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Biomedical subjects

A Nishimoto

Publications and source records attributed to A Nishimoto.

At least 91 records · Page 5Linked to original sources
PubMed1986

[Long-term follow-up study of spasmodic torticollis].

Since 1958, 61 patients with spasmodic torticollis, 46 of whom did not develop other kinds of involuntary movements, have been experienced in our neurosurgical clinic. The course of these 46 patients was followed for more than one year. The retrospective analysis revealed 25 patients were treated conservatively, and 21 patients were treated surgically. Surgical treatment consisted of stereotactic ventrolateral thalamotomy in 19 patients, and Olivecrona's operation in the other 2. The long-term outcome of conservative therapy was compared to that of surgical therapy. One patient with severe retrocollis with horizontal components was treated successfully but transiently by implantation of stimulating electrodes in the cervical epidural spinal cord. The peak incidence of the onset of the disease was in the fourth decade; however, the time of onset ranged from 7 to 55 years of age. The period from disease onset to the final evaluation in the follow-up was 9.3 years (mean) in the conservative group, and 8.5 years in the surgically treated group (no significant difference). There were no significant differences between the groups in the interval from the time of disease onset to the initial evaluation in our clinic, stage determined at evaluation, and follow-up period after the initial evaluation. Of the 25 conservatively treated patients, symptoms and signs remained unchanged in 8, deteriorated in one, but improved significantly in most of the remaining patients. Many of the surgically treated patients showed improvement one week after surgery, but the long-term outcome was not significantly better than that of the conservatively treated patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[A new treatment by occluding spring embolus for carotid-cavernous fistula].

The authors describe a new technique for simple, direct and safe obliteration of a carotid cavernous fistula (CCF) with occluding spring embolus (OSE), preserving the carotid artery flow. The patient was 47 year-old man who was admitted to our department on September 3, 1984 complaining of left conjunctival injection, exophthalmos and bruit at the left temporal region. Angiograms revealed a typical cavernous dural AVM (spontaneous CCF) on the left side with bilateral dural ECA-ICA blood supply. He was treated with transvascular Ivalon embolization of the bilateral ECA. A clinical symptom after transvascular embolization improved transiently, but one month later he developed progressive chemosis in addition to the previous symptom. A left frontotemporal craniotomy was done and six OSEs through polyethylene tube was inserted into the cavernous sinus and the fistula was closed completely. Angiogram during procedure was taken to establish the topographical relationship of OSE, carotid artery and the cavernous sinus. Postoperatively his chemosis and conjunctival injection were decreased and gradually cleared up within three weeks. Postoperative angiogram showed complete closure of the fistula.

Carotid Artery Diseases↗
PubMed1986

[The effect of brain-stem vasomotor centers on the neurogenic control of cerebrovascular tonus--Part 3. The effects of destruction and stimulation of the brain-stem on intracranial pressure in acute subarachnoid hemorrhage].

The purpose of the present study is to clarify the effects of destruction and stimulation of the brain-stem on intracranial pressure (ICP) in experimentally induced subarachnoid hemorrhage (SAH). Using 23 cats, blood pressure (BP), ICP and local cerebral blood volume (CBV) were continuously measured. Acute SAH was produced by injection of autogenous blood (3 to 7 ml) into the cisterna magna. The animals were divided into two groups. Group A: those in which hypothalamic dorsomedial nucleus (DM) and reticular formation of the midbrain (MBRF) were coagulated bilaterally one hour after SAH and Group B: in addition to the procedure of Group A, reticular formation of the medulla oblongata (MORF) was electrically stimulated bilaterally. In 19 out of 23 cats of both groups, transient small increases in ICP and CBV were observed during coagulation and/or stimulation of DM, MBRF and MORF respectively in the animals whose ICP remained approximately 20 mmHg or below and progressive increase in ICP was never evoked. In 3 animals of Group A whose ICPs remained high at more than 20 mmHg, sequential destruction of DM and MBRF induced stepwise increase in ICP to 40 to 80 mmHg and consequently resulted in acute brain swelling. In 1 animal of Group B whose ICP fluctuated around 20 to 40 mmHg, biphasic increase in ICP to 100 mmHg was repeatedly evoked by stimulation of MORF. It is concluded that in the condition of increased ICP produced by SAH, lesions in the DM and MBRF and stimulating condition of MBRF may result in acute brain swelling.

Acute Disease↗
PubMed1986

[Dissociative sensory disturbance after removal of an arteriovenous malformation in the posterior thalamic region].

