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Biomedical subjects

T Isu

Publications and source records attributed to T Isu.

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

Secretion of tears in patients with hemifacial spasm.

Hemifacial spasm can cause abnormal tear secretion on the affected side. Thirty patients with this disease were examined using the Schirmer's test without topical anesthetic. Twelve of them showed more tear secretion on the affected side than on the unaffected side. The average Schirmer test value was 30.4 +/- 12.3 mm (+/- SD) on the affected side in the patients and 17.4 +/- 10.9 mm (n = 148) in the control subjects (P less than 0.001). Microvascular decompression surgery reduced the hypersecretion of tears. The results suggest that compression of the facial nerve by a blood vessel causes an excitatory stimulus for tear secretion in patients with hemifacial spasm.

Adult↗
PubMed1990

[A case of intramedullary spinal cord metastasis from adenocarcinoma of corpus uteri].

The authors present a case of a woman with intramedullary spinal cord metastasis from adenocarcinoma of the corpus uteri. Such a case was not able to be found in the literature. A 54 year-old woman complained of right upper extremity weakness and headache. CT scan showed abnormality, and removal of a brain tumor was performed. After that, total hysterectomy, retroperitoneal lymphadenectomy and chemotherapy was carried out. Three months later, she suddenly experienced bilateral weakness in her lower extremities. After a few days she was unable to walk. Gd-DTPA enhanced MRI showed an abnormal mass at the upper part of the conus medullaris. Total removal of the intramedullary tumor was performed and adenocarcinoma was diagnosed histopathologically.

Adenocarcinoma↗
PubMed1989

Significance of spinal cord swelling in the prognosis of acute cervical spinal cord injury.

Seven cases of acute cervical cord injury examined by CT-myelography are reported. Cord swelling was observed in 2 patients who developed complete lesions. Another 5 cases had an incomplete lesions. Spinal cord swelling indicated severe cord damage. External decompression seemed to have little effect on cord swelling. When cord swelling is absent, neurological improvement was expected though the initial neurological state showed severe deficits. A further 4 patients who had an acute cervical cord injury who were treated by myelotomy at the injury site are also reported. Two patients obtained significant improvement in upper limb function. The presence or absence of cord swelling as shown by CT-myelography is important for diagnosing the severity of cord damage. Myelotomy in the immediate post-accident period may relieve the effects of cord swelling.

Acute Disease↗
PubMed1989

Mobile schwannoma of the cauda equina diagnosed by magnetic resonance imaging.

Three cases of a mobile cauda equina schwannoma, preoperatively diagnosed by magnetic resonance imaging, are described. When dealing with tumors of the cauda equina, it is important to carry out a second magnetic resonance imaging scan after changes in posture, bearing in mind the possibility of mobility of the tumor.

Adult↗
PubMed1989

Magnetic resonance imaging in cases of spinal dural arteriovenous malformation.

Two patients with spinal dural arteriovenous malformations associated with intramedullary changes confirmed by the T2-weighted magnetic resonance imaging (MRI) scans are reported. The characteristics of the MRI findings for these 2 patients were as follows. 1) In the T2-weighted spin-echo image, intramedullary changes observed by MRI were visualized as a high signal intensity area at the level where delay in venous circulation of the spinal cord was revealed by the angiography of the spinal cord. 2) After the obliteration of the arteriovenous shunt by surgical management, intramedullary changes remarkably decreased and disappeared with the disappearance of swelling of the spinal cord observed preoperatively. After that, the atrophy of the spinal cord was shown. 3) The level, extent, and severity of intramedullary changes were decided by the condition of the level where the radiculospinal vein, as the flowing vein, refluxes into the coronal venous plexus and venous flow occurs through the radiculospinal vein into the epidural veins. We suspect that intramedullary changes shown by the T2-weighted MRI scan chiefly represent edema of the spinal cord, caused by an increase in venous pressure due to venous congestion of the spinal cord. MRI is a very useful diagnostic aid to detect intramedullary changes associated with a spinal dural arteriovenous malformation and to evaluate therapeutic results after surgery.

