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Biomedical subjects

K Hashi

Publications and source records attributed to K Hashi.

At least 109 records · Page 6Linked to original sources
PubMed1988

[Intravenous hydrocortisone in large doses in the treatment of delayed ischemic neurological deficits following subarachnoid hemorrhage--results of a multi-center controlled double-blind clinical study].

Glucocorticoid in high dose has known to reduce vascular sensitivity to various vasoconstrictive stimuli. It inhibits phospholipase to reduce production of prostaglandins. It stabilizes the cell membrane and prevents cerebral edema. All these pharmacological effects indicate possible usefulness of this drug for the treatment of cerebral ischemia due to vasospasm. Based on these theoretical backgrounds a multi-center controlled double blind clinical study was carried out. The patient who showed manifestations of delayed cerebral ischemia due to vasospasm were selected for this study. As soon as the clinical manifestation appeared, the patient was given either 3 grams of hydrocortisone intravenously in a 60 ml solution or the placebo. The administration was repeated 6 times with interval of 12 hours. The patients were allowed to be treated according to the independent protocol of each institute except for the maximum daily use of glucocorticoid. The effect of the therapy was evaluated at 4th, 7th day and 1 month after the initiation. The study involved 52 institutes and a total of 140 patients, seventy-one patients who received hydrocortisone (group A) and 69 patients who received placebo (group P) was analysed. There were no significant differences in background data between both groups. In patients with grade I, II or III on admission, the favorable effects of hydrocortisone were demonstrated on changes in neurological findings. In group A, there were significantly more cases of improvement at 4th day for orientation about place and person. At 1 month or on discharge group A showed significant improvement almost in every aspect of neurological findings including mental, speech and motor functions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Reconstruction of the venous outflow using a vein graft in dural arteriovenous malformation associated with sinus occlusion].

In some cases of dural arteriovenous malformations (dural AVMs) of the transverse-sigmoid sinuses, the presence of an occlusion or hypoplasia on the sinus contralateral to the affected side may significantly contribute to the development of intracranial hypertension. For these cases, closure of AV shunts or removal of the affected sinus may not be sufficient to improve intracranial hypertension. We encountered 2 cases of intracranial hypertension caused by dural AVMs at the transverse-sigmoid sinuses associated with disturbance of venous outflow contralateral to the lesion. Reconstruction of venous outflow using a saphenous vein graft was performed between the transverse sinus and the subclavian or external jugular vein after the dural AVMs were partially occluded by catheter embolization. Intracranial hypertension was relieved in both cases. In one case dural AVM was obstructed by both embolization and radical surgery after the bypass was confirmed unobstructed several weeks later. The bypass remained patent at the follow-up 4 months later. In the other case, patency of the bypass lasted only for approximately 1 month. In both cases clinical improvements were not remarkable. It is considered that the presence of AV shunt in the case of dural AVM may facilitate the patency of a graft placed between the venous systems. Reconstruction of the venous outflow may deserve further trial for the treatment of intracranial hypertension associated with some types of dural AVM.

Adult↗
PubMed1988

[Diagnosis of pituitary adenoma by dynamic CT scanning: concerning direct sign and indirect sign for diagnosis of pituitary microadenoma].

The advantage of high resolution CT in the diagnosis of pituitary microadenomas has been established, but the diagnosis becomes more difficult when the pituitary microadenoma is less than 5mm in diameter. We have studied the usefulness of dynamic CT scans particularly for diagnosis of small microadenomas. The dynamic CT scans were performed for 61 normal pituitary glands and 68 pituitary adenomas (36 microadenomas, 32 macroadenomas) with a GECT/T 9800 scanner. Coronal sections of 1.5mm thickness were taken at the plane just in front of the pituitary stalk of the pituitary gland. Following a bolus intra-venous injection of 40 - 60 ml of contrast media using an automatic injector, ten consecutive CT scans of 2 seconds scan time were obtained, beginning 2 seconds from the start of intravenous injection. The first seven scans were taken with an interval of 2.3 seconds, and the last three scans with an interval of 10 seconds. Then, time-density curves were obtained at the ROI which were set on the anterior pituitary gland, the vascular bed of the pituitary gland, the pituitary stalk and the area of the pituitary adenoma respectively. In a normal pituitary gland, the density increases gradually and makes an S shaped curve, then attains the maximum density value (92.3 CT number) approximately 60 seconds after the administration of contrast media. The pituitary vascular bed is located in midline on the upper surface of the pituitary gland, and shows a symmetrical square, triangular or rhomboid shape.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1988

[Use of a fenestrated aneurysm clip for transposition of the tortuous vertebral artery].

