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Currently, it is difficult to carry out refraction-contrast radiography by using a conventional X-ray generator. Thus, we developed an embossed radiography system utilizing dual-energy subtraction for decreasing the absorption contrast in unnecessary regions, and the contrast resolution of a target region was increased by use of image-shifting subtraction and a linear-contrast system in a flat panel detector (FPD). The X-ray generator had a 100-microm-focus tube. Energy subtraction was performed at tube voltages of 45 and 65 kV, a tube current of 0.50 mA, and an X-ray exposure time of 5.0 s. A 1.0-mm-thick aluminum filter was used for absorbing low-photon-energy bremsstrahlung X-rays. Embossed radiography was achieved with cohesion imaging by use of the FPD with pixel sizes of 48 x 48 microm, and the shifting dimension of an object in the horizontal direction ranged from 100 to 200 microm. At a shifting distance of 100 mum, the spatial resolutions in the horizontal and vertical directions measured with a lead test chart were both 83 microm. In embossed radiography of non-living animals, we obtained high-contrast embossed images of fine bones, gadolinium oxide particles in the kidney, and coronary arteries approximately 100 microm in diameter.

The anteromedial superior cerebellar tumor can be accessed by various routes. For tumor presenting at the cerebellar surface in this region, the optimal approach remains contentious. Furthermore, which of the various routes offers the optimal approach to a tumor that is not present at the cerebellar surface but lies deep anteromedial superior cerebellum is a matter of debate. We report herein the case of a 44-year-old woman with hemangioblastoma deep within the subcortex of the anteromedial superior cerebellum. Preoperative magnetic resonance (MR) imaging and three-dimensional anisotropy contrast MR axonography using diffusion-weighted MR imaging demonstrated that the posterior subtemporal transtentorial (PSTT) approach would provide a shorter surgical corridor, minimal cerebellar split, and better preservation of nerve fibers, compared to the other approaches. Surgical tumor removal was successfully achieved using the PSTT approach. During surgery, the PSTT approach provided an operative field that enabled visualization of the proximal side of the superior cerebellar artery as the tumor feeding vessel. Although the vein of Labbe inserted just into the transverse-sigmoid junction, injury to this vein was avoided using optimal head position, cerebrospinal fluid drainage, and various devices. For patients with tumor located within the subcortex of the anteromedial superior cerebellum, the PSTT approach is recommended as an optimal surgical route. Scrupulous evaluation using preoperative neuroimaging is crucial when deciding on the surgical approach.

A 48-year-old woman presented with a left cerebellopontine angle mass. Over a 93-month period, the patient underwent seven surgeries, two radiosurgeries, and one external beam radiotherapy. The tumor was histologically benign at the first operation, but exhibited unusually aggressive behavior after failed radiosurgery and demonstrated clinical characteristics of malignancy such as spinal metastasis. The patient underwent gamma knife radiosurgery (GKR) for recurrence after the first operation, despite the tumor being located in a resectable region. The tumor did not respond. Six months after the sixth surgery, the patient presented with progressive lower extremity paraparesis and sensory disturbance below the T11 dermatome. Magnetic resonance imaging revealed multiple intradural mass lesions located at the T2, T11-T12, and L2 levels. She died 4 months after the diagnosis of spinal metastases. Retrospectively, we speculate that if a tumor is located in a resectable region and Simpson grade I or II tumor resection is possible, direct surgery may be a safer option than GKR.

To clarify the presence or absence of cyclin D1 overexpression in extramedullary plasmacytomas (EMPs) , we examined 11 cases using an immunohistochemical study. None of the 11 cases showed evidence of underlying multiple myeloma at the diagnosis of EMP. The main clinicopathological findings of the 11 cases are summarized in Table I. Four (Nos. 14) of the 11 cases demonstrated greater than 30% Cyclin D1 tumor cells (Fig. 1a), whereas there were no cyclin D1 tumor cells in the remaining seven cases (Nos. 511). According to WHO classification standards, two of the four cyclin D1 cases were poorly differentiated EMP and the other two samples comprised cases of well differentiated EMP and moderately differentiated EMP. Five of the seven cyclin D1 cases were well differentiated EMP and two were moderately differentiated EMP. Two cases (Nos. 6 and 11) showed prominent amyloid deposition. Immunohistochemistry was performed on paraffin sections using a Ventana automated (BenchMarkTM) stainer. There were no CD5 or CD20 tumor cells in any of the 11 cases. All 11 cases showed monotypic intracytoplasmic immunoglobulins and expressed CD38 and CD138 antigens. The plasma cells exhibited monotypic intracytoplasmic k light chain in five patients (Nos. 1, 2, 4, 8, and 9) and l light chain in six (Nos. 3, 57, 10, and 11). Intracytoplasmic immunoglobulin heavy chains were positive in nine (Nos. 24, and 611) of the 10 lesions tested (Nos. 14, and 611) : of these, four (Nos. 3, 6, 7, and 10) stained positive for IgG, three (Nos. 4, 8, and 9) staind for IgG and IgA, and two (Nos. 2 and 11) stained for IgA alone. IgM were not detected in any of the lesions. There were no CD56 or human-herpes virus type8 tumor cells in any of the 11 cases. A two-color fluoresence in situ hybridization (FISH) assay using commercially available 14q32 and 11q13 probes (Vysis Inc, Downers Grove, IL, USA) disclosed separate BCL1 and IgH signals in the nuclei of tumor cells, which is a pattern seen in non-rearranged cells (Fig. 1b). However, two (Nos. 2 and 3) of the three cases (Nos. 13) were scored as having an 11q13 trisomy or polysomy (Fig. 1c). In the remaining one case (No. 4), there were insufficient materials available for FISH analysis. Among the four cyclin D1 cases, one case (No. 1) showed only partial remission and bone marrow involvement was found 13 months after the onset of disease. Complete remission was obtained in the remaining three cases (Nos. 24). However, all of the three cases were relapsed (bone marrow = 2, duodenum = 1). Three (Nos. 13) of the four cyclin D1 cases died of disease. Complete remission was achieved in all seven cyclin D1 cases. Three cases (Nos. 6, 9, and 11) relapsed. The remaining one (No. 11) died due to ovarian cancer. EMPs are rare, typically solitary tumors lacking any signs of systemic spread, and represent approximately 4% of all

