Intracranial Aspergillus granuloma originating in the sphenoidal sinus--case report.
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Biomedical subjects
Publications and source records attributed to T Nose.
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Arachnoid cysts of the quadrigeminal cistern are rare. Patients with this lesion are usually normal at birth, and signs of increased intracranial pressure (IICP) develop at about 4 to 12 months of age. However, there has been no report about this mechanism. A case of arachnoid cyst of the quadrigeminal cistern is presented. In this case, the process of the cyst growth was observed during the course of follow-up for shunted hydrocephalus. Symptoms coincided with the growth of the cyst. Therefore, the development of the clinical symptoms was thought to be due to IICP caused by cyst expansion. Our case was complicated by inflammation, something that may offer a key to solving the mechanism of cyst fluid accumulation and the relationship between symptoms and development of the cyst.
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A case of ruptured cerebral aneurysm with hemophilia B is reported, and discussion is made concerning the management of mild type hemophilia in surgical operations. A 41-year-old male came to our hospital with complaints of severe headache, vomiting, and transient consciousness disturbance. His dentist said the patient had a mild bleeding tendency when he was 30 years old, however no postoperative hemorrhage was repeated in appendectomy in his childhood. He also had had no episodes of spontaneous bleeding. CT scan on admission showed subarachnoid hemorrhage, and angiography revealed a ruptured aneurysm at the trifurcation of the left middle cerebral artery. His coagulation screening tests (bleeding time, clotting time, prothrombin time, and activated partial thromboplastin time) were normal. An aneurysmal neck clipping was carried out, and operators did not detect any bleeding tendency during the surgery. CT scan on the next day showed no remarkable finding. On the third postoperative day, right hemiparesis occurred. Left putaminal hemorrhage took place. His coagulation tests and FDP were also normal. The hematoma was partially evacuated. After the second operation his condition was good, and rehabilitation program started. On the 15th hospital day his consciousness deteriorated suddenly, and CT scan showed a massive epidural hematoma on the left. His prothrombin time elongated mildly, but other tests were normal. Coagulation factors VIII and IX were examined and the factor IX was 22.5% of control. He was thought to be a patient with mild type hemophilia B. Despite a third operation for hematoma removal he died on the 20th hospital day. Mild type hemophilia B does not bleed spontaneously.(ABSTRACT TRUNCATED AT 250 WORDS)
Absorption of metal ions by KB, HeLa and L-59 cells has been analyzed by atomic absorption spectrophotometry in the course of culture. Ions of the elements of the fourth period in the periodic chart such as Fe(II), Cu(II), Zn(II), Mn(II) and Ni(II) were not taken up, but those of the higher periods, such as Cd(II), Pb(II), Hg(II) and Ag(I) were were taken up easily. The uptake behavior by the cultured cells was in accordance with the characteristic features of metals, that metals in the fourth period are essential elements, and most of the elements of the fifth and the sixth periods are non-essential or toxic elements. The initial rate of Cd(II) uptake and the Cd(II) concentration has a sigmoidal relationship. Cd(II) was absorbed homotropically through cell membranes. The uptake of Cd(II) was specifically inhibited by Cu(II), but was affected little by Zn(II). The toxicity of Cd(II) to KB cells was greatly enhanced in the presence of Cu(II). On the contrary, the toxicity of Cd(II) was reduced by the addition of Zn(II) at several concentrations of Cd(II). The toxicity of Cd(II) did not depend on the amount of Cd(II) absorbed in the cells, but was determined by cofactors such as Cu(II). The interaction between Cd(II) and Cu(II) may be important for Itai-itai disease.
A case of aneurysm of the middle cerebral artery with congenital porencephaly in the same region is reported. The cyst was opened and the aneurysm was wrapped with a muscle strip. The resected specimen of the cyst wall contained a parenchymal layer with hemosiderinladen macrophages. It is speculated that bleeding from the aneurysm during the perinatal period caused the porencephaly.
The mechanisms causing unclear differentiation of ICH in the acute phase by MRI are discussed. The increase of the hemoglobin concentration in the hematoma, caused by loss of the plasma component directly after onset, is one of the reasons for the shortening of relaxation times. The clotting system is also responsible for this shortening. Thus, the hematoma reaches the same intensity as the brain in the acute stage. Although knowledge from our animal experiments, in vivo as well as in vitro, cannot be directly transferred to the human, such experiments are useful for the understanding of the pathomechanism influencing MR imaging.
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A clinico-radiological analysis of 74 cases of ossification of the posterior longitudinal ligament is reported. Eighteen cases (24%) were asymptomatic or only had neck or shoulder pain; 16 cases (22%) showed signs of radiculopathy, and the remaining 40 cases (54%) had myelopathy. Ossification of the posterior longitudinal ligament developed most frequently at C5, and was rare in thoracic and lumbar regions. Ossification of the posterior longitudinal ligament led to stenosis of the spinal canal; more marked stenosis caused clinical myelopathy. The data showed that 30% of stenosis caused by ossification of the posterior longitudinal ligament was critical for the production of myelopathy.
We report a case of pituitary adenoma with two compartments, i.e. a part within the sella turcica and a part infiltrating the sphenoid bone beneath the sella, producing growth hormone (GH) and prolactin. The patient had the amenorrhea-galactorrhea syndrome, but not acromegalic symptoms. Although the two compartments were united through a small dural perforation, immunohistochemical studies demonstrated that GH and prolactin were separately secreted from the intrasellar and extrasellar components, respectively. Somatotropic adenomas frequently produce prolactin, but it is unusual for these hormones to be secreted from distinctly different parts of the same lesion.
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The authors report a case of spontaneous occlusion of an arteriovenous malformation (AVM) verified by the second angiography performed 3 days after the initial one. This 65-year-old man had a sudden attack of headache, nausea, and vomiting and was admitted to our hospital next day. On admission, CT scan showed subcortical hemorrhage in the right temporo-parietal area and right CAG showed a small AVM in the same area. The main feeder was a MCA distal branch and the drainer joined Labbe's vein. Repeated angiography 3 days after initial one failed to demonstrate the AVM. Craniotomy was performed and thrombosed AVM was totally removed. Mechanism for disappearance of the malformation is assumed to be acute thrombosis due to intracranial hemorrhage and arteriosclerotic change. The literature is reviewed.
Here is a case of long-term cortical blindness after a head trauma. Its etiology is ascribed to the cerebral vascular occlusion caused by the head trauma. From the findings of both a computerized tomography (CT) and magnetic resonance image (MRI), the lesions of our case are assumed to be in the bilateral areas 17 (Brodmann), some part of the bilateral areas 18, 19 (Brodmann) and bilateral optic radiations. On determination of the areas of these lesions, the location of the lesion in the bilateral areas 17 has been especially done by using the MRI. The MRI findings in our case have a full significance on this point.
Phenylalanine ammonia-lyase was entrapped in silk fibroin. The entrapped enzyme showed a similar Km for Phe and pH optimum to the free enzyme. It was resistant against chymotrypsin and trypsin in vitro. To assess the activity in vivo, the free or entrapped enzymes and then Phe were injected into rat duodenum, and cinnamate, a product, in plasma was determined as the most direct evidence of the enzyme activity. The entrapped enzyme but not the free form caused a marked raise of plasma cinnamate. It declined with a half life of about 45 min, which was significantly longer than that (10-15 min) observed upon i.v. administration of cinnamate. These results indicated that the entrapped enzyme was actively degrading Phe in the intestinal tract. Entrapment of phenylalanine ammonia-lyase in fibroin thus provides a new prospect for oral enzyme therapy of phenylketonuria.