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Biomedical subjects

J Mukawa

Publications and source records attributed to J Mukawa.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Sequential change of cerebral angiography in a case of cerebral angiitis following herpes zoster ophthalmicus].

Delayed neurological symptoms and signs following herpes zoster ophthalmicus (HZO) such as "Delayed contralateral hemiplegia with HZO" are supposed to be due to ipsilateral intracranial angiitis and ischemic disorder. We experienced a rare case with ipsilateral cerebral hemorrhage following HZO. Under the diagnosis of cerebral angiitis associated with HZO, we treated her conservatively and observed sequential change of angiography for four months. A 54-year-old female, who had been treated for systemic lupus erythematosus (SLE), developed HZO on left ophthalmic nerve area. Seven weeks after the onset of HZO, she complained of headache, mild right hemiparesis, and disturbance of consciousness. Computed tomography revealed subcortical hemorrhage at the left temporo-occipital lobe. Cerebral angiography showed vascular irregularities such as segmental narrowing and sausage-like dilation on proximal portion of the ipsilateral anterior, middle and posterior cerebral arteries. Same findings were seen on peripheral portions of the posterior cerebral artery on the same side. Moreover sequential angiograms showed appearance of an aneurysm in the left middle cerebral artery (M2 potion). Under the diagnosis of cerebral angiitis associated with HZO, she was treated with antiviral agents, antiplatelet drugs, steroid and stellate ganglion block. Those irregularities were found to diminish on the sequential angiograms, and the aneurysm disappeared four month later.

Cerebral Angiography↗
PubMed1994

[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↗
PubMed1993

Human recombinant interleukin-1 beta-mediated growth inhibition of cultured malignant glioma cells.

The effect of human recombinant interleukin-1 beta (hrIL-1 beta) on tumor growth was studied in eight glioma cell lines. hrIL-1 beta inhibited growth in all cell lines, but to varying extents. Two cell lines were suppressed by 0.5 ng/ml hrIL-1 beta, and three cell lines required 20 ng/ml. hrIL-1 beta also induced morphological changes and increased F-actin contents. hrIL-1 beta-treated cells demonstrated multipolar shapes and numerous processes with a greater number of cell-cell contacts 24 hours after treatment. Fluorescence microscopy revealed that these processes contained a large amount of polymerized F-actin. These results suggest that hrIL-1 beta-mediated growth inhibition may be related to the differentiation of glioma cells.

Brain Neoplasms↗
PubMed1993

[Intraosseous meningioma associated with lung cancer: a case of multiple neoplasms].

Intraosseous tumor was found in a 63 year old male patient with lung cancer during metastatic work-up study. Plain skull X-ray film showed a large osteolytic lesion in the left temporo-parietal bone. Bone and Ga scintigrams revealed an increased activity in this lesion. CT scan demonstrated an isodense lentiform configuration, which was homogeneously enhanced with contrast medium. It was iso-intense in T1, and high-intense in T2 and proton weighted MR images. The tumor was removed en bloc with surrounding normal bone. The attached dura was markedly thickened, but there was no tumor infiltration. Histological diagnosis was transitional meningioma with psammoma body. Postoperatively he was transferred back to Okinawa Hospital and right lower lobectomy was performed for the lung tumor. Histological diagnosis was well-differentiated adenocarcinoma. We examined immunohistochemically p53 protein expression, but p53 immunoactivity was observed in neither tumor. Multiple neoplasms associated with brain tumor are relatively rare, but the incidence will increase in the future as the diagnostic work-up develops. Pathological diagnosis will give us the decisive opportunity for proper treatment. It is to be stressed that, in multiple neoplasms, care should be taken to avoid misdiagnosis of metastasis.

Adenocarcinoma↗
PubMed1992

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↗
PubMed1992

Analysis of retained ventricular shunt catheters.

