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Biomedical subjects

K Yuki

Publications and source records attributed to K Yuki.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Two cases of traumatic intracerebral pneumocephalus].

Two cases of traumatic intracerebral pneumocephalus, a rare complication of head trauma, are presented. Case 1: A 14-year-old boy had a strong concussion in his forehead due to a motorbike accident. Slightly obtunded on admission showing GCS 10, he became conscious in several days. Head CT performed after 17 days showed a round air image in the right frontal lobe which kept increasing in size thereafter. Bilateral frontal craniotomy was performed 31 days after the injury. A craniodural defect with a herniated brain was found in the superior wall of the posterior ethmoid sinus and repaired. Case 2: A 55-year-old man received a left forehead concussion when his motorbike ran into a car from behind. Although he had been conscious ever since admission, head CT after 15 days showed a round air image in the left frontal lobe. MRI demonstrated the air to be located in the cerebral parenchyma distinctly and the brain to have herniated into the frontal sinus. As the air showed a tendency to increase in volume and mild psychic and memory disturbances appeared, bilateral frontal craniotomy was performed 34 days after the injury. A craniodural defect with a herniated brain was detected in the posterior wall of the frontal sinus and repaired. These two patients showed a small amount of cerebrospinal fluid (CSF) rhinorrhea before the operation. Following the surgical repair, no recurrence of pneumocephalus and CSF rhinorrhea has been seen in either case. Intracerebral pneumocephalus secondary to closed head trauma was thought to have been due to herniation of contused brain into a craniodural defect.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[A case of brain abscess of the basal ganglia which resulted in disastrous outcome due to ventricular ruptures].

A case of deep-seated brain abscess that ruptured twice into the ventricle and resulted in death is presented. A 45-year-old man had experienced pyrexia and headache for 3 days before admission. On admission he was somnolent (GCS: 13) but there were no abnormal neurological findings except nuchal rigidity and Kernig's sign. Computed tomography (CT) scan showed a ring enhanced mass near the left caudate head and dilated ventricles. In comparison with CT performed at the former hospital it was diagnosed that a rupture into the ventricle of the brain abscess had occurred. Ventricular drainage was performed at once and white purulent cerebrospinal fluid was obtained. Thereafter, he was treated with some antibiotics and his conditions seemed to stabilize for a while. Serial CT images demonstrated that the size of the abscess seemed to be enlarging. Just when we planned to undertake stereotactic aspiration, the second ventricular rupture occurred and he died. According to this case, it is suggested that once a deep-seated brain abscess near the ventricular system is suspected, it should be aspirated by means of CT-guided stereotactic surgery immediately.

Basal Ganglia Diseases↗
PubMed1993

Age-related modification of regional left ventricular filling in normal subjects.

Left ventricular diastolic filling has been reported to be impaired with advancing age in normal subjects. To investigate the influence of regional ventricular diastolic asynchrony on global ventricular filling as a function of age and to assess the location of asynchronous regions within the left ventricle, radionuclide ventriculography was conducted in 48 normal subjects aged 15 to 73 years. Left ventricular regional filling was assessed by dividing the left ventricular region of interest into 4 quadrants, from which global, septal, apical and lateral time-activity curves and first-derivative curves were derived. Indexes of global left ventricular systolic function at rest did not correlate with age. However, indexes of global early diastolic filling declined significantly with age; peak filling rate normalized to end-diastolic volume (r = -0.42; p < 0.01), to stroke volume (r = -0.48; p < 0.001) and to peak ejection rate (r = -0.47; p < 0.001) decreased with advancing age. Global time to peak filling rate also increased with aging (r = 0.41; p < 0.01). Early diastolic asynchrony was measured as the sum of the absolute values of the time differences from global peak filling rate to that in each of three quadrants (delta TPFR). delta TPFR increased with age (r = 0.37; p < 0.01). Global peak filling rate normalized to end-diastolic volume (r = -0.40; p < 0.01), to stroke volume (r = -0.45; p < 0.01) and to peak ejection rate (r = -0.51; p < 0.001) decreased significantly with increasing delta TPFR. Time to peak filling rate of the lateral region occurred first (163 +/- 33 ms), followed by the apical (184 +/- 38 ms) and finally the septal region (195 +/- 35 ms). With regard to the sequence of regional filling, this suggests that a physiologic asynchrony exists in resting condition in normal subjects. Times to peak filling rate in the septal and apical regions were modestly correlated with age (r = 0.29; p < 0.05, r = 0.30; p < 0.05 respectively), but that in the lateral region did not show significant correlation with age. This may indicated that the effects of advancing age on the regional filling differ in regions within the left ventricle. These results suggest that aging alters left ventricular early diastolic filling in association with the increase in physiologic asynchrony.

