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Biomedical subjects

A Asai

Publications and source records attributed to A Asai.

At least 163 records · Page 9Linked to original sources

[Angioblastic meningioma with metastases to the vertebra and adjacent bones: a case report].

A case of angioblastic meningioma with multiple metastases to the vertebra and the adjacent bones is presented. A 60-year-old man was admitted to our hospital complaining of pain in the left arm, right chest and abdominal wall, the left buttock, and on the posterior surface of the both legs. He had first undergone subtotal removal of tentorial meningioma eight years before admission. Histological diagnosis of angioblastic meningioma was confirmed. He subsequently received radiation therapy when the tumor recurred six years before admission and again underwent subtotal removal of the recurrent tumor, followed by radiation therapy, four years before admission. Bone scintigrams demonstrated abnormal uptake of radionuclide by the vertebral arches of Th 1, Th 10, Th 11, the vertebral bodies of L 4, L 5, the right 7th rib, and the left iliac bone. Myelography and CT examination with intrathecal infusion of metrizamide revealed marked cord-compression by the space-occupying lesions at the level of the first and the tenth thoracic vertebral bodies. Chest roentgenograms, ultrasonograms and whole body CT examinations showed no other lesions. The tumor was partially resected from the iliac lesion. The diagnosis of metastatic meningioma was confirmed by the histological findings. Postoperative radiation therapy to the first, tenth, and eleventh portions of the thoracic vertebra, and the fourth and the fifth portions of the lumbar vertebra--the causative lesions of the pain--relieved the pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Neoplasms↗

[Regional cerebral blood flow in brain tumors analyzed by N-isopropyl-(123I)-p-iodoamphetamine (IMP)].

N-Isopropyl-(123I)-p-Iodoamphetamine (IMP), a newly developed tracer for regional cerebral blood flow, was applied to 18 patients with brain tumors. The static scan images were obtained by a single photon emission CT 20 minutes after IMP injection, and revealed decreased IMP uptake in the tumor region in 17 out of 18 patients. This result suggests the lack of an IMP-trapping mechanism in the tumor. In dynamic scan images, which were taken every 2 minutes just after IMP injection, IMP uptake in the tumor was intermediate between that of contralateral white matter and gray matter, and it increased momentarily in accordance with that of the gray and white matter. This finding indicates that the IMP uptake in a dynamic scan would express the regional tissue blood flow in the tumor.

Aged↗

[Clinicopathological study of colorectal cancer in young adults including a case of cancer family syndrome].

During the last 6 years, we examined 402 cases (including 5 cases in their 20's and 17 cases in their 30's) of colorectal cancer. We compared three groups (cases in their 20's, cases in their 30's, and cases over 40 years old), and had the following results. Cases in their 20's had a higher rate of familial history of colorectal cancer, and the cancer was located mainly in the proximal colon. Well differentiated and moderately differentiated adenocarcinoma was dominant in the cases in their 30's and in those over 40 years old. On the other hand mucinous adenocarcinoma and signet ring cell carcinoma was dominant in the cases in their 20's. A case of cancer family syndrome is also presented.

Adenocarcinoma↗

[Subacute brain atrophy induced by radiation therapy of malignant brain tumors].

In order to analyze brain atrophy after radiation therapy to the brain tumors, we calculated a CSF-cranial volume ratio on CT scan as an index of brain atrophy, and estimated dementia-score by Hasegawa's method in 91 post-irradiated patients with malignant brain tumors. Radiation-induced brain atrophy was observed in 51 out of 91 patients (56%) and dementia in 23 out of 47 patients (49%). These two conditions were closely related, and observed significantly more often in aged and whole-brain-irradiated patients. As radiation-induced brain atrophy accompanied by dementia appeared 2-3 months after the completion of radiation therapy, it should be regarded as a subacute brain injury caused by radiation therapy.

Adolescent↗

Cerebral venous thrombosis due to high-altitude polycythemia. Case report.

A case of cerebral venous thrombosis due to polycythemia secondary to adaptation to a high altitude is reported. A 27-year-old previously healthy man developed severe neurological symptoms after climbing 8511 m. Computerized tomography and cerebral angiography suggested hemorrhagic infarction or intratumoral hemorrhage, and a craniotomy was performed. Pathological examination confirmed the diagnosis of hemorrhagic infarction secondary to cortical venous thrombosis. The etiology and incidence of cerebral venous thrombosis secondary to polycythemia are discussed.

