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Biomedical subjects

O Kubo

Publications and source records attributed to O Kubo.

At least 73 records · Page 4Linked to original sources

[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↗

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↗

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↗

[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↗

Clinicopathological study of bacterial intracranial aneurysms.

The authors report the clinicopathological findings in six cases of bacterial intracranial aneurysms. All patients received appropriate high-dose antibiotics, and four were treated surgically. One patient with multiple aneurysms of the main trunks died of disseminated intravascular coagulation. Autopsy disclosed no apparent aneurysm or inflammatory cell infiltration, but a partially interrupted internal elastic lamina and thickened intima were disclosed at the angiographical aneurysm sites. These findings suggest that 1) appropriate high-dose antibiotics are effective against inoperable bacterial aneurysms in the main trunks, 2) new aneurysms may be formed in patients with cyanotic congenital heart disease, because bacterial emboli can directly reach the cerebral circulation and reimplant on the fragile arterial walls after vasculitis. Histological examination of aneurysmal walls revealed inflammatory cell infiltration after resolution of clinical endocarditis. This suggests that both appropriate high-dose antibiotic therapy and surgery should be considered in patients with distal bacterial aneurysms.

Adolescent↗

[Clinicopathological studies of three cases of cerebral aneurysms associated with systemic lupus erythematosus].

We report three cases of ruptured cerebral aneurysms associated with systemic lupus erythematosus (SLE). A 52-year-old woman (case 1) with a fifteen-year history of systemic lupus erythematosus suddenly lost consciousness. She was admitted in a state of deep coma. A computed tomography (CT) scan revealed acute hydrocephalus and diffuse subarachnoid hemorrhage in the basal, interhemispheric and bilateral Sylvian cisterns. Fifteen years prior to this admission, cerebral angiograms demonstrated no cerebral aneurysm. She underwent ventricular drainage immediately. Postoperatively, her condition did not improve, and she died on the 18th day. During the autopsy, two saccular cerebral aneurysms were found: one aneurysm was at the right middle cerebral artery bifurcation, and another one was on the anterior communicating artery, which had disruption of the internal elastic lamina and medial smooth muscle, and infiltration of inflammatory cells. In the major cerebral arteries, for example the bilateral internal carotid arteries, disruption or dissection of the internal elastic lamina, intimal fibrosis and transmural infiltration of inflammatory cells were observed. The second patient, a 36-year-old woman with a six-year history of SLE, was admitted to our hospital with sudden severe headache. A CT scan showed subarachnoid hemorrhage, and cerebral angiograms disclosed saccular cerebral aneurysms on the anterior communicating artery and the left superior cerebellar artery, and a fusiform one on the left posterior cerebral artery. Surgery was not recommended because of her multiple medical problems. Her consciousness improved gradually over 2 months. She was transferred to the department of internal medicine for treatment of renal failure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[A case showing the infraoptic course of the anterior cerebral artery associated with anterior cerebral artery aneurysm].

A ruptured anterior cerebral artery aneurysm with anomalous right infraoptic course of the anterior cerebral artery (ACA) was reported. A 40-year old male was admitted because of SAH episode, and computerized tomography (CT) on the day of admission revealed hemorrhage in both Sylvian and interhemispheric fissures. Four-vessel angiography was performed on the same day. A saccular aneurysm was demonstrated in the region of the anterior communicating artery (ACoA), and anomalous artery, which originated from the intradural right carotid artery at the level of the right ophthalmic artery was found to be running medially and superiorly. It supplied the bilateral callosomarginal arteries and the unpaired pericallosal artery. The fenestration of the vertebral artery, duplication of bilateral superior cerebellar arteries, and an occipital artery arising from the right internal carotid artery at the C3 level were found. Surgery was performed on the first day of admission, and the anterior interhemispheric approach was selected. The anomalous branch of the right ICA ran beneath the right optic nerve, ascended between the optic nerves, and supplied the ACoA system. The left hypoplastic A1 segment entered the ACoA. However, the right A1 segment could not be found. The aneurysmal neck, situated between the bilateral callosomarginal arteries and the unpaired pericallosal artery, was clipped with Sugitas curved clip. The postoperative course was uneventful and a follow-up angiograph revealed successful obliteration of the aneurysm.

Adult↗

Clivus epidural hematoma. Case report.

