Biomedical subjects

S Kuramoto

Publications and source records attributed to S Kuramoto.

At least 73 records · Page 4Linked to original sources

PubMed1991

[Pseudoaneurysm of the extracranial vertebral artery; a case report].

Traumatic injury of the vertebral artery is rare and only a few reports have been presented. We treated a case of iatrogenic pseudoaneurysm of the extracranial vertebral artery. A 65-year-old man complained of headache and had a pulsating mass in the soft tissue of the neck which had continued for one month after evacuation of hypertensive cerebellar hemorrhage. The left VAG revealed a large pseudoaneurysm at the third portion of the vertebral artery and the right retrograde VAG revealed agenesis of the vertebral artery. To select the proper treatment was a dilemma. This case was treated by embolization using an occluding spring embolus with direct transcutaneous puncture of pseudoaneurysm. Following this treatment, the mass and associated symptoms resolved without neurological deficit.

Aged↗

PubMed1991

[A case of intraosseous meningioma].

A case of intraosseous meningioma at the posterior fossa was reported. Intraosseous meningioma is very rate and only six cases have been reported in Japanese literature. A 64 year-old woman complained of progressive headache and was admitted to Ichinomiya Neurosurgical Hospital. On admission, neurological examination did not reveal any abnormalities. However, plain skull X-p showed a hyperostotic lesion in the right posterior fossa. CT scan demonstrated homogeneously enhanced mass by contrast medium. MRI showed a mass lesion of the posterior fossa on T1 and T2 weighted images. The right vertebral angiogram showed an avascular area in the right posterior fossa and no tumor stain. The tumor, which was partially attached to the underlying dura, was successfully removed surgically. The operative finding confirmed an intraosseous meningioma which had arisen from the right asterion. The post operative course was uneventful. Histological examination revealed fibroblastic meningioma.

Female↗

PubMed1990

Intracranial haemodynamics in diffuse and focal brain injuries. Evaluation with transcranial Doppler (TCD) ultrasound.

Intracranial haemodynamics were studied in 20 patients with diffuse and focal brain injury and experimental animals with acute intracranial hypertension by the use of TCD ultrasound. The mean flow velocity in the middle cerebral artery (MCA) commonly decreased on the side of the haematoma depending on intracranial pressure (ICP) elevation and cerebral perfusion pressure (CPP) reduction in focal injury. The decrease of the MCA flow velocity returned to normal after treatment. The flow velocities decreased bilaterally and there was no difference between the right and left side in diffuse injury. But the velocities increased in spite of ICP elevation when diffuse cerebral swelling developed. Cerebrovascular CO2 reactivity was impaired in two groups of patients with low Glasgow Coma Scale (GCS) scores. The mean velocity of the MCA and blood flow in the internal carotid artery exhibited flow patterns which changed correlatively depending on CPP reduction in experimental animals. Noninvasive study by use of TCD ultrasound can provide valuable information on variant haemodynamic phenomena in patients with diffuse and focal brain injury.

Adolescent↗

PubMed1990

Depressed adenoma in the large intestine. Endoscopic features.

To clarify the presence of depressed adenomas in the human large intestine, a prospective study was performed from January 1986 to December 1987. During these two years, 997 colonoscopies were conducted in patients, excluding cases of familial adenomatosis coli. Of 32 small, depressed lesions biopsied, seven were depressed adenomas, demonstrating that depressed adenomas do exist in the colon and rectum, and can be detected endoscopically. Resembling a sucker, they are easily detected through inflation and deflation.

Adenoma↗

PubMed1990

Effect of monosialoganglioside (GM1) on transected monoaminergic pathways.

The effects of exogenous monosialogangliosides (GM1) on transected monoaminergic cerebral cortical pathways were investigated in mice. Norepinephrine (NE), 5-hydroxytryptamine (5-HT), and 5-hydroxyindole-3-acetic acid (5-HIAA) contents were determined in cerebral cortex rostral and caudal to unilateral coronal transection sites. The transmitter contents were expressed as a ratio of those in the unlesioned contralateral cortex. In the caudal cortex, NE ratios fell to 70% within a week after transection and decreased further to 35-40% by 4 weeks. Treatment with exogenous GM1 for 2 weeks starting shortly after the lesion increased NE concentrations in the caudal cortex to 47.4-55.0% at 4 weeks, significantly greater than control animals (p less than 0.01, Mann-Whitney U-test). GM1 treatment for 2 and 4 weeks, starting 2 weeks after the lesion, yielded similar results. The 5-HT and 5-HIAA ratios in the caudal cortex also rose significantly after GM1 treatment. Thus, GM1 increased monoaminergic levels nonspecifically in the cortex caudal to the cortical lesion. The treatment effect did not depend on the timing or duration of treatment. These results indicate that exogenous GM1 treatment has a nonspecific restorative effect on the central nervous system after axonal lesions.

