PubMed Health⌕ Search

Biomedical subjects

T Kinjo

Publications and source records attributed to T Kinjo.

At least 55 records · Page 3Linked to original sources
PubMed1997

An extensive cranial base meningioma extending bilaterally into Meckel's cave: case report.

OBJECTIVE AND IMPORTANCE: A patient with an extensive cranial base meningioma that included bilateral invasion of Meckel's cave underwent surgical resection and had an unexpected rare complication, malocclusion from bilateral trigeminal dysfunction. CLINICAL PRESENTATION: A 19-year-old male patient was admitted to our hospital with alternating painful ophthalmoplegia. He had been blind since the age of 10 years. At the time of admission, neurological findings included bilateral visual loss and optic atrophy. Magnetic resonance images showed an extensive tumor located at the planum sphenoidale, tuberculum sellae, and bilaterally at Meckel's cave and the medial tentorial incisura. INTERVENTION: The patient underwent a two-stage operation. During the first procedure, the masses in the planum sphenoidale, tuberculum sellae, and the left side of Meckel's cave were excised intradurally. At the second operation, the mass in the right side of Meckel's cave was excised extradurally and the tentorial mass was removed intradurally. The patient's postoperative course was complicated by bilateral trigeminal nerve dysfunction, which caused malocclusion. CONCLUSION: Bilateral dysfunction of the trigeminal nerve may cause a number of problems. Thus, extreme caution must be taken to preserve the function of this nerve.

Adult↗
PubMed1997

[Lymphocytic infundibulo-hypophysitis with diabetes insipidus as a new clinical entity: a case report and review of the literature].

In 1992, we reported a lymphocytic adenohypophysitis (LIH) (Neurol Med Chir). We considered this case unusual in that the case was that of a menopausal female and that it was accompanied with diabetes insipidus as classical lymphocytic adenohypohysitis (LAH). Subsequently, Ahmed reported two cases which presented a similar pathological manifestation, except for necrosis, as did our case and named them "necrotizing infundibulo-hypophysitis." Recently we encountered another similar case, which is reported hereunder. A female, 34 years of age, had suffered from headache, polyuria, and amenorrhea. CT scan showed a pituitary mass, and pituitary tumor was surgically removed transcranially at a local hospital. The pathological examination revealed the findings of chronic inflammation and necrosis. One month after the operation, however, she was an in-patient again under the suspicion of meningitis for fever and, when antibiotic therapy at the local hospital resulted in no improvement, she was referred to our hospital. Endocrinological studies showed low FSH, LH, ACTH and plasma cortisol level. Antibodies of serum to RNP, Sm, mitochondria, nucleus, AChR, and DNA were all negative. Because of an intrasellar mass with suprasellar extension on MRI, transsphenoidal operation was conducted four months after the initial operation. The pathological examination revealed the infiltration of lymphocytes, plasma cells, and foamy macrophages, and necrosis. After this operation, the headache was cured and the patient was discharged. Two months subsequent to the second operation, headache recurred and temporal upper quadrantic anopsia was noted. An enlarged tumor was found, but prednisolone worked to cure the pain and the visual field defect was found to have been remedied. The patient's diabetes insipidus is presently persisting, and she still relies on the use of desmopressin acetate and is still in need of cortisol replacement therapy. Including our cases, ten cases of lymphocytic hypophysitis, not related to pregnancy or delivery but with diabetes insipidus, have been reported. Several clinical and anatomical features distinguish these 10 cases from classical LAH. The classical LAH was predominantly related to pregnancy or delivery. However 6 of 10 cases were male in LIH. LAH related to pregnancy or delivery does not accompany diabetes insipidus, but all reported cases of LIH had a diabetes insipidus. Visual field and/or ocular movement disturbance are LAH's chief complaints (15 out of 25 cases) but visual field disturbance seldom occurs in LIH (1 out of 10 cases). Hypopituitarism is more serious in LAH, and 4 cases became fatal from an adrenal crisis. Anatomically, inflammatory change of LIH is located anterior and posterior to the pituitary gland and extends to the pituitary stalk and, at times, hypothalamus. On the other hand, LAH relates to pregnancy or delivery, the inflammatory change localizes to the adenohypophysis. Ahmed emphasized necrosis, while necrosis was not a prominent histological finding in LIH. Necrosis was noted only in 3 of 10 cases. To be stressed, rather, are the inflammatory changes seen on the neurohypophysis and the pituitary stalk, together with the characteristic diabetes insipidus. We believe, in view of the above, that what Ahmed named necrotizing infundibulo-hypophysitis should be named "LIH with diabetes insipidus." Whereas differential diagnosis is necessary between this said new disorder and the conventional LAH, we advocate that the latter, which is related to pregnancy or parturition but is free from neurohypophysitis be identified as "LAH related to pregnancy or delivery." With respect to treatment, steroid therapy is essential. If the symptoms do not improve, a transsphenoidal operation for diagnosis (LIH and LAH) and decompression (the case of LAH with visual or external ocular movement disturbance) is advisable. However, extensive surgery is not recommended, because per