A 69-year-old female was admitted to our clinic on August 19, 1985 with a 5 year history of intermittent left facial pain. She had undergone various types of medical treatment and multiple procedures of nerve blocking which resulted in only a temporary relief of pain. On admission, the intermittent facial pain and hypesthesia were recognized in the 2nd and 3rd divisions of the left trigeminal nerve. CT scan with contrast enhancement showed a shift of the basilar artery to the left side. An elongated and tortuous vertebral artery was recognized at the left cerebello-pontine angle both by CT scan and vertebral angiograms. This tortuous vertebral artery compressed the trigeminal nerve entry zone causing neuralgia. Vascular decompression was carried out by inserting a muscle piece sandwiched in the lyodura between the artery and brain stem. Facial pain disappeared but recurred nine months after this operation. At the 2nd operation, the vertebral artery was passed through the fenestrated aneurysm clip and fixed on the petrous bone. With this procedure the vertebral artery was successfully transposed and the patient was discharged without any episodes of facial pain.

Aged↗
PubMed1988

[Cerebellar arteriovenous malformation presenting as trigeminal neuralgia].

A 44-year-old female had been suffering from left facial pain for six years. On admission, intermittent facial pain, hypesthesia and paresthesia were recognized in the 2nd division of the left trigeminal nerve. CT scan revealed an enhanced curvilinear mass on the left cerebellar hemisphere. The left vertebral angiogram demonstrated cerebellar arteriovenous malformation fed by the duplicated superior cerebellar arteries and drained into the inferior petrosal vein. The feeding arteries and the draining vein compressed the trigeminal nerve at its nerve entry zone. Removal of the nidus combined with neurovascular decompression of the trigeminal nerve resulted in complete relief of any facial pain.

Adult↗
PubMed1988

[A case of adenomatoid odontogenic tumor with intracranial extension].

A 49-year-old female of adenomatoid odontogenic tumor with intracranial extension was reported. She had 3 months history of left nasal obstruction and visual disturbance. Endocrinological examinations revealed a low basal level of serum cortisol and low level of urinary 17-OHCS. Neurological examinations revealed left anosmia and left visual disturbance (hand movement, marked afferent pupillary defect, and lower hemianopsia). Plain X-ray films and frontal tomograms of the skull showed a mass of soft tissue density in the left upper maxillary, left posterior ethmoid, and sphenoid sinuses with extensive destruction of the sella turcica, dorsum sellae, and anterior clinoid process. Plain axial CT scans demonstrated a low density mass filling up the left maxillary, left posterior ethmoid, and sphenoid sinuses and extending into the left middle fossa with bony destructions. Contrast-enhanced coronal CT scans demonstrated an extradural extension of the tumor into the left middle fossa and upward displacement of the pituitary complex. Left carotid angiograms showed a faint narrowing of the left internal carotid artery between the cisternal portion and the origin of the ophthalmic artery. Subtotal removal of the tumor and decompression of the optic canal and superior orbital fissure were performed via a left subtemporal extradural approach. Adenomatoid odontogenic tumor is a comparatively rare benign lesion which exhibits a slowly expansive growth without recurrence or metastasis after the surgical removal. No other case that recurred several times and extended into the intracranial space has been reported in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Neoplasms↗
PubMed1987

Immunohistochemical, electron microscopic and morphometric studies of estrogen-induced rat prolactinomas after bromocriptine treatment.

To clarify the effects of bromocriptine on prolactinoma cells in vivo, immunohistochemical, ultrastructural and morphometrical analyses were applied to estrogen-induced rat prolactinoma cells 1 h and 6 h after injection of bromocriptine (3 mg/kg of body weight). One h after treatment, serum prolactin levels decreased markedly. Electron microscopy disclosed many secretory granules, slightly distorted rough endoplasmic reticulum, and partially dilated Golgi cisternae in the prolactinoma cells. Morphometric analysis revealed that the volume density of secretory granules increased, while the volume density of cytoplasmic microtubules decreased. These findings suggest that lowered serum prolactin levels in the early phase of bromocriptine treatment may result from an impaired secretion of prolactin due to decreasing numbers of cytoplasmic microtubules. At 6 h after injection, serum prolactin levels were still considerably lower than in controls. The prolactinoma cells at this time were well granulated, with vesiculated rough endoplasmic reticulum and markedly dilated Golgi cisternae. Electron microscopical immunohistochemistry revealed positive reaction products noted on the secretory granules, Golgi cisternae, and endoplasmic reticulum of the untreated rat prolactinoma cells. However, only secretory granules showed the positive reaction products for prolactin 6 h after bromocriptine treatment of the adenoma cells. An increase in the volume density of secretory granules and a decrease in the volume densities of rough endoplasmic reticulum and microtubules was determined by morphometric analysis, suggesting that bromocriptine inhibits protein synthesis as well as bringing about a disturbance of the prolactin secretion.

