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T Nishiguchi

Publications and source records attributed to T Nishiguchi.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Pitfalls of endovascular treatment for cerebral aneurysms].

Seventeen cases of unclippable aneurysms were treated by the endovascular balloon technique. Nine of them involved the anterior circulation, and eight involved the posterior circulation. Eleven of them were treated by parent artery occlusion with detachable balloons. Three were treated by endosaccular balloon embolization, and three cases combined with AVMs were occluded using ethylene vinyl alcohol copolymer (EVAL) including feeding arteries of the AVMs. Embolic complications occurred in one case of an IC bifurcation giant aneurysm treated by parent artery occlusion. Ischemic complications also appeared in two cases of aneurysms treated by endosaccular balloon embolization. In one case, the thrombus in the aneurysm propagated into the parent artery and occluded it later. In another case, the displaced balloon had obliterated the parent artery 6 hours after the embolization. Parent artery occlusion is a safe way to treat internal carotid giant aneurysms. However, endosaccular treatment still has some problems, i.e., 1) maintaining the balloon's position to preserve the parent artery, 2) balloon migration into the clot, 3) rupture of the aneurysm during or after treatment. Our studies indicate that endosaccular balloon embolization is still a high risk procedure and should be used only in selected cases, until new embolic agents, such as detachable coils, become available.

Adult↗
PubMed1992

[Clinical usefulness of carcinoembryonic antigen measurement in nipple discharge as an adjunctive tool for diagnosis of breast cancer].

We measured carcinoembryonic antigen (CEA) in 43 cases with abnormal nipple discharge by means of enzyme immunoassay utilizing monoclonal anti-CEA antibodies. When the cut-off value was set at 400 ng/ml so that the cases where measured values are not less than this value may be interpreted to be positive, the sensitivity and specificity were 60% and 75% respectively. The clear relationship was virtually observed between the concentration of CEA in nipple discharge and the cytological diagnosis. 9 of 10 malignant cases showed positive in both or either of the CEA assay and the cytological examination. And we could find 1 case of the zero stage of breast cancer and 4 cases in non-invasive carcinoma (Tis) through the combined diagnosis. On the other hand, only 2 of 8 benign cases showed false positive results. The correlation between the CEA concentration in nipple discharge and intratumoral expression of CEA was also observed. In this study, we concluded that the combined use of the enzyme immunoassay and the cytological examination would be more effective in the detection of early breast cancer accompanied with abnormal nipple discharge.

Adult↗
PubMed1991

Synaptic connections of a low-threshold mechanoreceptive primary neuron within the trigeminal subnucleus oralis.

The central axon of a primary afferent neuron that responded to indentation of the glabrous skin of the lower lip in a slowly adapting fashion was intra-axonally injected with horseradish peroxidase. The labeled terminal within the subnucleus oralis was examined electron microscopically. The labeled ending had a pale axoplasm and contained clear spherical synaptic vesicles. The labeled ending formed a synaptic triad with a dendrite and an unlabeled axonal ending with pleomorphic vesicles (a mixture of oval, flattened and dense core vesicles). The labeled primary ending was presynaptic only to the dendrite, while the unlabeled ending was presynaptic to both the dendrite and the labeled primary ending.

Animals↗
PubMed1991

Location of the motoneurons supplying the rabbit pharyngeal constrictor muscles and the peripheral course of their axons: a study using the retrograde HRP or fluorescent labeling technique.