Adult↗
PubMed1997

[Transarterial platinum coil embolization for direct carotid-cavernous fistula].

Two cases of direct carotid-cavernous fistula (CCF) were treated by transarterial platinum coil embolization (TACE) following unsuccessful transarterial balloon embolization (TABE). Case 1 was a 47-year-old man who complained of pulsatile left exophthalmos, chemosis and bruit. Left carotid angiograms showed a CCF with anterior, posterior and cortical venous drainage. Near total obliteration of the CCF was achieved by TABE, but it showed recurrence in the next morning. At this time, left carotid angiograms showed a CCF which drained only into the cortical veins via the enlarged sphenoparietal sinus. Because of high risk of intracranial hemorrhage, TACE was performed immediately. The result was successful. Case 2 was an 82-year-old woman who suffered from traumatic subarachnoid hemorrhage. First right carotid angiograms showed a small CCF which drained only into the inferior petrosal sinus. Right exophthalmos, swelling of the eyelids, severe eye pain and bruit appeared gradually. The second right CAG performed three months after the head trauma showed markedly dilated superior ophthalmic vein which was the new main draining root of the CCF. Because of progressive symptoms, TACE was performed immediately after the angiography, which proved successful. Direct CCFs must be treated aggressively because they don't cure by spontaneous obstruction of fistula. Although TABE is the first choice for direct CCF, complete occlusion of CCF in difficult in some cases. Those cases have; 1) small fistula of CCF for balloon insertion, 2) large fistula for occlusion by balloons, 3) not enough space for inserting a balloon after recurrence of CCF, and 4) sharp objects (bone fracture fragments, foreign objects) may puncture the balloon. If TABE couldn't provide successful treatments, TACE should be considered as an alternative treatment for direct CCF after angiography without delay because it is less complex compared with TABE.

Aged↗
PubMed1997

[Organ preservation in the treatment of malignant solid tumors in children].

Organ preservation is one of the requirements for maintaining the high quality of life after the treatment of malignant solid tumors in children. We analyze our recent results of renal preservation in the abdominal neuroblastoma and describe 3 cases of successful organ preservation in pelvic malignancy. Between 1982 and 1996, 29 patients with adrenal or retroperitoneal neuroblastoma, that extended into the surrounding tissues and organs and/or to the contralateral side, underwent delayed primary excision. Before 1982, 9 patients were treated and only one ipsilateral kidney was preserved. On the other hand, 13 of 20 kidneys were preserved after 1987. Adoption of cis-platinum deepened our awareness of preserving the kidney. Furthermore, we have altered our strategy since 1987 to continuing preoperative chemotherapy until the size of the tumor becomes as small as it is estimated completely resectable by our own index, which is derived from computed tomography. Kidneys are shielded during intraoperative irradiation, and the tumor relapsed from the shielded area of retroperitoneum in one patient. Four of 14 preserved kidneys became atrophic and lost their function. The bladder and the rectum were left intact at tumor resection after intensive chemotherapy in two patients with pelvic (one retroperitoneal and one vaginal) rhabdomyosarcoma. A yolk sac tumor of the vagina responded completely to chemotherapy with cis-platinum, etoposide and bleomycin. The patient has survived 7.5 years without any local and distant relapse in spite of the fact that surgery, aside from several diagnostic biopsies, was not undertaken.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Mapping of antigenic sites on the major inner capsid protein of avian rotavirus using an Escherichia coli expression system.

