PubMed HealthSearch

Biomedical subjects

S Shibuya

Publications and source records attributed to S Shibuya.

9 recordsLinked to original sources

High levels of nervous system-specific proteins in cerebrospinal fluid in patients with early stage Creutzfeldt-Jakob disease.

Concentrations of several proteins that are characteristic of the nervous system were time-sequentially analyzed by radio- and enzyme-immunoassay in the cerebrospinal fluid (CSF) of patients with Creutzfeldt-Jakob disease (CJD). We found abnormally high levels of several proteins, such as neuron-specific enolase (NSE), S-100b protein, brain-type isozyme of creatine kinase (CK-BB) and alpha subunit of GTP binding protein G0 (G0 alpha) in the early stage of the disease. Generally, these protein levels were far higher in CJD patients than in normal controls and other neurological patients in the early stage before the typical clinical manifestations were evident. These levels increased to maxima when the disease activity was most prominent and returned to normal or mildly elevated levels in the terminal stage. The results imply that these protein levels can serve as biochemical markers for the presence of an active destructive process in CJD brain and provide us with a useful indicator for early diagnosis of CJD.

Brain

Esophageal ulcer due to ingestion of melted copper.

We report a patient with esophageal stricture as a result of the accidental swallowing of melted copper by a 49-year-old male. As a result, esophagogastric ulcers developed and left a cicatrical stricture. The patient could only manage to swallow liquid food. Radiology of the upper gastrointestinal tract showed marked stricture of the esophagus from the middle thoracic portion to the esophagogastric junction and shortening of the lesser curvature of the stomach. The patient underwent a single-session total gastrectomy, and excision of the thoracic esophagus and construction of anterior thoracic esophagocolic and duodenocolic anastomoses were performed by right thoracotomy and laparotomy, respectively. Macroscopic findings of the surgical specimens showed extensive circular ulcers at the esophagus, and microscopic findings showed deep ulcers extending to the muscle layer with marked fibrosis. The postoperative course was uneventful.

Accidents, Occupational

Mycotic aneurysms of the internal carotid artery. Case report.

The authors report a case with two mycotic aneurysms in the cavernous portion of the internal carotid artery, presumably secondary to a transient bacteremia from pneumonia. The strikingly rapid development of the aneurysms was demonstrated by angiography. Painful total ophthalmoplegia and extophthalmos were the main clinical features.

Adult

[The bone scintigraphy in eosinophilic granuloma (author's transl)].

The significance of bone scintigraphy using 99mTc-polyphosphate or 99mTc-diphosphate in the diagnosis of eosinophilic granuloma was discussed on the basis of our experience with four cases. The summary is following: 1. On diagnostic procedure of eosinophilic granuloma, it was found that abnormal RI accumulation in the bone scintigram was more marked than that in the ordinary brain scintigram. 2. The bone scintigram of eosinophilic granuloma showed more accurately the extent of skull involvement of cellular infiltration than the plain skull X-rays or brain scintigram. Accordingly, the bone scintigram was helpful for neurosurgeon in planning the operative procedure and determining the extent of removal of the involved skull. 3. The plain skull X-rays show the size of skull defect, and the brain scintigram reveals the size of the size of granuloma per se, as well as soft tissue involvements. We can conjecture the stage of the diseases by comparison between the findings of bone scintigram and those of above procedures: plain skull X-rays and brain scintigram. Viz, the bone scintigram showed more extensive areas of RI accumulation including the surrounding cellular infiltration in the acute stage, but the same size of the lesions shown by the ordinary brain scintigram and plain skull X-rays is chronic stage. Furthermore, we discussed the possibility of the differential diagnosis between eosinophilic granuloma and other neoplastic bone diseases, such as intracranial metastatic tumors and multiple myelomas etc., by further experience with the bone scintigram.

Adult

[The accessory middle cerebral artery (author's transl)].

The accessory middle cerebral artery has rarely been documented. Four cases of the anomalous artery were found in 1240 carotid angiograms, the incidence being estimated to be 0.24 to 0.34%. Ages of the patients were 45, 52, 53, and 56. They were two males and two females. In two patients, the angiography was carried out because of positive neurological signs after head injury, and in the other two, because of cerebrovascular stroke. All the anomalous arteries were found as incidental findings. The angiography was carried out bilaterally in two patients and the anomalous arteries were found only on one side. They arose from the horizontal portion of the anterior cerebral artery and coursed laterally in paralled with the stem of the middle cerebral artery. Two of them gave rise to the perforating arteries into the brain which accompanied those from the middle cerebral artery. These atomalous arteries were identified very easily on an antero-posterior projection of the angiogram. In the most striking patient, the 52-year-old man, a selective angiography for the middle cerebral artery, which did not demonstrate the anterior cerebral artery and its branch, the accessory middle cerebral artery, was carried out and in the light of the findings, the accessory middle cerebral artery could be identified running in elliptic circle just above D1 on the lateral projection of the routine carotid angiogram. All the accessory middle cerebral arteries in our series were not associated with either intracranial aneurysm or anomalies such as agenesis of the corpus callosum and reduplication of the circle of Willis.

Cerebral Angiography