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Biomedical subjects

M Ide

Publications and source records attributed to M Ide.

At least 37 records · Page 2Linked to original sources

Recurrence of symptomatic Rathke's cleft cyst: a case report.

A 65-year-old man presented with bitemporal hemianopsia. He had undergone frontal craniotomy for a Rathke's cleft cyst associated with narrowed visual field 8 years earlier. His vision had returned to normal soon after surgery and he remained asymptomatic until the present complaint. Neurodiagnostic imaging revealed a recurrence of the intrasellar cyst extending into the suprasellar cistern. His vision improved rapidly after a second surgery. The histological findings were the same as those of the previous operation; the cyst wall was composed of a single layer of ciliated columnar epithelium resting on a collagenous connective tissue stroma.

Aged

Postradiation volume changes in gamma unit-treated cerebral arteriovenous malformations.

Postradiation changes in angiographically determined nidus volume were quantitatively studied in 22 arteriovenous malformation (AVM) cases treated by gamma unit radiosurgery. The postradiosurgical decrease was statistically significant by post-treatment year 2 (p < .05). In children, AVMs tended to be obliterated more quickly than in adults. Volume reduction was more rapid in nidi receiving 25 Gy or more than in those receiving less than 25 Gy (p < .01). However, there were no significant differences in nidus volume decrease between these two dose groups at the second or third postradiosurgical year. Dose response curves were obtained 1, 2, and 3 years following treatment.

Adolescent

Subcutaneous wire traction technique without CO2 insufflation for laparoscopic cholecystectomy.

One hundred laparoscopic cholecystectomies were performed since April 1991. Eleven patients were treated with a new technique without CO2 insufflation, using a traction device to elevate the right upper quadrant wall. Two Kirschner wires were introduced subcutaneously to permit the abdominal wall to be lifted for satisfactory laparoscopic view, as the gas insufflation technique yields. Preoperative evacuation of the intestines and intraoperative muscle relaxation are necessary for easy and successful cholecystectomy. Three cases were converted to laparotomy because of remarkably distended intestine due to incorrect endotracheal intubations. No complications related to subcutaneous wire traction technique were noted in this series. Subcutaneous wire traction technique provides a simpler, and possibly safer alternative to the gas insufflation technique.

Cholecystectomy, Laparoscopic

Penetration of intravenous antibiotics into brain abscesses.

INTRA-ABSCESS CONCENTRATIONS OF the intravenously administered latamoxef (LMOX, moxalactam in the United States) and cefotetan (CTT), were studied in 11 patients with intracranial abscess. None of these patients underwent surgical ablation of the abscess. In all cases, the abscess was aspirated, and multiple aspirations were required in five patients. Antibiotic concentrations in 18 aspirates were, therefore, determined by the agar well method. LMOX concentrations in 16 aspirates drawn from nine brain abscess cases ranged from 0 to 10.9 micrograms/ml, with a mean (standard deviation) of 4.18 (3.04) micrograms/ml. The CTT concentration in one patient with a brain abscess was 8.51 micrograms/ml, and the LMOX concentration in the one remaining patient with subdural empyema was 5.20 micrograms/ml. In one patient, the serum-to-pus penetration rate of LMOX was estimated to be 0.11 against the peak value of the concentration in serum or 0.44 against the simultaneously obtained level in serum. Significantly higher concentrations of LMOX were produced in abscess cavities with multiple-dose administration or by prior drainage of pus. More-advanced stages of local inflammation, as demonstrated by computed tomography, correlated with higher concentrations. However, the routine indexes of systemic inflammation, such as body temperature, white blood cell count, and level of C-reactive protein in serum, cannot be used to predict the concentration present in intracerebral pus. A tendency for LMOX concentrations in pus obtained after single dose-administration to decrease with increasing duration from symptom onset to sampling was observed but was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Posttraumatic cerebral arterial spasm--case report.

Posttraumatic cerebral arterial spasm occurred in a 51-year-old male after a fall striking the left frontal region of the head. The initial computed tomography was identical to that of severe subarachnoid hemorrhage from ruptured aneurysm. He was neurologically stable for the 1st week following the accident, but his condition deteriorated rapidly, culminating in death due to severe delayed cerebral arterial spasm on the 15th day after injury. Postmortem examination revealed neither cerebrovascular abnormalities such as aneurysm or arteriovenous malformation nor evidence of torn arteries.