To identify the causes of ventricular shunt catheter retention, 42 shunt removals in 28 patients in our neurosurgical clinic from 1982 to 1991 were analyzed. The mean patient age was 13.8 years (2 mos-78 yrs), and mean shunt duration was 20.1 months (0.5-94 mos). There were nine retained ventricular catheters, including five with obstruction of the ventricular catheter. Shunt duration was significantly longer compared with the unretained group. Three retained ventricular catheters were stained by HE for histological examination. Light microscopy showed the inner lumen of catheters filled with granulomatous connective tissue and reactive glial tissue, and giant cell reaction to silicone material. Scanning electron microscopy of two catheters found peeling on the inner surface of the catheter, evidence of aging of the material. Granulomatous connective tissue and glial tissue reaction to aged silicone are suggested as the cause of catheter retention.

Adolescent↗
PubMed1992

[Electrophysiological evaluation of human consciousness level by "Automated Fluctuation Analysis" of human high frequency EEG].

This study is done to clarify the clinical meaning of "Automated Fluctuation Analysis" of high frequency EEG in man especially focused on the fine alteration of consciousness level of the subjects. Twenty normal volunteers were utilized for this study. They were divided into two groups, the subjects who felt sleepiness (Group S; N = 8) and the subjects who denied it (Group W; N = 12), during the EEG recording. "Automated Fluctuation Analysis" of high frequency EEG had been presented in our previous paper. In short, it is made of three steps, amplification of EEG signal, A/D conversion and Fast Fourier Transform by signal processor and extraction of Lorentzian parameters. Power spectral density (PSD) was displayed on log-log graph. Then the third step is performed by the best curve fitting program to the following equation, S (f) = S1/[1 + (f/fc1)2] + S2/ [1 + (f/fc2)2], where S(f) is power spectral density at any frequency f, S1 and S2 are plateau level of initial and second Lorentz, respectively and fc1 and fc2 are the corner or half power frequency of initial and second Lorentz, respectively. The algorithm of this program to extract these parameters were mathematically based on Brown & Dennis. As results, 1. PSD of human high frequency EEG was composed of double Lorentzians and vanished into white level within 1kHz. 2. A topographical display of S1 value revealed hyperfrontal in group W, which is in accordance with the cerebral blood flow study by Ingvar.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[The motility of IL-2 activated lymphocytes into malignant glioma].

The effects of glioma culture supernatant (GCS) and interleukin-2(IL-2) on the motility of autologous stimulated lymphocytes (ASL) were studied by using collagen gel system, chemotaxic chamber system and flow cytometric analysis. GCS inhibited the migration of ASL into collagen gel. It enhanced the ASL motility and the expression of CD 26 antigen on the cell surface. IL-2 inhibited the migration of ASL into collagen gel and had no influence on the motility of ASL, but enhanced the expression of CD 26 antigen. On the other hand, a clinical glioma specimen showed limited depth of ASL migration when injected into the tumor cavity in addition to the formation of fibrin like membrane on its surface and a layer of degenerated ASL under it. To make ASL therapy more effective to malignant glioma, the following measures should be recommended; 1) inject adequate volume of IL-2 into tumor cavity, 2) reduce the frequency of ASL administration, 3) wash out of glioma secreting factors, degenerated ASL and glioma cells in addition to reduce the volume of tumor tissue.

Cell Movement↗
PubMed1992

[Electrophysiological evaluation of diazepam anesthetic effect by "automated fluctuation analysis" of high frequency EEG in human].

"Automated fluctuation analysis" of human scalp EEG was made in order to evaluate anaesthetic effect of intravenous diazepam injection. Seven patients without disturbed consciousness were utilized for this study. Analytical system is composed of high fidelity pre-amplifier and signal processor. After 10,000 amplification of the signal, A/D conversion and Fast Fourier Transform were programmed with following parameters, sweep time; 12 sec., frequency resolvability; 1.2 Hz, frequency limit; 1 kHz, Fourier points; 2048 and Fourier time; 15. Power spectral density (PSD) was displayed on log-log graph. The best curve fitting program was next applied to the following equation, S(f) = S1/[1 + (f/fcl)2]+S2/[1 + (f/fc2)2] S(f): power spectral density, S1,S2: plateau levels of the initial and the second Lorentz, fcl, fc2: the corner or half power frequencies of the initial and the second Lorentz). As results, 1) PSDs of high frequency EEG up to 1 kHz were composed of double Lorentzian fluctuations. 2) From our previous animal study, it is suggested that the initial and the second Lorentz reflect the cortical and subcortical functions, respectively. 3) After diazepam injection, the second Lorentz was suppressed according to the time and dose and disappeared when the subjects fell asleep, and reappeared when waked up. There was excellent correlation between the consciousness level and the second Lorentz. 4) The initial Lorentz reflected higher cortical function; the ability of calculation or language were reduced after diazepam injection, and the hyperfrontal activity of the initial Lorentz disappeared. These results may suggest that "Automated Fluctuation Analysis" of high frequency EEG may have a potential to develop a new field in clinical neuroelectrophysiology.

