Reproductive senescence in female Japanese monkeys (Macaca fuscata): age- and season-related changes in hypothalamic-pituitary-ovarian functions and fecundity rates

Age- and season-related changes in gonadotropin-gonadal functions were studied in captive female Japanese monkeys (Macaca fuscata fuscata), with special reference to reproductive senescence. In experiment 1, a total of 57 nonlactating females at ages 3-32 yr were used. Blood samples were collected for at least one breeding season (September through March), and changes in plasma concentrations of LH, estradiol, and progesterone were examined. In experiment 2, two groups of females (older females, n = 5, over 21 yr old; mature females, n = 5, aged 8-12 yr) received s.c. injections of 50 micrograms/kg of estradiol benzoate during the mid-breeding season. In experiment 1, ovarian functions as well as fecundity rates were maintained in the animals aged 5-20 yr. A decline in ovarian activity became apparent at 21-25 yr of age, when animals exhibited a slight increase in plasma LH during the breeding season. Onset of menopause occurred at around 27 yr of age, near the end of the life span. Menopausal females exhibited a marked seasonal difference in plasma LH concentrations, with high levels during the breeding season. In experiment 2, estradiol treatment elicited an LH surge in both old and mature females. The marked seasonal difference in plasma LH, as well as the maintenance of LH response to estradiol in menopausal females, suggests a possibility that biannual changes in sensitivity of the hypothalamo-hypophysial axis to the negative feedback action of estradiol are maintained even after menopause.

Purification of a Ras-dependent mitogen-activated protein kinase kinase kinase from bovine brain cytosol and its identification as a complex of B-Raf and 14-3-3 proteins

We previously purified a protein factor, named REKS (Ras-dependent Extracellular Signal-regulated Kinase (ERK)/mitogen-activated protein kinase Kinase (MEK) Stimulator), from Xenopus eggs by use of a cell-free assay system in which recombinant GTP gamma S (guanosine 5'-(3-O-thio)triphosphate)-Ki-Ras activates recombinant MEK. By use of this assay system, we purified here bovine REKS to near homogeneity from the cytosol fraction of bovine brain by successive chromatographies of Mono S, Mono Q, GTP gamma S-glutathione S-transferase-Ha-Ras-coupled glutathione-agarose, and Mono Q columns. It was composed of three proteins with masses of about 95, 32, and 30 kDa as estimated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The 95-, 32-, and 30-kDa proteins were identified by immunoblot analysis to be B-Raf protein kinase, 14-3-3 protein, and 14-3-3 protein, respectively. Moreover, the REKS activity was specifically immunoprecipitated by an anti-B-Raf antibody. Bovine REKS was activated by lipid-modified GTP gamma S-Ki-Ras far more effectively than by a lipid-unmodified one. Lipid-modified GDP-Ki-Ras was inactive. Exogenous addition of 14-3-3 proteins stimulated further the REKS activity both in the presence and absence of GTP gamma S-Ki-Ras. These results indicate that at least one of the direct targets of Ras is B-Raf complexed with 14-3-3 proteins in bovine brain.

Excimer Laser Photorefractive Keratectomy For Myopia: Two-year Follow Up

This study, comprising 60 eyes with a follow up of at least 2 years, was designed to evaluate the efficacy and safety of excimer laser photorefractive keratectomy (PRK) for myopia in Japanese people. Eyes were divided into three groups: low myopia group (-2.00 diopters (D) to -3.00 D), 11 eyes; medium myopia group (-3.10 D to -6.00 D), 28 eyes; and high myopia group (-6.10 D to -14.00 D), 21 eyes. In 60 eyes, uncorrected visual acuity improved and spectacle corrected visual acuity remained unchanged. At 2 years, 100%, 75%, and 52%, respectively, of the low, medium, and high myopia groups, were within +/- 1.00 D of the attempted correction. Twenty-two eyes (37%) developed corneal haze of grade 2 or more. These data show that in low or medium myopia the predictability is good. But we think we have to pay attention to the strong haze, which seems to have developed more frequently in Japanese people than in previous reports of PRK in Caucasians.

