Biomedical subjects
Publications and source records attributed to S Wakisaka.
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A case of glomus jugulare tumor with intra- and extracranial extension is described. The patient was a 63-year-old woman who complained of gait and memory disturbances. On admission neurological examination revealed recent memory disturbance, left deafness, left XI, XIIth cranial nerve palsies, and slight ataxic gait. Roentgenogram of the skull showed an enlarged left jugular foramen with bone erosion. Plain X-ray computerized tomography scan (X-CT) indicated obstructive hydrocephalus and X-CT with contrast enhancement revealed a mass lesion in the left posterior cranial fossa extending through enlarged left jugular foramen to the extracranial space toward the level of C2. Cerebral angiography demonstrated a large mass with blood supply from branches of left external carotid and vertebral arteries. The tumor stain was not remarkable. Left internal jugular vein was completely obstructed at the level of the second cervical vertebral body. Magnetic resonance imaging (MRI) clearly showed the tumor extending from the anterolateral portion to the second cervical vertebral body through the enlarged jugular foramen to the posterior cranial fossa. Brain stem and cerebellar hemisphere which were markedly compressed by the mass were clearly visualized. At first a ventriculo-peritoneal shunt was made and four weeks later subtotal removal of the tumor was undertaken. Histopathology of tumor specimen showed typical glomus jugulare tumor. MRI was considered to be very useful for the diagnosis and treatment of the glomus jugulare tumor with intra- and extracranial extension.
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The distribution of exogenous horseradish peroxidase (HRP) in the secretory ameloblast layer of developing rat molar tooth germs was examined in a culture system with and without colchicine. The secretory ameloblast of cultured tooth germs engulfed HRP added to the medium regardless of the presence of colchicine. The reaction product was localized in various vesicles and granules. Without colchicine in the medium, many small vesicles containing HRP were located in the Tomes' processes, whereas only a few were present with colchicine at concentrations above 5 microM. An intense reaction of HRP also appeared in the distal extracellular spaces beyond the distal junctional complexes of ameloblasts cultured without colchicine, whereas it became almost indiscernible in the tooth germs cultured with colchicine. The lack of HRP in the Tomes' processes and distal extracellular spaces of ameloblasts treated with colchicine might be attributed to the disruption of microtubules. The present study suggests that the secretory ameloblast is able to transport tracer molecules through the intracellular pathway from the proximal and lateral extracellular spaces to the distal extracellular space.
Two cases of arachnoid cysts in the quadrigeminal cistern are presented, and one occurred in an adult. Signs and symptoms of increased intracranial pressure were noted, and obstructive hydrocephalus was shown by computed tomography scans in both cases. Arachnoid cysts in the quadrigeminal cistern have rarely been reported, especially in adults. The definition, classification, and etiology of arachnoid cyst are still confused in the literature, and various terms have also been used to indicate this particular location of cyst. In this study, these confusing problems are reviewed, and the usefulness of metrizamide computed tomographic cisternography is emphasized as a noninvasive method of diagnosis.
Substance P-like immunoreactivity (SPLI) was demonstrated in mouse spinal cord by an indirect immunofluorescence method after decalcification of the vertebra with a mixture of EDTA and Zamboni's fixative. SPLI was observed mainly in the gray matter of the spinal cord, especially the superficial layers of the dorsal horn; the distribution was the same as in the control spinal cord. No diffusion and depletion of SPLI were recognized after decalcification and no specific fluorescence was observed. The findings reported here indicate that decalcification with a mixture of EDTA and Zamboni's fixative is a useful method for examining SPLI in nervous tissue surrounded in situ by calcified tissues.
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Distribution of enkephalin (Enk)-like immunoreactivity in the feline heart was investigated by indirect immunofluorescence method. Enk-like immunoreactive (Enk-IR) nerve fibers and cells predominated in the atria but were rare in the ventricles. Enk-IR cells were mainly distributed near sinoatrial (SA) node and between aorta and pulmonary artery. These cells were usually grouped in clusters near blood vessels or cardiac ganglia. Some Enk-IR cells appeared to extend their processes to other Enk-IR cells, cardiac ganglia, blood vessels and rarely cardiac muscles in the atria. Furthermore, substance P (SP)- and vasoactive intestinal polypeptide (VIP)-IR nerve fibers were closely associated with some Enk-IR cells. Moreover, the distribution and morphological profiles of Enk-IR cells were very similar to those of catecholamine (CA)-containing cells.
