Search PubMed⌕ Search

Biomedical subjects

H Handa

Publications and source records attributed to H Handa.

At least 307 records · Page 17Linked to original sources
PubMed1986

[Combination therapy (hypervolemia, Fluosol-DA 20%, hypertension) in the treatment of symptomatic vasospasm].

Combination therapy of (1) hypervolemia with albumin (1 g/kg/day), (2) artificial blood substitute (Fluosol-DA 20%, 10 ml/kg/day) and (3) induced hypertension was performed for the treatment of symptomatic vasospasm. Outcome was compared between thus treated patients (Treated group) and those without specific treatment (Non-treated group) in (1) 30 patients presenting with vasospasm who were planned to undergo delayed operation (Delayed operation group), (2) 23 patients undergoing early operation whose subarachnoid hemorrhage (DAH) was in group 2 according to Fisher's classification (Fisher Group-2) and (3) 25 patients undergoing early operation whose SAH was in group 3 (Fisher Group-3). In delayed operation group, the combination therapy improves the outcome to some extent resulting in increase of "Excellent" and "Good" patient from the rate of 25% to 35% (Table 1). Vasospasm appears at a low rate of 26% as well as in mild degree in Fisher Group-2 regardless of the treatment, which contributes to the satisfactory result observed in this group (Table 2). The outcome of the treated group in Fisher Group-3 is proved to be fairly good with "Excellent" and "Good" patient rate of 70% (Table 3), which seems largely to be attributed to the prophylactic effect of hypervolemia on vasospasm (Table 4). From these results, the combination therapy is considered to be performed with relatively small load on cardiovascular system compared with conventional hypervolemia-hypertension therapy.

Albumins↗
PubMed1986

[Clinical studies of cefoperazone in neurosurgery].

A multicenter trial consisting of 164 institutions through out Japan, has been conducted to study the transfer of cefoperazone (CPZ) into the cerebrospinal fluid (CSF), and the clinical effectiveness of CPZ as a therapeutic or prophylactic agent in neurosurgery. The levels of CPZ in serum and CSF were determined in 96 patients. After initial dose of 2 g CPZ (intravenous drip infusion for 30 minutes), the serum level of CPZ after 1 hour was 124.5 +/- 6.6 micrograms/ml (Mean +/- S.E.), and even after 6 hours, it maintained as high as 47.8 +/- 16.6 micrograms/ml. The peak CPZ levels in CSF in patients with normal or minimal impairment in blood-CSF-barrier (BCB) (group I) and in those of localized impairment in BCB (group II) were 1.0 +/- 0.5 micrograms/ml at 2 hours and 3.0 +/- 1.8 micrograms/ml at 3 hours, respectively. The highest CSF level was seen in patients with meningitis (group III) and showed 5.0 +/- 2.4 micrograms/ml at 6 hours. After multiple dose of 2 g CPZ (intravenous drip infusion for 30 minutes), the serum kinetics of CPZ were not significantly different from those obtained after initial dose. However, the CPZ levels in CSF were higher than those observed after initial dose in all 3 groups and were higher than MIC75 against relevant pathogens for meningitis such as Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus. Moreover, in group III peak level of CPZ in CSF exceeded the MIC75 against Pseudomonas aeruginosa which is also frequently isolated from patients with meningitis in neurosurgery. As a therapeutic agent CPZ administered as sole agent was effective in 42 out of 55 cases (76.4%) in meningitis, in 78 out of 116 cases (67.2%) in pneumonia and in 36 out of 47 cases (76.6%) in urinary tract infection (UTI). Its efficacy rate against all infections treated was 72.2% (184/255). Regarding CPZ's prophylactic use, 39 out of 514 cases (7.6%) were judged as having or possibly having infections as follows; meningitis (13/514, 2.5%), pneumonia (15/514, 2.9%), UTI (2/514, 0.4%). In prophylactic use of CPZ, the incidence rates of postoperative meningitis and other central nervous system (CNS) infection following ventricular drainage and supratentorial craniotomy for aneurysm were higher than those observed in other types of operation, 12.0% (3/25) and 6.2% (8/130), respectively. Also, regarding prophylactic use of CPZ, the organisms isolated by culture from 13 cases of postoperative CNS infections included 2 strains of Staphylococcus sp., 1 strain of Serratia sp. and 3 strains of other Gram-negative bacteria (GNB).(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1986

[CT findings of growth hormone secreting pituitary adenomas].

