Juji Takeuchi

The nd:yag laser in neurological surgery

The Nd:YAG laser has been applied in microneuro-surgery and has been found to be quite effective in removing had and hemorrhagic tumors such as meningiomas, tumors of the deep skull base, or tumors deep in the ventricle. Another indication for the use of the Nd:YAG laser is to open the thick sellar floor in transsphenoidal operations.

Results of Treatment for Craniopharyngioma

A review of the results of treatment for 155 cases of craniopharyngioma during the past 47 years by the palliative operation was made. Steroid and operative microscope reduced operative mortality and gave more chance of total extirpation, but survival rate was almost unchanged. It is noteworthy that 3 cases who underwent palliative operation more than 30 years ago are still alive and leading useful lives. The quality of survival was somewhat less favorable in pediatric than adult cases. Morbidity frequently encountered in pediatric cases was growth retardaton. Craniopharyngioma is a benign tumor pathohistologically, but it should be considered as malignant because of the region it occurs in. Therefore, no forceful attempt to total extirpation should be made and the operations should, as a rule, be palliative.

Radiation therapy of craniopharyngioma.

The histories of 32 patients with craniopharygioma who had received radiotherapy after surgery were reviewed to assess the effect and adequacy of the radiation dose. The survival rates were 69% at 5 years and 60% at 10 years in all cases, but depended markedly on sex and age. Symptomatic improvement and histological changes in the irradiated tumor are also discussed. Radiation therapy with a dose ranging from 5500 to 6000 rads (approximately 1700 rets) after the first surgical intervention definitely improves the prognosis.

Single agent therapy of interferon for brain tumours: Correlation between natural killer activity and clinical course

SummaryThe anti-tumour effect of mouse interferon (IFN) on an intracranially transplanted 203-glioma in C 57 BL mice and the natural killer (NK) activity of spleen cells were studied. As a clinical trial, five patients with glioblastomas were treated with human fibroblast IFN and the anti-tumour effect of IFN and the NK activity of peripheral blood lymphocytes were also studied. The NK activity increased after the beginning of IFN therapy but there was no remarkable antitumour effect of IFN in both mouse and human studies. There was no marked correlation between the increased NK activity and the anti-tumour effect of IFN in this study.

Polygonal crystalline structures and crystalline aggregates of cylindrical particles in human glioma

ZusammenfassungPolygonale kristalline Strukturen fanden sich im Cytoplasma von Oligodendrogliomzellen. Sie zeigten eine regelmäßige Anordnung von dichten und weniger dichten Lagen, die entlang einer bis drei Achsen angeordnet waren und rechteckige oder hexagonale Formationen bildeten. Die Überschneidung von zwei oder drei Achsen erfolgte in einem Winkel von ungefähr 120°. Die Periodizität betrug durchschnittlich 150 Å. Die dichten und weniger dichten Lagen hatten Durchmesser von durchschnittlich 50 und 100 Å. Einige der polygonalen kristallinen Strukturen zeigten eine Periodizität von 75 Å.Kristalline Aggregate zylindrischer Partikel wurden gleichfalls beobachtet. Der mittlere Durchmesser der Einzelpartikel betrug ungefähr 150 Å. Sie waren meist auf Querschnitten in hexagonaler Ausrichtung und auf Längsschnitten in gekrümmter oder geradliniger Ausrichtung angeordnet.Die anatomische Ähnlichkeit und Kontinuität zwischen den polygonalen kristallinen Strukturen und den zylindrischen Partikeln war offensichtlich. Es kann angenommen werden, daß beide Strukturen in ihrem Entstehungsvorgang weitgehend verwandt sind.SummaryPolygonal crystalline structures were evident in the cytoplasm of oligodendroglioma cells. They demonstrated a regular spacing of alternating dense and less dense layers oriented along one to three axes, and formed rectilinear or hexagonal arrays. The intersection of two or three axes occurred at angle of approximately 120 degrees. The periodicity averaged about 150 Å. The dense and less dense layers measured about 50 Å and 100 Å, respectively. Few of polygonal crystalline structures showed around 75 Å in periodicity.Crystalline aggregates of cylindrical particles were also visualized. The mean diameter of the individual particles was approximately 150 A. They were oriented mostly in hexagonal arrays in transverse sections, and curvilinear or rectilinear arrays in longitudinal sections.The anatomical approximation and continuity were evident between the polygonal crystalline structures and the cylindrical particles. It may be reasonably assumed that both of structures are closely correlated in process of formation.

Choriocarcinoma arising from the pituitary fossa with extracranial metastasis: A review of the literature

Since Askanazys first report on a case of primary intracranial choriocarcinoma in 1906, more than 60 cases have been reported so far. We add to that a case of intrasellar choriocarcinoma with suprasellar extension: A 12-year-old girl showed cranial nerve palsies, hypopituitarism, and abnormally high titers of human chorionic gonadotropin (HCG) in blood and in cerebrospinal fluid (CSF). She died 3 months after surgery. At autopsy, an intra- and suprasellar choriocarcinoma, which penetrated through the clivus into the cerebellopontine angle and metastasized remotely to the lungs, was confirmed. This rare case is presented with a thorough review of the literature.

Craniopharyngiomas with unusual topography and associated with vascular pathology

SummaryOut of 155 cases of craniopharyngioma seen in the past 47 years, 19 are considered unusual. These 19 cases have been placed under the following headings— 1. unusual topography, and 2. associated vascular pathology. Since CT scanning offers important information about extension of craniopharyngiomas, it is very helpful for planning operative approach. However, cerebral angiography is still important for demonstrating vascular pathology.

Rat pituitary adenoma and hyperplasia induced by caffeine administration

The effect of caffeine by oral administration on female Wistar rats was studied for 12 months. High concentrations (2000 micrograms/mL) of caffeine caused a decrease in body weight and an increase in the weight of the pituitary gland in these rats. Increased pituitary weight was caused by the growth of a pituitary adenoma or hyperplasia. Pituitary adenomas and instances of hyperplasia were found in 27 of the 40 rats in the caffeine group, compared to 9 of the 30 rats in the control group. The histologic classification used was microadenoma, papillary (or sinusoidal) macroadenoma, and diffuse macroadenomas. These adenomas appeared to be endocrinologically nonfunctioning.

Extent of thermal penetration of Nd-YAG laser--histological considerations.

SummaryThe extent of thermal penetration of Nd-YAG laser was studied histologically. The material was obtained from seven cases of various types of intracranial and extracranial tumours and normal temporal muscle obtained at operation. After irradiation of the tumour surface with the laser, the tumours were removed and depth and width of pathological changes caused by heat were studied. Histologically, materials consisted of a vaporized surface, carbonized, vesicular, necrotic, oedematous layers and surrounding intact brain tumour tissue. There was a direct relationship between the thermal effect and the irradiated thermal energy (watt × exposure time × pulse number). The results showed that the thermal effect was limited to a depth of 6 to 10 mm from the irradiated surface when irradiated 4 times at the power of 90 watts for 2 seconds.

Neuroradiological aspects of suprasellar germinoma

SummaryThe plain skull roentgenography, angiography, air encephalography or positive contrast medium ventriculography and computed tomography (CT) of twelve cases of suprasellar germinoma were reviewed. In over half of the cases, plain skull roentgenography and angiography showed some abnormalities suggesting a suprasellar mass. CT was found to be the most appropriate for routine examination. And air encephalography or positive contrast medium ventriculography offered decisive information.