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Biomedical subjects

H Handa

Publications and source records attributed to H Handa.

At least 271 records · Page 15Linked to original sources
PubMed1987

Changes of neuropeptide immunoreactivity in cerebrovascular nerve fibers after experimentally produced SAH. Immunohistochemical study in the dog.

The immunoreactivity of vasoactive intestinal polypeptide (VIP)-, substance P (SP)-, and neuropeptide Y (NPY)-containing nerve fibers in the basilar artery (BA) and proximal portion of the middle cerebral artery (M1) was immunohistochemically examined in the dog after experimentally produced subarachnoid hemorrhage (SAH). The SAH was produced by a single injection of fresh autologous arterial blood (1 ml/kg body weight) into the cisterna magna. The density (the averaged number of nerve fibers in a unit area) of VIP-, SP-, and NPY-immunoreactive perivascular nerve fibers in the M1 segment and the BA was markedly decreased (5% to 40% of the normal value) immediately after the injection. The density of VIP- and SP-immunoreactive perivascular fibers increased 2 or 3 weeks after SAH and became normal by the 63rd day after injection. On the other hand, no substantial recovery was observed in the density of NPY-immunoreactive perivascular fibers by 63 days after injection.

Animals↗
PubMed1987

Nonsuture microvascular anastomosis using an Nd-YAG laser and a water-soluble polyvinyl alcohol splint.

Anastomosis of rat common carotid artery was performed without sutures, using a neodymium (Nd)-YAG laser at 20 W for 100 msec; this power and exposure had been found optimal in preliminary experiments. An intraluminal intervascular splint made of water-soluble polyvinyl alcohol, which dissolved and disappeared within a few minutes after recirculation of blood, was used for precise "intima-to-intima" coaptation. No stay sutures or glue were required during the procedure. There was a 92% patency rate 24 hours after surgery, and the anastomosed vessels were still patent on the 7th and 30th postoperative days. Complications such as aneurysm formation or stenotic change were negligible. The fusion of the muscle layer and collagen fibers of the media in the anastomosis was confirmed histologically. A tensile strength test immediately following operation and 1 week later showed that this anastomosis was significantly better than that achieved with the usual manual suture method. The major advantages of this technique, combined with use of a water-soluble polyvinyl alcohol splint, are rapidity, consistency of results, and firm fusion with no residual foreign body.

Anastomosis, Surgical↗
PubMed1987

[The potential usefulness of transcranial Doppler sonography in cerebrovascular surgery].

In 30 patients undergoing neurosurgical intervention, the authors evaluated the hemodynamics in the circle of Willis by transcranial Doppler sonography. By avoiding confusion with collateral effects, the transcranial Doppler sonography yielded direct and more significant information concerning the intracranial hemodynamics than extracranial Doppler sonography. Therefore, it made possible to detect intracranial occlusive lesions with less false findings. It gave us more accurate information on the effectiveness of reconstructive vascular surgery. In two of five consecutive patients with a proven aneurysmal subarachnoid hemorrhage, sound-spectrogram specific to stenosis was detected from the basal cerebral arteries which accompanied increase of the time-mean velocity of the upper spectrum and decrease of S/D ratio. Transcranial Doppler sonography was considered to contribute to the establishment of a protocol for early diagnosis and treatment of vasospasm. Transcranial Doppler sonography was also utilized as a useful tool for classification of arteriovenous malformation from the viewpoint of hemodynamics, namely high-flow or low-flow and with or without steal phenomenon. Transcranial Doppler sonography appears sufficiently promising to justify further development and utilization in cerebrovascular surgery.

Carotid Artery Diseases↗
PubMed1987

[Pterional approach to the basilar artery aneurysm--with special reference to the accessibility via optic-carotid triangle].

There have been known two routes in pterional approach to the distal basilar artery aneurysms: one is via the space between the optic nerve and internal carotid artery (optic-carotid triangle: OCT) and the other is lateral to the ICA (retrocarotid approach: RCA). Although the approach via OCT has several advantages of its own, it had been considered to be used in very limited cases. Since we successfully clipped the aneurysms via OCT in 4 cases out of 12 (33%), neuroradiological findings observed in these 4 cases are analyzed and reported. Measurements were made in the following items on the carotid angiogram of the cases operated via OCT (OCT group) and RCA (RCA group): the distance of ICA bifurcation from midline (D), height of ICA bifurcation from the base line between anterior and posterior clinoid processes (H). Although these two values seemed higher in OCT group than those in RCA group, no significant difference was found. The product of D and H (D X H) was observed to be significantly higher in OCT group than in RCA group. The value of D X H is considered one of the indicators of the size of OCT and is proved to be useful to judge whether approach via OCT is applicable or not. Values of D X H obtained from cases with aneurysm increase with age. Regression line calculated between age and D X H value suggests that more than half of the patients over 45 years of age should have space in OCT wide enough to apply clips to the aneurysms.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[Revascularization for simultaneous carotid and coronary ischemia].

