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Biomedical subjects

S Maeshima

Publications and source records attributed to S Maeshima.

At least 55 records · Page 3Linked to original sources

[A case of malignant rheumatoid arthritis with lupus anticoagulant and cerebral infarction].

We reported a case of malignant rheumatoid arthritis (MRA) with cerebral infarction associated with a possible cause of lupus anticoagulant. The patient was a 68-year-old woman who had received treatment for rheumatoid arthritis (RA) from 15 to 16 years ago. She consulted to our hospital with a major complaint of right hemiplegia. Brain CT revealed a low density area in the left hemisphere. She was diagnosed as cerebral infarction and hospitalized. Since she was noted to have hypocomplementemia, interstitial pneumonia and pericarditis, she was diagnosed as MRA. Coagulation test disclosed positive lupus anticoagulant (LA). Generally, CNS disorders in MRA are uncommon. Cerebral infarction was complicated in the present case, suggesting the involvement of antiphospholipid antibodies as its pathogenesis.

Aged↗

Unilateral spatial neglect due to right frontal lobe haematoma.

Two patients with unilateral spatial neglect caused by right frontal lobe lesions underwent cerebral blood flow studies. A 54-year-old, right-handed woman developed left hemiplegia and frontal lobe neglect associated with cerebral haemorrhage after surgical excision of a frontal tumour. A 66-year-old, right-handed woman developed a haemorrhage in the right frontal lobe caused by rupture of an aneurysm. This was followed by left hemiplegia and frontal lobe neglect. In both cases, 123I-iodoamphetamine single photon emission CT disclosed a reduction in regional cerebral blood flow localised along the circumference of the haematoma in the frontal lobe, but did not reveal any lesions in the parieto-occipital junction. These findings suggest that, in these two cases, the frontal lobe neglect was caused by lesions confined to the frontal lobe.

Cerebral Hemorrhage↗

[Transcortical sensory aphasia in a patient with metastatic brain tumor in the left frontal lobe].

We reported a case of a 62-year-old right-handed woman who had transcortical sensory aphasia caused by a metastatic brain tumor in the left frontal lobe. She had mild right hemiparesis involving the face, without hyperactive tendon reflexes. She had neither sensory disturbance nor other cranial nerve deficits. Her spontaneous speech was fluent, and she sometimes had echolalia. Her object naming, word fluency, verbal comprehension and writing were severely disturbed. This contrasted with full preservation of repetition of phonemes and short sentences. Reading of words was preserved. CT scan revealed a subcortical lesion in the left superior frontal gyrus. Gd-enhanced MRI showed a ring-enhanced mass lesion in the frontal lobe outside of Broca's area. We thereby concluded that transcortical sensory aphasia may be caused by frontal lobe lesion independent of the perisylvian speech areas.

Adenocarcinoma, Papillary↗

[Cortical atrophy and higher cortical dysfunction in systemic lupus erythematosus].

The relationships between cortical atrophy and higher cortical dysfunction in systemic lupus erythematosus (SLE) were investigated. The subjects were 27 females, right-handed patients with SLE. None of them had a history of cerebro-vascular disorders. The CT index of cortical atrophy included Huckman number, Evans' ratio, Ventricular index, and Cella-media index calculated from the brain CT. As controls, 27 age- and sex- matched, healthy subjects were studied and compared with the SLE group. All underwent the following neuropsychological examinations: intelligence and mental state, linguistic function, and recognition and praxis. As a result, Huckman number and Evans' ratio were significantly higher in the SLE group than in controls, clearly showing evidence of cortical atrophy. With regard to the relationships between cortical atrophy and neuropsychological tests, there were significant relationships between digit span and Huckman number and Evans' ratio, and between word fluency and Evans' ratio. These findings suggested that the atrophy of frontal lobe was characteristic in SLE, being associated with dysfunction of frontal lobe.

Adolescent↗

Computed topographic electroencephalographic study in left hemiplegic patients with higher cortical dysfunction.