The cDNA encoding the VP6 gene of avian rotavirus PO-13 strain was inserted into the bacterial expression vector pET-3a. Upon isopropyl-1-thio-beta-D-galactoside induction, the E. coli BL21 (DE3) harboring the vector containing cDNA of the VP6 gene produced an approximately 45-kDa polypeptide, which reacted with rabbit serum against PO-13 strain in Western blotting. To study the antigenic sites on VP6, various deletion mutants were constructed, expressed in E. coli and the reactivity with antigenic site I- and II-specific MAbs analyzed by Western blotting. Site I, which is shared with all group A mammalian and avian rotaviruses except for chicken rotavirus, was found to be located at amino acid positions 45 to 65, and site II, which probably contributes to an authentic group A antigen common to both mammalian and avian rotaviruses, at amino acid positions 134 to 142.

Animals↗
PubMed1996

Expression of the major inner capsid protein, VP6, of avian rotavirus in mammalian cells.

A gene encoding the major inner capsid protein, VP6, of avian rotavirus was inserted into the eukaryotic expression vector pAX-91 under the control of the SR alpha promoter and was expressed at a high level in simian COS7 cells. The expressed VP6 was indistinguishable in terms of electrophoretic mobility from the corresponding protein synthesized in simian MA104 cells infected with avian rotavirus. Binding assays with a series of monoclonal antibodies (mAbs) that corresponded to four antigenic sites on VP6 of avian rotavirus showed that the antigenic characteristics of the expressed product were identical to those of the native VP6 of avian rotavirus virions. Fiber-like structures that reacted strongly with antiserum against rotavirus were observed in VP6-expressing COS7 cells. Furthermore, an analysis of the tertiary structure of the expressed VP6 protein indicated that it adopts a trimeric configuration, similar to that of the major inner capsid protein of PO-13 virus. From these results, it appears that recombinant VP6 will facilitate studies of the structure and function of authentic VP6, an important protein in avian rotavirus.

Animals↗
PubMed1996

The nucleotide sequence of the hemagglutinin gene of the LA strain of rinderpest virus, a seed virus strain used for vaccine production in Japan.

The sequence of the hemagglutinin (HA) gene of the LA strain of rinderpest virus (RPV) has been determined by the direct sequencing method. The amino acid sequence of the protein which it encodes displays conservation of its structural determinants with the HA proteins of the other RPV strains. The LA-HA protein was shown to have three conserved potential N-linked glycosylation sites, compared with four such sites in the HA protein of L strain. The glycosylation site at position 200 on the L-HA molecule is absent from its LA-HA counterpart, due to a lysine for an asparagine substitution. The HA proteins of L and LA strains were the same molecular weight as judged by mobility on SDS-PAGE, suggesting that the site at position 200 is not used for glycosylation.

Amino Acid Sequence↗
PubMed1996

Modified petrosal approach using cosmetic osteoplastic craniotomy with NEURO-SAT guidance.

The petrosal approach has become a routine procedure for petroclival lesions, but there are some disadvantages such as the time-consuming craniotomy during surgery and depressed deformity of the mastoid area after surgery. To solve these disadvantages, we modified the petrosal approach. Before surgery, the three-dimensional points of the sigmoid sinus and semicircular canals are calculated on computed tomography scan and are input to a computer. A single temporooccipital bone flap is made, and the outer table of bone overlying the mastoid is preserved by forming a narrow groove with a small air drill and cutting the outer table with a chisel. After removing these two free bone flaps, mastoidectomy is performed guided by NEURO-SAT (neuronavigation by computer-assisted frameless stereotaxy). The mastoid bone can be drilled out safely and quickly. The two bone flaps are connected and replaced at the end of the procedure. Osteoplastic petrosal craniotomy guided by NEURO-SAT can achieve a quick craniotomy and satisfactory cosmetic result.

Abducens Nerve↗
PubMed1996

[Cranio-orbital zygomatic extradural approach for cavernous sinus or Meckel's cave tumors].

Direct surgery to cavernous sinus (CS) lesions has become one of the optimal treatments based on advancement in microsurgical anatomy and imaging modality, and the progress of microsurgical techniques. We have removed the CS or Meckel's cave tumors extradurally when they do not extend intradurally, using modified Al-Mefty's cranio-orbital zygomatic craniotomy. Three CS tumors; trigeminal neurofibroma, squamous cell carcinoma and chondrosarcoma, and a Meckel's cave meningioma were reported. Total removal was achieved in all but one (case 4). Postoperative complications were permanent ophthalmoplegia in one, transient ophthalmoplegia in one, subcutaneous CSF accumulation in two and trigeminal dysfunction in one. The extradural approach can be the first choice of methods for total removal of tumors when they are confined to the CS or Meckel's cave.

