Biomedical subjects

O Kubo

Publications and source records attributed to O Kubo.

At least 91 records · Page 5Linked to original sources

PubMed1988

[Microtumor presenting with temporal lobe epilepsy--a case report].

A 15-year-old girl was admitted to our clinic on July 16, 1985 with the epilepsy which had been resistant to various anticonvulsant therapies. At the age of 10 years automatism seizure, characterized by purposeless movement of arms and head of which the patient was unaware, began to occur and became as frequent as two to three times each day. From the age of 13 years, there were also grand mal seizures several times a year in spite of medical treatment. She had normal delivery and no history of febrile convulsion. There was no family history of epilepsy or mental disease. When examined on admission, she had normal personality and intelligence. There was no neurological abnormality. She complained of sleepiness and hirsutiness. Fit of automatism occurred two to three times a day during admission, though the blood levels of anticonvulsant drugs such as phenobarbital, phenytoin and carbamazepine reached to therapeutic concentration. EEG examination including infratemporal lead recording showed right temporal spike focus. But all the neuroradiological studies such as skull X-rays, CT, cerebral angiography and magnetic resonance imaging failed to show abnormal finding. Right temporal lobectomy was carried out under general anesthesia on Aug 22, 1985, and anterior two-thirds of the middle and the inferior temporal gyri were resected deeply to anterior hippocampus. To the naked eye, no abnormal finding was noted during the operation. In the surgical specimen, macroscopically nothing abnormal was found. Microscopically, serial sections of the lobe revealed clusters of oligodendroglial cells in cortical to subcortical region of the medial basal part of the temporal lobe.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1987

Trochlear neurinoma.

A case of neurinoma of the trochlear nerve presenting with the sudden onset of headache followed by transient paresis of the right trochlear nerve in a 37-year-old woman is reported. Unique clinical manifestations of the tumor are discussed with a brief review of five cases reported in the literature.

Adult↗

PubMed1987

[Intracerebral granuloma with serum anti-human ascaris antibody: case report].

A 1.5-year-old girl with a convulsion attack due to intracerebral granuloma in the right frontal lobe is reported. Her serum was positive with anti-human ascaris antibody, although no ova of the parasites were detected in the feces. She had grown up intimately with several cats in the home. These findings suggested that the granuloma was due to larva migrans of toxocara, which cross-reacts immunologically with human ascaris. Histological examination of the granuloma revealed no eosinophilic infiltration. No systemic reactions such as eosinophilia and hepatomegaly were found except for elevation of protein in cerebrospinal fluid. These were similar to those of ocular type of toxocara larva migrans.

Animals↗

PubMed1987

[Gliosarcoma--a case report].

UNLABELLED: A 60-year-old woman was admitted to our clinic on September 29, 1983 because of a five months history of personality change and progressive left sided motor weakness. Neurological examination on admission revealed left hemiparesis and papilledema. She was severely demented. Skull X-rays were normal. CT scan showed a large right parietoccipital mass which was markedly enhanced by contrast medium. Right internal carotid angiogram showed abnormal vascular shadow, early draining veins and tumor stain in parietoccipital region. Right external carotid angiogram showed that the tumor was partly fed by the middle meningeal artery in "sunburst" pattern. The tumor was resected subtotally through right parietoccipital craniotomy on October 4, 1983. At operation, well demarcated, reddish-grey tumor attached to the dura was found. Several branches of the middle meningeal artery were penetrated into the tumor through the attachment. The tumor grossly appeared to be a meningioma in its superficial part, but demarcation was found being obscured in removing the deeper part of the tumor. PATHOLOGICAL FINDINGS: The specimens obtained from the superficial part of the tumor showed admixture of two distinctive neoplastic tissues. One was malignant mesenchymal features. Fibrosarcomatous nature was obvious, characterized by cells with moderately chromatic, fusiform nuclei arranged in parallel rows and eosinophilic fibers deeply stained in silver preparation for reticulin. The other was gliomatous tissue forming islands surrounded by the sarcomatous tissues. Both tissues were histologically malignant, as evidenced by mitotic figure, high cellularity, atypical features and variability. In deeper part, sarcomatous findings was less noticed and features of glioblastoma multiforme more prominent, characterized by marked astrocytic anaplasia, endothelial proliferation and extensive perinecrotic pseudopalisading.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Neoplasms↗

PubMed1986

The significance of alpha-subunit as a tumor marker for gonadotropin-producing pituitary adenomas.

