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Biomedical subjects

S Utsumi

Publications and source records attributed to S Utsumi.

At least 73 records · Page 4Linked to original sources
PubMed1990

Hemangioblastomas of the central nervous system--immunohistochemical and ultrastructural study.

Immunohistochemical studies using immunoperoxidase staining for glial fibrillary acidic protein (GFAP), S-100 protein, and factor VIII-related antigen (VIII-RAg) were performed on 10 hemangioblastomas of the central nervous system to determine the origin of stromal cells. No cytoplasmic immunoreactivity for anti-GFAP, anti-S-100 protein, or anti-VIII-RAg was detected in most stromal cells. A small number of GFAP-positive cells were found only in the periphery of the tumor; they were thought to be trapped astrocytes or stromal cells taking up GFAP. Most stromal cells had abundant, clear cytoplasm with some microfilaments and lipid vacuoles. Cylindrical cytoplasmic processes and intermediate junctions were observed in some stromal cells, but most cells did not possess any junctional device. No stromal cell possessed any feature clearly suggesting endothelial cells or pericytes. Our immunohistochemical and ultrastructural investigations did not support the theories of stromal cell origin from astrocytes or endothelial cells. We concluded that stromal cells can be regarded as an aberrant cell type of angiogenic mesenchymal derivation.

Adolescent↗
PubMed1990

[The influence of volume expansion with induced hypertension on vessel reactivities, blood-brain-barrier, cerebral edema and infarction].

Eighteen anesthetized cats were randomly divided into 3 groups. One group was treated with 10 ml/kg of 6% hydroxyethyl starch (HES). Another group was treated with 15 ml/kg, and there was a control group. There were six cats in each group. Cerebral pial arterial reactivities were measured by means of intravital microscopic observation through a cranial window. Middle cerebral artery (MCA) was clipped for 70 minutes using a transorbital approach. Five hours later, Evans blue dye was injected intravenously and then the animals were killed. Administration of HES or Ringer's solution (control) was started 15 minutes before clipping of MCA. Systemic arterial pressure was elevated by using dopamine at the same time as the MCA occlusion was carried out. Pial arteries dilated soon after the clipping of MCA in all three groups, but showed different patterns in each group after recirculation of MCA. In the control group, they returned to 20% of their dilated state first, but, after about 4 hours, they redilated by 45% at the end of experiment periods. In the group treated with 10 ml/kg of 6% HES, they remained in an almost resting state after MCA recirculation, but in the group with 15 ml/kg, they constricted by 10% at the end of the experiment periods. Regarding the Evans blue dye extravasation, cerebral edema and infarction, they were largest in the control group. But animals treated with 15 ml/kg of 6% HES showed significantly larger Evans blue dye extravasation and cerebral edema than that of animals with 10 ml/kg. However cerebral infarctions were almost the same sizes in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

[Dissecting aneurysm of the vertebral artery as a cause of Wallenberg's syndrome].

Although it is well known that Wallenberg's syndrome is caused by occlusion of the vertebral artery (VA) or the posterior inferior cerebellar artery (PICA), the etiology of the occlusion is rarely documented. During the course of Wallenberg's syndrome, patients often complain of headache. We thought that these headaches might be caused by dissecting aneurysm (DA) of the vertebral artery, and so we studied the incidence of DA in our cases with Wallenberg's syndrome. Although many variants exist, Wallenberg's syndrome encompasses several neurological symptoms due to a disorder of the nucleus and nerve tracts located in the lateral part of the medulla. We diagnosed our patients as having Wallenberg's syndrome on the basis of symptoms such as loss of pain and temperature sensation in the unilateral face and contralateral body, cerebellar ataxia, and dysphasia. We investigated 22 cases of Wallenberg's syndrome over a five-year period, and excluded patients who developed subarachnoid hemorrhage upon onset of the syndrome. Our cases can be divided into two groups; one with severe stenosis or occlusion of VA (n = 15) and the other with occlusion of PICA (n = 5). The angiograms of the two remaining patients showed no abnormal findings. The mean age of the VA group (42.5 yrs.) was younger than that of the PICA group (64.2 yrs.). The age distribution of the PICA group is similar to that of other occlusive cerebrovascular diseases. Seven cases of the VA group demonstrated aneurysmal dilatation and luminal stenosis, and so they were diagnosed as having dissecting aneurysm of VA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[A case of achondroplasia showing diffuse spinal canal stenosis].

