[Diaphragmatic myoclonus of spinal origin].
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Cervical Vertebrae↗
Biomedical subjects
J Suzuki
Publications and source records attributed to J Suzuki.
[Trigeminal neurinoma associated with suprasellar arachnoid cyst].
A rare case of trigeminal neurinoma associated with suprasellar arachnoid cyst is reported. A 49-year-old female had been suffering from character change, memory disturbance and mild headache for three years prior to admission. On admission, there were bilateral choked disc and binasal lower quadrant anopsia. Visual acuity was 20/200 on the left side and 10/200 on the right side. Facial and auditory nerves were intact. Cerebellar sign was not present. In plain skull roentgenograms, there were destruction of the right apex of the pyramis. However, the internal auditory meatuses were normal. Computed tomography revealed a contrast enhanced mass at the right cerebellopontine angle and a large cystic lesion in the suprasellar region. The relation between both lesions was clearly demonstrated in the coronal computed tomography and the NMR imaging of the sagittal section. The patient was operated on through subtemporal approach. The well-defined yellowish tumor was totally removed and the cyst was opened. The tumor and the cyst were distinguished separately. Post-operative course was uneventful except for the right trigeminal palsy. Mental symptoms disappeared. The mechanism of the appearance of symptoms in the case is considered as follows. That is, the slowly expanding tumor progressively compressed the cyst and the cyst enlarged, then the various symptoms appeared. The possibility that the suprasellar arachnoid cyst was a secondary arachnoid cyst due to the trigeminal neurinoma is also discussed.
Arachnoid↗
[A case showing angiographically moyamoya vessels combined with intracranial calcification].
This case was 36-year-old female with the past history of pulmonary tuberculosis on her 10 years old. During the treatment for pulmonary tuberculosis, transient tetraparesis appeared, and improved completely. She was admitted to our hospital, complaining sensory disturbance of left face and arm on July 25, 1983. Plain skull roentogenogram showed calcification at the base of brain. Computerized tomography (CT scan) showed dilatation of lateral and third ventricles. Cerebral angiograms revealed an occlusion of the right internal carotid artery and the left middle cerebral artery, the stenosis of the basilar artery and bilateral posterior cerebral arteries, transdural anastomosis (so-called vault moyamoya), leptomeningeal anastomosis and moyamoya vessels at the base of brain. Four days after the admission, left hemiplegia appeared suddenly. Because the findings of CT scan and angiogram showed no change, conservative treatment was performed and motor disturbance improved. Biopsy of the calcified mass was carried out and histological findings suggested an old inflammation. Based on the clinical course and examination, it was considered that moyamoya vessels of this case had been formed as a result of tuberculous meningitis. Up to now, only 6 cases with moyamoya vessels at the base of brain coursed by tuberculous meningitis Up to now, only 6 cases with moyamoya vessels at the base of brain coursed by tuberculous meningitis have been reported. In our case, neurological symptoms appeared 26 years after tuberculous meningitis and occlusive changes were seen in bilateral carotid system and vertebrobasilar system.
Adult↗
[Treatment of carotid-cavernous sinus fistula by the balloon technique combined with a by-pass procedure using a vein graft-technical note note].
A case with spontaneous carotid-cavernous fistula treated by balloon catheter technique combined with a extra-intracranial by-pass using a saphenous vein graft between the common carotid artery and the middle cerebral artery is reported. A 72-year-old female was admitted with complaints of recurrent symptoms of carotid-cavernous fistula 4 months after spontaneous remission. Angiograms showed the presence left internal carotid-cavernous sinus fistula. Poor cross-filling from the right internal carotid artery to the territory of the left internal carotid artery via the hypoplastic right A1 and left posterior communicating artery was also observed. Symptoms such as chemosis, exophthalmos and visual disturbance gradually progressed during the hospitalization. A common carotid-middle cerebral artery anastomosis was performed with a saphenous vein graft and the carotid cavernous fistula was occluded directly with a balloon catheter. The blood flow via the graft, cortical blood flow, cortical tissue O2 and CO2 were continuously measured during the operation. After the internal carotid artery occlusion, sufficient blood flow via the graft and no significant changes of the cortical blood flow, cortical tissue O2 and CO2 were observed. The postoperative angiogram showed that the by-pass was patent and all branches of the left internal carotid artery were filled via the by-pass. The postoperative course was uneventful and the progressive symptoms improved except for visual disturbance on the left. She is in good condition one year after the operation. The usefulness of this surgical procedure with monitoring of cerebral blood flow and metabolism during operation is also discussed.
