Endoscopic combined "transseptal/transnasal" approach for pituitary adenoma: reconstruction of skull base using pedicled nasoseptal flap in 91 consecutive cases O acesso endoscópico transeptal/transnasal em cirurgias de resseção de adenoma de hipófise: reconstrução da base do crânio combinado com...more
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BACKGROUND Spontaneous regression in intracranial germ cell tumors has been reported in some literatures, but the mechanism has not been well known. We retrospectively measured the tumor volume before chemoradiotherapy and analyzed... more
BACKGROUND Spontaneous regression in intracranial germ cell tumors has been reported in some literatures, but the mechanism has not been well known. We retrospectively measured the tumor volume before chemoradiotherapy and analyzed factors that influence reduction of tumor volume. PATIENTS AND METHODS Plural MRI scans were done before the first course of chemotherapy regimen in 27 patients with primary intracranial germinomas. Their age ranged from 8 to 31 years. 35 lesions from them were enrolled and included 13 pineal, 4 neurohypophyseal, 4 basal ganglia, 4 bifocal type, and 2 multiple lesions. All regions were verified as pure germinoma or HCG-producing germinoma by histopathological examination. Tumor volume of 35 lesions was analyzed by volumetric assessment based on MRI. Ratio of volumetric change between the first MRI and the scan immediately before chemotherapy was defined as shrinking rate (%). Period between disease onset and the first chemotherapy was 20 to 47 days. Diagn...
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Identification of genotypes is crucial for treatment of glioma. Here, we developed a method to predict tumor genotypes using a pretrained convolutional neural network (CNN) from magnetic resonance (MR) images and compared the accuracy to... more
Identification of genotypes is crucial for treatment of glioma. Here, we developed a method to predict tumor genotypes using a pretrained convolutional neural network (CNN) from magnetic resonance (MR) images and compared the accuracy to that of a diagnosis based on conventional radiomic features and patient age. Multisite preoperative MR images of 164 patients with grade II/III glioma were grouped by IDH and TERT promoter (pTERT) mutations as follows: (1) IDH wild type, (2) IDH and pTERT co-mutations, (3) IDH mutant and pTERT wild type. We applied a CNN (AlexNet) to four types of MR sequence and obtained the CNN texture features to classify the groups with a linear support vector machine. The classification was also performed using conventional radiomic features and/or patient age. Using all features, we succeeded in classifying patients with an accuracy of 63.1%, which was significantly higher than the accuracy obtained from using either the radiomic features or patient age alone....
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Treatment planning and lesion-follow up are generally conducted by contrast-enhanced MRI in glioma patient care. On the other hand, there are, however, substantial concerns whether MRI actually reflects the extension or activity of this... more
Treatment planning and lesion-follow up are generally conducted by contrast-enhanced MRI in glioma patient care. On the other hand, there are, however, substantial concerns whether MRI actually reflects the extension or activity of this neoplasm, which information should be fundamentally important at every step when treating this disease. As a matter of fact, the authors of this investigation have already shown that there is no difference in tumor cell density within areas with and without contrast enhancement (J Neurosurg. 2016,125(5):1136–1142.) and furthermore that the geometry of MRI based-radiation treatment planning is significantly altered when methionine PET is integrated for this purpose (J Neurosurg. 2018 published on-line). Regardless of these concerns, there is great interest in the research community to construct a machine learning based fully automated brain tumor segmentation tool specific for gliomas using MRI. The authors attempted to validate this method by compari...
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Molecular biological characterization of tumors has become a pivotal procedure for glioma patient care. The aim of this study is to build conventional MRI-based radiomics model to predict genetic alterations within grade II/III gliomas... more
Molecular biological characterization of tumors has become a pivotal procedure for glioma patient care. The aim of this study is to build conventional MRI-based radiomics model to predict genetic alterations within grade II/III gliomas attempting to implement lesion location information in the model to improve diagnostic accuracy. One-hundred and ninety-nine grade II/III gliomas patients were enrolled. Three molecular subtypes were identified: IDH1/2-mutant, IDH1/2-mutant with TERT promoter mutation, and IDH-wild type. A total of 109 radiomics features from 169 MRI datasets and location information from 199 datasets were extracted. Prediction modeling for genetic alteration was trained via LASSO regression for 111 datasets and validated by the remaining 58 datasets. IDH mutation was detected with an accuracy of 0.82 for the training set and 0.83 for the validation set without lesion location information. Diagnostic accuracy improved to 0.85 for the training set and 0.87 for the vali...
