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Biomedical subjects

K Kitami

Publications and source records attributed to K Kitami.

At least 37 records · Page 2Linked to original sources
PubMed1990

Holoprosencephaly with Dandy-Walker cyst. Rare coexistence of two major malformations.

A case of holoprosencephaly associated with Dandy-Walker cyst is reported. The patient was a male baby whose mother had normal serum titers for toxoplasma, syphilis, rubella and hepatitis B. She had no history of diabetes mellitus, administration of drugs or irradiation during the pregnancy. At the 8th month of gestation, fetal hydrocephalus was diagnosed by ultrasonic imaging. He was delivered by caesarean section at 34 weeks and 4 days, weighing 2,644 g. His head circumference was 42 cm; the anterior fontanel was not distended and its tension was normal. The chromosomal karyotype was a normal 46 XY. X-ray CT showed a large dorsal sac cyst in the supratentorial space and a hypoplastic cerebellum with a large cyst in the posterior fossa. He received a cyst-peritoneal shunt 24 days after birth. After this procedure, his head enlargement was arrested. We discuss the etiology of this rare coexistence of two major malformations.

Abnormalities, Multiple↗
PubMed1990

A case of intraventricular arachnoid cyst. How should it be treated?

A rare case of arachnoid cyst in the trigone of a lateral ventricle is reported. The patient was an 8-year-old boy who had had four episodes of convulsions prior to admission. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a cystic lesion containing fluid resembling cerebrospinal fluid. Although he received a cyst-peritoneal shunt, the lesion did not decrease in size. Direct removal of the cyst was then scheduled. The entire cyst was finally removed, although it was firmly attached to the choroid plexus. The enlarged trigone gradually decreased in postoperative CT. The effectiveness of a cyst-peritoneal shunt is not always satisfactory. We recommend total resection of the cyst without use of a shunt system.

Arachnoid Cysts↗
PubMed1990

New method of MVD using a vascular tape for neurovascular compression involving the vertebrobasilar artery--report of two cases.

In the treatment of hemifacial spasm and trigeminal neuralgia by microvascular decompression (MVD), lack of improvement or recurrence may occur because of the difficulties in positioning prostheses and the involvement of the large vertebrobasilar arteries, even with use of fenestrated aneurysm clips or adhesives. We have developed a new method of MVD, in which a vascular tape is anchored to the dura mater to transpose the responsible large artery. This method achieved successful results in our two patients with nerve compression involving the vertebrobasilar arteries.

Aged↗
PubMed1990

[Paratesticular rhabdomyosarcoma: a case report].

A thirteen-year-old boy noted a swelling in his right scrotum one year prior to admission. On August 7, right high orchiectomy was performed. The tumor mass measured 10 x 6 x 7 cm. Microscopic examination revealed alveolar type rhabdomyosarcoma. Lymphangiography and computed tomography revealed retroperitoneal lymph node metastasis. He was treated with VAC therapy (vincristine, actinomycin D, cyclophosphamide) and VAD therapy (vincristine, adriamycin). This drug combination was effective, and he has been followed for two years with no evidence of recurrence.

Adolescent↗
PubMed1990

[A case of 2,8-dihydroxyadenine stone with a partial deficiency of adenine phosphoribosyltransferase].

A 37-year old female was admitted with a complaint of gross hematuria. Intravenous pyelography and retrograde pyelography showed right non-functioning kidney with a radiolucent stone in the ureter. Computerized tomographic scan revealed right hydronephrosis and ureteral stone. Ureterolithotomy was performed. Infrared spectrometric analysis of the stone revealed a 2,8-dihydroxyadenine calculus. The adenine phosphoribosyltransferase activity in red blood cells was partially deficient. After the operation the patient has been given 100 mg/day of allopurinol and is on a low purine diet. There have been no signs of recurrence.

Adenine↗
PubMed1989

Hemorrhage into fibrous dysplasia following minor head injury--effective decompression for the ophthalmic artery and optic nerve.

We performed an effective optic canal decompression in a patient with ethmoid and sphenoid fibrous dysplasia and visual impairment following minor head trauma. On admission, the patient's left visual acuity consisted only of light perception, and the left ophthalmic artery was not visible by angiography. A hematoma and fibrous dysplasia tissue in the sphenoid sinus were excised and the left optic canal was decompressed. The vision was markedly improved to an ability to count fingers in the following 2 weeks. The left ophthalmic artery was fully opacified in the postoperative angiogram.

