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OBJECTIVE A recent comparative analysis between neurosurgical and endovascular treatments for craniocervical junction (CCJ) arteriovenous fistulas (AVFs) revealed better treatment outcomes in the neurosurgery group than in the endovascular group. This finding was attributed to the higher than expected rate of ischemic complications in the endovascular group than in the neurosurgery group (26% vs 7.7%, p = 0.037). The aim of the present study was to describe ischemic complications associated with treatments for CCJ AVFs. METHODS This descriptive study was authorized by the Neurospinal Society of Japan. Data from 97 consecutive patients with CCJ AVFs who underwent neurosurgical (n = 78) or endovascular (n = 19) treatment between 2009 and 2019 were collected from 29 centers. The primary endpoints were details on ischemic complications and their risk factors. Secondary endpoints were details on other complications. RESULTS Among all major complications, ischemic complications were the most common (11% of 97 patients), followed by hemorrhagic complications (7.2%), hydrocephalus (2.1%), and CSF leakage (2.1%). Ischemic complications included 8 spinal, 2 brainstem, and 1 cerebellar infarctions. Iatrogenic occlusion of the anterior or posterior spinal artery from the radiculomedullary or radiculopial arteries caused these complications. Ischemic complications resulted in neurological deficits, including motor paresis, sensory disturbances, and brainstem dysfunction. The modified Rankin Scale score was 3 or higher in 36% of patients with ischemic complications at the final follow-up of 23 months. Risk factors associated with ischemic complications were endovascular treatment (OR 4.3, 95% CI 1.1–16) and spinal feeding arteries (OR 3.8, 95% CI 1.03–14). Most of the other complications were addressed by additional treatment without permanent neurological deficits. CONCLUSIONS Among ischemic complications associated with treatments for CCJ AVFs, spinal infarctions were the most common and were mostly attributed to endovascular procedures for CCJ AVFs fed by spinal arteries. These results support the use of neurosurgery as the first-line treatment for CCJ AVFs.

Parkinson's disease (PD) patients often suffer from spinal diseases requiring surgeries, although the risk of complications is high. There are few reports on outcomes after spinal surgery for PD patients with deep brain stimulation (DBS). The objective of this study was to explore the data on spinal surgery for PD patients with precedent DBS. We evaluated 24 consecutive PD patients with 28 spinal surgeries from 2007 to 2017 who received at least a 2-year follow-up. The characteristics and outcomes of PD patients after spinal surgery were compared to those of 156 non-PD patients with degenerative spinal diseases treated in 2013-2017. Then, the characteristics, outcomes, and spinal alignment of PD patients receiving DBS were analyzed in degenerative spinal/ lumbar diseases. The mean age at the time of spinal surgery was 68 years. The Hoehn and Yahr score regarding PD was stage 1 for 8 patients, stage 2 for 2 patients, stage 3 for 8 patients, stage 4 for 10 patients, and stage 5 for 0 patient. The median preoperative L-DOPA equivalent daily dose was 410 mg. Thirteen patients (46%) received precedent subthalamic nucleus (STN) DBS. Lumbar lesions with pain were common, and operation and anesthesia times were long in PD patients. Pain and functional improvement of PD patients persisted for 2 years after surgery with a higher complication rate than for non-PD patients. PD patients with STN DBS maintained better lumbar lordosis for 2 years after spinal surgery. STN DBS significantly maintained spinal alignment with subsequent pain and functional amelioration 2 years after surgery. The outcomes of spinal surgery for PD patients might be favorably affected by thorough treatment for PD including DBS.

