoplásicos/administração & dosagem , Antineoplásicos/química , Antineoplásicos/farmacocinética , Carboplatina/administração & dosagem , Carboplatina/química , Cromatografia Líquida de Alta Pressão/instrumentação , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Estrutura Molecular , Reprodutibilidade dos Testes , Fatores de Tempo , Ultrafiltração/métodos
18.
Neurobiol Dis ; 20(1): 38-48, 2005 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16137565

RESUMO

We induced neural cells by treating cynomolgus monkey embryonic stem (ES) cells with retinoic acid. The treated cells mainly expressed betaIIItubulin. They further differentiated into neurons expressing neurofilament middle chain (NFM) in elongated axons. Half of the cells differentiated into Islet1+ motoneurons in vitro. The monkey ES-derived neural cells were transplanted to hemiplegic mice with experimental brain injury mimicking stroke. The neural cells that had grafted into periventricular area of the mice distributed extensively over the injured cortex. Some of the transplanted cells expressed the neural stem/progenitor marker nestin 2 days after transplantation. The cells expressed markers characteristic of mature motoneurons 28 days after transplantation. Mice with the neural cell graft gradually recovered motor function, whereas control animals remained hemiplegic. This is the first demonstration that neural cells derived from nonhuman primate ES cells have the ability to restore motor function in an animal model of brain injury.


Assuntos
Dano Encefálico Crônico/terapia , Hemiplegia/terapia , Neurônios/transplante , Recuperação de Função Fisiológica/fisiologia , Transplante de Células-Tronco/métodos , Acidente Vascular Cerebral/terapia , Animais , Biomarcadores/metabolismo , Dano Encefálico Crônico/etiologia , Dano Encefálico Crônico/fisiopatologia , Diferenciação Celular/efeitos dos fármacos , Diferenciação Celular/fisiologia , Linhagem Celular , Movimento Celular/fisiologia , Infarto Cerebral/complicações , Infarto Cerebral/fisiopatologia , Infarto Cerebral/terapia , Modelos Animais de Doenças , Feminino , Sobrevivência de Enxerto/fisiologia , Hemiplegia/etiologia , Hemiplegia/fisiopatologia , Proteínas de Filamentos Intermediários/metabolismo , Macaca fascicularis , Camundongos , Camundongos Endogâmicos C57BL , Proteínas do Tecido Nervoso/genética , Proteínas do Tecido Nervoso/metabolismo , Nestina , Proteínas de Neurofilamentos/metabolismo , Neurônios/efeitos dos fármacos , Neurônios/fisiologia , Células-Tronco/efeitos dos fármacos , Células-Tronco/fisiologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/fisiopatologia , Resultado do Tratamento , Tretinoína/farmacologia
19.
Exp Brain Res ; 163(1): 86-99, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-15703886

RESUMO

We developed neural tube-like structures accompanying neural crest-like cells by treating embryonic stem (ES) cells with retinoic acid. The structures contained pseudostratified Nestin+Vimentin+ neuroepithelial cells surrounded by Masson staining+ basement membrane. betaIIItubulin+Synaptophysin+ mature neurons and glial fibrillary acidic protein (GFAP)+ glial cells dispersed outside of the membrane. Addition of Noggin to the culture induced prominent proliferation of the neuroepithelial cells, leading to epithelial hyperstratification of the structures. mRNAs of transcription factors essential for forebrain development such as Emx1/2 and Pax6 were specifically expressed and Islet1+Lim1/2- motoneurons appeared by the addition of Noggin. In contrast, basic fibroblast growth factor (bFGF) promoted enlargement of central lumen and elongation of the structures. mRNAs of caudal markers, Gbx2, Cdx2 and Hoxb4/9 were expressed and Lim1/2+ spinal motoneurons appeared by the addition of bFGF. Addition of BMP-4 similarly brought about mild enlargement of central lumen of the structures. Interestingly, the addition of BMP-4 induced Slug+ neural crest-like cells surrounding the tube-like structures. mRNAs of Snail and dHand, other markers for neural crest cells, were also expressed by the addition of BMP-4. These results suggest that Noggin lead the neural-tube like structures to forebrain fate, whereas bFGF was involved in the caudalization. BMP-4 was implicated in emergence of the neural crest-like cells. Differentiation of ES cells by the present methods may mimic neurulation and subsequent neural development of early embryos, and elucidates the opposite effects of Noggin and bFGF for the neural tube development.


Assuntos
Proteínas de Transporte/genética , Fator 2 de Crescimento de Fibroblastos/genética , Prosencéfalo/embriologia , Rombencéfalo/embriologia , Células-Tronco/fisiologia , Animais , Antineoplásicos/farmacologia , Proteína Morfogenética Óssea 4 , Proteínas Morfogenéticas Ósseas/farmacologia , Proteínas de Transporte/farmacologia , Linhagem da Célula/fisiologia , Células Cultivadas , Fator 2 de Crescimento de Fibroblastos/farmacologia , Regulação da Expressão Gênica no Desenvolvimento/efeitos dos fármacos , Regulação da Expressão Gênica no Desenvolvimento/fisiologia , Mesencéfalo/citologia , Mesencéfalo/embriologia , Mesencéfalo/fisiologia , Camundongos , Crista Neural/citologia , Crista Neural/embriologia , Crista Neural/fisiologia , Técnicas de Cultura de Órgãos , Prosencéfalo/citologia , Prosencéfalo/fisiologia , RNA Mensageiro/análise , Rombencéfalo/citologia , Rombencéfalo/fisiologia , Células-Tronco/citologia , Fatores de Transcrição/genética , Tretinoína/farmacologia
20.
No Shinkei Geka ; 32(6): 613-8, 2004 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-15352631

RESUMO

We reported a case of severe spasticity of the bilateral upper and lower limbs which was improved by cervical spinal cord stimulation (SCS). A 53-year-old man was suffering from sudden cardiopulmonary arrest while walking. After receiving cardiopulmonary resuscitation for 40 minutes, his cardiopulmonary function re-started, but he failed to regain consciousness. MRI revealed a hypoxic brain in his bilateral basal ganglia and occipital lobes. After 2 months, his consciousness advanced to a vegetative state and the muscle tone of his bilateral upper and lower limbs deteriorated to severe spasticity. SCS was performed in the expectation of improving his consciousness. Contrary to this anticipated result, his vegetative state continued but the severe spasticity of his upper and lower limbs improved during the SCS. Single photon emission computed tomography (SPECT) during the period of stimulation revealed a high blood flow, especially in the area of the basal ganglia, thalamus, brain stem and cerebellum, compared with off-stimulation blood flow. The neurophysiologic mechanisms of these abnormal fields and the underlying aberrant afferent nerve impulses from the posterior funiculus in the cervical cord to the cerebral sensory cortex, which may indeed be secondary to ischemic brain, may be regulated by SCS, also adding the effect of increased blood flow to the brain.


Assuntos
Terapia por Estimulação Elétrica , Hipóxia Encefálica/complicações , Espasticidade Muscular/terapia , Medula Espinal/fisiopatologia , Encéfalo/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Espasticidade Muscular/etiologia
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