Under harsh environmental conditions Caenorhabditis elegans larvae undergo arrest and form dauer larvae that can attach to other animals to facilitate dispersal[1]. It has been argued that this phenomenon, called phoresy, represents an intermediate step towards parasitism[2, 3]. Indeed, parasitic nematodes invade their hosts as infective larvae, a stage that shows striking morphological similarities to dauer larvae[1]. While the molecular regulation of dauer entry in C. elegans involves insulin and TGF-ß signaling[4-8], studies of TGF-ß orthologues in parasitic nematodes did not provide evidence for a common origin of dauer and infective larvae[9-14]. To identify conserved candidate regulators between Caenorhabditis and parasitic nematodes we used an evolutionary approach involving Pristionchus pacificus as intermediate. We show by mutational and pharmacological analysis that Pristionchus and Caenorhabditis share the dafachronic acid-DAF-12 system as core endocrine module for dauer formation. One of the dafachronic acids, Δ7-DA, has a conserved role in the mammalian parasite Strongyloides papillosus where it controls entry into the infective stage. Application of Δ7-DA blocks formation of infective larvae and results in the generation of free-living animals. The conservation of this small molecule ligand represents a fundamental link between dauer and infective larvae and might provide a general strategy for nematode parasitism.

This study evaluated the mechanical properties and the surface elemental composition of Yasargil Phynox aneurysm clips implanted for 10 years in a patient with cerebral aneurysm. Two Yasargil Phynox aneurysm clips implanted 10 years previously to treat a ruptured vertebral artery aneurysm were retrieved when the regrown and ruptured aneurysm was repaired with a new aneurysm clip. Two new Yasargil aneurysm clips were used as controls. Measurements of closing force, bending strength, and the elemental composition of the clip surface were performed. The closing force of the retrieved clips was similar or greater compared to the force before implantation. The bending test showed that the elastic limit and 0.2% proof load of the retrieved clip were higher than those of the unused clip, whereas the ultimate load of the retrieved clip was similar to that of the unused clip. The elemental concentration of Cr oxide on the surface of the retrieved clips was almost the same as that on the unused clips. The present study demonstrated that Yasargil Phynox aneurysm clips retain their mechanical properties and surface elemental composition in vivo for a long time, which indicates that Yasargil aneurysm clips will remain reliable in patients for extended periods.

BACKGROUND AND PURPOSE: Visualization of the peripheral arteries on single-slab 3D time-of-flight (TOF) MR angiography (MRA) can reflect blood flow velocity. The velocity in the middle cerebral artery (MCA) may correlate with cerebrovascular reactivity (CVR) to acetazolamide, which can be used to assess hemodynamic impairment. The goal of this study was to compare the signal intensity of the MCA on MRA versus CVR quantified by perfusion single-photon emission CT (SPECT). MATERIALS AND METHODS: The signal intensity of the MCA on single-slab 3D time-of-flight MRA was graded according to the ability to visualize the MCA in 108 cerebral hemispheres of 87 patients with unilateral or bilateral cervical internal carotid artery (ICA) steno-occlusive diseases. SPECT-CVR was also calculated by measuring cerebral blood flow before and after acetazolamide challenge. Ten healthy subjects were studied to obtain control SPECT-CVR values. All subjects provided written informed consent before the study. RESULTS: CVR was significantly lower in cerebral hemispheres with reduced MCA signal intensity than in those with normal intensity (P < .05). When the reduced signal intensity of the MCA on MRA was defined as abnormal, and when a CVR less than the mean − 2 SD of healthy subjects was defined as reduced, MRA grading resulted in a 86.2% sensitivity and 69.6% specificity, with 51.0% positive-predictive and 93.2% negative-predictive values to detect reduced CVR. CONCLUSIONS: This simple MRA method can assess hemodynamic impairment with a high negative-predictive value.

