SEVERAL SURGICAL PROCEDURES have been used for the treatment of syringomyelia associated with Chiari I malformation at our institute. The purpose of this article is to evaluate the results of two major surgical procedures, foramen magnum decompression (FMD) and syringosubarachnoid (SS) shunting. The series consisted of 70 patients with syringomyelia associated with Chiari I malformation who were surgically treated. Their ages ranged from 3 to 59 years (median, 29.4 yr). FMD was performed on 33 patients, and SS shunting was performed on 37 patients. The follow-up period ranged from 6 months to 12.5 years, with a mean of 60 months. The clinical and radiological outcomes were analyzed comparing the two groups. We principally performed FMD in patients with symptoms of Chiari I malformation and/or a small syrinx. We prefer to use SS shunting in patients with large syringes. Postoperative magnetic resonance imaging demonstrated that the syrinx had collapsed or decreased in size in 94% of the patients who underwent FMD and in 100% of the patients who underwent SS shunting. Neurological improvements were observed in 82% and in 97% of the patients who underwent FMD and SS shunting, respectively. In particular, the relief of pain was more fully achieved after SS shunting than after FMD. The average time for the syrinx to collapse was 6.3 weeks after surgery in the FMD group and 1.8 weeks in the SS shunting group. These results indicate that clinical symptoms and radiological findings improved much more quickly in the SS shunting group than in the FMD group. SS shunting may be superior to FMD as an initial treatment for syringomyelia with Chiari I malformation, especially for those patients who have large syringes.
Apple flavor has been linked to the composition of aroma compounds; however, the impact of varying concentrations of aroma compounds remains poorly understood. While sensory evaluation is commonly used to analyze food palatability, assessing the effect of concentration of all aroma compounds poses challenges. This study screened 174 apple genotypes for significant aroma compounds using regression models, Gas chromatography–mass spectroscopy analysis, and sensory palatability scores. Two models viz. Random Forest and XGBoost were employed to predict palatability scores, surpassing the limitations of correlation analysis. Shapley's additive explanatory value analysis identified 5-hexenol, ethyl 2-methyl butyrate, 2-methylbutyl acetate, (E,E)-α-farnesene, and (Z)-3-hexenol as key aroma compounds. In a sensory evaluation validating the effect of aroma compound concentration, the variation in (E,E)-α-farnesene concentration negatively affected sensory palatability scores. This study demonstrated a novel approach for identifying aroma compounds that impact apple flavor, providing valuable insights to enhance apple quality and palatability.
A 30-year-old female presented with a central neurocytoma manifesting as positional headache. Magnetic resonance imaging showed a large calcified mass in the right lateral ventricle. The tumor was completely removed surgically. Light microscopy showed a linear arrangement of well-defined cells (beaded-string pattern) containing small round nuclei with abundant perikarya. A perinuclear halo reminiscent of oligodendroglioma was prominent in some cell groups. The tumor was entirely amitotic and free of atypia. Large, plump spheroid bodies lacking nuclei but containing coarse brown pigments were present among the tumor cells. The tumor cells were immunoreactive to neuron-specific enolase and synaptophysin but not glial fibrillary acidic protein or neurofilament. The ultrastructure of the tumor cells included abundant spheroid bodies containing secretory granules around neurons, indicating a dystrophic or aborted process of neuronal differentiation rather than a completelydifferentiated central neurocytoma.
Moyamoya disease is a disease characterized by chronic occlusion of the circle of Willis with subsequent development of fine vascular networks in the ganglionic region, which is common in Japanese people. The term of 'moyamoya' means puff of smoke in the Japanese language and represents the characteristic angiographic findings of subsequent development of fine vascular networks in the ganglionic region. Although reconstructive surgery for moyamoya disease has been widely accepted nowadays1,2,5-7, there is still no definite consensus as to a surgical indication for patients with an haemorrhagic attack6 and as to the selection of an operative method for each individual patient5-7. This paper presents our overall surgical results and introduces a new operation, devised by Y. Nakagawa (i.e. EMAS). It refers also to surgical intervention for patients with haemorrhagic attacks.
Expression of the two types of tumor necrosis factor (TNF) receptor, p55 and p75, in 12 human glioblastoma cell lines was studied. Reverse-transcription polymerase chain reaction detected messenger ribonucleic acid (mRNA) transcripts of p55 TNF receptor in all 12 cell lines tested, but p75 TNF receptor mRNA in only four cell lines. Flow cytometric analysis with anti-p55 and anti-p75 TNF receptor monoclonal antibodies demonstrated both p55 and p75 proteins in these four cell lines, but the level of expression of p75 molecule was very low. Correlation of p55 and p75 TNF receptor expression with TNF-induced growth suppression and production of bioactive molecules (interleukin-6, interleukin-8, manganase-superoxide dismutase, prostaglandin E2) showed that p55 TNF receptor mediates these TNF actions, but none of the responses were influenced by the presence of the p75 TNF receptor, which apparently has no specific role.
Abstract We present a modified method for reconstruction of calvarial bone defects for patients with a history of infectious complications. Three patients who had experienced implanted bone infections underwent reconstruction of calvarial bone defect. For reconstruction of the calvarial bone defects, autologous split calvarial bone grafts were used to cover the calvarial bone defect. The full or half layered fronto-parietal bone used as implants were fixed with titanium mini-plates for primary bone defect site, while the new bone defect site caused by getting autologous bone graft were covered with titanium mesh plates assisted by residual half layered calvarias. The average follow-up span of patients was 64 months. Evaluated clinical and radiologic results are stable, showing no measurable side effects. Split calvarial bone graft in combination with titanium mesh plates is recommended in patients with a history of infection or high risk of infection.
