Search

Objectives To summarise the present evidence for an association between circulating fibrinogen or D-dimer and presence of abdominal aortic aneurysm (AAA) presence. Design MEDLINE database was searched to identify all case-control studies that compared plasma fibrinogen or D-dimer concentrations between patients with AAA and subjects without AAA. For each study, data regarding fibrinogen or D-dimer concentrations in both the AAA and control groups were used to generate mean differences (MDs) and 95% confidence intervals (CIs). Study-specific estimates were combined using inverse variance-weighted average of logarithmic MDs in both fixed- and random-effects models. Results Our search identified 10 eligible studies including 834 cases with AAA and 6971 controls without AAA for fibrinogen and six studies including 264 patients with AAA and 403 subjects without AAA for D-dimer. Pooled analysis demonstrated significantly higher fibrinogen (fixed-effects MD, 0.37 g l−1; 95% CI: 0.30–0.44 g l−1) and D-dimer (random-effects MD: 415.36 ng ml−1; 95% CI: 128.97–701.76 ng ml−1) concentrations in the AAA group than those in the control group. Conclusions We found that plasma fibrinogen and D-dimer concentrations are likely to be higher in cases with AAA than control subjects. Higher plasma fibrinogen and D-dimer concentrations may be associated with the presence of AAA.

Background/Aims: Recent reports have demonstrated that some patients are unable to undergo scheduled liver resection after preoperative portal vein embolization due to insufficient hypertrophy of the future remnant liver. The present study examined whether two-stage portal vein ligation (PVL) increases hypertrophy of the future remnant liver compared to conventional PVL in rats. Methods: Rats were divided into 3 groups: group A, ligation of left primary branch; group B, ligation of right and left primary branches; group C, ligation of the left primary branch, followed by 2-stage PVL 7 days postoperatively. To evaluate liver regeneration, the proliferating cell nuclear antigen labeling index (LI), mitotic index (MI) in the caudate lobe and weight ratio of caudate lobe to body weight were measured. Results: The weight ratio of caudate lobe to body weight was significantly higher in group C than in groups A or B 14 days postoperatively. In groups A and B, LI and MI in the caudate lobe peaked 2 days postoperatively, then decreased to preoperative levels by 7–8 days postoperatively, but remained significantly elevated until 10–14 days postoperatively in group C. Conclusion: Two-stage PVL increases hypertrophy of the future remnant liver compared to conventional PVL in rats.

The social condition of bi-directional sex change in the gobiid fish Trimma okinawae was investigated at Akamizu Beach, Kagoshima, Japan. Social groups of T. okinawae usually consisted of a large male and one or more smaller females. The number of females in the group was positively correlated with male body size and groups were usually separated from each other by 1–3 m. In total, 22 instances of female-to-male sex change and three instances of maleto-female sex change were observed during the 16 months that social groups were monitored. Two individuals changed sex twice: female to male and back to female. Female-to-male sex change occurred when the male disappeared from a group. Either the largest remaining female changed sex to male or a large female from another group immigrated and changed sex to male. Larger individuals appear to benefit from becoming male because they can monopolize the breeding opportunities with several females, as reported in other protogynous fishes. Sex change from male-to-female only occurred when a solitary male joined another group as a subordinate. Mortality rates are high in these small fish, therefore joining another group and reproducing as a female is likely to increase the reproductive value of a solitary male. # 2007 The Authors Journal compilation # 2007 The Fisheries Society of the British Isles

A new method for positioning fine particles on surfaces has been developed. Supercritical CO2-assisted printing (SCAP) was utilized to spray and deposit the prepared particles on solid substrates. By means of masks, regular arrays of the particles were successfully created in designed patterns. Typical size of the particles employed was in the range of submicrometers to micrometers. Supercritical CO2 (sc-CO2) acted as an effective dispersion and transportation medium in this process. Good dispersion state of the particles was achieved by stirring in sc-CO2. Fabrications of fine patterns of solder particles and other ceramic powders on smooth plates were demonstrated. Under optimum operation conditions, fine structures of 30 μm in width can be formed in a minimal pitch of 60 μm. Ultra high yield of the patterning was obtained since the deposition rate could be as high as 100 μm per second. Main factors affecting the process were discussed. The research results indicate that the SCAP is a potential approach to the organization of fine particles into microstructures. Hopefully, it may find wide industrial applications where lithography is needed, such as solder printing in surface mounting technology for higher density electronics and thick film fabrication for miniature systems.

