Cervical spondylosis with thoracic level Brown-Séquard syndrome.

Brown-Sequard Syndrome (BSS) caused by cervical spondylosis (CS) is rare. About 70% of patients with CS presenting with BSS show lesion-dermatome discrepancy, which may be due to spinal cord lamination. From the clinical point of view, this discrepancy should be carefully evaluated and these patients should be treated as an emergency.

Normal pressure hydrocephalus after gamma knife radiosurgery for cerebellopontine angle meningioma.

There are no reports of hydrocephalus following radiosurgery for a meningioma. We report on a case where gamma knife therapy for a 4 cm diameter right cerebellopontine meningioma accelerated hydrocephalus three months post treatment. Examination of the cerebrospinal fluid (CSF) revealed a high protein level and thus, CSF malabsorption and CSF obstruction might have occurred after the radio surgery. It is important to consider this pathology, and the need for long term follow up.

Neuropsychologic function in chronic carotid obstructive disease.

OBJECTIVE: The goal of this study was to investigate the factors affecting neuropsychologic function in patients with high-grade stenosis or occlusion of the internal carotid (IC) artery system. PATIENTS AND METHODS: The study included 52 patients with over 70% stenosis or obstruction of the cervical IC artery or obstruction of the intracranial IC artery, whose physical ability had recovered to Rankin disability scale 2 or above. The mean duration from the last ischemic attack to assessment was 41 weeks. Neuropsychologic function was measured by Wechsler Adult Intelligence Scale (WAIS) in the 52 patients. The neuropsychologic function was analyzed concerning disease duration; side of carotid lesion; side, number, or size of cerebral infarction; and cerebral circulation. RESULTS: No significant difference in WAIS IQs of the patients was observed when the patients were stratified by side of cerebral infarction, side of carotid lesion, or duration from the last attack to WAIS assessment. The performance IQ was significantly higher in the group without infarction than in the group with single, small lesions, or the group with multiple or large lesions. The group with normal cerebral circulation had the highest mean full scale IQ, and the group showing misery perfusion showed the widest distribution of IQ values. The group showing matched low perfusion had a significantly lower full-scale IQ than the groups showing normal cerebral blood flow, and consisted of a large proportion of patients with prolonged duration from the last attack to WAIS assessment. CONCLUSION: Patients with IC stenosis or obstruction show various degrees of cerebral circulatory impairment. The neuropsychologic function in these patients is frequently impaired, which is probably caused by a prolonged impaired cerebral circulatory state in addition to ischemic lesions.

Heat-resistant flexible-film optical waveguides from fluorinated polyimides.

Heat-resistant flexible-film optical waveguides were fabricated from fluorinated polyimides. These waveguides operated in single mode and had low optical loss (0.3 dB/cm) at a wavelength of 1.3 microm for TE and TM polarizations. They also had good flexibility: The optical loss did not significantly change above a minimum radius of curvature of less than 20 mm. The birefringence of 9 x 10(-5) between the TE and TM polarizations is 2 orders of magnitude smaller than that for a waveguide upon a substrate. Moreover, these waveguides had high thermal stability and moisture resistance: The optical loss and single-mode behavior changed little after heating the waveguides at 420 degrees C for 1 h or after their exposure to 85% relative humidity at 85 degrees C for more than 350 h.

Facial spasm and paroxysmal tinnitus associated with an arachnoid cyst of the cerebellopontine angle--case report.

A 59-year-old female presented with a 3-year history of hemifacial spasm and paroxysmal tinnitus associated with an arachnoid cyst of the cerebellopontine angle, which was identified preoperatively by magnetic resonance imaging. Surgical decompression of the cyst and arterial decompression of the facial and acoustic nerves at their root exit zones resulted in complete resolution of the symptoms.

Single-mode optical waveguides fabricated from fluorinated polyimides.

