Densely calcified anterior cerebral arteries. Case illustration.
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Aged↗
Biomedical subjects
T Morikawa
Publications and source records attributed to T Morikawa.
[A case of report of idiopathic epilepsy with combined attacks of typical absence and sylvian seizure].
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Anticonvulsants↗
[Rerupture mechanism of ruptured intracranial dissecting aneurysm in the vertebral artery following proximal occlusion].
Proximal occlusion is commonly employed to prevent rebleeding of intracranial dissecting aneurysms of the vertebral artery (VA), but rebleeding sometimes occurs. To determine the cause of such rebleeding we reviewed nine cases, including eight reported in the literature and one treated at our hospital. We classified the techniques used to proximally occlude the VA into two types. In Type I, occlusion is performed immediately proximal to the aneurysm so that there are no perforating arteries or the posterior inferior cerebellar artery (PICA) between the clip and the aneurysm. In Type II, occlusion is performed proximal to the PICA so postoperative retrograde flow persists from the contralateral VA through the aneurysm into the ipsilateral PICA. Among the four Type I cases reviewed, it was found that the interval between occlusion and rebleeding was very short: three developed rebleeding within four hours of occlusion, and the fourth showed rebleeding on the fourth day. In the five Type II patients, rebleeding occurred more than four days (mean 15.2 days) after occlusion. It is thought that in Type I occlusion, retrograde flow into the aneurysm immediately after occlusion may raise the intraaneurysmal pressure enough to cause rerupture within just a few hours of occlusion. In Type II occlusion, postoperative retrograde flow through the aneurysm into the ipsilateral PICA exists, so the intraaneurysmal pressure is not likely to rise as rapidly, with the result that rebleeding occurred after more than four days probably due to recurrence of dissection. The short interval between proximal occlusion and rebleeding, especially in Type I cases, suggests that postoperative angiography is only of limited usefulness in evaluating the possibility of rebleeding. The mortality rate reported for cases with reruptured vertebral dissecting aneurysms after proximal occlusion is very high (55.6%). These data indicate that surgical trapping or endovascular intraluminal occlusion, which is difficult to perform in some patients, should be considered the most suitable procedure from the view point of preventing postoperative rebleeding.
Cerebral Hemorrhage↗
[Regional differences of in vivo proton MR spectroscopy in developing human brain].
The purpose of this study was to clarify regional differences in proton MR spectroscopy (1H-MRS) in the developing human brain. Proton MR spectra were obtained from 24 infants aged 0 to 24 months old. Proton MR spectroscopy was performed on a 1.5 Tesla clinical MR unit using a 3D-chemical shift imaging sequence (3D-CSI). MR spectra obtained from voxels in frontal white matter and those in parietal white matter were compared. The NAA/Cho ratios of the frontal region were lower than those of the parietal region at birth but increased rapidly during the first six months of life. The rate of increase was reduced in the second year of life. In contrast, NAA/Cho ratios in paracentral areas were already high at birth but increased slowly through the first two years of life. Cho/Cr ratios of the frontal region were stable during the first year of life and started to decrease in the second year of life. In the parietal region, Cho/Cr ratios were decreased throughout infancy. Regional differences in 1H-MRS spectra were apparent during infancy, and these differences were suggested to reflect regional differences in the maturation of the developing human brain.
Adult↗
[A patient with epilepsy, congenital alopecia and mental retardation: combination of atypical absence in waking and nocturnal partial seizure].
We report a 7-year-old girl with epilepsy, congenital alopecia, and mental retardation. She was hairless at birth. Very scanty hair, eyebrows and eyelashes appeared at 2 years of age. Developmental delay was first recognized at 6 years. Nocturnal partial seizures occurred at 4 years, and atypical absence in waking at 6 years. Electroencephalogram showed spike-waves in the centrotemporal area which increased and developed into a generalized continuous spike and wave complexes upon sleeping at the age of 7 years 1 month. Ictal electroencephalogram in atypical absence showed generalized 3 c/s spike and wave complexes. Skin biopsy of the scalp showed scanty, immature hair follicles and immature sebaceous glands. Whether this case is related to ectodermal dysplasia is unclear.
Alopecia↗
A case report of video-assisted thoracoscopic pneumonectomy for pulmonary atypical mycobacteriosis.
