Oxidation and reduction of nitrite ion in the TiO2 photo-induced catalytic reaction

During a photo-induced catalytic reaction under near UV irradiation to an aqueous suspension of Ti4O2, about 95% of NO2- was oxidized to NO3-, but NH4+ was not detected. The oxidation was inhibited by the addition of mannitol or under anaerobic conditions. The nitration of HPA was observed in the presence of t-buthanol, suggesting the formation of ONOO. An ESR spectrum gave a triplet signal at g = 2.041,in the presence of NO2-, mannitol, FeSO4, and MGD, indicating the reduction of NO2- to NO.

[The usefulness of dynamic computed tomography scanning in predicting the outcome of acute stroke patients]

The aim of this study was to investigate whether brain dynamic computed tomography (CT) is useful in predicting clinical outcome. Thirty patients suffering from cerebral ischemia in the territory of the middle cerebral artery (MCA) underwent dynamic CT scanning within 6 hours of stroke onset. Regions of interest (ROIs) were placed in the bilateral MCA territories and three parameters, peak value (PV), time to peak (TP), and PV divided by TP, were calculated from time-density curves (TDCs) on ROIs. After conventional treatment using pharmacological agents, the 30-day clinical outcome was evaluated on the Glasgow outcome scale. To investigate the relationship between the disease-to-contralateral side ratio of each parameter's value and 30-day clinical outcome, TDCs were classified into the following four types; type 1, with TP ratio less than 1.1; type 2, with TP ratio ranging from 1.1 to 1.5 and PV/TP ratio more than 0.75; type 3, with TP ratio ranging from 1.1 to 1.5 and PV/TP ratio less than 0.75; and type 4, with TP ratio more than 1.5 and PV/TP ratio less than 0.3. Clinical outcome in patients with type 1 or 2 TDC was better than in patients with type 3 or 4 TDC (p < 0.01, Fisher's exact test). We can conclude that dynamic CT is a useful means for estimating the clinical prognosis of acute stroke patients after conventional treatment. Poor clinical outcome following conventional therapy is expected in patients with type 3 or 4 TDC in contrast to patients with type 1 or 2 TDC.

A case of Rathke's cleft cyst with apoplexy

We report a case of Rathke's cleft cyst associated with cholesterin granuloma in an 8-year-old girl with apoplexy. She was admitted to our hospital in April 1996 because of repeated headache and deep ophthalmic pain, without any visual disturbance. Computed tomography (CT) of the pituitary demonstrated an intrasellar isodense mass extending to the suprasellar cistern. Magnetic resonance imaging (MRI) showed a high-intensity mass on both T1- and T2-weighted images. The preoperative diagnosis of this lesion was Rathke's cleft cyst associated with a craniopharyngioma and/or hemorrhage. Transsphenoidal microsurgery was performed, and a bloody coffee-like serous and mucinous-yellowish substance was evacuated. Curettage of the wall removed the yellowish hard mass and soft membranous tissue. Histological examination of this tumor revealed a Rathke's cleft cyst with cholesterin granuloma.

Differential cytoprotection by glycine against oxidant damage to proximal tubule cells

Tert-butyl hydroperoxide (tBHP) injured freshly isolated proximal tubules in an Fe-dependent fashion that was ameliorated by a lipophilic antioxidant, diphenyl-p-phenylenediamine (DPPD), but was only minimally affected by glycine. Menadione-induced injury was Fe-independent and was unaffected by DPPD, but was strongly blocked by glycine. Fe was highly toxic when intracellular loading was facilitated by concomitant treatment with hydroxyquinoline (HQ). This toxicity was blocked by DPPD or chelating the Fe, but not by glycine. All of the lesions were characterized by severe depletion of glutathione and other soluble thiols. Menadione induced large increases in protein associated with the Triton-insoluble cytoskeleton and decreases in protein thiol content, consistent with extensive cross linking, but did not increase thiobarbituric acid reactive substances (TBARS). tBHP and HQ + Fe had either no effect or only moderate, delayed effects on cytoskeletal proteins, but induced substantial increases of TBARS. Glycine did not the alter changes in cytoskeletal proteins, thiols, or TBARS produced by any of the agents. Protection against tBHP toxicity by deferoxamine and DPPD was accompanied by substantial suppression of TBARS accumulation. Superimposition of hypoxia during tBHP exposure reduced TBARS accumulation and restored cytoprotective activity to glycine. Thus, in contrast to its consistently strong cytoprotection against a number of other insults, glycine is only variably cytoprotective against oxidant lesions in freshly isolated proximal tubules. Extensive oxidative crosslinking of proteins is compatible with maintenance of glycine cytoprotection against lethal membrane damage. Fe-induced injury to proximal tubules associated with lipid peroxidation as manifested by TBARS formation is a relatively glycine-insensitive insult.