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OBJECTIVEIn the present study the authors aimed to determine preferred locations of meningiomas by avoiding descriptive analysis and instead using voxel-based lesion mapping and 3D image-rendering techniques.METHODSMagnetic resonance... more
OBJECTIVEIn the present study the authors aimed to determine preferred locations of meningiomas by avoiding descriptive analysis and instead using voxel-based lesion mapping and 3D image-rendering techniques.METHODSMagnetic resonance images obtained in 248 treatment-naïve meningioma patients with 260 lesions were retrospectively and consecutively collected. All images were registered to a 1-mm isotropic, high-resolution, T1-weighted brain atlas provided by the Montreal Neurological Institute (the MNI152), and a lesion frequency map was created, followed by 3D volume rendering to visualize the preferred locations of meningiomas in 3D.RESULTSThe 3D lesion frequency map clearly showed that skull base structures such as parasellar, sphenoid wing, and petroclival regions were commonly affected by the tumor. The middle one-third of the superior sagittal sinus was most commonly affected in parasagittal tumors. Substantial lesion accumulation was observed around the leptomeninges covering t...
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OBJECTIVE Diffuse astrocytomas (DAs) have a high recurrence rate due to diffuse infiltration into the brain and spinal cord. Micro RNAs (miRNAs) are small noncoding RNAs that regulate gene expression by binding to complementary sequences... more
OBJECTIVE Diffuse astrocytomas (DAs) have a high recurrence rate due to diffuse infiltration into the brain and spinal cord. Micro RNAs (miRNAs) are small noncoding RNAs that regulate gene expression by binding to complementary sequences of target messenger RNA (mRNA). It has been reported that miRNA-22 (miR-22) is involved in the invasion of some cancer cell lines. The aim of this study was to identify the biological effects of miR-22 in regard to the invasion of human DAs. METHODS The authors evaluated whether the level of miR-22 is elevated in human spinal DAs by using miRNA chips. Next, the role of miR-22 in 1321N1 human astrocytoma cells was investigated. Finally, to elucidate whether miR-22 promotes invasion by astrocytoma cells in vivo, the authors transplanted miR-22 overexpressed astrocytoma cells into mouse thoracic spinal cord. RESULTS The miR-22 significantly upregulated the invasion capacity of 1321N1 cells. Computational in silico analysis predicted that tissue inhibit...
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Reports have suggested that tumor textures presented on T2-weighted images correlate with the genetic status of glioma. Therefore, development of an image analyzing framework that is capable of objective and high throughput image texture... more
Reports have suggested that tumor textures presented on T2-weighted images correlate with the genetic status of glioma. Therefore, development of an image analyzing framework that is capable of objective and high throughput image texture analysis for large scale image data collection is needed. The current study aimed to address the development of such a framework by introducing two novel parameters for image textures on T2-weighted images, i.e., Shannon entropy and Prewitt filtering. Twenty-two WHO grade 2 and 28 grade 3 glioma patients were collected whose pre-surgical MRI and IDH1 mutation status were available. Heterogeneous lesions showed statistically higher Shannon entropy than homogenous lesions (p = 0.006) and ROC curve analysis proved that Shannon entropy on T2WI was a reliable indicator for discrimination of homogenous and heterogeneous lesions (p = 0.015, AUC = 0.73). Lesions with well-defined borders exhibited statistically higher Edge mean and Edge median values using ...