Computed topographic electroencephalography (EEG) was performed on patients with right hemispheric injury due to cerebral infarction to investigate the relationship of wave form pattern with neurologic and neuropsychologic data and activities of daily living (ADL). Neurologic signs, unilateral spatial neglect, motor impersistence, and constructional apraxia were found to have no relation to the wave form pattern of computed topographic EEG. In patients with abnormalities detected by the "Mini-Mental State" examination (MMSE) or the "Kanahiroi" test, and in patients with abnormalities in word fluency, extensive slowing of EEG frequency was commonly observed ipsilateral to the side of the lesion or bilaterally, and the ADL were frequently poor. In contrast, among the patients with slow waves and retained alpha waves, the MMSE, "Kana-hiroi" test, word fluency, and ADL were less abnormal. Computed topographic EEG may thus be a useful tool to evaluate neuropsychological status in rehabilitation patients with cerebral infarction.

Activities of Daily Living↗

[An experimental study of a new embolic material--Lipiodol suspension of water-absorbent particle].

A water-absorbent particle (a polymer of polyacrylic acid soda) was investigated as a new embolic material. The size of a single particle is 200 microns (N-100) or 10 microns (NP-1010). A particle absorbs 100 times its own weight of physiologic NaCl solution within a few seconds. The particles have no acute or chronic toxicity or immunogenicity. This material suspended by Lipiodol was evaluated in an in vitro study using an AVM model composed of a plastic syringe and polyurethane sponge. The AVM model was perfused by physiological NaCl solution at a pressure of 150 mmHg. The swollen polymer worked as an adequate embolic material in the AVM model, using a minimum quantity. The embolic effect depended upon the quantity and concentration of the suspension. Restoration of flow was not observed within a period of ten minutes. The embolized part was clearly visualized due to the retention of Lipiodol. This material is a promising agent for arterial embolization.

Absorption↗

Influence of regional cerebral blood flow on event-related potential (P300).

The relationships between event-related potential (P300), higher brain functions, and regional cerebral blood flow (rCBF) were examined in 31 neurosurgical patients. The P300 latency, evaluated by an acoustic "odd-ball" paradigm, was normal in 14 and prolonged in 17 patients. Fourteen of 17 prolonged P300 patients had reduced rCBF in the right cerebral hemisphere, especially the frontal lobe and/or thalamus. There was a significant inverse relationship between P300 latency and laterality index (rt rCBF/lt rCBF) in the frontal lobe. Prolonged P300 patients revealed significant abnormalities in psychological tests compared to normal P300 patients. There were significant inverse relationships between the P300 latency and "orientation" and "memory" test scores. Decreased rCBF in the right cerebral hemisphere, especially the frontal lobe and/or thalamus, is associated with prolonged P300 latency, suggesting that the right cerebral hemisphere is important in human cognitive processes.

Adult↗

[Antiphospholipid antibodies and regional cerebral blood flow in systemic lupus erythematosus].

We investigated the relationship between antiphospholipid antibodies (APA) and regional cerebral blood flow (rCBF) on 25 patients with systemic lupus erythematosus (SLE). Lupus anticoagulant (LA) and anticardiolipin antibody-IgG (ACA-IgG) as a marker of APA were determined. Brain CT and single photon emission CT (SPECT) were performed to evaluate the rCBF. LA was positive in 8 cases (32%), and ACA-IgG was positive in 3 cases (12%), respectively. Brain CT revealed brain atrophy in 8 cases (32%), but none of them had localized lesions. SPECT disclosed a reduced rCBF in 11 cases (44%). A reduced rCBF was noted to have a significant relationship with LA (p < 0.005), but not with ACA-IgG. It was suggested that LA might be an important factor as the cause of rCBF disturbances detected by SPECT in SLE patients.

Adolescent↗

[MR imaging evaluation of plica synoviallis mediopatellaris of the knee joint].