OBJECTIVE Craniocervical junction (CCJ) arteriovenous fistulas (AVFs) are treated using neurosurgical or endovascular options; however, there is still no consensus on the safest and most effective treatment. The present study compared the treatment results of neurosurgical and endovascular procedures for CCJ AVFs, specifically regarding retreatment, complications, and outcomes. METHODS This was a multicenter cohort study authorized by the Neurospinal Society of Japan. Data on consecutive patients with CCJ AVFs who underwent neurosurgical or endovascular treatment between 2009 and 2019 at 29 centers were analyzed. The primary endpoint was the retreatment rate by procedure. Secondary endpoints were the overall complication rate, the ischemic complication rate, the mortality rate, posttreatment changes in the neurological status, independent risk factors for retreatment, and poor outcomes. RESULTS Ninety-seven patients underwent neurosurgical (78 patients) or endovascular (19 patients) treatment. Retreatment rates were 2.6% (2/78 patients) in the neurosurgery group and 63% (12/19 patients) in the endovascular group (p < 0.001). Overall complication rates were 22% and 42% in the neurosurgery and endovascular groups, respectively (p = 0.084). Ischemic complication rates were 7.7% and 26% in the neurosurgery and endovascular groups, respectively (p = 0.037). Ischemic complications included 8 spinal infarctions, 2 brainstem infarctions, and 1 cerebellar infarction, which resulted in permanent neurological deficits. Mortality rates were 2.6% and 0% in the neurosurgery and endovascular groups, respectively (p > 0.99). Two patients died of systemic complications. The percentages of patients with improved modified Rankin Scale (mRS) scores were 60% and 37% in the neurosurgery and endovascular groups, respectively, with a median follow-up of 23 months (p = 0.043). Multivariate analysis identified endovascular treatment as an independent risk factor associated with retreatment (OR 54, 95% CI 9.9–300; p < 0.001). Independent risk factors associated with poor outcomes (a postoperative mRS score of 3 or greater) were a pretreatment mRS score of 3 or greater (OR 13, 95% CI 2.7–62; p = 0.001) and complications (OR 5.8; 95% CI 1.3–26; p = 0.020). CONCLUSIONS Neurosurgical treatment was more effective and safer than endovascular treatment for patients with CCJ AVFs because of lower retreatment and ischemic complication rates and better outcomes.

The design and development for a compact 1 GHz (23.5 T)-class NMR magnet are presented. The magnet uses inner coils wound with Ni alloy-reinforced Bi-2223 conductors in combination with LTS outer coils. The series-connected coils are operated in a power supply-driven mode. The total magnet size is very compact, and is comparable to that of a currently commercialized 600-MHz (14.1 T) NMR magnet. This owes to a high current density operation of the Bi-2223 inner coils, which contribute as much as 53% of the total magnetic field. This paper investigated the following properties of the Bi-2223 inner coils: First, joint resistance under external magnetic fields; second, tensile stress tolerances of the Bi-2223 conductor under bending condition; third, high compressive stress on Bi-2223 coils; fourth, the effect of screening current-induced magnetic field on the field homogeneity and stability; and fifth, the maximum permissible Joule heating to avoid a thermal runaway. Two Bi-2223 inner coils for the magnet were built and tested in liquid nitrogen, which provided important knowledge for the magnet excitation.

We are developing a cryocooled (RE)Ba2Cu3O7 (REBCO; RE = rare earth) persistent-mode superconducting magnet system that generates 1 T with multiple superconducting joints. In parallel to the design of the system, we have investigated transport characteristics of the REBCO superconducting joints. Critical currents (Ic) were measured as a function of magnetic field and temperature. Two joint samples with Ic of 107 and 53 A at 77 K, self-field were measured. The first one showed Ic of 357 A at 50 K and 0.1 T (magnetic field is perpendicular to the tape surface). Ic of the REBCO joint samples showed remarkable hysteresis. The anisotropy of Ic changed with temperature. Ic at B perpendicular to the tape were higher than those at B parallel to the tape at temperatures below 20 K. The random pinning is possibly the dominant pinning mechanism in the whole temperatures for the REBCO superconducting joints in magnetic fields perpendicular to c-axis.

The technological development for a 3-T high-temperature superconducting (HTS) magnetic resonance imaging (MRI) magnet is underway. The 3-T HTS MRI magnet is imaged such that RE(= Rare Earth)Ba 2 Cu 3 O 7-δ (REBCO) coils are installed and cooled using a cryocooler between 30 and 50 K without liquid helium refrigerant. REBCO MRI magnets are expected to maintain the magnetic field with stability better than 0.1 ppm/h with superconducting joints for a persistent-current mode. The resistance in a joint must be suppressed less than 1 × 10 -12 Ω to achieve the expected stability. The resistance of REBCO joint was estimated measuring the decay rate of trapped magnetic field in a REBCO single-turn loop including a joint. An external magnetic field of up to 1 T was applied to the joint in the STL at temperatures of 35 K and 50 K. The order of resistance in the REBCO joint was less than 1 × 10 -13 Ω.

