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Biomedical subjects

E Takara

Publications and source records attributed to E Takara.

At least 19 recordsLinked to original sources

[Crossed cerebellar diaschisis in putaminal hemorrhage--evaluation by the Xe-133 clearance method].

Metabolic depression in the contralateral cerebellar hemisphere caused by a supratentorial lesion is called crossed cerebellar diaschisis (CCD). In order to investigate diaschisis based on the location and extension of lesions, time course and prognosis, 31 patients with putaminal hemorrhage were examined by the Xe-133 clearance method (67 studies in all). They consisted of 20 males and 11 females, from 40 to 77 years old (mean: 57.1 +/- 8.9). Small hematomas (mean volume: 16.1 +/- 8.4 ml) in 18 patients were treated nonsurgically, whereas medium and large hematomas (mean volume: 57.5 +/- 29.9 ml) in 13 patients were treated by craniotomy for evacuation. rCBF was measured using a BI 1400 rCBF Analyzer (Valmet, Denmark), and CCD was considered positive when the percentage difference in cerebellar blood flow was 10.1% (mean + 2SD) greater than obtained in 21 normal controls. CCD was observed in 10 patients (55.6%) in the non-surgical group and in 9 patients (69.2%) in the surgical group. In the non-surgical group, CCD was positive in 5 of the 7 cases (71.4%) involving the posterior limb of the internal capsule and in 7 of the 11 cases (63.6%) involving the corona radiata. The surgical group was divided into three types based on the time course of CCD after surgery, i.e., type A: persistent CCD found two months later, type B: postoperative CCD had resolved two months later, and type C: no CCD observed after surgery. Mean hematoma volume was significantly greater in type A (79.0 +/- 19.8 ml) than in type B (44.6 +/- 8.5 ml) or type C (30.7 +/- 3.7 ml) (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Lymphocytic adenohypophysitis with sudden onset of diabetes insipidus in menopausal female--case report.

A rare case of a postmenopausal (60-year-old) female with lymphocytic adenohypophysitis manifesting as a sudden onset of diabetes insipidus is reported. Magnetic resonance imaging with gadolinium-diethylene-triaminepentaacetic acid enhancement showed a spherical lesion, approximately 1 cm in diameter, in the sella turcica and a thickened, deviated pituitary stalk. The abnormal tissue was totally removed. Histological examination showed marked infiltration of lymphocytes and plasma cells. Postoperatively, the pituitary stalk became normal. Preoperative differentiation of lymphocytic adenohypophysitis from pituitary adenoma is extremely difficult, and biopsy is essential.

Adenoma↗

Tolerance of the cerebral venous system to retrograde perfusion pressure in focal cerebral ischemia in rats.

Using quantitative double-tracer autoradiography, we examined the tolerance of the rat cerebral venous system in focal cerebral ischemia to retrograde perfusion pressure into the inferior cerebral vein. At perfusion pressures of less than 150 mm Hg, there was no significant change in local cerebral blood flow (LCBF) and blood-brain barrier (BBB) permeability. At pressures of greater than 170 mm Hg, significant changes occurred in BBB permeability in the superficial cortical layers and there was a mild reduction of LCBF. In the group of rats subjected to 200 mm Hg perfusion pressure, the change in BBB permeability extended to the entire cortical zone and significant reduction of LCBF occurred. Our results indicate for the first time that during conditions of focal cerebral ischemia, the rat cerebral venous system can tolerate up to 150 mm Hg of retrograde perfusion pressure into the cerebral venous system without any change in BBB permeability or in LCBF. However, progressive change in BBB permeability and reduction in LCBF occur once the perfusion pressure exceeds 170 mm Hg. This finding may permit more efficient delivery of cytoprotective agents into ischemic tissue.

Animals↗

[Chronic subdural hematoma following advanced cancer: report of three cases].