Animals↗
PubMed1987

Changes in cerebral microvasculature in congenital hydrocephalus of the inbred rat LEW/Jms: light and electron microscopic examination.

The vascular apparatus in congenitally hydrocephalic rat brains was studied. The characteristic findings were structural changes in the small vessels with formation of an intracerebral cavity in the periventricular white matter. Stenotic or occluded blood vessels were located in an edematous area adjacent to the dilated lateral ventricles. Electron microscopically, the endothelial cells of capillaries and venules in the periventricular edematous region showed an irregular surface with indentations, and contained numerous plasmalemmal vesicles. Occluded capillaries were found in the border zone between the edematous and nonedematous area. These vascular changes indicate the presence of a disturbed microcirculation in the hydrocephalic brain.

Animals↗
PubMed1987

Immunohistochemical, electron microscopic, and morphometric studies of human prolactinomas after short-term bromocriptine treatment.

Two cases of human prolactinomas after short-term treatment with bromocriptine were studied by means of immunohistochemistry for prolactin, electron microscopy, and morphometry at the ultrastructural level. The results obtained showed an abundance of immunoreactive secretory granules in the tumor cells, a paucity in the electron microscopic images suggesting exocytosis of secretory granules, and no significant changes in the volume density of rough endoplasmic reticulum when compared with untreated (control) tumor cells. These findings strongly suggest that the effects of short-term bromocriptine treatment for lowering serum prolactin levels did not inhibit protein and secretory granule synthesis but rather caused a disturbance in the secretion of prolactin granules. The present morphometrical data suggest the possibility that a reduction in the number of cytoplasmic microtubules might be related to the disturbance of prolactin secretion.

Bromocriptine↗
PubMed1987

[Vascular compression neuropathy of the optic nerve by sclerotic internal carotid artery].

Although mechanical compression of the optic nerve by a dilated and/or tortuous sclerotic intracranial internal carotid artery is occasionally reported as an etiology for impairment of vision and visual field, early diagnosis of such condition has been hampered by the lack of characteristic neuro-ophthalmological and neuroradiological findings. The review of 35 previously reported cases (60 eyes) including ours showed that 41% out of the 34 operated eyes were improved neurologically by the decompressive procedure, while it was in 27% out of the 26 undecompressed or non-operated eyes. These unsatisfactory operative results are considered mainly due to the failure of early diagnosis. In order to investigate the relationship between the carotid artery and optic nerve, we proposed a method of angiographical projection consisting of the straight view along the long axis of the optic canal. By this projection, it is possible to detect a supero-medial enlargement and/or dislocation of the cisternal portion of the internal carotid artery. The addition of metrizamide CT cisternography which clarifies the relationship of the optic nerve, chiasm and internal carotid artery in the supersellar cistern may further provide an useful clue for the diagnosis of this condition.

Aged↗
PubMed1987

[Traumatic occlusion of the bilateral vertebral arteries associated with fracture of the cervical spine--a case report].

A case of traumatic occlusion of the bilateral vertebral arteries associated with fracture of the cervical spine is reported. A 34-year-old man, having no previously noted medical problems, fell to the bottom of a bathtub with a depth of 80 cm, and hit the vertex fronto-parietal region of his head. He was transferred to our hospital 6 hours after his fall with a crush fracture of the cervical spine at the C6 level. On admission he was alert, but having pain in the vertex region, dysarthria, blurred vision and hemiparesis. Roentgenograms confirmed a crush fracture of the C6 vertebral body. Computed tomograms of the brain revealed a high density of basilar artery. Cervical traction with a Halo brace was then carried out. Twelve hours after the trauma, left oculomotor and right facial palsy appeared followed by bilateral oculomotor palsy and respiratory difficulty. At the 14th hour, he displayed bilateral Babinski's signs and tetraparesis. Tetraparesis became complete with right-side Horner's syndrome at 16 hours. Cerebral arteriograms performed 20 hours after the trauma showed a complete occlusion of the right vertebral artery and an incomplete occlusion of the left vertebral artery at the C6-7 intervertebral disk space. Conscious level deteriorated to a 200 level on the Japan coma scale 28 hours after the trauma and to a 300 level after 32 hours. Computed tomograms revealed a marked low density on the cerebellum and brain stem 38 hours after the accident. He expired on the 22nd day after the trauma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Epithelioid cell-node induced by intracisternal injection of kaolin in rats].

