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Biomedical subjects

R Torigoe

Publications and source records attributed to R Torigoe.

At least 37 records · Page 2Linked to original sources
PubMed1993

Meningomyelocele associated with cranium bifidum: rare coexistence of two major malformations.

Three cases of lumbosacral meningomyelocele associated with cranium bifidum are reported. The meningomyeloceles were of the neural placode type and the cranium bifidum was an interfrontal encephalomeningocele in all cases. Two of the patients received ventriculoperitoneal shunts and had evidence of type II Chiari malformation on magnetic resonance imaging. No evidence of a Chiari malformation was revealed in the third patient. We discuss the etiology of the rare coexistence of these two major malformations.

Abnormalities, Multiple↗
PubMed1993

Interaction of Staphylococcus aureus cells and silk threads in vitro and in mouse skin.

Staphylococcus aureus cell suspension was epicutaneously inoculated on the back skin of cyclophosphamide-treated mice with silk stitches and these sites were occluded. Biopsy specimens were taken from three mice at 1, 3, 6, 12, 24, 48, and 72 h after inoculation and were examined by electron microscopy. Fibril-like structures (glycocalyx) were seen around the S. aureus cells at 1 h. At 3 h, they had extended towards the silk threads. There were microcolonies on the surfaces of the silk threads and at 12 h the S. aureus cells were enclosed in membrane-like structures. The electron density of the membrane-like structures increased over time. After ruthenium red staining, the membrane-like structures and the fibril-like structures were stained positive, suggesting that these structures contain polysaccharide components. With a combination chemotherapy using clarithromycin and ofloxacin, S. aureus cells in the membrane-like structures were degenerated, whereas the use of clarithromycin or ofloxacin alone had little effect. Chlorhexidin gluconate and povidone iodine were effective if they were able to reach the biofilm. The fibril-like structures appeared in vitro only in the presence of silk threads, and were enhanced by the presence of mouse plasma. These structures did not form with formaldehyde-killed S. aureus cells. Thus, S. aureus cells may interact with foreign bodies to form biofilms, thereby evading the effect of antibacterial agents.

Animals↗
PubMed1993

Dilated fourth ventricle in Arnold-Chiari malformation type II: isolated fourth ventricle as sequelae of shunt?--Case report.

A female infant with Arnold-Chiari malformation type II developed cystic dilatation of the fourth ventricle at age 15 months. She received shunt emplacement into the dilated fourth ventricle to restore communication to the subarachnoid space and achieved improved symptoms and decreased ventricular size. Such dilatation is a typical feature of this malformation, and the isolation of the fourth ventricle is supposed to result from the cerebrospinal fluid shunting procedure. In this patient, the cause appeared to be external compression of the aqueduct by the beaking deformity of the mesencephalic spur, a characteristic of Arnold-Chiari malformation type II.

Arnold-Chiari Malformation↗
PubMed1993

Pineocytoma with intratumoral hemorrhage following ventriculoperitoneal shunt--case report.

A 58-year-old female with pineocytoma developed intratumoral hemorrhage after ventriculoperitoneal shunting for hydrocephalus. Neurological examination revealed Parinaud's sign and papilledema. Computed tomography and magnetic resonance (MR) imaging revealed a pineal neoplasm and obstructive hydrocephalus. Serum and cerebrospinal fluid levels of human chorionic gonadotropin, alpha-fetoprotein, carcinoembryonic antigen, and placental alkaline phosphatase were negative or within normal limits. MR images after the ventriculoperitoneal shunting disclosed intratumoral hemorrhage and markedly smaller ventricles. The tumor was totally removed via the occipital transtentorial approach and was diagnosed histologically as a pineocytoma with astrocytic differentiation. The tumor probably shifted away from the surrounding structures following the marked reduction in ventricular size after ventriculoperitoneal shunting, resulting in changed venous circulation in the tumor and the formation of intratumoral hematoma.

Brain↗
PubMed1993

[Transcranial Doppler sonography in acute intracranial hypertension model--usefulness of pulsatility index].