Basi-parallel anatomical scanning (BPAS)-MRI is a simple MRI technique to reveal the surface contour of the intracranial vertebrobasilar artery. The purpose of this study was to investigate the usefulness of BPAS-MRI for observing the temporal course of unruptured vertebral artery (VA) dissection in patients by means of serial MR examinations. Since April 2003, we performed serial MR examinations in four patients with unruptured acute vertebral artery dissection. The frequency of the MR examinations during the follow-up period in each patient varied from twice within seven months to five times within 19 months. Both MRA and BPAS-MRI were obtained in each MR examination. We investigated the course of morphological changes within the dissected artery on BPAS-MRI (outer contour) and on MRA (inner lumen). Although the initial MRA showed fusiform dilatation, irregular stenosis or normal caliber at the dissected lesion, the initial BPAS-MRI disclosed fusiform dilatation in all of the four patients. In two patients, MRA finding of the VA lesion had changed, though the fusiform appearance had been stationary on BPAS-MRI. Then both dissolution of the fusiform dilatation on BPAS-MRI and normalization of the inner luminal caliber on MRA were confirmed within nine months. In one patient, fusiform dilatation on both BPAS-MRI and MRA resolved simultaneously on the MR examination at eight months after the initial symptom. In another patient, fusiform dilatation of the outer contour was still enlarging on BPAS-MRI ten months after the onset, though the fusiform dilatation on MRA had been stationary since the eighth week. We performed endovascular coil embolization in this patient eleven months after the initial symptom. Resolution of the fusiform dilatation on BPAS-MRI should be a healing sign of VA dissection. Persisting the fusiform dilatation or progressively enlarging outer contour on BPAS-MRI may be an unstable sign. BPAS-MRI provides more information about the instability of the dissected lesion. We should obtain not only MRA but also BPAS-MRI for the course observation of unruptured VA dissection.

The surgical treatment of ruptured blister-like dissecting aneurysm on the internal carotid artery (ICA) is still controversial. We report a case of this disease successfully managed by a staged treatment: GDC packing into the blister-like aneurysm in the acute stage followed by proximal occlusion in the chronic stage. The merit of this staged treatment is to prevent rerupture in the acute stage and to allow the proximal occlusion in the chronic stage with or without an extracranial-intracranial bypass, after assessment of tolerance of the ICA occlusion.

We describe a rare case of having both symptomatic ipsilateral retinal embolization and asymptomatic cerebellar embolization occurring after carotid stenting with use of distal protect device. In this case, external carotid angiograms revealed accessory meningeal artery-ophthalmic artery and occipital artery-vertebral artery anastomoses. This case suggested that the protection for external carotid artery should be considered during carotid stenting to avoid retinal embolization and cerebellar or cerebral embolization in cases showing angiographical anastomoses between external carotid artery and ophthalmic artery or intracranial arteries.

Objective: We examined the effect of erdosteine (KW-9144), an expectorant, and related compounds on inflammatory cell-derived reactive oxygen species which are involved in airway inflammation.¶Methods: Neutrophils were isolated from peritoneal lavages of casein-injected rats and from peripheral blood of healthy human donors. Eosinophils were isolated from peritoneal lavages of horse serum-injected guinea pigs. These cells were stimulated with phorbol 12-myristate 13-acetate (PMA) and the production of reactive oxygen species was measured with luminol-dependent chemiluminescence (LDCL).¶Results: M1, an active metabolite of erdosteine, significantly inhibited PMA-induced LDCL of the all cell populations with treatment before stimulation. The effects of S-carboxymethylcysteine (S-CMC), ambroxol and N-acetylcysteine (NAC) on the LDCL response were weaker than those of M1. Furthermore, PMA-induced LDCL was decreased by posttreatment with M1.¶Conclusion: These results suggest that M1 (an active metabolite of erdosteine) may exert an antiinflammatory effect by scavenging inflammatory cells-derived reactive oxygen species.

