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Biomedical subjects

K Sano

Publications and source records attributed to K Sano.

At least 37 records · Page 2Linked to original sources
PubMed1979

[Usefulness and adverse effects of intrathecal metrizamide instillation (author's transl)].

Radiographic quality as well as adverse effects of intrathecal metrizamide instillation was prospectively investigated in thirty-three clinical cases admitted to the department of neurosurgery, University of Tokyo Hospital, and Kantoh Teishin Hospital. Metrizamide CT cisternography was performed in fifteen cases using in most cases 10 ml of 170 mg I/ml solution through lumbar route. Eleven cases exhibited "normal" pattern CSF circulation and the remaining four, "delayed" pattern. Eight cases (53%) experienced headache, nausea, and/or vomiting several hours after the instillation. All of these belong to the "normal" pattern group. Four cases of "normal" pattern received electroencephalographic examinations before and after metrizamide instillation. Three revealed appearance of negative spike and slow wave burst or sharp waves one to twenty-four hours after the instillation, along with penetration of metrizamide into brain parenchyma. Diagnostic quality was interpreted as "good" in eleven cases. Small acoustic neurinoma, pituitary adenoma, arachnoid cyst, and subdural hygroma were diagnosed among others. Metrizamide ventriculography was done in four cases. No untoward effect of significance was attributed to metrizamide per se. Cervical myelograpy and/or CT myelography was done in fourteen cases using, in most cases, 10 ml of metrizamide 170 mgI/ml. Polytome tomography with metrizamide instillation through lateral cervical puncture was highly diagnostic, whereas, ordinary X-ray with lumbar instillation yielded less satisfactory results. CT myelography in cases of subarachnoid block required good consideration on instillation site and positioning of the patient. Six cases (50%) among twelve cases where metrizamide had run into the cranial cavity experienced headache, nausea, and/or vomiting to a lesser degree than those of cisterno graphy. Metrizamide is the first contrast agent ever made which can be safely introduced into human subarachnoid space, if administered judiciously, nervous. However, metrizamide is weakly toxic to central system and provokes minor untoward effects as well as electroencephalographic abnormalities and, sometimes, clinical convulsive seizure. It would be wiser to restrict the dosage of metrizamide in cisternographic study, expecially in cases of "normal" pattern CSF circulation, to 1.2 gI or 7 ml of 170 mg I/ml solution. Routine use of X-ray cisternography should thus be discouraged because it needs higher concentration of metrizamide in the intracranial cisterns.

Adolescent↗
PubMed1979

Pharmacological and biochemical studies on a new potential neuroleptic, N-(1-benzyl-3-pyrrolidinyl)-5-chloro-2-methoxy-4-methylaminobenzamide (YM-08050).

Pharmacological and biochemical properties of a novel compound, N-(1-benzyl-3-pyrrolidinyl)-5-chloro-2-methoxy-4-methylaminobenzamide (YM-08050) were compared with those of haloperidol (HPD) and chlorpromazine (CPZ) in animals. YM-08050 was more potent than either HPD or CPZ in inhibitory effects on a variety of behaviors such as apomorphine-induced stereotypes behavior and emesis, methamphetamine-induced stereotyped behavior, conditioned avoidance response and open field behavior. YM-08050 induced catalepsy only at much higher doses than to exhibit the inhibitory activities. The inhibitory effects of YM-08050 on [3H]dopamine binding and dopamine-sensitive adenylate cyclase in the synaptic membrane fractions of canine caudate nucleus were much greater than those of HPD and CPZ. The results suggest that YM-08050, a potent central dopaminergic blocker, is a potential antipsychotic drug with less extrapyramidal side effects than those of HPD and CPZ.

Animals↗
PubMed1979

[The ultrastructural study of choroid plexus papillomas (author's transl)].

Four cases of choroid plexus papilloma (CPP) obtained at the time of surgical excision were examined by light and electron microscopy and compared with normal choroid plexus (CP) of mouse and chick. Ultrastructurally CPPs were the same as CP except in the following two points: In CCPs 1) pinocytotic vesicles of the vascular endothelium and 2) cytoplasmic filaments were more increased in number than in CP. In one case, which showed malignant changes in some parts, we found prominently increased spot desmosomes and cytoplasmic filaments as compared with other three cases, microcysts at the apical portion with other features suggesting the secretory process except for the absence of basal infoldings and myelin bodies. As for the apical tight junction fusion of the two outer-leaflets of the adjacent cytoplasmic membrane was observed as in CP. This fact suggests that there is a blood-CSF barrier also in CPPs as in CP.