Adult↗
PubMed1991

Why are most GABA agonists not effective antiepileptic drugs?

The role of the GABAergic system in the induction and control of seizures remains elusive despite considerable research. In this report, the action of GABA agonists and antagonists is investigated both iontophoretically and intravenously on the trigeminal nucleus model. This technique permitted us to differentiate the direct effect of these drugs on the trigeminal neurons from the action on neurons elsewhere in the central nervous system which impinge on the trigeminal neurons.

Animals↗
PubMed1991

Afferent connections of the neurons in the Forel's field of H in cat.

An anatomico-physiological analysis was made to elucidate afferent connections of the neurons in the Forel's field of H (FFH) by horseradish peroxidase retrograde tracing technique and by evoked potential technique. 1) The FFH neurons receive fibers from the neocortex (layer V) and brainstem reticular formations. 2) Physiological projections from the mesencephalic reticular formation to the FFH as well as to the motor cortex were ipsilateral, but those from the pons and medulla oblongata were bilateral. 3) These data will suggest that the FFH neurons are in junction of the cortico-reticular connections and play an important role in the maintenance of an epileptic excitability of the neocortical system as suggested by Jinnai and Mukawa.

Afferent Pathways↗
PubMed1991

Treatment of metastatic brain tumor from esophageal carcinoma--report of four cases.

Metastasis to the brain from esophageal carcinoma is rare. Recently we had four cases, all treated by tumor removal. Three received postoperative whole or local brain irradiation. Anticancer pellets were implanted in two. The postoperative 1-year survival rate was 37.5%, which suggests the prognosis is not worse than for other metastatic brain tumors.

Aged↗
PubMed1991

[Total removal of hypothalamic glioma 15 years after irradiation of right optic glioma].

Hypothalamic glioma was found in a 17 year old male patient 15 years after irradiation of right optic glioma. It was totally removed by surgery. He was first admitted to Ryukyu University Hospital at the age of 1 year and 11 months, with right exophthalmos and visual disturbance. Diagnosis was anterior type of right optic glioma. This was treated by irradiation (47 Gy). Follow-up CT scans revealed no regrowth in intraorbital and intracranial regions. At the age of 17 years, CT scan and MRI showed an enhanced mass in the hypothalamus above the suprasellar cistern. Total removal was performed by bifrontal interhemispheric trans-lamina terminalis approach. Histological diagnosis was pilocytic astrocytoma. Postoperatively, consciousness remained disturbed for 3 weeks because of infarction in the bilateral medial nucleus of the thalamus. Radical excision of hypothalamic glioma was reviewed in the literature. We concluded that such excision has a potentially good outcome, and should be attempted when circumstances indicate its feasibility.

Adolescent↗
PubMed1991

[A case of chondrosarcoma in the cavernous sinus].

A 24-year-old female patient complained of headache and right abducens nerve paralysis. No abnormality was found in plain CT scan, but a ring-like enhanced mass was disclosed behind the right posterior clinoid process in enhanced CT scan. MRI revealed a low intensity mass in T1-weighted image and a ring-like enhanced mass in gadolinium-DTPA enhanced image. It was a circumferential high intensity mass in T2-weighted image and an isointensity mass in proton image. Cerebral angiography indicated that it was avascular. Preoperative diagnosis was trigeminal neurinoma or petroclival meningioma. The tumor was removed almost completely by orbitozygomatic infratemporal approach. Histologically, it was low grade chondrosarcoma. Postoperatively, neither radiation therapy nor chemotherapy was added. Differential diagnosis and treatment was discussed. It was suggested that MRI was the most useful diagnostic tool to distinguish chondrosarcoma from other skull base tumors.

