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Biomedical subjects

H Tsukagoshi

Publications and source records attributed to H Tsukagoshi.

At least 145 records · Page 8Linked to original sources
PubMed1990

[A case of syphilitic meningitis presenting the seventh nerve and the eighth nerve palsies].

Here we described a case of syphilitic meningitis presenting the seventh nerve and the eighth nerve palsies. A 56-year-old man was admitted because of left facial palsy and hearing loss of bilateral ears. He had a penile chancre five months before admission. Cerebrospinal fluid examination showed high pressure, pleocytosis predominantly with mononuclear cells and high protein content. STS and TPHA of serum and CSF were positive. High dose penicillin G was effective, and he was discharged with only mild hearing loss in the left. Considering the penetration of penicillin G into the CSF and the minimum fully treponemicidal concentration of penicillin, the administration of large doses of aqueous penicillin G intravenously or intramuscularly was effective in such a case to prevent permanent deafness, though CDC recommends relatively low dose.

Facial Paralysis↗
PubMed1990

[Distribution of skeletal muscle involvement in myotonic dystrophy--a computed tomographic study].

The computed tomography (CT) scan was performed on 8 myotonic dystrophy (MD) and 3 congenital myotonic dystrophy (CMD) patients on the following seven levels; the jaw, the neck, the shoulder girdle, the abdomen, the pelvic girdle, the thigh and the lower leg. Muscle atrophy was shown as low density areas or a reduction in the cross-sectional area of the muscles. The earliest finding in the disease was severe atrophy of the sternocleidomastoid and mild atrophy of the masseter and the pterygoid medialis. In addition, spinal, abdominal wall and lower leg muscles were involved. The distal muscles were more markedly affected than the proximal in the lower limbs. These changes were characteristically observed in cases without apparent muscle symptoms. Levator scapulae, psoas major, rectus femoris, peroneal longus et brevis and tibialis posterior were relatively well preserved and were even hypertrophic in some cases. The shoulder girdle muscles were more markedly affected than the pelvic girdle muscles. There was no substantial difference in the CT findings between MD and CMD.

Adolescent↗
PubMed1990

[Bronchial hyperresponsiveness to histamine in guinea pig induced by intravenous administration of platelet activating factor].

Platelet activating factor (PAF) has recently been demonstrated to play an important role in allergic diseases such as bronchial asthma. Changes in airway wall thickness have recently been suggested to cause excess airway narrowing of asthma. In this study, the authors examined the bronchial hyperresponsiveness to histamine in guinea pig induced by intravenous administration of PAF by measuring dynamic compliance and dynamic respiratory resistance. Moreover, a new formula which can exclude the effect of the changes of the airway wall thickness was proposed. With this formula, the administration of PAF was suggested to induce airway wall to be thickened. The ratio of bronchial smooth muscle constriction by histamine was significantly enhanced by the administration of PAF (p less than 0.05). Moreover, antagonists such as CV3988 and CV6209 inhibited the effect of PAF. The above results suggest that PAF may be an important mediator affecting bronchial hyperresponsiveness.

Airway Resistance↗
PubMed1990

[A case of cerebral gigantism with cerebellar atrophy].

A 37-year-old housewife, who had physical characteristics of cerebral gigantism, such as the tall stature, acromegaly, macrocephalia, high arched palate and antimongoloid slant, developed cerebellar ataxia and dysarthria. Her mother, uncle and grandmother were also reported to have slowly progressive gait disturbance. Her mother was also tall. Endocrinological studies failed to show any definite abnormality. CT and MRI revealed remarkable cerebellar atrophy. Though cerebral gigantism is often associated with clumsiness and incoordination, the etiology of the ataxia is poorly understood. This case indicates that the ataxia in cerebral gigantism may be, at least partly, caused by cerebellar atrophy.

Adult↗
PubMed1989

Motor paresis improved by sympathetic block. A motor form of reflex sympathetic dystrophy?

