Brain tumors induced in rats by human adenovirus type 12

Oncogenesis of human adenovirus type 12 in the brain of rats was examined. Newborn rats of Sprague-Dawley and Donryu&#12288;strains were injected intracranially with human adenovirus type 12.&#12288;The incidence of intracranial tumors was 91% (30/33) in SpragueDawley&#12288;and 56% (14/25) in Donryu rats. Except for one tumor nodule&#12288;located in the parietal cortex of a Sprague.Dawley rat, all tumors&#12288;developed in the paraventricular areas or in the meninges. Tumors were quite similar histologically to those induced in hamsters and&#12288;mice resembling the undifferentiated human brain tumors such as medulloblastoma,&#12288;ependymoblastoma and embryonic gliomas. From&#12288;the histological features and primary sites of tumor development, it is&#12288;suggested that the tumors in the brain of rats induced by adenovirus type 12 originate from the embryonic cells in the&#12288;paraventricular area&#12288;and also from the undifferentiated supporting cells of the peripheral&#12288;nerves in the&#12288;leptomeninges.</p

Magnetic Resonance Imaging of Kernohan\u27s Notch in Chronic Subdural Hematoma: Significance of Coronal Images for Preoperative Diagnosis

A 67-year-old man presented with headache and gait disturbance. On admission, he was mildly confused but aroused by verbal stimulus, with normal motor function. A CT scan showed bilateral subdural hematomas (right >> left) and a midline shift to the left. One hour after admission, he suddenly became somnolent and developed right hemiparesis. While repeated CT examinations failed to reveal new findings, coronal MRI clearly depicted the left cerebral peduncle pressed against the free edge of the tentorium. Craniotomy was immediately performed to remove the right chronic subdural hematoma. Soon after the operation, neurological functions were markedly improved. When paradoxical (ipsilateral to the lesion) motor deficit is observed in patients with head injuries, including cases of chronic subdural hematomas, coronal MR imaging and magnetic resonance angiography should be immediately performed to detect Kernohan\u27s notch and to rule out other possible complications, such as diffuse axonal injury or cerebral stroke

Long-term follow-up of endovascular coil embolization for cerebral aneurysms using three-dimensional time-of-flight magnetic resonance angiography.

OBJECTIVES: As endovascular treatment becomes more prevalent, aneurysm recurrence from neck remnants, recanalization, incomplete obliteration and bleeding remain major concerns. In the current analysis, we attempted to identify factors related to disease progression and clinical outcome in patients treated with coil embolization. METHODS: This study included 58 patients who underwent endovascular coil embolization for treatment of intracranial aneurysm. The result of embolization was evaluated with three-dimensional time-of-flight magnetic resonance angiography (TOF MRA) and classified as a complete occlusion, a residual neck (minor, central and marginal types), a residual dome (central and marginal types). Patients were followed up clinically and radiologically. Statistical analyses were performed to establish factors that influenced the occurrence of adverse events such as recurrence of aneurysm. RESULTS: Overall, the complete occlusion rate was 18.8%, the occurrence of a residual neck was 67.2%, and the residual dome rate was 14.1%. The mean clinical follow-up was 31.2 months. Recurrences were found in 18 aneurysms, and major recurrences were retreated with coiling or surgery. The post-treatment study revealed that the marginal-type aneurysm filling has a significant impact on outcome. Thus, perianeurysmal edema was correlated with recurrence of the aneurysm. CONCLUSIONS: Three-dimensional TOF MRA was a sensitive tool for visualizing residual filling of embolized aneurysm and is useful for long-term follow-up of patients

Recurrence of the cavernous sinus dural arteriovenous fistula at adjacent sinuses following repeated transvenous embolizations: case report and literature review.

