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Biomedical subjects

T Shimoji

Publications and source records attributed to T Shimoji.

At least 91 records · Page 5Linked to original sources
PubMed1984

Dissecting aneurysm of the vertebral artery. Report of seven cases and angiographic findings.

Seven cases of dissecting aneurysm of the vertebral artery, all appearing to be of fusiform type, are reported. Clinically, all seven cases initially showed symptoms of subarachnoid hemorrhage; however, three of these were associated with Wallenberg's syndrome. The characteristic angiographic findings in these cases were: 1) retention of contrast medium in the aneurysm; 2) the presence of a true (vertebral artery) and false (arterial wall) lumen in the late arterial and/or venous phase; and 3) irregular arterial narrowing proximal and/or distal to the aneurysm. Autopsy findings of one patient supported the angiographic findings. Recently, reports of fusiform aneurysms associated with subarachnoid hemorrhage have been increasing. As dissecting aneurysms are found in the fusiform group, it is very important to analyze serial angiograms in order to choose a method of surgical treatment.

Adult↗
PubMed1984

[Hemorrhage into tha cavity of chronic subdural hematoma].

Mean quantity of daily hemorrhage into the hematoma cavity was determined at the craniotomy in 39 cases with chronic subdural hematoma. Mean daily hemorrhage amounted 6.7 per cent of hematoma volume. Those in infancy, adults younger or older than 70 years old were 6.8%, 6.9% and 6.2%, respectively. When the period from head trauma till the craniotomy was less 3 months, one fourth of cases showed more bleeding than 10% of hematoma content into the cavity. Over 3 months after the head trauma, hemorrhage decreased in volume, amounted less than 2%. The severer the clinical grading of chronic subdural hematoma was, the more the daily hemorrhage was. The cases with dementia demonstrated usually less hemorrhage. The daily hemorrhage into the hematoma cavity did not correlate clearly with the maximum breadth of subdural hematoma in CT scans or carotid angiograms. Not only bleeding but also its dilution and condensation in the subdural hematoma modifies the density of hematoma cavity in CT scans. There were many cases showing more hemorrhage at FDP levels among 320 and 640 micrograms/ml. The hemorrhage into the chronic subdural hematoma cavity is caused by imbalance of local hyper-fibrinolysis and coagulability and daily hemorrhage amounts 6.7% of hematoma content. Such interrupted or continuous hemorrhage results in aggravation of clinical symptoms and high density of hematoma space in CT scans.

Adult↗
PubMed1984

[Histological study of cases of bladder cancer and chronic cystitis with difficulty in cystoscopic diagnosis].

Twenty-seven cases in which cancer could not be distinguished from chronic cystitis were reviewed. These cases were divided into those with and those without a past history of bladder tumor. The high frequency of hyperplasia in the group with a history of bladder tumor suggested that hyperplasia may be a precursor of papillary tumor. On the other hand, proliferative lesions such as cystitis cystica and metaplasia were encountered in the group with no history of bladder tumor and 50 percent had symptoms of chronic cystitis. These findings suggested that proliferative lesions in the bladder developed by inflammatory irritation. Urinary cytology was done in 18 cases. Cytology was positive in 2 of the 3 cases of transitional cell carcinoma. Therefore, urinary cytology was useful, but it did not provide distinction in two cases of follicular cystitis and a case of squamous metaplasia was false positive.

Adult↗
PubMed1984

[Pelvic recurrence of bladder carcinoma following total cystectomy].

The patients who undergo total cystectomy for high stage bladder carcinoma have poor prognosis because of local extension or distant metastases. In the case of recurrent lesions after total cystectomy, radiotherapy and chemotherapy are generally selected. In some cases of recurrent tumors localized within the pelvic cavity and with no distant metastases, however, surgical resection of the tumor is effective in local disease control combined with radio- and chemotherapy. Surgical treatment is not only effective in reducing the cell number in a bulky tumor, but also improves clinical symptoms and conditions such as pain, bleeding, rectal irritability, intestinal obstruction and so on. We present here three patients who underwent extensive operation for pelvic recurrence of bladder carcinoma following total cystectomy. Two of these cases died of progressive disease, nine months and five months after the extensive operations. The third patient died of acute pericarditis thirteen months after the second operation. Autopsy revealed that the surgical treatment was effective in controlling the local recurrence in the third case. Furthermore, some problems regarding pelvic recurrence and surgical treatment are discussed.

Aged↗
PubMed1984

[A case report of retroperitoneal malignant schwannoma].