A 34-year-old male developed consciousness disturbance; semicoma, on December 15, 1984, and diagnosed as a thalamic hemorrhage perforating into the ventricular system after a computed tomographical (CT) examination. Angiography revealed an arteriovenous malformation (AVM) in the right posterior thalamic region, which was fed by a posteromedial choroidal artery. He was transferred to our neurosurgical clinic on February 18, 1985. On admission, he was alert, however, disorientation and slight mental retardation were seen as well as Parinaud's sign. Mild left hemiparesis was also detected with equivocal hypesthesia on the left lower limb. The AVM was subtotally removed on March, 12, via transventricular approach after right parietooccipital craniotomy. Consciousness disturbance (drowsy) and left hemiplegia developed after the operation, however, these deteriorations were transient, recovering to the preoperative or better status by 2 weeks after the operation. Postoperative repetitive examinations of the sensory perceptibility of various modalities revealed remarkable disturbance or complete loss of perception in joint and vibration senses (0-3/10 compared to the healthy left side). Touch sensation was also severely deteriorated (0-3/10) on the affected extremities. The disturbances in these modalities of the sensation did not show any trend to improve until the time of discharge on 57th postoperative day. On the other hand, pain and temperature sensations were less remarkably disturbed (5-8/10), and with tendency of gradual improvement. Estimation of the range of lesion by the CT scan with projecting on the Schaltenbrand & Bailey's atlas revealed that the nucleus ventralis caudalis, centre-median nucleus and pulvinar thalami were involved.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Superficial temporal to superior cerebellar artery anastomosis for rostral brain stem infarction].

The authors report a case of superficial temporal to superior cerebellar artery anastomosis (STA-SCA anastomosis) for progressing rostral brain stem infarction with an excellent result. Precise operative techniques were also described. A 47-year-old male was admitted to our hospital on November 9, 1984, because of sudden onset of dysarthria and ataxic gait. CT revealed a low density area in the pons. Left vertebral angiogram showed occlusion of the left vertebral artery just distal to the origin of the posterior inferior cerebellar artery (PICA). Arterial branch of the left cerebellar hemisphere were filled via the left PICA to the left SCA and anterior inferior cerebellar artery anastomosis. Right brachial angiogram showed the hypoplastic right vertebral artery which ended at the PICA. The rostral basilar artery, both posterior cerebral arteries (PCA's) and right SCA were filled through anastomosis from the right PICA. The posterior circulation was not filled by either of the carotid arteries. In spite of antiplatelet agglutination therapy, the patient had two more episodes of dysarthria, dysphagia, right hemiparesis and gait disturbance. Because of progressing stroke, STA-SCA anastomosis was carried out on the right side on February 27, 1985. During operation, the blood pressure was maintained above the level of 130 mmHg, and intravenous mannitol injection and spinal drainage were done to preserve the right temporal lobe from intracerebral hematoma and/or edema caused by retraction. Postoperatively, the patient has been free from new ischemic attack. He has only slight hemiparesis now eight months after operation. Right external carotid angiogram showed a patent STA-SCA bypass and good filling of SCA's and PCA's bilaterally.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Stem↗
PubMed1985

Diencephalic syndrome of emaciation (Russell's syndrome). Long-term survival.

Three cases of diencephalic syndrome are reported. Two of them, which have been observed postoperatively for more than 7 years, showed typical clinical and endocrinologic features at the time of their first admission, but showed mass signs uncharacteristic of diencephalic syndrome after recurrence of the tumor. Recent data showed a normal baseline for plasma growth hormone but abnormalities in provocation tests. The significance of age in the manifestation of the syndrome is briefly discussed, especially in relation to the tendency toward normalization in the growth hormone level at a later age.

Astrocytoma↗
PubMed1985

Glossopharyngeal neuralgia with cardiac syncope. A case successfully treated by microvascular decompression.

A case of glossopharyngeal neuralgia associated with episodic cardiac arrest and syncope is presented. Posterior fossa exploration showed that the left glossopharyngeal and vagus nerves were compressed by the posterior inferior cerebellar artery. Microvascular decompression resulted in complete relief of glossopharyngeal neuralgia, cardiac syncope, and seizure. The mechanism of glossopharyngeal neuralgia associated with cardiac syncope is discussed.

Adult↗
PubMed1985

The determination of glial fibrillary acidic protein for the diagnosis and histogenetic study of central nervous system tumors: a study of 152 cases.