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OBJECTIVE Diffusion MRI is attracting increasing interest for tissue characterization of gliomas, especially after the introduction of antiangiogenic therapy to treat malignant gliomas. The goal of the current study is to elucidate the... more
OBJECTIVE Diffusion MRI is attracting increasing interest for tissue characterization of gliomas, especially after the introduction of antiangiogenic therapy to treat malignant gliomas. The goal of the current study is to elucidate the actual magnitude of the correlation between diffusion MRI and cell density within the tissue. The obtained results were further extended and compared with metabolic imaging with 11C-methionine (MET) PET. METHODS Ninety-eight tissue samples from 37 patients were stereotactically obtained via an intraoperative neuronavigation system. Diffusion tensor imaging (DTI) and MET PET were performed as routine presurgical imaging studies for these patients. DTI was converted into fractional anisotropy (FA) and apparent diffusion coefficient (ADC) maps, and MET PET images were registered to Gd-administered T1-weighted images that were used for navigation. Metrics of FA, ADC, and tumor-to-normal tissue ratio of MET PET along with relative values of FA (rFA) and AD...
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Research Interests: Medicine, Endoscopy, Humans, Female, Male, and 15 moreMiddle Aged, Adult, Interdisciplinary Communication, Sphenoid sinus, Adenoma, Nose, Cooperative Behavior, Deviated Nasal Septum, Postoperative care, Pituitary Neoplasms, Nasal septum, Septoplasty, Nostril, Cerebrospinal Fluid Leak Repair, and Surgical Flaps
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Background. The pathophysiology of traumatic brain swelling remains little understood. An improved understanding of intracranial circulatory process related to brain herniation may have treatment implications.Objective. To investigate the... more
Background. The pathophysiology of traumatic brain swelling remains little understood. An improved understanding of intracranial circulatory process related to brain herniation may have treatment implications.Objective. To investigate the cerebral hemodynamic changes associated with brain herniation syndrome due to traumatic brain swelling.Methods. Nineteen head-injured patients with evidence of refractory intracranial hypertension and transtentorial herniation were prospectively studied. Cerebral hemodynamic assessment by transcranial Doppler (TCD) ultrasonography was performed prior to decompressive craniectomy. Patients and their cerebral hemispheres were classified according to TCD-hemodynamic patterns, and the data correlated with neurological status, midline shift on CT scan, and Glasgow outcome scale scores at 6 months after injury.Results. A wide variety of cerebral hemodynamic findings were observed. Ten patients (52.7%) presented with cerebral oligoemia, 3 patients (15.8%)...
Research Interests: Technology, Traumatic Brain Injury, Adolescent, Medicine, Biological Sciences, and 15 moreBrain, Humans, Hemodynamics, Female, Male, Biomed, Middle Aged, Adult, Intracranial Hypertension, ENCEPHALOCELE, Intracranial Pressure, Brain Edema, Brain Herniation, Decompressive Craniectomy, and Brain injuries
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Diffuse villous hyperplasia of the choroid plexus (DVHCP) that causes hydrocephalus by overproduction of cerebrospinal fluid is a very rare lesion and difficult to diagnose initially. We present a male infant who was diagnosed with... more
Diffuse villous hyperplasia of the choroid plexus (DVHCP) that causes hydrocephalus by overproduction of cerebrospinal fluid is a very rare lesion and difficult to diagnose initially. We present a male infant who was diagnosed with communicating hydrocephalus at 16 months of age and treated initially by ventriculoperitoneal shunt. In the postoperative course, he developed massive ascites. Magnetic resonance imaging obtained after the operation revealed DVHCP. Resection of the choroid plexus of the left lateral ventricle was performed, and postoperatively, his ascites was resolved. We review the literature and discuss the diagnosis and treatment of this rare entity.
