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Biomedical subjects

H Katsunuma

Publications and source records attributed to H Katsunuma.

At least 37 records · Page 2Linked to original sources
PubMed1991

[A clinical study in elderly patients with Parkinson's disease using MRI and SPECT--Parkinson's disease and the lacunar state].

Parkinson's disease (PD) is often associated with dementia in elderly patients, and sometimes PD coexists with senile dementia of the Alzheimer type (SDAT) or cerebrovascular disease (CVD) in the elderly. However, since there are few previous clinical studies on the coincidence of, or relationship between PD and CVD, the authors evaluated these aspects in 34 elderly patients with PD using MRI and SPECT. All the patients were over 70 years old. The diagnosis of PD was based on the presence of three symptoms (resting tremor, cogwheel rigidity and bradikinesia) which are characteristic of PD, and the effectiveness of L-DOPA therapy. We therefore believe that patients with vascular Parkinsonism were excluded from our study. In 34 cases, 24 (71%) had MRI evidence of CVD (mainly the lacunar state). In the 10 cases who had no CVD, 2 (20%) had severe dementia and the decrease of regional cerebral blood flow (rCBF) in the temporal and parietal lobes bilaterally correlated with the SPECT findings commonly found in SDAT. A comparison of the rCBF and the results of Hasegawa's dementia score (HDS) (verbal intelligence score) was made between the patients with PD associated with CVD and the patients with PD who had no CVD and no SPECT findings which correlated with SDAT. The rCBF in the frontal lobes and the results of the HDS of the former group were significantly lower than those of the latter. As mentioned above, elderly patients with PD often had CVD, leading to dementia.(ABSTRACT TRUNCATED AT 250 WORDS)

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PubMed1991

[Effects of cerebral cortical lesions on the ipsilateral thalamus].

An injury to the central nervous system causes a focal logical disturbance, and further may affect the blood flow, metabolism, and function of other brain regions. Recent studies using PET or SPECT have demonstrated that impairment of regional hemodynamics or metabolism in cerebrovascular disease involves not only the site of the lesion itself but also more remote areas. Although depression of the metabolism of the ipsilateral thalamus in patients with cerebral cortical lesions has been shown by PET study, the pathophysiological implications of this remain unclear. The functional and morphological effects of cortical infarcts on the ipsilateral thalamus were studied by assessment of cerebral blood flow using 123I-IMP SPECT and by determining atrophic changes on CT or MRI. Nine out of 17 patients with cortical infarcts showed hypoperfusion of the ipsilateral thalamus, especially patients with larger infarcts involving the frontal or parietal cortex. Thalamic hypoperfusion persisted from early after the insult to several months or even years later. In addition, atrophy of the ipsilateral thalamus was not uncommon following larger cortical infarcts. This tended to be evident about 1 year after the infarct and progressed over several years. Furthermore, atrophic changes in the thalamus was often demonstrated in such patients as hypoperfusion in the later stages. Thus, cortical lesions had functional and morphological effects on the ipsilateral thalamus ranging from early hypoperfusion to later irreversible atrophic changes.(ABSTRACT TRUNCATED AT 250 WORDS)

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PubMed1991

[The functional relationship between the cerebral cortex and deep brain areas in normal individuals].

Recent PET or SPECT studies have demonstrated a reduction of blood flow and metabolism in the cortex ipsilateral to a deep-seated lesion, and in the thalamus and/or basal ganglia ipsilateral to a cortical lesion. A close relationship between the cerebral cortex and deep areas of the brain has been shown in pathological conditions, presumably because of functional interconnections between the cortex and deeper area. The present study was designed to investigate the relationship of cerebral blood flow in the cerebral cortex to that in the deep gray matter including the basal ganglia and the thalamus in normal subjects. Twenty-two healthy subjects were studied using SPECT with N-isopropyl-p[123I]iodoamphetamine while in a resting state. The asymmetry index (AI) of blood flow in both the cerebral cortex and deep gray matter was calculated as follows; AI = (R-L)/(R+L)/200 (%) (R: right side, L: left side). The AI in deep gray matter was significantly correlated with the AI values in the upper frontal cortex (r = 0.54, p less than 0.01), and parietal cortex (r = 0.58, p less than 0.01), as well as the mean cortical hemispheric AI (r = 0.48, p less than 0.05). Our results suggest the existence of a functional relationship between the cerebral cortex and deep areas not only in pathological conditions but also in the resting state in normal subjects. This functional relationship is likely to be mediated by neuronal mechanisms through the projectional fiber connections between the cortex and the deep gray matter.