Glial fibrillary acidic protein (GFAP) was purified from human spinal cord and cerebral white matter. GFAP was localized by an immuno-peroxidase method in normal adult and fetal human brains, rat brains, and 152 central nervous system (CNS) tumors. GFAP was found in reactive and normal astrocytes, immature cells of fetal brain at the 18th to 21st gestational weeks, and normal rat astrocytes. This GFAP staining was quite specific for glial tumors, including astrocytomas, glioblastomas, astroblastomas, and ependymomas. GFAP-positive cells were also found in oligodendrogliomas and choroid plexus papillomas, and they were interpreted as being astroglial or ependymal differentiations. Stromal cells in cerebellar hemangioblastomas were negative. However, engulfed astrocytes were found at the periphery of such tumors and often adjacent to the proliferate blood vessels. In meningiomas, neurinomas, metastatic carcinomas, pituitary adenomas and other non-glial tumors, GFAP-positive cells were not identified.

Animals↗
PubMed1985

Primary central nervous system lymphoma.

A retrospective analysis of 21 cases of primary central nervous system (CNS) lymphoma is reported. All patients presented with a solitary mass in the supratentorial region. None had previously received immunosuppressive therapy. Neuroradiological studies included technetium-99m-pertechnetate brain scanning in eight cases, cerebral arteriography in all 21 cases, and computerized tomography (CT) in 14 cases. The characteristic features were increased uptake in brain scans, mass effect in arteriograms, and marked contrast enhancement on CT scans. Abnormal tumor vessels were occasionally seen on arteriography, and subtraction films were usually required to appreciate tumor stain. All patients underwent craniotomy, and histological studies of the tumors showed a diffuse type of lymphoma in all cases. Immunoglobulin testing was performed in 19 cases and a monoclonal spike was verified in 10, suggesting a B cell origin. All patients were followed until their death except one who was still alive 12 months from onset of symptoms. Therapy included subtotal resection in all 21 cases, whole-brain irradiation in six cases, chemotherapy in two cases, and a combination of whole-brain irradiation and chemotherapy in nine cases. Three different forms of chemotherapy were used. The results suggest that chemotherapy is an important addition to subtotal resection and whole-brain irradiation in the treatment of primary CNS lymphoma.

Adult↗
PubMed1985

Sensory and motor responses to deep brain stimulation. Correlation with anatomical structures.

Motor and sensory responses induced by trial stimulation were examined before stereotaxically implanting a permanent stimulating electrode for pain relief in 11 patients with intractable pain of central origin. The total number of points eliciting a response when stimulated was 70. The points of stimulation were determined as exactly as possible from Schaltenbrand and Bailey's Atlas. Motor responses were detected upon stimulating 21 points, the majority of which were in the posterior third of the posterior limb of the internal capsule (IC). Stimulation of these 21 points was accompanied by pain relief in only two points (10%). Warm (22) or cool sensations (three) were provoked in the most posteromedial portion of the posterior limb of the IC, nucleus reticularis pulvinaris, and area triangularis, and seven (28%) of these 25 sensations were accompanied by pain relief. A burning sensation was found upon stimulation of 12 points, with stimulation in the mesencephalic lateral tegmental field eliciting the most severe burning pain. A tingling sensation was elicited at 12 points, in a distribution similar to that of the warm sensation. Five (42%) of these 12 points provided pain relief. The best stimulating point for pain relief is not in the center of the posterior limb of the IC, directly lateral to the posterior commissure, but rather in its most posteromedial part; that is, at the nucleus reticularis pulvinaris or area triangularis.

Adult↗
PubMed1985

Establishment of a brain-tumor model in adult monkeys.

A brain-tumor model in adult monkeys may be significant because of the biological similarity to humans as well as the feasibility for surgical manipulation and for sequential computerized tomography (CT) scanning. In the present study, brain tumors were successfully produced in Japanese monkeys (Macaca fuscata), each weighing 2 to 10.8 kg, with an average age of 5.1 years old. Tumor cells were implanted by intracerebral inoculation of 4 X 10(7) chick embryo fibroblasts infected with the Schmidt-Ruppin strain of Rous sarcoma virus (RSV). With a 15- to 67-day latency, brain tumors were induced in 11 (73.3%) of 15 RSV-inoculated monkeys. Contrast-enhanced CT scans delineated all solitary intracerebral tumors greater than 4 to 6 mm in diameter. The CT images were proved at autopsy to be accurate within 2 mm in determining the size of tumor. Five of the 11 monkeys with intracerebral tumors died, with an average survival time of 26.6 days after RSV inoculation. The induced tumors were classified as either glioma or sarcoma by the presence or absence of glial fibrillary acidic protein (GFAP) and S-100 protein. A chromosome analysis of cultured tumor cells showed a diploid number of 42, indicating monkey origin. It is concluded that the reproducible brain tumor in the adult Japanese monkey inoculated with RSV can serve as a good experimental brain-tumor model for the further study of human malignant brain tumors.

