Search

A simulation model was developed to better understand the mechanisms of brain injuries in sports. A three-dimensional model comprising approximately 1.22 million elements was constructed from cranial computed tomography images of adult male volunteers by the voxel method. To simulate contact sports that permit actions such as tackling, a sinusoidal wave with duration of 10 ms and maximum acceleration of 2000 m/s2 was applied to the lowest point of the model to apply rotational acceleration to the head from different directions. The von Mises stress was then observed at five points in the coronal plane of the brain: cingulate gyrus (CG), corpus callosum (CC), brain stem (BS), lateral temporal lobe (LT), and medial temporal lobe (MT). LS-DYNA universal finite element analysis software with explicit time integration was used for the analysis. Concentrations of stress started to appear in the CC and BS at 10 ms post-impact, after which they also became evident in the CG and MT. The maximum changes in stress at each location occurred 10-15 ms post-impact. The von Mises stress was 9-14 kPa in the CG, 8-24 kPa in the CC, 12-24 kPa in the BS, 7-12 kPa in the LT, and 12-18 kPa in the MT. The highest stress in every part of the brain occurred after lateral impact, followed by oblique impact and sagittal impact. Such simulations may help elucidate the mechanisms of brain injuries in sports and help develop measures to prevent chronic traumatic encephalopathy.

The enormous number of spores produced by fruiting bodies during cultivation of mushrooms can lead to allergic reactions of workers, reduction of commercial value, spread of mushroom disease, pollution of facilities, and depletion of genetic diversity in natural populations. A cultivar harboring a sporulation-deficient (sporeless) mutation would be very useful for preventing these problems, but sporeless commercial cultivars are very limited in usefulness because sporeless traits are often linked with traits that are unfavorable for commercial cultivation. Thus, identifying a causal gene of a sporeless phenotype not linked to the adverse traits in breeding and cultivation is crucial for the establishment of sporeless breeding using a strategy employing targeting induced local lesions in genomes (TILLING) in cultivated mushrooms. We used a Pleurotus pulmonarius (Fr.) Quél. sporeless strain to identify and characterize the single recessive gene controlling the mutation. The 3,853-bp stpp1 gene encodes a protein of 854 amino acids and belongs to the MutS homolog (MSH) family associated with mismatch repair in DNA synthesis or recombination in meiosis. Gene expression analysis of the fruiting body showed that this gene is strongly expressed in the gills. Phenotypic analysis of disruptants formed by gene targeting suggested a reproducible sporeless phenotype. Mutants deficient in a functional copy of this gene have no unfavorable traits for sporeless cultivar breeding, so this gene will be an extremely useful target for efficient and versatile sporeless breeding in P. pulmonarius and various other cultivated mushrooms.

The protective effect of autoclaved water extract from spent mushroom substrate (AWESMS) and autoclaved spent mushroom substrate (ASMS) of the edible mushrooms Lyophyllum decastes (hatakeshimeji) and Pleurotus eryngii (eringi) against fungal and bacterial diseases was investigated on cucumber plants. When the plants were treated with AWESMS by spraying the first true leaves and inoculated with the target pathogen 7 days later, AWESMS of hatakeshimeji significantly reduced powdery mildew by Podosphaera xanthii, angular leaf spot by Pseudomonas syringae pv. lachrymans, but not Corynespora leaf spot by Corynespora cassiicola and scab by Cladosporium cucumerinum. When the plants were grown in a mixture (1 : 2, v ⁄ v) of ASMS of hatakeshimeji and soil, a significant disease reduction was observed in powdery mildew, scab and angular leaf spot. The protective effect was also observed against anthracnose on plants treated with AWESMS or on plants grown in a mixture of ASMS of eringi (1 : 3, v ⁄ v). Our results indicated that AWESMS and ASMS, independently of the mushroom type, provide a protective effect against fungal and bacterial diseases. Therefore, SMS should be considered an easily available source of active compounds to protect plants from fungal and bacteria infections, helping alleviate the waste disposal problem in the mushroom industry and creating an environmentally friendly method to reduce plant pathogens.

In the cultivation of edible mushrooms, including Pleurotus pulmonarius (Fr.) Quel., the enormous number of spores produced by fruiting bodies can adversely affect mushroom growers’ health, mushroom cultivation facilities, and the genetic diversity of natural populations. In this study, we constructed a primary genetic linkage map and identified the locus associated with the sporulation-deficient (sporeless) mutation of P. pulmonarius using 150 progeny isolates derived from a cross between sporeless and wild-type isolates. Based on the segregation of 300 AFLP markers, two mating-type factors, and the sporeless trait, a linkage map was generated consisting of 12 linkage groups. The map covered a total genetic distance of 971 cM, with an average marker interval of 5.2 cM. The gene region responsible for the sporeless mutation was located in linkage group II including 40 AFLP markers and the A mating-type factor locus. Of these markers, the nearest marker to the sporeless locus was located 1.4 cM away. Construction of this P. pulmonarius genetic linkage map and identification of markers that are closely linked to the sporeless locus will facilitate marker-assisted selective breeding of a sporeless strain with economically important traits.