A rare case of epidural hematoma of the clivus is reported in an 11-year-old girl involved in a traffic accident which caused a severe hyperextension injury. Only one similar case has been reported in the literature. The mechanism for the formation of the hematoma of this region is discussed.

Child↗

[A case of hemangioblastoma with subarachnoid dissemination].

A case is reported in which a diffuse subarachnoid dissemination occurred after successful removal of a posterior fossa hemangioblastoma. The patient was a 51-year-old man who suffered from headache and gait disturbance, and who was admitted to our hospital on September 25, 1985. Neurological examination revealed trunkal ataxia and increased intracranial pressure. A CT scan with contrast media revealed a high-density lesion with surrounding low-density area in the posterior fossa. Right vertebral angiography demonstrated a round tumor stain behind the medulla oblongata, which was fed by the right posterior inferior cerebellar artery. The complete resection of the tumor was carried out. A biopsy specimen from the tumor showed a picture characteristic of hemangioblastoma. Fourteen months later the patient was readmitted due to the sudden onset of disturbance of consciousness. A CT scan revealed a large intracerebral hematoma in the right putaminal region. Right carotid angiography demonstrated two small tumor stains in the right temporal lobe. An emergency operation to extirpate the hematoma was performed. But the disturbance of consciousness did not improve, and the patient died. At necropsy a lot of small round tumors were recognized at the surface of the bilateral cerebral and cerebellar cortex. They were present in the subarachnoid space and partially invaded the cerebral and cerebellar parenchyma, extending through Virchow-Robin's space. There was no recurrence of the tumor at the site of the original operation. No doubt, a subarachnoid dissemination had occurred. However the histological findings of tumors were similar to the findings recorded in the first biopsy.

Brain Neoplasms↗

[Intramedullary hemangiopericytoma of the spinal cord; case report and review of the literature].

Hemangiopericytoma is a rare tumor deriving from capillaries and pericytes. Although it is a well established entity clinically and histologically, its occurrence in the central nervous system adhering to the meninges has been controversial. We described a case of a 39-year-old man with intramedullary hemangiopericytoma. To the best of our knowledge, no previous case of hemangiopericytoma in this location has been reported. We reviewed differential diagnosis of spinal hemangiopericytoma based on neuroradiological points, and clinical findings of the 14 primary cases reported in the literature. The nosological problem of hemangiopericytoma was also discussed.

Adult↗

[Magnetic resonance image of pituitary adenoma--comparison of functioning tumor and non-functioning tumor].

Thirty three cases of pituitary adenoma were examined by MRI with 0.15 T system. Eight cases of functioning tumor showed iso-minimally low intensity, and 10 cases of non-functioning tumor did slightly-markedly low intensity on IR image. Functioning tumor cells contain well-developed rough-surfaced endoplasmic reticulum, Golgi complexes and numerous secretary granule, so that bound water more increases and T 1 relaxation time less prolongs in functioning tumor than in non-functioning tumor. Two cases of functioning tumor disclosed slightly low intensity on IR image because of its poor stroma. It is necessary to know the exact bleeding time so as to measure the signal intensity in pituitary apoplexy case. Microadenoma appeared spotty hypointensity and upward convexity of superior surface of the gland on IR image.

Adenoma↗

[An intracranial collision tumor composed of intrasellar gangliocytoma and pituitary adenoma].

The authors report a rare case of collision tumor composed of intrasellar gangliocytoma and pituitary adenoma. The patient was a 56-year-old woman, who had a mild acromegalic feature and slightly elevated plasma GH level. But she had no abnormal neurological findings. Transsphenoidal microsurgery was performed and an intrasellar tumor was totally removed. After the operation, plasma GH level decreased to within normal level. She was discharged with no neurological deficit. Histological examination showed two components. One of them was gangliocytoma composed of many large, and often binucleated cells with Nissl substance. The other had the appearance of chromophobe adenoma. In this part, some of the cells showed positive stain for GH. The clinical and histological features of this lesion are discussed and compared with 31 other cases of intrasellar ganglioglioma or gangliocytoma.

Adenoma, Chromophobe↗

[Clinicopathological study of oligodendroglioma with special reference to immunohistochemical investigation].

