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Biomedical subjects

K Hasuo

Publications and source records attributed to K Hasuo.

At least 91 records · Page 5Linked to original sources
PubMed1990

Magnetic resonance imaging compared with computed tomography and angiography in moyamoya disease.

Magnetic resonance (MR) imaging performed in 13 patients with moyamoya disease was reviewed and compared with computed tomography (CT) and angiography. The MR findings consisted of occlusion of arteries, collateral vessels and parenchymal changes. Narrowing or occlusion of the middle cerebral artery and the supraclinoid portion of the internal carotid artery were seen in all hemispheres but one. Collateral vessels, cerebral infarcts and atrophy with dilatation of the ventricles were observed on MR imaging. In general, the MR findings correlated well with angiography regarding occlusive changes and moyamoya vessels but was less sensitive in a few cases. Because of its higher sensitivity in detecting occlusive changes and collateral vessels, MR imaging was superior to CT in the diagnosis of this disease.

Adolescent↗
PubMed1990

[A case of spinal dural arteriovenous malformation associated with the broad lesion within spinal cord--diagnostic value of MRI with Gd-DTPA enhancement].

A 70-year-old man, with slowly progressive gait disturbance, numbness in his lower limbs and dysuria, was admitted to our hospital in July, 1988. Neurological examination revealed flaccid paraparesis, hyperesthesia below the level of Th-10 combined with the disturbance of pain and temperature sensations below the level of Th-11, and neurogenic bladder. Midsagittal Tl-weighed image of MRI did not reveal any abnormal finding except for a mild enlargement of the conus medullaris. With Gadolinium (Gd)-DTPA injection, however, the spinal cord was diffusely enhanced below the level of the 9th thoracic spine. This enhancement effect was particularly remarkable at the periphery of the spinal image showing several high intensity spots in the posterior aspect of the spinal cord, which was thought to be incompatible with the spinal cord neoplasm. The angiographic examination of the selective Th-7 intercostal artery on the left showed vascular malformation lying adjacent to the 7th intervertebral foramen with markedly dilated tortuous spinal veins going upwards and downwards, which was compatible with spinal dural arteriovenous malformation (AVM). After the artificial embolization, draining veins as well the nidus of AVM had completely disappeared on angiogram. There was an improvement on his neurological findings and Gd-DTPA enhancement had been diminished on MRI. It was suggested that Gd-DTPA enhancement on MRI was due to the dilated and remarkably congestive spinal veins, and that both the elevated venous pressure and reduction of intramedullary arteriovenous pressure gradient were the cause of the development of clinical symptoms.

Aged↗
PubMed1989

[Surgical treatment of renal cell carcinoma associated with pulmonary metastasis].

Fifty-nine nephrectomies have been performed in patients with renal cell carcinoma during a 15-year-period from 1973 to 1987 in Fukuoka University Hospital. Of whom 13 had pulmonary metastasis and 10 had other organ metastasis. The 1, 3, 5-year survival rates in patients with metastasis were significantly worse than those without metastasis. No significant difference was observed between the survival rates in patients with pulmonary metastasis and other organ metastasis. Only 1-year-survival rate was better in patients with delayed metastasis after nephrectomy than that of patients with synchronous lung metastasis to the primary tumor. Resection of pulmonary metastasis was performed in 6 patients. Four of them, however, underwent another resection for recurrence in the lung. The average survival periods of the patients with and without surgical removal of pulmonary metastasis were almost same in the alive cases, but in the dead cases there was observed a 26-month-longer survival period in patients undergoing resection of metastatic lesion than those without resection. In conclusion, resection of pulmonary metastasis may not bring eradication of the disease in the majority of cases. However, aggressive surgery for pulmonary metastasis should be accepted because no effective adjuvant therapy is practically available in the treatment of renal cell carcinoma. Additionally, a case was reported of spontaneous regression of a pulmonary metastasis seen in a 61-year-old male with renal carcinoma. The lesion showed an apparent regression after radical nephrectomy on chest films and completely disappeared at 8 months postoperatively. After 9 months disease-free period, heterotopic recurrence developed in the same lung.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Renal Cell↗
PubMed1989

Moyamoya disease. Posterior cerebral artery occlusion and pattern-reversal visual-evoked potential.

