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Biomedical subjects

H Kikuchi

Publications and source records attributed to H Kikuchi.

At least 919 records · Page 51Linked to original sources
PubMed1977

[The combination of STA-MCA anastomosis with another operation for the occlusive cerebrovascular disease (author's transl)].

Case 1. A 65 year old male had left hemiparesis with sudden onset since 8 years ago, which gradually aggravated for these 2 years. On Sept. 27, 1973, he was admitted to the Department of Neurosurgery, Kitano Hospital. There was left spastic hemiparesis with hemisensory disturbance and he could not walk without help for the maked spasticity. Left carotid angiogram revealed the complete occlusion of the internal carotid artery and marked stenosis of the external carotid artery at the common carotid bifurcation. External carotid endarterectomy was performed on Nov. 19, 1973, which was followed by STA-MCA anastomosis 2 months later. The spasticity of extremities and left hemisparesis were gradually improved and he was able to walk without help. Case 2. On Apr. 14, 1974, a 63 year old female developed complete stroke with right hemiparesis and speech disturbance after transient ischemic attacks of 5 days duration. On Aug. 9, he was admitted and had emotional incontinence, right hemiparesis, Gerstmann's syndrome and motor aphasia. Left carotid angiogram revealed a saccular aneurysm of the middle cerebral artery and the occlusion of the distal middle cerebral arterys. These findings suggested that the occlusion was caused by embolus from the middle cerebral aneurysm, and the combined surgery with STA-MCA anastomosis and operation for the aneurysm was planned. On Aug. 30, 1974, under left frontotemporal craniotomy, aneurysmal neck clipping and aneurysmectomy were performed and thereafter, STA-MCA double anastomosis was done. One week after operation, the gradual improvement of pre-operative symptomes was noted. Recently, STA-MCA anatomosis is well known to be one of the effective operative methods for the occlusive methods for the occlusive cerebrovascular diseases and in addition, we found that the combination of STA-MCA anastomosis with other operations was effective for unusual cases presenting in this report. Furthermore, except for the occlusive cerebrovascular diseases, we usually plan STA-MCA anastomosis for the cases of 1) carotid ligation or trapping for carotid-cavernous sinus fistula and some internal carotid aneurysms, 2) some intracranial tumors with the danger involving the main cerebral arteries by operation to protect the cerebrovascular insufficiency.

Aged↗
PubMed1976

Stabilization of glucosaminephosphate synthase from rat liver by hexose 6-phosphates. Properties and interconversion of two molecular forms.

Glucosaminephosphate synthase (glucosaminephosphate isomerase (glutamine-forming), EC 5.3.1.19) prepared from rat liver by extraction in the presence of glucose 6-phosphate (Glc-6-P) followed by precipitation with (NH4)2SO4 is susceptible to digestion by trypsin. This enzyme, designated form A, can be converted to tryptic-insusceptible form B upon incubation with Glc-6-P or fructose 6-phosphate (Fru-6-P) at 37 degrees C. The two forms also differ in the degree of activation by dithiothreitol, the degree of inhibition by methyl-glyoxal and the behavior on DEAE-Sephadex and Sephadex G-200 column chromatography. During purification with DEAE-Sephadex followed by hydroxyapatite, form B is converted to form A if Fru-6-P is absent and form A to form B if Fru-6-P is present. The two forms are therefore intercovertible. Under the conditions of purification, form B is more stable than form A, since the purity and yield of the final product are greater with form B than with form A. These findings suggest that the two forms of glucosaminephosphate synthase differ conformationally and that the equilibrium position depends on the concentration of Fru-6-P. Glc-6-P is effective only when it gives rise to Fru-6-P by mediation of glucose-phosphate isomerase.

Animals↗
PubMed1976

Glucosaminephosphate synthase of human liver.

Although human liver contains glucosaminephosphate synthase (glucosaminephosphate isomerase (glutamine-forming), EC 5.3.1.19), its activity is rapidly lost during the course of extraction. The inactivation, however, is largely prevented if the extraction medium contains isopropanol at 1% concentration; using these "stabilized" extracts, the glucosaminephosphate synthase activity of human liver has been shown to be similar to the activity previously reported in rat liver. The enzyme precipitated from these extracts by (NH4)2SO4 is inhibited by UDP-N-acetylglucosamine, the concentration required to produce a half-maximal inhibition being 6 muM. These results seem to be sufficient to postulate that glucosaminephosphate synthase is important for UDP-N-acetylglucosamine synthesis in human liver. In contrast to the rat liver enzyme, the (NH4)2SO4-precipitated human liver enzyme is resistant to trypsin and undergoes no conversion reaction when incubated with glucose 6-phosphate.

Carbohydrate Epimerases↗
PubMed1976

[Surgery of vertebral aneurysms at the origin of PICA (author's transl)].

