Trigeminal pain caused by a parapontine epidermal cyst

A case of trigeminal neuralgia caused by a parapontine epidermal cyst is reported. The trigeminal inlet zone at the pons was completely surrounded by the tumor. No vascular element was detected around the trigeminal nerve root. Neurological symptoms were completely normal except for typical tic douloureux. Pain was controlled initially by carbamazepine, later by radiofrequency trigeminal nerve coagulation, and finally by microsurgical decompression. Review of the literature suggested the importance of lesions of the middle fossa as another etiological factor. When surgery is performed by the posterior route, the possibility of overlooking these lesions may exist.

Adenocarcinoma arising at a colostomy site. Report of a case

Primary adenocarcinoma arising at a colostomy or ileostomy site is very rare, and only three cases have been reported following surgical treatment of ulcerative colitis. A 38-year-old man who developed an adenocarcinoma originating at the site of a colonic stoma and producing a large fungating tumor mass in the surrounding abdominal wall is described. This occurred 19 years after Miles' operation for a carcinoma of the rectum.

A growth-hormone--producing pituitary adenoma and an internal carotid artery aneurysm

The case of a growth-hormone-producing pituitary adenoma which was in direct contact with a right internal carotid, medial-type aneurysm is reported. Direct clipping of the aneurysm and subcapsular removal of the adenoma were performed through a right frontotemporal craniotomy. The rarity of this direct contact and the cause of formation and enlargement of the aneurysm are discussed. The importance of angiography in cases of pituitary adenoma is stressed.

[Postoperative treatment of malignant brain tumors with ACNU and PSK-particularly immunological follow-up research]

From the recent progress in immunological study, many authors have reported immune suppression in patients with malignant brain tumors. On the other hand, many factors are considered to influence the patterns of cellular and humoral immune parameters in patients with brain tumors, pre- and post-operatively. We treated the patients with malignant brain tumors using ACNU and PSK pre- and post-operatively, and 4 year survival rate was 35.3% (N: 17) in glioblastomas. We planned this time to measure immune parameters (Ig,lymprocyte number,Lyn and T-cell, Tn) pre- and post-operatively in order to study the immune states of patients. The results were as follows: The most significant finding was the elevated serum level of IgG in longterm survival of the patients with glioblastoma and the reduced one in patients with postoperative death. No other humoral immunocompetence existed except slightly reduced IgM level in the patients with death. Contrary to many previous studies, our research has suggested that humoral immune parameters are considered to be valuable to understand postoperative immune states of patients, and administration of PSK be effective as an immunomodulator.

[A rare case of HGH producing adenoma in direct contact with an IC medial type aneurysm]

A rare case of HGH producing pituitary adenoma which was in direct contact with right IC medial type aneurysm was reported. A 60-year-old woman was admitted to our clinic in February, 1981, for the acromegalic features, who was treated by 5 mg/day of CB-154 since 1976 under the diagnosis of HGH secreting adenoma. The diagnosis of bitemporal hemianopsia was made in 1977, but it was disappeared at the time of admission to our clinic. A coronal section of computed tomography demonstrated a high contrasted tumor shadow in the sella turcica without definite suprasellar extension. A right carotid angiography showed the right IC-medial type aneurysm between the right posterior communicating artery and ophthalmic artery. In March, 2-81, direct neck clipping of the aneurysm and subcapsular removal of the adenoma were performed by the right frontal approach. From the operative findings it was concluded that the aneurysm was partially embedded in the adenoma tissue. Post operative course was uneventful except for the fact that the basal HGH level could not be normalized without CB-154 therapy. Many cases of association of cerebral aneurysm with pituitary adenoma were reported in the literature. However, direct contact between the tumor and the aneurysm could not be detected. This case seems the first report of the direct association of cerebral aneurysm with pituitary adenoma. Etiology for the unique combination of adenoma and aneurysm was discussed. It has been well known that the prolonged high level of serum growth hormone in acromegaly produces arteriosclerotic and degenerative changes in the arterial wall. It was speculated that the formation of the aneurysm in our case particular was due to the combination effects of the following events. That is, the direct mechanical pressure of pituitary adenoma to the right IC arterial wall, the arteriosclerotic or degenerative change of the arterial wall due to the prolonged exposure to the high level of HGH, and finally traction effect of the adenoma to the arterial wall because of the reduction of the size of the adenoma due to CB-154 therapy, all above mentioned influences were considered to contribute to the aneurysm formation. Finally, the preoperative bilateral carotid angiography is not unnecessary to the operative planning of the pituitary adenoma, especially when the adenoma was HGH producing one.