To evaluate the diagnostic ability of MR imaging for plica synoviallis mediopatellaris (PSM), we retrospectively reviewed the MR imaging findings of patellofemoral space in 20 knee joints of 11 patients. In all 20 knee joints, arthroscopy and MR imaging were available. MR imaging was performed with a 1.5 Tesla Magnetom (Siemens) using a round surface coil. Pulse sequences were SE (TR 600 ms/TE 26 ms), SE (TR 200 ms/TE 26, 70 ms) and FLASH (TR 450 ms/TE 15 ms/FA 90 degrees). In six of the 20 knees with PSM proved by arthroscopy, a low intensity band was shown above the medial condyle of the femur on both T1- and T2-weighted MR images, and on FLASH images this band was shown as intermediate intensity. In the other 14 knees with no PSM observed by arthroscopy, the low intensity band was not shown on MR imaging. In all 20 knees, a similar low intensity band was shown about 1 cm cranial to the medial condyle of the femur. This should not be diagnosed as PSM. The low intensity band seen on T1- and T2-weighted MR images and its anatomical relation to the medial condyle are important in diagnosing PSM.

Adolescent↗

[Differentiation between hepatoma and hemangioma by inversion recovery snapshot FLASH MR imaging with variable TIs].

To differentiate hepatoma from hemangioma, MR studies were performed for 18 patients with 21 untreated liver tumors (hepatoma 10, hemangioma 11). We obtained inversion recovery snapshot FLASH images of liver tumors with variable TIs (50, 100, 150, 200, 250, 300, 400, and 500 msec). 8 hemangiomas showed higher intensity than liver parenchyma on the images at 150 msec and less of TI, and lower intensity at 200 msec or more TI. In 7, signal intensity of hepatoma became low at 150 msec or less of TI or remained high with prolonged TI. Inversion recovery snapshot FLASH imaging with variable TIs will be useful for differentiating between hepatoma and hemangioma.

Adult↗

A study of right unilateral spatial neglect in left hemispheric lesions: the difference between right-handed and non-right-handed post-stroke patients.

We report 20 cases of right unilateral spatial neglect caused by lesions in the left cerebral hemisphere. Differences in neuropsychological symptoms and lesions sites are discussed in connection with handedness. Of the right-handed patients, 6 had severe aphasia, 4 had Gerstmann's syndrome, and 1 had pure agraphia, but unilateral spatial neglect in these cases disappeared after a number of months. Six of the non-right-handed patients had moderate-to-severe aphasia, while the other 3 cases had no aphasia at all. Eight of the 9 cases in this group continued to have right unilateral spatial neglect for more than 6 months. Lesion site as determined by CT differed as to hemisphere, but all fell into the common area previously mentioned in connection with such disorders: i.e., the temporal, parietal and occipital lobes.

Adult↗

[Stage III, IV hepatocellular carcinoma patients surviving more than five years after transcatheter chemoembolization].

Twelve of the patients with advanced (Stage III or IV) hepatocellular carcinoma who received transcatheter chemoembolization survived for more than 5 years. These survivors consisted of 6 Stage III cases and 6 Stage IV cases. Of the 6 Stage III cases, 5 had multiple tumors (larger than 2 cm) in one lobe of the liver, and 1 had tumor invasion into the second portal branch before treatment. Of the 6 Stage IV cases, 4 had had multiple tumors in both lobes, and 2 had had tumor invasion into the main portal branches. Before treatment, 9 of the 12 survivors had been rated as Child's class A. Lipiodol was used in all 12 cases. The results of the present study suggest the usefulness of Lipiodol in treating advanced hepatocellular carcinoma.

Aged↗

["Left unilateral agraphia with right hemiparesis" after occlusion of the left middle cerebral artery].