We report a case of a 61-year old woman with pulmonary atypical mycobacteriosis. Although she had been treated with chemotherapy, image findings gradually deteriorated. Chest X-ray and CT scan demonstrated that the advanced destruction with cavity formation and diffused shadow in the right lung. She underwent a right pneumonectomy under the video-assisted thoracic surgery (VATS) approach. The operation time was 4.9 hours, and the amount of intraoperative bleeding was 550 ml. The postoperative course was uneventful and the patient was discharged from hospital on 13th postoperative day. At present, two years after the operation, there is no progress of the pathogen into the other lung, and the patient is doing well with no postoperative complaint. Anatomically, pneumonectomy is a simple procedure, and in consideration of postoperative quality of life with alleviation of pain as well, VATS is worth trying in the cases where the status and nature of the disease are suitable for this technique.
Female↗
[Dural arteriovenous fistulae in the anterior cranial fossa--report of three cases].
Dural arteriovenous fistulae (DAVF's) in the anterior cranial fossa are uncommon. We encountered three patients with DAVF's in the anterior cranial fossa and reviewed the pertinent literature with regard to the etiology. All patients are middle-aged males. Two of three patients had massive intracranial hemorrhage, subarachnoidal hemorrhage in one and subdural hemorrhage in the other. One patient had a ruptured middle cerebral artery aneurysm and DAVF at the anterior cranial fossa was detected only incidentally. Angiographically, blood supplies were from the bilateral enlarged anterior ethmoidal arteries. These drained into the superior sagittal sinus via dilated frontal cortical veins. In all the patients, coagulation of the fistulous connections was carried out and the postoperative courses were uneventful. Angiographies revealed complete disappearance of the DAVF's. In conclusion, compared to cases of DAVF's in the other locations, DAVF's of the anterior cranial fossa are more likely to be brought on by sudden massive intracranial hemorrhage, and should be treated, even if asymptomatic, at the time of diagnosis. Surgical obliteration of the fistulous connection is sufficient treatment for DAVF in the anterior cranial fossa. Literature review strongly suggests that DAVF's involving the anterior cranial fossa are acquired lesions.
Aged↗
[The limitations of three-dimensional CT angiography (3D-CTA) in the diagnosis of cerebral aneurysms].
OBJECT: The purpose of this study is to show some limitations of 3D-CTA to diagnose cerebral aneurysms. METHODS: Sixteen saccular aneurysms less than 10 mm in diameter were included. Large and complicated aneurysms were excluded. RESULTS: Although information about perforating arteries from the posterior cerebral artery is very important for surgery of basilar bifurcation aneurysms, 3D-CTA could not delineate the perforating arteries. A small posterior communicating artery (Pcom.A.) was not detected, and it was very difficult to differentiate infundibular dilatation of the Pcom. A. from an aneurysm. A small aneurysm of the distal middle cerebral artery could not be detected. Flow direction can not be determined by 3D-CTA, and nor could the side of the neck of the anterior communicating artery aneurysm be determined. Fenestration of the anterior communicating artery and the origin of the triple anterior cerebral artery were both misdiagnosed as anterior communicating artery aneurysms. CONCLUSION: It is premature to consider 3D-CTA as a replacement for conventional angiography.
Adult↗
Thymic neuroendocrine carcinoma: a clinicopathologic study in four patients.
BACKGROUND: Thymic neuroendocrine carcinoma (carcinoid) is rare. Here we present four cases of this unusual neoplasm to provide more clinical, radiologic, and prognostic data. MATERIALS AND METHODS: Four male patients with an average age of 44 years (range 27-63) were identified as having thymic neuroendocrine carcinoma and were reviewed retrospectively. RESULTS: One patient had Cushing's syndrome with elevated serum ACTH. Three others were asymptomatic with normal laboratory findings, one case was associated with MEN type 1. All underwent complete resection along with invaded adjacent structures. Local recurrence developed in two patients at 45 and 98 months after the initial excision. Both patients died at 90 and 105 months, respectively. The other two patients are alive and have been disease-free for 27 and 120 months, respectively. CONCLUSIONS: Thymic neuroendocrine carcinomas have a rather poor prognosis based on their tendency to recur and metastasize many years after the initial operation. Therefore, prolonged follow-up is essential for these tumors.
Adult↗
Rolandic discharges in benign childhood epilepsy with centrotemporal spikes, and in other forms of partial epilepsies.
