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Biomedical subjects

H Tanabe

Publications and source records attributed to H Tanabe.

At least 289 records · Page 16Linked to original sources

[Left unilateral apraxia].

A 32-year-old right-handed man suffered a traffic accident with head injury, resulting in loss of spontaneity, right hemiparesis, severe aphasia, and unilateral apraxia, which was noticed on his non-paralyzed left hand. An MRI scan conducted 11 months after onset revealed a large lesion in the left frontal lobe, a small lesion in the right frontal lobe and a striking thinning of the trunk of the corpus callosum with remarkable dilatation of the lateral ventricles. An IMP-SPECT scan, performed 1 year after onset, showed a diffuse hypoperfusion extending to the left temporo-parietal area further than the MRI verified abnormal density areas. The patient's praxic abilities were precisely evaluated 1 year after onset. The performance on the object use task was characterized by content errors. For example, when using a match with his left hand, he always treated with it like a cigarette. The right hand performance of this task was clumsy due to his right hemiparesis but successful. The performance on his left hand did not improved even when the patient was given visual examples. The term "ideational apraxia" proposed by Liepmann, which was characterized by content errors, implies a conceptual deficit. Morlaas defined ideational apraxia as a agnosia of usage. Ideational apraxia has been so far investigated mainly on patients with these difficulties in both hands. On the other hand, left unilateral apraxia has been explained by callosal disconnection. Liepmann and Maas thought that a lesion of the corpus callosum would prevent the space-time engrams in the left hemisphere from reaching the right sensorimotor area necessary to carry out the skilled act with the left hand, thereby inducing apraxia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[A case of chondroblastoma originating from the right 6th rib].

Chondroblastomas are rare neoplasms, and comprise 0.5-1% of histologically proved primary bone tumors. We report a case of the tumor originating form the right 6th rib. The patient, a 15-year-old female, was admitted because the abnormal shadow was found on routine chest X-ray film. It was suspected to be the posterior mediastinal tumor based on the chest X-ray, CT and MRI. In surgery, the tumor was 4.0 x 4.0 x 2.5 cm in size and fixed on the rib, but not invasive to other tissue. The content was rough and soft granuloma like. Histological examination confirmed the diagnosis of chondroblastoma of the rib. The patient is doing well without symptoms of recurrence fifteen months after surgery.

Adolescent↗

[A case of coronary artery bypass utilizing natural bifurcation of the right internal mammary artery].

A Forty five year old male with unstable angina due to multiple coronary artery stenosis underwent successful complete coronary revascularization utilizing the natural bifurcation of the right internal mammary artery. As this procedure has not been reported in detail previously in the literature and since the use of the natural bifurcation of the internal mammary artery was considered to be useful for the treatment of multiple coronary stenosis, this case was presented. Pre and post operative angiography is included.

Angina, Unstable↗

[A case of carcinoma of the esophagus involving the trachea undergoing anterior mediastinal tracheostomy with pedicled omental wrapping].

A 62-year-old male who complained of dysphagia, body weight loss and hoarseness was admitted to our hospital. Chest x-ray film disclosed right superior mediastinal mass compressing membranous portion of trachea. Esophageal fiberscope revealed carcinoma of cervical esophagus. Bronchofiberscope revealed the paralysis of right recurrent laryngeal nerve and the invasion of esophageal cancer to tracheal membranous portion from the 5th tracheal ring to the 12th. The cancer also invaded the right lobe of thyroid which was shown by echogram. Operation was performed. On dissecting the cervical region, it was found that the tumor invaded both sides of the trachea so that tracheal reconstruction could not be done without injuring left recurrent laryngeal nerve. Sternotomy was added. Anterior mediastinal tracheostomy was done after laryngeal resection with total thoracic esophagectomy and tracheal resection leaving 5 rings long cartilage from carina. The trachea was wrapped with pedicled omentum. Post-operative course was uneventful. This procedure helps to increase blood supply to the tracheal anastomosis and turns to advantage in preventing infectious extension around trachea to mediastinum as well as tracheal compression to major vessels.

Esophageal Neoplasms↗

Separation of high-molecular mass RNAs by high-performance liquid chromatography on hydroxyapatite.

