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Biomedical subjects

H Kamiyama

Publications and source records attributed to H Kamiyama.

At least 91 records · Page 5Linked to original sources
PubMed1990

Giant internal carotid aneurysm at the cavernous portion with abrupt disappearance of N20 100 minutes after carotid occlusion--case report.

A 69-year-old female with bilateral giant internal carotid aneurysms at the cavernous portion was admitted with complaints of diplopia and radiating pain. The aneurysm on the left side was larger and symptomatic, and treated with the internal carotid artery ligation and the superficial temporal artery-middle cerebral artery (STA-MCA) double bypasses. However, intraoperative somatosensory evoked potential (SEP) monitoring revealed the disappearance of N20 100 minutes after the carotid occlusion and rapid recovery of N20 following flow restoration. Therefore, a high-flow bypass using radial artery grafting was installed, and carotid ligation was performed again without any change in SEP. Postoperative angiograms demonstrated complete disappearance of the aneurysm and sufficient blood supply through a patent high-flow bypass. Although both STA-MCA double bypasses were occluded, no change in cerebral blood flow was detected by single photon emission computed tomography. Her neurological deficits improved, and she is being followed as an outpatient with a plan of second surgery for the remaining aneurysm.

Aged↗
PubMed1990

[Complete occlusion of right middle cerebral artery by radiation therapy after removal of pituitary adenoma: case report].

Radiation angiopathy is a well-known complication accompanying irradiation. But the majority of effected vessels are small vessels. Cases of intracranial major arteries being effected are not so numerous. We report the case of a 47-year-old female patient. The removal of pituitary adenoma was carried out on her in 1982. After that, 4500rad irradiation was performed. It was about six years after irradiation that the first angiography was made. Right MCA occlusion, multiple stenosis of both ACAs and Moya-Moya like vessels were discovered. On admission light paresis on her left lower extremity was recognized and hyperlipidemia was noted. It was interesting that the multiple stenosis was found in an area outside the irradiation field. MCA-STA anastomosis was performed and the prognosis was good. The authors described this case and reviewed the pertinent literature.

Adenoma↗
PubMed1990

[Diagnosis of hemodynamic compromise in patients with chronic cerebral ischemia; the detection of impaired vasodilatory capacity with 133Xe SPECT and acetazolamide (Diamox) test].

To evaluate the efficacy of 133Xe SPECT and Diamox test, for selecting patients with hemodynamic compromise, tests using 133Xe inhalation method and single photon emission computed tomography (SPECT) with acetazolamide (Diamox) were performed in twenty-three patients with chronic cerebral ischemia, before and after extracranial-intracranial bypass surgery or carotid-endarterectomy. All patients complained of TIA, RIND, or minor completed stroke, and cerebral angiography of all patients demonstrated severe stenosis or occlusion in the ipsilateral internal carotid artery or middle cerebral artery. Cerebral blood flow (CBF) was also measured 15 minutes after intravenous administration of 10-12 mg/kg Diamox, which is known as a cerebral vasodilatory agent (Diamox test). Our results revealed that all patients could be divided into four types according to the findings of their resting rCBF and Diamox reactivity. The patients who had normal resting rCBF and normal Diamox reactivity (type 1) were considered to have well-developed collateral circulation and normal cerebral perfusion pressure (CPP) in spite of severe occlusive lesions in the carotid system. Moderate vasodilatation due to reduced CPP was considered to occur in patients who had normal resting rCBF and decreased Diamox reactivity (type 2). The resting rCBF remained unchanged, but Diamox reactivity improved to the normal range after surgery in the patients of type 2 (p less than 0.01), which indicated the improvement of CPP and the resolution of the autoregulatory vasodilatation. Maximum vasodilatation or dysautoregulation was considered to occur due to the inadequate collateral flow and the severely reduced CPP in patients whose findings revealed decrease in the resting rCBF and impaired Diamox reactivity (type 3).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetazolamide↗
PubMed1990

[Diagnosis of hemodynamic compromise in patients with chronic cerebral ischemia; measurement of cerebral blood volume (CBV) with 99mTc-RBC SPECT].