Adult↗
PubMed1996

[A successfully operated case of tuberous sclerosis presenting with intractable epilepsy].

A 20-year-old male patient with tuberous sclerosis was admitted to our hospital complaining of intractable epilepsy. He had been suffering from frequent seizures despite anticonvulsant treatment since the age of 1 year. CT scan and magnetic resonance images showed multiple calcified lesions at the paraventricle and temporal lobe on both sides. Electroencephalogram showed left temporal lobe dominant spike waves. After deep electrodes were inserted into the left amygdala and hippocampus and subdural electrodes were placed on the left temporal cortex, clinical seizures were monitored by video and EEG. The primary focus was found in the amygdala. Left temporal lobectomy was carried out through the cranio-orbital zygomatic approach. Postoperatively, the patient has been seizure-free for one year. Despite multiple intracerebral lesions in tuberous sclerosis, resection of the primary epileptogenic focus is needed to solve the seizure problem if the focus is localized.

Adult↗
PubMed1995

Expression of the nucleoprotein of rabies virus in Escherichia coli and mapping of antigenic sites.

Investigations were performed to delineate the antigenic sites I and IV of rabies virus nucleoprotein (N), the former of which is well conserved among the rabies and rabies-related viruses. The N cDNA of the RC-HL strain was inserted into an expression vector pET3a, with which the E. coli BL21(DE3) was transformed. Upon induction with isopropyl-1-thio-beta-D-galactoside, the transformants produced a protein with a size (56 k-Da) almost identical to that of the authentic N protein. The protein also reacted with a panel of our N protein-specific monoclonal antibodies (N-MAbs) including the antibodies against the antigenic sites I and IV. By using the cDNA, various deletion mutants were generated and expressed in E. coli to examine the reactivity of mutant proteins with N-MAbs by Western blot analysis. Deletion of the C-terminal 67 amino acid residues did not abolish their reactivity with any of the N-MAbs specific for the sites I and IV. When 91 residues or more were deleted from the C-terminus, however, the protein lost the reactivity, indicating that the antigenic sites I and IV are mapped to a small region which is comprised of at most 24 amino acid residues from positions 360 to 383. Comparison of the 24-amino acid sequence with the corresponding region of N protein of several other Lyssavirus strains suggests that the antigenic site I is mapped to positions 360 to 369.

Amino Acid Sequence↗
PubMed1995

Sequence analysis of cDNA for the VP6 protein of group A avian rotavirus: a comparison with group A mammalian rotaviruses.

cDNA corresponding to the genomic segment 6 of avian rotavirus strain PO-13, which has group A common and subgroup I antigens, but does not hybridize in Northern blots with RNA probes from group A mammalian rotaviruses, was cloned and sequenced. When the deduced amino acid sequence was compared between strain PO-13 and eight group A mammalian rotaviruses, the extent of homology ranged from 73-75%. An alignment of the amino acid sequences allowed us to identify three amino acids (Positions 120, 317 and 350) that may contribute to determining the subgroup epitopes. A phylogenetic tree constructed on the basis of nucleotide substitutions in the VP6 gene of nine rotaviruses strongly suggests that the avian rotavirus is an ancestral prototype of mammalian rotaviruses.

Amino Acid Sequence↗
PubMed1995

Symptomatic intraventricular arachnoid cyst in an elderly man.

A case of intraventricular arachnoid cyst in an elderly man is reported. A 63-year-old man developed a progressive gait disturbance over a five-year period. CT scan showed a large cyst in the left lateral ventricle which was negative to contrast enhancement. CT cisternography revealed gradual accumulation and more than 48 hours retention of contrast medium in the cyst. The patient underwent left frontal craniotomy, and the cyst wall was partially resected for histopathological examination. Although limit microscopic examination could not establish a diagnosis, arachnoid cyst was diagnosed by electron microscopic findings. Biochemical analysis did not detect any difference between cyst fluid and CSF obtained during surgery. It is suggested that a ball-valve mechanism caused progressive enlargement of the cyst and gradual development of symptoms in this elderly patient.

Arachnoid↗
PubMed1995

Skull base approaches for posterior circulation aneurysms.

