[Clinical and fundamental studies on a solid phase cortisol RIA kit 'Consul cortisol' (author's transl)].
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Biomedical subjects
Publications and source records attributed to S Bito.
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A case of internal carotid artery occlusion due to attempted hanging was reported. This 51-year-old man, who failed in suicidal hanging, remained in right hemiplegia and total aphasia. Left carotid arteriogram revealed complete occlusion of the internal carotid artery approximately 1 cm distal to its origin. Surgical exposure of the internal carotid artery was performed 4 weeks after the attempted hanging. The occlusive portion was percutaneously injured by ligature, whereby there was a horizontal breach of intima, media and adventitia at the level of the ligature. The damaged arterial wall was resected, and a reconstructive vascular surgery in the neck was performed. But postoperative arteriogram showed an unsatisfactory result. Pathogenesis of traumatic involvements of the internal carotid artery was discussed with literature. Also it was discussed that internal carotid artery occlusion was a very important factor causing death in suicidal hanging.
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A case of primary osteosarcoma of the skull is reported in this paper. The patient was a 41-year-old male, who complained of painless swelling of the left upper eyelid and became unable to open his left eye. He was admitted to our hospital on March 27, 1972. A bony hard tumor, fingertip in size, was palpable subcutaneously at the left superior orbital margin. The tumor was inmovable and not tender. Ophthalmological examinations of the left eye revealed disturbance of upward ocular movement without exophthalmos. The ocular fundus showed slight dilatation of the retinal veins and the normal disc. The visual acuity and the visual field appeared intact. X-ray films of the skull showed irregular osteolytic changes in the left orbital roof and the superior orbital margin. Left carotid angiogram showed abnormal vessels forming pools and arterio-venuous fistulae in the osteolytic lesion. An April 5, 1972, surgical removal of the tumor was performed successfully and the dura attached to the tumor was also excised. After operation, chemotherapy and radiation therapy were applied. Histological examination showed osteosarcoma invading the dura. At present, two years and seven months after surgical treatment, the patient is doing well without evidences of recurrence of this disease.
Cerebral infarction and petechial hemorrhage are seen in autopsied brains with subarachnoid hemorrhage as most important findings. However, the pathogenesis for the development of these lesions are still obscure. We have been doing clinico-pathological study on the cerebral petechial hemorrhages following subarachnoid hemorrhage. In this report, the findings of these hemorrhagic lesions were presented in detail by means of Perls-Stieda's iron staining. The results are as follows. Cerebral petechial hemorrhages were seen in 3 out of 13 autopsied cases with subarachnoid hemorrhage and almost all hemarrhagic lesions were perivascular. These hemorrhagic lesions were dominantly seen in the regions, thalamus, hypothalamus, midbrain which were close to the accumulated blood clot in the basal cistern, and in the cerebral cortex beneath the accumulated blood clot. Iron containing granular cells were seen not only in the brain surrounding the petechial hemorrhages but also around the vessels which did not show any hemorrhages. On the other hand, it is well known that it needs more than 7 days after hemorrhage in tissue to demonstrate iron containing granular cells by Perls-Stieda' iron staining. So, it might be estimated that the patients survived more than 7 days after the occurance of intracerebral hemorrhages when iron containing granular cells were demonstrated in the autopsied brains. It could be presumed in this study that the petechial hemorrhages following subarachnoid hemorrhage occurred at an early stage of their clinical courses.
The patient was a thirty years old male, who was diagnosed as having pineal body tumors in June,1969, and treated by irradiation after a ventriculo-atrial shunt operation. He recovered well, and participated in some simple work. In May 1972, he suddenly had convulsions followed by incontinence, and he became nearly apallic. Neuroradiological examinations revealed the presence of left frontal tumor, which was removed, on June 22, 1972. Histological examinations of the tumor proved to be pinealoma of two-cell pattern. Though improved slightly after operation, he became apallic again, developed pneumonia, and died on February 22, 1973.
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