The present study was undertaken to evaluate the utility of pathologic features and specific immunohistochemical studies in estimating the prognosis of oligodendroglioma. The pathological diagnosis of an oligodendroglioma was made on HE stained-sections according to WHO classification. Sixteen oligodendrogliomas, twelve mixed oligoastrocytomas and ten anaplastic oligodendrogliomas were immunotested by the peroxidase-antiperoxidase (PAP) method with anti-GFAP serum, anti-S-100 serum and anti-MBP (Myelin basic protein) serum and by the avidin biotin peroxidase-complex (ABC) method with anti-vimentin serum and ant-Leu 7 monoclonal antibody. GFAP positive cells were interpreted as reactive astrocytes, neoplastic astrocytes and neoplastic oligodendrocytes, S-100 positive cells were interpreted as reactive astrocytes and neoplastic astrocytes. Leu 7 positive cells were found in only one case of anaplastic oligodendroglioma. Anti-Leu 7 could not be considered as a specific marker for oligodendroglioma. Of the anaplastic oligodendroglioma 60% displayed MBP positively and 70% displayed vimentin positively. NSE positive cells were found in a few anaplastic oligodendrogliomas. The present study has not so far uncovered any marker that is restricted to oligodendrogliomas. However GFAP may be useful to assess the extent of reactive astrocytes and neoplastic astrocytes in the oligodendroglioma or mixed oligoastrocytoma. MBP and vimentin will help to determine the malignancy of oligodendroglioma.

Adult↗

[Ossified choroid plexus papilloma--case report].

While the calcification has been documented radiologically in 4 - 25 percent of the cases with choroid plexus papilloma, the ossification of choroid plexus papilloma has been reported only in 3 cases on literature. In this paper, we present a case of large ossified choroid plexus papilloma in the right lateral ventricle. A 35-year-old man was admitted with left hemiparesis and headache. Skull X-rays showed an abnormal calcified mass (25 mm x 23 mm x 14 mm) in the right temporal region. CT scan revealed an abnormal high density area protruding into the right lateral ventricle, and a low density area at the right corona radiata. Operation was carried out with a right temporal craniotomy. The mass was yellowish-elastic hard and protruded into the right inferior horn of the lateral ventricle. The histological examination of surgical specimen showed an ossified choroid plexus papilloma with some bone marrow formation and numerous calcification. Calcification of choroid plexus papilloma is found frequently, but ossification is a very rare neuropathological abnormality. Bone and/or cartilage formation in neuroepithelial neoplasms is an unusual event histopathologically. Several mechanisms have been proposed, such as (1) metaplasia of connective tissue, (2) transformation of neuroepithelial cells to mesenchymal tissue, (3) teratomatous nature, (4) heteroplasia, (5) mixed mesenchymal-neuroepithelial nature, and (6) ossification as an end stage of mucoid degeneration. In our case, it was considered that the bone formation resulted from metaplasia of connective tissue of choroid plexus papilloma.

Adult↗

[Glial fibrillary acidic protein and neurofilament protein in medulloblastoma].

Medulloblastoma is the most common primitive neuroectodermal tumor (PNET) with the potential to differentiate along glial or neuronal lines. Thirty cases of medulloblastoma were tested by the peroxidase-antiperoxidase (PAP) method with anti-GFAP serum (DAKO) and by the avidin-biotin peroxidase complex (ABC) method with 68kd subunit of anti-NF antibody. All the cases were classified into three subtypes based on these immunohistochemical findings and were analyzed in relation to clinico-pathological features. Fifteen of thirty medulloblastomas contained GFAP positive cells, seventeen showed cells reacting to NF. The reactions for both proteins were present in eight medulloblastomas (PNET-BD, bipotential differentiation). Seventeen medulloblastomas reacted to only one protein (PNET-MD, monopotential differentiation). No reaction for either was found in five cases (PNET-NOS, not otherwise specified). The two year survival rate was 12.5% for PNET-BD compared to 49.2% for PNET-MD and 53.3% for PNET-NOS. Nine variables, i.e. age, tumor stage, metastatic stage, operation, radiotherapy, chemotherapy, histology, GFAP and NF, were analyzed using Cox's proportional hazard model. This revealed that the significant factors were tumor stage (p = 0.0002), GFAP (p = 0.0008) and operation (p less than 0.05). In conclusion, GFAP is the most important histological factor for prognosis and medulloblastoma without glial differentiation has a much better prognosis than one with glial differentiation.

Adolescent↗