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Purpose: The occipital bone is located on the boundary between the membranous and cartilage bones and contains a wide variety of accessory sutures. In this study, we describe the age distribution of pediatric patients who are less than 2 years of age with occipital cranial sutures using a three-dimensional computed tomography (3D-CT). Methods: A total of 167 consecutive patients who are less than 2 years of age and underwent computed tomography for head trauma were included in this study. Results: Based on the results of this study, various types of sutures were observed among the pediatric participants. In particular, superior median fissures, mendosal sutures, other interparietal segment's accessory sutures, and interparietal sutures were noted in 21%, 35%, 9%, and 6% of the participants, respectively. Additionally, Wormian bones within the lambdoid suture were noted in 32% of the patients. The median age of children with superior median fissure and mendosal suture was 0 month. Meanwhile, superior median fissure was not observed among children older than 5 months of age. In this population, 13 patients (8%) were found to have skull fracture. Conclusions: Knowledge of the normal cranial anatomy and developmental patterns of cranial sutures is crucial in the evaluation of questionable fractures in the occipital region. A combination of 3D-CT and axial bone window imaging is useful in differentiating normal structures from pathological changes in the cranium. [ABSTRACT FROM AUTHOR]

This paper reports a possible mechanism of acetic acid formation from CO2, CH3I and H2 in aqueous media and the central role played by a water-soluble Rh-based electron storage catalyst. In addition to water-solubility, we also report the crystal structures of two presumed intermediates. These findings together reveal (1) the advantage of water, not only as a green solvent, but also as a reactive Lewis base to extract H+ from H2, (2) the role of the metal (Rh) centre as a point for storing electrons from H2 and (3) the importance of an electron-withdrawing ligand (quaterpyridine, qpy) that supports electron storage. [ABSTRACT FROM AUTHOR]

We report an Ir complex as an anode catalyst capable of switching between a hydrogenase-type fuel-cell mode and a photosystem II-type solar-cell mode. This catalyst is connected to carbon-black-supported platinum as a cathode catalyst, which reduces dioxygen in a manner analogous to cytochrome c oxidase. Together, they make a system capable of switching between the two modes. [ABSTRACT FROM AUTHOR]

We report an acid-stable Si oxide-doped Ir oxide film (IrSi oxide film), made by metal organic chemical vapour deposition (MOCVD) of an IrV complex for electrochemical water-oxidation. This is a successful improvement of catalytic ability and stability depending upon the pH of Ir oxide by doping of Si oxide. The turnover frequency (TOF) of the electrochemical water-oxidation by the IrSi oxide film is the highest of any Si oxide-doped Ir oxide materials and higher even than that of Ir oxide in acidic media. [ABSTRACT FROM AUTHOR]

A pilot study was performed to investigate the safety and feasibility of autologous formalin-fixed tumor vaccines (AFTV) and the clinical responses to these vaccines by glioblastoma multiforme (GBM) patients. Twelve primary GBM patients were recruited. Eight had recurrent disease while four had been treated for primary disease but retained a visible tumor mass. AFTV were prepared from formalin-fixed and/or paraffin-embedded tumor tissue obtained upon surgery and premixed with original adjuvant materials. The patients were given three five-site intradermal inoculations at weekly intervals. A delayed-type hypersensitivity test was performed before and after each vaccination. In addition, the tumor tissues were subjected to immunohistochemical analysis to determine whether MIB-1, p53, and major histocompatibility complex (MHC) class-I complex expression could predict the response to the treatment. The treatment was well tolerated, with only local erythema, induration, and low-grade fever being reported. Of the 12 patients, one showed a complete response, one showed a partial response, two showed minor responses, one had stable disease, and seven exhibited progressive disease. The median survival period was 10.7 months from the initiation of the AFTV treatment but three of the five responders survived for 20 months or more after AFTV inoculation. Low p53 and high MHC class-I expression by the tumor may help predict the efficacy of this therapy. Thus, the AFTV is safe and feasible, and could significantly improve the outcome of GBM. Further clinical investigations to confirm this are highly desirable. ( Cancer Sci 2007; 98: 1226–1233) [ABSTRACT FROM AUTHOR]

We report a case of a holocord high-intensity lesion extending from L1 up to the medulla oblongata on T2-weighted spinal magnetic resonance imaging (MRI) associated with an intramedullary spinal abscess secondary to an infected dermoid cyst. The intraoperative findings revealed that the high-intensity lesion on the T2-weighted image was edematous tissue. The MRI change in the spinal cord gradually improved in response to the use of postoperative antibiotics. The change was considered to represent reversible inflammatory changes, as there was no neurological deficit found at the cervical level and it resolved after surgery and medical treatment. The pathomechanism is discussed herein.Copyright © 2002 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Course: A 15-year-old boy who had suffered motor tics since age 9 developed progressive cervical myelopathy involving both his hands and his lower extremities. T2-weighted MRI revealed mild canal stenosis and increased signal intensity in the cervical spinal cord beginning at the C-4 level and continuing upward to the medulla oblongata. Treatment: After C-3 to C-7 laminoplasty, the patient's clinical symptoms improved. Discussion: It is possible that movement disorders such as tics may contribute to the development of cervical myelopathy owing to the effects of involuntary movements on the neck. Such an intensity change on a T2-weighted image has never been reported in an adolescent tic disorder. Despite such changes, surgical treatment may bring about clinical improvement. [ABSTRACT FROM AUTHOR]

