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Biomedical subjects

K Hashi

Publications and source records attributed to K Hashi.

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

The heterogeneity of target recognition by lymphokine-activated killer precursor cells.

Lymphokine-activated killer (LAK) cells were generated from peripheral blood lymphocytes (PBL) that were depleted of mature cytotoxic natural killer (NK) cells. PBL NK activity was abolished by pretreatment of effector cells with the toxic lysosomotropic agent L-leucine methyl ester (LME) or by depletion of effector cells by K562 monolayer absorption (MA). Both treatments markedly reduced the proportion of cells expressing NK-associated markers such as CD 16 (Leu 11b, B73.1), Leu 7, and NKH-1 (Leu 19), whereas these treatments had minimal effects on cells expressing T cell markers (CD 3, CD 4, and CD 8). LME and MA also drastically decreased the proportion of K562 target-binding lymphocytes. LAK activity against NK-sensitive and NK-resistant targets can be generated from the NK cell-depleted PBL by incubation with interleukin-2. Peak LAK activity generated from MA-treated PBL was later than the peak of LAK activity generated from either untreated or LME-treated PBL. Although MA of PBL on NK-resistant S4 sarcoma targets had little effect on NK activity, LAK activity against both K562 and S4 targets was reduced. These results suggest that there are at least three LAK precursor subpopulations in PBL: mature NK cells that can bind and kill K562 targets (LME-sensitive and MA-sensitive); "pre-NK" cells that can bind but cannot kill (LME-resistant and MA-sensitive); and non-NK cells that cannot bind and cannot kill K562 targets (MA-resistant).

Antigens, CD↗
PubMed1990

[High flow medullary venous malformation with aneurysm on the proximal artery--a case report].

Medullary Venous Malformation with an aneurysm is uncommon and only 4 cases have been reported in previous papers. We reported a case of a medullary venous malformation (MVM) of the frontal lobe with an aneurysm on its proximal artery. A 48 year old female with numbness of right fingers visited our hospital. On the CT scan, an abnormal enhanced area was found inside the left frontal lobe. The left carotid angiography showed both of an aneurysm around A com A in early arterial phase, and "MVM with early blush" in capillary-early venous phase. MRI showed linear signal void crossing the cortex to join paraventricular low intensity area (LIA) with slight cortical atrophy on sagittal slice. The CBF study by Xe-SPECT proved a high flow lesion, with mean CBF 69 (left), 59 (right) mg/100 g brain/min, Protective operation only for aneurysm was performed. The MVM in our case was proved to be a "high flow-low resistance system" by CBF study, although MVM has been considered a "low flow system". Reviewing papers, there were 3 cases of "high flow MVMs" confirmed by the measurement of CBF, all of them were large sized (greater than 4 cm) and with early blush angiographically. We conclude that large sized MVM with early blush needs hemodynamic inspection and special care to prevent "high flow MVMs" from hemorrhage and the steal.

Cerebral Angiography↗
PubMed1990

[Elevation of intracranial pressure during hemodialysis--continuous measurement of cerebrospinal fluid pressure in a patient with acoustic neurinoma].

Intracranial pressure (ICP) was continuously monitored in a thirty-two-year-old female of acoustic neurinoma complicated with chronic renal failure. Severe headache with vomiting has begun to appear during hemodialysis for several months, prompting a diagnosis of an obstructive hydrocephalus. Continuous ventricular drainage was placed after admission and changes of ICP were monitored during hemodialysis. Dynamic changes of electrolytes, protein, sugar, urea nitrogen, and creatinine levels in the cerebrospinal fluid (CSF) as well as osmolarity were measured every one hour during the hemodialysis. An increment of ICP started to occur gradually after initiation of hemodialysis reaching the maximum value 23 minutes later. It was spontaneously decreased to the initial level 8 minutes later followed by fluctuations thereafter consisting of the changes of 20 to 30 mmHg. A remarkable rise in osmotic pressure in CSF has been observed corresponding to the rise of ICP which created a large difference from the blood osmotic pressure that consistently decreased following the onset of hemodialysis. Whereas, the absolute values of all measured factors including electrolytes and urea nitrogen in CSF have decreased consistently which did not seem to contribute intermittent increment of osmotic pressure of CSF. The cause of ICP increment in our case was considered mainly due to increase of water content in the brain tissue caused by the widening of osmotic gradient between the CSF and blood, although the substances responsible to the actual increase of CSF osmotic pressure remained unclear.

Adult↗
PubMed1990

[A case of pulmonary embolism with diabetes insipidus developed after removal of craniopharyngioma].