Adult↗
PubMed1991

[Functional relationship between the cerebrum and cerebellum in normal subjects].

To determine whether a functional relationship between the cerebrum and cerebellum exists in normal subjects, the correlation between asymmetry in cerebral blood flow and asymmetry in cerebellar blood flow was investigated. Twenty-one healthy right-handed subjects were studied using SPECT with N-isopropyl-p-(123I)iodoamphetamine while in a resting state. The asymmetry index (AI) for both the cerebral and cerebellar hemisphere was calculated as follows. AI = R - L/R + L/200 (%) (R: right side, L: left side). A negative correlation was found between AI in the cerebellum and AI in cerebrum. Especially, AI in cerebellar hemisphere was significantly correlated with AIs in the upper frontal cortex (r = -0.58, p less than 0.01), middle frontal cortex (r = -0.55, p less than 0.02), lower frontal cortex (r = -0.49, p less than 0.05), and mean cerebral hemisphere (r = -0.52, p less than 0.02). These results suggest the existence of a functional relationship between the cerebral hemisphere and the contralateral cerebellar hemisphere in the resting state of normal subjects. We strongly suspect that the frontal cortex exert an influence on the function in the contralateral cerebellum, probably due to a transneuronal mechanism, mainly through the corticopontocerebellar pathway.

Adult↗
PubMed1990

[Wallenberg's syndrome caused by a brain tumor--a case report and literature review].

we report a patient with Wallenberg's syndrome caused by glioma of the lateral medulla oblongata, and review the literature for Wallenberg's syndrome associated with neoplastic disease. A 46-year-old man was admitted because of progressive dysphagia and vertigo. Neurological examination revealed atypical symptoms and signs of Wallenberg's syndrome on the right side, hypalgesia on the second and third divisions of the left trigeminal nerve, paresis of the right palate and uvula, and ataxia of the right extremities. Although CT showed no abnormality in the posterior fossa, MRI demonstrated a mass with abnormal signal intensities in the right dorsolateral portion of the medulla. Biopsy specimens showed astrocytoma (grade III). Based on the present case and a review of 10 previously reported cases of Wallenberg's syndrome caused by neoplastic disease, the clinical features of this syndrome are characterized by gradual development and steady progression of symptoms, non-classical or atypical symptomatology, numerous additional symptoms and signs depending on the site and size of tumors, and poor prognosis.

Brain Neoplasms↗
PubMed1990

[A comparison study of SPECT and MRI in remote effects of chronic cerebrovascular disease].

A comparison study of SPECT and MRI was performed to investigate remote effects in 10 patients with chronic cerebrovascular disease. Hypoperfusion in the cerebellar hemisphere contralateral to supratentorial lesions, the overlying cerebral cortex ipsilateral to subcortical lesions, the thalamus ipsilateral to cortical lesions, and the visual cortex distant to optic radiation lesions was demonstrated using SPECT with 123I-IMP. Although hypoperfusion in these remote areas was considered to be related to irreversible degenerative processes in the chronic phase, MR images did not reveal any abnormalities.

Aged↗
PubMed1990

[Remote effects in cerebral infarction--123I-IMP SPECT study].

We studied the remote effects in 29 patients with middle cerebral artery territory infarction by using single photon emission computed tomography (SPECT) with N-isopropyl-p-[123I]iodoamphetamine. SPECT demonstrated a reduction in blood flow in the cerebellar hemisphere contralateral to the cerebral infarct, the cortex ipsilateral to the subcortical infarct, the visual cortex distal to the optic radiation lesion, and the thalamus ipsilateral to the cortical infarct. In addition to transient neuronal depression identified with diaschisis, our results indicated that persistent phenomena were apparently involved in these remote effects. The degenerative processes might be related to irreversible effects in remote areas. Clinical symptoms corresponding to the areas of hypoperfusion remote from infarcted lesions were not necessarily present.

Aged↗
PubMed1990

[Asymmetry of cerebral blood flow in patients with senile dementia of Alzheimer type by SPECT using I-123 IMP].