Adolescent↗
PubMed1992

[A case of unilateral atypical moyamoya disease of adult onset with stenosis of the basilar artery].

A 29-year-old, 39-week-pregnant female who had headache and nausea was admitted to our hospital. She bore a baby son by natural delivery after several hours. After labor, her headache was continuous. Brain CT scan demonstrated intracerebral and intraventricular hemorrhage. After conservative treatment for two weeks, her only neurological deficiency was visual field defect. Angiography demonstrated that her left internal carotid artery had partial stenosis at the C2 portion. Her right internal carotid artery had stenosis at the C2 portion. Her right middle cerebral artery was occluded at the M1 portion, and abnormal vascular networks had developed in the ganglionic region. Stenosis was also found in the basilar artery. We diagnosed her as being a case of adult-onset, unilateral, atypical Moyamoya disease with basilar artery stenosis. As our case was of adult-onset, and as she showed no ischemic signs, we did not think that reconstructive surgery was indicated. About the posterior circulation of Moyamoya or atypical Moyamoya disease, it was reported that in cases of juvenile onset the vertebral, basilar or posterior cerebral artery was sometimes stenosed or occluded, but, in adult-onset cases, stenosis or occlusion of the posterior cerebral artery would be an abnormality. Our case is a very rare example of unilateral atypical Moyamoya disease of adult onset with basilar artery stenosis.

Adult↗
PubMed1991

Coronary vasospasm following subarachnoid hemorrhage as a cause of stunned myocardium. Case report.

A patient with subarachnoid hemorrhage was found to have electrocardiographic abnormalities resembling an acute myocardial infarction as well as left ventriculographic findings of cardiac dysfunction. These cardiac abnormalities resolved following surgical clipping of the aneurysm and the patient recovered well from the operation. She died 2 months later from cancer and a postmortem examination at that time revealed no evidence of myocardial necrosis. In this report, the authors discuss coronary vasospasm and reversible postischemic "stunned myocardium," a condition that has not been considered previously in relation to subarachnoid hemorrhage.

Aged↗
PubMed1990

Growth and spread of hepatocellular carcinoma. A review of 240 consecutive autopsy cases.

All 240 consecutive cases of hepatocellular carcinoma (HCC) that underwent autopsy at the National Cancer Center Hospital (Tokyo, Japan) between September 1962 and August 1986 were reviewed. Among these cases, 162, for which photographs of cut surfaces of the primary tumors were available, were grossly classified using a combination of both Eggel's classification and our own into three major types, i.e., nodular, massive, and diffuse as described by Eggel (Eggel H, Beitr Pathol Anat 1901; 30:506-604), and three subgroups of nodular type, i.e., single nodular type (type 1), single nodular type with extranodular growth (type 2), and contiguous multinodular type (type 3) by our classification (Kanai T et al., Cancer 1987; 60:810-819). Seventy-eight cases were classified as nodular type, comprising seven cases of type 1, 61 cases of type 2, and ten cases of type 3. Sixty-seven and 17 cases were classified as massive and diffuse type, respectively. Of the 78 nodular-type tumors, 59 measured less than 10 cm, whereas 64 of 67 massive-type tumors were 10 cm or more in size. The incidence of intrahepatic and extrahepatic tumor spread of HCC was significantly higher for tumors measuring more than 5 cm. As to the relationship between macroscopic type and tumor spread, the frequency of spread was lowest for type 1 tumors, and high for the other types. Intrahepatic metastasis was detected in 28.6% of type 1, 93.4% of type 2, 100% of type 3, and 98.5% of massive-type tumors. Lymph node metastasis was detected in 14.3% of type 1, 24.6% of type 2, 70% of type 3, 38.8% of massive-type and 52.9% of diffuse-type tumors. Hematogenous extrahepatic metastasis was detected in 14.3% of type 1, 47.5% of type 2, 70% of type 3, 74.6% of massive-type and 82.4% of diffuse-type tumors. It appears that not only primary tumor size but also its macroscopic type has an important influence on the growth and spread of HCC.

Adolescent↗
PubMed1990

Effects of dialysis on left ventricular diastolic filling in patients with chronic renal failure--assessment with radionuclide ventriculography.

