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Biomedical subjects

S Ohba

Publications and source records attributed to S Ohba.

At least 19 recordsLinked to original sources

Transcranial Doppler sonography in carotid-cavernous fistulas: analysis of five cases.

Transcranial doppler sonography was performed transorbitally in five patients clinically diagnosed as unilateral carotid-cavernous fistula. Dural arteriovenous malformation related-shunts were detected in all the patients. In the normal eyes, the only doppler signals observed at an insonation depth of 45 to 55 mm were those of the ophthalmic artery. In the affected eyes, abnormal doppler signals with relatively higher flow velocity and lower resistance were observed. In three of the cases, these abnormal signals showed a flow directed anteriorly or away from the cavernous sinus, consistent with changes in the ophthalmic veins caused by the presence of the shunts. In two cases, however, the observed flows were directed posteriorly, the normal direction of these veins. The possible explanations for this discrepancy are discussed in relation with angiographic findings. The use of transcranial doppler might provide a better understanding about hemodynamic changes in carotid cavernous fistulas.

Aged

Moyamoya disease associated with pituitary adenoma--report of two cases.

Moyamoya disease associated with prolactin (PRL)-producing pituitary adenomas occurred in two females with elevated blood PRL levels (285 and 120 ng/ml). Computed tomography revealed cystic tumors extending from the sella turcica to the suprasellar cistern. Carotid angiography demonstrated stenoses or obstructions of the bilateral internal carotid arteries at their end point and development of bilateral basal moyamoya vessels. Histological diagnosis in one case was PRL-producing chromophobe adenoma. No stigmata of neurofibromatosis or any history of irradiation was found. Compression of carotid arteries by the tumor was unlikely. These cases should therefore be classified as moyamoya disease accompanied by brain tumor, a very rare occurrence. The hypothalamic disturbance caused by moyamoya disease may have induced the hyperprolactinemia, resulting in secondary prolactinoma.

Adenoma, Chromophobe

Hemichorea associated with ipsilateral chronic subdural hematoma--case report.

Left-sided hemichorea developed suddenly in a 73-year-old male. Computed tomography revealed a left subdural hematoma (SDH) and infarction in the right corona radiata and temporo-occipital region. Hemichorea subsided completely after removal of the SDH. Postoperative single photon emission computed tomography with technetium-99m-hexamethyl-propyleneamine oxime revealed a global low-perfusion area in the right cerebral hemisphere. Right carotid angiography demonstrated severe stenosis of the trunk of the right middle cerebral artery. The cerebral blood flow in the right cerebral hemisphere had probably already decreased to nearly the critical level and was reduced further by the left SDH, inducing the left-sided hemichorea due to dysfunction of the right cerebral hemisphere. This case shows that when hemichorea ipsilateral to a SDH is present, it is important to ascertain whether there is a pre-existing ischemic lesion in the contralateral cerebral hemisphere, particularly in the basal ganglia, thalamus, or corona radiata.

Aged

[Acute renal failure due to rhabdomyolysis--clinical investigation on our 6 cases].

Six cases of acute renal failure (ARF) due to rhabdomyolysis were experienced between 1984 and 1989. Patients' ages ranged from 33 to 92 years old (average ages 61) and all were male. The causes of rhabdomyolysis were as follows: one crush syndrome, one acute arterial occlusion, one diabetic hyperosmolar nonketotic coma and three cases of malignant syndrome due to neuroleptica (mainly haloperidol). Underlying diseases included, one case of abdominal aneurysm, two cases of diabetes mellitus, two cases of schizophrenia and one case of reactive psychosis. Dehydration was considered as an important factor in the onset of rhabdomyolysis and ARF, because it was observed in 4 of the cases in this study. In all cases, the serum levels of potassium, phosphorus and uric acid as well as myoglobin and myogenic enzymes increased markedly. In patients with myoglobinuric ARF, severe metabolic acidosis and hypocalcemia in the oliguric phase and hypercalcemia in the diuretic phase were prominent. Muscle biopsy showed myolytic degeneration in 2 of 4 cases. Five cases were treated with hemodialysis and one case was managed conservatively. All 6 cases had relatively good prognosis. However, 3 cases with malignant syndrome showed outcomes more severe than in the other 3 cases without such syndrome.

Acute Kidney Injury

Automated determination of orotic acid, uracil and pseudouridine in urine by high-performance liquid chromatography with column switching.