Three cases of chronic subdural hematoma (CSH) following advanced cancer are reported. Case 1. A 54-year-old male patient was referred to our clinic in a semicomatose state. Bilateral CSH was evacuated through a pair of burr holes, and consciousness was recovered. However, subependymal hemorrhage occurred at the third ventricle 6 days after the operation. Hematological examination revealed thrombocytopenia. He died 12 days after operation because of hemorrhage in the lung. Postmortem examination disclosed metastatic adenocarcinoma of unknown origin to the dura mater, lymph nodes, lung and bone marrow. Case 2. A 50-year-old male patient who was diagnosed as having gastric cancer was referred to our clinic in a state of deep coma. CT scan revealed CSH and putaminal hemorrhage at the left side. Hematological examination revealed disseminated intravascular coagulation (DIC). After the subdural hematoma was evacuated, the putaminal hematoma enlarged and hemorrhagic infarction at the left temporo-occipital lobes occurred. He died 2 days after operation. Autopsy was not carried out, but histological examination revealed poorly differentiated malignant cells in the outer membrane of the subdural hematoma. Case 3. A 53-year-old female patient who had a history of gastric cancer operated on 4 years ago was admitted to our clinic complaining of headache and vomiting. CT scan revealed bilateral subdural hematoma. Following a pair of burr-holes and irrigation of the hematoma, hemorrhage recurred alternatively at the left side on the 6th and at the right side on the 27th day after the operation. Hematological examination revealed DIC, and bone marrow puncture disclosed metastasis of the adenocarcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

Triple-tracer autoradiography demonstrates effects of hyperglycemia on cerebral blood flow, pH, and glucose utilization in cerebral ischemia of rats.

Triple-tracer autoradiography was used to measure topographic changes in local cerebral blood flow, cerebral tissue pH, and local cerebral glucose utilization in hyperglycemic and normoglycemic rats, all of which had undergone occlusion of the middle cerebral artery. More severe and extensive reduction of all three variables was observed in the hyperglycemic than in the normoglycemic rats. In seven normoglycemic rats, significant reduction in local cerebral blood flow (p less than 0.025) was observed in the ischemic but not in the contralateral nonischemic side at the lateral portion of the caudate nucleus and the neocortex. Tissue pH was significantly lower (p less than 0.025) only at the lateral portion of the caudate nucleus in the ischemic side. No significant differences in local cerebral glucose utilization were observed when the two hemispheres were compared. In the ischemic hemisphere of five hyperglycemic rats, the caudate nucleus and the neocortex exhibited significant reduction (p less than 0.025) in local cerebral blood flow, tissue pH, and local cerebral glucose utilization. Even in the nonischemic hemisphere of the hyperglycemic rats, local cerebral blood flow in the caudate nucleus and the neocortex was significantly reduced (p less than 0.025) compared with the normoglycemic rats. No significant change in tissue pH or local cerebral glucose utilization was observed throughout the nonischemic hemisphere of the hyperglycemic compared with the normoglycemic rats. Tissue pH was systematically lower in the hyperglycemic than in the normoglycemic rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Moyamoya disease associated with persistent primitive trigeminal artery--a case report and review of literature].

A case of moyamoya disease associated with the persistent primitive trigeminal artery (PTA) is reported. 5 such cases reported in literature are reviewed. A 16-year-old female patient was admitted to our clinic, having complained of right hemiparesis for 8 years. CT scan revealed multiple low density areas in the left frontal, temporal and parietal lobes. In left carotid angiogram, the internal carotid artery was occluded at the C3 portion and basal moyamoya (stage IV) was found. In right carotid angiogram, the internal carotid artery was occluded at the C3 portion and basal moyamoya (stage V) was found. Furthermore the persistent primitive trigeminal artery was seen with marked moyamoya vessels from the posterior cerebral artery. In vertebral angiogram, the posterior cerebral artery was seen bilaterally with moyamoya vessels. In 133Xe-rCBF study, compared with the mean flow in each hemisphere, the flow decreased at the temporal lobe, but, in contrast, increased at the parieto-occipital lobes. Reviewing the literature, the following conclusions are suggested. 1. Persistent primitive trigeminal artery will promote the stage of moyamoya disease. 2. It will protect the brain from hemorrhage and/or ischemia in moyamoya disease.

Adolescent↗

[A case of calcified intracranial tuberculoma presenting unique MRI findings].

A 41-year-old male patient was admitted in our Ryukyu University Hospital complaining of parosmia. He had a history of miliary tuberculosis 21 years ago. Neurologically he showed left anosmia and hyperreflexia of the right upper extremity. Plain skull X-P and CT scan revealed a calcified mass, 25mm in diameter, at the left frontal base. In MRI, the mass showed isointensity using the T1 weighted inversion recovery sequence and heterogenously low intensity using the T2 weighted spin echo sequence. Surgery was performed by bifrontal craniotomy. Then the tumor was removed totally including two coexisting small tumors. Histologically, they consisted of calcified caseous tissue and thick collagen capsule, suggesting old calcified tuberculomas. Postoperative course was uneventful and did not result in meningitis. Antituberculous therapy of streptomycin, isoniazid and rifampin was given for 2 weeks, started on the operative day. MRI findings were presented in detail and the guideline of antituberculous therapy to the tuberculoma was discussed.