Four patients had a characteristic motor paresis that was dramatically improved by sympathetic block. The cause of this paresis could not be determined by the usual neurological examinations. It was similar to reflex sympathetic dystrophy in that the patients experienced severe pain, swelling, coldness, and muscle atrophy in the affected limbs or other parts of the body in the course of their illness. However, the motor paresis could precede the pain or develop after the pain had disappeared. Even in the absence of pain, the motor paresis was exacerbated by sympathetic stimulation using epinephrine, norepinephrine (nor-adrenalin), or isoproterenol hydrochloride (Proternol) loading and was improved by regional intravenous infusion of reserpine or by sympathetic ganglion block. Loading with pilocarpine, atropine sulfate (Bosmin), and edrophonium chloride (Antirex) did not influence the paresis. This motor paresis is thought to be due to abnormally increased sympathetic tone and may be considered a motor form of reflex sympathetic dystrophy. However, motor paresis closely related to sympathetic dysfunction is quite a new condition that we call "sympathetic motor paresis." This is important clinically because a long-standing effect can be expected from permanent sympathetic ganglion block with dehydrated ethanol.

Adult↗
PubMed1989

MRI findings of inferior olives in palatal myoclonus.

Four patients with palatal myoclonus (PM) were studied with magnetic resonance imaging (MRI). Increased signal intensity and bilateral enlargement of the inferior olives were recognized in two patients with bilateral PM, pontine haemorrhage and neuro-Behçet disease, and a similar olivary change on the contralateral side was noted in a case of pontine infarction with unilateral PM. These findings were consistent with the pathology. The changes were more obvious in proton density-weighted images than in T2-weighted images, which thus differ from the changes in common gliosis. The other patient with the syndrome of PM and progressive ataxia did not show any olivary change. These changes on MRI are considered to indicate pseudo-hypertrophy of the inferior olives, although this is not consistently shown by the imaging method.

Adult↗
PubMed1989

Visuospatial processes of line bisection and the mechanisms underlying unilateral spatial neglect.

Patients with unilateral spatial neglect fail to report or respond to stimuli contralateral to the lesion which usually involves the right parietal lobe. When asked to mark the centre of a horizontal line, these patients place the mark to the right of the true midpoint. It has been considered that they neglect the left part of the line and bisect the perceived line segment. We investigated the eye-fixation patterns of hemianopic patients with or without unilateral spatial neglect during the bisection of lines, using an eye camera. Hemianopic patients without unilateral spatial neglect saw the whole lines, searching to the endpoint on the hemianopic side, and bisected it correctly. In contrast, left hemianopics with unilateral spatial neglect never searched to the left hemianopic side. Once they fixated a certain point on the right part of the line, they persisted with this point and marked the subjective midpoint there. Taking left homonymous hemianopia into account, the subjective midpoint appeared to be marked, not at the centre of the line segment perceived in the seeing right visual field, but at the leftmost point of it. However, they could appreciate the deviation of the subjective midpoint in the right visual field when forced to fixate the left endpoint of the line. These findings suggest that the left hemisphere has the ability to estimate the midpoint of the line through the right visual field and that visuospatial disorder in the line bisection test is attributable to the pathological change in the right hemisphere. The results are interpreted to mean that left hemianopic patients with unilateral spatial neglect see a totalized image of a line extending equally to either side of the point where they are going to mark the subjective midpoint. We considered that the right hemisphere completes the line, using the visual input relating to the right part of the line perceived by the left hemisphere.

Adult↗
PubMed1989

Absence of the cystatin C amyloid in the cerebral amyloid angiopathy, senile plaque, and extra-CNS amyloid deposits of aged Japanese.

Amyloid protein in Icelandic patients with hereditary cerebral amyloid angiopathy (CAA) is a variant of cystatin C. Immunoreactivities of the cystatin C and other amyloid proteins were investigated in CAA and other senile amyloid deposits in the Japanese sporadic aged cases including patients with dementia of Alzheimer type, and compared with those in Icelandic hereditary CAA. Compared with positive reaction of cystatin C in Icelandic hereditary CAA, no immunoreactivity of cystatin C was found in senile amyloid deposits of the Japanese aged including CAA. Immunoreactivity of the amyloid beta protein was negative in Icelandic hereditary CAA, for which CAA and senile plaque amyloid in the Japanese senile brains were positive. Our data suggest that the cystatin C amyloid would be present only in hereditary CAA, but not in the CAA and other senile amyloid deposits of the sporadic aged cases.

