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Biomedical subjects

K Hida

Publications and source records attributed to K Hida.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Clinical study of intraspinal neoplasms in children].

The authors report a series of 10 children under 15 years of age with primary intraspinal neoplasm who underwent surgical resection from 1981 to 1994. The tumors consisted of 4 intramedullary tumors (myxopapillary ependymoma, pilocytic astrocytoma, subpial liporna, cavernous angioma), 2 intradural extramedullary tumors (2 neurinomas), and 4 extradural tumors (ganglioneuroma, chordoma, osteochondroma, rhabdomyosarcoma). The initial symptoms in these patients were gait disturbance (50%), weakness of lower extremities (50%), pain (40%), weakness of upper extremities (10%), and tetraparesis (10%). The neurological findings on admission in these patients revealed motor paresis (90%), sensory disturbance (60%), abnormality of deep tendon reflex (60%), pathological reflex (30%), neurogenic bladder (30%), and Lasegue's sign (10%). All patients were treated surgically; laminectoy was performed in 8 patients, laminoplasty in one patient, and transoral approach in one patient. Five patients (50%) underwent a grossly total resection, 3 (30%) had a subtotal resection, and 2 (20%) had a partial resection. Mean follow-up period was 5.6 years. One (10%) patient died due to recurrence and dissemination of the tumor at eight months after surgery in a case of rhabdomyosarcoma. 9 (90%) have had no recurrent tumor and have improved neurologically. In 4 patients (40%) spinal deformity developed, and 2 patients required operative treatment for the spinal deformity. We emphasized the advantage of laminoplasty to prevent postoperative spinal deformity in children.

Adolescent↗
PubMed1996

Correlated expression of matrix metalloproteinases and ets family transcription factor E1A-F in invasive oral squamous-cell-carcinoma-derived cell lines.

Matrix metalloproteinases (MMPs) have been implicated in invasion and metastasis of tumor cells. Transcription regulatory regions of MMP genes often contain binding sites for ets transcription factors. We recently isolated a cDNA encoding human E1A-F, a member of the ets oncogene family, and showed that E1A-F can upregulate MMP genes by CAT assay. We attempted to investigate the relationship between E1A-F mRNA expression and MMP protein expression in four different types of oral squamous-cell-carcinoma-derived cell lines (HSC 3, SAS, KB, and Ca 9.22). HSC 3 and SAS are highly invasive cell lines when they are injected in the tongue of nude mice. Raft culture of HSC 3 and SAS revealed the same characteristics as seen in tumors implanted in vivo. Both type I collagenase (MMP-1) and 92-kd type IV collagenase (MMP-9) were detected in cultured HSC 3 and SAS cells. E1A-F mRNA was demonstrated to be highly expressed in HSC 3 and SAS by Northern blotting, and in situ hybridization confirmed E1A-F mRNA expression at the invasion front of tumor cells seeded on collagen gel. On the other hand, KB and Ca 9.22 have little potential for invasion, and MMP-1 and MMP-9 protein and E1A-F mRNA could not be detected. These results suggest that the ets-related E1A-F participates in the regulation of invasion-associated MMP genes and is involved in presenting invasive activity in tumor cells of oral squamous cell carcinoma.

Blotting, Northern↗
PubMed1996

[A case of spinal epidermoid caused by lumbar punctures].

A case of spinal epidermoid caused by lumbar punctures is reported. The 50-year-old man, who had been diagnosed as having poliomyelitis and who had been treated with lumbar puncture 24 times when he was 1 year old, came to our clinic complaining of gradual worsening of atrophy and weakness in his right leg during the last 10 years. Neuroradiologically, intraspinal tumor with calcification was detected in the lumbar region and partial removal of the tumor was performed. Pathological diagnosis was that it was epidermoid. During frequent lumbar puncture at the age of 1, some small skin grafts had been implanted intrathecally and we concluded that, changing its original nature, it had grown slowly to become epidermoid. We want to emphasize especially here that, when we performe lumbar puncture, we should, as far as possible, use a small needle with stilette so as not to induce future spinal epidermoid.