A 10-year-old boy who had been diagnosed as having hemophilia A presented with episodes of transient ischemic attack. Cerebral angiography showed occlusions of the bilateral anterior cerebral arteries and the right middle cerebral artery with the development of an abnormal vascular network. The patient was diagnosed as having moyamoya disease associated with hemophilia A and subsequently underwent multiple burr hole surgery for revascularization under sufficient factor VIII supplementation. He remained asymptomatic after surgery, and follow-up cerebral angiography 5 months after the operation demonstrated significant neovascularization through the burr holes. Multiple burr hole surgery is proposed as a method of choice for the treatment of moyamoya disease associated with a bleeding tendency.Copyright © 2002 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Non-communicating hydrocephalus can cause rupture of the lateral or third ventricle, generally in the medial wall of the trigone or the posterior wall of the third ventricle, resulting in a cystic lesion known as ventricular diverticulum. In this paper, we describe a rare case of ventricular diverticulum located in the posterior horn of the lateral ventricle and expanding to bulge with a convexity reaching into the subdural space in a neonate. Aplasia cutis congenita and a bone defect were also present in the same neonate. Early surgical repair of the scalp defect and ventriculoperitoneal shunting were performed. In addition to illustrating the rare co-existence of a ventricular diverticulum at the posterior horn of the lateral ventricle and aplasia cutis congenita in a neonate, this case also offers new insights into the pathogenesis of these congenital anomalies. [ABSTRACT FROM AUTHOR]

An 8-year-old boy presenting with a transient weakness of the left extremities had a rare association of moyamoya disease and persistent primitive hypoglossal artery (PPHA). Digital subtraction angiography demonstrated intracranial moyamoya vessels and a PPHA on the right side. There was collateral blood flow from the posterior circulation to the anterior circulation, with the PPHA functioning as a blood supplier vessel. The patient underwent multiple burr hole formation, and neovascularization via the burr holes was observed on follow-up angiography. In this case, blood flow into the posterior circulation via the PPHA, which served as the collateral vessel to the moyamoya phenomenon, may have disturbed the spontaneous closure of the PPHA. Thus, this case serves as a basis for studying important pathogenic and embryological processes that contribute to the development of these vascular abnormalities.Copyright © 2001 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

We report two cases of atretic cephalocele, a diverse form of cranium bifidum. The patients were 15-year-old and 3-month-old girls, who each had a hard, nonpulsatile, nonreducible lump covered by alopecic scalp in the parieto-occipital area. They were surgically treated. In case 2, microscopical examination of the operative specimen revealed a meninges under the mass, which was devoid of nervous tissue. Such lesions have rarely been reported, and their essential nature is still the subject of controversy. Pathological and embryological aspects of atretic cephalocele are discussed on the basis of the findings; the neural crest remnant was assumed to be the developmental origin of the lesion in each of these cases. [ABSTRACT FROM AUTHOR]

Arachnoid cysts of the quadrigeminal cistern are rare. Patients with this lesion are usually normal at birth, and signs of increased intracranial pressure (IICP) develop at about 4 to 12 months of age. However, there has been no report about this mechanism. A case of arachnoid cyst of the quadrigeminal cistern is presented. In this case, the process of the cyst growth was observed during the course of follow-up for shunted hydrocephalus. Symptoms coincided with the growth of the cyst. Therefore, the development of the clinical symptoms was thought to be due to IICP caused by cyst expansion. Our case was complicated by inflammation, something that may offer a key to solving the mechanism of cyst fluid accumulation and the relationship between symptoms and development of the cyst. [ABSTRACT FROM AUTHOR]

The authors reviewed the Japanese literature on moyamoya disease. In the article we discuss the history of such investigations in Japan, the signs and symptoms, the diagnosis (especially concerning diagnostic criteria and magnetic resonance imaging), the pathology in relation to its etiology, and the current methods of treatment. On the whole, the main aim of the paper was to introduce our concept of moyamoya disease that is now current in Japan. [ABSTRACT FROM AUTHOR]

EEG and CT scans of 280 cases of minor head injury in children under 15 years of age were studied. Abnormality on initial EEG was shown in 42.5%. Those who lost consciousness had a higher incidence of abnormality than those who did not, and it was higher between 4 and 13 years of age. The sleep state has much influence on the finding. The patients should be awake or in a light sleep stage. The most frequent abnormality was slow waves, seen predominantly in the occipital regions, and which tended to disappear more easily than the paroxysmal ones. The EEGs became or remained normal in 95%, excluding incompletely followed-up cases. There was no case of post-traumatic epilepsy in our series, but 4 cases of post-traumatic early convulsions, in which the EEGs were variable. CT scan disclosed abnormality in 6%. [ABSTRACT FROM AUTHOR]