We studied gonadotropin hormone alpha-subunit and gonadotropin secretion in four patients with gonadotropin-producing pituitary adenomas. All four patients had elevated plasma alpha-subunit levels, ranging from 2.8-8.5 ng/ml (normal, less than 0.5 ng/ml). alpha-Subunit responses to LHRH were less than those in seven patients with primary gonadal failure. The relative proportions of the gonadotropin and alpha-subunit peaks in one patient were the same before and after LHRH administration, based on gel filtration studies of plasma. The alpha-subunit levels decreased little during testosterone treatment in the two adenoma patients so treated. Immunohistochemical study of the adenomas from two patients demonstrated definite staining with alpha-subunit and gonadotropin antisera. Elevated plasma levels of alpha-subunit and its relative unresponsiveness to LHRH stimulation or testosterone suppression suggest that the alpha-subunit originated in tumor tissue and that its measurement is useful for the diagnosis of a gonadotropin-producing tumor in patients with elevated plasma levels of LH and/or FSH.

Adenoma↗

PubMed1986

[Combination of radiation and PVB chemotherapy for intracranial malignant germ cell tumor].

Intracranial malignant germ cell tumors such as embryonal carcinoma, endodermal sinus tumor, and choriocarcinoma are neoplasms of poor prognosis in the pediatric age group. Recently evidences of effectiveness of combination chemotherapy using cisplatin, vinblastine, and bleomycin (PVB therapy) have been reported. The authors experienced two cases with these tumors treated with radiation therapy and PVB therapy. PVB therapy was performed along with irradiation in hoping the effect of radiation sensitizer of cisplatin. Both patients showed no signs of tumor recurrence and no re-elevation of tumor makers even in the cerebrospinal fluid after more than ten months from the onset. Cisplatin has radiation sensitizing effect besides antitumor activity, but its permeability through the blood-CSF barrier is very poor. Also true is that germ cell tumors often disseminate in the cerebrospinal fluid. From these points, combination of irradiation and chemotherapy using cisplatin seems reasonable, though the superiority of this radiochemotherapy to simple PVB therapy can not be concluded from the present experience. Side effects of this combination therapy were the same as PVB therapy alone and tolerable.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1986

Correlation between MR signal intensity and histologic findings in neurinomas and meningiomas of the brain.

The signal intensity of magnetic resonance imaging (MRI) was compared with the histologic findings in 20 cases of neurinoma and 18 cases of meningioma. The apparatus was a Hitachi G-10 unit (0.15 T). The pulse sequences were SR (500/32), SE (1200/60), IR (1400/400). The intensity of tumor signal, as compared with that of normal white matter signal, was divided into 9 grades. In neurinomas, the signal intensity appeared markedly low with IR and markedly high with SE sequence in the Antoni B type, while it was slightly low with IR and minimally to markedly high with SE sequence in the Antoni A type, and intermediate between Antoni A type and B type in the mixed type. In meningiomas, it appeared moderately to slightly low with IR and slightly to moderately high with SE sequence in the meningotheliomatous type, minimally low with IR and minimally to slightly high with SE sequence in the fibrous type, and intermediate as compared with the above two in the transitional type. The angiomatous type was characterized by a low intensity on SR and IR images and an iso to high intensity on SE images, while the psammomatous type showed a low intensity with all of the sequences used. We clarified that the signal intensity on MRI varied among different histologic types of neurinoma or meningioma, and correlated differences in the intensity of signals on MRI to that of histologic characteristics, such as size and shape of cells, intercellular material, intracellular biologic polymers, area of membrane surface, blood flow and calcified matter.

Adult↗

PubMed1986

[Clinicopathological study of supratentorial tumors with multipotential differentiation in childhood. Primitive neuroectodermal tumor].