In the cultivation of edible mushrooms including Pleurotus pulmonarius, the enormous number of spores produced by fruiting bodies adversely affects the health of mushroom farmers, mushroom cultivation facilities and the genetic diversity of natural populations. A sporeless mutant of P. pulmonarius (TMIC-30058) has been introduced with a high potential for breeding sporeless cultivars to reduce these adverse effects. We report here the conversion of the amplified fragment length polymorphism (AFLP) marker, closely linked to a sporeless locus, to a sequence tagged site (STS) marker for use in marker-assisted selection (MAS). By mainly bulked segregant analysis-based AFLP (BSA-AFLP), a total of 18 markers were identified the linkage to the sporeless locus with genetic distances ranging from 0 (co-segregation) from 3.4 cM. Out of them, 2 AFLP markers could be converted into STS markers, SD192 and SD296, and their implementations in various genetic backgrounds were validated by the amplification test against 15 wild type isolates from different geographical origin. Furthermore, we could amplify these 2 STS markers’ fragments by using multiplex PCR reproducibly. These results indicated that 2 STS markers can be used in MAS targeted at the sporeless trait in P. pulmonarius breeding.

In this paper, a three-dimensional digital human-head model was developed and several dynamic analyses on the head trauma were conducted. This model was built up by the VOXEL approach using 433 slice CT images (512×512 pixels) and made of 1.22 million parallelepiped finite elements with 10 anatomical tissue properties such as scalp, CSF, skull, brain, dura mater and so on. The numerical analyses were conducted using a finite element code the authors have developed. The main features of the code are 1) it is based on the explicit time integration method and 2) it uses the one point integration method to evaluate the equivalent nodal forces with the hourglass control proposed by Flanagan and Belytschko(1) and 3) it utilizes the parallel computation system based on MPI. In order to verify the developed model, the head impact experiment for a cadaver by Nahum et al.(2) was simulated. The calculated results showed good agreement with the experimental ones. A front and rear impact analyses were also performed to discuss on the characteristic measure of the brain injury, in which the von-Mises stress was high in the frontal lobe in both of the analyses because of the large deformations of a frontal cranial base. This result suggests that the von-Mises stress can be a good measure of the brain injury since it is empirically well known that the frontal lobe tends to get injured regardless of the impact positions.

In this paper, a three-dimensional digital human-head model was developed and several dynamic analyses on the head trauma were conducted. This model was built up by the VOXEL approach using 433 slice CT images (512×512 pixels) and made of 1.22 million parallelepiped finite elements with 10 anatomical tissue properties such as scalp, CSF, skull, brain, dura mater and so on. The numerical analyses were conducted using a finite element code the authors have developed. The main features of the code are 1) it is based on the explicit time integration method and 2) it uses the one point integration method to evaluate the equivalent nodal forces with the hourglass control proposed by Flanagan and Belythcko and 3) it utilizes the parallel computation with the MPI. In order to verify the developed model, the head impact experiment for a cadaver by Nahum et al. was simulated. The calculated results showed good agreement with experimental ones. A front and rear impact analyses were also performed investigate the relation between the impact direction and the positions of the high measurement of pressure and stresses in brain. The obtained results represent that brain injury has a closer relation with the Mises equivalent stress rather than the pressure. At this time, the large deformation of a frontal cranial base was observed in both frontal and occipital impact analyses. We expect that it induces the brain injury in a frontal lobe regardless of the impact positions.

The brain is the most important organ for life activity and humanity and is also an organ that tends to have residual disabilities after an accident because neuron cells cannot repair themselves. Therefore, protecting the brain from serious damage should be one of the most important objectives in automotive safety design for both passengers and pedestrians. For this reason, the Seikei University Graduate School and others have examined head impacts and the subsequent responses.

To obtain a homothallic mutant in Lentinula edodes, basidiospores derived from the common Bmut dikaryon (A1B1mut × A2B1mut) were treated with UV irradiation. Of a total of approximately 5000 monosporous cultures recovered, a single basidiospore isolate was found to produce the hyphae bearing clamp connections without mating. This mutant strain could form fruit bodies, and all its single basidiospore isolates developed into colonies with clamp connections. Such homothallic behaviors were transmitted from the mutant strain to the next generation. During the germination and following hyphal elongation in a single basidiospore of mutant strain, clamp connections were clearly detected in multicellular hyphae, which contained two nuclei in each cell. Their clamp connections were morphologically variable, viz., pseudo, abnormal, and true clamps. Amplified fragment length polymorphism (AFLP) profiles among the basidiospore isolates of mutant strain were identical, indicating that the mutant strain produced isogenic basidiospore progeny.

