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Biomedical subjects

M Shigemori

Publications and source records attributed to M Shigemori.

At least 73 records · Page 4Linked to original sources
PubMed1996

Tolosa-Hunt syndrome with atypical intrasellar and juxtasellar lesions--two case reports.

Two patients with Tolosa-Hunt syndrome (THS) who had atypical lesions in the intrasellar and juxtasellar regions are reported. They manifested with painful ophthalmoplegia. Magnetic resonance imaging (MRI) commonly showed an increase in the volume of the cavernous sinus occupied by homogeneously well-enhanced lesions in both cases. These lesions extended to the intrasellar and juxtasellar regions with meningela enhancement. Follow-up MRI after steroid treatment demonstrated normalized or decreased size of the cavernous sinus. These findings suggested nonspecific inflammatory granulomatosis with atypical extension.

Female↗
PubMed1996

Transient global amnesia and dural arteriovenous fistula of the anterior cranial fossa.

Dural arteriovenous fistula (AVF) of the anterior cranial fossa is associated usually with cerebral hemorrhage or subarachnoid hemorrhage, while an association with transient global amnesia has not been reported previously. A case presenting the latter unusual symptom is described and the surgical treatment of AVF is discussed. A 64-year-old woman was hospitalized complaining of transient memory impairment. Magnetic resonance (MR) imaging demonstrated a flow void in the left frontal lobe and temporal pole. Cerebral angiography revealed an AVF in the anterior cranial fossa, which was fed bilaterally by the ethmoidal arteries and by branches of the external carotid arteries. The AVF drained into the superior sagittal sinus and the superficial sylvian vein via large varices. Following transfemoral embolization, surgical treatment was carried out. Postoperative angiography revealed complete obliteration of the anomaly. There were no further episodes of amnesia. In our presented case, there is an association between the presenting symptoms and the AVF. The combination of ischemia and congestion in the frontal and temporal lobes may have caused transient memory impairment. From our surgical experience, the excision of the vascular connection between the dura and the frontal lobe following the coagulation of the dura mater of the anterior part of the base of the skull without extensive excision seems to be recommended.

Acute Disease↗
PubMed1996

[Motor evoked potentials of transcranial magnetic stimulation for Parkinson's disease].

We studied motor evoked potential (MEP) elicited by transcranial magnetic stimulation (TMS) in 37 patients with Parkinson's disease (PD). TMS was used at high energy capacity (800 Volts) in all patients and normal subjects under resting position. MEPs were recorded from the abductor pollicis brevis and the abductor hallucis. Magnetic stimulator equipped with an 8-shaped coil and a flat type coil was used for TMS. The data were statistically evaluated using a paired Student t test. The latency of MEPs were slightly shorter in PD patients than that in normal subjects. There were significant differences between HV. (Healthy volunteers) and group B (Hoehn & Yahr's stage III) (p = 0.012), HV, and group C (Hoehn & Yahr's stage IV.V) (p = 0.002), group A (Hoehn & Yahr's stage I.II) and C (p = 0.005) respectively. The duration of MEPs became longer depending on the severity of PD evaluated by Hoehn & Yahr's disability rating. Significant correlations were found between HV, and group C (p = 0.001), group A and C (p = 0.015). The amplitude of MEPs also increased with the severity on the rating. There were significant differences between HV, and group C (p = 0.0002), group A and B (p = 0.0004), group B and C (p = 0.0009) respectively. These changes of MEP findings indicated the dysfunction of pyramidal motor pathways in PD. Thus, the disability in patients with PD can be well evaluated by MEP measurement.

Adult↗
PubMed1996

Serum levels of hyaluronic acid indicate the severity of joint symptoms in patients with systemic and polyarticular juvenile rheumatoid arthritis.