Arterial Occlusive Diseases↗
PubMed1989

[Multiple ureteral diverticula: a case report].

A 73-year-old male was admitted to our hospital with the complaint of difficulty and frequency of urination. Needle biopsy of the prostate was done and microscopic examination revealed adenocarcinoma. Bone scintigram showed multiple bone metastasis and he was diagnosed as having prostatic carcinoma stage D2. Intravenous pyelography revealed multiple out-pouching lesion of mid left ureter and left mild hydronephrosis. Fosfestrol was given for prostatic carcinoma and no treatment was given for multiple ureteral diverticula. Sixteen cases of multiple ureteral diverticula from Japan were collected and discussed.

Adenocarcinoma↗
PubMed1989

[A case of cystitis cystica and glandularis suspected of submucosal tumor of urinary bladder].

A case of cystitis cystica and glandularis is reported. The patient visited our hospital with the complaint of terminal miction pain. Cystoscopic examination showed a walnut-sized, well-defined mass in the retrotrigone. The surface of the mass was nodular and partially cystic. Computer tomography showed a mass protruding inside and outside of the bladder. Transurethral biopsies of the mass revealed cystitis cystica and glandularis.

Adult↗
PubMed1989

[Psychogenic urinary retention: report of two cases].

Case 1 was a 24-year-old woman, with a broken heart who complained of urinary retention. Cystometry revealed a hypoactive bladder without detrusor contraction. Case 2 was a 30-year-old man, who thought that he had renal failure. Urodynamic study showed hypoactive bladder without detrusor contraction. External sphincter electromyograph revealed no evidense of detrusor sphincter dyssynergia. These 2 cases were treated by psychotherapy, administration of diazepam and bethanechole, and intermittent self catheterization. The Japanese literature on the psychogenic urinary retention is briefly discussed.

Adult↗
PubMed1989

[A case of retrocaval ureter in childhood].

We report a case of retrocaval ureter in a 14-year-old boy with the complaint of right flank pain. Intravenous pyelography and drip infusion pyelography showed right hydronephrosis and "inverted J" shaped ureter. A retrograde pyelography with venocavography revealed a typical retrocaval ureter, but abdominal CT scan did not show the "retrocaval segment". Ureterouretero-reanastomosis was performed and hydronephrosis was markedly improved. We analyzed 20 cases of retrocaval ureter in childhood.

Adolescent↗
PubMed1988

[Emergency embolectomy in embolic occlusion of the middle cerebral artery].

UNLABELLED: The natural course of embolic occlusion of the middle cerebral artery (MCA) has many variations, which include the frequent appearance of hemorrhagic infarction. There are also fatal cases among which severe ischemic edema is found. There haven's been many cases reported of MCA embolectomy in the acute stage, and findings concerning them have been very complicated and hard to analyze. Nevertheless there certainly exist cases where remarkable improvement of neurological signs is shown soon after the procedure. Five cases of emergency embolectomy have been undergone in our hospital in the past 2 years. The results were better than results obtained in cases where embolectomy was not performed. Three male and two female cases are the objectives, whose average age was 61 +/- 6 years (ranging from 54 to 67 years). The left side of the MC was involved in three cases and the right in two, and all cases had past history of heart diseases which may have been the embolic source. Each case had undergone CT scan soon after admission to make sure not to be the other type of intracranial lesion. Cerebral angiography was performed next, to discover the site of the occlusion and the degree of collateral circulation. Emergency embolectomy was performed as soon as possible in every case. The functional outcome was estimated from the ADL three months later using the international fifth degree grading. RESULTS: The period from onset to recanalization ranges between 4.5 to 11 hours (average 6.9 +/- 2.5 hours). Good MC recanalization was demonstrated in each case angiographically within a week after the operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

[The influence and outcome of acute infantile intracranial hematoma with hypoxemia].