The value of high-resolution computed tomography (CT) in the diagnosis of pituitary adenoma has recently been stressed, especially of the coronal view with contrast enhancement. Analysis of the CT scans of 33 growth hormone (GH) secreting pituitary adenomas was done (11 cases of microadenomas, 7 cases of intrasellar adenomas and 15 cases of macroadenomas with suprasellar extension). In macroadenomas, the density was high in five cases, high with isodense portion in two cases, mixed in four cases, isodense in three cases, and isodense and low dense in one case. Six adenomas showed homogeneous density and nine were heterogeneous. After contrast enhancement, two cases showed marked enhancement, ten cases mild and three cases ring enhancement. Margin of adenoma was smooth in nine cases and irregular in six. Among seven cases of intrasellar adenoma one accompanied primary empty sella. In microadenomas ten of eleven cases had hypodense mass inside the normally enhanced pituitary gland. The margin was ill-defined in seven cases and well-defined in three. Eight cases had pituitary height 7 mm or more. Upper surface of the pituitary gland was convex upward in five cases, flat in four and concave in two. Deviation of pituitary stalk was found in seven cases. Bony changes of sellar floor were recognized in three cases. There was a tendency that serum GH level increased with the increment of the size of adenoma. Serum GH levels in adenomas with ring enhancement were lower than those in the homogeneously enhanced adenomas of similar size. One case with marked enhancement showed the highest GH level among all adenomas of the presented series.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1986

[Primary choroid plexus papilloma presenting as a cerebellopontine angle mass lesion].

A rare case of primary choroid plexus papilloma of the cerebellopontine angle, which might have been originated from the lateral choroid plexus of the fourth ventricle and proliferated into the extraventricular space, is reported. The patient had no neurological abnormalities except for recurrent episodes of headache. Although radiological examinations did not offer a definitive diagnosis, he was successfully treated by operation without any neurological deficit. So far reported in the literature, the number of such cases is less than twenty, and the prognosis has been reported not so good despite benign biological nature. The size of the tumor and preoperative symptoms appear to determine the prognosis. It should be emphasized that an early diagnosis and early surgical treatment are extremely important for this kind of lesions.

Adult↗
PubMed1986

[Pharmacokinetics and toxicity of intrathecal administration of recombinant interleukin 2].

In order to contribute to the development of adoptive immunotherapy against malignant brain tumors, the pharmacokinetics and toxicity of intrathecally administered recombinant interleukin-2 in dogs and human patients were analyzed. The pharmacokinetics showed that a high concentration of IL-2 was maintained in the intrathecal cavity in both dogs and human (t1/2 = 1.41 and 1.68 hours, respectively) after administration. However, no activity of IL-2 was detected in the cerebrospinal fluid after the systemic administration of rIL-2 in one dog. No meningitis, ventriculitis or degeneration of neurons was seen histopathologically in dogs 3 weeks after the intrathecal administration of rIL-2 (200 units). A high concentration of IL-2 in the tumor cavity was maintained for a very long time (t1/2 = 14.8 hours) after the intratumoral administration of rIL-2 in one of the patients. Although low-grade fever and mild headache were sometimes observed after the intrathecal administration of rIL-2 in patients, there was no other side effect mentioned. Intrathecal or intratumoral administration of rIL-2 appeared to be an valuable procedure which should be evaluated in conjunction with adoptive immunotherapy against malignant brain tumors.

