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Biomedical subjects

S Wakai

Publications and source records attributed to S Wakai.

At least 199 records · Page 11Linked to original sources
PubMed1979

Association of cerebral aneurysm with pituitary adenoma.

Seven cases of coincidental aneurysm with pituitary adenoma found through the review of our personal series of 95 pituitary adenomas over a period of five years are reported. The incidence of coexisting aneurysms in our series of pituitary adenomas (7.4%) was significantly higher than that in other brain tumors (1.1%) (p less than 0.001). Its clinical significance is discussed including the indications for four-vessel angiography, the surgical approaches to these pituitary adenomas, and the management of the associated aneurysms.

Adenoma↗
PubMed1978

Development of the blood-brain barrier to horseradish peroxidase in the chick embryo.

One to 20 mg of horseradish peroxidase (HRP) was injected into the allantoic vein of chick embryos between the 7th to 21st day of incubation and its penetration from blood into the interstitium of cerebellum and spinal cord (upper thoracic) was examined by light and electron microscopy in order to study development of the blood-brain barrier. Until the 12th day of incubation (stage 38) the reaction products, indicating the presence of peroxidase, were distributed in every region of the intercellular spaces in both cerebellum and spinal cord, whereas in 13th and 14th day embryos (stage 39 and 40) they were observed only in the medullary regions. In the embryos after 15th day (stage 41) they filled only the intravascular lumen and some micropinocytotic vesicles in the endothelium. These results show that the blood-brain barrier to HRP develops roughly synchronously in various parts of the central nervous system and evolves independently of neurogenesis, the course of which differs considerably in the cerebellum and spinal cord.

Animals↗
PubMed1978

[Intrathecal gentamicin in the treatment of meningitis--clinical case study (author's transl)].

The authors report 33 cases of meningitis treated with intrathecally administered gentamicin (GM) and examine it's effectiveness for meningitis side effects and optimum dose. Of 33 cases 15 cases (group I1 were treated with GM alone 7 cases (group IIa) with GM combined with SB--PC or CP. In 8 cases of the other 11 cases (group IIb) GM was changed for SB--PC or CP because of it's inefficiency and side effects (6 cases) and other reasons (2 cases). In the remaining three cases of group IIb SB--PC or CP was changed for GM due to their inefficiecy. Maximum intrathecal dose is shown below : 4 mg--7 cases, 8 mg--5 cases, 10 mg--15 cases, 20 mg--4cases, 40 mg--2 cases. In all cases GM was not administered systemically, but each of CP, CB--PC, SB--PC and TC was administereed systemically. In group I, only one case did not G--I tract bleeding but the others were cured. In group IIa all but one case was cured. In group IIb one case of cyptococcosis was dead. Total effective cases of intrathecal GM were 17 of 24 cases excluding group IIa (7 cases) and 3 cases of group IIb. There was no side effect in cases of which maximum dose was 4--20 mg, but in one of 40 mg administered cases in which GM was injected from cisternal puncture hearing, vestibular and visual function were disturbed permanently. Therefore GM should not be injected into the cistern. In our conclusion intrathecal GM is thought to be effective in the treatment of meningitis without systemic GM. Effective optimum dose in 4--8 mg/day day in adult and if ineffective after 7--10 days GM should be changed for other antibiotics.

Adolescent↗
PubMed1978

[A case of colloid cyst of the third ventricle (author's transl)].

The authors report a case of colloid cyst of the third ventricle diagnosed preoperatively through CT scan, pneumoencephalography and carotid angiography. The patient was a twenty-six year old housewife with a history of two repeated episodic headaches followed by gait disturbance, vomiting and cold sweating. At operation, the colloid cyst which completely occluded the right foramen of Monro, was reached by anterior transcallosal approach and was partially removed with subsequent cure of her symptoms. The cyst fluid contained cholesterin crystals, cholesterol, protein (12.8 g/dl), and sugar (16 mg/dl). Histologically, the cyst wall consisted of a single layered cuboidal or columnar epithelium with many cilias internally and loose connective tissue rich in vascluar channels externally. Cytoplasm and cellular surface was partly positive at mucicarmine, PAS and alusian blue staining. The fact would confirm that there is mucin secreting function among the epithelial cells of the cyst.

Adult↗
PubMed1977

[A case of posterior fossa acute subdural hematoma diagnosed through extravasated contrast media (author's transl)].

The authors report a case of posterior fossa acute subdural hematoma diagnosed preoperatively through extravasted contrast media from the hemispheric branch of the posterior inferior cerebellar artery along a linear fracture across the transverse sinus unto the pyramis. In a review of the literature it is to be noted that in acute cases, nystagmus and cerebellar signs are very rare and patients fall in coma within 24 hours after injury with promptly advancing severe brain stem compression signs in contrast to subacute or chronic cases. Therefore, whenever the diagnosis is suspected, time should not be lost for a burr hole opening and decompressive craniectomy. Vertebral angiography is sometimes very confirmative but it should be done only when time affording.