To examine the effects of dialysis on left ventricular (LV) filling, gated radionuclide ventriculography was conducted in 15 patients with renal failure before and after dialysis. The LV regional function was assessed by subdividing the LV region of interest into 4 regions from which global and regional time-activity curves and their first-derivative curves were obtained. Early diastolic asynchrony was measured as the sum of the absolute values (total delta t) of the time differences (delta t) between the global peak LV filling rate (PFR) and that for each of the other 3 regions. Dialysis produced an increase in the peak LV ejection rate (PER), heart rate, total delta t and total delta t/diastolic time. It caused a delay or tendency to delay in the time to PFR without significant changes in the PFR either globally or regionally, and the PFR/PER ratio decreased both globally and regionally. These alterations indicated a failure of improvement of the global and regional LV filling, with more asynchronous filling occurring after dialysis despite the increases in PER and heart rate, both of which are expected to increase PFR and shorten the time to PFR. There was a negative correlation between the change in total delta t/diastolic time and the change in the PFR/PER ratio (r = -0.62, p less than 0.01), with a greater increase in asynchrony occurring with the relative greater reduction in the relative global PFR compared with the global PER after dialysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Age-related modification of regional left ventricular filling in normal subjects].

Age-related reduction in global left ventricular filling has been reported. To assess how regional left ventricular filling is modified by aging, radionuclide ventriculography was conducted in 48 normal subjects aged 15 to 73 years. Left ventricular regional filling was assessed by dividing left ventricular region of interest into 4 quadrants, from which global (GLB), septal (SEP), apical (Ax) and lateral (LAT) time-activity curves and first-derivative curves were derived. Indexes of left ventricular systolic function at rest did not vary with age, but early diastolic filling significantly declined with age: peak filling rate normalized to end-diastolic volume (EDV/S), peak filling rate normalized to stroke volume (SV/s) and peak filling rate/peak ejection rate decreased (r = -0.42; p less than 0.01, r = -0.48; p less than 0.001, r = -0.47; p less than 0.001), time to peak filling rate increased (r = 0.41; p less than 0.01) with aging. Early diastolic asynchrony was measured as the sum of the absolute values of the time differences from global peak filling rate to that in each of three quadrants (delta TPFR). delta TPFR increased with age (r = 0.37; p less than 0.01). Moreover, delta TPFR correlated with global peak filling rate (EDV/s), peak filling rate (SV/s) and peak filling rate/peak ejection rate (r = -0.40; p less than 0.01, r = -0.45; p less than 0.01, r = -0.51; p less than 0.001). Time to peak filling rate of the lateral region was the shortest (163 +/- 38 ms), followed by the global (179 +/- 36 ms), apical (184 +/- 38 ms) and finally the septal region (195 +/- 35 ms). This suggested that physiologic asynchrony with regard to the sequence of regional filling exists in resting condition in normal subjects. Time to peak filling rate in the septal and apical regions increased with age (r = 0.29; p less than 0.05, r = 0.30; p less than 0.05), but that in the lateral region did not correlate with age (r = 0.11). These regional differences correlated with increase in delta TPFR. Thus, aging alter left ventricular diastolic function, with reduced rate related to increased asynchronous early diastolic filling due to prolongation of time to peak filling rate in the septal and apical regions.

Adolescent↗
PubMed1990

[A case of epidural hematoma occurring on the opposite site of craniotomy after clipping surgery performed on internal carotid giant aneurysm].

Postoperative epidural hematomas remote from the operating field are sometimes seen as a complication after ventricle drainage, ventricle-peritoneal shunt or suboccipital craniotomy. Reported here is a very rare case of epidural hematoma which occurred on the opposite site of craniotomy after clipping surgery performed on internal carotid giant aneurysm. A 43-year-old woman was admitted to our hospital because of progressive visual disturbance in her right eye for twelve months. Precise examinations of her right eye revealed deterioration of visual acuity (0.02) right temporal-hemianopsia and an optic disc atrophy. A computed tomography scan (CT) showed a suprasellar round mass which was homogeneously well enhanced. Right carotid angiogram disclosed a large internal carotid artery aneurysm directed supramedially. The aneurysm was explored in June 1988. The neck was clipped with Sugita's ring clips through right frontotemporal craniotomy. The patient recovered fully and extubation was performed soon after the operation. Neurological examinations revealed no abnormal findings. Two days after the operation, she gradually developed impairment of consciousness and nausea. CT scan showed mass effect caused by epidural hematoma over the left temporoparietal region contralateral to the craniotomy site. Evacuation of the hematoma was carried out urgently. She had a good clinical course and postoperative angiogram demonstrated disappearance of the giant aneurysm. She was discharged and returned home without new neurological deficits. We review literature, and discuss presumptive pathogenesis responsible for such unexpected postoperative epidural hematomas.

