[Chondroblastoma of the Temporal Bone Removed Using a Middle Cranial Fossa Approach].

We report a case of chondroblastoma of the middle cranial fossa, probably arising from the (infra) mandibular fossa, and expanding to the attic and external auditory canal that was successfully removed using a middle cranial fossa approach. No recurrences occurred during an 8-year postoperative follow-up period. Initial biopsy findings suggested a pathological diagnosis of giant cell tumor that was later confirmed to be a chondroblastoma based on an immunohistochemical study of S-100. This case study suggests a profound understanding of the clinical features, histopathological characteristics, and possible treatment. of chondroblastoma.

Safe and efficient drug delivery system with liposomes for intrathecal application of an antivasospastic drug, fasudil.

Pharmacological treatment for cerebral ischemia and cerebral vasospasm following subarachnoid hemorrhage (SAH) cannot attain sufficiently high concentrations of the drugs in the cerebrospinal fluid (CSF) without precipitating systemic side effects. We recently developed a liposomal drug delivery system for intrathecal application that can maintain effective concentrations of cerebral vasodilator, fasudil, in the CSF. A single intrathecal injection of liposomal fasudil could maintain a therapeutic drug concentration in the CSF over a period time due to their sustained-release property, significantly decreasing infarct size in a rat model of acute ischemia and reducing vasoconstriction of the rat and dog basilar artery in a model of SAH. In this review, we are introducing our new less-invasive intrathecal drug delivery system that provides an alternative and safe method to deliver therapeutic agents.

Three-dimensional computed tomographic angiography with low loads of contrast agent in acute subarachnoid hemorrhage.

In the pre-operative evaluation of aneurysmal subarachnoid hemorrhage (SAH), three-dimensional computed tomographic angiography (3D-CTA) is very helpful. However, it is usually difficult to perform 3D-CTA following four-vessel cerebral angiography in the setting of acute SAH because of high loads of contrast agent. The present report is designed to enable 3D-CTA following catheter angiography for surgical planning. Fourteen consecutive patients with acute SAH underwent four-vessel cerebral angiography. After identification of the aneurysm, all patients were moved to the CT room next to the angiography room under catheterization. Contrast agent (10 ml) was diluted with 40 ml of heparinized saline. This diluted contrast agent was then injected through intra-arterial catheter for 3D-CTA. 3D-CTA with diluted contrast agent which was injected through intra-arterial catheter revealed sufficiently clear images. In addition, this method could provide anatomical information that was not readily available from catheter angiography. 3D-CTA with additional low dose of contrast agent can immediately follow four-vessel cerebral angiography in the setting of acute SAH. No complications were noted throughout the procedures. It has been our experience that the imaging modality in combination with not only catheter angiography but also 3D-CTA is advantageous in case of acute SAH and provides better detail for surgical planning.

Encapsulation of an antivasospastic drug, fasudil, into liposomes, and in vitro stability of the fasudil-loaded liposomes.

The objectives of this work were to develop a liposomal fasudil, an antivasospastic drug, as a possible means to deliver the encapsulated drug to the brain, and to characterize the stability of the liposomal formulation in vitro. Transmembrane electrochemical gradients of H+ or ammonium sulfate were created, and their effect on the uptake of fasudil into preformed hydrogenated soy phosphatidylcholine/cholesterol (HSPC/CHOL) liposomes were examined. Fasudil was successfully loaded into preformed liposomes in response to sulfate ion (SO4(2-)) and, in part, by H+. Encapsulation levels approaching 100% could be achieved up to a drug to lipid ratio of 0.364 (mol/mol). A stability study of the fasudil-loaded liposomes was performed by storage at 4 degrees C in 4-(2-hydroxyethyl)-1-piperazineethanesulphonic acid (HEPES)-buffer (pH 7.4) and by incubation in human cerebrospinal fluid (CSF) at 37 degrees C. The formulations were stable with respect to drug retention as well as size alteration, for the period studied. A leakage study clearly showed the sustained release properties of the fasudil-loaded liposomes in human CSF. We recently reported that the intrathecal administration of liposomal fasudil significantly decreased ischemia, with no obvious adverse effect in a rat model [Neurol. Med. Chir. 41 (2001) 109]. Taken together, efficient encapsulation of fasudil into preformed liposomes, their long-term stability at 4 degrees C and the sustained release characteristics in CSF indicate that fasudil-loaded liposomes could be potential candidates for further clinical evaluation.