Angiography↗
PubMed1989

[Myelotomy for acute cervical cord injury. Report of four cases].

Four cases of acute cervical cord injury treated by posterior midline myelotomy are described. The initial neurological examinations of these four patients indicated complete cord lesions. On plain neck X-rays, two exhibited anterior dislocation and two showed no bony injury other than ossification of the posterior longitudinal ligament. Myelography via C1/2 lateral puncture showed complete block of the subarachnoid space in two cases, and incomplete block in the other two. Computed tomographic myelography revealed cord swelling in all cases. Posterior midline myelotomy was performed after administration of a steroid and mannitol, or reduction of spinal dislocation. The time from injury to myelotomy ranged from 5 to 21 hours. No patient developed new deficits postoperatively. During long-term follow-up, which ranged from 10 to 19 months, all patients showed improvement in motor function of the upper extremities. Sensory disturbances also diminished to some degree. However, in one patient, who underwent myelotomy 18 hours after injury and had shown progressive neurological deterioration before surgery, the improvement in motor function was only slight. In this case, earlier myelotomy may have been more beneficial. These results support the indication for myelotomy in cases of acute cervical cord injury with cord swelling. Particularly if performed early, this procedure is effective in preventing secondary neurological damage.

Acute Disease↗
PubMed1989

[Surgical treatment of syringomyelia. Selection of surgical procedures].

The surgical approach to syringomyelia is controversial. In this study, the authors evaluated the results of various operative procedures applied in 31 patients with syringomyelia. Syringomyelia was associated with Chiari malformation in 17 cases, with spinal adhesive arachnoiditis in nine, with trauma in three, and with epidural arachnoid cyst in one. One case was idiopathic. A total of 38 operations were performed. Syringosubarachnoid shunting was applied in 17 patients, syringoperitoneal shunting in 11, terminal syringostomy in three, ventriculoperitoneal shunting in three, lumboperitoneal shunting in two, foramen magnum decompression (suboccipital craniectomy plus upper cervical laminectomy) and terminal syringostomy in one, and foramen magnum decompression with syringosubarachnoid shunting in one. The postoperative follow-up period ranged from 2 to 55 months (average, 26 months). Of the 31 patients, 23 showed neurological improvement, five were unchanged, and three deteriorated. Among the last three, one patient with Chiari malformation developed shunt malfunction due to arachnoiditis after syringosubarachnoid shunting. In two patients with syringomyelia secondary to adhesive arachnoiditis, the spinal cord was damaged by extensive separation of the arachnoid membrane at surgery. On the basis of the results in these 31 cases, the authors conclude that syringosubarachnoid shunting is effective for syringomyelia associated with Chiari malformation if syringomyelia is responsible for the clinical symptoms. Post-traumatic syringomyelia and syringomyelia secondary to adhesive arachnoiditis should be treated by syringoperitoneal shunting. If hydrocephalus is present, ventriculoperitoneal shunting is indicated. Finally, terminal syringostomy is no more effective than syringosubarachnoid or syringoperitoneal shunting.

Arnold-Chiari Malformation↗
PubMed1989

[Carpal tunnel syndrome in acromegaly--4-case report and review of literature].

Four cases of carpal tunnel syndrome in acromegaly were reported. These 4 cases were found in 21 acromegalies (19%). Besides change of features, they complained bilateral sensory disturbances of their hands. After transsphenoidal removal of pituitary adenoma, GH levels returned to the normal range and sensory disturbances were improved in all cases. Mechanism of carpal tunnel syndrome in acromegaly is that edematous synovial tissues compress the median nerve because oversecretion of growth hormone causes increase of sodium and water retention in the extracellular fluid. The patient who showes high basal level of growth hormone and/or acromegalic pattern by various tolerance tests does not always have the carpal tunnel syndrome. But this syndrome is apt to be found in active acromegaly. So the detection of the symptom showed by this activity such as hypersudation in our cases leads to the early diagnosis of acromegaly.