Unusually broad areas of cerebral infarction were demonstrated by CT scan in three head injured infants with acute intracranial hematoma. They revealed very characteristic CT findings including contralateral hemispheric ischemic zone. Case 1 is a 5-month-old boy who had hit his head 4 days before. On admission he was semicomatose and his respiration had suffered from generalized seizures with arterial PO2 value of 43 mmHg. CT scan revealed right subdural hematoma, and bihemispheric ischemic low density was also demonstrable. Hematoma clot weighing 10 grams was removed through emergency craniotomy, followed by external decompression. There was a marked atrophic change in the right cerebral hemisphere and contralateral frontal base during the following few months, but the basal ganglionic region, brainstem and cerebellum were hardly affected. The patient developed comparatively well mentally for the next one and a half years. Case 2 was a 2-year-old boy who had a previous history of moderate head trauma 8 hours before admission. After a lucid interval, sudden epileptic attacks hospitalized him in a condition of cardiopulmonary arrest. CT scan revealed severe epidural hematoma on the patient's right cerebrum. Emergency craniotomy was performed and hematoma 95 g in weight was removed followed by decompression. Postoperative CT showed broad ipsilateral ischemic edema including the contralateral cerebral hemisphere and brainstem. One and a half years later, the patient shows decorticated posture with ataxic respiration and negative light reflexes. Case 3 was an 8-month-old boy who had fallen down and hit his head on the floor. Status epilepticus had attacked him, causing him to be admitted in a dyspneic state.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1988

[Non-clostridial gas-producing brain abscess in a brain death patient--report of a case].

A 46 year old female was admitted to our emergency room because of cardiopulmonary arrest by hanging. After ten minutes cardiopulmonary resuscitation, she was resuscitated but her consciousness did'nt recover. CT-scans on the day of admission showed no abnormalities but on the second hospital day it showed symmetrical low density areas within the basal ganglia, the thalamus, the hippocampus, and the occipital lobe. There were marked enhanced effect in cerebral sulci due to cytotoxic edema of hypoxic encephalopathy. She was comatose for a week, her pupils were dilated, light reflex and other brain stem reflex were absent. CT-scans on the sixth hospital day showed marked brain swelling with disappearance of the ventricular systems (so called brain tamponade). Brain death was confirmed on the basis of Japanese Criteria on the seventh and tenth day of admission. She had been suffering from pneumonia and urinary tract infection with an elevation of temperature since the fourth hospital day. We detected Enterobacter Cloacae (E. Cloacae), Klebsiella Oxytoca from the cultures of sputum and urine. On the tenth hospital day her temperature was running up to 39.4 degrees C and blood count revealed a peripheral blood leucocytosis of 40,300/mm3 with a shift to the left. E. Cloacae was also detected from the cultures of blood. Skull roentgenogram showed multiple gas collections in the ventricular systems. CT-scans on the fourteenth hospital day showed multiple gas-containing brain abscess. The etiology of this infection was considered due to septicemia of E. Cloacae. She died from acute renal failure on the fifteenth hospital day. Consent for autopsy was not accepted.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Abscess↗
PubMed1987

[Carcinoma of the urachus with variable pathological findings: report of a case and review of literature].

A 71-year-old man was admitted with the chief complaint of gross hematuria. Cystoscopic examination showed a broadbased papillary tumor at the apex of the bladder. There was edema of the mucous membrane around the tumor. CT-scan demonstrated a mass extending from the bladder dome superiorly. Partial resection of the bladder was done. Pathological examination revealed grade 3 transitional cell carcinoma, with scattered adenocarcinoma and squamous cell carcinoma foci. Chemotherapy with bleomycin (BLM) and cis-dichlorodiamine platinum (CDDP) was done postoperatively. Ten months after the operation, he was readmitted because of recurrence in retroperitoneal lymph nodes. Chemotherapy with BLM and CDDP was done, but he died of pulmonary complications. Autopsy revealed retroperitoneal lymph node metastasis of transitional cell carcinoma. There was no metastasis to any other organ. We briefly discuss 275 cases of the carcinoma of the urachus collected from the Japanese literature.

Adenocarcinoma↗
PubMed1987

[Metastatic renal tumor originating from esophageal carcinoma: a case report].

A 61-year-old male, who had undergone operation of esophageal carcinoma 11 months earlier, was admitted for left flank pain and high fever. Intravenous pyelography showed a space occupying lesion in the upper half of the left kidney. Computed tomographic scan showed an irregular low density area in the upper half of the left kidney. Angiograms revealed a hypovascular mass with encasement vessels in the same site. Left nephrectomy and paraaortic lymph node biopsy was performed. Pathological examination revealed a metastatic squamous carcinoma from the esophageal carcinoma. Chemotherapy was conducted, but he died 2 months later. Autopsy revealed recurrence in the retroperitoneum, and no metastasis in the right kidney. The literature on secondary renal tumor is reviewed.

Carcinoma, Squamous Cell↗