Background and Purpose— Microemboli generated during dissection of the carotid arteries in patients undergoing carotid endarterectomy result in postoperative cerebral ischemic events. The purpose of this study was to determine whether these events correlate with middle cerebral artery blood flow velocity. Methods— One hundred sixty-three patients with ipsilateral internal carotid artery stenosis (>70%) underwent carotid endarterectomy under transcranial Doppler monitoring of mean blood flow velocity and microembolic signals in the ipsilateral middle cerebral artery. Results— Logistic regression analysis of several variables demonstrated that only middle cerebral artery mean blood flow velocity during carotid dissection was significantly associated with new postoperative neurological deficits in patients with microembolic signals during carotid dissection (95% CI, 1.069 to 1.528; P =0.0072). The combination of low middle cerebral artery mean blood flow velocity (≤28 cm/s) and microembolic signals ≥10 during carotid dissection resulted in improved specificity and positive predictive value for the development of new postoperative neurological deficits when compared with either criterion used alone. Conclusions— Intraoperative microemboli and low middle cerebral artery mean blood flow velocity are additive in predicting the development of cerebral ischemic events after carotid endarterectomy.

Visualization of a brain neural pathway is a useful tool for supporting surgical planning. In this paper, we propose a method for visualizing a brain neural pathway by using both critical points and target regions in order to extract necessary pathways. Here, critical points are those points at which the magnitude of the vector vanishes, and we assume that a neural pathway consists of a set of streamlines in a vortical flow field and we find the start points of streamlines by classifying critical points. The user also specifies target regions, such as regions of interest, and visualizes the important streamlines that pass through the target regions.

The aim of the present study was to determine whether preoperative cerebrovascular reactivity (CVR) to acetazolamide measured by quantitative brain perfusion single-photon emission computed tomography (SPECT) predicts development of cerebral ischemic lesions on postoperative diffusion-weighted magnetic resonance imaging (DWI) that are caused by microemboli during carotid endarterectomy (CEA).One hundred and fifty patients with ipsilateral internal carotid artery stenosis (70%) underwent CEA under transcranial Doppler monitoring of microembolic signals (MES) in the ipsilateral middle cerebral artery (MCA). Preoperative CVR to acetazolamide was measured using [(123)I]N-isopropyl-p-iodoamphetamine SPECT, and region of interest (ROI) analysis in the ipsilateral MCA territory was performed using a three-dimensional stereotaxic ROI template. DWI was performed within 3 days before and 24 h after surgery.Twenty-six patients (17.3%) developed new postoperative ischemic lesions on DWI. Logistic regression analysis demonstrated that, among the variables tested, a high number of MES during carotid dissection (95% CIs, 1.179 to 1.486; P0.0001) and preoperative reduced CVR to acetazolamide (95% CIs, 0.902 to 0.974; P = 0.0008), which were significantly associated with the development of new postoperative ischemic lesions on DWI. In 47 patients with MES during carotid dissection, the combination of number of MES during carotid dissection and CVR to acetazolamide identified development of new postoperative ischemic lesions on DWI with a positive predictive value of 100% or zero.Preoperative CVR to acetazolamide measured by quantitative brain perfusion SPECT predicts development of cerebral ischemic lesions on postoperative DWI that are caused by microemboli during CEA.

Shunsuke Kakino, Kuniaki Ogasawara, Yoshitaka Kubo, Hideaki Nishimoto, Akira OgawaDepartment of Neurosurgery, Iwate Medical University School of Medicine, Morioka, Iwate, JapanAbstract: The subtemporal approach with division of the posterior communicating artery (PcomA) is described for treating aneurysms of the basilar tip. When the ipsilateral posterior cerebral artery (PCA) interferes with visibility and manipulation around the aneurysm neck and the artery is tethered by the PcomA and not mobilized, the PcomA can be divided near the junction with the PCA. The procedure permits PCA mobilization and exposes the neck of the aneurysm. We applied this procedure to a patient with a ruptured aneurysm of the basilar tip. The postoperative course was uneventful except for transient left oculomotor nerve palsy. Postoperative cerebral angiography and magnetic resonance imaging confirmed the respective disappearance of the aneurysm and no new ischemic lesions. The subtemporal approach allows safer and easier division of the PcomA near the junction to the PCA compared with the pterional approach, and the present procedure is more suitable for the subtemporal approach.Keywords: basilar tip aneurysm, subtemporal approach, posterior communicating artery

A microfocus X-ray tube is useful for performing magnification digital radiography. The 100-µm-focus X-ray generator consists of a main controller, for regulating tube voltage and current, and a tube unit with a high-voltage circuit and a fixed anode X-ray tube. The maximum tube voltage, current, and electric power were 106 kV, 0.5 mA, and 50 W, respectively. Using a 100-µm-thick tungsten filter, the X-ray intensity was 19.8 µGy/s at 1.0 m from the source with a tube voltage of 100 kV and a current of 0.50 mA. Since Kα rays from tungsten targets are absorbed effectively by gadolinium-based contrast media, these rays are useful for performing enhanced angiography. Magnification angiography was performed by threefold magnification imaging using a computed radiography system and the filter at a tube voltage of 100 kV. In angiography of nonliving animals, we observed fine blood vessels of approximately 100 µm with high contrasts.

