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Biomedical subjects

M Fukui

Publications and source records attributed to M Fukui.

At least 487 records · Page 27Linked to original sources
PubMed1991

Direct spinal versus peripheral nerve stimulation as monitoring techniques in epidurally recorded spinal cord potentials.

We recorded spinal cord evoked potentials (SCEPs) and spinal somatosensory evoked potentials (spinal SEPs) in 30 operations following stimulation of the epidural spinal cord and the peripheral nerve, respectively, to compare their feasibility as an intraoperative technique for spinal cord monitoring. SCEPs produced quicker responses and had larger amplitudes with simpler waveforms. SCEPs could reflect residual function of the pathological spinal cord and predict the postoperative clinical outcome, findings which are not observed with spinal SEPs. Moreover, SCEPs had a much higher sensitivity to spinal cord insult. Therefore, we conclude that the SCEPs were more appropriate indicator than the spinal SEPs as an intra-operative monitoring method for spinal cord function.

Adolescent↗
PubMed1991

Usefulness of epidurally evoked cortical potential monitoring during cervicomedullary glioma surgery.

This report describes a patient with an intramedullary ependymoma at the region of the cervicomedullary junction in whom there was an abolition of somatosensory evoked potentials following median nerve stimulation. During intraoperative monitoring of cortical potentials elicited by epidural cervical cord stimulation, the tumor was removed. Posterior epidural stimulation appeared to depolarize more ascending fibers than did stimulation of a single peripheral nerve. We recommend that, in cases of operations in this vital area, epidurally evoked cortical potentials be monitored intraoperatively.

Evoked Potentials, Somatosensory↗
PubMed1991

Management of syringomyelia associated with Chiari malformation: comparative study of syrinx size and symptoms by magnetic resonance imaging.

The authors reviewed the postoperative alteration of symptoms and syrinx size by magnetic resonance imaging (MRI) in 14 consecutive patients with syringomyelia associated with Chiari malformation. The patients were treated according to our treatment regimen and were divided into five groups according to operative modalities: (1) only foramen magnum decompression (D) for small syrinx; (2) D with ventriculoperitoneal (VP) shunt for small syrinx with hydrocephalus; (3) D with syringosubarachnoid (SS) shunt or (4) D with syringoperitoneal (SP) shunt for large syrinx; and (5) only VP shunt for syrinx with hydrocephalus and atlantoaxial dislocation, respectively. From the preoperative and postoperative sagittal MR images, the areas of the spinal cord and syrinx were measured by a digitizer and the syringo-cord (S-C) ratio was calculated. Out of 14 patients, 12 showed a reduction of syrinx size and a stabilization or improvement of symptoms after surgery. In the other two patients, the syrinx size did not change and their symptoms worsened. Magnetic resonance imaging follow-up showed that foramen magnum decompression without shunt is effective for patients with a small syrinx below 35% of the S-C ratio, and foramen magnum decompression with shunt was effective for patients with a large syrinx over 35% of the S-C ratio, but there was no significant difference between the SS and SP shunt group.

Adolescent↗
PubMed1991

Effects of methylprednisolone on glomerular and medullary mRNA levels for extracellular matrices in puromycin aminonucleoside nephrosis.

We examined the effects of methylprednisolone (MPSL) on type IV collagen, laminin and heparan sulfate proteoglycan (HSPG) mRNA levels in the renal glomeruli and medulla of puromycin aminonucleoside (PAN) nephrosis. mRNA levels encoding for type IV collagen and laminin increased markedly, whereas those for HSPG decreased significantly in glomeruli of PAN nephrosis. Administration of MPSL partially ameliorated the abnormal gene expression for basement membrane components. Furthermore, we showed that medullary mRNA levels for all these basement membrane components decreased with age in PAN nephrosis with or without MPSL treatment, suggesting that neither PAN nor MPSL has any effect on basement membrane component mRNA levels in the renal medulla. In contrast, mRNA levels for the interstitial collagens including alpha 1 (I) and alpha 1 (III) chains in glomeruli showed little change with or without MPSL treatment, whereas those in medulla increased significantly in PAN nephrosis when compared with the control. MPSL ameliorated the abnormal gene expression of alpha 1 (I) and alpha 1 (III) collagen in renal medulla. These results indicate that PAN affects both glomerular mRNA encoding for basement membrane components and medullary mRNA encoding for interstitial collagens, and that MPSL has marked effects on the amelioration of abnormal gene expression in both glomeruli and medulla of PAN nephrosis.

Animals↗
PubMed1991

Evaluation of EC-IC bypass for patients with atherosclerotic occlusive cerebrovascular disease: clinical and positron emission tomographic studies.