Aged↗
PubMed1989

[Malignant lymphoma presenting with bilateral orbital apex syndrome].

This is the first report of bilateral orbital apex syndrome caused by malignant lymphoma. A 73-year-old man suffered from right forehead pain, diplopia and right numb cheek. Thereafter progressed bilateral visual disturbance rapidly, and soon he became blind. Cavernous sinus thrombosis was suspected clinically, but histological study of the biopsied specimen from the nasopharynx revealed malignant lymphoma (non-Hodgkin, diffuse, large cell type) (LSG). The patient died 5 months after the onset of his illness. Autopsy revealed lymphoma cell invasion and necrosis in parasellar region, bilateral optic nerves, nasopharynx, and left posterior root of L3. There was no lymphoma cell in the liver, spleen, or gastrointestinal tract. The nasopharynx was suspected to be the primary site of the tumor. In bilateral orbital apex syndrome, malignant lymphoma should be taken into consideration. Remission can be expected if treatment is started in early stage.

Aged↗
PubMed1989

[Idiopathic hypokalemic periodic paralysis presenting peculiar insulin secretion].

A 24-year-old male was admitted to our hospital because of the paralytic attack. He was well until he went to bed the day before, and he found his limbs unmovable in the morning. The initial attack occurred at age 11 and subsequently he had two episodes of the reversible generalized weakness which always appeared in the morning and continued for about one day at age 14 and 21, respectively. The provocative factors were uncertain. There was no family history of paralytic attacks nor thyroid diseases. On the neurologic examination he presented flaccid tetraparesis without the facial and respiratory involvements. The laboratory studies showed that the serum potassium was 2.4 mEq/l and the thyroid function was normal. The oral and intravenous potassium chloride was given and within two days the serum potassium turned back to the normal level, and he has recovered completely from the paralysis. An oral 75g glucose load was performed. The serum immunoreactive insulin (IRI) was elevated from the basal level to 289 microU/l, showing the prominent peak response at 30 min after the load, and both the serum potassium and the grasping power decreased significantly, although the blood glucose fluctuated within the normal level. After the prophylactic treatment with acetazolamide 2,000 mg daily for 7 days, this markedly elevated initial insulin response has disappeared and moreover the weakness of grip was milder, however, the serum potassium decreased notedly. This case revealed that in the idiopathic hypokalemic periodic paralysis the attack was possibly induced by the extraordinarily secreted insulin which was supported by the acetazolamide treatment.

Acetazolamide↗
PubMed1989

[An autopsy case of panencephalopathic type of Creutzfeldt-Jakob disease: an early clinical sign documented by magnetic resonance imaging].

We reported an autopsy case of panencephalopathic type of Creutzfeldt-Jakob disease (CJD), one of whose early clinical signs, visual loss, had been documented by magnetic resonance imaging (MRI). The patient was a 59-year-old woman, who showed disturbance of visual acuity, memory and calculation at the early stage. About 2 months later she developed apallic syndrome and revealed myoclonic jerks in her eye balls, face, neck and extremities. Electroencephalography showed periodic synchronous discharge. Three months later after her first symptoms MR showed bilateral occipital atrophy, although we could find no brain atrophy on CT scan. She died of the suffocation caused by bronchopneumonia at the age of 60 years. The total duration of her illness was about 20 months. Neuropathological examination revealed a pronounced diffuse atrophy of the cerebral cortex and white matter. In addition to severe cortical neuronal loss and astrocytosis, spongiform changes were evident. The hippocampus was relatively well preserved. In the cerebral white matter both myelin sheaths and axons disappeared almost completely. The cerebellum showed the severe degeneration of granule cells. These neuropathological findings are consistent with those of panencephalopathic type of CJD. It is important to clarify the abnormalities of MR findings in relation to such early clinical signs of CJD. To the best of our knowledge such reports as ours have not been published previously.

