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Biomedical subjects

H Kowa

Publications and source records attributed to H Kowa.

At least 73 records · Page 4Linked to original sources
PubMed1991

Treatment of tension-type headache with tizanidine hydrochloride: its efficacy and relationship to the plasma MHPG concentration.

Seventy-eight patients with tension-type headache (TH) were treated with tizanidine hydrochloride (tizanidine). Plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) and serum free fatty acids (FFA) levels in these patients were determined before the treatment with tizanidine. Eighteen healthy volunteers composed the control group. Four weeks after the treatment with tizanidine 24 (31%) of 78 patients showed excellent improvement (excellent group); 28 (35%) showed moderate improvement (moderate group); 18 (23%) showed mild improvement (mild group); 7 (10%) showed no improvement and one (1%) showed worsening of her headache (no change and worsened group). The plasma MHPG levels in the excellent group were significantly higher than in the other groups, including the control group. The serum FFA levels in the excellent group were significantly higher than in the controls. In this study, 66% of the patients reported improvement in their headaches. Some patients with TH had high plasma MHPG levels and these patients in particular showed excellent improvement after the administration of tizanidine. Though there may be a placebo response to some extent, the clinical usefulness of tizanidine for TH seems to be excellent. Further study is necessary concerning the pharmacological effect of tizanidine and plasma MHPG levels in patients with TH.

Clonidine↗
PubMed1991

A nationwide collaborative study on the long-term effects of bromocriptine in patients with Parkinson's disease. The fourth interim report.

The interim results of the nationwide collaborative study on the long-term effects of bromocriptine in patients with Parkinson's disease are reported. Four years ago, two prospective clinical studies were started to evaluate the long-term effects of bromocriptine in Parkinson's disease. The first was to investigate the long-term effects of bromocriptine monotherapy and the second to see the long-term effects of a combination therapy of bromocriptine with levodopa. Patients who had never been treated with levodopa were placed on bromocriptine monotherapy, and those who had been treated with levodopa for not more than 5 years were allocated randomly to either the combination or the levodopa group. Two hundred and eighty-six patients were enrolled in the former study and 416 in the latter. Among the 286 patients, 164 continued for further observation at the end of the fourth year, and 74 of them were still being treated with bromocriptine monotherapy. However, in 78, levodopa had to be added. Among the 416 patients in the second study, 216 were allocated to the combination group and 200 to the levodopa control group. At the end of the fourth year, 130 in the former and 140 in the latter group remained for further observation. In all three groups, a gradual loss of efficacy was noted. The rate of efficacy loss appeared largest in the monotherapy group and smallest in the combination group. Effects on tremor and rigidity are still maintained, but effects on akinesia and gait were lost by the end of the fourth year in all groups. Wearing-off and dyskinesias seem to be better managed by the combination therapy. The incidence of wearing-off was very small in the monotherapy group. No serious side effects were encountered except for 1 patient who died of pulmonary fibrosis in the combination group.

Bromocriptine↗
PubMed1991

A multi-center, double-blind study on slow-release bromocriptine in the treatment of Parkinson's disease.

We report on the clinical efficacy of a slow-release formulation of bromocriptine studied in a multi-center, double-blind trial using standard bromocriptine as the control. We randomly allocated enrolled patients (N = 243) to either the slow-release or normal bromocriptine group. Sixty of them were de novo patients. The maintenance dose of slow-release bromocriptine was 14.2 +/- 0.7 mg/d and that of standard bromocriptine 13.5 +/- 0.7 mg/d (mean +/- SE). The slow-release formulation was taken twice and the standard three times a day. Forty-one percent of the patients treated with the slow-release bromocriptine and 32% of the patients treated with the standard bromocriptine showed moderate or marked improvement in the global improvement rating. There were no serious side effects, and the frequency of vomiting and epigastric discomfort was lower in the patients treated with the slow-release bromocriptine. Clinical efficacies for tremor, rigidity, akinesia, and gait disturbance were comparable between the two drugs tested. The slow-release bromocriptine seems to be a valuable drug for the treatment of Parkinson's disease with less severe side effects than regular bromocriptine.