Aged↗
[A case of agenesis of the corpus callosum accompanied by a ruptured azygos anterior cerebral artery aneurysm and lipoma--a case report].
A 53-year-old woman suffered from sudden onset of severe headache on February 28 in 1982. She was admitted to our hospital soon after onset. On admission, she had a severe headache and nausea, and her consciousness was drowsy. CT scan showed a marked subarachnoid hemorrhage with intracerebral and intraventricular hematoma, a separation of the lateral ventricles with enlargement of posterior horns, and deformity of anterior horn. By these findings, the patient was diagnosed as an agenesis of the corpus callosum with subarachnoid hemorrhage. Left carotid arteriogram revealed an azygos anterior cerebral artery and an aneurysm at the terminal portion of this artery. Surgery was performed on the 24 th day after subarachnoid hemorrhage. Operative finding revealed a little finger's head-sized tumor was situated over the right frontobasal artery. An azygos anterior cerebral artery aneurysm was clipped and tumor was removed. Pathological diagnosis of the tumor was a lipoma. Namely, she had an agenesis of the corpus callosum, an azygos anterior cerebral artery, an aneurysm and a lipoma. There are some reports in which an agenesis of the corpus callosum is accompanied with a lipoma and an azygos anterior cerebral artery is accompanied with an aneurysm. But a case of agenesis of the corpus callosum with an azygos anterior cerebral artery was rarely reported. So this rare case with these anomalies was reported and pathogenesis about the development of 4 anomalies was also discussed.
Agenesis of Corpus Callosum↗
[Sequential changes of autoregulation in experimental focal cerebral ischemia--pathophysiology at the center, periphery and outside of the focal cerebral ischemia].
In order to elucidate the relationship between the degree of autoregulatory loss and the intensity or the duration of ischemia, and the difference of locations in and around the ischemic focus, we used the canine thalamic infarction model and studied the sequential changes of rCBF and autoregulation during 6 hours following vascular occlusion. The value of rCBF was measured by the hydrogen clearance method and autoregulation was tested by raising the blood pressure with drip infusion of angiotensin II. In the center of ischemic focus, autoregulation was impaired after 1, 3 and 5 hours following occlusion in the animals with moderate ischemia. In the animals with mild and severe ischemia, autoregulation was preserved during occlusion, but in the latter we thought it false autoregulation. In the periphery of infarctic focus with severe ischemia, autoregulation was impaired after 3 and 5 hours following occlusion. Outside of the infarctic focus with severe ischemia, autoregulation was preserved during occlusion, but in 2 of 6 animals rCBF decreased despite of raising blood pressure and it was thought to be paradoxical response.
Animals↗
[Bifrontal interhemispheric approach to carotid-ophthalmic aneurysms].
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Carotid Artery Diseases↗
[Intracerebral hemorrhage and characteristic angiographic changes associated with methamphetamine--a case report].
A case of intracerebral hemorrhage and characteristic angiographic changes associated with methamphetamine is reported. A 23-year-old woman suddenly complained of headache, nausea, vomiting and gait disturbance several minutes after intravenous injection of 30 mg of methamphetamine. She was admitted with consciousness disturbance, aphasia and right hemiparesis 26 hours after the onset. CT scan revealed subcortical hemorrhage in the left fronto-parietal region. Left carotid angiogram showed irregular segmental arterial narrowing, "beading" of the anterior and middle cerebral arteries. Emergency craniotomy was performed and a left fronto-parietal hematoma was removed totally. Histologically, the surgical specimen showed many vessels in which included thrombi with perivascular hemorrhage. Post-operative course was uneventful. Repeat carotid angiogram 4 months after the operation revealed normal anterior and middle cerebral arteries. We discussed about associations between the abuse of methamphetamine and the occurrence of intracranial hemorrhage and characteristic angiographic changes. As far as we know, there were 23 reports in an extensive review of the literature on intracranial hemorrhage associated with methamphetamine abuse. In the present case "beading" of the intracranial vessels may be related to angiitis induced by methamphetamine. Both the presence of arterial inflammation and increased blood pressure caused by sympathomimetic action of methamphetamine are probably the important factors in the occurrence of intracranial hemorrhage associated with methamphetamine.
