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The authors studied the changes in neurological signs and cerebral circulation by using dynamic CT scans before and after cranioplasty in six externally decompressed patients. Five of the 6 patients showed some improvements in neurological signs. The results of the dynamic CT scans in 6 cases suggested that increases of bilateral cerebral blood flow may play a role in their neurological improvement.

There are few reported cases of nontraumatic dissecting aneurysms of the middle cerebral artery (MCA), and their neuroradiological and clinical features have not been analysed. We looked at these aspects in a collaborative study. We reviewed 13 patients diagnosed as having a dissecting aneurysm of the MCA based on clinical signs and neuroradiological findings in 46 stroke centres between 1995 and 1999. There were four patients who presented with cerebral ischaemia, and nine who presented with bleeding. Of the former group, three were aged less than 15 years. Cerebral angiography showed extensive stenosis and a double lumen of the M1 portion in all four patients. High signal on T1-weighted images around the arterial flow void, due to intramural haematoma, was often seen in the second week. MR angiography showed findings corresponding those of intra-arterial angiography in all four cases. We saw an infarct on CT or MRI in territory of the perforating branches of the M1 segment in all four patients. In the patients presenting with bleeding, pure subarachnoid haemorrhage or a sylvian fissure haematoma was seen on initial CT, and the predominant angiographic finding was dilatation with stenosis, but the site of the lesions was not uniform. A double lumen or intimal flap was seen in about half the cases. Rebleeding occurred within 14 days of the onset in five of the nine patients, with a poor prognosis.

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Accumulation of basophils in inflammatory sites is an important aspect of the late-phase allergic reaction involving skin and upper and lower airways, suggesting the existence of mechanisms for basophil migration. Because haemopoietic growth factors have been shown to stimulate various functions of human basophils, we tested the ability of haemopoietic growth factors to migrate basophils in vitro. Both IL-3 and granulocyte-macrophage colony-stimulating factor (GM-CSF) induced migration of purified normal basophils (purity c. 80%) in a dose-dependent fashion at picomolar concentrations, while granulocyte (G)-CSF, macrophage (M)-CSF, and IL-4 had no effect at all. Chequerboard analyses indicate that migratory activity of both factors are chemokinetic. These results suggest that local production of both factors during allergic reactions might potentially play an initial role in the recruitment of basophils from the circulation to sites of inflammatory reactions.

An endoscopic dyeing method with methylene blue solution was described for an accurate and safe diagnostic dyeing of cancer and intestinal metaplasia in the stomach, after washing the surlace of gastric mucosa with proteinase. An introduction of methylene blue into the stomach 2 hours before endoscopy, selectively dyed the cancer and the intestinal metaplasia a dark blue. Normal gastric mucosa, the margin and scar of gastric ulcer, erosion, benign polyp and gastritis without intestinal metaplasia remained undyed.This method was performed on 77 gastric lesions and 33 (92°/o) of 36 gastric cancers have been successfully dyed. In all 24 cases, biopsy specimens from dyed areas confirmed the presence of severe intestinal inetaplasia; and from undyed areas, at/ ophic mucosa without intestinal metaplasia. The endoscopic close-up views of dyed lesions showed the different patterns between the cancer and the intestinal metaplasia. This finding allows the differential diagnosis between them. Fresh frozen sections by cryostat of the specimens from dyed areas showed histologically staining of the superficial cells of the cancerous lesions and the intestinal metaplasia. Endoscopic examination of gastric lesions dyed with methylene blue solution provides the endoscopist with an excellent method of identifying early cancer and intestinal metaplasia of the stomach. Key-Words: Endoscopic dyeing method, early gastric cancer, intestinal metaplasia, vital staining of gastric lesions. Recently in gastroscopy, great efforts have been made for detection of minute lesions of the gastric mucosa, especially early gastric cancer with an excellent fibergastroscope. However, it is often very difficult to recognize such a small lesion even by an experienced endoscopist. Therefore, every endoscopist Endoscopy 5 (1973) 124-129 C) Georg Thieme Verlag, Stuttgart Endoskopisdm Färbemethode zur Diagnostik von Friihkarzinom und intestinaler Metaplasie des Magens Nach Beseitigung des wandadhärenten Magenschleims durch eine Proteinasenl6sung lassen sich Karzinom und intestinale Metaplasie mit Methylenblau anfärben, wenn die Schleimhaut für zwei Stunden dem Farbstoff exponiert wird. Normale Schleimhaut, Ulkusrand, Erosionen, Polypen und Gastritis ohne intestinale Metaplasie färben sich nicht an. Diese Metliode wurde bei 77 Magenläsionen angewandt; von 36 Magenkarzinomen fiirbten sich 32 (92%) an. Bei allen 24 Fallen von intestinaler Metaplasie konnte die Diagnose bioptisch aus den angefärbten Arcaico gesichert werden. Die Nahbetrachtung gestattet eine sichere Differenzierung zwischen Karzinom und intestinaler Metaplasie. In Gefrierschnitten aus den intravital gefärbten Schleimhautpartien konnte eine Anfärbung der oberflächlichen Zellen bei Karzinom und intestinaler Metaplasie dokumentiert werden.used to have a dream in which the minute early cancer might be stained selectively by a dye, and could be easily detected under gastroscopic observation. Fortunately, we were almost succeeded in realizing this dream with dyeing gastric lesions by using methylene...

Ganglion cell tumours are mostly seen in children and young people, but they are extremely rare, accounting for 0.1-0.5% of all brain tumours. It usually occurs in the floor of the third ventricle and the temporal lobe. Recently we have experienced a pineal gangliocytoma, probably the first ever seen in Japan and the fourth case in the world, and have succeeded in a total removal of it. The case concerns a 51-year-old man who suffered from intermittent blurred vision and headache of 3 years' duration. CT showed, together with severe hydrocephalus, positive contrast medium enhancement and a somewhat irregular but sharply circumscribed high density lesion suggestive of a meningioma. But the brain scintiscan revealed a badly and irregularly demarcated region of warm activity and having little change with time mainly in the pineal region, which was strongly suspicious of gliomas. Hence this scan was thought to be important in diagnosing this tumour. As an operative procedure, biparieto-occipital craniotomy was successfully performed in the "sea lion" position to remove the tumour totally. Pathological findings indicated a mixture of dispersion and concentration of giant cells possessing prominent nucleoli, abundant chromatin and a prominent nucleus or several nuclei of varying sizes and process-like cell bodies polygonal or irregular in shape. GFAP stain showing no glial fibres and the tumour was thought to be a gangliocytoma.

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