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Biomedical subjects

N Saeki

Publications and source records attributed to N Saeki.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Intravenous DSA as a screening method for cerebral aneurysms].

Intravenous DSA (IVDSA) was evaluated as a screening method for cerebral aneurysms. It was performed 390 times in 372 cases. Clinically useful images were obtained in 94.1% in all examinations. Nineteen aneurysms were visualized in cerebral angiography among 21 cases with SAH or 3rd nerve palsy, whereas in IVDSA 15 aneurysms were noted. Aneurysms not visualized in IVDSA were all 4 mm or less in size. Therefore, aneurysms, more than 4 mm in size, which have higher risks for rupture, were detectable in IVDSA. Based on these findings, IVDSA is considered to be clinically useful in screening for aneurysms. In all 372 cases, 33 aneurysms were suspected in IVDSA findings, whereas in cerebral angiography 21 of them turned to be aneurysms. Such 12 false positive cases were distributed mainly at anterior communicating and middle cerebral arteries. Improvement of image resolution, avoidance of vessel overlapping and proper selection of screened cases should be investigated for further development of this screening method.

Angiography, Digital Subtraction↗
PubMed1989

Post-traumatic intention tremor--clinical features and CT findings.

Eight patients with post-traumatic intention tremor were reported. Intention tremor developed in the young as a late complication of severe head injury (Glasgow Coma Scale was below 8 in all cases) and impaired their functional outcome. This state was treatable with medication or by stereotactic thalamotomy. Neurologically, all the patients lapsed into coma immediately after the injury and many patients manifested clinical signs of a midbrain lesion in the chronic stage. The characteristic CT (computed tomography) findings in the acute stage were a high density area in the midbrain, accompanied by diffuse cerebral swelling or intraventricular hemorrhage, and in the chronic stage, brain atrophy or ventricular enlargement were the most prominent CT findings. These characteristics, indicating diffuse brain damage in addition to midbrain injury, may suggest the presence of shearing injury. The midbrain damage is consistent with the classical hypothesis that the damage to the Dentate-Rubro-thalamic system accounts for the occurrence of intention tremor. Furthermore, the presence of diffuse brain damage suggests that a more widespread brain injury may participate in its development.

Adolescent↗
PubMed1989

[Intention tremor after head injury. Clinical features and computed tomographic findings].

Eight cases of intention tremor as a late complication of head injury were investigated. The patients ranged in age from 3 to 24 years. All received severe head injuries and lapsed into coma immediately afterward (Glasgow Coma Scale scores less than or equal to 8). Six patients exhibited decerebration or decortication. Hemiparesis was present in six cases and oculomotor nerve palsy in four. In the chronic stage, all patients displayed some degree of impairment of higher cortical function and five had dysarthria and/or ataxia. Initial computed tomography (CT) scans within 3 hours after the injury were obtained in five cases, of which four showed a hemorrhagic lesion in the midbrain or its surroundings. Other CT findings were diffuse cerebral swelling (four cases), intraventricular hemorrhage (three), and multiple hemorrhagic lesions (two). In the chronic stage, generalized cortical atrophy or ventricular enlargement was noted in five cases. These clinical features and CT findings indicate diffuse brain damage as well as midbrain damage and may reflect shearing injury.

Adolescent↗
PubMed1989

[Umbilical blood-gas status at cesarean section for breech presentation: a comparison with vertex presentation].

Umbilical blood-gas status at elective cesarean section with oxygen inhalation for breech presentation (25 cases) was compared with that for vertex presentation (25 cases), so as to confirm the security of full-term breech fetuses delivered by cesarean section under spinal anesthesia. Umbilical arterial oxygen levels were significantly lower in the breech group (Mean PO2:18.9 mmHg; SO2:37.3%; Oxygen content:7.6 ml/dl). The number of hypoxemic fetuses was significantly higher in the breech group (the breech: 7; the vertex; 0). The other umbilical blood-gas values revealed no significant differences between the breech and vertex groups, and were within normal limits in both groups. Oxygen extraction in the breech (Mean: 49.0%) was higher than that in the vertex (32.9%). Therefore decreased umbilical blood flow in the breech was suggested. The incidence of depression at 1 minute after delivery in the breech infants (24%) was significantly higher than that in the vertex infants (0%). It became obvious in the breech that as the interval between the uterine incision and delivery increased, umbilical arterial blood tended to acidosis and the 1 minute Apgar score decreased. Cesarean section for breech presentation requires sufficient and optimal incisions of the abdominal wall and uterus as well as a skillful manual delivery technique, because the fetus or neonate should be protected against asphyxia resulting from umbilical compression and prolonged delivery interval.