Adult↗
PubMed1989

[Metastatic malignant lymphoma of the skull with extradural and extracranial extension. Case report].

A 72-year-old male was hospitalized because of a steadily growing mass (4 x 4 x 2 cm) in the frontal region, noticed following head injury. Six months earlier, he had declined treatment for malignant lymphoma (small non-cleaved cell type), discovered upon evaluation of a subcutaneous mass in his forearm. Neurological examination on admission was negative. Plain skull films revealed a large, osteolytic lesion with an irregular margin. Bone scintigraphy disclosed no uptake other than in the frontal bone. Computed tomography (CT) showed a large, homogeneously enhanced mass with both extradural and extracranial extension, which had destroyed the left frontal bone. The skull tumor was totally resected, and the diagnosis was malignant lymphoma, large cell, immunoblastic and plasmacytoid type. Postoperative combined chemotherapy with vincristine, cyclophosphamide, prednisolone, and adriamycin resulted in the complete disappearance of liver metastases. The patient was readmitted 2 months later, however, because of headache and gradually progressive impairment of consciousness. A CT scan disclosed brain metastasis in the paraventricular region. Radiation therapy (20 Gy) was administered but no further treatment was given. Skull metastasis is not uncommon in cases of malignant lymphoma, but a large mass with both extradural and extracranial extension is rare. Although aggressive chemotherapy was effective, prophylactic irradiation of the brain should have been considered in this case.

Aged↗
PubMed1989

[A case report of advanced malignant mixed germ cell tumor of parasellar origin indicating marked efficacy of a salvage combined chemotherapy of CDDP and etoposide and subsequent chemotherapy using oral etoposide].

A case of a 13-year-old boy with malignant mixed germ cell tumor of parasellar origin was reported. After partial removal of the tumor, combined chemotherapy (using cisplatin, vinblastine and bleomycin: PVB therapy) and irradiation were performed, and the tumor was reduced to under one tenth. In spite of PVB maintenance chemotherapy, it became refractory later. The patient was then treated with both CDDP 20 mg/m2 daily for 5 days and etoposide 100 mg/m2 for 1, 3, 5 days. After this one course, the tumor was diminished. Oral etoposide was administered at our outpatient department, and the boy was free of disease for six months.

Administration, Oral↗
PubMed1989

[A case of renal tumor with erythrocytosis].

A case of renal tumor with secondary erythrocytosis and acute occlusion of the left common iliac artery is reported. The patient was a 73-year-old male who complained of right upper abdominal pain. Laboratory investigation at admission revealed erythrocytosis. Radiological examinations including excretory urography, angiography and computed tomographic (CT) scan showed that the hypervascular tumor was related to the right kidney with pulmonary metastases. Transabdominal echography revealed a tumor thrombus in the inferior vena cava. The tumor was not surgically removed, and IFN-alpha (HLBI) at a dose of 3 x 10(6) units was administered intramuscularly for 6 consecutive days every week and UFT at a dose of 3 capsules was given by oral route daily. About two months later, acute occlusion of the left common iliac artery with necrosis of the left toes occurred, and the left lower extremity was amputated. The high haematocrit resulted in an increase of blood viscosity which caused acute arterial occlusive disease. The association between renal tumor and erythrocytosis is discussed.

Aged↗
PubMed1988

[A case of primary intrasellar malignant germ cell tumor].

A case of a 13-year-old boy with a primary, intrasellar malignant germ cell tumor is reported. An immunohistochemical study revealed that the serum HCG and AFP levels were highly elevated and that the tumor contained elements of seminoma, choriocarcinoma, a yolk sac tumor, and an embryonal carcinoma. After operation, combined chemotherapy (cisplatin, vinblastine and bleomycin, i.e. PVB therapy) and irradiation were performed in hope of achieving the radiosensitizing effect of cisplatin. As a result, partial remission was obtained. Although PVB therapy is considered effective, combined radio-chemotherapy, as was done in this case, is thought to be better method for treating an intracranial, malignant germ cell tumor.

Adolescent↗
PubMed1988

[Postoperative consideration of diagnostic value of ultrasonography and excretory urography on seven patients with renal calculi].

Seven patients with renal calculi were evaluated by ultrasonography and intravenous pyelography (IVP). After surgical treatment, the diagnostic value of these examinations was considered. Correct diagnosis of renal calculus size and number had been established in 4 of the 7 patients by ultrasonography, and 5 of the 7 patients by IVP. In some cases, ultrasonography gave a more accurate diagnosis of renal stone than drip intravenous pyelography.

Adult↗