Adult↗
PubMed1986

[Electrocardiographic alterations in expired cases due to ruptured cerebral aneurysm: correlation with other complications relating to the autonomic nervous system].

Forty three expired cases due to ruptured cerebral aneurysm were studied in electrocardiographic alterations with special reference to other complications of the autonomic nervous system. The cases with past history of ischemic cardiovascular disease had been excluded. The age of the patients ranged between 23 to 79 years old (average 50.1 years old). The clinical condition of the patients according to Hunt & Kosnik classification I in 1 case, II in 11 cases, III in 14 cases, and IV & V in 17 cases. The duration between the aneurysm rupture and admission was within 24 hours in 16 cases, 2 to 3 days in 13 cases, 4 to 7 days in 9 cases, and 2 to 3 weeks in 5 cases. The site of ruptured aneurysms was anterior communicating artery in 12 cases, internal carotid artery in 24 cases, and others in 7 cases. The direct surgeries to the aneurysms were performed in 22 cases, and not done in 21 cases. The electrocardiographic alterations were found as follows: flat or inverted T in 19 cases, prolonged QTc in 33 cases, manifest U in 14 cases, ST elevation or depression in 10 cases, Ta (atrial T) in 10 cases, left ventricular hypertrophy in 8 cases, sinus tachycardia in 7 cases, sinus bradycardia in 12 cases, and arrhythmias with SVPC or VPC (supraventricular or ventricular premature contraction), or sinus arrhythmia in 12 cases. Prolonged QTc, and flat or inverted T were most often found in the cases with ruptured aneurysm of the anterior communicating artery, and next in those with the internal carotid artery, and least often in those with others.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Effects of the subarachnoid hemorrhage on the release of arachidonate metabolites from canine cerebral arteries].

Release of arachidonate metabolites from isolated canine cerebral arteries into perfusing medium were estimated using radioimmunoassay (RIA) in vitro. The cerebral arteries were isolated from dogs sustained experimental subarachnoid hemorrhages (SAH) and the results were compared with that of normal canine cerebral arteries. The amount of 6-Keto-PG F1 alpha (stable metabolite of PGI2) and PGE2 released from normal cerebral arteries were 455 +/- 84 (n = 7) and 177 +/- 72 (n = 8) ng/min/g dry weight (mean +/- SEM), respectively. Among other arachidonate metabolites, TXB2 (stable metabolite of TXA2), PGF2 alpha, PGD2 were also measured, but release of these arachidonate metabolites were little compared with PGI2 or PGE2. The amount of 6-Keto-PGF1 alpha and PGE2 released from the cerebral arteries subjected to subarachnoid hemorrhage were 110 +/- 34 (n = 6), 169 +/- 40 (n = 6) ng/min/g dry weight respectively. In SAH group, release of 6-Keto-PGF1 alpha had diminished remarkably, but no remarkable quantitative change were seen among other arachidonate metabolite between normal and SAH groups. The diminution of PGI2 release in the cerebral artery subjected to SAH may be involved in the pathogenesis of cerebral vasospasm. The release of PGs from canine pial arteries induced by the exposure of the pial arteries to red blood cell hemolysate was also estimated by RIA. The release of PGE2 tended to increase following to exposure to hemolysate but no other arachidonate was increased.

Animals↗
PubMed1986

[Technical problems in intraoperative monitoring of sensory evoked potentials].