Kinetic aspects of hemoglobin.haptoglobin-receptor interaction in rat liver plasma membranes, isolated liver cells, and liver cells in primary culture

125I-Hemoglobin.haptoglobin injected intravenously into rats was incorporated into liver parenchymal cells as evidenced by a cell separation technique. A mixture of freshly isolated liver parenchymal and nonparenchymal cells failed to internalize and degrade the 125I-hemoglobin.haptoglobin added, although it retained the ability to bind the molecule. The liver parenchymal cells in primary culture also lacked the ability to degrade 125I-hemoglobin.haptoglobin, although they bound the molecule more extensively as compared with the freshly isolated liver cells. It was confirmed that the 125I-hemoglobin.haptoglobin which was bound to the freshly isolated liver parenchymal cells localized on the outer surface of liver plasma membranes. Scatchard plots revealed the existence of two binding sites for 125I-hemoglobin-haptoglobin on the isolated liver plasma membrane: an apparent high affinity binding site (Kd = 1.3 X 10(-7) M) and an apparent low affinity binding site (Kd = 4.0 X 10(-6) M) at 37 degrees C. In contrast, freshly isolated liver parenchymal cells had only an apparent low affinity binding site (Kd = 1.4 X 10(-6) M) at 37 degrees C. Impairment of the apparent high affinity binding site during the isolation procedure with collagenase seemed to be related to loss of the ability to internalize and degrade the 125I-hemoglobin.haptoglobin molecules into the freshly isolated liver parenchymal cells or liver parenchymal cells in primary culture.

Malignant transformation of intrathoracic ancient neurilemoma in a patient without von Recklinghausen's disease

A case of intrathoracic ancient neurilemoma undergoing malignant change in a 48-year-old woman is reported. The lesion was first discovered incidentally during routine roentgenologic examination of the chest 15 years before its surgical removal. The gross and histologic examination of the tumor showed the features of ancient neurilemoma with extensive regressive changes as well as small preserved areas composed of Antoni type A and B tissues. In addition, obviously histologically malignant foci manifested by the presence of increased cellularity, active mitotic activity, and gradual loss of orginary neurilemomatous differentiation were present. The patient died 16 months after operation of recurrent and distant metastatic disease. At autopsy, there was no evidence of generalized neurofibromatosis or other primary cancer. A review of the available literature revealed only two other similar cases documenting malignant transformation of solitary benign neurilemomas in patienets without von Recklinghausen's disease.

Luminous intensity of a gradient-index lens array

The illuminance of a gradient-index lens array is analyzed theoretically, and some examples of the design of a line scanning optical system are discussed.

[Studies on the suppressor cells acting on the mitogen induced blastogenesis in tumor-bearing hosts. II. Suppressor cells in the peripheral blood of patients with malignant bone and soft tissue sarcoma (author's transl)]

The responses to Concanavalin A (Con A) of peripheral blood mononuclear cells were studied in 22 patients with malignant bone and soft tissue sarcoma. The decreases of response were shown in many cases depending on their clinical stages. The responses were increased by removal of the adherent cells from mononuclear cells by passing through a Sephadex G-10 column in 7 of 13 cases tested. The enhancement of responses to Con A was also found when indomethacin, a inhibitor of prostaglandin biosynthesis, was added to mononuclear cell suspensions. However, no additional increase of the responses was found when indomethacin was supplemented to the adherent cell-depleted mononuclear cell suspensions. Since it has been previously shown that prostaglandin was primarily produced from macrophages, the author concluded that the suppressor cells affecting on the lymphocyte transformation probably belong to monocyte-macrophage series and their suppressive effect may be mediated by prostaglandin. In the normal control, the responses of mononuclear cells to Con A stimulation were rather reduced by removal of the adherent cells, suggesting that these suppressor cells were contained only in mononuclear cells of the tumor-bearing hosts.

[Studies on the suppressor cells acting on the mitogen-induced blastogenesis in tumor-bearing hosts. I. Suppressor cells in the spleens and peripheral blood of tumor-bearing rats (author's transl)]

When Walker carcinosarcoma 256 cells were transplanted to the inbred Fischer male rats, the responses of spleen cells to Concanavalin A (Con A) or Phytohemagglutinin (PHA) stimulation were gradually reduced as tumor grew up. However, these responses were significantly restored in most cases when the phagocytic or adherent cells were removed from spleen cell suspensions by treating them with a carbonyl iron-magnetic procedure or the passing through a Sephadex G-10 column. Similarly, the decreased responses of peripheral blood mononuclear cells from tumor-bearing rats to Con A stimulation were also restored by removal of the adherent cells with a Sephadex G-10 column. These results strongly suggest a possibility that the suppressor cells, probably the monocyte-macrophage series, were contained in both spleen cells and peripheral blood mononuclear cells and these cells exert their suppressive effect on the mitogen-induced lymphocyte transformation.

Hemoglobin-haptoglobin receptor in rat liver plasma membrane

The presence of a receptor specific for the hemoglobin . haptoglobin complex is demonstrated in rat liver plasma membranes. Hemoglobin . haptoglobin complex, administered intravenously to rats, was cleared from the circulation at a constant rate with exclusive incorporation of the molecule into hepatocytes. This incorporation was unaffected by the simultaneous injection of asialoglycoprotein or heme . hemopexin complex. In vitro experiments with isolated liver plasma membranes indicated the absence of competitive binding of these molecules to the membrane and suggested that this receptor might recognize an altered conformation of the haptoglobin moiety of the complex resulting from the binding with hemoglobin. These observations suggest that the mechanism of recognition and binding of hemoglobin . haptoglobin complex by the receptor is different from that of the asialoglycoprotein receptor or heme . hemopexin receptor.