The selective endothelin ETA receptor antagonist FR139317 inhibits neointimal thickening in the rat

Endothelin is known as a potent mitogenic mediator. We tested the in vivo ability of FR139,317((R)2-[(R)-2-[(S)-2-[[1-(hexahydro- 1H-azepinyl)]carbonyl]amino-4-methylpentanoyl] amino-3-[3-(1-methyl-1 H-indoyl)]propionyl]amino-3-(2-pyridyl)propionic acid), a selective antagonist of the endothelin ETA receptor subtype, to inhibit neointimal thickening following photochemically induced injury of the endothelium of rat femoral artery. FR139,317 (32 mg/kg s.c., twice a day) was administered for 3 weeks after the injury. FR139,317 significantly decreased the neointimal area (76.3%) without changing the medial area. Therefore, it is suggested that endothelin may play an important role, via mainly endothelin ETA receptors, in neointima formation in injured artery.

Calcium dependence of integrity of the actin cytoskeleton of proximal tubule cell microvilli

To better define the role of Ca2+ in pathophysiological alterations of the proximal tubule microvillus actin cytoskeleton, we studied freshly isolated tubules in which intracellular free Ca2+ was equilibrated with highly buffered, precisely defined medium Ca2+ levels using a combination of the metabolic inhibitor, antimycin, and the ionophore, ionomycin, in the presence of glycine, to prevent lethal membrane damage and resulting nonspecific changes. Increases of Ca2+ to > or = 10 microM were sufficient to initiate concurrent actin depolymerization, fragmentation of F-actin into forms requiring high-speed centrifugation for recovery, redistribution of villin to sedimentable fractions, and structural microvillar damage consisting of severe swelling and fragmentation of actin cores. These observations implicate Ca(2+)-dependent, villin-mediated actin cytoskeletal disruption in tubule cell microvillar damage under conditions conceivably present during pathophysiological states. However, despite prior evidence for cytosolic free Ca2+ increases of the same order of magnitude and similar structural microvillar alterations, Ca(2+)- and villin-mediated events did not appear to account for the initial microvillar damage that occurs during ATP depletion induced by antimycin alone or hypoxia.

Contribution of actin cytoskeletal alterations to ATP depletion and calcium-induced proximal tubule cell injury

The actin cytoskeleton of rabbit proximal tubules was assessed by deoxyribonuclease (DNase) binding, sedimentability of detergent-insoluble actin, laser-scanning confocal microscopy, and ultrastructure during exposure to hypoxia, antimycin, or antimycin plus ionomycin. One-third of total actin was DNase reactive in control cells prior to deliberate depolymerization, and a similar proportion was unsedimentable from detergent lysates during 2.5 h at 100,000 g. Tubules injured by hypoxia or antimycin alone, without glycine, showed Ca(2+)-dependent pathology of the cytoskeleton, consisting of increases in DNase-reactive actin, redistribution of pelletable actin, and loss of microvilli concurrent with lethal membrane damage. In contrast, tubules similarly depleted of ATP and incubated with glycine showed no significant changes of DNase-reactive actin or actin sedimentability for up to 60 min, but, nevertheless, developed substantial loss of basal membrane-associated actin within 15 min and disruption of actin cores and clubbing of microvilli at durations > 30 min. These structural changes that occurred in the presence of glycine were not prevented by limiting Ca2+ availability or pH 6.9. Very rapid and extensive cytoskeletal disruption followed antimycin-plus-ionomycin treatment. In this setting, glycine and pH 6.9 decreased lethal membrane damage but did not ameliorate pathology in the cytoskeleton or microvilli; limiting Ca2+ availability partially protected the cytoskeleton but did not prevent lethal membrane damage. The data suggest that both ATP depletion-dependent but Ca(2+)-independent, as well as Ca(2+)-mediated, processes can disrupt the actin cytoskeleton during acute proximal tubule cell injury; that both types of change occur, despite protection afforded by glycine and reduced pH against lethal membrane damage; and that Ca(2+)-independent processes primarily account for prelethal actin cytoskeletal alterations during simple ATP depletion of proximal tubule cells.

