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Biomedical subjects

K Kyoshima

Publications and source records attributed to K Kyoshima.

At least 19 recordsLinked to original sources
PubMed1992

[Growth of the graft and astrocytic reaction following transplantation of fetal brain to adult rat's brain. Part I: Tissue transplantation into cerebral cortex, lateral ventricle, subarachnoid space and cerebral cortical cavity].

Brain transplantation has been examined as one of the therapeutic methods in the animal models of Alzheimer's disease. Among a lot of problems inherent to therapeutic brain transplantation, we have investigated implanting techniques and methods. Small pieces of fetal basal forebrain tissue containing cholinergic neurons were transplanted into adult rats' cerebral cortex, lateral ventricle, subarachnoid space, and the cerebral cortical cavity which had been made 10 days before transplantation (delayed cavity technique). Two to 3 months after transplantation, growth of the grafts, neurites elongation and astrocytic reaction were observed by Nissl staining, histochemical staining for acetylcholinesterase and immunocytochemical staining for glial fibrillary acidic protein (GFAP). Intracortical grafts were small and surrounded by thick glial scar formation, but there was found a partial lack of glial scar and host-graft neuronal integration was also observed. Both intraventricular and subarachnoid grafts grew relatively well. GFAP-immunoreactive cells had a tendency to gather near the margin of the graft and perivascularly. These facts seemed to suggest that reactive astrocytes were also taking part in support of the homeostasis of environments in the graft tissue. By delayed cavity technique, better growth of the grafts was observed, but dense glial and connective tissue scar tissues developed and prevented the outgrowth of neuronal processes. Nevertheless, hyperinnervation from graft to host cortex was partially noticed. It should be stressed that although the hyperinnervation may be effective for recovery of the host from the central nervous system damages, it may possibly damage the host's neuronal circuits.

Animals↗
PubMed1992

[Growth of the graft and astrocytic reaction following transplantation of fetal brain to adult rat's brain. Part II: Cell suspension transplantation into the subarachnoid space].

Suspensions of basal forebrain cells of fetal rats were transplanted into the subarachnoid space of adult rats through a microsyringe needle which was transcortically inserted to the subarachnoid space. Two to 3 months after the transplantation, growth of the graft, neuritic elongation, neovascularization, and astrocytic reaction were examined by Nissl staining, histochemical staining for acethylcholinesterase and Klüver-Barrera's myelin staining, vascular relief images and immunohistochemical staining for laminin, and immunocytochemical staining for glial fibrillary acidic protein (GFAP). Transplanted fetal neurons survived and grew very well over the brain surface and exhibited facilitated neuritic elongation. Several bundles of myelinated fibers linking the subarachnoid and the subpial grafted cells were noticed, but the myelinated fibers penetrating the intact pia mater were not verified. In the grafted tissue, extracellular matrix was formed and a lot of small vessels and capillaries were noticed. Many GFAP-immunoreactive cells were seen in the graft. They had a tendency to gather perivascularly and near the margin of the graft tissue facing subarachnoid space. The subarachnoid space is thought to be an adequate place for transplanted neuronal and glial cells to grow. The subarachnoid space contains the cerebrospinal fluid and also it contacts with rich pial vessels, so that it seems to be superior to the intraparenchymal area in respects of a supply of oxygen and nutrition and of low tissue pressure. Transplanted tissue may be supposed to work as the exocrine and/or endocrine organ which secretes neurotransmitters and their synthetic enzymes and neurotrophic factors. If this is true, it would imply that the subarachnoid space is considered as a promising site for implantation.

Animals↗
PubMed1992

Dorsal internal carotid artery aneurysms with special reference to angiographic presentation and surgical management.