A 68-year-old woman presented with an extremely rare intracranial metastasis from a gastrointestinal stromal tumor (GIST) manifesting as left hemiparesis 2 years after resection of a sacral tumor adjacent to the coccygeal bone. Magnetic resonance imaging revealed an intracranial tumor in the right parietal lobe. Craniotomy was performed to completely remove the tumor. Although the tumor was located extra-axially, only internal carotid angiography showed mass staining. Seven months after surgery, the tumor recurred. Repeat craniotomy was performed to remove the recurrent tumor. Immunohistochemical analysis showed that the tumor cells were positive for c-kit and CD34, and the tumors were identified as intracranial metastasis of GIST. Following the second intracranial surgery, the patient developed severe lower back pain caused by metastatic tumor invading the lumbar spine and ureter. To avoid surgical complications and to reduce tumor volume, imatinib mesylate (Gleevec®) was administered. The severe pain was relieved, although the tumor was not reduced. In this case, the extra-axial tumor was fed only by the internal carotid artery.

A sporeless mutant dikaryon, completely defective in sporulation, was isolated from mycelial protoplasts of Pleurotus eryngii mutagenized by UV irradiation. Newly established dikaryons between one component monokaryon from the mutant, and 12 different wild type monokaryons from 3 other wild type dikaryons, all exhibited the sporeless phenotype, whereas those between the other monokaryon and the same wild type monokaryons all produced normal fruiting bodies. These results indicated that the sporeless mutation was induced in one of two nuclei of the mutant and was dominant. In the wild type basidia, the pattern of nuclear behavior during sporulation corresponded to the pattern C nuclear behavior as defined by Duncan and Galbraith. Cytological observation revealed that in the sporeless mutant meiosis was blocked at the meta-anaphase I in most basidia and hence basidiospores and sterigmata were not produced. Although fruiting bodies of the sporeless mutant showed a somewhat leaning growth, their gross morphology and its fruiting body productivity were comparable to that of the original wild type strain. Based on these results, it was considered that the sporeless mutant could serve as a potential material in breeding of sporeless P. eryngii commercial strains.

B incompatibility factor mutants (Bmut) in Pleurotus ostreatus were recovered from common-B mating heterokaryons resulted from matings between wild-type monokaryons with different A but the same B factors (A1B2 and A2B2) after NTG mutagenesis. The mutant monokaryons such as A1B2mut and A2B2mut were observed to have regularly uninucleated hyphal cells and to be compatible with each other. Matings between A1B2mut and A2B2mut monokaryons produced stable heterokaryons (A1B2mut + A2B2mut) that had binucleated hyphal cells with true clamp connections and formed normal fruit-bodies. Mating tests using basidiospore progeny from each of these heterokaryons revealed the bipolar mating pattern. Genetic analysis suggested that the mutation of B factor in P. ostreatus might occur in the B incompatibility factor genes.

This paper discusses the relation between head injury and the Head Injury Criterion (HIC), which is widely used as a vehicle crash safety standard, and considers the importance in traffic accidents of diffuse axonal injury (DAI), which exhibits symptoms of conscious disturbance. In our analytical study reported in this paper, we constructed a two-dimensional computer model reproducing an axial section of the human head to analyze causes of DAI. Simulation results of applying direct impacts to the head by an impactor are reported. We found that, although DAI has been widely believed to be caused by rotational impacts, it can also be caused by translational direct impacts due to the influence of internal head structures.

A 46-year-old woman was admitted with generalized convulsion and deep coma which occurred 3 weeks after sudden onset of severe headache and pyrexia. Initial computed tomography did not reveal any abnormal findings except for an arachnoid cyst in the right middle fossa. Three weeks later repeat computed tomography showed intracystic hematoma in the arachnoid cyst with uncal herniation. Angiography revealed a right internal carotid-posterior communicating artery aneurysm. The neck of the aneurysm was clipped successfully, but hemiparesis was persistent postoperatively. Angiography is required for investigation of intracystic hematoma of an arachnoid cyst, especially in the absence of head injury, to avoid delayed diagnosis of any ruptured aneurysm.

The Hyphozyma synanamorph of Eleuther- omyces subulatus was found to be the cause of black spot disease of Lentinula edodes fruiting bodies. Mul- tiplication of yeastlike cells and hyphae of Hyphozyma resulted in blackening and mild lysis of the infected host cap tissues where partially degraded skeletal mi- crofibrils of host cell walls were abundant. In general, host tissue lysis remained superficial; however in some cases, Hyphozyma caused severe lysis and formed deep cavities containing remnants of highly dissolved host cell walls and numerous yeastlike cells of the pathogen. Enzyme assays demonstrated the ability of Hyphozyma to produce both chitinase and (3-(1,3) glucanase enzymes, requirements for hyphal wall degradation. On agar, conidiogenesis is enter- oblastic in the Hyphozyma morph, whereas it is ap- parently holoblastic in the Eleutheromyces morph. No evidence of phialidic conidiogenesis was obtained.