A column-switching high-performance liquid chromatographic method, requiring no sample preparation apart from filtration, is described for quantification of urinary orotic acid, uracil and pseudouridine. The analyses were carried out using a reversed-phase octadecylsilane-bonded column for sample clean-up and a cation-exchange column for separation; 5-20 microliters samples of urine were directly analysed, and more than 100 samples could be analysed consecutively. Each sample required only 30 min. Detection limits of these compounds were 5 pmol. Creatinine-related urinary uracil excretion was lowest in the newborn period (17.3 +/- 14.4 mumol/g of creatinine). A patient with partial ornithine transcarbamylase deficiency and his mother usually excreted a high level of uracil during the period of normal orotic acid excretion and normal serum ammonia level.

Adolescent

[MR studies of extension and spread pattern of nasopharyngeal carcinoma].

Seven patients with T2-T4 nasopharyngeal carcinoma were examined by MRI on a 0.5T superconducting system. The obtained MRI images were reviewed focusing on the signal intensity (SI) of tumors, and the extension of tumors into the related spaces from the pharyngeal mucosal space (PMS). Consequently, the SI of tumors demonstrated low on T1 weighted images and high on T2 weighted images. The parapharyngeal space was the first space where the tumors extended from the pharyngeal mucosa. The parapharyngeal space was an intermediate point of extension to the masticator space (MS), the carotid space (CS), the retropharyngeal space (RPS), and the prevertebral space (PVS). The PVS involvement by tumors was not a direct extension from the PMS, because the posterior portion of pharyngobasilar fascia worked as a barrier on MR. Therefore, the longus capitus muscle in the prevertebral space was considered to be involved via the parapharyngeal space (PPS). The masticator space involvement was indicated by slightly high SI of pterygoid muscle on T2 weighted images, and also the effacement of the PPS fat and parapharyngeal venous plexus were considered as a sign of involvement into the masticator space. The retropharyngeal lateral lymph node (Rouviere) metastases were recognized by MR. These metastasized lymph nodes were low on T1 weighted images and high on T2 weighted images.

Adult

Vasospasm after traumatic subarachnoid haemorrhage: transcranial Doppler evaluation. Case report.

A case of vasospasm after traumatic subarachnoid haemorrhage (SAH) is reported here. Transcranial Doppler Sonography (TCD) was used to evaluate mean flow velocity (MFV) changes of the basal cerebral arteries related to vasospasm. Acceleration of MFV of the right middle cerebral artery (MCA) indicating vasospasm was first noted on TCD evaluation, and then proved by carotid angiography (CAG). Evaluation of all TCD results revealed that the process of relaxation or normalization of the spastic artery started from the proximal side of the basal intracranial artery and gradually moving to the distal side. This interesting phenomenon could be a common process found in vasospasm cases.

Blood Flow Velocity

Changes of plasma concentrations of steroid hormones, prostaglandin F2 alpha-metabolite and pregnant mare serum gonadotropin during pregnancy in thoroughbred mares.

Plasma concentrations of estrogens, gestagens, cortisol (F), 13, 14-dihydro, 15-keto PGF2 alpha (PGFM) and pregnant mare serum gonadotropin (PMSG) in 10 Thoroughbred mares were measured for a 11-month pregnancy period. Estrone (E1) and estradiol-17 beta (E2) levels gradually increased as the pregnancy advanced, showing a peak around Month 8 and decreased thereafter. Progesterone (P) levels increased on Months 3 and 11, and 17 alpha-OH-progesterone (17 alpha-OHP) levels peaked on Month 3, whereas 20 alpha-OH-progesterone (20 alpha-OHP) levels increased sharply after Month 6. PGFM indicated peaks on Months 2 and 11. F and PMSG levels peaked on Months 2 and 3. From factor analysis, Month, E1, E2 and 20 alpha-OHP were discriminated as Factor 1, increasing with the progress of pregnancy, PMSG, 17 alpha-OHP and P as Factor 2, showing a relation with the secondary corpus luteum, and PGFM and F as Factor 3, affecting PGFM change on Month 2 by F. P also related to both Factors 1 and 3, showing an inverse relation against PGFM. In conclusion E1, E2 and 20 alpha-OHP contained in Factor 1 were suggested to be important especially as parameters of placental function after Month 6.

Animals

Hypothalamic histiocytosis X with diabetes insipidus and Korsakoff's syndrome--case report.

