Magnetic resonance imaging and angiographic appearance of meningioma of the fourth ventricle--two case reports

A 47-year-old female presented with a transitional type meningioma entirely confined to the fourth ventricle. The tumor was totally resected. A 67-year-old female had undergone resection of an intraventricular transitional type meningioma of the fourth ventricle 9 years previously. She presented with a new meningioma of an obviously different origin at the posterior rim of the foramen magnum. The new meningioma was totally resected and the histological diagnosis was atypical meningioma. The magnetic resonance (MR) imaging characteristics of these two intraventricular meningiomas of the fourth ventricle were isointense and slightly hypointense to gray matter on the T1-weighted images, and hyperintense to gray matter on the T2-weighted images, with intense and homogeneous enhancement with gadolinium. Angiography showed the two intraventricular meningiomas fed by branches of the posterior inferior cerebellar arteries or superior cerebellar arteries. The second meningioma with dural attachment was fed by the right occipital artery. Intraventricular meningiomas of the fourth ventricle are not supplied by meningeal branches from vertebral and external cerebral arteries. MR imaging is the most useful tool in preoperative diagnosis, but cerebral angiography should also be performed to confirm the feeding vessels and the correct diagnosis.

Prediction of hemorrhagic complications after thrombolytic therapy for middle cerebral artery occlusion: value of pre- and post-therapeutic computed tomographic findings and angiographic occlusive site

OBJECTIVE

To evaluate the usefulness of pre- and post-therapeutic computed tomographic (CT) findings in predicting hemorrhagic complications, we retrospectively examined 35 patients treated with intra-arterial thrombolytic therapy for middle cerebral artery (MCA) occlusion.

METHODS

The presence or absence of early CT findings (loss of the insular ribbon, obscuration of the lentiform nucleus, and cortical effacement) and the presence and location of extravasation of contrast medium were evaluated on pre- and post-therapeutic CT scans, respectively. According to the angiographic occlusive site, the patients were classified into the following three groups: Group 1 (n = 13), MCA trunk occlusion involved lenticulostriate arteries; Group 2 (n = 11), occlusion of the MCA trunk without involvement of the lenticulostriate arteries; Group 3 (n = 11), occlusion of a branch of the MCA. Hemorrhagic complications (hemorrhagic transformation and/or massive brain swelling) were evaluated by reviewing CT scans obtained 3 to 14 days after thrombolytic therapy.

RESULTS

No patient without extravasation (n = 17) showed hemorrhagic complications, and extravasation is the most useful finding in predicting hemorrhagic complications. There was significant correlation between extravasation and hemorrhagic complications (P < 0.01). In Groups 1 and 2, there was also significant correlation between early CT findings and hemorrhagic complications (P < 0.01), indicating that early CT findings are also useful in predicting hemorrhagic complications. In Group 1, 10 of 13 (76.9%) patients had both early CT findings and extravasation, and 6 of these 10 patients had hemorrhagic complications with clinical deterioration, suggesting the difficulty of thrombolytic therapy in this group. On the contrary, in Group 2, 8 of 11 (72.7%) patients had neither early CT findings nor extravasation and none of these 8 patients had hemorrhagic complications. In Group 3, however, early CT findings and extravasation had no correlation. Because the affected area was small in this group, it was difficult to evaluate cortical effacement. Although negative early CT findings did not always mean absence of extravasation and hemorrhagic complications in this group, the patients with hemorrhagic complications did not clinically deteriorate because of the small affected area.

CONCLUSION

Hemorrhagic complications could be predicted by evaluation of angiographic occlusive site and pre- and post-therapeutic CT findings.

Expression of cytokeratin 14 in ameloblast-lineage cells of the developing tooth of rat, both in vivo and in vitro

In the search for a cell marker useful for studying tooth development, immunohistochemical studies using antibodies against cytokeratin 14 (K14), c-Met/hepatocyte growth factor receptor and amelogenin were carried out in the developing tooth of the newborn rat and in primary cultured cells of the ameloblast lineage, including inner enamel epithelium cells, preameloblasts and ameloblasts, prepared from the mandibular incisors of postnatal 7-day-old rats. The appearance of K14 was cell- and differentiation-stage specific, i.e. there was a weak expression signal within inner enamel epithelial cells that were in the proliferating stage, and there were strong signals within preameloblasts and ameloblasts that were in the post-proliferating and amelogenesis stages, respectively. In the culture system, c-Met appeared in all cells, whereas K14 and amelogenin appeared mainly in clustered cells that were considered to be in the post-proliferating stage. K14 was detected earlier than amelogenin, and it was also confirmed by immunofluorostaining that c-Met, K14 and amelogenin were coexpressed in ameloblasts. These findings indicate that K14 is a good new marker for ameloblast-lineage cells during rat tooth development both in vivo and in vitro.