Chronic pancreatitis is a common cause of splenic artery pseudoaneurysm. An abdominal aortic pseudoaneurysm associated with pancreatitis is extremely rare and thus far only seen in an acute exacerbation of chronic pancreatitis with multiple fluid collections in the retroperitoneum. We describe an abdominal aortic pseudoaneurysm associated with chronic pancreatitis without acute inflammation. This was successfully treated with a prosthetic tube graft.

Basi-parallel anatomical scanning (BPAS)-MRI is a simple MRI technique that we designed to reveal the surface appearance of the vertebrobasilar artery within the cistern. Because it requires only 2 cm-thick heavily T2-weighted coronal imaging with gray-scale reversal, we can obtain BPAS-MRI with any MR machine of any company. BPAS-MRI can easily show the outer contour of the vertebrobasilar artery even if occluded. Therefore, BPAS-MRI can also reveal the occluded basilar trunk and the shape of basilar top branching that we cannot see with any other imaging modality before the recanalizing interventional procedure. To avoid a dangerous blind manipulation of guidewires or micro-catheters, BPAS-MRI should be obtained prior to the interventional procedure in cases of acute basilar artery occlusion.

The aim of this paper is to design conspicuous region by color features, HSV and Lab. To attract attention, road sign and advertising display are designed. However, it is difficult for us to recognize such kind of objects in a confusing environment. Therefore, this paper clarifies the relation between the saliency of color features of original image and the “conspicuousness” of the selected region, and discusses what kind of color feature makes a contribution to the conspicuousness of the region. In addition, we propose an example of design method to improve conspicuousness.

A contralateral inferior petrosal sinus approach is described for the successful treatment of a case of a dural arteriovenous fistula at an isolated right jugular bulb presenting with chemosis. A microcatheter could be inserted into the right jugular bulb from the left jugular bulb through the left inferior petrosal sinus, basilar sinus on the dorsum sellae, and the right inferior petrosal sinus. This unusual approach represents an alternative route to the jugular bulb.

To summarize the present evidence for an association between high-density lipoprotein (HDL) or low-density lipoprotein (LDL) cholesterol and abdominal aortic aneurysm (AAA) presence, we performed a systematic review and meta-analysis of case-control studies that compared serum HDL or LDL cholesterol between patients with AAA and control subjects.MEDLINE and EMBASE databases were searched to identify all case-control studies that compared serum HDL or LDL cholesterol between patients with AAA and control subjects. For each study, data regarding serum HDL or LDL cholesterol in both the AAA and control groups were used to generate mean differences (MDs) and 95% confidence intervals (CIs). Study-specific estimates were combined using inverse variance-weighted average of logarithmic MDs in both fixed- and random-effects models.Our search identified 8 eligible studies including 812 patients with AAA and 8 267 control subjects. Pooled analysis demonstrated significantly lower serum HDL cholesterol (MD, -0.15 mmol/L; 95% CI, -0.24 to -0.07 mmol/L; P=0.0006) and significantly higher serum LDL cholesterol (MD, 0.25 mmol/L; 95% CI, 0.08 to 0.42 mmol/L; P=0.004) in the AAA group than those in the control group in random-effect models. There was significant study heterogeneity of results but no evidence of significant publication bias. Several sensitivity analyses did not substantively alter the overall result of our analysis.We found that, based on a systematic review and meta-analysis, serum HDL cholesterol is likely lower and serum LDL cholesterol is likely higher in patients with AAA than control subjects. Lower serum HDL cholesterol and higher serum LDL cholesterol may be associated with AAA presence.

Two cases of acutely ruptured cerebral aneurysm of low dome/neck ratio treated by stent-assisted GDC embolization using balloon-expandable coronary stent, and also their long-term follow-up results are reported. After embolization, the basilar trunk aneurysm was completely occluded, and partial occlusion was obtained for the internal carotid (IC)-paraclinoid aneurysm. Oral ticropidine (200 mg/day) was given after the embolization, and no neurological events were seen during long-term follow-up (64-68 months). Follow-up angiograms of the basilar trunk aneurysm at 20 months showed complete occlusion and no in-stent stenosis. Follow-up angiograms of the IC-paraclinoid aneurysm at 52 months showed complete occlusion of the aneurysm, but mild stenosis at the distal end of the stent graft. These cases suggested that stent-assisted GDC embolization is effective for prevention of rebleeding from ruptured aneurysm during long-term observation even with sufficient dose of antiplatelets therapy. Caution should be taken on aneurysmal recanalization and parent artery stenosis due to stent deployment during long-term period.

