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Biomedical subjects

S Kuramoto

Publications and source records attributed to S Kuramoto.

At least 145 records · Page 8Linked to original sources
PubMed1985

[Results of the surgical treatment of metastatic brain tumors].

Results of surgical treatment in 85 cases with metastatic brain tumors are reviewed. The lung was the most frequent site of primary lesion and the following sites were GI tract and the breast. Adequate treatment consisted of total removal of tumor, irradiation and/or chemotherapy were carried out in 51 cases. The remaining 34 cases had an unsuccessful treatment because of their poor physical condition. Mean survival time after adequate treatment was 8.75 months in the former group and 3.06 months in the latter group. Of 51 patients (86.3%) in the former group, 44 showed improvement of the neurological signs after treatment. In the latter group, only 14 patients (41.2%) revealed neurological improvement. Total removal of tumor was carried out in 55 of 85 cases. The one-month operative mortality for all patients was 19.2%. Postoperative one-year survival rate was 12.5% in 16 cases with multiple metastases and in 36 cases with single metastasis was 25.6%. Follow-up study of 77 cases showed 31.2% of survival rate in 6 months, 18.2% in one-year and 5.2% in two-years. Only four patients survived more than 3 years after treatment. The direct causes of death in cases of total removal were attributed in recurrence of primary lesion or remote metastases to other organs. This study revealed that the prognosis of the patient with metastatic brain tumor was influenced by existence of intracranial hypertension due to brain edema or metastatic tumor itself and metastases to other organs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Significance of multimodality evoked potentials (MEPs) in severe head injuries].

Clinical significance of multimodality evoked potentials (MEPs) consisting of auditory evoked brainstem response (ABR), cortical somatosensory evoked potential (SEP) and visual evoked potential (VEP) was studied in 14 cases with severe head injuries. The cases in this series associated with cerebral contusion and/or intracranial mass lesions such as acute subdural, intracerebral and acute epidural hematomas and Glasgow Coma Scale (GCS) score was less than 8 in all instances. MEPs were recorded for 14 days after injury and evaluated by MEP grade modified from Greenberg, et al. Intracranial pressure (ICP) was monitored from the extradural space on main lesion side in all cases for 3 to 5 days. Transtentorial herniation on CT scan was also graded according to the status of subarachnoid cisterns around the tentorium. The outcome was assessed by Glasgow Outcome Scale at 3 months after injury and was classified into good, poor and dead. MEPs on admission showed mild to severe abnormalities determined by single or all modalities in all cases and they were fairly well correlated with GCS score on admission and initial ICP. In the cases with good outcome, initial MEPs showed mild to moderate abnormalities determined by single modality and improved within 3 days after injury. They returned to normal or remained at mild abnormality at 7 days. But abnormality on initial MEPs was more severe in the cases with poor outcome and they were deteriorated within 3 to 7 days when elevation of ICP above 25 mmHg was observed. MEPs remained at moderate abnormality even at 14 days after injury in these cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

[Brain metastasis of hepatoblastoma--a case report and review of literature].

Hepatoblastoma is a rare abdominal tumor which affects infant, especially two or three year old boy. The authors experienced a rare case of cerebral metastasis of hepatoblastoma. The patient was a 1 and one thirds year old boy who was admitted because of left hemiparesis, somnolent consciousness, and abdominal tumor in September 21, 1982. At admission physical examination showed massive epigastric tumor with emaciated and dehydrated condition. Neurological evaluation indicated left spastic hemiparesis, somnolent consciousness and bilateral choked disc. Laboratory data were leukocytosis, marked thrombocytosis and slight abnormality of the liver function test. Alpha-fetoprotein level was 61 X 10(4) ng/ml and human chronic gonadotropin 20 IU/l. Chest X-P was suspected to be multiple metastatic lesions. Celiac angiogram showed a giant malignant tumor of the liver. Cranial CT scan revealed an intracerebral mass in the right frontal lobe which was visualized an enhanced high density area by contrast enhancement with a cystic component. The patient was diagnosed metastatic tumors of the brain and the lung with primary hepatoblastoma. En bloc tumor removal with right frontotemporal craniotomy was performed. Histological diagnosis of the removed tumor was a well differentiated type of the hepatoblastoma. Postoperative course was fine as for consciousness and hemiparesis. With recent development of chemotherapy and medical treatment for infantile malignancy, the prognosis of hepatoblastoma has been improved. This report is believed to be the first operative case for metastatic brain tumor of hepatoblastoma.

Brain Neoplasms↗
PubMed1984

[3 operated cases of congenital deficiency of Factor XIII associated with intracranial hematomas].

Three operated cases of congenital deficiency of factor XIII (fibrin-stabilizing factor) associated with intracranial hematomas were described and the diagnosis, replacement therapy of the factor were discussed. Congenital deficiency of factor XIII is quite rare coagulation disorder and only 100 patients were reported in the literatures in which we could find only one case who had craniotomy for associated intracranial hemorrhage. Case 1: A 41-year-old female with the history of unknown hemorrhagic diathesis complained of headache and right hemiparesis on August 2, 1980. CT scan showed left parietal intracerebral hematoma caused by unknown hemorrhagic diathesis and operated on under fresh blood transfusion. Postoperative state was uneventful but bleeding from the operated wound and rebleeding in the operated hematoma cavity were found on 5th postoperative day. The screening test for factor XIII was abnormal but replacement therapy with fresh plasma and factor XIII failed to control hemorrhagic diathesis. The patients died of GI bleeding and recurrent intracerebral hematoma on 21st postoperative day. Case 2: A 1.4-year-old boy with the history of umbilical bleeding on delivery and diagnosed as congenital deficiency of factor XIII in the other hospital fall down and struck his occiput on September 20, 1980. He vomited and became stuporous two days after injury, and was transferred to Ryukyu University Hospital. CT can revealed epidural hematoma at the left posterior fossa which extended to the supratentorium. The hematoma was successfully evacuated under infusion of fresh plasma and he showed uneventful recovery without rebleeding by postoperative appropriate replacement therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Trial production of non-invasive monitoring system from the anterior fontanelle on intracranial pressure].

The aim of utilizing P-50 Statham transducer as one of the monitoring systems for intracranial pressure consists in the case for its attachment and simplified identification of the zero point and calibration which are of problem for operation as in the cases of electrocardiogram and respiration. The P-50 transducer is a semiconductor strain gage transducer which was developed for the measurement of blood pressure. By attaching the foot plate of it, the applanation principle could be applied and the measurement from the anterior fontanelle could be made feasible. The accuracy of the measurement in this manner could be confirmed by various experiments. Being a semiconductor strain gage, it could be made into an extremely small weight, which made it most adequate for continuous measurement. Although some problems have been left yet to be clarified relative to the method for the fixation, it can be deemed to be fully applicable as one of clinical monitoring systems for intracranial pressure.

Humans↗
PubMed1983

[Fontanelle pressure in infantile hydrocephalus--with special reference to 6 cases of hydrocephalus with normal head circumference and without shunting operation].

Follow-up study on ICP was carried out in 6 cases of hydrocephalus within normal head circumference for 8-9 months after birth. There were no cases with shunting operation. Abnormal plateau-like wave was recorded in 2 cases with myelomeningocele during follow-up period. In other cases of postemeningitic hydrocephalus, almost normal baseline pressure without abnormal pressure wave was recorded and all showed favorable morbidity (function). These results showed the importance of follow-up study on ICP for 9 months after birth in cases of hydrocephalus without large head circumference and shunting operation should be recommended in cases showing abnormal pressure wave recorded during follow-up period.

Age Factors↗