The effects of peripheral nerve injury of the masseteric nerve on the levels of calcium binding proteins and neuropeptide Y, and their correlation in the mesencephalic trigeminal nucleus of the rat

Combined retrograde neuronal tracing with FluoroGold (FG) and a double immunofluorescence method was performed to examine the effects of peripheral nerve injury of the masseteric nerve (MassN) on the levels of two calcium binding proteins (CaBPs), parvalbumin (PV) and calbindin D28k (CB), and neuropeptide Y (NPY) in the mesencephalic trigeminal nucleus (MesV) in the rat. In the normal MesV, many medium- to large-sized unipolar PV-like immunoreactive (-IR) cells were detected through the entire rostrocaudal extent, but CB-IR cells were rarely observed. No NPY-IR cells were observed in the normal MesV. The distributions of these three neurochemical markers in the MesV contralateral to the transection of Mass were almost identical to those observed in the normal MesV. Four days following transection and application of FG to the MassN, approximately 52% (572/1104) and 38% (414/1104) of FG-labeled cells (FG cells) in the MesV displayed PV-like immunoreactivity (-LI) and NPY-LI, respectively; Approximately 24% (265/1104) of FG cells showed both PV-LI and NPY-LI. Approximately 47% (265/572) of FG cells with PV-LI showed NPY-LI or 64% (265/414) of FG cells with NPY-LI displayed PV-LI. Fourteen days following transection and application of FG, the percentage of FG cells with PV-LI significantly decreased to 36% (365/1024) compared to that observed 4 days post-injury; approximately 44% (448/1024) of FG cells displayed NPY-LI; approximately 38% (141/365) of FG cells with PV-LI showed NPY-LI and approximately 31% (141/448) of FG cells with NPY-LI displayed PV-LI. In contrast, FG cells showing CB-LI were very rare on 4 days (1%; 15/1182) or 14 days (1%; 16/1085) following MassN transection. The present results indicate that the levels of PV in the MesV decreased 14 days following the MassN injury compared to those observed 4 days post-injury and rapid induction of NPY in the injured MesV neurons, and that the correlation between CaBP and NPY in the MesV following the MassN transection is different from that observed in the trigeminal ganglion, which is equivalent to the MesV, following peripheral nerve injury of the inferior alveolar nerve.

Protein gene-product 9.5 in developing mouse circumvallate papilla: comparison with neuron-specific enolase and calcitonin gene-related peptide

The present study was made to investigate the ontogeny of protein gene-product 9.5 (PGP 9.5)-like immunoreactivity (-LI) in the developing mouse circumvallate papilla (CVP), and its distribution was compared to that of neuron-specific enolase (NSE) and calcitonin gene-related peptide (CGRP). In adult CVP, PGP 9.5-LI was observed in the subgemmal nerve plexus; some thin PGP 9.5-like immunoreactive (-IR) nerve fibers penetrated taste buds and apical epithelium. PGP 9.5-LI was also observed in the spindle-shaped cells in taste buds, and a small number of round- or oval-shaped ganglionic cells in the lamina propria. The distribution of NSE-LI was comparable to that of PGP 9.5-LI. CGRP-LI was observed in the nerve fibers only; distribution of CGRP-IR nerve fibers was similar to that of PGP 9.5-IR nerve fibers, although the number of CGRP-IR nerve fibers was smaller than that of PGP 9.5-IR nerve fibers. At least six developmental stages were defined with regard to the developmental changes in the distribution of PGP 9.5-LI from embryonic day (E) 12 to adulthood: Stage I (E12-13)-a dense nerve plexus of PGP 9.5-IR nerve fibers was detected in the lamina propria beneath the core of newly-formed papilla. Stage II (E14-16) - thin PGP 9.5-IR nerve fibers penetrated the apical epithelium, and a few round-shaped cells in the apical epithelium also displayed PGP 9.5-LI. Stage III (E17-18) - thin PGP 9.5-IR nerve fibers penetrated the inner lateral epithelium of the trench. Stage IV [Postnatal day (P) 0-3] - many PGP 9.5-IR nerve fibers penetrated the outer lateral epithelium of the trench; later in this stage, taste buds appeared. Stage V (P5-10) - a small number of PGP 9.5-IR cells in the taste buds appeared, and their number increased gradually. Stage VI (P14-adult) - the number of PGP 9.5-IR taste cells increased and reached the adult level, while the number of PGP 9.5-IR nerve fibers decreased. The development of NSE-LI was similar to that of PGP 9.5-LI. CGRP-IR nerve fibers were detected at E12 in the lamina propria, and the development of the intraepithelial CGRP-IR nerve fibers was similar to that of PGP 9.5-IR nerve fibers. The present results indicate that invasion by nerve fibers of the epithelium of lingual papillae occurs in a complex manner, and that these nerve fibers may participate in the formation of the taste buds.

