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Biomedical subjects

K Hasuo

Publications and source records attributed to K Hasuo.

At least 73 records · Page 4Linked to original sources

[MRI of brain abscesses].

Four cases of brain abscess were examined on 1.5T MR and their findings were evaluated retrospectively. Preoperative cases had relatively characteristic findings, such as 1) peripheral edema producing hypointensity on T1-weighted images (T1WI) and hyperintensity on T2-weighted images (T2WI); 2) central necrosis with abscess fluid hypointense relative to white matter on T1WI and hyperintense on T2WI; 3) abscess rim iso- to hypointense on T2WI. Gd-DTPA enhanced T1WI carried further information; comparison of iso- to hypointense rim on T2WI (abscess rim) and enhanced area by Gd-DTPA on T1WI suggested that the former represented zone of macrophage infiltration.

Adult↗

Leukoencephalopathy in HTLV-I-associated myelopathy/tropical spastic paraparesis: MRI analysis and a two year follow-up study after corticosteroid therapy.

Magnetic resonance imaging (MRI) of the brain was studied in 35 patients with HTLV-I-associated myelopathy (HAM)/tropical spastic paraparesis (TSP), 19 HTLV-I seropositive carriers without HAM/TSP (non-HAM/TSP carriers), 18 patients with HTLV-I seronegative spastic spinal paraparesis (SSP), and 82 HTLV-I seronegative controls with other neurological disorders. The incidence of white matter lesions was significantly higher in HAM/TSP (66%) than in the controls (23%) and SSP (11%). HAM/TSP exceeded non-HAM/TSP carriers significantly in the incidence of multiple white matter lesions (37% vs 10%). HAM/TSP affected the deep and subcortical cerebral white matter multifocally, sparing the periventricular regions. None of the lesions were enhanced by gadolinium-DTPA. HAM/TSP patients with the white matter lesions had both a longer duration of disease and a greater disability than did those without lesions. The white matter lesions gradually increased in number, as the disability status became worse, in spite of the high dose corticosteroid treatment. All these observations suggest that the MRI abnormalities of the HAM/TSP brain may reflect the chronic perivascular inflammation with progressive gliosis (chronic disseminated encephalomyelitis). We propose that brain MRI can be successfully utilized as a reliable and non-invasive measure for following the disease progression in HAM/TSP.

Age Factors↗

Arterioenteric fistulae: diagnosis and treatment by angiography.

Two cases of massive gastrointestinal haemorrhage caused by arterioenteric fistulae are presented. In both cases, bleeding was controlled by interventional angiography. In the first case, a fistula between an aberrant right subclavian artery and a reconstructed oesophagus was temporarily occluded with a balloon catheter as a pre-surgical measure. In the second case a communication between the external iliac artery and the colon in a patient with invasive cervical cancer was treated by embolization. An arterioenteric fistula should be considered as a possible cause of acute gastrointestinal haemorrhage in post-operative or cancer patients and aortography or pelvic arteriography may be required to make the diagnosis.

Catheterization↗

[A case of liver cirrhosis associated with chronic subdural hematoma and hepatic encephalopathy].

A 58-year-old male liver cirrhosis patient, who had a history of recurrent hepatic encephalopathy, was admitted to our hospital because of clouding of consciousness. He had an episode of recent head trauma. On admission, he was drowsy and exhibited flapping tremor, fetor hepaticus and ascites. Laboratory data showed an increase in blood ammonia level, and a decrease in peripheral thrombocytes, serum albumin and prothrombin value. A ratio of branched-chain to aromatic amino acids was reduced. Antibody against hepatitis C virus was positive. His electroencephalogram showed bilaterally large synchronous slow waves. He was treated with intravenous branched-chain amino acids, and recovered. Cranial computed tomography on day 9 demonstrated a crescent shaped area of low density in the right frontotempoparietal subdural region. He was diagnosed as chronic subdural hematoma, which was treated surgically. It has been suggested that chronic subdural hematomas develop as a complication of hemostatic deficiency due to liver cirrhosis.

Chronic Disease↗

Transcatheter embolization of testicular vein for varicocele testis.

Percutaneous transcatheter embolization of the testicular vein was performed on 28 patients with angiographically proven varicocele testis. In 2 patients bilateral and in 26 only the left vein was embolized using 3-, 5-, or 8-mm stainless steel coils. All patients had clinically palpable varicoceles and male infertility. The grade of varicoceles improved after embolization in 23 of 28 cases (82%). Effective sperm count increased significantly from 34.5 +/- 44.6 to 65.1 +/- 71.0 following embolization. However, pregnancy was achieved only in one of 28 cases. Technically, the basilic vein approach was felt to be superior to the femoral vein or jugular vein approach for this procedure.

Adult↗

[Enhanced effect of intraperitoneal administration of CDDP combined with caffeine against peritoneal metastasis].