Adult↗

Time-dependent changes of lumped and rate constants in the deoxyglucose method in experimental cerebral ischemia.

Time-dependent changes in the lumped and rate constants in a bilateral middle cerebral artery (MCA) occlusion in cats were evaluated. These variables were measured in 11 cats after a sham operation, in five after a 1-h occlusion, in two after a 2-h occlusion, in five after a 4-h occlusion, and in four after a 16-h occlusion. The time course of the cerebral tissue radioactivity [Ci* (t)] was monitored by external coincidence counting during a programmed infusion of [18F]2-fluorodeoxyglucose (FDG). Arterial plasma concentration [Cp* (t)] of tracer was kept constant during the first 45 min. Comparison of k2* and k3* in the sham-operated group, estimated by external coincidence counting, and by the ratio of extraction fractions of glucose and [18F]2-FDG, demonstrated no significant difference between these rate constants in these two groups of animals. The rate and lumped constants were also estimated from Ci* (t) and Cp* (t), as well as from the ratio of extraction fractions of glucose and [18F]2-FDG, respectively, in the MCA occlusion group. Significant decrease in k3* was observed after 1 h of occlusion (20% lower than in the sham operation, p less than 0.05); in k1* decrease occurred within 4 h of occlusion (21% lower than in the sham operation, p less than 0.05). However, decrease in k2* was observed only after 16 h of occlusion (26% lower than in the sham operation, p less than 0.05). Namely, decrease of rate constants occurred first in k3* then in k1* and k2*.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Case of intracranial and spinal dissemination of primary spinal glioma].

A case of glioblastoma multiforme of spinal cord followed by intracranial dissemination was reported. A 20-year-old man was admitted on Sep. 22, 1981, with motor disturbance of both legs and loss of urinary control. Neurological examination showed spastic paraplegia with bilateral Babinski signs. Abdominal and cremaster reflexes were absent. There was no abnormalities in cranial nerves and upper limbs. Cerebral CT was normal at that time. Myelography showed complete block at the level of 8th thoracic vertebra. Spinal angiography revealed abnormal vascularity at the level of Th7 fed via anterior spinal artery. Intramedullary tumor was partially removed through 5th-8th thoracic laminectomy. Total 5600 rads of irradiation was administered after the operation. The postoperative course was deteriorating. Two months after the operation paresis of both upper extremities had been developed. State of consciousness had been disturbed due to increased intracranial pressure which was subsided for a time while by ventriculoperitoneal shunt. Repeated CT showed high density spots scattered in basal cisterns spreading to all ventricular systems. He expired Feb. 21, 1982. Autopsy revealed that the whole spinal cord was covered by tumor tissue. Basal cisterns were filled with tumor tissue. The tumor was infiltrated subependymally into ventricular systems with intramedullary invasions in some places. Histological diagnosis was glioblastoma multiforme.

Adult↗

[Rathke's cleft cyst. Report of two cases].

Two cases of Rathke's cleft cysts were reported. Case 1. A 57-year-old man was admitted to our hospital on Sep. 29th. 1982, complaining of visual field defect. Visual acuity was 0.7 in the left eye and 0.1 in the right eye. Visual field examination revealed upper temporal quadrantanopsia on the left side and incomplete temporal hemianopia on the right side. He was neurologically free otherwise. Endocrinological study disclosed general hypopituitarism except for elevated serum prolactin level. CT scan showed a high density mass in the enlarged sellar cavity extending to suprasellar area. Right frontal craniotomy was performed on Oct. 26th, 1982, and about 3 ml of reddish-brown colloid substance was aspirated and the capsule of the cyst was excised. Postoperative course was uneventful. The visual acuity and field defects were improved. Microscopic section of the cyst demonstrated a loose fibrous wall, lined by single layer of ciliated columnar epithelial cells containing secreting vesicles. Histological diagnosis was Rathke's cleft cyst. Case 2. A 43-year-old female was attacked by subarachnoid hemorrhage on Jan. 1st, 1983. Angiography revealed an anterior communicating aneurysm. Operation was performed on Jan. 18th, 1983 and the aneurysm was successfully clipped. During surgery a suprasellar cystic mass was incidentally discovered and the cyst wall was resected. Microscopic section of the cyst demonstrated one layer of cuboidal cells supported by thick connective tissue. Precise check of her early history disclosed that her menstruation had been delayed and visual acuity had been impaired. CT scan was negative as far as the suprasellar region was concerned.

Adult↗

[Trochlear neurinoma: case report].