Accidental Falls

Asymptomatic calcified chronic subdural hematoma--report of three cases.

Three adults with asymptomatic calcified chronic subdural hematoma are described. Plain skull x-ray films following head trauma disclosed calcified chronic subdural hematomas and computed tomography (CT) revealed large, frontoparietal, calcified hematomas in all cases. A 49-year-old male received hematoma removal because of his lower age and CT evidence of cerebral compression. An 83-year-old male was not operated on and remained asymptomatic. The third patient died of trauma-related injuries. In the non-elderly, surgery for asymptomatic calcified chronic subdural hematoma with significant cerebral compression should be considered for relief of cerebral compression and prevention of possible future brain damage.

Aged

Solitary pyogenic thalamic abscess--two case reports.

We report two patients with solitary thalamic abscesses, occurring among 91 consecutive patients (2.2%) with computed tomography (CT)-diagnosed and surgically-verified brain abscess experienced in our college during 1975 to 1991. A 9-year-old girl with congenital heart disease experienced frequent vomiting followed by left hemiparesis and deterioration of consciousness. CT demonstrated a right thalamic ring-enhanced lesion. Purulent material was aspirated via a burr hole. She died of heart failure on the 5th postoperative day. Autopsy disclosed diffuse brain swelling and an encapsulated abscess in the right thalamus, which had ruptured into the third ventricle. A 30-year-old female experienced headache, nausea, and vomiting, which progressed to somnolence and right hemiparesis. CT demonstrated a left thalamic ring-enhanced lesion. Purulent material was aspirated by stereotactic procedures. All symptoms had resolved by the end of the 2nd postoperative week.

Adult

Incidence of antibodies to hepatitis C virus in patients undergoing chronic dialysis and CAPD.

We measured antibodies to hepatitis C virus (anti-HCV) in patients who were receiving hemodialysis or continuous ambulatory peritoneal dialysis (CAPD). Sixty seven patients (28%) were anti-HCV positive. The anti-HCV positive frequency increased with the time of treatment with dialysis, the frequency being 50% with a dialysis period > or = 10 years. The frequency of anti-HCV positivity was similar in patients with a history of blood transfusion (48/152, 32%) and in those without this history (19/89, 21%, p > 0.05). Therefore, in addition to blood transfusion, there may be other routes of HCV infection associated with long-term dialysis. Chronic liver disease was observed in 31% (21/67) of the patients positive for anti-HCV but in only 6% (11/174) of the negative patients (p < 0.01). HCV seems to be important as a cause of chronic liver disease in dialysis patients.

Adult

[Multi-directional stereo viewing of MR angiography].

A new method was developed to display MR angiographic images. Nine MR angiographic images rotated along the cranio-caudal axis with ten incremental degree were constructed. These images were printed from left-anterior-oblique view to give a stereoscopic effect. With the stereoscopic viewing of these images, multiple stereoscopic images with different viewing directions were observed at once. Anatomical relationships of the vessels were more clearly understood than usual stereoscopic viewing. This multi-directional stereo viewing method is useful to display not only the MR angiographic images but also other multi-viewing techniques.

Blood Vessels

Giant negative U waves in a patient with uncontrolled hypertension and severe hypokalemia.

A 66-year-old woman with a long history of hypertension had an electrocardiogram with giant negative U waves in left precordial leads despite hypokalemia. This seems to be the first report of giant negative U waves induced by uncontrolled hypertension with hypokalemia. The occurrence of negative U waves in the presence of profound hypokalemia is an important observation because it masks the electrocardiographic manifestation of hypokalemia.

Aged

Long-term follow-up of radiosurgically treated arteriovenous malformations in children: report of nine cases.