The location of the motoneurons supplying the rabbit pharyngeal constrictor muscles (the superior and the middle constrictors, and the thyropharyngeus and the cricopharyngeus; the last two collectively compose the inferior constrictor) was investigated with intramuscular injection of HRP or the fluorescent tracer nuclear yellow into the individual muscles. Moreover, the peripheral course of their axons was investigated by injection of HRP into all of the pharyngeal constrictors in conjunction with intracranial severing of either the vagus or the glossopharyngeal nerves. The pharyngeal constrictor motoneurons were ipsilaterally located within a subdivision of the nucleus ambiguus which is formed by a compact arrangement of the smallest neurons of the nucleus and situated in the rostral half of the nucleus. We named that subdivision the compact cell group (CoG). Axons of the pharyngeal constrictor motoneurons traversed the vagal rootlets. The rostrocaudal extent of the pharyngeal constrictor motoneurons covered almost the entire length of CoG at a level from about 500 to 2,900 microns rostral to the obex, with their number being most numerous in the middle one-third level of the CoG. Although the motoneurons of the superior constrictor, those of the middle constrictor, and those of the thyropharyngeous and the cricopharyngeus overlapped considerably in location, they tended to be arranged rostrocaudally in that order. At the middle one-third level of the CoG, where the CoG is subdivided into dorsomedial and ventrolateral subgroups of neurons, the superior and the middle constrictor motoneurons were confined to the medial portion of the dorsomedial subgroup, while the inferior constrictor motoneurons were distributed throughout its entirety.

Animals↗
PubMed1991

Dynamic computed tomography for the evaluation of cerebrovascular disease.

Dynamic computed tomography (DCT) was evaluated as a diagnostic indicator for chronic supratentorial ischemia in 50 cases with or without minor neurological deficits. Peak height (PH, the maximum value of the gamma fitted curve), peak time (PT, the time to PH from the start of DCT), transit time (TT, the time between the first and second inflection points of the gamma fitted curve), and their functional maps were analyzed. Cerebral angiography was then performed in all cases to identify stenotic or occlusive vascular lesions in major cerebral arteries. DCT clearly detected 12 of 13 occlusions of the internal carotid artery (ICA) or middle cerebral artery (MCA), although one ICA occlusion was masked by the contralateral MCA occlusion. However, DCT detected only severe ICA or MCA stenosis (more than 90%). Probably, stenotic lesions of less than 90% did not cause detectable hemodynamic compromise. DCT using PH, PT, and TT functional maps is a useful diagnostic method for hemodynamic changes in ischemic cerebrovascular disease, although bilateral lesions and less stenotic lesions (less than 90%) are difficult to detect.

Adult↗
PubMed1991

Embolization of arteriovenous malformations with peripheral aneurysms using ethylene vinyl alcohol copolymer. Report of three cases.

The authors report three cases of arteriovenous malformations (AVM's) with aneurysms arising from the feeding artery; all were successfully treated with a new nonadhesive liquid embolic material, ethylene vinyl alcohol copolymer (EVAL). In two patients the AVM's were totally removed without difficulty, and in one the AVM was managed conservatively after embolization. No new neurological deficits appeared during or after embolization. After road-mapping techniques, EVAL was injected slowly until the feeding artery and aneurysm were completely obliterated. This embolic agent is easy to handle and is considered safe compared with other adhesive liquid embolic agents, such as isobutyl-2-cyanoacrylate or n-butyl cyanoacrylate. It is concluded that EVAL is an excellent agent for embolizing an AVM with a peripheral aneurysm on the feeding artery.

Adult↗
PubMed1990

Assessment of risk of carotid occlusion with balloon Matas testing and dynamic computed tomography.

Temporary occlusion of the internal carotid artery with a balloon catheter (balloon Matas test) and simultaneous dynamic computerized tomography scanning (DCT) were performed to determine the tolerance of permanent carotid occlusion in eight cerebral aneurysm and two carotid-cavernous fistula (CCF) cases, in whom internal carotid occlusion might be necessary during operation or as a choice of treatment. All patients were evaluated by mean transit time (MTT), especially % transit time (MTT of the occluded side x 100/MTT of the control side). In six patients, % transit time (%TT) was less than 155 and no neurological signs appeared after permanent internal carotid occlusion. Neurological deficit appeared when mean arterial blood pressure was 80, and disappeared when mean arterial blood pressure was 100 during the balloon Matas test in a case whose %TT was 200. Neurological deficit appeared several seconds after the balloon Matas test in a case whose %TT was 250. The critical %TT value to cause symptomatic ischaemia was 200 from our results. Therefore, it is necessary to undertake treatment such as bypass surgery for the patients whose %TT is near 200, even if the balloon Matas test was negative.

