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Biomedical subjects

H Tanabe

Publications and source records attributed to H Tanabe.

At least 217 records · Page 12Linked to original sources
PubMed1993

Studies on early enteral nutrition for patients with gastric cancer from the view of immunity.

The enteral nutrition after operation for gastric cancer patients with special reference to its immunological improving effect was examined. The subjects were 25 patients who underwent an operation and they were classified into 2 groups by the postoperative nutritional control method. E group: patients who received enteral nutrition after operation (n = 12) and T group those who reviewed TPN postoperatively (n = 13). In the 25 subjects the serum proteins, nitrogen balance and 3-methylhistidine (3-Mehis) were measured before and after the operation. The total lymphocyte counts were measured before and after operation. The total lymphocyte subsets and NK cell activity were determined with monoclonal antibodies. Nutritionally, there was no significant difference in the serum proteins and nitrogen balance and 3-Mehis/Cr ratio also showed no significant difference. Immunologically, an improving effect was observed in E group postoperatively with CD4+CD45R-Leu8- (helper T) cell subpopulation, CD8+CD11b- (cytotoxic T) cell subpopulation and CD3-CD16+CD56+ (NK-LAK) cell subpopulation.

Aged↗
PubMed1993

Study of effect of surgical stress on immunity in patients with gastrointestinal cancer.

We investigated the effect of surgical stress on immunity in patients with gastrointestinal cancer by three color flow cytometry centering on lymphocyte subsets. The control group consisted of patients with cholelithiasis as a benign disease and the cancer groups consisted of patients with gastric cancer and those with colorectal cancer. Total lymphocyte in peripheral blood, lymphocyte subsets by monoclonal antibody and NK cell activity were measured before and after operation in the target patients. The cell ratio of CD4+CD45R+Leu8+ (suppressor inducer T), CD8+CD11b+ (suppressor T) were significantly higher in the gastrointestinal cancer group when lymphocyte subsets were investigated after operation. Further, the cell ratio of CD3+CD16-CD56+ (T-LAK) was significantly lower. These findings suggest that decrease in immunity as a result of surgical stress is greater in patients with gastrointestinal cancer than in those with a benign disease.

Adult↗
PubMed1993

Sympathetic skin response in patients with cerebellar degeneration.

Sudomotor function was studied based on sympathetic skin responses (SSRs) in 87 patients with various types of cerebellar degeneration. Evaluations of orthostatic hypotension and the R-R interval variation were also performed in these patients. The respective incidences of SSR abnormality and orthostatic hypotension were 44 (50.6%) of 87 and 39 (44.8%) of 87. Fourteen percent of the patients with abnormal SSRs did not have orthostatic hypotension, but 8% of the patients with normal SSRs did have orthostatic hypotension. Sympathetic skin responses were abnormal in most patients with Shy-Drager syndrome, sporadic olivopontocerebellar atrophy (OPCA), and striatonigral degeneration, whereas SSRs were normal in patients with familial OPCA, sporadic cerebellar atrophy, and familial cerebellar atrophy. We demonstrated that SSR can be used to evaluate sudomotor function in degenerative disorders of the central nervous system as well as in peripheral neuropathies. The vasomotor and sudomotor functions usually are both disturbed in patients with cerebellar degeneration, and the SSR can detect autonomic dysfunction as sensitively as does the head-up tilt test. We also concluded that sporadic OPCA differs from familial OPCA in that it has a much higher incidence of autonomic dysfunction and that degeneration of the cerebellar cortex did not affect the autonomic regulation.

Adolescent↗
PubMed1993

A kindred of hereditary adult-onset leukodystrophy with sparing of the optic radiations.

We describe a family with hereditary adult-onset leukodystrophy with sparing of the optic radiations, shown clinically, neuroradiologically and electrophysiologically. All five affected members developed their leukodystrophy in their fourth decade and clinical features steadily progressed. The sparing of the optic radiations is not typical of other leukodystrophies. We suggest that this is a new clinical entity.

Adult↗
PubMed1993

Diminution of dopaminergic neurons in the substantia nigra of sporadic amyotrophic lateral sclerosis.