Calbindin D28k-like immunoreactivity in the gustatory epithelium in the rat

The distribution of calbindin D28k (CB)-like immunoreactivity (-LI) in the gustatory epithelium was examined in the adult rat. In the circumvallate and foliate papillae, CB-like immunoreactive (-IR) nerve fibers were observed in the subgemmal region, and some of these penetrated the taste buds. Two or three spindle-shaped gustatory cells displayed CB-LI in each taste bud of these lingual papillae; the immunoreactivity was restricted to the cytoplasm. In the fungiform papilla, CB-IR nerve fibers were detected in the subgemmal region, but no CB-IR cells were observed in the taste buds of the fungiform papillae. In the taste buds of the incisive papillae, many CB-IR intragemmal nerve fibers were observed, but no apparent CB-IR cells were detected. In the soft palate, CB-IR nerve fibers associated with the taste buds were also observed, but no CB-IR cells were detected in the taste buds. The present findings indicate that CB-IR gustatory cells were only localized in the taste buds in the posterior lingual papillae (circumvallate and foliate papillae), but not in the taste buds in other gustatory epithelium.

Immunoelectron microscopic study on neuropeptide Y in the periodontal ligament of the incisor following peripheral nerve injury to the inferior alveolar nerve in the rat

Immunoelectron microscopic analysis was carried out to examine whether neuropeptide Y (NPY)-like immunoreactivity (-LI) is localized in mechanoreceptors in the lingual periodontal ligament of the rat incisor following peripheral nerve injury to the inferior alveolar nerve (IAN). In the lingual periodontal ligament of normal animals, no NPY-like immunoreactive (-IR) primary afferents were observed, except for a very few sympathetic perivascular nerve fibers which showed NPY-LI. Fourteen days following chronic constriction injury to the IAN combined with sympathectomy of the superior cervical ganglion, thick NPY-IR nerve fibers showing tree-like raminifications were detected in the shear zone between the tooth-related part and alveolus-related part as well as in the alveolus-related part. Immunoelectron microscopy revealed that expanded NPY-IR nerve terminals were covered with several Schwann sheaths and that a part of the axoplasm expanded to the surrounding tissues. These ultrastructural features of NPY-IR structures were identical to those of periodontal Ruffini endings, categorized as slowly adapting mechanoreceptors. Thick (6-8 microns in diameter) NPY-IR axons were also observed without any apparent myelin sheath. The present results provide further evidence that NPY is closely associated with thick axons, probably myelinated nerves and Ruffini endings, following peripheral nerve injury.

Neuropeptide Y-like immunoreactive primary afferents in the periodontal tissues following dental injury in the rat