Feasibility studies for the sailing-type offshore wind farm have been carried out by National Institute for Environmental Studies. This system is composed of a very large floating offshore structure with sails and a lot of wind turbines on the structure. Conventional catenary mooring system is no longer practical for station-keeping a kilometer sized floating structures in over hundreds meters of water depth. This floating structure sails around EEZ of Japan seeking appropriate breezing and avoiding meeting heavy storm. This floating structure has self-mobile and station-keeping capability using the sail control system and semi-sub hull structure. This paper presents the development of this floating structure based on the hydro-elastic response analysis in waves and structural optimization.

This paper introduces our R&D, which has been sponsored by JRTT and conducted by NMRI, of the most suitable floating platform for CO2 release in order to carry out CO2 storage on deep seabed (FPCS). FPCS requires, at first, large CO2 storage tanks in it and small motion characteristic to continue stable production and release of CO2 slurry via injection pipes into the sea and to carry out on-loading of CO2 liquid from CO2 shuttle tankers to the Platform in a considerably severe sea condition. We designed the hull shape twice. In addition, FPCS shall have a reliable mooring system, on-loading system, cooling compressors, slurry pumps, and large deck for process plant and utilities. We successfully completed the R&D including cost estimation of FPCS.

This paper presents two new circuit topologies of voltage source-fed soft-switching PWM inverter using a high frequency transformer parasitic inductive components with full- bridge or half-bridge configuration, which are more suitable for utility AC 400 V-rms input mains. These circuits have each reverse conducting power semiconductor switching devices in series with high and low DC buslines, a single or two lossless snubbing capacitors in parallel with two DC buslines and additional diode components. Under the newly proposed high frequency softswitching PWM inverter link DC-DC power converter circuits for utility AC 400V-rms input, all the active power switches in the full- bridge arms or half-bridge arm and DC buslines achieve ZCS turn- on commutation operation and ZVS turn-off commutation operation, and consequently the total turn-off switching power losses can be significantly reduced. As a result, a high switching frequency for IGBTs used can be actually realized at a frequency band more than about 20 kHz. It is proved that the more the switching frequency of inverter increases, the more soft switching PWM DC-DC converters with a high frequency transformer have remarkable advantages for its power conversion efficiency and power density as compared with the conventional hard switching PWM full-bridge inverter type DC-DC converter. The practical effectiveness of these new converter topologies are confirmed for low voltage and large current DC power supplies as high performance arc welding machine from a practical point of view.

This paper presents a new circuit topology of DC bus line switch-assisted half-bridge soft switching PWM inverter type DC-DC converter for arc welder. The proposed power converter is composed of typical voltage source half-bridge high frequency PWM inverter with a high frequency transformer link in addition to DC bus line side power semiconductor switching devices for PWM control scheme and capacitive lossless snubbers. All the active power switches in the half-bridge arm and DC bus lines can achieve ZCS turn-on and ZVS turn-off commutation operation and consequently the total turn-off switching losses can be significantly reduced. As a result, a high switching frequency of using IGBTs can be actually selected more than about 10 kHz. The effectiveness of this new converter topology is proved for low voltage and large current DC-DC power supplies such as arc welder from a practical point of view

A rescue clot disruption using a basket snare is described for acute basilar artery embolic occlusion resistant to balloon angioplasty and fibrinolysis therapy. In spite of failed balloon angioplasty in conjunction with fibrinolysis, a basket-shaped snare connected to a microguide wire could be used to catch and crush the clot in the upper basilar artery. The rescue use of a snare may be effective for angioplasty-resistant acute embolic stroke.