Acromegaly↗
PubMed1989

[Spinal cord evoked potential in experimental spinal cord injury: the changes of spinal cord evoked potential following impact injury, and the correlation between the change in amplitude of the spinal cord evoked potential after injury and the prognosis for motor recovery of legs].

The authors reported the changes of spinal-cord-evoked potential following impact injury by the weight dropping technique (Allen's method). The correlation between the change in amplitude of the spinal-cord-evoked potential after injury, and the prognosis for motor recovery of the legs was discussed. The spinal cord of adult dogs was traumatized by the weight dropping technique (Allen's method) at the level of Th10. The trauma consisted of a 300 gm-cm impact injury, a 400 gm-cm impact injury, and a 500 gm-cm impact injury. The spinal-cord-evoked potential following direct stimulation of the spinal cord was recorded from the epidural space for 5 hours. The recording electrode was located cephalad to the site of the impact injury. The stimulating electrode was located at the caudal site of the injured area. The motor function of the dogs was observed by clinical scale for rating hind limb motor function (modified Tarlov score) for one month after the trauma. The recovery of the spinal cord evoked potential following impact injury by the weight dropping technique could be estimated one hour after trauma in the 300 gm-cm injury, 30 minutes after trauma in the 400 gm-cm injury and immediately only after trauma in the 500 gm-cm injury. A greater reduction of amplitude of I potential was noted with the higher energy injury (p less than 0.05). There was no parallel correlation between the change in amplitude of the spinal cord evoked potential after injury and the prognosis for motor recovery of legs. However, the changes in amplitude corresponded moderately well to the prognosis of motor function.

Animals↗
PubMed1988

[Spinal intramedullary tumor with exophytic growth].

We experienced 22 cases of spinal intramedullary tumor, in which 5 cases were accompanied with exophytic growth. We discussed their clinical and radiological features, and therapeutic problems. Concerning the locations of tumors with exophytic growth, the most common site was conus medullaris, accounting for 60% (3 cases). Histopathological findings were astrocytoma in two cases, and in one case, mixed glioma, ependymoma and hemangioblastoma. In neurological observation, the most common initial symptom was back pain and lumbago, suggesting root pain. No neurological features distinguishable from those of extramedullary tumors were presented. In radiological examination, myelography and CT myelography were very helpful for diagnosis. Myelography and CT myelography showed extramedullary mass, shift and deformity of spinal cord that was not serious as compared with the size of extramedullary mass, and showed the portion where the spinal cord was swollen. Good outcomes were obtained in a case with total removal, and two cases with subtotal and partial removal that were managed with additional irradiation and chemotherapy. However recurrence and intracranial seeding made prognosis poor in two cases where total removal was impossible. We thought that postoperative careful follow-up was necessary not only to detect recurrence but also to detect intracranial seeding in the cases of spinal intramedullary tumor with exophytic growth.

Adult↗
PubMed1988

[Multiple neurinoma of the spinal cord: case report].

The patient, a 72-year-old female, was admitted with an 11-year history of progressive dysesthesia in the left leg. Neurological findings on admission revealed weakness in the bilateral legs, hyperreflexia of left leg, hypalgesia and hypesthesia under the Th 8 level, and urinary incontinence. Plain lumber X-ray showed enlargement of the intervertebral foramen of L 1/2. Myelography disclosed block age at the level of Th 9 and filling defect at the level of Th 10/11 and L1/2. CT myelography revealed a cord swelling and partially exophytic tumor from Th 8 to Th 9, another tumor located posterior-laterally at the level of Th 11, and another tumor located extra and intradural at the level of L1/2. Laminectomy was performed from Th 8 to L 3. A tumor of the Th 9 was located intramedullary, another tumor of the Th 11 was located intradural extramedullary, and another tumor of the L1/2 was located in the epidural space (so-called dumb-bell type tumor). These tumors were removed completely except the extra-canal part of L1/2 tumor. Histopathological examination revealed typical Antoni type A schwannoma in all tumors. This case was considered multiple neurinomas of the spine in which tumors were located in three separate anatomical sites, intramedullary, intradural extramedullary, and epidural sites. This patient did not show café-au-lait spot, and neurofibroma in her body. The authors considered the patient might be a case of central neurofibromatosis. The authors stressed that multiple neurinomas of the spine is not rare, so careful study of the whole spine is necessary including its intramedullar space.