The mechanism of diffuse axonal injury (DAI) has been analyzed by means of computer simulations. A standard human model that reproduced the human head structure, and modified human models with some head substructures such as falx cerebri eliminated are constructed as finite element models. Rotational impacts are applied to the finite element models through the cranium. The bottom of the third ventricle is considered to be deemed the center of rotation. The rotational impact data of the standard human model evaluated from shear stresses such as von Mises stress show that those stresses are concentrated on the corpus callosum, thalamus and rostral brain stem located at the central region of the brain, which agrees very well with regions of DAI indicated by small hemorrhages found by clinical findings. The cause of the concentration of shear stress is investigated using the modified human models, and it is found that the high shear stress on periventricle such as the corpus callosum and thalamus is affected by the falx cerebri, while the high stress on the rostral brain stem is affected by the tentorium cerebelli. It is deduced that the mechanism of DAI is independent of the type of impact, and the shear stress is concentrated in the central region of the brain due to the effect of the head structure.

A rare case of central retinal artery occlusion associated with internal carotid artery stenosis due to closed head and neck injuries is reported. A five-year-old boy was hit over the head and neck in an automobile accident. On admission, he was semicomatose and had sustained a subcutaneous hematoma in the right occipital region, face and the right side of the neck. Craniograms revealed a linear skull fracture in the occipital bone. Computed tomography did not show intracranial mass lesions but mild brain swelling. Three weeks after the injury, he complained of blurred vision in the right eye. An angiogram of the right common carotid artery disclosed right internal carotid artery stenosis. It is suggested that the central retinal artery occlusion resulted from an embolism due to thrombosis of the internal carotid artery. Traumatic thrombosis of the internal carotid artery should be considered whenever a patient who has suffered a head or neck injury exhibits progressive neurological deterioration without an intracranial hematoma.

A bacterial disease occurred on fruiting bodies ofLentinula edodes that formed outdoors onQuercus bedlogs during winter. The pathogen was identified asPseudomonas tolaasii based on morphological and bacteriological characteristics. Symptoms exhibited by infected fruiting bodies ranged from mild browning to severe necrotic cavities that characteristically developed in the cap tissue along the periphery of the attachment area to the stalk. The mode of symptom development was greatly influenced by the internal tissue structure of fruiting bodies. Multiplication of bacterial cells within the fruiting bodies was strictly intercellular and thus differed from previously reported bacterial disease ofL. edodes incited by an unidentified rod-shaped bacterium. The present strain ofP. tolaasii was capable of attacking theL. edodes mycelium in the inner bark and outer sapwood regions and caused lysis of heavily infected hyphae.

The purpose of this study is to understand the mechanical properties of the human cranium in order to develop a FEM simulation model of the head. Craniectomy samples, autoclave bone flaps and dry cadaver skulls were tested using values of radial bending moment considered typical in the case of head injury. In this study, we developed a procedure for estimation of the mechanical properties of the cranium by assuming a proportional relation between the bone mineral density and Young's modulus. The mechanical properties of the human cranium have been determined from the three-point bending test and the bone mineral density measured by the dual energy X-ray absorptiometry. The human cranium consisted of inner and outer tables (cortical bones) and a diploe (a cancellous bone). The stress on the cortical and the cancellous bones in the field of bending stress was assumed that the cranium was a beam in which two different materials were combined. The experiment showed that fresh cranial fractures start at the inner table and the diploe and then propagate to the outer table. The fracture of a cranium taken out of a human being will exhibit elastic-plastic fractures. This fact implies that the inner table and the diploe fractures can occur even if no fracture is detected using plain X-rays in cases of acute extradural hematomas (EDH).

A large number of spores from fruiting bodies can lead to allergic reactions and other problems during the cultivation of edible mushrooms, including Pleurotus eryngii (DC.) Quél. A cultivar harboring a sporulation-deficient (sporeless) mutation would be useful for preventing these problems, but traditional breeding requires extensive time and labor. In this study, using a sporeless P. eryngii strain, we constructed a genetic linkage map to introduce a molecular breeding program like marker-assisted selection. Based on the segregation of 294 amplified fragment length polymorphism markers, two mating type factors, and the sporeless trait, the linkage map consisted of 11 linkage groups with a total length of 837.2 centimorgans (cM). The gene region responsible for the sporeless trait was located in linkage group IX with 32 amplified fragment length polymorphism markers and the B mating type factor. We also identified eight markers closely linked (within 1.2 cM) to the sporeless locus using bulked-segregant analysis-based amplified fragment length polymorphism. One such amplified fragment length polymorphism marker was converted into two sequence-tagged site markers, SD488-I and SD488-II. Using 14 wild isolates, sequence-tagged site analysis indicated the potential usefulness of the combination of two sequence-tagged site markers in cross-breeding of the sporeless strain. It also suggested that a map constructed for P. eryngii has adequate accuracy for marker-assisted selection.

