Hypoplasia of internal carotid artery at cervical portion associated with neurofibromatosis type I]

Congenital absence of the internal carotid artery (ICA) is a rare anomaly and aplasia/hypoplasia of the ICA associated with other congenital malformations is uncommon, too. We report a very rare case of hypoplastic carotid canal due to hypoplastic ICA at cervical portion associated with neurofibromatosis type I (NF I). A 22-year-old male with NF I was admitted to our hospital for transient weakness of the left upper and lower limbs. Computed tomography (CT) of the brain demonstrated no abnormal findings. But bone target CT and three dimensional computed tomography (3 D-CT) showed a hypoplasia of right carotid canal. Cerebral angiography revealed that the right ICA was hypoplastic at its cervical portion and occluded at the carotid canal. Rest single photon emission computed tomography (SPECT) demonstrated normal cerebral perfusion, and SPECT with acetazolamide demonstrated showed cerebral perfusion reserve of both hemispheres, too. So he was treated conservatively at the present time. Careful follow up should be performed for such patients, because they are very rare cases and the natural history of them is unknown, too.     

Ruptured intracranial aneurysm combined with multiple cerebral vessel anomalies; a case report

We report a very rare case of subarachnoid hemorrhage associated with fenestration of the anterior cerebral artery (ACA), the accessory middle cerebral artery (A-MCA) and the duplication of the middle cerebral artery (D-MCA). It seems that this is the first report of these combined intracranial vascular anomalies, although many authors have reported each anomaly in isolation. A 50-year-old male visited a local physician complaining of the sudden onset of a severe pulsating headache. A lumbar puncture showed bloody cerebrospinal fluid, and he was transferred to our institution. An emergency CT scan showed no apparent subarachnoid hemorrhage, but the left internal carotid angiography showed a saccular aneurysm at the origin of the D-MCA. Other anomalies, such as the fenestration of the ACA and the A-MCA, were also apparent during angiography. The ruptured aneurysm was safely clipped on the next day and the patient was discharged with no neurological deficits three weeks after the operation. The incidence of fenestration of the ACA is 0.2% in the angiographic series, and 0.1-7.2% at autopsy. Fenestration of the ACA is thought to be less than that of the vertebral artery. Ever since it was proposed by Teal et al, the term A-MCA has been restricted to an artery that arises from the ACA, and a branch arising from the internal carotid artery has been termed as the D-MCA. These anomalous vessels supply the cortex in the distribution of the middle cerebral artery. The angiographic incidence of A-MCA is about 4%, and six cases of aneurysm located at the origin of the A-MCA have been reported so far.(ABSTRACT TRUNCATED AT 250 WORDS)     

Flowcytometric Analysis of DNA Pattern of Cells Derived from Xeroderma Pigmentosum A– Hypersensitivity to Vincristine, Etoposide and Methotrexate–

Xeroderma pigmentosum complementation gropu A(XPA) is one of the DNA repair deficient syndromes. The cell biological features of XPA were examined by flowcytometry using Epstein Barr (EB) virus-transformed lymphoblastoid cells. Cellular sensitivity to vincristine (VCR), etoposide (VP-16) and methotrexate (MTX) were assayed by DNA pattern changes by flowcytometry. Recently, ataxia-telangiectasia (AT), one of the same kindof disorder, has been reported to have an increased sensitivity to VCR and VP-16. Howerver, AT showed some resistance ot MTX according to other reports. Our results showed that XPA had an; increased sensitivity to VCR and also to VP-16. Moreover, different from AT, XPA showed some sensitivity to MTX. Thus there is some cell biological similarity between XPA and AT, as well as some difference of the abnormality in the DNA repair pathway.     

Effect of danazol on bone mineral content and bone metabolism in patients with endometriosis

Danazol, which is commonly employed in the treatment of endometriosis creates a low estrogen and high androgen condition by suppressing ovarian steroidogenesis. When a reproductive-aged woman suddenly develops low estrogen, even if it is reversible, it is possible that it can have some effect on her bone mineral content and there is the danger that this might constitute a risk factor in the development of postmenopausal bone metabolism. In 12 cases of endometriosis (average age 42.2) 400 mg/day Danazol was given for 4 months to determine if a low estrogen and high androgen condition actually continued. The effect on the bone metabolism which provides a background to metacarpal bone mineral content was also examined in comparison with before and after seven months' administration. As a result, after Danazol administration, estradiol showed a tendency to decrease and dehydroepiandrosterone showed a tendency to increase although no significant change in the estrogen and androgen level was recognized. There was also no change on the bone mineral content and there was no significant change in bone metabolism, calcitonin excepted. Therefore, from the results of calcitonin evaluation, 400mg/day Danazol administered for 4 months does not seem to be absorbed by bone and at least appears not to have any significance as a bone metabolism risk factor.     