A case of solitary neurinoma of the trochlear nerve was reported. The patient was a 37-year-old female, who had a sudden attack of right-sided temporal headache with nausea and vomiting on August 1, 1982. Headache was subsided in a few days but she had complained of diplopia since the episode. Ophthalmological examination revealed right superior oblique muscle palsy. She was neurologically free otherwise. CT scan, taken about three weeks after the onset, showed a solitary enhancing mass in the region of tentorial incisura on the right side. She was admitted to our clinic on August 24, 1982. Extensive work-up including polytomography, cerebral angiography, lumbar puncture, and so forth, revealed no abnormality. There were no cutaneous manifestations of von Recklinghausen's disease. Craniotomy was performed on October 28, 1982 and the tumor was totally removed by way of right subtemporal-transtentorial route. The tumor, size of which was 1.0 X 0.9 X 0.7 cm, was located just underneath the tentorial edge, and was adherent to it. The trochlear nerve was found incorporated in the tumor. Histological diagnosis was neurinoma of Antoni A type. Postoperatively, she was well and fully active, except for diplopia due to the sacrificed trochlear nerve.

Adult↗

[A case of arachnoid cyst associated with chronic subdural hematoma].

An 11-year-old boy was admitted to our clinic with complaint of headache. On admission he was in drowsy state and neurological examination revealed minimal motor weakness of the right hand. Plain skull roentgenogram demonstrated a thinning of the left temporal bone and elevation of the left sphenoidal wing. CT showed marked displacement of the midline structures from left to right. The left lateral ventricle was collapsed. A well circumscribed, homogenous, high density area was delineated in the left middle fossa. Contrast enhancement was negative. A-P view of left CAG showed a crescent shaped subdural avascular area in the parietal region. The anterior cerebral artery was roundly shifted from left to right. Chronic subdural hematoma due to bleeding of arachnoid cyst was most likely. Subdural collection was evacuated by trephination. The postoperative course was uneventful. Postoperative CT 3 week after operation delineated the arachnoid cyst more clearly as round low density area. Follow-up CT 6 months later showed the arachnoid cyst markedly reduced in size.

Arachnoid↗

[A case of intracranial tuberculoma].

The patient was a 20-year-old male who was admitted with epileptic seizure in March 5, 1981. For 3 months prior to admission, he had been affected by 3 seizure attacks. At admission, he was completely free neurologically. Laboratory examination showed no abnormality except for markedly positive result of tuberculin reaction test. Chest X-P was normal. Episode of pulmonary tuberculosis was denied. CT revealed irregular shaped low density area in the left postero-parietal region, in which two small high density spots were visualized by contrast enhancement. Craniotomy was made over the left postero-parietal region. The surface of the parietal lobe was slightly hyperemic and edematous. In some parts, the arachnoid membrane was thickened and turbid and cortical vessels involved in it were occluded. Subcortical tissue was softened and appeared necrotic. Two finger's tip sized nodules were touched in it and removed. Histology verified tuberculoma. Post-operative course was uneventful. The anti-tuberculous therapy was started immediately after the operation. CT, 2 months later, showed the low density area reduced markedly in size.

Adult↗

[Disappearance of the co-existing aneurysm and arteriovenous malformation after wrapping of aneurysm (author's transl)].

The authors reported a case of an arteriovenous malformation associated with an aneurysm on its feeding vessel that is the left anterior inferior cerebellar artery. A housewife, aged 56-years, was admitted to our hospital with severe headache, nausea and vomiting. On admission, lumbar puncture revealed grossly bloody CSF. Neurological examination revealed meningeal irritation sign, horizontal nystgmus and disturbance of left auditory acuity. Bilateral carotid and retrograde brachial arteryography revealed an AVM near the left cerebellopontine angle and a small aneurysm of the left anterior inferior cerebellar artery at the left internal auditory meatus. At operation, the aneurysm was wrapped with a muscle piece and no surgical intervention for AVM. Post-operative course was uneventful except for disterbance of the left auditory acuity. Follow-up angiographies revealed a change of size the aneurysm and AVM and finaly failed to demonstrate the aneurysm and AVM demonstrated preoperatively. The spontaneous regression of the AVM might be due to the post-operative brain swelling and adhesion. We also speculated that the spontaneous disappearance of the aneurysm might be due to the decreased blood flow of parent artery by the spontaneous regression of the AVM. It is very rare that an aneurysm of anterior inferior cerebellar artery co-existed with AVM, and resulted in thrombosis of the aneurysm and regression of the AVM after wrapping alone.

Arteries↗