Long-term follow-up results of nine children treated for cerebral arteriovenous malformation with a gamma unit are presented. Complete nidus obliteration was angiographically confirmed in six cases and significant decreases in arteriovenous malformation size were observed in the other three. There were no radiation-related deteriorations in physical or mental development. In seven patients who underwent endocrinological examination more than 3 years after irradiation, five were normal and the other two showed only low serum adrenocorticotropic hormone levels, which, however, did not necessitate replacement therapy. Neurodiagnostic imaging follow-up studies revealed no radiation-induced lesions in any of the nine cases.

Adolescent

Long-term results of radiosurgery for arteriovenous malformation: neurodiagnostic imaging and histological studies of angiographically confirmed nidus obliteration.

Detailed follow-up results for 25 patients treated for cerebral arteriovenous malformation (AVM) with a gamma unit are presented. Complete nidus obliteration was angiographically confirmed in 16 (73%) of 22 cases receiving full-dose irradiation. There were no radiation- or AVM-related mortalities. However, we did experience one case of radiation-related morbidity and one of angiography-related mortality, the autopsy findings of which are discussed. Computed tomography scan and magnetic resonance imaging follow-up studies of radiosurgically treated AVMs indicated that increased enhancement of the nidus after contrast or gadolinium administration could persist even after obliteration of the AVM was angiographically confirmed.

Adolescent

[A 13-week percutaneous toxicity study of prednisolone farnesylate (PNF) gel in beagle dogs with a recovery period of 5 weeks].

The toxicity of Prednisolone farnesylate (PNF) gel, a synthetic glucocorticoid, was investigated in the Beagle dog. PNF gel was administered percutaneously at doses of 0.2, 0.8 and 3.2 mg/kg/day for 13 weeks, then the drug was withdrawn for 5 weeks to evaluate the reversibility. In addition, 2 mg/kg/day prednisolone gel (PN gel), which is approximate to 3.2 mg/kg/day PNF gel in prednisolone molarity, was also administered for comparison. The results are summarized as follows: 1. No deaths were observed in any of the PNF gel test groups or the PN gel group, nor were there any abnormal findings in the clinical signs of the animals. 2. In the hematology, a tendency toward a decrease in the lymphocyte ratio was observed in males from the PNF gel 0.8 mg/kg/day and above groups. In the PN gel group, a significant decrease or a tendency toward a decrease in the lymphocyte ratio was observed, as well as an increase in the white blood cell count in some animals. 3. In the blood biochemistry, a significant decrease or a tendency toward a decrease in total cholesterol and phospholipid was observed in males from the PNF gel 3.2 mg/kg/day group and a tendency toward an increase in triglyceride in females from the PNF gel 3.2 mg/kg/day group was observed. In the PN gel group, a tendency toward an increase in AIP activity, a tendency toward an increase in triglyceride were observed. 4. In the histological examinations, a decrease in the weight of the thymus and adrenal glands, vacuolation of hepatocytes in the middle zone of the liver, atrophy of zona fasciculata of the adrenal glands, hypertrophy of zona glomeruli, swelling of cortical cells of zona faciculate and atrophy of the thymus were observed in the PNF gel 0.8 mg/kg/day and above groups. In the PN gel group, atrophy of submandibular lymph nodes and mesenteric lymph nodes was observed in addition to the same changes as observed in the PNF gel groups. Furthermore, thinning, atrophy or a decrease in the weight of the adrenal glands was also observed both in the PNF gel 3.2 mg/kg/day group and the PN gel group at the end of the 5-week recovery period. 5. As described above, a decrease in the lymphocyte ratio, in the weight of the thymus and adrenal glands and vacuolation of hepatocytes were observed in the PNF gel 0.8 mg/kg/day and above groups.(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Cutaneous

[A 52-week percutaneous toxicity study of prednisolone farnesylate (PNF) gel in beagle dogs with a recovery period of 8 weeks].