A case of pulmonary embolism associated with diabetes insipidus is reported in an 18-year-old male. The patient, who had been treated with DDAVP for diabetes insipidus and hydrocortisone for hypocorticism for two years after first operation for the removal of craniopharyngioma, was admitted with recurrence of that tumor. Diabetes insipidus immediately after second operation was controlled with intermittent drip infusion of a small amount of aqueous pitressin under monitorings of body weight hourly using a patient weighing system to keep the weight changes within +/- one kilogram. Serum and urine electrolytes levels, osmolarity, and free water clearance were also monitored every three hours to maintain water-electrolytes balances appropriately. Postoperative course had been uneventful except that CSF rhinorrhea occurred 7 days after operation. The patient was, then, kept in bed with horizontal plane to avoid further leakage of CSF. Two days later, he developed chest pain suddenly with tachypnea, tachycardia, and general cyanosis. The arterial-BGA showed PaO2 of 53.5mmHg and PaCO2 of 35.3mmHg in room air. The definite diagnosis of pulmonary embolism was made by technetium microaggregate lung perfusion scans and by pulmonary angiograms. The patient was treated with heparin, 15000IU/day, and urokinase, 720000IU/day. The symptoms due to pulmonary embolism had improved gradually within a couple of weeks. Recent articles have shown an unexpected high incidence of deep vein thrombosis and pulmonary embolism in neurosurgical patients associated with the elevation of blood coagulability. Brain tumors, especially suprasellar mass with hypothalamic dysfunction have been suggested to cause thromboembolic disorders frequently. The clinical course was described and factors causing pulmonary embolism on this patient was discussed.

Adolescent↗
PubMed1990

[Reconstruction of skull base by omentum transplantation].

The majority of skull base tumors have been considered inoperable not because of the difficulty of surgical removal, but for lack of reliable methods to reconstruct the skull base following extensive removal of those tumors. In this report a trial fo reconstruction using a transplanted omentum is described. A free sheet of vascularized omentum was taken via laparotomy and transplanted into the skull base in four patients who had undergone extensive resection of skull base tumors. The transplanted omentum served satisfactorily as a barrier to prevent CSF leakage and subsequent infection and was considered to be a reliable material to reconstruct large defects in the skull base. The advantage of the omentum is its applicability in covering defects of all sizes and shapes. The omentum also contains various factors to promote tissue adhesion, such as angiogenic factors and fibroblastic growth factors. Furthermore, it can be expected to prevent secondary infections of the transplanted area, and as being a defense organ in the abdominal cavity. Practical methods to harvest and transplant the free vascularized omentum are described, and four cases of patients who have undergone these procedures are reported.

Adolescent↗
PubMed1989

An experimental model of cerebral venous hypertension in the rat.

Several means of establishing a useful experimental model of cerebral venous hypertension were examined in rats. Retrograde embolization with an autologous blood clot passed through a catheter inserted in an external jugular vein, combined with ligation of the contralateral external jugular vein, was found to produce consistent, sustained cerebral venous hypertension. This model has the advantages of being technically easy to prepare, well tolerated by the animals, and suitable for autoradiographic and/or histochemical assessment of regional circulation and metabolism.

Anastomosis, Surgical↗
PubMed1989

[Parasagittal meningioma with unusual venous drainage manifesting through peritumoral hemorrhage. Case report].

A 63-year-old female was admitted with a 5-day history of left hemiparesis. Computed tomography showed an enhanced mass with perifocal edema in the right frontal parasagittal region and an irregular-shaped, high-density mass anterior to the tumor. Right carotid angiography disclosed the prominent middle meningeal artery (MMA) to be the main feeding vessel of the tumor. In the venous phase, the superior sagittal sinus (SSS) was obstructed and a dilated middle meningeal vein (MMV) drained downward to the sphenoparietal sinus. Left carotid angiography demonstrated similar findings. There was a filling defect in the lumen of the MMV due to the MMA running within the vein. At surgery, careful manipulation was required, as the venous blood in the left MMV drained not only from the tumor but also from the anterior half of the SSS. The left MMA was found to run through the cavity of the dilated MMV. The SSS was invaded by tumor. There was an old hematoma cavity containing xanthochromic fluid in the brain parenchyma adjacent to the tumor. Histological examination showed meningothelial meningioma. The postoperative course was uneventful, although the right MMV was opacified on carotid angiography. It was suspected that obstruction of the SSS by tumor invasion had caused dilatation of the bilateral MMV and peritumoral hemorrhage due to disturbance of the venous drainage.

Cerebral Hemorrhage↗
PubMed1989

[Optic nerve hemangioblastoma. Case report].