OBJECTIVE: Elevated serum levels of hyaluronic acid (HA) correlate with joint inflammation in adult rheumatoid arthritis (RA). There are no laboratory indices for specifically assessing joint inflammation. Therefore, serial measurements of HA were assessed as a possible tool for measuring the severity of arthritic symptoms in children with juvenile rheumatoid arthritis (JRA). METHODS: Serum levels of HA, measured by a sandwich assay method using HA binding protein, were correlated with the severity of joint symptoms and with laboratory test values in 71 patients with JRA, 30 children with other rheumatic diseases, and 138 children without rheumatic disease. RESULTS: Serum levels of HA showed significant correlation with the severity of joint symptoms, but not with systemic symptoms, in patients with systemic and polyarticular JRA. No other laboratory tests, including C-reactive protein and erythrocyte sedimentation rate, reflected the severity of joint symptoms. This correlation of serum levels of HA with joint symptoms was observed in patients with systemic and polyarticular JRA, but not in pauciarticular JRA, other rheumatic diseases, or nonrheumatic diseases, even when signs of arthritis were present in the latter 3 groups. CONCLUSION: Serum levels of HA are useful in objectively evaluating arthritic symptoms in patients with systemic and polyarticular JRA, and may have diagnostic value in this disease.

Adolescent↗
PubMed1996

Intracranial plasma-cell granuloma: a case report.

A 57-year-old woman presented with right-sided ptosis and diplopia. CT scans showed a tumor in the right cerebellopontine angle attached to the tentorium. Subtotal resection was conducted prior to local irradiation (20 Gy). Histological examination of the resected specimen indicated a diagnosis of plasma-cell granuloma. Diffuse thickening of the tentorium and falx were seen on follow-up MR imaging six years after the operation. Only eleven cases of intracranial plasma-cell granuloma have been reported in the literature. This paper reports a new case with unusual recurrence on neuroimagings.

Brain↗
PubMed1996

[Choroidal epithelial cyst of the quadrigeminal plate].

A case of choroidal epithelial cyst of the quadrigeminal plate is reported. A twenty-five-year-old man was admitted to our department because of Parinaud's sign and intermittent headache. CT and MRI showed a cyst in the posterior part of the third ventricle. Left occipital transtentorial approach was carried out and the wall of the cyst was subtotally removed. The cyst contained watery clear fluid. On light microscopy, the cyst wall consisted of a single layer, flat epithelial cells and thick collagenous connective tissue. An electronmicroscopic study revealed that the epithelial cells rested on a basement membrane separating them from the underlying collagenous tissue. Microvilli without coating material were presented on the surface of the cells. With this data in hand, the cyst was considered to originate from the developing choroid plexus.

Adult↗
PubMed1995

Giant aneurysm at the origin of the accessory middle cerebral artery.

BACKGROUND: Aneurysms of the A1 portion of the anterior cerebral artery are rare. The accessory middle cerebral artery is also a rare anomalous artery. CASE REPORT: We operated on a 53-year-old man because of a giant aneurysm which arose at the junction of the accessory middle cerebral artery and the horizontal portion of the anterior cerebral artery (A1 portion). CONCLUSION: This is the first report of a giant aneurysm of that region. A detailed evaluation of the angiogram is necessary prior to the operation, in order to select the most appropriate operative method to secure the blood flow of the accessory middle cerebral artery and distal anterior cerebral artery.

Cerebral Angiography↗
PubMed1995

A case of pituitary apoplexy in a child.

A case of pituitary apoplexy is reported in a 14-year-old girl who presented with headaches and progressive visual disturbance. Magnetic resonance imaging demonstrated subacute hemorrhage into a pituitary adenoma. Transsphenoidal removal of the tumor was performed successfully. Pituitary apoplexy in children is rare. Thus we will discuss the clinical features and neuroradiological findings.

Adolescent↗
PubMed1995

Simultaneous occurrence of aneurysmal subarachnoid hemorrhage and remote intracerebral hemorrhage--case report.

