Life threatening epilepsy in a child.
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Arrhythmias, Cardiac↗
Biomedical subjects
H Tanabe
Publications and source records attributed to H Tanabe.
Parietal pleural invasion of lung masses: evaluation with CT performed during deep inspiration and expiration.
PURPOSE: To determine whether respiratory phase shift of lung masses at computed tomography (CT) indicates the absence of parietal pleural invasion. MATERIALS AND METHODS: Helical CT was performed during deep inspiration and expiration in 17 patients with peripheral lung tumors in contact with the chest wall. Changes in the location of the tumor relative to a chest wall marker were noted. RESULTS: Six of 10 lesions in the middle or lower lobes showed substantial respiratory phase shift; all were proved at surgery not to have invaded the parietal pleura. Three of the 10 showed no respiratory phase shift and were found at surgery to have invaded the parietal pleura. CT findings for tumors in the upper lobe did not correlate with the surgical findings. CONCLUSION: The presence of respiratory phase shift is a reliable indicator of the lack of parietal pleural invasion for tumors in the middle or lower lobes.
Adult↗
Regional assignment of the human immunoglobulin processed pseudogene C epsilon 3 (IGHEP2) to 9p24.2-->p24.1 by fluorescence in situ hybridization.
The human immunoglobulin processed pseudogene C epsilon 3 (IGHEP2), which was assigned to chromosome 9 by somatic cell hybrid analysis, has not been regionally localized as yet. In this study, using fluorescence in situ hybridization (FISH) combined with conventional QFQ-, RBG- or GTG-banding, IGHEP2 was assigned to the p terminus region of chromosome 9, at band 9p24.2-->p24.1. This result suggests that the C epsilon 3 gene is a novel telomeric DNA marker useful not only for constructing the physical map of human chromosome 9 but also for cytogenetic analyses such as cryptic translocations. In addition, comparative mapping of this gene in other catarrhine primates would contribute to investigations of human and other primate karyotype evolution.
Cells, Cultured↗
A phase II clinical trial of recombinant human tissue-type plasminogen activator against cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
The results of a Phase II clinical trial of intrathecal recombinant tissue-type plasminogen activator for the prevention of vasospasm were reported. The subjects were 53 patients with aneurysmal subarachnoid hemorrhage (SAH), Groups 2 to 4 in Fisher's preoperative computed tomography classification and Grades II to IV in the Hunt-Kosnik classification. Twenty-four hours after surgery, tissue-type plasminogen activator (TD-2061) was intracisternally administered via a catheter (0.1, 0.2, or 0.4 mg, three times daily for 5 days). The clot-dissolving effects assessed as "effective" and "markedly effective" were virtually the same in the 0.1- and 0.2-mg groups (66.7% and 64.3%, respectively) but slightly lower (53.3%) in the 0.4-mg group, suggesting an adequate effect in the 0.1- and 0.2-mg groups. Severe angiographic vasospasm was not observed in any of three groups. No intergroup differences were noted in the incidence of symptomatic vasospasm, low density on computed tomography 1 month after SAH, and functional prognosis. Bleeding complications were noted in 4 patients (7.5%), including 1 case of SAH in the low 0.1-mg group, 2 cases of SAH in the 0.2-mg group, and 1 case of epidural hematoma in the 0.4-mg group. In overall safety rating, 3 cases with increased SAH and 1 case of epidural hematoma were assessed as "safety doubtful." Other minor side effects such as headache and hepatic dysfunction attributed to the effect of other simultaneously used drugs were assessed as "almost safe," and the rate of "almost safe" and "better" for all dose groups was about 90%, suggesting a safe dose level for all groups. These results suggest that repeated intrathecal administration of tissue-type plasminogen activator is useful for preventing vasospasm even in the low dose of 0.1 mg.
Adult↗
Paramedian thalamic infarction following blunt head injury--case report.