Recent advances in both the equipment and the recording technique of sensory evoked potentials (EP) have brought high levels of versatility and reliability of objective measurement to the assessment of nervous system function. They have also allowed the use of intraoperative evoked potentials. The operating room, however, is usually considered a hostile environment, where various kinds of artifacts from surgical manipulation and generated by electrical armamentaria disturb electrophysiological recordings. Although several authors have reported on intraoperative EP monitoring, they have described few of the practical details of recording techniques. Having developed an intraoperative recording technique for evoked potentials over the past 3 years, we present the technical measures taken to overcome interference and obtain sufficiently stable and reliable EP recordings for intraoperative monitoring. All electrical equipment used in the operating rooms must, of course, be grounded securely. Even after grounding in the usual manner, however, artifacts appeared intermittently. The source was found to be a Mayfield-Kees three-pin head rest and a self-retaining retractor, both of which seemed to pick up electromagnetic radiation originating from electrocauteries and others. These artifacts could be minimized by grounding the head pins all each point of insertion into the patient's head and by use of a silicon-coated spatula rather than a metal one. In addition automatic artifact rejection by voltage overload sensing seems to be indispensable to eliminate the effect of extraneous mechanical and electrical interference which occur inevitably in surgical procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Stem↗
PubMed1986

[One-stage bilateral STA-MCA anastomosis in multiple occlusive cerebrovascular disease].

Out of 12 cases of bilateral stenosis of the internal carotid (IC) system underwent unilateral STA-MCA anastomosis on the symptomatic side, no ischemic signs recurred in 8 cases, while, in the remaining 4, symptoms appeared postoperatively, requiring the anastomosis of the contralateral side. Preoperative findings of CT scan, CAG and r-CBF were reviewed and compared. It has, consequently, become evident that, in the latter 4 cases, angiography showed stenotic lesion of over 50% of the ICA lumen, between the mastoid-mandibular line (MML) and the circle of Willis, on the initially asymptomatic side. Furthermore, in the same 4 cases, multiple thrombotic foci were more liable to be demonstrated on the CT scans and r-CBF was lowered in both hemispheres without significant difference in laterality. In additional 7 cases presenting such characteristics as stated above, one-stage bilateral STA-MCA anastomosis was carried out with a successful result.

Aged↗
PubMed1986

[Technical details for recording trigeminal evoked potentials in the cat].

Experiments were undertaken to establish technical standards for recording of trigeminal evoked potentials (TEP) as a tool for assessment of the effectiveness of various therapeutic procedures for trigeminal neuralgia. Serial changes in the action potentials of the maxillary nerve and TEP were studied when parameters of electrical stimulation, namely, intensity and frequency, and position of electrodes were altered. The effects of use of muscle relaxants and change of body temperature of animals on TEP were also studied. On the basis of these experimental results, the technical details most suitable for TEP recording in cat were explored. The most distinct TEP was recorded under the following animal conditions and parameters: keeping rectal temperature between 37.5 degrees C and 38.5 degrees C, slackening with muscle relaxants, stimulating the infraorbital nerve with 10 volts of square-pulse electricity 5 times per second in short latency TEP and 2 times per second in long latency TEP, placing the active electrode on the vertex for short latency TEP and on the primary sensory area for long latency TEP. Eight positive peaks and three negative peaks were recorded under these conditions. The average and standard deviations of peak latency of potential from 10 cats were as follows: P 1, 0.67 +/- 0.04 msec; N 1, 0.89 +/- 0.07 msec; P 2, 1.35 +/- 0.10 msec; P 3, 1.89 +/- 0.08 msec; P 4, 2.43 +/- 0.26 msec; P 5, 3.17 +/- 0.15 msec; P 6, 3.36 +/- 0.21 msec; P 7, 5.02 +/- 0.39 msec; P 8, 6.07 +/- 0.35 msec; N 2, 10.4 +/- 1.15 msec; N 3, 18.5 +/- 1.74 msec.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

[Effects of thiopental on sensory evoked potentials in the cat].

