Biomedical subjects
Publications and source records attributed to K Tashiro.
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We have made a study on the postoperative course of 20 cases with cerebellar astrocytoma observed and treated in Hokkaido University Hospital from 1957 to 1978. Following conclusions were obtained. (1) Among those 20 patients, 16 were alive at the time of submission. The survival rate was 80% at 5 years respectively and the longest survival period for one of our patients is 19 years postoperatively. (2) Removal of tumor was attemped in all cases and the prognosis was best influenced by the degree of removal. The cases who received a complete extirpation of their tumors resulted in a permanent and complete cure, but the cases of incomplete removal did not give so good results as the cases of complete removal. (3) In the cases who could removed completely, those cases had several factors in common, and from our clinical data, the following factors should be considered. 1. Growth of tumors was circumscribed and tumors did not infiltrate the substance of the brainstem. 2. Tumors arising in the cerebellar hemisphere were found to be more common than those originating in the vermis. 3. It was notable that gross appearance of tumors was high incidence of cystic lesions. 4. Those tumors were a well-differentiated histomorphology and it was found that an overwhelming majority of those astrocytoma were so-called astrocytoma grade I. (4) A particularly benign prognosis was expected when the neoplasm occurred in childhood, but even adult cases if removed completely with several factors mentioned above, demonstrated a good prognosis.
The case of a 38-year-old female with primary argyrophil cell carcinoma of the uterine cervix is reported. Two years after operation the patient developed widespread metastases with typical Cushing's syndrome. Microscopically, the tumor consisted of solid anaplastic cells, adenocarcinoma, and squamous cells. The plasma levels of ACTH and cortisol were elevated. Many cells of both the primary and metastatic tumors showed argyrophilia. Almost all the cells of the metastases contained numerous round secretory granules measuring about 117 micrometers in diameter. Small rod-shaped or larger round secretory granules, measuring 250 and 430 micrometers respectively, were also found in a few of these cells. The tumors in the right lung, pancreas, and kidney contained high levels of ACTH, beta-MSH, serotonin, histamine, and amylase. This is the first report of ectopic production of these five substances from argyrophil cell carcinoma of the uterine cervix.
A case of cerebral metastasis of chorioepithelioma with an occlusion of the angular artery is presented. The occlusion was verified angiographically, surgically, and microscopically.
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Sixteen cases of juvenile, non-progressive muscular atrophy localized in the hand and forearm were seen at our neurology out-patient clinic for the past 8 years. The analyses of these 16 cases disclosed characteristic features as follows: 1) juvenile onset 2) male preponderance 3) unique distribution of muscular atrophy and weakness in the hand and forearm. 4) insidious onset, initial progressive period and subsequent non-progressive course 5) tendon reflexes of the arms are hypoactive in half of the cases 6) no pathological reflexes 7) cold paresis 8) no definite sensory disturbance 9) no cranial nerve involvement 10) neurogenic patterns on EMG According to these features, this clinical entity carrying good prognosis must be differentiated from several diseases associated with similar muscular atrophy of extremities, especially amyotrophic lateral sclerosis which is notorious as a fetal disease.
Cervical vertebral venography using catheterzation via the femoral vein was carried out in 78 cases. In disc disease the internal vertebral venous plexus (IVVP) are interrupted at single or multiple levels, and sometimes completely blocked. In ossification of posterior longitudinal ligament, the IVVP are separated bilaterally and interrupted at multiple levels due to centrally situated ossification and associated osteophytes. Venography helps to determine the upper and lower limits of laminectomy, and the necessary sites of facetectomy. The IVVP in the thoracic region were clearly opacified in 86% of 37 normal selective azygograms.
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The clinical investigations especially on symptomatology of 30 cases of the tumors of the lateral ventricle are carried out. For the clinical analysis, in agreement with Koos and Laubichler, the tumors of the lateral ventricle are classified into 2 groups, as follows: 1. Intraventricular tumors group (11 cases). 2. Paraventricular tumors group (18 cases). The following points are emphasized in the clinical features excluding radiological findings. 1. Because of symptomatologically no difference between the intraventricular tumors group and paraventricular tumors group, paraventricular tumors are included into the tumors of the lateral ventricle. 2. On neurological signs and symptoms, we contrast "false" localising signs which are common in patients with objective evidence of raised intracranial pressure and intermittent symptoms which occur more frequently with tumors in the ventricular system. 3. The results of surgical removal of the tumors are not always good. The diversity of results probably reflects the grade of malignancy and growth of the tumors, and skillfulness of operative technique is required, not to do damage to essential neurological elements and vital structures neighbouring the lateral ventricle.
In the first report, the clinical manifestations of 30 cases of the lateral ventricle tumor were reviewed. This report summarizes neuroradiological findings of the same 30 cases, in which 26 cases were examined by cerebral angiograms and 3 cases by CT scan. For the radiological analyses, the tumors of the lateral ventricle are classified into two groups, as follows: 1. Intraventricular tumors arise in the projection of the choroid plexus, the tela and the ependyma and grow in the lateral ventricle. 2. Paraventricular tumors arise from the wall of the neuroglia not only bulge into ventricle, but in addition infliltrate the substance of the surrounding brain. Following conclusions are obtained. (1) Unilateral hydrocephalus, which is shown clearly by vascular displacements in subependymal veins, is demonstrated in both tumors groups. (2) There are different findings on the feeding arteries, the draining veins and the tumor stains between two tumors groups. (3) In the intraventricular tumors groups, the anterior choroidal artery supplying the tumor is its the plexal segments and atrial segments. (4) On the other hand, the paraventricular tumors group, the anterior choroidal artery supplying the tumor is its the superior penetrating branch to the cerebral parenchyma. (5) Cerebral angiograms can reveal the definite signs of the intraventricular mass, but it is sometimes difficult to evaluate whether its space occupying lesions infiltrates the cerebral substance below the wall of the lateral ventricle, or not. (6) CT scan is useful neuroradiological method in the different diagnosis between two tumor groups, and CT scan provides and anantomical diagnosis rather than a histological one. (7) The accurate diagnosis of the tumors of the lateral ventricle can be demonstrated by both cerebral angiograms and CT scan.
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