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Biomedical subjects

S Kadoya

Publications and source records attributed to S Kadoya.

At least 37 records · Page 2Linked to original sources
PubMed1988

[MRI findings of cervical cord injury. A case report of long-term follow-up].

A 63 year-old male, who sustained anterior cervical cord injury in a fall on his back during skiing, was consecutively examined by MRI from acute, up to the chronic stage. Right after the fall (2.5 hours later) the injured cord showed high intensity in T2 weighted images. This high intensity area stayed the same up to the chronic stage (6 months later). T1 weighted SE images showed no parenchymal change in the acute stage, but 3 months later a low intensity area appeared in the damaged cord. Thereafter, the injured cord exhibited localized low intensity on T1 weighted images, and high intensity on T2 weighted images, at subsequent MRI examinations. During the course of the examinations no significant neurological recovery was observed. Referring to the findings of our experimental cord injury studies, the high intensity in the T2 weighted images of the acute stage represents hemorrhagic necrotic tissue with edema, while those of the chronic stage suggest myelomalacia, and surrounding gliotic tissue. The low intensity in the T1 weighted images of the chronic stage reflects also this myelomalacia itself. We conclude that MRI of cervical cord injury is a useful diagnostic tool, not only delineating the level of the cord injury, but also aiding in the prognosis.

Follow-Up Studies↗
PubMed1988

[Intracranial physiological calcification on computed tomography (Part 2): Calcification in the choroid plexus of the lateral ventricles].

In this paper, we describe calcification in the choroid plexus of lateral ventricles with a discussion of the frequency of occurrence in categories of age, sex, and laterality, and its correlation with pineal calcification. The study was conducted on 2877 consecutive cases (1450 males and 1427 females) that had plain CT scanning. Three types of CT scanners (SCN-200, Somatom 2 and TCT-10 A) were used. This series included only calcification of the choroid plexus in the trigone of the lateral ventricles (glomus). Calcification was found in none of the cases aged under 9 years, 5.9% aged from 10 to 14 years and 17.4% aged from 15 to 19 years. The calcification rate strikingly increased with increasing age of the cases. It was 51.5% of cases between 30 and 39 years of age. After that, the increasing rate of calcification gradually decreased, however calcification was found in 74.4% of cases aged over 80 years. The calcification rate was 64.7% in our total series of cases aged over 20 years, 66.5% aged over 30 years and 70.7% aged over 50 years. The calcification rate of male cases was greater than that of females in the age group of over 15 years. However, there was a significant difference only in the cases ranging from 60 to 79 years of age. The initial incidence of male cases was found at the age of 12 years and that of females at the age of 16 years. There was no difference in calcification on right and left sides.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

[A case report of simultaneous multiple intracerebral hematomas].

A case of multiple spontaneous intracerebral hematomas is presented. A 67-year-old man with 7 years history of hypertension had sudden clumsiness in his right hand and an hour later dysarthria appeared. A CT scan taken 3 hours after the onset revealed two well demarcated high density areas in the left putamen and in the parietal subcortex. A diagnosis of multiple intracerebral hematomas was made. On neurological examination he was midly stuporous (13 points of Glasgow Coma Scale). Dysarthria, right hemiparesis and right extensor plantar response were seen. CT scan of 6 hours later disclosed the same findings as the previous study. He recovered well and neurologically free in a few days. On the following CT scans both hematomas were isodense 2 weeks later, and ring-like enhancement effect was noted. CT scan showed normal appearance 7 weeks later. On MRI using 0.5 T unit t-1 and t-2 weighted spin echo images of these hematomas also showed the similar chronological changes. The history, these CT and MRI studies suggest that two hematomas of this case occurred almost simultaneously in one cerebral hemisphere. No causative factors such as blood dyscrasias, AVM, angioma, septicemia, malignancies or sinus thrombosis was identified. We consider that a hypertensive intracerebral hematoma of the putamen was followed by the parietal intracerebral hematoma within a few hours, although amyloid angiopathy was not completely excluded because no cerebral biopsy of the lesion was performed.

Aged↗
PubMed1987

Magnetic resonance imaging of acute spinal cord injury. Report of three cases.

Magnetic resonance imaging of acute spinal cord injury is described. The traumatized cord segment was clearly shown as a hyperintensity in a T2-weighted image whereas it appeared as an isointensity in a moderately T1-weighted image. This different sensitivity may result from parenchymal hemorrhagic tissue and edematous changes due to direct trauma. Hyperintense tissue was also seen in the retro-pharyngeal and -tracheal spaces.

Accidents, Home↗
PubMed1987

[EC-IC bypass surgery using a long vein graft--reconstructive procedures for the occluded long vein grafts].

EC-IC bypass using a long vein graft has an advantage creating a large amount of blood flow immediately after the anastomosis, but on the other hand, disadvantage of relatively frequent incidence of the vein graft occlusion. In this report, we present three kinds of reconstructive operative procedures for the stenotic or occluded long vein grafts. Type A: A long vein graft bypass between external carotid and posterior cerebral artery was found occluded intraoperatively by the thrombosis occurred where the vein graft was injured during harvesting. Reconstruction was made simply by resecting the occluded segment of the graft and end-to-end suturing. Type B: A long vein graft used in subclavian artery-middle cerebral artery bypass was occluded three days postoperatively at the supraclavicular fossa by bleeding from the anastomosis site. The vein graft was found compressed and thrombosed. We reconstructed the occluded bypass by resecting the occluded supraclavicular segment and interposing a short vein graft with end-to-end anastomosis. Then, thrombectomy of the remaining vein graft was followed. Type C: A long vein graft used in external carotid-middle cerebral artery bypass stenosed at the anastomosis site with the external carotid artery a day after the operation. The stenotic bypass was successfully reconstructed by bridging a new short vein graft from another portion of the external carotid artery on the long vein graft distal to the stenotic site. All the long vein grafts we have done reconstructive surgery have been working well one to four years follow-up periods. So, we conclude that whenever a long vein graft occludes it should be reconstructed promptly before the vein graft becomes necrotic.

Adult↗
PubMed1987

[Aplasia of the posterior arch of the atlas--report on two cases].

Two cases of aplasia of the posterior arch of the atlas incidentally found are reported. Case 1: A 37-year-old man hit the forehead and the right mandible against the front glass at a head-on collision of his car and was brought to the emergency room. He was alert and neurologically normal except for multiple incision wounds with glass fragments in the face. CT, and cervical X-rays revealed total absence of the posterior arch of the atlas. Case 2: A 73-year-old woman, who sustained whip lash injury at an automobile accident, was admitted several hours after injury, complaining of neck and occipital pain. No neurological deficit was seen. CT demonstrated hemi-aplasia of the posterior arch of the atlas and isolated rudimentary posterior tubercle. Review of the literature and discussions were made on the incidence and genesis of this anomaly.

Adult↗
PubMed1986

Experimental spinal cord injury: quantitation of axonal damage by automated image analysis.

The severity of acute experimental spinal cord injury in rats was assessed quantitatively with the aid of an automated image analyzer by measuring the amount of degenerating axons that had developed distal to the site of mechanical insult. Spinal cord injury was produced in adult male rats by epidural compression at T-11 with a Biemer vascular clip. On the 7th postoperative day, the animals were graded according to the degree of hindlimb motor deficit, as follows: Grade 0: normal (three rats); Grade 1: crawling with difficulty (10 rats); Grade 2: some voluntary movement (nine rats); and Grade 3: no voluntary movement (nine rats). The rats were then sacrificed. The L-6 segment was chosen for selective silver impregnation of degenerating axons by the Fink-Heimer method. Silver grains, representing degenerating axons and their terminals, were accumulated in the descending tracts and in Rexed's laminae VII and VIII. The extent of axonal damage was expressed by the percentage of the area occupied by silver grains in Rexed's lamina VIII. The area occupied by silver grains was 17.0% (mean) in Grade 0 rats, 22.3% +/- 2.63% (mean +/- standard deviation) in Grade 1 rats, 28.7% +/- 3.35% in Grade 2 rats, and 35.9% +/- 2.76% in Grade 3 rats. The severity in Grade 3 rats was close to that of rats with transected cords (37.6% +/- 0.89%). The differences among the groups were statistically significant (p less than 0.001). This method may serve as a useful tool for the objective assessment of therapeutic modalities in large series of small experimental animals.

Animals↗
PubMed1986

Morphometric assessment of drug effects in experimental spinal cord injury.

The effect of large doses of methylprednisolone sodium succinate (MPSS) and two protease inhibitors, leupeptin and bestatin, on experimental acute spinal cord injury was evaluated by morphometric analysis of degenerating axons with the aid of an automated image analyzer. Spinal cord injury was produced by epidural compression with a surgical clip on the T-11 segment in rats. The extent of axonal damage was assessed in Rexed's lamina VIII in the L-6 segment by measuring the amount of silver grains, representing degenerating axons and their terminals, using the Fink-Heimer method. The severity of axonal damage was expressed as the degeneration index: that is, the amount of silver grains in experimental animals/the amount of silver grains in cord-transected animals. When examined on the 7th postoperative day, axonal degeneration in MPSS-treated rats was significantly decreased, with an average degeneration index difference of 6 (p less than 0.05). Increased preservation of axons was seen in the leupeptin-treated rats sacrificed 7, 10, and 14 days after trauma. The difference in the degeneration index between the leupeptin-treated and untreated groups was 16 on Day 7 (p less than 0.001), 12 on Day 10 (p less than 0.001), and 13 on Day 14 (p less than 0.01). Bestatin had no beneficial effect. The implications for the use of calcium-activated neutral protease inhibitors in acute spinal cord injury are discussed.

Animals↗
PubMed1985

Alleviation of axonal damage in acute spinal cord injury by a protease inhibitor: automated morphometric analysis of drug-effects.

The degenerating axons and axon terminals developed in Rexed's lamina VIII in the anterior horn of the L6 segment after acute spinal cord compression at Th11 level in rats were visualized by the method of Fink-Heimer and the extent of axonal damage was quantitatively assayed with the aid of an automated image analyzer. Leupeptin, a potent protease inhibitor, substantially reduced the extent of the axonal damage (17% on average).

Animals↗
PubMed1985

Anterior osteophytectomy for cervical spondylotic myelopathy in developmentally narrow canal.

The authors present 19 cases of cervical spondylotic myelopathy in patients with developmentally narrow canal treated by microsurgical anterior osteophytectomy with interbody fusion, with follow-up periods of 1 to 8 years (mean 38 months). Postoperatively, the lower limb function, evaluated by Nurick's six-grade classification, improved two or three grades in 16 cases, one grade in two cases, and remained unchanged in one case. The upper limb function, evaluated by the authors' own four-grade classification, improved two or three grades in 11 cases, one grade in seven cases, and remained unchanged in one case. No deterioration caused by the osteophytectomy was seen. During the follow-up period, spondylolisthesis appeared 31 months postoperatively in one patient and soft disc hernia occurred 66 months postoperatively in another; these two patients were treated by a second operation and cervical traction, respectively. The authors conclude that anterior osteophytectomy with interbody fusion is applicable as a surgical treatment of cervical spondylotic myelopathy even where developmental canal stenosis is present.

Adult↗
PubMed1985

Prognostic factors in children with acute lymphoblastic leukemia. Part II: Multivariate analysis. Children's Cancer and Leukemia Study Group.

The pretreatment characteristics of 158 children with previously untreated acute lymphoblastic leukemia diagnosed April 1972 to June 1978 were analyzed for their ability to predict prognosis. The children were treated according to therapeutic protocols 721, 745 and 765, by members of the Japanese Children's Cancer and Leukemia Study Group. Multivariate analysis was performed to determined the relationship between the characteristics and duration of survival of the patients. The following characteristics were analyzed: initial white blood cell (WBC) count, age at diagnosis, initial hemoglobin level, initial platelet count, sex, organomegaly, and treatment regimen that was provided. By using multivariate techniques, factors were found which the independently and significantly predict the length of survival. These factors were initial WBC count (r0 = 0.2908), age at diagnosis (r0 = 0.2982), and treatment regimen (r0 = 0.2488). Using the major prognostic factors of age at diagnosis and initial WBC count, a formula to predict the survival time was established. According to the initial WBC count and age at diagnosis, we classified all cases of childhood ALL as standard risk and high risk.

Adolescent↗
PubMed1985

Prognostic factors in children with acute lymphoblastic leukemia. Part I: Univariate analysis. Children's Cancer and Leukemia Study Group.

The pretreatment characteristics of 158 children with previously untreated acute lymphoblastic leukemia diagnosed April 1972 to June 1978 were analyzed for their ability to predict prognosis. The children were treated according to therapeutic protocols 721, 745 and 765, by members of the Japanese Children's Cancer and Leukemia Study Group. A univariate analysis was performed to determine the relationship between the characteristics and the duration of the patients' survival. The following characteristics were analyzed: initial white blood cell (WBC) count, age at diagnosis, initial hemoglobin level, initial platelet count, sex, organomegaly, and treatment regimen that was provided. Favorable prognosis was exhibited only by those patients with initial WBC counts of less than 50,000/mm3, with age at onset between 2 and 6 years, without splenomegaly, and with hemoglobin levels between 5 and 10 g/dl. The most significant contributions among the various individual prognostic factors were initial WBC count (p less than 0.001) and the age at diagnosis (p less than 0.01).

Adolescent↗
PubMed1985

[Risk factors of cerebral aneurysm re-rupture during angiography].

Although re-rupture of cerebral aneurysm during angiography has been reported occasionally, we have encountered 13 such patients during eight years since 1974, the incidence corresponding to 4.4 percent of 295 consecutive aneurysm patients on whom a total of 467 angiographies were performed. Extravasation on angiogram was noticed in 10 of these patients. We carefully analyzed the following factors to determine which one is significantly related to aneurysm re-rupture during cerebral angiography. The factors we investigated were sex, age, sites of ruptured aneurysm, surgical risk grade and time interval between the latest rupture of aneurysm and angiography. Our procedures of angiography were standardized as such that contrast material was injected by means of power injector and the injection pressure was adjusted at 2.5 kg/cm2 in vertebral angiography, 3 kg/cm2 in carotid angiography and 4 kg/cm2 in retrograde brachial angiography. Volume of contrast material was 6-8 ml, 10-12 ml and 30-32 ml, respectively. An incidence of re-rupture during angiography when performed within the initial 24 hours after the latest bleeding episode was 12 out of 123 angiographies (9.8%), whereas 1 out of 344 angiographies (0.3%) which were performed later than 24 hours. This difference was significant (p less than 0.001). These data were further analyzed every one hour period. It was learned that re-rupture rate was significantly high, 9 out of 45 patients (20.0%) when angiography was done within 5 hours after the latest aneurysm rupture (p less than 0.01), particularly, 8 out of 27 patients (29.6%) within 3 hours (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Trigeminal neurinoma presenting abducens nerve palsy as initial symptom: a report of two cases].

Two cases of trigeminal neurinoma presenting abducens nerve palsy as initial symptom are reported. Case 1. A 33-year-old female was admitted because of double vision of two months duration. Neurological examination revealed left abducens nerve palsy. CT scan disclosed a left parasellar tumor with a homogeneous enhancement effect. The tumor was subtotally resected by left extradural subtemporal approach, and diagnosed as trigeminal neurinoma. Case 2. A 18-year-old female was admitted because of double vision of one month duration. Neurological examination revealed left mydriasis and left abducens nerve palsy. CT scan disclosed a low density mass in the left cerebellopontine angle region and enhanced parasellar mass. The cystic mass located at the posterior fossa was removed by left retromastoid suboccipital approach, and diagnosed as trigeminal neurinoma. In these two cases, the abducens nerve palsy disappeared within two months postoperatively. The trigeminal neurinoma presenting abducens nerve palsy as initial symptoms is rare. We were able to collect six similar cases from the literature. All of them, including present two cases, were classified as ganglion type. It was suspected that the abducens nerve was compressed by the trigeminal neurinoma at the cavernous sinus, the petrous apex or the posterior fossa.

Abducens Nerve↗