Adult↗
PubMed1988

[Effects of maternal hyperventilation and oxygen inhalation during labor on fetal blood-gas status].

The effects of maternal hyperventilation and oxygen inhalation on fetal blood-gas status were studied in 54 fetuses, vaginally delivered of mothers without medical and obstetrical complications. The cases were divided into four groups according to MA (maternal arterial) pH and PCO2 values and by respiring either oxygen or room-air as follows. Group N: pH less than 7.5, PCO2 greater than 23 mmHg (normoventilation), without maternal oxygen inhalation, group H: pH greater than 7.5, PCO2 less than 23 mmHg (hyperventilation), without oxygen inhalation, group NO: pH less than 7.5, PCO2 greater than 23 mmHg, with oxygen inhalation and group HO: pH greater than 7.5, PCO2 less than 23 mmHg, with oxygen inhalation. Umbilical venous (UV) PO2 (27.8 mmHg: mean), SO2 (60.8%) and CO2 (oxygen content, 12.4 ml/dl), and umbilical arterial (UA) PO2 (17.9 mmHg), SO2 (35.6%) and CO2 (7.3 ml/dl) values in group H were significantly lower than those in group N. The fetal oxygenation in group HO was similar to that in group N, and the fetal oxygen values in group NO were significantly higher than those in the other groups. The fetuses in groups H and HO tended to respiratory alkalosis. The UV oxygen values had negative correlations with MA pH and positive correlations with the MA PCO2 value in both oxygen and no-oxygen groups. There was no significant correlation between maternal and fetal PCO2 values, and higher fetal oxygen extraction (41%: mean) in group H. These facts suggest that severe maternal respiratory alkalosis due to hyperventilation may lead to a disorder in placental circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid-Base Equilibrium↗
PubMed1988

[Three cases of involuntary movements following pontine hemorrhage].

We reported three cases with involuntary movements following pontine hemorrhage. All cases had various symptoms indicating brain-stem lesions, but the consciousness and motor functions were not severely disturbed. CT scans showed a small hematoma localized in unilateral pontine tegmentum in all cases. Intention tremor developed six to ten months after the hemorrhage when the initial neurological symptoms were almost relieved. Electromyogram (EMG) showed a rhythmic 3-4 Hz alternating or synchronized tremor pattern which was induced by finger-nose test and arm stretching. In one case which had showed bilateral horizontal gaze palsy indicating bilateral PPRF involvement in the acute stage, spontaneous vertical nystagmus was observed when the tremor developed. Electronystagmogram (ENG) and its differential calculus showed a pendular nature of the eye movement. This abnormal eye movement did not disappear while the patient was asleep. This case also developed a palatal myoclonus in the chronic stage. Magnetic resonance images (MRI's) obtained one to three years after the hemorrhage revealed a lesion localized in hemipontine tegmentum. The responsible lesion of these involuntary movements was thought to be located in pontine tegmentum from the MRI findings. The functional Prognosis of small hemorrhage in unilateral pontine tegmentum is generally good, but care should be taken for the possibility of late development of various types of involuntary movement.

Cerebral Hemorrhage↗
PubMed1988

[Partial oculomotor nerve palsy due to midbrain lesion--case report and discussion on its characteristics].