Buried channel optical waveguides were fabricated from fluorinated polyimides. They operated in single mode and showed an optical loss of less than 0.3 and 0.7 dB/cm for TE and TM polarizations, respectively, at a wavelength of 1.3 mum. Moreover, these waveguides had high heat and moisture resistance; the optical loss did not significantly change after heating at 380 degrees C for 1 h or after exposure to 85% relative humidity at 85 degrees C for over 200 h.

[Usefulness and limitations of 99mTc-MIBI scintigraphy for detection of parathyroid lesions].

To evaluate the usefulness of MIBI scintigraphy (MIBI) for parathyroid lesions, the detectability of lesions by MIBI was compared with that by Tl-Tc subtraction imaging, ultrasonography, CT and MRI in 56 histologically proved lesions. In neck lesions, ultrasonography (92%) and MIBI (85%) showed better detectability than those by the other three modalities. With MIBI, detectability was decreased for smaller parathyroid lesions that coexisted with thyroid disease. Among the five modalities, MIBI showed the highest detectability (88%) for ectopic or metastatic lesions. The smallest parathyroid lesions detected by MIBI were a parathyroid adenoma weighing 220mg and a parathyroid hyperplasia weighing 200mg. MIBI was thought to be more valuable for ectopic or metastatic parathyroid lesions.

Concentration of vascular endothelial growth factor in the serum and tumor tissue of brain tumor patients.

Vascular endothelial growth factor (VEGF) has been investigated as a potent mediator of brain tumor angiogenesis, vascular permeability, and glioma growth. Using a VEGF ELISA, we determined the concentration of VEGF in the sera and tumor extracts of 19 brain tumor patients including glioblastoma, anaplastic astrocytoma, low grade astrocytoma, meningioma, malignant lymphoma, and metastatic brain tumor as well as normal brain. Although VEGF concentration of the serum was not correlated with that of the tissue, VEGF concentrations of glioblastoma cyst fluid were 200-300-fold higher than those of serum in the patients. VEGF concentration in the tumors was significantly correlated with the vascularity measured by counting vessels stained with von Willebrand factor antibody. VEGF protein localized to the cytoplasm of tumor cells and vasculature in gliomas, predominantly in the peripheral microvessel "hot spots" as well as around the necrosis in glioblastomas. VEGF immunopositivities were well reflected with VEGF concentration determined by ELISA. VEGF ELISA demonstrated time-dependent increase of the VEGF concentration in the serum-free conditioned medium of various glioma cell lines. The conditioned medium with high VEGF concentration induced endothelial cell migration. These observations suggest that VEGF represents a useful marker and measurable element of glioblastoma angiogenesis. The measurement of VEGF concentration by ELISA in tumor and tumor cyst fluid may allow for the assessment of vascularity in gliomas.

Low grade astrocytoma in the medial part of the frontal lobe manifesting as paroxysmal speech disturbance--case report.

A right-handed 48-year-old female had clustered groups of seizures characterized by speech disturbance (attacks of verbal repetition and speech arrest) over a period of 7 years. Later, speech arrest was accompanied by perioral focal seizures. Magnetic resonance imaging and surgery found a low grade astrocytoma, centered in the left supplementary motor area. Postoperatively, no seizures or speech disturbances occurred for 3 years. This case confirms the main function of the supplementary motor area of the dominant hemisphere is connected with the initiation of speech and the setting into motion of the mechanism of speech.

[99mTc-MIBI scintigraphy for the detection of parathyroid lesions in patients with hyperparathyroidism].

The usefulness of 99mTc-MIBI scintigraphy for the detection of parathyroid lesions was evaluated in 17 patients with hyperparathyroidism. Delayed image was used to evaluate the lesions. Detectability of MIBI for parathyroid lesions was 86% (18/21). The smallest lesion detected was parathyroid hyperplasia weighted 270 mg. Ectopic parathyroid adenoma and bone metastases of parathyroid carcinoma were clearly demonstrated. Detectability of MIBI scintigraphy for the lesions including ectopic and metastatic lesions was the highest among those of ultrasonography, CT and MRI methods. MIBI scintigraphy was thought to be useful for the detection of parathyroid lesions, especially for ectopic and metastatic lesions.