Thirteen cases of vertebral aneurysm at the origin of PICA (VA-PICA aneurysm) were operated on at the Department of Neurological Surgery of Kitano Hospital from March, 1970 through July, 1975. Those included 9 cases of saccular aneurysm and 5 cases of fusiform aneurysm (Table 1). The incidence of VA-PICA aneurysms among our whole series of intracranial aneurysms was 4.2%. Patients with subarachnoid hemorrhage were subjected to our routine 4 vessel angiography. For those with suspected vertebral aneurysm vertebral angiography was performed in a transoral projection. In this method, when the angle between the film and the horizontal plain of Frankfurt is fixed at 50 degrees, the origin of PICA is projected on the film between the upper and lower teeth line. Since X-ray beam falls vertically on the origin of PICA, the resultant vascular shadow is free from shortening, elongation and distortion, leading to precise demonstration of anatomical arrangement of the vessels. At surgery a lateral suboccipital incision was made. With the position of VA-PICA junction the surgical approach was slightly different. When the junction was located higher than the line between the lowest point of the occipital bone and the basion by 1 cm or more, the approach was made through the middle of the sigmoid sinus which was exposed by suboccipital osteoclastic craniectomy (mid-lateral cerebellar approach). When the VA-PICA junction was situated lower than the line by 1 cm or more, the operation was initiated at the upper limit of the lower one-third of the sigmoid sinus (lower-lateral cerebellar approach). Since VA-PICA junction is ventrally situated to the lower cranial nerves, surgical attack to the junction can be attained only through the space among the nerves. Two spaces are available for this direct attack. One is the space between the facial nerve, acoustic nerve and the group of vagal nerves. The other is between accessory nerve bundles or between the group of accessory nerves and the hypoglossal nerves. The former procedure is employed for reaching the aneurysm by mid-lateral cerebellar approach and the latter by lower-lateral cerebellar approach. In the patients in acute stage of ruptured VA-PICA aneurysm, hemisuboccipital craniectomy and laminectomy of the atlas were carried out for the purpose of decompression. Surgical procedures used included coating in 2 cases, trapping in 2, proximal ligation of the vertebral artery in 2 and neck clipping in 6. Two patients died due to grastrointestinal bleeding. Surgical complications noted were hypoglossal nerve palsy in 1 case mild sensory disturbance contralateral to the aneurysm in 3 cases. Those symptoms were thought to be caused either by direct injury to the lower cranial nerves or circulatory disturbance in the medullary branches of the vertebral artery. To eliminate those postoperative complications it is desirable to devise smaller aneurysm clips and smaller clip foreceps.

Adult↗
PubMed1976

[Dermoid tumor in left cerebellum--A case report (author's transl)].

This paper describes a dermoid tumor which developed in the dorso-lateral area of the left cerebellar hemisphere. It is the first to be reported in Japan. The patient was a 31 year old female who suffered from severe occipital headaches, frequent vomiting and gait disturbances. Neurological findings on admission included marked bilateral choked discs, horizontal nystagmus on gaze to the left, and poor coordination on the finger to nose test, nose-finger-nose test and and heel-shin test on the left side. Left suboccipital craniectomy was performed. A tumor was found which displaced the left cerebellum anteromedially and inferiorly. The postero-lateral surface of the tumor was adherent to the overlying dura matter. It was completely removed and found to be about the size of a hen's egg. It contained a yellow, porridge-like substance and short hairs. Histological examination of the capsule of the tumor showed stratified squamous epithelium and cutaneous structures, such as hair follicles and sebaceous glands. The diagnosis was dermoid tumors. We could find as many as 78 cases of the posterior fossa dermoids in the literature. In 72 cases (92.4%), the mass existed along the midline in the posterior fossa. The dermoids developed in the cerebellar hemisphere were reported in only 6 cases (7.6%) including the present case. Laterally growing dermoids are considered to be very rare. The pathogenesis is discussed and the literature reviewed.

Adult↗
PubMed1976

[Spinal cord arteriovenous malformation during pregnancy (author's transl)].

On May 7, 1973, a 23-year-old female, para ii, gravida ii, suddenly developed severe chest pain at 10th month of her pregnancy and soon after became paraplegic with sensory impairment lower than the level of 5th thoracic nerve and urinary incontinence. On May 8, she was admitted to our clinic and 4 days after, labour was induced by Caesarean section. Myodil myelography demonstrated "worm like defects" at the level of Th4-Th5, but sabarachnoid block was not found. Selective spinal angiography showed the image of typical arteriovenous malformation at the level of Th2-Th6. On June 26, about 1.5 months after delivery total removal of arteriovenous malformation (from Th2 to Th6)) was performed by the use of operative microscope. 10 months after operation, the patient could walk with her baby in her arms and no urinary incontinence was seen. We discussed the clinical characteristics and the treatment of spinal cord arteriovenous malformation during pregnancy.

Adult↗