Measurement of the longitudinal spin-dependent neutron-proton total cross-section difference Delta sigma L(np) between 500 and 800 MeV.
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Journal Article↗
Biomedical subjects
T Shima
Publications and source records attributed to T Shima.
Diffusion anisotropy of cerebral ischaemia.
Focal cerebral ischemia was produced by occlusion of the middle cerebral artery with a silicone cylinder in Wistar rats. Diffusion-weighted echo-planar images (DW-EPIs) using the motion-probing gradient (MPG) method were acquired at 1-3 hours and 24-48 hours after occlusion. Apparent diffusion coefficients (ADCs) were calculated from these images in ischemic lesions and in normal unoccluded regions. Results were as follows. 1. Ischemic lesions could be detected on the DW-EPIs at 1 hour after occlusion. 2. The ADC of water in the brain tissue was smaller than that of free water as a result of restricted diffusion. 3. Anisotropic diffusion that probably can be attributed to the myelin sheath was observed in the normal deep white matter. 4. In the ischemic lesions, the ADC decreased rapidly within 1-3 hours after occlusion and then slightly further declined after 24-48 hours. In the ischemic deep white matter, diffusion anisotropy disappeared at 24-48 hours after occlusion. Diffusion-weighted imaging may have applications in the examination of pathophysiological mechanisms in cerebral ischemia by means of evaluation of ADC and diffusion anisotropy.
Animals↗
A case of allergic liver injury induced by tegafur.
A 51-year-old woman constitutionally susceptible to allergy presented with acute allergic liver injury. She was taking tegafur for treatment of carcinoma of the uterus. The acute liver injury appeared 3 weeks after the first drug administration. She had marked elevation of glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT), moderate jaundice, and eosinophilia. The virus markers revealed hepatitis B surface antigen (HBsAg) (-) antibody to hepatitis B surface antigen (HBsAb) (+), and immunoglobulin M HA antibody (IgM HA Ab) (-). The laparoscopic and histologic findings were compatible with drug-induced liver injury. Further, the results of the lymphocyte stimulation test (LST) and challenge test by tegafur were positive. From the above findings, the liver injury was diagnosed to be an allergic reaction induced by tegafur. The hepatic function returned to normal about 20 days after tegafur administration was suspended. Allergic liver injury induced by tegafur is very rare. We report the case with a short review of the literature.
Drug Hypersensitivity↗
Acute brain swelling in cerebral embolization model of rats. I: Epidural pressure monitoring.
The authors measured epidural pressure of rats using a microballoon to monitor brain swelling after cerebral embolism. Rats with embolization of the major cerebral artery frequently demonstrated acute brain swelling. Within 5 hours of embolization, the increase in epidural pressure was 29.7 +/- 20.3 mm Hg (mean +/- SD), ranging from 3 to 68 mm Hg. The increase in epidural pressure tended to reach a near-maximal value within 30 minutes of embolization and thereafter stayed at that point until the end of the experiment. These results suggest that measuring epidural pressure can quantitatively assess acute brain swelling in rats.
Acute Disease↗
Primary pineal melanoma with long-term survival: case report.
A rare case of primary pineal melanoma is reported. The patient was a 53-year-old woman who complained of a severe headache. Computed tomography and magnetic resonance images revealed obstructive hydrocephalus caused by a mass lesion in the pineal region. A biopsy was performed through an occipital transtentorial approach. A black pigmented solitary tumor was seen without leptomeningeal dissemination. Histologic examination revealed melanoma. Chemotherapy consisting of dacarbazine, ACNU, vincristine, and interferon was used. Follow-up imaging studies showed dramatic reduction of the tumor without recurrence for 4 years. This report demonstrates that a solitary primary intracranial melanoma without leptomeningeal dissemination and with rare mitoses may yield a good result with chemotherapy.
Antineoplastic Combined Chemotherapy Protocols↗
Acute brain swelling in cerebral embolization model of rats. II: Biochemical study.
To investigate the mechanism of acute brain swelling after cerebral embolism in rats, the authors evaluated the regional changes in tissue pH, ATP, blood-brain barrier function, and water content. The deep cerebrum--thalamus, hypothalamus, and hippocampus--had alkaline change in tissue pH accompanied with the disruption of the blood-brain barrier, decrease of ATP, and increase of water content. The cortex and the caudate putamen, on the other hand, did not show edema though acidic change and ATP decrease were seen. These results suggest that an early vasogenic edema in the deep cerebrum is a main factor for evolving acute brain swelling in this embolization model of rats.