Animals↗

PubMed1990

Behavioral changes in 6-hydroxydopamine-treated rotation rats after delivery of various neuromodifying agents by means of a stereotactically implanted pellet to the brain.

Small pellets loaded with apomorphine, thyrotropin-releasing hormone, and bromocriptine were implanted into the right striatum of 6-hydroxydopamine-treated rotation rats, and the efficacy of this drug delivery system was examined. Pellets containing neuromodifying agents, when implanted into the brain, may be just as effective as brain grafting in delivering various chemical agents to the brain. This method is much safer and simpler than brain grafting, since it bypasses many of the complicated problems associated with brain grafting. Application of this method to an animal experimental model for brain grafting and possibly in the treatment of parkinsonism should be considered along with brain grafting.

Animals↗

PubMed1990

Adrenal medullary graft to brain in 6-hydroxydopamine-lesioned rotation rats. Comparison of two different graft sites (striatum versus lateral ventricle) by behavioral observation and fluorescence histochemistry.

Using 6-hydroxydopamine-lesioned rotation rats as a model of Parkinson's disease, an investigation was made of the optimal site for transplantation of adrenal medulla. One site was selected in the striatum (striatum group) and one in the lateral ventricle close to the striatum (lateral ventricle group). 6 weeks after grafting, the rotational behavior in the striatum and ventricle group was reduced by 43% (p less than 0.01) and 35% (p less than 0.01), respectively, as compared to the control group. 12 weeks after grafting, these figures were 30% (p less than 0.05) and 17% (n.s.). The striatum was slightly superior to the lateral ventricle as the site for transplantation.

Adrenal Medulla↗

PubMed1990

Pharmacological studies on 6-amidino-2-naphthyl[4-(4,5-dihydro-1H-imidazol-2-yl)amino] benzoate dimethane sulfonate (FUT-187). I: Inhibitory activities on various kinds of enzymes in vitro and anticomplement activity in vivo.

FUT-187, a newly synthesized compound, was studied on its inhibitory activities mainly on proteolytic enzymes, in comparison with those of FUT-175 and FOY-305, known serine protease inhibitors. FUT-187, as well as FUT-175 and FOY-305, had selective inhibitory activities on serine proteases including Clr, Cls, kallikrein, trypsin, plasmin and thrombin; its activities on these enzymes except Clr and pancreatic kallikrein were relatively lower than those of FUT-175 and FOY-305. Further studies were conducted focusing on complement-mediated reactions. In spite of its lower activities against Clr and Cls, inhibitions by FUT-187 on the complement-mediated hemolysis in vitro and in vivo were only a little weaker than or equivalent to that of FUT-175. FOY-305 was ineffective in these tests. Forssman shock in guinea pigs is known to be initiated by the activation of the complement system. The protective effect of intravenous or oral FUT-187 against this shock was definitely superior to that of FUT-175. Furthermore, FUT-187 inhibited changes accompanied with Forssman shock, such as increase in lung weight, the decrease in platelet counts and CH50, and histopathological changes. These results suggested that FUT-187 should be a more potent oral therapeutic agent than FUT-175 for various inflammatory diseases attributed to the excessive activation of the complement system followed by platelet aggregation.

Amylases↗

PubMed1990

Invagination of a shunt valve: an unusual complication--case report.

The authors present an unusual case of ventriculoperitoneal shunt failure due to invagination of a valve in the proximal portion of the silicone casing of the shunt system. The shunt had been in place for 5 years and the 57-year-old male patient had incurred no head injury during that period. The valve failure was discovered during evaluation of his gradual deterioration, which culminated in his functional incapacitation. Nine such cases have been reported in the literature. This complication is specifically associated with the Holter and Hakim valves and seems to a primary mechanical failure attributable to the structure of these two valves.

Cerebral Hemorrhage↗

PubMed1990

Clinical significance of traumatic subarachnoid hemorrhage.

