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Biomedical subjects

M Kurisaka

Publications and source records attributed to M Kurisaka.

At least 37 records · Page 2Linked to original sources

Immunohistochemical localization of superoxide dismutase in congenital hydrocephalic rat brain.

The effects of active oxygen species in the development of congenital hydrocephalus have been investigated. Superoxide dismutase (SOD) is one of the scavengers of active oxygen species and there have been many recent reports on the relationship between neurological disorders by active oxygen species following reperfusion for ischemic brain and SOD. In this study, the localization of Cu-SOD and Zn-SOD in WIC-Hyd congenitally hydrocephalic rat brains was identified by the enzyme unlabeled antibody method. We examined the localization of SOD in the choroid plexus, hippocampus, and ependymal cells of the lateral ventricle and aqueduct of WIC-Hyd rats. SOD was hardly observed in the choroid plexus and faintly localized in the hippocampus and ependymal cells of the congenitally hydrocephalic brain, but was observed equally in the cytoplasm of the choroid plexus, hippocampus, and ependymal cells in control animals. In the hippocampus, less SOD was found in hydrocephalic rats than in controls. The SOD was slightly observed in the CA1 pyramidal cells in hydrocephalic rats. In the lateral ventricle and aqueductal ependyma, less SOD was found in hydrocephalic than in controls rats. The amount of Cu, Zn-SOD in the congenitally hydrocephalic rat brain was less than in the control, especially in the choroid plexus. Therefore, we suspect that the production of SOD is congenitally reduced in the congenitally hydrocephalic rat brain, and this may promote the impairment of the function of choroid plexus and cilia due to increased active oxygen species. The reduction of SOD in the choroid plexus, hippocampus and ependymal cells of ventricles or aqueduct may promote the development of hydrocephalus in the congenitally hydrocephalic rat.

Animals↗

Successful combination chemotherapy (cisplatin, vinblastine, and bleomycin) with small-dose irradiation in the treatment of pineoblastoma metastasized into spinal cord: case report.

A case of successful combination chemotherapy using cisplatin, vinblastine, and bleomycin (PVB) therapy with small-dose irradiation (25 Gy) to treat a pineoblastoma that metastasized into the lumbar region through the cerebrospinal fluid is presented. Pain in the lower extremities and urinary incontinence with paraplegia improved during irradiation of the spinal cord after two courses of PVB therapy administered during a period of 6 weeks. The patient is presently attending school normally and has a score of 100% on the Karnofsky performance scale 4 years after therapy. These results suggest that combination chemotherapy with small-dose back-up radiotherapy may be one of the treatments of choice for recurrent or disseminated pineoblastoma.

Antineoplastic Combined Chemotherapy Protocols↗

Management of a broken atrial catheter migrated into the heart: a rare complication of ventriculoatrial shunt--case report.

A 21-year-old male, who had undergone a ventriculoatrial shunt for hydrocephalus 5 years previously, became stuporous. A roentgenogram revealed that the distal segment of the broken atrial catheter had migrated and become lodged in the heart. Because the fragment had not adhered to the myocardium, it was easily retrieved by the transvenous approach with a retriever catheter. If the migrated catheter does not adhere to the myocardium, transvenous catheter retrieval is absolutely necessary. If, however, the migrated catheter adheres to the myocardium, an open thoracotomy would be required for retrieval, or the alternative of warfarin administration without retrieval may be the treatment of choice, as long as other problems do not occur.

Adult↗

Immunohistochemical study of copper and zinc-superoxide dismutase (Cu, Zn-SOD) in meningiomas.

A localization of copper and zinc-superoxide dismutase (Cu, Zn-SOD) in meningiomas was examined with immunohistochemical technique. Meningiomas include five meningotheliomatous, five transitional, two fibroblastic, and one of each angioblastic, malignant and hemangiopericytic types. The Cu, Zn-SOD localized diffusely in the cytoplasm of tumor cells and in the endothelial cell of vessels and neutrophils, macrophages and red blood cells in the vessels or in the tumor tissue. The Cu, Zn-SOD content in meningiomas was markedly higher in angioblastic, malignant and hemangiopericytic than in meningotheliomatous, transitional and fibroblastic types.