We present a unique case of a cavernous sinus (CS) dural arteriovenous fistula (DAVF), which recurred at adjacent sinuses following repeated transvenous embolizations (TVEs). A 68-year-old woman presented with progressive left conjunctival chemosis and diplopia. Cerebral angiography revealed a left CS DAVF, which was completely obliterated by TVE via the left inferior petrosal sinus (IPS). Two years later, the DAVF recurred in the left IPS, and again in the left sigmoid sinus (SS) 3 years after the initial treatment in spite of a second TVE. Moreover, the left SS and the left internal jugular vein, which had been previously stenotic, had been occluded. The third TVE resulted in the complete obliteration of the SS DAVF. CS DAVFs may recur at adjacent sinuses even after complete obliteration by TVE. Careful follow-up is necessary to check for the recurrence of DAVFs, especially in cases with venous flow changes, such as sinus occlusion, following endovascular treatment.The original publication is available at www.springerlink.co

Current status of a helicopter transportation system on remote islands for patients undergoing mechanical thrombectomy

Background: Mechanical thrombectomy (MT) is standard treatment for acute ischemic stroke (AIS) with large-vessel occlusion within 6 h of symptom onset to treatment initiation (OTP). Recent trials have extended the therapeutic time window for MT to within 24 h. However, MT treatment remains low in remote areas. Nagasaki Prefecture, Japan has many inhabited islands with no neurointerventionalists. Our hospital on the mainland is a regional hub for eight island hospitals. We evaluated clinical outcomes of MT for patients with AIS on these islands versus on the mainland. Methods: During 2014–2019, we reviewed consecutive patients with AIS who received MT at our hospital. Patients comprised the Islands group and Mainland group. Patient characteristics and clinical outcomes were compared between groups. Results: We included 91 patients (Islands group: 15 patients, Mainland group: 76 patients). Seven patients (46.7%) in the Islands group versus 43 (56.6%) in the Mainland group achieved favorable outcomes. Successful recanalization was obtained in 11 patients (73.3%) on the islands and 67 (88.2%) on the mainland. The median OTP time in the Islands was 365 min. In both the Islands and Mainland groups, the OTP time and successful recanalization were associated with functional outcome. The modified Rankin Scale (mRS) score at 90 days ≤2 was obtained in two patients and mRS = 3 in four patients among eight patients with OTP time >6 h. Conclusions: Few patients with AIS on remote islands have received MT. Although patients who underwent MT on the islands had longer OTP, the clinical outcomes were acceptable. OTP time on remote islands must be shortened, as this is related to functional outcome. In some cases with successful recanalization, a favorable outcome can still be obtained even after 6 h. Even if OTP exceeds 6 h, it is desirable to appropriately select patients and actively perform MT

A hydroxypropyl methylcellulose plaque assay for human respiratory syncytial virus

ウイルスの研究において感染性のあるウイルス粒子を正確に定量することは，病原性の評価のみならずウイルスに対する新規治療薬の効果を客観的に評価するために極めて重要な手技である．プラークアッセイ法はウイルス粒子を定量するために不可欠な技術であるが，Respiratory syncytial virus（RSV）において，プラークアッセイ法を安定して行うことはしばしば困難である．今回我々は，overlay material（充填化合物）が細胞増殖に与える影響を中心にRSVおよびhuman metapneumovirus（hMPV）におけるプラークアッセイ法の最適化の検討を行った

Progressive perianeurysmal edema preceding the rupture of a small basilar artery aneurysm.

We herein report the first case of progressive perianeurysmal edema preceding the rupture of a small saccular aneurysm, without any intervention or intraluminal thrombosis. A 71-year-old woman was incidentally noted to have a cerebral aneurysm (5mm in diameter) at the lower basilar artery. Twelve months later, magnetic resonance (MR) imaging showed a T2-elongated area around a dome of the aneurysm buried in the brain stem, suggesting perianeurysmal edema formation. Interestingly, the edema progressed with the formation of a bleb, in addition to an increase in size of the aneurysm over the following 3-year period. The aneurysm eventually ruptured as a brain stem hemorrhage without any subarachnoid clots 3 days after the final check-up with MR imaging, by which a significant increase of edema formation with an increase in size of the aneurysm and a marked expansion of the bleb was observed. These findings raise the possibility that bleb formation and an enlargement of a small cerebral aneurysm might also be associated with perianeurysmal edema and a subsequent aneurysmal rupture. In addition to the pulsatile flow and/or compression from the expanded aneurysm, local inflammation in the aneurysm wall may play an important role in such edema formation

Early intervention to promote oral feeding in patients with intracerebral hemorrhage: a retrospective cohort study