Analysis of target organs for the latency of murine cytomegalovirus DNA using specific pathogen free and germfree mice

Cytomegalovirus (CMV) establishes a latent infection in its host; however, the organ sites of viral latency and its mechanism still remain to be fully clarified. To elucidate this issue, a latent infection with murine (M) CMV was attempted to induce in mice and the organ sites of the latent viral genome were examined for more than one year by a polymerase chain reaction (PCR). As a result, latent MCMV DNA was detectable in both the lung and the spleen as late as 59 weeks after infection. The heart was also observed to be a target organ of latent MCMV DNA, though the amount of viral DNA was much less than that seen in the lung and spleen. In germfree (GF) mice, on the other hand, no such latent viral DNA was observed in the spleens, while it was seen, but to a significantly smaller degree, in the lungs and the hearts than in the same organs of specific pathogen-free (SPF) mice. The amount of infectious virions generated in the host appeared to be almost equal between the GF and SPF mice. The above findings therefore suggest that the spleen, lung and heart are target organs for MCMV latency and the indigenous bacterial flora, which are not colonizing in GF mice, play an important role in the establishment of such viral latency in SPF mice.

Sympatho-inhibitory effects of gamma-l-glutamyl-l-dopa are not mediated by activation of dopamine-2 receptors in conscious rabbits

AIM

To define the role of dopamine-2 receptors in the sympatho-inhibitory effects of gamma-l-glutamyl-l-dopa in conscious rabbits.

METHOD

gamma-l-glutamyl-l-dopa (gludopa) was infused iv at 25 and 100 micrograms.kg-1.min-1 with and without prior dopamine-2 receptor blockade by YM-09151-2 (50 micrograms.kg-1 iv) in conscious rabbits.

RESULTS

Mean arterial pressure and heart rate remained unchanged while renal plasma flow increased. Arterial norepinephrine (NE) concentration, total and renal NE spillover rate were markedly decreased in a dose-related manner, which were not affected by prior dopamine-2 receptor blockade. Gludopa was detected in the whole brain (92 +/- 112 ng/g wet brain tissue) at the end of experiment although brain tissue levodopa, NE, and dopamine contents were not much different from those in the control group.

CONCLUSION

Gludopa decreased dose-dependently plasma NE concentration, and total and renal NE overflow to plasma, which were not mediated by activation of dopamine D2 receptors.

[Fine needle aspiration cytology in screening of prostatic cancer]

Between October 1990 and June 1993, 112 patients underwent fine needle aspiration cytology and core needle biopsy of the prostate under transrectal ultrasonographic guidance. They were suspected of having prostatic cancer from the prostatic antigen level, digital rectal examination and/or transrectal ultrasonography. Twenty seven of the 112 cases (24%) were diagnosed with prostatic cancer. Their cytological diagnoses showed 22 class IV or V, 2 class III, and 3 class I or II. Efficiency, false negative rate and false positive rate were 86%, 11% and 0% in fine needle aspiration cytology. We could obtain sufficient samples for fine needle aspiration cytology in all cases. No severe complication was observed. However, we missed 3 patients, in fine needle aspiration cytology, who were strongly suspected of having prostatic cancer, and reexamination or additional core needle biopsy would have been necessary on 15 of the 112 patients (13%) who showed false negative or class III cytological results, if we had screened prostatic cancer only by fine needle aspiration cytology. In conclusion, fine needle aspiration cytology may not be as useful as core needle biopsy to screen prostatic cancer.

The inhibitory effect of Li+ on contractile elements of intestinal smooth muscle

The mechanism of the inhibitory effect of Li+ on contraction was examined in guinea pig ileal longitudinal smooth muscle. Li(+)-substitution (68.4 mM) reversed contractions induced by high K+ (45.4 mM), carbachol (1 microM) and histamine (1 microM) without changing the cytosolic Ca2+ level. Li+ also had no effect on the increase in 45Ca2+ uptake stimulated by high K+. High K+ transiently increased myosin light chain (MLC) phosphorylation, reaching a peak at 6-9 sec. Li(+)-substitution inhibited the high K(+)-induced MLC phosphorylation. In permeabilized ileal strips, contraction induced by 1 microM Ca2+ was inhibited by 10 mM Li+. The inhibitory effect was antagonized by increasing the concentration of Ca2+ or calmodulin. In the permeabilized muscle in which MLC was previously thiophosphorylated with 1 mM ATP gamma S and 3 microM Ca2+, ATP induced contraction in Ca2+ free buffer. Li+ added during this contraction did not show an inhibitory effect. In contrast, when 30 mM Li+ was added during the thiophosphorylation, the contraction induced by the subsequent addition of ATP was inhibited. Li+ (30 mM) changed neither the rate of relaxation induced by removing external Ca2+ in permeabilized muscle nor the rate of dephosphorylation of MLC induced by crude phosphatase extracted from the ileum. Li+ (15 mM), on the other hand, inhibited the rate of phosphorylation of MLC caused by crude MLC kinase extracted from the ileum. Li+ did not inhibit the calmodulin activity as measured with the (Ca2+ +Mg2+)-ATPase activity of the erythrocyte membrane. These results suggest that the inhibitory effect of Li+ on contractions is attributable to the inhibition of MLC kinase in guinea pig ileum.