Although vascular abnormality in moyamoya disease predominates in the anterior and middle cerebral arteries, the posterior cerebral artery (PCA) has been found to be involved in the course of the disease. To explore PCA occlusion by noninvasive means, we studied visual-evoked potentials in the patients with PCA occlusion (occlusive group), as well as in those without PCA occlusion (nonocclusive group). The results were compared with those of other examinations that also detected an occipital lobe pathologic condition. Abnormalities of those examinations were highly specific to PCA occlusion. Positron emission tomography and pattern-reversal visual-evoked potentials yielded high incidence of abnormality in the occlusive group (86% and 75%, respectively), and expressed the side of PCA occlusion if the occlusion was unilateral. Since pattern-reversal visual-evoked potentials is popular and a low-cost examination compared with positron emission tomography, we conclude that pattern-reversal visual-evoked potentials is the most practical mean to explore PCA occlusion in the course of moyamoya disease.

Arterial Occlusive Diseases↗
PubMed1989

A 5-year experience of lipiodolization: selective regional chemotherapy for 200 patients with hepatocellular carcinoma.

Between 1982 and 1987, selective regional cancer chemotherapy using Lipiodol plus an anticancer drug (lipiodolization) was prescribed for 200 patients with hepatocellular carcinoma. One hundred forty-nine patients were given lipiodolization alone, and the remaining 51 underwent hepatic resection following lipiodolization. The grades of deposits of the oily contrast medium in the neoplastic tissue seen on the plain X-ray correlated well with the antitumor effect. In the resected specimens of 17 patients treated with lipiodolization prior to surgery, concentrations of adriamycin in the malignant liver tissues were 13.2 +/- 18.2 micrograms per gm, whereas the adjacent liver parenchyma contained 1.4 +/- 2.0 micrograms per gm of adriamycin; the difference was statistically significant (p less than 0.05). In the 149 patients treated with lipiodolization, 1-, 2-, 3- and 4-year survival rates were 56.1, 28.9, 17.3 and 7.4%, respectively. Thus, lipiodolization was considerably more effective, compared to the results achieved by hepatic artery ligation and cannulation into the hepatic artery for patients in Stages I and II. In this sequential nonrandomized study, the survival rates for patients undergoing hepatic resection were superior to those for patients in Stage I and treated with lipiodolization. The significant difference appeared to depend on incomplete killing of tumor cells, which are most often present in the fibrous capsule, by lipiodolization. We conclude from these data that lipiodolization is an effective treatment for hepatocellular carcinoma when the tumor is not curatively resectable. When the clinical status is good, then surgery is warranted.

Antineoplastic Agents↗
PubMed1989

Surgical treatment for paediatric patients with moyamoya disease by indirect revascularization procedures (EDAS, EMS, EMAS).

Surgical results of paediatric patients with Moyamoya disease who were treated by indirect revascularization procedures are reported. Encephalo-duro-arterio-synangiosis (EDAS), encephalomyo-arterio-synangiosis (EMAS), and/or encephalo-myo-synangiosis (EMS) were performed on 47 sides of 29 children with Moyamoya disease. The results of those non-anastomotic EC-IC bypass procedures were evaluated clinically, angiographically, and by computed tomography (CT). Postoperative external carotid angiograms showed a good collateral formation through EDAS, EMAS, or EMS in about 70-80 percent of all surgically treated sides. The symptoms such as TIA, RIND, and/or involuntary movements disappeared in the cases with a good collateral formation but not in those with insufficient development of the collateral circulation. The indirect EC-IC bypass surgery seems effective for most of the children with Moyamoya disease who present with ischaemic signs.

