[The Efficacy of CT angiography using the IVR-CT/angio system for surgical treatment of spinal hemangioblastoma].

We performed 3D-CT angiography (3D-CTA) with contrast injection to a feeding artery through a selectively introduced catheter into the intercostal artery in a patient with spinal hemangioblastoma. It revealed a relative three-dimensional (3D) anatomy between a tumor body, feeding arteries, draining veins, and surrounding vertebrae with superior resolution to 3D-CTA with intravenous contrast injection. This observation was used for preoperative planning facilitating tumor removal, through reconstructed 3D fly-through animation providing intraoperative identification and obliteration of feeding arteries. This examination was carried out without difficulty by utilizing IVR-CT/angio system (IVR: interventional radiology) which combines angiographic and CT equipment with a single fluoroscopy table, because it does not require a room-to-room transfer of the patient with the catheter left cannulated. DSA detection for any spinal lesions, neoplastic or vascular ones, is always better assisted by 3D-CTA with the IVR-CT/angio system (IVR-CTA).

Ossifying choroid plexus papilloma recurring with features of atypical papilloma.

A case of ossifying choroid plexus papilloma (CPP) with an unusual clinical course is reported. The patient was a 46-year-old woman who underwent surgery for a 3-cm tumor occupying the fourth ventricle. The tumor showed typical histopathological features of CPP, and the formation of psammoma bodies and mature bone trabeculae was prominent in the stroma. The tumor recurred locally after a dormant period of 15 years, and the recurrent lesion showed invasion of the cerebellum as well as increased cellularity, cellular stratification, nuclear atypism, and mitotic activity, all of which were consistent with a diagnosis of "atypical" CPP. The recurrent tumor did not show ossification of the stroma, although many psammoma bodies were found. There have been very few reported cases of ossifying CPP, and all of the previous cases behaved in a benign fashion. The present case is the first report of ossifying CPP that showed postoperative recurrence with progression to atypical CPP after an unusually long dormant period.

Size-selective loosening of the blood-brain barrier in claudin-5-deficient mice.

Tight junctions are well-developed between adjacent endothelial cells of blood vessels in the central nervous system, and play a central role in establishing the blood-brain barrier (BBB). Claudin-5 is a major cell adhesion molecule of tight junctions in brain endothelial cells. To examine its possible involvement in the BBB, claudin-5-deficient mice were generated. In the brains of these mice, the development and morphology of blood vessels were not altered, showing no bleeding or edema. However, tracer experiments and magnetic resonance imaging revealed that in these mice, the BBB against small molecules (<800 D), but not larger molecules, was selectively affected. This unexpected finding (i.e., the size-selective loosening of the BBB) not only provides new insight into the basic molecular physiology of BBB but also opens a new way to deliver potential drugs across the BBB into the central nervous system.