Tetsuji Orita

Nucleolar Organizer Regions in Meningioma

Seventy-eight cases of meningioma and related tumors were examined independently using a simple and reproducible argyrophilic method for the demonstration of nucleolar organizer regions (AgNORs) and staining with bromodeoxyuridine monoclonal antibody. The mean number of AgNORs per cell and the bromodeoxyuridine labeling index were shown to be linearly related (r = 0.84, P less than 0.001). The mean AgNOR number was 2.99 for meningeal sarcoma, 2.29 for anaplastic meningioma, 2.08 for hemangiopericytic meningioma. 1.72 for recurrent meningioma without atypical histological findings, and 1.52 for nonrecurrent meningioma. We noted that the mean number of AgNORs reflected the cellular kinetics of a tumor and was related to histological grade and clinical behavior.

Transferrin receptors in injured brain

SummaryRecent studies have demonstrated the presence of transferrin receptors (Tf-R) in the central nervous system. The present study of Wistar rats with experimentally induced brain injuries, using immunohistochemistry at the light microscopy level, demonstrated the presence of Tf-R in regenerated endothelial cells, reactive astrocytes and in other cells, probably macrophages. Although Tf-R were seen in proliferating cells, Tf-R were also observed in nonproliferating cells, many of them macrophages. The receptors perhaps bind transferrin in edema fluid and play an important role in lesion repair.

Malignant meningioma metastasizing through the cerebrospinal pathway

A case of malignant meningioma metastasizing through the cerebrospinal pathway is presented. The primary tumor was a parasagittal malignant meningioma invading into the brain. The tumor seeded to the cerebellopontine angle cistern and thoracic spine after multiple operations. Although this type of tumor borders the CSF, metastasis through the cerebrospinal pathway is rare, and only 18 such cases have been reported (2, 3, 10, 12).

Glial fibrillary acidic protein (GFAP) expression and nucleolar organizer regions (NORs) in human gliomas.

The frequency of nucleolar organizer regions (NORs) in each glioma tissue and the relation between the expression of glial fibrillary acidic protein (GFAP) and the frequency of NORs was investigated. The number of Ag-NORs per cell for glioblastoma multiforme was significantly higher than that for anaplastic astrocytoma (P less than 0.05) and that for astrocytoma (P less than 0.01). The number of Ag-NORs per cell for GFAP-positive cells was significantly lower than that for GFAP-negative cells in each histopathological grade (P less than 0.01). Moreover, the linear relationship was demonstrated between the Ag-NORs numbers of GFAP-negative cells and bromodeoxyuridine (BUdR) labeling indices. From these results, it is concluded that many GFAP-positive glioma cells may have low growth potential in glioma tissue and GFAP-negative cells may have a close relation to cell proliferation. The combination of immunohistochemical and silver colloid staining is a useful method for investigating the biological characteristics of brain tumors.

Primitive neuroectodermal tumor of the leptomeninges

SummaryPrimitive neuroectodermal tumor (PNET) without an obvious intraparenchymal mass lesion and with diffuse spread in the subarachnoid space is rare. We report such a rare case and discuss the computed tomography (CT) and magnetic resonance (MR) features.

P2 aneurysm approached via the temporal horn: technical case report.

OBJECTIVE AND IMPORTANCE We report the use of a transcortical transventricular approach to a P2 aneurysm, which was located near the choroidal fissure, protruded into the temporal horn, and was considered to be too difficult to approach by the conventional subtemporal route. CLINICAL PRESENTATION An 81-year-old woman suddenly developed severe headache with vomiting and subsequently lost consciousness. Computed tomographic scans revealed a diffuse intraventricular hemorrhage and subarachnoid hemorrhage. Cerebral angiography disclosed a saccular aneurysm in the right P2 segment. INTERVENTION On the 16th day after admission, successful neck clipping was easily performed through the temporal horn via the inferior temporal gyrus. The postoperative course was uneventful. CONCLUSION This special approach may be preferable in such cases, because it protects the brain from the detrimental effects of strong temporal retraction and provides a wider working space.

