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Biomedical subjects

S Kasamo

Publications and source records attributed to S Kasamo.

14 recordsLinked to original sources
PubMed1996

[The prognostic factors in astrocytic tumors: analysis by the Kaplan-Meier method and the Weibull log-linear model].

As the prognosis of astrocytic tumors depends on various factors, identifying prognostic factors should be useful for developing strategies to cope with them. Between 1975 and 1994, more than 200 patients with astrocytic tumors were treated in Kagoshima University. Of these patients, 149 (grade I: 17, grade II: 42, grade III: 41, grade IV: 42, unproven: 7) have been followed up. Records of these patients were retrospectively reviewed for age at the time of initial symptoms, gender, histological grade (WHO), extent of tumor resection, radiation therapy, and administration of anticancer agents. We used the Kaplan-Meier method and the Weibull log-linear model to analyze the relation between survival time and these prognostic factors. Survival time was counted from onset of symptoms, and age of initial treatment was used as a covariant. The mean age of males at the initial diagnosis was 40.8 years (n = 77), and that of females was 39 years (n = 72). Using the Kaplan-Meier method, the mean survival time of the 149 patients was 101 months (males; 72.7 months, females; 134.5 months). Mean survival time of grade II was 144.3 months, that of grade III was 95.2 months, and grade IV (glioblastoma) was 15.9 months. Histological grades and mean ages of the groups showed a positive correlation. Among grades II, III and IV, the Kaplan-Meier survival curves were significantly different (p < 0.0001) according to the log-rank test. By the extent of surgical resection (subtotal or greater resection, partial resection, and less than partial resection), the mean survival time showed a significant difference (p < 0.05) on the log-rank test. However, we could not detect a significant difference in survival time between the group that received chemotherapy and the group which did not. The Weibull log-linear analysis indicated that gender, age, histological grade (WHO), extent of surgery, and dose of radiation therapy were prognostic factors. Covariants of grades II, III, and IV made survival time 0.314, 0.179, and 0.069 times as long as that of grade I. The survival time after "partial resection" became 1.415 times as long as the survival time after "less than partial resection". The covariant of "greater than subtotal resection" showed a prolonged survival time of 2.916 compared with that of "less than partial resection". As for age at treatment, the older the patient was, the shorter the survival time. The rate was 0.986 for each year of age. Irradiation of one Gy increased survival time by 1.015 times. Chemoimmunotherapy (dose of ACNU and interferon beta) could not be confirmed as an effective covariant.

Adult↗
PubMed1995

[Ventilatory insufficiency due to upper cervical injury treated by diaphragm pacing: a case report].

A 33-year-old man suffered chronic ventilatory insufficiency with tetraplegia after an operation for atlantoaxial dislocation. He was alert and his tetraplegia gradually improved. However, continuous mechanical ventilation was necessary for him. Thirteen months after the operation, a diaphragm pacer (Avery Laboratory Inc.) was implanted on the right phrenic nerve in the cervical region. Nineteen days after the implantation of the right side pacer, a left side diaphragm pacer was also implanted. Diaphragm pacing was started two weeks after the second implantation. The pacing period was gradually prolonged and continuous pacing for 9 hours by the right side pacer and three hours by the left side pacer was able to be obtained. One year after implantation, twelve continuous hours of diaphragm pacing became possible. During diaphragm pacing, blood gas analysis was satisfactory and the patient could move sitting on a wheel chair, watch television and write letters using a word processor. We were unable to achieve total ventilatory support for him using these diaphragm pacers. We thought that the main cause of our partial failure originated from the procedure used in implanting the electrode onto the phrenic nerve. Left side pacing needs higher amplitude than that used on the right side to obtain sufficient tidal volume. The patient refused our continuing the left side pacing because of pain around the anterior chest and shoulder. Another problem to be watched is diaphragm fatigue. However, diaphragm pacing has been continued for six years and it has been useful in improving his quality of life.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

31P-magnetic resonance spectroscopic study on the effect of glycerol on cold-induced brain edema.

The aim of the present study was to determine the effects of a hyperosmotic agent, 10% glycerol, on both brain energy metabolism and intracellular pH (pHi) in experimental vasogenic brain edema. Vasogenic brain edema was induced by cold injury applied to bilateral parietal portions in 13 mongrel dogs (7 glycerol, 6 control) while, 3 dogs were used as control. Before and at 24 hours after the injury, sequential phosphorous-31 magnetic resonance spectroscopy (31P-MRS) was performed for 2 hours in order to determine phosphocreatine (PCr), beta-adenosine triphosphate (beta-ATP), inorganic phosphate (Pi) levels and pHi. At 24 hours following cold injury, both PCr/Pi and ATP/Pi ratios significantly decreased from 7.75 to 3.97 and from 2.26 to 1.25, respectively. Furthermore, a moderate decrease in pHi of 7.16 to 7.01 was significantly demonstrated during the same experimental period. Administration of glycerol for 30 minutes significantly increased PCr/Pi from 3.97 to 5.06 and ATP/Pi from 1.25 to 1.72, respectively. Also, glycerol administration caused a significant increase in pHi from 7.01 to 7.11. This study indicates that cryogenic injury, in which formation and expansion of vasogenic brain edema a known to occur, results in disturbed brain energy metabolism and in intracellular acidosis; moreover, the administration of glycerol can ameliorate either or both of these derangements.