Background The purpose of the present study was to investigate the relationship between serum concentrations of the immunoglobulin-like superfamily, selectins, hsCRP, and the development of DIND in patients with aneurysmal SAH. Methods Serum ICAM-1, VCAM-1, E-selectin, P-selectin, L-selectin, and hsCRP were measured in 33 patients with SAH who underwent aneurysmal clipping within 48 hours of the onset of symptoms. Serum samples were obtained during the early period (day 0) and the late period (day 7). Results The serum concentrations of ICAM-1 (P = .009), VCAM-1 (P = .0383) and hsCRP (P = .0014) during the early period were significantly higher in patients with SAH than in control patients. Further, serum hsCRP concentration during the late period was significantly higher in patients with SAH than in control patients (P = 0033). Finally, serum concentrations of ICAM-1, VCAM-1, and hsCRP during the early (P = .0055, P = .0266, and P = .0266) and late (P = .0423, P = .0041, and P = .0004) period were significantly higher in patients with DIND than in patients without DIND. Conclusions Serum levels of ICAM-1, VCAM-1 and hsCRP during the early and late period following SAH correlate with DIND.

Background Pial single-channel arteriovenous (AV) fistulae are usually cured by interrupting only the feeding arteries identified in cerebral angiography. Case Description A 27-year-old woman presented after 3 complex partial seizures due to a pial single-channel AV fistula with the varix located in the right temporal lobe. When all feeding arteries identified by preoperative cerebral angiography were temporarily occluded, varix blood flow was confirmed with Doppler ultrasonography. Many small feeding arteries were identified, and the varix was dissected and removed. The postoperative course was uneventful and postoperative cerebral angiography revealed no abnormal vascular lesions. Conclusion Pial single-channel AV fistulae are not always cured by interrupting only the feeding arteries identified in cerebral angiography and might require varix removal.

✓A desmoplastic infantile astrocytoma (DIA) is an extremely rare tumor that comprises a solid astrocytic tumor accompanied by a large cyst and involves the superficial cerebral cortex and leptomeninges in infants. The solid part of this type of tumor has been well described in various reports and books, but characteristics of the cystic portion have remained unclear. Because adequate resection is required to ensure a favorable prognosis, information about the cyst is very important for diagnostic purposes and surgical planning. The authors report on the clinical and histological features of the cyst in a case of a DIA. A 12-month-old boy presented with vomiting. Contrast-enhanced magnetic resonance imaging revealed a strongly enhancing single-lobed large cyst located in the deep white matter, under the solid part of the tumor attached to the dura mater of the left frontal lobe. Both the solid and cystic portions of the tumor were surgically removed. The border between the cyst wall and surrounding white matter was unclear. Histologically, the cyst wall was composed of gliosis representing a rough accumulation of reactive astrocytes, lymphocytes, and small capillary vessels in edematous parenchyma, but no tumor cells. The present case and previous reports suggest that the cyst does not contain tumor cells, even if strongly depicted on contrast-enhanced neuroimaging, and that a thickly enhancing cyst wall indicates gliosis with accumulation of numerous small vessels.

Background Symptomatic atherosclerotic steno-occlusive diseases of the vertebrobasilar artery portend a poor prognosis and high risk of stroke recurrence despite medical therapy. We describe 5 medically refractory patients with occlusion at the origin of the VA and the distal portion of the cervical VA perfused via muscular collateral vessels who underwent ECA–cervical VA (V2 segment) bypass with interposed SVG. Methods The ECA was isolated through a linear incision along the anterior portion of the sternocleidomastoid muscles. The ECA was either laterally or medially retracted, the longus colli muscle was dissected, and the anterior wall of the foramen transversarium was partially removed, which exposed the cervical VA. Each end of the SVG was anastomosed to both the VA and the ECA in a side-to-end fashion. Results Surgery proceeded smoothly in all patients without any new neurologic postoperative deficits. Postoperative cerebral angiography demonstrated that the anastomosis was patent. None of the patients developed further brain ischemic events during follow-up periods ranging from 13 to 114 months (mean, 62 months) after surgery. Conclusion The ECA–cervical VA bypass with interposed SVG is useful when the VA is occluded at the origin and when the distal portion of the cervical VA is perfused via muscular collateral vessels of patients with medically refractory ischemic events in the vertebrobasilar territory.