The toxicity of Prednisolone farnesylate (PNF) gel, a synthetic glucocorticoid, was investigated in the Beagle dog. PNF gel was administered percutaneously at doses of 0.05, 0.2 and 0.8 mg/kg/day for 52 weeks, then the drug was with held for 8 weeks to evaluate reversibility. The results are summarized in the following. 1. In the 0.05 mg/kg/day and above groups, hypotrichosis in the application site of the skin, thinning of the skin and atrophy of the appendages, and in the 0.2 mg/kg/day and above groups a tendency toward retarded body weight gain, were observed. 2. In the 0.2 mg/kg/day and above groups, a drop in the lymphocyte ratio, a rise in GOT activity and A1P level, and in the 0.8 mg/kg/day group a rise in free fatty acid were observed. 3. In the 0.2 mg/kg/day group and above groups, atrophy of the zona fasciculata and zona reticularis were observed. In the 0.8 mg/kg/day group, a decrease in the weight of the thymus and adrenal glands, and a increase in the weight of the liver, were observed. 4. At the end of the recovery period, most of the changes disappeared, except for those in the adrenals and treated area. From the above results, under the conditions of this study, it was concluded that when the changes observed in the application site of the skin in each group were not taken into consideration, the toxicological no effect level was 0.05 mg/kg/day for both males and females and the overt toxic dose level was 0.8 mg/kg/day.

Administration, Cutaneous

Peritumoral brain edema associated with meningioma--histological study of the tumor margin and surrounding brain.

Thirty-nine cases of intracranial meningiomas were analyzed to identify factors causing brain edema. Edema was significantly correlated with tumor size and the destruction of the leptomeninges and cortex. Meningotheliomatous meningioma tended to have more peritumoral edema. There was no correlation between the presence of edema and location of the tumor or histological features including lymphocytic infiltration and the presence of glial fibrillary acidic protein-positive cells in the tumor tissue. Larger tumors destroy the leptomeninges and cerebral cortex, allowing direct transmission of humoral edema-promoting factor or edema fluid into the white matter, resulting in vasogenic edema.

Adolescent

Postoperative neurosurgical infection and antibiotic prophylaxis.

The most suitable antibiotics for chemoprophylaxis in neurosurgery and risk factors for postoperative neurosurgical infection were investigated by retrospective analysis of 807 neurosurgical procedures in 566 patients between 1980 and 1989. Prophylactic antibiotics were administered intravenously for 6 or 7 postoperative days in all instances. The 807 operations were classified according to the antibiotics used into: 1) penicillin, 2) cephem-I, 3) cephem-II, 4) cephem-III, and 5) others. Postoperative neurosurgical infections occurred in 27 of 807 operations (3.3%), or 27 of 566 patients (4.8%). Hypertension and surgery performed in summer carried a significantly higher risk of infection. Diabetes mellitus, steroid administration, prolonged surgery, re-exploration, and surgery for hemorrhagic cerebrovascular diseases were associated with increased risk, but were not statistically significant. Infection rates by type of chemoprophylaxis were: 3.6% in the penicillin group, 3.7% in the cephem-I group, 1.7% in the cephem-II group, 5.7% in the cephem-III group, and 2.8% in the others group. This result indicates that the best choice for prophylactic antibiotic therapy may be a second-generation cephem.

Adolescent

[Right ventricular volume determination by continuous 81mKr infusion and 99mTc blood pool imaging].

Our newly developed radionuclide method for the calculation of right ventricular (RV) volume was examined in this study. Using a semi-geometric count-based method, volume can be measured by the following equation: Cv = Cm/(L/d). V = (Ct/Cv) x d3 = (Ct/Cm) x L x d2. (V = volume, Cv = voxel count, Cm = the maximum count of a container, Ct = the total count of the container, L = maximum length of the image of the container obtained from a direction perpendicular to the direction where the count data were collected, and d = pixel size.) A phantom study was performed by setting a cylindrical container in a system which circulated 5 liters of water per minute. 81mKr solution was infused continuously into the container, and images of the container were collected for one minute. Cm and Ct were obtained and, because the container was cylindrical, the maximum width of the image of the container was measured as L. The volume of the container was calculated using the above equation. The container's true volume and the volume measured by this method showed a good correlation with r = 0.997 (n = 13, p < 0.001). This theorem was applied to RV images obtained in the 30 degree right anterior oblique position by continuous infusion of the 81mKr solution. Multiple gated acquisition was performed and RV end-diastolic maximum counts and total counts were obtained. The RV maximum width was measured as L on the end-diastolic cardiac pool image with 99mTc-D-HSA collected in the 40 degree left anterior oblique position.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult