[Management of acute cerebrovascular disease--diagnostic methods and guideline of initial treatment].
Explore the source record for details and available documents.
Acute Disease↗
Biomedical subjects
M Kagawa
Publications and source records attributed to M Kagawa.
[Two cases of giant aneurysms arising from the distal segment of the anterior cerebral circulation].
Giant aneurysm arising from the distal segment of the anterior cerebral circulation is extremely rare, and only 14 cases of anterior cerebral circulation aneurysms have been reported in the literature. This report describes two cases of giant intracranial aneurysms, one arising from the distal segment of the middle cerebral artery, and the other from the azygos anterior cerebral artery. Although both of the patients started with intracranial hemorrhage, their surgical outcomes were good. The growth mechanisms of each aneurysm are discussed based on the clinical and pathological findings. Since the wall of the middle cerebral artery aneurysm showed granulomatous changes with infiltration of many inflammatory cells, the aneurysmal enlargement is considered to have resulted from chronic inflammation of the wall. In the case of anterior cerebral artery aneurysm, hemodynamic stress through the azygos artery may have caused the giant aneurysm. Operative indication for giant intracranial aneurysm is controversial. Since the surgical outcomes of reported cases are definitely better than those of the patients with proximal giant aneurysm, we conclude that giant aneurysm arising from the distal segment of the cerebral artery should be treated surgically.
Adult↗
[Falx metastasis of thymic carcinoma: a case report and review of literature].
A patient, a 72-year-old male, with a thymic carcinoma spreading to the extrathoracic region, is reported. he had undergone a thoracotomy and received radiation-and chemotherapy. Four months later, the patient was noticed to have a mild left sided hemiparesis. Further evaluations revealed metastasis of thymic carcinoma to the bone and intracranial region. Surgical treatment for intracranial lesion was performed, and the patient's left sided hemiparesis was cleared. Thymic carcinoma is uncommon, and its intracranial metastasis is rare. We found 27 previous reports of intracranial metastasis of thymic carcinoma and malignant thymoma. This time, we report a case of thymic carcinoma with intracranial (falx) metastasis, and discuss the concept of thymic carcinoma and thymomas in a review of the literature.
Aged↗
[Clinical application of calculation software of the four rules of arithmetic on computed tomography].
Calculation program software of the four rules of arithmetic in computed tomography (CT) has been introduced for clinical purposes since 1990. Evaluation of hemodynamic reserve and cerebral autoregulation can be calculated using this software in ischemic cerebrovascular diseases and delayed cerebral vasospasm after ruptured intracranial aneurysms. Eight hemodynamic maps can be entered and calculation based on the four rules of arithmetic can be performed between them and shown visually. For example, delta CBF [CBF after administration of acetazolamide (B)-CBF before its administration(A)] and % CBF [(B - A)/A x 100] maps are useful in evaluation of the capacity of hemodynamic reserve in ischemic cerebrovascular diseases. And delta CBF [CBF before induced hypertension using intravenous dopamine administration (B)-CBF during induced hypertension (A)] and % CBF [(B - A)/A x 100] also can be used in evaluation of cerebral autoregulation and decision concerning indication of the need for induced hypertension during the period of delayed cerebral vasospasm after subarachnoid hemorrhage.
Brain↗
Purification of forensic specimens for the polymerase chain reaction (PCR) analysis.
Purification methods of deoxyribonucleic acid (DNA) from degraded and contaminated forensic samples were investigated for polymerase chain reaction (PCR) analysis. DNA extracted from putrefied tissue or bloodstains sometimes contained the copurified contaminant, that was identified as the porphyrin compound (hematin). When contaminated but less degraded DNA was analyzed by PCR, it was necessary to eliminate the impurity by anion exchange column chromatography or chelating resin preparation, and ultrafiltration using Centricon microconcentrators. When highly degraded DNA was analyzed, trace amounts of high molecular weight DNA was recovered by electroelution method, and then further purified by both column chromatography and ultrafiltration. From thus purified samples, the amelogenin gene for sex determination could be amplified by dual PCR technique.
Adipose Tissue↗
Carcinogenicity of uracil, a nongenotoxic chemical, in rats and mice and its rationale.