A fusion technique for magnetic resonance (MR) angiography and MR imaging was developed to help assess the peritumoral angioarchitecture during surgical planning for meningioma. Three-dimensional time-of-flight (3D-TOF) and 3D-spoiled gradient recalled (SPGR) datasets were obtained from 10 patients with intracranial meningioma, and fused using newly developed volume registration and visualization software. Maximum intensity projection (MIP) images from 3D-TOF MR angiography and axial SPGR MR imaging were displayed at the same time on the monitor. Selecting a vessel on the real-time MIP image indicated the corresponding points on the axial image automatically. Fusion images showed displacement of the anterior cerebral or middle cerebral artery in 7 patients and encasement of the anterior cerebral arteries in 1 patient, with no relationship between the main arterial trunk and tumor in 2 patients. Fusion of MR angiography and MR imaging can clarify relationships between the intracranial vasculature and meningioma, and may be helpful for surgical planning for meningioma.

A 55-year-old man presented with a rare lipomatous meningioma associated with acute subdural hematoma manifesting as sudden onset of severe headache, but no neurological deficit. No evidence of trauma or underlying predisposition to hemorrhage was seen. Fluid-attenuated inversion-recovery magnetic resonance imaging showed a thin hyperintense area in the right temporal convexity, and an extra-axial mass appearing as mixed hypointensity and hyperintensity. Two weeks later, right temporal craniotomy was performed and the tumor was totally resected with the attached dura. The hematoma was localized at the inferior margin of the mass and connected directly with the tumor. Histological examination of the resected specimen revealed typical meningothelial meningioma admixed with mature adipose tissue. Longstanding intratumoral congestion probably caused hyaline deposition in the tissue, leading to vessel rupture.

A 62-year-old man and a 44-year-old man with unilateral cervical carotid artery stenosis (less than 50% with echolucent plaque and ulceration) suffered recurrent ischemic stroke events despite treatment with antiplatelet and anticoagulation drugs. Carotid endarterectomy (CEA) was performed under transcranial Doppler monitoring for the detection of micro-emboli using a microscope inserted through a skin incision to minimize pressure on the carotid arteries. The atheroma plaque included an ulcer with fresh thrombi in both patients. Both patients awoke from anesthesia without new neurological deficits, and no ischemic stroke events have recurred since CEA. Endarterectomy is an effective method for preventing stroke in patients with severe carotid stenosis (>70%), but the efficacy of this procedure for mild carotid stenosis (

Wide exposure of lesions during the subtemporal approach often leads to temporal lobe injury caused by excessive retraction. A brain retraction technique using gelatin sponge pieces was developed to minimize intraoperative brain retraction during the subtemporal approach. After aspirating cerebrospinal fluid and slackening the temporal lobe, 2-3 pieces of gelatin sponge are inserted between the dura and surfaces of the anterior and posterior parts of the temporal lobe, then covered with cottonoids. The gelatin sponge pieces expand and thus expose the free margin of the tentorium with minimal brain retraction. This technique was used in 50 patients undergoing clipping for cerebral aneurysms. Although computed tomography indicated minor brain injury caused by retraction in three patients with ruptured aneurysm of the basilar artery bifurcation, no patients experienced new neurological deficits other than transient ipsilateral oculomotor nerve paresis. In conclusion, gelatin sponge, with its innate mechanical characteristics and ease of application, seems to offer an alternative retractor in neurosurgical interventions using the subtemporal approach for patients with unruptured aneurysm or non-severe subarachnoid hemorrhage.

Protease-activated receptors (PARs) expressed in the endothelia and smooth muscles of vessels may play important roles in blood vessel function. Using intracellular calcium ion concentration ([Ca2+]i) imaging, we recently observed that small - but not large - arterioles of the brain responded to proteases, while testicular arterioles showed no response. The purpose of the present study was to examine the heterogeneity of the localization of PARs in arterioles using immunohistochemistry. Consistent with the [Ca2+]i imaging results, neither the thrombin receptor nor PAR2 were evident in large arterioles of the brain. However, the small arterioles of the brain, vascular smooth muscles, and endothelia showed a distinct immunoreactivity against the thrombin receptor and PAR2. The immunoreactivity of PARs in testicular arterioles was faint. In conclusion, size-dependent and/or organ-specific responses of arterioles to proteases are due to the heterogeneous localization of PARs.

Background: Matrix metalloproteinase (MMP)-9 targets major components of the basal lamina of cerebral blood vessels and is a biochemical marker of blood-brain barrier disruption. The goal of this study was to determine whether plasma concentrations of MMP-9 in the jugular bulb during carotid endarterectomy (CEA) correlate with severity of intraoperative cerebral ischemia. Methods:In 41 patients undergoing CEA for ipsilateral internal carotid artery (ICA) stenosis, plasma samples for measurement of MMP-9 concentration were intraoperatively obtained from a venous catheter inserted into the ipsilateral jugular bulb. Transcranial cerebral oxygen saturation using near-infrared spectroscopy was also monitored intraoperatively to assess the severity of the ischemic insult during ICA clamping. Results: The MMP-9 concentrations were significantly higher after ICA declamping than before ICA clamping (p = 0.0023). A strong linear correlation was observed between the severity of the ischemic insult during carotid clamping and the increase in MMP-9 levels after ICA declamping (r = 0.776; p < 0.0001). At the postoperative neurological assessment, 3 patients showed transient minor neurological deficits. The MMP-9 level in the jugular bulb after ICA declamping was increased in patients with postoperative transient neurological deficits relative to those without. Conclusions: The concentration of MMP-9 in the jugular bulb during CEA correlates with the severity of intraoperative cerebral ischemia.

