Biomedical subjects

T Fujimaki

Publications and source records attributed to T Fujimaki.

At least 19 recordsLinked to original sources

PubMed1992

Differential permeability of the blood-brain barrier in experimental brain metastases produced by human neoplasms implanted into nude mice.

This study clarified whether and when the blood-brain barrier in experimental brain metastases is impaired by using hydrosoluble sodium fluorescein (MW 376) as a blood-brain barrier function indicator. Cells from eight human tumor lines (four melanomas, two breast carcinomas, one colon carcinoma, and one renal carcinoma) were inoculated into the internal carotid artery of nude mice. Brain metastases at different stages of development were sampled and the permeability of the blood-brain barrier around the metastases determined. Histologic examination showed two patterns of tumor growth. In the first, tumor cells formed isolated, well-defined nodules in the parenchyma of the brain. In lesions smaller than 0.2 mm2, the blood-brain barrier was intact. In the second, small diffuse nests of tumor cells were distributed throughout the brain parenchyma. The blood-brain barrier was intact until the small tumor cell colonies coalesced to form large tumor masses. These results suggest that the permeability of the blood-brain barrier varies among different experimental brain metastases and that its function is related to the growth pattern and size of the lesions.

Animals↗

PubMed1991

Correlation between bromodeoxyuridine-labeling indices and patient prognosis in cerebral astrocytic tumors of adults.

Bromodeoxyuridine (BUdR), a nonradioactive thymidine analogue, is taken up by cells in S-phase, and the ratio of BUdR-positive nuclei to the total number of cells counted is defined as the labeling index (LI). In this study, BUdR LI and the clinical course of 50 cerebral astrocytic tumors in adults were analyzed. The obtained LI distributed continuously in a broad range from 0% to 19%. The mean LI of 28 glioblastomas, 12 anaplastic astrocytomas, and ten astrocytomas were 8.5%, 4.2%, and 1.2%, respectively, and these differences were statistically significant (P = 0.05). In the analysis of LI and the recurrence-free period (RFP), regardless of the histologic findings, 23 patients with LI more than 5% had a median RFP of 9.0 months; the median RFP of nine patients with LI of 3% to 5% was 14.7 months. Nine of 13 patients with LI less than 3% have not yet recurred after a median follow-up of 36 months. These differences were also statistically significant by the generalized Wilcoxon test (P = 0.05). The proliferative potential reflected by the BUdR LI is a good clinical indicator for predicting the rate of tumor growth in cerebral astrocytic tumors. In combination with histologic diagnosis, BUdR LI could help in determining a patient's prognosis more precisely.

Adult↗

PubMed1991

[The distribution of solutions in the epidural space].

In 21 patients the distribution within the epidural space of epidurally injected 99mTc-DTPA was assessed. The gamma emissions from the epidural space were measured externally with the patients in supine position by use of a gamma camera. The recordings over the patient's back were stored in digital computer for 60 min. The results were as follows; 1) The spread of the radionuclide was mainly to cephalad direction, and seldom crossed the L5 level to sacral region. 2) The solution injected in the epidural space would distribute to less resistant compartments and the spread depends on the power of injection, negative pressure in the high epidural space and capillary pressure. 3) The elimination half-life of the injected radionuclide was between 1 to 17 min depending on the region in the epidural space. 4) The solution injected in the epidural space may penetrate dura mater at the ink cuff area and local anesthetic agents may affect the spinal nerve roots in the subarachnoid space rather than at the extra-dural space. 5) With continuous infusion technique the diffusion and penetration of the local agent through the dura mater are facilitated and more profound anesthetic effects would be expected. In clinical practice the utilization of the continuous infusion method should be considered along with the bolus injection.

Adult↗

PubMed1990

Resection of high-cervical paraganglioma with cervical-to-petrous internal carotid artery saphenous vein bypass. Report of two cases.

Two patients with large high-cervical paragangliomas were treated with radical resection and placement of a cervical-to-petrous internal carotid artery saphenous vein bypass. The high-cervical and infratemporal segments of the internal carotid artery engulfed within the tumor were resected and successfully replaced with a saphenous vein interposition graft. The postoperative course was uneventful in both cases and follow-up angiography revealed satisfactory reconstruction of the high-cervical and infratemporal skull base carotid artery. The operative technique, indications, and potential future applications of this newly developed skull base bypass procedure are discussed.

Adult↗

PubMed1990

Percutaneous retrogasserian glycerol injection in the management of trigeminal neuralgia: long-term follow-up results.

The results in 122 patients with trigeminal neuralgia who underwent percutaneous retrogasserian glycerol injection are presented. Eighty patients were followed from 38 to 54 months. The recurrence rate at 54 months was 72% (Kaplan-Meier analysis), and the median pain-free interval was 32 months. Complications associated with the procedure were significantly high: 63% of the patients had definite hypesthesia of the face and 29% had unpleasant dysesthesias, including two cases of anesthesia dolorosa. Sensory disturbances were most frequent in patients who had received a previous alcohol block procedure. Among the patients without previous peripheral procedures, 50% developed sensory disturbances. Because of the high rates of recurrence and sensory disturbances, the authors prefer microvascular decompression for the management of trigeminal neuralgia.

Adult↗

PubMed1989

Subacute brain atrophy after radiation therapy for malignant brain tumor.