In Experiment 1, groups of thirty 6-wk-old male and female F344 rats were given diets containing 0 (control) or 3% uracil for 104 wk. In the uracil-treated groups, carcinomas, in particular transitional cell carcinomas, developed in the urinary bladder of 90% of the males and 19% of the females. Squamous cell carcinomas also developed in 10% of the males, but not in females. Striking findings were that calculi were present in the urinary bladder of almost all males, but in only 30% of the females, and that induction of urinary bladder carcinomas was related to the presence of calculi. In Experiment 2, groups of thirty 6-wk-old male and female C57BL/6 x C3H F1 mice were given a diet containing 0 (control) or 3% (from Wk 1 to Wk 6) and 2.5% (from Wk 7 to Wk 96) uracil. The total observation period was 96 wk. In the uracil-treated groups, transitional cell carcinomas developed in 76% of the females and 8% of the males. Squamous cell carcinomas developed in only 8% of the males. In Experiment 3, 6-wk-old male F344 rats were given diets containing 3% uracil, 3% uracil plus 5% or 10% NaCl, or 10% NaCl for 36 wk and then diet without chemicals for a recovery period of 4 wk. The incidences of carcinomas and calculi of the urinary bladder were 75% and 81% in the group given uracil alone, 6% and 6% in the group given uracil plus 5% NaCl, and both zero in the group given uracil plus 10% NaCl. Thus, the present study showed that the inductions of urinary bladder carcinomas by uracil, a nongenotoxic compound, in rats and mice showed sex differences and were related to the presence of calculi in the urinary bladder.
Animals↗
Isologous monoclonal antibodies can induce anti-GBM glomerulonephritis in rats.
Injection of isologous monoclonal antibodies (SR2, SR3) caused anti-glomerular basement membrane antibody-induced glomerulonephritis (anti-GBM nephritis) in WKY/NCrj rats. The antibodies were obtained from hybridoma cells derived from fusion of the spleen of a nephritic WKY/NCrj rat injected with rat solubilized renal basement membranes with adjuvant, and mouse SP2-myeloma cells. They belonged to the rat IgG2a subclass and bound to rat kidney in a linear pattern along the glomerular and tubular basement membranes. Histological changes in glomeruli were detected at day 1 after the injection; proteinuria with haematuria appeared on day 2; and proteinuria became severe and reached a plateau by day 5. These results demonstrate that anti-GBM nephritis can even be induced by an isologous monoclonal antibody and that the rat IgG2a subclass is at least nephritogenic. The experimental model of anti-GBM nephritis with isologous monoclonal antibodies makes it possible and easier to analyse further the mechanism of anti-GBM nephritis.
Animals↗
Aspergillotic aneurysm formation of cerebral artery following neurosurgical operation.
A rare case of intracranial aspergillotic aneurysm following neurosurgical operation for facial spasm is presented. Severe meningitis had persisted several days prior to the subarachnoid hemorrhage which occurred on 70th postoperative day. Angiography demonstrated a fusiform aneurysm at the peduncular segment of the superior cerebellar artery on the other side of operation. As the repeated cultures of CSF were negative, the pathogenetic factor causing aneurysm formation could not be identified before second operation of aneurysmal resection. Pathological study of the specimen revealed the arterial wall being deeply invaded by aspergillotic hyphae.
Adult↗
Uracil-induced urolithiasis in the urinary bladder of rats is irritation-dependent.
The correlation between urolithiasis due to uracil administration and epithelial proliferation in the urinary bladder was investigated in male F344 rats. Animals, 6 weeks old at the start, which ingested 3% uracil alone in the diet for 4 weeks developed urolithiasis and papillomatosis of the urinary bladder, whereas addition of NaCl, particularly at high concentration (10%), to the 3% uracil in the diet blocked production of both. In contrast, NaHCO3 was without influence on either calculi or proliferative changes. These results indicate that uracil-induced epithelial proliferation is due to direct mechanical irritation by calculi, and not to any chemical stimulus presented by uracil itself.
Animals↗
Sex determination of forensic samples by dual PCR amplification of an X-Y homologous gene.
Sex determination by polymerase chain reaction (PCR) analysis of the X-Y homologous amelogenin gene is highly reliable since the detection of an X-specific amplified fragment validates the procedure. Previously, we reported that 250 ng of template DNA are required for sex determination by this method. We report here a refinement of the technique to include dual PCR. Dual PCR using two sets of primers results in the detection of X- and Y-specific amplified fragments from as little as 0.005 ng of template DNA. This is a powerful technique for the analysis of trace forensic samples and its application is discussed.
Amelogenin↗
Risk factors for brain abscess in patients with congenital cyanotic heart disease.