A 19-year-old male was admitted following a blow to the face. Computed tomographic (CT) scans 1 hour after injury revealed low-density areas in the bilateral thalami and midbrain, which were enhanced postcontrast except for the core 3 hours later. CT scans 2 days after injury revealed that the size of the low-density areas had increased. CT scans and magnetic resonance images 3 weeks after injury disclosed only small infarcted lesions in the bilateral thalami, the right side of the midbrain, and the left internal capsule. These findings suggest that the injury initially caused thrombus on the basilar arterial wall, leading to occlusion of the perforators, but almost all affected perforators were recanalized. Bilateral thalamic infarction resulting from head injury is unusual, as is the transient nature of the infarction in this case.
Adult↗
Unusual presentation of brain metastasis from hepatocellular carcinoma--two case reports.
Two unusual cases of brain metastasis from hepatocellular carcinoma (HCC) are described. A 15-year-old boy presented with intracerebral hemorrhage from brain metastasis from HCC, and died of rebleeding 1 month after surgery. Cerebral metastatic HCC in a child is quite rare, and has not previously been reported. A 65-year-old male with a 2-year history of treatment for HCC presented with a brain metastasis from HCC without intracerebral hematoma manifesting as gradual onset of headache. Brain metastases from HCC presenting without intracerebral hemorrhage are rare.
Adolescent↗
Traumatic intracranial foreign body embolization--case report.
A 27-year-old male presented with intracranial embolization due to accidental penetration of his neck by an iron fragment at work. Cerebral angiography revealed foreign body embolization of the left middle cerebral artery. The foreign body was successfully removed via craniotomy and arteriotomy. The extended period from onset to surgical treatment prevented acute hemodynamic reconstruction. However, he had good collateral circulation and was discharged with mild hemiparesis and moderate motor aphasia. The possibility of intracranial embolization should be considered in patients presenting with penetrating injury of the neck.
Adult↗
[A case of acute disseminated encephalomyelitis with pathologically-proven acute demyelinating lesion in the peripheral nervous system].
We present a case of acute severe demyelination affecting both CNS and PNS with pathological evidence. A 62-year-old man presented with acute onset of coma preceded by common cold-like symptoms. He was diagnosed as acute disseminated encephalomyelopathy (ADEM), and died of brain herniation in two weeks. At autopsy, in addition to severe demyelination of the white matter of the central nervous system, there was widespread acute demyelinating process in the peripheral nervous system. Myelin destruction by macrophage was most conspicuous in the spinal nerve root with preservation of the axon cylinder. So far the association of hypertrophic demyelinating neuropathy was reported in cases of multiple sclerosis. However, there have not been any papers in which substantial involvement of both CNS and PNS in cases of ADEM except for the clinical report by Amit. Antigenic cross-reactivity between CNS and PNS against myelin proteins or other antigens like glycolipid may elicit similar immune responses producing demyelination.
Acute Disease↗
[Re-coronary artery bypass grafting for anomalous origin of left coronary artery from pulmonary artery (Bland-White-Garland syndrome) after operation in infancy: a case of 18-year follow-up].
Anomalous origin of the left coronary artery from the pulmonary artery is a very rare congenital malformation. Re-coronary artery bypass grafting was performed in a 18-year-old man who had received coronary artery reconstruction with a homologous saphenous vein (from his mother) at 7-months old. After the first operation, clinical course was uneventful, but the patient became symptomatic because of effort angina at age 15. The electrocardiogram showed abnormal ST segments in Lead V2-5 and abnormal T waves in Lead V5-6. Coronary arteriography revealed that saphenous vein graft was occluded. The left internal thoracic artery (LITA) was anastomosed to the left anterior descending artery and a two coronary system was established. Postoperative angiography revealed that LITA was patent, and relief of angina was obtained.
Adolescent↗
[A case of lobar atrophy with stereotypic unusual laughing].
We report a case of a Pick's disease (frontal predominant type) with unusual laughing. The patient was a 54-year-old, right handed, female. The patient began to show low activity and inappropriate laughing at about 51 years. She did not speak at all and showed weird laughing with a voice "hi hi hi hi hi hi" frequently at first presentation. When asked some questions, she sometimes answered with a nod. Almost all of her laughing did not match with the situation and seemed to lack a relationship between affective change and observed expressions. The laughing could be elicited by non specific and varied stimuli. She often interrupt laughing voluntarily unlike pathological laughing. Neurological examination revealed visual rooting reflex and forced grasping reflex but there was no signs of pseudobulbar palsy often observed in patients with pathological laughing. Her electromyogram of facial expression during the laughing showed that electric discharge of M. corrugator supercilii was over 4 times as much as that in normal laughing. And it showed also that the duration of her laughing was several seconds as normal laughing. CT and MRI scans demonstrated atrophy in the fronto-temporo-parietal lobe bilaterally (L > R), most prominent in the frontal lobe. SPECT scan showed a significant diminution of blood flow in the atrophic region. An EEG was normal. We consider that the laughing of the present case is not due to an emotional disturbance but rather a disorder of affective expression as pathological laughing.
