Biomedical subjects
S Utsumi
Publications and source records attributed to S Utsumi.
Intraventricular arachnoid cyst. Report of two cases.
Two patients with intraventricular arachnoid cysts are reported and a brief review of the relevant literature is presented. Arachnoid cysts are usually extracerebral or extraventricular. Intraventricular arachnoid cysts are rare: including the two cases reported here, only five cases have been described. The following characteristics were noted in these five patients: all were young; headache was the initial symptom in four; the cyst was in the trigone of a lateral ventricle in four; and there was dilatation of the inferior horn in three.
[Evaluation of tumor specific antigens in bladder cancer using anti Thomsen-Friedenreich monoclonal antibody and soybean agglutinin].
Explore the source record for details and available documents.
[Clinical study of cortical and brainstem evoked potentials in head injury].
Three types of evoked potentials (EPs) auditory brainstem response (ABR), somatosensory evoked potential (SEP), and visual evoked potential (VEP) were recorded among 100 cases of head injuries within three days after the trauma had occurred. In order to assess these EPs, the normal wave patterns of 20 healthy subjects were used for comparison. For indices, wave I, III and V were used for ABR, N1, N2 and N3 for SEP, and N70, P100 and N125 for VEP. On this basis, five EP grades were constructed, from normal (grade I) to highly abnormal (grade V). Furthermore, an EP pattern classification was devised to integrate the respective EP grade. Namely, pattern A (PA), consisting of grade (G). I-III of the 3 types of EP; PB, composed of one type of EP or both ABR and VEP at G. IV-V; PC, consisting of both SEP and VEP at G. IV-V; PD, comprising both ABR and SEP at G. IV-V; and PE, covering all three types EPs at G. IV-V. In this EP pattern classification, PA signifies no severe damage, PB localized damage, PC severe cerebral damage, PD severe brainstem damage, PE severe diffuse damage. The significance was studied for an understanding of the pathological state, and for making a prognosis. The following conclusions were reached. 1. In severe head trauma, primary brainstem damage is very rare, and in cases where brainstem damage is shown, it is accompanied by extensive cerebral damage. To assess the pathological state of such primary cerebral damage EP in the acute stage is useful, and by performing further EP, successively, it becomes also possible to evaluate the secondary cerebral damage.(ABSTRACT TRUNCATED AT 250 WORDS)
[Usefulness of radial artery graft bypass: two cases of internal carotid artery aneurysms].
Trapping and EC-IC bypass surgery was performed for two cases of internal carotid aneurysm using the radial artery as bypass material. Neither case has any permanent neurological deficit 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 saphenous vein and superficial temporal artery. In properly selected cases, the radial artery graft is efficient in preventing the ischemic damage caused by trapping of aneurysm at the main arterial trunk.
Thomsen-Friedenreich antigen in bladder cancer tissues detected by monoclonal antibody.
Monoclonal antibodies against Thomsen-Friedenreich antigen (T-Ag) were obtained by the hybridoma technique. The expression of T-Ag in 73 specimens of bladder cancer was examined by the immunofluorescence method using these monoclonal antibodies. Seventeen (53%) of grade I, 18 (44%) of grade II and 5 (50%) of grade III were diffusely stained with anti-T. Of the T-negative tumors, 14 (44%) of grade I and 13 (32%) of grade II showed positive staining after neuraminidase treatment (cryptic T-positive) while only 1 (10%) of grade III was cryptic T-positive. On the contrary, only 1 case (3%) of grade I was cryptic T-negative while 10 (24%) of grade II and 4 (40%) of grade III (were. The T-antigen expression and the histological grades correlated significantly (p less than 0.05). Twenty-eight (70%) of the T-positive cases and 9 (60%) of the cryptic T-negative cases recurred while only 3 (11%) of the cryptic T-positive cases did (p less than 0.01). The monoclonal antibodies were more useful than peanut lectin (PNA) or conventional polyclonal antibodies on the detection of T-antigen.
Microsurgical treatment of patients with vestibular and cochlear symptoms.
Eighteen patients with vertigo, tinnitus, and various hearing disturbances were treated by posterior fossa exploration and microvascular decompression of the eighth cranial nerve; they were followed for more than 3 years. After successful decompression of the eighth nerve from offending vessels, the attacks of vertigo disappeared in 11 patients, improved markedly in 3 patients, and improved mildly in 4 patients. The tinnitus vanished in three patients and decreased in nine. The hearing disturbance improved in only five patients and worsened in three. Because of the satisfactory improvement of the attacks of vertigo, which are the most distressing symptoms for patients, we recommend surgical exploration for patients with severe symptoms of vestibular disturbances.