Brain atrophy with mental and neurologic deterioration developing a few months after radiation therapy in patients without residual or recurrent brain tumors has been recognized. Two illustrative case reports of this pathologic entity are presented. Six autopsy cases with this entity including the two cases were reviewed neurologically, radiographically, and histopathologically. All patients presented progressive disturbances of mental status and consciousness, akinesia, and tremor-like involuntary movement. Computerized tomography (CT) demonstrated marked enlargement of the ventricles, moderate widening of the cortical sulci, and a moderately attenuated CT number for the white matter in all six patients. Four of the six patients had CSF drainage (ventriculoperitoneal shunt or continuous lumbar drainage), however, none of them improved. Histologic examination demonstrated swelling and loss of the myelin sheath in the white matter in all patients, and reactive astrocytosis in three of the six patients. Neither prominent neuronal loss in the cerebral cortex or basal ganglia, nor axonal loss in the white matter was generally identified. The blood vessels of the cerebral cortex and white matter were normal. Ependymal layer and the surrounding brain tissue were normal in all patients. These findings suggested that this pathologic condition results from demyelination secondary to direct neurotoxic effect of irradiation. The authors' previous report was reviewed and the differential diagnoses, the risk factors for this pathologic entity, and the indication for radiation therapy in aged patients with a malignant brain tumor are discussed.

Aged↗

PubMed1989

Successful combination chemotherapy (cisplatinum, vinblastine, and bleomycin) in the treatment of medulloblastoma disseminated by cerebrospinal fluid: case report.

A case of successful combination chemotherapy using cisplatinum, vinblastine, and bleomycin (PVB therapy) to treat medulloblastoma disseminated by cerebrospinal fluid is presented. In this case, a locally recurrent tumor and several disseminated tumors were seen to decrease in size on CT examinations. Pain in the lower extremities and urinary incontinence improved during three courses of PVB therapy administered during a period of 9 weeks. These results suggest that combination PVB therapy may offer one of the treatments of choice for recurrent or disseminated medulloblastoma.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1989

Multiple saccular cerebral aneurysms associated with systemic lupus erythematosus--case report.

A rare case of multiple saccular cerebral aneurysms in a patient with systemic lupus erythematosus (SLE) is presented. The aneurysms were located at the junction of the left internal carotid artery (ICA) and the posterior communicating artery (PComA), at the anterior communicating artery, at the middle cerebral artery, at the junction of the right ICA and the PComA, and at the top of the basilar artery. All the aneurysms, except for the one on the basilar artery, which was unruptured, were successfully clipped. Histopathological examination of one resected aneurysmal dome confirmed the diagnosis of transmural arteritis secondary to SLE. Postoperatively, she died of a massive hemorrhage from a rectal ulcer. The etiology and prognosis of cerebral aneurysms in SLE are discussed.

Arteritis↗

PubMed1988

Leptomeningeal and orbital benign lymphophagocytic histiocytosis. Case report.

An extremely rare case of isolated histioproliferative lesions arising from the subarachnoid space of the left occipital convexity and the orbit is presented. The presence of histiocytes showing lymphophagocytosis and positivity for S-100 protein staining confirmed that the lesions represented extranodal forms of sinus histiocytosis with massive lymphadenopathy.

Adult↗

PubMed1988

[Decreased tumor viability of gliomas after radiation therapy, evaluated by dynamic CT scan].

The tumor viability of 28 gliomas after radiation therapy has been investigated by dynamic CT scan that estimated 4 parameters (Area, Peak, Time of Peak, and, Height of Plateau) from a time-density curve. Glioblastoma showed higher values of Area and Peak, whereas astrocytomas showed lower values when compared to those found in normal gray matter. After radiation therapy, the Area and Peak decreased and the Time to Peak was prolonged, suggesting a decrease in blood volume and blood flow in the tumor tissue. The increased Height of Plateau showed an increased permeability of the tumor-vessels. These results suggest that a dynamic CT scan provides a useful indicator of the change in tumor-viability after radiation therapy.

Adult↗

PubMed1987

[Regional cerebral blood flow in brain tumors analyzed by N-isopropyl-(123I)-p-iodoamphetamine (IMP)].

N-Isopropyl-(123I)-p-Iodoamphetamine (IMP), a newly developed tracer for regional cerebral blood flow, was applied to 18 patients with brain tumors. The static scan images were obtained by a single photon emission CT 20 minutes after IMP injection, and revealed decreased IMP uptake in the tumor region in 17 out of 18 patients. This result suggests the lack of an IMP-trapping mechanism in the tumor. In dynamic scan images, which were taken every 2 minutes just after IMP injection, IMP uptake in the tumor was intermediate between that of contralateral white matter and gray matter, and it increased momentarily in accordance with that of the gray and white matter. This finding indicates that the IMP uptake in a dynamic scan would express the regional tissue blood flow in the tumor.

Aged↗

PubMed1986

Cerebral venous thrombosis due to high-altitude polycythemia. Case report.

A case of cerebral venous thrombosis due to polycythemia secondary to adaptation to a high altitude is reported. A 27-year-old previously healthy man developed severe neurological symptoms after climbing 8511 m. Computerized tomography and cerebral angiography suggested hemorrhagic infarction or intratumoral hemorrhage, and a craniotomy was performed. Pathological examination confirmed the diagnosis of hemorrhagic infarction secondary to cortical venous thrombosis. The etiology and incidence of cerebral venous thrombosis secondary to polycythemia are discussed.

Adult↗

PubMed1986

Cerebral thrombosis at altitude: its pathogenesis and the problems of prevention and treatment.

In analyzing cerebral thrombosis at altitude--own case and in the literature--we anatomically confirmed that cerebral thrombi in mountain sickness were all of venous origin. All climbers went higher than 5,000 m and most stayed in that altitude longer than 3 weeks. Hemoconcentration was confirmed in two cases, including our own patient. It was suspected that hemoconcentration resulting from secondary polycythemia and dehydration at altitude, as well as cerebral circulatory disturbance produced by high-altitude cerebral edema, played a major role in the development of cerebral thrombosis. The problems of prevention and treatment of cerebral thrombosis at altitude are discussed.

Adult↗

PubMed1977