To compare complications, anigographical results, duration of postoperative hospital stay and cost for treatment of surgical clipping and coil embolization in the treatment of unruptured cerebral aneurysm. One hundred and nine non-giant saccular aneurysms in 90 patients were treated by either endovascular treatment (E group) or direct surgery (S group) in our Neurosurgical Department between April 1996 and April 2002. The complications and angiographical results were reviewed. The duration of postoperative hospital stay and cost for the treatment were calculated from bills for health insurance for 38 operations and 12 embolizations in 47 patients whose aim of hospitalization was only treatment for their unruptured aneurysm. Neck clipping was performed for 89 aneurysms (S group), wrapping for four (S group), embolization using Guglielmi's detachable coils (GDCs) for 15 (E group), and failed embolization followed by clipping for one (E group). The postoperative temporary deficit (disappeared within one month) and permanent deficit was seen in five cases (6.7%) and in three cases (morbidity: 4.0%) of S group, and in one case (6.7%) and none (morbidity; 0%) of E group, respectively. No death was seen in both group (mortality; 0% in both group). The rate of angiographical complete occlusion of the aneurysm was significantly higher in S group (P = 0.015, 88% in S group vs 50% in E group). The postoperative hospital stay was significantly shorter in E group (P= 0.000013, mean days: 17.1 in S group vs 6.3 in E group), but cost for treatment was rather cheep in S group (N.S., mean cost: 1684329 yen in S group vs. 2259011 in E group). This retrospective study suggested that surgical treatment may be less expensive treatment with higher rate of postoperative angiographical complete occlusion than coil embolization, and treatment-related complication rate was similar in both treatment.

We investigated the role of GDC embolization as a second choice for the treatment of ruptured cerebral aneurysm. From september 1997 to may 2001, 139 ruptured aneurysms out of 151 consecutive ruptured aneurysms transferred to our hospital were treated by clipping (first choice) or GDC embolization (second choice). Patient selection was decided by more than two neurosurgeons under the policy that GDC embolization is the second choice of treatment. The mid-term (longer than three months) outcome of both group was examined. One hundred and nineteen Ans (BA two, IC-paraclinoid one, IC-PC or IC-Ach 36, IC-ant. Wall two, ACoA34, ACA six, MCA38) were treated by clipping (clipping group), 20 Ans (surgical difficulty; BA three, IC-paraclinoid three, VA dissection six, general complications; IC-PC two, IC-dissection one, ACoA four, VAPICA one) by GDC embolization (GDC group) within 24 hours after admission. SAH grade and GOS of each group were Gr1: 35&4, Gr2: 41&5, Gr3: 23&5, Gr4: 11&4, Gr5: 9&2, respectively, and GR: 79&14, MD: 8&3, SD: 11&0, VS: 8&0, D: 13&3 respectively. Good prognosis (better than MD) was gained in 73% of clipping group and 85% of GDC group. No rebleeding was seen in GDC group. GDC embolization for the cases with surgical difficulty or general complication raised the overall outcome. GDC embolization would be suitable for IC-paraclinoid Ans, BA-VA Ans, and ruptured VA dissections. Because of the good clinical outcome gained in the GDC group, GDC treatment would be the first choice of treatment for such aneurysms as geometrically suitable for coiling.

Objective and design: Bronchial epithelium plays an important role in the regulation of inflammatory reactions in the airways. We investigated the effect of KF19514, a phosphodiesterase (PDE) 4 and 1 inhibitor, on granulocyte-macrophage colony-stimulating factor (GM-CSF) production by a human bronchial epithelial cell line, BEAS-2B. Methods: BEAS-2B cells were stimulated with the tumor necrosis factor-α (TNF-α) and various concentrations of test agents for 48 h. Supernatants were assayed for GM-CSF by using an enzyme-linked immunosorbent assay (ELISA). In addition, intracellular cyclic AMP (cAMP) levels were measured in the presence of various agents. Results: KF19514 significantly inhibited the release of GM-CSF by BEAS-2B cells in a concentration-dependent manner. The other PDE4 inhibitors and cAMP-elevating agents also inhibited the GM-CSF production. In the BEAS-2B cells, KF19514 and PDE4 inhibitors concentration-dependently increased intracellular cAMP levels. The inhibitory effect of KF19514 on the GM-CSF production was significantly reduced by a cAMP-dependent protein kinase A (PKA) inhibitor, H89. On the other hand, other PDE isozyme inhibitors did not inhibit the GM-CSF production by BEAS-2B cells, and did not elevate the intracellular cAMP levels. Conclusions: These results indicate that KF19514 and PDE4 inhibitors reduce TNF-α-induced GM-CSF production of BEAS-2B cells via a cAMP-dependent pathway. PDE4 may be a possible target for the regulation of cytokine production in epithelial cells.