Acid-Base Equilibrium↗
PubMed1994

Extra-axial ependymoma--case report.

A 13-year-old boy presented with a very unusual ependymoma extending extra-axially. Computed tomography demonstrated a tumor with a cyst and calcification adjacent to the dura and extending over the right occipital and parietal lobes. The cyst wall and solid tumor were enhanced postcontrast. Magnetic resonance imaging revealed that the solid tumor was isointense on T1-weighted images and a mixed iso- and high-intensity on T2-weighted images. The solid tumor and tissue surrounding the cyst were enhanced markedly by gadolinium-diethylenetriaminepentaacetic acid. Sagittal and coronal images demonstrated a multilocular tumor shadow. Cerebral angiography demonstrated a tumor fed by a posterior branch of the right middle meningeal artery but no feeders from the internal carotid and vertebral arteries. The tumor was removed en bloc. The histological diagnosis was clear cell-type ependymoma.

Adolescent↗
PubMed1994

Hydrocephalus due to villous hypertrophy of the choroid plexus in the lateral ventricles. Case report.

A case is reported of hydrocephalus due to overproduction of cerebrospinal fluid (CSF) caused by villous hypertrophy of the choroid plexus in the lateral ventricles. A 7-year-old girl with mental retardation developed gait disturbance; hydrocephalus and a Dandy-Walker cyst were detected on computerized tomography. She was initially treated with a ventriculoperitoneal shunt; however, shunting failed to control the hydrocephalus. The excessive outflow of CSF suggested choroid plexus abnormality, and magnetic resonance (MR) imaging revealed enlargement of the choroid plexus in both lateral ventricles. The patient was therefore diagnosed as having hydrocephalus induced by overproduction of CSF, which was controlled by resection of the choroid plexus. Histological examination showed the structure typical of normal choroid plexus. This is a rare case of villous hypertrophy of the choroid plexus in which MR imaging assisted in the diagnosis.

Brain Diseases↗
PubMed1994

[Trigeminal neurinoma in the cavernous sinus revealed by intratumoral hemorrhage: a case report].

A case of trigeminal neurinoma located in the left cavernous sinus and revealed by intratumoral hemorrhage is reported. Preoperatively, magnetic resonance imaging provided the accurate localization of the lesion, allowing precise planning of the surgical approach. The neurinoma inside the cavernous sinus wall was removed successfully, and the patient developed no new neurological deficits except for anesthesia in the 1st division of the trigeminal nerve. The characteristic findings of magnetic resonance imaging of the trigeminal neurinoma in the cavernous sinus are reported.

Adult↗
PubMed1992

[Transorbital penetrating brain injury].

Transorbital penetrating brain injury is rare during this time of peace. In our paper, we reported seven cases of these injuries and discussed the mechanism and treatment of intracranial complications. Transorbital penetrating brain injuries were caused by thin, long and relative hard objects such as chop-stick (case 3), pencil (case 6), bamboo stick (case 1, 2, 7) and a piece of metal (case 4, 5). CT scan, MRI and angiography demonstrated a large variety of intracranial complications. For instance, intracerebral hematoma, cerebral contusion, intraventricular hemorrhage, pneumocephalus, brain stem injury and carotid cavernous sinus fistula. We had no case of infectious complications such as meningitis and brain abscess. If the direction of the injuring object runs parallel to the orbital roof, it penetrates the cranial cavity commonly via the superior orbital fissure or the optic canal, which routes provide direct access without bone fracture. This direction will cause critical intracranial complications such as CCF or brain stem injury. If the injuring object runs upward and across the orbital roof which has thin bone and therefore offers little resistance, the frontal lobe will be easily damaged, and it will cause intracerebral hematoma. But the prognosis for this type of injury is not so poor because we can easily remove the hematoma and the foreign body. With our treatment policy of "pull and see", all our cases but one recovered well. The one exception was a case in which a large intracerebral hematoma was over-looked in an ophthalmological clinic. This patient died. Nowadays, CT scan and MRI give clear information about the anatomical location of injuring objects and intracranial complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Spinal artery aneurysm associated with dural AVM of the posterior fossa].