Azygos venous blood flow: measurement with direct bolus imaging

PURPOSE

To evaluate a magnetic resonance (MR) imaging technique for measurement of azygos blood flow volume, which is an important indicator of superior collateral circulation in patients with portal hypertension.

MATERIALS AND METHODS

Azygos blood flow was measured by means of direct bolus (DB) imaging, an MR flow measurement technique. A presaturation pulse was applied in combination with electrocardiographic gating.

RESULTS

The measured flow volume was 320 mL/min +/- 30 (mean +/- standard error of mean) in the control subjects, 550 mL/min +/- 130 in patients with cirrhosis of the liver and without varices, and 660 mL/min +/- 60 in patients with cirrhosis of the liver and with varices. The flow volume was significantly higher in each of the groups with cirrhosis of the liver than in the control group (P < .01). Furthermore, a significant correlation was shown between DB imaging and continuous thermodilution measurements (r = .707, P < .01).

CONCLUSION

DB imaging, which is noninvasive, was useful in the monitoring of the effect of treatment and in determination of the prognosis in patients with portal hypertension.

Comparison of phenotypic characteristics, DNA-DNA hybridization results, and results with a commercial rapid biochemical and enzymatic reaction system for identification of viridans group streptococci

The rapid ID 32 Strep system (bioMérieux, Marcy l'Etoile, France) was evaluated for its ability to identify 21 species of viridans group streptococci; results were compared with DNA-DNA hybridization results and results of conventional physiological tests. A total of 171 strains of the 21 species including 147 clinical strains was analyzed. Of the 156 strains of species included in the database of this system, 136 strains (87%) were correctly identified. Incorrect identification occurred for 13 strains (8%), and no identification was given for 7 strains (5%). It was difficult to differentiate S. mitis and S. oralis accurately with this system. Of the 17 strains identified as S. mitis by the rapid ID 32 Strep system, the results of DNA-DNA hybridization were in agreement for only 3 strains. S. crista and S. parasanguis, which are not included in the database, were identified as S. mitis or S. sanguis or were not identified, but S. parasanguis could probably be identified by using the rapid ID 32 Strep system because the biochemical profile is well characterized for this species. The rapid ID 32 Strep system can be used to differentiate most species for which phenotypic characteristics have been described if the database is revised according to recently reported amended criteria for the identification of viridans group streptococci. However, identification of a few species such as S. mitis and S. oralis is problematic with this system.

Direct tumorigenic conversion of human gallbladder carcinoma cells by v-src but not by activated c-H-ras oncogene

The roles of activated ras and src oncogene products in the acquisition of fully neoplastic phenotype by human gallbladder adenocarcinoma cells were investigated by co-transfecting non-tumorigenic HAG-I human gallbladder carcinoma cells with the pSV2neo plasmid and a plasmid carrying either activated c-H-ras or v-src oncogene. G418-resistant clones were isolated and assessed for the acquisition of anchorage-independent growth potential. Neither the 10 established clones transfected with pSV2neo alone nor the 17 clones transfected with activated c-H-ras, including 4 clones expressing the mutated p21H-ras protein, could form colonies in soft agar. By contrast, out of 10 clones transfected with v-src, 2 formed colonies in soft agar and produced tumors in athymic nude mice, the resulting progressive neoplasms being poorly differentiated adenocarcinomas. These tumorigenic clones were shown to have v-src DNA and mRNA levels with p60v-src protein, but there were no significant chromosomal alterations following tumorigenic conversion. Moreover, herbimycin A, a selective src-kinase inhibitor, markedly reduced clonogenic growth of these cells in soft agar rather than monolayer growth, suggesting that anchorage-independent growth of the v-src-transformed HAG-I cells might be driven directly by p60v-src kinase activity. Taken together, our data suggest that the fully neoplastic conversion of HAG-I cells depends on src-related tyrosine-kinase activity, but not solely on the function mediated by activated ras, thus providing evidence of an src-related signaling pathway for the acquisition of tumorigenic potential by human gallbladder adenocarcinoma cells.

