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Biomedical subjects

B Ishijima

Publications and source records attributed to B Ishijima.

At least 55 records · Page 3Linked to original sources
PubMed1986

[Myxopapillary ependymoma of the filum terminale with a holocord cyst: a case report].

This paper describes a case of myxopapillary ependymoma of the filum terminale with a holocord cyst. A fifteen-year-old boy was admitted because of dysarthria, dysphagia and tetraparesis. He also suffered from severe lumbago and ankle pain for three years. On admission his vital signs were stable and neurological examination revealed lower cranial nerve palsies (from 9th through 12th), tetraparesis, bilateral impairment of vibratory and position sense of the lower extremities and urinary incontinence. All deep tendon reflexes were hypoactive bilaterally. Babinski reflex and Lasègue sign were negative bilaterally. The spine roentgenograms revealed widening of the interpedicular distance from C 1 to L5 except L2, 3 vertebrae. Lumber puncture at the L 1-2 interspace revealed a cyst at the site and the protein content of the cyst fluid was 2400 mg/dl. MRI demonstrated a syrinx extending from the medulla to the entire cervical cord. From these results, it was concluded that the medulla and the entire spinal cord were occupied by the tumor and some parts of the lesion were cystic. First Operation: After a suboccipital craniectomy and a laminectomy from C 1 to Th 2, the medulla and the cervical cord were decompressed by evacuating the cyst at the 4th cervical segment. After the first operation, the C 1-2 myelography and MRI confirmed that the medulla and the spinal cord above the Th 11 vertebra were decompressed and the lower end of the cyst was extending to the Th 11 level. Second Operation: After a laminectomy from Th 12 to L4, a solid tumor arising from the filum terminale was completely removed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Diagnosis of temporal lobe epilepsy by positron emission tomography.

Temporal lobe epilepsy was studied by the 11C-glucose method of positron emission tomography. The temporal lobe at the level 25 mm above the orbitomeatal line showed the amygdala, hippocampus and hippocampal gyrus medially, and the T1, T2 and T3 neocortices laterally. The focus locations in these structures were divided into mesial, lateral and combined groups on the PECT images. This classification showed a close correlation between the clinical symptoms and the anatomical focus sites.

Adolescent↗
PubMed1985

Dynamic EEG topography and analysis of epileptic spikes and evoked potentials following thalamic stimulation.

Dynamic EEG topography is used to study evoked potentials following thalamic stimulation as well as epileptic spikes and spike-wave complexes during stereotactic operations. Dynamic EEG topography is an effective method for displaying the distribution pattern of evoked potentials following thalamic stimulation. This technique makes it possible to observe successive increases in augmenting responses and to define the localization of epileptic foci.

Brain Mapping↗
PubMed1985

Hemiparesis caused by vertebral artery compression of the medulla oblongata. Case report.

The case is reported of a patient with progressive left hemiparesis due to vascular compression of the medulla oblongata. Metrizamide computerized tomography cisternography revealed that the left vertebral artery was compressing and distorting the left lateral surface of the medulla. Compression was surgically relieved and symptoms improved postoperatively. Neurological and symptomatic considerations are discussed in relation to the topographical anatomy of the lateral corticospinal tract.

Brain Diseases↗
PubMed1985

[Diagnosis of temporal lobe epilepsy by positron emission tomography].

Positron emission tomography (PET) was performed in 18 temporal lobe epileptics. About 20 mCi of 11C-glucose was perorally administered to the patients and 30 minutes later scanning was started when the transport of 11C-glucose from blood to the brain tissue reached equilibrium. At the level of 25 mm above orbitomeatal line, the slice image of the temporal lobe shows a relatively high metabolic oval ring involving the amygdala, hippocapal formation and the hippocampal gyrus medially and the T1, T2 and T3 neocortices laterally in normal subjects. The epileptic focus, when detected on PET images, was observed as a defect in this oval ring. In 15(83.3%) out of 18 cases, the location of epileptic focus was confirmed as a low metabolic defect. This diagnosis rate was higher than that of other focal epilepsy by PET study. The locations of foci were divided into three types: mesial (5 cases), lateral (4 cases) and combined (6 cases). The seizure symptoms of the patients were analyzed in terms of the correspondence to the focus types. The results showed that automatism and pseudoabsence had a close relation to the mesial and combined types and psychical, vertiginous or visual seizures correlated to the combined and lateral types. Visceral or motor seizures were induced equally by any focus types. These facts suggested that automatism and pseudoabsence were correlated with the mesial organs such as the amygdala and hippocampus and psychical, vertiginous or visual seizures had origin in lateral neocortices. Visceral or motor seizures were supposed to be the results of the spread from the temporal focus to the adjacent structures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[A case of toxic leucoencephalopathy induced by 5FU derivatives].

A case of toxic leucoencephalopathy induced by 5 FU derivatives is reported. A 46-year-old woman was diagnosed as having breast cancer, and radical mastectomy was performed on May, 1982. After operation, she was given irradiation and 5FU derivative (tegafur or carmofur) 600 mg and Nolvadex 20 mg (tamoxifen citrate) were administered every day. After taking the medication for a month, she began to stagger and developed a tremor in both arms. She was admitted to our hospital on August 16, because she showed evidence of dysarthria and memory disturbance in addition to her initial complaints. Soon after admission, she developed akinetic mutism, and metastasis in the brain stem was suspected. In spite of her severe condition, she was given radiation over the posterior fossa and continued the medication. On September 22, CT disclosed low density area in the centrum semiovale bilaterally. She died of DIC on November 30. An autopsy was performed. The brain weight was 1110 g and the outer surface of the brain was normal. In frontal cut surfaces stained with K.B., bilateral degeneration of the centrum semiovale was apparent. Microscopically, the degree of myelin degeneration was stronger than that of axon, and numerous fatty granular cells were found in the degenerated area. There were no bizarre shaped astrocytes, inclusion body or cellular infiltration. Fibrillary gliosis was scanty. No metastasis was found in the central nervous system or other organs. Based on these pathological findings and clinical history, toxic leucoencephalopathy induced by 5 FU derivatives was suggested.