Some of the patients who suffer from cerebral ischemia may at the same time have coronary insufficiency. For such cases, not only extracranial-intracranial (EC-IC) bypass but also cardiac revascularization is considered to be necessary. One-stage surgery of both carotid endarterectomy and coronary artery bypass grafting (CABG) has not infrequently been published. However, the combination of EC-IC bypass and CABG is rarely reported in the literature. The indication of EC-IC bypass and/or CABG for such patients above stated has been searched for. In fact, CABG runs the risk of aggravating cerebral ischemia and/or intracranial hemorrhage by inevitable hypotension, hypothermia and heparinization of a large amount, while EC-IC bypass may safely be carried out so long as cardiac conditions are carefully controlled during the operation. It is consequently presumed that the preliminary EC-IC bypass followed by CABG seems to be the method of choice for simultaneous carotid and coronary ischemia. Two cases underwent the staged revascularization, first for the brain and next for the heart, with a successful result are reported in the present paper.

Aged↗
PubMed1987

[The sequential changes of energy metabolism following cold-induced brain edema--a histochemical study].

The changes of energy metabolism on vasogenic edema have been largely examined using biochemical quantitative assay. However, the relationship between the sequential changes and blood-brain barrier (BBB) breakdown is not well understood. In the present study, the sequential changes of energy metabolism and potassium in relation to BBB breakdown following the cold-induced brain edema were investigated histochemically. Adult male Wistar rats, weighing 200-250g, were anesthesized with pentobarbital and a burr hole was made in the left parietal region. For evaluating the breakdown of BBB, 2.5% Evans blue (EB) was injected 30 min. before injury, except in the 5 min. model in which it was injected at the time of cold injury. An iron-bar precooled in liquid N2 was placed over the surface for 30 seconds and they were frozen in situ in liquid N2 at 5 min., 2 hrs., 6 hrs., 12 hrs., and 24 hrs., after producing the lesion. The frozen brain was sectioned using a precooled saw in the coronal plane. The brain section was placed in liquid N2 bath and illuminated with 366 nm light (UV) from a 200 watt mercury lamp and Corning filter 5840. NADH fluorescence was recorded photographically through Corning filter 3387 and 5562. Regional ATP and potassium content were investigated histochemically in thin sections with luciferine-luciferase method and Macallum's technique, respectively. At 5 min. after cold injury, leakage of EB was limited within the lesion. Potassium and ATP were decreased in the lesion. NADH fluorescence was increased slightly in the cortex around the lesion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗
PubMed1987

[Follow-up results after STA-MCA anastomosis in cases of middle cerebral artery stenosis].

To elucidate hemodynamic changes and prognosis after STA-MCA anastomosis, thirteen cases with middle cerebral artery stenosis were systematically analyzed from the pre- and postoperative findings of cerebral angiography, CT scan and rCBF. They were followed up about 3 years long on the average postoperatively. Postoperative angiography revealed patent bypass in all cases. No remarkable changes at the site of stenosis were observed in the group A (6 in 13 cases), who had angiographically sufficient inherent collateral circulation. By contrast, group B (7 in 13 cases), who had insufficient inherent collateral circulation, showed remarkable progress in the degree of stenosis and significant changes of flow patterns were observed after operation. However, these postoperative changes did not bring any clinical deterioration. During follow-up period (31.2 months on the average) after operation, no cerebrovascular accident were encountered in all cases and clinically improved. In conclusion, the STA-MCA bypass rendered more beneficial effect to the patient with MCA stenosis when compared with natural histories reported in the literature.

Cerebral Angiography↗
PubMed1987

[Sutureless method of micro-vascular anastomosis using low-energy Nd-YAG laser].

Sutureless end-to-end anastomosis of rat common carotid artery was carried out, low energy Nd-YAG laser being used thereby. An intraluminal-intervascular splint, made of water-soluble poval, was used for precise adaptation of the intimas. Neither stay suture nor glue was required. The patency rate of the anastomosed vessels, 24 hours after operation, was as high as 91%. The vessels were confirmed to be likewise patent on the 7th and 30th postoperative day. Complications such as pseudoaneurysm formation or stenotic change, were negligible. The fusion of the anastomosis with Nd-YAG laser was histologically proved to be satisfactory and the result of tensile strength test was excellent. Temperature at the anastomotic site during laser irradiation was measured, optimal energy for anastomosis determined and possible mechanism of vascular fusion by laser beam postulated. The major advantages of the laser technique combined with poval splint, such as rapidity, consistency and no residual foreign body (thread or adhesive), are discussed.