Aneurysms arising from the dorsal wall of the internal carotid artery are rare. The authors surgically treated twenty dorsal internal carotid artery aneurysms. Pre-operative angiographic findings were reviewed and classified into three types. Eleven aneurysms projecting superiorly on the lateral angiogram were found to be adherent to the base of the frontal lobe by the pterional approach. Five aneurysms which had been superimposed with the internal carotid artery on the lateral angiogram were found adhered to the medial surface of the temporal lobe. Four aneurysms not seen on the angiogram had no adhesion. Two aneurysms, which had not been seen on the initial angiograms, were visualized on the angiograms taken during the period of vasospasm. This type of aneurysms can be the source of a subarachnoid haemorrhage of unknown origin and requires repeated examinations. Premature rupture occurred intra-operatively in five cases and postoperative bleeding was encountered in two. Clipping technique is discussed from the viewpoint of preventing intra- and postoperative rupture.

Adult↗
PubMed1992

Multiple spinal neurinomas presenting visual disturbance as the initial symptom: case report.

A case of multiple spinal neurinomas with visual disturbance is reported. A 63-year-old man was admitted with a complaint of progressive visual disturbance due to papilledema without spinal symptoms and signs. The neuroimaging studies demonstrated communicating hydrocephalus and two mass lesions in the cauda equina. Both tumors were found to be neurinomas. Intracranial hypertension secondary to spinal tumors is unusual, and multiple spinal neurinomas are rare. In the patient without spinal symptoms and signs, it is difficult to make a diagnosis of spinal tumor. Importance of checking for a spinal cord lesion by magnetic resonance imaging in such a case is stressed.

Diagnosis, Differential↗
PubMed1992

Introduction of high definition television system to neurosurgical documentation.

The high definition television (HDTV) system is introduced to microneurosurgery. Five cases with intracranial lesions: three cerebral aneurysms (giant aneurysms of the anterior communicating artery and internal carotid artery, aneurysm of the basilar artery), one acoustic neurinoma and one skull base meningioma, were operated on under the microscope using the HDTV system. The surgical procedures of each case were relayed and recorded by the system. In two of the five cases, we used two sets of HDTV system to produce stereoscopic projection. The HDTV system provided us with images of superior quality with a distinctly greater resolution than ordinary video systems.

Adult↗
PubMed1992

Transpetrosal extreme lateral suboccipital approach for extensive posterior fossa epidermoid cyst--case report.

A new transpetrosal extreme lateral suboccipital approach was adopted to totally remove an extensive posterior fossa epidermoid cyst in a 36-year-old male. The pathological behavior of intracranial epidermoid cysts may impose surgical problems during removal of the tumor. However, planning based on neuroimaging allows optimum access to tumors and microsurgery achieves safer and more complete removal.

Adult↗
PubMed1992

Subfrontal schwannoma--case report.

A rare case of subfrontal schwannoma occurred in a 33-year-old male with the chief complaint of headache. Computed tomography demonstrated a low-density mass in the subfrontal region. Magnetic resonance imaging indicated the mass extension into the ethmoidal sinus. The tumor was totally removed via a subfrontal approach. The histological diagnosis was schwannoma. The most likely origin of the tumor is the meningeal branches or anterior ethmoidal nerve.

Adult↗
PubMed1992

A newly designed puncture needle for suction decompression of giant aneurysms. Technical note.

A newly designed puncture needle for aspirating large or giant aneurysms is described. This puncture needle represents a modification of an intravenous catheter with an internal needle. It is designed to prevent blood from leaking when the internal needle is removed and has a lateral tube for aspiration. Following aneurysm puncture with the parent artery temporarily trapped, the catheter is positioned on the head frame with a brain spatula and a self-retaining retractor. Blood is suctioned through the lateral tube with a syringe or the suction system normally used in the operating room.

Equipment Design↗
PubMed1992

[Reconstruction of anterior cranial base and face with free musculocutaneous flap; report of two cases].