We studied the origin of the epithelioid cells (macrophages) observed in the rat brain in response to the intracisternal injection of kaolin. The rats, two days of age, were used. The animals were killed after thirteen weeks following cisternal injection of kaolin. Massive epithelioid cell-nodes with multifocal necrosis were seen in the subarachnoid space of the cerebellum, in the cerebellar parenchyma and in the fourth ventricle. They were also present in the choroid plexus. The papillary epithelioid cell-nodes were observed onto the aqueduct of Sylvius, the third and lateral ventricles. These were associated with the proliferation of the adventitia of the blood vessel in the subependymal white matter. This suggested that the vascular adventitia played a role for a formation of the epithelioid cell-node in this case. The epithelioid cell was negative in silver-stained preparation. This indicated that microglia was not a source of the epithelioid cell. Reticulin fibers were moderately increased in the lesions. The epithelioid cells phagocytized kaolin granules and gave a strong PAS-positive reaction. However, it seemed that the PAS-positive materials were not identical to the kaolin granules. A rich accumulation of apparently extra- and intracellular kaolin deposits stained metachromatically violet with toluidine blue was seen in the necrotic areas. A large number of the degenerated cells containing kaolin deposits was found especially in the marginal zone of the necrotic areas. Granulation tissue with the amount of spindle-form cells and collagen fibers was also observed in the subarachnoid space. The granulation tissue was formed by hyperplasia of fibroblasts following the proliferation of the epithelioid cells and their necrotic processes.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Nizofenone administration in the acute stage following subarachnoid hemorrhage. Results of a multi-center controlled double-blind clinical study.

A multi-center controlled double-blind clinical study was carried out to evaluate the effects of nizofenone in patients with subarachnoid hemorrhage who were treated within 2 weeks of the ictus. The test drug was administered as an addition to conventional therapy, which was maintained during the study. Of 208 patients studied, 102 were treated with nizofenone and 106 with placebo. Treatment with nizofenone was significantly more effective (p less than 0.05) than that with placebo based on functional recovery and other clinical findings. Although no significant difference was found in mortality rate between the nizofenone- and placebo-treated groups, a higher percentage of survivors in the former group exhibited a good outcome (p less than 0.05). The effects of nizofenone administration were found to be especially notable in patients with delayed ischemic symptoms, moderately severe preoperative deficits (Hunt and Hess Grade II or III), and diffuse high-density areas in pre- and postoperative computerized tomography scans. No significant side effects were observed.

Adult↗
PubMed1986

[Aneurysm of the anterior inferior cerebellar artery at the internal auditory meatus: report of two cases].

Aneurysm of the vertebrobasilar system is not a rare lesion but constituting 5-10% of all intracranial aneurysms. Aneurysm at the peripheral part of the anterior inferior cerebellar artery (AICA), however, is rare and only 20 cases have been reported previously. In this report, two cases of aneurysm arising at the junction between the AICA and internal auditory artery and extending into the internal auditory meatus are reported. The first patient was a 51-year-old male who was admitted because of sudden onset of dizziness, rt. tinnitus and deafness. Left vertebral angiograms demonstrated an AVM in the rt. cerebellar hemisphere and two aneurysms on the feeding arteries, one on the superior cerebellar artery and the other on the meatal loop of the rt. AICA. Removal of the AVM and neck clipping of the aneurysms, which were found unruptured, were performed through the rt. suboccipital approach. The second patient was a 42-year-old female who was admitted because of sudden onset of severe headache and vomiting followed by rt. tinnitus, deafness and double vision. CT scan showed subarachnoid clot mainly located in the rt. cerebellopontine angle. Repeated vertebral angiograms revealed an aneurysm at the meatal loop of the rt. AICA. Complete neck clipping was carried out. The clinical features of the aneurysms of this location can be divided into three subgroups according to the characters of onset: sudden onset with subarachnoid hemorrhage, insidious onset of the VII th, VIII th, nerve palsies by the mass effect of the aneurysm, intermittent episodes of the VIII th nerve disfunction due to the insufficiency of the internal auditory artery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Pituitary abscess: report of two cases and a review].