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Research Interests: Traumatic Brain Injury, Microcirculation, Medicine, Brain, Humans, and 13 moreClinical Sciences, Microdialysis, Homeostasis, Oxygen, Cerebral edema, Cerebral Blood Flow, Brain Chemistry, Neurosciences, Intracranial Pressure, Brain Edema, Decompressive Craniectomy, Neurosurgical, and Cerebral perfusion pressure
Research Interests: Chemistry, Stem Cells, Flow Cytometry, Biology, Cancer Research, and 15 moreMedicine, Humans, Mutation, Mice, Glioblastoma, Animals, Cell, Male, Neoplasm Invasiveness, Cell Proliferation, Neurosciences, Brain Neoplasms, Neoplasm grading, real time polymerase chain reaction, and reverse transcriptase polymerase chain reaction
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Object The precise natural history of incidentally discovered meningiomas (IDMs) remains unknown. It has been reported that for symptomatic meningiomas, tumor location can be used to predict growth. As to whether the same is true for IDMs... more
Object The precise natural history of incidentally discovered meningiomas (IDMs) remains unknown. It has been reported that for symptomatic meningiomas, tumor location can be used to predict growth. As to whether the same is true for IDMs has not been reported. This study aims to answer this question and provide biological evidence for this assumption by extending the study to involve symptomatic cases. Methods A total of 113 IDMs were analyzed by fine volumetry. A comparison of growth rates and patterns between skull base and non–skull base IDMs was made. Subsequently, materials obtained from 210 patients with symptomatic meningiomas who were treated in the authors' hospital during the same period were included for a biological comparison between skull base and non–skull base tumors using the MIB-1 index. Results The 110 patients with IDMs included 93 females and 17 males, with a mean follow-up period of 46.9 months. There were 38 skull base (34%) and 75 non–skull base (66%) me...
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Three-dimensional (3-D) stereoscopic vision is theoretically superior to two-dimensional (2-D) vision in endoscopic endonasal surgery. However, only few reports have quantitatively compared endoscopic performance under the two visual... more
Three-dimensional (3-D) stereoscopic vision is theoretically superior to two-dimensional (2-D) vision in endoscopic endonasal surgery. However, only few reports have quantitatively compared endoscopic performance under the two visual conditions. We introduced a newly designed stereoendoscopic system with a "dual-lens and single camera" for endoscopic endonasal surgery and objectively compared the performances under 3-D and high-definition 2-D visualizations on a dry laboratory model. Thirty subjects without experience performing endoscopic surgery, computer-simulated training or any 3-D video system were recruited and divided into two groups (Group A and Group B) for performing two different tasks. The novel 4.7-mm-diameter stereoendoscope provided high-definition (HD) images. In Task 1, Group A started the task under the 3-D condition followed by the 2-D condition, and Group B vice versa. In Task 2, Group A started the task under the 2-D condition followed by the 3-D condition, and Group B vice versa. The performance accuracy and speed under the two visual conditions were analyzed. Significant improvement in performance accuracy and speed was seen under 3-D conditions in the both "3-D first" and "2-D first" subgroups during both tasks (P < .001). Regardless of order, the inaccuracy rate and performance time under 3-D conditions was significantly lower than that under 2-D conditions in each subject. We demonstrated the advantage of 3-D visualization over 2-D visualization for inexperienced subjects. Further quantitative clinical studies are required to confirm whether stereoendoscopy actually provides benefits in clinical settings.
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Objective The purpose of this study was to describe the endoscopic combined "transseptal/transnasal" approach with a pedicled nasoseptal flap for pituitary adenoma and skull base reconstruction, especially with respect to... more
Objective The purpose of this study was to describe the endoscopic combined "transseptal/transnasal" approach with a pedicled nasoseptal flap for pituitary adenoma and skull base reconstruction, especially with respect to cerebrospinal fluid (CSF) fistula.Method Ninety-one consecutive patients with pituitary adenomas were retrospectively reviewed. All patients underwent the endoscopic combined "transseptal/transnasal" approach by the single team including the otorhinolaryngologists and neurosurgeons. Postoperative complications related to the flap were analyzed.Results Intra- and postoperative CSF fistulae were observed in 36 (40%) and 4 (4.4%) patients, respectively. Among the 4 patients, lumbar drainage and bed rest healed the CSF fistula in 3 patients and reoperation for revision was necessary in one patient. Other flap-related complications included nasal bleeding in 3 patients (3.3%).Conclusion The endoscopic combined "transseptal/transnasal" appro...