Humanization of mouse ONS-M21 antibody with the aid of hybrid variable regions

Mouse monoclonal antibody, ONS-M21, directed against human medulloblastoma cells, has been humanized by complementarity determining region (CDR) grafting. A humanized ONS-M21 VH region, comparable to the original mouse ONS-M21 VH region, was easily constructed based on framework regions (FRs) 1, 2 and 3 from human EU antibody and on FR4 from human ND antibody. Five alterations in the FRs were made at amino acids 27, 28, 29, 30 and 94 which are all part of the canonical structure for CDR1 (H1). The humanized ONS-M21 VL regions were constructed based on the FRs from human REI antibody. We first identified five amino acid residues in the FRs at positions 20, 21, 71, 73 and 87 as having a possible adverse influences on antigen binding. None of the versions with a variety of combinations at these five positions showed any bindings to antigen. In order to identify the mouse residues that must be retained in the human FRs, hybrid VL regions were constructed by joining the mouse ONS-M21 VL region and the first humanized version within CDR2. The hybrid VL regions revealed that residues in FR1 and/or FR2 were critical in creating a functional antigen binding site. Redesigning several versions with alterations in FR1 and FR2 revealed that the Pro-46 residue was the only critical residue for creating an antigen binding site. This approach should be helpful in identifying key residues in difficult cases of antibody humanization.

A simplified general method for determination of recombinant retrovirus titers

To construct recombinant retroviruses with only a single active promoter, we introduced point mutations into the TATA box region of the 3'-LTR, and successfully obtained high-titer virus with sufficient self-inactivating activity. However, the viral titer could not be determined by the number of G418 resistant colonies since the neomycin resistance gene was under 5'-LTR control, because of inactivation of the selection marker in target glioma cells. To overcome this problem, we constructed PCR primers with homology to a gene under the control of the internal promoter of recombinant retrovirus, and to retrovirus-specific sequences. There was good correlation between the amount of PCR-amplified product and the number of colony forming units when glioma cells were transduced with the retroviruses containing both the neomycin resistance gene and the HTK gene. Amplified PCR products quantitated by densitometry after glioma cells were transduced with SIV retrovirus vectors, and there was good correlation between density and sensitivity to GCV following transduction. Therefore, detection of HTK PCR products from glioma cells transduced with HTK-bearing retroviruses is useful for determining the appropriate packaging cell for efficient production of viral particles. This detection system is especially useful for isolating high titer clones producing SIV-type retroviruses.

[Prognostic evaluation of endometrial carcinoma by DNA content and histologic factors]

Paraffin-embedded tumor samples from 51 endometrial cancer patients were analyzed by DNA flow cytometry to investigate relationship between DNA content and histologic prognostic factors. Twenty of the tumors were DNA aneuploid. With regard to clinical stage, DNA aneuploid tumors were observed in 22.9% of stage I, 72.7% of stage II and 80.0% of stage III cases. Concerning the histologic type, DNA aneuploid tumors were seen in 31.4% of endometrial carcinomas, 28.6% of adenosquamous cell carcinomas and 87.5% of serous adenocarcinoma cases. As to the depth of invasion, in 16.0% of cases there was invasion within 1/3 myometrium, in 42.9% of cases the middle 2/3, and in 80.0% of cases there was invasion throughout 2/3, these all being aneuploid cases. The above findings suggest that DNA aneuploidy is associated with the clinical stage, myometrial invasion and especially the histologic type. Furthermore, lymph node metastasis was detected in 3.4 and 26.3% of DNA diploid and aneuploid groups, respectively, and the frequencies were significantly different. Moreover, the 5 year survival rate was significantly higher in the DNA diploid group (96.8%) than in the aneuploid group (62.7%) (p < 0.05). The results suggest that flow cytometric ploidy determination is useful in making the prognosis for patients with endometrial carcinoma.