The clinical significance of traumatic subarachnoid hemorrhage (TSAH) was studied in 20 head-injured patients. They were classified into mild (9) and severe (11) groups by their initial Glasgow Coma Scale (GCS) scores. TSAH detected by computed tomography was localized in the Sylvian fissure in four of the nine mild group patients, but was also found in other basal subarachnoid cisterns in the other five. Except for one patient who developed delayed vasospasm and communicating hydrocephalus, all had favorable outcomes in this group. Massive TSAH was noted in the basal subarachnoid cisterns in 10 severe group patients and only one had a good outcome. Delayed intracerebral hematoma in the frontal or temporal lobe in the vicinity of the Sylvian fissure was found in two mild and two severe group patients with TSAH in the Sylvian fissures. Traumatic parenchymal lesions in the brainstem were minimal in one of the two autopsied patients and no evidence of diffuse axonal injury was found in both cases. Thus, TSAH in the Sylvian fissure is suggestive of focal brain contusion around the fissures. Massive TSAH in the basal subarachnoid cisterns is not necessarily associated with severe parenchymal injury of the brainstem.

Adolescent↗

PubMed1990

Central neurocytoma--case report.

A 29-year-old male was admitted with chronic headache on February 26, 1987, when there were no neurological deficits or physical abnormalities. Computed tomographic (CT) scans showed a mixed-density mass with no evidence of calcification in the left lateral ventricle, which was irregularly enhanced by contrast medium. Under a diagnosis of an intraventricular glial tumor, surgery was performed via a left transcortical-transventricular approach on March 31. The highly vascular, nodular tumor, originated from the lateral wall of the left lateral ventricle near the foramen of Monro, was successfully removed. The postoperative course was uneventful and he was discharged 3 months after postoperative irradiation. Light microscopic examination revealed the tumor cells with the clear cytoplasm and perinuclear halos characteristic of an oligodendroglioma. However, electron microscopy showed neuronal elements identical with central neurocytoma as reported by Hassoun et al. in 1982. These included large numbers of dense-core or clear vesicles in the cell processes and synaptic structures.

Adult↗

PubMed1990

Diffuse axonal injury associated with multiple traumatic aneurysms of the distal anterior cerebral artery--case report.

A rare case of multiple traumatic aneurysms, arising from the distal anterior cerebral artery (ACA), associated with a diffuse axonal injury is presented. An 18-year-old male sustained a frontal impact injury in a traffic accident on February 19, 1988. He immediately lost consciousness and was transported to a local hospital where his Glasgow Coma Scale score was 6. A computed tomographic scan showed a traumatic subarachnoid hemorrhage extending from the corpus callosum to the left parietal lobe. With conservative treatment, he gradually regained consciousness and was referred to our hospital 12 days later. Skull x-rays revealed no fracture. A right common carotid angiogram revealed multiple aneurysmal dilatations on the right distal ACA. A left frontoparietal craniotomy was then performed to determine the nature of the aneurysmal dilatation, and to evacuate the intracerebral hematoma because his right hemiparesis persisted. Two aneurysmal dilatations on the distal ACA were tightly surrounded by clots and a hematoma extended from the corpus callosum to the parietal lobe. The ACA was trapped proximal and distal to the aneurysmal dilatations. The postoperative course was uneventful.

Adolescent↗

PubMed1990

[A case of lymphocytic adenohypophysitis associated with sarcoidosis of the lung and eye].

Lymphocytic adenohypophysitis is considered to be an inflammatory disease of the adenohypophysis that is commonly present with visual disturbance and hypopituitarism. Its etiology remains unclear but it is often related to an autoimmune disorder involving other organs, such as the thyroid, parathyroid, or adrenal glands. We encountered a rare case of lymphocytic adenohypophysitis associated with sarcoidosis of the lung and eye during the follow-up period. A 23-year-old woman was hospitalized in July 1986, with a one-month history of headache and visual disturbances which began three days after her second normal delivery. On admission, she showed slight visual impairment and had a left temporal superior quadrantanopia. Endocrinological evaluation revealed thyroid and adrenal hypofunction, and low response of human growth hormone to the loading test. A skull X-ray showed normal shaped sella with some erosion of the dorsum. CT scan showed a rounded contrast-enhanced intrasellar mass extending into the suprasellar cistern. MRI (SR: 500/30) showed a homogeneous low intensity mass which contained a small high intensity area on the relative T2-weighted image (2000/50). A biopsy was performed via right frontotemporal craniotomy. The consistency of the resected tissue was firmer than that of pituitary adenoma. Histologically, the tissue showed diffuse lymphocytic infiltration with some normal adenohypophysis. Her postoperative course was uneventful and the visual impairment improved two months later after the operation. Six months after the operation, she was readmitted with complaints of general fatigue and breathlessness. Chest X-ray showed diffuse infiltration throughout both lung fields, but there was no bilateral hilar lymphadenopathy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

[Massive traumatic hematoma localized in the basal ganglia: treatment by CT-guided stereotactic aspiration surgery].

