[Visuomotor ataxia. Clinical and CT scan studies in three cases].
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Biomedical subjects
Publications and source records attributed to G Hirose.
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beta-Glucuronidase (beta-GL) and beta 2-microglobulin (beta 2-m) of the cerebrospinal fluid (CSF) were assayed from the patients with various neurological diseases, in order to evaluate the difference of mean value of these enzyme activities in several groups of neurological diseases, diagnostic usefulness for one of the central nervous system tumor markers, and the usefulness to differentiate carcinomatous meningitis from infectious meningitides. The subjects were 99 patients with various neurological diseases, and these were classified in the following eight diagnostic groups, central nervous system degenerative diseases (6 cases), cervical spondylotic radiculomyelopathy (15 cases), Guillain-Barre syndrome (8 cases), subarachnoid hemorrhage secondary to ruptured aneurysm (6 cases), infectious meningitides (21 cases), carcinomatous meningitis (9 cases), metastatic extradural spinal cord tumors (10 cases) and brain tumors (24 cases). CSF was also obtained from 13 subjects without any known neurological diseases for beta-GL and beta 2-m as the normal control values. beta-GL and beta 2-m were measured by Tsukamoto's method and the radioimmunoassay method (Phadebas, beta 2-m test) respectively. The statistical analyse were done by using the student t-test and expressed as p values. In the normal control group of 13 individuals without any obvious neurological diseases, the mean values +/- standard error of means (SEM) of beta-GL and beta 2-m were 122.5 +/- 10.8 micrograms/dl/hr, and 0.99 +/- 0.15 mg/l respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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A case of multiple intracerebral tuberculoma occurred in the course of anti-tuberculous therapy is reported. A 16-year-old high school boy had been treated with isoniagid, streptomycin and paramino-salicylic acid on the tuberculous pleulitis for 3 months previously. He was admitted to our hospital because of progressive headache associated with vomiting. Neurological examination revealed bilateral full papilledema and incomplete bilateral abducens palsy. An immediate CT study with contrast enhancement demonstrated two small ring-like mass with considerable perifocal edema in the left temporal and occipital lobe, respectively. Intracerebral tuberculoma was considered to be most likely, so the patient was given antituberculous therapy with steroid and mannitol. However, despite of medical decompression, he developed intracranial hypertension aggravated, leading to removal of tumor 7 days after admission. Initially left temporal tuberculoma, which had more extensive and prominent perifocal edema, was successfully excised. The specimen was a walnut-sized granuloma with hard capsule including pus inside. Numerous tuberculous bacilli were identified with Ziel-Nielsen staining technique from the pus. Postoperative course was gratifying, and other tumor in the left occipital lobe, which was also diagnosed as tuberculoma, was treated with continuing administration of isoniagid, ethanbutol and rifampicin. However, the former two drugs were forced to be discontinued because of agranulocytosis. Only rifampicin was maintained for 2 months thereafter but no decrease of the size was observed in serial CT studies. Then left occipital tuberculoma was removed. The pathology was tuberculoma with positive bacilli staining. He discharged 1 month later without any neurological deficit but was on antituberculous therapy (rifampisin) as an outpatient for 3 years.(ABSTRACT TRUNCATED AT 250 WORDS)
An autopsy case of central pontine myelinolysis (CPM) was reported. The patient, a 48-year-old man, with a long history of alcoholic intake appeared in a hospital with the diagnosis of alcoholic hepatitis and the neurologic symptoms of delirium tremens. During the hospital course he fell into "locked in" with concomitant development of marked hyponatremia (92 mEq/1). An autopsy revealed typical CPM and the extra-pontine myelinolytic lesions distributed symmetrically in the thalami, subthalamic nuclei, and lateral geniculate bodies. Spongiosis was also found in the deep layer of the cerebral cortex and in the putamen. It was suggested that CPM occur in close association with marked hyponatremia and the extrapontine involvement be likely to manifest in the deep layer of the cerebral cortex, putamen, thalamus, and lateral geniculate body, where the myelin cylinders form an interlacing network embedding large neurons and oligodendrocytes.