Background and Purpose: Rho-kinase (ROK)-mediated Ca2+ sensitization of vascular smooth muscle (VSM) contraction plays a pivotal role in cerebral vasospasm (CV). We previously demonstrated that sphingosylphosphorylcholine (SPC) induces Ca2+ sensitization through sequential activation of the Src family protein tyrosine kinases (Src-PTKs) and ROK in vitro, and that Ca2+ sensitization is inhibited by eicosapentaenoic acid (EPA) through the selective inactivation of Src-PTK. In this study, we examined whether SPC induced CV in vivo, and, if it did, whether EPA would inhibit CV, as induced by SPC or in an in vivo model of subarachnoid hemorrhage (SAH). Methods: Changes in the diameter of the canine basilar artery were investigated by angiography after administering SPC into the cisterna magna. Then, Y27632, a specific Rho-kinase inhibitor, or EPA was injected intracisternally and the effects of both agents were investigated. In another experiment using a single-hemorrhage model, Y27632 or EPA was injected on day 7 after SAH and the changes in the diameter of the canine basilar artery were investigated. Results: At cerebrospinal fluid concentrations of 100 and 300 µmol/l, SPC induced severe vasoconstriction (maximum vasoconstriction by SPC (100 µmol/l): 61.8 ± 8.2%), which was markedly reversed by Y27632 (96.3 ± 4.4%) or EPA (92.6 ± 12.8%). SAH caused severe vasospasm on day 7 (67.6 ± 7.8%), which was significantly blocked by Y27632 (95.5 ± 10.6%) or EPA (90.0 ± 4.4%). Conclusions: SPC is a novel mediator of ROK-induced CV in vivo. The inhibition of CV induced by SPC or after SAH by EPA suggests beneficial roles of EPA in the treatment of CV. Our findings are compatible with the notion that the SPC-ROK pathway may be involved in CV.

Reported herein is a case of central neurocytoma with differentiation toward ganglion cells, considered to be a typical case of ganglioneurocytoma. Tumor cells of various degree of differentiation toward ganglion cells were intermingled with typical neurocytoma cells in a fibrillary background, with transition of tumor cells from typical neurocytoma cells to differentiated ganglion cells evident throughout the tumor. The tumor cell nuclei were positive for NeuN. Fine granular positivity for synaptophysin was seen in the cytoplasm of the tumor cells, and background fibrils and the cytoplasm of some ganglioid cells were positive for neurofilament. Several cases of central neurocytoma with ganglioid cells have been reported, with some diagnosed as ganglioneurocytoma. However, histopathological details and persuasive figures have been lacking. It is considered that the diagnosis of ganglioneurocytoma should be applied to tumors displaying the following characteristics: (i) clinical aspects such as location, demarcation and growth rate consistent with neurocytoma; (ii) transition between neurocytoma cells and ganglion cells; and (iii) ganglioid cells distributed throughout the tumors.

Damped oscillation of Newtonian liquid in a vertical U-tube is one of the well known phenomena and the solution of this liquid motion for the laminar flow regime in the circular pipe was solved, however, generally speaking, even if the period of the oscillational motion by this solution is nearly coincided with that of the experimental result, the estimation of the damped oscillational process with lapse of time by the solved equation is not in agreement with that of the experimental result. Therefore basing upon the experimental results of the velocity distributions of the oscillational motion in the circular U-tube for the Newtonian and non-Newtonian liquids, the velocity distribution of the Bingham plastic flow is assumed. The solutions of the damped oscillation and also of the vertical falling and rising velocities of the free surface in the vertical U-tube of the diameters D=10mm, 20mm and 40mm are compared with water and water-glycerine solution for the Newtonian liquids and the acrylic co-polymer solutions for the non-Newtonian liquid. The comparisons of these solved equations by the new flow model are shown in good agreement with the experimental results. The above stated results are described in detail.

We attempted to assess the feasibility of a 1.6-mm isotropic voxel diffusion tensor imaging (DTI) tractography at 3T in visualizing nerve bundles in the limbic system. We examined 20 healthy volunteers by conventional DTI with a voxel size of 1.6 × 1.6 × 3.0 mm and by high-resolution DTI with a voxel size of 1.6 × 1.6 × 1.6 mm and generated tractographs of three limbic nerve bundles: the fornix, cingulum, and uncinate fasciculus. We visually assessed whether these bundles reached their targets and compared their diffusion parameters between the two techniques. The entire pathways of the fornix, cingulum, and uncinate fasciculus were more readily visualized by high-resolution DTI than by conventional DTI. Among these, the fimbria of the fornix and the uncinate fasciculus adjacent to the temporal pole were identified more frequently by high-resolution DTI (visualization rate 83 and 100%, respectively) than by conventional DTI (visualization rate 63 and 83%, respectively) at a statistical significance of P