[Analysis of sex chromosomal DNA markers by a molecular biological method and it's application to forensic medicine]

We attempted sex and individual identifications of several forensic specimens by detecting various sex chromosome-specific sequences by the polymerase chain reaction (PCR) method. The specimens were 30 blood stains that were attached to gauze and stored for 11 months -15 years (15 males, 14 females and 1 of unknown gender) and 10 bleached white bones (8- about 10000 years after death). Of the known 29 blood stains, the sex determination rate was the highest by DYZ-1 (amplified DNA fragment = 149bp, about 3000 copies on Y chromosome) recombinated with DXZ-1 (28 of the 29 samples) although 27 samples could be determined by DYZ-1 (amplified DNA fragment = 1000bp, about 3000 copies on Y chromosome) recombinated with DXZ-1. The sex determination rate was relatively low by DYZ-3 (amplified DNA fragment = 170bp, about 100 copies on Y chromosome) recombinated with DXZ-1 (23 of the 29 samples). The sex determination rate by two single locus markers, PAB or Amelogenin was markedly low (7 and 9 of 29 samples, respectively). The sex determination rate by the 27H39 locus was 27 of the 29 samples; 14 of the 15 male were determined (A = 186bp, 1; B = 190bp, 7; C = 194bp, 5; D = 198bp, 1; E = 202bp, 0). One unknown gender could be identified as male by multiple locus markers, but could not be identified by any single locus markers except for the 27H39 locus.(ABSTRACT TRUNCATED AT 250 WORDS)

Epidural spinal cord compression as an initial symptom in childhood acute lymphoblastic leukemia: rapid decompression by local irradiation and systemic chemotherapy

We treated an 11-year-old girl with spinal cord compression near an epidural tumor. Bone marrow examination confirmed the diagnosis of acute lymphoblastic leukemia (ALL). To reduce the compression we treated her immediately with high-dose dexamethasone and vincristine administered intravenously along with local irradiation. Three days later, radiation was discontinued because magnetic resonance imaging showed that the spinal cord compression was reduced. Complete remission has continued without evidence of neurologic sequelae for more than 3 years since diagnosis. Rapid reduction of the blasts resulted in tumor lysis syndrome, which was treated with conventional management and additional diuresis without hemodialysis. Epidural spinal cord compression in childhood ALL can be treated effectively with systemic chemotherapy and local radiotherapy without laminectomy.

An intra-arterial electrode for intracranial electro-encephalogram recordings

A new method for intracranial monitoring of brain electrical activity by means of an intra-arterial guide wire as electrode is described. We carried out intracranial electro-encephalography (EEG) using an insulated Seeker Lite-10 guide wire 18 times in 14 patients: ten times in 6 patients with cerebral arteriovenous malformation (AVM) before embolization, and another 8 times in 8 patients with epilepsy. In all cases, a 2-5 times stronger high voltage potential EEG compared with scalp EEG could be recorded. In 3 patients with complex partial epilepsy, intra-arterial (IA) EEG was recorded under subdural strip electrode monitoring, and IAEEG at the sphenoidal portion of the middle cerebral artery was compared with subdural electrode recordings. Frequent interictal spike discharges recorded with subdural electrodes in the lesional medial temporal lobe were simultaneously visible on IAEEG recording. This method is equivalent to that using a semi-invasive electrode, but ECoG recording can be performed at angiography. IAEEG is a method of electrode recording that has the possibility of clinical application.

Measurement of distributed strain and temperature in a branched optical fiber network by use of Brillouin optical time-domain reflectometry

A new scheme is proposed for sensing distributed strain and temperature in optical fibers. This scheme uses Brillouin scattering as the sensing mechanism and a branched optical fiber network as the sensing fibers. Brillouin optical time-domain reflectometry makes it possible to distinguish Brillouin-scattered light waves from different optical fiber branches in the network when the different Brillouin frequency shifts are assigned to each branch. The technical feasibility of this scheme is confirmed experimentally for a branched optical network composed of two branches connected to a trunk optical fiber.

Expulsion of the placenta from the uterus is the principal initiator for collagen degradation in mouse uterus

In unilaterally pregnant mice, collagen degradation in the non-pregnant uterine horn was not initiated by removal of the fetus only but by removal of both the fetus and placenta. The results indicate that expulsion of the placenta from the uterus is a principal factor in the initiation of the process of collagen degradation simultaneously in the whole uterus.

Purification and characterization of REKS from Xenopus eggs. Identification of REKS as a Ras-dependent mitogen-activated protein kinase kinase kinase