[Surgical treatment of subaortic stenosis]

We reviewed 10 cases with subaortic stenosis (SAS) who underwent surgical repairs in our hospital. They were divided into 3 groups. Group I-A included patients with discrete SAS which had been detected before the initial operation. Group I-B included patients with discrete SAS which became apparent following the initial operations. Group II patients included SAS except the discrete type. Surgical treatment of each group was discussed. In group IA, there were no early deaths nor late deaths. There was 1 reoperation due to restenosis. Group IB had 3 cases which included VSD with CoA, Taussig-Bing anomaly, and common atrioventricular canal with VSD. In the Taussig-Bing anomaly case, an arterial switch (Lecompte maneuver) was performed 3 years ago. SAS was successfully relieved with the right ventriculotomy and VSD patch incision. Group II had 3 cases. There were 2 operative deaths and 1 late death. SAS was relieved by, in two cases, Stansel anastomosis with BT shunt and, in the last one, palliative arterial switch operation. It was extremely difficult to detect SAS in group II, when SAS had rapidly progressed following PAB in neonate and early infant. Our present policy is that PAB would be performed if there is no apparent SAS before the initial operation. SAS should be relieved as soon as possible if it is apparent at the postoperative period. Either Stansel anastomosis with BT shunt or palliative arterial switch operation would be the best choice in such a difficult case.

[Two cases of coronary artery fistula with coronary artery aneurysm]

Two cases of coronary artery fistula with coronary artery aneurysm were reported. Coronary angiography showed dilated right coronary artery with the formation of aneurysm drained to the right atrium and to the right ventricle respectively. The inflow ostium from the coronary artery to the aneurysm were closed from inside adding aneurysmorraphy. Postoperative clinical courses were uneventful and residual shunts were not detected by angiography. We reported these cases with literature.

[Right-sided infective endocarditis with ventricular septal defect]

Two patients underwent surgical treatment for right-sided infective endocarditis with ventricular septal defect. In both cases, blood cultures showed Peptostreptococcus, and the operation was performed at non-active phase after antibiotics therapy. The case 1 was a 7-year-old girl who was observed a vegetation on the chorda of the anterior paillary muscle by echocardiography. The defect was directly closed and the vegetation was excised. The case 2 was 22-year-old female who had been diagnosed of VSD in her infancy. A high fever continued and echocardiography revealed a vegetation attached to the septal tricuspid leaflet. Partial excision of the leaflet and autopericard patch plasty was performed, and the VSD was directly closed. Postoperatively intravenous antibiotic therapy was given for periods of 6 weeks, and clinical course were uneventful in both cases. Local excision of vegetation and leaflet repair by autopericard patch plasty should be performed in cases with localized vegetation and minor valvular regurgitation.

