Biomedical subjects
Publications and source records attributed to I Kitano.
We report an infant girl with congenital alveolar adhesions and a cleft palate. The mucosal bands were resected the day after birth. Stretching exercises of the mandible improved the range of movement at the temporomandibular joint. Two weeks of therapy were required before full mouth opening was possible. Previously reported patients and theories of embryogenesis are reviewed.
A 54-year-old woman with cerebellar metastasis from ovarian adenocarcinoma was reported. Two years before admission, she underwent 7 courses of CAP therapy (cisplatin, adriamycin, cyclophosphamide) for ovarian cancer. On admission, no extracranial tumor was noticed. After the removal of a cerebellar tumor, she was treated by combination chemotherapy with cisplatin and etoposide. Her serum level of CA-125, which was still high after surgery, decreased to the normal level following chemotherapy. Chemotherapy was repeated six times, and no recurrence was noticed 1 year after surgery. Combination chemotherapy with cisplatin and etoposide was considered effective in the treatment of intracranial metastasis from ovarian cancer.
Patients with the Beckwith-Wiedemann syndrome have numerous anomalies, varying somewhat from case to case. The most common presentation is exomphalos, macroglossia, and somatic gigantism. Although cleft palate in association with this syndrome has been rarely reported, we have observed 6 patients with cleft palate in 10 patients who were diagnosed with the Beckwith-Wiedemann syndrome. The literature is reviewed and discussed.
The authors report a newborn girl with a large meningoencephalocele, 18.5 cm in diameter, at the anterior fontanel. She had several accompanying anomalies, including microcephalus, cleft palate, and a uvula bifida. A plain skull x-ray revealed craniolacunia and a computed tomography (CT) scan showed maldevelopment of the cerebrum. The mass was resected, after which the fontanel was noted to bulge. CT demonstrated dilated lateral ventricles. A successful shunting procedure permitted the infant to leave the hospital in good general condition.
A 58-year-old male presented with painful right ophthalmoplegia and was diagnosed as having Tolosa-Hunt syndrome. High-dose oral administration of a corticosteroid provided significant pain relief, but total ophthalmoplegia persisted. Computed tomography (CT) showed a tumor-like mass in the bilateral cavernous sinus. Angiography revealed occlusion of the right internal carotid artery. According to the literature, about 70% of cases of Tolosa-Hunt syndrome are caused by parasellar neoplasms. A transcranial biopsy of the patient's lesion revealed a nonspecific granulomatous process in the wall of the right cavernous sinus. He was again placed on high-dose corticosteroid therapy and within 1 week the right visual acuity improved slightly. The corticosteroid dose was gradually tapered over 3 months. After 2 months of therapy, the external ocular movement had almost fully recovered, although the light reflex was absent and the CT findings did not change.
Patients with the Beckwith-Wiedemann syndrome have numerous anomalies, varying somewhat from case to case. A 2-year-old boy with the Beckwith-Wiedemann syndrome who had a branchial cyst is reported. The literature is reviewed and discussed.
Two cases of arachnoid cysts in the quadrigeminal cistern are presented, and one occurred in an adult. Signs and symptoms of increased intracranial pressure were noted, and obstructive hydrocephalus was shown by computed tomography scans in both cases. Arachnoid cysts in the quadrigeminal cistern have rarely been reported, especially in adults. The definition, classification, and etiology of arachnoid cyst are still confused in the literature, and various terms have also been used to indicate this particular location of cyst. In this study, these confusing problems are reviewed, and the usefulness of metrizamide computed tomographic cisternography is emphasized as a noninvasive method of diagnosis.
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The patient is a 30-year-old man who has suffered from recurrent attacks of tonsilitis, oral aphthae and scrotal ulcerations, erythema nodosum and thrombophlebitis. In April, 1980, he gradually developed headache and visual disturbance. On April 14, 1980, he was pointed out remarked bilateral choked disc by an ophthalmologist and then admitted to the Miyazaki Medical College Hospital. On admission to our service, he showed atypical symptoms of Behçet's disease, namely, oral aphthae and scrotal ulcerations, erythema nodosum and bilateral choked disc. Laboratory data demonstrated hyperimmunoglobulinemia, increased clotting factors and decreased fibrinolytic activity. Immunogenetically, HLA BW51 type was demonstrated. The angiograms showed complete obstructions of the superior sagittal sinus and the common trunk of the femoral artery. Histological examination of the skin lesion demonstrated atypical chronic inflammation and thrombophlebitis. A diagnosis of atypical Vasculo-Behçet's disease was made. The response to the steroid therapy was dramatic, though the fibrinolytic drugs, anticoagulants and vasodilators were not effective. Thrombophlebitis is a well recognized complication of Behçet's disease occurring in major vessels, however thrombosis of the dural sinus has rarely reported. This case may be the first one which had superior sagittal sinus thrombosis with Vasculo-Behçet's disease in literature. We discussed the mechanism of the thrombogenesis, the relationship to HLA, the coexistence of Neuro-Behçet's disease and the therapy of Vasculo-Behçet's disease.
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The findings on computed tomography (CT) of a huge cystic craniopharyngioma in a 3-year-old girl are described. The cyst occupied both anterior cranial fossae and a part of it extended to the region of the third ventricle which was displaced posteriorly. The tumor showed no contrast enhancement after the intravenous administration of contrast medium.
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