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Biomedical subjects

K Tashiro

Publications and source records attributed to K Tashiro.

At least 577 records · Page 32Linked to original sources
PubMed1982

[Vertebral angiography of cerebellar astrocytoma-tumor stain, tumor circulation, CT and angiography in diagnosis (author's transl)].

Twelve cases of cerebellar astrocytoma experienced in the Department of Neurosurgery, Hokkaido University School of Medicine were examined primarily for tumor stain and pathological tumor circulation by angiography. In addition, comparison on neuroradiological findings between cerebellar astrocytoma and hemispheric supratentorial astrocytoma (low-grade) was carried out, and neuroradiological differential diagnosis of cerebellar astrocytoma and cerebellar hemangioblastoma was discussed on the basis of the present results and those which were already reported by other investigations and the authors. The results are as follows: 1) Tumor stain was observed in only one case. A tumor was demonstrated as an avascular mass in the remaining 12 cases. 2) Demonstration of cerebellar astrocytoma as hypovascular or avascular masses was related to their low-grade malignancy in histology and cystic nature in gross appearance, as already pointed out. Furthermore, the present study suggested that mural nodules of cystic lesions should have certain weight and sizes so that they could be demonstrated as tumor stain. 3) Abnormal findings concerning tumor circulation were mostly limited to the cases with tumor stain. Early filling veins were not found in any case. Neither feeding artery nor draining vein was clearly identified in some cases. In addition, the abnormal vessels lacked hypertrophic and tortuous changes. 4) In the supratentorial region, five of the 12 low-grade astrocytoma exhibited abnormal tumor stain and tumor circulation by cerebral angiogram and we think that supratentorial and posterior fossa astrocytoma must usually exhibit different pathological tumor circulation by cerebral angiogram, since each group has distinctive clinical and biological characteristics. 5) CT was performed in 7 of 13 cases. It appeared to be more useful than cerebral angiography in the morphological diagnosis Especially in cystic tumors, CT produced minute information concerning peritumoral edema, enhancement of margin of cystic astrocytoma after intravenous contrast medium, and marginal enhancement with layering in the dependent part of the cyst. 6) Neuroradiological different diagnosis of cerebellar astrocytoma and cerebellar hemangioblastoma by CT was difficult in our cases of cystic tumors. However, both tumors were differentiated from each other with ease by tumor stain and tumor circulation in cerebral angiography, since cerebellar astrocytoma was lacking in abnormal vessels, whereas cerebellar hemangioblastoma was marked by many abnormal vessels. Thus, we concluded that cerebral angiography is superior to CT in differential diagnosis between cerebellar astrocytoma and cerebellar hemangioblastoma.

Astrocytoma↗
PubMed1982

[Clinical studies on chaddock reflex].

One hundred neurological cases were evaluated for the positive rates of 6 pathological reflexes by the same examiner (author). Chaddock and Babinski reflexes were highly sensitive, their positive occurrence being 97.1% and 80.3% of the cases respectively, compared with other pathological reflexes. In patients with paresthesia on the soles, cold feet or foot grasping, Chaddock reflex was superior to Babinski, but in some cases Chaddock became definitely positive despite negative Babinski without attributable reasons, suggestive of the former is more sensitive than the latter. The original stimulation site in Chaddock reflex is the skin area just beneath the external malleolus, and within sural nerve distribution. The elicitation of Chaddock reflex was attempted by stimulating the dorsum of the foot from medial to lateral border, with definite positive responses from the areas of sural nerve distribution. To evaluate the sensitivity and receptive field of Chaddock reflex more objectively, the electromyographic method was employed in 13 cases. The needle electrode was inserted into the extensor hallucis longus (EHL) to monitor the up-going toe, as well as flexor hallucis brevis (FHB) for the plantar flexion of the toe, and the surface electric stimulator was applied to 7 different points of the foot and leg, including original Chaddock and Babinski zones. The results of electrical stimulations to 7 different sites revealed that definitely better responses of EHL in sural nerve distribution, compared with other nerve supply. The threshold strength to evoke the action potentials in EHL proved that Chaddock's area was significantly more sensitive than Babinski's area. The relationship of latencies between EHL and FHB on electrical stimulations to the Chaddock's and Babinski's areas showed that earlier and better responses in EHL than in FHB in Chaddock, which could be another reason that Chaddock reflex was more sensitive than Babinski. From the clinical and electromyographic evaluations mentioned above, Chaddock reflex is not just a variant of Babinski reflex, more sensitive and accurate, and its receptive field is considered to be in sural nerve distribution.

Adolescent↗
PubMed1982

[Germinoma originating in the basal ganglia--report of 2 cases].

We reported two cases of germinoma originating in the basal ganglia among the 50 cases of intracranial germinoma which were experienced at the Department of Neurosurgery, Hokkaido University Hospital. (Case 1) A 8-year-old boy was admitted to our hospital in October 1977, because of precocious puberty and left hemiparesis. Plain CT showed an irregularly-defined high density lesion in the right basal ganglia, which had several low density spots and was moderately enhanced on contrast CT. Endocrinological examination by radioimmunoassay revealed abnormally high level of serum luteinizing hormone and scanty level of serum follicle stimulating hormone. Beta-subunit of human chorionic gonadotropin (HCG) showed 46.4 ng/ml. Following radiation, the lesion on CT disappeared and beta-subunit turned to be in the normal range. It was concluded that the precocious puberty was due to hypersecretion of HCG by the tumor. About 2 years after the first admission, the tumors were disseminated to the spinal cord, followed several months later by the intracranial recurrence. The neurosurgical exploration was performed to both intracranial and spinal tumor lesions, which were proved to be germinoma by histological examination. Postoperative course was uneventful without recurrent signs. (Case 2) A 10-year-old boy was admitted to our hospital with 6-month history of right hemiparesis in February, 1979. CT at the first admission disclosed a slight high density lesion in the left basal ganglia, which had low density area suggesting cyst formation and was moderately enhanced on contrast CT. CT after one year showed multiple cysts in the tumor and displacement of neighboring structures. In February, 1980, a piece of the tumor was removed under bifrontal craniotomy and histologically diagnosed to be germinoma. Following radiation, the tumor disappeared on CT and his clinical features improved. In August, 1981, no recurrent signs were noted. From our 2 cases and review of the literature, it can be concluded that germinoma originating in the basal ganglia is rare and have high radiosensitivity as well as germinoma arising in the other sites, and common symptoms and signs are hemiparesis in all cases, not accompanied by intracranial hypertension in the early stage.