Recent development in the superconducting REBCO joints is an encouraging prospect for realizing an HTS magnet in persistent current mode operation. In our ongoing project, we are developing a cryocooled 1 T REBCO magnet system with joints to demonstrate the joint performance in an operating condition expected, for example, for an MRI. Preliminarily, the small test coils have been fabricated to verify the winding method. Additionally, we have designed and manufactured the new leads structures for feeding the conductor from the winding to the joints.

This paper describes the first persistent-mode medium magnetic field (400 MHz; 9.39 T) nuclear magnetic resonance (NMR) magnet which uses superconducting joints between high-temperature superconductors (HTSs). As the ultimate goal, we aim to develop a high-resolution 1.3 GHz (30.5 T) NMR magnet operated in the persistent-mode. The magnet requires superconducting joints between HTSs and those between an HTS and a low-temperature superconductor (LTS). Towards this goal, we have been developing persistent-mode HTS inner coils to be operated in a 400 MHz (9.39 T) NMR magnet and here we present the first prototype inner coil wound with a single piece (RE = rare earth)Ba2Cu3O7−x (REBCO) conductor. The coil and a REBCO persistent current switch are connected with intermediate grown superconducting joints with high critical currents in external magnetic fields. To evaluate the performance of the joints in an ultimately stable and homogeneous magnetic field, the coil is operated in the persistent-mode, generating 0.1 T, in a 9.3 T background magnetic field of a persistent-mode LTS outer coil. The magnetic field drift over two years of the 400 MHz LTS/REBCO NMR magnet is as small as ∼1 ppm, giving high-resolution NMR spectra. The magnetic field drift rate over the second year was 0.03 × 10−3 ppm h−1, which is more than three orders of magnitude smaller than that required for an NMR magnet, demonstrating that the superconducting joints function satisfactorily in a high-resolution NMR system. The corresponding joint resistance is inferred to be −14 Ω.

The epidemiology of patients with traumatic brain injury (TBI) has changed dramatically over recent decades as a result of rapid advances in aging societies. We assessed the influence of age on outcomes of patients with TBI and sought to identify prognostic factors for in-hospital mortality of TBI among elderly patients.Using a nationwide database, we analyzed data from 5651 patients with TBI. Univariate analysis was conducted to compare patient demographics, neurologic status on admission, radiologic findings, systemic complication rates, length of hospital stay, in-hospital mortality, and home discharge rates between elderly and nonelderly groups. Multivariable analysis was conducted to determine prognostic factors for in-hospital mortality among elderly patients.Overall in-hospital mortality was significantly higher in elderly patients (12.8% vs. 19.3%; P0.001). In-hospital mortality of elderly patients with mild TBI increased significantly at7 days after admission, whereas that of elderly patients with moderate or severe TBI was significantly higher immediately after admission. Age (odds ratio [OR], 1.62; P = 0.024), male sex (OR, 1.30; P = 0.004), Japan Coma Scale score on admission (OR, 5.95, P0.001), and incidence of acute subdural hematoma (OR, 1.89; P0.001) were associated with in-hospital mortality in elderly patients with TBI.Elderly patients with TBI showed significantly higher in-hospital mortality. Delayed increases in in-hospital mortality were observed among elderly patients with mild TBI. Level of consciousness on admission was the strongest predictor of in-hospital mortality among elderly patients.

This paper presents experimental results on a quench of an intra-layer no-insulation (LNI) (RE: rare earth)Ba2Cu3O7−δ (REBCO) coil in a 31.4 T central magnetic field and simulated results on the quench. We have been designing a persistent-mode 1.3 GHz (30.5 T) nuclear magnetic resonance (NMR) magnet with a layer-wound REBCO inner coil. Protection of the REBCO coil from quench is a significant issue and the coil employs the LNI method to obtain self-protecting characteristics. We conducted high-field generation and quench experiments on an LNI-REBCO coil connected to an insulated Bi2Sr2Ca2Cu3O x (Bi-2223) coil under a background magnetic field of 17.2 T as a model of the 1.3 GHz NMR magnet. The coils successfully generated a central magnetic field of 31.4 T. Although the LNI-REBCO coil quenched at 31.4 T, this quench did not cause any degradation to the coil. A numerical simulation showed the current distribution during the quench was non-uniform and changed rapidly over time due to current bypassing through copper sheets between layers, resulting in faster quench propagation than in an insulated REBCO coil. During the quench propagation, the peak temperature (T peak) and the peak hoop stress BzJR (σθ, peak) were calculated to be 330 K and 718 MPa, respectively. These are below critical values that cause degradation. The simulation also showed that the high electrical contact resistivity (ρ ct) of 10 000 µΩ cm2, between REBCO conductors and copper sheets in the LNI-REBCO coil winding, played an important role in protection. When ρ ct was as low as 70 µΩ cm2, the quench propagation became too fast and large additional currents were induced, resulting in an extremely high σθ, peak of 1398 MPa, while the T peak was as low as 75 K. In short, the high ρ ct in the present coil caused a high T peak, but succeeded in suppressing σθ, peak and protecting the coil from the quench.