The distribution of neuropeptide Y (NPY)-like immunoreactive (-IR) nerve fibers in the periodontal tissues following dental injury to the rat maxillary first molar was examined with a combination of dental injury and surgical sympathectomy of the superior cervical ganglion (SCGx). In normal animals, NPY-IR nerve fibers were observed around the blood vessels of the trigeminal ganglion, dental pulp and periodontal tissues. These nerve fibers completely disappeared following SCGx. Fourteen days following dental injury of the maxillary first molar combined with SCGx, a small number NPY-IR cells was observed in the dorsal to middle portion of the maxillary division of the trigeminal ganglion. These were mostly medium- to large-sized cells with a mean +/- SD cross-sectional area of 541.4 +/- 239.3 microns 2. Approx. 50% of these cells had the cross-sectional areas between 400-600 micron 2. In the periodontal tissues of injured first molar, thick NPY-IR nerve fibers showing an irregular appearance were detected in the apical region. Immunoelectron microscopy showed that most NPY-IR nerve fibers near the lower half of the injured periodontal ligament had an axonal diameter of approx. 7-8 microns, and lacked apparent myelin sheaths. Near NPY-IR nerve fibers, many macrophages with phagosomes containing debris of the myelin sheaths were observed. At the oral epithelium covering the injured roots of the maxillary first molar, thick NPY-IR nerve fibers were recognizable and some penetrated the epithelium. No NPY-IR nerve fibers were observed in the dental pulp or periodontal tissues in second and third molars, and ultrastructural views of nerve fibers were almost intact following combined SCGx and dental injury to the first molar. The present results indicate that NPY-IR primary afferents appeared in the periodontal tissues following dental injury, and that NPY may be closely associated with the regeneration process of injured primary afferents.

Distribution and possible origin of galanin-like immunoreactive nerve fibers in the mammalian dental pulp

Human, dog, cat and rat dental pulps were investigated for the presence and distribution of galanin-like immunoreactive (-IR) nerve fibers, and the possible origin of pulpal galanin-IR nerve fibers in the rat was examined. Galanin-IR nerve fibers were present in the dental pulps of all species examined. Two types of galanin-IR nerve fibers were distinguished with regard to morphology; thin varicose nerve fibers and thick smooth-surfaced nerve fibers. Thin varicose galanin-IR nerve fibers were seen to run along the blood vessel in the human, dog and cat root pulp. In the coronal pulp, galanin-IR nerve fibers ran toward the odontoblastic layer but they did not form the subodontoblastic nerve plexus. In rat molar pulp, few galanin-IR nerve fibers were observed; the distribution of these nerve fibers was similar to those in human, dog and cat pulp. In contrast, many thick smooth-surfaced galanin-IR nerve fibers were observed near the blood vessels in incisor pulp of the rat; occasionally a few varicose galanin-IR nerve fibers were also observed. Transection of the inferior alveolar nerve or mandibular nerve caused complete disappearance of galanin-IR nerve fibers in rat dental pulp, while surgical sympathectomy of the superior cervical ganglion did not affect their distribution. The present results indicate that galanin-IR nerve fibers are present in the mammalian dental pulp, and that the intrapulpal galanin-IR nerve fibers in the rat originate from the trigeminal ganglion and are primary afferents.

Repeating hemorrhage with a long duration after radiotherapy for glioma: radiological and histological observations

A case of radiation necrosis which was observed 6 years after radiotherapy for a glioma in the right parietal lobe is reported. This patient developed hemiparesis, and radiological examinations showed similar findings consisted with recurrent glioma. Histological examination disclosed the lesion to be radiation necrosis. Repeated episodes of hemorrhage and cystic formation in the right hemisphere appeared during 8 to 10 years after radiotherapy, and removal of the mass lesion conducted four times. Histological examinations of each specimen showed the increasing proliferation of neo-vessels accompanied by hemorrhage and cystic formation.

Hepatocyte growth factor is involved in the morphogenesis of tooth germ in murine molars

The patterns of gene expression for hepatocyte growth factor (HGF) and its receptor, c-Met, were revealed in the tooth germ of rat mandibular molars using RT-PCR. In situ hybridization demonstrated that the HGF gene was expressed only in the cells of the dental papilla of the tooth germ in vivo. The characteristic temporospatial distribution of HGF and c-Met during germ development was revealed using immunohistochemical studies in vivo. In order to demonstrate the functional role played by HGF in tooth development, HGF translation arrest by antisense phosphorothioate oligodeoxynucleotide (ODN) was carried out in vitro. In the control experiment, explants of tooth germs from embryonic 14 day mice were cultured in a modification of Trowell's system under serum-free and chemically defined conditions for two weeks. Other explants were cultured with 15mer antisense or sense ODN targeted to the HGF mRNA. Both the control and the sense-treated explants showed normal histological structure, as observed in vivo. On the other hand, antisense-treated explants exhibited an abnormal structure in which the enamel organs were surrounded by a thin layer of dentin and dental papilla, appearing ‘inside-out’ compared to the control and sense-treated explants, although the cytodifferentiation of ameloblasts and odontoblasts was not inhibited. The explants treated with recombinant human HGF combined with antisense ODN showed normal development, indicating that exogenous HGF rescued the explants from the abnormal structure caused by antisense ODN. The findings of a BrdU incorporation experiment suggested that the imbalance between the proliferation activity of the inner enamel epithelium and that of the dental papilla caused by HGF translation arrest results in the abnormal structure of the tooth germ. These results indicate that HGF is involved in the morphogenesis of the murine molar.