A case of retroperitoneal malignant schwannoma is reported. The patient was a 66-years-old man who was referred to our clinic because of an abdominal lump. CT scan and renal arteriography pointed out right renal cyst, but the tumor was separate from the right kidney at operation. Pathological diagnosis of this retroperitoneal tumor was malignant schwannoma. After 10 months he developed local recurrence and had transabdominal excision. He has been doing well 12 months after the second operation. Thirty-one cases of retroperitoneal malignant schwannoma in Japan are reviewed.

Aged↗
PubMed1984

[Brain stone. A case report].

A 43-year-old woman with an abnormally calcified shadow in right temporal lobe as seen on the plain skull films is reported. She was free of any neurological deficit except a recent episode of generalized tonic clonic convulsive seizures. Clinical observations, including EEG have proved unhelpful. Despite intensive neuro-radiological examinations, it only revealed the existence of a dumb-bell shaped calculus measuring 17 x 10 mm in right temporal lobe. Operation and histo-pathological examination were carried out. The mass was a hard calculus, surrounded by minimal perifocal gliosis, and was easy to separate from the normal brain tissue. The decalcified specimen was identified as a collection of PAS positive spherical lamellar particles without any diagnostic cell or structure. After the operation, the calcified shadow was disappeared and the patient is free from seizure. Based on these findings, the calculus can be classified as a very rare category, "idiopathic brain stone".

Adult↗
PubMed1983

Middle fossa arachnoid cyst: clinical, neuroradiological, and surgical features.

16 patients and 4 adult cases of small-or medium-sized middle fossa arachnoid cyst were subjected to various neuroradiological investigations and their results were analyzed in terms of possible mechanisms of cyst expansion. Based on the results of the investigations which strongly suggested that the cyst is an expanding lesion, all cases were surgically treated by the same techniques of craniotomy, excision of the outer cyst membrane, followed by a cystoperitoneal shunt, resulting in complete disappearance of the cyst concomitant with reexpansion of the surrounding brain and marked improvement in the clinical pictures of the patients.

Adolescent↗
PubMed1983

[A case of malignant fibrous histiocytoma occurring in the retroperitoneum with giant pyonephrosis].

A case of malignant fibrous histiocytoma (MFH) occurring in th retroperitoneum with giant pyonephrosis is reported. The patient was a 45-year-old male and his chief complaint was an abdominal mass. The abdominal fullness progressed so rapidly that he was admitted to our hospital. After examination, this case was diagnosed as a malignant tumor with left hydronephrosis, and an operation was performed on August 5, 1982. At operation, the left kidney contained about 11,000 ml of a pus-like fluid and in the retroperitoneum was found a hen-egg-sized solid tumor which was invading into the left kidney and the feeding vessels of the descending colon. So the tumor, left kidney and a part of the descending colon were resected en bloc. Pathological diagnosis was malignant fibrous histiocytoma. Chemotherapy (PPM regimen) and immunotherapy (OK-432) were administered after the operation, but multiple metastases appeared in the liver and bilateral lungs within 3 months. Then, the CY-VA-DIC regimen was followed. But, local recurrence was found in about 5 months, and the patient died on the 174 th day after the operation. Local recurrence and metastases in the liver, bilateral lungs, pleura and bones were confirmed at autopsy. Besides our case, a review of case reports of retroperitoneal MFH in Japan and comments are presented.

Histiocytoma, Benign Fibrous↗
PubMed1982

[A case of Sturge-Weber syndrome with the abnormal angiographic findings in the cerebral venous system (author's transl)].

A case of Sturge-Weber syndrome with marked abnormalities in the cerebral venous system was reported. The patient was a 2-year old boy who was admitted to the Department of Neurosurgery with the chief complaints of left hemiparesis and left focal seizures. He had vascular nevi on the forehead and upper lip of his face, scalp, right forearm and thigh (Fig. 1). Neurological examination of admission revealed left hemiparesis. Plain skull films indicated no intracranial calcification. EEG showed paroxysmal focus in the right parieto-temporal area. Plain CT scan showed calcium deposits in the right parietooccipital area and contrast enhancement occurred around the areas of calcification (Fig. 2). Venous phases of bilateral CAGs showed abnormalities of the cortical veins and sinuses and abnormal drainage from the cerebral cortex to the deep veins. It also demonstrated persistence of the primitive straight sinus (Fig. 3, 4). From the neurological and neuroradiological findings, this case was diagnosed as the Sturge-Weber syndrome with marked abnormalities in the cerebral venous system. These abnormal findings of veins and sinuses seemed to be brought about by development abnormalities of veins and sinuses which continuously occurred following Streeter's primordial plexus, which has been considered to be a cause of the Sturge-Weber syndrome.

Angiomatosis↗
PubMed1981

[Clinical findings of cefoxitin in the treatment of serious infections and the prevention of postoperative infections (author's transl)].

