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Biomedical subjects

K J Kiwak

Publications and source records attributed to K J Kiwak.

10 recordsLinked to original sources
PubMed1988

Embolism of cerebral tissue to lungs: report of two cases and review of the literature.

Two patients with head injury and pulmonary emboli of brain tissue are described. Both patients developed persistent bleeding with elevations of prothrombin time, partial thromboplastin time, and decreased platelet counts. Postmortem examination identified multiple skull fractures, subdural and subarachnoid blood, cortical tears, and intraparenchymal hemorrhages. Lacerations of dural venous sinuses were documented in each case. Multiple pulmonary arteries contained plugs of cerebral tissue, including fragments of cerebral and cerebellar cortex, and white matter. The literature concerning brain tissue emboli is reviewed. In neonates, three patients who survived longer than 1 hour were found to have evidence of persistent hemorrhage. Among both children and adults, our two cases are the only ones reported with associated clotting abnormalities. Brain tissue embolism in neonates occurs after difficult vaginal deliveries, often in conjunction with the use of forceps. Tears of the tentorium cerebelli or falx cerebri have been documented at postmortem examination in the majority of these cases. By contrast, brain tissue embolism in children and adults occurs in association with severe closed or penetrating head injury. In several cases, as in the two reported here, postmortem examination has demonstrated a large cerebral venous defect as the probable site of entry of brain tissue into the systemic circulation.

Accidents, Traffic↗
PubMed1985

Leukotriene production in gerbil brain after ischemic insult, subarachnoid hemorrhage, and concussive injury.

A leukotriene-like immunoreactivity was measured by radioimmunoassay in the gerbil forebrain following ischemia and reperfusion, subarachnoid hemorrhage (SAH), or nonlethal concussive brain injury. In each paradigm an increase in immunoreactivity levels was found. Peak levels were reached 15 to 30 minutes after each insult, and slowly returned to baseline over the next 24 hours. The study supports the suggestion that cerebral vessels and circulating blood are capable of producing leukotrienes, and that a major source of production is a nonvascular component within gray matter, possibly the cortical neuron. Leukotrienes may play a role in the pathophysiology of cerebral edema formation, cerebral vasospasm, seizure activity, and other central nervous system abnormalities. These studies are the first to demonstrate leukotriene production in gerbil brain following SAH or concussive brain injury.

Animals↗
PubMed1984

Synthesis of compounds with properties of leukotrienes C4 and D4 in gerbil brains after ischemia and reperfusion.

6-Sulfidopeptide-containing leukotriene-like immunoreactivity was synthesized in gerbil forebrains after bilateral common carotid occlusion and reperfusion. At 5, 10, or 15 minutes of ischemia, concentrations increased significantly and became more marked on reperfusion. Immunoreactivity was highest in forebrain gray matter and was below the detection limit of the assay in brain regions remote from the zone of ischemia. In vitro experiments with vascular cells and organ cultures of cerebral arteries indicate that the cerebral blood vessel wall is not a major source of biosynthetic activity in the brain. These experiments demonstrate leukotriene biosynthesis by the brain. Because synthesis occurs during ischemia and reperfusion and because leukotrienes are potent vasoconstrictors and promoters of tissue edema, they may play a role in the pathophysiology of cerebral ischemia.

Animals↗
PubMed1984

Benign intracranial hypertension and facial diplegia.

Benign intracranial hypertension (BIH) may occasionally be associated with false localizing cranial nerve palsies. Abducens nerve palsies reportedly occur in 10% to 60% of patients with BIH, whereas other cranial nerve palsies occur much less frequently. We treated a woman with benign intracranial hypertension and facial diplegia who showed complete resolution of her cranial nerve palsies after control of her elevated intracranial pressure with a lumboperitoneal shunt. The pathophysiologic course of cranial nerve palsies in patients with BIH is uncertain but in most cases probably represents a nonspecific pressure-related phenomenon, as was clearly demonstrated in this patient. The clinical association of BIH and facial diplegia has not, to our knowledge, been reported previously.

Adult↗
PubMed1983

Torticollis in three children with syringomyelia and spinal cord tumor.

There are numerous well-known causes of acquired torticollis. However, an extensive review of the literature reveals only a rare, brief remark that associates torticollis with syringomyelia. We present three children found to have syringomyelia and spinal cord tumor, with torticollis as an early finding in each.

Astrocytoma↗