Adult↗
[Experimental study on reversibility of cerebral ischemia--residual blood flow and duration of ischemia].
This experimental study was designed to estimate the flow thresholds and the time thresholds for reversibility of cerebral ischemia. We used a "canine model of completely ischemic brain regulated with a perfusion method", in which the cerebral blood flow (CBF) could be controlled. The residual blood flow was reduced to 10%, 20%, 30% or 40% of normal CBF, and the recirculation was started after 1, 2, 3 or 4 hours of ischemia. CBF was measured by a laser doppler flow meter. EEG and somatosensory evoked potential (SEP) was monitored and used as a parameter expressing the brain function. In the 10% and 20% ischemia group, functional recovery could not be obtained even if reperfusion was started at 1 hour after the onset of ischemia. On the other hand, in the 30% ischemia group, nearly complete recovery of EEG and SEP could be seen when reperfusion was done at 1 hour from the onset of ischemia. But recirculation after 2 hours of ischemia did not lead to significant functional recovery. In the 40% ischemia group, reperfusion within 3 hours of ischemia allowed full recovery of ischemic brain. On the contrary, reperfusion after 4 hours of ischemia showed a gradual deterioration of EEG and SEP. Accordingly, it was clearly demonstrated that the reversibility of ischemic brain was critically correlated to severity and duration of cerebral ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Sequential changes of extracellular matrix and proliferation of Ito cells with enhanced expression of desmin and actin in focal hepatic injury.
Immunohistochemical investigations were carried out on the properties of the cells and extracellular matrix (ECM) in focal hepatic injuries. A liquid nitrogen-cooled syringe needle was thrust into the rat liver. Necrotic areas became permeated with plasma within 24-hour period. Areas became strongly positive for fibronectin and were infiltrated with inflammatory cells positive for lysozyme. By the third day, Ito cells were proliferated in the peripheral portions of the damaged areas. These Ito cells showed enhanced immunostaining for desmin and actin but were negative for lysozyme. Interstitial fibers which were immunochemically positive for Types I and IV collagens, laminin, and fibronectin, began to increase from Day 3. They appeared on the rim of the hepatocytes adjacent to the damaged areas and extended into the injured regions with the Ito cells. An increase in basal laminas associated with capillaries and bile ducts also increased with a 1-day delay. The damaged areas were replaced by granulation tissue by Day 5. A rapid diminution then occurred in the granulation tissue, and normal hepatic tissue was restored in 7-10 days. These observations demonstrate that ECM changed in a sequential manner and then finally disappeared from the damaged site within 10 days. Although various cells, including parenchymal cells, macrophages, endothelial cells, and cholangiolar cells contributed to the healing of the damaged area, Ito cells, which exhibit unique phenotypic changes, presumably had a major role in the process.
Actins↗
[A new superselective balloon catheter--all-silicone catheter with a floppy tip].
We have introduced concept of "chemical" embolization and have tried to develop a new agent which would enable us to embolize the lesion with one-shot injection. Such an agent must be able to occlude diffusely the lesion distal to the catheter. This has made it mandatory to develop a new catheter which can be introduced into the vessel as close to the lesion as possible with fewer risks of clot formation and/or vessel damage. A new superselective balloon catheter for angiography and infusion of liquid embolizing materials has been developed. This catheter consists of a proximal relatively stiff silicone catheter, a short distal thin-walled flexible silicone catheter and silicone balloon. These three silicone components are connected by silicone adhesives. The distal catheter allows us to catheterize fine arteries such as lenticulostriates, while the proximal catheter assures easy manipulation. This balloon catheter can be used for superselective angiography and infusion of liquid embolizing materials. It has been used on nine patients; one with a dural arterio-venous malformation (AVM), four with meningiomas, and four with brain and spinal cord AVMs. In the case of dural AVM and meningiomas, it was possible to easily introduce into the middle meningeal artery distal to the foramen spinosum. In addition, in one of the cases of meningioma, we were able to catheterize one of the main feeding pedicles beyond the pterion. Chemical embolization was carried out in 5 cases with good results. In the case of brain and spinal cord AVM, useful information was obtained from the superselective angiography.(ABSTRACT TRUNCATED AT 250 WORDS)
Angiography↗
[A case of arachnoid cyst in the middle cranial fossa presenting with trigeminal neuralgia].
