Biomedical subjects

K Hashi

Publications and source records attributed to K Hashi.

At least 19 recordsLinked to original sources

PubMed1996

A case of calcification of the cervical ligamentum flavum.

We report a case of cervical myelopathy caused by the calcification of the cervical ligamentum flavum. A 42-year-old woman with gait disturbance and an episode of dysuria was transferred to our hospital on June 30, 1994. Neurological examination revealed only a mild right hemiparesis. A plain neck X-ray and a tomogram revealed a nodular calcification in the posterior part of the spinal canal at the level of C5/6. Three dimensional computed tomography clearly demonstrated that the mass consisted of three nodular structures on the vertebral lamina. Magnetic resonance images demonstrated severe compression of the spinal cord by the mass whose intensity was low. The mass was removed en bloc together with the ligamentum flavum and C5 and C6 lamina. The mass showed no continuity to the dura mater. The calcification was confined within the ligament. The patient's neurological deficits were resolved two weeks after the surgery. X-ray diffraction study demonstrated the component of the mass was found to be pure hydroxyapatite. Clinical features of calcification of the ligamentum flavum are reviewed from 85 reported cases including ours, and the difference between this calcification and the ossification of the ligament is emphasized. Calcification of the ligamentum flaum is a distinct clinical entity.

Adult↗

PubMed1996

[Surgical approach for cervical dumbbell type neurinoma: posterior approach by partial hemilaminectomy with preservation of a facet joint].

We report on a case harboring a cervical dumbbell type neurinoma. The tumor was completely removed by a modified posterior approach, consisting of partial hemilaminectomies of C2 and C3 with preservation of the facet joint. The operative field under microscope was limited by the preserved facet joint of C2/3. However, sufficient bulk reduction of the epidural and paravertebral mass enabled us to obtain a good operative field. The paravertebral mass, which extended anteriorly to just beside the posterior aspect of the carotid sheath, was removed through the lateral space. The operative field was easily widened beside the right facet joint of C2/3 with partial removal of the posterior part of the transverse process of C2 and C3. The transit portion of the tumor to the normal nerve fiber was also identified through this space. The intracanalicular mass was removed by the partial hemilaminectomies of C2 and C3 without compressing the dural sac. Following sufficient reduction of the bulk, the right vertebral artery was identified at the anteromedial margin of the enlarged intervertebral foramen. Finally the intradural part of the tumor was removed through this space. Our modified posterior approach is a less invasive method to the bony elements of the cervical vertebrae and may minimize the incidence of postoperative instability and angular deformity. This approach also eliminates the necessity of long postoperative immobilization using a rigid cervicothoracic brace.

Cervical Vertebrae↗

PubMed1995

Novel modification of ceramide: rat glioma ganglioside GM3 having 3-O-acetylated sphingenine.

A novel O-acetylated GM3 containing 3-O-acetyl 4-sphingenine was isolated with one having a non-acetylated base from transplanted rat glioma tissue. The presence and position of the acetyl group were estimated by one- and two-dimensional proton nuclear magnetic resonance, and fast atom bombardment-mass spectrometries. In addition, the O-acetyl GM3 showed higher immunological activity toward anti-melanoma antibody in the presence of non-acetylated GM3 in complement-dependent liposome lysis than did non-acetylated or acetylated GM3 alone in the liposome, suggesting enhancement of immunological reactivity of the intact tumor cells by a small amount of O-acetyl GM3.

Animals↗

PubMed1995

Interleukin 4 enhances ganglioside GD3 expression on the human fibroblast cell line WI-38.