Epidermal Cyst↗
PubMed1995

The role of radiotherapy in the management of spinal cord glioma.

PURPOSE: To determine the role of radiotherapy in the management of spinal cord gliomas. METHODS AND MATERIALS: Thirty-six patients with spinal cord glioma treated between 1979 and 1993 were examined. The patients had 13 astrocytic tumors (7 astrocytomas, 4 anaplastic astrocytomas, 2 glioblastomas), 22 ependymal tumors (18 ependymomas, 4 myxopapillary ependymomas), and 1 unclassified glioma. Fifteen of the patients were treated by surgery alone, but the remaining 21 patients also received postoperative radiotherapy. Total resection was performed on 1 astrocytoma and 13 ependymomas. In general, 40-50 Gy/16-20 fractions/4-5 weeks were given after parital resection, but no radiotherapy was given after total resection. RESULTS: Actuarial survival was significantly better for patients with ependymal tumors than for those with astrocytic tumors (p = 0007), 5-year actuarial survival rates being 96% and 50% for patients with ependymal tumors and astrocytic tumors, respectively. For patients with ependymal tumors, there was no difference in motor function and survival between those with total resection and those with partial resection followed by radiotherapy. Actuarial 3-year survival was 80% for patients with astrocytomas and 40% for those with anaplastic astrocytomas plus glioblastomas. The difference in the degree of motor function between the patients treated with radiotherapy and those without radiotherapy was not statistically significant. One anaplastic astrocytoma and one glioblastoma patient have lived longer than 4 years after radical treatment including radiocordectomy, or irradiation using doses larger than the tolerance threshold of the spinal cord. CONCLUSION: Postoperative conventional radiotherapy is indicated after less than total resection of low-grade ependymal tumors and astrocytomas but not after total resection of ependymomas. Radiocordectomy may be an option for certain cases with high-grade astrocytic tumors.

Adolescent↗
PubMed1995

Benefits of arterial reconstruction in claudication.

We conducted a midterm follow-up of 150 claudicants who underwent surgical reconstruction by assessing cumulative patency, survival, and palliation (graft patency in live patients) rates. Eighty-nine claudicants (group I) underwent direct (in situ) proximal revascularization, 33 (group II) had indirect (ex situ) proximal revascularization, while 28 (group III) had distal revascularization. The secondary patency rates at 3 years were 97.5% in group I, 97.0% in group II, and 75.0% in group III, respectively. Only one patient with limb graft thrombosis required below-knee amputation. There were 3 perioperative deaths (2 in group I and 1 in group II). The survival rates at 3 years were 86.0% in group I, 69.5% in group II, and 95.8% in group III, respectively. The palliation rates at 3 years were 84.8% in group I, 70.0% in group II, and 77.9% in group III, respectively. These findings indicate the midterm benefits of supra- and infrainguinal arterial reconstructions, and also suggest that the preoperative assessment of risks in individual patients, the selection of the appropriate operative procedure and graft material, and intensive postoperative follow-up and management of any associated disease are all important aspects in the treatment of claudicants.

Aged↗
PubMed1995

Surgical indication and results of foramen magnum decompression versus syringosubarachnoid shunting for syringomyelia associated with Chiari I malformation.