The authors studied intracranial hemodynamics in experimental animals (Macaca Fuscatus) with acute intracranial hypertension by use of transcranial Doppler (TCD) ultrasound. The blood mean flow velocity in the middle cerebral artery (MCA-FV) and pulsatility index (PI) was recorded using TCD ultrasound (TC2-64, EME) as in the clinical study. Acute intracranial hypertension was produced to determine the correlation of MCA-FV with intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in 11 monkeys, and the correlation of PI with ICP and CPP in 7 monkeys. ICP was elevated by infusing 0.1-0.2 ml/min of saline into the balloon using infusion pump. ICP was raised until maximum level. Changes of MCA-FV, PI, ICP and CPP were evaluated until the CPP of 0mmHg. There was a significant correlation between MCA-FV and ICP (p < 0.01) as well as between MCA-FV and CPP (p < 0.01) in all 11 monkeys. There was also a significant correlation between PI and ICP (p < 0.01) and between PI and CPP (p < 0.01) in 7 monkeys. PI increased markedly when ICP was 80mmHg or greater or when CPP was 60mmHg or less. ICP was always above 80mmHg when PI was above 1.2. All PI values were above 1.0 when CPP was 40mmHg or less. Thus, we could not estimate the absolute values of ICP or CPP from MCA-FV and PI. It seems possible, however, to follow changes in intracranial hemodynamics at the time of increased ICP if MCA-FV and PI are measured continuously while paying attention to factors influencing MCA-FV.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

[Arteriovenous malformation resembling galenic aneurysm].

A girl who had just turned one year old was transported to our hospital because of an episode of general convulsive seizure. Neurological examinations demonstrated a comatose consciousness level, moderate right hemiparesis and conjugate deviation to the right. CT scan on admission revealed an intracerebral hematoma in the left medial temporal lobe associated with intraventricular hemorrhage in the lateral and third ventricles. MRI also showed the hematoma with evidence of a dilated venous system. Angiography demonstrated a huge venous sac fed by the left posterior choroidal artery and left anterior choroidal artery drained ultimately into the remnant of the tentorial sinus. Firstly, two courses of transfemoral embolization using platinum micro-coils were performed. Initially, the posterior choroidal artery and a branch of the anterior choroidal artery were occluded successfully. Then, two branches from the posterior cerebral artery were occluded one week after the initial procedure. She underwent the operation via the left subtemporal approach. After the CSF removal through the Sylvian fissure, the gentle elevation of the left temporal lobe allowed the visualization of the feeders and the pulsating venous sac. After the complete obliteration of the feeding arteries and removal of the nidus, the interruption was verified by using doppler sonography and intraoperative angiography. Postoperative course was uneventful. The infant was discharged without deficit on the 30th postoperative day. The authors discussed the embryological implications of this type of AVM and the role of endovascular surgery.

Cerebral Veins↗
PubMed1993

[Effect of rapid mannitol infusion on middle cerebral artery blood flow velocity and pulsatility index--a transcranial Doppler ultrasonography study in monkeys].

Hemodynamic changes immediately after the administration of mannitol were investigated in monkeys (Macaca Fuscata) using transcranial Doppler ultrasound (TC2-64) and were compared with those after CO2 loading. The CO2 loading group was hyperventilated to an end-tidal PCO2 of 36.5 +/- 2.21 and hypoventilated to an end-tidal PCO2 of 46.3 +/- 2.69. Mean flow velocity in the middle cerebral artery (MCA-FV), Pulsatility index (PI) and blood flow in the internal carotid artery (IC-BF) studies were performed twice before and after hypercapnea. In the Mannitol group, Mannitol (2 g/kg) was infused at a rate 20 to 30 ml/min. MCA-FV, PI, IC-BF and intracranial pressure (ICP) studies were performed twice before administration and 10 minutes after administration of Mannitol. In the Mannitol group (n = 8), MCA-FV and IC-BF and ICP increased significantly after administration of Mannitol (p < 0.005, p < 0.005, p < 0.025), but there was no significant difference in the PI. In the CO2 loading group (n = 15), MCA-FV and IC-BF increased significantly (both p < 0.005) and PI decreased significantly (p < 0.005). These results indicated that, in the presence of normal autoregulation without intracranial hypertension, there was no change in the resistance of the peripheral cerebral vessels, while a decrease in viscosity after administration of Mannitol caused an increase in cerebral blood flow. Hence, according to Poiseuille's law, peripheral vasoconstriction occurred in the early period after administration of Mannitol. This change was considered to be due to autoregulation of the cerebral vessels.

Animals↗
PubMed1992

Contralateral development of acute subdural hematoma following surgery for chronic subdural hematoma--case report.