The pharmacological characterization of FK 739, a new angiotensin II-receptor antagonist

The pharmacological properties of FK 739, a new angiotensin II-receptor antagonist, were examined. FK 739 inhibited the specific binding of [125I]-angiotensin II to rat aortic smooth muscle cell membrane with an IC50 value of 8.6 nM, but did not displace the specific binding of [125I]-angiotensin II to bovine cerebellum membrane. In isolated helical strips of rabbit aorta, FK 739 shifted the concentration-response curve of angiotensin II-induced contraction in parallel to the right, and the values of the slope and pA2 were 1.06 and 8.45, respectively. In in vivo studies, oral administration of FK 739 at 10 mg/kg significantly inhibited the angiotensin I-induced pressor response in normotensive rats and dogs, and it caused a fall of mean blood pressure in renal hypertensive rats and dogs. In spontaneously hypertensive rats, FK 739 at 32 and 100 mg/kg significantly decreased the mean blood pressure in a dose-dependent manner. Additionally, we studied whether FK 739 would cause side effects such as dry cough, like other ACE inhibitors did. Oral administration of FK 739 (10 and 32 mg/kg) did not affect the capsaicin-induced bronchial edema. On the other hand, captopril (10 mg/kg) significantly enhanced capsaicin-induced bronchial edema. These results indicate that FK 739 is a potent and competitive antagonist for AT1-type receptors, and suggest that FK 739 might be a safe and useful agent for the treatment of hypertension in clinical trials.

Pharmacological profile of FR139317, a novel, potent endothelin ETA receptor antagonist

The effects of FR139317 on the cardiovascular system were investigated in cultured cells, isolated organs and whole animals. FR139317 inhibited the specific binding of [125]endothelin(ET)-1 to porcine aortic microsomes in a concentration-dependent, monophasic fashion with an IC50 of 0.53 nM. In contrast, FR139317 showed low affinity for [125I]ET-1 specific binding sites in porcine kidney (IC50, 4.7 microM). In isolated rabbit aorta, FR139317 shifted the ET-1-induced concentration-contractile response curve to the right with a pA2 value of 7.2 and lacked agonist activity. A single (i.v.) bolus dose of FR139317 completely inhibited the pressor response to ET-1 in vivo, but had no effect on the initial depressor response in conscious normotensive rats. These data indicate that FR139317 is a potent, highly specific ETA receptor antagonist. In addition, FR139317 also inhibited ET-1 induced [3H]thymidine incorporation in cultured vascular smooth muscle cells from rat aorta (IC50, 4.1 nM), suggesting that ET-1-induced mitogenesis is mediated only by the ETA receptor. FR139317 could become a useful tool for investigating the physiological and pharmacological actions of ET.

Subtype selectivity of a novel endothelin antagonist, FR139317, for the two endothelin receptors in transfected Chinese hamster ovary cells

We investigated the receptor-binding properties and the antagonist activities of FR139317, a novel endothelin (ET) antagonist, in transfected Chinese hamster ovary cells permanently expressing the two ET receptor subtypes (ETA and ETB). In displacement analysis using membrane preparations derived from the receptor-expressing cells, FR139317 showed a high affinity for ETA (Ki = 1 nM) and a lower affinity for ETB (Ki = 7.3 microM). FR139317 inhibited ETA-mediated phosphatidylinositol hydrolysis and arachidonic acid release and produced a parallel shift in the dose-response curve for ET-1, with respective pA2 values of 8.2 and 7.7. In contrast, FR139317 had no inhibitory effects on these ET-1-induced responses in ETB-expressing cells. FR139317 itself showed no stimulatory effects on phosphatidylinositol hydrolysis and arachidonic acid release in ETA- and ETB-expressing cells. Thus, FR139317 is a potent, competitive, and highly selective antagonist for ETA. This compound should be a powerful tool for investigation of the physiological properties of ETA and exploration of its role in diseases.

An endothelin ETA receptor antagonist, FR139317, ameliorates cerebral vasospasm in dogs

The role of endothelin in the pathogenesis of cerebral vasospasm after subarachinoid hemorrhage was investigated by evaluating the effect of FR139317, a novel potent ETA receptor antagonist, on the vasospasm in a canine two-hemorrhage model. Intracisternal administration of FR139317 (0.1 mg) significantly reduced the vasoconstriction of the basilar artery at day 7 (control group, n = 6, 61.6 +/- 4.0%, FR139317 treated group, n = 6, 75.9 +/- 1.5% of basal diameter, p < 0.01). In normal anesthetized dogs, the intracisternal administration of FR139317 did not affect the basal diameter of the basilar artery, blood pressure or heart rate. These results suggest that endothelin plays an important role in the pathogenesis of cerebral vasospasm after subarachnoid hemorrhage, and that FR139317 could be a valuable tool for preventing vasospasm after subarachnoid hemorrhage.