Animals↗
PubMed1985

[A case of cerebellar ganglioglioma in an infant--immunohistochemical study].

Ganglioglioma is a rare brain tumor which occurs in an infant and young adult. The term "ganglioglioma" was originally proposed by Ewing in 1926 and subsequently adopted by Courville in 1930. Histogenesis of ganglioglioma is still speculative, but the hypothesis that ganglioglioma is derived from hamartomatous sympathetic neurons is generally thought to be probable. Gangliogliomas of the brain arise frequently from the temporal lobe, frontal lobe, cerebellum and spinal cord. Its growth is gradual and clinically it is a benign tumor, but its malignant transformation has been reported. Ganglioglioma is a tumor composed of both neuronal and glial cells, but the ratio of these two-cell components varies a great deal from case to case and in different areas even of the same tumor. The authors experienced a cerebellar ganglioglioma in an infant which was successfully removed. Histopathological and immunohistochemical studies of the biopsy specimen have been done. That is, histopathological staining with H-E (hematoxylin eosin), PTAH (phosphotangustic acid hematoxylin), cresyl-violet and Bodian, and electron microscopical studies were performed. Also the authors immunohistochemically examined the presence or absence of GFAP (glial fibrillary acidic protein), NSE (neuron specific enolase), S-100 alpha and beta subunits. Histopathologically, the authors could find nerve fiber, glial fiber and identify neuronal cells which had Nisslgranules in the cytoplasm. Electron microscopically the authors could distinguish the neuronal cells which had large nuclei and prominant nucleoli from the glial cells which had processes filled with intermediate glial filaments.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebellar Neoplasms↗
PubMed1985

[beta-Endorphin and monoamine metabolite concentrations in patients with intractable pain--changes before and after deep brain or spinal dorsal column stimulation].

Baseline concentrations of beta-endorphin (beta-EP) and monoamine metabolites (MHPG: 3-methoxy-4-hydroxy-phenylglycol, HVA: homovanillic acid, 5-HIAA: 5-hydroxyindoleacetic acid) in lumbar CSF (LCSF) and ventricular CSF (VCSF) were measured in 18 patients with intractable pain; 10 with deafferented pain and 8 with peripheral pain. Control values were obtained from 37 individuals of various ages. Changes in the concentrations of these substances were determined before and after giving stimulations (2-5 V, 0.2-0.5 msec, 40-50 Hz, 20-sec duration) to 6 patients through electrodes implanted in deep brain structures (DBS; posterior limb of the internal capsule in 5 patients and rostral mesencephalic lemniscus medialis in one patient), and to 2 other patients through electrodes implanted in the spinal dorsal column (DCS). The control value of beta-EP in LCSF was 57.6 +/- 24.7 pg/ml, which was not significantly different from that of VCSF. Great variation in the individual control LCSF beta-EP concentrations was found, but it was not related to differences in age. The mean baseline LCSF beta-EP concentration was significantly higher (p less than 0.05) than the control in the patients with deaffernted pain before stimulation. One of the monoamine-metabolites, MHPG, showed higher level in the patients with peripheral pain (p less than 0.01). The LCSF beta-EP concentration was not affected by deep brain stimulation, but was increased by dorsal column stimulation. In one patient with excellent pain relief by stimulation of the posterior limb of the internal capsule, the LCSF HVA and 5-HIAA concentrations were conspicuously increased.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Spinal epidural metastasis of glioblastoma multiforme: a case report].

It is generally accepted that the metastases of intracranial glioma to extracranial location are rare. In such a case the minimal criteria proposed originally by Weiss should usually be satisfied if a report is to be considered as an acceptable case of metastasizing central nervous system glioma outside the central nervous system. We report a case of glioblastoma multiforme, fulfilling Weiss' criteria, metastasizing the spinal epidural space. The patient was a 32-year-old male, who underwent craniotomy and subtotal removal of a glioblastoma multiforme in the left parietooccipital area. He was additionally treated with irradiation and chemotherapeutic agents. Twelve months after the craniotomy, he was admitted again to our clinic because of sudden onset of severe lumbago, paraplegia and urinary disturbance. Diagnosis of a spinal epidural tumor was made and laminectomy (Th10-L1) was performed. At operation, an epidural mass was found, however no invasion to the spinal cord or dura was noted. Histological diagnosis of the tumor was glioblastoma multiforme. Although he was treated with radiation, pulmonary metastasis was manifested one month later, and the condition of the patient deteriorated. He died 21 months after the first operation and 8 months after the second operation. Even at the terminal stage, his consciousness was clear without any sign for recurrence of intracranial tumor. The general autopsy was done and multiple metastatic lesions of glioblastoma multiforme in paratracheal and paraaortic lymph node, left pleura, both lungs and spinal cord were observed. The present case suggests that the surgical intervention, irradiation, and chemotherapy may contribute to extracranial metastasis of a glioblastoma.