Neuropeptide Y-immunoreactive primary afferents in the dental pulp and periodontal ligament following nerve injury to the inferior alveolar nerve in the rat

The distribution of neuropeptide Y (NPY)-immunoreactive (IR) primary afferents in the dental pulp and periodontal ligament of the rat mandible were examined following combined chronic constriction injury (CCI) of the inferior alveolar nerve (IAN) and sympathectomy of the superior cervical ganglion (SCG). NPY-IR nerve fibers were observed around the blood vessels in the trigeminal ganglion, dental pulp and periodontal ligament in normal animals. Following combined CCI of the IAN and sympathectomy of SCG (SCGx), perivascular NPY-IR nerve fibers originating from SCG disappeared completely, but many NPY-IR nerve fibers coming from the trigeminal ganglion appeared in the dental pulp and periodontal ligament. In the molar dental pulp, thick NPY-IR nerve fibers were observed within the nerve bundle, and some thin NPY-IR nerve fibers ran towards the odontoblast layer; very few NPY-IR nerve fibers were observed in the incisor pulp. In the periodontal ligament of molar, thick NPY-IR nerve fibers appeared at the alveolar part following combined CCI of IAN and SCGx. In the lingual portion of the periodontal ligament of the incisor, many thick NPY-IR nerve fibers were observed. These occasionally showed a tree-like appearance, resembling immature Ruffini endings; slowly adapting mechanoreceptors. The present results indicate that periodontal mechanoreceptors are among the main targets of injury-evoked NPY following IAN injury.

Fos-like immunoreactivity increases in the lumbar spinal cord following a chronic constriction injury to the sciatic nerve of rat

A chronic constriction injury (CCI), transection injury, or sham injury to the sciatic nerve was induced in 30 rats. Rats were then sacrificed at 1, 3, 5, 10, and 20 days following injury, and the number of cells immunohistochemically labeled for Fos-like immunoreactivity (Fos-LI) was determined in random sections from the lumbar 4 and 5 (L4 and L5) spinal segments. Non-parametric statistics (Wilcoxon) were used to compare the number of labeled cells ipsilateral to the injury to the number of labeled cells on the contralateral side. At 1 and 5 days following injury, in all treatment groups, significantly more labeled cells (P < 0.05) were observed ipsilaterally. In addition, at 3 and 10 days following injury, the CCI groups exhibited significantly more labeled cells ipsilaterally. The significant increases for the CCI groups ranged from 161% to 360%. Generally, increases were greater for the CCI groups. These results indicate that Fos-LI increases to a greater extent and for a longer duration following the CCI than following either a transection or sham injury.

NADPH-diaphorase in the developing rat: lower brainstem and cervical spinal cord, with special reference to the trigemino-solitary complex

