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K Kitamura

Publications and source records attributed to K Kitamura.

At least 1,099 records · Page 61Linked to original sources
PubMed1986

[Autoimmune antibody in moyamoya disease].

The association of autoimmune antibody and HLA antibody has been documented concerning the pathogenesis of moyamoya disease. In this paper, we study the autoimmune antibody in moyamoya disease and discuss its relationship with the pathogenesis. Autoimmune antibody was evaluated in 13 cases of moyamoya disease. The age distribution of the patients ranged from 13 to 55, with an average of 37 years. Eight were females, 5 males. Autoantibody was studied with native DNA (double strand DNA) and ANA (antinuclear antibody). Antibody was noted in 3 cases (23%) in native DNA study, and 2 cases (15%) in ANA study. Significantly high incidence was recognized compared with normal control (4%). In relation to the clinical features, such as initial symptoms, time of onset, neurological findings, no significant correlation was recognized. This study suggests that immunological factors might play a partial role in the pathogenesis of moyamoya disease.

Adolescent↗
PubMed1986

[Influence of hemisphere lesions on the contralateral blink reflex].

Electrically elicited blink reflexes were investigated in 28 patients with unilateral hemispheral lesion. The reflex evoked by electrical stimulation of the supraorbital nerve contralateral to the side of the hemispheral lesion was absent or depressed in 14 out of 28 cases. The abnormal patterns of the blink reflexes were devided into four different types (Type AB, Type AD, Type EB, and Type AB-EB). The Type AB, recorded in 4 cases, consisted of bilateral absence of late component (R2) when the supraorbital nerve on the non-lesion side was stimulated. In contrast, the reflex responses were almost normal bilatarally when the stimulus was applied to the nerve on the lesion side. The Type AD was observed in 2 cases. When the stimulus applied on the non-lesion side, both ipsilateral and consensual R2 were markedly delayed in latency. The Type EB was seen in one case. In this type the absence of the late component (R2) was confined to the clinically affected side independent of the side of stimulation. The Type AB-EB was observed in 4 cases. This type consisted of bilateral absence of R2 component after stimulation on the non-lesion side as seen in Type AB. However, when the stimulus applied on the lesion side, R2 component was only elicited on the ipsilateral side of stimulation. Based on our results, the authors emphasize that abnormality of the contralateral blink reflex in the patients with unilateral hemispheral lesion showed not only Type AB or Type AD but also Type AB-EB which may indicate lowered excitability of bulbar lateral reticular formation of the lower brain stem as well as spinal trigeminal system. This type was presumably due to loss of facilitatory influences associated with the contralateral hemispheral lesion, closely correlated with the lower postcentral region advocated by Ongerboer de Visser.

Adult↗
PubMed1986

[A case of pituitary adenoma combined with Rathke's cleft cyst].

A case of pituitary adenoma associated with Rathke's cleft cyst is reported. A 35-year-old woman suffering from visual disturbance, polydipsia-polyuria and amenorrhea galactorrhea was admitted. Since 3 years before admission, she had been administered thyradin under the diagnosis of primary hypothyroidism. Visual acuity was 0.1 on the right and 0.06 on the left, and visual field examination showed bitemporal hemianopsia. Endocrinological study disclosed primary hypothyroidism and moderate hypopituitarism. CT scan showed a low density mass with ring-like enhancement extending in the enlarged sellar cavity and in the suprasellar region. MRI showed a cystic mass in the sellar cavity extending to the suprasellar region, and a solid mass in the left posterior part of the sellar cavity, and the later was thought to be pituitary adenoma. On August 27, 1984, right frontal craniotomy was performed. The right optic nerve was compressed upward, and the right carotid artery laterally with a grayish bulging mass. About 3 ml of grayish colloidal fluid was aspirated and the capsule of the cyst was excised. Postoperative course was uneventful. The visual acuity and visual field defects were improved. Endocrine examination revealed panhypopituitarism. Histologically, the cyst wall was composed of ciliated columnar cells and partially stratified squamous cells. The solid part showed typical pituitary adenoma. There are 5 reports in the literature on the combination of a pituitary adenoma and a Rathke's cleft cyst. In our case, it is thought that the long-standing hypothyroidism induced pituitary adenoma. Therefore, our case with combination of a pituitary adenoma and a Rathke's cleft cyst should be regarded as an occasional coexistence rather than the entity of the transitional cell tumor.