A solitary hemangioblastoma of the optic nerve was found in a 36-year-old male with a distinct family history of intracranial hemangioblastoma. The patient was admitted with complaints of visual loss and exophthalmos of the right eye. X-rays showed enlargement of the right optic canal. Right carotid angiography revealed a hypervascular tumor in the orbital apex, supplied by the ophthalmic artery. Computed tomography disclosed a pear-shaped, isodense mass with moderate contrast enhancement in the orbital apex. The right optic nerve was enlarged along its entire course and was involved with the apical mass. Surgery via the right frontal extradural approach disclosed a solid, vascular tumor involving the optic nerve at the apex of the orbit. Histological examination showed the tumor to be a characteristic hemangioblastoma. Over 90% of intracranial hemangioblastomas are located in the posterior fossa. Supratentorial hemangioblastomas, especially those arising in the optic nerve, are extremely rare. In addition, optic nerve hemangioblastomas are frequently familial and are associated with infratentorial hemangioblastomas, angiomatosis retinae, and cysts of the abdominal viscera.

Adult↗
PubMed1989

[Angiogenic properties of various tissues utilized for synangiosis in moyamoya disease].

In order to evaluate the adequacy of materials utilized for synangiosis in Moyamoya disease, angiogenic activities of various human tissues were examined. Tissue samples were freshly obtained at operation. A small piece of the sample was placed on the chick chorioallantoic membrane (CAM), and, using an operative microscope, the production of neovascularization was evaluated 96 hours later. The scalp artery (STA and OA) showed the highest activity of angiogenesis, followed by the omentum and galea, while the temporal muscle, dura mater, and fat tissue showed poor activity. Histological examination confirmed the development of vasculature in CAM. The production of neovascularization is known to be related to the tissue content of the angiogenic factor (AF). The AF is known to be present in the vascular endothelial cell, fibroblast, tumor, brain, or omentum, etc. The rationale for the selection of materials for the neovascularization in Moyamoya disease was discussed in relation to its ability to produce new vessels.

Adipose Tissue↗
PubMed1989

[Spinal subdural empyema diagnosed by MRI and recovered by conservative treatment].

Localized suppuration involving the spinal cord is uncommon. A case of spinal subdural empyema is reported. The patient is 54-year-old male who had been suffering a diabetes mellitus but did not receive any treatment. His initial symptom was lumbago. Then he noticed a palpitation and general malaise which made him visit a hospital. Because he did not show any improvement by a fluid therapy, he was transferred to our institute for the further evaluation. On admission, physical examination showed no abnormality. Blood pressure was 170/90 mmHg, heart rate 128/min. and body temperature 37.1 degrees C suggesting a septic shock state. Neurological examination revealed slight consciousness disturbance, mild tetraparesis and bilateral hypesthesia lower than the level of L3. Laboratory examination showed the elevated leukocyte count and fasting blood sugar and urine ketone body levels of 20,500/mm3, 257 mg/dl and 226 mg/dl respectively. Blood culture proved a septicemia of Streptococcus agalactiae afterwards. On the second day of admission, lumbar puncture revealed a purulent cerebrospinal fluid, though X-ray CT of lumbar spine did not confirm a diagnosis. Spinal magnetic resonance imaging (MRI) revealed a widespread abnormal intensity of the spinal canal from the level of Th11 to L4. On the T1-weighted image (TR 300 msec., TE 40 msec.), cerebrospinal fluid space was abnormally isointense. On the T2-weighted image (TR 2,000 msec., TE 80 msec.), subdural and cerebrospinal space was filled with an abnormal high-intense lesion especially on the ventral side. He developed semicoma due to hydrocephalus following a intraventricular empyema. He was also complicated disseminated intravascular coagulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed1989

[Tethered cord syndrome of adult onset: report of a case and a review of the literature].

A 47-year-old female was admitted with complaints of spontaneous pain at the medial surface of the right thigh, and worsening of urinary incontinence and weakness of the legs. These phenomena had been noticed previously 20 years ago, and again 10 years ago, respectively. There was a scar like skin abnormality of 4 X 6 cm over the lumbosacral region. Compression on this region induced neuralgic pain around the anus radiating down to both legs. Neurologically, weakness of the legs, sensory impairment on the L2-S5 dermatomes and urinary incontinence were recognized. Plain X-P revealed spina bifida on the lower lumber and sacral vertebrae (L4-S1), where a low density mass was found by spinal CT. Metrizamide CT myelography and MRI disclosed medullaris to be low and the spinal cord to be elongated. There was a meningocele surrounded by subcutaneous lipoma at the caudal end of the spinal cord at L5 level. Upon operation, a meningocele containing neural elements and adherent to the intra and extra-dural lipoma was found protruding through the laminar defect. Lipoma was removed partially. The conus medullaris and cauda equina were freed from the surrounding tissue. Dural plasty using the Lyodura was made. Postoperatively, the pain disappeared and her gait disturbance and sensory impairment were significantly improved, but urinary incontinence remained unchanged. Fifty-six cases of tethered cord syndrome of adult onset were reviewed from the literatures. Clinical symptoms, etiologies of the tethering, surgical outcomes and factors causing symptoms were discussed.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1989

[Enlarging of intracranial hemorrhagic lesions and coagulative-fibrinolytic abnormalities in multiple-injury patients].