Two cases of pituitary abscesses are reported. The first case was a 22-year-old female who was admitted with 14 months history of intermittent fever and headache followed by amenorrhea and polyuria. Plain craniograms showed no remarkable changes on the sella turcica. Direct coronal CT demonstrated a cystic lesion with a ring-like enhanced capsule in the pituitary complex with the apparent bulging of the pituitary top surface. On dynamic CT, the cystic lesion showed no remarkable increase in density. Transsphenoidal surgery was performed and a purulent materials was drained by cutting the underlying fibrous pituitary tissue. Pathological specimen revealed a marked inflammatory reaction around the degenerative pituitary gland. The second case was a 27-year-old female who underwent transsphenoidal excision of craniopharyngioma on May 12, 1983. Postoperatively she did well with the hormonal replacement therapy until 9 months after surgery when a follow up direct coronal CT revealed a cystic lesion with ring-like enhancement in the pituitary fossa. Purulent material was found at transsphenoidal surgery. Pathological specimen from the hard capsule was a chronic inflammatory fibrous tissue without tumorous component. Over seventy cases of pituitary abscesses have been reported previously, but the majority of them were secondary infections associated with systemic sepsis, chronic sphenoid sinusitis or pituitary tumors. Primary pituitary abscesses were rare and would be difficult to be diagnosed preoperatively without an aid of recent CT technology. Thirty cases in the literature since 1970 are reviewed and its clinical pictures and radiological findings are discussed.

Abscess↗
PubMed1986

[A case of pineal teratoma with intraventricular free fat seen in CT scan].

Detection of an intraventricular or intratumoral fat-fluid level on the plain craniograms has been known as a characteristic sign indicating the presence of intracranial teratomatous tumors. On CT scans, however, only thirteen cases have been previously reported to be found an intraventricular and/or subarachnoid free fat associated with spontaneous ruptures of these tumors. We reported a case of pineal teratoma with intraventricular free-fat seen on CT scans. A nine-year-old male with precocious puberty was admitted to our hospital complaining a moderate nonpulsatile headache. Neurological examinations were normal without signs of meningeal irritation. The serum and CSF titer of HCG were raised markedly. The laboratory data of the CSF were normal and there were no pathological cells in the CSF. The CT scans revealed a large heterogeneous mass containing multiple areas of negative density in the pineal region. There were negative density droplets in the bilateral frontal horn on the same CT scans indicating a presence of free fats. At surgery, an yellowish oily material was drained from the tumor, but there was no sign of meningitis over the cortical surface of the occipital lobe. An intraventricular free fat on CT scan have been reported in fourteen cases including ours following the first case described by Fawcitt in 1976. Although most of the cases presented headache, only two cases was diagnosed clinically as chemical meningitis. Pathological changes indicating granulomatous meningitis, however, were noted in five cases, all of them presenting seizure attacks.

Brain Neoplasms↗
PubMed1986

[Characteristics of brain tissue damage in kaolin-induced infantile rat hydrocephalus].

Experimental hydrocephalus was induced by an intracisternal injection of 4% or 40% kaolin suspension in 2 days old Wistar rats. They were examined histologically and microangiographically 2 weeks after the injection of kaolin. Hydrocephalic rats were classified into 2 groups, severe hydrocephalic group A and mild hydrocephalic group B. In group A, a marked enlargement of the entire ventricular system with a thinning of the cerebral mantle was observed. On the other hand, the dilatation of the fourth ventricle was more pronounced compared with the other ventricles in group B. In group A, a spongy appearance of brain tissue was observed in the periventricular white matter accompanied with an intracerebral cavity. In these edematous areas, the lack of carbon black perfusion was apparent indicating an occurrence of microcirculatory disturbances. These microcirculatory disturbances and mechanical compression to the cerebral parenchyma may produce defective brain tissue (intracerebral cavity formation). The ependymal cell walls and subependymal glial cell layers were well preserved in spite of the damaged periventricular white matter. In group A, kaolin was present in the fourth ventricle and Sylvian aqueduct. Subependymal gliosis containing macrophages and newly produced blood vessels were observed in the region between the periventricular brain tissue and kaolin granules. These findings indicate that kaolin may produce changes in the ependymal cell and cerebral parenchyma as well as fibrosis and meningitis in the subarachnoid space.

Animals↗