Fetal nondopaminergic neural implants in parkinsonian primates

1991 ◽  
Vol 74 (1) ◽  
pp. 97-104 ◽  
Author(s):  
Krzysztof S. Bankiewicz ◽  
Robert J. Plunkett ◽  
David M. Jacobowitz ◽  
Irwin J. Kopin ◽  
Edward H. Oldfield
Keyword(s):  
Dopaminergic Neurons ◽  
Neural Implants ◽  
Behavioral Recovery ◽  
Foramen Of Monro ◽  
Caudate Nuclei ◽  
Content Type ◽  
Primate Brain ◽  
Brain Implants ◽  
Microsurgical Approach ◽  
Fine Print

✓ Implantation of fetal dopamine-containing tissue into preformed cavities in the caudate nucleus of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced parkinsonian monkeys leads to behavioral recovery. Recovery may be related to two sources of dopamine: the grafted cells and/or the sprouted fibers from host dopaminergic neurons. The authors undertook this study to determine whether behavioral recovery requires release of dopamine by the implanted tissue, and to establish if nondopaminergic fetal central nervous system implants can induce sprouting of dopamine fibers in the primate brain and cause behavioral recovery. Rhesus monkeys with MPTP-induced hemiparkinsonism or full parkinsonism and a stable neurological deficit were used for this study. Cavities were created in the caudate nuclei anterior to the foramen of Monro via an open microsurgical approach. Fetal cerebellum or spinal cord was implanted into the preformed cavities of three monkeys. Control parkinsonian monkeys showed no recovery. However, implant-induced improvement was stable for up to 6 months after implantation. Sprouted dopaminergic fibers oriented from the ventral striatum and nucleus accumbens were found in the area of the tissue implant in the animals that received fetal grafts but were not present in the control monkeys. It is concluded that brain implants do not need to contain dopamine to induce functional recovery in MPTP-induced parkinsonian primates. Implant-induced and trophic factor-mediated dopaminergic sprouting by the host brain plays a role in the behavioral recovery and may well be responsible for the clinical improvement seen in parkinsonian patients after brain implants.

Intrastriatal implantation of interleukin-1

1994 ◽  
Vol 80 (3) ◽  
pp. 484-490 ◽  
Author(s):  
Jin Wang ◽  
Krzysztof S. Bankiewicz ◽  
Robert J. Plunkett ◽  
Edward H. Oldfield
Keyword(s):  
Substantia Nigra ◽  
Caudate Nucleus ◽  
Ventral Tegmental Area ◽  
Dopaminergic Neurons ◽  
Interleukin 1 ◽  
Behavioral Recovery ◽  
Content Type ◽  
Median Forebrain Bundle ◽  
Ventral Tegmental ◽  
Fine Print

✓ Intrastriatal implantation with dopaminergic or nondopaminergic tissue can elicit behavioral recovery in parkinsonian animals. Because in these animals, especially in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned monkeys, there are still considerable numbers of dopaminergic neurons left in the mesencephalon, implantation-induced trophic effects on host residual dopaminergic neurons have been suggested as a mechanism underlying the behavioral recovery. Gliosis around the graft is a universal finding in any implantation procedure and is probably mediated by interleukin-1 (IL-1); in addition, activated astrocytes secrete several neurotrophic factors in vitro. Therefore, the authors postulated that trophic effects from IL-1-induced gliosis may be a “final common pathway” for recovery in parkinsonian animals after implantation. Hemiparkinsonism was induced in rats by injection of 6-hydroxydopamine either directly into the substantia nigra or into the median forebrain bundle. The substantia nigra-lesioned rats showed complete depletion of dopaminergic neurons in the substantia nigra but sparing of those in the ventral tegmental area, whereas the median forebrain bundle-lesioned animals had depletion of dopaminergic cells in the substantia nigra and the ventral tegmental area. Polymer pellets containing either slow-released IL-1 alpha and beta or placebo pellets were implanted in the caudate nucleus on the lesioned side in both groups. The rats' rotational response to amphetamine was tested weekly for 8 weeks. Selective substantia nigra-lesioned rats with implantation of IL-1 pellets had a 45% reduction in amphetamine-induced rotation, whereas placebo-implanted substantia nigra-lesioned rats had a 14% reduction in rotation. In the median forebrain bundle-lesioned group, neither IL-1 nor placebo implantation elicited any effect on turning. Immunohistochemical staining for glial fibrillary acidic protein was markedly increased surrounding the IL-1 pellets compared to the placebo pellets. In the selective substantia nigra-lesioned rats with IL-1 pellets implanted in the caudate nucleus, a considerable number of tyrosine hydroxylase immunoreactive (TH-IR) fibers were observed in the medial and middle portions of the caudate nucleus. Fewer TH-IR fibers were seen in the rats with placebo-bearing pellets. These results suggest that neurotrophic activities mediated by IL-1 and reactive astrocytes might be a common path through which tissue trauma and some tissue transplants exert their beneficial effects in parkinsonian animals. Furthermore, most of the sprouted dopaminergic fibers induced by IL-1 in the caudate nucleus come from dopaminergic neurons in the ventral tegmental area.