Previous reports concerning benign childhood epilepsy with centrotemporal spikes (BECT) were re-investigated, including new data concerning both the presentation of the long-term clinical courses of three cases and the results of magnetoencephalography (MEG) in one patient, with respect to the following points; (1) the electro-clinical characteristics of sylvian seizures and rolandic discharges (RD), and (2) long-term outcome of idiopathic and symptomatic partial epilepsies with RD other than BECT. The epileptic focus of sylvian seizures is located either in the inferior rolandic cortex or underneath the sylvian fissure, which is strongly supported by the results of clinical seizure manifestations, ictal and interictal EEG findings, and interictal MEG findings. The presence of rolandic discharges is not a hallmark of benign outcome. Instead, the presence of sylvian seizures heralds a benign outcome of partial epilepsy regardless of the presence or absence of an organic lesion. The pathophysiological mechanism of BECT remains unknown. Further neurophysiological as well as genetic investigations are needed.
Adolescent↗
Sequence diversity of serine repeat antigen gene exon II of Plasmodium falciparum in worldwide collected wild isolates.
Field isolates of Plasmodium falciparum collected from endemic areas of Southeast Asia, Solomon Islands, tropical African countries and Brazil were analyzed for the genetic diversity of the exon II of serine repeat antigen gene (SERA) by sequencing of genomic DNA. Of sixty-nine isolates, as compared to the reported FCR3, K1 and Honduras-1 types of exon II sequences, 5, 9 and 20 new allelic forms were found in 23 isolates of the FCR3 type, 36 of the K1 type and 10 of the Honduras-1 type. A group of novel non-synonymous substitutions, 4 new insertions and 3 new deletions of octamer units were found in the octamer repeat region (OR) of the exon II, and most of them clustered within a 40-residues domain. An octamer "SNPVSSEP" revealed in the OR was confirmed as a new repeat unit. Based on the sequences of the serine repeat region (SR) of the exon II, the allelic forms of the Honduras-1 type were conjectured to be the recombinant forms between the K1 type and FCR3 type. The allelic forms of K1 type with less or more repeat serine residues in the serine stretch of the SR than the reported 21 serine residues had most of the variations in the OR. Moreover, a biased geographical distribution of allelic forms was observed. Isolates from African and Southeast Asian countries accounted for most of the new allelic forms (29/33). All of the three types were detected in Southeast Asia but none of the FCR3 type in Africa. One of two groups of FCR3 new allelic forms was found solely in Brazil while another was mainly in Solomon Islands.
Alleles↗
Synthesis and evaluation of glucocerebrosidase inhibitory activity of anhydro deoxyinositols from (+)-epi- and (-)-vibo-quercitols.
Twelve 1,2- and 2,3-anhydro-1,2,3,4,5-cyclohexanepentols were synthesized from (+)-epi- and (-)-vibo-quercitols, readily available by bioconversion of myo-inositol, and assayed for inhibitory activity against glucocerebrosidase (mouse liver). Among them 1L-1,2-anhydro-1,2,4/3,5-cyclohexanepentol, the 3-deoxy derivative of the irreversible inhibitor conduritol B epoxide (CBE), has been demonstrated to be a highly potent and specific inhibitor, almost comparable to the parent compound.
Animals↗
Synthesis and biological evaluation of alpha-mannosidase inhibitory activity of three deoxy derivatives of mannostatin A.
Three deoxy derivatives of alpha-mannosidase inhibitor mannostatin A have been synthesized and their inhibitors activity for Jack beans alpha-mannosidase evaluated in order to elucidate roles of each hydroxyl groups of the inhibitor The 1- and 2-deoxy derivatives have preserved inhibitory potentials although they lowered the activity one-hundred fold compared to the parent, but the 3-deoxy derivative lost activity.
Cyclopentanes↗
The optically active center of Er-doped Si produced by laser ablation.
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Journal Article↗
A novel mutation of the doublecortin gene in Japanese patients with X-linked lissencephaly and subcortical band heterotopia.
The doublecortin (DCX) gene was recently found to be involved in patients with X-linked lissencephaly and subcortical band heterotopia or double cortex syndrome. We have studied the coding regions of the DCX gene in 11 Japanese patients with cortical dysplasia and have identified three different mutations (R186C in exon 3, R272X and R303X in exon 5) in four sporadic female cases. R272X, which has been detected in two unrelated cases, is a novel mutation. Although the number of cases studied remains limited, exon 5 may be a common mutational site in Japanese patients in contrast to many previous reports concerning exons 2 and 3.
Adolescent↗
Cyclin D1 expression in non-small-cell lung cancers: its association with altered p53 expression, cell proliferation and clinical outcome.