A new mechanism is presented for high-energy-electron acceleration from an electron beam by an electromagnetic (EM) wave with a static magnetic (B) field. Numerical analyses and simulations show that this mechanism works well for high-energy-electron acceleration. Typically, the magnitude of the static B field is significantly small compared with the amplitude of the EM wave. The optimal magnitude of the static B field is also discussed. Possible application is in particle acceleration and in laser fusion. >

The test consulting system (TCS) is an expert system that can automatically generate test scripts for testing switching systems from feature operation descriptions written in feature description elements (FDE). TCS also provides general information of switching system features and testing for reference. TCS has on-line help to explain concepts and questions that relate to the system and test process. Automatically generating test procedures is based on the logic within switching systems features and the knowledge of experienced testers. TCS can accumulate testers' experience in efficiently finding errors, identifying critical parts of the system, and locating related materials. >

We evaluated the surgical results of postinfarction ventricular septal perforation by endocardial patch with infarction exclusion.We reviewed 8 patients complicating AMI who underwent surgical treatment at our institution from July 1997 to August 2000 (6 males, 2 females, mean age 73.9 +/- 9, range 57-87). The localization of AMI and VSP was anterior in 6 patients, inferior in 2. All patients had coronary angiography preoperatively. And 7 patients had the percutaneous transluminal coronary angioplasty of the infarct artery.There were 2 hospital deaths due to cerebral infarction and pulmonary hemorrhage. All deaths occurred in patients with cardiogenic shock.Good results were obtained by infarction exclusion technique. Better operative results may be expected with the preoperative coronary angioplasty of the infarct artery.

From March 1989 to July 2000, 82 patients have received the aortic-mitral replacement in our hospital. Among these patients, 11 patients had left ventricular ejection fraction less than 40%. We evaluated the mortality, the cause of death, postoperative complications and mid-term results of these patients. Five-years' survival rate was determined by means of the Kaplan-Meire method. Follow-up was complete for 100% of the patients.One patient (9%) died on 7 days after operation, due to multiorgan failure. Postoperativery, all patients had anticoagurant therapy with warfarin sodium and showed improvement in functional class. Mean follow-up was 3.4 years (0-5.9 years). The late death rate was 20% (2 patients). But there were no valve-related deaths during the follow-up periods. Overall survivals rate at 5 years was 70%.Despite the poor left ventricular function, we obtained satisfactory mid-term results of mitral-aortic valve operations.

From January 1995 to August 2000, 34 patients received the triple valve operation in our hospital. We evaluated the mortality, the cause of death, postoperative complications and mid-term results in these patients. Five-years'survival rate was determined by means of the Kaplan-Meire method.Two patient died after operation due to cardiac failure and cerebral infarction. Postoperativery, all patients had anticoagurant therapy with warfarin sodium. Mean follow-up was 3.2 years (0-5.6 years). There was one late sudden death among 32 perioerative survivors. There were 3 episodes of cerebral infarction. The rate of freedom from cardiac event at 5 years was 79%. Overall survival rate at 5 years was 94%.We obtained good mid-term results of triple valve operation. We recommend aggressive treatment for functional tricuspid valve regurgitation.

The authors reported a rare case of chronic subdural hematoma presenting bilateral visual impairment caused by papilledema. A 49-year-old man was admitted to our department due to left blurred vision. On admission, ophthalmological examination revealed visual acuity disturbance on the left eye, bilateral nasal visual field defect and papilledema. CT scan and MRI demonstrated bilateral subdural hematoma. No remarkable findings were detected on cerebral angiography. After evacuation of bilateral subdural hematomas, his visual symptoms recovered. In this report, we discuss the mechanism of visual impairment caused by chronic subdural hematoma.

