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Tadao Nose

Publications and source records attributed to Tadao Nose.

At least 55 records · Page 3Linked to original sources
PubMed2003

[Changes in 1H-MRS in glioma patients before and after irradiation: the significance of quantitative analysis of choline-containing compounds].

The evaluation of the response to radiation therapy in brain tumor patients is a major and an important issue. Although CT and MRI can measure changes in tumor size, it is difficult to use these imaging methods to evaluate the viability or the proliferation activity of a tumor. In this study, we investigated the metabolite changes in glioma patients using 1H-MRS from before to after radiation therapy, to see whether or not early metabolic changes occur during therapy. Seven patients with histologically proven glioma (1 astrocytoma, 1 anaplastic astrocytoma, 2 oligoastrocytoma, 1 oligodendroglioma, 2 glioblastoma) were examined by means of 1H-MRS using a point-resolved spectroscopy (PRESS) sequence with a repetition time of 2,000 ms and echo times of 68 ms, 136 ms and 272 ms. The 1H-MRS was evaluated by both the spectrum pattern and the quantification of the metabolites. As to radiation therapy, each patient received a total dose of 64.8 Gy (1.8 Gy/fraction) with a 10-MeV linear accelerator. The results revealed that the concentration of choline-containing compounds (Cho) was 4.55 +/- 1.08 mmol/kg wet weight before radiation therapy and was reduced to 2.69 +/- 0.56 mmol/kg wet weight (p < 0.01) after radiation therapy. Moreover, both the N-acetylaspartate (NAA) peak and creatine/phosphocreatine (t-Cr) peak were lower after radiation therapy than before. The peaks of both the lipids (Lip) and lactate (Lac) were higher after radiation therapy than before. In conclusion, Cho concentration is thought to be a useful marker for the evaluation of early post-radiation response. The effect of radiation therapy can be evaluated according to the value of Cho. Further long-term MRS study is needed to prove whether or not the decrease of the Cho value in the present study will change before recurrence at later stages.

Adult↗
PubMed2002

Myelopathy caused by tics in an adolescent, associated with T2 signal intensity changes of the spinal cord.

COURSE: A 15-year-old boy who had suffered motor tics since age 9 developed progressive cervical myelopathy involving both his hands and his lower extremities. T2-weighted MRI revealed mild canal stenosis and increased signal intensity in the cervical spinal cord beginning at the C-4 level and continuing upward to the medulla oblongata. TREATMENT: After C-3 to C-7 laminoplasty, the patient's clinical symptoms improved. DISCUSSION: It is possible that movement disorders such as tics may contribute to the development of cervical myelopathy owing to the effects of involuntary movements on the neck. Such an intensity change on a T2-weighted image has never been reported in an adolescent tic disorder. Despite such changes, surgical treatment may bring about clinical improvement.

Adolescent↗
PubMed2002

Quantification of cerebral metabolites in glioma patients with proton MR spectroscopy using T2 relaxation time correction.

This study was aimed to investigate the significance of absolute concentration of metabolites in glioma patients using proton MR spectroscopy (MRS) with T2 relaxation time correction using three different echo times. The absolute concentrations of metabolites in 7 normal subjects and in 23 gliomas (10 low-grade, 13 high-grade) were obtained by proton MRS using a tissue water signal as an internal standard. The signal intensities of metabolites and tissue water were corrected by T2 relaxation time. In low-grade glioma, the T2 relaxation time of NAA was shorter, and T2 relaxation time of water was prolonged as compared to normal subjects (p < 0.001). In high-grade glioma, the T2 relaxation time of NAA (p < 0.001) and T2 relaxation time of Cr (p < 0.01) were shorter, and T2 relaxation time of water (p < 0.001) was prolonged as compared to normal subjects. Moreover, high-grade gliomas revealed a shorter T2 relaxation time of Cr than low-grade gliomas (p < 0.05). In glioma, NAA and Cr concentration were decreased, and Cho were increased as compared to normal subjects. Moreover, high-grade glioma revealed a significant lower Cr (p < 0.001) and Cho (p < 0.01) concentration compared to low-grade gliomas. Low Cr concentration is the most reliable indicator of malignancy in glioma. Cho concentration did not correlate with malignancy in gliomas.