Three cases of supratentorial tumor in childhood were studied clinico-pathologically in an attempt to clarify its histological character. Case 1: A 3-year-old boy. Carotid angiogram revealed avascular lesion in the left parietal lobe. Twice operations and radiotherapy were performed. Ten months after the second operation, he died. Surgical specimen at the first operation was composed mainly of round tumor cells. The tumor tissue contained many collagen fibers. At the periphery of this tissue, medulloblastomatous areas consisting of closely aggregated hyperchromatic small round cells were found. There were perivascular rosettes and Homer Wright rosettes. In part, tubular and papillary arrangement of cells was also present. Astrocytomatous and oligodendrogliomatous structures were also present. Surgical specimens at the second operation showed the predominance of sarcomatous areas consisting of spindle-shaped cells with abundant argyrophilic fibers. Case 2: A 10-year-old girl. CT scan revealed a heterogeneous enhanced mass with a cyst and calcification in the right parietal lobe. Operation and radiotherapy were performed. Twelve months after operation, she is still alive. Most of the surgical specimens showed sarcomatous structure with abundant argyrophilic fibers. In these tissues, there were medulloblastomatous and ependymomatous features. Papillary arrangement of cells was also present. In part, there was oligodendrogliomatous structure. Case 3: A 2-year-old girl. CT scan revealed a heterogeneous enhanced mass in the right frontal lobe. The tumor tissue was composed of an aggregation of undifferentiated small round cells with Homer Wright rosettes.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Neoplasms↗

PubMed1986

[Clinicopathological study on malignant glioma--with special reference to GFAP].

In surgical specimens of 91 cases of malignant glial tumor, the correlation between the clinical malignancy of the tumors and the presence of GFA protein in the surgical specimen was examined. In anaplastic astrocytomas, 20 of 27 cases revealed positive staining of GFAP. In the cases of glioblastoma multiforme 27 of 35 cases showed GFAP positive staining. On the other hand, in medulloblastomas, all 29 cases were negative. In anaplastic astrocytomas and glioblastoma multiforms, the difference between the survival curves of GFAP positive groups and negative groups were examined. Between two groups, there was no statistical differences. In this study, the presence of GFAP was not proportional to the degree of tumor differentiation, and the GFAP staining of the tumor tissue was not a valuable examination showing the prognosis of the patient.

Adult↗

PubMed1986

[Treatment of malignant brain tumors with slowly releasing anticancer drug-polymer composites].

The purpose of this study is to present the methodology and results of a clinical trial of local chemotherapy of malignant brain tumors based on slowly-releasing anticancer drug-polymer composites. The slowly releasing drugs were prepared by combining and mutually dispersing anticancer agents with glassified monomers containing 10% polymetacrylic methyl acid and then this compound was frozen at -78 degrees C and exposed to 1 X 10(6) rad of gamma rays from cobalt 60. Thus we prepared a compound of polymers and anticancer agents. We used needle-shaped capsules of this compound. These capsules release the drug very slowly over 40 days. We administered locally to the malignant brain tumors with either slowly releasing mitomycin, slowly releasing adriamycin, slowly releasing ACNU or slowly releasing 5 Fu drugs. The following techniques were employed in implantation these capsules. Implantation into the remaining tumor wall at the time of excision. Implantation into the tumor by CT-guided stereotactic method. We implanted these drugs into tumor of 55 cases, thereafter we conducted both radiation and chemotherapy with ACNU in most patients. This method has the following advantages: It is possible to be employed to different types of anticancer agents. Both dosage and releasing time can be adjusted. It is possible to administer these capsules postoperatively by the stereotactic method. The clinical study consists of 55 patients, 20 cases of anaplastic astrocytoma, 23 cases of glioblastoma multiforme, 5 cases of oligodendroglioma, 3 cases of medulloblastoma and 4 cases of others. Survival rate estimated by Kaplan-Meier method was 47% in glioblastoma at 12 months and 91% in anaplastic astrocytoma at 18 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Agents↗

PubMed1986

Forme fruste of von Recklinghausen's disease: unilateral association of an orbital neurofibroma, a trigeminal neurinoma, and an acoustic neurinoma. Case Report.

A patient who presented with a tumor of the left ambient cistern, a left cerebellopontine angle tumor, and a left orbital tumor causing left hearing loss and left exophthalmos without café au lait spots or cutaneous neurofibromas is described. There was no family history of von Recklinghausen's disease. A cerebellopontine angle tumor removed by a suboccipital craniectomy was an acoustic neurinoma. An ambient cistern tumor was approached through a subtemporal route. A tumor arising from the trigeminal nerve was also a neurinoma. An orbital neurofibroma was excised by a frontal craniotomy with removal of the orbital roof. This rare unilateral association of neurinomas and a neurofibroma on the left side was thought to be a forme fruste of von Recklinghausen's disease, and it could be considered a presentation of a mosaic of von Recklinghausen's disease.