An unusual case of acute subdural hematoma developed after drainage of chronic subdural hematoma in a 71-year-old male. The acute subdural hematoma was located over a membranous layer in the subdural space similar to the outer membrane of the chronic subdural hematoma. Intraoperatively, bleeding from the bridging vein and oozing from the superior sagittal sinus were observed. The membranous layer probably separated from the dura mater following decompression after drainage of the contralateral hematoma, and this separation then damaged the bridging vein and superior sagittal sinus, resulting in the acute subdural hematoma.

Acute Disease↗
PubMed1992

[Intracranial primary malignant lymphoma following Behçet's disease--case report].

We reported a case of intracranial primary malignant lymphoma following Behçet disease treated with colchicine. A 43-year-old female with a past history of oral ulcer and folliculitis visited the Department of Ophthalmology on December, 1990, because of her impaired visual acuity. A diagnosis of uveitis due to incomplete type Behçet disease was made from funduscopic examination and her past history. She had been received 1.0mg/day colchicine for six months in the outpatient clinic. She was referred to our department on August 19, 1991, with nausea and headache. On admission, neurological examination revealed slight right cerebellar ataxia showing dysmetria and dysdiadochokinesis. Computed tomography scan and magnetic resonance images demonstrated a malignant lymphoma in the left cerebellar hemisphere. Stereotaxic biopsy resulted in the B cell type malignant lymphoma (Diffuse large cell type). Galliumscintigraphy, physical examination and peripheral blood examination disclosed no systemic abnormalities. There was a reduction of lymphocyte's response to PHA (phytohemagglutinin) stimulation (1.24). The tuberculin reaction was negative. Colchicine was discontinued and the therapy with radiation and prednisolone (20 mg/day) was started under the diagnosis of intracranial primary malignant lymphoma. She was discharged without any neurological deficits on November 25, 1991. She still suffers from impaired visual acuity, but has no problems in daily life. To our knowledge no intracranial primary malignant lymphoma following Behçet disease has been reported previously. The relationship between Behçet disease treated with colchicine and the occurrence of malignant lymphoma is discussed. In our case we speculated that malignant lymphoma might have occurred in an immunosuppressive state due to administration colchicine.

Adult↗
PubMed1992

[Levofloxacin in the field of dermatology].

1. Minimum inhibitory concentrations (MICs) of levofloxacin (LVFX, DR-3355), ofloxacin (OFLX), tosufloxacin (TFLX), norfloxacin (NFLX) were determined, with an inoculum size of 10(6) cfu/ml, against 122 strains of Staphylococcus aureus isolated from lesions of skin infections. LVFX showed most frequent MIC values of 0.20 micrograms/ml. OFLX, TFLX, and NFLX showed most frequent MIC values of 0.39 micrograms/ml, less than or equal to 0.05 micrograms/ml and 0.78 micrograms/ml, respectively. 2. Serum and skin levels of LVFX after oral administration (10 mg/kg, fasting) were determined in rats. Serum levels were 1.79, 1.29, 0.60, 0.43 and 0.18 micrograms/ml, and corresponding skin levels were 1.63, 1.77, 1.04, 0.87 and 0.64 micrograms/g (wet weight) at 0.5, 1, 2, 4 and 8 hours after administration (n = 5), respectively. 3. LVFX was used clinically in 43 cases at doses of 200-300 mg divided into 2 or 3 doses, and evaluated for final overall clinical efficacy in 41 cases. Cure was observed in 21 cases, remarkable improvement in 13 cases, improvement in 4 cases, unchanged in 1 case, aggravation in 1 case, and remarkable aggravation in 1 case. Diarrhea was observed in 2 cases, diffuse erythema with feverishness in 1 case and slight dyspnea in 1 case. Transient slight eosinophilia, elevation of Al-P, anemia and leukopenia were observed.

Adolescent↗
PubMed1992

[Cerebral embolism following trivial trauma in children--report of three cases].

Three cases of cerebral embolism secondary to trivial trauma are reported. Case 1: A 12-year-old male suffered a severe headache followed by a generalized convulsion after he turned his head when he was flying a kite. A neurological examination on admission demonstrated right hemiparesis and aphasia. A CT revealed a low density in the left putamen, temporal lobe and frontal lobe. Left carotid angiography (CAG) showed irregular narrowing of the internal carotid with an embolic occlusion and narrowing of the middle cerebral artery with the intraluminal presence of emboli both in the anterior and middle cerebral arteries. He is now doing well but has right hemiparesis. Case 2: This 6-year-old female could not grasp chopsticks and had neck pain 10 minutes after being pulled up by the right arm by her father. Neurological examination demonstrated a right hemiparesis and aphasia. A CT scan and magnetic resonance imaging (MRI) of the head showed an infarcted area in the left caudate head, anterior limb of the internal capsule and putamen. Left CAG revealed an obstruction of the trunk of the middle cerebral artery. She has slight weakness in her right extremities. Case 3: This 11-year-old female noted a weakness in her left lower limb soon after her hair was pulled backward. On admission, a neurological examination failed to demonstrate any abnormality. CT showed an ill defined low density lesion in the right putamen. MRI revealed a high intensity lesion in a T2 weighted image. Right CAG showed an irregularity of the arterial wall in the cavernous portion of the right internal carotid artery.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidental Falls↗
PubMed1991