To evaluate the efficacy of tests for selecting patients with hemodynamic compromise, measurement of cerebral blood volume (CBV) with 99mTc-RBC single photon emission computed tomography (SPECT) was performed in thirteen patients with occlusive cerebrovascular disease, and was compared with results obtained by 133Xe SPECT and acetazolamide (Diamox) test. All patients in our study suffered TIA, RIND, or minor complete stroke. Cerebral angiography demonstrated severe stenosis or occlusion in the ipsilateral internal carotid artery or middle cerebral artery, although plain CT scan or MRI revealed no or, if any, only localized infarcted lesions. Regional cerebral blood volume (rCBV) was measured with 99mTc-RBC SPECT and regional cerebral blood flow (rCBF) was measured with 133Xe SPECT before and after intravenous injection of 10 - 12 mg/kg acetazolamide (Diamox). Our results suggest that the ipsilateral rCBV/rCBF (mean transit time) is a more sensitive index of the cerebral perfusion reserve than the use of only rCBV or rCBF of the ipsilateral hemisphere. Also, the ipsilateral rCBV/rCBF is significantly correlated (r = -0.72) with the Diamox reactivity of rCBF, which is considered to represent the cerebral vasodilatory capacity in patients with chronic cerebral ischemia. Postoperative SPECT study revealed remarkable improvement of ipsilateral rCBV/rCBF and Diamox reactivity in four patients who underwent EC/IC bypass surgery to improve the hemodynamic compromise. In conclusion, our results suggest that the measurement of rCBV/rCBF with 133Xe SPECT and 99mTc-RBC SPECT is useful for detecting the hemodynamic compromise in patients with occlusive cerebrovascular disease.

Acetazolamide↗
PubMed1989

[Transoral transclival approach to vertebral-posterior inferior cerebellar artery aneurysm. Case report].

A 61-year-old male was hospitalized for subarachnoid hemorrhage. Cerebral angiography revealed a small left vertebral-posterior inferior cerebellar artery aneurysm, 5 mm to the right of the midline and in the lower third level of the clivus--the so-called "no man's land." It was felt that surgery through the lateral suboccipital approach would likely result in neurological deficits, since the aneurysm would be obscured by the tortuous parent artery or the basilar artery. Therefore, the transoral transclival approach was undertaken and the aneurysm was successfully obliterated. Postoperatively, the patient developed transient right hemiparesis and mild meningitis without evidence of liquorrhea, but fully recovered with conservative management. Certain specific sites of aneurysms, as well as excessive tortuosity of the parent artery, are considered to be indications for the transoral transclival approach. Meningitis is the most worrisome complication of this approach, and mortality is high. Effective preventative measures, which were taken in this case, include tight closure of the dura mater and the pharyngeal mucous membrane, use of the smallest possible clip, and continuous cerebrospinal fluid drainage.

Arteries↗
PubMed1988

Revascularization surgery for moyamoya disease.

Moyamoya disease is a disease characterized by chronic occlusion of the circle of Willis with subsequent development of fine vascular networks in the ganglionic region, which is common in Japanese people. The term of 'moyamoya' means puff of smoke in the Japanese language and represents the characteristic angiographic findings of subsequent development of fine vascular networks in the ganglionic region. Although reconstructive surgery for moyamoya disease has been widely accepted nowadays, there is still no definite consensus as to a surgical indication for patients with an haemorrhagic attack and as to the selection of an operative method for each individual patient. This paper presents our overall surgical results and introduces a new operation, devised by Y. Nakagawa (i.e. EMAS). It refers also to surgical intervention for patients with haemorrhagic attacks.

Adolescent↗
PubMed1988

Central effects of N-substituted derivatives of 2,6-dioxopiperidine in mice.