Adult↗
PubMed2002

Fatal cerebral infarction after intraventricular hemorrhage in a pregnant patient with moyamoya disease.

Moyamoya disease is a progressive occlusive cerebrovascular disorder of unknown etiology. We describe a case of a fatal cerebral infarction after intraventricular hemorrhage in a 29-year-old primipara with moyamoya disease. The patient had been stable for about 10 days after the initial hemorrhage, but she showed a fulminant clinical course of cerebral infarction, and died on the 16th day after the initial hemorrhage. Abnormality in coagulation system and/or cerebral vasospasm may have resulted in such a fulminant clinical course. A possible pathogenesis of this rare condition is discussed.

Adult↗
PubMed2002

Intratumoral hemorrhage due to hemangioblastoma arising from a cervical nerve root--a case report.

We describe a case of a 70 year old man suffering from sudden weakness of the left foot. Preoperative neuroimaging examinations showed an oval mass 2 cm in maximal diameter with intratumoral hemorrhage at the seventh cervical vertebra. The mass was supplied by the right lateral thoracocervical artery and was drained to the anterior spinal vein. The intraoperative findings showed the hard reddish tumor was not attached to the pia and the posterior root of the fifth cervical nerve was totally encased by the tumor. A histopathological examination revealed that hemangioblastoma encasing the posterior nerve root totally, so that the tumor was thought to arise from it. Unusual presentation of the neuroimaging examinations is described.

Aged↗
PubMed2002

Coil migration during endovascular treatment in a patient with Galenic arteriovenous malformation.

High flow arteriovenous malformations are commonly treated by using an endovascular approach with detachable coils. Although the risk of coil migration or distal embolisation into the venous system is almost always a consideration when treating these lesions, coil migration of a coil mass comprised of several coils is uncommonly seen, and not recorded. We report a case of Galenic arteriovenous malformation in a 22-year-old male in which coil migration was observed during the endovascular procedure. Possible mechanisms are discussed.

Adult↗
PubMed2002

Repair of a tear at the base of a blister-like aneurysm with suturing and an encircling clip: technical note.

OBJECTIVE: An aneurysm can produce large defects in the parent vessel if the aneurysm tears at the neck of the vessel. The authors present a technique to repair a tear at the base of a blister-like aneurysm encountered during microsurgical clipping of an anterior wall aneurysm of the internal carotid artery. METHODS: The repair technique involved suturing and covering the aneurysm with an encircling aneurysm clip. A large tear had destroyed the vessel's tubular structure, and repair was not sufficient using an encircling clip alone. Two microsuture stitches were placed on the tear, so that a split artery re-formed a tubular structure. The lesion was then covered with Surgicel (Ethicon, Inc., Somerville, NJ) and fibrin glue. When the Surgicel and fibrin glue were applied, the temporary clip on the distal internal carotid artery was removed for a moment, allowing retrograde blood flow to provide the counterforce necessary to maintain the vessel's tubular structure. An encircling clip was then applied to cover the entire circumference of the lesion. RESULTS: This method required only a short occlusion time for arterial repair, thus helping avoid ischemic complications. The patient awoke with transient hemiparesis, but recovery was prompt. CONCLUSION: This technique is useful for repairing an aneurysmal tear at its base, especially if the tear is large.

Aneurysm, Ruptured↗
PubMed2002

Ruptured aneurysm of the ophthalmic artery trunk demonstrated by three-dimensional rotational angiography: case report.