Adult↗

New technique for removable implantation of radionuclides in central nervous system neoplasm by ultrasonic guidance.

Introduced here is a new technique for the insertion of removable tubes into a brain tumor guided by a real-time ultrasonic B-mode scanner as a preliminary stage for interstitial brachytherapy of malignant brain tumors. Because tube insertion is conducted while watching in real time the tumor echo displayed on the cathode ray tube, the tube-positioning locations for insertion into the tumor can be freely selected with this technique. Additionally, the length of the tube that remains within the tumor bulk can be easily measured and recorded during the operation. Moreover, in that all these procedures can be carried out in the operating room, the operation will be performed under aseptic conditions and in a shorter time. These are the major advantages of this technique.

Brachytherapy↗

Comparison between electrocochleography and glycerol test in the diagnosis of Meniere's disease.

Electrocochleography (ECoG) and glycerol test were performed in 51 Meniere ears. The positive rate of both tests was compared. The positive rate of ECoG and glycerol test was 63% and 51%, respectively. The ears with positive result of both tests and of either test were 15 of 51 ears (29%) and 43 of 51 ears (84%), respectively. The positive rate of ECoG was higher in ears with a moderate to severe hearing loss at high frequencies, while the positive rate of glycerol test was higher in ears with a moderate to severe hearing loss at low frequencies. The present study has demonstrated that ECoG is different in selectivity of detection of the endolymphatic hydrops from glycerol test and that the combination of both tests increases the detection rate of the endolymphatic hydrops in Meniere's disease.

Adult↗

[Central alveolar hypoventilation as a complication of massive intracerebellar hemorrhage: report of a case treated by diaphragm pacing].

The author reported a case of central alveolar hypoventilation (Ondine's curse) which was treated by diaphragm pacing. A 59-year-old man was admitted because of sudden deep coma and tetraparesis. Neurological examination on admission showed miotic pupils with absent light reaction, no oculocephalic reflex, no corneal reflex and tetraparesis. Glasgow scale was evaluated to be E-1 V-1, and M-3 with total of 5 points. Computed tomography confirmed a large hematoma in the cerebellum with ventricular rupture. Immediately, a suboccipital craniectomy was performed and the hematoma was evacuated. His neurological condition was improved gradually within a month after the operation. He responded to verbal orders and moved all his limbs against gravity. His respiration, however, was irregular with a pattern of so-called "cluster breathing" followed by prolonged apnea, that was more pronounced in night. He was suffered from hypoxic hypercapnea and recurrent pneumonia. Therefore, authors decided to employ diaphragm pacing for management of central alveolar hypoventilation. A diaphragm pacemaker (radiofrequency induction) was implanted. A cuff electrode was put around the right phrenic nerve in the right thorax, and the receiver installed subcutaneously in the right anterior chest. Postoperative respiratory study showed ventilation on pacing with satisfactory blood gas and he became able to move around using a wheel chair. In 1966 Glenn demonstrated a new technique to move the diaphragm paced by a receiver through the phrenic nerve, triggered by radio wave from external device.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebellar Diseases↗

[A case of cerebral cryptococcosis, with special reference to computerized tomography findings].