The substantia nigra was examined immunohistochemically using the antibody to tyrosine hydroxylase in 15 patients with sporadic amyotrophic lateral sclerosis (ALS). The number of dopaminergic neurons was diminished in the substantia nigra of seven cases. The diminution was not related to the age, duration of the illness or use of respirators. Supranuclear ophthalmoplegia developed in four and dementia in three out of seven patients with reduction of nigral dopaminergic neurons. In addition, five out of the seven patients developed respiratory failure within 2 years after the onset of the illness. The nigral dopaminergic system may be involved in rapidly progressive ALS patients with supranuclear ophthalmoplegia and/or dementia.

Aged↗
PubMed1993

Mental health in family members living with elders.

We assessed the mental health conditions of 217 subjects who took care of elders at home, using our depression scale by the surveillance of the elders living at home in Ibaraki Prefecture. An analysis was made on how depression in the caretakers was related with each item of demographical results of the caretakers and the elders living together at home, and with ADL, depression, dementia, personality change and the personality trait of the elders. Our study revealed that depression, personality change and the viscous character of the elders are three factors associated with depression in the female caretakers. Furthermore, we pointed out the necessity of an education campaign to provide the caretakers with information on the elders' personality and personality change for maintenance of the good mental health of the caretakers living with the elders.

Adolescent↗
PubMed1993

Discrete cortical infarction with prominent impairment of thumb flexion.

BACKGROUND: Intracortical efferent zones in the primary motor cortex for thumb movements, namely thumb flexion, extension, adduction, and abduction, have been described in Macaca mulatta monkeys but not in humans. Even recent cortical mapping based on intraoperative monitoring does not provide information about intracortical efferent zones as it is not ethically possible to search the human motor cortex extensively by punctate electrodes. CASE DESCRIPTION: A 78-year-old man with discrete cortical embolism over the left central sulcus is described. Only a mild weakness of his right thumb was observed. Thumb flexion was affected to a greater degree than thumb extension, adduction, and abduction. The lesion ran along the bottom of the central sulcus and affected part of the precentral and postcentral gyri on both sides of it. Animal studies in Macaca mulatta monkeys have shown that the intracortical efferent zones for thumb movement, especially for thumb flexion, are located in the part of the motor cortex just adjoining the central sulcus that folds down from the "bank" to the depth of the central sulcus. It was possible to explain the prominent weakness of thumb flexion if we applied the results of the animal studies. CONCLUSIONS: Our case suggests that the same arrangement of intracortical efferent zones found in monkeys may also exist in human beings.

Aged↗
PubMed1993

Rigid spine syndrome and nocturnal alveolar hypoventilation.

A 17-year-old Japanese woman with rigid spine syndrome (RSS) presented with respiratory failure leading to CO2 narcosis. The clinical symptoms were drowsiness, asterixis and cardiac arrhythmias. Tracheostomy and temporary ventilatory support abolished these symptoms. However, polygraphic sleep studies without a ventilator revealed Cheyne-Stokes respiration and profound arterial oxygen desaturation during rapid eye movement sleep. Nocturnal ventilatory support improved not only nocturnal hypoxemia, but daytime blood gas values during spontaneous breathing. These findings indicate that the onset of respiratory failure is preceded by severe nocturnal hypoxemia and that the evaluation and control of nocturnal respiratory insufficiency is essential for RSS patients.

Adolescent↗
PubMed1993

[Molecular genetic analysis of sporadic Alzheimer's disease].

The authors report the clinical findings and the results of molecular genetic analysis of 8 patients with sporadic Alzheimer's disease. Differential diagnosis was carried out on the basis of familial history, laboratory data, brain imaging analysis using CT, MRI and SPECT. According to the clinical stage criteria made by Cummings and Benson, 6 cases were in stage 1 and the remaining 2 in stage 2. Recently, it was reported that affected members from 6 Japanese kindreds with familial Alzheimer's disease (FAD) had missense mutation in exon 17 of the gene for beta/A4 amyloid precursor protein (APP). Amino acid substitution (Val-Ile) at codon 717 by this mutation was considered to be responsible for FAD in these kindreds. We used genomic DNA from 8 sporadic cases to determine whether the disease in these families is associated with an APP 717 mutation and the mutated codons, 102, 117, 129, 178, and 200, on the gene for proteinase-resistant prion protein (Prp) which causes transmissible dementia, Creuzfelt-Jacob disease (CJD) and Gerstmann-Sträussler syndrome (GSS). The results showed that there were no mutations on these genes in 8 patients. It would be necessary to analyze DNA from patient with sporadic Alzheimer's disease to examine the mutations found in the APP gene and Prp gene of heredity Alzheimer's disease patients.