Object Preoperative planning for meningiomas requires information about tumor consistency as well as location and size. In the present study the authors aimed to determine whether the fractional anisotropy (FA) value calculated on the basis of preoperative magnetic resonance (MR) diffusion tensor (DT) imaging could predict meningioma consistency. Methods In 29 patients with intracranial meningiomas, MR DT imaging was performed preoperatively, and the FA values of the tumors were calculated. Tumor consistency was intraoperatively determined as hard or soft, and the histological diagnosis of the tumor was established. Results Of the 29 tumors, 11 were classified as hard and 18 as soft. The FA values of fibroblastic meningiomas were significantly higher than those of meningothelial meningiomas (p = 0.002). The FA values of hard tumors were significantly higher than those of soft tumors (p = 0.0003). Logistic regression analysis demonstrated that the FA value was a significant independent predictor of tumor consistency (p = 0.007). Conclusions The FA value calculated from preoperative MR DT imaging predicts meningioma consistency.

The lithium intercalation properties of anatase TiO2 electrodes with a bimodal pore size distribution were examined. Porous anatase TiO2 was prepared by hydrolyzing titanium tetrabutoxide using polyoxietylene cetyl ether as a surfactant and its subsequent calcination at 500°C for 4 hours. A porous anatase TiO2 electrode with a relatively large pore volume and 50-nm-diamater pores showed a discharge capacity of approximately 150 mAh g-1. It maintained a relatively large discharge capacity of 125 mAh g-1 at a current density of 1 A g-1, and exhibited a good high-rate capability.

Purpose: We used a whole-brain, isotropic-voxel acquisition technique to improve the geometric distortion in diffusion-weighted (DWI) and diffusion tensor imaging (DTI) in coronal directions, which is remarkable at high magnetic fields. Materials and Methods: We performed magnetic resonance imaging of 17 healthy volunteers using a 3T scanner and obtained coronal DWI/DTI as well as coronal images that were reformatted from isotropic volume data acquired by 1.6-mm-thick axial DWI/DTI. We visually evaluated the degree of image distortion and quantitated the findings by co-registration analysis. Results: In-plane geometric distortions in coronal DWI/DTI, particularly at the frontal base and medial temporal lobe, were dramatically diminished when the isotropic-voxel acquisition technique was used. Quantitative measurement revealed a reduction in areas of misregistration, but not their absence, in reformatted coronal images, mainly because of distortion in the anteroposterior direction in the source images. Conclusion: The isotropic-voxel DWI/DTI technique enabled acquisition of coronal images that represented anatomical details accurately with permissible spatial distortion while maintaining spatial resolution, even at 3T.

A simple x-ray computed tomography(CT) system utilizing a cadmium telluride detector is described. The CT system is of the first generation type and consists of an x-ray generator, a turn table, a translation table, a motor drive unit, a cadmium telluride detector, an interface unit for the detector, and a personal computer(PC). Tomography was performed by the repetition of the translation and rotation of an object. The maximum values of the tube voltage and the tube current were 110kV and 2.0mA, respectively. Tomography was performed at a tube voltage of 60kV and a current of 1.5mA.

The construction of a photon-counting x-ray computed tomography(CT) system utilizing a cadmium telluride(CdTe) detector is described. The CT system is of the first generation type and consists of an x-ray generator, a turn table, a translation table, a motor drive unit, a CdTe detector, two amplifiers, multi-channel analyzer(MCA), and a personal computer(PC). Tomography was performed by the repetition of the translation and rotation of an object. Penetrating x-ray spectra from an object are measured by a spectrometer utilizing a CdTe detector and a MCA, and both the photon energy and the energy width are determined by the MCA.

A 54-year-old man presented with a rare ruptured distal middle cerebral artery (MCA) aneurysm manifesting as subarachnoid hemorrhage. Cerebral angiography demonstrated a fusiform aneurysm in the central artery of the left MCA. The patient underwent anastomosis between the superficial temporal artery and the central artery distal to the lesion followed by trapping and excision of the lesion. The postoperative course was uneventful. Histological examination of the excised specimen revealed a saccular aneurysm and absence of bacteria, inflammation, or neoplasm. The present case shows that a spontaneous saccular aneurysm can develop at the cortical segment of the MCA, and can be successfully treated with bypass surgery combined with trapping.