A 54-year-old female presented with apparent isolated hypothalamic histiocytosis X associated with diabetes insipidus and Korsakoff's syndrome. Computed tomographic and magnetic resonance imaging demonstrated a single hypothalamic mass. A craniotomy for biopsy found granulation tissue of unknown cause. Further investigation discovered genital bleeding before admission. Biopsy of the cervix uteri revealed histiocytosis X. Further studies showed the disease was restricted to the hypothalamus and the endometrium of the cervix uteri. Low-dose irradiation led to partial regression of the hypothalamic mass and improvement of Korsakoff's syndrome. Even when a diagnosis of isolated hypothalamic histiocytosis X is confirmed, the possibility of another histiocytosis X lesion in an unexpected region must be considered.

Alcohol Amnestic Disorder

[Effect, recurrence and prognosis of intra-arterial infusion chemotherapy with anticancer agents for advanced breast cancer--especially, the significance of tumor blood vessels].

Between January 1977 and March 1991, 86 patients of Stage III and Stage IV breast cancer were treated by intra-arterial infusion chemotherapy (IAIC) in Sapporo Medical College. The 5- and 10-year overall survival rates of Stage III b were: infusion group 53.1% and 53.1%, non infusion group 50.1% and 16.7%, respectively. A significant difference was seen in the 10-year survival rate (p less than 0.05). The 5- and 10-year overall survival rate of Stage III b histologically effective group was 67.3% and non-effective group 31.8%. A significant difference was seen between these two groups (p = 0.0241). A significant difference was seen between n2 positive Stage III b infusion group and non-infusion group in 7-year survival rate (p less than 0.01). The ischemic effect on tumor cells by degeneration changes of the blood vessels was important for the histological effect. Pre-operative angiography helped in the choice of anticancer agents. The sufficient adjuvant chemo-endocrine therapy will assure a good prognosis for IAIC-treated Stage III b breast cancer patients.

Antineoplastic Combined Chemotherapy Protocols

Papilloma of renal pelvis in childhood.

A papilloma in the renal pelvis of a five-year-old girl is reported. The transitional cell tumors of the renal pelvis in the pediatric age group are reviewed, and this is found to be the first case of a benign papilloma in childhood. We believe this pathologic entity should be included in the differential diagnosis of hematuria in a child.

Child, Preschool

Muscular sarcoidosis: findings at MR imaging.

Twelve patients with muscular sarcoidosis were evaluated with magnetic resonance (MR) imaging: Nine patients had the nodular type and three had the myopathic type of muscular sarcoidosis. The nodular type showed a characteristic appearance on MR images. In each patient with the nodular type, both T1- and T2-weighted axial spin-echo images showed an oval nodule consisting of a star-shaped area of low signal intensity surrounded by an area of high signal intensity. Histopathologic correlation in patients with the nodular type revealed that the central portion of the nodule was fibrotic tissue surrounded by inflammatory granulomatous tissue. In each patient with the myopathic type of muscular sarcoidosis, MR images failed to show any abnormality; the authors hypothesize that this failure correlated with the sparse distribution of epithelioid cell granulomas. Identification of the star-shaped area of low signal intensity may help in the diagnosis of muscular sarcoidosis and the differentiation of lesions associated with sarcoidosis from other soft-tissue masses.

Adult

[Intra-arterial infusion chemotherapeutic effect of stage III breast cancer by survival rates].

Between January 1977 and December 1989, 140 patients of Stage III breast cancer were treated in Sapporo Medical College. Sixty-six of these patients received intra-arterial infusion chemotherapy. The anticancer drugs were mainly given by two routes, infusion into the internal mammary artery and the subclavian artery. Continuous infusion of 5-FU and intermittent injections of ADR, MMC, 4'-epi-ADR or THP-ADR were jointly or individually made in each artery. The 5-and 10-year overall survival rates were: infusion group 49.2% and 49.2%, non-infusion group 64.0% and 45.0%, respectively. Intra-arterial infusion chemotherapy seems to be useful because non-infusion group contained mostly Stage IIIa and conversely the infusion group contained mostly Stage IIIb. A significant difference was seen between 5-FU infusion group and MMC.ADR group (p=0.026). MMC group, MMC + ADR combination group and 4'-epi-ADR group were marginally significantly different in terms of survival rates of the anticancer drugs of Stage IIIb.

Antineoplastic Combined Chemotherapy Protocols