Masako Suzuki

Evaluation of the malignancy of glioma using 11C-methionine positron emission tomography and proliferating cell nuclear antigen staining.

Abstract 11C-methionine positron emission tomography (PET) and proliferating cell nuclear antigen (PCNA) staining were performed in 13 cases of glioma to investigate the relationship between the uptake of l-[methyl]-11C-methionine and the degree of malignancy and proliferative potential. The 11C-methionine uptake was significantly greater in high-grade gliomas compared to low-grade gliomas (P<0.05). The PCNA indexes were also significantly higher in the high-grade cases (P<0.05). Moreover, a strong positive correlation was found between the 11C-methionine values and the PCNA indexes (P<0.005), demonstrating that higher 11C-methionine uptake was associated with greater proliferative potential and greater malignancy. 11C-methionine PET is a potentially useful preoperative method to discriminate the malignacy of glioma.

Susceptibility of Tmax to tracer delay on perfusion analysis: quantitative evaluation of various deconvolution algorithms using digital phantoms

The time-to-maximum of the tissue residue function (T max) perfusion index has proven very predictive of infarct growth in large clinical trials, yet its dependency on simple tracer delays remains unknown. Here, we determine the dependency of computed tomography (CT) perfusion (CTP) T max estimates on tracer delay using a range of deconvolution techniques and digital phantoms. Digital phantom data sets simulating the tracer delay were created from CTP data of six healthy individuals, in which time frames of the left cerebral hemisphere were shifted forward and backward by up to ±5 seconds. These phantoms were postprocessed with three common singular value decomposition (SVD) deconvolution algorithms—standard SVD (sSVD), block-circulant SVD (bSVD), and delay-corrected SVD (dSVD)—with an arterial input function (AIF) obtained from the right middle cerebral artery (MCA). The T max values of the left hemisphere were compared among different tracer delays and algorithms by a region of interest-based analysis. The T max values by sSVD were positively correlated with ‘positive shifts’ but unchanged with ‘negative shifts,’ those by bSVD had an excellent positive linear correlation with both positive and negative shifts, and those by dSVD were relatively constant, although slightly increased with the positive shifts. The T max is a parameter highly dependent on tracer delays and deconvolution algorithm.

A case of subcortical meningioma.

Summary¶ Subcortical meningioma, which has been reported as meningioma without dural attachment, a cerebral subcortical lesion, is extremely rare. Very few findings of radiological examination of subcortical meningioma have been described. Pre-operative differentiation of this lesion is generally difficult. We characterize the peritum oural oedema adjacent to the meningioma in this region, and we suggest that radiological findings of peritum oural oedema contribute to differential diagnosis of subcortical meningiomas.

Microvascular decompression for treating glossopharyngeal neuralgia complicated by sick sinus syndrome.

Glossopharyngeal neuralgia is a very rare condition characterized by paroxysms of lancinating pain in the regions of the tonsils, ears, larynx and tongue lasting from a few seconds to one minute. Interestingly, it is occasionally associated with cardiovascular symptoms such as cardiac arrest, syncope and bradycardia. Here, we describe a case of glossopharyngeal neuralgia associated with sick sinus syndrome (SSS), and we present evidence, based on a comparison of preand post operative 24-hour Holter electrocardiograms (ECG), that microvascular decompression (MVD) ameliorated SSS as well as pain in a patient with glossopharyngeal neuralgia. Case Report

Changes in trace elements of cerebrospinal fluid after subarachnoid hemorrhage, and effects of trace elements on vasospasm

Abstract Various causal factors have been proposed for cerebral vasospasm after subarachnoid hemorrhage (SAH), such as serotonin, acetylcholine, angiotensin, thrombin and thromboxane A2. However, none of them explain the whole pathomechanism of vasospasm. To evaluate the role of trace elements on vasospasm, we have examined these sequential changes in the cerebrospinal fluid (CSF) after SAH by PIXE, and have investigated the relation between trace elements and vasospasm. We obtained the CSF samples from cisternal drainage in patients with SAH who underwent radical surgery within 48 h from the onset. The drainage was placed into basal cisterns at the end of the operation. Three sampling times (3–5, 7–9 and 12–14 days from the onset) has been scheduled because vasospasm is likely to occur from day 4 to day 14 after the onset. In this study, we focused on the levels of Mg, Ca, Mn, Al, Zn, P, Pb, Sr, Br, Co, Cu, Si, Ti, Mn,Co, Cu, Zn, Br, Sr, Mo and Pb, and we found a significantly lower level of Mg in the CSF of patients with vasospasm on days 7–9 after the onset. These results suggest that Mg in the CSF may ameliorate vasoconstriction due to Ca in the pathomechanism of vasospasm.

