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  • 1
    Electronic Resource
    Electronic Resource
    Surgical Treatment of Pineal Region Tumours Through the Occipital Transtentorial Approach: Evaluation of the Effectiveness of Intra-Operative Micro-Endoscopy Combined with Neuronavigation (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 801-809 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Pineal region tumour; endoscope; navigation; surgery.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Object. To determine the efficacy and accuracy of surgically-assisted systems including endoscopy combined with neuronavigation in the treatment of pineal region tumours through the occipital transtentorial approach, an evaluation of thirty-one patients undergoing surgery was performed over a 10-year period.  Method. The study was performed in 2 parts. The surgical approach to the pineal region was the same in the two parts, but in part 2 a smaller craniotomy window was used. Part 1 (from March 1989 to March 1997) included 15 patients who underwent surgical removal of pineal region tumours without using assisted systems; four out of the fifteen patients had surgery-related complications, including seizure and hemianopsia. Part 2 (from April 1997 to February 1999) included 16 patients who underwent surgical treatment by the same surgical team and with assisted systems; all 16 patients had excellent outcomes, with no complications.  Conclusions. Although this study was the first specifically to examine the efficacy of endoscopy combined with neuronavigation in the treatment of pineal region tumours, our findings suggest that these systems are very useful, safe, and accurate in evaluating the primary tumour and surrounding anatomy as well as in determining operative strategy, such as the location and size of the scalp incision, craniotomy, and the extent of surgical removal. Therefore, we conclude that the addition of endoscopy combined with neuronavigation to standard surgical procedures can improve the outcome of surgical treatment of pineal region tumours.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050380
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  • 2
    Electronic Resource
    Electronic Resource
    Subarachnoid haemorrhage induced proliferation of leptomeningeal cells and deposition of extracellular matrices in the arachnoid granulations and subarachnoid space (1995)
    Springer
    Acta neurochirurgica 136 (1995), S. 88-91 
    Details
    ISSN: 0942-0940
    Keywords: Subarachnoid haemorrhage ; leptomeningeal cells ; arachnoid granulations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Subarachnoid haemorrhage (SAH) often leads to subarachnoid fibrosis and resultant normal pressure hydrocephalus; however, how subarachnoid fibrosis occurs is unknown. We examined the changes within arachnoid granulations (AGs) and the subarachnoid space (SAS) chronologically at the parasagittal region obtained from patients with SAH at autopsy and made comparison with controls by immunostaining for cytokeratin, specific marker for leptomeningeal cells and by the elastica Masson-Goldner methods. Within a week some AGs were torn, and many inflammatory cells filled the AGs and SAS. Cytokeratin positive cells were scarce. During the next two weeks cytokeratin positive cells increased. After three weeks, AGs and SAS were filled by dense deposits of extracellular matrices surrounded by multiple layers of leptomeningeal cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411441
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  • 3
    Electronic Resource
    Electronic Resource
    Development of calcitonin gene-related peptide slow-release tablet implanted in CSF space for prevention of cerebral vasospasm after experimental subarachnoid haemorrhage (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 1230-1240 
    Details
    ISSN: 0942-0940
    Keywords: Calcitonin gene-related peptide ; slow-release tablet ; subarachnoid haemorrhage ; cerebral vasospasm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The calcitonin gene-related peptide (CGRP), a known potent intrinsic cerebral vasodilator, is contained in the sensory nerves from trigeminal ganglia that inervate the cerebral arteries. We previously reported that human α CGRP (hCGRP) dilates spastic cerebral arteries after experimental subarachnoid haemorrhage (SAH) in rabbits. In the present study, we investigated the prophylactic potential of a sustained higher cerebrospinal fluid level ofhCGRP against experimental cerebral vasospasm. AnhCGRP slow-release tablet (hCGRP s-r tablet) was developed for cisternal implantation. Experimental SAH was induced by percutaneous cisternal injection of autologous arterial blood. Angiography was initiated on day 1 (before SAH) and performed everyday. ThehCGRP s-r tablet was implanted into the cisterna magna on day 2 in the treated groups. The spastic response of the basilar artery was maximized on day 4 in the non-treated (80.7% of day 1) and the placebo-treated (79.3%) groups. In contrast, the arterial diameters on day 4 were 96.1% and 90.5% of day 1 in the groups implanted withhCGRP 24 μg and 153 μg s-r tablets, respectively. We also measured the concentration ofhCGRP in the cerebrospinal fluid (CSF) following implantation of thehCGRP 24 μg s-r tablet in the cisterna magna. The hCGRP concentration before implantation was below the dectable level. Following implantation, thehCGRP level in the CSF was 23.12 nmol/L on the second day and remained at elevated levels until the fifth day. These experiments suggest that the intrathecal single implantation of thehCGRP s-r tablet could produce an elevated concentration ofhCGRP in the CSF over five days and have prevented the cerebral vasospasm after SAH in the rabbit. ThehCGRP s-r tablet may be clinically applicable in the treatment of patients with SAH against cerebral vasospasm.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01809753