Regional cerebral blood flow (rCBF) was determined by single photon emission CT (SPECT) with N-isopropyl-p-[123I]iodoamphetamine in 22 patients with clinically diagnosed senile dementia of Alzheimer type (SDAT) and in 18 age matched controls. We calculated asymmetry indices (AIs) of rCBF for matched right-left regions of interest. rCBF of parietal lobe in SDAT patients was significantly most laterally asymmetrical, but the least in occipital lobe. Lateral asymmetry of rCBF in SDAT patients correlated with asymmetry of language and visuospatial functions; decreased rCBF in the left parietal lobe was associated with language dysfunction, and that in the right parietal lobe, with visuospatial dysfunction. Furthermore cerebellar AIs correlated negatively with those of the cerebral hemisphere and lower frontal region in SDAT patients. The results demonstrate that rCBF measurement by 123I-IMP SPECT is useful to detect lateral asymmetry in reduction of rCBF in SDAT.

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PubMed1989

[Clinical study on the relationship between middle cerebral artery lesions and Binswanger type infarction].

To investigate the relationship between middle cerebral artery (MCA) trunk lesions and the etiology of Binswanger type (B type) infarction, which was demonstrated as a diffuse subcortical low density area/high intensity area by CT/MRI, patients with both MCA lesions and B type infarction were studied clinically. Eighteen patients with B type infarction were diagnosed among 224 patients with MCA occlusion/stenosis on angiography accounting for 8%. The incidence was as high as 25% in M2 stenosis. The mean age of B type infarction patients was 64 years and 16 of them were men. Chronologically stepwize/slowly-progressive deterioration of clinical manifestations were observed in 14. All patients had hemiplegia, though half of them were mild or moderate in severity. Furthermore, aphasia, Gerstmann syndrome and dementia were present in 10, 1 and 2 patients, respectively. Twelve had a history of hypertension, while 11 showed transient decreases with marked changes (more than 31 mmHg in mean arterial blood pressure) in arterial blood pressure during their clinical course. Out of 9 patients in whom cerebral blood flow (CBF) was measured by 133Xe injection method/inhalation method, 7 demonstrated mild to moderate decreases in mean CBF (more than 30 ml/100 g/min) with no relation to the severity of MCA lesions. These findings suggested that hemodynamic mechanisms associated with hypoperfusion due to marked fluctuations in blood pressure are accelerating factors of B type infarction and MCA lesions, even though ischemia in the subcortical area due to leptomeningeal anastomosis may be mild or moderate.

Aged↗
PubMed1989

[Drug-protein binding in elderly subjects].

It is important to know the magnitude of serum-protein binding of drug dynamics in vivo. The authors investigated the effects of a variety of serum free fatty acids in elderly subjects. Serum albumin levels and ceftezole (CTZ)-protein binding in elderly subjects were lower than in younger subjects. No significant difference was noted between the two groups in regard to total free fatty acid (T-FFA) level. However, compared with younger subjects, palmitolic and oleic acid were higher and myristic and linoleic acid were lower in elderly subjects, suggesting that free fatty acid (FFA) undergoes qualitative changes due to ageing. In elderly subjects CTZ-binding correlated negatively with T-FFA, oleic acid and linoleic acid, but positively with stearic acid. Oleic acid decreased CTZ-protein binding. This decrease was higher than that due to decreased albumin levels in elderly subjects with albumin levels less than 4.0 g/dl. These findings indicated that reduced protein binding in elderly subjects is due to decreased serum albumin and changes in FFA constitution with ageing. Therefore it was suggested that drug-albumin binding may change due to the competitive action of albumin sites, and albumin-drug binding capacity. Since drug-protein binding capacity seriously affect metabolism, excretion, efficacy and side effects due to the presence of free drugs, these aspects require further investigation in elderly subjects.

Adult↗
PubMed1989

[Comparison between PVHIS on the MRI and the permeability of brain blood vessels in elderly patients].