Research Interests: Cognitive Science, Fistula, Humans, Female, Male, and 15 moreSkull Base, Risk factors, Clinical Sciences, Aged, Middle Aged, Adult, Nasal cavity, Retrospective Studies, Reproducibility of Results, Risk Factors, Adenoma, Pituitary Neoplasms, Postoperative Complications, Nasal septum, and Reconstructive Surgical Procedures
Rathke's cleft cyst (RCC) apoplexy is a rare clinical entity. We report a case of apoplexy of an RCC followed by cerebral infarction. A 67-year-old woman was found lying on the street unconscious. She had fallen from her motorbike. On... more
Rathke's cleft cyst (RCC) apoplexy is a rare clinical entity. We report a case of apoplexy of an RCC followed by cerebral infarction. A 67-year-old woman was found lying on the street unconscious. She had fallen from her motorbike. On referral to our hospital she gradually regained consciousness and presented with no neurological deficits. CT showed a round and slightly hyperdense area in the suprasellar region. However, the attending physician did not find this abnormal finding on CT and the patient was discharged the same day. Thirteen days after the first emergency visit she developed left hemiparesis and dysarthria. CT showed a round hypodense area in the suprasellar region. The change of the density in the suprasellar region on CT suggested the pituitary apoplexy. CT also showed a low density area in the territory of the right middle cerebral artery, which indicated the cerebral infarction. MR angiography revealed poor visibility and stenotic changes of right middle cerebra...
We describe a practical technique of superior turbinectomy followed by posterior ethmoidectomy as a less invasive procedure for two-surgeon technique on endoscopic endonasal transsphenoidal surgery. After identification of the superior... more
We describe a practical technique of superior turbinectomy followed by posterior ethmoidectomy as a less invasive procedure for two-surgeon technique on endoscopic endonasal transsphenoidal surgery. After identification of the superior turbinate and the sphenoid ostium, the inferior third portion of the superior turbinate was coagulated and resected. This partial superior turbinectomy procedure exposed the posterior ethmoidal sinus. Resection of the bony walls between the sphenoid and posterior ethmoid sinuses provided more lateral and superior exposure of the sphenoid sinus. This technique was performed in 56 patients with midline skull base lesions, including 49 pituitary adenomas and 7 other lesions. Meticulous manipulation of instruments was performed in all cases without surgical complications such as permanent hyposmia/anosmia or nasal bleeding. Our findings suggested that the partial superior turbinectomy followed by retrograde posterior ethmoidectomy is a simple and safe tec...
Although craniopharyngiomas have a histologically benign nature, their treatment can be difficult. The correlation among clinical, proliferative, and immunohistologic features of female sex hormone receptors was determined in... more
Although craniopharyngiomas have a histologically benign nature, their treatment can be difficult. The correlation among clinical, proliferative, and immunohistologic features of female sex hormone receptors was determined in craniopharyngiomas to analyze whether they influence the growth of the tumor. The study subjects were 43 patients with previously untreated craniopharyngioma who underwent surgery at our department over the past 15 years. Serial tissue sections were immunostained with the antibodies against estrogen receptor (ER), progesterone receptor (PR), and Ki-67. The Ki-67 labeling index was significantly higher in patients with regrowth (7.8%) than without regrowth (3.9%). ER and PR were detected in 9 of 30 (30%) craniopharyngiomas, and the incidence of postoperative tumor regrowth was significantly higher in patients negative for ER and PR (29%) than in those positive for both receptors (11%). A high Ki-67 labeling index suggests a high possibility of tumor regrowth, an...