Long-term evaluation of hemiparkinsonian monkeys after adrenal autografting or cavitation alone

1990 ◽  
Vol 73 (6) ◽  
pp. 918-926 ◽  
Author(s):  
Robert J. Plunkett ◽  
Krysztof S. Bankiewicz ◽  
Alex C. Cummins ◽  
Robert S. Miletich ◽  
Joan P. Schwartz ◽  
...  
Keyword(s):  
Adrenal Medulla ◽  
Chromaffin Cells ◽  
Behavioral Recovery ◽  
Caudate Nuclei ◽  
Content Type ◽  
Term Evaluation ◽  
Tissue Implantation ◽  
Dopaminergic Grafts ◽  
Fine Print

✓ Autografts of adrenal medulla were implanted into preformed cavities in the caudate nuclei of four rhesus monkeys with hemiparkinsonism induced by l-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Five other hemiparkinsonian monkeys underwent caudate cavitation, but received no tissue implant. All of the animals had marked bradykinesia of the affected arm and stable apomorphine-induced turning before cavitation or implantation. Moderate behavioral recovery was seen in all five monkeys with cavitation and two of the three monkeys with long-term adrenal autografts (the fourth adrenal recipient was sacrificed 10 days after grafting). The improvement occurred months after the procedure and was not as early or as complete as that seen after fetal dopaminergic grafts. Surviving adrenal tissue was found only in the animal that showed no behavioral recovery. The other two adrenal autograft recipients (with no surviving adrenal medulla) and all of the animals with cavitation had ingrowth of dopaminergic fibers from the area olfactoria and nucleus accumbens into the caudate, oriented toward the cavity. These findings show that the mechanism of improvement after adrenal medullary implants for parkinsonism is not dopamine secretion by chromaffin cells, but may be related to the sprouted host fibers. The results also indicate that the limited recovery after adrenal implants in parkinsonian patients may be a result of the cavitation, and not necessarily the result of tissue implantation.

Diagnosis and microsurgical approach to far-lateral disc herniation in the lumbar spine

1990 ◽  
Vol 72 (3) ◽  
pp. 378-382 ◽  
Author(s):  
Joseph C. Maroon ◽  
Thomas A. Kopitnik ◽  
Larry A. Schulhof ◽  
Adnan Abla ◽  
James E. Wilberger
Keyword(s):  
Facet Joint ◽  
Lumbar Disc ◽  
Spinal Nerve ◽  
Magnetic Resonance Images ◽  
Content Type ◽  
Enhanced Ct ◽  
Disc Herniations ◽  
Microsurgical Approach ◽  
Far Lateral ◽  
Fine Print