UNLABELLED: This clinical trial was designed to evaluate the efficacy, safety and patient tolerance of cefoxitin in 23 patients who were admitted to the hospital from March 1980 to November 1980. The daily dose of cefoxitin for 21 adult patients (ages ranged from 26 to 74 years old) were 6 g for the treatment of infections, and 2 to 6 g for the prevention of infections by either direct or intermittent intravenous infusions. Two children were given 100 mg/kg of cefoxitin either by direct or intermittent intravenous infusions 2 to 3 times a day in divided doses. SUMMARY OF FINDINGS: I. Treatment of intracranial infections 1. A 60-year-old man with a brain abscess was admitted to the hospital after the unsuccessful treatment with a cephalothin for 9 days. After, the initiation of therapy with cefoxitin, given 6 g a day for 3 days, the abscess was surgically removed. On the second day of treatment with cefoxitin following the operation, his highest temperature was 37.0 degrees C and was normal on the third day of treatment. He was discharged after 12 days after the surgical procedure. 2. A 56-year-old woman with cerebrospinal rhinorrhea and meningitis after the transsphenoidal removal of pituitary microadenoma responded satisfactorily to therapy with cefoxitin, given 6 g a day for 14 days after the unsuccessful treatment with a cephalothin. II. The prevention of infections following surgical operation of the central nervous system 1. Seventeen patients undergoing surgical procedures were treated with cefoxitin for the prevention of postoperative infections. None of the 17 patients developed postoperative infections. 2. A 53-year-old man undergoing repair of cerebrospinal rhinorrhea in the possibly contaminated area was successfully treated with cefoxitin, given intravenous 2 g every 8 hours for 10 days without meningitis having developed. III. The treatment and prevention of complications 1. A 74-year-old comatose male with a brain stem concussion, who was expectorating insufficiently and had difficulty swallowing and developed into pneumonia as a complication. He was successfully treated with cefoxitin, given intravenous 6 g a day for 2 weeks. 2. A 26-year-old male with a brain stem concussion complicated by pneumonia and a urinary tract infection was successfully treated with the same dose regimen of cefoxitin as the previous patient. 3. The prevention of complications A 58-year-old male with pontine glioma undergoing a tracheotomy was administered cefoxitin for the prevention of pulmonary complication. He died of pontine glioma after the three-month treatment. IV. Side effects Results of skin sensitivity tests given prior to the administration of cefoxitin were negative in all of the 23 patients. Neither anaphylaxis nor other allergic reactions or thrombophlebitis occurred with the intravenous administration of cefoxitin. No abnormalities in blood, hepatic function or renal function were observed. Anorexia occurred in 1 patient who was given cefoxitin, 6 g a day.

Adult↗
PubMed1980

Suprasellar cysts: surgical treatment and results.

The purpose of this paper is to present the clinical picture, diagnostic studies, and treatment of 5 cases of suprasellar cyst. The clinical symptoms and signs result from increased intracranial pressure without lateralizing signs (midline syndrome) and direct compression of the adjacent structures (hypothalmopituitary syndrome). The findings of computerized transmission tomography (CTT) and cerebral angiography in patients with suprasellar cyst are very similar to those of severe hydrocephalus. Cerebral angiography, however, reveals in inordinate mass effect in the parasellar area. Even though the location of the parasellar cyst is well demonstrated on postventriculoperitoneal shunt CTT scans, pneumonencephalography is necessary to confirm the diagnosis. We treated our patients with uni- or bilateral ventriculoperitoneal shunts, followed by craniotomy and cystosubarachnoid marsupialization. Cystoperitoneal shunting was performed after craniotomy in some instances, in place of it in others.

Cerebrospinal Fluid Shunts↗
PubMed1980

[A case of up-beat nystagmus associated with Chiari malformation type I (author's transl)].

A case of Chiari malformation type 1 with sign of upbeat nystagmus was reported. The patient was a 9-year-old girl who was admitted to the Department of Neurosurgery with the chief complaints of snoring and headaches. The neurological examination on admission revealed a lower cranial nerve disturbance bilaterally and upbeat nystagmus in the primary ocular position that increased in amplitude upon gazing upward, and horizontal nystagmus on gazing laterally. The skull tomogram showed platybasia. The vertebral arteriogram and the pneumoencephalotomogram showed downward displacement of cerebellar tonsils to the level of C2. The patient received suboccipital craniectomy and C1, C2 laminectomy for decompression and the foramen of Majendie was opened. From the operative findings the diagnosis was confirmed as Chiari malformation type 1. In the first two postoperative weeks, the upbeat nystagmus as well as other symptoms was gradually improved. It was therefore considered that the responsible lesion of the upbeat nystagmus in this case might be in the lower brain stem or the inferior vermis due to mechanical compression or circulatory disturbance.

Arnold-Chiari Malformation↗