Adult↗

[Predictive factors for in-hospital mortality and delayed mortality following aneurysmal subarachnoid hemorrhage].

It is important to detect predictive factors for in-hospital and delayed mortality of patients with subarachnoid hemorrhage (SAH) due to ruptured aneurysm. Forty-eight patients with initial bleeding of aneurysmal SAH were referred to our hospital from January 1982 to December 1985. In-hospital mortality was 16.7% (8 to 48), and 15% (6) of forty patients died later during the follow-up period. Using the Kaplan-Meier method we were able to conclude that, cumulatively, there was 70.8% probability that much patients would survive for 10 years. We analysed predictive factors of in-hospital and delayed mortality retrospectively. The most significant predictive factor for in-hospital mortality was SAH grading on admission, and for delayed mortality (29.2%) age on admission was the best predictive factor. In fact, two patients died with cardiac event during the follow-up period. This result suggests that, although the SAH grading on admission was the second most significant factor for delayed mortality, patients who survived in the acute phase had a survival probability similar to those in a normal control group.

Adult↗

[Application of intravascular ultrasound imaging to carotid artery].

Although conventional angiography is utilized to assess the extent and severity of carotid artery disease, it yields only a silhouette of the vessel lumen. Intravascular ultrasound imaging (IUI), which has been developed for imaging the coronary artery, can supplement angiography by providing a tomographic perspective of the vessel wall structure. Therefore, we applied IUI (4.3F, 30MHz) to the carotid artery to evaluate the extent of arteriosclerosis, and we were successful in imaging the perspective of the carotid artery. Our results suggest that IUI is a useful device to evaluate the extent of atherosclerosis of the carotid artery.

Aged↗

[Three months angiographic follow-up after successful percutaneous transluminal angioplasty].

Percutaneous Transluminal Angioplasty (PTA) is applied to supra-aortic arteries. Although first follow-up angiography after coronary angioplasty is usually undergone three or four months later, there are few reports of follow-up angiography after PTA of supraaortic arteries. Because of this, we performed follow-up angiography three months after successful PTA on eight cases of stenosis in seven patients. Although no symptom due to restenosis occurred, it was shown to have occurred in one of four cases of internal carotid arterial stenosis. It was a case of ostial stenosis of a left common carotid artery. Restenosis occurred in neither two cases of subclavian arterial stenosis, nor in a case of left middle cerebral arterial stenosis. The overall restenosis rate was 25%. We suspect that it is important to perform a follow-up angiography after angioplasty of supra-aortic arteries, and our result suggests that the restenosis might occur before three months after PTA as well as after coronary angioplasty.

Aged↗

Cerebral paragonimiasis--report of five cases.

Five cases of cerebral paragonimiasis presenting with hemianopsia, convulsion, and gait disturbance are discussed. The cases were all in the chronic stage. The intradermal paragonimiasis reaction, complement fixation, and Ouchterlony tests were not useful for diagnosis. Computed tomography demonstrated calcifications in all cases in sites consistent with the foci of symptoms. Surgical treatment in two cases failed to improve symptoms.

Adult↗

Intracranial lipomas: current perspectives in their diagnosis and treatment.

Intracranial lipomas are very rare lesions, which are probably congenital. Though they can occur anywhere in the intracranial space, a high proportion of cases tend to be ++located around the midline. They are usually asymptomatic. When symptoms do occur, they are frequently the result of co-existing general clinical conditions. Lipomas used to be reported mainly as incidental findings at autopsy, but advances in neuroimaging techniques have greatly improved the likelihood of their being discovered during life. Surgical extirpation is not necessary in the majority of patients, many of whom show remarkable clinical improvement following shunt procedures for obstructive hydrocephalus (when present) as well as vigorous treatment of co-existing conditions.