Noninvasive electrophysiological evaluation with sensory evoked potentials would be of clear diagnostic and prognostic value in evaluating comatose patients with stroke or severe head injury. In order to protect the brain from such kinds of insults, barbiturate coma therapy has been employed and its effectiveness has been already established. However, in the barbiturate coma therapy, it is occasionally difficult to distinguish the pharmacological effect of barbiturate from the preexisting brain dysfunction caused by the underlying process of the disease. In adult cats, authors studied changes of sensory evoked potentials following cumulative intravenous administration of thiopental which is used clinically for barbiturate coma therapy. P1 and N1 of cortical SEP showed tendency of gradual decrease in amplitude. However, no significant changes occurred in latency by stepwise increment of thiopental dose. Changes in amplitude of P1 and N1 of cortical SEP preceded to the flattening on electroencephalogram. Around at the level of the concentration where EEG changes began, I-II interpeak latency of BAEP and latency of wave I of short latency SEP started to increase. BAEP and early components of SEP (I.II.III.IV) persisted even in by far the higher level of serum concentration of thiopental than that of clinical use. Furthermore, most of these parameters showed no statistically significant change neither in amplitude nor in latency. These experimental results suggest that sensory evoked potentials will provide us with useful information in the assessment of the brainstem function in patients under thiopental induced deep coma.

Animals↗
PubMed1986

[Implantable continuous epidural morphine infusion system for relief of chronic cancer pain].

Chronic cancer pain remains intractable by standard treatment in many patients and interferes with their mobility and independence. Epidural morphine infusion therapy is adopted for providing adequate analgesia in patients who are generally morphine independent and have intractable pain. A totally implantable pump system, Infusaid, has allowed continuous epidural morphine infusion without wound care or frequent percutaneous injections and with a potentially lowered risk of adverse reactions including respiratory suppression. Since December 1984, the authors have used this totally implantable drug delivery system for continuous epidural morphine infusion in two patients who had been suffering from chronic pain caused by pelvic cancer associated with metastatic and/or invasive lesions: Case 1: a 61-year-old man with rectum cancer; and Case 2: a 44-year-old man with colon cancer. Before system implantation, a therapeutic response to epidural morphine was confirmed by a one-shot test injection. Pain relief was evaluated by use of Visual Pain Analogue Scale Scores (VPASS). In spite of the presence of an artificial anus on the left abdomen in both patients and of pus discharge from a sacral infectious fistula on admission in Case 2, no infectious complication occurred in either case. Urinary retention developed after the implantation in Case 2, but this improved following the reduction of morphine concentration. No other adverse reaction was observed. In Case 1, the system was effective for 6 months until his death from advancing malignancy, and the patient was able to return to work three months after discharge.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Follow-up study on the relationship between age at onset of illness and outcome in patients with moyamoya disease].

Follow-up studies over more than one and a half years (average 6.5 years) were performed in 51 patients with "moyamoya disease". Activities of daily living (ADL) was assessed and graded into five levels both at the time of admission into hospital and at the last assessment in the follow-up study, as follows. Grade I: Fully capable of work or study with no or minimal difficulty, II: Capable of limited work or study with difficulty, III: Incapable of work or study but capable of home life alone, IV: Incapable of home life without help, V: Vegetative state or dead. Patients were divided into three groups by the age of clinical onset: younger pediatric, less than 5 years old (21 patients); older pediatric, 5 to 15 years old (14 patients); and adult, 16 years old and over (16 patients). Although analysis of the angiographical and neurological pictures is important, the present paper concerns only the age of clinical onset and whether reconstructive vascular surgery was performed, because of the small number of clinical materials. Seven of 16 adults suffered hemorrhagic attacks and 2 of them died of hemorrhagic insults. In contrast, none of the pediatric cases had hemorrhagic attacks and none died. Both at the time of admission and last assessment, ADL of younger pediatric cases was much lower than that of older ones. These results suggest that clinical course in patients with "moyamoya disease" closely related with the age of the onset of illness, and the border age of onset of illness between patients with good outcome and with poor outcome is around 5 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1986

[Experimental study on the origins of far-field SEP to median nerve stimulation in the cat].