Anastomosis, Surgical↗
PubMed1987

[Experimental study of evoked potentials in predicting the reversibility of brain function following tentorial herniation].

Brainstem auditory evoked potentials (BAEP), somatosensory evoked potentials (SEP) and EEG were recorded sequentially in cat with mass-induced intracranial hypertension in correlation with mass volume, intracranial pressure (ICP), systemic blood pressure (BP) and size of the pupils. 1) As the intracranial pressure was raised by expansion of a supratentorial epidural balloon, suppression of cortical SEP (CSEP) and pupillary abnormality appeared first, EEG, waves IV and III of BAEP and wave III of short latency SEP (SSEP) were suppressed in this order. 2) As far as wave IV of BAEP remained and decompression was started within 30 minutes after peaks of CSEP completely suppressed, changes in P1 and N1 of CSEP were reversible. 3) Further raising of ICP was followed by loss of waves IV and III of BAEP and wave III of SSEP in this order. Simultaneously with loss of wave III in SSEP, systemic blood pressure dropped rapidly. By immediate balloon deflation after disappearance of wave III of SSEP, animals recovered from hypotension, but hardly from suppression in EEG, CSEP and BAEP. 4) Preservation of wave IV of BAEP indicated good improvement of pupillary abnormality even after removal of compression. These results suggest that for the patient with disturbed consciousness caused by supratentorial mass lesion, decompressive procedure should be started before wave V of BAEP and brainstem components of SEP disappear. EP monitor seems to be useful clinical method for preventing irreversible change of the brain in patients with coma caused by supratentorial mass lesions.

Animals↗
PubMed1987

[Clinical validity of lumbar subarachnoid pressure measurement].

To evaluate the clinical usefulness for measuring lumbar subarachnoid pressure (LSP) as an index of intracranial pressure, the relation between LSP and epidural pressure (EDP) was studied by the cisternal saline infusion and bolus injection in 12 cats at the range of pressure up to 50 mmHg. In the steady state infusion (0.238 ml/min, 0.476 ml/min), the data from LSP and EDP were correlated very well and the LSP value was at least above 80-90% of EDP value at any pressure level. In the bolus injection (0.4 ml), the degree of pressure rise and the time course of both LSP and EDP were quite similar at any pressure level. However, the compliance calculated from the pressure change of LSP and EDP revealed to have a different tendency according to the baseline pressure level at bolus injection. Below 10 mmHg of EDP, the compliance calculated from LSP was usually higher that of EDP. This was considered due to the distensibility of spinal theca. But above 10 mmHg of EDP, the compliance of both LSP and EDP became almost equal and then gradually decreased as the elevation of baseline pressure at bolus injection. This was considered to be the result of disappearance of the distensible effect of spinal theca. In this study, two polyethylene tubes of different size (I. D. 0.45 mm, 0.58 mm) were used for spinal drainage tube to compare the pressure dumping effect of tube. However, on both tubes, the pulse pressure of LSP was usually smaller than that of EDP, with each having almost constant difference.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

T-kininogen in rats with carrageenin-induced inflammation.

Specific antiserum against T-kininogen was prepared in rabbits, using T-kininogen purified from rat plasma. The antigenic activity of T-kininogen was completely lost with the release of kinin from native kininogen by cathepsin D treatment. In the determination for T-kininogen in rat plasma and pouch fluid, there was a close relationship between the single radial immunodiffusion method and the amount of total kinin released by trypsin treatment using biological assay. The kininogen levels in plasma and pouch fluid were determined and found to be related to the inflammatory responses, using a single radial immunodiffusion method. Subsequently, the increase in T-kininogen levels in plasma and pouch fluid were not in parallel with the granuloma tissue formation and exudation. However, a significant positive correlation was observed between the total T-kininogen in pouch fluid and the volume of pouch fluid.

Animals↗
PubMed1986

Changes of vasoactive intestinal polypeptide-like immunoreactivity in cerebrovascular nerve fibers after subarachnoid hemorrhage: an experimental study in the dog.

A model of subarachnoid hemorrhage (SAH) was experimentally produced in the dog by a single injection of fresh autologous arterial blood into the cisterna magna, and then changes of vasoactive intestinal polypeptide-like immunoreactivity (VIP-LI) in perivascular nerve fibers were examined immunohistochemically in the proximal portions of the middle cerebral artery. Perivascular nerve fibers with VIP-LI were markedly decreased in number during the 1st week after SAH. However, they were gradually reincreased during the 2nd to 9th week after SAH to be recovered to the normal level on the 63rd day after SAH.

Animals↗