Basal Ganglia↗
PubMed1981

[Vertebral angiography of cerebellar hemangioblatoma -tumor stain, tumor circulation, CT and angiography in diagnosis(author's transl)].

Tumor "stain" and pathological tumor circulation were investigated mainly by cerebral angiography in 8 patients of cerebellar hemangioblastoma who were hospitalized in the Hokkaido University Hospital and considered to be suitable for this study. The results are presented with some speculation in this paper. (1) Tumor stain was found in all of the 8 cases. (2) Histologically all 8 cases were composed of endothelial cells with numerous vascular channels. The characteristic tumor "stain" in cerebellar hemangioblastoma was supposed to be closely related to the histologic features. (3) Review of the reports published on tumor stain indicates that tumor staining patterns have been classified into 3 to 5 types. Similar items were established in all the classifications. (4) The 8 cases were divided into 4 types: cystic type, cystic and solid type, solid type, and multiple type based on macroscopic natures of the tumor. Tumor staining patterns in angiography were also tentatively classified into types 1 to 4 according to the natures of the tumor. (5) Concerning pathological tumor circulation, (a) the time of appearance of tumor "stain" was long; (b) early filling veins in the tumor were found in 4 of the 8 cases; (c) almost all feeding arteries had one or two branches; (d) arteries originating from meningeal vessels were enlarged in 2 cases and angiography of the external carotid artery was useful for their identification; and (3) draining veins were enlarged more markedly than feeding arteries and were mostly a single superficial vein. (6) CT was performed in 4 of the 8 cases. It was compared with vertebral angiography regarding diagnostic capability in consideration of the published reports. Vertebral angiography was superior to CT in (a) verification of the presence of multiple lesions in cerebellar hemangioblastoma and (b) differential diagnosis between cerebellar astrocytoma and hemangioblastoma.

Adolescent↗
PubMed1980

[Findings of computed tomography in multiple sclerosis-correlation of clinical findings with computed tomography in clinically definite 14 patients of multiple sclerosis (author's transl)].

Recent introduction of Computed Tomography (CT) in clinical neurology made it possible to visualize the brain lesion without any invasive procedures. In multiple sclerosis (MS), the demyelinating foci were reported to be observed as low density areas on CT, but occasionally contrast enhanced high density areas were reported also. So far as we know, only a few reports which analysed interrelationship between clinical signs and CT findings were published. In this report we tried to examine the correlation of clinical findings with CT in MS. All scans were performed using an EMI head scanner (EMI 1000) with a 160 X 160 matrix. Contrast material was administered as an intravenous bolus of 60% meglumine iothalamate. In clinically definite 14 MS patients, CT showed localized, circumscribed low density areas in 4 patients, periventricular low density in 1 patient, widening of cortical sulci with ventricular dilatation in 11 patients and no abnormalities in 3 patients. The widening of cortical sulci with ventricular dilatation were noted to be particularly common findings. The periventricular low density was not so frequently seen as we expected. Localized, circumscribed low density areas on CT were well correlated with the neurological findings in 2 patients. In these cases the abnormalities on CT persisted in spite of neurological improvement. As a conclusion, we think CT might be useful as a diagnostic evaluation of MS.

Adolescent↗
PubMed1980

[A clinical survey of cerebellar astrocytoma--comparison between childhood and adult cases (author's transl)].

The symptomatological investigations on 20 cases of cerebellar astocytoma were carried out. These cases, observed and treated in Hokkaido University Hospital from 1959 to 1978, were divided into two groups, such as childhood group (under 15 years old) and adult group (over 16 years old). The following conclusions were obtained: (1) The youngest was 2 years old and the oldest was 64 years old. The age distribution showed higher incidence in younger age group under the age of 30, especially in the first decade. (2) The most frequent symptoms were vomiting, headache and unsteady gait in all cases, but vomiting was constantly seen in childhood cases. (3) The average length of history in children was 2.4 months in childhood, and 17.6 months in adult cases. (4) Neurological signs on admission could be summarized as follows. The signs indicating increased intracranial pressure was most frequent, and the next common findings were ataxia of the limbs and trunk. Impairment of the cranial nerves and brainstem were uncommon. On neurological signs there was little difference between in children and in adults. (5) The total cases of complete removal of the tumor were many, but in adults there were not a few cases in which incomplete removal of the tumor was accomplished. (6) The majority of cerebellar astrocytoma were cystic and laterally placed in the cerebellum especially in children. (7) Microscopically in children, the frequent type was pilocytic astrocytoma of juvenile type. (8) The result of surgical removal of cerebellar astrocytoma was excellent, and the long-term survivours were found frequently and the quality of survival was good. The follow-up results in children were better than those in adults.

Adolescent↗