Aged↗
PubMed1993

[A case of herpes simplex encephalitis presenting complete destruction of the medial portions in the bilateral temporal lobes].

A 57-year old man, who had suffered from herpes simplex encephalitis and had been cured without antiviral agents, was admitted to our hospital three years after the encephalitis. He had a complete loss of memory for events subsequent to the encephalitis and a retrograde amnesia for the several years leading up the encephalitis. MRI revealed the abnormalities located in the limbic system, especially the medial portions in the bilateral temporal lobes of the cerebrum were completely destroyed. We consider that this case suggests the specific affinity of herpes simplex virus especially for the medial portions in the temporal lobes of the cerebrum.

Amnesia, Retrograde↗
PubMed1993

[Sudomotor dysfunction in Parkinson's disease].

Sudomotor function was evaluated by using the sympathetic skin response (SSR) and the sweat response to intradermal acetylcholine (ACh) injection in 69 patients with Parkinson's diseases (PD). The incidence of SSR abnormality (34.8%) was as high as that of orthostatic hypotension (30.4%) and increased with the severity of the illness. Anticholinergic drug did not influence the incidence of SSR abnormality. Therefore, the SSR is useful in evaluating sudomotor efferent pathway in PD patients. Moreover, in all patients, sweat response to ACh showed a reduced number of excitable sweat glands and a low volume of sweat. In a patient in whom sweat response to ACh was markedly impaired, however, the density of acetylcholinesterase-positive unmyelinated fibers in biopsied sural nerve was in normal range. Therefore, this is considered to indicate functional disturbance of the postganglionic sympathetic fibers in PD patients, without morphological changes.

Aged↗
PubMed1993

[Significance of serum neuron-specific enolase levels after head injury].

Enolase is an enzyme involved in glycolysis and neurospecific enolase (NSE) has two types of isoenzyme (alpha gamma and gamma gamma enolase). Found in nerve cells and axons, the NSE is reported to be released into the serum and cerebrospinal fluid following nerve injury. We recently analyzed serum NSE levels in 47 patients with solitary head injury who were transported to our center immediately after injury. There were 35 men and 12 women, with a mean age of 35.1 years. In each case, blood was sampled within 8 hours after injury. Serum NSE was measured and analyzed in relation to the level of consciousness (Japan Coma Scale) upon admission, the modified Araki's classification, the presence or absence of skull fracture, findings from computed tomography (CT) scans and the prognosis according to the Glasgow outcome scale. Differences were compared by t-test to determine significance. When the level of consciousness was compared with the serum NSE level upon admission, the NSE level was significantly higher in patients showing a three digit code disturbance of consciousness than in the other patients (p < 0.005). When NSE was analyzed in relation to the modified Araki's classification, the NSE level for the prolonged type with focal signs was higher than the NSE level for any other type (p < 0.001 compared to the transient type). The NSE level was significantly higher in patients with skull fracture than in patients without skull fracture (p < 0.01). The NSE level was significantly higher in patients showing contusion on CT scans than in patients without contusion (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[A case of macrocystic cervical neurinoma diagnosed by MRI with Gd-DTPA].

The authors report a rare case of a large cystic cervical neurinoma. A 45-year-old female was admitted to our clinic because of motor weakness of the right upper extremity, numbness of the right fingers and right posterior cervical pain. Metrizamide CT myelography demonstrated the outline of a low density mass. MRI showed a mass revealing low signal intensity on T1-weighted image, high signal intensity on T2-weighted image and marginal enhancement on contrast image with Gd-DTPA. The mass which was diagnosed as cystic tumor, was located in the intradural extramedullary space between C4 to C5 segments. After C4 through C5 laminectomy, the tumor was found to originate from the C5 anterior motor root. The tumor consisted mostly of a cystic part with a very thin solid compartment beneath the capsule. Postoperative course of the patient was uneventful. Although spinal neurinoma is one of the most common spinal tumors, an almost completely degenerated large cystic spinal neurinoma is extremely rare. MRI with Gd-DTPA was useful for the diagnosis of the cystic neurinoma by clearly enhancing the margin of the tumor.

