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排序方式: 共有3930条查询结果,搜索用时 15 毫秒
1.
H Ishihara M Bjeljac D Straumann Y Kaku P Roth Y Yonekawa 《Minimally invasive neurosurgery》2006,49(3):168-172
OBJECTIVE: A safe entry zone to tegmental lesions was identified based on intraoperative electrophysiological findings, the compound muscle action potentials (CMAP) from the extraocular muscles, and anatomic considerations. This entry zone is bordered caudally by the intramesencephalic path of the trochlear, laterally by the spinothalamic tract, and rostrally by the caudal margin of the brachium of the superior colliculus. METHODS: Four intrinsic midbrain lesions were operated upon via the safe entry zone using the infratentorial paramedian supracerebellar approach. All lesions involved the tegmentum and included an anaplastic astrocytoma, a metastatic brain tumor, a radiation necrosis, and a cavernous angioma. CMAP were bilaterally monitored from the inferior recti (for oculomotor function) and superior oblique (for trochlear nerve function) muscles. RESULTS: In three of four cases, CMAP related to the oculomotor nerve were obtained upon stimulation at the cavity wall after removal of the tumor. Stimulation at the surface of the quadrigeminal plate, however, did not cause any CMAP response. Using this monitoring as an indicator, the lesions were totally removed. CONCLUSIONS: In the surgery of tegmental lesions, CMAP monitoring from extraocular muscles is particularly helpful to prevent damage to crucial neural structures during removal of intrinsic lesions, but less so to select the site of the medullary incision. The approach via the lateral part of the colliculi is considered to be a safe route to approach the tegmental lesions. 相似文献
2.
Shinsuke Hamaguchi Yasuhisa Okuda Toshimitsu Kitajima Nobuhide Masawa 《Journal canadien d'anesthésie》2002,49(7):745-748
PURPOSE: To clarify the appropriate concentration and dose of hypertonic saline solution (HSS) for preventing delayed neuronal death in the hippocampal CA1 subfield after transient forebrain ischemia in gerbils. METHODS: Thirty gerbils were randomly assigned to five groups: physiological saline solution (PSS) group, ischemia/reperfusion treated with PSS 2 mL x kg(-1); 5% HSS group, treated with 5% HSS 2 mL x kg(-1); 7.5% HSS group, treated with 7.5% HSS 2 mL x kg(-1); 10% HSS group, treated with 10% HSS 2 mL x kg(-1); 20% HSS group, treated with 20% HSS 2 mL x kg(-1). Transient forebrain ischemia was induced by occluding the bilateral common carotid arteries for four minutes. Five days later, histopathological changes in the hippocampal area were examined, and the degenerative ratio of the pyramidal cells were measured according to the following formula: (number of degenerative pyramidal cells/total number of pyramidal cells per 1 mm of hippocampal CA1 subfield) x 100. RESULTS: In PSS and 20% groups, neuronal cell damage was observed five days after ischemia. In the other three groups, these changes were not observed. The degenerative ratios of pyramidal cells were as follows; PSS group: 91.6 +/- 5.6%, 5% HSS group: 7.2 +/- 1.6%, 7.5% group: 8.3 +/- 1.4%, 10% HSS group: 6.2 +/- 1.1%, 20% HSS group: 85.8 +/- 8.7% (P < 0.05; PSS and 20% HSS vs three other groups). CONCLUSION: This study demonstrates that 5, 7.5 or 10% HSS 2 mL x kg(-1) may prevent delayed neuronal death in the hippocampal CA1 subfield after cerebral ischemia/reperfusion in gerbils. 相似文献
3.
Successful treatment of a patient with penetrating injury of the esophagus and brachiocephalic artery due to migration of Kirschner wires. 总被引:2,自引:0,他引:2
Shinsuke Wada Tsuyoshi Noguchi Tsuyoshi Hashimoto Yuzo Uchida Katsunobu Kawahara 《Annals of thoracic and cardiovascular surgery》2005,11(5):313-315
Pins and wires offer the simplest and most effective tools for managing bone fractures and dislocations. Migration of these devices within the chest is rare, but can cause serious problems. The spontaneous migration of Kirschner wires from the right clavicle to the mediastinum resulted in penetrating injury of the esophagus and pseudo-aneurysm of the brachiocephalic artery in an 84-year-old patient. Two Kirschner wires were removed via a vertical incision on the right shoulder without thoracotomy and the brachiocephalic artery was replaced with a Dacron graft. 相似文献
4.
Toshiya Takemura Masazumi Watanabe Keigo Takagi Susumu Tanaka Shinsuke Aida 《Surgery today》1995,25(7):651-653
We present herein the rare case of a young man who was found to have a solitary tumor in the right upper lobe of his lung by a routine chest X-ray. The tumor was removed by thoracoscopic surgery, and pathological examinations confirmed the diagnosis of a primary lymphangioma of the lung. A brief review of the available literature on this extremely rare type of benign tumor follows the case report. 相似文献
5.
Eiji Takeuchi Yuji Nimura Shin-ichi Mizuno Hideaki Suzuki Shinsuke Iyomasa Masaki Terasaki Hiroshi Kuriki Keiko Tamiya-Koizumi Shonen Yoshida 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(3):254-262
Hepatocyte regeneration has been widely investigated, with the mitotic index and the incorporation of [3H]thymidine being used as regeneration markers. We focused on the induction of DNA replication enzymes, particularly DNA polymerases
(pol) α, δ, and ε. Using rat models, we have shown that the activity of pol α in crude liver extract well represents the regenerating
capacity of hepatocytes. Using pol α as an indicator, we analyzed liver regeneration in rat models under various conditions:
obstructive jaundice, external or internal biliary drainage, and the obstruction of portal vein branches. It has been revealed
that the ligation of the common bile duct alone induces a certain amount of hepatocyte proliferation. It was striking that
external biliary drainage suppressed regeneration capacity in cholestatic rat liver after partial hepatectomy. The strong
regeneration in nonligated lobes induced by portal branch ligation was similar to the liver regeneration seen after partial
hepatectomy with respect to the induction of DNA polymerases. Taken together, the aspects of DNA replication, particularly
the induction of DNA polymerases, may contribute to shedding new light on the regeneration of human liver.