Early, evolving Wallerian degeneration of the pyramidal tract in cerebrovascular diseases: MR study.

Objective The purpose of this study was to demonstrate the early features of the Wallerian degenerative process and their relationship with the severity of motor deficit. Materials and Methods Fourteen patients with infarction or hemorrhage of the basal ganglia were studied by MRI of the same coronal slice along the pyramidal line. Results The earliest sign of abnormal signal intensity was detected 0.7 month after the initial insult. On proton-density (PD) imaging, low signal intensity was observed on 11 (73.3%) of 15 occasions from 0.7 to 2.0 months, and abnormal signal intensity was not detected 5 (83.3%) of 6 times from 2.1 to 3.7 months. High signal intensity was revealed on 11 (78.6%) of 14 occasions after 3.8 months. The widest extent of the low-intensity signal band on PD imaging was closely related to the severity of motor deficits at >4 months. Conclusion The development of the Wallerian degenerative process was divided into four stages by MRI. We conclude that the extent of Wallerian degeneration is related to the severity of motor deficit.

Major histocompatibility complex expression in brain of rats with graft-versus-host disease

In a healthy state, the central nervous system (CNS) is believed to be an immunologically privileged site, which does not participate in the immune reactions of the rest of the body, and in which identifiable components of the immune system are rare or non-existent. In this study, an immunohistochemical examination of the CNS of F1 hybrid rats following induction of graft-versus-host disease (GVHD) was carried out to determine whether specific immune reactions in the normal CNS could occur during a systemic immune reaction. The results revealed extensive parenchymal and vascular expression of class I and II major histocompatibility complex (MHC) encoded cell surface molecules. The strongest expressors of class I and II molecules were endothelial cells and parenchymal cells, respectively, the latter being apparently activated microglia, in the cerebrum and cerebellum of rats with GVHD. In addition, occasional scattered lymphocytes were detected in the CNS of GVHD rats without blood-brain barrier disruption. Thus, evidence was obtained for the presence of immune responses such as MHC antigen expression and lymphocyte infiltration in the CNS during a strong systemic immune response such as GVHD, microglia and endothelial cells apparently playing an important role.

Clinical evaluation of DNA index in human brain tumors

We evaluated the DNA index values in 28 brain-tumor patients showing DNA aneuploidy on the DNA histogram obtained by flow cytometry. In 17 cases among them, the DNA index values were compared to BUdR labeling indices (BUdR-LI). Average DNA indices of individual tumor types were 1.89 +- 0.10 (6 glioblastomas multiforme), 1.93 +- 0.05 (4 anaplastic astrocytomas), 1.68 +- 0.09 (3 malignant meningiomas), 1.24 +- 0.03 (7 meningiomas), 1.19 +- 0.05 (2 pituitary adenomas) and 1.86 +- 0.24 (6 metastatic brain tumors). Slow-growing tumors such as meningioma and pituitary adenoma, had lower values than malignant tumors, except a case of a metastatic brain tumor. All malignant meningiomas had higher DNA index values than the other meningiomas. No difference was observed between the DNA index values of glioblastomas multiforme and anaplastic astrocytomas. DNA index values were correlated with BUdR-LI values (p < 0.05), and seven cases with low DNA index values (1.13–1.31) had low BUdR-LI values of less than 1%. Others with high DNA index values of 1.44 or more had high BUdR-LI values of 3.5% or more. These results suggest that high DNA index values is related to tumor malignancy, and despite the presence of some disparities, many slow-growing brain tumor has low DNA index values.

The microvascular architecture of human malignant glioma

SummaryThe three-dimensional microvascular architecture of human glioma was investigated. The results of the study, the first of its kind, suggested that the process of vascularization in glioma is based on two patterns. In a large proportion of the glioma, one pattern is similar to the vascularization observed in normal developing fetal and newborn rat brain, while in a small proportion of the glioma, another pattern including complicated vascular protrusion and spiral running, is seen.