Aged↗
PubMed1990

Truncus solitarius pulmonalis.

The case of a female neonate with truncus solitarius pulmonalis (TSP), a rare congenital heart anomaly, is reported. She died four days after birth. A single right ventricle with common atrioventricular (AV) valve was associated with (Collet & Edwards type II) truncus arteriosus communis, and appeared to have a single coronary artery with an abnormally high take-off near the origin of the right subclavian artery. However, the vessel that appeared to be the single coronary artery was in fact an extremely hypoplastic ascending aorta associated with aortic atresia and agenesis of the left ventricle and mitral valve.

Coronary Vessel Anomalies↗
PubMed1990

Continuous wave Doppler echocardiographic evaluation of St. Jude prosthetic mitral valves in children.

The function of 9 St. Jude prosthetic mitral valves in 8 children was evaluated by continuous wave Doppler (CWD) echocardiography 28 +/- 22 months after implantation. All valves were apparently functioning normally on clinical examination. Peak flow velocity, mean flow velocity, pressure half-time and mean pressure gradient were determined from the transmitral flow velocity curve by CWD echocardiography. For comparison, the same parameters were examined in 15 normal children and 14 adults who had undergone mitral valve replacement. All measured values were greater in adults and children who had undergone valve replacement than in normal children. There were no differences in any parameter in adults or children in whom prostheses 25 mm or larger had been implanted. Although 3 children in whom prostheses 23 mm or smaller had been implanted had greater values for each parameter than those who received 25 mm or larger prostheses, there were no symptoms or signs of mitral stenosis. These data may be useful as guidelines for normal Doppler characteristics for St. Jude mitral valves in children. In an asymptomatic child whose prosthetic valve developed obstruction by granulation tissue overgrowth, each parameter significantly worsened as the heart rate increased. The changes in these parameters in 2 normally functioning St. Jude valves during atrial pacing were insignificant. The fluctuation of Doppler characteristics with changes in heart rate is useful for differentiating normally functioning prosthetic valves from impending stenosis.

Adolescent↗
PubMed1990

[Cervical spinal epidural abscess: case report].

Most cases of spinal epidural abscesses occur in a midthoracic or lower lumbar location. Cervical spinal epidural abscess is distinctly rare, and its prognosis is not favorable due to respiratory problems. We report a case of cervical spinal epidural abscess. A 77-year-old male was admitted because of tetraparesis and dyspnea. Two months before admission, he had been treated by femoro-femoral bypass for arteriosclerosis obliterans , and he had suffered from postoperative wound infection one month later. He had noticed neck pain two days before admission, followed by a numbness and motor weakness in both hands. Neurological examination showed flaccid tetraplegy with an absence of DTRs, paralysis of intercostal muscles, loss of sensation below the C4 dermatome, and bladder dysfunction. A spinal CT scan revealed a mass lesion in the anterior epidural space from C2 to C6, which displaced the spinal cord posteriorly. A myelogram showed complete blockage of contrast medium at the level of C7-T1. He was treated by emergency laminectomy of C3 to C6 with evacuation of the epidural abscess. Culture showed staphylococcus aureus, for which appropriate antibiotics were administered. In spite of such an intensive treatment, the patient showed poor neurological improvement and died 42 days after operation.

Abscess↗
PubMed1989

Neurons of origin of the internal ramus of the rabbit accessory nerve: localization in the dorsal nucleus of the vagus nerve and the nucleus retroambigualis.