Angiography↗
PubMed1989

Balloon test occlusion of the internal carotid artery with monitoring of compressed spectral arrays (CSAs) of electroencephalogram.

We used the compressed spectral arrays (CSAs) of the electroencephalogram (EEG) to monitor cerebral blood flow related events in balloon test occlusion of the internal carotid artery (balloon Matas test). Reliability of the CSAs was examined in 22 patients subjected to the test. Of 9 patients who underwent subsequent permanent carotid occlusion, in 6 there was no change on CSAs and/or in neurological conditions. In 2 patients, there was a slowing on CSAs prior to the appearance of neurological deterioration during clinical testing. CSAs transformed these EEG changes into a succinct graphic display. In 1 of the 2, for whom the Matas test was repeated 1 year later, there was a change from positive to negative and delayed cerebral infarction occurred after carotid occlusion. In the other patient, an ischemic insult occurred during the balloon occlusive procedures. The third patient had a fatal delayed ischaemic complication 3 days after surgical ligation of the cervical carotid artery, despite the negative balloon Matas test. Complications in these 3 patients were presumably related to thromboembolic mechanisms. The balloon Matas test monitored by CSAs is useful for detecting change in brain functions attributed to an inadequate blood flow. However, this test is unreliable for predicting thrombo-embolic complications.

Aged↗
PubMed1989

Magnetic resonance imaging of jugular foramen neurinomas.

Four cases of jugular foramen neurinoma, extending from the posterior fossa into the temporal bone through the jugular foramen, are reported. The information provided by magnetic resonance imaging was compared with that by computed tomography. Due to the excellent sensitivity, the absence of bone artifacts, and the ease of imaging in any plane, magnetic resonance imaging gave better information particularly about the location of the tumour than X-CT scan did. It included the dumb-bell shaped tumour through the jugular foramen, the extra-axial nature of the tumour, and the precise anatomical relationships between the tumour and the facial and acoustic nerves or the internal carotid artery. Sagittal and coronal views clearly demonstrated the superior and inferior margins of the tumour. The information is very useful not only for preoperative diagnosis but also for planning the surgical approaches and postoperative follow-up.

Adult↗
PubMed1989

Microsurgical procedures for management of giant middle cerebral aneurysm causing increased intracranial pressure.

There have not been many cases reported of giant aneurysms of the middle cerebral artery with a remarkable mass and causing increased intracranial pressure, and the successful operation for resecting an aneurysm is still low. Considering it essential that the mass of an aneurysm should be reduced and the blood flow of parent and distal arteries should be preserved, we are reporting two successful results.

Adult↗
PubMed1989

[Flexion myelopathy due to tic of neck].

A 22-year-old male developed a tic of neck-flexion at the age of 14. The tic occurred 40 to 50 times per minute on its peak at age 16. Since then he noticed the atrophy and weakness of his both upper limbs. His right leg became weak at age 22. On admission, neurological examination revealed tic of lip and neck, severe muscle atrophy and weakness of bilateral upper limbs, mild muscle weakness and spasticity of right lower limb and hyperreflexia in four limbs. Needle EMG studies revealed fibrillation, positive sharp wave and giant MUP in the biceps, triceps and first interossei muscles. There were no abnormal findings suggesting cervical spondylosis or disc herniation on neck roentgenogram and neck MRI in neutral position. Neck MRI in the ventro-flexed position showed a flattening of the lower cervical cord and a band-like isointensity lesion in the posterior epidural space at C4-6. This isointensity lesion was considered to represent a congestion of the internal vertebral venous plexus. These findings suggest that frequent neck flexion by itself causes the injury of the lower cervical cord through (1) over-stretching of the cord, (2) compression of the cord by dural sac, (3) arterior ischemia, and/or (4) stagnant hypoxia due to venous congestion. Flexion myelopathy may represent one of the most important mechanisms of cervical cord injury accompanied with involuntary movement of neck.

Adult↗
PubMed1988

Leukoencephalopathy in HTLV-I-associated myelopathy: MRI and EEG data.