High-molecular-mass RNAs [transfer-(t-), 5S-, 18S- and 28S-RNA] in 25 mM sodium acetate buffer (pH 6.0) were separated by high-performance liquid chromatography (HPLC) on hydroxyapatite using a linear gradient (120 min-duration) from 0.03 to 0.147 M of phosphate buffer (pH 7.0) containing 0.3 M potassium chloride and 1 mM sodium azide with a slope of 2 mM/ml at a flow-rate of 0.5 ml/min. When the RNAs were dissolved in 4 M guanidine isothiocyanate-25 mM sodium acetate buffer (pH 6.0)-0.1 M beta-mercaptoethanol (4 M GIT), t-, 5S- and 18S- or 28S-RNAs but not 18S- and 28S-RNAs were separated. RNAs extracted from rat superior cervical ganglia with 4 M GIT could be separated. Thus, HPLC on hydroxyapatite is a rapid and accurate means of quantifying and/or preparing high-molecular-mass RNAs such as t- and ribosomal RNAs.

Animals↗

[Studies on usefulness of postoperative adjuvant chemotherapy with lentinan in patients with gastrointestinal cancer].

The usefulness of Lentinan, as an agent for postoperative adjuvant therapy, was investigated in patients with gastrointestinal cancer. Sixty-one patients were classified into three stages by a degree of advance for cancer (Stage II, III, IV). Furthermore, each group was put into the control group (C group) and the Lentinan group (L group), received 600 mg/day of Tegafur p. o. only or 600 mg/day of Tegafur p. o. and 2 mg/week of Lentinan i. v., respectively. Then total lymphocyte counts and NK cell activities were measured and analysis of lymphocyte subsets by two color flow cytometry was carried out every two months. The results were as follows: 1) Some parameters were preserved in higher levels in the L group especially in the stage IV. 2) In the stage IV, total lymphocyte counts of the L group were preserved higher levels compared to those of the C group. The same tendency was observed in OKT3, OKT4 and OKT8 positive cell counts. 3) In the stage IV, both OKT8+ x Leu15+ cell (suppressor T cell) and OKT8+ x Leu15- cell (killer T cell) counts tended to decrease in the C group. 4) In the stage IV, the NK cell activities of the L group were preserved in higher level compared to those of the C group. Leu7+ x Leu11-, Leu7+ x Leu11+ and Leu11- x Leu11+ cells counts tended to preserve in the L group. From these results, it was suggested that Lentinan had a marked immunopotentiating efficacy in the stage IV among gastrointestinal cancer patients.

Adult↗

Purification and identification of a growth factor produced by Paramecium tetraurelia.

We previously reported that the jumyo mutant of a cilate protozoan Paramecium tetraurelia excretes into the medium a factor which promotes its own cell division. Here, the factor was purified to electrophoretic homogeneity through a series of liquid chromatographic procedures. This substance is a protein with a molecular weight of 17,000 which at concentrations of 1 X 10(-9) M (17 ng/ml) or more results in the recovery of the cell division rate of the jumyo mutant to the level of the wild type. The factor is therefore considered to be a growth factor and was named Paramecium growth factor (ParGF). This is the first report of direct proof for the production of a growth factor in an organism other than vertebrates.

Animals↗

Unusual blink reflex with four components in a patient with periodic ataxia.

Characteristic findings in blink reflex are reported in a 55-year-old female with periodic ataxia. The blink reflexes on the side ipsilateral to the stimulation consisted of four components with latencies of 11, 21, 35 and 47 ms, instead of the usual two components seen in normal subjects. On the contralateral side, the last three components were also present. The second component was different from the normal R2 response in that its latency was shorter than normal and it did not habituate by stimulation at a rate of 10 Hz. In addition, it was more affected by diazepam than the third or fourth components. It is considered that R2 may have consisted of three components and that a shorter latency of the second component could be explained by facilitation.

Ataxia↗

Chronic progressive spinobulbar spasticity with disturbance of voluntary eyelid closure. Report of a case with special reference to MRI and electrophysiological findings.

We describe a 56-year-old man who had a progressive pseudobulbar palsy, spastic tetraparesis, forced laughing and disturbance of voluntary eyelid closure, and was clinically compatible with chronic progressive spinobulbar spasticity. Magnetic resonance images (MRI) revealed atrophy of the bilateral motor cortices and single photon emission tomography after intravenous injection of N-isopropyl-p-iodoamphetamine iodine-123 (IMP-SPECT) showed hyporadioactivity in the same regions. Electrophysiological studies on supranuclear paralysis of eyelid closure demonstrated that so-called apraxia and motor impersistence coexisted and that in attempts to keep the eyelid closed the inhibition of basal activity of the levator palpebrae superioris muscle and activation of the orbicularis oculi muscle were insufficient, indicating the impaired reciprocity of these ocular muscles. The corresponding lesion of these eyelid symptoms was considered to be the bilateral motor cortices.

