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Biomedical subjects

J Nagata

Publications and source records attributed to J Nagata.

At least 73 records · Page 4Linked to original sources
PubMed1986

[Evaluation of the hypertensive intracerebral hematoma based on the study on long-term outcome--Part I. Mode of hematoma extension and its clinical significance in putaminal hemorrhage].

A retrospective analysis of our series of 355 cases of putaminal hemorrhage revealed some interesting aspects of its pathogenesis. All the cases were studied in detail with special attention to clinical presentation, diagnostic findings and the long-term clinical outcome. Role of surgery in management of putaminal hemorrhage is still controversial. Inability to form proper useful classification has been one of the reasons responsible for this controversy. A new classification is formulated which divides putaminal hemorrhage into four types. Mild type has hematoma localized to external capsule while moderate type shows hematoma extension to corona radiata from external capsule. In severe type, hematoma extends to internal capsule also while in very severe type it further extends to midbrain. These four types could be very well correlated to long-term clinical outcome. Accessory hematoma is discussed in detail. It is found to be more common in severe and very severe types. Its presence in mild or moderate types results in worse clinical outcome. Hypertension (BP greater than 200 mm of Hg) may play an important role in further extension of hematoma.

Cerebral Hemorrhage↗
PubMed1986

[Evaluation of the hypertensive intracerebral hematoma based on the study of long-term outcome--Part II. A role of surgery in putaminal hemorrhage].

Since CT was introduced, 355 cases of putaminal hemorrhage were experienced and surgical indication was evaluated in relation to long-term outcome (ADL). Among these cases, 198 (55.8%) were from operated group and 237 cases (66.8%) were admitted within 6 hours of onset. Comparison of ADL among operated, operated within 6 hours and non operated group was done. In general, results showed no advantage of surgery, and surgery at super-acute stage (within 6 hours). However it showed some surgical advantage in Moderate type, cases of operated within 6 hours and some Severe type.

Basal Ganglia Diseases↗
PubMed1986

[Evaluation of the hypertensive intracerebral hematoma based on the study of long-term outcome--Part III. Evaluation of neurological grading and CT classification].

It is very important to have a standard neurological grading system and CT classification for "putaminal hemorrhage" to compare, contrast and discuss the results and the surgical indications of various workers. We evaluated 355 cases of putaminal hemorrhage for their long-term outcome by using neurological grading and CT classification of Kanaya et al and compared it with our new classification based on the mode of hematoma extension. The long-term outcome (ADL) showed a better correlation with our new classification. While by using the earlier method (Kanaya et al), there was no significant statistical difference in the ADL between the patients of neurological grade IVb & grade V and also between the patients of CT class II and IIIa. In this classification, the definition of CT class V is not clear as the putaminal hemorrhage does not penetrate into the thalamus. It also ignores the upward or downward extension of the hematoma. Therefore, we emphasize the need for the modification of the presently existing neurological grading system and the CT classification for a better correlation with the long-term outcome.

Basal Ganglia Diseases↗
PubMed1986

[Evaluation of hypertensive intracerebral hematomas based on the study of long-term outcome--part IV: Prognostic importance of the age of the patient and the laterality of the lesion in putaminal hematoma].

The age of the patient and the laterality of the lesion are said to play an important role in determining surgical indications and prognosis of any neurosurgical disease. These two factors have been evaluated in 355 cases of putaminal haematoma, which were seen during the last 10 years after the introduction of the CT scan. Patients have been divided in three age groups; less than 59 years, 60-69 years and greater than 70 years, consisting of 235, 80 and 40 cases in each group respectively. Long-term outcome of three groups has been compared in both surgically and conservatively treated patients. The hematoma was situated on left side in 182 and on right side in 173 cases. 56.6% of left sided and 48.7% of right sided hematoma cases were operated. The long-term outcome of the two sides has also been compared in both surgically and conservatively treated patients. One has to be careful while considering patients of greater than 70 years of age as there is always some natural selection among these patients before they are referred to the hospital or are operated upon thereafter. One tends to be less aggressive for so old patients. Only in moderate type and operated cases the younger patients (less than 59 years) showed a better long-term outcome (ADL) than other surgically treated patients. Otherwise age did not effect the long-term outcome (ADL) in any type of putaminal haematoma. No effect of laterality was found in mild and very severe types of hematoma for the long-term outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1985

High single-dose alternate-day corticosteroid regimens in treatment of polymyositis.