A previous study indicated that in adult rat, a distinctive neuronal group in the dorsomedial division of the subnucleus oralis of the spinal trigeminal nucleus (SpVo) and the rostrolateral part of the nucleus of the solitary tract (Sn) is stained for nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d), and suggested that the labeled structures are involved with sensorimotor reflexive functions. This study aimed to characterize the developmental expression of NADPH-d in SpVo and Sn, including other areas of the lower brainstem and cervical spinal cord, by means of the enzyme histochemical staining technique, from the prenatal through the postnatal period. On embryonic day 12 (E12), no neurons in the brain were stained for NADPH-d, whereas blood vessels were stained. Labeling in the vessels was consistently present throughout pre- and postnatal periods but decreased with development. On E15, labeled neurons appeared in the dorsomedial part of SpVo and the rostrolateral part of Sn, but not in the other nuclei. The labeled neurons in both nuclei increased in numbers drastically to E17. Postnatally, they tended to increase gradually in Sn, but to decrease slightly in SpVo. The cell size of labeled neurons reached a plateau at E17 in SpVo, but at postnatal day 4 (P4) in Sn. In other nuclei on E17, labeling appeared in the lateral paragigantocellular reticular, intermediate reticular, medullary reticular, pedunculopontine tegmental, and spinal vestibular nuclei, and laminae V, VI, and X of the cervical spinal cord. On E20 and P0, labeling appeared in the dorsal column, laterodorsal tegmental, raphe obscurus, parvocellular reticular, ventral gigantocellular reticular, and parahypoglossal nuclei, and laminae IX of the cervical spinal cord. On P4 labeling appeared in the parabrachial and median raphe nuclei, medial and caudolateral Sn, the magnocellular zone of subnucleus caudalis of the spinal trigeminal nucleus (SpVc), and laminae III/IV of the cervical spinal cord. On P10, labeling appeared in the paratrigeminal and dorsal raphe nuclei, the superficial zone of SpVc, and laminae I/II of the cervical spinal cord. No newly labeled neurons appeared in any nuclei after P14. The very early appearance of NADPH-d staining in SpVo and Sn, which precedes the appearance of NADPH-d elsewhere in the brainstem, suggests that the nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) system has an important role for primitive orofacial sensorimotor reflexive functions. Furthermore, the pattern of developmental expression of NADPH-d in SpVo and Sn suggests that the NO/cGMP system is organized in a distinct manner in different nuclei.

Partial coexistence of neuropeptide Y and calbindin D28k in the trigeminal ganglion following peripheral axotomy of the inferior alveolar nerve in the rat

Immunohistochemistry was applied to examine the correlation between neuropeptide Y (NPY) and the two calcium binding proteins (CaBPs) parvalbumin (PV) and calbindin D28k (CB) in the trigeminal ganglion following peripheral axotomy of the inferior alveolar nerve (IAN) in the rat. Five days following transection and application of FluoroGold (FG) to the cut end of the IAN, approximately 14.8% (80/539) and 18.6% (90/483) of FG-labeled IAN neurons in the trigeminal ganglion showed PV-like immunoreactivity (-LI) and CB-LI, respectively. The mean +/- S.D. area of FG-labeled PV-like immunoreactive (-IR) cells (FG/PV-IR cells) and FG/CB-IR cells were 835.9 +/- 303.1 mu m2 and 712.7 +/- 246.0 mu m2, respectively. FG/PV-IR cells were significantly larger than FG/CB-IR cells. Fourteen days following peripheral axotomy of the IAN, NPY-LI appeared in the medium- to large-sized cells. Double immunostaining revealed that approximately 3.3% (52/1569) of NPY-IR cells in the axotomized trigeminal ganglion displayed PV-LI, while approximately 26.7% (371/1392) of NPY-IR cells displayed CB-LI. The mean +/- S.D. cross-sectional areas of PV-IR and CB-IR trigeminal ganglion cells displaying NPY-LI were 819.5 +/- 265.6 mu m2 and 766.5 +/- 279.7 mu m2, respectively. There were no significant differences in the cross-sectional areas either between NPY/PV-IR cells and NPY/CB-IR cells, or between FG/PV-IR cells and NPY/PV-IR cells, or between FG/CB-IR cells and NPY/CB-IR cells. The present results indicate that injury-evoked medium- to large-sized NPY neurons were a different population from large-sized PV neurons, and NPY was partly co-localized with CB.

Immunohistochemical changes in the distribution of nerve fibers in the periodontal ligament during an experimental tooth movement of the rat molar