Cysts↗
PubMed1993

[Late deterioration of functional abilities in adult cerebral palsy].

Clinical characteristics of late deterioration in adult cerebral palsy were reported with detailed neurological evaluations and analyses. 10 adult cases, 9 male and 1 female, with cerebral palsy (CP) were included aged from 24 to 58 years on admission. Without marked mental retardation all had been ambulant and completely independent of ADL with residual spasticity and/or dyskinesia of minimal degree until the second or third decade. Late deterioration of functional abilities starting with numbness or pain in upper extremities at age 24-45 (mean: 36.2 y), associated with profound atrophy of the shoulder girdle and hand muscles. Dyskinesia and spasticity markedly aggravated with urinary and respiratory dysfunctions, resulting in tetraplegia in a couple of years. Mentality is generally unaffected, however, severe dementia occurred in one case. Intensive clinical examinations revealed no particular abnormalities except for mild segmental neurogenic changes by needle EMG. Neuroradiological surveys revealed a marked narrowing of upper to middle cervical spinal canal with deformity and shrinkage of the corresponding cord in most cases. Cranial CT scans and MRI were unremarkable except for diffuse cortical atrophy and ventricular dilation. These studies showed that in adult CP an unexpectedly severe deterioration of sensory, motor and/or mental functions may appear even in previously well achieved cases. These dramatic changes of the clinical features of CP after middle age might be suggestive of the degenerating process and precocious aging of the CNS.

Adult↗
PubMed1993

[Primary adenomatous tumor of the middle ear: a case report].

A case of primary adenomatous tumor of the middle ear is described. A 16-year-old male was admitted with a one-year history of left hearing disturbance. Skull X-ray disclosed destruction of the left petrous bone. Computed tomographic scans revealed an iso-dense mass in the left petrous bone, which was slightly enhanced. The tumor appeared as a low intensity mass on T1-weighted magnetic resonance image (MRI) and as high-intensity mass on T2-weighted MRI, and was enhanced by Gd-DTPA. Fluid in the peritumoral area showed high intensity on T1- and T2-weighted MRI. External carotid angiography revealed a marked tumor stain fed by the ascending pharyngeal artery. At operation, the tumor was found to be soft and to bleed easily. Histological diagnosis was adenomatous tumor presenting a papillary pattern. Adenomatous tumor of the middle ear is rare and difficult to classify. Nevertheless, papillary adenomatous tumor of the middle ear could often be aggressive and malignant in behavior and this patient will require long-term follow up. This is the first report to our knowledge of MRI findings about primary adenomatous tumor of the middle ear.

Adolescent↗
PubMed1993

[Two autopsy cases of sporadic amyotrophic lateral sclerosis with 20-year-clinical course without respirators].

The present paper concerns the clinicopathological study of two patients with sporadic amyotrophic lateral sclerosis (ALS) with 21 or 22 years' clinical course without respirators. The two cases developed marked upper motor neuron signs and continually progressive paralysis. Involvement of the facial and bulbar muscles remained fairly mild. At autopsy, the anterior horns showed marked loss of motor neurons associated with numerous reactive astrocytes. On the other hand, the motor cortex and the pyramidal tract showed diminution of Betz cells and large myelinated fibers but no positive materials by fat stain. In addition, the anterolateral funiculi of the spinal cords revealed widespread myelin pallor. One of the case showed intracytoplasmic eosinophilic inclusions in some neurons of the medullary reticular formation. Recent articles have reported several rapidly progressive ALS patients who developed ophthalmoplegia, while on respirators, and widespread degeneration in the CNS. By contrast, our extremely slowly progressive ALS patients developed alterations confined to upper and lower motor neurons. There may exist some diversities in ALS.

Aged↗