Biomedical subjects

K Shoin

Publications and source records attributed to K Shoin.

25 records · Page 2Linked to original sources

PubMed1986

[A large AVM extensively involving the parietal region and posterior fossa].

A 47-year-old male was concerned with a large AVM involved extensively in the parietal region and the posterior fossa. Radiological examinations showed multiple radiolucencies in the parietal and occipital bone and torturous vascular nets (nidus) in those bones on the angiograms. Nidus was found also in the dura mater in the posterior fossa. Therefore, this case seemed to be an extremely rare case of calvarial AVM in the parietal region with the mixed calvarial dural AVM in the posterior fossa. His symptoms were bruit, transient hemiparesis and Gerstmann's syndrome in addition to the symptoms due to raised intracranial pressure. Favorable results of therapies could be attained by extensive exfoliation of dura mater from the cranial bone and incision of proximal dura mater in the sinus.

Arteriovenous Malformations↗

PubMed1985

[Intraventricular and intracerebral hemorrhage as complication of hemodynamic therapy for vasospasm after subarachnoid hemorrhage--analysis of 2 cases].

Intraventricular and intracerebral hemorrhage were observed in two patients (36-year-old male and 45-year-old female) whose ischemic deficits from vasospasm after subarachnoid hemorrhage due to ruptured aneurysm were treated or prevented with hemodynamic therapy. Both patients had a long history of arterial hypertension and showed high values of urinary catecholamine after subarachnoid hemorrhage. The cause of hemorrhage seemed to be the induced hypertension and the volume expansion in one case and the uncontrolled hypertension and the volume expansion in the other case. Although two patients were treated with the volume expansion therapy continuously after hemorrhage, neurological status deteriorated due to infarction caused by vasospasm. We discussed the limit and risk of hemodynamic therapy for patients who had a long history of arterial hypertension and increased catecholamine release after subarachnoid hemorrhage.

Adult↗

PubMed1985

[Necrotomy of brain stem glioma and local administration of anticancer agents].

We studied 14 cases with brain stem glioma. Five cases in 7 malignant gliomas showed large central necrosis in CT scans. The central necrosis neighboring the surface of the pons or the fourth ventricle was removed with CO2-LASER and cavitron ultrasonic aspirator (necrotomy) and a few pellets were given in the residual tumor in four cases. Three cases showed remarkable improvement of clinical course. A case came back to work. Other two children resulted in high Karnofsky rating. A case did not improve and died 10 months after the surgery. CT scans showed the decompression of the fourth ventricle due to decrease in volume of central necrosis. The preoperative enhanced lesion was decreased in degree of contrast enhancement. The necrotomy of brain stem glioma and local administration of anti-tumor-agents in residual tumor showed excellent results in some cases. We should scrutinize CT scans and NMR in cases with brain stem glioma.

Administration, Topical↗

PubMed1984

Diagnosis of an "isodense" pituitary microadenoma by dynamic CT scanning. Case report.

A case of Nelson's syndrome with an adrenocorticotropic hormone-secreting pituitary chromophobe microadenoma is presented to demonstrate the potential capability of rapid sequential (dynamic) computerized tomography (CT) scanning for the diagnosis of a pituitary microadenoma that was isodense with the adjacent pituitary gland on conventional enhanced CT scanning. The dynamic CT scans showed transient high density in this microadenoma contrasting with the pituitary gland in the early-enhancement phase, and thereafter the contrast density was indistinguishable from that of the pituitary gland in the delayed-enhancement phase. For the detection of pituitary microadenoma, dynamic CT combined with subsequent delayed CT scanning can provide diagnostic and localizing information.

Adenoma, Chromophobe↗

PubMed1984

[Concentration of antibiotics (cefoperazone) in human brain, brain tumor tissue and cerebrospinal fluid].

The transfer of cefoperazone (CPZ) into cerebrospinal fluid (CSF), brain or brain tumor tissue was studied in 13 cases with brain tumor, chronic subdural hematoma and benign intracranial hypertension in 1982. The peak values of CPZ in serum came up immediately after its rapid intravenous administration and then decreased exponentially. The concentration of CPZ in CSF started to increase with a long delay of about 60 min. The average peak level in CSF remained 21.6 micrograms/ml and corresponded to 10.3% of the peak level in serum. The best transfer of chloramphenicol into CSF has been reported, while that of CPZ would be one of the next. The CPZ levels in CSF showed a slower decay than in serum. The concentration of CPZ in brain reached the peak level in less than 30 min and the average peak level was 36.5 micrograms/g cerebral tissue. The brain to blood rate of the CPZ concentration was 11.1%. The CPZ levels in the brain showed a rapid decrease like the transition of antibiotic levels in serum. The antibiotic levels in brain tumors were divided into two groups. The one showed sharp peak about one tenth of the values in serum. The other was of a slowly increasing type.

Adult↗

PubMed1983

[Hemangiopericytoma of the meninges].

A 44-year-old farmer complained blurred vision and disturbance of recent memory. During his driving car traffic accident happened due to his right homonymous hemianopsia. On the 1st admission, neurological examination revealed choked disc(1 D.), hemianopsia, memory disturbance, dyscalculia, dyslexia and dysgraphia. The angiograms showed feeding arteries from left middle cerebral artery and posterior cerebral artery. Tumor vessels looked like cork-screw in the arterial phase and homogeneous tumor shadow was depicted in late venous phase. Contrast enhancement CT scan revealed a nodular homogeneous high dense lesion on the occipital region. Hemorrhage during every craniotomy was too much to remove and at last metastasized to left II rib and right VIII rib and right radius. Their histological examination reveals numerous endothelial-lined vascular channels and atypia of tumor cells with mitoses. Silver impregnation demonstrates networks of reticulum fibers surrounding the capillaries and tumor cells. Hemangiopericytoma in meninges forms entity and our case reports the WHO classification. Total removal should have to be done once for all by means of LASER (light amplification by stimulated emission of radiation).

Adult↗

PubMed1983

[Intrathecal administration of amikacin in postoperative refractory meningitis].

The intrathecal administration of amikacin (AMK) (50--100 mg/day) was effective for 3 cases of postoperative refractory meningitis caused by gentamicin (GM) resistant organisms. The infecting pathogen of case 1 was K. pneumoniae and that of case 2 was S. epidermidis, while no pathogen was cultured in case 3. The causative pathogens in the former were eradicated only with AMK. No therapeutic response was gained with GM, but with AMK in the latter. High tone hearing impairment was observed in case 1 and transient vomiting was observed in case 3. However, these side effects were trivial for the severity of disease. It is suggested in these 3 cases that the high dose intrathecal administration of AMK may be extremely useful in the treatment of postoperative refractory meningitis which has shown no response to GM.

Aged↗