A rare case of achondroplasia showing diffuse spinal canal stenosis is presented. A 39-year-old woman was admitted to our hospital because of numbness of lower extremities and intermittent claudication. The patient's height was 121cm and she had the typical clinical features of an achondroplastic dwarf. Neurological examination revealed spastic paraparesis, and sensory impairment below the level of T11 in the left side and L1 in the right. A plain X-ray feature of the spine showed spinal canal stenosis. The interpedicular distances were short in all vertebrae, and especially more prominent in the caudal lumbar region. The sacrum laid horizontally and the sacral angle was narrower than normal case. Myelography and computed tomographic myelography demonstrated severe stenosis of the subarachnoid space at the level of T9-11. Laminectomy was performed from the inferior half of T9 to T11. The yellow ligaments were prominently hypertrophic and these were removed as far as possible. Postoperatively, the weakness of the lower extremities was improved immediately, but numbness remained. Five months after the operation, she suffered from urinary dysfunction, so further laminectomy from T12 to L5 was performed. Also in this operation, hypertrophic yellow ligament was pathognomonic. Following this operation the patient had a good recovery course and returned to work.

Achondroplasia↗
PubMed1990

[Effect of calcium antagonist nimodipine and induced hypertension on cerebral vessel reactivities, cerebral blood flow, cerebral edema and infarction in cats with one hour middle-cerebral-artery occlusion].

Treatment with the calcium entry blocker nimodipine is recommended as effective therapy for cerebral ischemia due to cerebral vasospasm or cerebral thrombosis. On the other hand, treatment with induced hypertension is a widely accepted measure to reverse ischemic deficits caused by vasospasm. Thus, a combination of the two regimens--nimodipine and induced hypertension--may have real benefits for cerebral ischemia. But it is possible that the benefit of one is abolished by adverse effects of the other, or that a combination of both may not be as effective as the use of only one therapy. In order to investigate these problems, the effects of nimodipine and induced hypertension on cerebral vessel, cerebral blood flow, cerebral edema and cerebral infarction using a one hour middle-cerebral-artery occlusion model in cats. Twenty-one anesthetized cats were divided into a control group, the nimodipine-treated group, and the nimodipine-and-induced-hypertension group. There were seven cats in each group. Occlusion of the middle cerebral artery (MCA) was continued for one hour in each animal. Induced hypertension was a little higher than resting values, and it was continued for only one hour during MCA occlusion, brought on by instillation of dopamine. Cerebral pial arteries dilated much more prominently during and after the occlusion of MCA in the nimodipine-and-induced-hypertension group than other groups. Although cerebral blood flow in the nimodipine group, and the nimodipine-and-induced-hypertension group increased more in the non-ischemic hemisphere, the most remarkable increase was seen around the infarcted cortex in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Role for the third constant domain of the IgG H chain in activation of complement in the presence of C1 inhibitor.

The multidomain architecture of Ig H chains was initially implicated in the variety of functions imposed on each species of Ig. However, the activation of C by IgG is the only function that has been attributed to a single domain of C gamma 2, whereas most of other functions of IgG require both C gamma 2 and C gamma 3 domains. This one domain-one function relationship in the C activation by IgG, too, was questioned recently by the fact that a C gamma 3-less fragment of rabbit IgG, F(acb)2, is definitely less capable of activating C than intact IgG. Here we reexamined capacities of F(acb)2 to bind and activate C1 in the presence and absence of C1 inhibitor (C1-In) in comparison with intact IgG, by using SRBC sensitized with these proteins (EFacb, EIgG). At an ionic strength of 0.065 and 37 degrees C, where C1q was bound equally well by these cells and the dissociation was limited, C1s, presumably in the form of C1r2C1s2, dissociated from EFacb at a rate 7-fold greater than that from EIgG, irrespective of the presence or absence of C1-In. A physiologic concentration of C1-In reduced the rate of C1 activation by EFacb to 5% that by EIgG. The results present evidence that the C gamma 3 domain, too, plays a crucial part in the C1 activation process by stabilizing the zymogenic conformation of C1 and protecting it from the attack by C1 inhibitor.

Animals↗
PubMed1989

[Time course of blood velocity changes and clinical symptoms related to cerebral vasospasm and prognosis after aneurysmal surgery].