Reconstruction of cerebral cortical veins using silicone tubing. Technical note.
A technique for reconstruction of a cerebral cortical vein which has been sacrificed during an interhemispheric or subtemporal surgical approach is described. The method involves the use of silicone tubing. The author's clinical experience in six patients is summarized.
[Clinical value of peak hold DSA (PH-DSA) for transcatheter arterial embolization of head and neck lesions].
Explore the source record for details and available documents.
Beta-receptor involvement in locus coeruleus-induced inhibition of spinal trigeminal nucleus neurons: microiontophoretic and HRP studies.
Microiontophoretic and HRP studies were performed on cats anesthetized with alpha-chloralose to determine whether or not the locus coeruleus (LC)- and noradrenaline (NA)-induced inhibition of relay neurons in the subnucleus oralis of the spinal trigeminal nucleus (STN) is mediated by beta-adrenergic receptors. The inhibition of orthodromic spike generation upon intracranial trigeminal nerve stimulation by LC conditioning stimulation and microiontophoretically applied NA (100-200 nA) was antagonized during microiontophoretic application of sotalol, a beta-adrenergic antagonist, but not affected by phentolamine, an alpha-adrenergic antagonist. When HRP at doses of 300-500 nA was applied for 5-15 min to the immediate vicinity of the STN relay or interneuron, which was electrophysiologically identified by stimulating the ipsilateral trigeminal nerve and contralateral medial lemniscus, the injection site was localized to an area 0.3 mm in diameter and HRP-reactive cells were found in the ipsilateral LC, dorsal raphe nucleus and periaqueductal gray ventral to the aqueduct. These results strongly suggest that NA released from the nerve terminals of LC cells inhibits transmission in the STN relay neuron via beta-adrenergic receptors.
Induction of rheumatoid factors in mice by immune complexes of bacterial lipopolysaccharide with mouse IgG antibody.
Administration of 2,4,6-trinitrophenylated E. coli lipopolysaccharide (TNP-LPS) complexed with mouse IgG antibody to TNP specifically gave rise to a marked production of rheumatoid-like factors (RF) in the recipient mice, in contrast to the low and nonspecific RF production via polyclonal B cell activation by the same dosage of LPS or TNP-LPS alone. The RF activity induced by the LPS immune complexes was associated with both IgG and IgM and directed primarily to the C gamma 2 region as judged by the heterophilic reactivity toward fragments of rabbit IgG. The results suggest that antibody molecules attached to LPS constitute novel epitopic groups on the mitogenic carrier and stimulate B cells in a specific manner to induce the autoantibodies.
Co-operation between the pair of C gamma 2 domains in Clq-binding by rabbit IgG.
The single site binding constants of rabbit IgG and its plasmin-derived fragments F(acb)2, Facb and F(ab)2 for human C1q were measured by the sedimentation velocity method. The intact IgG and F(acb)2 having the paired C gamma 2 domains gave an identical association constant at 20 degrees C (Ka) of 3.02 X 10(4) M-1 in the presence of a physiological concn of salt and on the basis of six sites per C1q. The C1q-binding affinity was found to be decreased to 1.04 X 10(4) M-1 in the reduced, monomerized fragment Facb. Under the same conditions F(ab)2, which is completely unable to activate the classical complement cascade, gave an apparent C1q-affinity of 0.36 X 10(4) M-1. The results, together with previous observations, led us to the conclusion that the C1q-binding site of rabbit IgG is constituted associatively by the pair of C gamma 2 domains, each of which providing a limited, complementary part of the binding free energy between IgG and C1q.
[Diverticulum of the lateral ventricle trigone in communicating hydrocephalus. Case report].
Explore the source record for details and available documents.
[Changes in immunoglobulins in association with immune complex formation].
Explore the source record for details and available documents.
[Clinical characteristics of contrast medium extravasation from intracranial aneurysms during cerebral angiography: studies on personal experience and review of the literature].
Angiography is essential to diagnosis and treatment for the patients with ruptured intracranial aneurysm in early stage, but on the other hand angiography always involves a risk that extravasation (EV) occurs from the aneurysm during angiography. Once EV occurs, the patient's outcome is poor and, in general, the patient tends to be regard as hopeless of recovery. Over the past 5 years, in 154 patients with ruptured intracranial aneurysm angiography was performed, and in 7 of them EV occurred. We performed neck clipping for ruptured aneurysm in 3 of 7 patients and were able to save the life of 2 patients. We investigated factors to cause EV and to decide outcome in 7 cases and 75 cases of literature, totally 82 cases. Following results were obtained. Occurrence of EV seems to be related to the causal factors of the time interval (within 6 hours) from SAH to angiography and the severity of disturbance of consciousness prior to angiography. It is considered that the patient's outcome is related to age, pre-angiographic severity of disturbance of consciousness, and also time interval from SAH to angiography, but the extent of EV and the number of past history of SAH are not important as the factors related to the outcome. Consequently, the utmost care must be taken for cerebral angiography particularly in patients within 6 hours after the onset of SAH, and in patients with severe disturbance of consciousness. Even if EV should occur, there is a fair chance for life-saving by an emergency surgery in cases with mild disturbance of cerebral function before angiography.
