PubMed Health⌕ Search

Biomedical subjects

M Motomochi

Publications and source records attributed to M Motomochi.

At least 19 recordsLinked to original sources

[Electrocardiographic alterations in expired cases due to ruptured cerebral aneurysm: correlation with other complications relating to the autonomic nervous system].

Forty three expired cases due to ruptured cerebral aneurysm were studied in electrocardiographic alterations with special reference to other complications of the autonomic nervous system. The cases with past history of ischemic cardiovascular disease had been excluded. The age of the patients ranged between 23 to 79 years old (average 50.1 years old). The clinical condition of the patients according to Hunt & Kosnik classification I in 1 case, II in 11 cases, III in 14 cases, and IV & V in 17 cases. The duration between the aneurysm rupture and admission was within 24 hours in 16 cases, 2 to 3 days in 13 cases, 4 to 7 days in 9 cases, and 2 to 3 weeks in 5 cases. The site of ruptured aneurysms was anterior communicating artery in 12 cases, internal carotid artery in 24 cases, and others in 7 cases. The direct surgeries to the aneurysms were performed in 22 cases, and not done in 21 cases. The electrocardiographic alterations were found as follows: flat or inverted T in 19 cases, prolonged QTc in 33 cases, manifest U in 14 cases, ST elevation or depression in 10 cases, Ta (atrial T) in 10 cases, left ventricular hypertrophy in 8 cases, sinus tachycardia in 7 cases, sinus bradycardia in 12 cases, and arrhythmias with SVPC or VPC (supraventricular or ventricular premature contraction), or sinus arrhythmia in 12 cases. Prolonged QTc, and flat or inverted T were most often found in the cases with ruptured aneurysm of the anterior communicating artery, and next in those with the internal carotid artery, and least often in those with others.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Giant cell tumor of the skull.

Two cases of giant cell tumor of the skull are reported. The first patient had a radical operation for a giant cell tumor of the temporal base followed by radiation therapy. The second patient had a partial removal of a giant cell tumor of the occipital bone followed by radiation therapy. The pertinent literature on giant cell tumors originating from the cranial bones other than the sphenoid bone is reviewed.

Adolescent↗

Intracranial double teratomas.

A case of double teratomas located in the pineal region and the fourth ventricle is presented. A simultaneous occurrence from nonmetastatic, separate origins seems rare in cases of mature teratomas. Computerized tomographic scans led to detection of another asymptomatic teratoma. Surgical treatment produced good results.

Brain Neoplasms↗

[A case of hemangioma calcificans (author's transl)].

A 32-year-old male, who had had temporal lobe seizure for the past 10 years, was admitted to the neurosurgical institute of Tenri Hospital on March 10, 1981. Physical examination on admission revealed some memory disturbance, neuroasthenic tendency and a purplish nevus in the left foot. Plain x-ray series of the skull showed several nodular calcified lesions in the medial aspect of the left temporal lobe. Electroencephalography showed sporadic negative spikes and irregular slow waves dominant in the left anterior quadrant of the head. CT scan showed a high-density area in the left hippocampal gyrus with slight enhancement by contrast medium. Under stereotactic consideration, a left temporal osteoplastic craniotomy and total removal of the mass were performed on March 20, 1981. The histological examination proved it to be calcified cavernous hemangioma or hemangioma calcificans after Penfield and Ward (1948). Postoperative course was uneventful; even 4 weeks after surgery, electroencephalogram became normalized, and memory and anxiety scores became better. At present, in spite of decreased anticonvulsant, the patient has had no more seizure since surgery, and has returned to his business without any complaint. The authors have emphasized the necessity of active operation for hemangioma calcificans even for the one located in the depth of the dominant cerebral hemisphere. Stereotactic consideration can make the surgical risk minimize. CT scan especially with its contour plot of the images is helpful precisely to locate the lesion. For the nevus in the left foot, the biopsy was refused by the patient, which might have connection with the intracerebral cavernous angioma.

Adult↗

[Three cases of arachnoid cysts associated with chronic subdural hematoma (author's transl)].