This work was supported in part by a Grant-in-Aid for General Scientific Research and for Cancer Research from the Ministry
of Education, Science and Culture, Japan, and by grants from the Uehara Memorial Foundation 相似文献
6.
7.
Resolution of homonymous visual field loss documented with functional magnetic resonance and diffusion tensor imaging. 总被引:5,自引:0,他引:5
Masaki Yoshida Masahiro Ida Thien Huong Nguyen Marie-Therese Iba-Zizen Luc Bellinger Jean Louis Stievenart Takehiko Nagao Shinsuke Kikuchi Takaaki Hara Takuya Shiba Kenji Kitahara Emmanuel Alain Cabanis 《Journal of neuro-ophthalmology》2006,26(1):11-17
A 68-year-old man developed right homonymous hemianopic paracentral scotomas from acute infarction of the left extrastriate area. He was studied over the ensuing 12 months with visual fields, conventional MRI, functional MRI (fMRI), and diffusion tensor imaging (DTI). As the visual field defect became smaller, fMRI demonstrated progressively larger areas of cortical activation. DTI initially showed that the lesioned posterior optic radiations were completely interrupted. This interruption lessened in time and had disappeared by one year after onset. fMRI and DTI are innovative measures to follow functional and structural recovery in the central nervous system. This is the first reported application of these imaging techniques to acute cerebral visual field disorders. 相似文献
8.
Masafumi Yamaguchi Shinsuke Mii Takashi Kai Hisanobu Sakata Akira Mori 《Surgery today》1997,27(9):863-867
Two elderly women complaining of intermittent claudication complicated with persistent sciatic artery are herein reported.
A direct femoral arteriogram showed hypoplasty of the superficial femoral artery and an unnatural anatomical relationship
between the distal superficial femoral artery and the proximal popliteal artery, thus suggesting the presence of persistent
sciatic artery. The diagnosis of persistent sciatic artery was finally made based on the aortography findings including the
iliac arterial system and computed tomography (CT) scan. Magnetic resonance imaging (MRI) was helpful to demonstrate the entire
image of this anomaly in cases with non-thrombolized sciatic artery. These diagnostic methods were useful in designing the
optimal surgical strategy. The first case with a gluteal pulsating mass underwent exclusion of the persistent sciatic artery
including the aneurysm through a retroperitoneal approach with a combination of femorotibial bypass, while the second case
with thrombosed persistent sciatic artery only underwent femoropopliteal bypass. To recognize such a rare lesion, awareness
of the differential diagnosis is important, and to provide appropriate treatment, an accurate whole image including adequate
angiography, a CT scan, and magnetic resonance imaging is necessary. 相似文献
9.
β2-glycoprotein-I (β2GPI) is a phospholipid-binding plasma protein that consists of five homologous domains. Domain V is distinguished from others by bearing a positively charged lysine cluster and hydrophobic extra C-terminal loop. β2GPI has been known as a natural anticoagulant regulator. β2GPI exerts anticoagulant activity by inhibition of phospholipid-dependent coagulation reactions such as prothrombinase, tenase, and factor XII activation. It also binds factor XI and inhibits its activation. On the other hand, β2GPI inhibits anticoagulant activity of activated protein C. According to the data from knockout mice, β2GPI may contribute to thrombin generation in vivo. Phospholipid-bound β2GPI is one of the major target antigens for antiphospholipid antibodies present in patients with antiphospholipid syndrome (APS). Binding of pathogenic anti-β2GPI antibodies increases the affinity of β2GPI to the cell surface and disrupts the coagulation/fibrinolysis balance on the cell surface. These pathogenic antibodies activate endothelial cells via signal transduction events in the presence of β2GPI. Impaired fibrinolysis has been reported in patients with APS. Using a newly developed chromogenic assay, we demonstrated lower activity of intrinsic fibrinolysis in euglobulin fractions from APS patients. Addition of monoclonal anti-β2GPI antibodies with β2GPI also decreased fibrinolytic activity in this assay system. β2GPI is proteolytically cleaved by plasmin in domain V (nicked β2GPI) and becomes unable to bind to phospholipids, reducing antigenicity against antiphospholipid antibodies. This cleavage occurs in patients with increased fibrinolysis turnover. Nicked β2GPI binds to plasminogen and suppresses plasmin generation in the presence of fibrin, plasminogen, and tissue plasminogen activator (tPA). Thus, nicked β2GPI plays a role in the extrinsic fibrinolysis via a negative feedback pathway loop. 相似文献
10.
Gliomatosis peritonei, the miliary implants of mature glial tissues on the peritoneum or omentum, is a rare complication of solid ovarian teratoma. Our case is reported and 38 previously reported cases are reviewed. The grade of the primary tumors varied from grade 0 to grade 3. Only five cases were composed entirely of mature tissues. Five of the 39 patients died. Despite of varied therapy, the rest of the patients were alive from 3 months to 38 years later. Inspite of intraperitoneal implants, the prognosis in patients with these tumors is good, irrespective of the mode of therapy. On the basis of this study, we recommended a conservative therapy for the primary tumor and therapy for the implants is not required. 相似文献