[Carotid-ophthalmic aneurysms and visual abnormalities].
The direct neck clipping for carotid-ophthalmic aneurysm is hazardous and difficult as compared with other intracranial aneurysms because of its location adjacent to the anterior clinoid process, the optic nerve, and the cavernous sinus. The authors discuss the visual abnormalities accompanied by carotid-ophthalmic aneurysm on the basis of our experiences with 30 patients with 33 aneurysms. Ten patients (4 of 14 with ruptured aneurysms, 6 of 16 intact aneurysms) had preoperative visual abnormalities. Of our series of patients, visual acuity and visual field were impaired in one eye. The most common field abnormalities were unilateral inner or upper side defects. In the patients whose aneurysms were intact, visual abnormalities had been slowly progressive over many months. Otherwise, 2 cases with ruptured aneurysm experienced their first visual symptoms at the same time their hemorrhage. According to the projection of aneurysm with respect to internal carotid artery, superomedial and posteromedial projections were common in the patients with visual abnormalities. Seven patients with visual dysfunctions were operated on. Improvement of the visual symptoms was observed in 3 cases. In these cases, complete collapse of the aneurysm with good decompression of the optic nerve was obtained at operation. Two patients deteriorated following surgery; this occurred in relation to attempts to clip the aneurysm neck directly, and optic nerve was probably excessively manipulated. Two patients had no change in visual symptom: one was treated with trapping of internal carotid artery combined with STA-MCA anastomosis, another had direct hemorrhage into the ipsilateral optic nerve.(ABSTRACT TRUNCATED AT 250 WORDS)
Thomsen-Friedenreich antigen in bladder tumors as detected by specific antibody: a possible marker of recurrence.
TUR specimens of non-invasive transitional-cell carcinomas were examined for their expression of Thomsen-Friedenreich (T) antigen by indirect immunofluorescence staining using rabbit IgG antibody which was raised with desialated glycophorin. Nine (45%) out of 20 tumors of low grade (Grade I and II), and 5 (56%) of 9 tumors of high grade (III) were diffusely stained with anti-T (T-positive), whereas T-antigen in normal tissue was cryptic and stained only after neuraminidase treatment (cryptic T-positive). Of the T-negative tumors, 9 (45%) of the low grade but only one of the high grade tumors, were stained positively for the cryptic T-antigen. The rest of the tumors were devoid of the cryptic T-antigen. Eighty percent of both Tumors expressing T-antigen and those lacking the cryptic T-antigen recurred within two years. Recurrence was not influenced by initial histological grade.
Co-operative interaction of subcomponents of the first component of complement with IgG: a functional defect of dimeric Facb from rabbit IgG.
By following dissociation kinetics of radiolabelled C1q from rabbit IgG antibody-sensitized sheep red blood cells (SRBC) before and after its incorporation in the C1 complex, it was demonstrated that the binding stability is markedly enhanced by the presence of the C1r2-C1s2 subunit of C1 which by itself exhibits no significant binding capacity to immune complexes. The dissociation of C1q was decreased by up to 95%, the extent of decrease being pronounced as the cell surface IgG antibody density increased. However, such a stabilizing effect of C1r2-C1s2 was largely abolished when SRBC sensitized with the dimeric fragment F(acb)2 lacking C gamma 3 was used as the C1 binder, whereas the dissociation rate of uncomplexed C1q from F(acb)2-sensitized cells was similar to that from whole IgG-sensitized cells. It was also shown that, although the C1r2-C1s2 subunit is dissociated selectively from C1 bound to either IgG- or F(acb)2-sensitized cells in the presence of EDTA, it is held on much longer by the former cells than the latter cells. These results were taken to indicate that, although the C1 fixation by immune complexes of IgG is undertaken primarily by the interaction between C1q and the C gamma 2 domain, it is also strengthened by the secondary interaction between the C1r2-C1s2 subunit of C1 and the C gamma 3 domain or a structure which is dependent on the pair of C gamma 3 domains.