The authors report clinical evaluations of extracranial-intracranial (EC-IC) bypass surgery for patients presenting with misery perfusion on positron emission tomography (PET) due to atherosclerotic occlusive cerebrovascular disease. Seven patients underwent PET both before and after undergoing EC-IC bypass surgery. Three of the 7 patients had transient ischaemic attacks (TIAs) and 4 had minor strokes. Five of the 7 had unilateral superficial temporal-middle cerebral artery (STA-MCA) anastomosis, one had bilateral STA-MCA anastomoses and one had STA-MCA anastomosis on one side and carotid endarterectomy on the other side. PET showed postoperative improvement in regional cerebral blood flow and metabolism in 5 of the 7 patients. In the remaining 2 patients, one showed no remarkable changes on PET and the other showed exacerbation on PET due to postoperative cerebral infarction. All three patients who had TIAs had no further TIAs after surgery. Two of the 3 patients postoperatively showed improvement in misery perfusion on PET. In the 4 patients who had minor strokes, 2 showed clinical improvements. One of the 2 showed improvement not only in motor function but also in the higher cortical functions such as verbal and performance intelligence quotients. Changes on PET correlated to the clinical improvement in 4 of 7 patients. The EC-IC bypass is therefore effective in patients with haemodynamic hypoperfusion syndromes by improving the state of low perfusion.

Adult↗
PubMed1991

Localization of stereotactic targets by microrecordings of thalamic somatosensory evoked potentials.

To improve the localization of stereotactic targets, somatosensory evoked potentials (SEPs) were recorded from the thalamus and subthalamic area using a specially designed semimicroelectrode in 61 patients and a conventional "macroelectrode" in 17 patients. By means of the semimicroelectrode, median nerve stimulation evoked two distinct SEPs, consisting of a diphasic wave with a huge positivity restricted to the nucleus ventrocaudalis (Vc) and a triphasic wave of lower amplitude with a major negativity in the ventral part of the nucleus ventrointermedius (Vim) and nucleus ventrooralis posterior (Vop) as well as the subthalamic lemniscal pathway. The Vim-Vc junction could thus be clearly delineated by an abrupt transition of SEPs from one type to the other with a precision of 1 mm. The parvicellular part of the Vc (Vcpc), situated in its basal region, was distinguishable from the Vc proper by a significant reduction of the positivity elicited by stimulation of the median nerve and by a rapid growth of a diphasic SEPs to stimulation of the posterior tibial nerve. In the other thalamic nuclei, stimulation of the median nerve elicited triphasic SEPs of a very small amplitude, suggesting a volume conduction current from the lemniscal pathway. With the macroelectrode, the positivity in the Vc was sensitive to electrode manipulation and the thalamic nuclei could not be distinctly outlined. SEP monitoring using the semimicroelectrode significantly improved the precision of target localization, which allowed minimizing of the volume of the therapeutic lesion without losing surgical effectiveness, while avoiding complications associated with increased penetration of the coagulating electrode. It is suggested that recording serial thalamic SEPs with the semimicroelectrode is a practical method to refine stereotactic targets in the thalamus.

Adult↗
PubMed1991

Chordoma in early childhood: a clinicopathological study.

A case of clival chordoma in a 4-year-old girl is presented. The tumor regrew rapidly after it was partially removed, and the patient died after a clinical course of 11 months. An autopsy revealed a massive clival mass and widespread metastases in the dura mater, skull bone, bilateral lungs, liver, sternum, left humerus, and vertebrae. Pathological findings showed that the tumor cells were poorly differentiated, with a rare, but typical, physaliphorous appearance. The presence of epithelial differentiation proteins, mitochondria surrounded by rough endoplasmic reticulum, and desmosomes was demonstrated in the tumor cells both immunohistochemically and ultrastructurally. Thus, the tumor was diagnosed as a chordoma. The literature pertaining to intracranial chordoma in early childhood is reviewed. Rapid growth and distant metastases may occur in chordomas at a young age.

Brain Neoplasms↗
PubMed1991

Glomerular nonenzymatic glycosylation and lipid peroxide are increased in the early phase of streptozotocin-induced diabetic rats prior to major histopathologic alterations.