The acute onset of symptoms of severe cervical radiculo-myelopathy in four patients with athetoid-dystonic cerebral palsy is reported. Neurological and radiological examination showed that the spondylotic changes of the cervical spine were responsible for new neurological deficits leading to the patients being bedridden. Dystonic-athetoid neck movements may cause excessive axial neck rotation as well as flexion and extension movements of the spine. These repetitive exaggerated movements may result in early degenerative changes of the vertebrae which may enhance the radiculo-myelopathy. The four patients were treated with an anterior discectomy with interbody fusion. They were bedridden pre-operatively but all have since been able to walk with or without a cane. It is concluded that early anterior decompression with interbody fusion is a treatment of choice for cervical spondylotic radiculo-myelopathy in association with athetoid cerebral palsy.
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Myosin was extracted from the larvae and adult flies of Drosophila melanogaster, and purified by column chromatography in the presence of KI. Myosin light chains were separated from heavy chains by column chromatography after treatment of the myosin with urea, and they were identified by 2D-gel electrophoresis. Tubular muscles and fibrillar muscles have different light chains. Lt1 (Mw = 31,000), Lt2 (Mw = 30,000), Lt2' (Mw = 30,000), and Lt3 (Mw = 20,000) exist in the tubular myosin of both larvae and adult flies; Lf1 (Mw = 34,000), Lf2 (Mw = 30,000), Lf2' (Mw = 30,000), and Lf3 (Mw = 20,000) exist in the fibrillar myosin. Polyacrylamide gel electrophoresis of myosin under nondissociating conditions revealed that there was one major myosin isozyme in each type of adult muscle, and the re-electrophoresis of each isozyme on SDS gel confirmed our identification of the light chains.
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Characteristic movement disorders were observed in two siblings who had neuroacanthocytosis syndrome with normal serum lipoprotein levels. The disorders included orolingual tic-like movements associated with vocalization, biting of the lip and tongue, peculiar dysphagia with bird-like drinking, and postural lapse with abrupt buckling of the knees. In addition, subtle features of parkinsonism and chorea were observed. These movement problems are strikingly similar to those described in cases of neuroacanthocytosis syndrome in several other familial and sporadic cases. Careful observations of these unusual movement disorders may provide a clue to the diagnosis of this rare syndrome.
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Localized polymorphic delta wave activity appears ipsilaterally in patients with intracerebral hematoma without a shift of midline structures, regardless of the location of hematoma. Appearance of delta wave slowing after thalamic bleeding is quite variable, however, and may produce localized slowing or unilateral diffuse polymorphic delta wave activity. Unilateral diffuse polymorphic delta wave activity is seen in patients with larger hematomas of 30 mL or more, which cause a shift of the midline structures. The shift of midline structures, including the hypothalamus and surrounding structures, is thought to be one of the main factors responsible for the production of unilateral responsible for the production of unilateral diffuse polymorphic delta wave slowing.
Horseradish peroxidase injected into individual blastomeres of 32- and 64-cell embryos of Xenopus laevis was identified in cells of the central nervous system (CNS) at larval stages 31 to 39. The CNS received contributions from 24 blastomeres of the 32-cell stage and 38 blastomeres of the 64-cell stage. The region of CNS in which all of the labeled descendants of a single blastomere were dispersed is called a clonal domain. Mingling of labeled and unlabeled cells always occurred in a clonal domain, but boundaries were seen between such a labeled region and completely unlabeled regions. These boundaries occurred at various places in the CNS but were most frequently seen in the transverse plane at the level of the isthmus between mesencephalon and rhombencephalon and in the horizontal plane between dorsal and ventral regions of the CNS. When the maternal clonal domain was partitioned between the descendants of the daughter cells, the partitioning occurred only at one or both of those boundaries. The constant relationship between the position of each of the initially labeled blastomeres and the final spatial distribution of the labeled descendants in the CNS provided a detailed fate map of the main regions of the CNS in the 32- and 64-cell embryo.