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We report here a 74-year-old woman with a skull metastasis from papillary thyroid carcinoma (PTC). In her medical history, she was diagnosed with neurofibromatosis type 1 (NF1) at age 28 years, and she underwent thyroidectomy for PTC at... more
We report here a 74-year-old woman with a skull metastasis from papillary thyroid carcinoma (PTC). In her medical history, she was diagnosed with neurofibromatosis type 1 (NF1) at age 28 years, and she underwent thyroidectomy for PTC at age 52 years and adrenectomy for pheochromocytoma (PC) at age 58 years. She was admitted to our hospital with an increased mass in the forehead. Head computed tomography (CT) showed an expansive, osteolytic, and solid tumor extending from the dura mater into the subcutis, destroying part of the frontal bone. Head magnetic resonance imaging (MRI) revealed that the tumor was chiefly extradural but partially invaded the dura mater. Cerebral angiography showed that the tumor was fed from a branch of the external carotid artery. She underwent surgery, and histological examination revealed that the skull tumor was a metastasis from PTC, indicating that skull metastasis occurred 23 years after curative surgery for PTC. The patient also underwent adjuvant ra...
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A novel technique was developed to detect coil migration to the stent interior using mask images of rotational angiography. Stent-assisted coil embolization under x-ray fluoroscopy control was simulated with a hand-made vessel model. The... more
A novel technique was developed to detect coil migration to the stent interior using mask images of rotational angiography. Stent-assisted coil embolization under x-ray fluoroscopy control was simulated with a hand-made vessel model. The stent interior was observed with a rigid endoscope during coil embolization. After insertion of the coil, mask images using rotational angiography were acquired and multi-planar reformation (MPR) images were reconstructed on a workstation. The stent interior could be observed during coil embolization. Longitudinal MPR images showed the positional relationships between the stent, coil, and tip of the microcatheter. This technique was successfully employed in a patient to detect displacement of the tip of the microcatheter inside the stent. This technique is useful for monitoring stent-assisted coil embolization of an ultra-wide necked aneurysm, but requires extra time and increased radiation exposure, so we recommend use only if coil migration is str...
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A 59-year-old woman presented with subarachnoid hemorrhage. Conventional angiography and three-dimensional computed tomography (3-D CT) angiography showed a saccular aneurysm at the junction of the azygos anterior cerebral artery (ACA)... more
A 59-year-old woman presented with subarachnoid hemorrhage. Conventional angiography and three-dimensional computed tomography (3-D CT) angiography showed a saccular aneurysm at the junction of the azygos anterior cerebral artery (ACA) and the left A1 segment. This aneurysm was associated with a fenestration of the right hypoplastic A1 segment. The aneurysm neck was completely clipped, preserving the azygos ACA and other perforators. Aneurysm of the azygos ACA is almost always located at the distal bifurcation, and rarely at the proximal end. Proximal azygos ACA aneurysm can mimic anterior communicating artery aneurysm. Therefore, accurate preoperative diagnosis is critical using 3-D CT angiography as well as conventional angiography, and close follow up of patient is necessary to monitor for development of a de novo aneurysm at the distal bifurcation of the azygos ACA.
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Cystic meningiomas are radiologically difficult to differentiate from malignant brain tumors, particularly when the tumors are intraparenchymally located. In such cases, a surgical strategy relies on intraoperative histological diagnosis.... more
Cystic meningiomas are radiologically difficult to differentiate from malignant brain tumors, particularly when the tumors are intraparenchymally located. In such cases, a surgical strategy relies on intraoperative histological diagnosis. A 60-year-old man had a tumor with multiple cysts in the left parietal lobe that was diagnosed radiologically as malignant glioma. In operative findings, there was no dural attachment of the tumor, and the border between the tumor and normal brain tissue was unclear. Intraoperative histological examination supported the diagnosis of malignant glioma based on a high cellularity and an existence of a multinuclear giant cell in the tumor tissue. We finished the surgery with partial tumor resection; however, postoperative histological diagnosis of the tumor was a typical meningothelial meningioma showing characteristic whorl formations, and in conclusion, a definite diagnosis of the tumor was an intraparenchymal cystic meningioma. In further histological investigations, the tumor tissue around cysts exhibited significantly different features from meningothelial meningioma, demonstrating small lymphocytes and histiocytes with a large nucleus, which resembled intraoperative histological findings. We deliberated that the removal of the tumor tissue from the degenerated portion for intraoperative histological examination might lead to the misdiagnosis of malignant glioma. Operative strategy is strongly influenced by intraoperative histological diagnosis. Therefore, surgeons are obliged to facilitate more precise intraoperative histological examinations by obtaining sufficient tissue from different parts of the tumor.