Adolescent↗
PubMed1979

[Diagnosis and treatment of cerebellar hemorrhage: comparison of hypertensive hemorrhage with hemorrhage caused by small angiomas, and CT findings (author's transl)].

In spontaneous cerebellar hemorrhage emergency surgical intervention is often life-saving. Clinical features and the operative results of hypertensive cerebellar hemorrhage (18 cases) were compared with those of hemorrhage caused by small angiomas (7 cases). Hypertensive hemorrhage occured most frequently in the seventh decades. Two thirds of the patients developed brainstem compression syndrome within a week from onset. One third remained awake or drowsy throughout their clinical course. Surgical removal of a hematoma was carried out in 13 patients with four deaths. Of note, two comatose patients regained consciousness after surgery, and were discharged with residual ataxia. Rupture of a small angioma occurred in younger patients. Their clinical course was sub-acute or chronic associated with focal cerebellar dysfunction. All seven surgically treated patients subsequently regained independent function. CT findings have been found helpful not only for diagnosis but also in defining appropriate therapy. Hematomas larger than 3 cm in diameter produced signs of rapidly progressing compression of the brainstem. Thereby, regardless of the cause of bleeding, emergency removal of a clot is indicated even in awake patients. Hematomas of 2 to 3 cm produced brainstem compression or prolonged cerebellar dysfunction, and occasionally require surgical decompression. Hematomas smaller than 2 cm can be managed conservatively, since they were absorbed spontaneously in three weeks without residual functional disturbances. However, in case of a young patient exploration should be performed for a probable "cryptic" angioma.

Adolescent↗
PubMed1979

[The temporary occlusion of middle cerebral artery in cats--the correlation between the rCBF and the histological changes (author's transl)].

The correlation between the changes of regional cerebral blood flow (rCBF) and the histological changes were examined using the middle cerebral arterial (MCA) occlusion model in cats. A total of 24 adult cats were tracheostomized and anesthetized by inhalation of halothane. The right MCA was clipped by the transorbital approach. Two hours after the application, the clip was removed and the brain was recirculated for two hours. Then, the brain was perfusion-fixated and the histological studies were carried out. The animals were separated into two groups according to the severity of histological damages using light and electron microscope. Severe cortical damage was present in 8 cats (Group A). In the remaining 16 cats, little or no cortical damage was found (Group B). The averaged rCBF values before occlusion were 45.4 +/- 2.3 ml/100 gm/min in group A and 46.5 +/- 1.6 in group B, showing no statistically significant difference. Between these two groups, however, there was a statistically significant difference in the averaged rCBF values during the ischemic period. In group A, the averaged rCBF values during MCA occlusion was only 6.8 +/- 0.9 and in group B, it was 25.3 +/- 0.8. In the recirculation period, there was a prompt and uniform recovery of rCBF in group B. Whereas in group A, a marked diversity of rCBF ranging from oligemia to hyperemia ensued. This is presumably a reflection of inhomogeneous blood flow, or patchy non-filling of the cerebral cortex. The critical values of rCBF as to the occurrence of severe cortical damage in two-hours MCA occlusion is considered to lie between the lowest value of group B and the highest value of group A, i.e., around 12--15 ml/100 gm/min.

Animals↗
PubMed1979

[Morphological changes of platelets in disturbed cerebral microcirculation--a clinical study using a scanning electron microscope (author's transl)].

Many factors are known that contribute to the pathogenesis of the cerebral microcirculatory disturbances, but, there are few reports investigating the roles of the intravascular components directly. The present study was undertaken to evaluate morphological changes of platelets in patients with cerebral damage, in relation to neurological signs, especially consciousness levels. Morphological changes of platelets were observed in 72 patients with intracranial organic lesions. These lesions included subarachnoid hemorrhages, hypertensive cerebral hemorrhages, cerebral infarctions, brain tumors, chronic subdural hematomas, and acute epidural hematomas. Two blood samples were taken, one from the internal jugular vein (the blood after cerebral perfusion), the other from the cubital vein (systemic blood). After fixative procedures with 1% glutaraldehyde, the differences in the three-dimensional structures of platelets were compared, using a scanning electron microscope. In general, remarkably activated forms of platelets were found in the blood after cerebral perfusion in cases with severely impaired consciousness in the acute stage. But, in cases without severe neurological deficits, such changes of platelet forms were rarely seen. A close relationship was suggested between the degree of neurological damage (especially consciousness levels) and that of platelet activation in the acute stage. In the chronic stage, these changes of platelets in the cerebral blood disappeared. Changes of platelet forms were not found in the systemic blood from the cubital vein, even in the acute stage. It is clinically suggested that morphological changes of platelets play an important role in the pathogenesis of the disturbed cerebral microcirculation. Obstruction of cerebral microvasculature may be caused, mechanically by the activated platelets themselves, and/or chemically by vasoconstrictive substances released from these platelets. Therefore, in the treatment of these intracranial organic lesions, it is concluded that the possible roles of activated platelets should be taken into consideration.