<p>Abstract</p> <p>Background</p> <p>Stroke is a major cause of dysphagia, but little is known about when and how dysphagic patients should be fed and treated after an acute stroke. The purpose of this study is to establish the feasibility, risks and clinical outcomes of early intensive oral care and a new speech and language therapist/nurse led structured policy for oral feeding in patients with an acute intracerebral hemorrhage (ICH).</p> <p>Methods</p> <p>A total of 219 patients with spontaneous ICH who were admitted to our institution from 2004 to 2007 were retrospectively analyzed. An early intervention program for oral feeding, which consisted of intensive oral care and early behavioral interventions, was introduced from April 2005 and fully operational by January 2006. Outcomes were compared between an early intervention group of 129 patients recruited after January 2006 and a historical control group of 90 patients recruited between January 2004 and March 2005. A logistic regression technique was used to adjust for baseline differences between the groups. To analyze time to attain oral feeding, the Kaplan-Meier method and Cox proportional hazard model were used.</p> <p>Results</p> <p>The proportion of patients who could tolerate oral feeding was significantly higher in the early intervention group compared with the control group (112/129 (86.8%) vs. 61/90 (67.8%); odds ratio 3.13, 95% CI, 1.59-6.15; P < 0.001). After adjusting for baseline imbalances, the odds ratio was 4.42 (95% CI, 1.81-10.8; P = 0.001). The incidence of chest infection was lower in the early intervention group compared with the control group (27/129 (20.9%) vs. 32/90 (35.6%); odds ratio 0.48, 95% CI, 0.26-0.88; P = 0.016). A log-rank test found a significant difference in nutritional supplementation-free survival between the two groups (hazard ratio 1.94, 95% CI, 1.46-2.71; P < 0.001).</p> <p>Conclusions</p> <p>Our data suggest that the techniques can be used safely and possibly with enough benefit to justify a randomized controlled trial. Further investigation is needed to solve the eating problems that are associated with patients recovering from a severe stroke.</p

The detection of carotid plaque rupture caused by intraplaque hemorrhage by serial high-resolution magnetic resonance imaging: a case report.

BACKGROUND: Plaque rupture is believed to be a critical event that leads to thromboembolic complications in atherosclerotic carotid artery disease. Intraplaque hemorrhage can also cause fibrous cap disruption and may be related to the progression of atherosclerosis. However, the mechanism that leads to fibrous cap disruption is not well defined, and there have been few reports in the literature that carotid plaque rupture could be clearly visualized by serial high-resolution MRI. CASE DESCRIPTION: We describe a case of a 79-year-old man who presented with minor ischemic stroke. On diffusion-weighted image, new multiple embolic spots were detected. Plaque rupture caused by intraplaque hemorrhage could be clearly detected by serial high-resolution MRI of the cervical carotid artery. The patient underwent carotid endarterectomy, and an atheromatous plaque was extracted intact for histologic analysis. In the histologic section corresponding to the MRI slices, plaque rupture caused by intraplaque hemorrhage was demonstrated. CONCLUSIONS: This case represents a valuable example of artery-to-artery embolisms from a carotid plaque rupture secondary to intraplaque hemorrhage. High-resolution MRI may have important applications in natural history studies and in clinical trials of carotid plaques

Intracranial internal carotid artery stenosis with vulnerable plaques successfully treated by stenting under cerebral protection.

Percutaneous transluminal angioplasty with stenting (PTA/stenting) for intracranial atherosclerotic stenoses is usually performed without any protection devices. We report a unique case of atherothrombotic stenosis with the vulnerable plaque in the cavernous portion of the internal carotid artery (ICA), which was successfully treated by PTA/stenting under cerebral protection with the flow reversal system. A 68-year-old woman presented repetitive transient ischemic attacks in the right ICA territory. Cerebral angiography revealed 80% stenosis in the cavernous portion of the right ICA. High-resolution magnetic resonance imaging (HR-MRI) demonstrated lipid-rich plaques at this lesion. PTA/stenting was performed with a proximal protection device under flow reversal. A filter device captured much amount of atherothrombotic debris with lipid-rich macrophages and leukocytes, which was consistent with HR-MRI findings. Some selected cases of intracranial atherothrombotic ICA stenoses may need endovascular treatment with cerebral protection system. HR-MRI is useful to evaluate plaque characteristics even in the cavernous portion of the ICA