The neurons of origin of the internal ramus of the rabbit accessory nerve were identified in the dorsal nucleus of the vagus nerve, using bilateral injections of horseradish peroxidase into the inferior vagal ganglion, soft palate, and pharynx, which were preceded by different combinations of the unilateral intracranial severings of the rootlets of the vagus and glossopharyngeal nerves, those of the cranial root of the accessory nerve, and the trunk of its spinal root. The neurons of origin occupied the caudal four-fifths of the dorsal vagal nucleus extending from about 1.0 mm rostral to the obex as far caudally as the second cervical spinal segment, with their number being about half the total number of neurons of the nucleus. Although considerably fewer, they were also located in the nucleus retroambigualis of the caudal half of the first cervical spinal segment and the second segment. Axons of most internal ramus neurons traversed the rootlets of the cranial accessory root. Axons of the few neurons located more caudally than about 1.0 mm caudal to the obex emerged from the upper cervical spinal cord to run along the trunk of the spinal accessory root before finally joining the internal ramus; caudal to the midlevel of the first cervical segment, the dorsal vagal nucleus and the nucleus retroambigualis contained neurons whose axons followed only that course.

Accessory Nerve↗
PubMed1989

Cystic arteriovenous malformation. A case report.

The authors report on a rare case of arteriovenous malformation (AVM) associated with cyst formation. Only five similar cases have been reported. CT findings of the cyst are divided into two types: 1) slit-like low density and 2) round one. Three patients showing slit-like cysts had experienced sudden severe headaches, probably due to haemorrhage. In contrast, two patients showing round cystic lesions had not experienced such sudden headaches and they revealed a nodule in the cyst at surgery. These facts suggest that there may be two different mechanisms for cyst formation in AVM's: haemorrhage and exudation. Slit-like cysts may result from old haemorrhage from the AVM nidus. Round cystic lesions may be due to exudation from the AVM nidus.

Adult↗
PubMed1989

Transient myocardial thickening in acute myocarditis--serial study by two-dimensional echocardiography.

A 13-year-old girl developed viral myocarditis complicated by pulmonary thromboembolism. Marked dilatation and reduction in the contractility of the left ventricle were noted in a two-dimensional echocardiogram on admission. The thicknesses of the left ventricle and the interventricular septum were both 8 mm at this time, but increased after the 9th day of the illness to reach 2 cm by the 15th day, with a concomitant reduction in the left ventricular cavity. The myocardial thickening gradually decreased and the ejection fraction improved on serial echocardiographic evaluations, and the wall thickness and ejection fraction returned to normal by the 32nd day. The myocarditis resolved without sequelae. The implications of this transient myocardial thickening are discussed.

Acute Disease↗
PubMed1989

[Arteriovenous malformation associated with cyst. Case report].

The authors present the fifth reported case of arteriovenous malformation (AVM) associated with cyst formation. Among these five cases, computed tomography has demonstrated two types of cyst: round, and slit-like with low density. The three patients with slit-like cysts experienced sudden, severe headache, probably due to hemorrhage. The two patients with round cystic lesions did not have sudden headache, and at surgery the cysts were found to contain a mural nodule. These facts suggest that there may be two different mechanisms of cyst formation in the vicinity of an AVM: hemorrhage (slit-like cysts) and exudation (round cysts).

Adult↗
PubMed1989

[A study on the vascular permeability of brain tumors using dynamic CT].

The vascular permeability of 50 brain tumors of various kinds was examined by means of dynamic CT. The degree of the vascular permeability within the tumor was evaluated according to the theoretical basis that the regression of the time-density curve after the peak to the base line became less in accord with the increase in vascular permeability. The time-density curves obtained from dynamic CT were classified into the following four types. Type 1; This type shows a similar pattern to normal brain tissue and is thought to reveal the normal vascular permeability. Type 2; this type shows intermediate pattern between type 1 and type 3. And the vascular permeability is thought to have been moderately increased. Type 3; This type shows the flattening or gradual increase in the time-density curve after forming the peak. The vascular permeability is thought to have increased markedly. Type 4; The peak of the time-density curve is lower than that of the white matter. This type of tumor is regarded to be least vascularized. All tumors except for gliomas and AVMs showed type 2 or 3 and their vascular permeability was thought to be increased. Most of the gliomas showed type 2 or 3, although some gliomas showed type 1 even in the lesion with positive contrast enhancement. In the lesions of such cases, it was thought that the vascular permeability was not affected significantly, so that blood brain barrier modification therapy by intraarterial mannitol infusion may be quite effective. All AVMs showed type 1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