The association of arachnoid cyst of the middle cranial fossa and subdural hematoma has been emphasized previously but is not common knowledge. We present three cases of arachnoid cyst of the middle cranial fossa and associated chronic subdural hematoma. The importance of computed tomography for the diagnosis of arachnoid cyst associated with the hematoma is emphasized. Pathogenesis of arachnoid cyst and the hematoma remain uncertain. However histological findings suggested that subdural CSF collection might be important to develop hemorrhagic outer membrane of the chronic subdural hematoma.

Adolescent↗

[Secondary empty sella syndrome: report of three cases and review of the literature].

Three cases of the secondary empty sella syndrome were reported. Case 1. A 57-year-old female was admitted to our clinic because of recurrent visual disturbance. Fourteen years previously a pituitary adenoma was diagnosed and two courses of radiation therapy was given elsewhere, the total dosage being unknown. Pneumoencephalography revealed air collection in the sellar cavity. Exploratory craniotomy demonstrated an empty sella with downward migration of the optic nerve and chiasm. Case 2. A 40-year-old female was readmitted to our clinic for possible recurrent pituitary adenoma. Three years previously she underwent transsphenoidal surgery and postoperative radiation therapy with a tumor dose of 6,400 rad. She had headache and visual disturbance. Pneumoencephalography showed air extension into the sellar cavity. Case 3. A 50-year-old female was readmitted to our clinic because of general prostration and headache. Ten years previously she received transsphenoidal surgery and postoperative radiation therapy with a tumor dose of 6,650 rad for a pituitary adenoma. Endocrine evaluation revealed a hypopituitarism. Pneumoencephalography showed air extension into the sellar cavity. The etiology of secondary empty sella has not been clarified yet, although the primary empty sella has been considered to result from incomplete development of the diaphragma sellae. We consider that the most important factor should be present in the diaphragma itself. It is conceivable that the diaphragma sellae becomes weak due to 1) compression by the tumor, 2) mechanical injury during operation, 3) radiation effect. Then, these preceding factors might bring about herniation of the optic nerve and chiasm with the diaphragma sellae into the sellar cavity. Therefore, we propose that early diagnosis of pituitary tumor should be important, and that careful packing of the sellar floor at transsphenoidal surgery should be essential to prevent occurrence of the secondary empty sella syndrome.

Adenoma↗

[Case report of acute central cervical cord injury with C7 laminar fracture and extradural hematoma (author's transl)].

A 57-year-old epileptic male with an acute central cervical cord injury was reported, who fell down from 2.5 meter height to a dry river bed presumably during a convulsive seizure. Upon physical examination at the time of admission, 4 hours post trauma, there were severe neck pain with limited neck motion, sensory level at C4 bilaterally, no motion at all in the upper extremities, and minimal motion in the lower extremities as well as apparent urinary retention. Plain cervical spine series showed moderate posterior osteophytes at C4--C5 and C5--C6, although the film of lateral view did not visualize a part of C7 well. After 4 days' clinical observation, a myelography was done at lateral cervical approach between C1 and C2, which showed a complete block at C3. Urgent laminectomy C3 through C7 showed a fracture of the C7 spinous process extending to the bilateral lamina and an extradural hematoma from C3 to C7 with thickness of 3 to 5 mm. Neither pial incision nor dorsal myelotomy was performed because of no remarkable swelling of the cord. Post-operative course was uneventful, the patient recovering first the motion in the lower extremities, urinary retention, and motion in the upper extremities. At 10 months' follow-up after the operation, he could take care of himself in dressing, eating and toileting, although he had had residual motor disturbance in his hands and fingers especially in fine finger movements. It was keenly felt important to visualize C7-T1 in roentgenograms of lateral cervical view in cases of acute cervical injury, for which swimmer view and/or tomogram might be necessary. Queckenstedt's test was criticized as a dangerous maneuver in such case but C1--C2 myelography is considered safer and more informative. Literature on the acute central cervical cord injury were reviewed.

Acute Disease↗

[Two cases of the diencephalic syndrome were reported with hormonal studies (author's transl)].

