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Biomedical subjects

K Fujii

Publications and source records attributed to K Fujii.

At least 577 records · Page 32Linked to original sources
PubMed1992

Somatosensory and spinal evoked potentials in patients with cervical syringomyelia.

We recorded somatosensory evoked potentials (SEPs) from the skin surface and spinal evoked potentials (SpEP) from the posterior epidural space after median nerve stimulation in 11 patients with cervical syringomyelia. We compared SEPs with SpEP to assess the possible feasibility of using these techniques to localize the offending lesion. SEP abnormalities were present on one or both sides of 7 patients (9 of 22 upper limbs; 41%). The abnormal SEP pattern was the attenuation or loss of N13, which was of little value for delineating the lesion. In patients with abnormal SEPs, three types of abnormal SpEPs were noted. In the Type A abnormality (three limbs), potentials were attenuated in all cervical segments, suggesting that the syrinx itself had enlarged to involve the posterior column. In Type B (two limbs), there was reduced amplitude or absent upper cervical potentials, probably a result of the accompanying tonsilar herniation. Finally, the Type C (four limbs) abnormality was a mixture of Type A and B abnormalities in that the attenuated cervical potentials were again affected in the most upper cervical segment. We concluded that SpEP revealed various kinds of involvement of the dorsal column pathway in the syringomyelic patients, a finding not expressed with conventional SEPs.

Adult↗
PubMed1992

Microsurgical and magnetic resonance imaging anatomy of the cerebello-medullary fissure and its application during fourth ventricle surgery.

The cerebellomedullary fissure, the only entrance or exit to the fourth ventricle, is surrounded rostrally by the cerebellar tonsils and the biventral lobules and caudally by the medulla oblongata, the tela choroidea, and the lateral recesses. This fissure is an important route in operations on the fourth ventricle. We studied the microsurgical and magnetic resonance imaging (MRI) anatomy of the fissure by using autopsied normal cerebellum. MRI revealed that the fissure is visible as a slit and is indicated by the enhanced choroid plexus and the flocculus. Oriented by the anatomical information thus obtained, we have surgically treated nine patients with a tumor either in or around the fourth ventricle. Preoperative MRI clearly demonstrated the tumors in relation to the cerebellomedullary fissure. It revealed the precise anatomical location and extension of the tumor, not only its inferior extension but also its lateral one. The MRI findings and microsurgical anatomy of the cerebellomedullary fissure were quite useful for the removal of the tumors in the fourth ventricle.

Aged↗
PubMed1992

Surgical treatment of moyamoya disease in pediatric patients--comparison between the results of indirect and direct revascularization procedures.

Either encephaloduroarteriosynangiosis (EDAS) or superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis combined with encephalomyosynangiosis (EMS) has been performed on most of the children with moyamoya disease in our department. EDAS alone was done in the parietal region of 13 sides in 10 patients, and STA-MCA anastomosis with EMS in the parietal region was done on 7 sides in 6 patients. The surgical results of these two different procedures were then compared. Postoperative collateral formation was observed on external carotid angiograms, and the improvement of clinical symptoms was monitored for 1 year after the bypass procedure. STA-MCA anastomosis with EMS was found to be superior to EDAS in both the development of collateral circulation (P less than 0.05) and postoperative clinical improvement (P less than 0.01). EDAS can be done easily and safely on small children with moyamoya disease, but STA-MCA anastomosis with EMS is considered to be more appropriate, whenever possible.

Cerebral Angiography↗
PubMed1992

Effect of anhepatic phase of surgery using veno-venous bypass technique on plasma fentanyl concentration. Report of two cases.

We administered fentanyl continuously and measured its concentration in plasma in two patients undergoing surgery which produced an anhepatic phase using the veno-venous bypass technique; one patient had extracorporal liver resection and the other had venoplasty of the inferior vena cava and the right hepatic vein. The plasma fentanyl concentration increased during the anhepatic phase and decreased in the post-anhepatic phase in both cases. Though fentanyl has a wide safety margin, attention must be paid to such drug characteristics in the management of anaesthesia during the anhepatic phase.

Adult↗
PubMed1992

Cystic pineocytoma--case report.

Pineocytoma and pineoblastoma, originating from pineal parenchyma, are rare and usually solid. An unusual case of totally cystic pineocytoma in a 37-year-old female is reported. The tumor showed neuronal differentiation and had a good outcome. Prominent calcification associated with pineocytoma and pineoblastoma is an useful finding to differentiate these from benign pineal cysts.

Adult↗
PubMed1992

Isolated bilateral abducens nerve palsies caused by the rupture of a vertebral artery aneurysm.

We report two cases with isolated bilateral abducens nerve palsies due to the rupture of a vertebral aneurysm. Surgery revealed that the aneurysm did not directly compress the abducens nerve. Within a year after the subarachnoid hemorrhage, the patients gained full recovery from the bilateral abducens nerve palsies. In view of the clinical and operative findings, it may be regarded as a compression and/or stretching of the bilateral abducens nerves by a thick clot in the prepontine cistern, and not as a manifestation of the raised intracranial pressure. The mechanisms of the isolated abducens nerve palsy are discussed.