International audience; New improvements in high temperature superconductors (HTS) make them a promising candidate for building the next generation of high field magnets. As the conductors became recently available in long length, new projects such as NOUGAT (new magnet generation to generate Tesla at low cost) were started. This project aims at designing and building an HTS magnet prototype generating 10 T inside a 20 T resistive magnet. In this configuration, severe mechanical stress is applied on the insert and its extremities are subject to a high transverse component of the field. Because the conductor has anisotropic properties, it has to be studied carefully under similar conditions as the final prototype. First, this paper presents both the NOUGAT project and its context. Then, it shows the experimental results on short HTS tapes studied under high magnetic field up to 23 T with varying orientation. These results allow validating the current margin of the prototype. Finally, a first wound prototype is presented with experimental results up to 200 A under 16 T.

Transport characteristic of a (Bi, Pb)2 Sr2Ca2Cu3O10 (Bi-2223) solenoid coil was investigated in liquid helium in high magnetic fields up to 17 T. The solenoid coil was fabricated using the silver sheathed Bi-2223 superconducting tape, which has 2.8 mm in width and 0.32 mm in thickness, including a 0.05-mm-thick copper alloy lamination on both sides. The coil (winding pack) inner diameter, outer diameter, height, and number of turns were 65 mm, 83 mm, 60 mm, and 456 turns, respectively. The coil critical current (Ic) was 28 A at 77 K in self-field. Two noise-canceling coils were set inside and outside of the Bi-2223 coil to reduce the inductive noise. The measurement setup of the noise-canceling coils is similar to that of the magnetization measurement using pick-up coils. Transport measurements were performed at 4.2 K (liquid helium) in the 20-T resistive magnet with 170-mm bore in LNCMI-Grenoble. The coil Ic was 151 A at 17 T, 4.2 K. It was also demonstrated that the noise-canceling coil noticeably reduced the inductive noise by 1/10, which made possible higher resolution voltage measurements.

Epilepsy is a chronic neurological disorder, which presents with various forms of seizures. Traditional treatments, including medication using antiepileptic drugs, remain the treatment of choice for epilepsy. Recent development in surgical techniques and approaches has improved treatment outcomes. However, several epileptic patients still suffer from intractable seizures despite the advent of the multimodality of therapies. In this article, we initially provide an overview of clinical presentation of epilepsy then describe clinically relevant animal models of epilepsy. Subsequently, we discuss the concepts of regenerative medicine including cell therapy, neuroprotective agents, and electrical stimulation, which are reviewed within the context of our data.

Some cases with lumbar degenerative diseases require multi-level fusion surgeries. At our institute, 27 and 4 procedures of 3- and 4-level fusion were performed out of a total 672 posterior lumbar interfusions (PLIFs) on patients with lumbar degenerative disease from 2005 to 2010. We present 2 osteoporotic patients who developed proximal vertebral body fracture after 4-level fusion. Both cases presented with gait disability for leg pain by degenerative lumbar scoliosis and canal stenosis at the levels of L1/2-4/5. After 4-level fusion using L1 as the upper instrumented vertebra, proximal vertebral body fractures were found along with the right pedicle fractures of L1 in both cases. One of these patients, aged 82 years, was treated as an outpatient using a hard corset for 24 months, but the fractures were exacerbated over time. In the other patient, posterolateral fusion was extended from Th10 to L5. Both patients can walk alone and have been thoroughly followed up. In both cases, the fracture of the right L1 pedicle might be related to the subsequent fractures and fusion failure. In consideration of multi-level fusion, L1 should be avoided as an upper instrumented vertebra to prevent junctional kyphosis, especially in cases with osteoporosis and flat back posture.