This paper presented a case of a right-handed male who showed a right hemiplegia without aphasia and apraxia. He lost the ability to write with the left hand. A 56-year-old right-handed man, who had a daughter of left-handedness, was sent to our hospital with a homonymous hemianopsia, facial weakness, spastic hemiparesis and sensory disturbance in the right side. CT scan revealed an infarction in the territory of the left middle cerebral artery. On a month after the onset, he was alert and oriented. His speech was normal and verbal comprehension was intact. Although he neglected the right side of the page, he could read and comprehend it correctly. In contrast with his normal abilities to speak, comprehend, and read, difficulties in writing were prominent. Spontaneous writing with the left hand was extremely poor, and he even had difficulty writing his own name. His dictation was also poor, but his writing improved with copying letters. Agraphia had seen even after USN was recovered. Analysis of this case suggested the presence of the dominance for speech, comprehension, and praxis in the intact right hemisphere, and writing center in the damaged left hemisphere.

Agraphia↗

[Dynamic MRI of hepatocellular carcinoma with portal vein tumor thrombus].

Dynamic MRI with injection of Gd-DTPA was performed in 7 patients with hepatocellular carcinoma associated with portal vein tumor thrombus. A portal vein tumor thrombus was clearly visualized as a low intense structure. The segment supplied with this portal vein shows high intensity, probably due to the decrease in portal blood flow and compensated arterial blood flow. A tumor itself, located in this segment, was shown as a low intense area. Thus dynamic MRI is a useful method for differentiating the tumor from the surrounding nontumorous tissue with decrease in portal flow.

Aged↗

[Airbronchogram sign in small peripheral bronchogenic carcinomas].

18 bronchogenic carcinomas (16 adenocarcinomas, one squamous cell carcinoma, and one large cell carcinoma) in 17 patients and the control group (benign nodules) were examined with high resolution and thin section CT. Thin-section CT images showed airbronchogram or airbronchiologram in 63%, multiple small cavitations in 63%, and heterogeneous densities 50% of the adenocarcinomas with excellent spatial and contrast resolution. Airbronchogram or airbronchiologram was not seen in other types of bronchogenic carcinomas and benign nodules. Therefore, demonstration of airbronchogram or airbronchiologram in nodular lesions can make the CT diagnosis of small peripheral bronchogenic carcinomas, especially adenocarcinomas.

Adenocarcinoma↗

Squamous cell carcinoma of the uroepithelium: CT evaluation.

Fourteen cases of primary squamous cell carcinoma (SCC) originating in the uroepithelium were studied with computed tomography (CT). Nine cases were of vesical origin, three were of renal pelvic origin, and two were of ureteral origin. CT scans of eight of the 14 cases, including four cases of vesical origin and four cases of renal pelvic or ureteral origin, demonstrated predominantly extraluminal extension with invasion into adjacent organs or the renal parenchyma. CT scans of the remaining six cases showed almost equal extra- and intraluminal tumor growth and no predominantly intraluminal extension. An associated urinary stone was demonstrated in four of the five cases of SCC of renal pelvic or ureteral origin. Two of these cases were diagnosed as urinary stones before CT was performed. Eight of the nine cases of SCC of vesical origin and four of the five cases of SCC of renal pelvic or ureteral origin were correctly staged with the aid of CT.

Aged↗

[Computed tomography of gastric cancer].

CT scans of 52 patients with advanced gastric cancer were reviewed, and the layer structure of the gastric wall was analyzed. Administration of 600 ml water, orally, expanded the gastric wall, while patients were in the prone position. Intravenous infusion of contrast media was routinely administered. We found that the normal layer structure of the gastric wall could be shown despite the cancer in the lesion. Borrmann 3 and 4 types. We guess that CT has a possibility in the assessment of the spread in the wall of gastric cancer.

Humans↗

Retroperitoneal schwannomas simulating adrenal tumors.

Tumors in the area of the adrenal were detected by chance in two patients who underwent a regular physical check-up. On arteriography the tumors were found to be fed by the adrenal artery. The diagnosis was retroperitoneal schwannoma, but in both patients it was difficult to differentiate the schwannoma from an adrenal tumor preoperatively.

Adrenal Gland Neoplasms↗