Human fibroblast cell line WI-38 cultured in vitro was treated with a human recombinant IL-4 at concentrations of 1 to 100 U/ml to examine the alteration of glycosphingolipid (GSL) expression of the cells. Neutral GSL of non-treated WI-38 cells consisted of CMH (GlcCer), CDH, CTH, and Gb4Cer; CMH and CTH were the major components. The acidic GSL were composed of GM3 as the predominant component and other minor gangliosides including GD3. The neutral GSLs did not change in profile during the treatment with IL-4, while the acidic GSLs showed a prominent change, an increase of GD3 content. The increase of GD3 was detectable with IL-4 concentrations over 1 U/ml, and reached a plateau at 10 U/ml, where the amount of GD3 was almost equal to that of GM3. The GD3 increase occurred at 24 h after the IL-4 treatment, and lasted for at least 96 h, as long as IL-4 remained present in the culture media. The GD3 synthase (sialyltransferase) level was found to be increased in an IL-4 dose-dependent manner. IL-4 did not influence the growth or morphological appearance of WI-38 cells. The results demonstrate a novel biological effect of IL-4, modulating GSL in non-hematopoietic cells.

Cell Line↗

PubMed1995

Isotonic mannitol and the prevention of local heat generation and tissue adherence to bipolar diathermy forceps tips during electrical coagulation. Technical note.

The authors observed temperature levels of saline and mannitol on the tips of bipolar diathermy forceps during application of power to the forceps and compared the effects of irrigation with saline and isotonic mannitol on electrical coagulation of vessels during neurosurgical operations. There was a marked rise in the temperature of saline corresponding to increased output power of the coagulator; there was no rise in the temperature of the mannitol. Irrigation with isotonic mannitol during surgery resulted in a considerable reduction of adherence of burned tissue and blood clots to forceps tips during coagulation of both arteries and veins compared with that which occurred during irrigation with saline. These results demonstrate that irrigation with an isotonic mannitol surpasses that with conventional ionic fluids, such as a saline, for prevention of both tissue adherence to bipolar diathermy forceps and removal of heat generated during electrical coagulation.

Burns↗

PubMed1995

[Spinal intradural arachnoid cyst associated with enlarged filum terminale].

This is a report of a spinal intradural arachnoid cyst associated with an enlarged filum terminale. A 9-year-old female was admitted to our hospital complaining of lumbosacral pain. Neurological examination revealed no abnormal findings. CT scan showed a round shaped mass lesion in the right dorsolateral side of the spinal canal between the level of L1 to S1/2. The mass lesion disclosed isodensity and was not enhanced. A small low density mass lesion was visualized in the dural sac at the same level. MRI showed the mass lesion with low signal intensity on the T1-weighted image, and high signal intensity on the T2. The small mass lesion in the dural sac was demonstrated with low signal intensity on the T1 and T2-weighted image. In addition to this finding, Chiari malformation type I was disclosed. It was suspected that this mass lesion was extradural arachnoid cyst associated with an enlarged filum terminale. Osteoplastic laminotomy between L3 to S1/2 was performed, and an arachnoid cyst was found in the intradural space. It compressed the cauda equina and enlarged tough filum terminale. The cyst was removed subtotally, and the filum terminale was cut off. Postoperative course was uneventful and the lumbosacral pain disappeared. It was thought that this pain might be derived from the intradural arachnoid cyst, or the enlarged filum terminale.(ABSTRACT TRUNCATED AT 250 WORDS)

Arachnoid Cysts↗

PubMed1995

[Diagnosis of ruptured and unruptured cerebral aneurysms with three-dimensional CT angiography (3D-CTA)].