Aged↗
PubMed1990

Third interim report of the nationwide collaborative study on the long-term effects of bromocriptine in the treatment of parkinsonian patients.

The interim results obtained up to the end of the 3rd year of the multicenter nationwide cooperative study on the long-term effects of bromocriptine in parkinsonian patients are reported. Bromocriptine monotherapy could be continued in approximately 33% of the patients at the mean maintenance dose of 11.4 mg/day. The combined use of bromocriptine (11.1 mg/day) in parkinsonian patients already treated with levodopa had a favorable influence on the long-term side effects of levodopa such as the on-off phenomenon and dyskinesia. The beneficial effects of bromocriptine, levodopa and an early combination on parkinsonian symptoms such as rigidity and tremor remained at the end of the 3rd year. However, the effects of each mode of therapy on another parkinsonian symptom, akinesia, ceased by the end of the 3rd year.

Adult↗
PubMed1990

[A case of myopathy with ulcerative colitis].

A 41-year-old woman was admitted to a local hospital because of bloody diarrhea and diagnosed as having ulcerative colitis (UC). Despite prednisolone of 40 mg/day administration, her symptoms aggravated rapidly and she developed muscle weakness of lower limbs two weeks after steroid administration. On admission, she was bed-ridden and could not lift her knees and arms from bed. The serum CK level was increased slightly and total protein decreased markedly. She had moderate liver dysfunction, mild hyperthyroidism, mild glucose intolerance, and some results suggestive of immuno-deficiency including positive cold agglutinin and microsome tests, and positive antinuclear antibody. Her muscle biopsy showed both type 1 and 2 fiber atrophy and focal myofibrillar degeneration with autophagic phenomenon. There were a few fibers with nemaline bodies probably formed from marked degeneration of myofibrils. Although she had been on prednisolone for 2 weeks, the degenerative muscle pathology differed from that of steroid myopathy in which type 2 fiber atrophy is one of characteristic findings. Some additional factors including marked malnutrition, possible immuno-deficiency and hyperthyroidism should be considered for the pathogenesis of this particular myopathic changes. Since her general condition and muscle weakness gradually improved postoperatively, UC itself might have played an important role in inducing muscle symptoms.

Adult↗
PubMed1989

Natural history of incidental hyperglycemia and glycosuria of childhood.

We prospectively followed 29 children and adolescents over a 1- to 8-year period who were referred for evaluation of hyperglycemia (in the absence of diabetes) or glycosuria found on routine screening or during acute illness. On initial examination, four subjects had islet cell autoantibodies, 4 of 22 had an abnormal intravenous glucose tolerance test result, 6 of 22 had low first-phase insulin release on intravenous glucose tolerance testing, and 10 of 20 had impaired glucose tolerance on oral glucose tolerance testing. On follow-up, insulin-dependent diabetes had developed in two of the four subjects with islet cell autoantibodies. The other two subjects with islet cell antibodies have had persistently abnormal glucose tolerance on both oral and intravenous glucose tolerance testing and have low first-phase insulin responses. Diabetes has developed in none of 25 subjects without islet cell antibodies, although two have persistently abnormal glucose tolerance or insulinopenia. All five subjects with islet cell antibodies or human leukocyte antigen DR3/DR4 with initial impaired glucose tolerance have either acquired diabetes or have abnormal glucose tolerance. In contrast, only one of five subjects with initial impaired glucose tolerance but lacking these markers has persistent glucose intolerance. We conclude that in the absence of islet cell antibodies or human leukocyte antigen DR3/DR4 heterozygosity, incidental hyperglycemia or glycosuria is unlikely to be associated with progression or diabetes.

Adolescent↗
PubMed1989

Second interim report of the nation-wide collaborative study on the long-term effects of bromocriptine in the treatment of parkinsonian patients.

The interim data obtained up to the end of the 2nd year of the nation-wide multicentric cooperative study on the long-term effects of bromocriptine in parkinsonian patients revealed the following results. Firstly, the bromocriptine monotherapy could be continued in about 40% of the patients at the mean maintenance dose of 10.8 mg daily. Secondly, the additional use of bromocriptine in parkinsonian patients already treated with levodopa had a favorable influence on late side effects of levodopa such as on-off phenomenon and dyskinesia. No significant difference has been found so far as to the management of the wearing-off phenomenon between the patients with levodopa alone and those with levodopa and bromocriptine.