A case of massive traumatic hematoma of the basal ganglia which was treated successfully by CT-guided stereotactic aspiration surgery, was reported. A 6-year-old boy was admitted 2 hours after a traffic accident. He had no neurological focal signs except for disturbance of consciousness on admission. CT scan revealed a massive hematoma in the right basal ganglia. His neurological status gradually deteriorated 6 hours after the trauma and the size of the hematoma increased on serial CT scan. Then, CT-guided stereotactic aspiration surgery was performed and about 15.5 ml of hematoma clot was successfully evacuated. He made an uneventful recovery from the operation and gradually improved. The final outcome was that he showed moderate disability at 3 months after the trauma. The possible mechanism of development of hematoma in this lesion, and indication of CT-guided stereotactic aspiration surgery were also discussed.

Basal Ganglia Diseases↗

PubMed1990

[Behavioral and histochemical observation in rotational rat with adrenal medulla transplantation].

It is widely known that rotation rat is prepared by destroying substantia nigra pars compacta in the rat. Adrenal medulla was transplanted to the rat. The transplantation was judged to be effective in the rat to which adrenal medullary cell was transplanted as the number of rotation decreased evidently in the rat with transplanted adrenal medulla even in the change in the rotating motion after actual transplantation. On the other hand, many transplanted cells transformed into nerve cell which was considered to have produced dopamine were observed in the rat in which transplantation was judged as effective in the histochemical assessment made of the group undergone transplantation of the adrenal medulla. However, in the rat in which no decrease in the number of rotation was observed, only the transplanted cells which were presumed to be the primary adrenal medullary cells were existent. The fact suggests that take of dopamine-producing cells is necessary to see decrease in rotating motion which is found to be the judging criterion for clinical effect.

Adrenal Medulla↗

PubMed1990

[Fenestrated basilar artery with ruptured cerebral aneurysms: case report].

Two cases of aneurysms with basilar artery fenestration are presented. A 45 year-old lady had a saccular aneurysm associated with a fenestrated basilar artery. The fenestration was located in the proximal third of the basilar artery. The aneurysm arose from the proximal end of the fenestration, projecting antero-inferiorly. Via a left retromastoid craniectomy, the aneurysm was successfully obliterated through the space between the eighth cranial nerve and the lower cranial nerve complexes. Postoperative deficit in the lower cranial nerves was minimal and transient. The other patient, a 63 year-old lady, had multiple aneurysms arising from the anterior circulation associated with a basilar artery fenestration. These aneurysms were clipped uneventfully. Surgical approach to an aneurysm arising from the basilar artery fenestration is discussed with other related literature. Full study of posterior circulation with multiple projection is mandatory to detect basilar artery fenestration, and the possible presence of saccular aneurysm at the site of the anomaly.

Basilar Artery↗

PubMed1990

[Coexistence of multiple metastatic brain tumors from thyroid carcinoma and cerebral aneurysms].

A 73-year-old woman was admitted with coexistence of multiple metastatic brain tumor and cerebral aneurysm. She has been operated on for a tumor of the thyroid gland 3 years before. Computed tomography (CT) scan revealed well-defined, homogeneously enhanced masses in the left frontal and right posterior temporal region. Right carotid angiography showed a tumor stain supplied by the branch of the fronto-polar artery. Left carotid angiography showed an aneurysm at the anterior communicating artery and a tumor stain supplied by the posterior temporal artery. Total removal of the bilateral tumor and aneurysmal neck clipping were performed simultaneously with bi-frontal craniotomy and right temporal craniotomy in April of 1988. Histology of tumor was papillary carcinoma. The surgical indication and treatment for patients with coexistence of multiple brain tumor and cerebral aneurysm were discussed.

Aged↗

PubMed1989

Flat early cancers of the large intestine.

From January 1976 to December 1987, 37 early colorectal cancers of the flat type were treated. Thirty-four of them (91.9%) were not accompanied by adenoma, and were thought to have arisen de novo. There is indeed a de novo route of cancer development in the human large intestine, and cancers de novo merely show polypoid growth. Flat type cancers arising de novo tend to reach deeper layers at an earlier stage than polypoid-type carcinomas in adenoma. Of those with a diameter of less than 10 mm, only 40% stayed in the mucosa. Consequently, advanced cancers cannot be prevented by snare polypectomy alone. More attention should be directed to the discovery of small, flat, nonpolypoid cancers.

Aged↗