Three-dimensional CT angiography (3D-CTA) is a new, minimally invasive technique for the diagnosis of cerebral aneurysms. The purpose of this study is to compare the diagnostic value of 3D-CTA for ruptured and unruptured cerebral aneurysms with that of MR angiography (MRA) and digital subtraction angiography (DSA). Forty-one cases consisting of 11 cases of ruptured aneurysms and 30 cases of unruptured aneurysms, with a total of 67 cerebral aneurysms, were included in this study. 3D-CTA was performed with a bolus injection of nonionic contrast medium on the SOMATOM PLUS-S scanner and the ProSeed Accell scanner. Three-dimensional images were obtained by both shaded surface reconstruction (SSR) method and maximum intensity projection (MIP) method. The CT values of cisternal clot in cases of ruptured cerebral aneurysms did not exceed 90HU in any of the cases. The effect of SAH was, therefore, eliminated in the SSR images through a threshold level processing of a CT value of 150HU. All the cerebral aneurysms were visualized by this process. With regard to the detectability of cerebral aneurysms, 3D-CTA was able to demonstrate cerebral aneurysms with diameters of larger than 1mm as well as giant aneurysms which MRA would sometimes fail to reveal. 3D-CTA was superior to MRA and DSA in making diagnosis of small aneurysms such as those with diameters of less than 3mm.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1995

[A case of systemic lupus erythematosus associated with cerebral infarction and cerebral hemorrhage].

This is a report of cerebral infarction and cerebral hemorrhage derived from systemic lupus erythematosus. A 49-year-old male was admitted to our hospital due to dysarthria and supranuclear facial palsy. He had been suffering from SLE and medicated incompletely since 9 years prior to admission. A CT scan showed a small infarction in the left parietal area. An angiography revealed a tapering stenosis of the left carotid siphon and an occlusion of the left vertebral artery at the cisternal portion. On the 13 days after the admission, he complained of a high fever and right hemiparesis. The CT scan disclosed newly multiple small infarctions in the left parietal area. The angiography showed the progressing of the tapering stenosis at the left carotid siphon, and demonstrated the narrowing of the left superior temporal artery and ophthalmic artery in addition to the disappearance of a left posterior communicating artery. High dose of steroid was given to him, but cerebral hemorrhage and huge left cerebral infarction were complicated. On the 26 days after the admission, his general condition was worsened and died. It was considered that the cerebral infarction and hemorrhage might be derived from the vasculitis of SLE.

Cerebral Angiography↗

PubMed1995

[A case of growing up aneurysms with occlusion of basilar artery].

This is a report of unruptured aneurysms with occlusion of the basilar artery. A 61-year-old female was admitted to our hospital because of dysarthria and numbness of her left face. Angiography revealed occlusion of the basilar artery and severe arteriosclerosis of the bilateral cerebral carotid arteries. Pcom was not visualized on bilateral carotid angiogram. These neurological signs were considered to be derived from vertebrobasilar insufficiency by occlusion of the basilar artery. Right STA-SCA anatomosis was performed to prevent brain stem infarction. Postoperative angiography showed a good filling of both PCA and SCA by collateral circulation via a right STA and an unruptured basilar top aneurysm. Seven months after the bypass surgery, angiography disclosed that the basilar top aneurysm was visualized clearly, and its size was unchanged. The fact that there was no thrombus formation in the aneurysm was considered to be due to ticlopidine, and the hemodynamic changes after the bypass surgery were suspected to have increased the intraaneurysmal pressure. Therefore we performed neck clipping of the basilar top aneurysm by using a right pterional approach. Two years after the second operation, the patient complained of severe headache and vomiting. CT scan showed subarachnoid hemorrhage, and angiography demonstrated a newly developed aneurysm which might have ruptured on left internal carotid anterior choroidal artery bifurcation. Emergency neck clipping of the second aneurysm was performed, and the patient showed a good postoperative course. The newly developed second aneurysm might have been caused by severe arteriosclerosis and hypertension in addition to hemodynamic stress.

Arterial Occlusive Diseases↗

PubMed1995

[Percutaneous transluminal angioplasty for cervical carotid artery stenosis].

