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  • 1
    ISSN: 0942-0940
    Keywords: Subarachnoid haemorrhage ; chronic cerebral vasospasm ; calcium antagonist ; AT877 ; HA 1077
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The initial dose-escalating clinical trial of a novel calcium antagonist, AT877, in patients with aneurysmal subarachnoid haemorrhage is reported. AT877 is characterized by its strong spasmolytic activity, its inhibition of intracellular calcium ion activity, and the inhibiton of several protein kinases. A total of 113 patients (Hunt and Hess grades I to IV) who had undergone surgery within 3 days of aneurysmal rupture entered the study. Patients were divided into 5 groups according to the total daily dose of AT877: I: 20 mg; II: 40 mg; III: 60 mg; IV: 90 mg; and V: 120–180 mg. AT877 was given by intravenous infusion over 30 min two or three times a day for 14 days after surgery. Although AT877 did not completely abolish angiographic vasospasm, severe vasospasm was seen less frequently in patients given higher doses. Vasospasm was the cause of a poor clinical outcome (Glasgow outcome scale rating 3 or greater) in 19%, 7%, 9%, 8%, and 6% of the patients in groups I to V, respectively. The results indicated a favourable clinical effect of AT877 at doses above 40 mg per day. Only mild hypotension was seen, even when 60 mg of AT877 was infused over 30 min. AT877 appears to be effective in patients with subarachnoid haemorrhage. Part of its effect may be attributable to protection of the brain from ischaemic insults due to chronic cerebral vasospasm. However, the drug still needs to be evaluated in a placebo-controlled double-blind trial (which is currently being carried out).
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0942-0940
    Keywords: Endothelin ; neuropeptide Y ; angiotensin II ; cerebral arteries ; cerebral circulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We have studied the effect of endothelin, an endothelium-derived peptide, on isolated canine and bovine cerebral arteries in vitro and on canine vertebral blood flow (VBF) in vivo. Endothelin produced a dose-dependent contraction of canine and bovine arterial smooth muscle with ED50 values ranging from 4 to 8 nM. The response to endothelin developed slowly and persisted as a sustained contraction. Maximal contraction by endothelin required the presence of extracellular calcium and was independent of the presence of endothelium. The maximal contraction produced by endothelin was approximately 2–3 times greater than that produced by neuropeptide Y or angiotensin II. The injection of endothelin into the vertebral artery decreased vertebral blood flow (VBF) dose-dependently without affecting systemic blood pressure or heart rate. The decrease in VBF produced by endothelin was long-lasting, like that produced by neuropeptide Y, but more potent. The present data, together with our previous study demonstrating that the intracisternal injection of endothelin induces an unusually long-lasting decrease in the basilar artery diameter angiographically, suggests that endothelin may act as a long-acting vasoconstrictor in cerebral vascular disease.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1076
    Keywords: Magnetic resonance imaging ; Mumps ; Acute disseminated encephalomyelitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 5-year-old male patient with asymptomatic optic neuritis and mumps postinfectious encephalitis or acute disseminated encephalomyelitis is reported. Magnetic resonance imaging (MRI) with a short inversion time inversion recovery sequence was valuable in detecting clinically silent lesions of the unilateral right optic nerve in addition to visual evoked potentials. Evidence of concurrent optic neuritis was useful for detecting more extensive neurological involvement, leading to the diagnosis of mumps postinfectious encephalitis. A systmatic MRI study should be performed in children with mumps encephalitis, regardless of appreciable clinical deficits.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 153 (1994), S. 181-183 
    ISSN: 1432-1076
    Keywords: Key words: Guillain-Barré syndrome – Anti-GM1 antibody – Anti-GM2 antibody –Campylobacter jejuni– HLA-B35
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We report a 4-year-old girl diagnosed as having Guillain-Barré syndrome after infection by Penner serotype 19 of Campylobacter jejuni. The patient had the HLA-B35 antigen. Neurological examination revealed distal-dominant weakness and intact sensation. Serial electrophysiological studies indicated that the predominant process was axonal degeneration involving motor nerves. An enzyme-linked immunosorbent assay revealed the presence of high titres of serum IgM antibodies to gangliosides GM1 and GM2. The IgM auto-antibody titres decreased concurrently with the clinical course of the illness and no switching from IgM to IgG secretion took place.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 153 (1994), S. 181-183 
    ISSN: 1432-1076
    Keywords: Guillain-Barré syndrome ; Anti-GM1 antibody ; Anti-GM2 antibody ; Campylobacter jejuni ; HLA-B35
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 4-year-old girl diagnosed as having Guillain-Barré syndrome after infection by Penner serotype 19 ofCampylobacter jejuni. The patient had the HLA-B35 antigen. Neurological examination revealed distal-dominant weakness and intact sensation. Serial electrophysiological studies indicated that the predominant process was axonal degeneration involving motor nerves. An enzyme-linked immunosorbent assay revealed the presence of high titres of serum IgM antibodies to gangliosides GM1 and GM2. The IgM auto-antibody titres decreased concurrently with the clinical course of the illness and no switching from IgM to IgG secretion took place.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 0942-0940
    Keywords: Computerized tomography ; neurosurgery ; clinical imaging ; operating room