UNLABELLED: A case of partial oculomotor palsy due to midbrain infarction is reported. CASE PRESENTATION: Fifty-one-year old man noted a sudden onset of double vision. He transiently presented right hemiparesis, right hemihyposthenia and cerebellar ataxia. The main symptom was the left oculomotor palsy selectively involving extraocular muscles (levator and pupil sparing), lasting for more than 6 months. The CT scan showed localized and well demarcated low-density areas at the left tegmentum of midbrain and left anteromedial thalamus, diagnosed as lacunar infarction due to occlusion of paramedian perforators at the basilar bifurcation. This midbrain infarct was supposed to be responsible for the partial oculomotor palsy. Extramedullary compressive and ischemic lesions have been well-known main causes of partial oculomotor palsy. This case, however, has emphasized the importance of recognition of midbrain lesion as a causative location of the partial oculomotor palsy. While the anatomical elucidation of this infrequent palsy is not sufficient, a topography of oculomotor nuclear complex in rhesus monkey proposed by Warwick, is worthwhile to correlate with midbrain oculomotor palsy in human cases. The pupil and levator sparing oculomotor palsy is most frequently caused by the laterally localized lesion at the fascicular portion which extends transversely at the midbrain tegmentum. This is the most likely lesion in this reported case. It is reported, on the other hand, that the levator sparing type oculomotor palsy is caused by a paramedian lesion of rostral midbrain and pupil sparing type by caudal midbrain. These may be explainable by rostro-caudal extension of the nuclear complex.

Cerebral Infarction↗
PubMed1987

IgG4 antibodies in patients with atopic dermatitis.

The role of IgG4 in atopic dermatitis was investigated by determining the total amounts of IgG4 and of IgG4 specific for ovalbumin (a food allergen), Dermatophagoides farinae mite antigen and house dust (inhalant allergens) and Candida. These were related to the amounts of total and antigen specific IgE in patients with atopic dermatitis and normal healthy controls. Most patients with atopic dermatitis had greater amounts of total IgG4 and of antigen-specific IgG4 than did normal control individuals. Patients who had received hyposensitization treatment injections had greater amounts of IgG4 than the atopic dermatitis patients not so treated. In patients treated by hyposensitization there was a large increase in the amount of blocking antibody detected by incubating the antigen with the serum overnight before injecting the mixture into the skin of a patient sensitive to the antigen. Blocking activity was also examined by partial inhibition by the serum of IgE-mediated mast cell degranulation and by injection of serum into the skin of sensitive patients before challenge with antigens. In all tests the blocking activity of the serum was related to the amount of antigen-specific IgG4 but not related to total IgG4. In patients with atopic dermatitis who were sensitive to mite antigen, severe cases had small amounts of specific IgG4 and large amounts of specific IgE but in mild cases there was an opposite trend with relatively large amounts of specific IgG4. Large amounts of IgG4 ovalbumin specific antibody were found in children and adults with atopic dermatitis and egg allergy but small amounts of IgE. In infants most of the anti-ovalbumin antibody was IgE with little or no IgG4. The work of others has confirmed that increased amounts of total and antigen-specific IgG4 occur in atopic dermatitis, and it is concluded that IgG4 is a blocking antibody for anaphylactic sensitization responses.

Adolescent↗
PubMed1987

[Ephedrine administration for cesarean section under spinal anesthesia].

Prophylactic ephedrine was administered to healthy parturients undergoing elective cesarean section under spinal anesthesia. The methods of ephedrine administration were as follows: intramuscular injection of 0.3 mg/kg, 15 minutes before the block (20 cases: group M), infusion of 0.02% solution immediately after the block (20 cases: group D), premedication with atropine 0.5 mg and infusion immediately after the block (20 cases: group AD). The mean ephedrine dosage was 18.8 +/- 2.2 gm (SD) in group M, 12.6 +/- 6.2 mg in group D and 5.2 +/- 0.7 mg in group AD, and there were significant differences among the three groups. The base line (a), the minimal postanesthetic (b) and the maximal postpartum systolic blood pressures (c) revealed no significant difference among the three groups, and 'b' was significantly higher than 'a' and lower than 'c' in all groups. Only one case (group M) was transiently hypotensive, while hypertension was not found in any of the subjects. One- and 5-minute Apgar scores were 8 or more in all, and umbilical acid-base values were within normal limits in all of them, though the base deficit in group AD was significantly lower than that in group M. Atropine premedication makes it possible to retrench the ephedrine dosage without any harmful effect on either mother or fetus, and ephedrine infusion makes it easy to cope with changes in maternal blood pressure. Consequently, for healthy parturients receiving elective cesarean section under spinal block, we recommend atropine premedication and minimal infusion of ephedrine immediately following the block.

Adult↗
PubMed1986

Horizontal excision and suture of benign lesions on the upper and lower eyelids: indications and limitations.