Cerebral vasospasm is a major complication associated with subarachnoid hemorrhage. In spite of extensive research, the pathogenesis of vasospasm remains obscure, and clinical management has so far been extremely difficult. For the evaluation of the efficacy of any treatment and the timing of operation, the development and resolution of the arterial narrowing should be monitored. It is important to know the correlation between the change in flow velocity and the course of clinical symptoms. In this study, the blood flow velocity in the different arteries was measured at short intervals (at least every third day) with transcranial Doppler ultrasonography, in eighteen patients with ruptured cerebral aneurysm. Flow velocity changes began to accelerate from 3 days after surgery, and reached the maximum value between 7 and 10 days, with normalization occurring within the following 2 weeks. The changes showed a significant relationship to the severity of vasospasm, the side of the operative approach, and the administration of calcium antagonist. Based on our results, we categorized the flow velocity changes of vasospasm for clinical practice as follows. (1) A slight acceleration of up to 120 cm/s in MCA and 90 cm/s in ACA was defined as within the normal range. In this state vasospasm was never observed angiographically. (2) Flow velocity changes between 120 and 140 cm/s were a subcritical state. These changes were seen in vasospastic patients who did not develop ischemic deficits. (3) Flow velocity changes of over 140 cm/s in MCA and 100 cm/s in ACA were critical vasospasm, since all of the patients who developed ischemic symptoms were in this group. Velocity changes higher than 170 cm/s in MCA and 130 cm/s in ACA seem to indicate a critical condition with a tendency to develop into brain infarction. The comparison between the time course of the flow velocity changes and clinical status showed that in symptomatic vasospasm the increase in velocity occurred before the manifestation of clinical symptoms. The transcranial Doppler measurements help to identify those patients who have a high risk of developing neurological deficits due to vasospasm, and help to select those who would benefit from preventive treatment in asymptomatic stage.

Adult↗
PubMed1989

[Ectopic meningioma of the ethmoid sinus: case report and a review of the literature].

A rare case of ectopic meningioma of the ethmoid sinus is reported. A 57 year-old male patient was admitted with complaints of anosmia and headache. Computed tomography revealed a relatively high-density mass in the bilateral ethmoid and sphenoid sinuses. The mass was markedly enhanced after intravenous administration of contrast medium. The cerebral angiography showed tumor stains fed by bilateral internal and external carotid arteries with right side dominance. The tumor in the ethmoidal sinus was removed by otolaryngologists at first and then the tumor in the sphenoid sinus was removed using sublabial transseptal sphenotomy. The histological examination resulted in a diagnosis of transitional meningioma with psammoma bodies. The tumor in this case is suspected to have originated from heterotopic meningocytes or meningocytes accompanying the perineural sheath of the olfactory nerve.

Cerebral Angiography↗
PubMed1989

[Therapeutic irradiation of brain tumor and cerebrovasculopathy].

The first case was a 5-year-old girl treated with a total of 6000 rads after total removal of a left temporoparietal tumor extending into the basal ganglia. About 4 years after completion of the radiation therapy, she showed left hemiplegia and deterioration in her level of consciousness. A plain CT scan showed calcification in the region of the bilateral basal ganglia and low density area in the right fronto-parietal region. An enhanced CT revealed gyral enhancements in the pre- and postcentral gyrus of the right hemisphere. Left carotid angiograms showed a narrowing of the horizontal portion and an occlusion of the distal portion of the left anterior cerebral artery. The distal portion of the right anterior cerebral artery was filled through the anterior communicating artery. Right carotid angiograms revealed an occlusion of the terminal portion of the internal carotid artery, retrograde filling of the anterior and middle cerebral arteries by leptomeningeal anastomosis via the posterior cerebral artery, and partial filling of the anterior cerebral artery via the anterior falx artery. Preoperative arteriography did not show occlusion and stenosis of the cerebral arteries. Superficial temporal artery-middle cerebral artery anastomosis in the right hemisphere was performed. Regional cerebral blood flow measured during operation increased from 34 to 72 ml/100 gr/min due to the surgery. About two weeks after surgery, left hemiplegia disappeared completely. The second case was a 67-year-old man who had received radiotherapy, following surgery of a chromophobe pituitary adenoma. About one year after irradiation he began to complain of gait disturbance and dysarthria.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[Squamous cell carcinoma of the lung metastasized solitary cystic formation in the cerebellum].