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A computerized tomographic (CT) scanner system for intraoperative imaging is presented. The system consists of the following: 1) CT scanner with a mobile gantry, 2) digitally controlled operating table with central processing unit (CPU) and encoder unit; the table can be controlled by the scanner computer as accurately as the scanner bed, and 3) exclusively designed head fixation devices. It allows us to scan the patient on the operating table in the operating room pre-operatively, intra-operatively and immediately after surgery.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 123 (1993), S. 8-13 
    ISSN: 0942-0940
    Keywords: Acoustic neurinoma ; cochlear nerve ; hearing preservation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A total of 55 cases with unilateral acoustic neurinoma which were operated on by the lateral suboccipital approach was studied to elucidate factors which influence postoperative hearing acuity. We analyzed several factors: preoperative hearing level, tumour size, tumour consistency (cystic or solid), and anatomical location of the cochlear nerve. The size of the tumours ranged from 1.2 to 5.8 cm in diameter. Thirty of 55 cases (55%) preoperatively had remaining cochlear function. The smaller the size of tumour, the higher was the preoperative hearing level excepting those tumours with a diameter of 5 cm or greater, which had relatively good hearing and often contained large cysts. As to the consistency of the tumours, 41 were solid and 14 were cystic, where 19 (46%) and 11 (79%) cases had had preoperative hearing, respectively. Anatomical continuity of the cochlear nerve was maintained at surgery in 15 of 30 cases with preoperatively remaining hearing; cochelar function was preserved after surgery in 9 of the 15 cases. It was located counter-clockwise (caudally) to the facial nerve at an angle of 50 degrees on average when they were projected on the right side. The distance or interrelation between the two nerves had no bearing on postoperative hearing preservation. Postoperatively, hearing acuity was improved in 6 cases (20%) with a mean value of 5.6 dB, unchanged in 3 (10%), and deteriorated in 21 (70%) among the 30 cases with remaining preoperative-hearing. When the tumour was less than 2 cm or cystic, better hearing preservation was expected. Hearing was preserved in 4 cases of the 19 solid tumours (21%) and in 5 of the 11 cystic tumours (45%). No cases with preoperative hearing deficit greater than 60 dB showed postoperative improvement to a useful hearing level.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 0942-0940
    Keywords: Tumour consistency ; meningiomas ; MRI ; T 2-weighted image
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The findings on magnetic resonance imaging (MRI) in 73 surgically verified intracranial meningiomas were correlated with their histology and consistency during resection. T 1-weighted imaging was least useful since most of the tumours were iso-intense, similar to cortical grey matter regardless of histology or tumour consistency. The signal intensity on T 2-weighted images was found to best correlate with both the histology and consistency of the meningioma. Generally, the low intensity portion of the tumour on T 2-weighted images indicated a more fibrous and harder character, while the higher intensity portions indicated a more soft character. Most of the fibroblastic meningiomas showed the features of a hard tumour while angioblastic tumours showed the features of soft tumours. Tumours predicted to be harder on MR imaging generally took longer to resect than softer ones, and this relationship was shown best for the larger tumours. Using linear regression analysis, it appears that operative time for soft tumours is more affected by factors other than tumour consistency. Blood loss during surgery was also unrelated to the consistency of the tumour. These results suggest that the histology and consistency of meningiomas may be predictable from findings on T 2-weighted imaging, and this may also predict the difficulty and time required for resection.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 0942-0940
    Keywords: Acoustic tumour ; cranial nerve ; nerve monitor ; pressure sensor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors describe a newly designed nerve monitor which is useful for numerous microneurosurgical procedures. Standard bipolar forceps are used to apply constant current stimulation. Muscle contraction evoked by the stimulation is detected by a small discshaped pressure sensor taped to the overlying skin. The responses are monitored both quantitatively on a liquid crystal display and qualitatively through an on-off auditory signal. Surgery can proceed without interruption. This apparatus can safely and reliably monitor the facial nerve, nerves involved in eye movements, lower cranial nerves and spinal nerves. This portable system weighs only 1.8 kg and can easily be used by a neurosurgeon.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 0942-0940
    Keywords: Instrumentation ; head fixation ; intraoperative CT ; open neurosurgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A newly developed head fixation for intraoperative computerized tomographic (IOCT) scanning is presented. The system is developed based on the head holder of multipurpose head frame and is made of two kinds of advanced engineering material; carbon fiber reinforced plastic for head holder and frames, polyamide-imide polymer for joints, screws, and head pin. Clinical tests including autoclaving and sterilization were performed and revealed all materials had sufficient strength for clinical use. This fixation system enables us to increase the efficacy of IOCT scanning during open-field neurosurgery.
    Type of Medium: Electronic Resource
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