Nilvadipine as a neuroprotective calcium entry blocker in a rat model of global cerebral ischemia. A comparative study with nicardipine hydrochloride

The effects of two dihydropyridine type calcium entry blockers, nilvadipine and nicardipine hydrochloride (nicardipine), on the liberation of free fatty acids (FFAs) were investigated using an experimental model of global cerebral ischemia in rats, and were compared with their pharmacokinetic properties. Nilvadipine, but not nicardipine, at a dose of 100 micrograms/kg i.v., significantly attenuated the liberation of FFAs, particularly docosahexaenoic and arachidonic acid. Furthermore, the brain concentration of nilvadipine was higher than that of nicardipine after equivalent dosing. The results of the present study demonstrate that pharmacokinetic differences between these two calcium entry blockers might explain the difference in their pharmacological efficacy.

WS009 A and B, new endothelin receptor antagonists isolated from Streptomyces sp. no. 89009. II. Biological characterization and pharmacological characterization of WS009 A and B

WS009 A and B, produced by Streptomyces sp. No. 89009, were found to be competitive and specific antagonists against endothelin (ET)-1 receptors in in vitro studies and also active in in vivo studies. Furthermore, WS009 A and B were specific antagonists for vascular ET-1 receptors (ETA receptors) and significantly prevented the accumulation of intracellular inositol 1,4,5-triphosphate (IP3) in endothelin treated rat aorta tissues.

[Dural arteriovenous malformation in the falx with subarachnoid hemorrhage]

A case of falx dural arteriovenous malformation was reported. A 62 year old man was admitted to Nakamura City Hospital on August 15, 1989, with severe headache as his chief complaint. On admission, his consciousness was lethargic. CT scan showed subarachnoid hemorrhage with ventricular perforation and hematoma of the corpus callosum. Angiograms demonstrated a dural arteriovenous malformation (DAVM) in the frontal falx, which was fed by bilateral middle meningeal arteries and the left anterior falx artery and drained into the superior sagittal sinus via the dural vein. Bifrontal craniotomy was performed. At first, bilateral middle meningeal arteries were coagulated, and the frontoparietal dura was excised widely. Then, the falx was cut at the crista galli. The DAVM was found in the falx, including a vascular sac embedded in the brain tissue. The DAVM was coagulated as much as possible. Carotid angiograms revealed complete disappearance of the DAVM, 4 months after the operation. Although angiograms performed after only one month still showed a small residual DAVM. On reviewing the literature we found only 5 patients with the DAVM in the falx. In 6 cases including our own, intracranial hemorrhage occurred in 4 cases (3 cases were subarachnoid hemorrhage). Vascular sacs were seen in 4 cases, and drainage to the pial vein was noted in 3 cases. It seemed to be rare that the DAVM drained into the dural vein. In our particular case, operative findings showed the DAVM drained into the dural vein without the pial vein, and intracranial hemorrhage was attributed to rupture of the vascular sac.

Application of thermography to the evaluation of the histamine skin test in man

The degree of skin flare 10 min after intradermal injection of histamine (0.06-2 micrograms in 0.1 ml saline) was evaluated both visually and by thermography in 6 healthy male volunteers. Intradermally injected histamine increased the skin flare area in a dose-dependent manner. There was a good exponential correlation (r = 0.963) between the flare area evaluated visually and that evaluated by thermography, indicating that the degree of underestimation of the flare area by visual inspection increased with increasing flare size. This could be due to the fact that the rather irregular shape of a flare was rounded by the eyes. Suppressive effects of an antihistamine, terfenadine (20, 40, 60, and 120 mg, p.o.), on the flare caused by histamine (2 micrograms/0.1 ml saline) were evaluated in a similar way in a single-blind, crossover controlled trial using 15 healthy male volunteers. The histamine skin test was evaluated both visually and by thermography before and 4 hr after administration of placebo or each of 4 doses of terfenadine. Terfenadine (20, 40, and 60 mg) suppressed the skin flare in a dose-dependent manner, but 60 and 120 mg had almost the same effect. In all cases the flare area evaluated visually was smaller than that obtained by the thermography, although the degrees of reduction of flare area by the drug were similar by both methods when expressed as a percentage of placebo. In conclusion, thermography could serve as a tool for the objective evaluation of the histamine skin test.