We investigated nuclear behavior during basidiosporogenesis in Lentinw, Panus, and Neolenti- nus in an attempt to discover characters for taxonomic segregation of lentinoid-pleurotoid fungi. In Lentinus tigrinus and Panus lecomtei somatic hyphae are binu- cleate. Karyogamy and meiosis occur in the basidia, meiotic products migrate into spores and postmeiotic mitosis occurs; this is followed by back-migration of one nucleus from each spore into the basidium. Ma- ture spores are consequently uninucleate and dis- charged basidia are quadrinucleate. In Neolentinus le- pideus many somatic cells are multinucleate. Karyogamy, meiosis, and postmeiotic mitosis occur as in L. tigrinus and P. lecomtei, but there is no back- migration, mature spores are binucleate, and dis- charged basidia are anucleate. The patterns of nuclear behavior in L. tigrinus and P. lecomtei correspond to type C nuclear behavior as defined by Duncan and Galbraith, whereas that of Neolentinus corresponds to type D nuclear behavior. Lentinus and Panus cannot be distinguished on the basis of postmeiotic nuclear behavior, but both can be distinguished from Pleurotus

Morphological evolution of the Lentinus hymenophore was investigated through scanning electron microscopic observations of development in cultured sporocarps of Lentinus tigrinus, L. crinitus, L. s...

二輪車交通事故における頭部外傷のメカニズムを検討する目的で,臨床情報をふまえて事故後回収したヘルメット120例について分析を加えた。臨床データから頭部外傷の程度によって負傷者を軽症,重症,死亡に分類した。また,障害の内容も細分しそれぞれの延べ数を求めた。ヘルメットは外表の観察にとどめず,切断して衝撃吸収ライナーとして使用されている発泡スチロールの状態も検査した。この方法によりヘルメットの損傷部位と程度を評価した。ヘルメットが事故に際し脱落したもの(脱落例)では脱落しなかったもの(非脱落例)に比べ障害が重症となる傾向を示した。局所性脳損傷は脱落例で多いのに対し,びまん性脳損傷は脱落例,非脱落例で明らかな差はみられなかった。ヘルメットの分析結果から衝撃の強さと方向を推定し頭部外傷の傷害内容と比較したところ,急性硬膜下血腫ではヘルメットの辺縁部に前後方向から衝撃を受けた場合に生じやすく,びまん性軸索損傷は円蓋部に横方向から衝撃を受けた場合に生じやすかった。脳組織の損傷メカニズムとして,実験的に回転外力でびまん性脳損傷が生じやすいことが証明されている。ヘルメットの円蓋部を打ったときにびまん性軸索損傷が多かったのは,ヘルメットの円蓋部への衝撃では頭部の重心より上部に外力が加わり,辺縁部への衝撃に比べ回転外力が生じやすいためと考えられた。急性硬膜下血腫,脳挫創,びまん性軸索損傷などの重症の脳外傷はヘルメットの損傷の強い場合が多かった。ヘルメットにそのような損傷を来す外力がヘルメットを着用せず直接頭部に加わっていたならば,さらに重篤な脳損傷を来して死亡していた可能性が強いと推定された。したがって,重症度の軽減の面からはヘルメットは十分に脳保護作用を発揮していると考えられる。

A 46-year-old woman was admitted with generalized convulsion and deep coma which occurred 3 weeks after sudden onset of severe headache and pyrexia. Initial computed tomography did not reveal any abnormal findings except for an arachnoid cyst in the right middle fossa. Three weeks later repeat computed tomography showed intracystic hematoma in the arachnoid cyst with uncal herniation. Angiography revealed a right internal carotid-posterior communicating artery aneurysm. The neck of the aneurysm was clipped successfully, but hemiparesis was persistent postoperatively. Angiography is required for investigation of intracystic hematoma of an arachnoid cyst, especially in the absence of head injury, to avoid delayed diagnosis of any ruptured aneurysm.

The aim of this study was to analyze and compare the epidemiology of injury mechanisms in acute subdural hematoma (ASDH) with those of diffuse brain injury (DBI) in the Japan Neurotrauma Data Bank.Data in the Japan Neurotrauma Data Bank were reviewed for 1,002 patients with severe head injury treated at hospitals between 1998 and 2001 (ASDH, n=246; DBI, n=341). Clinical variables including mechanisms of injury were evaluated.Patients with DBI were significantly younger, with higher incidence of skull fracture, lower Glasgow coma scale score and higher injury severity score than patients with ASDH. Different mechanisms of injury were involved, with ASDH occurring much more commonly in non-vehicular injuries, particularly falls (47.2%), while DBI resulted almost exclusively from vehicular injuries (79.7%). Impact sites on the head with ASDH were more commonly occipital or temporal, while those for DBI were frontal, temporal or facial. Alcohol use was involved in 13.8% of drivers with ASDH and 33.6% of drivers with DBI.The principal mechanical damage in DBI was to the brain itself, while primary damage in ASDH occurred to surface blood vessels. ASDH and DBI remain the two worst and most-important types of traumatic brain injury, although the pathogenesis differs with age and mechanism injury.

