The complications of dural and direct cavernous sinus fistula (CCF) arise mainly from the specific venous route. However, embolization at an inappropriate site within the cavernous sinus (CS) is also a major factor. Therefore, we first diagrammed the surrounding structures of the CS to elucidate the specificity of the venous routes. Next, we divided the inside structure of the CS into four compartments, to examine orifices at which part we can start embolization with the least danger of causing complications when we have to embolize them within the CS. We obtained findings which will be useful to prevent complications such as subarachnoid haemorrhage, glaucoma, central retinal vein thrombosis and marked neurological impairment.
Photophobia and osmophobia are typical symptoms associated with migraine, but the contributions of gene polymorphisms to these symptoms are not fully elucidated. We investigated whether the gene polymorphisms are involved in photophobia and osmophobia in patients with migraine.Ninety-one migraine patients and 119 non-headache healthy volunteers were enrolled. The 12 gene polymorphisms were determined by polymerase-chain-reaction (PCR) and PCR restriction-fragment-length polymorphism analysis.Photophobia and osmophobia were observed in 49 (54%) and 31 patients (34%), respectively. Distributions of monoamine oxidase A (MAOA) T941G and tumour necrosis factor-β (TNF-β) G252A polymorphisms were significantly different between patients with photophobia and controls. However, no gene polymorphism differences were observed between patients with osmophobia and controls.The MAOA T941G and TNF-β G252A gene polymorphisms appear to contribute to photophobia but not to osmophobia. We propose that different gene polymorphisms are responsible for photophobia and osmophobia symptoms during migraine.
MS Contin tablet is a newly formulated controlled-release morphine sulfate tablet. It has the advantage of less frequence of dosing over conventional dosage forms because of the long-lasting effective plasma concentration.In this study, pharmacokinetics of morphine and its metabolites (M-6-G, morphine-6-glucuronide ; M-3-G, morphine-3-glucuronide) were studied in patients with advanced cancer, following multiple administrations of MS Contin.Morphine was well absorbed from MS Contin tablet, comparably with aqueous morphine hydrochloride. The plasma concentrations of M-6-G and M-3-G were 5- to 10-fold and 40- to 70-fold higher, respectively, than those of morphine, indicating that morphine is substantially metabolized at the first pass through the intestine and liver.The elimination half-lives of morphine and its metabolites were constant during multiple dosing, but the ratios of Cmax and AUC of morphine at steady state to those after the first dose were greater than the calculated accumulation factor. On the other hand, the ratios of Cmax of M-6-G and M-3-G were comparable with the accumulation factor. The nonlinearity observed for morphine and the linearity found for the two metabolites during multiple doses may be explained by the very small reduction of first-pass metabolism which is thought to be caused by advances of cancer.
SummaryWith the use of albumin-I131, the volume of plasma trapped in the packed cell column of hematocrit tubes was determined for blood samples obtained from 5 animal species. The volume of plasma trapped was least in blood samples obtained from elephant, man and dog (MCV 112 to 72 μ3), larger in sheep blood (MCV 37 μ3) and largest in goat blood (MCV 18 μ3). Increasing the force of centrifugation or removal of plasma proteins reduced the volume of fluid trapped in the packed cell column, and the reduction was most pronounced for goat blood.