✓ Lumbar-disc herniations that occur beneath or far lateral to the intervertebral facet joint are increasingly recognized as a cause of spinal nerve root compression syndromes at the upper lumbar levels. Failure to diagnose and precisely localize these herniations can lead to unsuccessful surgical exploration or exploration of the incorrect interspace. If these herniations are diagnosed, they often cannot be adequately exposed through the typical midline hemilaminectomy approach. Many authors have advocated a partial or complete unilateral facetectomy to expose these herniations, which can lead to vertebral instability or contribute to continued postoperative back pain. The authors present a series of 25 patients who were diagnosed as having far lateral lumbar disc herniations and underwent paramedian microsurgical lumbar-disc excision. Twelve of these were at the L4–5 level, six at the L5–S1 level, and seven at the L3–4 level. In these cases, myelography is uniformly normal and high-quality magnetic resonance images may not be helpful. High-resolution computerized tomography (CT) appears to be the best study, but even this may be negative unless enhanced by performing CT-discography. Discography with enhanced CT is ideally suited to precisely diagnose and localize these far-lateral herniations. The paramedian muscle splitting microsurgical approach was found to be the most direct and favorable anatomical route to herniations lateral to the neural foramen. With this approach, there is no facet destruction and postoperative pain is minimal. Patients were typically discharged on the 3rd or 4th postoperative day. The clinical and radiographic characteristics of far-lateral lumbar-disc herniations are reviewed and the paramedian microsurgical approach is discussed.

Frameless neuronavigation in intracranial endoscopic neurosurgery

2001 ◽  
Vol 94 (1) ◽  
pp. 72-79 ◽  
Author(s):  
Henry W. S. Schroeder ◽  
Wolfgang Wagner ◽  
Wolfgang Tschiltschke ◽  
Michael R. Gaab
Keyword(s):  
Third Ventricle ◽  
Colloid Cyst ◽  
Endoscopic Approach ◽  
Arachnoid Cysts ◽  
Tumor Biopsy ◽  
Foramen Of Monro ◽  
Endoscopic Neurosurgery ◽  
Content Type ◽  
Multiloculated Hydrocephalus ◽  
Fine Print

Object. Frameless computerized neuronavigation has been increasingly used in intracranial endoscopic neurosurgery. However, clear indications for the application of neuronavigation in neuroendoscopy have not yet been defined. The purpose of this study was to determine in which intracranial neuroendoscopic procedures frameless neuronavigation is necessary and really beneficial compared with a free-hand endoscopic approach. Methods. A frameless infrared-based computerized neuronavigation system was used in 44 patients who underwent intracranial endoscopic procedures, including 13 third ventriculostomies, nine aqueductoplasties, eight intraventricular tumor biopsy procedures or resections, six cystocisternostomies in arachnoid cysts, five colloid cyst removals, four septostomies in multiloculated hydrocephalus, four cystoventriculostomies in intraparenchymal cysts, two aqueductal stent placements, and fenestration of one pineal cyst and one cavum veli interpositi. All interventions were successfully accomplished. In all procedures, the navigational system guided the surgeons precisely to the target. Navigational tracking was helpful in entering small ventricles, in approaching the posterior third ventricle when the foramen of Monro was narrow, and in selecting the best approach to colloid cysts. Neuronavigation was essential in some cystic lesions lacking clear landmarks, such as intraparenchymal cysts or multiloculated hydrocephalus. Neuronavigation was not necessary in standard third ventriculostomies, tumor biopsy procedures, and large sylvian arachnoid cysts, or for approaching the posterior third ventricle when the foramen of Monro was enlarged. Conclusions. Frameless neuronavigation has proven to be accurate, reliable, and extremely useful in selected intracranial neuroendoscopic procedures. Image-guided neuroendoscopy improved the accuracy of the endoscopic approach and minimized brain trauma.

Lateral microsurgical approach to intraorbital tumors

1976 ◽  
Vol 44 (5) ◽  
pp. 556-561 ◽  
Author(s):  
Joseph C. Maroon ◽  
John S. Kennerdell
Keyword(s):  
Optic Nerve ◽  
Skin Incision ◽  
Team Approach ◽  
Tumor Localization ◽  
Axial Tomography ◽  
Content Type ◽  
Ultrasonic Scanning ◽  
Microsurgical Approach ◽  
Computerized Axial Tomography ◽  
Fine Print

✓ The authors describe their microsurgical lateral orbital approach to intraorbital tumors. In seven patients ultrasonic scanning, computerized axial tomography, polytomography, orbital venography, and arteriography have allowed precise intraorbital tumor localization relative to the optic nerve. The authors believe that circumscribed tumors superior, lateral, or inferior to the optic nerve can be safely and completely removed through a 30–35-mm lateral skin incision with microsurgical dissecting techniques. A combined neurosurgical-ophthalmological team approach is emphasized.