Several surgical procedures have been used for the treatment of syringomyelia associated with Chiari I malformation at our institute. The purpose of this article is to evaluate the results of two major surgical procedures, foramen magnum decompression (FMD) and syringosubarachnoid (SS) shunting. The series consisted of 70 patients with syringomyelia associated with Chiari I malformation who were surgically treated. Their ages ranged from 3 to 59 years (median, 29.4 yr). FMD was performed on 33 patients, and SS shunting was performed on 37 patients. The follow-up period ranged from 6 months to 12.5 years, with a mean of 60 months. The clinical and radiological outcomes were analyzed comparing the two groups. We principally performed FMD in patients with symptoms of Chiari I malformation and/or a small syrinx. We prefer to use SS shunting in patients with large syringes. Postoperative magnetic resonance imaging demonstrated that the syrinx had collapsed or decreased in size in 94% of the patients who underwent FMD and in 100% of the patients who underwent SS shunting. Neurological improvements were observed in 82% and in 97% of the patients who underwent FMD and SS shunting, respectively. In particular, the relief of pain was more fully achieved after SS shunting than after FMD. The average time for the syrinx to collapse was 6.3 weeks after surgery in the FMD group and 1.8 weeks in the SS shunting group. These results indicate that clinical symptoms and radiological findings improved much more quickly in the SS shunting group than in the FMD group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Serial changes in metabolism and histology in the cold-injury trauma rat brain model--proton magnetic resonance imaging and spectroscopy study.

The serial changes in metabolism and histology during the first 24 hours in the cold-injury trauma rat brain model were investigated by proton magnetic resonance (MR) imaging and high-resolution proton MR spectroscopy. Edema developed extensively via the corpus callosum in the ipsi- and contralateral hemispheres during observation as shown by gradually increased signal intensity on proton MR images. Proton MR spectroscopy showed increased levels of acetate (Ace), lactate (Lac), and glutamine (Glmi) 1 hour after lesion formation. The elevated Glmi level slightly decreased, the level of alanine (Ala) increased substantially, and that of N-acetyl-aspartate (NAA) decreased markedly after 24 hours. Increased Lac, Ace, and Ala might reflect anaerobic glycolysis associated with mitochondrial dysfunction, while decreased Glmi and NAA reveal brain tissue breakdown. The relationship between brain edema and tissue viability can be analyzed in detail using this simple traumatic model and MR techniques which will be useful in the development of therapeutic agents for brain injury.

Acetates↗
PubMed1995

Intraoperative spinal sonography in the cervical anterior approach.

Intraoperative spinal sonography was used during cervical anterior approach procedures for cervical discectomy and osteophytectomy to demonstrate spinal pulsation, the protruded disc or osteophyte, the anterior subarachnoid space, and the spinal cord. Spinal pulsation was recognized in some cases before removal of the disc but the anterior subarachnoid space and spinal cord could not be observed. However, the latter were more clearly observed during removal of the disc and could be seen after total removal of the disc and osteophyte. This method allows confirmation of decompression and pulsation of the spinal cord without cutting and removal of the posterior longitudinal ligament.

Adult↗
PubMed1995

[Surgical treatment for syringomyelia associated with Chiari malformation].

Two major surgical procedures, i.e., foramen magnum decompression (FMD) and syringo-subarachnoid shunt (S-S shunt) have been performed as the treatment for syringomyelia with Chiari malformation in our department. FMD was done principally in patients with symptoms due to Chiari malformation and for small size or localized syrinx, and S-S shunt was applied to patients with main symptoms due to syringomyelia, especially with local pain and for large syrinx in size. Eighty patients of syringomyelia with Chiari malformation were surgically treated. FMD was performed in 38 patients, and S-S shunt in 39 patients as the first operation. FMD were done with craniectomy of posterior fossa, C1 laminectomy and resection of epidural band, but without opening dura, and S-S shunt were done with hemipartial laminectomy and DREZtomy. The clinical outcome was evaluated, comparing the two major surgical procedures. Satisfactory neurological improvement was obtained in the two groups, but S-S shunt group took better improvement than FMD group. These results suggest that both procedures are effective, but should be selected by preoperative clinical and radiological findings.

Adolescent↗
PubMed1994

Localized proton spectroscopy of focal brain pathology in humans: significant effects of edema on spin-spin relaxation time.