Percutaneous transluminal angioplasty (PTA) was attempted in 16 patients (17 procedures) with cervical internal carotid artery (ICA) stenosis. Among the 16 patients, 14 were male and 2 were female aged from 44 to 76 years (average 63.4 years). One had cerebral infarction on the acute stage, and the other 15 were in the chronic stage. On CT scan and MRI, there were nine multiple lacunar infarctions and seven watershed infarctions. On angiographical findings, 13 had Rt.-ICA stenosis and 4 had Lt. ICA stenosis. Stenotic lesion existed beyond the level of the third cervical vertebral body in eleven cases, and so-called long segmental stenosis ranged from 3 to 5 cervical vertebral bodies in 3 cases. Before PTA, 14 patients underwent a balloon occlusion test for 3 to 20 minutes (average 9 minutes). Neurological symptoms of hemiparesis or sensory disturbance occurred in 3 patients during balloon inflation, but these disappeared completely after balloon deflation. It took from 1.5 to 2 hours (average 1.7 hours) to carry out PTA including the balloon occlusion test. All cases had satisfactory results with no morbidity or mortality. The mean stenosis ratio of pre-PTA, approximately 80% (55-93%), improved to that of 22% (0-50%) after PTA. Bradycardia and hypotension occurred transiently in 9 cases during and after PTA, but no symptoms remained by atropine sulfate and catecholamine infusion intravenously. In the following 1 to 26 months (mean 9.0 months) after PTA, 3 cases restenosed. The restenosis was recognized by MR angiography after 8 to 26 months (average 15.7 months) of PTA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

The incidence and treatment of asymptomatic, unruptured cerebral aneurysms.

The importance of early detection by various radiological techniques of asymptomatic, unruptured aneurysms as a means of preventing subarachnoid hemorrhage (SAH) is discussed in this report. Four hundred volunteers underwent clinical and radiological evaluations between March, 1988, and September, 1992. Studies included a neurological examination as well as digital subtraction cerebral angiography via a femoral arterial catheter, computerized tomography, T1- and T2-weighted magnetic resonance (MR) imaging of the whole brain, and MR angiography. The evaluation revealed 27 asymptomatic, unruptured intracranial aneurysms in 26 volunteers, for an incidence of 6.5%. The subjects ranged in age from 39 to 71 years, with an average of 55 years. The aneurysms were located on the internal carotid artery in 13 cases (48%), the anterior communicating artery in six (22%), the middle cerebral artery in six (22%), and the basilar artery in two (7%). Aneurysms ranged in size from 5 mm or less in 16 cases, 6 to 10 mm in nine, and 11 to 15 mm in one; one aneurysm was more than 15 mm, with a maximum diameter of 2 cm. Volunteers with a family history of SAH within the second degree of consanguinity showed a higher incidence of aneurysms (17.9%). Aneurysm clipping was performed on 20 of the 26 cases with no significant morbidity or mortality. These findings support the contention that aggressive early detection of unruptured aneurysms may improve the outcome in patients harboring cerebral aneurysms by preventing the devastating effects of SAH.

Adult↗

PubMed1994

[A case report of interstitial pneumonia caused by granulocyte colony-stimulating factor].

Several clinical trials have demonstrated that granulocyte colony-stimulating factor (G-CSF) accelerates the recovery of neutropenia in chemotherapy-induced bone marrow suppression. In this report, we describe a 46-year-old female with glioblastoma multiforme who developed interstitial pneumonia due to administration of G-CSF during the phase of immunochemoradiotherapy-induced neutropenia. Thirty-three days after starting immunochemoradiotherapy (ACNU, VCR, IFN -beta, radiation), she developed neutropenia (1,000/microliters). Administration of G-CSF at doses of 125-250 micrograms/day led to an increase of peripheral neutrophil counts. Eleven days later, the patient developed sudden severe respiratory failure and cyanosis with worsening of lung shadows. Blood gas levels on room air were PaO2 49.3mmHg, PaCO2 28.0mmHg, and pH 7.46. At this time, her neutrophil count had risen to 26,080/microliters. LDH and alpha - HBD had also increased to 1,439 IU/l and 1,117IU/l respectively. Chest radiograph and CT scan demonstrated interstitial pneumonia. After treatment with methyl prednisolone, her respiratory symptoms were gradually resolved. A number of side-effects have been reported with granulocyte-macrophage colony-stimulating factor (GM-CSF). These include fluid retention with pericardial and pleural effusion, fever, bone pain, fatigue, and rash. This report also suggests that G-CSF might be a cause of interstitial pneumonia during the phase of immunochemoradiotherapy-induced neutropenia.