Unilateral septal technique for transsphenoidal microsurgical approach to the sella turcica

1978 ◽  
Vol 49 (1) ◽  
pp. 138-142 ◽  
Author(s):  
George T. Tindall ◽  
William F. Collins ◽  
John A. Kirchner
Keyword(s):  
Nasal Mucosa ◽  
Nasal Septum ◽  
Sella Turcica ◽  
Practical Approach ◽  
Transsphenoidal Approach ◽  
Content Type ◽  
Microsurgical Approach ◽  
Septal Perforations ◽  
Fine Print

✓ A modification of the transseptal, transsphenoidal approach to the sella turcica is described; it consists of a unilateral separation of the nasal mucosa from the nasal septum. Experience with the technique in 215 cases has indicated that it is a useful, practical approach. The advantages are that the septum is spared, reoperation is made easier, and the procedure is quicker than the bilateral septal procedure. Asymptomatic nasal septal perforations (less than 3 mm) were seen in eight of 215 cases, and represented the only complication related to the operation.

Transsphenoidal hypophysectomy for disseminated carcinoma of the prostate gland

1979 ◽  
Vol 50 (3) ◽  
pp. 275-282 ◽  
Author(s):  
George T. Tindall ◽  
Nettleton S. Payne ◽  
Daniel W. Nixon
Keyword(s):  
Pain Relief ◽  
Operative Procedure ◽  
Prostate Gland ◽  
Stage Iv ◽  
Early Postoperative Period ◽  
Significant Feature ◽  
Content Type ◽  
Carcinoma Of The Prostate ◽  
Microsurgical Approach ◽  
Fine Print

✓ Transsphenoidal microsurgical hypophysectomy was performed in 53 men with disseminated carcinoma (Stage IV) of the prostate gland. The mean age was 64.8 years. Forty-three of the 53 men had severe pain due to their disease. Significant pain relief was obtained following hypophysectomy, usually within 24 hours, in 39 (91%) of these 43 patients. Objective remission occurred in 16 (36%) of 45 patients in whom the follow-up review was adequate to make this decision. Although dramatic, pain relief was not permanent in every patient. Four patients died in the early postoperative period, and in one, death was directly related to the operative procedure. Significant complications included partial diabetes insipidus in 40 cases (75.5%), and cerebrospinal fluid leaks in six (11.3%). The authors conclude that hypophysectomy is an appropriate operation in patients with disseminated carcinoma of the prostate gland, particularly when pain is a significant feature of the illness. Further, the transsphenoidal microsurgical approach appears to be the operative procedure of choice for performing hypophysectomy.

Early transplantation of an encapsulated glial cell line—derived neurotrophic factor—producing cell demonstrating strong neuroprotective effects in a rat model of Parkinson disease

2005 ◽  
Vol 102 (1) ◽  
pp. 80-89 ◽  
Author(s):  
Takao Yasuhara ◽  
Tetsuro Shingo ◽  
Kenichiro Muraoka ◽  
Kazuki Kobayashi ◽  
Akira Takeuchi ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Cell Line ◽  
Glial Cell ◽  
Rat Model ◽  
Neurotrophic Factor ◽  
Dopaminergic Neurons ◽  
Neuroprotective Effects ◽  
Content Type ◽  
Glial Proliferation ◽  
Fine Print

