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  • 1
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We report a case of hyperimmunoglobulin E syndrome (HIE) complicated by neutrophil deficiency which was successfully treated with oral administration of disodium cromoglycate. A 48-year-old Japanese man with HIE developed Streptococcus pneumoniae meningitis. Laboratory tests after the meningitis revealed persistent neutropenia (300-800/mm3) and defects of phagocytosis and bacterial killing by neutrophils. Administration of disodium cromoglycate was started, and neutrophil counts gradually increased to 1200-1600/mm3 TTie impaired neutrophil activities returned to normal. The patient improved clinically; during the 2-year treatment, he had only two brief episodes of the common cold. Disodium cromoglycate may have potential clinical use in the treatment of cases of HIE even with neutrophil deficiency.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 42 (2000), S. 509-514 
    ISSN: 1432-1920
    Keywords: Key words Pineal ; tumours ; Pineocytoma ; Pineoblastoma ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed neuroradiological images in two histologically proven cases of pineocytoma and three of pineoblastoma to delineate the characteristic features of these rare tumours. CT revealed isodense or slightly hyperdense masses with central or peripheral calcification; enhancement with contrast medium tended to be homogeneous in pineocytomas and heterogeneous in pineoblastomas. In the pineocytomas, T1-weighted images revealed rounded, sometimes or slightly lobulated low-signal masses with strong, homogeneous contrast enhancement. Their margin was clear, without invasion of adjacent structures. In the pineoblastomas, however, T1-weighted images revealed multilobulated tumours with heterogeneous contrast enhancement. All three pineoblastomas had poorly defined margins with adjacent structures such as the posterior thalamus or corpus callosum, suggesting a more invasive nature. T2-weighted images revealed nonspecific high signal lesions in all five case.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 140 (1998), S. 779-786 
    ISSN: 0942-0940
    Keywords: Keywords: Collagen; magnetic resonance imaging; pituitary adenoma; transsphenoidal surgery.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  The transsphenoidal approach is a less invasive and safer procedure for removing pituitary adenomas. However, this procedure becomes extremely difficult when the tumour consistency is fibrous as encountered in about 10% of pituitary adenomas. In this study, we investigated predicting factors of tumour consistency in magnetic resonance images (MRIs).  MRIs of two groups, twenty-one soft and five firm (fibrous) adenomas, were retrospectively evaluated and compared in respect of tumour consistency. To compare the two groups objectively, tumour densities on MRI films and percentage of collagen content on operative specimens were expressed as numerical data using NIH-imageTM. The relationships between collagen content and T1-weighted images, T2-weighted images, grade of enhancement effect, and heterogeneity of enhancement were investigated.  Signal intensities on T1-weighted images were not correlated with tumour consistency, whereas those on T2-weighted images were significantly correlated with the percentage of collagen content. Adenomas, showing lower signal intensities on T2-weighted images, contained more collagen. On enhanced images, homogeneously enhanced adenomas tended to include more collagen, even though the grade of enhancement effect showed only weak correlation with the tumour hardness.  MRIs give us useful information on tumour consistency. Adenomas may be firm and fibrous if they show low signal intensities on T2-weighted images and homogeneous enhancement. To remove such tumours, a long sized and small-calibred ultrasonic aspirators applicable to transsphenoidal approach must be prepared and multi-staged operations may be more than likely needed.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 141 (1999), S. 165-169 
    ISSN: 0942-0940
    Keywords: Keywords: CSF rhinorrhea; intrasellar arachnoid cyst; pituitary gland; MRI.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  CSF rhinorrhea due to a transsphenoidal approach usually follows accidental or intentional arachnoid opening. We report a patient with an intrasellar arachnoid cyst, who developed delayed onset of CSF rhinorrhea. A sixty-two-year-old man presented with bitemporal type visual field defect for the last 3 years. With the diagnosis of arachnoid cyst or Rathke's cleft cyst, based on MRI findings of intra-and supra-sellar cyst with CSF intensity, he successfully underwent transsphenoidal surgery without evidence of intra-operative CSF leakage. He developed CSF rhinorrhea one week later. This needed another operation for sellar floor repair. The pathomechanism of this delayed onset is explained as follows. Incomplete or one-way communication of subarachnoid space to cyst cavity, unrecognized during surgery, might cause delayed onset of CSF rhinorrhea. By using MRI, identification of the residual gland, which was compressed posteriorly, is useful for differentiating an arachnoid cyst from other cystic lesions. In highly suspect cases, even without evidence of intra-operative CSF leakage, peri-operative measures to prevent occurrence of postoperative CSF rhinorrhea are required.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 141 (1999), S. 1055-1061 
    ISSN: 0942-0940
    Keywords: Keywords: MRI; Rathke's cleft cyst; pituitary cyst; pituitary adenoma; incidentaloma.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  We retrospectively analysed patients with histologically proven Rathke's cleft cyst (RCC) in relation to the clinical manifestations and MRI findings, in particular, of cyst size and intensity in order to obtain an insight into their growing mechanisms, clinical presentations and their management.  Eleven patients with RCC were divided into two groups based on T1 weighted images(WI). The A group consisted of 4 patients with cyst of low intensity in T1 WI. The age averaged 64.5 years. Their initial complaints were visual field defects(VFD). Their complaints were rather insidious. The maximum cyst size averaged 27.8±2.4 mm. The B group consisted of 7 patients with cyst of iso- or high-intensity in T1 WI. Two patients in the B group showed mixture of low and high and iso- and high-intensity, suggesting the presence of bleeding at the onset of symptoms or growing mechanism of the cysts. In the B group the age averaged 39.9 years, being lower than that in the A group. (P=0.0140 with Mann-Whitney's U test) The 5 patients out of 7 showed headache of insidious type or acute onset and the 3 showed a fluctuation of the VFD. The average size was 21.7±3.5 mm and smaller than that of the A group. (P=0.0298 with Mann-Whitney's U test)  Our study has shown that the cyst with iso-to high intensity on T1 WI may cause clinical symptoms with a smaller size than cysts of the low intensity. In the former cyst pattern the onset and growing mechanism may be related to bleeding. The patients with this pattern are more likely to have acute and/or fluctuation of clinical presentations. Knowing these various clinical manifestations based on MRI pattern will be of help in following and managing patients with RCC.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Neurosurgical review 12 (1989), S. 400-411 