Atrophy↗
PubMed1989

[Unilateral palatal myoclonus with peculiar ocular movements--neurotological studies and MRI].

This is the first report of unilateral palatal myoclonus with which two different ocular movements were synchronized. A 55-year-old woman was admitted to our hospital due to intubation and dysarthria of sudden onset after three similar attacks for these four years. On admission right ptosis, hypalgesia in the right face, right facial nerve palsy, dysarthria, bilaterally increased deep tendon reflexes and trunkal ataxia were noted. Continuous repetitive contractions at 110/min frequencies were observed in the left soft palate, pharynx and larynx. On electronystagmography and electro-magnetic search coil system (Skala system), two different ocular movements, i.e., rotary oscillation with torsion and nystagmus to the right, successively alternated each other at random during eyelids closure. They were synchronized with palatal myoclonus. True nystagmus synchronized with palatal myoclonus has not been reported. When she calculated, rotary oscillation disappeared. In sleep polygraphy, rotary oscillation reduced in amplitude in stage 1 and disappeared in stages 2, 3, 4 and REM. On the other hand, the nystagmus reduced in amplitude in stage 1 and 2 and disappeared in stages 3, 4 and REM. The direction of nystagmus was converted to the left in stages 1 and 2. Similarly, in a drowsy state induced by intravenous injection of 7 mg diazepam, the direction of the nystagmus was converted to the left. On brain magnetic resonance imaging (MRI) right inferior olive was identified as a well circumscribed, enlarged increased signal area on T2-weighted and proton density-weighted images in addition to the lesions of infarcts in left corona radiata, posterior limb of right internal capsule and tegmentum pontis.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Stem↗
PubMed1989

[Familial spastic paraplegia with syndrome of continuous muscle fiber activity (Isaacs)].

A woman aged fifty-three developed paraparesis at the age of 4, which progressed slowly and required crutches by the age of 30. At the age of 51, muscle stiffness involved bilateral hands and arms gradually. At the age of 53, she suffered from painful spasms in right deltoid muscle. Her two brothers had spastic paraplegia without other neurological deficits. Her paternal grandfather and maternal grandmother were cousins. Slight dementia was noted (WAIS: IQ, 79). Her posture was stiff and muscles of upper limbs were in a persistent contraction; Subcutaneous tissue was thin, and muscles were well-defined and firm. There was moderate muscle weakness of legs and hands. Continuous fasciculations and myokymias were recognized in muscles of the arms and the limb girdles. Muscle tone was considerably increased especially in the bilateral arms. The deep tendon reflexes were exaggerated with extensor plantar responses. Profuse sweating affected palms, soles and backs. No sensory disturbance was appreciated. There was no myotonic responses to percussion of muscles. Following laboratory data were normal; thyroid functions, CSF studies, anti HTLV-I antibody and long chain fatty acid in red blood cells, myelography and brain CT except for increased basal metabolic rate (53%). Electromyographic study in the arms and hands revealed spontaneous motor unit activities including doublets at rest and increased proportion of polyphasic potentials and high amplitude potentials in voluntary contraction. Biopsy of right quadriceps femoris muscle showed hypertrophy of type I fibers and angulated atrophy of type II fibers. Continuous muscle activities in upper limbs did not change at sleep or with intravenous administration of 7 mg diazepam.(ABSTRACT TRUNCATED AT 250 WORDS)

Electromyography↗
PubMed1988

Peripheral neuropathy with predominantly motor manifestations in a patient with carcinoma of the uterus.

An autopsy case of a 56-year-old woman who had carcinoma of the corpus uteri and peripheral neuropathy with predominantly motor manifestations is described. The neurological abnormalities included subacute weakness of the limbs and loss of deep reflexes, which improved after the surgical removal of the uterine carcinoma. Neuropathologically, peripheral nerves mainly presented features of axonal degeneration with a mild loss of myelinated fibres. Anterior horns of the spinal cord showed central chromatolysis of the motor nerve cells and many spheroids without neuronal loss. Axonopathy of peripheral nerves was considered to be the main pathological process in this paraneoplastic syndrome.

Carcinoma↗