Traumatic acute subdural hematomas (ASDH) in Japan Neurotrauma Data Bank were categorized into focal brain injury (FBI) group and diffuse brain injury (DBI) group, and were analyzed to clarify the pathophysiological and therapeutic aspects of these injuries.Data in Japan Neurotrauma Data Bank were reviewed for 1,002 severely head-injured patients treated at hospitals between 1998 and 2001; 526 of these patients had ASDH. ASDH in this data bank were categorized into FBI group and DBI group on the findings of CT scan. The clinical variables in these injuries were evaluated.Of 526 patients with ASDH, 246 (46.8%) were categorized into FBI group, 280, (53.2%) were DBI group. The patients with DBI group were younger, injured in traffic accident, lower Glasgow Coma Scale (GCS), higher Injury Severity Score, poorer outcome, compared to those with FBI group. The patients in DBI group, who underwent decompressive craniectomy and craniotomy, had a significantly better outcome than those who underwent hematoma evacuation via burr hole. There were no relationship between the time from injury to operation and outcome in the patients with DBI group, whereas patients with early surgery in FBI group showed significantly poorer outcome. Hypothermia and the placement of intracranial pressure monitor improved outcome only in patients of DBI group.It seems that the pathophysiological and therapeutic aspects of ASDH associated with DBI might differ from that with FBI alone.

A 87-year old male was admitted to our hospital due to generalized convulsion with loss of consiousness. He was afebrile and his blood sampling was not infectious. Computed tomography scan suspected left chronic subdural hematoma. Burr hole drainage was performed to remove the hematoma, but the abscess was aspirated in the subdural space. Infected subdural hematoma is rare. We discuss the clinical presentation, diagnosis and. treatment, and also briefly review the literature.

Despite the relative rarity of school shootings, targeted violence, and school-associated violent deaths, any youth who presents with words, gestures, or actions of a threatening or violent nature in a school setting should be assessed and referred for further evaluation by a mental health professional and, if clinically indicated, a forensic evaluator.The request for a juvenile risk assessment for future dangerousness requires careful delineation of role and agency; confidentiality issues; a comprehensive diagnostic evaluation of the youth; and a detailed assessment of the youth's perceived threat or problematic behavior. Various protective and risk factors and consideration of other individual, family, school/peer, and situational factors should also be explored.There is still much information that is unknown when considering school violence or targeted school violence. There is clearly a need for additional research on the identification of at-risk youths, the contributions and significance of various protective and risk factors, the impact of peer relationships, and perceived rejection, socioeconomic status, subtypes of aggression, and developmental stages. Examples of future research direction might include difference by gender, presence of affective or psychotic disorders, substance abuse, emerging characterologic disturbances, and physiologic markers, such as cortisol or serotonin. Additional research regarding best practices and the development of clinical guidelines or practice parameters is also needed.

A 68-year-old woman presented with an extremely rare intracranial metastasis from a gastrointestinal stromal tumor (GIST) manifesting as left hemiparesis 2 years after resection of a sacral tumor adjacent to the coccygeal bone. Magnetic resonance imaging revealed an intracranial tumor in the right parietal lobe. Craniotomy was performed to completely remove the tumor. Although the tumor was located extra-axially, only internal carotid angiography showed mass staining. Seven months after surgery, the tumor recurred. Repeat craniotomy was performed to remove the recurrent tumor. Immunohistochemical analysis showed that the tumor cells were positive for c-kit and CD34, and the tumors were identified as intracranial metastasis of GIST. Following the second intracranial surgery, the patient developed severe lower back pain caused by metastatic tumor invading the lumbar spine and ureter. To avoid surgical complications and to reduce tumor volume, imatinib mesylate (Gleevec) was administered. The severe pain was relieved, although the tumor was not reduced. In this case, the extra-axial tumor was fed only by the internal carotid artery.

The aim of this study was to investigate S-100B protein and NSE as a serum marker of brain cell damage after traumatic brain injury.Forty-one patients with traumatic brain injury were included in this prospective study. Venous blood samples for S-100B protein and NSE were taken after admission and on the next day. Serum levels of S-100 protein and NSE were compared with Glasgow Coma Scale score, computed tomographic findings and outcome after 3 months.Serum S-100B protein and NSE were significantly correlated with Glasgow Coma Scale score and outcome after 3 months. The significant correlation was found between the initial S-100B and NSE (P0.001). In patients without parenchymal injuries on computed tomographic scan such as epidural hematoma and concussion, the elevation of S-100B protein and NSE was observed. The initial values of S-100B and NSE in acute subdural hematomas with unfavorable outcome were significantly higher than in those with favorable outcome. Secondary increase of serum markers was associated with the presence of secondary insult such as hypoxia or hypotension, and was found to have an unfavorable outcome.Serum concentration and kinetics of S-100B protein and NSE provide the clinical assessment of the primary brain damage and have a predictive value for outcome after traumatic brain injury.