The treatment of extensive cranial base tumor is still challenging. Wide resection of a cranial base tumor would lead to exposure of the vital structures such as the brain and dura, and would result in a large dead space in the cranium and in the connecting area between the nasal cavity and the intracranial space. Recently free tissue transfer has become a reliable method in the field of reconstructive surgery. In the craniofacial region, free tissue transfer is useful to reconstruct a complicated defect. We report two cases where free latissimus dorsi M-C flap and rectus abdominis M-C flap were useful in reconstructing the defect following removal of an anterior cranial base tumor. We discuss the advantages.

Aged↗
PubMed1991

Development of the operating computerized tomographic scanner system for neurosurgery.

A computerized tomographic (CT) scanner system for intraoperative imaging is presented. The system consists of the following: 1) CT scanner with a mobile gantry, 2) digitally controlled operating table with central processing unit (CPU) and encoder unit; the table can be controlled by the scanner computer as accurately as the scanner bed, and 3) exclusively designed head fixation devices. It allows us to scan the patient on the operating table in the operating room pre-operatively, intra-operatively and immediately after surgery.

Computer Systems↗
PubMed1991

Intraoperative monitoring of somatosensory evoked potentials in patients with cerebral aneurysm--correlation between central conduction time and postoperative neurological status.

Somatosensory evoked potentials (SEPs) were monitored during 55 aneurysm procedures in 49 patients to investigate the relationship between central conduction time (CCT) and neurological status in the immediate postoperative period. Significant CCT prolongation was observed in 15 cases. The postoperative neurological status deteriorated in nine of the 15 cases, compared with three of 40 cases without appreciable CCT changes. This difference was significant at p less than 0.05. The CCT prolongation was ascribable to temporary vascular occlusion in half of the cases. Intraoperative SEP monitoring is useful in predicting neurological morbidities in the immediate postoperative period in patients with cerebral aneurysm.

Adult↗
PubMed1991

[Generalized choreic movement associated with subarachnoid hemorrhage].

A case of generalized choreic movement associated with subarachnoid hemorrhage is reported. A 71 year-old hypertensive woman suddenly developed severe headache 14 days before admission. Consciousness disturbance and involuntary movement involving the face and upper extremities appeared about 8 days after onset. The involuntary motion was diagnosed as generalized choreic movement. CT scans showed subarachnoid hemorrhage with ventricular dilatation and periventricular lucency involving bilateral caudate nuclei. On admission the patient was stuporous with Hunt & Kosnik Grade 4. She showed involuntary choreic movement in both arms, trunk and face; hemiparenis and hyperreflexia were absent. An angiography revealed a right internal carotid-anterior choroidal artery aneurysm with vasospasm. After clipping the aneurysm in the following day, the consciousness disturbance and choreic movement gradually improved. By eight days after operation, the choreic movement completely disappeared. An MRI showed lacunar infarcts in the bilateral basal ganglia, predominantly in the caudate nuclei. In our case, the choreic movement is supposed to have been caused by impaired circulation in the bilateral corpora striata due to vasospasm and hydrocephalus after subarachnoid hemorrhage, in addition to the preexisting lacunar infarcts in the basal ganglia. This is claimed to be the first reported case of generalized choreic movement in associated with subarachnoid hemorrhage, which improved after surgery.

Aged↗
PubMed1991

[A case of disproportionately large communicating fourth ventricle (DLCFV) combined with syringomyelia and Chiari malformation].