Adult↗
PubMed1989

[Isolated angitis of the central nervous system--case report and review].

Isolated angitis of the central nervous system (IACNS) is rare condition with inflammation limited to vessels supplying the brain. This IACNS has been a poorly characterized and infrequently reported illness since it was first described as a separate entity in 1959. However, a patient with IACNS has not been reported in Japan. A patient, 39-year old-male, with IACNS limited to small and middle vessels is described. Recurrent, transient consciousness disturbances, focal myoclonus, papilloedema and temporal lobe epilepsy were observed during disease course. CSF finding of this patient showed lymphocytosis with marked increased protein. Carotid and vertebral angiogram showed irregular luminal outline in branches of all arteries. The most specific finding is that of alternating areas of focal stenosis and ectasia giving a "sausage" pattern. These characteristic findings showed in the branch of external carotid arteries. There was no evidence of systemic vasculitis by systemic angiography. Biopsy of temporal artery showed lymphocyte infiltration, fibrinoid necrosis without giant cell and granuloma. Formation of A-V malformation in the branch of external carotid artery was also observed. This histopathological finding was compatible with necrotizing angitis, not granulomatous angitis. Isolated angitis of the central nervous system was diagnosed. In spite of his administration of corticosteroid, cerebrospinal fluid abnormalities has not responded markedly. Abnormal findings of carotid and vertebral angiogram also has not changed. After 7 years from his onset, his neurologic signs and symptoms were well controlled with administration of anti-epileptic drugs.

Adult↗
PubMed1989

[Clinical, electrophysiological and histological analysis of adult onset chronic sensory neuropathy].

We reported clinical, electrophysiological and pathological findings in 10 patients with acquired, slowly progressive sensory neuropathy. Group I patients which had delayed sensory nerve conduction velocities (SNCV) or no response of SCV in electrophysiological studies were observed to have marked deep sensory disturbances. On the other hand, Group II who had abnormalities of both SNCV and motor nerve conduction velocities electrophysiologically has tendency to show superficial sensory disturbances more dominantly than that of deep sensation. Histological findings of biopsied sural nerve in Group I were mainly composed of diminution of large myelinated fibers, in Group II the diminution of large myelinated fibers with decreased unmyelinated fibers were observed. However, there were no significant difference between Group I and Group II in the quantitative analysis of myelinated fibers. There were no definite tendency under the basic disease or background factors of these 10 patients. Only 3 of these 10 patients had immunological abnormalities such as RA factors or antinuclear antibodies.

Adult↗
PubMed1988

A nation-wide collaborative study on the long-term effects of bromocriptine in patients with Parkinson's disease. First interim report in Japan.

Two prospective projects were started in May 1985 to evaluate the long-term effects of bromocriptine in patients with Parkinson's disease. One of the projects is to see if combination therapy with levodopa and bromocriptine is superior to levodopa alone with regard to the prevention of late side effects of levodopa therapy. The other is to see the long-term effects of bromocriptine monotherapy. Patients with Parkinson's disease were allocated randomly to either combination or levodopa group in the first project. Parkinsonian symptoms, disabilities of daily life and severity of late side effects of long-term levodopa therapy were evaluated by a semiquantitative rating scale. This communication represents the first interim report. Methods of the studies and synopsis of the results at the end of the 12th month are described. A total of 702 patients was enrolled in the study (combination therapy, n = 216; levodopa therapy, n = 200, bromocriptine monotherapy, n = 286). At the end of the 12th month, the numbers of patients who dropped out from the study were 19, 16 and 55 in the three groups, respectively. It appears to be too early to make any definite conclusion with regard to which mode of treatment is superior, however, some evidence suggesting a superiority of the combination therapy over levodopa alone was noted in managing wearing-off phenomenon and dyskinesia. As many patients are sticking to the originally intended mode of treatment, it appears to be possible to obtain more meaningful data in several years.

Adult↗