A very rare case of non-functional pituitary adenoma associated with Rathke's cleft cyst is reported. A 42-year-old male suffering from visual disturbance and headache was admitted. Visual acuity was 1.2 on the right and 0.5 on the left, and visual field examination showed bitemporal hemianopsia. Endocrinological study disclosed that the basal serum level of prolactin was elevated slightly to 52.6 ng/ml, whereas those of other hormones were within normal limits. MRI showed a dumbbell-shaped cystic sellar mass extending to the suprasellar region beyond the diaphragm sellae, which consisted of two isolated components around the sellar turcica. At the middle of May, the tumor was partially removed by bifrontal craniotomy. The suprasellar tumor tightly adhered to the frontal lobe and the optic nerve, the tumor was grayish cyst and cyst fluid from the suprasellar mass had the appearance of motor oil and the intrasellar tumor contained old hematoma. Histological findings revealed that the suprasellar mass was Rathke's cleft cyst and the intrasellar mass was diagnosed as pituitary adenoma (non-functional). Visual acuity was improved following surgical operation. So far twenty-three cases of pituitary adenoma associated with Rathke's cleft cysts have been reported in the literature, but there was only one case reported of a non-functional pituitary adenoma associated with a Rathke's cleft cyst. Etiology and pathogenesis of the coexistence of non-functional pituitary adenoma and Rathke's cleft cyst in the present case were not elucidated.

Acute subdural hematoma is usually associated with cerebral contusion or laceration of the bridging veins following a head injury. However, several cases of acute subdural hematoma without head injury (acute spontaneous subdural hematoma) have been reported.Among 162 cases of acute subdural hematoma admitted to our departments between 1996 and 2003, we repoort eight cases of acute spontaneous subdural hematoma. These cases fulfilled the following criteria. 1) Head injury was either trivial or absent. 2) Neither aneurysm nor arteriovenous malformation was apparent. 3) CT scan revealed neither brain contusion nor traumatic subarachnoid hemorrhage. 4) At operation, laceration of the cortical artery was observed. In this article, we describe the clinical feature (age, sex, Glasgow Coma Scale [GCS] Score on admission, past history, CT appearance, and outcome) associated with this condition.Patients ranged in age from 68 to 85 years (average 74.8 years), and were comprised of 3 males and 5 females. Previous medical history included cerebral infarction in 6 of the 8 patients and myocardial infarction in 1 patient. These seven patients were taking antiplatelet manifestation. GCS on admission ranged from 4 to 13. Five of the 7 patients on antiplatelet medication had secondary insults, such as hypoxia. On CT, hematoma thickness ranged from 13.2mm to 42.5mm (average 22.6mm), and midline shift ranged from 10.0mm to 24.0mm (average 16.5mm). Neurological outcome evaluated using the Glasgow Outcome Scale was as follows, good recovery n = 2, moderate disability n = 2, severe disability n = 3, persistent vegetative state n = 1.The mechanism of acute spontaneous subdural hematoma is influenced by the presence of pre-existing cerebrovascular disease and by the use of antiplatelet agents. In such cases, the possibility of cortical arterial bleeding should be taken into account, and craniotomy should be performed.

Histoplasma capsulatum infection is, for the most part, asymptomatic or of little clinical consequence. Disseminated infection due to H. capsulatum is rather uncommon. Clinically apparent infection of central nervous system (CNS) is rare, and involves in 10 to 50% of patients with disseminated histoplasmosis. Although CNS histoplasmosis is frequently fetal or only discovered as an autopsy, some patients can be effectively treated with anti-fungal agents. We describe a 44-year-old civil man who is engineering contractor with headache without evidence of systemic infection. Magnetic resonance imaging showed enhancing masses in the third and forth ventricles, right interpeduncular cistern, and right cerebello-pontine angle. After biopsy of what was presumed to be a malignant lymphoma, the patient died of rapidly progressive multiple cerebral infarctions. The autopsy revealed the CNS histoplasmoma disseminating systemically. And we finally diagnosed him as histoplasmoma by gene analysis. It was extremely difficult to make a diagnosis based on his physical and radiological findings because it should be included in the differential diagnosis of a well or ring enhanced lesion. It is very important to ask patients about their birthplace, past illness, occupation, and where they had traveled. In the present case, the patient working for the construction has visited many countries including the African Continent and Central America. Clinicians should maintain a high index of suspicion in patients who are from any area endemic for histoplasmosis. The clinical, radiological and pathological features of this infection were reviewed in this report.

We reported a case of severe spasticity of the bilateral upper and lower limbs which was improved by cervical spinal cord stimulation (SCS). A 53-year-old man was suffering from sudden cardiopulmonary arrest while walking. After receiving cardiopulmonary resuscitation for 40 minutes, his cardiopulmonary function re-started, but he failed to regain consciousness. MRI revealed a hypoxic brain in his bilateral basal ganglia and occipital lobes. After 2 months, his consciousness advanced to a vegetative state and the muscle tone of his bilateral upper and lower limbs deteriorated to severe spasticity. SCS was performed in the expectation of improving his consciousness. Contrary to this anticipated result, his vegetative state continued but the severe spasticity of his upper and lower limbs improved during the SCS. Single photon emission computed tomography (SPECT) during the period of stimulation revealed a high blood flow, especially in the area of the basal ganglia, thalamus, brain stem and cerebellum, compared with off-stimulation blood flow. The neurophysiologic mechanisms of these abnormal fields and the underlying aberrant afferent nerve impulses from the posterior funiculus in the cervical cord to the cerebral sensory cortex, which may indeed be secondary to ischemic brain, may be regulated by SCS, also adding the effect of increased blood flow to the brain.