We report a rare case of disproportionately large communicating fourth ventricle (DLCFV) combined with syringomyelia and Chiari malformation. The case was a 27-year-old male who underwent ventriculoperitoneal (V-P) shunt on the right side for hydrocephalus caused by traumatic intracerebral and intraventricular hemorrhage. One month later, he became somnolent with posterior fossa symptoms (nausea, vomiting and nystagmus). CT scan demonstrated enlarged fourth ventricle, which was diagnosed as DLCFV because the ventriculogram revealed patency of the aqueduct. One and half month later a second V-P shunt was made on the left side to increase the shunt flow. He became ambulatory with a cane, although the fourth ventricle remained moderately dilated on CT scan. Two months after the additional V-P shunt, he slipped and hit the occiput and immediately became tetraparetic. The patient was treated conservatively under the diagnosis of central spinal cord injury. The MRI taken 2 months after the accident revealed Chiari malformation (type 1), syringomyelia and a dilated fourth ventricle which was compressing the brainstem. After the fourth ventriculoperitoneal (FV-P) shunt, the tetraparesis transiently improved but then again worsened. On the CT scan the syrinx did non change in size, while the size of the fourth ventricle became normal. After syringoperitoneal (S-P) shunt the patient showed a moderate improvement of tetraparesis. Unfortunately he suffered appendicitis complicated with peritonitis and all the shunts were immediately changed to external drainage. However, the patient developed meningitis and became paraplegic. The motor function of the upper extremities slightly improved by aspiration of fluid via the external drainage system from the syrinx.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Astrocytoma with granular cell tumor-like changes. Report of a case with histochemical and ultrastructural characterization of granular cells.

A peculiar case of astrocytoma showing a histological appearance similar to granular cell tumor was reported. The tumor consisted of large round cells containing numerous intracytoplasmic eosinophilic granules, partially intermingled with atypical astrocytes, and part of it showed a transition to distinct areas of fibrillary astrocytoma. The granules were periodic acid-Schiff-positive (with resistance to diastase digestion), negative for fat stains and revealed lectin-binding patterns similar to those in granular cell tumor. Ultrastructurally the granules were partially membrane-bound, dense bodies compatible with secondary lysosomes. It was suggested that the granular cells were of astrocytic origin because of their immunoreactivity for glial fibrillary acidic protein (GFAP) and ultrastructural observation of intermediate filaments corresponding to GFAP.

Adult↗
PubMed1989

[Angiographically occult vascular malformations in the posterior fossa].

Three cases of spontaneous intraparenchymal hemorrhage in the posterior fossa were operated upon, and the diagnosis of thrombosed vascular malformation was histologically confirmed in two of them. So-called "angiographically occult" vascular malformations often present characteristic magnetic resonance (MR) images, namely, iso- to high intensity signal core surrounded by a low intensity signal rim or area on both T1 and T2 weighted images. Such findings are thought to indicate that subacute and chronic intraparenchymal hematoma has a relatively short T1 and long T2 relaxation times, resulting in an area of relatively increased signal intensity, and that hemosiderin deposits apparently decrease T2 relaxation time by paramagnetic effect. Most such lesions do not show significant perifocal edema. Occasionally, however, perifocal edema may be seen as in our Case 3, and the differential diagnosis from the tumor, particularly bleeding tumor, may become difficult even with the recent technical standards of high resolution CT and MRI. Reasons responsible for non-visualization of such vascular malformations at angiography are discussed. Small size of the lesion, slow blood flow through it, compression by adjacent clot or gliotic scar, spontaneous or secondary thrombosis with hyalin degeneration, and destruction at its rupture are possible factors.

Adult↗
PubMed1989

Bilateral subdural empyema due to Salmonella enteritidis in an infant.

A case is reported of an infant with bilateral subdural empyema due to Salmonella enteritidis. This Salmonella species is extremely uncommon as a pathogen in a focal infection in the central nervous system. Treatment by early surgical drainage, followed by systemic antibiotics and subdural irrigation, was successful. This is the first case reported of infantile subdural empyema due to S. enteritidis.

Drainage↗
PubMed1989

Pituitary adenoma with multiple ciliated cysts: transitional cell tumor?

The case of a prolactin-secreting pituitary tumor with multiple cyst formation is described. Ultrastructurally, the cyst-lining cells were ciliated and closely resembled those of Rathke's cleft cyst but contained secretory granules, and no basal lamina formation was seen between the adenoma cells and the lining cells. Immunohistochemical study revealed that the adenoma cells consisted of both prolactin-secreting cells and growth hormone-secreting cells. The lining cells were immunoreactive with the antiserum to cytokeratin. No S-100 protein-positive cells were seen. The origin of this tumor is discussed.

Adult↗