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Biomedical subjects

M Hokama

Publications and source records attributed to M Hokama.

17 recordsLinked to original sources
PubMed1995

Noninvasive cerebral optical spectroscopy: depth-resolved measurements of cerebral haemodynamics using indocyanine green.

To investigate the feasibility of a newly developed, near-infrared optical spectroscopy device, we analysed measurements of the infrared tracer indocyanine green (ICG) using sensors with a single near infrared light source and multiple light detectors. Two ml of ICG dye, 1.0 mg ml-1 in concentration, were injected into the internal carotid artery during cerebral angiography in 14 adult patients. The resultant washout curves were measured bilaterally using sensors with 4 detectors spaced at 10, 20, 30 and 40 mm from the infrared light source on the right side, and 15, 25, 35 and 45 mm from the source for the left side, respectively. Washout curves were analysed to determine the relative amplitude of the ICG absorption signal and deduce each detector's penetration distance. When ICG was injected into the internal carotid artery, relative absorption increased with detector distance from the light source. No substantial difference in attenuation was observed in any of the detectors during external carotid injection of ICG. The resultant information related depth of penetration of the light with source-detector separation distances. The feasibility of the system for measuring cerebral oxygen saturation and haemodynamics noninvasively or monitoring at bedside is discussed.

Adult↗
PubMed1994

[An autopsy case of periarteritis nodosa associated with disseminated strongyloidiasis].

An autopsy case of periarteritis nodosa associated with disseminated strongyloidiasis in a 59-year-old woman is reported. The patient had unknown fever of 38 degrees C and marked impairment of renal function, for which pulse therapy of steroid was performed. Electromyogram showed myogenic pattern, and biopsy of the biceps presented necrotizing angitis of small arteries. Renal biopsy showed marked infiltration of lymphocytes in the stroma, and frequent hyalinosis and crescent formation of the glomeruli. Two months after admission, the patient died of respiratory failure associated with sepsis and disseminated intravascular coagulopathy. Postmortem examination disclosed strongyloides stercolaris and fungi in both lungs with extensive hemorrhage. Terminal ileum and ascending colon had multiple erosions, extensive hemorrhage, numerous strongyloides stercolaris, and frequent necrotizing angitis in the mucosa. Necrotizing angitis was also demonstrated in both kidneys.

Animals↗
PubMed1993

Indications and limitations for CT-guided stereotaxic surgery of hypertensive intracerebral haemorrhage, based on the analysis of postoperative complications and poor ability of daily living in 158 cases.

The authors have studied the indications and limitations for computerized tomography (CT)-guided stereotaxic surgery (CTGS Surgery) of hypertensive intracerebral haematomas (ICH), based on the analysis of 158 patients in our institutions. Of 158 patients, 120 had putaminal haemorrhage, 21 thalamic, 14 subcortical and 3 in other locations. The patients ranged in age from 37 to 82 years (average 60). Haematoma volume ranged from 8 to 140 ml (average 43). Eleven patients in the series worsened postoperatively because of rebleeding in 6 cases, cerebral infarction in 2, and unknown causes in the remaining 3 cases. Seven of the 11 patients pre-operatively had untreated hypertension and 3 had mild liver dysfunction without major haemorrhagic tendency. Most postoperative complications were seen in older patients and in those with severe neurological deficit or chronic disease. All these cases ended in poor outcome. From our study, we propose three indications for CTGS Surgery: absolute, aggressive and passive indications. The absolute indication is applied to those who would have been operated on by conventional open surgery. The aggressive indication is for those with mild neurological deficit so that early rehabilitation can be started to regain higher cerebral function. The passive indication is for elderly patients and those with severe neurological deficit or chronic disease. This indication must be decided carefully because poor outcome is likely.

Activities of Daily Living↗
PubMed1993

Surgical approaches to the anterior communicating artery aneurysm and their results.

In the past 12 years, 102 cases of anterior communicating artery aneurysm have been operated upon in our institution. Two basic microsurgical approaches (pterional and interhemispheric) were used. The combined pterional and interhemispheric approach was performed in a few cases. The rational for each surgical approach is discussed in relation to anatomical factors such as the height of the aneurysm neck, the side of dominance of A1, the relationship between the bilateral proximal parts of A2s, and the projection of the aneurysm. The final outcome was correlated to the preoperative clinical grading and timing of surgery. The overall results were as follows; 82.4% good, 5.9% fair, 4.9% poor, and 6.8% mortality rate. The operative results for pterional and interhemispheric approach were comparable with each other. In the combined approach, we got poorer results which could be related to excessive brain retraction and unfavourable clinical grading.

Adult↗
PubMed1993

Remote-control vascular occluder: technical note.

We have designed a new remote-control vascular occluder for the temporary control of arterial blood flow. It is a modification of the biopsy forceps used in stereotactic surgery. The arm of the occluder is flexible and can be set so that it does not disturb the surgeon's view. The occluder is positioned with the blades open on the vessel to be occluded. This device, which is held with a self-retaining retractor connected to the head frame, enables an immediate on-off remote control of arterial occlusion by closing and releasing the blades with a closing button and releasing lever, respectively. Partial closure of the blades is also feasible. The device can be set in a narrow operating field, when proximal control of a parent artery is necessary at its segment distant from the exposed operating field. It can be used in a variety of vascular cases, including giant aneurysms and large arteriovenous malformations.

