Clinical and experimental studies of epilepsy associated with focal cortical dysplasia

The definitive version is available at www.blackwell-synergy.comThe results of clinical and experimental studies on epilepsy associated with focal cortical dysplasia (FCD) are presented. We have been interested in the findings of abnormal increases in the numbers of small vessels in specimens of FCD resected from epilepsy patients. In the clinical study of 13 patients with epilepsy, specimens of FCD or dysembryoplastic neuroepithelial tumor (DNT) were examined using immunohistochemistry. The number of vessels in both lesions were greater than those in cortical specimens of autopsy cases without epilepsy. Because the vessels showed negative staining of VEGF, it was thought that the phenomenon of increase in the number of vessels was simply a hypervascularity, not a neovascularity. The local hypervascularity was expected to show local hyperperfusion in CBF-SPECT study, but interictal SPECT demonstrated local hypoperfusion and ictal SPECT showed hyperperfusion. This may have been caused by a functional change in those vessels. In the experimental study, we tried to make a new animal model of FCD to study epileptogenicity of FCD. When kainic acid had been infused into the neocortex in the neonatal rats, FCD was induced in adult Wistar rats. Histopathological examination revealed cortical dyslamination and abnormal neurons. On EEG, local spike bursts were elicited from the lesions, however, clinical seizures were not detected. Although the data are preliminary and observation over a longer period is required to determine whether spontaneous seizures will occur in this model, it is expected that this new model will be useful for studying epilepsy associated with FCD

Focal cortical dysplasia: pathophysiological approach

The original publication is available at www.springerlink.com. authorOverview: Clinical and experimental studies on focal cortical dysplasia (FCD) were carried out. Materials and methods: For the experimental study, an experimental FCD model of rats was developed. Twenty Wistar rats at 0–2 days after birth were used for the study. Kainic acid (KA) solution was injected stereotaxically into medial and lateral sites of the sensori-motor cortex. Bipolar electrodes were inserted in five rats. Their behavior and electroencephalogram (EEG) were recorded using a digital-video-EEG monitoring system. After observation periods of 1, 2, and 6 months, rats were perfused for pathological study. FCD was observed adjacent to the site of KA injection in all rats more than 1 month after the injection. Results and discussions: EEG recording demonstrated focal spike discharges in and around the site of injection. However, clinical seizure was not observed. Pathological studies showed decrease in GABA-A receptors and increase in GABA-B receptors not only in the lesion but also in perilesional areas. Fifteen surgical cases of FCD with intractable epilepsy were subjected to the clinical study. Neuro-imaging studies including high-resolution magnetic resonance imaging and single-photon emission computed tomography were performed. Conventional EEG studies demonstrated focal EEG abnormalities with epileptic phenomena. At surgery, intraoperative electrocorticography (ECoG) was performed to localize epileptic foci under neuroleptoanalgesia. Thirteen patients showed epileptiform discharges on preresection ECoG. All foci in non-eloquent areas were resected. Pathological studies including immunohistochemical staining were performed, and the characteristics of the FCD in relation to EEG findings were analyzed. Patients in whom total lesionectomy with complete focus resection was performed had favorable postoperative courses. Nine patients (64.3%) have been seizure-free with reduced medication, and significant improvement was achieved in two patients (14.3%). Electrophysiological examination revealed epileptogenecity not only in the lesions but also in perilesional areas. The immunohistochemical studies showed a decrease in GABA-A receptors and an increase in GABA-B receptors in both the lesions and perilesional areas, but N-methyl-d-aspartate receptors were almost negative in both areas. Glutamate R1 was decreased in both areas, but glutamate R2 was increased in both areas. These findings support the results of a electrophysiological study. Conclusions: In conclusion, not only the epileptic property of experimental focal cortical dysplasia but also perilesional epileptogenesis was demonstrated. These findings supported the results of surgery for patients with focal cortical dysplasia. In cases of FCD, total removal of the lesion and resection of the perilesional epileptic focus are needed for a good outcome

Diffuse Low-density Areas in White Matter on CT Scans After Intracarotid ACNU Infusion ―Report of Three Case― (頸動脈内ACNU注入後におけるCTスキャンでの白質内瀰漫性低吸収領域 3例の報告)

雑誌掲載版1984年以降,悪性神経膠腫患者11例で,切除及び照射の外に ACNU〔1-(4-amino-2-methyl-5-pyrimidinyl)-methyl-3-(2-chloroethyl)-3-nitrourea hydrochloride〕の頸動脈内注入を行った.白質脳症の臨床症状,及びCTにおけるACNU注入側白質内瀰漫性低吸収域を3例が示し,更に,中2例は側頭-後頭領域でCT上リング増強を示した.第1例の組織学的診断は照射壊死であったのに対し,他の症例のそれは周囲脳内凝固壊死を伴う再発腫瘍であった

Measurement of 137Cs(γ,n) Cross Section by Nuclear Recoil Method

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乳癌を併発した先端巨大症の一例

雑誌掲載版39歳女.無月経と右乳房腫瘤を主訴に受診し,精査によりGH/PRL産生下垂体腺腫,先端巨大症,乳癌(invasive ductal carcinoma)と診断した.乳癌に対して右乳房切除術,下垂体腺腫に対して経鼻的摘出術を施行した.切除・摘出標本を病理組織学的に検索したところ,下垂体腺腫ではGHとPRLに染まる腫瘍細胞が主体,乳癌では多くの腫瘍細胞でエストロゲン受容体とIGF-1受容体が強陽性を示した.このことから乳癌の併発にはGHやIGF-1の高値が深く関与していたものと考えられ