We examined the distribution of nerve fibers containing neurofilament protein (NFP), calcitonin gene-related peptide (CGRP), vasoactive intestinal polypeptide (VIP) and neuropeptide Y (NPY) in the periodontal ligament (PDL) of the rat first molar. In addition, we observed changes in the distribution of these nerve fibers in the PDL during experimental tooth movement induced by insertion of a separating elastic. In normal animals, both NFP- and CGRP-containing nerve fibers were observed in the apical part of the PDL, smaller numbers being found in the cervical part in normal rats. They terminated as free nerve endings in the apical part; no specialized endings were observed. VIP- and NPY-containing nerve fibers were associated with blood vessels near the alveolar bone in the apical part of the PDL of normal animals. Three days after tooth movement, the number of NFP- and CGRP-containing nerve fibers increased in both stretched and compressed parts of the PDL, and returned to normal levels after 14 days. Immediately after tooth movement, VIP-containing nerve fibers disappeared in the stretched part, and returned to the normal level after 14 days. VIP-containing nerve fibers were always observed during tooth movement in the compressed part of the PDL. NPY-containing nerve fibers disappeared immediately after tooth movement in the stretched part and returned to the normal level after 3 days. NPY-containing nerve fibers were not observed 1 day after insertion of the elastic in the compressed part and were the same as in the normal controls after 14 days. These results suggest that NFP-, CGRP-, VIP- and NPY-containing nerve fibers in the PDL play important roles in the modulation of pain, tissue remodeling and blood flow regulation during tooth movement.

Acute thrombolytic therapy and subsequent angioplasty for atherosclerotic stenosis of the basilar artery--case report

A 50-year-old male presented with severe atherosclerotic stenosis of the basilar artery at its origin with very poor blood flow distally, manifesting as sudden onset of deterioration of consciousness to semicomatose with decerebrate posture. He regained consciousness dramatically after acute thrombolysis, although right hemiparesis persisted due to left pontine infarction. Follow-up angiography after 3 months of antiplatelet and anticoagulation therapy demonstrated severe residual stenosis of the basilar artery. Percutaneous transluminal angioplasty (PTA) resulted in wide patency of the basilar artery stenosis with excellent blood flow distally. Combination of acute thrombolytic therapy and subsequent PTA is an effective treatment for severe basilar artery occlusive disease.

CT-defined large subcortical infarcts: correlation of location with site of cerebrovascular occlusive disease

PURPOSE

To correlate the location of large subcortical infarcts with the site of cerebrovascular occlusive disease.

METHODS

We examined CT and angiographic findings of 38 patients with major arterial occlusive disease and newly developed large subcortical infarcts of 2.0 cm or more, which were classified into three types: striatocapsular infarcts in the basal ganglia, terminal supply area infarcts in the corona radiata, and terminal supply area infarcts in the centrum semiovale.

RESULTS

Two or three of the types of infarct were sometimes combined; the combination of the striatocapsular and corona radiata infarcts was the most frequent (14 [36.8%] of 38). Thirty-four (89.5%) had atherosclerotic major arterial occlusive diseases; 22 (57.9%) had occlusive diseases of the internal carotid artery, and 12 (31.6%) had diseases of the middle cerebral artery. The other 4 (10.5%) had embolic transient middle cerebral artery occlusion. Middle cerebral artery occlusive diseases frequently produced striatocapsular (13 [81.3%] of 16) and corona radiata (13 [81.3%] of 16) infarcts but never induced the centrum semiovale lesions. On the other hand, in patients with internal carotid artery occlusive disease, the centrum semiovale (16 [72.7%] of 22) was more susceptible to ischemia than the striatocapsular region (11 [50%] of 22) or the corona radiata (9 [40.9%] of 22).

CONCLUSIONS

Middle cerebral artery occlusive diseases frequently produced striatocapsular and/or corona radiata infarcts but never induced the centrum semiovale lesions, which were usually associated with internal carotid artery occlusive diseases.

Rapid detection of mycoplasma contamination in cell cultures by enzymatic detection of polymerase chain reaction (PCR) products

Enzymatic detection of polymerase chain reaction (ED-PCR) was applied for rapid and easy identification of mycoplasmas from contaminated cell culture. This method was based on the capture of amplified products via biotin-streptavidine affinity and the detection of an incorporated hapten in amplified products with enzyme-linked antibody. Primers corresponding to common sequence of Mollicutes in 16S ribosomal RNA dominated gene was used. Nineteen of twenty Mollicutes so far reported as cell contaminants appeared positive by ED-PCR, whereas remaining one, Acholeplasma axanthum, appeared negative. Samples from sixty-two cell culture were tested for contamination of mycoplasmas by means of ED-PCR, cultivation, and electronmicroscopy. The results of ED-PCR were the same as those of cultivating method. The time required for all the detection process in ED-PCR was about 5 hr for 20 samples. We suggest that ED-PCR can be used in the rapid detection of mycoplasms from cell culture.