Abducens Nerve↗
PubMed1992

[Primary hemangiopericytoma of the chest wall--a case report].

An extremely rare case of a primary hemangiopericytoma of the chest wall was reported. A 40-year-old female without any complaints was detected to have an abnormal shadow in the right chest wall on a chest X-ray film. The tumor was 2.6 x 2.2 x 2.0 cm in size and was resected together with the 8th rib which adhered to the tumor. Postoperative pathohistological examination led to the diagnosis of hemangiopericytoma. Postoperative course was uneventful, and the patient is now doing well and has had no recurrence for 11 months since the operation. A brief review was made on 9 cases collected from the literature.

Adult↗
PubMed1992

[Clinical usefulness of the measurement of type-II procollagen carboxypeptide (C-II propeptide, pColl-II-C) in synovial fluid as a marker of collagen metabolism in cartilage].

Type-II procollagen-C-peptide (pColl-II-C) in synovial fluids was studied in 319 patients with osteoarthritis (OA; 151), rheumatoid arthritis (RA; 141), traumatic arthritis (TA; 27) and 15 healthy volunteers using the newly developed ELISA kit. The mean levels of pColl-II-C in synovial fluids of healthy controls, OA, TA, and RA were 0.3 +/- 0.1 ng/ml, 5.9 +/- 0.3 ng/ml, 6.8 +/- 1.4 ng/ml and 1.1 +/- 0.1 ng/ml, respectively. pColl-II-C levels in synovial fluids of OA and TA were significantly higher compared to those of healthy controls and RA. It was also demonstrated that pColl-II-C levels could reflect the quantitative and qualitative change of cartilage metabolism. Therefore, the quantification of this molecule in synovial fluid could be beneficial to know the synthetic activity of type II collagen of chondrocytes, since pColl-II-C is a part of the precursor molecule of type II collagen.

Adolescent↗
PubMed1992

Microsurgical and angiographic analysis of anterior communicating artery aneurysms with associated anomalies.

A direct operation was performed on 110 patients with an aneurysm of the anterior communicating artery (ACoA). During the surgery, in 52% of the cases, the neck of the aneurysm was found at the junction of the A-1 segment and ACoA and they presented with a hypoplastic contralateral A-1 segment. Associated ACoA anomalies were seen in 13 (12%) of the 110 cases. The most common anomaly was duplication of the ACoA, found in 11 cases (10%). In 2 other cases triplicate ACoA was found. Preoperative bilateral carotid angiograms were reviewed and duplication of the ACoA associated with the aneurysms able to be pointed out on angiograms in 4 cases, retrospectively. The anatomical and radiological aspects of aneurysms with associated anomalies are also discussed.

Adult↗
PubMed1991

Experimental studies on tumor promotion by nitrogen dioxide.

The effects of nitrogen dioxide (NO2) on promotion of lung tumorigenesis induced by N-bis(2-hydroxypropyl) nitrosamine (BHPN) were investigated in male Wistar rats. In a preliminary study, the highest non-effective dose of BHPN was found to be 0.5 g per kg body weight. Rats were given a single intraperitoneal injection of BHPN at a dose of 0.5 g per kg body weight or saline at 6 weeks of age, and then exposed to clean air, 0.04 ppm, 0.4 ppm or 4 ppm of NO2 for 17 months, respectively. The incidence of pulmonary tumors in rats exposed to BHPN plus 4 ppm of NO2 was 12.5%; the tumors were adenomas and adenocarcinomas. Adenomas were found in 4 out of 40 rats (10%) and adenocarcinomas were found in 1 out of 40 rats (2.5%). The tumor incidence in the lungs of rats kept in BHPN plus clean air and BHPN plus 0.04 ppm of NO2 was 2.5% (1/40). In both groups adenomas were found. There was no significant difference in tumor incidence between animals exposed to BHPN plus clean air and to BHPN plus 4 ppm of NO2. No lung tumors were found in the group of BHPN plus 0.4 ppm NO2 and in animals exposed to NO2 without BHPN treatment. A high incidence of alveolar cell hyperplasia was observed in the lungs of rats injected with BHPN, and the effect of NO2 on development of alveolar cell hyperplasia was slight. On the other hand, marked bronchiolar mucosal hyperplasia was found in 17 out of 40 rats (42.5%) in the group of BHPN plus 4 ppm of NO2, and in 1 out of 40 rats (2.5%) in each of the group exposed to clean air, 0.04 ppm or 0.4 ppm of NO2 with BHPN treatment, respectively. The hyperplasia in lungs of rats exposed to 4 ppm of NO2 without BHPN treatment was slighter than that in lung of rat exposed to 4 ppm of NO2 with BHPN treatment. On the other hand, tumor incidence in the nasal cavity of rats in each of group exposed to clean air and NO2 with BHPN treatment was 97-100%. Incidence of tumors in other organs in the groups exposed to clean air and NO2 with and without BHPN treatment was very low, and NO2 had no effect on tumor development in the nasal cavity and other organs whether animals were treated with BHPN or not.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenocarcinoma↗
PubMed1991

Effect of calcium channel blocking agents on the reductive metabolism of halothane.