OBJECTIVE AND IMPORTANCE: Aneurysms arising from the ophthalmic artery are extremely rare, compared with carotid-ophthalmic aneurysms arising from the wall of the internal carotid artery. We present a very unusual type of aneurysm arising from the ophthalmic artery itself. CLINICAL PRESENTATION: A 54-year-old man presented with a sudden onset of headache and was transferred to a local hospital. Computed tomography demonstrated subarachnoid hemorrhage around the left anterior clinoid process, but digital subtraction angiography failed to localize the source of the hemorrhage. The patient was referred to our hospital for further evaluation and treatment. Conventional cerebral angiography did not reveal the source of the hemorrhage, but three-dimensional rotational angiography clearly demonstrated an aneurysm arising from the ophthalmic artery trunk, apart from the internal carotid artery. INTERVENTION: The patient underwent microsurgical clipping of the aneurysm via a left pterional craniotomy. The aneurysm originated from the bifurcation of the ophthalmic artery and a perforating artery to the optic nerve. The aneurysm was successfully obliterated, and the postoperative course was uneventful. CONCLUSION: This report is the first to describe a case of a ruptured aneurysm arising from the ophthalmic artery trunk. We discuss the clinical significance of an aneurysm at this site, as well as the role of three-dimensional rotational angiography in determining the source of subarachnoid hemorrhage.

Aneurysm↗
PubMed2002

Selective expansion of human natural killer cells from peripheral blood mononuclear cells by the cell line, HFWT.

An anchorage-dependent Wilms tumor cell line HFWT was found to stimulate selective and remarkable expansion of human natural killer (NK) cells from human peripheral blood mononuclear cells (PBMC). After PBMC of healthy donors were cultured on irradiated HFWT cells for 10 - 21 days, the lymphocytes expanded 58- to 401-fold. This NK cell expansion required direct contact of PBMC with live, but not fixed, HFWT cells. The PBMC from an end-stage brain tumor patient also expanded 156-fold, whereas those cultured with irradiated NK-sensitive K562 grew only 30.5-fold. CD16+ CD56+ NK cells accounted for more than 70% of the population expanded on HFWT cells. No essential difference in expression of NK receptors was observed in the expanded NK cells on HFWT and K562 and without feeder cells. The expanded NK cells killed not only fresh HFWT cells but, unexpectedly, also MHC class I-expressing autologous brain tumor cells at an effector/target ratio of 4 for 24 h. These results will contribute to the development of a large-scale preparation method for human NK cells, which will aid studies of NK cell biology and possible treatment of brain tumors.

Animals↗
PubMed2002

Cervical intramedullary gliofibroma in a child: a case report and review of the literature.

A rare case of intramedullary gliofibroma in a 12-year-old girl is reported. MRI revealed an intramedullary tumor with two different intensities, and these portions showed different staining patterns after gadolinium contrast enhancement, with faint enhancement at the periphery and strong enhancement in the central portion. Intraoperatively, the tumor had a relatively clear margin to the spinal cord and was composed of two portions of different consistencies, one soft in the periphery and the other elastic and firm in the central portion. This tumor was grossly, totally removed. The patient made a full recovery and there was no recurrence 2 years and 9 months after operation. There have only been 7 previous case reports of spinal intramedullary gliofibroma. Gliofibroma is usually a relatively benign astroglial variant. Recognition of such a variant is clinically important in considering the extent of the operation and postoperative adjuvant therapy.

Astrocytoma↗
PubMed2002

Moyamoya disease associated with hemophilia A. Case report.

A 10-year-old boy who had been diagnosed as having hemophilia A presented with episodes of transient ischemic attack. Cerebral angiography showed occlusions of the bilateral anterior cerebral arteries and the right middle cerebral artery with the development of an abnormal vascular network. The patient was diagnosed as having moyamoya disease associated with hemophilia A and subsequently underwent multiple burr hole surgery for revascularization under sufficient factor VIII supplementation. He remained asymptomatic after surgery, and follow-up cerebral angiography 5 months after the operation demonstrated significant neovascularization through the burr holes. Multiple burr hole surgery is proposed as a method of choice for the treatment of moyamoya disease associated with a bleeding tendency.