Levels of glomerular nonenzymatic glycosylation and lipid peroxide in streptozotocin (STZ)-induced diabetic rats were examined. Isolation of glomeruli was performed using a sieving technique. The levels of nonenzymatic glycosylation in the glomeruli of these rats were measured by the thiobarbituric acid (TBA) method. Measurement of lipid peroxide, i.e., malondialdehyde (MDA), levels in the renal cortex, medulla and isolated glomeruli was performed by the TBA test. Light-microscopic and immunofluorescent examinations were also performed. An increase in nonenzymatic glycosylation in the glomeruli was observed in the early phase, i.e., after 4 and 12 weeks, in STZ-induced diabetic rats. The levels of MDA in the renal cortex of 12-week-old STZ-induced diabetic rats were also significantly increased compared with those of control rats at the same age. Levels of MDA in the glomeruli of 12-week-old STZ-induced diabetic rats were slightly increased compared with those of control rats, but there was no statistical significance. In immunofluorescence, IgG or IgM was deposited in the glomerular mesangial areas and capillary walls in 12-week-old diabetic rats. However, there was no significant change in renal tissues after 4 and 12 weeks in STZ-induced diabetic rats. It was concluded that glomerular nonenzymatic glycosylation and lipid peroxide were already increased in the early phase of STZ-induced diabetic rats prior to the appearance of marked histologic alterations.

Animals↗
PubMed1991

Glycine conjugation of the substituted benzoic acids in mice: structure-metabolism relationship study II.

Glycine conjugation of a series of substituted benzoic acids was investigated in the mouse liver and kidney mitochondria. Correlations between the structure of 24 substituted benzoic acids and glycine conjugation were obtained. The extent of glycine conjugation of a series of substituted benzoic acids in liver mitochondria was different from that in kidney mitochondria. Glycine conjugation increased with greater lipid solubility in the mouse liver and kidney. The steric effect of the substituent had a far greater influence over the glycine conjugation in kidney, while the size of the substituent played a small role in the pattern of conjugation in liver. The formation of the glycine conjugate in liver was also dependent on the substituent electronegativity.

Animals↗
PubMed1991

Hemifacial spasm caused by CP angle AVM associated with ruptured aneurysm in the feeding artery--case report.

A 66-year-old male presented with clinical features of hemifacial spasm. Cerebral angiograms disclosed an arteriovenous malformation (AVM) in the cerebellopontine angle. The hemifacial spasm was caused by a dilated feeding artery of the AVM compressing the facial nerve at the root exit zone. Surgery was not initially performed because of his age and absence of AVM rupture. However, the AVM was associated with a small aneurysm in the feeding artery, which rapidly grew during 20 days after discharge and ruptured causing subarachnoid hemorrhage. The aneurysm was clipped and the feeding artery of the AVM partially obliterated. Careful angiographic examination for associated aneurysms and consequent surgical obliteration to prevent hemorrhage are suggested in cases of AVM.

Aged↗
PubMed1991

Metabolism of chlorpheniramine in rat and human by use of stable isotopes.

1. The metabolism of chlorpheniramine (I) was examined in vivo in rats and a human volunteer; in the rats a stable isotope was used. 2. In addition to the unchanged drug (I) and the N-demethylated metabolites (II and III), nine further metabolites were identified in rat urine, four of which were also found in human urine. Chlorpheniramine N-oxide (IV), 3-(p-chlorophenyl)-3-(2-pyridyl) propanol (V), 3-(p-chlorophenyl)-3-(2-pyridyl)-N-acetylaminopropane (VII) and 3-(p-chlorophenyl)-3-(2-pyridyl)-propionic acid (XIII) were identified in rat and human urine. 3. The hydroxylated metabolites of the pyridyl ring of the unchanged drug, II, V and VII, and the glucuronide of XIII were identified only in rat urine. XIII was found in rat urine as long as 6 days after the last dose.

Adult↗
PubMed1991

Brain stem glioma: the role of a biopsy.

A retrospective review of the clinical and histopathological features of 31 patients with brain stem gliomas treated between 1965 and 1990 at Kyushu University Hospital was performed to determine the role of biopsy on these lesions. These 16 male and 15 female patients ranged in age from 3 to 50 years at diagnosis (average: 18.1 years). The primary site of the tumour was the pons in 20 patients, followed by the medulla oblongata and midbrain, and the final histological diagnoses of the lesions based on either the biopsy or autopsy materials were grade I astrocytomas in five patients, grade II in nine, grade III in 10, grade IV in five, and ependymoma in two patients. No consistent correlation could be obtained between the CT findings and histological diagnoses. Open surgical posterior fossa exploration was performed on 17 patients (diagnostic biopsy: 10; volume reduction by tumour removal with or without cyst evacuation: 7) and stereotaxic biopsy on three patients, without any mortality related to these procedures. In our biopsy series, half of the patients with grade II astrocytoma died within 12 months after diagnosis, whereas three out of four patients with grade I astrocytoma survived more than 10 years after diagnosis. Because of the relative safety of the tissue sampling technique, and the importance of an accurate diagnosis in order to select appropriate treatment modalities, histological verification of the lesion should be considered for all patients harbouring a brain stem mass lesion.