Dementia↗
[Measurement of serum neuron-specific enolase levels after subarachnoid hemorrhage and intracerebral hemorrhage].
Neuron-specific enolase (NSE) is an enzyme involved in glycolysis and has a gamma-subunit. It is localized in neurons and axonal processes, and escapes into the blood and cerebrospinal fluid at the time of neural injury. In this study, the serum NSE levels in cases of subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (HIH) were measured. The subjects were 20 patients with subarachnoid hemorrhage (mean age; 53.4 +/- 14.5, 12 men and 8 women) and 20 with hypertensive intracerebral hemorrhage (mean age; 57.9 +/- 13.6, 11 men and 9 women). Although the serum NSE levels of all of these patients were measured on admission, measurement in patients with SAH were serially measured for an additional three weeks. There was no correlation between the serum NSE levels on admission in patients with SAH and consciousness level or clinical grade on admission, or prognosis. However, in Fisher's CT group 3 or 4, patients showed significantly higher levels of NSE than patients in group 2. Seven patients in whom vasospasm was observed by cerebral angiography during the course of treatment demonstrated elevated serum NSE levels from the 5th to the 15th days. In cases of HIH, there was also no correlation between the serum NSE levels from admission and consciousness level on admission or prognosis. However, the relationship between the size of the hematoma and serum NSE level on admission was significantly higher in patients in whom the maximum diameter was 5cm or more in comparison to those in whom the maximum diameter was less than 5cm.(ABSTRACT TRUNCATED AT 250 WORDS)
Cerebral Hemorrhage↗
[MRI imaging of purulent cerebral ventriculitis].
This report concerns a 68-year-old male who was diagnosed as having purulent ventriculitis based on CT and MRI findings. He was first admitted to a nearby hospital with fever and impaired consciousness and thought to be suffering from herpes simplex encephalitis based on laboratory findings. In spite of treatment with acyclovir and antibiotics, his symptoms persisted for one and a half months. Because of gradual deterioration of his neurological status, he was transferred to our hospital. On admission he was stuporous with nuchal rigidity and a fever of 38.5 degrees C. The CSF leukocyte count was elevated (217/mm3) with predominantly polymorphonuclear cells (mononuclear 20, polymorphonuclear 197). Gd-DTPA MRI (T1-weighted) showed marked enhancement of the ependyma of the fourth ventricle and both lateral ventricles. A diagnosis of purulent ventriculitis was made and high-dose antibiotics (ABPC 12g, CTX 9g) were started intravenously. Gradual improvement in the clinical signs was observed with rapid normalization of the CSF cell-count. The patient had completely recovered one month after the start of treatment and this was associated with disappearance of abnormal enhancement on the MRI images. Although cerebral ventriculitis occasionally occurs as a complication of neonatal meningitis, it is rare in adult purulent meningitis. In our patient, persistent meningitis combined with impaired drainage of CSF from the ventricles are presumed to have caused ventriculitis. Serial enhanced MRI is particularly helpful in diagnosing ventriculitis, and can serve as a good index for monitoring the effects of treatment.
Aged↗
[Acute encephalopathy with symmetrical lesions of the thalamus, the putamen and the cerebellum on magnetic resonance imaging].