Aneurysm, Ruptured↗
PubMed1993

Vertebral artery section for treating arterial compression of the medulla oblongata. Case report.

A case of a 30-year-old man who showed progressive pyramidal tract signs caused by compression of the left vertebral artery is presented. Initial decompression of the vertebral artery by placing a piece of sponge between the artery and medulla had no long-term effect. The left vertebral artery distal to the origin of the posterior inferior cerebellar artery was then sectioned, decompressing the medulla oblongata. The patient's symptoms improved postoperatively. This is the first reported case of brain-stem compression by an elongated vertebral artery treated by sectioning of the artery.

Adult↗
PubMed1993

[Arteries to the pituitary].

The arteries of the pituitary stalk and gland were described using our results as well as data obtained from the literature. There were three types of vessels to the pituitary from above: the superior hypophyseal artery originating from the internal carotid artery, the infundibular artery originating from the posterior communicating artery, and the prechiasmal artery from the ophthalmic artery. There were also three arteries from the cavernous carotid artery; the inferior hypophyseal artery, the capsular artery, and the artery of the inferior cavernous sinus. These arteries were anastomosed each other, making the rich vascular networks, called the "circuminfundibular anastomosis" around the pituitary stalk, and the "inferior hypophyseal arterial circle (or inferior capsular arterial rete)" in the base of the pituitary.

Carotid Artery, Internal↗
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↗
PubMed1991

[A case report of supernumerary deciduous teeth with the permanent successor in the maxillary region].

We found pure primary supernumerary teeth in the maxillary right deciduous incisor region of a 3 year 11 month old girl. We reported the results of her oral and X-ray analysis results. We would like to report our findings on the results of her oral and X-ray analysis. 1) Two of the primary supernumerary teeth were found between the incisor and canine teeth in the right side of the primary dental arch, and their color, form and size were very similar to normal primary lateral incisor teeth. 2) We also found pure secondary supernumerary teeth by means of X-ray analysis. 3) We suggest that the permeability of the X-ray is important for the ascertainment of both primary and secondary supernumerary teeth by mean of X-ray analysis.

Child, Preschool↗
PubMed1990

The benefit of cisplatin-based polychemotherapy for adenocarcinoma of the lung. The Kyushu Lung Cancer Chemotherapy Study Group.

We studied the efficacy of cisplatin-based polychemotherapy for adenocarcinoma of the lung. A total of 136 patients were randomized for treatment with either cyclophosphamide, Adriamycin, cisplatin and mitomycin C (CAPM) or mitomycin C, cytosine arabinoside and tegafur (MCT). Radiation was given to the chests of patients at stage III. The differences in the response rate (35% in the CAPM arm and 13% in the MCT arm) were statistically significant (P less than 0.01). However, the significant difference was observed in stage-IV patients (CAPM, 33%; MCT, 4%; P less than 0.001) and not in stage-III patients (CAPM, 40%; MCT, 40%). The median period of survival was 9.5 months for the CAPM arm and 5.5 months for the MCT arm (P less than 0.035, Wilcoxon-Gehan test; P less than 0.1, log-rank test). Improved median survival for the CAPM regimen was demonstrated only by stage-IV patients (CAPM, 10 months; MCT, 5.5 months; P less than 0.025, Wilcoxon-Gehan test; P less than 0.05, log-rank test). The duration of the response, including PRs and NCs, was significantly different depending on the treatment, showing 5 months for the CAPM arm and 3 months for the MCT arm (P less than 0.05). The significant difference was also only observed in stage-IV patients. Myelosuppression was more severe with CAPM than with the MCT regimen. Nausea and vomiting were significantly increased in patients receiving the CAPM regimen. However, all toxicities were acceptable and there were no treatment-related deaths. We concluded that cisplatin-based chemotherapy, CAPM therapy, was of more benefit to patients with adenocarcinoma of the lung than MCT therapy.

Adenocarcinoma↗
PubMed1990

[Clinical use of prostaglandin E1 during intracranial surgery].

Prostaglandin E1 was administered to 19 patients to induce hypotension during intracranial surgery. Urine volume during the operation and after the first day was well maintained, and serum BUN and creatinine were within normal ranges after the surgery. Serum GOT and GPT increased significantly on the 7th and 14th day after the operation compared with the control, but this did not seem to be the results of PGE1 administration. LDH and ALP showed no significant change. Thirty minutes and two hours after the administration of PGE1, arterial blood oxygen tension decreased significantly. These results suggest that PGE1 does not adversely affect the liver and kidneys, and it can be used safely and is useful to control blood pressure during intracranial operation.

Adolescent↗
PubMed1988

Microsurgical anatomy of the arteries of the pituitary stalk and gland as viewed from above.