A rare case of primary central nervous system lymphoma that regressed spontaneously as shown on serial cranial magnetic resonance imagings (MRI) is described. A 60-year-old woman was admitted to our hospital with a well-enhanced mass lesion in the cerebellum although MRI had demonstrated no abnormal findings 4 months before admission. On admission, She complained of headache, but no neurological deficits were observed. The patient underwent exploratory craniotomy and the tumor was partially removed on February 14. Pathologic examination suspected B-cell type of malignant lymphoma. Postoperative MRI performed on February 23, 2001 showed disappearance of the mass lesion without further treatment. Different polymerase chain reaction (PCR) assays detected clonal immunoglobulin heavy chain gene rearrangements in paraffin-embedded tissues diagnosed as B-cell lymphoma. The patient was discharged without any neurological deficits for two weeks and was followed up on MRI. One year after operation, MRI revealed an abnormal finding in the cerebellum without apparent neurological deterioration. Radiation therapy of the whole brain and the local site was carried out with a total dose of 50Gy. MRI demonstrated complete remission of the tumor following radiation therapy. She was admitted again to our hospital with right hemiparesis on May, 2003. Subsequently, systemic chemotherapy was carried out. The patient died 2 years and 10 months after her initial presentation.

We report a multicentric glioma case which revealed different pathological appearances. A 45-year-old male had been admitted to our hospital complaining of an attack of transient sudden aphasia. On magnetic resonance imaging (MRI), T1-weighted images revealed a low intensity and T2-weighted images demonstrated a homogeneous high intensity abnormal mass in the frontal lobe, which was not enhanced with gadolinium. Removal of the tumor was performed through a right frontal transcortical approach in March, 2002. Histological diagnosis was gemistocytic astrocytoma. The patient's condition was uneventful and postoperative MRI revealed a marked decrease in the volume of the tumor. A total of 54 Gy radiation to the brain in the locality was performed. Four months after the initial surgery, the patient suffered from incomplete right hemiparesis. MRI showed a left parietal abnormal mass which had a ring formation enhancement after gadolinium administration. This Neuro-radiological examination demonstrated complete independence from the initial right frontal tumor. A second surgery which was concerned with cyst aspiration was carried out on August 10, 2002. During the next month, a third operation for partial removal of a left parietal abnormal mass was performed. Histological diagnosis was anaplastic astrocytoma. The right frontal and left parietal tumors revealed neither continuous relation suggesting intracerebral invasion, nor dissemination through the subarachnoid space nor intracerebral metastasis. Our case was diagnosed as multicentric glioma with different pathological appearances, of which only 9 cases have been reported previously.

In this paper, a three-dimensional human-head model was developed using the VOXEL approach. The human-head VOXEL model is based on 433 scanned images (512 x 512 pixels) taken by CT (Computed Tomography). The precision of the head model depends on the resolution of slice images. The number of elements is then defined by the resolution and number of slice images. The maximum number of elements for a human-head VOXEL model developed from slice images is about 40.0 million. This model included the scalp, soft tissue, subarachnoid space, eyes, skull, brain, falx cerebri, dura mater, tentorium cerebelli and ventricles. All of these biological tissues were modeled as tiny cubic elements with one-point integration. To investigate the relation between CPU time and the number of elements, finite-element analysis was conducted using an original finite-element analysis code. Direct-impact analysis was conducted frontally on the human-head VOXEL model by a cylinder to simulate the cadaveric tests.

Occupational populations have become increasingly diverse, requiring novel accommodation technologies for inclusive design. Hence, further attention is required to identify potential differences in work perception between workers with varying physical limitations. The major aim of this study was to identify differences in shoulder loading and perception of effort between a control population (C) and populations affected by chronic back pain (LBP) and spinal cord injury (SCI) in one-handed seated transfer tasks to targets. The effects of the injuries, and associated pain, are likely to produce variations in movement patterns, muscle loading and perceived effort. The main results show that a) the LBP group had the highest movement time required for an exertion; significantly higher than both the SCI and C groups, while the SCI group had significantly longer exertion times than group C, b) the SCI and LBP groups had significantly higher total, maximum, and mean shoulder torques than the C group, c) the mean shoulder effort ratings for LBPs and SCIs were significantly higher than those for Cs, d) LBPs reported higher shoulder effort ratings than SCIs, e) SCIs and/or LBPs were unable to reach some of the targets; and f) the perception of effort tended to increase as a function of the linear distance between the seat and the target shelf. Differences in shoulder loading and perception were attributed to differences in movement velocities and strategies between the groups. These results suggest that workplace adaptation must take into account population specific characteristics.