A 77-year-old female presented with a rare aneurysmal subarachnoid hemorrhage accompanied by a remote hypertensive intracerebral hemorrhage. With a past history of hypertension, she suddenly developed right hemiparesis followed by delayed loss of consciousness. Left carotid angiography demonstrated a left internal carotid-posterior communicating artery aneurysm. The intracerebral hematoma was located in the posterior limb of the internal capsule ipsilateral to the ruptured aneurysm. The aneurysm was clipped with a fenestrated clip 3 weeks after the onset. The rise in blood pressure at the onset of intracerebral hemorrhage probably caused the rupture of the internal carotid-posterior communicating artery aneurysm.

Aged↗
PubMed1995

Postoperative chronic subdural hematoma following craniotomy--four case reports.

Postoperative chronic subdural hematoma (CSH) following craniotomy developed in only four of 372 patients undergoing craniotomy for aneurysm surgery (1 patient) and brain tumor surgery (3 patients) between April, 1991 and November, 1993, an incidence of only 1.1%. There were three males and one female, aged from 32 to 66 years (mean 56 yrs). The period between craniotomy and development of CSH ranged from 3 to 5 months (mean 4.3 mos). Postoperative hematomas were located on the operative sides in three patients and the contralateral side in the other. Early postoperative computed tomographic scans found subdural fluid collection in all patients. Magnetic resonance images showed linear meningeal enhancement in all patients. Postoperative CSH may be caused by mixture of blood in subdural cerebrospinal fluid collection which persists due to reduced brain elasticity and wide subarachnoid membrane opening resulting in neomembrane formation and finally development of hematoma.

Adult↗
PubMed1995

The effect of Antineoplaston, a new antitumor agent on malignant brain tumors.

Antineoplaston (Ap), a new antitumor agent, was clinically tested for effects on malignant brain tumors. The materials were 3 cases of glioblastoma (G,B), 2 cases of anaplastic astrocytoma, 1 case of pontine glioma, 2 cases of metastatic brain tumor and 1 case of medulloblastoma. All patients underwent radiochemotherapy and surgical resection of the tumors except the cases of pontine glioma, metastatic brain tumor and anaplastic astrocytoma. For gliomas, radiochemotherapy was used with Hu-IFN-beta. Ap was administered at a dose of 7-10 g/day in combination with remission maintenance therapy of gliomas. Complete response was obtained in one anaplastic astrocytoma. Partial response was obtained in 2 cases, a pontine glioma and a metastatic brain tumor. No change was observed in 2 cases, an anaplastic astrocytoma and a multiple brain metastasis. Progression of the disease was observed in 4 cases, 3 glioblastomas and 1 medulloblastoma, which showed continuous increase in tumor size. The effects of Ap on malignant brain tumors were considered due to synergy, since it was administered with other drugs and acceleration of tumor cellular differentiation. Ap is useful as an approach to remission maintenance therapy for brain tumors.

Adult↗
PubMed1995

[A case of atypical course after balloon occlusion for high flow traumatic carotid-cavernous fistula].

We treated a patient with a high flow traumatic carotid-cavernous fistula (CCF) by transarterial balloon occlusion. A 26-year-old male sustained an injury of the head. After 2 months he was admitted to our hospital due to exophthalmos, congestion of the palpebral conjunctiva. Right common carotid angiography showed a CCF with high flow shunt. He was treated by the endovascular balloon technique. Following the operation, abducens nerve palsy, headache, vomiting and convulsion developed and disappeared gradually within one week. Post operative 123I-IMP-SPECT revealed hyperperfusion of cerebral circulation compared to preoperative one. Post operative rt-carotid angiography showed pseudoaneurysm at cavernous portion of internal carotid artery. We discussed on abducent nerve palsy, pseudoaneurysm and hyperperfusion syndrome.

Accidents, Traffic↗
PubMed1995

Thallium-201 in brain tumors: relationship between tumor cell activity in astrocytic tumor and proliferating cell nuclear antigen.