Acute Disease↗
PubMed1976

[A case of the lateral ventricular tumor (subependymal glomerate astrocytoma) with preceding Parkinsonian symptoms due to normal pressure hydrocephalus (author's transl)].

Authors report a patient with a subependymal glomerate astrocytoma in the right lateral ventricle. He maifested parkinsonian symptoms and dementia related to the preceding normal pressure hydrocephalus which was proved by an infusion test, and then advanced an akinetic mutism. Soon after a shunting operation was carried out he showed a full recovery from the symptoms, which may suggest that an incomplete block of the ventricular system is one cause of the normal pressure hydrocephalus. From pathology it was revealed that the tumor is an intraventricular astrocytoma with a fibrous stalk and was totally removed with an ease. The findings seem to accord with "Subependymal glomerate astrocytoma" (Boykin.) Further corroboration would be necessary to establish this entity.

Aged↗
PubMedDate not supplied

Childhood multiple sclerosis: MR images and clinical variations in four Japanese cases.

We report four Japanese cases of multiple sclerosis (MS) starting during childhood. In three of them, onset occurred in the prepubertal period. Case 1 showed a rare clinical condition: the patient presented with Devic disease, and 2 years later she was complicated by chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). The other three cases had symptoms of gait disturbance, cerebellar signs, weakness of the extremities and impaired visual acuity. Headache was seen in Case 2 and medial longitudinal fasciculus (MLF) syndrome in Case 4. In Cases 2, 3 and 4, diagnoses were conclusively made by T2-weighted magnetic resonance imaging (MRI). MRI, brain stem auditory, visual and somatosensory evoked potentials are extremely useful for evaluating the clinical conditions of children with MS.

Adolescent↗
PubMedDate not supplied

Skeletal muscle involvement in mucopolysaccharidosis type IIA: severe type of Hunter syndrome.

A patient with mucopolysaccharidosis type IIA (MPS IIA) and progressive gait disturbance is described. The histopathology of biopsied muscle was studied; Dorling's method revealed muscle fibers and interstitial cells containing metachromatic granules which suggested the storage of sulfated acidic glycosaminoglycans. Electron microscopy demonstrated that the membrane-bound vacuoles were present in muscle fibers, subsarcolemmal area, vascular endothelial cells, satellite cells, and endomysial fibroblasts. Besides clinical features, this ultrastructural pathology in MPS IIA muscles of MPS IIA was more severe than MPS IIB muscles. The accumulation of glycosaminoglycans in muscle tissue may be an additional factor contributing to gradual motor impairment of patients with MPS IIA.

Biopsy↗
PubMedDate not supplied

Glycogen storage disease with normal acid maltase: skeletal and cardiac muscles.

We report a 5-year-old boy with lysosomal glycogen storage disease and normal acid maltase activity. This patient, the fourth reported in the literature, was referred to our hospital for evaluation of elevated serum GOT, GPT, and CK activities. He had neither muscle weakness nor atrophy. Echocardiography demonstrated marked thickening of the intraventricular septum and left ventricular wall which indicated hypertrophic cardiomyopathy. Biopsied skeletal muscle disclosed massive accumulation of glycogen and autophagic vacuoles. Electron microscopy of biopsied cardiac muscle revealed severe myofibrillar disruption with marked accumulation of free and intralysosomal glycogen. Activities of all major glycolytic enzymes in skeletal muscle, including acid maltase, were normal. It is unknown why muscle lysosomes appeared to be unable to digest the trapped glycogen despite the presence of acid maltase. Our findings illustrate the importance of performing skeletal muscle investigation during childhood in patients with hypertrophic cardiomyopathy.

Biopsy↗
PubMedDate not supplied

Rett syndrome: findings suggesting axonopathy and mitochondrial abnormalities.

We report the histopathologic findings of 3 sural nerve biopsies and 1 muscle biopsy from 3 patients with Rett syndrome. The 3 sural nerve biopsies demonstrated a few ultrastructural abnormalities, including the presence of many Pi-granules and mitochondrial changes in the cytoplasm of Schwann cells, occasional bands of Büngner and onion-bulb formations, and mitochondrial alterations in myelinated axons. Morphometric analysis disclosed reduction in the number of large myelinated fibers with normal densities in comparison to those of an age-matched normal control. Light microscopic examination of the biopsied muscle from a 6-year-old patient with Rett syndrome revealed the existence of many small, dark, angulated fibers with NADH-TR staining. Ultrastructural investigation of the muscle confirmed the presence of the dumbbell-shaped mitochondria. Peripheral nerve involvement and the possibility of mitochondrial abnormalities in Rett syndrome were suggested by the results.

Axons↗
PubMedDate not supplied

Congenital muscular dystrophy in Marinesco-Sjögren syndrome.