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  • 4
    Electronic Resource
    Electronic Resource
    Intra-Operative Premature Rupture of the Cerebral Aneurysms. Analysis of the Causes and Management (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 1255-1263 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Premature rupture; cerebral aneurysm; microsurgery; temporary clipping.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ The causes and management of intra-operative premature rupture are analysed and discussed.  During the past 6 years, the authors, performed 398 consecutive direct surgical interventions for ruptured cerebral aneurysms. Intra-operative premature rupture is defined as a rupture which occurs before the securing of the parent arteries or the neck of the aneurysm and is out of control, at least temporarily. The causes and management were retrospectively analysed by reviewing video tape recordings.  Intra-operative premature ruptures which met the above definition occurred in 24 cases (6.0%). The causes were as follows: 1.) dural opening and arachnoid opening (8.3%), 2.) haematoma removal (12.5%), 3.) brain retraction (16.7%), 4.) aneurysm dissection (62.5%). A double suction technique was used to control bleeding and haemostasis with a small piece of cotton or a temporary clip, performed in 20 cases (83.3%). However, in cases with premature rupture immediately after the dural or arachnoid opening, the extension of the haematoma into the subarachnoid space resulted in severe brain swelling and partial resection of the brain had to be done to secure temporary clipping. The double suction technique and primary haemostasis using a small piece of cotton or temporary clip resulted in good outcome even in cases with premature rupture. However, very early premature rupture also occurred although its incidence was extremely rare. The removal of part of the brain can secure the working space but the outcome was poor.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050428
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  • 5
    Electronic Resource
    Electronic Resource
    Advantage of Intravenous Anaesthesia for Acute Stage Surgery of Aneurysmal Subarachnoid Haemorrhage (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 161-164 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Subarachnoid haemorrhage; cerebral aneurysm; inhaled anaesthesia; intravenous anaesthesia.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  To investigate the clinical effects of intravenous anaesthesia on surgical procedure and the outcome in acute stage surgery for aneurysmal subarachnoid haemorrhage (SAH), pre-, intra-, and post-operative factors were analyzed to compare between inhalational (IA, n=38) and intravenous (IVA, n=37) anaesthesia. IVA significantly shortened the duration of surgery (p〈0.05) and the duration of hospital stay (p〈0.01). These results suggest that IVA may be more suitable than IA for acute stage surgery of aneurysmal SAH. These effects may be mainly caused by IVA's pharmakokinetics, by effects on intracranial homeostasis and metabolism, and neuroprotective properties.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050280
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  • 6
    Electronic Resource
    Electronic Resource
    Circulating Blood Volume in Patients with Subarachnoid Haemorrhage (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 1069-1073 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Blood volume; subarachnoid haemorrhage; pulse-spectrophotometry; ICG; spasm.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  To establish the fluid management for patients with subarachnoid haemorrhage (SAH), circulating blood volume (BV) was measured by pulse-spectrophotometry using indocyanine green (ICG) in 34 cases with SAH and 20 cases with neurosurgical disorders as control. BV measured immediately after induction of anaesthesia was lower in cases with SAH than that in controls. (62.8±12.3 vs. 73.3±11.2 ml/kg, p〈0.01). In cases with SAH, the BV was significantly decreased in females (p〈0.05) but not so significantly in males. In female cases with SAH, reduced BV was increased 3 days after operation (p〈0.01). In conclusion BV is decreased in cases with SAH, especially in females. Active fluid therapy may be necessary when temporary vascular occlusion is required during aneurysm surgery. Since hypovolaemia may cause symptomatic vasospasm, BV measurement with pulse-spectrophotometry may provide useful information to insure normovolaemia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050484
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  • 7
    Electronic Resource
    Electronic Resource
    Anaplastic ependymomas: Clinical features and tumour suppressor gene p53 analysis (1995)
    Springer
    Acta neurochirurgica 135 (1995), S. 163-170 
    Details
    ISSN: 0942-0940
    Keywords: Anaplastic ependymoma ; tumour suppressor gene p53