Moyamoya disease is a cerebrovascular obstructive disease of unknown etiology. The rebuild-up phenomenon, slowing of waves on electroencephalogram (EEG) seen after cessation of hyperventilation (HV), is one of the characteristic phenomena of the disease and is though to be related to a development of its symptoms. Therefore, we investigated the mechanism involved in the rebuild-up phenomenon to clarify the mechanism of development of transient ischemic attack (TIA) in moyamoya disease. Ten patients with moyamoya disease were studied; they ranged in age from 7 to 17 years. The power spectra of the EEGs in the occipital region were obtained with a Berg Fourier EEG analyzer for quantitative analysis. Arterial blood gas change (pH, PaO, PaCO), respiratory pattern (abdominal and nasal), tidal volume and respiratory rate were analyzed simultaneously every 30 s-1 min before, during, and after HV. The slow wave power spectrum (rebuild-up) increased and symptoms of TIA developed as a result of the sharp decrease in PaO ( PaO 60.5±15.4 mmHg) after cessation of HV. Based on the fact that hypoxemia was playing a main role, 100% oxygen was administered at a rate of 0.5 l/min in 4 cases where the rebuild-up phenomenon was clear. The EEG power spectra and arterial blood gas were analyzed during rebuild-up with and without O administration. The effectiveness of O administration at the beginning of rebuild-up as measure to prevent the symptoms was checked by a recovery rate of slow wave power percentage, a recovery time of slow wave power percent and by clinical observation. The recovery rates were 11.8±4.2% min and 5.5±4.0% min with and without O inhalation, respectively ( P< 0.001). Recovery times of slow wave power percentage were 4.3±1.8 min and 8.1±1.2 min with and without O inhalation, respectively ( P< 0.01). Thus, oxygen administration soon after the cessation of HV was shown to be effective in eliminating the rebuild-up phenomenon and hence in abolishing its symptoms. [ABSTRACT FROM AUTHOR]

Crouzon disease is a form of craniosynostosis with the autosomal dominant mode of inheritance. Among the anomalies associated with craniosynostosis, aberrant dural sinus is well known. We report on identical twin sisters with Crouzon disease and sinus pericranii who were successfully treated surgically. In one of the sisters hydrocephalus was present, which eventually needed a shunt operation. The association of these anomalies is discussed. [ABSTRACT FROM AUTHOR]

The cases of four infants (five lesions) are reported, where 'porencephalic cysts,' located along the ventricular catheter after shunt malfunction and ommaya reservoir insertion, disappeared after ventriculoperitoneal (VP) shunt revision and combined cyst peritoneal (CP) shunt, or after VP shunt alone. This pathological state is thought to be a rare postoperative complication. Its pathogenesis and therapy are discussed. Shunt malfunction or Ommaya reservoir insertion may result in a hypertensive hydrocephalic state. Cerebrospinal fluid (CSF) flows out through a catheter penetrating the site of the ventricular wall and expands in the surrounding white matter to form a porencephalic cavity. Once this porencephalic state occurs, it will not disappear spontaneously because the CSF flows in one direction. As treatment for closed porencephaly, CP shunt following a VP shunt revision was markedly effective; for communicating porencephaly, a VP shunt revision alone was effective. [ABSTRACT FROM AUTHOR]

A 3-month-old male infant with intracranial hemorrhage attributable to a vitamin K deficiency is reported. Vitamin K2 was administered orally at birth and then at 5 days and 1 month of age. Oral antibiotics were also given 2 days before the onset of bleeding. Although the incidence of intracranial hemorrhage resulting from vitamin K deficiency has decreased since the introduction of vitamin K2 prophylaxis, spontaneous intracranial hemorrhages are still being reported in infants. We suggest that vitamin K prophylaxis is needed especially for breast-fed infants and for those undergoing antibiotic therapy. [ABSTRACT FROM AUTHOR]

A case of aneurysm of the middle cerebral artery with congenital porencephaly in the same region is reported. The cyst was opened and the aneurysm was wrapped with a muscle strip. The resected specimen of the cyst wall contained a parenchymal layer with hemosiderinladen macrophages. It is speculated that bleeding from the aneurysm during the perinatal period caused the porencephaly. [ABSTRACT FROM AUTHOR]

The Cover Feature shows a slim genie (hydrogenase) who oxidizes H2 and releases energy in the manner of a fuel cell, and a fat genie (photosystem II) that oxidizes H2O by absorbing energy, in the manner of a solar cell. In their Communication, M. Kikkawa et al. demonstrate that a single Ir catalyst is capable of mimicking both systems. By using the Ir complex as the H2‐ or H2O‐oxidizing anode catalyst and carbon black‐supported platinum as the O2‐reducing cathode catalyst, the functionality of the whole cell can be switched between fuel cell‐type and solar cell‐type. More information can be found in the Communication by M. Kikkawa et al. on page 4024 in Issue 21, 2017 (DOI: 10.1002/cctc.201700995). [ABSTRACT FROM AUTHOR]