Brain Neoplasms↗

PubMed1994

Immunohistochemical and electron microscopic studies on intracranial chordomas: difference between typical chordomas and chondroid chordomas.

Immunohistochemical and electron microscopic studies were carried out on 9 cases of intracranial chordomas. Three of them were typical chordomas and 6 were chondroid chordomas. Immunohistochemically, both typical chordomas and chondroid chordomas were positively stained for cytokeratin and epithelial membrane antigen. Chondroid chordomas were stained for vimentin with moderate intensity whereas typical chordomas were only slightly stained. In comparison to typical chordomas, the chondroid chordomas had relatively few desmosomes and intermediate filaments. These findings suggest that intracranial chordomas are of mixed epithelial-mesenchymal nature, and that chondroid chordomas have a predominant mesenchymal character as compared to typical chordomas.

Adult↗

PubMed1994

[Superacute changes in blood-brain barrier following cerebral venous hypertension due to an embolic occlusion of cerebral venous sinus].

Pathophysiological mechanism of hemorrhagic infarction and brain edema following obliteration of venous outflow tract has been poorly understood. We analyzed a superacute change of the blood-brain barrier in a rat experimental model of venous hypertension produced by an embolic occlusion of superior sagittal sinus (SSS). In all thirty-seven animals received retrograde embolization, marked increments of SSS pressure were noted immediately after embolic occlusion of the sinus. Severity and geographical patterns of the disruption of blood-brain barrier were then analyzed photomicrographically, visualized by the autofluorescence of the exuded Evans blue with Hematoxylin-eosin stain. Relationship between the degree of SSS pressure increment and the severity of the blood-brain barrier destruction was studied. In ten out of the seventeen animals (59%), analyzed five minutes after embolization, exudation of the dye was demonstrated. The degree of SSS pressure increment in the animals with dye exudation was higher than in the animals without them. In five out of the nine animals (56%), analyzed fifteen minutes after embolization, exudation of the dye was also demonstrated. The degree of SSS pressure increments in the animals with dye exudation was statistically higher than those in the non-exuded ones. Especially, all the animals with SSS pressure higher than 75 mmHg were associated with severe exudation of the dye. The exudation of the dye was more prominent in the white matter than in the cortical gray matter. Following pathological analysis have revealed that exudation of the dye was most prominent around the capillary and the venule in the white matter. Microvacuolation around these vessels was also noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMed1994

Photoaffinity labeling of lipoproteins in human cerebrospinal fluid with a heterobifunctional derivative of galactosylsphingosine.

The binding of a galactosylceramide (GalCer) analog to proteins in normal human cerebrospinal fluid (CSF) was examined by photo-affinity labeling using a radioiodolabeled 2-(p-azido-salicylamido) ethyl-1,3-dithiopropionate (ASD) derivative of galactosylsphingosine (GalSph) as a probe. The affinity-bound peptides appeared at 66, 36 and 28 kDa as radiolabeled bands. The latter two peptides, 36 and 28 kDa, were independently identified by immunostaining of the isolated peptides using biotinylated GalSph, and immobilized Avidin, and by immunoprecipitation of the photolabeled peptide, to apolipoproteins (ALPs) E and A-I, respectively. The direct binding of the GalCer analog to these apo-peptides suggested that the existence in the body fluids or the transfer between the fluids and cells of the glycolipid was related to high density lipoprotein (HDL) constructions.

Affinity Labels↗

PubMed1994

[Clinical analysis of the fatal cases of adult malignant gliomas after aggressive treatment].