A 50-year-old man had been suffering from left trigeminal neuralgia for 30 years. CT scan revealed an arachnoid cyst occupying the anterior two-thirds of the left middle cranial fossa. Cerebral angiography showed elevation of the left middle cerebral artery and medial shift of the left posterior cerebral artery. Metrizamide CT showed that the cyst was not communicating with the subarachnoid space. Air CT revealed the root of the left trigeminal nerve in contact with the arachnoid cyst. The patient became completely free from the trigeminal neuralgia 6 months after cystoperitoneal shunt. This case seems to be a very rare case of trigeminal neuralgia caused by an arachnoid cyst.
Arachnoid↗
[Traumatic anterior cerebral artery aneurysms--experiences in 4 cases and review of the literature].
Five cases of traumatic anterior cerebral artery aneurysms are reported with special emphasis on the initial CT findings of these cases. One case was already reported by Endo (1974). The cases are three in children and two in adults, male four cases and female one case. Four cases had closed head injury, one open. Consciousness level on admission were diversely from clear to semicomatose. Three cases experienced rupture of aneurysms. Time of diagnosis from trauma was from two days to 34 days. Location of aneurysms were near the junction of callosomarginal artery three cases, frontopolar artery one case, and A1-A2 junction one case. Operation was performed in four cases. Results were good in three cases and fair in a case. A case of no operation had fracture of anterior skull base and died from massive nasal and oral bleeding. Autopsy showed an aneurysm of A1-A2 junction, extending to sphenoid sinus. Histological findings of aneurysmal walls were pseudoaneurysm in all cases. There were 48 cases of traumatic anterior cerebral artery aneurysms in the literature. Most of cases are near the junction of callosomarginal artery. As the etiology of the aneurysm it is said that falx cerebri damages the arterial wall. We consider tear of junction of callosomarginal artery is a important factor, since the brain can easily move at the anterior portion of falx. It is very difficult to diagnosis traumatic aneurysms before rupture. But in our three cases of traumatic anterior cerebral artery aneurysms, computed tomographies of very early stage of trauma showed interhemispherical high density area, hematoma and hemorrhage of corpus callosum.(ABSTRACT TRUNCATED AT 250 WORDS)
Brain Injuries↗
[Long-term follow-up angiography of moyamoya disease--cases followed from childhood to adolescence].
We have reported the characteristic dynamic changes at the base of the brain in childhood Moyamoya disease in terms of follow-up angiography. So we have classified the angiographical findings of Moyamoya disease into six stages. However, there have been no report that proved these findings in long-term follow-up. On the other hand, these angiographical findings are mainly observed in children, we can seldom to find out any changes in adults. We performed long-term follow up angiography in adult cases whose onset was in childhood to clarify the natural course of this disease and to understand the difference between the cases of children and adults. Eleven cases (4 males and 7 females) of Moyamoya disease were investigated by angiography. Average onset was 5.1 years old. All of them were diagnosed by initial angiography in childhood (average age were 6.5 years old) and they grew up into adolescence (average age were 18.6 years old) at the time of follow-up study. Initial symptoms of them were all ischemic (TIA 7, RIND 2 or completed stroke 2). The symptoms at the time of follow-up were mental retardation in 5 patients, slight neurological deficits in 1, TIA in 2 and normal in 3. Among them, one patient had suffered from intraventricular hemorrhage. The results were as follows: the progression of angiographical stages was observed in 95% of sides. In 71% of sides, angiographical stage was in 5 or 6 which is thought to be an end stage of this disease.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Immunological quantitation of tyrosinase from wild-type and albino mutant mice.