The clinical course of ten cases of head injury complicated with multiple systemic injuries were studied by comparing two groups divided according to the presence or absence of associated coagulative-fibrinolytic abnormality. All these cases had intracranial hemorrhagic lesions proven by the high density area in the initial CT scan. Five cases showed signs of disseminated intravascular coagulation (DIC) as evidenced by decreased counts of platelet, and/or elevated value of FDP at the time of admission. Four cases out of these five were in a state of hemorrhagic shock. All these five cases showed a subsequent enlargement of intracranial hematoma. Four cases died. Two of them, who had low initial Glasgow Coma Scale (G.C.S) died of uncontrollable increase of intracranial pressure. The other two, who had high initial G.C.S., died of acute renal failure and multiple organ failure. In contrast with these cases, five cases without signs of DIC intracranial hematomas did not enlarge in spite of the similar neurological conditions to the former group. In head injured patients with systemic injury, DIC frequently causes secondary hemorrhage in the intracranial lesions of minor severity.

Adolescent↗
PubMed1989

[Clinical course of acute intracerebral hematoma which shows a fluid level presentation by X-ray CT].

Three cases of intracranial hematomas which showed a fluid level presentation and/or mixed density in the acute stage by X-ray CT were reported. Case 1 is a 7-year-old boy who had the epidural and intracerebral hematomas three hours after the traffic accident. During the course, intracerebral hematomas which showed a fluid-level presentation had grown both 6 and 17 hours after the episode. Case 2 is a 39-year-old female who had received an aortic valve replacement 20 years ago. She was diagnosed as cerebral infarction due to the occlusion of the right middle cerebral artery. Intracerebral hematomas with a fluid level presentation developed in the infarcted area 20 days after the embolectomy. Case 3 is a 67-year-old female who had a mild subarachnoid hemorrhage by the traffic accident. Intracerebral hematoma with mixed density developed 68 hours after the episode and it enlarged again 89 hours after the accident. All three cases showed the abnormalities in the coagulofibrinolytic activities during the hemorrhage and showed a growth of the hematomas. It should be noticed that the case which shows a mixed density and/or a fluid level presentation in the X-ray CT requires more intensive care in both neurosurgical and general management.

Acute Disease↗
PubMed1988

Extensive spinal necrosis with spinal leptomeningeal dissemination of cerebral astrocytoma. Case report.

A 58-year-old male with malignant astrocytoma in the right parietal lobe developed ascending spinal dysfunction 15 months after subtotal resection of the primary lesion. He was treated by postoperative radiation and combined chemotherapy. Autopsy revealed extensive spinal necrosis affecting the level below the lower cervical region. Microscopic examination demonstrated diffuse leptomeningeal metastasis of glioma cells to the whole spine. There was no previous report in the literature of massive myelomalacia attributable to leptomeningeal dissemination an astrocytic supratentorial tumour. Clinical and neuropathological findings suggested that disturbance of venous drainage of the spinal cord might be responsible for myelomalacia in this case.

Astrocytoma↗
PubMed1988

Removal of a large asymptomatic calcified chronic subdural hematoma.

An asymptomatic case of a large calcified chronic subdural hematoma was examined. The calcified mass was nearly totally removed at operation using a high-speed air drill. Immediately after the operation signs of brain compression seen in computed tomography scanning were somewhat relieved. However, at follow-up after 3 months, the shift was resumed and the calcification reappeared 10 months after the operation.

Adult↗
PubMed1988

Immunotherapy of solid tumor by intratumoral infusion of lymphokine-activated killer cells.

Fifty million lymphokine-activated killer (LAK) cells were infused into rat T9 gliosarcoma tumors for 1 hr at an infusion rate of 0.1 ml/hr. Cultured normal spleen cells were infused into similar tumors as a control. The LAK cell-treated tumors began to regress at approximately 3 weeks after infusion and disappeared by 6 weeks, while the cultured normal spleen cell-treated tumors grew progressively. Immunohistochemical analysis demonstrated prominent infiltration of cytotoxic/suppressor T cells in the LAK cell-treated tumors, while few lymphocytes were recognized in the control tumors. These data suggested that LAK cells infused intratumorally might be capable of mediating tumor regression by inducing host immunity against the tumor.

Animals↗