Changes in vascular responsiveness to vasoactive agents in the hindlimb of DOCA-salt hypertensive rats

The responsiveness to vasoactive agents in the perfused hindlimb of DOCA-salt hypertensive rats was examined and compared with that of normotensive rats. The vasoconstrictor responses in the femoral vascular bed to norepinephrine and serotonin were markedly potentiated in DOCA-salt hypertensive rats as compared with those in normotensive rats, and no change was found in the responses to angiotensin II. On the other hand, the vasodilatory response in DOCA-salt hypertensive rats to isoproterenol was attenuated without any marked changes in responsiveness to acetylcholine, nitroprusside and papaverine. These results suggested that the reduced vasodilator responses as well as the increased vasoconstrictor responses occur to some specific vasoactive agents in DOCA-salt hypertensive rats.

Retrogasserian glycerol injection or percutaneous stimulation in the treatment of typical and atypical trigeminal pain

Of 164 patients with trigeminal neuralgia treated by percutaneous retrogasserian glycerol injections, we have studied the long-term outcome (one to four years) of 72 patients. 51 patients suffered from idiopathic trigeminal neuralgia, and of these 92% were freed from pain by the operation. 21 patients suffered from symptomatic trigeminal neuralgia due to multiple sclerosis or of traumatic or infectious origin. Of these, only 38% became free of pain. A further 8 patients with facial deafferentation pain who underwent treatment by retrogasserian neurostimulation with a permanently implanted electrode were included in this study. 4 of these patients were rendered free of pain by this procedure.

Affinities of adrenergic drugs for alpha 2-adrenoceptors in dog saphenous vein in comparison with those in rat brain or human platelets

The affinities of drugs for the postsynaptic alpha 2-adrenoceptors in the dog saphenous vein were examined and compared with those in human platelets or in rat brain. The pA2 or pD2 values in the vein were determined in the presence of phenoxybenzamine. The pKi values (dissociation constant) of drugs for binding to alpha 2-adrenoceptors in human platelets or in rat brain were determined by radioligand binding assay using 3H-yohimbine (YOH) or 3H-clonidine (CLO) as ligands. The binding of agonists to 3H-YOH binding sites was carried out in the presence of GTP. The pA2 or pD2 values in the vein had a good correlation with pKi values for YOH sites but not with those for CLO sites in rat brain. The pKi values for YOH sites in human platelets had a good correlation with those for YOH sites in the brain or with pA2 or pD2 values in the vein. These results suggested that the affinities of adrenergic drugs for postsynaptic alpha 2-adrenoceptors in the dog saphenous vein are similar to those in brain and in platelets, and it is probable that the adrenergic drugs produce their alpha 2-adrenoceptor-mediated effects on vascular tissues primarily through binding to a low-affinity form of the alpha 2-adrenoceptors.

Anti-arrhythmic effect of nadolol in experimental arrhythmias: comparison with propranolol and alprenolol

The effects of nadolol on experimental arrhythmias were investigated and compared with those of propranolol and alprenolol. The arrhythmias were induced by either ouabain, holothane plus adrenaline or acute coronary occlusion in anesthetized dogs. All three beta-blocking drugs in a dose range of 10 to 200 micrograms/kg inhibited halothane plus adrenaline-induced arrhythmias. These drugs also attenuated coronary occlusion-induced ventricular arrhythmias as well as other electrical abnormalities such as electrical alternation and conduction delay. Among the three drugs, nadolol was the most potent in suppressing both types of arrhythmias. Contrary to the potent effects on these arrhythmias, nadolol was ineffective against ouabain-induced arrhythmias even in a dose of 3 mg kg, while propranolol and alprenolol were significantly effective in a dose of 100 micrograms/kg. It is probable that the anti-arrhythmic effect of nadolol is exclusively due to its beta-blocking activity.