Research Interests: Magnetic Resonance Imaging, Operations Strategy, Immunohistochemistry, Brain Tumor, Humans, and 13 moreGlioma, Male, Differential Diagnosis, Meningioma, Middle Aged, Thallium, Parietal Lobe, Degeneration, Glial Fibrillary Acidic Protein, Malignant Glioma, Mitotic Index, Brain Neoplasms, and Cerebral Angiography
GM3, the simplest ganglioside, modulates cell adhesion, proliferation and differentiation in the central nervous system and exogenously added GM3 regulates cell-cell and cell-extracellular matrix adhesion and induces apoptosis. To assess... more
GM3, the simplest ganglioside, modulates cell adhesion, proliferation and differentiation in the central nervous system and exogenously added GM3 regulates cell-cell and cell-extracellular matrix adhesion and induces apoptosis. To assess the anti-tumor action of exogenous GM3, we examined its effect on the proliferation and invasion of glioma cells. Its inhibitory effect on cell proliferation was demonstrated in vitro by 3-(4,5-dimethyl-2-thiazol-2-yl) 2,5-diphenyltetrazolium bromide (MTT) assay and in vitro in rats with meningeal gliomatosis whose survival was significantly prolonged by the intrathecal injection of GM3. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL) assay revealed that GM3 induced glioma cell apoptosis in vitro and in vitro. In rat brain slice cultures, GM3 suppressed the invasion of glioma cells; this effect manifested earlier than the inhibition of cell proliferation and before apoptosis induction. Our results suggest exogenous GM3 as a potential therapeutic agent in patients with glioma requiring adjuvant therapy.
Research Interests: Cell Adhesion, Apoptosis, Extracellular Matrix, Brain, Neuro-Oncology, and 14 moreHumans, Glioma, Animals, Neuro, Central Nervous System, Rat Brain, Neoplasm Invasiveness, Rats, Cell Proliferation, ADJUVANT THERAPY, Neurosciences, Brain Neoplasms, Terminal Deoxynucleotidyl Transferase, and MTT assay
Microfibrillar collagen hemostat (MCH) is accepted as an effective topical hemostatic agent during endoscopic endonasal transsphenoidal surgery (EETS), particularly to achieve venous hemostasis; however, handling MCH may be troublesome... more
Microfibrillar collagen hemostat (MCH) is accepted as an effective topical hemostatic agent during endoscopic endonasal transsphenoidal surgery (EETS), particularly to achieve venous hemostasis; however, handling MCH may be troublesome because of its adherence to gloves and instruments. We describe here a method of "injection" of MCH suspension using a syringe applicator. This technique allows a rapid and precise delivery of MCH to the bleeding points and thereby results in effective hemostasis; in addition, it is easy to prepare and it is also inexpensive.