Acute Disease↗
Alteration of coagulation and fibrinolysis systems after multidrug anticancer therapy for lung cancer.
Recently, an increased frequency of thromboembolic events has been reported after the administration of anticancer drugs. The precise mechanism by which these vascular phenomena occur is unknown. The current work aims at evaluating the alterations of the coagulation and the fibrinolysis systems during the administration of antineoplastic agents by means of newly developed markers of haemostasis. This investigation comprised 25 lung cancer patients treated with multidrug combination chemotherapy. D-dimer, plasmin-alpha 2-antiplasmin complex, fibrin degradation products, fibrinogen, antithrombin III, thrombin-antithrombin III complex, prothrombin time and activated partial thromboplastin time were measured from samples taken before and on days 2, 5, 7, 14 and 21 after the administration of antineoplastic drugs. A significant reduction in plasma concentration of fibrinolytic activity markers, DD and PAP, was observed on days 5 and 7, and on days 2, 5, 7 and 14, respectively, following the administration of chemotherapeutic drugs. Statistically significant shortening of PT and APTT on days 2, 5, 7 and 14, as well as significant elevation of the thrombin generation marker TAT were observed on days 5 and 7 after chemotherapy. These results show that relatively higher levels of coagulation activation and a lower fibrinolytic activity occur during cytotoxic drug therapy compared with basal values. Small variations of haemostatic values and a short follow-up period may explain why no thrombotic events were observed during this study. Although further studies must be done to clarify these findings, the results of this investigation suggest that an imbalance of the coagulation-fibrinolysis system might be a contributing factor in the pathogenesis of thrombotic complications during chemotherapy.
Adult↗
Effects of hexoses and their derivatives on glucagon secretion from isolated perfused rat pancreas.
Although it has been firmly established that D-glucose inhibits glucagon secretion from pancreatic A cells, the regulatory mechanism of glucagon secretion by D-glucose has not been elucidated. To study this regulatory mechanism by D-glucose, the effects of hexoses and their derivatives on glucagon secretion from the A cells of isolated perfused rat pancreas were investigated. When these cells were perfused with D-glucose, D-fructose, D-sorbitol, D-galactose, 2-deoxy-D-glucose, D-gluconic acid sodium salt and D-glucosamine HCl salt, glucagon secretion was significantly inhibited. None of the hexoses or their derivatives tested were found to stimulate glucagon secretion. The effects of these sugars on glucagon secretion were independent of their metabolism in the cells. From the findings that the sugars both metabolized and unmetabolized in the cells demonstrated comparable inhibition of glucagon secretion from the isolated perfused rat pancreas, it is speculated that the recognition system for these sugars may be probably present on the A cell membrane and responsible for mediating these inhibitory effects of glucagon secretion.
Animals↗
Characteristics of human hepatocellular carcinoma cell lines (Hep-KANO) derived from a non-hepatitic, non-cirrhotic hepatitis B virus carrier.
We have established two cell lines of hepatocellular carcinoma [Hep-KANO, clone 1 (CL-1) and clone 2 (CL-2)] from tissue obtained at autopsy of a hepatitis B virus (HBV) carrier without histological signs of hepatitis or liver cirrhosis. These cell lines differed considerably from each other in morphology, proliferation pattern, alpha-fetoprotein secretion, albumin synthesis, cytokine secretion, modal chromosome number and transplantability to nude mice. Histologic examinations also revealed differences between them. Amplification of N-myc, L-myc, H-ras, K-ras, N-ras, c-erb-B and c-erb-B-2 and rearrangement of p53 were not found in either of the cell lines. However, CL-1 and CL-2 showed an identical HBV-DNA integration pattern. A 4-fold amplification of c-myc was observed in CL-1, but not in CL-2. Hep-KANO cell lines, CL-1 and CL-2 may be useful in clarifying the question of whether hepatocarcinogenesis is directly caused by HBV infection.
Adult↗
Cavernous sinus cavernoma treated with radiation therapy--case report.
A 71-year-old female presented with a syncopal attack. She underwent surgery for what appeared to be a meningioma. However, a small incision in the dura mater caused severe bleeding. Histological examination of the biopsy specimen showed sinus cavernoma with an incomplete pseudocapsule. The dura mater encapsulated the cavernous sinus cavernoma, explaining the severe bleeding from the dural incision. She was treated with Linac irradiation (40 Gy) which resulted in a decrease in tumor size. Radiation therapy is indicated for the treatment of cavernous sinus cavernoma, especially if associated with severe intraoperative bleeding.