Adult↗
PubMed1985

[Immunohistochemical study of S-100 protein in the normal human brain and glioblastoma].

The authors investigated the immunohistochemical localization of S-100 protein in normal human brain and glioblastoma tissues by the peroxidase anti-peroxidase method of Sternberger. In normal human brain the positive immunoperoxidase reaction for S-100 protein was observed in astrocytes, oligodendrocytes, ependymal cells, Bergmann's glial cells and epithelial cells of choroid plexus. No positive staining was revealed in any cortical neurons. Immunoelectron-microscopically, the electron dense positive reaction for S-100 protein was seen throughout the cytoplasm, nucleoplasm and cell processes of astrocyte as well as oligodendrocyte. The positive reaction for S-100 protein was demonstrated occasionally in association with cytoplasmic membrane or the membrane constituting cell organelles. We suspect that this observation indicates the existence of membrane-bound form of S-100 protein. In glioblastoma cells, the positive reaction for S-100 protein was relatively weak in intensity as compared with astrocytes, and the degree of positive staining varied from cell to cell. Subcellular localization of S-100 protein in glioblastoma seemed to be essentially similar to that of normal astrocyte. There are some recent reports concerning immunohistochemical localization of alpha and beta subunits of S-100 protein. As compared with these reports, the present immunohistochemical results indicate that the rabbit anti-S-100 antibody embloyed in the present study is mainly against beta subunit of S-100 protein. Although there have been many reports concerning immunohistochemical localization of S-100 protein, the biological role of S-100 protein is still speculative. Some hypotheses are advocated in connection with the possible biological role of S-100 protein. For example, the modulation of synaptic transmission by S-100 protein, the participation of S-100 protein in hormonal secretion and in transport of cations through lipid membrane, the activation of protein kinase and the promotion of disassembly of microtubules by S-100 protein are postulated. It is hard to assume the biological role of S-100 protein based on the immunohistochemical results alone. The present study clearly indicates that S-100 protein exists widely in the cytoplasm, nucleoplasm, cytoplasmic membrane, outer membranes of cell organelles and cell processes of glial cells as well as glioblastoma cells. From these results we assume that S-100 protein plays an important role of intracellular transport of cations as one of the calcium binding proteins.

Brain↗
PubMed1985

[Pleomorphic xanthoastrocytoma (Kepes): a case report].

A case of tumor to be diagnosed as pleomorphic xanthoastrocytoma (Kepes) is reported. This patient was a 34-year-old female with a 6-year history of TIA. Neurological examination on admission showed no abnormalities except for bilateral choked disc. Plain CT scan revealed a well-defined low density area with a small high density region in the right temporal lobe. The small high density region and a part of peripheral portion of low density area were moderately enhanced with contrast media. At operation there was a cyst containing xanthochromic fluid at 1.5 cm depth from the cerebral surface. Temporal lobectomy and subtotal removal of tumor (5gr) were performed. The patient received postoperative radiation therapy (5960 rad). She has been doing extremely well for these 5 years following craniotomy and has no deficits except for the left upper quadrant hemianopsia which appeared immediately after surgery. There cannot be observed any symptoms or signs suggesting tumor recurrence. Histologically the tumor cells displayed marked pleomorphism. However, either necrosis or mitosis were very hard to find. The tumor cells were surrounded by a dense network of reticulin fibers. Electron-microscopically the tumor cells were occasionally filled with glial fibrils, and lipid granules were seen. Immunoperoxidase technique revealed both glial fibrillary acidic protein (GFAP) and S-100 protein in the cytoplasm of tumor cells, suggesting of neuroectodermal origin. Although this patient is older than previously reported cases (age 3 to 32), the histological findings as well as the good postoperative course indicate that this case may fulfill the criteria of pleomorphic xanthoastrocytoma first proposed by Kepes et al.

Adult↗