The incidence of an aneurysm of the spinal artery is extremely rare. Only several cases have been documented previously. Herewith, the authors present a patient with a ruptured aneurysm of the anterior spinal artery associated with dural AVM of the posterior fossa. A 51-year-old male had a sudden onset of occipital headache and left shoulder pain. Lumbar puncture revealed bloody CSF. Angiography showed a saccular aneurysm, filling from the anterior spinal artery and dural AVM of the posterior fossa. Aneurysmal neck clipping and cauterization for nidus of dural AVM was performed successfully through suboccipital craniectomy with laminectomy of C1 and C2. The authors reviewed the literature and discussed the features of the aneurysm of a spinal artery.

Aneurysm↗
PubMed1990

Unusual intra- and extracranial arteriovenous communication--case report.

The authors report an unusual case of arteriovenous communication between extracranial and intracranial vessels, accompanied by incidentally detected bilateral arachnoid cysts of the middle cranial fossa. A 52-year-old male was admitted with a sudden onset of headache, vomiting, and conjunctival hyperemia of the right eye followed by progressive chemosis and proptosis. He had undergone a craniotomy for hypertensive right putaminal hemorrhage 4 months previously. Angiography showed the main feeding artery to be the superficial temporal artery and the draining veins to be the superficial Sylvian veins and the basal vein of Rosenthal. Partial obstruction of the right cavernous sinus was also shown. At surgery, granulation tissue continued to the dura mater through the skull aperture of previous craniotomy and adhered to the underlying damaged cerebrum. The extremely unusual nature of the communication, the operative findings, and the atypical fistulous figures suggested that communication had occurred postoperatively via newly generated vessels in granulation tissue.

Arachnoid Cysts↗
PubMed1990

[A case of systemic lupus erythematosus with subarachnoid hemorrhage due to ruptured aneurysm].

A case of systemic lupus erythematosus (SLE) with subarachnoid hemorrhage due to a ruptured intracranial aneurysm is reported. A 31-year-old woman who had been treated with steroid for SLE was admitted to our department with severe headache, and nausea. CT scan showed subarachnoid hemorrhage and the left carotid angiogram revealed a small aneurysm at the supraclinoid portion of the left internal carotid artery. She had no neurological deficit. Hematological examination on admission showed disseminated intravascular coagulation (DIC), therefore, we decided to perform an intentionally delayed operation. In the meantime we treated the patient for DIC with FOY and methylprednisolone. The operation was performed after two weeks, when DIC had been eliminated completely. Postoperative hematological examination showed severe thrombocytopenia. We considered that SLE had come to the fore again, so we used Danazol in company with FOY and steroid. It seemed that Danazol was very effective for her. She was discharged about two months after admission with no problem. Cerebral apoplexy, such as cerebral infarction and cerebral hemorrhage, has often been seen in SLE, but subarachnoid hemorrhage due to a ruptured aneurysm is very rare. We could find only five reports of this phenomenon. Their prognoses were all, unfortunately, poor. It should be born in mind for therapy that a patient in SLE has a tendency to bleed. It seems that repeated hematological examinations and quick and proper management are important. We think that the aneurysmal formation in SLE is due to lupus vasculitis or the fragility of blood vessels due to a long use of Steroid.

Adult↗
PubMed1984

[Posttraumatic cerebrovascular narrowing. A case report and review of the literature].

We, neurosurgeons have sometimes confronted with the case of posttraumatic cerebrovascular narrowing or spasm. However, there have been few reports on the pathophysiology of the posttraumatic narrowing or spasm in comparison with those the spasm following the subarachnoid hemorrhage caused by the rupture of the aneurysm. The authors report here a case of temporal lobe contusion who demonstrated cerebrovascular narrowing angiographically at the 21st days after head injury. This 53-years-old male was examined again by angiography one week after the above-described angiography and the narrowing disappeared. The authors reviewed the literature on the posttraumatic cerebrovascular narrowing or spasm. Thirty seven cases have been reported in detail. Under the conditions of these 38 cases including the present case, the pathophysiology of the posttraumatic cerebrovascular narrowing or spasm was discussed. Two theories had been suggested for a long time: one was vasospasm caused by the traumatic subarachnoid hemorrhage and the other by direct mechanical irritation of cerebral artery. Recently, neurogenic factor is thought to take a part of this to a great extent such as hypothalamic dysfunction or dysfunctioning fragile autoregulation mechanism. It is seemed to be that such spasm caused by these mechanism will exist sure. However, in the posttraumatic cerebrovascular vasospasm, there are other accompanying intracranial lesions such as cerebral swelling, cerebral contusion, fracture of the base of the skull and so on. It is not assumed to be so simple environment as the spasm following the rupture of the aneurysm, and also the mechanism of genesis of the posttraumatic cerebrovascular spasm is not to be so simple. Several factors and their duplication will play a role in the mechanism. Further investigation is necessary for the clearness of the problem.

Adolescent↗