Aged↗
Laser beam in treating congenital choanal atresia in three patients.
We present the results of 3 patients with congenital unilateral choanal atresia who were treated surgically at our department. We report a method of surgical approach for repair of choanal atresia. A transpalatal procedure offers an approach which is straightforward. The use of carbon dioxide or Nd:YAG laser seemed better for recurrent cases. A tube stent should be placed for at least 6 weeks postoperatively.
Adolescent↗
Retroauricular subcutaneous Dacron tunnel for extracranial-intracranial autologous vein bypass graft. Technical note.
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Anastomosis, Surgical↗
Correlation between clotting and collagen metabolism markers in rheumatoid arthritis.
Rheumatoid arthritis is a chronic inflammatory disease caused essentially by an immune-mediated mechanism. However, abnormalities of the clotting system have also been incriminated as having an important role in the pathogenesis of this disease. This study aims at assessing the clotting system and collagen metabolism alterations and the relationship between perturbances of the hemostatic pathway and the destructive and fibroproliferative processes in patients with rheumatoid arthritis. The coagulation system was evaluated by measuring thrombin-antithrombin III complex (TAT), prothrombin time (PT), activated partial thromboplastin time (APTT), and antithrombin III (AT-III). The fibrinolysis system was assessed by measuring fibrin degradation products (FDP), fibrinogen (FBG), alpha 2-antiplasmin (alpha 2-PI), D-dimer (DD) and plasmin-alpha 2-antiplasmin complex (PAP). As markers of collagen metabolism, the type III procollagen peptide (PIIIP) and the 7S domain of type IV collagen (7S-collagen) were determined. Blood concentrations of DD, PAP, TAT, PIIIP, and 7S-collagen were significantly higher in rheumatoid arthritis patients compared to controls. Serum levels of PIIIP were significantly correlated with PT, APTT, AT-III, FDP, and DD. 7S-collagen levels were inversely related to AT-III and FBG values. This study demonstrated the occurrence of a subclinical intravascular coagulation in rheumatoid arthritis and suggested the important role of blood coagulation in the alteration of the extracellular matrix metabolism in this disease.
Adult↗
[Evaluation of Matas test by CBF studies, angiographic cross-filling and stump pressure in CEA patients].
Temporary and/or permanent occlusion of carotid artery is one of the most important strategy in the surgical treatment for cervical vascular and paraclinoid lesions. Cerebral ischemia produced by this procedure should be preoperatively grasped for the safety of the surgeries. Matas test has been widely applied to estimate the collateral blood flow at the main artery occlusion by observing only clinical features. In this study, we measured CBF and common carotid artery stump pressure (CCA stump P) in contrast to angiographic cross-filling in 43 carotid endarterectomy (CEA) patients to quantitatively evaluate Matas test. The patients were manually occluded the CCA on the affected side and clinically observed for at least 10 minutes. CCA stump P and cross-filling were evaluated in all patients and CBF measurements were carried out in the patients who clinically tolerated Matas test. CBF studies were performed by single photon emission CT with Xe-133 inhalation method and CBF values were obtained in the middle cerebral artery territory before and during Matas test. CCA stump P was measured during carotid angiography by manual occlusion of the proximal site of the CCA. Cross-filling was evaluated with the contralateral carotid angiography during the manual occlusion of the affected CCA. CBF changes in Matas test were classified into the following four patterns; bilateral mild decreases in CBF, unilateral severe decrease in CBF, unilateral mild decrease in CBF and no decrease in CBF. The frequency of bilateral mild decreases in CBF, unilateral severe decrease in CBF, unilateral mild decrease in CBF and no decrease in CBF were 8, 10, 14, 7 of 43 patients, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Brain Ischemia↗
[Near infrared spectrophotometric monitoring for cerebral ischemia during the occlusion of the internal carotid artery at CEA].
