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Biomedical subjects

K Kinugasa

Publications and source records attributed to K Kinugasa.

At least 55 records · Page 3Linked to original sources
PubMed1987

[Giant, fusiform and dissecting aneurysms at the vertebro-basilar junction--report of five cases and their clinical pathophysiological aspects].

Five cases of giant, fusiform, and dissecting aneurysms of the vertebro-basilar junction, in which direct surgical treatment was not feasible, are reported. Their initial symptoms were as follows: 3 subarachnoid hemorrhages (2 fusiform aneurysms, 1 giant aneurysm), 1 mass sign (giant aneurysm), and 1 ischemic sign (dissecting aneurysm). In two patients, one with a giant and one with a dissecting aneurysm, preoperative proximal vertebral occlusion was carried out by inflated balloon for 30 to 100 minutes, under observation of clinical signs and measurement of distal arterial pressure. This catheter technique with an inflated balloon provides the means to assess the effect of vertebral artery occlusion in the alert patient, and to determine if occlusion is tolerated or not. In one case with a giant aneurysm, the proximal vertebral artery was occluded extracranially with no complications and no recurrent subarachnoid hemorrhage for 1 year. The other four patients (1 thrombosed giant aneurysm, 2 fusiform aneurysms, 1 dissecting aneurysm) whose contralateral vertebral arteries were hypoplastic, and who refused to operation, were treated conservatively for 6 months to 6 years. Their outcomes were better than expected, with no recurrent subarachnoid hemorrhage nor aggravation of clinical symptoms except for the one case with a dissecting aneurysm whose deterioration was presumed attributable to late cerebellar cortical atrophy.

Aortic Dissection↗
PubMed1987

[Primary empty sella syndrome treated by transsphenoidal extradural balloon expansion--a case report].

A 34-year-old woman was admitted for the chief complaints of headache and blurred vision. She had bilateral papilledema and slight increase in CSF pressure (175mmH2O) with normal visual acuity and field. Neurological and hormonal examination were normal except for over response of PRL and TSH to TRH test. The sella was enlarged and MRI and metrizamide CT demonstrated intrasellar CSF filling with remodeling of the pituitary gland. The patient was diagnosed as primary empty sella syndrome associated with benign intracranial hypertension. The complaints did not subside for six months. The patient was treated via the transsphenoidal approach. The dura mater of the floor of the sella was elevated by extradural balloon expansion filled with silicone, and subsequently the empty sella was obliterated. Her headache disappeared and amblyopic attack also improved. Obliteration of the empty sella with an extradural silicone balloon via the transsphenoidal approach seemed to have been effective for headache and visual complaints of primary empty sella syndrome which did not respond to medical therapy.

Adult↗
PubMed1986

[A new treatment by occluding spring embolus for carotid-cavernous fistula].

The authors describe a new technique for simple, direct and safe obliteration of a carotid cavernous fistula (CCF) with occluding spring embolus (OSE), preserving the carotid artery flow. The patient was 47 year-old man who was admitted to our department on September 3, 1984 complaining of left conjunctival injection, exophthalmos and bruit at the left temporal region. Angiograms revealed a typical cavernous dural AVM (spontaneous CCF) on the left side with bilateral dural ECA-ICA blood supply. He was treated with transvascular Ivalon embolization of the bilateral ECA. A clinical symptom after transvascular embolization improved transiently, but one month later he developed progressive chemosis in addition to the previous symptom. A left frontotemporal craniotomy was done and six OSEs through polyethylene tube was inserted into the cavernous sinus and the fistula was closed completely. Angiogram during procedure was taken to establish the topographical relationship of OSE, carotid artery and the cavernous sinus. Postoperatively his chemosis and conjunctival injection were decreased and gradually cleared up within three weeks. Postoperative angiogram showed complete closure of the fistula.

Carotid Artery Diseases↗
PubMed1986

[Superficial temporal to superior cerebellar artery anastomosis for rostral brain stem infarction].