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We analyzed seven cases of anaplastic ependymoma, focusing on neuro-imaging, histopathology, and mutations of the tumour suppressor gene p53. Five of the seven tumours were supratentorial. All had both cystic and solid components, with fragment calcifications detectable on CT scan. The solid parts of the tumours were imaged as heterogenous hypo- or iso-intense areas with moderate enhancement on T1-weighted magnetic resonance images. Vascularity was not prominent on angiograms except for one case. Histologically, in addition to the WHO criteria, loss of typical cellular architecture, endothelial proliferation, and necrosis were commonly found. A mutation in Exon 5 of the tumour suppressor gene p53 was detected in one anaplastic ependymoma out of five tumours (two benign and three anaplastic ependymomas) examined by PCR-SSPC analysis of genomic DNA followed by direct sequencing. Anaplastic ependymoma typically presents as a calcified cystic tumour in the supratentorial parenchyma or transependyma. Mutations of p53 deserve further investigation to examine their possible role in the oncogenesis and malignant transformation of ependymoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02187763
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  • 8
    Electronic Resource
    Electronic Resource
    Types of unruptured cerebral aneurysms reviewed from operation video-recordings (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 965-969 
    Details
    ISSN: 0942-0940
    Keywords: Unruptured cerebral aneurysms ; surgical video-recording: mural thickness ; surgical indication
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To estimate the proportion of unruptured cerebral aneurysms with thin-walled sac, we have analyzed the operative findings of 78 incidental cerebral aneurysms found in 51 consecutive surgical cases by reviewing of intra-operative videotape recordings. Among 78 unruptured aneurysms, 23 (30%) were evaluated as thick-walled aneurysms (Type A), 39 (50%) with partially thin-walled sac (Type B) and 16 (20%) with entirely thin wall sacs (Type C). The mean size of Type A aneurysms was 10.4 mm (ranging from 3 to 22 mm), in Type B it was 9.8 mm (ranging 4 to 25 mm) and in Type C it was 4.4 mm (between 2–12 mm). Approximately two-thirds of Type C aneurysms were 4 mm in size or smaller, and Type C aneurysms were significantly smaller than Type A aneurysms. In summary, this preliminary study has provided two original data. 1) About 70% of incidental unruptured aneurysms have a partially or entirely thin-walled sac. 2) Many of the small aneurysms have an entirely thin sac. Assuming that thin-walled aneurysms are at a high risk of subsequent rupture, the surgical intervention for incidental unruptured aneurysms may be recommended irrespective of their size if the surgical risk is considered low.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411286
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  • 9
    Electronic Resource
    Electronic Resource
    Crystallization and preliminary X-ray crystallographic studies of 7α-hydroxysteroid dehydrogenase from Escherichia coli (1996)
    Copenhagen : International Union of Crystallography (IUCr)
    Acta crystallographica 52 (1996), S. 215-217 
    Details
    ISSN: 1399-0047
    Source: Crystallography Journals Online : IUCR Backfile Archive 1948-2001
    Topics: Chemistry and Pharmacology , Geosciences , Physics
    Notes: Crystals of 7α-hydroxysteroid dehydrogenase from E. coli, which is a tetramer in its active form, have been obtained by a hanging-drop vapor-diffusion method in the presence of the coenzyme NAD+. Crystals as large as 0.25 × 0.25 × 0.75 mm could be grown within a month at pH 8.5 with polyethylene glycol as precipitating agent. Preliminary X-ray crystallographic analysis revealed that they belong to one of the enantiomorphic space groups P41212 or P43212 with dimensions a = b = 81.66 and c = 214.6 Å, having two subunits in an asymmetric unit. The crystals diffract to at least 2.3 Å resolution.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1107/S090744499501002X
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  • 10
    Electronic Resource
    Electronic Resource
    Different serum soluble Fas levels in patients with allergic rhinitis and bronchial asthma (1999)
    Copenhagen : Munksgaard International Publishers
    Allergy 54 (1999), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The pathogeneses of allergic rhinitis and bronchial asthma are believed to be closely mutually related because of the similar dynamics of allergy-inducing cells and molecules and clinical overlap. In this study, we compared these diseases in the dynamics of cell apoptosis-regulating molecules. Methods: Allergic rhinitis patients (n=36), bronchial asthma patients (n=22), and healthy subjects (n=32) were subjected to measurement of serum (soluble Fas) (sFas) levels during the stable and attack disease phases by a sandwich enzyme-linked immunosorbent assay. Results: Serum sFas levels in patients with allergic rhinitis during the attack phase were significantly lower (P〈0.0001) than those in healthy individuals. There were no differences between them during the attack and stable disease phases. In contrast, serum sFas levels in patients with bronchial asthma during the attack phase were higher (P〈0.0005) than those in healthy individuals. Interestingly, the levels during the attack phase were lower (P〈0.002) than those during the stable phase. Conclusions: Our results suggest a different pathogenesis for allergic rhinitis and bronchial asthma at the cell apoptosis-linked step.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1034/j.1398-9995.1999.00303.x
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