Brain abscess is a serious complication of congenital cyanotic heart disease. We retrospectively evaluated the risk factors for brain abscess in 21 such patients treated between 1975 and 1990 in comparison with a control group. The mean arterial oxygen saturation, arterial partial pressure of O2, arterial blood oxygen content, and base excess in patients with brain abscess were significantly lower than in the control patients. The mean arterial partial pressure of CO2, pH, hematocrit, hemoglobin, and red blood cell content in patients with brain abscess were not significantly different. Patients with congenital cyanotic heart disease may develop minute encephalomalacia due to severe hypoxemia and increased blood viscosity resulting from compensatory polycythemia. The increased blood viscosity and reduced blood flow in the microcirculation may induce cerebral thrombosis or exaggerate minute encephalomalacia during dehydration or cardiac dysfunction, and shunted blood containing infectious organisms at such sites may be followed by focal cerebritis.
Brain Abscess↗
Airway response by neurokinin A.
We studied the effect of neurokinin A (NKA) on tracheal smooth muscle (TSM) contraction induced by the administration of acetylcholine (ACh) intra-arterially (ia) into the tracheal circulation or bilateral vagal stimulation in 18 mongrel dogs. In five dogs, 10(-12) to 10(-7) mol of NKA was injected selectively into the tracheal circulation. The tracheal contractile response to 10(-7) mol NKA was 3.12 +/- 0.48 g/cm, 6.3 +/- 0.7% AChmax. Plasma histamine concentration in the right atrium was measured at the peak response to NKA. Plasma histamine concentration was 3.33 +/- 2.05 ng/ml after 10(-7) mol NKA (vs 0.32 +/- 0.08 ng/ml for control, p > 0.10). In the other 5 dogs, dose-response was obtained with 10(-12) to 10(-7) mol ACh 10 min before and 10 min after administration of 10(-8) mol NKA. Frequency-response relationship also was induced by electrical stimulation of the distal cut ends of the cervical vagi in the range of frequencies 1-20 Hz (constant 30 V) at 15-s intervals 10 min before and after administration of 10(-8) NKA. Considerable potentiation of the tracheal contractile response to 10(-18) to 10(-7) mol ia ACh occurred 10 min after administration of 10(-8) mol NKA (p < 0.05). Significant potentiation of the tracheal contraction to vagal stimulation at 10-20 Hz was also observed 10 min after administration of 10(-8) mol NKA (p < 0.05). We demonstrate that the substantial contractile effects of NKA on canine tracheal smooth muscle are not related to histamine release from mast cells in the respiratory tract.(ABSTRACT TRUNCATED AT 250 WORDS)
Acetylcholine↗
Analysis of glycated albumin in postmortem blood samples as the diagnostic parameters of diabetes mellitus.
Glycated hemoglobin (GHb), fructosamine and glycated albumin (GA) in hemolytic sera from cadavers were analyzed for the postmortem diagnosis of diabetes mellitus. The levels of GHb and fructosamine were determined by boronate affinity chromatography and colorimetry, respectively. Albumin fraction was isolated from the samples by Affi-Gel Blue affinity chromatography. The glycated and non-glycated molecules were separated by boronate affinity chromatography, and quantitated by bromcresol green method. Fructosamine could not be analyzed from highly hemolytic sera containing more than 10 g/l hemoglobin. In such samples, the levels of GHb and GA were deviated from the standard values, indicating their postmortem degradation. In less hemolytic samples, GA was as informative as GHb and fructosamine for the diagnosis of diabetes mellitus.
Blood Specimen Collection↗
[A case of cystic optic glioma involving chiasma and bilateral posterior optic pathway].
A case of cystic optic glioma involving chiasma and bilateral posterior optic pathway was reported. A 26-year-old male was admitted to our hospital complaining of dysarthria and left hemiparesis. CT, MRI revealed a cystic tumor at the right basal ganglia to midbrain, a calcified one at the bilateral optic tract and left temporal to thalamic region, and a small one at the chiasma. Radiotherapy and chemotherapy were performed because anaplastic astrocytoma was suspected after stereotactic biopsy of the tumor at the right basal ganglia. The subsequent MRI showed continuity among the above three lesions to be well defined. About 2 years later, however, enlargement of the cyst, tumor invasion beyond the optic pathway and growth of the chiasmal lesion were noted, and direct surgery to the chiasmal lesion was performed. The chiasma was swollen and grayish soft tumor tissue was partly resected after aspiration of the intrachiasmal cyst. The definitive pathological diagnosis was pilocytic astrocytoma. This case was designated as a peculiar optic glioma in the following respects; the patient was an adult man suffering from dysarthria and left hemiparesis, the tumor involved not only the chiasma and the bilateral optic tract, but also the outside optic pathway and was accompanied by a large cyst.