We report a 69-year-old woman with a meningioma who presented with a 9-month history of progressive facial numbness in the distribution of the left mandibular nerve and left facial palsy. Magnetic resonance imaging revealed a mass in and... more
We report a 69-year-old woman with a meningioma who presented with a 9-month history of progressive facial numbness in the distribution of the left mandibular nerve and left facial palsy. Magnetic resonance imaging revealed a mass in and around the left Meckel's cave (MC). The tumor was totally resected through a lateral suboccipital and subtemporal combined approach. It appeared to
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Meningioma is one of the most common brain tumors, and a variety of genetic abnormalities have been detected by the Southern blotting, polymerase chain reaction (PCR), fluorescence in situ hybridization (FISH), and comparative genomic... more
Meningioma is one of the most common brain tumors, and a variety of genetic abnormalities have been detected by the Southern blotting, polymerase chain reaction (PCR), fluorescence in situ hybridization (FISH), and comparative genomic hybridization (CGH) methods. However, these methods detect only a very limited portion of the tumor genome or have a limited mapping resolution. In this study, we used DNA microarray assay, which detects numerous genetic abnormalities and analyzes a global assessment of molecular events in tumor cells. We analyzed genomic DNA from 26 patients with benign meningiomas by GenoSensor Array 300 in order to characterize gene amplifications, gene deletions, and chromosomal information in the whole genome. Loss of chromosome 22q was found most frequently. This chromosomal aberration was detected in 14 meningiomas (53.8%), particularly in transitional and fibrous meningiomas. In meningothelial meningiomas, amplification of INS and TCL1A was detected more frequently than in other meningioma subtypes. DNA microarray assay revealed new genetic differences among the meningioma subtypes, thus indicating that this novel technique is useful for understanding tumor genesis and for the diagnosis of meningioma subtype.
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The authors describe a case of an infant with congenital factor X deficiency. The patient presented with a central nervous system hemorrhage followed by hydrocephalus. He underwent a ventriculoperitoneal shunt and, during the... more
The authors describe a case of an infant with congenital factor X deficiency. The patient presented with a central nervous system hemorrhage followed by hydrocephalus. He underwent a ventriculoperitoneal shunt and, during the postoperative period, developed a spontaneous epidural hematoma, which was evacuated. The clinical and pathophysiological aspects of this case are discussed based on a literature review.
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Meningioma is the commonest brain tumor and many genetic abnormalities, such as the loss of chromosome 22q and the mutation of NF2, have been reported. These classical abnormalities were detected using Southern blot, PCR, fluorescence in... more
Meningioma is the commonest brain tumor and many genetic abnormalities, such as the loss of chromosome 22q and the mutation of NF2, have been reported. These classical abnormalities were detected using Southern blot, PCR, fluorescence in situ hybridization and comparative genomic hybridization, but these methods examine only very limited regions or limited mapping resolution of the tumor genome. In this study, we used DNA microarray assay, which detects numerous genetic abnormalities simultaneously and analyses a global assessment of molecular events in meningioma cells. We studied 31 meningiomas by GenoSensor Array 300 in order to detect the chromosomal aberrations and genetic abnormalities in the whole genome. This study demonstrated not only classical chromosomal aberration, such as loss of chromosome 22q in 19 meningiomas (61.3%), but also new genetic characteristics of meningiomas, such as amplification of MSH2 in 16 meningiomas (51.6%), deletion of GSCL in 13 meningiomas (41.9%) and deletion of HIRA in seven meningiomas (22.6%). These results suggest that DNA microarray assay is useful in research for the genetic characters of meningiomas and understanding tumorigenesis.
Research Interests: Genetics, Adolescent, Humans, Female, Male, and 7 moreMeningioma, Clinical Sciences, Neurological, Aged, Middle Aged, Adult, and Neurosciences
The authors report the case of a 65-year-old woman with atlantoaxial subluxation caused by rheumatoid arthritis. The patient had been hospitalized because of an infection after a total-knee replacement, when she suddenly lost... more
The authors report the case of a 65-year-old woman with atlantoaxial subluxation caused by rheumatoid arthritis. The patient had been hospitalized because of an infection after a total-knee replacement, when she suddenly lost consciousness and became apneic after an episode of intractable neck pain. Cranial computed tomography scanning demonstrated subarachnoid hemorrhage (SAH), and angiography revealed a dissecting aneurysm of the radiculomedullary artery that had originated from an extracranial vertebral artery dissection at the level of the atlantoaxial joint. Although coil embolization for the parent artery, including the dissecting aneurysm, was performed successfully, the patient died of worsening infection. The authors believe that the SAH occurred because of a ruptured dissecting aneurysm in the intradural portion of the radiculomedullary artery.