Near infrared spectrophotometry provides noninvasively real-time information on cerebral oxygenation and cerebral blood volume. Using this method of spectrophotometry we investigated the adequacy of collateral circulation during cross-clamping of the internal carotid artery in patients who underwent carotid endarterectomy. In 15 patients, oxy-hemoglobin, deoxyhemoglobin and total hemoglobin were monitored continuously by near infrared spectrophotometry at the ipsilateral frontal area on the operated side. Changes in these parameters following temporary cross-clamping of the internal carotid artery were evaluated. The stump pressure of the internal carotid artery was measured in every patient. Only the maximum decrease in oxy-hemoglobin during cross-clamping of the internal carotid artery correlated significantly with the stump pressure of the internal carotid artery. Changes in oxy-hemoglobin during cross-clamping of the internal carotid artery demonstrated three patterns; no change or minimally decreased (4 patients), decrease with recovery (4 patients), and decrease without recovery (7 patients). The stump pressure of the internal carotid artery in patients who had no recovery of their decreased oxy-Hb was significantly lower than that in any other pattern (p < 0.01, Mann-Whitney U analysis). Patients who experience decrease in oxy-Hb without recovery following cross-clamping of their internal carotid artery may have poor collateral circulation and therefore may develop cerebral ischemia.
Aged↗
[Ruptured distal anterior cerebral artery aneurysms presenting with acute subdural hematoma: report of two cases].
Two cases of ruptured distal anterior cerebral-artery aneurysms presenting with acute subdural hematoma are reported. Case 1 was a 55-year-old male, who showed abrupt disturbance of consciousness. An emergency CT revealed acute subdural hematoma at the right parietal convexity and interhemispheric fissure with moderate midline shift. There was no evidence of subarachnoid hemorrhage. Right carotid angiography showed an aneurysm at the right distal anterior cerebral artery. An emergency external decompression was performed and the aneurysm was clipped successfully through the interhemispheric fissure. In the operative field, subarachnoid hemorrhage could not been seen, and the patient had uneventful recovery. Case 2 was a 66-year-old female, who complained of severe headache. She deteriorated rapidly and become comatous with development of anisocoria. An emergency CT revealed acute subdural hematoma on the bilateral parietal convexities and interhemispheric fissure with severe midline shift. There was no evidence of subarachnoid hemorrhage. Carotid angiography showed right distal anterior cerebral artery aneurysm. An emergency external decompression was performed, then the aneurysm was clipped successfully. She recovered with disorientation and hemiparesis. Ruptured distal anterior cerebral artery aneurysms presenting with acute subdural hematoma without subarachnoid hemorrhage are rare. It is suggested that CT scans and history of patients are most important but an emergency angiography was prerequisite for correct diagnosis. Surgical treatment should be the best management in such cases.
Acute Disease↗
[Effect of epinephrine added to spinal anesthesia with lidocaine and tetracaine].
The effect of epinephrine added to the solution of lidocaine and tetracaine for spinal anesthesia was investigated in patients undergoing elective surgery of lower extremities. Thirty patients received 3ml of 2% lidocaine and 0.4% tetracaine and 30 patients received the solution with 0.1 mg of epinephrine added. A lumbar puncture was performed at the L2-3 interspace, using a midline approach with a 25-gauge spinal needle. Mean highest level of pinprick analgesia was Th6.1 without epinephrine and Th4.4 with epinephrine, and mean time for regression to Th10 was 2.3 hours without epinephrine and 3.6 hours with epinephrine. Progression of analgesia level was significantly faster and prolongation of duration was significant greater after adding epinephrine. No severe complications were found in any patients. We concluded that adding 0.1 mg of epinephrine to 3 ml of 2% lidocaine and 0.4% tetracaine could produce clinically useful prolongation of spinal analgesia.
Adolescent↗
[Clinicopathoradiological studies in 15 cases of megadolichobasilar anomaly].
We clinicopathoradiologically assessed 15 angiographically diagnosed megadolichobasilar anomalies. Nine of the patients were male and 6 were female; their average age was 61 years. Eleven patients presented with cerebral ischemic attacks, other two complained of trigeminal neuralgia and the remaining two suffered severe headaches. Twelve of the patients had severe hypertension. Vertebral angiography revealed marked elongation of the basilar artery with severe tortuousity and dilatation. The average distance from the dorsum sellae to the basilar artery bifurcation on the lateral view was 24.7 mm, and the average maximum diameter of the basilar artery was 8.6 mm. Aneurysmal dilatation of the basilar artery was also observed in four cases. In 14 of the 15 patients CT scans revealed characteristic findings, such as tubular high density mass with evident contrast enhancement extending from the ventral medulla to the interpeduncular cistern. The outcome was extremely poor, with five deaths and four patients with severe dementia. In the two autopsy cases, enlarged internal lumens could be observed despite severe atheroscrelotic changes, such as intimal thickening by atheromas.
Aged↗