We experienced an immediately post-operative death due to rupture of a giant basilar aneurysm four hours after right external carotid artery-posterior cerebral artery bypass surgery. As we had had preanesthetic discussions with neurosurgeons repeatedly, they did not seek for a cause of the death on our anesthetic management. However, in general, not few surgeons believe that many postsurgical complications may be mainly due to anesthetic management but not to surgery as they believe that their surgical procedures are always faultless. Therefore, we should have a wealth of anesthetic knowledge to respond to any surgeon's questions regarding anesthetic management and to precisely explain a causal relation between postsurgical complications and anesthesia. In addition, we should have frequent discussions with surgeons on postsurgical management in sick patients. These may reduce misapprehensions of surgeons, patients and their family for anesthesia.

Although many surgical or endovascular treatments for ruptured vertebral artery dissection have been reported, the best treatment is controversial. We treated five cases of ruptured vertebral artery dissection distal to the origin of the posterior inferior cerebellar artery (PICA), using retrievable platinum coils packed in the dissection site and the immediately proximal vertebral artery. All patients had a contralateral vertebral artery of the same calibre or larger. All dissections were occluded completely, together with the portion of the vertebral artery distal to the PICA origin. No complications related to the procedure were seen. The purpose of the treatment is to isolate the dissection from the cerebral circulation. Occlusion of the rupture site, preserving perforating arteries arising from the vertebral artery, would be ideal. Short-segment occlusion by retrievable platinum coils is close to the ideal.

We examined in this study the effect of KF19514, a phosphodiesterase 4 and 1 inhibitor, on antigen-induced lung inflammation by inhaled administration in guinea-pigs. It was previously reported that inhaled KF19514 prevented antigen-induced bronchoconstriction and platelet-activating factor (PAF)-induced lung inflammation. In fact, a variety of factors other than PAF are related to lung inflammation in real subjects with asthma. Guinea-pigs were actively sensitized by exposure to ovalbumin (OA). Fifteen to 20 days later, the guinea pigs were challenged by exposure to aerosols of five successively increasing concentrations of OA (0.01, 0.1, 0.5, 1 and 5 mg/ml). Bronchoalveolar lavages (BALs) were performed 24 h after the antigen challenge, and airway hyperresponsiveness to acetylcholine (ACh) was studied 24 h after the challenge by measuring lung resistance and dynamic compliance. Ovalbumin antigen challenge produced a marked and significant eosinophil accumulation in the BAL fluids and airway hyperresponsiveness to ACh 24 h after the challenge. Inhaled KF19514 (0.01-0.1%) inhibited the eosinophil accumulation significantly and dose-dependently but inhaled rolipram (0.01-0.1%) and aminophylline (0.1-1%) did not. In addition, the development of airway hyperresponsiveness was prevented by inhaled KF19514 (0.01%) but not by inhaled rolipram (0.01%) and aminophylline (0.1%). Based on these data, KF19514 was suggested to be a promising drug in the treatment of asthma by local administration to the lung.

We report the rare case of ipsilateral posterior inferior cerebellar artery originating from the carotid artery, and associated with multiple concurrent aneurysms. This is the 23rd reported case of carotid-cerebellar anastomosis and the first case with three concurrent aneurysms reported in the literature. Of the 23 cases, 6 had single aneurysms, 2 had double aneurysms and the present case had triple aneurysms.

Summary: We present two cases of dural arteriovenous fistula of the cavernous sinus with venous congestion of the brain stem. Both cases were detected by MR imaging and showed significant improvement on MR images after transvenous embolization.

