Biomedical subjects

Kaoru Kurisu

Publications and source records attributed to Kaoru Kurisu.

58 records · Page 4Linked to original sources

PubMed2002

Dissecting basilar artery aneurysm growing during long-term follow up--case report.

A 58-year-old male presented with a dissecting aneurysm of the basilar artery manifesting as dysarthria, left hemiparesis, and numbness of the left side. Angiography revealed a double lumen at the midportion of the basilar artery which was consistent with a diagnosis of dissecting basilar artery aneurysm. The patient was treated conservatively, and remained neurologically stable for a 5-year period following initial presentation, but serial magnetic resonance imaging revealed growth of the aneurysm compressing the brain stem. His condition then worsened. Computed tomography revealed obstructive hydrocephalus. Ventriculoperitoneal shunting was performed and the patient's symptoms improved. However, he died of subarachnoid hemorrhage. Autopsy showed the patient had had a type 3 "dolichoectatic dissecting aneurysm." Surgical treatment should be seriously considered for treating the patients with dissecting basilar artery aneurysm causing brain stem ischemia, especially if the aneurysm is growing. High-flow bypass and proximal occlusion may be the choice in patients with poor collateral circulations.

Aortic Dissection↗

PubMed2002

Changes in the epithelium of Rathke cleft cyst associated with inflammation.

OBJECT: Rathke cleft cysts (RCCs) are composed of tall, well-differentiated, ciliated columnar epithelia. Their structures are altered by hyperplasia or squamous metaplasia, but their cause remains unknown. METHODS: The authors studied pathological findings and anterior pituitary function in 20 patients harboring RCCs. They classified RCC epithelium as either single (a single ciliated columnar cell lining or a flattened cuboidal cell lining) or stratified (a stratified ciliated columnar cell lining, basal cell hyperplasia, columnar cell hyperplasia, or squamous metaplasia). Inflammation was classified as acute, subacute, chronic, or end stage. The epithelial cell lining was observed in 13 specimens obtained during surgery (six specimens contained single and seven contained stratified epithelia). Inflammation had penetrated the cyst epithelium or subjacent stroma in 10 patients, and the stage of inflammation correlated well with the type of epithelia group: early stages of inflammation in the single epithelium group and chronic or end-stage inflammation in the stratified epithelia (p = 0.0027). The adenohypophysis was identified in 21 surgical specimens. Postoperatively, growth hormone (p = 0.019), cortisol (p = 0.027), and thyroid-stimulating hormone (p = 0.039) responses significantly worsened as the inflammation progressed. The presence of diabetes insipidus correlated well with advanced stages of neurohypophysitis (p = 0.025). CONCLUSIONS: Epithelial stratification in the RCC is caused by inflammation that may extend into the adjacent adenohypophysis or neurohypophysis and overwhelm the hypophysis, resulting in panhypopituitarism. Transsphenoidal excision may represent the best choice for treatment, at least for cases of RCC in which there is partial impairment of hypophysial function.

Adult↗

PubMed2002

[Cerebellar ganglioglioma associated with a huge cyst: case report].

Gangliogliomas represent approximately 0.2% of all the intracranial tumors. Ganglioglioma arising from the cerebellum is rare, with a rate of 1.5-9% of CNS gangliogliomas. The authors report a case of cerebellar ganglioglioma with a huge cyst. A 28-year-old man presented headache and ataxia. Computerized tomography (CT) demonstrated a huge cyst at the vermian region with calcification located at the peripheral side of the cyst. Magnetic resonance imaging (MRI) with administration of Gd-DTPA showed a slightly enhanced small mass at the left side of the cyst. Preoperative diagnosis of the lesion seemed to be a cystic astrocytoma. The tumor was removed subtotally through the midline suboccipital approach. Pathological examination of the tumor specimen revealed a ganglioglioma. The postoperative course was uneventful with no sign of tumor regrowth on repeated MRI. According to the previous 17 reports of cerebellar ganglioglioma including our case, the shorter interval from onset to the diagnosis and clinical symptoms such as increased intracranial pressure were conspicuous as compared with supratentorial ganglioglioma because of the anatomically narrow space of the posterior fossa. Neuroradiological findings showed tumor enhancement in 86% of the cases, calcification in 67%, and cyst formation in 53%.

Adult↗

PubMedDate not supplied

Prognosis of cerebellar glioblastomas: correlation between prognosis and immunoreactivity for epidermal growth factor receptor compared with supratentorial glioblastomas.

BACKGROUND: Cerebellar glioblastomas (GBM) are rare tumors whose clinicopathological characteristics are not well understood. PATIENTS AND METHODS: Clinico-immunohistochemical findings were retrospectively analyzed in 43 supratentorial- and 7 cerebellar GBM. The correlation between survival and immunopositivity for p53, epidermal growth factor receptor (EGFR) and Ki-67 in these tumors was statistically analyzed and compared. RESULTS: Of the 43 patients with supratentorial GBM, 27 (62.8%) were EGFR immunopositive; their survival was significantly shorter than that of the 16 EGFR-negative patients (p=0.0248). There was no significant correlation between survival and p53 immunopositivity (p=0.7870) and Ki-67 labeling index (p =0.7133). All 5 cerebellar GBM patients treated with radio- and chemotherapy were EGFR-immunonegative; they survived significantly longer than patients with supratentorial GBM (p=0.0296) possibly because their EGFR negativity rendered their tumors more highly radiosensitive. CONCLUSION: The better prognosis of patients with cerebellar, EGFR-negative tumors compared to patients with supratentorial tumors is due to the higher radiosensitivity of these tumors.

Adult↗