We have previously identified a protein factor, named REKS (Ras-dependent Extracellular signal-regulated kinase/Mitogen-activated protein kinase kinase (MEK) Stimulator), which is necessary for Ras-dependent MEK activation. In this study, we attempted to highly purify and characterize REKS. We have highly purified REKS by successive column chromatographies using a cell-free assay system in which REKS activates recombinant extracellular signal-regulated kinase 2 through recombinant MEK in a guanosine 5'-O-(thiotriphosphate) (GTP gamma S)-Ki-Ras-dependent manner. REKS formed a stable complex with GTP gamma S-Ras; REKS was coimmunoprecipitated with GTP gamma S-Ki-Ras or GTP gamma S-Ha-Ras, but not with GDP-Ki-Ras or GDP-Ha-Ras by an anti-Ras antibody. REKS was absorbed to a GTP gamma S-glutathione S-transferase (GST)-Ha-Ras-coupled glutathione-agarose column but not to a GDP-GST-Ha-Ras-coupled glutathione-agarose column and was coeluted with GTP gamma S-GST-Ha-Ras by reduced glutathione. The minimum molecular mass of REKS was estimated to be about 98 kDa on SDS-polyacrylamide gel electrophoresis. REKS phosphorylated this 98-kDa protein as well as recombinant MEK. REKS was not recognized by any of the anti-c-Raf-1, anti-Mos, and anti-mSte11 antibodies. These results indicate that REKS is a Ras-dependent MEK kinase.

Proteoglycan degradation in hemarthrosis. Intraarticular, autologous blood injection in rat knees

We determined the degradation of articular cartilage proteoglycans in a single episode of experimental hemarthrosis in rat knees. The right knee joints of rats were injected once with autologous whole blood. Both knee joints were examined histologically. Biochemical studies of cartilage proteoglycans extracted from the knees were also conducted. Histological examination revealed an accumulation of mononuclear cells in intraarticular fibrin clots and subsynovial layers 8 hours after the injection of blood. Accordingly, initiation of proteoglycan degradation occurred 8 hours after injection of blood, lasting from 1 day of limited degradation to 3 days; recovery then occurred within 7 days. The proteoglycan degradation could be inhibited by 1 mM phenylmethylsulfonyl fluoride, a general serine proteinase inhibitor, 0.1 M 6-aminohexanoic acid, a specific inhibitor of plasminogen activators, 10 mM EDTA, and 10(-6) to 10(-8) M dexamethasone, indicating that the accumulation of mononuclear cells in intraarticular fibrin clots and subsynovial layers may play an important role in cartilage damage.

Prognostic significance of nucleolar organizer regions in hepatocellular carcinoma

It has been suggested that the number of argyrophilic nucleolar organizer regions (AgNORs) correlates with cellular activity and the aggressiveness of malignancy. The mean number of AgNORs per nucleus may, therefore, be a prognostic factor for hepatocellular carcinoma (HCC). The purpose of this study was to evaluate the prognostic significance of the number of AgNORs in HCC. The silver-staining technique was applied to surgically resected specimens to indicate AgNORs. Eighty-nine of the specimens were of HCC, 23 were of normal liver adjacent to HCC, and 32 were of cirrhotic liver adjacent to HCC. The number of AgNORs of HCC (mean +/- SD, 3.26 +/- 1.23) was significantly higher than those of normal liver (1.37 +/- 0.13) and cirrhotic liver (1.49 +/- 0.14). The number of AgNORs was significantly correlated with serum alpha-fetoprotein level, tumor size, portal vein invasion, and Edmondson-Steiner histological grade. In patients undergoing curative resection, the survival rate of those with a high number (> 3.04) of AgNORs was significantly worse than that of those with a low number (< or = 3.04) of AgNORs. Multivariate analysis showed that the number of AgNORs was a significant prognostic indicator in patients without portal vein invasion, and portal vein invasion was the only significant variable when all patients undergoing curative resection were assessed together. The results of this study suggest that the number of AgNORs is useful as an indicator of the grade of malignancy and as a predictor of the prognosis of patients with HCC who do not have portal vein involvement.

Intraoperative electrophysiologic monitoring of cranial motor nerves in skull base surgery

BACKGROUND

Intraoperative cranial nerve monitoring has been applied for the preservation of nerve function during skull base surgery. However, its usefulness is controversial because clinical results reported are limited.

METHODS

We evaluated the usefulness of intraoperative electrophysiologic monitoring of the third to seventh cranial motor nerves in 15 patients undergoing skull base surgery. Intracranial bipolar electrical stimulation of each nerve was performed, and compound muscle action potentials (CMAP) were recorded from the innervated muscles.

RESULTS

CMAPs were successfully recorded from 23 of the innervated muscles. The loss of the CMAP response during the manipulation of lesions or high stimulus intensity at the end of manipulation seem to be related to the postoperative deficits of nerve function.

CONCLUSIONS

The results suggest that intraoperative electrophysiologic monitoring of cranial motor nerves is useful for prediction of postoperative nerve function.