Object. Glial cell line—derived neurotrophic factor (GDNF) has been shown to confer neuroprotective effects on dopaminergic neurons. The authors investigated the effects of GDNF on 6-hydroxydopamine (6-OHDA)—treated dopaminergic neurons in vitro and in vivo. Methods. First, the authors examined how 1, 10, or 100 ng/ml of GDNF, administered to cells 24 hours before, simultaneously with, or 2 or 4 hours after 6-OHDA was added, affected dopaminergic neurons. In a primary culture of E14 murine ventral mesencephalic neurons, earlier treatment with the higher dosage of GDNF suppressed 6-OHDA—induced loss of dopaminergic neurons better than later treatment. Next, the authors examined whether continuous infusion of GDNF at earlier time points would demonstrate a greater neuroprotective effect in a rat model of Parkinson disease (PD). They established a human GDNF-secreting cell line, called BHK-GDNF, and encapsulated the cells into hollow fibers. The encapsulated cells were unilaterally implanted into the striatum of adult rats 1 week before; simultaneously with; or 1, 2, or 4 weeks after 6-OHDA was given to induce lesions of the same striatum. With the earlier transplantation of a BHK-GDNF capsule, there was a significant reduction in the number of amphetamine-induced rotations displayed by the animals. Rats that had received earlier implantation of BHK-GDNF capsules displayed more tyrosine hydroxylase—positive neurons in the substantia nigra pars compacta and a tendency for glial proliferation in the striatum. Conclusions. These neuroprotective effects may be related to glial proliferation and signaling via the GDNF receptor α1. The results of this study support a role for this grafting technique in the treatment of PD.

Migratory neurocysticercosis mimicking a third ventricular colloid cyst

2001 ◽  
Vol 95 (1) ◽  
pp. 122-123 ◽  
Author(s):  
Steven D. Wray ◽  
Thomas L. Ellis ◽  
Sabatino Bianco
Keyword(s):  
Preoperative Diagnosis ◽  
Histopathological Examination ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Foramen Of Monro ◽  
Radiographic Findings ◽  
Content Type ◽  
Intracranial Lesions ◽  
Microsurgical Approach ◽  
Mental Decline

✓ The authors report on a case of solitary neurocysticercosis located in the anterior third ventricle of a 21-year-old Hispanic man who presented with progressive headache, nausea, and mental decline. The appearance of the lesion on computerized tomography and magnetic resonance studies was typical of that of a colloid cyst, which was the presumptive preoperative diagnosis. A transcortical-transventricular microsurgical approach was used, and inspection of the anterior third ventricle via the ipsilateral foramen of Monro revealed no lesion. Inspection of the floor of the ipsilateral lateral ventricle revealed the intact cyst, which had migrated since the preoperative studies had been obtained. The lesion was removed intact, and histopathological examination confirmed the diagnosis of neurocysticercosis. The authors review the radiographic findings in this case and further illustrate the potential for neurocysticercosis to masquerade as other intracranial lesions.

Disturbances of the serum electrolytes after surgery of intracranial arterial aneurysms

1972 ◽  
Vol 37 (2) ◽  
pp. 210-218 ◽  
Author(s):  
Alex M. Landolt ◽  
M. Gazi Yasargil ◽  
Hugo Krayenbühl
Keyword(s):  
Clinical Results ◽  
Clinical Effects ◽  
Serum Electrolytes ◽  
Sodium Potassium ◽  
Content Type ◽  
Electrolyte Disturbances ◽  
Microsurgical Approach ◽  
Arterial Aneurysms ◽  
Anterior Circle ◽  
Fine Print

✓ Of 126 patients operated on for aneurysms of the anterior circle of Willis (pterional microsurgical approach), 44% showed electrolyte disturbances in the postoperative period in spite of excellent clinical results. The majority of cases (26% of the total) presented mild sodium-potassium shifts with no evidence of clinical effects, this type of electrolyte shift was not a complication but a normal consequence of surgery. Patients with preexistent brain damage (7%) showed a tendency for severe sodium-potassium shift and had a bad prognosis. Ten cases showed hyperelectrolytemias (mostly hypernatremias) caused by the following disorders: diabetes insipidus (5), disturbance of thirst center (2), inappropriate antidiuretic hormone (ADH) secretion (1), and 6 patients suffered from various other electrolyte disturbances. The influence of the aneurysm localization is discussed.

Sign in / Sign up

Export Citation Format

Share Document