Magnetic resonance imaging (MRI) of the brain and electroencephalography (EEG) were carried out for patients with human T-lymphotropic virus type I (HTLV-I)-associated myelopathy (HAM). Nineteen of 22 patients (86%) had abnormalities on brain MRI and/or EEG. Thirteen patients showed high signal intensity lesions scattered in the cerebral white matter, as seen on the T2-weighted MRI images. The lesions were mostly located in the subcortical and deep cerebral white matter and were not contiguous with the lateral ventricles. Patients with abnormalities on the brain MRI had a longer duration of disease and a greater disability than did those without MRI abnormalities. The EEG records showed definite abnormalities in 9, and minor abnormalities in 5. All patients with HAM for more than 5 years showed definite evidence of cerebral involvement. Our findings strongly suggest that a multifocal pathological process over the entire CNS is probably a common occurrence in HAM.

Adult↗
PubMed1988

A case of moyamoya disease with progressive involvement from unilateral to bilateral.

A case of Moyamoya disease in a child starting with unilateral lesion and developing into bilateral involvement is reported. Angiographic findings at onset showed unilateral involvement, hence, it was filed as a "probable" case according to the diagnostic criteria of the Japanese Cooperative Research Committee. The carotid angiograms, on the other side were totally normal. Three years later the occlusive lesion became bilateral, to meet the criteria as a "definite" case. Clinical manifestations, angiograms, electroencephalograms, and positron emission tomograms in this case are presented, and the relation between the probable and definite cases is discussed.

Arterial Occlusive Diseases↗
PubMed1988

Gliomas with dural invasion: computed tomography and angiography.

This report is a review of the findings of computed tomography and angiography of eight supratentorial gliomas with dural invasion. Computed tomography revealed localized increases in the thickness of ring enhancements at the sites of dural invasion in four cases, which was attributed to increased blood supplies by the meningeal vessels. Angiographically, feeders from the meningeal vessels entered the tumors mostly through relatively broad areas of tumor-dura attachment. A sunburst type of neovascularity from a meningeal artery was seen in only one case. In most such cases the differential diagnosis from meningioma was possible by the computed tomographic and angiographic findings. Selective external carotid angiography was the most important examination for diagnosing dural invasion by gliomas.

Astrocytoma↗
PubMed1988

[Relationship between angiographical manifestations and operative findings in 100 cases of hemifacial spasm].

Relationship between angiographical manifestations and operative findings of hemifacial spasm was studied in 100 cases. Vertebral angiography was performed, and Towne, straight AP, and lateral projections were routinely studied. The anterior inferior cerebellar artery (AICA) directly compressed the facial nerve root exit zone in 54 instances, the posterior inferior cerebellar artery (PICA) in 38, and the vertebral artery (VA) in 11. Compressions by multiple vessels were observed in 3 cases. Anatomical variations of the AICA and the PICA were classified into 3 groups according to their origins and their distributions of blood supply: Type I, normal distribution of AICA and PICA; Type II, common trunk anomaly with dominant AICA (basilar artery origin); and Type III, common trunk anomaly with dominant PICA (vertebral artery origin). In our cases, 35% of them showed normal distribution, 34% dominant AICA, and 35% dominant PICA. Analyses of the angiograms revealed significantly increased numbers of common trunk anomalies when compared with normal angiograms studied by Takahashi. In 60 of the 65 cases with common trunk anomalies, facial nerves were compressed by the main trunk or the branches of the dominant artery. There were 35 cases which belonged to Type I anatomical classification. They were subdivided into 2 groups according to the size of the AICA and PICA: 1. AICA greater than PICA, and, 2. PICA greater than AICA. In the AICA greater than PICA subgroup, the AICA was the offending artery in all but one case. In the PICA greater than AICA subgroup, the PICA was responsible in 9 of 17 cases. In 31 cases, angiograms showed a redundant VA with lateral elongation into the cerebellopontine angle.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