Blinking↗

Development of ophthalmoplegia in amyotrophic lateral sclerosis during long-term use of respirators.

Patients with amyotrophic lateral sclerosis (ALS), who survive longer on a life-support system, exceeding the natural course of this disease, show new features of ALS. We report here a clinico-pathologic study of a 51-year-old patient with sporadic ALS who developed progressive external ophthalmoplegia 3 years after he remained on a respirator and died 5 years later, 13 years after the onset of his illness. The external ophthalmoplegia was initially accompanied by preserved doll's eye phenomenon, which later became absent. Autopsy revealed not only degeneration of the upper and lower motor neuron systems typical of ALS, but also degeneration of the Clarke's dorsal nuclei, spinocerebellar tracts, substantia nigra and inferior olives in addition to intracytoplasmic neuronal inclusion bodies in various areas. The oculomotor and abducens nuclei were variably involved, accompanied by neurogenic atrophy of the extraocular muscles. Our case report is consistent with the idea that ALS comprises a heterogeneous group of disorders, and also indicates that long-term use of respirators may make some patients with this illness prone to developing atypical clinical and neuropathologic features which are not observed during the natural course of ALS.

Amyotrophic Lateral Sclerosis↗

Hemispatial neglect in a patient with callosal infarction.

Left hemispatial neglect, confined to right-hand and verbal responses, was exhibited by a 56-yr-old right-handed male patient with callosal lesions due to cerebral infarction. Various disconnection signs were also present. His CT and MRI scans disclosed major lesions situated in the posterior half of the genu and the whole trunk of the corpus callosum, as well as in the left medial frontal and temporo-occipital lobes. Left hemispatial neglect was invariably demonstrated in right-hand performance such as copying drawings, line bisection, matching identical figures and copying multiple digit numbers, and in verbal performance such as confrontation naming and reading aloud multiple digit numbers. In contrast, little or no right hemispatial neglect was demonstrated in tasks performed with the left hand. These findings support the hypothesis that the left hemisphere is only concerned with attending to the contralateral hemispace and that the right hemisphere is specialized for attending to both sides of space although the preponderant tendency is for attending to the contralateral hemispace. The neglect symptoms observed in our patient may be a disconnection sign which was attributable to a combination of lesions in the corpus callosum and in the left medial frontal lobe.

Attention↗

CNS involvement in Japanese patients with chronic inflammatory demyelinating polyradiculoneuropathy.

Thirteen consecutive Japanese patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) were studied by MRI, evoked potentials, and EEG. We found 3 of these patients exhibited symptoms of CNS disorders. Of these 3, 2 with abnormal MRI and visual evoked potentials, and one with abnormal brainstem auditory evoked potentials were detected. Another case without clinical CNS signs showed abnormal EEG findings. The subclinical CNS abnormalities found in the Japanese patients were considered to be less frequent than in cases from Western countries reported previously.

Adolescent↗

Idiopathic palatal myoclonus.

Two cases with idiopathic palatal myoclonus without other neurological deficits were described. They did not have any other neurological deficits other than myoclonus of branchial muscles. In these cases, the myoclonus disappeared during natural or induced sleep. In Case 1, the myoclonus ceased transiently when the patient was calculating or receiving an injection. In Case 2, the myoclonus disappeared with intravenous injection of saline as a placebo. Detailed examinations, including brain CT, MRI and multiple evoked potentials, showed normal results. The myoclonus in Case 2 disappeared after we had explained that her disease was benign. Since the clinical features and laboratory data in idiopathic palatal myoclonus are quite different from those in palatal myoclonus with other neurological deficits, idiopathic palatal myoclonus is considered to be a separate syndrome. Invasive examinations or excessive medications should be avoided because of its benign prognosis.

Adolescent↗

A case of slowly progressive aphasia without generalized dementia in a Japanese patient.