Adult↗
[One-year follow-up study of patients with severe head injury; comparison of outcomes for focal and diffuse brain injuries].
Forty patients with severe head injury were classified on the basis of initial CT findings into 2 groups of focal injury (n = 20, mean age = 55.2 years), and diffuse injury (n = 20, mean age = 45.0 years). Glasgow Outcome Scale (GOS) status at 2 post-injury intervals (at discharge and 1 year after injury) of the 2 groups were compared and prognostic factors examined. At discharge (less than 3 months after injury), there were slight differences between the 2 groups in GOS score distribution, with nearly half of the patients in each group being independent. One year after injury, mean GOS score of the focal injury group was relatively more favorable, with about 60% of patients being independent, while no significant improvement was observed in the diffuse injury group. With the exception of brainstem signs, in both groups, the parameters of type of lesion detected on initial CT, modality of treatment, patient age, and operative timing all proved of little prognostic value. Brainstem injury due to intracranial mass lesions or postoperative brain edema was presumably a critical factor affecting prognosis in the focal injury group, while both primary and secondary brainstem injuries could have been major factors affecting prognosis in the diffuse injury group. In the prognosis of patients with severe head injuries, not only the parameter of initial CT findings but also time course of changes in brainstem signs, serial CT findings, MRI, and electrophysiological analyses such as motor evoked response should be considered.
Age Factors↗
Comparative promoting activities of phosphate salts on rat two-stage bladder carcinogenesis under conditions of equivalent urinary Na+ or K+ levels.
Promoting effects of Na or K phosphate salts on rat two-stage bladder carcinogenesis were compared. Animals were treated with 0.05% N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) in their drinking water for 4 weeks and thereafter received 1.4% Na3PO4, 2.0% NaH2PO4, 1.0% K3PO4, or 2.5% KH2PO4, these dietary concentrations being selected because they result in approximately equal levels of Na+ and K+ in the urine, equivalent to moderate natriuresis or kaluresis in comparison with our previous data. Treatment with Na3PO4 or K3PO4 induced significant increase in urinary pH compared with control values, whereas urinary pH in the NaH2PO4 and KH2PO4 groups was comparable to control values. With regard to preneoplastic lesion development, both incidences and multiplicity were significantly increased in the groups given Na3PO4 or K3PO4 compared with both controls and NaH2PO4 or KH2PO4 groups, respectively. Furthermore, treatment with Na3PO4 significantly increased multiplicity of papillomas, accompanied by a tendency to increased incidence. No statistically significant difference in promoting potential between Na3PO4 and K3PO4 groups was evident. The present results thus suggest that tumor promotion under conditions of moderate natriuresis or kaluresis depends primarily on high urinary pH.
Animals↗
Carrier diagnosis by RFLP analysis in a family affected with infantile hypophosphatasia: case report.
Explore the source record for details and available documents.
Alkaline Phosphatase↗
Properties of bovine nephritogenic antigen that induces anti-GBM nephritis in rats and its similarity to the Goodpasture antigen.
The nephritogenic antigen that induces antiglomerular basement membrane antibody-induced glomerulonephritis (anti-GBM nephritis) in rats was isolated from collagenase-solubilized bovine renal basement membranes. Purification was achieved using antibody-coupled affinity columns which were originally used for the purification of trypsin-solubilized nephritogenic antigen (Sado et al. 1984a). The nephritogenic antigen was a heteropolymer composed of P2 (Mr 28 kDa) and P3 (Mr 30 kDa) polypeptides as monomers and their dimers in sodium-dodecyl-sulfate (SDS) polyacrylamide gel electrophoresis. The P3 polypeptide was considered to be the nephritogenic epitope, since a fraction composed of the P2 polypeptide alone was not nephritogenic. The properties of the nephritogenic epitope were the same as those of the Goodpasture epitope (M2*), which is a noncollagenous domain of the alpha 3 chain of type IV collagen (Butkowski et al. 1985; Saus et al. 1988), indicating that the nephritogenic antigen is the same as the Goodpasture antigen.
Animals↗