Adenoma↗
PubMed1986

Boron distribution analysis by alpha-autoradiography.

The distribution of the boron-10 compound, Na2 10B12H11SH, which is now in clinical use for boron neutron capture therapy for brain tumors, was studied topographically and quantitatively in rats using neutron-induced alpha-autoradiography. Transplanted intracerebral tumors in Sprague-Dawley rats were used. In the normal brain, only a minute amount of 10B (less than 1 microgram 10B/cm3) was found in the brain parenchyma, except for the infundibulum and area postrema. Boron-10 accumulated in the brain tumors. The tumor-to-blood concentration ratio of 10B increased with time after injection and reached unity 12 hr after injection. The tumor concentration calculated at that time was 18 micrograms 10B/cm3. This study clearly shows that this 10B compound accumulates in the transplanted rat tumors in the brain and that tumor concentration and tumor-to-blood ratio of 10B can provide a sufficient condition for brain tumor treatment.

Animals↗
PubMed1986

[Serial measurement of bradykinin of the cerebrospinal fluid in patients with subarachnoid hemorrhage].

The bradykinin (BK) concentration of the cerebrospinal fluid (CSF) in 21 patients with subarachnoid hemorrhage (SAH) was measured serially by radioimmunoassay (RIA). The values were 134.9 +/- 93.9 pg/ml (mean +/- standard deviation) on the day of onset, 38.3 +/- 31.8 pg/ml on the first day after onset, 23.4 +/- 22.8 pg/ml on the second day, 16.6 +/- 9.9 pg/ml on the third day, 15.5 +/- 6.0 pg/ml on the fourth day, and 14.8 +/- 5.9 pg/ml on the fifth day. In the controls the BK concentration in the CSF was 8.0 +/- 3.3 pg/ml (n = 10). On the other hand, none of 5 patients with intraventricular hematoma due to intracerebral hemorrhage had a high level of BK in the bloody CSF at the initial stage (15.2-26.0 pg/ml). This shows that BK is not produced only by the mixture of CSF and blood. BK is produced by the activation of Hageman factor that is considered to be activated by trabecula of collagen bundles in the subarachnoid space in the case of SAH.

Adult↗
PubMed1986

[Grading and operative indication for hypertensive cerebellar hemorrhage].

Fifty six patients with hypertensive cerebellar hemorrhage diagnosed by CT scan were hospitalized from November 1976 up to June 1984. The 35 male and 21 female patients ranged in age from 24 to 84 years, and 39 of them were operated on. The important factors related to prognosis of cerebellar hemorrhage were level of consciousness, size of hematoma on CT scan, and massive ventricular hemorrhage resulting in obstruction of the ventricular system. We classified the patient with cerebellar hemorrhage into 5 grades, according to the severity of these factors. Grade I indicates cerebellar signs without disturbance of consciousness and size of hematoma less than 25 mm measured by CT scan. Grade II indicates disturbance of consciousness (stupor), or progressive neurological deficits, and size of hematoma less than 50 mm without acute hydrocephalus. Grade III reveals disturbance of consciousness (stupor-semicoma), and size of hematoma less than 50 mm with acute hydrocephalus. Grade IV reveals severe disturbance of consciousness (semicoma), and size of hematoma less than 50 mm with massive ventricular hemorrhage. Grade V exhibits deep coma, and more than 50 mm diameter of hematoma. The prognosis of all of 9 patients in Grade I was good, Eleven out of 13 patients (85%) in Grade II and all of 9 patients in Grade III were alive. Fourteen out of 19 patients (74%) in Grade IV and all of 6 patients in Grade V expired in spite of operation. The patients of Grade I should be treated by conservative therapy. The patients of Grade II, Grade III, and Grade IV should be managed surgically. Surgical treatment for Grade V is not advisable.

Adult↗
PubMed1986

[Arteriovenous malformation. 3. Dynamic CT of arteriovenous malformation].

Various methods have been reported for the purpose of measurement of hemodynamics of the cerebral arteriovenous malformations. In this paper, using a TCT-60A-30 scanner, dynamic computed tomography was performed on 18 cases with arteriovenous malformations. The initial scan of the dynamic CT was started simultaneously with the start of an intravenous injection of uniodinated contrast medium (8 ml/sec.), serial 4.5 sec. scan repeated 8 times. The data for each scan were segmented into three, and a series of 24 rapid-sequence scan images (CT-angiography) was generated. The time-density curve by use of Thompson's methods was analyzed with multiple ROIs which were bilaterally set up for the nidus and its surrounding areas considering each arterial supply. And the flow parameters, such as the peak concentration (PC), the mean transit time (MTT) and the PC/MTT were calculated. We thought that under the condition of normal state of blood-brain-barrier and fixed standards of multiple factors such as the cardio-pulmonary function, systemic blood volume, viscosity of the blood and many others, PC manifested vascular beds of ROIs, MTT brain circulating time, PC/MTT blood flow respectively. In the ROIs of the nidus, high values of PC (115.7 +/- 51.9 CT number) and PC/MTT (14.8 +/- 6.28 CT number/sec.), and reduction of MTT (8.47 +/- 2.28 sec.) were revealed in comparison with surrounding areas. The ROIs of the nidus showed enlargement of vascular beds and blood flow and reduction of brain circulating time. On the other hand, in the ROIs surrounding the nidus, MTT of affected areas (10.33 +/- 2.78 sec.) was slow compared with it nonaffected areas (9.33 +/- 2.09 sec.), however PC and PC/MTT were equal in both areas.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[Efficacy of intracisternal papaverine on symptomatic vasospasm].

This study reports the effect of intracisternal administration of papaverine in 15 patients with vasospasm due to rupture of aneurysm. All patients had undergone clipping of aneurysm and had neurological deterioration and decreasing level of consciousness. Bolus injection of 40 mg of 1% papaverine hydrochloride was started on day 6.3 +/- 1.7 and continued for 4.4 +/- 1.6 days. In seven cases serial angiogram after initial dose revealed dilatation of IC and/or anterior, middle cerebral arteries at 30 min and further dilatation up to 85% increase in diameter at 60 min, which continued at least 90 min. Arteries with marked vasospasm responded more to papaverine than those with less vasospasm. There was a close correlation between degree of vasospasm and vasodilatation effect (r = 0.88, p less than 0.01). In all but two cases vasodilatation tended to become prominent by repeat doses, twice a day, for two to seven days (r = 0.87, p less than 0.01). Vasodilatation was observed only in IC and proximal trunks of ACA and MCA where papaverine could make direct contact, but not in the distal branches beyond A3 or M3. Neurological examination showed improvement of paresis or level of consciousness in 7 cases but no effect in 6 cases. Intracerebral hematoma occurred in two cases (one by high concentration 4% papaverine) during the treatment. Therefore intracisternal papaverine is the treatment of choice in cases with symptomatic vasospasm with some cautions on concentration to be administered.

Cerebral Angiography↗
PubMed1986

[Chronological changes in the blink reflex and MRI in a patient with lateral medullary infarction].

Recently, the brainstem pathways of bilateral late reflexes (R2) of electrically elicited blink reflex have been well established. An afferent delay or block of the late reflexes is closely related to a lesion of the lateral medullary portion. The chronological alteration of blink reflex (BR) was studied to compare with radiological abnormalities on MRI in a patient with lateral medullary infarction on the right side. A diagnosis of Wallenberg syndrome was made clinically and location of the lesion was identified in detail by MRI. The infarcted region which was well demonstrated as an increased intensity area on SE images obtained 52 days after the onset of symptoms was much smaller than that on SE as well as on IR image 21 days after the onset of symptoms. Therefore, it was concluded that more than half of the increased intensity area on the SE images obtained 21 days after the onset of symptoms recovered from the condition of being extremely damaged by ischemia on the right lateral medullary portion in this patient. On the other hand, in the initial BR 26 days after the onset of symptoms, the late reflexes (R2) were consistently absent bilaterally when the affected side (right) was stimulated and normal when the normal side (left) was stimulated. This type of BR abnormality is compatible with an afferent block of late reflexes (R2). The early reflex (R1) was normal on either side. Whereas in the second BR at 55 days after the onset of symptoms, the late reflexes turned to be normal in latency when the right side was stimulated.(ABSTRACT TRUNCATED AT 250 WORDS)

Blinking↗
PubMed1986

[A case report of cerebral venous dysgenesis].

A case classified to "cerebral venous dysgenesis" (Kagawa et al 1972) is reported. A 16-year-old girl was admitted complaining of psychomotor seizure which began seven years before. At the first admission (seven years ago) she was diagnosed as psychomotor seizure and cerebral venous dysgenesis by CT scan, EEG and cerebral angiography. Then she was treated by medication (anticonvulsants) for seven years. At the second admission (this time) left temporal lobectomy was performed by means of monitoring the cortical EEG. CT scan showed atrophy of the left temporal lobe. Spike and wave complex was seen in EEG. Carotid angiography disclosed the abnormal networks among the fine venules and their connection to tortuous and coiling veins. The abnormality was seen in the frontal, parietal, and temporal area. After operation psychomotor seizure has been controlled by medication. Pathologically tortuous vessels, gliosis and arachnoidal fibrosis were shown. This case should be classified to "cerebral venous dysgenesis" differentiated from the venous angioma. Classification of venous malformation, clinical signs, angiographical findings, and genesis were discussed.

Adolescent↗
PubMed1986

Assessment of outcome prediction in severe brain damage patients with brainstem auditory evoked response.

Patients with various neurological disease resulting in severe brain damage and having Glasgow Coma Scale (G.C.S.) score of less than ten (mean 5.6) were studied with brainstem auditory evoked response (BAER) during the first few days of onset. Among them were subarachnoid hemorrhage, head injury, intracerebral hemorrhage, pontine hemorrhage, intraventricular hemorrhage and bleeding tumor. BAERs were graded into four levels from one (normal) to four (most abnormal). Outcomes were categorized through the Glasgow Outcome Scale. Comparison of the results between BAER and G.C.S. as predictors of outcome was quite similar. Both were reliable in terms of predicting a correctly pessimistic outcome (90% or more), but not a correctly optimistic outcome (40% or less).

Adolescent↗
PubMed1986

[Cerebral arteriovenous malformations. 2. A study of cerebral hemodynamics].

Regional cerebral blood flow (rCBF) in 16 patients with cerebral AVM was measured using 133-Xe inhalation cerebrograph, and in 3 patients rCBF was measured using stable xenon enhanced CT. Neurological status and angiographical findings were studied in the connection with rCBF measurement. RCBF in almost patients with hemorrhagic episodes was low in the frontal area (frontal depression). The larger the size of nidus is, the higher the shunt flow through nidus is, therefore, there were no significant difference of mean rCBF between the affected and non-affected hemisphere independently of the size of nidus. But in the area adjacent to AVM nidus, particularly the nidus over 20 cm3 of volume, surrounding ischemic focus was noticed. And it was thought that brain swelling due to the normal perfusion pressure break through may occur when the nidus over 20 cm3 was removed. The reduction of rCBF of the non-affected cerebral hemisphere was noticed in the cases with nearly medical seated AVM and the rCBF reduction of the non-affected or affected hemisphere was noticed in the cases with posterior fossa AVM. There was similarity between the results concerning the hemodynamic status obtained by 133-Xe inhalation cerebrograph and stable xenon enhanced CT. But 133-Xe inhalation cerebrograph was less useful for estimation of cerebral hemodynamics than the stable xenon enhanced CT, because overestimation of rCBF was noticed in 133-Xe inhalation cerebrograph.

Adolescent↗