UNLABELLED: This study was performed to assess the relationship between 201Tl chloride uptake and brain tumor proliferation using monoclonal antibody Ki-67 and proliferating cell nuclear antigen (PCNA). METHODS: Thirty-four patients with brain tumors were studied. Serial SPECT images were recorded and thallium uptake (Tl index) and washout rates in the tumors were calculated. Imaging results were compared with those from biopsy and histology. Cell proliferation was determined by PCNA or Ki-67 monoclonal antibody staining. RESULTS: Thallium-201-chloride indices of the astrocytoma were 1.73 +/- 0.17 and 1.48 +/- 0.07 on early and delayed images, respectively. On the other hand, 201TI indices for anaplastic astrocytoma were 2.60 +/- 1.05 and 1.76 +/- 0.93 and 3.26 +/- 1.63 and 2.23 +/- 0.56 for glioblastoma. The correlation between the 201TI (delay) and Ki-67 indices for astrocytic tumor. There were no significant differences between Ki-67/PCNA indices and washout rates. CONCLUSION: There was a positive correlation between PCNA but not the Ki-67 labeling index and the 201Tl index. With the use of a noninvasive technique, 201TI index supports the PCNA index.

Astrocytoma↗
PubMed1994

Hemiatrophy of the tongue due to hypoglossal schwannoma shown by MRI.

Schwannomas account for 8.5% of all intracranial tumours; more than 90% arise from the 8th cranial nerve. Only 42 cases of schwannoma of the hypoglossal nerve have been reported. A 59 year-old woman developed right hemiatrophy of the tongue, clearly demonstrated on MRI, as was a small hypoglossal schwannoma. High signal was seen in the atrophic side of the tongue on both T1- and T2-weighted images, as described in the literature.

Cranial Nerve Neoplasms↗
PubMed1994

Benign intracerebellar cyst without epithelial lining.

A case of benign intracerebellar cyst is reported in a 61-year-old woman who presented progressive neurological deficits. MRI and operative findings could not reveal any evidence of neoplastic growth. The biopsied cyst wall revealed normal cerebellar tissue. The simple cyst of the cerebellum is rare, thus we discuss the clinical features and etiology of this rare entity.

Cerebellar Diseases↗
PubMed1994

Neuroblastomas of the central nervous system--clinicopathological features of a cerebellar neuroblastoma in comparison with a metastatic cerebral neuroblastoma.

Two patients with neuroblastoma of the central nervous system are described. The first, a 10-month-old male infant with symptoms of vomiting and weakness of the right upper extremity, was found on magnetic resonance imaging (MRI) to have enhanced mass lesion in the left hemisphere, vermis of the cerebellum and part of brain stem. The second, a 3-year-old boy who had swelling of the right side of the head, was found on computed tomography (CT) to have enhanced mass lesion of the frontal hemisphere and frontal bone. Histological examination of the surgical specimen of both cases demonstrated neuronal differentiation. The clinicopathological features of cerebellar neuroblastoma in comparison with metastatic neuroblastoma of the frontal lobe were discussed.

Brain Neoplasms↗
PubMed1994

[Clinical features of infantile patient with juvenile rheumatoid arthritis].

Little is known about clinical features of infantile juvenile rheumatoid arthritis (JRA) because it is very rare for the patients to develop JRA within one year of age. In the past 20 years, we experienced three JRA patients whose onset was under 1 year of age. The incidence of infantile JRA was 3.2% of all JRA patients in our facility. They are 9 month-old male with systemic onset, 6-month-old female with polyarticular onset and 8 month-old female with systemic onset. It was difficult to evaluate subjective symptoms such as arthralgia or morning stiffness since the patients could not complain precisely. Therefore, careful observation on their behaviors, such as the delayed development of their motor function and bad humor and/or loss of activity in the morning, was important for evaluating joint symptoms. In case 1, measuring the serum level of hyaluronic acid was specifically useful to evaluate the arthritis. Drug therapy was not successful especially in infantile JRA. One of the reason for this ineffectiveness of drug therapy might be explained by poor adsorption of drugs in infants; the serum acetyl salicylic acid level was lower in infantile patients than the other patients with JRA even though they received enough dose of aspirin. Infantile JRA was revealed to have specific difficulties in early diagnosis and adequate treatment. Therefore, accumulated case studies about clinical features of infantile JRA is essential for their better prognosis.

Arthritis, Juvenile↗