Cerebral Angiography↗
PubMed2002

Reversible holocord edema associated with intramedullary spinal abscess secondary to an infected dermoid cyst.

We report a case of a holocord high-intensity lesion extending from L1 up to the medulla oblongata on T2-weighted spinal magnetic resonance imaging (MRI) associated with an intramedullary spinal abscess secondary to an infected dermoid cyst. The intraoperative findings revealed that the high-intensity lesion on the T2-weighted image was edematous tissue. The MRI change in the spinal cord gradually improved in response to the use of postoperative antibiotics. The change was considered to represent reversible inflammatory changes, as there was no neurological deficit found at the cervical level and it resolved after surgery and medical treatment. The pathomechanism is discussed herein.

Abscess↗
PubMed2002

Intraoperative angiography evaluation of the microsurgical clipping of unruptured cerebral aneurysms.

Intraoperative angiography evaluation of the clippings of cerebral aneurysms was investigated in a series of 38 consecutive patients with unruptured cerebral aneurysms to determine any favorable impact on the outcome. Unexpected findings including major arterial occlusion or residual aneurysm were identified. Specific variables such as the size and site of aneurysm were analyzed to determine the impact on clinical outcome and the incidence of clip modification. There were 11 large and 27 small aneurysms in this series. Mortality and permanent morbidity after microsurgical clipping were 0.0% and 2.6%, respectively. Unexpected angiographic findings necessitating clip repositioning consisted of residual aneurysm in two cases and distal branch occlusion or parent vessel stenosis in four. The need for clip modification was significantly higher for large than for small aneurysms (p = 0.007), and the rate of clip adjustment increased with increasing aneurysm size (p = 0.008). Intraoperative assessment prior to wound closure allows for the recognition and correction of defects and decreases the risk of postoperative complications. Intraoperative angiography may become important in the microsurgical clipping of unruptured cerebral aneurysms, especially large aneurysms.

Aged↗
PubMed2002

Effect of expression of P-glycoprotein on technetium-99m methoxyisobutylisonitrile single photon emission computed tomography of brain tumors.

The expression of P-glycoprotein was investigated immunohistochemically in 26 brain tumor tissues and compared with the findings of technetium-99m methoxyisobutylisonitrile single photon emission computed tomography (99mTc-MIBI SPECT) to clarify the effect of P-glycoprotein on the diagnostic accuracy. P-glycoprotein labeling index of both tumor cells and vascular endothelial cells showed no clear relationship with the findings of 99mTc-MIBI SPECT imaging. Expression of P-glycoprotein has no effect on the diagnostic accuracy of 99mTc-MIBI SPECT.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2002

Chondroblastoma of the temporal base with high mitotic activity.

A 24-year-old man presented with a rare chondroblastoma of the temporal base manifesting as local pain accompanied by difficulty in opening the mouth. Gross total removal was achieved at initial surgery, but the tumor demonstrated rapid and destructive regrowth from a very small residual volume without definite histological malignant transformation. Growth activity estimated by MIB-1 staining increased spontaneously from 2.5% at the initial operation to 18.7% at recurrence. Further extensive radical tumor removal by surgeons from multiple disciplines was performed. The patient has been free of recurrence for 3 years without radiotherapy. Chondroblastoma of the temporal bone is widely accepted as a benign tumor and regrowth after gross total removal is very rare. However, some cases of chondroblastoma have potentially high mitotic activity.

Adult↗
PubMed2002

Reversible dementia in patients with chronic subdural hematomas.