Localized proton nuclear magnetic resonance (NMR) spectroscopy of human brain in two common focal pathologies producing brain edema (peritumor edema and acute edematous ischemic stroke) was performed utilizing point resolved spectroscopy (PRESS). The spectra obtained from the pathological tissues were characterized by a reduced N-acetyl-aspartate (NAA) to total creatine (Cr) ratio (NAA/Cr) and high level of lactate. While the spin lattice relaxation time (T1) of the main metabolite resonances, namely, those of NAA, Cr, and choline containing compounds (Cho), showed values similar to those of normal brain, the spin-spin relaxation time (T2) of these metabolites exhibited a dramatic shortening in pathological tissues. Serial postoperative measurements of T2 in two patients with peritumor edema showed a gradual recovery of the T2 shortening corresponding to improvement of the edema. The majority of localized spectroscopy studies in humans is performed using a sequence which utilizes spin echo signals with a fixed single echo time. Hence, the signal intensities of the metabolite resonances obtained are inherently T2 dependent. The current study underscores that cautious interpretation of clinical data with respect to metabolite quantification is warranted.

Adult↗
PubMed1994

Gliomas of the conus medullaris.

Six patients with histologically verified gliomas of the conus medullaris (two astrocytomas, two ependymomas, two myxopapillary ependymomas) were diagnosed and studied. There were four men and two women ranging in age from 23 to 47 years. Predominant initial symptoms were back pain (four cases) and leg weakness (two cases). The most common findings on admission were flaccid paparesis with impaired sensation and bladder dysfunction. Postoperative MR images with more than 95% removal of a tumour were defined as 'subtotal removal' (noted in two of six cases), and less than 95% as 'partial removal' (four of six cases). All patients had postoperative radiotherapy, and the two patients with an astrocytoma underwent chemotherapy. During the follow up period ranging from 2 to 7 years, there was no tumour recurrence or regrowth on MR images except in a patient with a malignant astrocytoma, who indeed died from intracranial dissemination 2 years after surgery. Adjuvant therapy following the excision of a spinal glioma is also discussed.

Adult↗
PubMed1994

Birth injury as a causative factor of syringomyelia with Chiari type I deformity.

The epidemiology of syringomyelia with Chiari type I deformity was investigated with particular reference to perinatal problems. All subjects in our study were born by vaginal delivery and had a high incidence of perinatal accidents (abnormal presentations, birth injuries, and neonatal asphyxia). This study suggests that these may be strong causative factors for syringomyelia associated with Chiari type I deformity.

Adolescent↗
PubMed1994

Posttraumatic syringomyelia: its characteristic magnetic resonance imaging findings and surgical management.

Posttraumatic syringomyelia should be considered in any patient showing a delayed neurological deterioration after spinal cord injury. The purpose of this article is to assess the posttraumatic syringomyelia on magnetic resonance images and to evaluate the results of its surgical treatment. Fourteen patients with posttraumatic syringomyelia were studied. There were 10 men and 4 women ranging in age from 25 to 67 years. Eleven patients with syringomyelia were symptomatic, and the three others were asymptomatic. The periods from spinal cord injury to onset of symptoms due to syringomyelia ranged from 3 to 33 years with a mean of 14 years. On magnetic resonance images, the mean length of the syrinx was 14 vertebral levels and ranged from 3 to 20 levels. At the rostral part of the injured cord, the syrinx was located off center. In contrast, at the caudal part of the injury, the syrinx was markedly large in size and its location was central. In 6 of 13 patients, the syringes extended into the medulla oblongata. Eleven symptomatic patients underwent surgical treatments: a syringosubarachnoid shunt was done in six patients, a syringoperitoneal shunt was done in four, and a ventriculoperitoneal shunt was carried out in one. Shunt malfunction was encountered in three of the four syringoperitoneal shunts and in the one ventriculoperitoneal shunt. Final neurological outcomes were satisfactory in all 11 patients who underwent surgery. Motor function improved in eight of nine patients, sensory disturbance improved in five of five patients, and relief of local pain or numbness was obtained in four of four patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Experimental model of posttraumatic syringomyelia: the role of adhesive arachnoiditis in syrinx formation.