Horizontal excision and closure is not usually recommended for lesions of the eyelids. We have used the technique for 35 benign lesions in 33 patients over the last 3 years with satisfactory results. This method is a simple one that can provide excellent cosmetic results in properly selected patients. Six representative cases are described in detail and the limitations of and indications for horizontal closure are discussed.

Adolescent↗
PubMed1986

Challenge reactions in atopic dermatitis after percutaneous entry of mite antigen.

We succeeded in reproducing an eczematous lesion on the apparently normal skin of a patient with atopic dermatitis by scratching and continuous application of an ointment containing ferritin-labelled mite antigen. Percutaneous entry of mite antigen was demonstrated in skin biopsies by Fe-staining. Scratched skin first showed an urticarial reaction typical of type I allergy which later changed into an eczematous reaction typical of type IV allergy. This change was also shown histologically.

Adult↗
PubMed1986

[Intervillous blood-gas status, especially oxygenation during cesarean section].

Intervillous (IV), arterial (MA), and umbilical venous (UV) and arterial (UA) blood-gas values were measured in 36 healthy pregnant women. The patients were divided into three equal groups and underwent elective cesarean sections under spinal block. Oxygen was administered through a nasal cannula (group OL) or a mask (group OH), through group RA received no oxygen inhalation. Mean MAPO2 in each group was 102.0, 213.9 and 482.4 mmHg, respectively. Intervillous PO2 (Mean +/- SD mmHg) was 49.0 +/- 7.1 in group RA, 63.1 +/- 14.5 in group OL, 84.6 +/- 25.2 in group OH, oxygen saturation (%) was 83.2 +/- 6.0, 89.6 +/- 5.5 and 94.3 +/- 2.6, respectively, and oxygen content (CO2: ml/dl) was 12.7 +/- 0.9, 13.7 +/- 1.0 and 14.4 +/- 0.5, severely. There were significant differences in the intervillous oxygen values among the three groups. The intervillous acid-base value in group RA (pH: 7.389 +/- 0.013, PCO2: 33.9 +/- 2.3 mmHg and BD: 4.4 +/- 0.9 m mol/l) showed no significant differences from those of the other groups. Mean UVCO2 was somewhat greater than mean IVCO2 in any group due to the relatively higher oxygen affinity of fetal blood. Both IV and UVPO2 were not so elevated with oxygen inhalation and this was assumed to be due to characteristics of the oxyhemoglobin dissociation curve. The other results produce reliable evidence that placental circulation is not affected by maternal hyperoxia and that an increase in (IV-UA)PO2 facilitates oxygen transfer to the fetus.

Carbon Dioxide↗
PubMed1986

[Neonatal effects of the delivery interval during cesarean section under spinal anesthesia].

The relationships between I-DI (induction to delivery interval) or U-DI (uterine incision to delivery interval) and fetal acid-base status or neonatal clinical condition were studied in 60 healthy parturients undergoing elective cesarean section under spinal anesthesia. The patients were divided into groups, i.e. group A (U-DI less than 90 sec, I-DI greater than 14 min, 18 cases), group B (U-DI less than 90 sec, I-DI greater than 14 min, 12 cases), group C (U-DI greater than 90 sec, I-DI less than 14 min, 15 cases) and group D (U-DI greater than 90 sec, I-DI greater than 14 min, 15 cases). Acid-base values for maternal arterial (MA), umbilical venous (UV) and umbilical arterial blood (UA), and acid-base gradients for (MA-UV) and (UV-UA) in each group were all in the normal range and revealed no significant differences among 4 groups, though U-DI was correlated with UVPCO2, UAPCO2, and (UV-UA) base deficit (r = 0.322, 0.266, -0.256: p less than 0.05). Acid-base states in cases of long and excessively long U-DI (greater than 90 sec and greater than 150 sec, respectively) were more acidotic than those of short U-DI groups (less than 90 sec). Both 1 and 5 minute Apgar scores were 8 or more in all neonates. There was no correlation between I-DI and fetal acid-base values or neonatal clinical conditions. It is conceivable that gentle and careful manipulations of the uterus and fetus rather than shortening of U-DI might be important in preventing against fetal or neonatal depression during cesarean section under spinal block.

Acid-Base Equilibrium↗