The relationship between gene dosage, enzyme activity, and level of immunologically cross-reacting material (CRM) was examined in mammalian tyrosinase (EC 1.14.18.1) by rocket immunoelectrophoresis. Skin extracts from mice heterozygous (C/c) and homozygous (c/c) for the albino locus contain 46% and 0% of CRM, respectively, as compared with wild-type (C/C) animals. Enzyme activity and CRM level were directly proportional in these genotypes, suggesting that the albino locus controls the quantity of tyrosinase produced in melanocytes.
Animals↗
Vestibulo-ocular reflexes after selective plugging of the semicircular canals in the monkey--response plane determinations.
The contribution from different pairs of semicircular canals to the generation of horizontal vestibular nystagmus was examined in monkeys. Animals with different pairs of semicircular canals surgically plugged were accelerated sinusoidally at 1 Hz (a predictive stimulus) or with steps of angular velocity (a non-predictive stimulus) about an earth vertical axis while the head was placed in various static pitch positions. In normal animals, and in animals with only the lateral canals intact, horizontal nystagmus elicited with angular velocity steps is maximal at a static pitch angle of 15 degrees nose-down (relative to the horizontal stereotaxic plane). The response follows a cosine function of the pitch angle, approaches zero at an angle of 90 degrees to the optimal orientation, and finally reverses. In animals with only the vertical canals operating, direction specific horizontal nystagmus can still be elicited. Using velocity steps, a null plane at which nystagmus reverses can be determined. It is found at about 32 degrees nose-down and thus is different from the optimal plane of the lateral canals. Consequently, it is not possible to stimulate the lateral canals maximally without stimulating the vertical canals simultaneously. Using sinusoidal rotation, nystagmus is attenuated at the static pitch position of 32 degrees nose-down, but does not reverse direction with further pitching.
Animals↗
Effects of calcium antagonists and calmodulin inhibitors on angiotensin II-induced prostaglandin productions in the isolated dog renal arteries.
Angiotensin II markedly potentiated both PGE2 and PGI2 productions in the isolated dog renal arteries. This angiotensin II-induced response was significantly reduced by the treatments of EGTA and calcium antagonists such as verapamil, nifedipine and 8-(N,N'-diethylamino)-octyl-3,4,5,-trimethoxybenzoate (TMB-8). Calmodulin inhibitors, trifluoperazine and W-7 also inhibited the angiotensin II-induced PG productions while an inactive analogue of W-7, W-5 did not have any effect. The results suggest that angiotensin II may enhance the intracellular Ca2+ level through the influx of extracellular Ca2+ and then, calmodulin activated with Ca2+ will stimulate both PGE2 and PGI2 productions via its activation of phospholipase A2 in the dog renal arteries.
6-Ketoprostaglandin F1 alpha↗
Cochlear ototoxicity of chlorhexidine gluconate in cats.
Chlorhexidine gluconate is a derivative of chlorhexidine and is a popular disinfectant with a strong bactericidal action that is widely used for preoperative sterilization in ear surgery. The purpose of this investigation is to ascertain the potential ototoxicity of this agent. After topically applying chlorhexidine gluconate solutions to the middle ear cavities of 12 cats, we observed the excised cochleas using both scanning and transmission electron microscope studies. Either 0.05% or 2% chlorhexidine gluconate solutions were infused into the right ear of the test animal through one of two tubes chronically installed in the tympanic bullae. The left ears were utilized as controls and were infused with sterilized physiological saline. The solutions were administered once every other day for three separate infusions. Nine animals were decapitated 7 days after the third application, while the other three animals were sacrificed at 4 weeks. In the 2% chlorhexidine group, we found that hair cells in the organ of Corti had degenerated and had lost their hair bundles over a wide range. This pathology was more marked in the lower cochlear turns. In the animals sacrificed at 4 weeks, the injuries present seemed to have progressed. Even at a clinical concentration of 0.05%, chlorhexidine caused intracellular degeneration but with little surface damage. Our findings would suggest a cause of hearing loss when chlorhexidine is used clinically in the ear.
Administration, Topical↗