A 19-year-old boy was admitted to our hospital because of impaired consciousness after experiencing fever and headaches for 7 days. The patient was in a deep coma or generalized convulsions, with retrocollis and decorticate posture. He never regained consciousness, remaining in an apallic state. The initial CSF pressure was 290 mm H2O, CSF cell count 18/3 mm3, protein 75 mg/100 ml, and sugar 74 mg/100 ml. There was no significant elevation in the viral titer in the serum or CSF. Plain CT on admission showed marked brain edema. MRI three months thereafter demonstrated symmetrical high intensity in the thalamus, the putamen and the cerebellum on both T1- and T2-weighted images, probably representing petechial bleeding. The lesions in the medial portion of the occipital lobes showed iso intensity on T1-weighted images and high intensity on T2-weighted images. These lesions were consistent with infarction of both posterior cerebral arteries, which may have been due to severe brain edema. The clinical and MRI findings were similar to those of patients with acute encephalopathy with low-density areas in the thalamus or bilateral striatal necrosis in childhood. To the best of our knowledge, there have been no reports of cases like ours in adults.
Acute Disease↗
[A case of epileptic laughter associated with temporal epidermoid cyst: surgical treatment combined with subdural grid electrode study].
A case of epileptic laughter associated with deep right temporal epidermoid cyst is reported. Interictal EEG with subdural grid electrodes demonstrated multifocal spike discharges in the right temporal lobe. Ictal EEG localized the epileptogenic foci at the base of the anterior medial temporal lobe. After standard temporal lobectomy, the tumor was completely removed. The patient is free from seizures postoperatively.
Brain Diseases↗
Bronchial circulation and airway complications after lung transplantation: possible role of pulmonary rejection.
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Animals↗
[Diploic epidermoid on the petrous bone: a case report].
An unusual case of a congenital petrous bone epidermoid which resulted in a sudden deafness is reported. The patient was a 25-year-old man who suddenly developed a right deafness and tinnitus. Neurological examination on admission revealed slight hearing disturbance in the high sound area. Plain craniogram showed a destructive bone lesion in the middle portion of the petrous bone on the right side. Bone-window CT scan disclosed a bony destructive mass in the petrous bone, and enlargement of the internal auditory canal. The mass lesion was almost isodense on plain CT scan and was not enhanced by contrast media. T1 weighted imaging of MRI demonstrated an isointense mass in the petrous bone, and T2 weighted imaging demonstrated hyperintensity. Gd-DTPA MRI revealed no enhancement. Angiogram did not reveal abnormal findings. Right lateral suboccipital craniectomy was performed to remove the posterior wall of the internal auditory canal. The tumor existed extradurally originating from the dipole of petrous bone. The tumor appeared pearly and fragile. The pathological examination of the specimen was diagnosed as epidermoid. The postoperative course was uneventful except for right hearing loss on the 4th postoperative day. Epidermoid arising in the middle portion of the petrous bone is quite rare, so this case was hereby reported with some references.
Adult↗
[A case of atypical presenile dementia].
Kosaka (1993) reviewed 16 cases of slowly progressive presenile cortical dementia thought to be a clinicopathological entity with pathological features characterized by circumscribed lobar atrophy, diffuse neurofibrillary tangles, and calcification of the Fahr type, however, the clilical features of this new entity are not known in the description of detail. We report a patient with atypical presenile dementia which appeared to be consistant with that entity, together with the results of a comprehensive neuropsychological and neuroradiological examination. The patient was a 65-year-old right-handed housewife. At about 58 years of age, she started to lose spontaneity and develop a mild memory disturbance. At age 61 she transiently, experienced hallucinations and delusions. During the subsequent 8 years there was a very slight decline in global intellectual efficiency. In addition, she showed slow but definite progression of language disturbances characterized by anomia and loss of ability to grasp the meaning of words, particularly abstract nouns. She performed poorly on tasks with good sensitivity for detecting frontal lobe dysfunction, such as the Wisconsin Card Sorting Test and the hand sequence test. All other cognitive functions appeared to be relatively well preserved, however moderate dyscalculia was present. There was no socially inappropriate or stereotyped behavior, but the patient lost insight into her disease. The patient's activities of daily living on the ward were self-maintained. An EEG was normal. CT and MRI scans showed circumscribed bilateral fronto-temporal atrophy and bilateral mineralization in the basal ganglia and cerebellar white matter.(ABSTRACT TRUNCATED AT 250 WORDS)
Aged↗
[Computer assisted neurosurgery based on individualized functional anatomy].
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Adolescent↗