ESR of a nitroxide radical and its radical pair in irradiated 1-hydroxyxanthine single crystals

Single crystals of 1- hydroxyxanthine have been X-irradiated at 77 K and studied by ESR at 300 K. A nitroxide radical formed by abstraction of a hydrogen atom at N1 is the primary species formed by the radiation. A nitrogen hyperfine tensor with principal values of 0.8, 2.6, and 13.6 G and a g tensor with principal values of 1.9985, 2.0031, and 2.0099 have been determined. These results indicate a spin density of 0.24 on N1. Pairwise trapping of the nitroxide radical was also detected and principal values of the dipolar coupling tensor were found to be 140.7, -69.4, and -67.8 G. These data indicate effective radical separations of 7.3 A and are consistent with molecular layer spacings of 3.5 A in this crystal structure.

[Primary endodermal sinus tumor of the fourth ventricle (author's transl)]

A case, a 18-year-old male, of an endodermal sinus tumor (yolk sac tumor) in the fourth ventricle, was reported. The patient had a month history of headache, vomiting and gait disturbance prior to the hospitalization, when he admitted to our service he was in lethargic condition with left cerebellar ataxia and horizontal nystagmus. Lumbar tap revealed clear CSF under normal pressure of 110 mm H2O with the CSF protein of 432.5 mg/dl and cell count of 147/3. The vertebral angiography demonstrated space occupying lesion in the posterior fossa. Plain CT demonstrated only disappearance of the fourth ventricle and slightly dilated bilateral ventricles and third ventricle. However diffuse high density area around the fourth ventricle was demonstrated and the wall of bilateral anterior horn was slightly enhanced, after injection of contrast media. There was no other abnormal findings around the pineal region. Suboccipital craniectomy was performed and the tumor was totally removed macroscopically. The tumor was situated in th floor of the fourth ventricle and infiltrated into the fourth ventricular wall and th adjacent cerebellar tissue. The tumor was with soft, greyish color and extremely vascular. Histologically the tumor was diagnosed as endodermal sinus tumor according to Teilum's classification. There were stellate cells arranged in a loose with vacuolated network which formed cystic cavities and a complicated network of honeycomb appearance with a system of communicating cavities and channels. Various size of intra- and extracellular PAS-positive hyaline globules were also seen. Glomerular-like structure (Schiller-Duval body) was not observed. Immunoperoxidase study clearly demonstrated the presence of intra- and extracytoplasmic alpha-fetoprotein granules in the tumor tissue. The amount of the serum alpha-fetoprotein, measured by radioimmunoassay, showed 400 ng/ml. After irradiation in the posterior fossa (5000 rad) the patient was discharged. Three months later, follow up CT demonstrated small high density area in the anterior horn of the left lateral ventricle, so he was rehospitalised. Irradiation in the whole brain was again administered. The tumor was very radiosensitive. CT, after 800 rad, demonstrated complete disappearance of the tumor. After irradiation totally (3000 rad), he discharged with left cerebellar ataxia.

Decorticate spasticity: a re-examination using quantitative assessment in the primate

Decorticate spasticity in the squirrel monkey was chosen as a convenient laboratory model of spasticity capable of quantitative assessment upon which to evaluate various currently popular clinical spasmolytic measures. The effects of a wide variety of cortical lesions were studied involving primary and supplementary motor, premotor and parietal cortex unilaterally and bilaterally, measuring muscle tone with the evoked integrated E.M.G. technique. Measurable spasticity resulted only if primary motor cortex was ablated bilaterally usually but not always preferentially involving biceps brachii and quadriceps. Resulting postures were variable offering no justification for the term "decorticate posture". The integrated evoked E.M.G. was proportional to rate of stretch and chiefly phasic in type as in hemiplegic man. Stereotactic dentatectomy resulted in profound ipsilateral reduction in this spasticity, but was without effect in intercollicular or anemic decerebrate cats. The mechanism of the spasticity and of the cerebellar effects are discussed.