An experimental model was devised to elucidate the role of spinal blockade in posttraumatic syringomyelia. Thirty-eight Japanese White rabbits, each weighing about 3 kg, were used in this study. The animals were divided into four groups: in Group 1, eight animals received traumatic injury only; in Group 2, 12 animals received traumatic injury following injection of 100 mg kaolin suspended in 1 cc normal saline solution into the subarachnoid space at the site of trauma; in Group 3, nine animals received traumatic injury following injection of 200 mg kaolin in 1 cc normal saline solution into the subarachnoid space at the site of trauma; and in Group 4, nine animals without traumatic injury received an injection of 200 mg kaolin in 1 cc normal saline solution into the subarachnoid space. The subjective criteria for syrinx formation were the presence of a definite round cyst having a smooth margin and an upper or lower extension of more than 2 cm from the injured site. Syrinx formation was seen in 12.5% (one of eight rabbits) in Group 1, 41.7% (five of 12 animals) in Group 2, 55.5% (five of nine rabbits) in Group 3 and 0% (none of nine animals) in Group 4 (p < 0.05). There was a tendency for the combined trauma/kaolin injection groups to be more prone to develop a syrinx. In the kaolin injection only group (Group 4), no animal showed a definite cyst or an extending cavity during the experimental period. The results suggest that kaolin enhances the extension of multiple small cavities that have already formed at the time of initial injury. The difference between the frequency of syrinx formation and the time of survival was statistically significant well beyond the 0.05% level. The overall difference, relating to the frequency of syrinx development, group, and duration of survival, was also statistically significant. In summary, subarachnoid block secondary to adhesive arachnoiditis is important in initiating the extension of the syringomyelia cavity.

Animals↗
PubMed1994

[CSF dynamics in the patients with syringomyelia associated with Chiari's malformation--quantitative analysis on cine MRI].

In a series of 12 patients with syringomyelia associated with Chiari's malformation, the authors quantitatively analyzed cerebrospinal fluid (CSF) dynamics in the subarachnoid space of the craniospinal junction, using cine MRI combined with pre-saturation method. In most of subjects, cine MRI revealed (1) decreased or increased maximum velocity of CSF in the caudal direction and (2) disturbed CSF motion in the caudal direction (delayed % cardiac cycle) in the craniospinal junction, strongly suggesting disturbed CSF dynamics in the craniospinal junction because of the tonsilar herniation. Of 12 subjects, 8 patients underwent foramen magnum decompression and 4 underwent syringo-subarachnoid shunt (SS shunt). In the patients who showed marked collapse of syrinx after foramen magnum decompression, follow-up cine MRI revealed the normalization of % cardiac cycle, representing postoperative improvement of CSF dynamics in the craniospinal junction. On the other hand, % cardiac cycle did not improve significantly in the patients who did not show marked collapse of the syrinx or suffered from meningitis after surgery. Significant changes were not observed in the patients who underwent SS shunt. In summary, these results suggested that cine MRI combined with pre-saturation method could detect the pathophysiological changes and evaluate the efficacy of the surgery, especially foramen magnum decompression, in the patients with syringomyelia associated with Chiari's malformation.

Adolescent↗
PubMed1993

Intramedullary disseminated capillary hemangioma with localized spinal cord swelling: case report.

A case of intramedullary disseminated capillary hemangioma in the cervical spinal cord is presented. The patient showed progressive neurological deficits. Magnetic resonance imaging showed localized swelling of the spinal cord. This case was initially misdiagnosed at another institution as syringomyelia. Decompression of the posterior fossa and a syringo-subarachnoid shunt operation were performed. However, the operative findings in the authors' institution showed edematous tissue with no apparent neoplastic characteristics. Pathological findings revealed angiomatous nests consisting of small capillary-like vessels, telangiectatic vessels, and aggregated venules scattered in the edematous and partially necrotic spinal cord tissue. The edema and necrosis of the cervical cord were considered to have been caused by circulatory disturbances in the spinal cord parenchyma resulting from these vascular lesions.

Diagnostic Errors↗