Two cases of the diencephalic syndrome were reported with hormonal studies. The first case was initially admitted at her age of 4 years and 10 months old. Progressive visual disturbance and horizontal nystagmus had developed one year prior to the admission. Her weight gain had stopped since 10 months old. Partial removal of the hypothalamic pilocytic astrocytoma and 5,000 rad of lineac radiotherapy brought satisfactory effects on her previous symptoms. She was readmitted, however, at her age of 8 years and 10 monts old because of precocious puberty. Her breast development was in Tanner's grade 2, and her bone maturation was equivalent to one of 11 years old. Hormonal studies showed decreased urine 17-OHCS and 17-KS, elevated serum LH, E1 and E2. The CT scan disclosed some enhanced area in the vicinity of the optic chiasm, which had not changed for the last one year. The second case was admitted at his age of 10 years and 9 months old because of progressive marked emaciation of 6 months' duration. Parinaud's sign was only positive neurological finding. The CT verified enhanced areas in the pineal and chiasm. Cytological study of CSF gave the diagnosis of germinoma. Hormonal studies showed decreased urine 17-OHCS and 17-KS, decreased T3, T4, ACTH, and increased PRL as well as increased HGH. Local lineac irradiation by 5,500 rads was given, during which the enhanced area in CT disappeared and his weight gain started. Increased HGH became normalized but paradoxical response of HGH to GTT remained same.

Astrocytoma↗

Spinal epidural meningioma in childhood.

A spinal epidural meningioma in a 14-year-old boy is presented and the literature reviewed. He had several café-au-lait spots and had previously had a subcutaneous lipoma removed from the mid-lumbosacral region.

Adolescent↗

[A case of intracranial germinoma with multiple remote metastases (author's transl)].

A case of suprasellar germinoma with multiple remote metastases was reported including its autopsy findings. Several series of radiation therapy and prolonged steroid administration were considered to be causes of immunosuppression bringing about such metastases. A 29-year-old man had undergone a suprasellar germinoma removal and 5,200 rad of postoperative local irradiation at a university hospital 5 months prior to the admission to our clinic. A walnut-sized left cerebellopontine angle mass was subtotally extirpated by us, which proved to be germinoma. Total dosis of 5,5550 rad with lineac was applied locally to the operated site. Since the second surgery, several nodules had been seen in the lumbosacral region, scalp and left cervical region, which were individually treated with lineac and beta-tron by 5,000, 6,000 and 4,750 rad. The patient had been on steroid substitution therapy for hypopituitarism since the first operation. Eventually the patient expired 9 months after the second operation. Autopsy findings included multiple metastases to the spinal arachnoid, dura, extradural space, spines, scalp, thoracic cage, lymph nodes, heart, lungs, liver, kidney, adrenal and pancreas. Nine cases including ours were reviewed as remote metastases of the tumors in the pineal region and of so-called ectopic pinealomas. The cases of only subarachnoid seeding of these were excluded in this study.

Adult↗

[Electron-microscopic study of the arachnoid cyst (author's transl)].

The primary arachnoid cyst developed on the left middle cranial fossa of 5 year-old girl was examined with electron-microscope and discussed its pathogenesis. The cyst wall was mainly composed of two distinct layers, one was compact arranged flattened cells and others loosely arranged of collagen fibers and fibroblast. Various junctions were observed between those cells. Those features were similar to that was seen in normal arachnoid membrane. However, the abundant attenuated cell processes, whole formation and psammoma body were observed in cyst wall. Those finding suggested the cyst was congenital arachnoid malformation, resulting from abnormal proliferation of developing arachnoid cells.

Arachnoid↗

[A case of Maffucci's syndrome with intracranial chondroma (author's transl)].

A rare case of Maffucci's syndrome with intracranial chondroma was reported and the literature reviewed. A 16-year-old female high-school student was reffered to our service with 2 month history of diplopia and headache. She had been noticed to have multiple subcutaneous blueish nodules in the lower extremities and multiple body deformities in the four extremities since 6 months old. A biopsy of a skin lesion revealed cavernous hemangioma with calcified thrombi. Another biopsy from the deformed right femur showed it to be enchondroma. Skull series, carotid and vertebral arteriographies, and CT scan revealed a left parasellar mass, which had brought her sensory impairment of the left V1 and the left abducens palsy. The biopsy of the extradural mass in the medial portion of the left middle fossa proved it to be chondroma identical with the right femur lesion. So far as one year postoperative follow-up, she has been doing well with the postoperative sequela of mild left oculomotor paresis, having no evidence of malignant degeneration.

Adolescent↗