Triamcinolone-assisted pars plana vitrectomy improves the surgical procedures and decreases the postoperative blood–ocular barrier breakdown

PURPOSE: To determine the effect of a triamcinolone-assisted pars plana vitrectomy (PPV) on the visibility of hyaloid during surgery and the postoperative clinical outcome. METHODS: Thirty-one patients with proliferative retinal disease [8 with diabetic macular edema (DME), 10 with proliferative diabetic retinopathy (PDR), 13 with proliferative vitreoretinopathy (PVR)] underwent PPV, where the vitreous body was visualized by the intravitreal injection of triamcinolone solution during the operation. The visual acuity, intraocular pressure (IOP), tamponade, corneal pathology, after-cataract, vitreous hemorrhage, and necessity of reoperation, were thereafter examined for at least 3 months after surgery. The anterior chamber laser flare cell meter was used on postoperative day 8 in DME eyes with triamcinolone-assisted PPV and with routine PPV to evaluate the breakdown of the blood-ocular barrier. RESULTS: The vitreous body was clearly seen by means of triamcinolone during surgery, which greatly helped us to perform a posterior hyaloid resection safely and thoroughly. Six of 8 DME eyes, 8 of 10 PDR eyes, and 5 of 13 PVR eyes showed an improvement in their vision postoperatively. No eye except one experienced IOP elevation above 21 mmHg for 7 days. Six eyes had vitreous hemorrhage. The DME eyes which received triamcinolone-assisted PPV showed significantly less breakdown of the blood-ocular barrier than those with routine PPV (Mann-Whitney U-test, P<0.01). CONCLUSION: Triamcinolone improved the visibility of the hyaloid and the safety of the surgical procedures during PPV and also inhibited the postoperative breakdown of the blood-ocular barrier. Although the long-term effects are still unknown, this method appears potentially useful as an improved treatment for proliferative retinal diseases.     

Effect of sofalcone on the gastric cell proliferation in the experimental gastritis of rats

Effects of sofalcone on the morphometrical glandular structure and the generative cell proliferation in the gastric mucosa of gastritis, induced in rats by the treatment of sodium taurocholate (TCA) for 3 and 6 months, were examined by means of 3H-thymidine autoradiography. Morphometrical observation revealed that the ratios of the length of the glandular portion/the total length of the gastric gland were generally decreased in both fundic and pyloric glands with TCA treatments, which may indicate mucosal atrophy. These atrophic changes were improved to the normal levels by the administration of sofalcone for 3 weeks after the treatment of TCA. On the other hand, cell proliferative activity, indicated by the labeling indexes in the generative cell zone of gastric mucosa, was increased in TCA induced gastritis rat, which seems to be the response to replace the increased cell loss. The administration of sofalcone to the gastritis rats further increased the labeling indexes, especially in pyloric gland with statistical significance in both TCA treated rats for 3 and 6 months. From these results, it is suggested that sofalcone stimulates the compensatory increase of proliferative activity of generative cells, which would be available to repair the gastric mucosa with gastritis.     

Histamine response in developing chick oesophagus. A pharmacological analysis of the response to histamine in the oesophagus of developing chick

Developmental changes in response to histamine were investigated in the oesophagus isolated from the chick between 15 days of incubation and 15 days after hatching. The contraction could be already caused by histamine (20 microM) in the chick oesophagus from 15 days of incubation. The pD2 values for histamine and acetylcholine did not change during the period between 17 days of incubation and 5 days after hatching. The response to histamine (20 microM) was extremely resistant to tetrodotoxin (0.78 microM), procaine (0.2 mM) and atropine (1 microM) during the period between 17 days of incubation and 20 days of incubation. The tetrodotoxin-resistant response was replaced by a tetrodotoxin-sensitive response after hatching. On the other hand, the neuronal response induced by transmural electrical stimulation (20 Hz) or dimethylphenylpiperazinium (20 microM) was uniformly sensitive to tetrodotoxin throughout the periods. Mepyramine (2 microM), but not metiamide (20 microM), inhibited the histamine-induced responses in every age tested. These results suggest that the myogenic receptivity of histamine transiently increases during the terminal period of embryonic development and declines after hatching.     

Continuous intra-arterial infusion chemotherapy by implantable catheter access connected with a continuous infusion pump

Eleven non-resectable cancer patients have been successfully treated by means of a one-shot and continuous intra-arterial infusion chemotherapy, utilizing an implantable vascular access device (Catheter Access) connected to a continuous infusion pump (Nipro portable syringe infusion pump) via a non-corning needle (Nipro coreless needle set). This result suggests that this simple and inexpensive method can be applied not only for cancer chemotherapy but also for intravenous hyper-alimentation and for treatment of epidural anesthesia.     

Heterotopic vascularized growth plate transfer in juvenile dogs

Prior animal studies of vascularized epiphyseal transfers placed growth plates in 2 bone systems where the independent growth of epiphyses and their response to altered stresses has been difficult to assess. This study assessed growth of vascularized ulnar epiphyses transferred to the ipsilateral humerus of 12-week-old puppies. Growth was permitted by a specially designed extensible plate. Control groups showed that humeral dissection, osteotomy and ostectomy alone do not stimulate growth. In 4 puppies initial growth of the transferred epiphysis was seen but late collapse and formation of bridging callus occurred so that overall humeral length at maturity was not significantly different from control humeri. Physical forces inherent in heterotopic transfer may preclude long term growth of transferred epiphyses particularly in sites of higher relative load. The extensible plate used here may be a useful device in the fixation of transferred epiphyses with growth potential. © 1994 Wiley-Liss, Inc.