The enhanced effect of CDDP combined with caffeine against P-388 leukemia was investigated. No synergistic effect was shown after one hour simultaneous treatment with CDDP and caffeine. But the growth inhibition was enhanced by the addition of caffeine after one hour treatment with CDDP. It is suggested that caffeine inhibits DNA repair by the reduction of CDDP-induced elongation of G2 + M phase. The increase in life span of mice after ip transplantation was observed by frequent ip injections of caffeine after CDDP injection. It is suggested that the effect of intraperitoneal administration of CDDP against peritoneal metastasis is enhanced by combination with caffeine.

Animals↗

Reoperation for moyamoya disease refractory to encephalo-duro-arterio-synangiosis.

Three cases of Moyamoya disease successfully treated by reoperation are reported with special reference to the operative techniques in the second operation. These children first underwent encephalo-duro-arterio-synangiosis (EDAS). Because two of the three postoperative collateral formations through EDAS were either poor or not present at all and their symptoms remained. Encephalo-myo-synangiosis (EMS) was later added in the posterior frontal and/or parietal regions of the same side as the former EDAS. In the remaining one, the collaterals through EDAS were well formed but transient ischaemic attack (TIA) persisted in the lower limb. The collateral to the middle cerebral arterial (MCA) distribution, even though seemingly well formed, was not sufficient to obtain a complete subsidence of the symptoms. In this case encephalo-myo-arterio-synangiosis (EMAS) was later added to the antero-medial frontal region of the same side as the EDAS to form collaterals to the anterior cerebral arterial (ACA) distribution. In all three cases the angiograms after the second operation showed good formation of collaterals, and the symptoms subsided. The causes of poor collateral formation through EDAS and operative techniques for the additional operation for those cases refractory to EDAS are discussed.

Brain↗

Encephalo-duro-arterio-synangiosis in children with moyamoya disease.

Encephalo-duro-arterio-synangiosis (EDAS) was done in 16 Japanese children with Moyamoya disease on 22 sides. The results were evaluated clinically, angiographically, and by positron emission computed tomography (PET). Postoperative external carotid angiograms showed a good collateral circulation through EDAS in 72 percent of the treated sides. Two-thirds of the sides examined by PET showed improvement in cerebral blood circulation, particularly at the surgically-treated cortex. Postoperatively the symptoms disappeared in those with good new collateral formation. TIA, RIND, and/or involuntary movement disappeared in 31 percent and partially so in 44 percent 6 months after EDAS. The TIA in the lower limb and/or involuntary movement persisted in some children. This surgical approach seems applicable particularly for children with the ischaemic type of Moyamoya disease, however, the procedure also has drawbacks. Development of collateral circulation was insufficient in some cases, and the territories of the anterior cerebral artery (ACA) or posterior cerebral artery (PCA) were often not covered, even in those with a good new collateral formation in the middle cerebral arterial (MCA) area.

Cerebral Angiography↗

Carotid-cavernous sinus fistula accompanying facial trauma. Report of a case with a review of the literature.

A case of traumatic carotid-cavernous sinus fistula, an abnormal communication at the base of the skull between the internal carotid artery and the cavernous sinus, complicating fractures of the zygoma and mandible is described. Typical signs and symptoms appeared immediately after the injury resulting from a traffic accident. Angiography revealed a definite CCSF and a balloon embolization was performed with a good result. The importance of a multidisciplinary examination of the ophthalmic function and periorbital condition following trauma is emphasized, and interdepartmental cooperation helped to establish a rational diagnosis and obtain a good result.

Arteriovenous Fistula↗

Cerebral aspergillosis after burr-hole surgery for chronic subdural hematoma: case report.

We report a case of aspergillosis in the subdural space and frontal lobe in an 83-year-old man. The clinical course simulated that of a brain tumor. The source for the infection was considered to be the previous burr-hole surgery for chronic subdural hematoma, which was performed 2.5 years before the onset of symptoms. The patient was treated by removal of the abscess and granuloma. The clinical features and treatment of aspergillosis after neurosurgical procedures are discussed.

Aged↗

Neuronal migration anomalies causing extensive ventricular indentation.

Neuronal migration disorders include various anomalies of the brain, and cortical heterotopia is the most common type. In this report, we present the radiological findings of two adults with unusually large cortical heterotopia associated with fused-lip schizencephaly that caused extensive ventricular indentation. The lesion showed density on a computed tomographic scan and signal intensity on a magnetic resonance imaging scan similar to normal gray matter. Perifocal edema, contrast enhancement, and calcification were not seen. An abnormally decreased volume of the ipsilateral cerebral hemisphere, the presence of adjacent microgyri, and deep fissures that contained blood vessels were also characteristic findings, indicating abnormal development. Knowledge of this entity is important in differentiating true intracerebral neoplasms.

Adult↗

Neurinoma in the cavernous sinus: report of two cases.

Two cases of trigeminal neurinoma located solely in the cavernous sinus are reported. Preoperatively, magnetic resonance imaging provided the accurate localization of the lesions, allowing precise planning of the surgical approach, that is, a subtemporal lateral approach and a pterional superior approach, respectively. The neurinomas inside the cavernous sinus were removed successfully, and the patients developed no new neurological deficits except for anesthesia in the 1st division of the trigeminal nerve. The characteristic magnetic resonance imaging findings of trigeminal neurinoma in the cavernous sinus are presented, and the different surgical approaches are discussed.