A case of cryptococcosis simulating brain tumor was reviewed. A 66-year-old female was admitted to our hospital with chief complaint of vertigo, gait disturbance and dysarthria. These symptoms started about one year before admission and worsened. Vomiting and urinary incontinence appeared. Neurological examination revealed left cerebellar ataxia and dysarthria. In plain CT (computerized tomography) irregular ill-defined low density area was noted in the cerebellar vermis and bilateral cerebellar hemispheres. And slight ventricular dilatation was found. Irregular shape of ring-like enhancement corresponding to capsule and patchy or mottled enhancement inside the tumor were seen. Suboccipital craniectomy was performed and yellowish necrotic tumor with hard capsule was removed. Histological diagnosis was not neoplasm or tuberculoma. Postoperatively liver function progressively worsened. She died due to disseminated intravascular coagulation. Autopsy revealed typical liver cirrhosis without malignant change. 3.0 X 2.5 cm sized, slightly hard, yellowish lesion was found on upper part of cerebellar hemispheres. This had extremely necrotic tissue and a great number of cryptococcus neoformans were found. And other intracranial lesion was not confirmed. Finding of pulmonary cryptococcosis was not gained. Our case is very rare because of solitary cerebellar abscess and absence of meningitic episode or pulmonary cryptococcosis. There are three types of inflammation in cerebral cryptococcosis. The commonest manifestation is the meningitic type, the second mode is granulomatous lesion and the third and the least presentation is intracranial abscess formation. CT reveals various findings according to clinical stage. CT findings are those of meningitis, meningoencephalitis, granuloma and abscess. Cryptococcal granuloma or abscess often simulates brain abscess, glioma and metastatic brain tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[The synthesis of valperinol and various 3-aminomethyl derivatives of 2,9-dioxatricyclo[4,3,1,0(3,7)]decane from didrovaltrate].

3-Aminomethyl derivatives of 2,9-dioxatricyclo [4,3,1,0(3,7)]decane, can be synthesized via an amination, starting from (1R, 3S, 4S, 6R, 7S, 8R, 10R)-3-iodomethyl-4-acetoxy-8-methoxy-10-methyl-2, 9-dioxatricyclo [4,3,1,0(3,7)]decane or (1R, 3S, 4S, 6R, 7S, 8R)-3-iodomethyl-4-acetoxy-8-methoxy-10-methylen-2,9- dioxatricyclo [4,3,1,0(3,7)]decane, which can be prepared from didrovaltrate.

Bridged-Ring Compounds↗

[The migration of cefotiam to cerebrospinal fluid].

The concentration of cefotiam (CTM), a newly synthesized cephem derivative antibiotic in serum and cerebrospinal fluid after single intravenous treatment was determined and its utility in the field of cerebral neurosurgery was studied. 1. One gram or 2 g of CTM was intravenously administered for 1 time to 10 patients admitted to our department. Dose dependency was observed in the progress of the mean serum concentration. There was no difference in the specific rate of constant, and the ratio of AUC between the group treated with 1 g and the one with 2 g was 1:1.9. The biological half-lives of the elimination phase for both dose levels were about 1.1 hours. 2. Disparity was recognized in the cerebrospinal fluid concentration in spite of the dose dependency. Although a case with comparatively high value of 1.37 micrograms/ml at 60 minutes after administration were seen in the 1 g treatment group, generally the migration concentration was low. Good cerebrospinal fluid concentration was attained in all of the cases in the 2 g treatment group, and the peak values ranged from 0.59 to 10.16 micrograms/ml. 3. The concentration ratio of cerebrospinal fluid to serum in the 2 g treatment group elevated till 360 minutes after administration, and the maximum values ranged from 15.8 to 89.8%. 4. The migration to the cerebrospinal fluid was faster in cases with slight inflammation than those without inflammation in the 2 g treatment group. 5. It was assumed that the prophylactic effect of CTM 2 g administration against staphylococci, streptococci and Klebsiella pneumoniae which are the major causative organisms can be expected in postoperative infection in the field of cerebral neurosurgery.

Adult↗

[Prophylactic administration of an antibiotic in neurosurgical operations--penetration of cefotiam into the cerebrospinal fluid].

Various antibiotics are widely used for the purpose of protection against postoperative infections. Neurosurgeon must select the effective antibiotics to bacterium, that which penetrated enough to the intracranial organ through the blood-brain barrier. Eighteen cases with ventriculo-peritoneal shunt received intravenous drip infusion of cefotiam (CTM) and the concentration of CTM in blood and cerebrospinal fluid (CSF) was measured. The conclusion drawn from this study on penetration of CTM is summarized as follows: The concentration of CTM in CSF and its ratio to that of serum (CSF/serum %) showed the values of 0.543 microgram/ml (3.66%) in the group of 1 g CTM injection and 0.900 microgram/ml (4.02%) in the group of 2 g CTM injection, 2 hours after an intravenous administration. The concentration of CTM in CSF were gradually decreased in comparison with antibiotic levels in the blood. The most cases of 1 g or 2 g intravenous administration were able to get the sufficient concentration in the CSF, which exceeds MIC (minimal inhibitory concentration) against Gram-positive cocci and Gram-negative bacilli. As a result of penetration of CTM into cerebrospinal fluid, we recommend the intermittent intravenous injection of 2 g CTM for prophylaxis of postoperative infections.