Cyclin D1, like p16INK4 (p16) and retinoblastoma (RB) proteins, participates in the cell cycle control at the G1-S transition. We have previously demonstrated altered p16 and RB protein status in non-small-cell lung cancers (NSCLCs) and their potential synergistic effect with altered p53 protein on proliferative activity (Kinoshita et al (1996) Cancer Res 56: 5557-5562). In the present study, cyclin D1 expression was studied by immunohistochemistry in the same cohort of 111 resected NSCLCs as in our previous study, and the amount of the cyclin D1 gene was analysed by Southern blot analysis in 29 NSCLCs. Cyclin D1 expression was analysed in relation to the status of p53, p16 and RB proteins, and proliferative activity determined by the Ki-67 index. It was also analysed in relation to survival of 77 patients with NSCLCs which were potentially curatively resected between 1990 and 1995. We found that: (1) cyclin D1 was expressed in 13 (11.7%) of 111 NSCLCs; (2) the cyclin D1 gene was neither significantly amplified nor rearranged; (3) cyclin D1 expression significantly correlated with altered p53 protein expression (P = 0.04), whereas it did not correlate with p16 and RB protein status; (4) proliferative activity tended to be higher in cyclin D1-positive (+) tumours than in cyclin D1-negative (-) tumours, although this difference was not statistically significant (P = 0.08); and (5) patients with cyclin D1+ tumours survived longer than patients with cyclin D1- tumours (5-year survival rates, 89% and 64% respectively, by the Kaplan-Meier method; P = 0.045 by the log-rank test), and cyclin D1 expression tended to be a favourable prognostic factor (P = 0.08 in univariate analysis). These findings suggest the involvement of cyclin D1 in the development and progression of NSCLCs, their proliferative activity and clinical outcome of NSCLC patients.
Aged↗
[Assay of specific anti-Chlamydia pneumoniae antibodies by ELISA method. 3. Setting of serological criteria].
"HITAZYME C. pneumoniae" (or "HITAZYME CPN", for short) is a diagnostic reagent that has been recently developed by adopting an ELISA method for detection of anti-Chlamydia pneumoniae (C. pneumoniae) antibodies. When this reagent is used under a current diagnostic standard that has been set as a provisional standard, however, high antibody positive rates are often produced for both IgG and IgA even using the specimens of healthy persons. So, it is difficult to distinguish C. pneumoniae-infected patients from healthy persons. Therefore, this time, we tried to establish a new diagnostic standard by setting up of special cut-off values for a single serum and rise rates of antibody titers for paired sera to improve the accuracy for diagnosis of C. pneumoniae infection. For a single serum testing, we set a special cut-off value at ID 3.00 for both IgG and IgA, so that most healthy persons fall within the range of the "negative" zone. This value was based on the calculation of "Mean+2SD" using measurement results (or IDs) of healthy persons. When this cut-off value was applied, the rate of > or = ID 3.00 for either IgG or IgA was 7.6% for healthy persons, and 64.9% for infected patients. (The rate reached 76.4% when the highest IDs of multiple specimens taken from each patient for this test were used in calculation) As a diagnostic standard for a single serum, therefore, it was defined that: "If ID is 3.00 or greater for IgG and/or IgA, it is highly likely that the case has an acute or a present infection." Using paired sera, we could confirm almost a linear relationship between the results by HITAZYME CPN and those by micro-IF method. Under micro-If method, if the antibody titer increases four times or greater using paired sera, acute infection is diagnosed. As it was found that the four-fold increase in antibody titer corresponds to the increase of 1.35 in ID for IgG and 1.00 for IgA, we defined a diagnostic standard for paired sera as follows: "If ID increases by 1.35 or greater for IgG, and/or if ID increases by 1.00 or greater for IgA, the case may be diagnosed as acute infection."
Acute Disease↗
Improved techniques of applying fibrin glue in lung surgery.
To enhance the adhesive property of fibrin glue, two techniques were developed. The first is an improvement of the conventional layer method, and the second is a further improvement of the first technique. Their adhesive properties were tested in canine lungs in two phases. In phase 1 of the experiment, two new techniques were compared with the conventional methods in the retrieved lung. In phase 2 of the experiment, the second technique examined how its adhesive properties changed after treatment comparing them with gelatin-resorcinol-formaldehyde-glutaraldehyde (GRFG) glue. In phase 1, the first technique showed a 3-fold enhancement of the adhesive properties as compared with the conventional methods, and with the second technique the adhesive properties were further improved by more than 2-fold in the retrieved canine lung. In phase 2, it was revealed that the bursting pressure of both the second new technique and GRFG glue was eventually equal, and enough to close the cut surface of the lung. In the clinical setting, two techniques showed a safe and satisfactory performance in closing the cut surface of the lung. Due to the low toxicity of fibrin glue and absorbable material, these two techniques, especially the second technique, provide better circumstances for the healing of lung injury.
Animals↗