Results of various experimental and clinical studies on the origins of somatosensory evoked potentials (SEP) suggested that the far-field and early near-field potentials are generated primarily from sources within the dorsal column-medial lemniscal system. However, there are a few studies where direct depth recordings of SEP were performed and they were compared with surface-recorded SEP components. The purpose of this investigation is to determine the origins of somatosensory far-field and early near-field evoked potentials in cat by the analysis of distribution mode of surface-recorded SEPs, the comparison of depth recorded with surface-recorded SEPs and by the study of SEP changes caused by serial destruction of the structures relating to sensory pathway. A complex patterns of evoked potentials were recorded from cerebral epidural surface in cat by forelimb median nerve stimulation. The largest positive to negative slope was recorded from the epidural electrode on the sensory cortex contralateral to the stimulation. Five small positive potentials could be identified on the positive slope. We labeled these potentials as I, II, IIIA, IIIB, IV according to the report by Iragui-Madoz. The largest positive potential recorded from the VPL was coincident with the surface-recorded IIIB in latency at different interstimulus intervals. After transection of the midbrain-pons junction, IIIA remained unchanged, and the following waves disappeared. However, IIIA decreased in latency and markedly decreased in amplitude after transection of the pons at its rostral level. IIIA seems to be generated from the medial lemniscus at the level of osseous cerebellar tentorium.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

[Effects of pentobarbital anesthetic induction on sensory evoked potentials in the cat].

During the last decade, noninvasive electrophysiological tests with sensory evoked potentials have rapidly blossomed into useful clinical tools. They have been studied in large groups of normal subjects and in patients with a wide variety of neurologic diseases. Almost all experimental animal studies on sensory evoked potential, however, have not been undertaken under sufficient consideration on the effects of drugs used for induction into anesthesia on evoked potentials. In order to use evoked potentials as a tool for assessing neurological function in animals, it is necessary to known the effect of anesthetic agents on evoked potentials. Pentobarbital, Somnopentyl, is one of the drugs most commonly used for induction into anesthesia is animal experiments. Authors have attempted to study the long term effects of pentobarbital on evoked potentials. Intramuscular administration of anesthetic dose of pentobarbital was followed by prolongation of 11 and III waves of SEP and I-II interpeak latency of BAEP. Latency of N1 of SEP was also prolonged. On electroencephalogram, amplitude have increased and frequency have got slower after pentobarbital administration. These electrophysiological changes persisted over 5 hours after pentobarbital administration. These results suggest that in some studies on animals the residual effect of agents used for induction into anesthesia must be taken account for analysis of data obtained.

Anesthesia↗
PubMed1986

Effects of the calcium antagonist nifedipine on thromboxane B2 level and platelet aggregation in hypertensive patients.

The effects of a calcium antagonist nifedipine (Adalat) on platelet aggregation was examined in vitro and in vivo. In vitro examination: Platelet aggregation induced by adenosine disphosphate (ADP), epinephrine, collagen, arachidonate, and thrombin was all inhibited dose-dependently in the platelet-rich plasma prepared from the blood of healthy individuals by the addition of nifedipine to a final concentration of 5 or 10 micrograms/ml. In vivo examination: 20 patients with essential hypertension were treated with 30 mg/d of nifedipine for 8 weeks. Significant decreases in both systolic and diastolic pressures were observed 2 weeks after the beginning of the administration, and continued throughout the administration period. ADP-induced platelet aggregation decreased by 25% after 2 weeks, 36% after 4 weeks, and 44% after 8 weeks (p less than 0.05 for all decreases). Plasma thromboxane B2 level also decreased markedly from 217.3 +/- 91.7 pg/ml before the administration to 119.0 +/- 29.7 pg/ml (p less than 0.01) 2 weeks after, and 99.1 +/- 25.4 pg/ml (p less than 0.01) 8 weeks after the beginning of the administration, suggesting suppressed thromboxane A2 production.

Adenosine Diphosphate↗