Adolescent↗
PubMed1979

Association of cerebral aneurysm with pituitary adenoma.

Seven cases of coincidental aneurysm with pituitary adenoma found through the review of our personal series of 95 pituitary adenomas over a period of five years are reported. The incidence of coexisting aneurysms in our series of pituitary adenomas (7.4%) was significantly higher than that in other brain tumors (1.1%) (p less than 0.001). Its clinical significance is discussed including the indications for four-vessel angiography, the surgical approaches to these pituitary adenomas, and the management of the associated aneurysms.

Adenoma↗
PubMed1978

Boron-neutron capture therapy in relation to immunotherapy.

The essential feature of tumour therapy rests upon host-tumour interaction. To achieve therapeutic effects, a prerequisite to immunotherapy is the reduction of tumour cells in the host's body. Such measures should not be immunosuppressive. Cytotoxic chemotherapy is not appropriate in this regard. Supraradical surgery and non-specific radiotherapy are not desirable for preservation of nervous function, if their immunosuppression is not as severe as cytotoxic substances. Boron-neutron capture therapy is a highly specific and least immunosuppressive means of reducing tumour cells of the central nervous system. A brief introductory review of basic research is presented. The interim clinical results are: (i) Treatment of recurrent glioblastoma: Survival extension obtained by neutron capture therapy is 21.9 +/- 7.2 mos in contrast to that obtained by conventional treatments of 6.7 +/- 0.6 mos (p less than 0.001), (Total survival 26.3 +/- 6.7 mos); and (ii) only three patients including two glioblastoma cases were treated with neutron by the same surgeon who, by performing the first tumour operation, had the advantage in topographic knowledge for determining the radiation field. They survived 4, 5, and 6 years in almost fully active conditions. The new Musashi Institute of Technology Reactor Thermal Neutron Therapy Facility and the increased domestic production of boron-10 isotope have enlarged the therapeutic capacity to two dozen patients a year.

Adolescent↗
PubMed1978

Timing and indication of surgery for ruptured intracranial aneurysms with regard to cerebral vasospasm.

The authors survey 443 cases of intracranial aneurysms treated in the past seven years. 403 cases were operated upon with microsurgical techniques. The operative mortality was 5.4 per cent, and 82.4 per cent of surgically treated cases are well and working, leading useful social lives. It was found that cases submitted to surgery in the first three days after subarachnoid haemorrhage (SAH) (the day of SAH being counted as the first day) showed good results, little appearance of postoperative vasospasm, and no mortality due to vasospasm. Cases operated upon after one week from the insult of SAH also showed good results, whereas fatal postoperative vasospasm was seen in cases operated upon on the 4th--7th day after SAH. Cisternal, ventricular, and epidural drainage are recommended after the clipping of aneurysms in the acute stage of SAH. There were 68 cases with preoperative vasospasm. There was no case in which vasospasm was identified during the first four days after SAH, while 66 per cent of the cases exhibited vasospasm between the sixth and ninth days after SAH. These 68 cases can be classified into four groups: 1. 8 cases died from vasospasm before surgery: 2. 8 cases had renewed bleeding mainly when vasospasm began to subside. 3. 22 cases underwent surgery after vasospasm had subsided, the duration of vasospasm ranging from 8 to 24 days, on an average 14 days; 4. 30 cases underwent surgery while vasospasm was still present; of this group, (4E) 15 cases submitted to surgery, on an average 4.5 days after the onset of vasospasm, manifested deterioration of clinical states because of aggravation or new appearance of vasospasm; (4L, 15 cases which underwent surgery, on an average 7.4 days after the onset of vasospasm, showed no such deterioration. In the follow-up, well and working cases were seen in 45.5 per cent (3.), 60 per cent (4E), and 80 per cent (4L), respectively. The authors classified vasospasm into three types: Type 1, extensive diffuse, Type 2, multi-segmental, and Type 3, local. Type 1 was prognostically worst, Type 3 good, and Type 2 was located between these two types.

Humans↗