The histochemical and immunocytochemical findings of biopsied muscle in a 2-year-old girl with Marinesco-Sjögren syndrome are reported. Muscle histology consisted of mild muscular dystrophy, such as that found in limb-girdle or non-Fukuyama congenital muscular dystrophy. By immunocytochemical stain using anti-dystrophin antibody, Duchenne and Becker muscular dystrophies were excluded. In addition to characteristic clinical features, including ataxia, congenital cataract, and psychomotor retardation, muscle involvement is essential to the diagnosis of Marinesco-Sjögren syndrome.

Biopsy↗
PubMedDate not supplied

Infantile neuroaxonal dystrophy: axonal changes in biopsied muscle tissue.

Dystrophic axons were found in the biopsied muscle tissue of a 17-month-old hypotonic infant after confirmation of a diagnosis of infantile neuroaxonal dystrophy (INAD) by subsequent peripheral nerve biopsy. He manifested gradual deterioration and had brief tonic seizures. The sural nerve biopsy, performed at age 42 months, confirmed INAD. Intensive ultrastructural investigation of the preceding muscle biopsy specimens demonstrated infrequent but definite findings of axonal degeneration in the musculature. Ultrastructural investigation of muscle biopsy should include a careful search for neural tissue because in INAD axonal changes occur primarily in the presynaptic region.

Axons↗
PubMedDate not supplied

Asymptomatic Becker muscular dystrophy: expression of dystrophin and dystrophin-related protein.

The expression of dystrophin and a dystrophin-related protein in muscle from 3 asymptomatic Becker muscular dystrophy patients is reported. Histology demonstrated moderate variation in fiber size with clustered basophilic regenerating fibers. Immunostaining for dystrophin revealed a patchy appearance on most fibers, but never on clustered regenerating fibers. Those regenerating fibers did, however, have positive immunoreactivity to a dystrophin-related protein. It is speculated that overexpression of the dystrophin-related protein in regenerating muscle fibers may contribute to the slow progression of muscle weakness or atrophy.

Biopsy↗
PubMedDate not supplied

Postoperative contrast enhancement in brain tumors and intracerebral hematomas: CT study.

Postcontrast cerebral CT was performed sequentially on days 3, 7, and 14 after surgery in 34 patients [11 with gliomas; 6 with metastatic tumors, and 17 with intracerebral hematomas (ICH)]. The purpose of this study was to investigate the natural course and mechanisms of postoperative contrast enhancement (CE) of the brain around the removed lesions. Contrast enhancement was noted on days 3-14 in 10 patients in whom the gliomas were partially or subtotally removed. The intensity of CE appeared to increase with time. Among the six patients in whom the metastatic tumors were totally removed, four showed no CE until day 14 after surgery. Contrast enhancement appeared on day 3 in one and on day 14 in another. In 12 patients with ICH, which had been evacuated during the first 5 days after hemorrhage, CE was not noted on day 3 but began to appear on day 7, and intensified on day 14 after surgery. Contrast enhancement was demonstrated on day 3 in four of the five patients in whom the ICH was removed later than 10 days after the hemorrhage. No CE was observed on days 3 through 14 in the one patient in whom the hematoma capsule was totally removed. The present study suggests that CE noted on day 3 after removal of gliomas and metastatic tumors seems to be caused by extravasation of contrast medium within the residual tumor, which is devoid of blood-brain barrier. Contrast enhancement noted in ICH cases and intensifying CE noted in tumors 7 days after surgery seems likely to be caused by neovascularization in the postoperative brain.

Brain Neoplasms↗
PubMedDate not supplied

Benign partial epilepsy with affective symptoms: hyperkinetic behavior during interictal periods.

We report a 4-year-old boy with benign partial epilepsy (BPE) with affective symptoms associated with hyperkinetic behavior during interictal periods. He had had hypermobility and restlessness since about age 3. At 4 years, 6 months, he developed episodes consisting of an expression of terror without complete loss of consciousness. Although we first suspected an acute psychic problem, the ictal EEG was abnormal. After carbamazepine (CBZ) therapy, the frequency of the attacks decreased dramatically and the hyperkinetic behavior gradually diminished.

Affective Symptoms↗
PubMedDate not supplied

Ictal video-EEG analysis of infantile neuroaxonal dystrophy.

A 4-year-old boy with infantile neuroaxonal dystrophy (INAD) showed gradual deterioration from age 9 months with seizure development at age approximately 36 months. Sural nerve biopsy performed at age 42 months confirmed INAD. The seizure, recorded by video-EEG, consisted of a series of symmetrical tonic spasms of both upper extremities after a prodrome period of staring and akinesis. Each spasm had phonation, and episodic autonomic symptoms such as hypertension and flushing of the face occurred throughout the seizure. Ictal EEG with each tonic spasm, showed diffuse 1-s, irregular sharp and high-voltage slow wave complexes followed by desynchronization.

Axons↗