Adult↗

[2 Cases of cystic meningioma].

Although meningiomas are usually a solid and firm tumor, some are associated with diagnostically confusing large cysts. The authors experienced two cases of meningioma associated with large cyst (cystic meningioma). The first case was a 20-year-old female. She was admitted because of blurred vision. On admission she was slightly apathetic and showed bilateral papilledema. Computed tomography showed a large area of low density in both frontal regions. CT scan after intravenous contrast enhancement revealed an enhancing mural nodule attached to the falx. At operation, dark-green fluid in an amount of 160 ml from the left cyst and 50 ml from the right cyst was aspirated. The nodular tumor was found attached to the falx. The pathological examination revealed meningotheliomatous meningioma. Neoplastic meningothelial cells were found also in the cyst wall. The second case was a 21-year-old female. She was admitted because of weakness of the left lower extremity. Neurological examination revealed left hemiparesis. Deep tendon reflexes were hyperactive on the left side and there were positive left Babinski and Chaddock reflex. The computed tomography with contrast enhancement showed a large area of low density in the right parietal region with markedly enhancing mural nodule. At operation, 70 ml of xanthochromic fluid was aspirated. The tumor was well-defined, hard and attached to the dura. Histologically the tumor was a typical meningotheliomatous meningioma. The diagnostic value of computed tomography, the pathogenesis of cyst formation and the surgical treatment were discussed. The authors emphasized the important role of computed tomography in the diagnosis of cystic meningioma. Theories were reviewed for the pathogenesis of cyst formation. At operation, not only the mural nodule but also the cyst wall should be removed, because the neoplastic cells are presented in the cyst wall.

Adult↗

[Pharmacokinetics of ACNU in cerebrospinal fluid].

Various nitrosoureas are widely used effectively for chemotherapy of brain tumors, clinically and experimentally. Fourteen cases of malignant brain tumor received intravenous injection of 100-150 mg/body of ACNU, and the concentration of ACNU in blood and cerebrospinal fluid (CSF) was measured. The conclusion drawn from this study on penetration of ACNU is summarized as follows: 1. ACNU concentration in CSF and its ratio to that of serum (CSF/serum %) showed the various values of 0-0.076 micrograms/ml (0-63%), 30 min. after administration; 2. Concentration of ACNU in spinal CSF differed from that in ventricular CSF and CSF/serum ratio was 19.9% in spinal CSF and 42% in ventricular CSF, respectively; 3. Statistically no correlation between ACNU CSF/serum ratio and the postoperative time was found. Transition of ACNU into cerebrospinal fluid during radiation therapy was noted with high value of CSF/serum ratio.

Adolescent↗

[A study on penetration of antibiotics into the cerebrospinal fluid after the ventriculo-peritoneal shunt (author's transl)].

Neurological surgeon must select the effective antibiotics to bacterium, that which penetrated enough to the intracranial organ through the blood-brain barrier. In this study, we measured the concentration of cefotiam (CTM), cephalothin (CET), cephacetrile (CEC) and sulbenicillin (SBPC) into the cerebrospinal fluid in the non inflammatory cases with V-P shunt. 1. Antibiotic concentrations in CSF and CSF/serum ratio (%) were evaluated at 2 hours after an intravenous administration of antibiotics. CTM; 0.543 microgram/ml (3.66%), CET; 1.84 micrograms/ml (7.45%), CEC; 1.77 micrograms/ml (7.5%), SBPC, 6.15 micrograms/ml (5.58%). 2. The peak of antibiotic concentration in CSF appeared from 2 hours after administration and gradually decreased. In cellular tumor cases, the penetration of antibiotics into CSF showed similar levels as the cerebrovascular disease cases. 3. Concentration of CTM in CSF was higher than MIC of CTM to S. pyogenes and E. coli.

Adult↗