Calcium deposition in the skin of a hemodialysis patient with widespread skin necrosis.

Rapidly progressive skin necrosis involving large areas of the skin associated with extensive vascular calcification was observed in a 39-year-old male patient on chronic hemodialysis. Histological examination of the periphery of a skin ulcer showed that subepidermal arterioles were occluded with fibrin deposits and that calcification was demonstrated in subcutaneous small arteries and arterioles. Electron microscopically, electron-dense materials, granular, crystal-like, vacuolar, or laminated, were found not only in arterial walls of the periphery of an ulcer but also, to a lesser extent, in those of normal-appearing skin. The skin necrosis gradually healed with antiseptic topical treatments and the injection of recombinant erythropoietin. The relationship between the vascular lesions in hemodialysis patients and progressive skin necrosis is not well known, although a combination of local and systemic factors may play an important role in the development of vascular calcification and skin necrosis in uremic and hemodialysis patients.

Adult↗
PubMed1991

Magnetic resonance imaging of fat embolism syndrome--case report.

The authors describe a case of fat embolism syndrome in a 20-year-old male. Magnetic resonance (MR) imaging demonstrated multiple small cerebral infarcts suggesting this is the cause of the associated cerebral dysfunction. He underwent chemotherapy and hyperbaric oxygen therapy and recovered rapidly. MR imaging can provide prognostic indications in fat embolism syndrome.

Accidents, Traffic↗
PubMed1991

[A case of primary fibrosarcoma caused by spontaneous intracerebral hematoma].

A rare case of repeated intracerebral hematoma associated with an intracerebral fibrosarcoma is reported. A 43-year-old man was referred to our clinic with headache and vomiting of sudden onset. On admission, he was lethargic. CT revealed a huge intracerebral hematoma in the left temporal lobe with midline shift. Angiography failed to demonstrate any evidence of an intracranial tumor. An operation was performed under the diagnosis of an idiopathic cerebral hematoma. The postoperative course was uneventful and he was discharged without any deficits except for a left upper quadrant homonymous hemianopia. Four and a half months after the first operation, he was readmitted to our clinic with the same symptoms as he had at the first admission. Neuroradiological examination again revealed an intracerebral hematoma in the left temporal lobe. At operation, a pinkish-gray discolored mass at the hematoma wall was found. An intraoperative histological examination of the mass indicated a malignant tumor and the tumor was totally removed. However the patient did not recover from the severe neurological deficits and died 3 months after the second surgery. Histological examinations of the tumor demonstrated a typical fibrosarcoma. Intracerebral primary fibrosarcoma with hemorrhage is quite rare. In such a case with a large hematoma, the presence of a tumor may be obscured on CT scan and angiography. Detailed observation of the hematoma wall using an operating microscope should be performed to allow a correct diagnosis.

Adult↗
PubMed1991

[Behavioral and histochemical observation in rotational rat with adrenal medulla transplantation--comparison of two different graft sites (striatum v.s. lateral ventricle)].

Effect of adrenal medullary allograft to two different sites of the brain (striatum and lateral ventricle) was compared on rotation rat. Rotation rats were prepared by chemical ablation of the right nigro-striatal system by 6-hydroxy-dopamine (6-OHDA). In this experiment, adrenal medulla was transplanted to the rotation rat brain and effects of the transplantation was evaluated by behavioral change of the rats, i.e., reduction in rotation behavior, and by histochemical examination of the grafts sites, i.e., presence and morphology of dopaminergic cells. The animals were divided in to 2 groups. The first group received the graft to the striatum (striatum group) and the second group to the lateral ventricle close to the striatum (ventricle group). Six weeks after grafting, the rotation behavior in striatum group and ventricle group was reduced by 43% (p less than 0.01) and 35% (p less than 0.01) respectively as compared to that in the pretransplantation state. Twelve weeks after grafting, the comparable figures were 30% (p less than 0.05) and 17% (n.s.) respectively. Histochemical examination of graft site was similar in both groups: Six weeks after grafting, many transplanted cells transformed into nerve cells which were considered to be capable of producing dopamine and, twelve weeks after grafting, honeycomb shaped fluorescence positive area without apparent viable cells. From above results, it was concluded that the striatum was somewhat superior to the lateral ventricle as the graft site. However, the effect of the transplantation was short lasting, being most manifest at six weeks after transplantation, and started to wear off as the grafted cells perished.