The microsurgical anatomy of the arteries of the pituitary stalk and gland as viewed from above was studied in 50 adult cadaveric hemispheres using the operating microscope. There were three types of vessels to the pituitary from above: the superior hypophyseal artery originating from the internal carotid artery, the infundibular artery from the posterior communicating artery, and the prechiasmal artery from the ophthalmic artery. The superior hypophyseal artery originated from the medial to posterior aspect of the internal carotid artery. The average number of vessels of the superior hypophyseal artery was 2.2 per hemisphere, and the diameter was 0.25 mm on average. The majority (76%) of superior hypophyseal arteries arose from the proximal half of the segment between the origins of the ophthalmic and posterior communicating arteries of the internal carotid artery. The infundibular artery originated mainly from the medial side (69%) of the posterior communicating artery. Its diameter was 0.22 mm, and number 0.23 per hemisphere. The number of prechiasmal arteries was 0.06 per hemisphere. As a result, there were on average 2.5 vessels per hemisphere, totally 5 per brain, with the average diameter 0.25 mm, supplying the pituitary stalk and gland from above. The clinical application of these anatomical data to the diagnosis and treatment of suprasellar tumours and carotid-ophthalmic aneurysms is discussed.

Arteries↗
PubMed1988

[Benefits of cisplatin-based polychemotherapy in non-small cell bronchogenic carcinoma. Kyushu Lung Cancer Chemotherapy Study Group].

We studied the efficacy of cisplatin-based polychemotherapy for non-small-cell lung cancer. One hundred nineteen patients with adenocarcinoma or large cell carcinoma were randomized to receive cyclophosphamide, adriamycin, cisplatin and mitomycin C (CAPM) or mitomycin C, cytosine arabinoside and tegafur (MCT), and 48 patients with squamous cell carcinoma were randomized to receive cisplatin, adriamycin and peplomycin (PAP) or mitomycin C, cyclophosphamide, tespamine, toyomycin and tegafur (MCTTT). Radiation was given to the chest in patients with stage I-III disease. The response rates were CAPM, 34.5%; MCT, 13.1% (p less than 0.01) and PAP, 63.3%; MCTTT, 42.3%. A significant difference in response rate between the CAPM and MCT regimens was observed only in stage IV patients and not in stage I-III patients. The median survival was 9.5 months in the CAPM arm vs. 6.5 months in the MCT arm (p less than 0.007), and 8.5 months in the PAP arm vs. 6.5 months in the MCTTT arm. Improved median survival for the CAPM regimen was noted only in stage IV patients and not in stage I-III patients when compared to patients given the MCT regimen, respectively. Nausea and vomiting were significantly increased in patients with cisplatin-based polychemotherapy. Myelosuppression was more severe with the CAPM regimen than with the other chemotherapy regimens. We concluded that cisplatin-based polychemotherapy, CAPM and PAP therapy were of more benefit to patients with disseminated non-small-cell lung cancer than MCT and MCTTT therapy.

Adult↗
PubMed1986

[Combination chemotherapy for bronchogenic carcinoma based on cell type].

Based on the cell types in bronchogenic carcinoma, we treated 123 patients with different regimens of combination chemotherapy. The chemotherapy regimens consisted of CAP (cyclophosphamide + adriamycin + platinum) for 60 patients with adenocarcinoma and large cell carcinoma, PP (peplomycin + platinum) for 29 patients with squamous cell carcinoma and CAV (cyclophosphamide + adriamycin + vincristine) for 35 patients with small cell carcinoma. These regimens were repeated every 4 weeks for at least 2 cycles. The response rates for CAP, PP and CAV were 18.3% (11 PR), 20.7% (6 PR) and 60% (10 CR + 11 PR), respectively. Median survival time (MST) was 12.5 months for CAP, 8.5 months for PP and 9.5 months for CAV. Responders had a significantly (P less than 0.002) improved survival (MST, 15.5 months) compared to non-responders (MST, 7.5 months) in small cell carcinoma. However, there was no significant difference between responders and non-responders in CAP and PP. Survival of patients with PS 0-1 was significantly better than that with PS 2-3 in all treated patients. Nausea and vomiting were severe in patients treated with platinum-based polychemotherapy. There was no renal failure although a transient increase of serum creatinine was noted in CAP and PP. Myelosuppression was mild to moderate in all patients treated with CAP, PP and CAV.

Adenocarcinoma↗
PubMed1985

New CT-guided stereotactic apparatus and clinical experience with intracerebral hematomas.

The conventional Sugita stereotactic frame has been improved to perform CT-guided stereotactic surgery both in the CT and operating rooms. The development of our instrument and the software of the scanners' computer are presented. Newly designed equipment produced almost no artifacts on the CT image. Using the improved stereotactic frame, we have operated upon 44 intracerebral hematomas in the CT room. More than 80% of the cases had satisfactory results. Two complications were encountered, and 1 patient died from pneumonia. Our initial experience of the pre- and postoperative cerebral blood flow measurement with 133Xe inhalation method and single photon emission CT is described.

Cerebral Hemorrhage↗