Brain Neoplasms↗

Intracranial lipomas.

Intracranial lipomas are very rare, probably congenital lesions. Though they can occur anywhere in the intracranial space, a good proportion of cases tend to be located around the midline. Review of the literature as well as our own three cases--which forms the basis of this article--shows that they are mostly asymptomatic. When symptoms occur, they are frequently the result of coexisting general clinical conditions. Lipomas used to be reported mainly as incidental findings at autopsy. Advances in neuro-imaging techniques have vastly improved the likelihood of their being discovered during life. At present however, significant increase in the reported incidence of these tumours is yet to be seen. Surgical extirpation of the tumour is not considered necessary in the majority of patients, many of whom show remarkable clinical improvement following shunt procedures for obstructive hydrocephalus as well as treatment of coexisting conditions such as epilepsy.

Brain↗

Central nervous system bioaminergic responses to mechanical trauma. An experimental study.

Changes in biogenic amines in the brain and spinal cord following penetrating injury were studied in male Wistar rats using high-performance liquid chromatography with electrochemical detection. Rapid increase in hemispheric concentration of these substances was noted beginning shortly after trauma. This trend continued until they were about three to four times control levels by about 24 to 48 hours postinjury. In the spinal cord, however, there was an initial sharp reduction in regional concentrations 2 hours postinjury followed by a slow rise thereafter. By 48 hours postinjury, levels of norepinephrine, dopamine, and serotonin of the cords of injured animals were still less than those of nontraumatized controls. This variation in the central nervous system bioaminergic response with the level of injury raises questions as to its precise role in neurological damage following mechanical insult.

Animals↗

[Ossifying fibroma in the cranial vault. Case report].

Ossifying fibroma is relatively common in the maxilla, but rare in the cranial vault. A 10-year-old girl was referred for painful swelling of the left temporal region. On admission, she presented no abnormal physical and neurological findings except for the painful swelling. Plain skull X-ray films showed a radiolucent lesion of the left temporal bone about 4 cm in diameter, with a hyperostotic area of the parietal side. Computed tomography scan using bone window level also showed an abnormal density lesion in the same site. Curettage of this tumor was performed from a cosmetic point of view and at the family's petition. Histological examination showed vascular fibrous tissue in which lamellar bone was surrounded by osteoblasts.

Child↗

[The studies of melatonin values in the cerebrospinal fluid of hydrocephalic patients].

The changes in daytime levels of melatonin (MLT) in the cerebrospinal fluid (CSF) of twenty seven hydrocephalic patients were studied by the high-performance liquid chromatography (HPLC) method. Patients comprised three with congenital hydrocephalus (spina bifida 1, Chiari type II malformation 2), four post-meningitic hydrocephalus, fifteen brain tumors (chiasmal germinoma 3; malignant glioma of frontal 3, and temporal lobes 1; germinoma 1, teratoma 2, yolk sac tumor 1, epidermoid 1 in pineal region) and five cases of normal pressure hydrocephalus. CSF was collected between 0930 and 1030 h through puncture of the flushing device of shunt system or the lateral ventricle. The lowest value of MLT detected by HPLC was 15 pg/ml. Melatonin values were higher in patients aged under 10 years than over 20 years in the absence of meningitis or tumor in the pineal region. Even at ages over 15 years, higher CSF MLT values were obtained in the patients with meningitis or tumors in the pineal region. These results suggest that the inflammation or invasion of tumor into the pineal gland may stimulate the secretion of MLT by the pineal gland. However, lower MLT values were obtained in all patients over 40 years old. For these reasons, if one may use the changes of MLT values in CSF as a tumor marker or for determination of the treatment modality, time of CSF collection, age of patient, location or character of the tumor and presence of meningitis should be given due consideration. Also, the presence or absence of the rhythmical changes of melatonin values in a day following circadian rhythm are very important in determination of the treatment modality.