A 54-year-old male previously diagnosed as having a lung squamous cell carcinoma T2N2M0 in stage III A was readmitted to our hospital, as he was complaining of a gait disturbance. A brain CT, an MRCT scan, and vertebral arteriography revealed that the lung carcinoma had metastasized as a solitary cystic formation in the right cerebellum. Thus, a craniotomy, a cyst fluid aspiration, and tumoral resection was performed. Histopathological findings of the cyst wall indicated a squamous cell carcinoma, and the protogram of the cyst fluid found it similar to that of the serum. These findings suggest that destruction of the blood-brain-barrier by the invasion of the carcinoma caused an exudation of serum, resulting in the accumulation of cyst fluid.

Body Fluids↗
PubMed1989

[The effect of neodymium yttrium aluminum garment laser on the cerebral blood vessel and blood brain barrier].

The effect of the laser energy to the cerebral vascular reactivity and the blood brain barrier. A Nd:YAG laser with 20 watt impacts of 0.5, 1.0, 2.5 and 5.0 seconds duration time were irradiated through the cranial window made at the parietal regions of anesthetized adult cats. The disruption of the blood brain barrier was examined by checking the degree of the extravasation of Evans blue dye administrated in the vein. The cortical vessel reactivity was observed through the cranial window and evaluated using an intravital microscope and a videoangiometer. The extravasation of Evans blue dye was seen uniformly extending from the histologically changed area into the surrounding tissue in all experiments. The extent of the extravasation of dye was 1 to 1.5 mm larger than the extent of the histologically changed area produced by laser irradiation. Pial arteries in the area with histological changes dilated markedly and some of them lost their blood stream. Pial arteries in the area of Evans blue extravasation, but outside it histological changes also dilated markedly. Furthermore, pial arteries within a distance of 200 to 400 microns from the edge of the Evans blue extravasation area also dilated moderately. A statistical estimation showed that the degree of dilatation of arteries in the area outside the histological change improved significantly in the time course of five minutes.

Animals↗
PubMed1988

Signal sequence of preproglycinin affects production of the expressed protein in Escherichia coli.

The effect of the signal peptide portion on the bacterial production of preproglycinin, a precursor of soybean storage protein, was examined. Nucleotide sequences corresponding to the signal peptide and the mature N-terminal region were deleted stepwise from the cDNA encoding the glycinin A1aB1b subunit precursor, and the deleted cDNAs were placed under the control of trc promoter in an expression vector pKK233-2. When the amounts of the protein products in Escherichia coli from each expression plasmid were determined, no accumulation of preproglycinin was observed from the plasmids with the full length or the five amino acids of the signal sequence. However, significant accumulation of the preproglycinin homologue proteins was noted from the plasmids retaining less than three amino acids of the signal sequence depending on the extent of deletion. N-terminal amino acid sequences of the products coincided with those predicted from the deleted cDNAs. The preproglycinin homologue proteins expressed from the mutant plasmids assembled into trimers of about 8S.

Amino Acid Sequence↗
PubMed1988

Radial artery graft for an extracranial-intracranial bypass in cases of internal carotid aneurysms. Report of two cases.

Two cases of internal carotid aneurysms, trapped and bypassed, by means of radial artery grafts are discussed. Neither case has permanent neurological deficit possibly because of an adequate blood supply via the radial artery graft bypass. Although the radial artery graft has been in common use among cardiac surgeons, it is still rare in the neurosurgical field. The advantage of the radial artery is discussed with comparison to other graft materials such as the saphenous vein and the superficial temporal artery. In properly selected cases, the radial artery graft is useful in preventing the ischemic damage caused by an aneurysm being trapped at the main arterial trunk.

Aneurysm↗
PubMed1988

Neuroradiological study of human brain in the fetal period.

Craniocerebral CT scans were performed on 50 subjects including embryos, fetuses and newborns. Fetuses were divided into three stages based upon CT findings. The first stage ranged from the 8th gestational week to the 12th week, and the second stage from the 13th to 23rd week. Beyond 24 gestational weeks, fetuses were classified as the third stage. In the first stage, it is difficult to recognize the intracranial structure on CT scans. In the second stage, the intracranial structures on CT scans become clearer. Around the lateral ventricle a symmetrical high-density area appears, which corresponds to the germinal matrix. However, at the third stage, the high-density area disappears. The morphological changes of the ventricular system with growth are ascribed to a remarkable development of the cerebral parenchyma.

Brain↗