Fingolimod induces BAFF and expands circulating transitional B cells without activating memory B cells and plasma cells in multiple sclerosis

Patients with multiple sclerosis (MS) who are treated with fingolimod have an increased proportion of transitional B cells in the circulation, but the underlying mechanism is not known. We hypothesized that B cell-activating factor of the tumor necrosis factor family (BAFF) is involved in the process. Compared with healthy controls and untreated MS patients, fingolimod-treated MS patients had significantly higher serum concentrations of BAFF, which positively correlated with the proportions and the absolute numbers of transitional B cells in blood. Despite the elevated concentrations of BAFF in fingolimod-treated MS patients, serum levels of soluble transmembrane activator and calcium-modulating cyclophilin ligand interactor, and B cell maturation antigen were not elevated. Our results show that fingolimod induces BAFF in the circulation and expands transitional B cells, but does not activate memory B cells or plasma cells in MS, which is favorable for the treatment of this disease.

Fingolimod suppresses bone resorption in female patients with multiple sclerosis

Fingolimod is a sphingosine-1-phosphate receptor agonist used to inhibit the inflammatory activity of multiple sclerosis (MS), and has been shown to suppress osteoporosis in mouse models. In this study, levels of bone turnover markers were quantified in serum and urine samples from MS patients treated with fingolimod. Compared with untreated MS patients and healthy controls, fingolimod-treated MS patients had a significantly lower level of the bone resorption marker type I collagen cross-linked N-telopeptide in urine. This finding was prominent in female but was not seen in male subjects. Our results suggest that fingolimod may have a beneficial effect on bone mass loss in female MS patients.

Evaluation of hippocampal structures in mild cognitive impairment and Alzheimer disease by 3 tesla MRI

MRI scan and standardized uptake ratio values (SUVR) for all VOI were obtained using the cerebellar cortex as reference region. Results: AD patients displayed higher cortical [18F]BAY 94-9172 retention (2.060.3) than HC (1.360.2). In AD patients, cortical SUVR test-retest variability was 6.8% (range 0.6-12.2%, median 8.2%). In HC cortical SUVR test-retest variability was 2.9% (range 0.1-9.0%, median 2.8%). Combined testretest variability was 4.7%. Variability was higher in smaller VOI. Conclusions: Overall, test-retest variability is similar to the one reported for PiB (Lopresti et al., 2005). Cortical test-retest variability in AD patients was higher than in HC, and not affected by the range of specific activity likely to be seen in clinical practice.

The longitudinal follow up of ‘Saving appearances answer’ among patients with dementia

180 AD patients, 59 MCI patients and 89 persons with subjective complaints who visited the Memory Clinic of the VU University Medical Center between 2004 and 2007 completed the S-IQCODE-N. Diagnoses were made independently of the S-IQCODE-N. Logistic regression and receiver operating characteristic (ROC) curves were used to evaluate the diagnostic ability. The dimensions of the questionnaire were investigated using exploratory and confirmatory factor analysis. Results: The S-IQCODE-N was able to differentiate AD from MCI or subjective complaints, but was not able to differentiate subjective complaints from MCI. A two factor model with memory versus IADL items provided a better fit than the one factor model. All subgroups differed from each other on the memory factor. For the IADL factor, no differences were found between MCI patients and people with subjective complaints, but both groups differed from AD patients. Conclusions: The S-IQCODE-N is useful in diagnosing AD, but of limited use in distinguishing between subjective complaints and MCI. Informant questionnaires with more complex IADL items might be able to discriminate between these relevant groups.

Sonic detection system for cervical and intracranial vascular disease.

Abstract A sonic analysis system was developed for the detection of cervical and intracranial vascular disease (CVD). In this study, sound signals detected through the patient’s forehead were analyzed using a short-time Fourier transformation method, and data were evaluated according to the intensity of spectra. A total of 49 patients with CVD and 34 control subjects were studied and classified into four grades according to the intensity of the spectra. The true positive rate was 83.7% in patients with CVD, and the true negative rate was 94.1% in the control group. The sensitivity and specificity of this analysis system were 83.7% and 5.9%, respectively. The true positive rates for cerebral stenosis/occlusion, cerebral aneurysm, and arteriovenous malformation/fistula were 85.7%, 73.7%, and 100%, respectively. The future goal is clinical application as a mass-screening test for brain disease. This system shows potential for this purpose, and further development will continue.