Adolescent↗

[A case of recurrent medulloblastoma treated by combination therapy with cisplatinum and tetrahydropyranyladriamycin (PP therapy)].

PP therapy, combination therapy with Cis-platinum (CDDP) and tetrahydropyranyladriamycin (THP-ADR), were performed on a case of recurrent medulloblastoma. CDDP and THP-ADR involve agents difficult to pass the blood brain barrier (BBB), but can pass BBB on the metastatic lesion. PP therapy is considered to be one of the most effective agents for the treatment of recurrent malignant brain tumor.

Adult↗

Bilateral aseptic femoral head necrosis associated with steroid therapy for prolactinoma--case report.

The authors report a recent case of prolactin-secreting pituitary adenoma in a young male who had earlier received treatment for infertility. Following partial adenomectomy, he was placed on postoperative steroid substitution among other treatments, but developed femoral head necrosis several months later. Hormone studies at the time showed significant findings, including an elevated serum cortisol level. The authors conclude that this complication resulted from prolonged steroid therapy and offer suggestions as to how a similar situation may be avoided.

Adult↗

[Gonadotropin, as a tumor marker, in body fluid and tumor tissues of germ cell tumors].

The value of gonadotropin in the body fluids of germ cell tumor patients is its usefulness as a tumor marker. It is also used for differential diagnosis and/or judgement of therapeutic effects. In order to clarify the most effective value of gonadotropin as a tumor marker in the body fluids, we compared the value in serum, liquor and urine with one another. The liquor contained highest (1650 IU/l) value of gonadotropin in the primary intracranial germ cell tumors, mostly in choriocarcinoma. But the gonadotropin value was highest (3050 IU/l) in the serum of secondary intracranial choriocarcinoma. Chiasmal germ cell tumor, except choriocarcinoma, which does frequently secrete gonadotropin (alpha, beta) showed moderate or very high values in the liquor. However, pineal germ cell tumors rarely secrete gonadotropin and sometimes mild high value are obtained in the serum without gonadotropin secretion immunohistochemically. In such cases, the gonadotropin may be increased by indirect mechanism of gonadotropin-secretion following pineal disorder. In most of such cases, the gonadotropin was not human chorionic gonadotropin (HCG) but lutein hormone (LH). Because alpha-subunit of such gonadotropin has the same structure, their antibodies show immunologic cross reaction. So, a count of beta-subunit gonadotropin in the serum or liquor is the best way for differential diagnosis or judgement of therapeutic effects. From our results, it is considered that the tumor secretes HCG if the serum beta-HCG value was higher than 30 IU/l, and that it doesn't secrete HCG if beta-HCG value was lower than 10 IU/l or non calculable. The mild increased HCG may be caused by hypothalamo-diencephalic disorder such as pineal tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[A case of eclampsia with intraventricular hemorrhage].

Our case is a 31-year-old primipara who had undergone a cesarean section for multiple pregnancy and was referred to our clinic because of attack of eclampsia. On admission, her consciousness level was lethargic. Computed tomography on admission showed high density area indicating right paraventricular hemorrhage with ventricular perforation, and low density areas in bilateral basal ganglia. Examination of the cerebral angiogram done six days after onset of symptoms revealed multisegmental vasospasm in Willis' circle mainly. An emergent ventricular drainage was performed. Two weeks later, repeat angiogram revealed that spasm had almost disappeared. Repeat CT scan three months after the onset showed small low density area in the right caudate nucleus and disappearance of the low density areas in bilateral basal ganglia. Her clinical course was uneventful and she was discharged without neurological deficit at about three weeks after the onset. In spite of absence of subarachnoid clot on CT scan, remarkable multisegmental spasm was found on cerebral angiogram. We suspected that eclampsia may have been responsible for the spasm in this case. Bleeding was believed to have originated in the superolateral angle of the lateral ventricle. It was supposed that infarcted hemorrhage or bleeding from small artery due to changes in arterial or venous pressure might have occurred and penetrated into the lateral ventricle.

Adult↗