Aged↗
PubMed1988

[Radiological diagnosis of chronic spinal cord compressive lesion at thoraco-lumbar junction].

Radiological findings in five cases with chronic spinal cord compressive lesion at thoraco-lumbar junction were reported. Three cases had spondylosis and two cases had ossification of yellow ligament (OYL). The levels of the lesions were T12/L1 in three cases and T11/12 in two cases. Two out of three spondylotic patients had also OYL at the same level. The five cases consisted of three men and two women. The ages ranged from 42 to 60 years old with a mean age of 53 years old. Neurologically, every patient showed flaccid paresis and sensory disturbance of the legs. Two cases had sensory disturbance of stocking type. The intervals from the onset of the symptoms to the final diagnosis were 6 months, 7 years, 8 years, 11 years and 12 years. Myelography showed anterior spinal cord compression by bony spur in spondylotic patients, and posterior compression by OYL in other cases. Myelography in flexion posture disclosed the cord compression by bony spur more clearly in two out of three spondylotic patients. Delayed CT-myelography showed intramedullary filling of contrast material in two cases, which indicated degenerative change or microcavitation due to long term compression of the spinal cord. MRI was taken in three spondylotic patients and could directly show compression of the spinal cord. Difficulty in detecting abnormality at thoraco-lumbar junction on plain roentgenogram, and similarity of the symptoms to peripheral nerve disease often lead to a delay in diagnosis. The significance of dynamic myelography and delayed CT-myelography when dealing with such a lesion was discussed here.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Spinal epidural tumors without destructive bone change: clinical and radiological studies].

CT in 61 patients having spinal epidural tumors were reviewed. Of these patients twelve had an epidural mass lacking of destructive bone change. Histological examination of these 12 cases revealed that usual carcinomatous tumors are relatively less common but sarcomatous tumors and malignant hematologic neoplasms are more likely to form an epidural mass without bone destruction. The tumors preponderance thoracic spine and extended usually more than three spinal levels along spinal axis. In all but one tumor masses were found in the intervertebral foramen and the paraspinal region in addition to the spinal canal. Contrast enhanced CT was particularly effective to delineate tumor location and extension. Ring enhancement of the dural sac which constricted by epidural masses was considered pathognomonic of epidural tumors.

Adult↗
PubMed1988

[Thermographic findings of syringomyelia].

Thermographic findings in 10 cases of syringomyelia were reported. 7 cases were associated with Arnold-Chiari malformation and 3 cases with spinal adhesive arachnoiditis. The cases included 3 men and 7 women, aged 7 to 56 years (mean age 27.7 years). Comparing the right side of the body with the left side, in 9 cases, thermography demonstrated asymmetric skin temperature of the trunk or extremities. MRI revealed laterality of the syrinx at the level of cervical or lumbo-sacral cord in 9 cases. The side with the lower temperature corresponded with the side of lateralized syrinx in 8 cases. Neurologically, 9 cases had laterality of sensory disturbance and 6 cases had asymmetric motor weakness. The side with the lower temperature also corresponded with the laterality of sensory disturbance in 8 cases, and the side of the motor weakness in 4 cases. Considering these findings, many of the patients with syringomyelia are thought to have asymmetric skin temperature. Intramedullary involvement of sympathetic pathway by the syrinx may cause such a change. As thermography is non-invasive and easy to carry out, it should be a useful method for estimating or even detecting cases of syringomyelia, especially when applied to out-patients.

Adolescent↗