The degree of PVHIS (periventricular high intensity signal) on the MRI was composed with the permeability of brain blood vessels using the cerebrospinal fluid (CSF)/serum ratio for albumin, and the CSF/serum ratio for IgG in elderly patients. The 47 elderly patients (mean age = 79.9) were divided into three groups: (1) Mild group (20 cases, M:6, F:14, mean age = 75.8), (2) Moderate group (18 cases, M:7, F:11, mean age = 82.6), (3) Severe group (9 cases, M:2, F:7, mean age = 82.9), in accordance with the degree of PVHIS on the MRI. The MRI was operated at a field strength of 0.22 tesla. The pulse sequence (used on all patients) had a repetition times (TR) of 2,000 msec and a time to echo (TE) of 40 msec. The levels of albumin and IgG in the serum and CSF were measured. The CSF/serum ratio for albumin was used of analyze the permeability of the brain blood vessels in each group. There was no significant difference in the level of the serum albumin, the CSF albumin, the serum IgG, the CSF IgG and the CSF/serum ratio for IgG among the three groups. The same was found to be true for the IgG index which indicates the synthesis of immunoglobulin in the central nervous system. However, there was a statistically significant difference (p less than 0.05) in the CSF/serum ratio for albumin between groups (1) and (3). The increased CSF/serum ratio for albumin in the severe group indicated there were confluent lesions involving the entire extent of the periventricular white matter on the MRI. This suggested an increased permeability of brain blood vessels which revealed the dysfunction of the blood brain barrier due to affected cerebral endothelial cells in capillaries.

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PubMed1986

Cytogenetic changes at 11q11, 11q23, and 17q11 in myelodysplastic syndrome.

Cytogenetic studies were performed on two patients with myelodysplastic syndromes. One patient was a 68 year old Japanese male in whose bone marrow cells two translocations were established, i.e., t(4;11)(q13;q23) and t(11;17)(q11?;q11), as well as other karyotypic changes (-6,-18,15p+). The other patient was a 74 year old white male whose bone marrow cells showed six marker chromosomes, i.e., der(5),t(5;17)(q12;q11), der(6),t(6;5)(q27;q22), der(8),t(8;11;?)(q11;q11----q23;?), der(11),t(11;?)(q11;?), an isochromosome of the long arm of chromosome #8, and a small G-group sized marker chromosome of unknown origin. Though the translocation patterns in the abnormal cells in these two cases were different, the breakpoints of the marker chromosomes were almost the same, i.e., 11q11, 11q23, and 17q11. Also, changes of chromosome #6 were observed; the first case showed monosomy 6 and the second a 6q+ marker chromosome. In these two cases of myelodysplastic syndromes, common sites of chromosome breakage and reunion of 11q23 and 17q11 were close to recently established sites of human cellular oncogene homologs, c-ets (11q23) and c-erbA (17q21----24). These associations draw attention to a possible relationship between chromosome changes in myelodysplastic syndromes and oncogene (or other gene) activation and/or dysfunction.

Aged↗
PubMed1985

Clinical evaluation of the effect of cefotaxime in senile pneumonia caused by gram-positive and gram-negative bacteria.

66 patients with predominantly community-acquired pneumonia were treated with cefotaxime. The group consisted of 45 males and 21 females, aged 56 to 90 years, 43 of the patients belonging to the age groups 65-80 years. Streptococcus pneumoniae was isolated in 21 of the 34 patients with gram-positive pneumonia, Staphylococcus aureus in six, Staphylococcus epidermidis in five and Streptococcus faecalis in two. Klebsiella pneumoniae was the predominant pathogen in gram-negative pneumonia (eight patients), followed by Enterobacter (n = 6), Pseudomonas aeruginosa (n = 5), Haemophilus influenzae (n = 4), Escherichia coli (n = 3), Serratia marcescens and Citrobacter (two cases each). The in vitro activity of cefotaxime against the isolates was compared to the activity of other beta-lactam antibiotics. Characteristically, the classical signs and symptoms of pneumonia were absent or discrete in some of the elderly patients. There was a delayed clearance of pulmonary infiltrates. 55 of 66 patients responded to cefotaxime within four weeks of treatment; the symptoms were aggravated or remained unchanged in seven patients. Patients with a delayed clinical response displayed decreased peripheral lymphocyte counts and T cell functions in PHA stimulation tests, as well as low immunoglobulin levels. A combination of cefotaxime and gamma-venin cleared the symptoms in some of these patients.

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PubMed1985

Involvement of chromosomes 4, 11, and 17 in a case of myelodysplastic syndrome.

A case of myelodysplastic syndrome in a 68-year-old male in whose marrow cells two translocations were established, i.e., t(4;11)(q13;q23) and t(11;17)(p?:q11), as well as other karyotypic changes (-6,-18,15p+), is described. The relation and identity of the bands involved in the translocations affecting chromosomes #11 and #17 in leukemias in which these chromosomes are specifically affected, i.e., t(4;11) in acute myelomonocytic leukemia and t(15;17) in acute promyelocytic leukemia, are discussed in relation to the case described.

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