Background and Purpose— This study investigated the safety and tolerability of desmoteplase administered within 3 to 9 hours after stroke symptoms onset in Japanese patients with acute ischemic stroke. Methods— Patients were randomized to treatment with either desmoteplase or placebo in a 2:1 ratio in 2 consecutive cohorts (70 μg/kg and then 90 μg/kg). Included patients had a baseline National Institutes of Health Stroke Scale score of 4 to 24 and occlusion or high-grade stenosis in the middle cerebral artery segment M1 or M2 on magnetic resonance angiography. The incidence of symptomatic intracranial hemorrhage (≤72 hours) was defined as the primary end point. The occurrence of asymptomatic ICH, symptomatic cerebral edemas, and adverse events were other safety outcomes of special interest. Results— Symptomatic intracranial hemorrhage was observed within 72 hours in 2 patients treated with placebo and in 1 patient treated with 70 μg/kg desmoteplase. Any ICH (symptomatic or asymptomatic ICH) within 72 hours were observed in 7 (43.8%) patients treated with placebo, in 8 (50%) patients treated with 70 μg/kg desmoteplase, and in 9 (56.3%) patients treated with 90 μg/kg desmoteplase. Desmoteplase treatment with 70 or 90 μg/kg was not associated with an increased risk of symptomatic cerebral edema compared with placebo. There were no other serious safety concerns associated with desmoteplase. Conclusions— Desmoteplase in both 70 and 90 μg/kg doses had a favorable safety profile and was well tolerated in Japanese patients with acute ischemic stroke when administered 3 to 9 hours after stroke symptoms onset. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01104467.

The x-ray generator consists of the following components : a constant high-voltage power supply, a filament power supply, a turbomolecular pump, and an x-ray tube. The x-ray tube is a demountable diode which is connected to the turbomolecular pump and consists of the following major devices : a tungsten hairpin cathode (filament), a focusing electrode, a polyethylene terephthalate x-ray window 0.25mm in thickness, a stainless-steel tube body, and a rod target. In the x-ray tube, the positive high voltage is applied to the anode (target) electrode, and the cathode is connected to the tube body (ground potential). In this experiment, the tube voltage applied was from 12 to 18kV, and the tube current was regulated to within 0.10mA by the filament temperature. The electron beams from the cathode are converged to the target by the focusing electrode, and x-rays are produced from the target plane. The x-ray spectra were measured from two directions with angles between the electron trajectory and the x-ray beam axis of 180° and 90°. As compared with the x-ray spectra with an angle of 90°, the bremsstrahlung x-ray intensity decreased slightly with an angle of 180° (opposite direction to that of electron trajectory).

The 100-μm-focus x-ray generator consists of a main controller for regulating the tube voltage and current and a tube unit with a high-voltage circuit and a fixed anode x-ray tube. The maximum tube voltage, current, and electric power were 105kV, 0.5mA, and 50W, respectively. Using a 3-mm-thick aluminum filter, the x-ray intensity was 26.0μGy/s at 1.0m from the source with a tube voltage of 60kV and a current of 0.50 mA. Because the peak photon energy was approximately 35keV using the filter with a tube voltage of 60kV, the bremsstrahlung x-rays were absorbed effectively by iodine-based contrast media with an iodine K-edge of 33.2keV. Enhanced angiography was achieved with a flat panel detector with a pixel size of 50μm using iodine-based microspheres 15μm in diameter. In angiography of non-living animals, we observed fine blood vessels of approximately 100gm with high contrasts.

A preliminary experiment for producing narrow-photon-energy cone-beam X-rays using a silicon single crystal is described. In order to produce low-photon-energy X-rays, a 100-μm-focus X-ray generator in conjunction with a (1 1 1) plane silicon crystal is employed. The X-ray generator consists of a main controller and a unit with a high-voltage circuit and a microfocus X-ray tube. The maximum tube voltage and current were 35 kV and 0.50 mA, respectively, and the X-ray intensity of the microfocus generator was 48.3 μGy/s at 1.0 m from the source with a tube voltage of 30 kV and a current of 0.50 mA. The effective photon energy is determined by Bragg's angle, and the photon-energy width is regulated by the angle delta. Using this generator in conjunction with a computed radiography system, quasi-monochromatic radiography was performed using a cone beam with an effective energy of approximately 17 keV.

The tungsten plasma flash X-ray generator is useful in order to perform high-speed enhanced K-edge angiography using cone beams because K-series characteristic X-rays from the tungsten target are absorbed effectively by gadolinium-based contrast media. In the flash X-ray generator, a 150 nF condenser is charged up to 80 kV by a power supply, and flash X-rays are produced by the discharging. The X-ray tube is a demountable diode, and the turbomolecular pump evacuates air from the tube with a pressure of approximately 1 mPa. Since the electric circuit of the high-voltage pulse generator employs a cable transmission line, the high-voltage pulse generator produces twice the potential of the condenser charging voltage. At a charging voltage of 80 kV, the estimated maximum tube voltage and current were approximately 160 kV and 40 kA, respectively. When the charging voltage was increased, the characteristic X-ray intensities of tungsten K α lines increased. The K α lines were clean, and hardly any bremsstrahlung rays were detected. The X-ray pulse widths were approximately 110 ns, and the time-integrated X-ray intensity had a value of approximately 0.35 mGy at 1.0 m from the X-ray source with a charging voltage of 80 kV. Angiography was performed using a film-less computed radiography (CR) system and gadolinium-based contrast media. In angiography of non-living animals, we observed fine blood vessels of approximately 100 μm with high contrasts.