The effect of calcium channel blocking agents on the reductive metabolism of halothane in liver microsomes of guinea pigs was investigated. The reaction mixture for the measurement of the end products consisted of microsomal suspension, 5 mM NADPH, calcium channel blocking agents (verapamil, diltiazem, nicardipine and nifedipine) and halothane in 0.1 M phosphate buffer (pH 7.4). The reductive metabolism of halothane was inhibited competitively by verapamil, diltiazem and nicardipine. The binding spectra for the interaction of these three drugs with cytochrome P-450 in microsomes were investigated. Verapamil caused the reverse type I difference spectrum and diltiazem caused the type I difference spectrum. However, the change caused by nicardipine was not observed by the presence of its specific spectra. NADPH-cytochrome P-450 reductase activity in microsomes did not change by the addition of these three drugs. These results suggest that these three calcium channel blocking agents inhibit the production of radical intermediates during the reductive metabolism of halothane.

Animals↗
PubMed1991

Pineal and third ventricle tumours in the CT and MR eras.

We have experienced 29 cases of tumour in the pineal region and posterior third ventricle in the CT and MR eras (from 1976 to 1989). An aggressive surgical removal was performed except for germinomas and suspected germinomas. The aggressive surgical cases were 5 teratomas including one inclusion foetus, one yolk sac tumour, 3 astrocytomas, one neurocytoma, one cavernous haemangioma and one telangiectasia. The surgery was performed by either the infratentorial supracerebellar approach or the occipital transtentorial approach. There was no surgical death and the quality of postoperative survival was good in patients with benign tumours. The cases of a typical teratoma, teratoma with an arterio-venous shunt, inclusion foetus, haemorrhagic nodule of telangiectasia etc. are briefly presented. A remarkable progress in the diagnosis and surgical treatment of tumours in the pineal region in the CT and MR eras is noted in our results.

Adolescent↗
PubMed1991

Lateral ventricular arteriovenous malformations: natural history and surgical indications.

The authors report 21 cases of lateral ventricular arteriovenous malformation (AVM) focusing on their natural history and surgical indications. Eighteen of 21 patients (86%) had bleedings prior to admission. We performed definitive surgery in 9 patients and conservative treatment in 12 patients. In 7 of 9 patients (78%) in the operative group and in 5 of 12 patients (42%) in the non-operative group, the nidus of the AVM was less than 4 cm in diameter. The other 2 AVMs in the operative group, more than 4 cm in diameter, were located in the temporal lobe and widely extended to the temporal horn of the lateral ventricle. The nidi of the AVMs were totally removed in all 9 cases in the operative group. All patients have been doing well except one who had a mental breakdown 6 years after surgery. In 10 patients in the non-operative group, AVMs were located in the left cerebral hemispheres. Three patients in the non-operative group had rebleeding of the AVM. Two of the 12 patients in the non-operative group (17%) died of the recurrent haemorrhages. The rate of bleeding of the lateral ventricular AVM seems to be higher than that of the cerebral cortical AVM, but the mortality due to recurrent bleeding might be similar between the two. The operative indications we made depended on the sizes and locations of the AVMs. For AVMs in the temporal horn, even though they were large, we performed total removals of the nidi and had good results. We did not perform any definitive surgery for AVMs more than 4 cm in diameter except for those in the temporal horn. The mortality and morbidity of the 21 cases were 10% and 14%, respectively. Patients with AVMs in the temporal horn and patients with small AVMs in the frontal horn were good candidates for definitive surgery. We undertook conservative treatment for patients with large AVMs, and the results were acceptable.

Adolescent↗
PubMed1991

Direct spinal versus peripheral nerve stimulation as monitoring techniques in epidurally recorded spinal cord potentials.

We recorded spinal cord evoked potentials (SCEPs) and spinal somatosensory evoked potentials (spinal SEPs) in 30 operations following stimulation of the epidural spinal cord and the peripheral nerve, respectively, to compare their feasibility as an intraoperative technique for spinal cord monitoring. SCEPs produced quicker responses and had larger amplitudes with simpler waveforms. SCEPs could reflect residual function of the pathological spinal cord and predict the postoperative clinical outcome, findings which are not observed with spinal SEPs. Moreover, SCEPs had a much higher sensitivity to spinal cord insult. Therefore, we conclude that the SCEPs were more appropriate indicator than the spinal SEPs as an intra-operative monitoring method for spinal cord function.

Adolescent↗
PubMed1991

Usefulness of epidurally evoked cortical potential monitoring during cervicomedullary glioma surgery.

This report describes a patient with an intramedullary ependymoma at the region of the cervicomedullary junction in whom there was an abolition of somatosensory evoked potentials following median nerve stimulation. During intraoperative monitoring of cortical potentials elicited by epidural cervical cord stimulation, the tumor was removed. Posterior epidural stimulation appeared to depolarize more ascending fibers than did stimulation of a single peripheral nerve. We recommend that, in cases of operations in this vital area, epidurally evoked cortical potentials be monitored intraoperatively.

Evoked Potentials, Somatosensory↗