[A case of posterior fossa hypertrophic pachymeningitis with hydrocephalus]

A 52-year-old woman was admitted to our hospital because of nausea, headache, ataxic gait, and memory disturbance. CT scans and MRI showed a markedly enhanced lesion in the dura mater of the posterior fossa, edema in the right cerebellar hemisphere, occlusion of the transverse sinus, and hydrocephalus, suggesting hypertrophic pachymeningitis. Chronic otitis media and mastoiditis were also noted. Subjective complaints diminished after steroid administration. The patient underwent right suboccipital craniectomy and biopsy. The dura mater was markedly thickened, and the cerebellar surface was edematous. Histological examination revealed the thickened dura mater to be infiltrated by chronic inflammatory cells of forming lymphatic follicles and accompanied by Langhans giant cells. Inflammatory cells were not found in the cerebellar parenchyma, but were present in the subarachnoid space. Acid-fast stain, PAS and Grocott stain were negative. The cause of the hypertrophic pachymeningitis in this patient, may have been related to the chronic otitis media, but the patient's clinical course suggested that it might represent so-called "idiopathic hypertrophic pachymeningitis".

Temporal analysis of neuropeptide Y expression in the rat trigeminal ganglion following peripheral axotomy of the inferior alveolar nerve

Temporal changes in the appearance and the cell-size spectrum of neuropeptide Y (NPY)-like immunoreactive (IR) cells in the rat trigeminal ganglion (TG) following peripheral axotomy of the inferior alveolar nerve (IAN) were studied by retrograde neuronal tracing with True Blue (TB) and immunohistochemistry for NPY. The number of labeled cells following application of TB to the cut-end of the IAN increased rapidly up to 3 days, and was maintained at a constant level thereafter. The size distribution of cross-sectional areas of TB-labeled cells was similar at 3 days and afterwards. NPY-IR cells, which were not detected in the normal TG, appeared on the first day following axotomy, and increased gradually in number reaching a maximum at 14 days. The frequency histogram of the cross-sectional areas of NPY-IR cells was similar at 3 days and afterwards. The present results indicate that the effect of nerve injury on the levels of NPY expression in the sensory neurons began soon after nerve injury, reaching a maximum around 14 days, and that induction of NPY in the sensory neurons occurred in the same cell size-specific manner for a long period.

Immunohistochemical study of giant cell in glioblastoma

The clinical and immunohistochemical features of supratentorial (5 patients) and cerebellar (1 patient) glioblastomas, in which giant cells were conspicuous were examined. Three of the patients died within 26 months after the first treatment, and the follow-up period is presently 1 year or less in the remaining patients. The giant cells either showed large and bizarre nuclei or were multinucleated. Both giant and smaller cells excluding neuronal, endothelial and infiltrative cells were positive for GFAP, vimentin, and alpha-1 anti-chymotrypsin. The strong positivity for PCNA staining indicated that the capacity of the giant cells to synthesis DNA was preserved. DNA fragmentation, measured by the terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine-5'-triphosphate (dUTP)-biotin nick end labeling method, was observed in only 1 patient, who had received radiotherapy just before biopsy, and none of the patients showed bcl-2 positivity. Mutant type of p53 tumor suppressor gene was observed in the giant cells of 3 patients. Giant cell in glioblastoma is of glial origin, synthesizes DNA, and its progression may be related to tumor suppressor gene.

Appearance of dynorphin in the spinal trigeminal nucleus complex following experimental tooth movement in the rat

Changes in the expression of dynorphin were investigated immunohistochemically. Cells showing dynorphin immunoreactivity first appeared 2 days and disappeared 15 days after the unilateral insertion of separating elastics between the upper molars. These immunopositive cells were localized in the superficial layers in the medial third of the subnucleus caudalis on the ipsilateral side, except at 1 and 15 days. On the contralateral side, a few immunoreactive cells only were observed in the subnucleus caudalis of the 3- to 8-day groups. No immunoreactivity was observed in the subnucleus interpolaris, subnucleus oralis spinal trigeminal nucleus complex (STNC), principal trigeminal nucleus and mesencephalic trigeminal nucleus of the experimental rats and all the trigeminal nuclei of control animals. The findings indicate that experimental tooth movement induced the expression of dynorphin in the superficial layers of the subnucleus caudalis STNC. The subnucleus caudalis may play an important part in modulation of the discomfort and pain evoked by tooth movement.