Adult↗

PubMed1986

[A case of pituitary adenoma combined with Rathke's cleft cyst].

A case of pituitary adenoma associated with Rathke's cleft cyst is reported. A 35-year-old woman suffering from visual disturbance, polydipsia-polyuria and amenorrhea galactorrhea was admitted. Since 3 years before admission, she had been administered thyradin under the diagnosis of primary hypothyroidism. Visual acuity was 0.1 on the right and 0.06 on the left, and visual field examination showed bitemporal hemianopsia. Endocrinological study disclosed primary hypothyroidism and moderate hypopituitarism. CT scan showed a low density mass with ring-like enhancement extending in the enlarged sellar cavity and in the suprasellar region. MRI showed a cystic mass in the sellar cavity extending to the suprasellar region, and a solid mass in the left posterior part of the sellar cavity, and the later was thought to be pituitary adenoma. On August 27, 1984, right frontal craniotomy was performed. The right optic nerve was compressed upward, and the right carotid artery laterally with a grayish bulging mass. About 3 ml of grayish colloidal fluid was aspirated and the capsule of the cyst was excised. Postoperative course was uneventful. The visual acuity and visual field defects were improved. Endocrine examination revealed panhypopituitarism. Histologically, the cyst wall was composed of ciliated columnar cells and partially stratified squamous cells. The solid part showed typical pituitary adenoma. There are 5 reports in the literature on the combination of a pituitary adenoma and a Rathke's cleft cyst. In our case, it is thought that the long-standing hypothyroidism induced pituitary adenoma. Therefore, our case with combination of a pituitary adenoma and a Rathke's cleft cyst should be regarded as an occasional coexistence rather than the entity of the transitional cell tumor.

Adenoma↗

PubMed1986

[Chronological changes in the blink reflex and MRI in a patient with lateral medullary infarction].

Recently, the brainstem pathways of bilateral late reflexes (R2) of electrically elicited blink reflex have been well established. An afferent delay or block of the late reflexes is closely related to a lesion of the lateral medullary portion. The chronological alteration of blink reflex (BR) was studied to compare with radiological abnormalities on MRI in a patient with lateral medullary infarction on the right side. A diagnosis of Wallenberg syndrome was made clinically and location of the lesion was identified in detail by MRI. The infarcted region which was well demonstrated as an increased intensity area on SE images obtained 52 days after the onset of symptoms was much smaller than that on SE as well as on IR image 21 days after the onset of symptoms. Therefore, it was concluded that more than half of the increased intensity area on the SE images obtained 21 days after the onset of symptoms recovered from the condition of being extremely damaged by ischemia on the right lateral medullary portion in this patient. On the other hand, in the initial BR 26 days after the onset of symptoms, the late reflexes (R2) were consistently absent bilaterally when the affected side (right) was stimulated and normal when the normal side (left) was stimulated. This type of BR abnormality is compatible with an afferent block of late reflexes (R2). The early reflex (R1) was normal on either side. Whereas in the second BR at 55 days after the onset of symptoms, the late reflexes turned to be normal in latency when the right side was stimulated.(ABSTRACT TRUNCATED AT 250 WORDS)

Blinking↗

PubMed1985

Changes in computed tomographic findings in microprolactinomas before and after bromocriptine.

Computed tomography (CT) of the pituitary before and after bromocriptine treatment were performed in 10 patients with microprolactinoma. Intrapituitary low densities were demonstrated in 7 out of the 10 patients before bromocriptine. Low densities shrank in size and increased in density after normalization of the plasma prolactin (Prl) level following bromocriptine. At the same time, various degrees of empty sella were demonstrated in these patients and in 2 out of the 3 without noticeable changes before treatment. It was concluded that enhanced CT scans, especially sagittal reconstruction images, were very informative for the diagnosis of microprolactinoma and that bromocriptine reduced the size of the microprolactinoma and often led to empty sella.

Adult↗

PubMed1985

[Clinico-pathological study of meningiomas in childhood--with special reference to malignant meningiomas].