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The patient was a 24-year-old male who was admitted to the Dept. of Neurosurgery of Miyazaki Medical College in April of 1982 with a history of generalized convulsive seizures. Neurological examination on admission revealed slight mental disturbance, bilateral marked papilloedema and homonymous right upper quadrantanopsia. Plain skull X-ray films showed a destructive change of the bone in the left sphenoid ridge and sella floor. CT scan showed a huge mass of slightly high density in the left anterior and middle fossae with a marked enhancement with contrast media. It was fed mainly by the left anterior and middle cerebral arteries and partly by the left middle meningeal artery on angiogram. The tumor was considered to be a type of malignant meningioma originating from the left sphenoid ridge. Total removal of the tumor without any morbidity was thought to be difficult because of its size, hypervascularity and location. From clinical and radiological features, this tumor was thought to be an angioblastic meningioma of hemangiopericytoma type and to be radiosensitive. Cobalt-60 irradiation to the tumor was attempted with a total dose of 49 Gy for over a period of 6 weeks. CT scan performed at the stage of 23 Gy-irradiation showed high radiosensitivity of the tumor and CT scan two weeks after the completion of irradiation showed a marked reduction of its volume to one third. The patient became free from headache and memory disturbance after radiotherapy. On the forty eighth day after completion of the irradiation, the tumor was totally removed with ease and minimal bleeding.(ABSTRACT TRUNCATED AT 250 WORDS)
Acupuncture has been widely performed for the treatment of many different disorders in Japan. Several complications of acupuncture such as pneumothorax, cardiac tamponade, serum hepatitis have been reported. Accidentally broken needle is also one of the causes of complications of acupuncture. Usually it produces little problem, but may cause spinal cord injury, as presented by this report. The patient was a 49-year-old man who received an acupuncture procedure in his left nuchal region for shoulder pain. During acupuncture the needle was accidentally broken. The needle was tried to be removed by a surgeon on the same day but it could not be found. He was seen at our hospital with no neurological deficit 3 month later. Plain X-ray films and CT scan revealed a 4 cm long needle between C2 and C3 vertebrae penetrating into the cord. The needle was removed to prevent the possible neurological deficit which might be produced by the moving needle. The operative procedure was done under operating microscope with the aids of X-ray monitoring and injected dye. The direction to reach the tail of the broken needle is most important for avoiding further spinal cord injury during procedure. The post-operative course of the patient was uneventful and he was discharged with no deficit.
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The present study was performed to investigate the relationship between substance P-positive (SP-positive) nerve fibers and regeneration of taste buds in the foliate papillae of the rat by means of immunohistochemistry. It was confirmed by neurotomy that taste buds in the foliate papillae of the rat were innervated mostly (90%) by the glossopharyngeal (IXth) nerve and partly (10%) by the chorda tympani. In this experiment, the IXth nerve was sectioned distal to the petrosal ganglion. The rats were sacrificed at various intervals from 20 days to 80 days after the operation. In the course of degeneration and disappearance of taste buds, both SP-positive fibers and taste buds disappeared completely from the posterior folds of the foliate papillae 7 days after the operation. Within 22 days, regenerated SP-positive fibers began to appear in the lamina propria, and following the penetration of the fibers into the epithelium, taste bud anlagen reappeared at the bottom of the trench, and in the posterior folds at 24 days. The process of new taste bud formation extended toward the apex of the trench and to the anterior folds, which seemed to follow the regeneration in the nerve trunk. Quantitative data showed a gradual increase in the number of taste buds and taste buds containing SP-positive fibers. These findings indicate that SP might have a role in regeneration of taste buds.
Rat mandibles were fixed in Zamboni fixative and demineralized in a mixture of EDTA and fixative. Substance P-like immunoreactivity was demonstrated by indirect immunofluorescence in molar pulp, periodontal ligament and gingiva. Substance P (SP) containing nerve fibres with varicosities were observed in the pulp horn and root pulp in general located around blood vessels. Some SP-containing fibres penetrated into the predentine and dentine. In the periodontal ligament, SP fibres were localized along the blood vessels in the middle and apical regions. Many SP-containing fibres were associated with the blood vessels in the lamina propria of gingiva. After inferior alveolar nerve section, SP-positive nerve fibres in the pulp and periodontal ligament disappeared completely. In gingiva the number of SP fibres decreased but not all fibres disappeared. Removal of the superior cervical ganglion did not affect the distribution of SP-containing nerve fibres.
In this study we discuss the clinical value of the sequential measurement of the CSF uric acid and CSF cells in patients with postoperative acute meningitis. CSF was investigated for uric acid and cells in 10 cases with postoperative meningitis and 12 cases without it for the control group. The results were as follows; The CSF uric acid level was markedly increased in direct proportion to neutrophilia in the CSF in the acute stage of postoperative meningitis. Some cases with postoperative meningitis had biphasic increasing pattern of the CSF uric acid level. In 12 cases without postoperative meningitis the CSF uric acid level had been progressively reduced and then normalized until the fourth day after operation. The factors contributing to the increase of the uric acid in CSF under the condition of postoperative meningitis were thought to be 1) increased permeability of the blood-CSF barrier, 2) neutrophilia in the CSF and increase of the nucleic acid due to it, 3) increase of hypoxanthine, xanthine or xanthine oxidase activity in the central nervous system and 4) dysfunction of the CSF dynamics.