Pharmacological activities of N-allyl, N-benzyl and N-o-xylyl derivatives of both 2,6-dioxopiperidine (DOP = glutarimide) and 4-ethyl-4-methyl-2,6-dioxopiperidine [bemegride(BG)] were studied in mice. Convulsant activity, hypnotic activity, anticonvulsant activity, acute toxicity and interactions with some hypnotics were used as pharmacological indexes. N-Benzyl-2,6-dioxopiperidine (ByDOP) and N-o-xylyl-2,6-dioxopiperidine (o-XyDOP) exhibited some hypnotic activity. N-Allyl-2,6-dioxopiperidine (ADOP), ByDOP and o-XyDOP prolonged the pentobarbital (PB)-induced sleep by 2.5-, 9- and 4-fold, respectively, as compared with the control at a dose of 80 mg/kg, i.p. On the other hand, N-allylbemegride (ABG) exhibited convulsant activity at a high dose. N-Benzylbemegride (ByBG) and N-o-xylylbemegride (o-XyBG) also showed some hypnotic and anticonvulsant activities. BG (20 mg/kg, i.p.) shortened the amobarbital (AB)- and thiopental (TP)-induced sleep, whereas ABG (80 mg/kg, i.p.) significantly shortened only the barbital (B)-induced sleep, in spite of showing with 20 and 80 mg/kg, i.p. the prolonging effect on the AB- and PB-induced sleep. At a dose of 80 mg/kg, i.p., ByBG significantly prolonged the phenobarbital (PheB)-, AB-, PB-, TP- and glutethimide (GI)-induced sleep, and o-XyBG also showed the prolonging effect on the PheB-, AB-, TP- and GI-induced sleep. These results indicate that ByDOP and o-XyDOP possess some central depressant effect, ABG has antagonistic effect on the B-induced sleep and that substitution of aromatic groups on the N position of BG reduces the convulsant activity but increases the depressant activity.

Animals↗
PubMed1986

[Surgical indication and limitation in hypertensive intracerebral hemorrhage of the basal ganglia].

The purpose of this paper is to elucidate surgical indication and limitation for severe hypertensive intracerebral hemorrhage in the basal ganglia (HIH) with a view toward good functional outcome. Materials were 32 patients of severe basal ganglionic hemorrhage (HIH). Neurological grading (G) for HIH, reported by Kanaya et al. in 1978, was applied. Grading on admission in 11 patients with conservative treatment was G-4a in 2, G-4b in 3 and, G-5 in 6. Preoperative grading in 21 patients with surgical treatment was G-4a in 9, G-4b in 8 and G-5 in 4. G-4a revealed semicoma without herniation signs, G-4b semicoma with herniation signs and G-5 deep coma. The interval from the onset of HIH to hematoma evacuation was from 3 to 10 hours in 14 patients, from 17 to 23 hours in 5, 44 hours in one and 5 days in one. Functional outcomes at hospital discharge were classified as follows: self-managing (SM); partially dependent (PD); fully dependent (FD); vegetative (V); dead (D). Factors which would have influenced functional outcomes were studied and the results follow. All 11 patients with conservative treatment died. On the contrary, in 21 patients with surgical treatment, the outcomes were SM in 2 patients, PD in 3, FD in 11, V in one and D in 4. Death in the 4 patients was caused by fatal complications from 8 to 24 days after the operation. In 17 surviving patients with surgical treatment, (a) Mean age of the SM or PD patients was 45 years, and that of FD or V patients was 55 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Rebleeding attack of the cerebral aneurysm--clinical significance of the early aneurysmal rebleeding].

When one mentioned about aneurysmal rebleeding, timing and incidence of the rebleeding attack (RA) have been mainly discussed in relation to long term prognosis. But it was rarely considered about necessity of emergency treatment based on timing and incidence of RA. In this study, clinical significance of RA especially in the early stage is discussed in relation to severity of the patient's condition, timing of surgery, clinical results and so on. Three hundred sixty-eight cases of anterior communicating, internal carotid and middle cerebral aneurysms who were admitted on our hospital within 7 days after last attack were studied. Among them, 127 cases had 192 times of RA (1 RA: 83 cases, 2 RAs: 28 cases, 3 RAs: 12 cases, 4 RAs: 3 cases and 5 RAs: 1 case). Incidence of rebleeding attack increased in the severe cases. Most frequent timing of second attack was within 6 hours after the first attack (40 cases, 31.5%). Fifty two cases (41%) had their second attack within 24 hours from the first attack. Successive attacks were also most frequent within 6 hours following the preceding one, even in the cases with long term interval period before it. Severity of the patient was increased after RA especially in the cases with early repetitive attack. We experienced 56 cases who had more than two RAs within each 6 hours. 28 out of 56 cases were severe attack whose consciousness was disturbed more than semicoma and 27 cases died. Mortality and morbidity were higher in the cases with RA than single attack.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