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Biomedical subjects

Y Kaku

Publications and source records attributed to Y Kaku.

68 records · Page 4Linked to original sources

Intra-abdominal cyst following revision of ventriculoperitoneal shunt--case report.

An intra-abdominal cyst is a rare complication of ventriculoperitoneal (VP) shunt. A 19-year-old male was admitted complaining of abdominal pain and distension, dysuria, constipation, headache, and fever. He had undergone a VP shunt for obstructive hydrocephalus caused by a cerebellar astrocytoma 16 years earlier, and had received shunt revision twice, 5 years and 3 months earlier, respectively. Examination on admission revealed neck stiffness, early papilledema, a mass in the lower abdomen, and abdominal muscular guarding with rebound tenderness. Laboratory studies showed leukocytosis of the peripheral blood and pleocytosis of the cerebrospinal fluid (CSF). Abdominal ultrasonograms and computed tomographic scans demonstrated a cystic lesion. Under the diagnosis of meningitis and local peritonitis with an intra-abdominal cyst, we sistemically administered antibiotics and externalized the shunt. However, since the cyst fluid could not be aspirated through the abdominal catheter, it was exchanged with a flexible catheter under fluoroscopic control, according to Seldinger's method. A total of 400 ml of cyst fluid was drained. Staphylococcus epidermidis was detected in both the cyst fluid and the CSF. After meningitis subsided, repositioning of the abdominal catheter into the other side of the abdomen was performed but resulted in shunt malfunction and meningitis due to the same organisms. After meningitis again subsided, the VP shunt was converted to a ventriculoatrial shunt. The clinical course was uneventful thereafter.

Abdomen↗

[Disappearance of hemifacial spasm following spinal drainage: a case report].

This report is concerned with a case of right hemifacial spasm (HFS) occurring in a 65-year-old woman, who incidentally had a left internal carotid-ophthalmic artery aneurysm. The aneurysm was successfully treated by clipping its neck. However, spinal drainage had to be performed postoperatively in order to prevent possible cerebrospinal fluid (CSF) rhinorrhea, as the roof of the sphenoid sinus was accidentally opened during the aneurysm surgery. Liquorrhea was observed and stopped on the 5th postoperative day. The drain was then removed only to be reset because CSF rhinorrhea recurred 8 days later, when the HFS began to subside. When the spinal drain was finally removed 9 days later, the HFS was scarcely seen. The HFS was thought to be due to the compression of the right facial nerve by the ipsilateral AICA. The draining of the CSF might have changed the amount and flow of the liquor and consequently the positional relationship among the facial nerve, the AICA and the arachnoid membrane, resulting in neurovascular decompression.

Aged↗

Mast cell degranulation in nasal polyps.

Light- and electronmicroscopic observations as well as immunohistochemical studies were made on nasal polyps from 15 patients. The patients included 2 cases of aspirin intolerance (AA), 6 cases of allergic rhinitis (NA) and 7 cases of chronic rhinitis (CS) with negative skin tests against major inhalant allergens. Nasal polyps commonly contained many inflammatory cells such as neutrophils (PMN), eosinophils, plasma cells, mast cells, lymphocytes and macrophages. Two morphological features were conspicuous in our study: 1) PMN migration and attachment to the basal lamina, 2) accelerated degranulation of mast cells. Mean values of degranulated granules were 0.532473/micron2 in AA, 0.492615/micron2 in NA and 0.253591/micron2 in CS. These results indicate that mast cell degranulation in CS is much less than that in AA and NA. Immunohistochemical investigations revealed very few IgE-positive cells in both AA and NA, and none in CS. On the other hand IgG and IgA were frequently observed in all cases of nasal polyps. The present study suggests that mast cell degranulation plays an important role in the formation of nasal polyps, but it may not only be an IgE-dependent mechanism. To elucidate other possibilities, more extensive immunological studies will be required.

Cytoplasmic Granules↗

Clinical detection of the hepatic lesion of pericentral sclerosis in chronic alcoholics.

It has been shown that a specific liver lesion--that is, pericentral sclerosis associated with pericellular fibrosis--is the precursor of alcoholic liver sclerosis. It is, however, difficult to diagnose this hepatic lesion in chronic alcoholics, using only clinical data without liver biopsy. To investigate the possibility of a clinical test reflecting the presence of this hepatic lesion, ethanol (0.75 g/kg body weight) was given orally to chronic alcoholics, and serum glycoprotein levels (prealbumin, alpha HS glycoprotein, haptoglobin, alpha 2-macroglobulin) were measured before and six hours after. Chronic alcoholics were divided into three groups according to the histological findings in the liver at the time of study. Group I (alcoholic fatty liver or non-specific change) consisted of seven cases without pericentral sclerosis. Group II (alcoholic hepatic fibrosis or alcoholic hepatitis) consisted of five cases with pericentral sclerosis and pericellular fibrosis. Group III consisted of five cases with alcoholic liver cirrhosis. After the ethanol administration, serum glycoprotein levels decreased significantly in group I (P less than 0.05), whereas they increased in group II and group III. Their alternative ratios (see text) apparently differed (P less than 0.005) between group I and group II, and between group I and group III. These results indicate that the determination of serum glycoprotein levels before and after oral ethanol administration is useful way of discriminating alcoholic patients with hepatic pericentral sclerosis and pericellular fibrosis from alcoholics without such lesions.

Adult↗

Epithelial changes in or of the middle ear mucoperiosteum. An experimental study.

In this study the time necessary for the increase of the secretory cells in the middle ear mucosa was investigated by EM and SEM and by histochemical observation of the secretory cells. The first experiment revealed that a minimum of six to seven days was required for the renewal of the columnar cytoarchitecture after the exposure to silver protein solution. In the next experiment 35 guinea pigs were subjected to tubal obstruction. Columnar metaplasia was found in one case sacrificed after the third month, and gland formations without myoepithelial cells and nerve endings were seen in those after the fourth month. In an additional experiment, since the frontal sinus of the dogs is simple and pneumatized, duct obstruction was performed. Slight epithelial change and accumulation of glue-like thick mucus, which was negative in culture, was found in all four cases after three months. In one of the two cases with obstruction for four months, typical exophthalmus in the pseduostratified epithelium with an increase in secretory cells or cuboidal epithelium with nonciliated cells was demonstrated.

Animals↗

Treatment of Alzheimer-type dementia with intravenous mecobalamin.

The efficacy of intravenous mecobalamin in the treatment of Alzheimer-type dementia was evaluated in ten patients using several rating scales. Vitamin B12 levels and unsaturated binding capacities were also measured and compared to the evaluated intellectual function scores. Mecobalamin was shown to improve intellectual functions, such as memory, emotional functions, and communication with other people. Improvements in cognitive functions were relatively constant when the vitamin B12 levels in the cerebrospinal fluid were high. Improvements in communication functions were seen when a certain level of vitamin B12 was maintained for a longer period. There were no side effects attributable to mecobalamin. We conclude that mecobalamin is a safe and effective treatment for psychiatric disorders in patients with Alzheimer-type dementia.

Activities of Daily Living↗