Adolescent↗
PubMed1991

[Neurocytoma in the left frontal lobe].

We report a case of a 7-year-old right-handed girl with neurocytoma in the left frontal lobe. She developed convulsive seizures on the right side of her face at the age of 1 year and 8 months, and CT scan revealed a low density lesion in the left frontal lobe near the Sylvian fissure. CT scan at the age of 7 years showed slight enlargement of the lesion in size, and linear calcification in the mass. MRI imaging revealed the lesion to be a solid mass involving the area of Brodmann 44 of the left cerebral hemisphere. However, amytal test disclosed that her speech center was not situated in the left cerebral hemisphere. Subtotal removal of the tumor and removal of the epileptogenic focus were performed and no neurological deficits including speech disturbance resulted. The tumor was diagnosed as neurocytoma by electron microscopy. Because this tumor was considered of low malignancy, no radiation or chemotherapy was given. It is emphasized that neurocytoma can occur in parts of the brain other than in the ventricular system, though the incidence of the tumor is more frequent in the latter.

Brain Neoplasms↗
PubMed1991

[Isolated gingival relapse during hematological remission in a patient with erythroleukemia].

A 54-year-old man was admitted to Kitano Hospital because of nuchal pain in November, 1984. The bone marrow was hypercellular with 18% of myeloblasts and 45% of erythroblasts many of which were megaloblastoid and positive for PAS-staining. BH-AC . DMP therapy induced a complete remission which was maintained for more than 3 years until April, 1988, when gingival swelling occurred. A biopsy of the gingiva revealed a diffuse infiltration of myeloblasts together with a few erythroblasts. Local irradiation resulted in he disappearance of the swelling. However, the microscopic infiltration of the leukemic cells in the gingiva still remained in December, 1988 when there was no apparent gingival swelling and the patient was in a second hematological remission. Bone marrow relapse occurred in September, 1988 and twice thereafter. Complete remissions were again achieved for the first two relapses and the leukemic infiltration of the gingiva disappeared after another irradiation. The third relapse was refractory to an intensive chemotherapy and the gingival swelling also recurred in July, 1989. The patient died of pneumonia in October, 1989. The gingiva may be more common site of extramedullary relapse. Careful observation of this organ would be necessary throughout the course of leukemias.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[Two pediatric cases of moyamoya disease with progressive involvement from unilateral to bilateral].

Moyamoya disease is defined as having bilateral involvement of the internal carotid arteries. Two pediatric cases of moyamoya disease starting with unilateral involvement of the internal carotid artery are reported. In both cases angiographic findings at onset showed unilateral involvement. Hence, they were filed as a "probable" case according to the diagnostic criteria of the Japanese Cooperative Research Committee. The carotid angiograms on the other side showed totally normal findings. Clinical manifestation, EEG findings, angiographic findings, and PET findings in these cases were the same as those of definitive bilateral moyamoya disease. The only exception was the unilaterality of the findings. One to three years later the occlusive lesions became bilateral, and this met the criteria as a "definite" case. We consider that some of the cases of moyamoya disease actually start with unilateral lesion and develop into bilateral. Angiograms in "probable" cases should be carefully followed up to establish the disease entity of this lesion.

Adolescent↗
PubMed1991

[Altered glomerular mRNA expression of basement membrane components and type I collagen in diabetic rats treated with or without insulin therapy].

Glomerular basement membrane (GBM) thickening has been reported to be a characteristic change of diabetic nephropathy. Previous studies of GBM in animal models of diabetes indicated that there are no consensus in the alteration of synthesis of GBM component. The aim of this study was to determine whether the glomerular mRNA levels encoding type I and type IV collagen. B1 laminin, and heparan sulfate proteoglycan (HSPG) are altered in streptozotocin diabetic rats with or without insulin therapy. Glomerular mRNA levels for type I and type IV collagen, laminin B1, were significantly increased, but that for HSPG were marked decreased in 4 week diabetic rats compared with age-matched control rats. Insulin therapy has normalized these abnormally regulated gene expressions. Renal morphology shows no significant changes between 4 weeks diabetic rats and age-matched control rats. These results indicate that abnormal gene expressions of BM components and type I collagen might play an important role in the initiation of glomerular changes in diabetes.

Animals↗
PubMed1991

Cranial fasciitis: case report.

A 2-year-old boy with cranial fasciitis is described. He had a rapidly growing subcutaneous right occipital mass, which was associated with a dimple in the overlying skin. It appeared similar to a malignant subcutaneous tumor with skin invasion. Total resection of the tumor was performed, and the histological diagnosis, cranial fasciitis, was confirmed.

Child, Preschool↗