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Biomedical subjects

H Tohgi

Publications and source records attributed to H Tohgi.

At least 145 records · Page 8Linked to original sources
PubMed1983

Statistical studies on evaluation of mild disturbance of consciousness. Study of a simpler scale for clinical use.

In an effort to express the grades of mild disturbance of consciousness (MDOC), or clouding of consciousness, 25 items were selected for application in clinical examination. Factor analysis of the 25 items revealed that MDOC has a two-factor structure; namely, the performance factor (F1) and the verbal factor (F2). This structure was maintained in the sequential examinations. Guttman's scale analysis showed that the scale using the 25 items may be considered to approximate a unidimensional scale. By item selection according to communality, the 25 items could be reduced to 12 items without losing the two-factor structure or the usefulness and reliability of the examination. The principal component analysis (PCA) score, the F1 score, and the F2 score, calculated from the 12 items, were found to be good scales to describe an overall picture and characteristics of the F1 and the F2 of MDOC, respectively. Furthermore, by means of the characteristic curve (ogive) method, it was revealed that MDOC consisted of four clusters of items, the F2 factor (mild), F1 factor (mild), F2 factor (moderate), and F1 factor (moderate), according to the MDOC severity, so that a simpler scale composed of a representative item from each cluster could be constructed which exhibited a high correlation coefficient with the original PCA score.

Brain Diseases↗
PubMed1982

Selective loss of small myelinated and unmyelinated fibers in Shy-Drager syndrome.

The number and sizes of myelinated and unmyelinated fibers in biopsied sural nerves in cases with Shy-Drager syndrome were studied in comparison with cases with olivopontocerebellar degeneration not having autonomic dysfunction. In Shy-Drager syndrome there was a tendency for both small myelinated and unmyelinated fiber densities to be reduced in comparison with cases with olivopontocerebellar degeneration. Unmyelinated fibers more than 0.5 micrometers in diameter were significantly reduced in Shy-Drager syndrome, a fact suggesting myelinated fiber degeneration. Multilamellated Schwann cell processes, isolated Schwann cell processes, and collagen pockets were more numerous and conspicuous in cases with Shy-Drager syndrome. It was concluded that unmyelinated fibers and small myelinated fibers in the peripheral nerves were involved selectively in Shy-Drager syndrome. The significance of the findings was discussed in terms of autonomic dysfunction observed clinically.

Aged↗
PubMed1982

Clinicopathologic study of progressive subcortical vascular encephalopathy (Binswanger type) in the elderly.

A clinicopathologic study was made of 45 elderly persons whose autopsied brains showed the pathologic changes of progressive subcortical vascular encephalopathy (Binswanger type). Progressive subcortical vascular encephalopathy (PSVE) was observed in 3.8 per cent of all autopsied brains of elderly persons and in 6.7 per cent of the brains of those with cerebrovascular diseases. White matter lesions were graded from I to III (slight to severe). Small infarcts in the basal ganglia, thalamus, and pons were common, but the cerebral cortex was usually preserved. Neuropsychiatric symptoms included dementia, urinary incontinence, hemiplegia, pseudobulbar palsy, psychosis, parkinsonism, and mutism. In thge Grade III group there was a high incidence of pseudobulbar palsy, parkinsonism, and mutism. Pathologic study showed marked cerebral arteriosclerosis in almost all cases. Angionecrosis was observed in 60 to 80 per cent. Fibrotic and stenotic changes of the blood vessels in the deep white matter were also noted, particularly in 90 per cent of the Grade III cases. A suggested explanation for the pathogenesis of PSVE is based on the effects of various complications such as hypertension, cardiac disease and malnutrition which may play an important role in PSVE when they occur in elderly persons with a history of long-standing hypertension, marked cerebral arteriosclerosis, and arteriolar changes in the cerebral white matter.

Aged↗
PubMed1981

A comparison between the computed tomogram and the neuropathological findings in cerebrovascular disease.

The findings on computed tomography (CT) and neuropathological examinations were correlated in 87 autopsied cases of cerebrovascular disease with regard to the seize and location of lesions, experience of reviewers, and improvement in CT quality. Small infarctions less than 5 mm were very difficult to detect accurately on CT. This was largely because of the limitations in the efficiency of the CT scanner. Accurate diagnosis of medium sized infarctions was also often difficult. This was mainly due to the anatomical location of lesions, the confluence of deep and widened sulci, periventricular white matter, and structures in the posterior fossa. Large infections could be visualized easily on CT, except in their early periods or in cases with hemorrhagic infarctions. The improved accuracy of CT diagnosis for small and medium sized infarctions could not be attained by the experience of reviewers, but was only possible by instrumental improvement of CT quality.

Cerebral Hemorrhage↗
PubMed1980

Dissociated nystagmus in a comatose patient. A clinicopathological study.

Electro-oculographic recordings of dissociated vertical (oblique and upbeat) nystagmus were carried out in a patient in coma due to vascular lesions. Based on the clinical and neuropathological findings, it was suggested that dissociated vertical (oblique and upbeat) nystagmus in a patient in coma can be caused by bilateral lesions in the brachium pontis.

Aged↗
PubMed1980

The correlation between electroencephalographical and neuropathological findings in acute stage of cerebrovascular disease.

A study was conducted on the electroencephalographical and neuropathological correlations on 96 cases of cerebrovascular disease in order to elucidate the reasons why EEGs are often misleading in the diagnosis of location and size cerebrovascular lesions. The study showed that EEG findings are particularly misleading when the lesions were in the locations as follows: 1) subcortical deep infarctions, 2) cortical infarctions occupying a small proportion of cerebral convexity, or involving an entire hemisphere, or affecting the right hemisphere, 3) basilar thrombosis and infratentorial hemorrhage (primary or secondary to supratentorial lesions). The pathophysiological significance of these results has been discussed.

Acute Disease↗
PubMed1978

Ultrastructure of the Bunina bodies in anterior horn cells of amyotrophic lateral sclerosis.

Light and electron microscopic studies were made on the anterior horn cells in a case o amyotrophic lateral sclerosis. Eosinophilic inclusions of Bunina type were observed almost selectively in the motor neurons of spinal cord, as well as of brain stem, at the light microscopic level. Fine structural study revealed the presence of two types of cytoplasmic inclusions. The first, mainly corresponding to the light microscopic inclusions, were homogeneous, electron-dense, round- or oval-shaped bodies with vesicular or tubular rims and ribosome particles, about 2-5 mu in diameter, which contained filaments or other cytoplasmic componenets in the clear areas within them. The second were lamellar structures (laminated cytoplasmic bodies, Morales) which appeared to be originating from endoplasmic reticulum. There was no distinct transition in these two types of inclusions and the relationship to each other is not clear. The significance of Bunina body is unknown, but some manifestation of a primary disorder, e.g., protein metabolism, rather than a secondary degenerative change in the motor neurons in amyotorophic lateral sclerosis.

Adult↗
PubMed1978

Parkinsonism and dementia with acoustic neurinomas. Report of three cases.

Three cases of acoustic neurinoma with parkinsonism and dementia are reported. The characteristics of parkinsonism seen in these cases consisted of the rapid development of symptoms and symmetrical rigidity. In all cases there was a marked enlargement of the ventricular system and transient improvement in their mental states was observed following ventriculoperitoneal shunt or removal of the tumor. In an autopsy case there were no pathological findings in the cerebral cortex, basal ganglia, substantia nigra or pontine nuclei. It was concluded that parkinsonism and dementia in these patients were caused by chronic hydrocephalus due to the acoustic neurinomas.

Cerebral Ventricles↗