New improvements in high-temperature superconductors (HTS) are encouraging for large-scale applications, particularly for high-field magnets. In this context, the “NOUGAT” project aims at designing and building a 10-T HTS insert operating inside a 20-T resistive magnet. The insert is foreseen as a stack of double pancakes wound with REBCO tapes. The combination of current and magnetic field generate large mechanical stresses. Moreover, as the conductor has strong anisotropic properties, its performances are affected by transverse magnetic fields. Therefore, they have to be studied under high magnetic field at a small disorientation, close to the longitudinal axis of the coil. The objective is to evaluate its limiting critical current. This paper reports critical current measurements on a 4-mm REBCO tape provided by SuperOx. They were performed on the tape full width under a high magnetic field of up to 23 T at 4.2 K at the Laboratoire National des Champs Magnetiques Intenses (LNCMI) at various field angles. The limiting critical current is found to be about 350 A, which represents a current margin of 57% on a basic model. Then, a preliminary test of a prototype double-pancake coil is reportedly tested at up to 16 T.

Deep brain stimulation (DBS) is used to treat a variety of neurological disorders including Parkinson's disease. In this study, we explored the effects of striatal stimulation (SS) in a rat model of chronic-phase ischemic stroke. The stimulation electrode was implanted into the ischemic penumbra at 1 month after middle cerebral artery occlusion (MCAO) and thereafter continuously delivered SS over a period of 1 week. Rats were evaluated behaviorally coupled with neuroradiological assessment of the infarct volumes using magnetic resonance imaging (MRI) at pre- and post-SS. The rats with SS showed significant behavioral recovery in the spontaneous activity and limb placement test compared to those without SS. MRI visualized that SS also significantly reduced the infarct volumes compared to that at pre-SS or without SS. Immunohistochemical analyses revealed a robust neurogenic response in rats that received SS characterized by a stream of proliferating cells from the subventricular zone migrating to and subsequently differentiating into neurons in the ischemic penumbra, which exhibited a significant GDNF upregulation. In tandem with this SS-mediated neurogenesis, enhanced angiogenesis was also recognized as revealed by a significant increase in VEGF levels in the penumbra. These results provide evidence that SS affords neurorestoration at the chronic phase of stroke by stimulating endogenous neurogenesis and angiogenesis.

The methodology in this article is a palladium(II)/copper(II)- or palladium(II)-catalyzed intermolecular cyclization of acrylic acid with alkenes to produce α-methylene-γ-butyrolactone derivatives using molecular oxygen as an environmentally benign oxidant. In this system, the carboxylato, especially trifluoroacetato, or trimethylacetato ligand, plays a quite important role to afford a high catalytic activity by suppressing the deposition of palladium(0) black.

An 18-year-old woman with a 2-year history of hypertension and headache was diagnosed with noradrenalin-secreting bilateral adrenal pheochromocytomas with paragangliomas in the background of von Hippel-Lindau disease with family histories and a missense mutation, 712C to T (Arg167Trp) in the VHL gene. She had optic disc hemangioma in the left eye which gradually enlarged and caused serous retinal detachment on the macula in one year. Low-dose external beam radiation (20 Gy) was administered to the left eye using a lens-sparing single lateral technique. She underwent craniotomy for cerebellar hemangioblastoma at the age of 22 years and total pancreatectomy for multiple neuroendocrine tumors at the age of 24 years. In the 6-year follow-up period after the radiotherapy, the optic disc hemangioma gradually reduced in size and its activity remained low, allowing good central vision to be maintained. External beam radiation is recommended as a treatment option for the initial therapy for optic disc hemangioma.

A 29-year-old man presented with a rare case of far-out foraminal stenosis with radiculopathy caused by osteophyte formation secondary to an anomalous articulation between the transverse process and the sacral ala. Diagnosis of unilateral far-out foraminal entrapment of the L5 spinal nerve below a transitional vertebra (TV) depended on selective radiculography and nerve root block. Computed tomography after selective radiculography clearly demonstrated foraminal entrapment of the L5 nerve root via the osteophytes. The patient underwent posterior decompression by resection of the osteophytes using an operating microscope and experienced good relief of radicular pain. This case illustrates the effectiveness and some refinements of posterior decompression for radicular pain caused by far-out foraminal stenosis below a TV and compression of the L5 spinal nerve.