Antineoplastic Agents↗
PubMed1984

[Indication for, the method of, and result of the prophylactic use of barbiturate therapy (B-therapy) against cerebral infarct from cerebral arterial vasospasm due to ruptured aneurysm].

A review of 45 cerebral vasospasm cases for cerebral infarct under computer tomography (CT) scanner and based on activities of daily living (ADL) resulted in the finding that, of 19 cases with vasospasm of "diffuse, severe" grade, 14 cases were rated "poor (disabled)" to "dead": CT-diagnosed cerebral infarct was found in 4 out of 6 cases. From this, it was believed that indication for B-therapy was clinically significant vasospasm (diffuse, severe), which falls under the clinical grade of III or IV by Hunt and Kosnik without considering such incidental condition as severe vasospasm. After B-therapy, 45% showed ADL of at least "fair". CT-diagnosed cerebral infarct was found in 4 out of 10 cases. None died from complications as a result of B-therapy. The examination of ineffectual cases pointed to the importance of the first choice application of B-therapy, the continuation of the therapy as long as vasospasm continues, and the sustenance of cerebral perfusion pressure by the use of vasopressor (Dopamine) to offset the hypotensive effect of barbiturate. With these points of care exercised, the B-therapy is believed to achieve good results.

Adult↗
PubMed1984

[Origin of short latency somatosensory evoked potential following median nerve stimulation].

Short latency somatosensory evoked potentials (S-SEP) to median nerve stimulation recorded from scalp-shoulder derivation consisted of four positivities (P1, P2, P3 and P4) and one negativity (N). There is still, however, significant controversy regarding the generators of these peaks. The purpose of the present study is to attempt to solve some of the controversies by comparing the potentials recorded on surface montages with intrasurgical tracing obtained while monitering evoked potentials. This is complemented by analysis of S-SEP in patients with disorders of the cervical cord, brain stem or thalamus. Average latency of each component in normal subjects (N = 17) was as follows; P1: 7.6 +/- 0.6 ms P2: 9.6 +/- 0.7 ms, P3: 11.8 +/- 0.8 ms, P4: 12.9 +/- 0.5 ms, N: 17.7 +/- 0.8 ms. The peak latency of P1 was always shorter than that of negativity recorded over the Erb's point following the median nerve stimulation. The peak latency of P2 corresponded to that of the earliest negativity of spinal evoked potential, recorded from the epidural dorsal surface of the lower cervical cord during the operation, which was considered as the potential of afferent volley at the posterior root or spinal entry portion. In a case with severe spondylotic radiculopathy, P2 and following components were abolished. The peak latency of P3 corresponded to that of negative potential recorded over the high cervical dorsal column or cuneate nucleus.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Our experiences of PISCES (percutaneously inserted spinal cord electrical stimulation) in SMON and other neurologic disorders].

Percutaneously inserted spinal cord electrical stimulation (PISCES) was carried out in eleven intractable pain cases and in one spastic paraplegic case. The causes of intractable pain constitute subacute myelo-optic neuropathy (SMON) 6 cases, cerebrovascular disease 2 cases, multiple sclerosis (MS) 1 case, Charcot-Marie-Tooth (CMT) 1 case and transverse myelitis (TM) 1 case. The cause of spastic paraplegia was due to the ossification of posterior longitudinal ligament (OPLL). A trial stimulation was performed about two weeks before planning a permanent implantation of PISCES system. For the trial stimulation, epidural electrodes were percutaneously inserted with a guide of fluoroscopy in a X-ray room. The conditions of stimulation were adjusted to give an optimal electric dysesthesia. We employed pulse width 0.1-1.0 msec, pulse rate 1-120 Hz and pulse amplitude 0-10 Volt. If an excellent effect was obtained by trial study, we proceeded to the chronic implantation of PISCES system which were composed of epidural electrodes, a subcutaneous receiver and a surface antenna. The procedure of implantation was carried out in an operating room under local anesthesia. In our series, seven subjects (58%) experienced a rewarding effect by the trial stimulation and three underwent the permanent implantation of PISCES. We summarized the clinical courses of these three cases which were OPLL, CMT and SMON. Compared with the other methods for pain relief, PISCES is most characteristic in its safety and simplicity. To date, PISCES has been applied to various disorders; such as ataxia, spasticity, intractable pain, neurogenic bladder and peripheral vascular disease. But its efficacy has not been established in all these disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1980

Determination of dose-plasma concentration relationship of phenobarbital in epileptic patients by a new specific radioimmunoassay.

A new phenobarbital hapten, 1-(4-carboxybutyl)-phenobarbital (CBP) was synthesized. Antiserum obtained from a rabbit immunized with CBP-bovine serum albumin conjugates is specific for phenobarbital and does not substantially cross-react with a major metabolite, p-hydroxyphenobarbital. The antiserum was used to develop a sensitive radioimmunoassay which could determine as little as 100 pg of phenobarbital. The radioimmunoassay was applied to the determination of plasma phenobarbital concentrations in epileptic patients and the results were compared with those obtained by a spectrophotometric technique (r = 0.950, P < 0.01). A significant dose-plasma concentration relationship for phenobarbital was observed in epileptic patients treated with phenobarbital for more than a month.

Animals↗