High single-dose alternate-day prednisolone therapy (ADT) was compared with daily-dose prednisolone therapy (DDT) for treatment of polymyositis. Thirty patients with polymyositis were treated with ADT for an average of 33.9 months. The combined number of improvements was 21 out of 30, a response rate of 70%. Side-effects were very rare and mild. On the other hand, 9 of 17 patients treated with DDT for an average 18.5 months improved, a response rate of 53%. The incidence of side-effects was strikingly higher than with ADT. ADT is therefore strongly advocated for treatment of polymyositis to avoid infectious complications and lessen cushingoid side-effects.

Adolescent↗
PubMed1985

Imino acid and related alicyclic amine levels in biological fluids.

Imino acid and related alicyclic amine concentrations in blood and urine of mammals including humans were concurrently determined by a selected ion monitoring technique. Nanomole levels of proline and pipecolic acid, and pyrrolidine and piperidine as well, were found in human urine. Proline levels but not pipecolic acid levels were higher in blood of humans than in urine. Pyrrolidine and piperidine levels in blood of humans were picomole levels and much lower than those in urine. Similar tendencies were also recognized when these 4 compounds were analyzed using animal blood and urine, although the levels were generally higher in animals than in humans. Significantly high concentrations of the imino acids and the amines were found also in animal semen.

Amines↗
PubMed1984

Quantification by selected ion monitoring of pipecolic acid, proline, gamma-aminobutyric acid and glycine in rat brain.

A procedure for the simultaneous analysis of brain pipecolic acid, proline, gamma-aminobutyric acid and glycine--amino acids with potent inhibitory actions on the central nervous system--was developed. The identification and quantification of the amino acids were performed with a gas chromatographic--mass spectrometric--computer system using deuterium-labelled amino acids as the internal standards. After separation of the amino acids by high-performance liquid chromatography, the methyl ester heptafluorobutyryl derivatives were prepared. The lower limit of quantification for this method is at the picomole level. The usefulness of this chromatographic procedure has been demonstrated by measurement of trace amounts of pipecolic acid in rat brain.

Animals↗
PubMed1984

Role of surgery in hypertensive intracerebral hematoma. A comparative study of 305 nonsurgical and 154 surgical cases.

The indications for surgery in hypertensive intracerebral hematoma are still controversial. The reason for this may be: 1) lack of adequate and comparable data in conservative and surgical therapy from the same institution; 2) lack of adequate close follow-up monitoring over an extended period of time; or 3) lack of proper classification of hematomas for comparison of results from different institutions. The authors have treated 459 cases of hypertensive intracerebral hematoma between October, 1975, and July, 1983. The hematomas have been classified according to their mode of extension on computerized tomography. The long-term outcome was assessed on the basis of activity of daily living. Putaminal hematomas were classified as mild, moderate, severe, and very severe. In general, there was no significant difference in outcome between the surgical and nonsurgical cases; however, the outcome in the moderate and severe hematomas was found to be a little better for the surgical cases in some restricted areas. Thalamic and pontine hemorrhages were classified as mild, moderate, or severe. If the hematoma is localized to the thalamus or pons, and if it extends to the midbrain, there is no indication for surgery; however, in patients with moderate hematomas, the prognosis showed a variable outcome, and the indications for surgery were questionable. In cerebellar hematomas, the authors propose that even a hematoma with a diameter greater than 3 cm might show a good outcome with nonsurgical therapy.

Activities of Daily Living↗
PubMed1984

[Treatment of esophageal cancer by endoscopic administration of peplomycin ointment].

Pepleomycin ointment was developed to improve the antitumor activity afforded by endoscopic therapy for esophageal cancer. Through the esophagoscope we could observe this ointment specifically attacking the lesion. Furthermore we were able to recognize that peplomycin was acting directly on the lymph nodes as well as the tumor in a resected portion of the esophagus. It is hopefully anticipated that this method will be used as a combination therapy in pre-operative and inoperable esophageal cancer.

Aged↗