A recombinant fimbrial protein of Edwardsiella tarda was designed to detect the specific antibody in Japanese flounder Paralichthys olivaceus. The specific antibody was detected from the fish intraperitoneally injected with E. tarda expressing the fimbria on LB agar containing 3% NaCl, but not from those injected with E. tarda without the fimbria, Streptococcus iniae, S. parauberis or viral hemorrhagic septicemia virus. In a flounder farm suffered with edwardsiellosis, the antibody-positive fish increased in ration with the occurrence of mortality. These results suggested that E. tarda with the fimbria was important for epidemics of edwardsiellosis at flounder farms.

A 27-year-old woman presented with a case of primary medulla oblongata germinoma manifesting as sleep apnea, aspiration pneumonia, and left hemiparesis. Magnetic resonance (MR) imaging revealed a dorsal mass in the medulla oblongata with heterogeneous enhancement by gadolinium (Gd). Emergent biopsy and foramen magnum decompression with C1 laminectomy were performed because of rapid worsening of her symptoms. The histological diagnosis was germinoma. Subsequently she received chemoradiation therapy with subsequent amelioration of her neurological deficits and disappearance of enhancement on MR imaging with Gd. Primary medulla oblongata germinoma is rare and difficult to diagnose preoperatively. However, correct diagnosis and subsequent adequate chemoradiation therapy is possible by understanding the common characteristics of the disease. Germinoma should be included in the differential diagnosis of midline medullary lesion in young patients, and biopsy should be considered.

A 11-year-old female with Noonan syndrome presented with occipito-atlantal dislocation and upper cervical cord compression due to C1 dysplasia and basilar invagination. Computed tomography (CT) of the cervical spine showed dysplasia of the C1 posterior arch and bilateral dislocation of the occipito-atlantal joints. Dynamic lateral radiography revealed no instability at the occipito-atlantal joints. CT also demonstrated basilar invagination. The tip of the odontoid process extended above the Chamberlain line by 9 mm and the McGregor line by 10 mm. Whole spinal radiography showed no scoliosis. C1 laminectomy was performed with instrumented occipito-C2 fixation. The postoperative course was uneventful, and magnetic resonance imaging revealed sufficient decompression of the upper cervical cord at 2 months after surgery. CT demonstrated solid bony fusion between the occipital bone and C2 at 8 months after surgery. Cervical neuraxial malformations are rare in patients with Noonan syndrome.

A high temperature superconducting wire (HTS wire) is promising for various superconducting magnet applications because it operates at a higher temperature than a low temperature superconducting wire (LTS wire) is. Particularly, a MRI magnet using the HTS wires (HTS-MRI magnet) is expected to obtain light-weight, compact and low operating cost compared to a LTS-MRI magnet. The MRI magnets are generally operated by a persistent current mode. A magnet of the persistent current mode consists of multiple superconducting magnets and persistent current switch (PCS) that connects with superconducting joints. However, the superconducting joint of the HTS wires has not been realized stably at this time. We have developed a superconducting joint by using a commercial REBCO wire. The HTS-MRI magnet requires that resistivity of less than 10−12 ohm and current capacity of more than 100 A is achieved by a direct-joint between superconducting layers of the two REBCO wires. Moreover, measurement equipment for low joint resistivity was prepared as measuring the decay of the magnetic field in the one-turn loop. In our R&D, the joint resistance and the critical current were achieved with 155 A and 5.3×10−13Ω.

A 2-month-old infant presented with a cervical intramedullary spinal cord cavernous angioma manifesting as left hemiparesis caused by hematomyelia. Osteoplastic laminotomy of the cervical spine was carried out with subsequent microsurgical excision of the intramedullary spinal cord cavernous angioma. Magnetic resonance imaging revealed no residual tumor. At 25 months after the surgery, she presented no neurological deficit without recurrence and cervical deformity. This case of infantile intramedullary spinal cord cavernous angioma presenting with cervical hematomyelia shows osteoplastic laminotomy of the cervical spine might be helpful to prevent consequent cervical deformity in pediatric cases.