The authors report a case of superficial temporal to superior cerebellar artery anastomosis (STA-SCA anastomosis) for progressing rostral brain stem infarction with an excellent result. Precise operative techniques were also described. A 47-year-old male was admitted to our hospital on November 9, 1984, because of sudden onset of dysarthria and ataxic gait. CT revealed a low density area in the pons. Left vertebral angiogram showed occlusion of the left vertebral artery just distal to the origin of the posterior inferior cerebellar artery (PICA). Arterial branch of the left cerebellar hemisphere were filled via the left PICA to the left SCA and anterior inferior cerebellar artery anastomosis. Right brachial angiogram showed the hypoplastic right vertebral artery which ended at the PICA. The rostral basilar artery, both posterior cerebral arteries (PCA's) and right SCA were filled through anastomosis from the right PICA. The posterior circulation was not filled by either of the carotid arteries. In spite of antiplatelet agglutination therapy, the patient had two more episodes of dysarthria, dysphagia, right hemiparesis and gait disturbance. Because of progressing stroke, STA-SCA anastomosis was carried out on the right side on February 27, 1985. During operation, the blood pressure was maintained above the level of 130 mmHg, and intravenous mannitol injection and spinal drainage were done to preserve the right temporal lobe from intracerebral hematoma and/or edema caused by retraction. Postoperatively, the patient has been free from new ischemic attack. He has only slight hemiparesis now eight months after operation. Right external carotid angiogram showed a patent STA-SCA bypass and good filling of SCA's and PCA's bilaterally.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Stem↗
PubMed1985

Effect of intraluminal bile on the feedback regulatory mechanism of pancreatic enzyme secretion in conscious rats.

The effect of intraluminal bile on the well-known feedback regulatory mechanism of exocrine pancreatic secretion exerted by intraluminal trypsin was investigated in conscious rats with pancreatic, biliary and duodenal fistulae. The stimulated pancreatic enzyme secretion caused by diversion of bile-pancreatic juice from the intestine was apparently suppressed by intraduodenal reintroduction of pancreatic juice or bile-pancreatic juice, while it was slightly suppressed by intraduodenal reintroduction of bile. Although additional reintroduction of bile did not alter the already suppressed pancreatic enzyme secretion by the presence of pancreatic juice in the intestine, diversion of bile stimulated the suppressed pancreatic enzyme secretion by intraluminal bile-pancreatic juice. Infusion of sodium taurocholate into the duodenum with diversion of bile-pancreatic juice effectively inhibited pancreatic enzyme secretion. The inhibitory effect seemed to be dependent on the concentration of taurocholate infused into the duodenum. The results suggest that bile and bile acid have an important role in the feedback regulatory mechanism of pancreatic enzyme secretion, at least partly directly inhibiting the secretion.

Amylases↗
PubMed1983

Effects of accumulation of phosphocreatine on utilization and restoration of high-energy phosphates during anoxia and recovery in thin hippocampal slices from the guinea pig.

Effects of accumulation of phosphocreatine (P-creatine) on utilization and restoration of high-energy phosphates during anoxia and recovery were studied using thin hippocampal slices from the guinea pig. Incubation of slices with creatine (5 to 30 mM) increased the content of tissue P-creatine, in a linear fashion, and these increases depended on the concentration of creatine and the incubation period to as long as 3 h. Concentration of ATP in the slices was not altered. A high concentration of tissue P-creatine (40 to 100 mmol/kg protein) accumulated by incubation with creatine reduced the rate of ATP exhaustion during anoxia whereas P-creatine itself was rapidly decreased. During reoxygenation after anoxia, concentrations of ATP and P-creatine rapidly recovered in slices preincubated with creatine. Concentrations of P-creatine previously exhausted during anoxia increased to 100 mmol/kg protein after 25 min of reoxygenation whereas the concentration was 35 mmol/kg in the control slice. Elevation of the concentration of P-creatine may therefore prolong the survival time of brain tissue during anoxia and facilitate recovery during reoxygenation.

Adenosine Triphosphate↗