Adrenal Medulla↗
PubMed1991

[Relationship between cardiovascular circulation and intracranial pressure--analyses of polygraphic recordings during cardiac surgery in congenital heart diseases].

Few reports have appeared in regard to cerebral perfusion pressure (CPP) accompanying fluctuations in intracranial pressure (ICP), arterial pressure (BP) and central venous pressure (CVP) as well as autoregulation of cerebral circulation in neonates and infants. Therefore, we report here on interesting findings we obtained from monitoring ICP, BP, and CVP during operations in 30 neonates or infants with congenital heart disease as our subjects. i) ICP fluctuates depending on arterial pressure and venous pressure, but changes in the latter display a clearer effect. ii) On inducing anesthesia the amplitude of ICP pulsating waves became gradually larger, but following intubation intracranial pressure was somewhat reduced and became stable. iii) Following thoracotomy CVP rose and at the same time intracranial pressure also increased somewhat. Before thoracotomy ICP pulsating waves resembled arterial pressure wave forms, but after thoracotomy they resembled central venous pressure wave forms. iv) In cases with two-peak ICP pulsating waves, when we conducted a study by blocking venous return from the internal carotid vein during the operation by the Queckenstedt method, ICP rose by increasing its amplitude, but the pulsating wave forms lost their venous component, and changed into a single peak consisting of an arterial component. v) In order to observe the relationship between changes in arterial pressure and ICP, when we looked at changes in ICP accompanying partial blockage of the descending aorta (DAo), simultaneously with the partial blocking of the DAo both AP and CVP rose, and ICP also rose accordingly. Also, when arterial blockage was relaxed, BP, CVP, and ICP immediately recovered completely to the status quo prior to the blocking procedure. This finding indicates that by blocking of the DAo, intracranial arterial and venous blood volume abruptly rapidly increase and since CVP also rises, therefore ICP rises to maintain a balance with these. As a result, this brings about the effect of normally maintaining the cerebral perfusion volume. vi) If we look at changes in ICP brought about by partial blocking of the ascending aorta, blockage of the artery brought about a further reduction in BP, and in this case since the arterial blood flow into the cranium also fell off markedly, we found that ICP also was reduced. The above results suggest that in the normal brains of neonates and infants even when under various conditions various fluctuations in corporeal circulation develop, cerebral perfusion volume adjusts itself in response to this, and thus autoregulation of cerebral blood flow is able to act in an adequate way.

Blood Pressure↗
PubMed1991

[Evaluation of SPECT with N-isopropyl [I-123]-p-iodoamphetamine (IMP) or technetium-99m [99mTc]-d,l-hexamethylpropyleneamine oxime (d, 1-HM-PAO) in cerebral concussion].

123I-IMP and Tc-PAO SPECT were performed in 20 cases of cerebral concussion ranging in age from 4 to 20 years old, including six cases of the juvenile head trauma syndrome (JHTS). The SPECT findings were divided into two main types: six cases in the normal group with no blood flow abnormalities, and 14 cases in abnormal group showing reduced blood flow, mainly in cerebellum and occipital lobe except in one case. In 10 cases with reduced blood flow which could be analyzed, calculation of the blood flow ratio in the temporal and occipital lobes and the cerebellum with the frontal lobe taken as 100 showed values of 93.5% for the temporal lobe, 82.7% for the occipital lobe and 76.8% for the cerebellum. A statistically significant reduction in blood flow occurred in the occipital lobe and cerebellum. In blood examination, abnormally high values of white blood cell counts were observed transiently in 94% of cerebral concussion cases. Abnormalities in brain stem and hypothalamus appeared to cause these abnormal WBC values. From these findings, it was suggested that the blood flow regions of the basilar and posterior cerebral arteries, i.e., the brain stem and hypothalamus are closely connected with the lesions responsible for cerebral concussion. It also appeared that the JHTS occurs in cerebral concussion cases where recovery of the abnormal blood flow in these regions in poor.

Adolescent↗