With the emergence of skull base surgery, surgical approaches have been developed and redefined, providing surgeons with accessible avenues to difficult lesions of the cranial base. Although the majority of lesions to which these techniques have been applied have been for tumors, we find that these skull base approaches can equally provide access to difficult vascular lesions, especially complex aneurysms of the posterior circulation. In this report three different skull base approaches were used in four patients for the treatment of posterior circulation aneurysms. A cranio-orbital-zygomatic approach was used for the acute stage of a ruptured basilar tip artery anenrysm and for a giant posterior cerebral artery aneurysm. A petrosal approach was used for a ruptured basilar trunk aneurysm, and the transcondylar approach was used for a vertebral artery aneurysm. Each approach provides a wide field and excellent exposure of vital structures with minimal brain retraction. Neck clipping of the aneurysms was successfully achieved in all cases. We believe that our skull base approaches facilitate the surgical treatment of posterior circulation aneurysms.

Journal Article↗
PubMed1995

Diaphragma sellae meningiomas.

Despite their unique clinical, radiological, and surgical considerations, diaphragma sellae meningiomas remain largely undistinguished from tuberculum sellae meningiomas. On the basis of our experience with 12 patients with diaphragma sellae meningiomas and our review of the literature, we classify these tumors into three groups: Type A, originating from the upper leaf of the diaphragma sellae anterior to the pituitary stalk; Type B, originating from the upper leaf of the diaphragma sellae posterior to the pituitary stalk; and Type C, originating from the inferior leaf of the diaphragma sellae. Each type has specific clinical symptoms. Type A mainly presents with unilateral visual disturbances and visual field defects resembling those of tuberculum sellae meningiomas, although preoperative diabetes insipidus occurred in patients with large tumors. Type B causes fewer visual disturbances, but memory disturbance and hypopituitarism occur. Type C closely resembles nonfunctioning pituitary adenomas; bitemporal hemianopsia and hypopituitarism are common. Multiplanar magnetic resonance images can accurately diagnose the tumor and establish its type. Surgical approaches include the cranio-orbital approach for Types A and B and the transcranial-transsphenoidal approach for Type C. Surgery is more difficult than for tuberculum sellae meningiomas because of the deep location and the difficulty of dissecting Types A and B from the pituitary stalk. Repair of the sphenoid sinus to prevent cerebrospinal fluid leakage is mandatory for Type C tumors.

Adult↗
PubMed1995

Isolation and characterization of a hantavirus from Rattus norvegicus in a residential area of Nagoya City, Japan.

The prevalence of antibodies to hantavirus among Rattus norvegicus in Nagoya city was examined during the period from 1986 to 1993. Eight sera of 675 were antibody positive in an indirect fluorescent antibody test. Antibody positive rats were found in 1988, 1990, 1991 and 1992 and the numbers of rats were 1, 1, 3 and 3, respectively. A hantavirus strain was isolated from a rat captured in 1990 at a residential area adjoining to a pier in Nagoya port. The virus strain, named NR-9, was identified antigenically as the Seoul type of hantavirus in a neutralization test. Suckling rats inoculated with NR-9 strain survived, while those with SR-11 strain succumbed. A difference between the virulence of strains, NR-9 and SR-11 was demonstrated.

Animals↗
PubMed1994

Nucleotide sequence of the nucleoprotein gene of the RC.HL strain of rabies virus, a seed strain used for animal vaccine production in Japan.

By using a phage vector (lambda ZAP II) and the mRNA extracted from IMR-32 cells infected with the RC.HL strain of rabies virus, we constructed a cDNA library from which four nucleoprotein (N)-specific cDNA clones were obtained by Southern blot hybridization. These clones contained a cDNA insert of about 1.4 kb, in which the longest open reading frame was the same length as that reported for the N cDNA of three fixed strains, CVS, PV, and SAD B19. When the nucleotide and deduced amino acid sequences were compared between the RC.HL and the three strains, homology was within the range of 91.5-91.8% and 95.1-96.0%, respectively. Of 183 nucleotides of the RC.HL N-cDNA that were not identical to that of the corresponding site of at least one of the three strains, 41 were shared with the CVS strain, whereas only three were shared with either of the other two strains. In the amino acid sequence, we found 29 residues that were not shared in common with all of the four strains, 11 of which were the substitutions with radically different amino acids that might cause conformational changes of the protein, and, in addition, five of which were located in the region close to the C terminus. The number of such amino acid substitutions between the RC,HL and CVS strains was smaller than that of the other three strains. These results are not inconsistent with the presumption that the RC.HL and CVS strains originated from the same laboratory strain of the Pasteur viruses.

Amino Acid Sequence↗