Adult↗
PubMed1991

[A case of successfully removed posttraumatic high flow dural arteriovenous fistula in the posterior fossa].

A 49-year-old male patient was admitted to Ryukyu University Hospital complaining chiefly of progressive loss of mental activity for one year. He had a history of head trauma at the right retromastoid region when he was 24. Generalized convulsions developed three years later, and left exophthalmos, facial varix and impairment of visual acuity developed seven years later. Dural arteriovenous fistula of the posterior fossa was diagnosed at the age of 32, and feeding EC and tentorial arteries were successively ligated on the right several times without any effect. Angiography during this admission revealed tremendous collateral flows; a marked dilated tortuous occipital artery fed from the right vertebral artery, meningeal branches of VA and PICA, the marginal tentorial artery, and the posterior temporal artery from MCA, PCA were drained into the right transverse sinus. But transverse sinuses were occluded bilaterally, and venous outflows were directed to the superior sagittal sinus retrograde via the ascending cortical vein, Trolard veins, and sphenoparietal and cavernous sinuses. The final drainer was the superior ophthalmic vein on the left. Normal deep veins were not visible. In park bench position, the nidus was totally resected with a part of the transverse and thrombosed sigmoid sinus. Postoperative course was uneventful, and an angiogram showed complete disappearance of the AVF. Dural AVG in the posterior fossa with characteristics such as high flow, and which is rich in collaterals following palliative treatment indicates that total surgical resection should be undertaken.

Arteriovenous Fistula↗
PubMed1991

[Experimental study on brain damage by extracerebral compression; alteration of cerebral circulation and microvascular architectures].

Effects of extracerebral compression on cerebral circulation and microvascular architectures were investigated in 23 adult cats. Brain compression was produced by inserting 12 steel balls (5 mm in diameter) into the extradural space through a burr hole at the left temporal bone. One ball was inserted every 10 minutes. Mean arterial blood pressure (MABP), intracranial pressure (ICP) and cerebral blood flow (CBF) were measured continuously. Cerebral perfusion pressure (CPP) and cerebrovascular resistance (CVR) were then calculated. Microvascular architectures of the brain were studied by scanning electron microscopy (SEM) with cerebrovascular casting methods. CBF decreased significantly on the compressed side though CPP remained unchanged till 5 balls had been inserted. CVR increased correlatively to the numbers of balls on the compressed side while remaining unchanged during insertion of the balls on the contralateral side. In SEM study, flection and interruption of capillaries and compressed phenomenon of veins were most remarkable on the compressed side. Alterations of microvascular architectures correspond to cortical deformity in degree. These data show that increase of CVR correlating to alteration of microvascular architectures plays an important role in decrease of CBF in a compressed brain. It is thus suggested that intracranial mass lesion causing deformity of the brain must be removed in order to avoid further brain tissue damage due to microvascular lesions.

Animals↗
PubMed1991

[Chronic subdural hematoma secondary to coagulopathy].

Eleven cases of chronic subdural hematoma (CSH) secondary to coagulopathy were experienced in our department in the last 5 years. They were classified into 4 groups, I: secondary to diffuse metastatic carcinomatosis of the bone marrow (4 cases), II: malignant hematological disease (acute lymphocytic leukemia and myelodysplastic syndrome 1 case each), III: postreplacement of cardiac valves or vein graft having been treated with anticoagulants (warfarin) (3 cases) and IV: chronic renal failure after having been hemodialyzed (2 cases). The outcomes were all good in group III, and there was one good outcome in group IV. However, death was the outcome in all the other cases. Conservative treatment (mannitol and steroid for 2 weeks) was carried out in 4 cases, all of which improved clinically with diminished hematoma. In 9 cases, surgical treatment was attempted by means of burr hole irrigation of the hematoma. Two of them developed intracerebral hematoma, and one developed acute brain swelling. In conclusion, treatment of CSH secondary to coagulopathy should be selected as follows. 1. Conservative treatment is to be the first choice, if conditions allow it. 2. Surgery can be performed by burr hole irrigation when indicated. Precautions should be taken not to injure the inner membrane of the hematoma or the brain proper, and the need for slow decompression should be kept in mind.

Aged↗