Adult↗

Abnormality in the cavernous sinus in three patients with Tolosa-Hunt syndrome: MRI and CT findings.

Three patients with Tolosa-Hunt syndrome (THS) were examined using computed tomography (CT), orbital venography and magnetic resonance imaging (MRI). CT of the brain showed no definite abnormality in two patients, right optic nerve enlargement and an abnormal area around the orbital apex in one patient. Orbital venography showed an occlusion of the superior ophthalmic vein in one of three patients. MRI showed an abnormal soft tissue area in the cavernous sinus, with intermediate to high signal intensity on T1- or intermediate weighted images. There was clinical improvement following corticosteroid therapy and the abnormal soft tissue on MRI decreased in volume and in signal intensity, although this was equivocal in one patient. Thus MRI proved to be useful in demonstrating lesions in the cavernous sinus in patients with THS.

Adrenal Cortex Hormones↗

Cerebral hemodynamic change in the child and the adult with moyamoya disease.

To clarify the differences in cerebral hemodynamics and metabolism between children and adults with bilateral moyamoya disease, we measured regional cerebral blood flow, regional oxygen extraction fraction, regional metabolic rate for oxygen, regional cerebral blood volume, and regional transit time using positron emission tomography in nine patients (five children and four adults) and compared the values with those in controls (four children with unilateral moyamoya disease and six normal adults). The major differences between pediatric and adult patients were in regional cerebral blood volume and regional oxygen extraction fraction. Regional cerebral blood volume was more markedly increased relative to the control value in the children than in the adults. Also, regional oxygen extraction fraction was greater than control in areas with low blood flow in the children but was never increased in the adults. However, in the adults, only regional transit time was significantly prolonged relative to the control values. The increased regional oxygen extraction fraction relative to the control value observed in children with moyamoya disease may explain why transient ischemic attacks are a common symptom in this group.

Adolescent↗

Primary intraventricular hemorrhage imaged by high-field magnetic resonance imaging--a case report.

Primary intraventricular hemorrhage (PIVH) imaged by magnetic resonance imaging (MRI) is reported. A fifty-seven-year-old man with long-standing hypertension suddenly developed severe headache, vomiting, and retrograde amnesia. A computed tomography scan on the same day revealed hematoma in the right posterior horn of the lateral ventricle and in the 4th ventricle. Angiography of the neck and head failed to demonstrate any vascular abnormalities. On the second day his neurological symptoms almost recovered except for the loss of the memory of the ictal day. High-field MRI on the sixteenth day demonstrated an isointense lesion surrounded by a hypointense area in the T1 weighted image or a hyperintense lesion in the T2 weighted image, suggesting subacute hematoma consistent with hypertension, just anterior to the right trigone of the lateral ventricle.

Cerebral Hemorrhage↗

Selective enhancement of intratumoral blood flow in malignant gliomas using intra-arterial adenosine triphosphate.

The effect of intravenous and intracarotid administration of adenosine triphosphate (ATP) on the regional blood flow of glioma patients has been examined by means of positron emission tomography. Intracarotid administration of ATP at a dose of 0.52 to 1.3 micrograms/kg/min selectively increased the blood flow in the tumor by 26.2% +/- 10.5% (mean +/- standard deviation). The side effects observed were tolerable. In contrast, intravenous administration of ATP failed to increase tumor blood flow. It is suggested that intracarotid administration of ATP may serve to selectively enhance the delivery of anticancer agents to malignant brain tumors.

Adenosine Triphosphate↗

[A 17-year experience with ileal conduit urinary diversion--early and late complications].

A series of 185 patients, 133 males and 52 females, were treated by ileal conduit urinary diversion in the past 17 years. The patients ranged in age from 7 months to 81 years with an average of 59 years. Diversions were performed for malignant diseases in 174 patients, 85% of whom underwent a simultaneous radical surgery. The follow-up covered the postoperative period from 4 months to 16 years 8 months with an average of 4 years 8 months. Six patients (3%) died within 1 month of operation, and 43 of a total of 58 mortal cases died of cancer thereafter. The survival rates of 143 patients with bladder cancer were 84% for 1 year, 72% for 3 years, 67% for 5 years, 62% for 10 years and 54% for 15 years. Early complications were noticed in 38% of the patients. Delayed wound healing due to local infection (20%) and intestinal obstruction (10%) were the two major complications in this period. Late complications were encountered in 51% of the patients. Mild peristomal dermatitis (22%) and gradually developing renal complications (22%) are two major problems in the standard ileal conduit urinary diversion. The latter was significantly more frequent in patients who underwent the operation between 1973 and 1981 than in those who had the surgery between 1982 and 1989. Postoperative hydronephrosis was observed in 15 (13%) of 117 patients who showed normal urograms preoperatively. Ileoureteral reflux was observed in 50% of the cases with nonobstructing conduits, while it increased up to 70% along with obstruction of the conduit.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