ヒラメの腹腔内，血管内，体側筋肉内，背鰭基部挙屈筋内，背鰭基部皮下または前鰓蓋外側皮下にS. parauberisを接種したところ，腹腔内接種では保菌状態になるものの，死亡個体が出現しない場合があった。腹腔内以外の接種法では比較的高い累積死亡率が得られたが，接種菌量と死亡率に正の関係が認められたのは皮下接種法だけであった。皮下接種感染魚の肉眼症状，病理組織ともに自然感染魚と異なる像は観察されなかったことから，皮下組織は感染実験の接種部位として妥当と思われる。

Recent studies demonstrate that rehabilitation ameliorates physical and cognitive impairments of patients with stroke, spinal cord injury, and other neurological diseases and that rehabilitation also has potencies to modulate brain plasticity. Here we examined the effects of compulsive exercise on Parkinson's disease model of rats. Before 6-hydroxydopamine (6-OHDA, 20 microg) lesion into the right striatum of female SD rats, bromodeoxyuridine (BrdU) was injected to label the proliferating cells. Subsequently, at 24 h after the lesion, the rats were forced to run on the treadmill (5 days/week, 30 min/day, 11 m/min). As behavioral evaluations, cylinder test was performed at 1, 2, 3, and 4 weeks and amphetamine-induced rotational test was performed at 2 and 4 weeks with consequent euthanasia for immunohistochemical investigations. The exercise group showed better behavioral recovery in cylinder test and significant decrease in the number of amphetamine-induced rotations, compared to the non-exercise group. Correspondingly, significant preservation of tyrosine hydroxylase (TH)-positive fibers in the striatum and TH-positive neurons in the substantia nigra pars compacta (SNc) was demonstrated, compared to the non-exercise group. Additionally, the number of migrated BrdU- and Doublecortin-positive cells toward the lesioned striatum was increased in the exercise group. Furthermore, brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor increased in the striatum by exercise. The results suggest that exercise exerts neuroprotective effects or enhances the neuronal differentiation in Parkinson's disease model of rats with subsequent improvement in deteriorated motor function.

We explored the effects of exogenous and endogenous erythropoietin (EPO) in a seizure model of rat. Adult male Fischer 344 rats received continuous intraventricular infusion of EPO dissolved in saline containing 1 mg/ml of rat serum albumin, anti-EPO antibody, saline containing 1 mg/ml of rat serum albumin or combined EPO and neuropeptide Y (NPY) Y2-receptor antagonist. Animals were behaviorally evaluated for seizure development over 6 h after kainic acid injection followed by immunohistochemical assays. Mortality rate, seizure severity, apoptotic cell death and abnormal cell proliferation in the hippocampus of EPO-treated epileptic rats were significantly attenuated, compared to control rats. Anti-EPO antibody in non-EPO-treated animals worsened seizures and CA1 neuronal cell death, while NPY Y2-receptor antagonist cancelled the therapeutic effects of exogenous EPO. Both exogenous and endogenous EPO might modulate seizure severity and protect the hippocampal neurons in epileptic rats, via novel mechanistic pathways involving blockade of epileptogenic cell formation coupled with NPY receptor modulation in the hippocampus.

Parkinsonism related to brain tumor is reviewed with the presentation of our case. Neurosurgeons or neurolo- gists know that some patients with brain tumor present parkinsonism, although further enlightenment is required. The mechanisms are divided into 6 subgroups, 1. direct oppression to the basal ganglia; 2. distortion and stress to the mid- brain; 3. neuronal loss in the substantia nigra; 4. involvement of the basal ganglia; 5. damage of the fiber connection be- tween the basal ganglia and supplementary motor area; 6. old age. In the recent 11 years, 16 cases were reported. Pediatric cases, localized cases with relatively small lesion and post-irradiation cases were increasingly reported. The prognoses of brain tumor-related parkinsonism varied and independent of the pathology, location, and therapies of the tumor. All we can do is to select the appropriate therapy including surgical removal of the tumor by the correct estimation of the dam- aged region.