Eosinophils are prominent inflammatory cells which play a critical role in the pathogenesis of allergic diseases and bronchial asthma. The aim of this experiment was to examine the effects of oxatomide (CAS 60607-34-3, KW-4354), an antiallergic agent, on oxygen-radical generation and peptide-leukotriene (p-LT) release from guinea pig eosinophils. Ketotifen (CAS 345080-13-7) and epinastine (CAS 80012-43-7) were used as reference drugs. Eosinophils were isolated from the peritoneal exudate of guinea pigs, in which peritoneal eosinophilia had been induced by injection of horse serum. Oxygen-radicals were measured with luminol-dependent chemiluminescence and p-LT release was measured with enzyme immunoassay. When eosinophils were stimulated with phorbol miristate acetate, oxatomide and ketotifen inhibited the oxygen-radical generation with a concentration required for 50% inhibition (IC50) of 11.7 mumol/l and 28.4 mumol/l. Oxatomide, ketotifen or epinastine showed an inhibition of oxygen-radical generation induced by calcium ionophore A-23187 and the IC50 value was 11.3 mumol/l for oxatomide, 15.1 mumol/l for ketotifen and 27.3 mumol/l for epinastine, suggesting that oxatomide is a more potent inhibitor of oxygen-radical generation than ketotifen and epinastine. Oxatomide also inhibited p-LT release induced by calcium ionophore A-23187 (IC50, 9.83 mumol/l). Ketotifen and epinastine only weakly inhibited p-LT release. These results suggest that oxatomide may regulate inflammatory diseases, such as bronchial asthma, through suppression of eosinophil function.

Effect of KW-4679, an antiallergic agent, on the experimental allergic rhinitis was studied in guinea pigs. 1) KW-4679 inhibited the sneeze response and the nasal rubbing induced after the intranasal administration of antigen in sensitized guinea pigs. The inhibitions were dose-related and significant at 0.03 mg/kg p.o. for sneeze response and 1 mg/kg p.o. for nasal rubbing, respectively. 2) The nasal vascular permeability was increased after the intranasal administration of antigen in sensitized guinea pigs. KW-4679 significantly reduced the increase of the nasal vascular permeability at 1 mg/kg p.o. or higher. From these results, KW-4679 may have inhibitory effects on sneeze, nasal irritation and rhinorrhea in clinical use.

The dura mater adjacent to the attachment of meningiomas was enhanced on MR imaging with intravenous Gd-DTPA infusion. It was examined histologically in four patients with intracranial globoid meningiomas. Histological examination revealed that there was no tumor cell invasion within the dura mater enhanced on MR imaging, except at the point of their attachment. A layer of tumor cells was occasionally observed on the surface of the dura mater, but this was limited to within 5 mm of the tumor margin. Our electronmicroscopic observation indicated that enhancement of the dura mater adjacent to the attachment of meningiomas was caused by increased vascular permeability of the dural vessels and extended extravascular space.

Pretreatment of mice with hot water and alkaline extracts of Catuaba casca (Erythroxylum catuaba Arr. Cam.) effectively protected them from lethal infection of Escherichia coli and Staphylococcus aureus. The extracts significantly inhibited both the human immunodeficiency virus (HIV)-induced cytopathic effect and the expression of HIV antigen in HIV-1HTLV-IIIB or HIV-2ROD infected human lymphotropic virus type I (HTLV-1) positive MT-4 cells. The 50% effective concentrations of the active fractions (21-263 micrograms/ml) were 1/4 - 1/43 of their 50% cytotoxic concentrations. Their anti-HIV activity was shown to be induced, at least in part, via the inhibition of HIV adsorption to the cells. The data suggest a medicinal potential of Catuaba extracts against opportunistic infection in HIV patients.

A 1-year-8-month-old boy was admitted to our service on September 30, 1986, complaining of nausea, vomiting and consciousness disturbance lasted for about 2 weeks. In CTs, right frontal cystic mass which was homogeneously enhanced by contrast media was revealed. Neither hypervascularity nor tumor staining were seen angiographically. On October 9, 1986, total removal of the tumor was performed. The tumor was located extracerebrally in the right anterior cranial fossa, but was covered with arachnoid membrane. The tumor showed tight adhesion with falx cerebri, particularly at crista galli where an invasive infiltration was seen. Light microscopic examination demonstrated oval or spherical small cells arranged multilobularly with rosette like formation and numerous mitoses. Ultrastructurally, cilia, microvilli and junctional complexes were observed. No dense-cored secretory granules were found in the tumor cells. Immunohistochemical study on this tumor showed negative NF and GFAP; positive NSE, S-100, vimentin and keratin. From these findings, the tumor was diagnosed as esthesioneuroepithelioma. Postoperatively, irradiation and chemotherapies were also performed, and the patient showed uneventful course. On January 31, 1987, he was discharged on his foot, and no recurrent or metastatic signs could be found until the end of March of 1990.