Six patients operated on for supratentorial malignant astrocytomas and seven patients operated on for glioblastoma multiforme were analyzed to evaluate the effect of aggressive surgical resection on the length of survival and causes of death. Early postoperative contrast enhanced CT scan was used to assess the extent of surgical resection. A gross total resection was considered to have been accomplished when there was no evidence of any residual enhanced mass. When 10% or less of the preoperative enhanced mass remained, the resection was classified as a subtotal resection. Subsequent follow-up CT scan showed that a gross total resection was accomplished in nine patients, and a subtotal resection was attained in four patients. The patients' ages ranged from 40 to 78 years (mean, 59 years). The median survival after the first aggressive surgical resection was 18.0 months in patients with malignant astrocytoma and 13.6 months in those with glioblastoma multiforme. The median duration between first operation and recurrence of tumor was 8.8 months in patients with malignant astrocytoma and 11.5 months in those with glioblastoma multiforme. A second aggressive surgical resection for recurrent malignant astrocytoma or glioblastoma multiforme was carried out in four patients (40%) of the evaluated ten patients. The median survival of these patients after reoperation was 8.25 months. Accordingly, aggressive surgical resection of malignant astrocytoma and glioblastoma multiforme is correlated with longer survival and is advocated in the treatment of recurrent tumors. Leptomeningeal dissemination was diagnosed in nine patients (90%) of evaluated ten patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

[Percutaneous transluminal angioplasty for progressing stroke caused by severe basilar artery stenosis: case report].

We encountered one case of progressing stroke caused by severe basilar artery stenosis. The patient was treated with emergent percutaneous transluminal angioplasty (PTA) with satisfactory results. A 54 year-old woman was admitted 15 minutes after the sudden onset of rt. hemiparesis, rt. hemidysesthesia, dysarthria and consciousness disturbance. CT scan on admission showed no abnormal findings. The consciousness level of the patient deteriorated rapidly from JCS 1 to JCS 20 within 30 minutes from the ictus. An emergent angiogram revealed severe basilar artery stenosis at its middle portion and poorly developed collateral circulation. One hour after the stroke occurred, PTA was performed. Using a 3mm diameter balloon catheter, we introduced the balloon into the stenotic lesion and inflated it 6 times from 4 atm to 8 atm pressure. The patient recovered immediately on the operating table improving from JCS 20 to JCS 1. Rt. hemiparesis also improved. Follow-up MRI showed a small area of ischemic change in the brain stem, but no large infarction appeared. The patient was discharged with no neurosurgical deficits after 30 days of PTA. PTA for basilar artery stenosis is still a controversial subject. One reason is the risk of basilar artery perforating branches occlusion by balloon catheter and the other is the difficulty of introducing a flexible balloon catheter into the basilar artery beyond the acute angulation of the vertebral artery. If those two problems were solved, PTA would be the first-choice therapy for basilar artery stenosis in both acute and chronic stages.

Acute Disease↗

PubMed1994

[Cerebellar infarcts that require differentiation from tumors: diagnosis with MRI].

It is often difficult to differentiate cerebellar infarct with cerebellar swelling from neoplastic disorders, because former can be shown as cerebellar mass with marked contrast enhancement on CT scan. We analyzed radiologically three cases with cerebellar infarction by using MRI, conventional CT scan and angiography. Two cases in the acute stage could be diagnosed as cerebellar infarction by MRI alone based on the following findings: 1) the lesion was distributed in the territory of cerebellar arteries; 2) the normal pattern of cerebellar folia and fissures was preserved in Gd enhancement MRI image; 3) characteristics of MRI intensity were compatible with hemorrhagic infarction. The other case in the chronic stage showed peculiar enhancement, which was unusual for infarction. It was diagnosed as cellular infarction with reference to the angiographic findings. MRI is generally useful to obtain early diagnosis of tumor-like cerebellar infarcts, and proper treatment should be started as early as possible.

Aged↗