A Japanese patient with a 4-year history of slowly progressive aphasia without generalized dementia is described. From 1985 on, this 61-yr-old right-handed dentist showed insidiously progressive deterioration in his speech and auditory comprehension, but has no memory disturbance, disorientation of space, time or persons, acalculia or other impairments in his behavior. His personality changes are unremarkable. He still treats patients at his clinic. General physical and neurological examinations were normal. CT and MRI (1.5T) scans showed widening of the left sylvian fissure and lateral ventricle without any vascular lesions. A PET scan demonstrated focal hypometabolism restricted to the left temporal lobe. The clinical course and picture of our patient corresponds, well to those of slowly progressive aphasia without generalized dementia, described by Mesulam.

Aphasia↗

Effect of temperature on myosin phosphorylation in mouse skeletal muscle.

The effect of muscle contraction on phosphorylatable myosin light chain (P-light chain) phosphate content and isometric twitch tension was examined at 25, 30, and 35 degrees C in intact mouse extensor digitorum longus muscle. Peak tetanic tension was unaffected by temperature, whereas peak unpotentiated isometric twitch tension was inversely proportional to muscle incubation temperature. The extent of phosphate incorporation into P-light chain elicited by a 20-s train of twitches (5/s) was inversely proportional to muscle incubation temperature, whereas the fractional increase in twitch tension (twitch potentiation) elicited by repetitive stimulation was directly proportional to muscle incubation temperature. After the twitch train, the rate of decline of potentiated twitch tension and of P-light chain dephosphorylation was directly proportional to muscle incubation temperature. The net result was that a significant and unique relationship between P-light chain phosphate content and contraction-induced tension potentiation existed at each temperature examined. The slope of the P-light chain phosphate vs. isometric twitch potentiation relationship varied directly as a function of muscle incubation temperature. The observations that the slope of this relationship increases and that unpotentiated twitch tension decreases when muscle incubation temperature is increased support the hypothesis that contraction-induced tension potentiation in intact mammalian skeletal muscle is the result of a sensitization of the contractile element to activation by Ca2+ that is brought about by P-light chain phosphorylation.

Animals↗

Partial callosotomy for Lennox-Gastaut syndrome--first cases in Japan.

Corpus callosotomy is a well established procedure for the treatment of intractable epilepsy. However, this is the first clinical report of surgical division of the corpus callosum in Japan. Four patients with refractory seizures suffering from Lennox-Gastaut syndrome underwent anterior partial corpus callosotomy. Their seizures consisted of absences, tonic, atonic, tonic-clonic attacks and were characterized by frequent falls. Electroencephalograms showed paroxysms of bilateral synchrony of slow spike and wave complexes. Postoperative follow-up during 12-27 months showed that partial callosotomy reduced the frequency and severity of seizures in all the patients, although they still require antiepileptic medication. This procedure was effective even in patients with mixed cerebral dominance and also in a patient with low intelligence quotient. Postoperatively, disconnection syndrome developed in three patients, which was transient in one and lasting in two.

Adult↗

[Evaluation of aortocoronary bypass operation using a He-Ne laser flowmeter--comparison between internal mammary artery grafts and saphenous vein grafts].

It was very difficult to measure myocardial blood flow in clinical cases. Recently, a He-Ne laser doppler flowmeter was developed, and we made it possible to measure the pre-and post-operative myocardial blood flow in cases of coronary artery bypass grafting (CABG). We applied a laser flowmeter to 30 cases of bypass grafting to the left anterior descending coronary artery (18 cases with IMAG and 12 cases with SVG). The preoperative myocardial blood flow at the right ventricular anterior wall was 77 +/- 15 ml/min/100 gr, and the postoperative flow at the same point was 81 +/- 12 ml/min/100 gr. There was no significant change between the pre-operative value and the postoperative one. Myocardial blood flow at the left ventricular anterior wall in SVG group significantly increased from the preoperative value of 58 +/- 11 ml/min/100 gr to the postoperative value of 86 +/- 9 ml/min/100 gr (p less than 0.001). In IMAG group, myocardial blood flow at the left ventricular anterior wall similarly increased from 73 +/- 14 ml/min/100 gr to 83 +/- 15 ml/min/100 gr (p less than 0.01). The postoperative value of IMAG group was almost equal to the value of SVG group. The increased rate of myocardial blood flow at the left ventricular anterior wall was 52 +/- 32% in SVG group and 18 +/- 12% in IMAG group. These rates were obviously distinguished from the increased rate at the right ventricular anterior wall.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