Six cases of meningiomas which accounted for 3.6% out of 167 intracranial tumors in children were studied with clinico-pathological method. Four meningiomas located in the convexity, two meningiomas developed within the lateral ventricle. CT scan with contrast material showed homogeneous enhanced tumors in four cases. Heterogeneous enhanced tumors were observed in two malignant meningiomas. There was evidence of recurrence in three cases. Two of in these cases were malignant meningiomas. Three patients received postoperative radiotherapy. One case of malignant meningiomas died seven years after the first operation. Five cases are still alive. Macroscopically three cases had cyst formation. Four convexity meningiomas were attached to the dura matter. Three malignant meningiomas were ill-defined and invaded the normal brain tissue. One case of malignant meningiomas invaded the skull. Six meningiomas were classified histologically into two fibrous, one transitional and three malignant meningiomas according to the World Health Organization (WHO) classification of brain tumors. All cases were examined for glial fibrillary acidic protein (GFAP) using the immunohistochemical method. Two cases of malignant meningiomas demonstrated the positive reaction to GFAP. Four cases were negative. These findings suggest that malignant meningiomas grow invasively into the surrounding normal brain tissue.

Adolescent↗

PubMed1985

[Myocardial damage (myocytolysis) caused by subarachnoid hemorrhage].

A case of subarachnoid hemorrhage complicated by neurogenic pulmonary edema and neurogenic myocardial damage is reported. A 50-year-old woman was admitted following the sudden onset of headache and disturbance of consciousness due to a ruptured internal carotid posterior communicating artery aneurysm on the right side. She showed respiratory failure due to pulmonary edema, which subsequently improved with the mechanical ventilation. After that, she manifested chest distress and hypotensive episode then occurred. An ECG showed QS wave and ST elevation which suggested the presence of inferolateral myocardial damage. Subsequent rises in serum GOT, GPT, LDH and CPK were noticed. CPK-MB and LDH I and V isozyme levels rose. An echo cardiogram showed hypokinesis of the apical half of the left ventricular septum. The patient died on 5th hospital day due to rerupture of the cerebral aneurysm. Autopsy revealed diffuse myocytolysis with coagulation necrosis of the heart muscle without occlusion of coronary arteries. A small hemorrhagic lesion was found in the hypothalamus. We suggested that a hypothalamic lesion due to subarachnoid hemorrhage stimulated the sympathetic nervous system which in turn discharged endogenic catecholamine. This was probably accompanied by vasospasm of the coronary arteries and systemic peripheral arterioles. Furthermore, myocardial oxygen consumption could have been increased by the increase in catecholamine. Finally, it gave rise to neurogenic pulmonary edema and extensive diffuse myocytolysis of the heart occurred.

Cardiomyopathies↗

PubMed1984

Restoration of fertility with gonadotropin and bromocriptine in a hypogonadal man after removal of macroprolactinoma.

A case of male hypogonadism after removal of macroprolactinoma was successfully treated with gonadotropin. A 35-year-old man treated surgically for pituitary adenoma had elevated plasma prolactin and impaired pituitary function after the operation. He was on replacement of hydrocortisone, levothyroxine and testosterone depot along with bromocriptine. Normal plasma testosterone levels were achieved with HCG, 3,000 IU three times a week. The addition of 75 IU of FSH daily restored spermatogenesis and the sperm count reached the fertile range at the 11th month. Doses of HCG and FSH were cut in half at the 10th month without affecting the plasma testosterone levels. His wife was impregnated at the 12th month and gave birth to a normal baby girl.

Adult↗

PubMed1984

Puberty due to ectopic HCG production in a girl with suprasellar ectopic pinealoma associated with panhypopituitarism.

A 13.5-year-old girl who developed puberty due to HCG production by suprasellar ectopic pinealoma was reported. This girl appeared to be in a state of precocious puberty at the age of 5 when ectopic pinealoma was first diagnosed. Her breasts started to develop at 13 years of age in spite of hypopituitarism. Plasma LH was found to increase for several months and gave rise to suspicion of the recurrence of the tumor, which was confirmed by the detection of HCG in plasma and CSF. Precocious puberty or puberty can be a characteristic endocrinological manifestation of an HCG producing tumor not only in boys but also in girls. The measurement of plasma HCG (or LH) can be a useful tumor marker in following the clinical course of an HCG producing tumor.

Adolescent↗