OBJECT: Neuropsychiatric changes following surgery for chronic subdural hematomas (CSDHs) were analyzed in 26 patients (21 men and five women) by using the Mini-Mental State Examination (MMSE) and the Hasegawa Dementia Scale-Revised (HDS-R) to determine factors that potentially contribute to neuropsychiatric recovery. METHODS: Burr hole irrigation was performed in every patient to treat the CSDH. The patients' profiles, including age and sex, neuroimaging findings (such as hematoma volume and thickness, as well as midline shift), and preoperative and postoperative scores on the MMSE, HDS-R, and activities of daily living (ADL) scale were recorded. According to preoperative MMSE scores, eight patients (30.8%) were classified as mentally healthy and 18 (69.2%) as suffering from dementia before surgery. Nine of the 18 patients with dementia recovered to a normal psychological state following surgery. Surgery improved not only the patients' independence in ADL (p = 0.0026), but also their neuropsychiatric functions such as orientation and calculation, as estimated by scores on the MMSE (p = 0.0002) and the HDS-R (p = 0.0008). Factors affecting neuropsychiatric status on admission were midline shift (p = 0.0398) and ADL score (p = 0.0124); factors that could be used to predict neuropsychiatric recovery after surgery were patient age (p = 0.0027) and ADL score (p = 0.0193). The results of a logistic regression analysis demonstrated that significant predictors of neuropsychiatric recovery after surgery include the following: patient age (p = 0.0049, odds ratio [OR] = 0.842) and preoperative ADL (p = 0.0056, OR = 0.471), MMSE (p < 0.0001, OR = 1.895), and HDS-R (p = 0.0073, OR = 1.303) scores. Results of subgroup analyses demonstrated that patients younger than 74 years of age and those who had preoperative scores lower than 5 on the converted ADL scale, higher than 10 on the MMSE, or higher than 9 on the HDS-R on admission were found to have a significantly better recovery of neuropsychiatric functions after surgery. CONCLUSIONS: Dementia is reversible in many patients with CSDH, and surgery can improve not only independence in ADL, but also neuropsychiatric functions. Patients who are younger and/or those who have lower preoperative ADL scores and/or higher preoperative MMSE or HDS-R scores will achieve a good recovery with regard to neuropsychiatric functions after surgery. Estimations of neuropsychiatric function based on MMSE and HDS-R scores were found to be useful in predicting functional outcomes in patients with CSDH.

Activities of Daily Living↗
PubMed2002

Increased levels of lipid peroxides as predictive of symptomatic vasospasm and poor outcome after aneurysmal subarachnoid hemorrhage.

OBJECT: Cerebral vasospasm remains a devastating medical complication of aneurysmal subarachnoid hemorrhage (SAH). Reactive oxygen species and subsequent lipid peroxidation are reported to participate in the causes of cerebral vasospasm. This clinical study was performed to investigate the relationships between levels of lipid peroxides in cerebrospinal fluid (CSF) and both delayed cerebral vasospasm and clinical outcome after SAH. METHODS: Levels of phosphatidylcholine hydroperoxide (PCOOH) and cholesteryl ester hydroperoxide (CEOOH) in the CSF were measured in 20 patients with aneurysmal SAH. The patients' CSF was collected within 48 hours of hemorrhage onset and on Day 6 or 7 post-SAH. On Day 7, angiography was performed to verify the degree and extent of the vasospasm. The relationship between the patients' clinical profiles and the levels of lipid peroxides in the CSF were investigated. Both PCOOH and CEOOH were detectable in CSF, and their levels decreased within 7 days after onset of SAH. The levels of CEOOH within 48 hours after onset of hemorrhage were significantly higher in patients in whom symptomatic vasospasm later developed than in patients in whom symptomatic vasospasm did not develop (p = 0.002). Levels of PCOOH measured within 48 hours after onset of hemorrhage were significantly higher in patients with poor outcomes than in patients with good outcomes (p = 0.043). CONCLUSIONS: Increased levels of lipid peroxides measured in the CSF during the acute stage of SAH were predictive of both symptomatic vasospasm and poor outcome. Measurements of lipid peroxides in the CSF may be useful prognostically for patient outcomes as well as for predicting symptomatic vasospasm.

Adult↗