    ISSN: 1437-2320
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Local cerebral glucose utilization (LCGU) was studied in 35 conscious rats after a fluid percussion injury (cerebral contusion). The experiments were divided into two parts. (I) Natural course: LCGU was quantitatively measured in 17 rats by the14C-deoxyglucose autoradiographic method (Sokoloff et al. 1977) at 1, 2, 4 and 24 hours after injury. Sham operation was made in six rats. (II) DC-potential and LCGU: LCGU was studied with DC-potential and EEG monitoring in 12 rats. Results were as follows: (I) i) Glucose uptake was reduced at the center of the contusion in all cases. ii) Two different effects were observed in LCGU change two hours after injury: normal or slight increase in four of six rats (type A) and a remarkable increase in the cortex of the injured hemisphere in two of six rats (type B). iii) The pattern of increase in LCGU (type B) resembles that of cortical spreading depression. (II) i) Negative shift of DC-potential concomitant with EEG suppression in the injured hemisphere was observed frequently one to two hours after injury. ii) The increased LCGU pattern during DC-potential negative shift was identical with that of type B. iii) LCGU pattern without DC-potential change resembles that of type A. We concluded that the hypermetabolism occurring in the damaged cortex was due to a spreading depression. The findings obtained here should yield very important information concerning pathogenesis and treatment of human head injury.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1437-2320
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The negative shift of DC potential was associated with an increase of extracellular potassium and energy metabolism. Therefore this dramatic phenomenon following the trauma to the brain was thought to be identical to spreading depression. 1. Spreading depression was most frequently observed between one and two hours after injury. 2. Spreading depression can be elicited in the deep structures as well as in the cortex. The more severe the injury, the more frequently the negative shifts were observed. The DC index seems to correlate well with the severity of the experimental model. It is concluded that the energy metabolism after the brain contusion was different from structure to structure and was changing continuously in the course of time.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    European archives of oto-rhino-laryngology and head & neck 255 (1998), S. 127-131 
    ISSN: 1434-4726
    Keywords: Key words Cochlea ; Aminoglycoside toxicity ; Hair cell apoptosis ; Nick-end labeling
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Although aminoglycosides have been investigated for their cochleotoxicity, it has still not been determined whether apoptosis or necrosis results in cochlear hair cell death following aminoglycoside treatment. To study possible mechanisms of cell death, we used in situ DNA break-labeling to examine guinea pig cochleae affected by kanamycin ototoxicity. Chronic kanamycin treatment induced DNA fragmentation that was detectable in both outer and inner hair cells, suggesting the occurrence of apoptosis. These findings suggest that apoptosis achieves deletion of affected hair cells without disrupting tissue architecture in the organ of Corti.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    European archives of oto-rhino-laryngology and head & neck 256 (1999), S. 323-329 
    ISSN: 1434-4726
    Keywords: Key words Cochlear hair cells ; Glutamate toxicity ; Nitric oxide synthase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to examine the roles of glutamate (GLU) toxicity and involvement of nitric oxide (NO) in the pathogenesis of cochlear degeneration. We examined guinea pig cochleae following chronic exposure to GLU. Trypan blue extrusion and transmission electron microscopy were performed to evaluate degeneration in the organ of Corti. In parallel, nitric oxide synthase (NOS) activity was demonstrated by histochemical staining of NADPH diapholase. GLU treatment caused time-dependent degeneration of outer hair cells (OHCs) in conjunction with a temporal increase of NOS activity in the organ of Corti. This suggests that GLU may be involved in OHC degeneration under toxic conditions, with NO production possibly playing a role in this process.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European archives of oto-rhino-laryngology and head & neck 254 (1997), S. 153-157 
    ISSN: 1434-4726
    Keywords: Apoptosis ; Labyrinthine vestibule ; Aminoglycoside toxicity ; Zinc toxicity ; Nick-end labeling
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reported that apoptosis occurred in the guinea pig vestibular hair cells after chronic aminoglycoside treatments. In the present study, we used in situ nick-end labeling to determine whether apoptosis was also induced by the acute effects of aminoglycosides in guinea pig ampullar cristae. In addition, we evaluated the effect of zinc supplements upon these ototoxic treatments. After a local application of streptomycin directly to the round window, we found labeled bodies in the vestibular hair cells. The zinc supplement increased the number of labeled bodies resulting in severe hair cell loss. These findings indicate that the acute effects of aminoglycosides also induce apoptosis of the vestibular hair cells, and that zinc enhances aminoglycoside ototoxicity. Consequently, we propose that an interaction with ion channels may play a key mechanism in the processes of apoptosis affecting the vestibular hair cells.
    Type of Medium: Electronic Resource
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