Parkinson's disease (PD) is characterized by degeneration of nigrostriatal dopaminergic neuronal systems. Several therapeutic tools for PD include medication using L-DOPA and surgeries such as deep brain stimulation are established. However, the therapies are considered as symptomatic therapy, but not basic remedy for PD and a new regenerative therapy would be desired to explore. In this study, the neuroprotective/rescue effects of erythropoietin (EPO), a well known hematopoietic hormone, on dopaminergic neurons were explored with neurogeneic potencies of EPO. EPO (100 IU/day) was continuously administered with micro-osmotic pump for a week to PD model of rats induced by intrastriatal 6-hydroxydopamine (6-OHDA) injection with subsequent behavioral and immunohistochemical investigations. The number of amphetamine-induced rotations of EPO-treated rats significantly decreased, compared to the control rats. The preservation of dopaminergic neurons of EPO-treated rats were confirmed by tyrosine hydroxylase staining and Fluoro-Gold staining. The number of bromodeoxyuridine (BrdU)/polysialic acid-neural cell adhesion molecule (PSA-NCAM) double positive cells in the subventricular zone of EPO treated rats significantly increased with migratory potencies to the damaged striatum,compared to the control rats. Furthermore, TUNEL staining and phosphorylated Akt staining revealed that the neuroprotective/rescue effects of EPO might be mediated by anti-apoptotic effects through the increase of phosphorylated Akt. These results suggest that continuous low dose infusion of EPO exerts neuroprotective/rescue effects with neurogeneic potentials. EPO might be a strong tool for PD therapy, although the further experiments should be added.

症例は50歳の男性で，1998年9月上旬，心窩部痛を主訴に受診した．腹部単純X線検査でfree airが認められ，上部消化管内視鏡検査では胃体下部前壁に潰瘍を認めた．胃潰瘍穿孔の診断で緊急開腹手術を施行した．胃体下部大彎前壁に穿孔部を認め，広範囲胃切除とBillroth-I法による再建術を行った．切除標本では胃体下部大彎側前壁に2.5×1.8 cm大の潰瘍性病変を認め，中心に0.3 cm大の穿孔を認めた．病理組織学的検査では，潰瘍縁に壁深達度sm2の中分化型腺癌を認めた．術後は定期的に画像，血液検査を施行するも再発傾向はみられなかった．2003年9月上旬に胆石症の診断で，腹腔鏡下胆嚢摘出術を施行した．術中に腹膜播種と思われる白色の結節を多数認め，病理組織学的検査で腹膜播種と診断され，化学療法を施行したが，効果なく癌性腹膜炎で死亡した．早期胃癌穿孔はまれであり，穿孔5年後に，癌性腹膜炎を来した早期胃癌の1例を経験したので報告する．

わが国のヒラメ由来 Streptococcus parauberis の血清学的性状を調べた結果，ウサギ抗血清を用いた凝集試験で 2 つの血清型に分けられた。各血清型のオートクレーブ抽出菌体抗原はそれぞれの血清型抗血清とゲル内沈降反応を示した。培養菌体からは酸性多糖が検出され，それぞれの血清型抗血清で前処理した培養菌体には透過型電顕で莢膜構造が観察された。以上のことから，莢膜抗原が血清型決定因子となっていることが示唆された。

Metabotropic glutamate receptors (mGluRs) have been recently implicated as robust therapeutic targets for Parkinson's disease (PD). Here, we explored how activation of mGluRs in globus pallidus (GP) affected the amphetamine-induced rotational behavior in the unilateral 6-hydroxydopamine (6-OHDA) lesion rat model of PD. The amphetamine-induced rotations were completely suppressed by the ipsilateral intrapallidal injection of the non-selective mGluR agonist, 1-aminocyclopentane-1S,3R-dicarboxylic acid (ACPD) and the selective group I mGluR agonist, (R,S)-3,5-dihydroxyphenylglycine (DHPG), but not the selective group III mGluR agonist, l-2-amino-4-phosphonobutyric acid (l-AP4). The suppressive effects were detected at 2, 4, 6, 8, and 12 h after ACPD injection, but returned to the control level at 24 h. A remarkable c-fos expression was found in the lesioned side of GP, subthalamic nucleus (STN), and substantia nigra pars reticulata (SNr) of rats that received the ACPD or DHPG injection, compared to rats treated with L-AP-4 or phosphate buffer-injection. The results indicate that the blockade of amphetamine-induced rotations might be at least partially mediated by group I mGluR activation. This study advances the use of selective group I mGluRs directed toward the GP for PD treatment.