Study on sleep-wake rhythm disorders in two outpatient clinics.
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Adult↗
Biomedical subjects
J Yamazaki
Publications and source records attributed to J Yamazaki.
[Sudden death due to bilateral pulmonary thromboembolism in a patient with multiple myeloma: an autopsy case report].
We encountered a patient with multiple myeloma who died suddenly, in whom bilateral pulmonary artery thrombosis was found at autopsy. The patient was a 50-year-old woman who had received chemotherapy for multiple myeloma at a local clinic for 4 years, and was transferred to our hospital because of recurrence of multiple myeloma in August 1990. Despite chemotherapy performed after admission, serum globulin level increased and her low back pain worsened, and she was generally restricted to bed. On October 21, she developed sudden dyspnea, became markedly cyanotic, lost consciousness, and then suffered a cardiopulmonary arrest. Autopsy revealed bilateral pulmonary artery thrombosis as well as thrombosis in the pelvic veins. Hyperviscosity due to multiple myeloma and long-term recumbency were the probable causes of pelvic venous thrombosis and subsequent pulmonary artery thrombosis. We report a rare case of bilateral pulmonary artery thrombosis which developed during the course of multiple myeloma and led to sudden death.
Death, Sudden↗
[Evaluation of myocardial disorders in patients with dilated cardiomyopathy and left ventricular eccentric hypertrophy--by 201Tl myocardial SPECT].
201Tl myocardial SPECT was performed in cases of dilated cardiomyopathy and valvular heart disease with left ventricular eccentric hypertrophy, and the two groups were compared from the standpoint of the mechanism of onset of myocardial disorders. Significant coefficients of correlation were seen between the Tl score and LVDd (r = 0.792, r = 0.785) and Tl score and LVEF (r = -0.634, r = -0.555) in both dilated cardiomyopathy and valvular heart disease. In cases of valvular heart disease, significant correlation coefficients (r = -0.756, r = -0.720) between LVDd and r-WR (relative-washout rate), and Tl score and r-WR were observed, but no such correlation was seen in dilated cardiomyopathy. In valvular heart disease, a decrease in myocardial perfusion associated with enlargement of the left ventricle appeared, while in dilated cardiomyopathy, there was a marked decrease in LVEF in proportion to the thallium defect. Therefore, it was assumed that left ventricular wall disorders occur due to myocardial metabolic disorders and coronary microcirculation disorders.
Adult↗
Lateral elbow pain syndrome and entrapment of the radial nerve.
Lateral elbow pain syndrome is probably a fairly common condition and known to be resistant to conservative treatments. It is suggested that this syndrome is caused by entrapment of the radial nerve. Thirty patients with lateral elbow pain syndrome, in which entrapment of the radial nerve was diagnosed, have been operated upon to release the radial nerve at the elbow. There were 9 men and 21 women. Their age ranged from 17 to 64 with an average of 42.5. Twenty one of thirty nerves were entraped by the arcade of Frohse or other soft tissues. Nine nerves were adherent to the tissues overlying the radial head. Follow-up has been from six months to two years and eight months. Postoperative results were excellent in 16 patients, good in 11, fair in two and poor in one. These results would indicate that entrapment of the radial nerve at the elbow is considered as a cause of lateral elbow pain syndrome.
Adolescent↗
Multi-center study of seasonal affective disorders in Japan. A preliminary report.
A multi-center study on seasonal affective disorder (SAD) was conducted from the autumn of 1988 to the spring of 1989 with the cooperation of 16 facilities in Japan. Forty-six SAD patients were identified among 1104 respondents to our advertisements in mass media, or patients seen at the outpatient clinics. Essentially similar findings to other previous reports were obtained in terms of onset age of the first episode, duration of episode, high proportion of depression in first-degree relatives and atypical vegetative symptoms. However, a nearly equal sex ratio, together with a high proportion of unipolar depression, is characteristic of the present study. Increased appetite and carbohydrate craving were predominant only in female patients, whereas hypersomnia was prominent in both sexes. Effective response to light therapy was found in 17 SAD patients. However, a controlled study on a large number of patients is required to allow final conclusions on the efficacy of light therapy in Japanese SAD patients.
Adolescent↗
Atypical depressive symptoms possibly predict responsiveness to phototherapy in seasonal affective disorder.
Phototherapy was administered to 24 depressed patients with seasonal affective disorder (SAD), of which 62%, 24%, and 14%, respectively, showed improvements of greater than or equal to 50%, 25-50%, and less than 25% based on the Hamilton rating scale for depression for SAD (HAMSAD). No patients showed aggravation or side effects. Although the improvement rate in HAMSAD correlated significantly with the pretreatment severity of atypical symptoms of depression, it did not correlate with that of typical symptoms. This suggests that phototherapy is a useful treatment in SAD and that responsiveness to phototherapy in SAD can possibly be predicted by the atypical depressive symptoms before treatment.
Adolescent↗
The effects of vitamin B12 on the suppression of melatonin secretion under illumination.
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Adult↗
[Left ventricular wall damage as an indicator for valve replacement in patients with volume overload: a radionuclide study].
Using Tl-201 myocardial single photon emission computed tomography (SPECT), we tried to utilize the Tl-defects to determine the timing for aortic or mitral valve replacement in cases with chronic aortic (AR) or mitral regurgitation (MR), or both. Examinations including echocardiography and angiography were performed to evaluate left ventricular dilatation. Subjects consisted of 80 patients, including 22 with AR, 26 with MR, 17 with AR+MR, and 15 post-operative cases. The Tl-scores (sum of the grade of Tl-defects) correlated well with T wave abnormalities (V5) and NYHA functional class. The scores also correlated with left ventricular end-diastolic dimension (LVDd) and LV ejection fraction (LVEF), indicating that the LV wall defect progressed as the LV dimension increased with the increase in the volume load. Exercise Tl-201 myocardial SPECT revealed redistribution at an early stage of valvular regurgitation, indicating the development of LV wall damage in cases of LV enlargement due to regurgitation. Valve replacement caused a decrease in LVDd, with mild improvement in the Tl-score. We concluded that, in addition to the T wave changes and the echocardiographic measurements, Tl-201 myocardial SPECT should be included in the criteria for valve replacement.
Aortic Valve Insufficiency↗
NG-monomethyl-L-arginine-induced pressor response at developmental and established stages in spontaneously hypertensive rats.
The effect of nitric oxide (NO) pathway inhibitor, NG-monomethyl-L- arginine (L-NMMA), on arterial blood pressure was examined in spontaneously hypertensive rats (SHRs) and normotensive Wistar-Kyoto rats (WKYs) to investigate whether the vasodilating effect of basal levels of NO, one of the endothelium-derived relaxing factors, is preserved during the development of hypertension. L-NMMA (1-100 mg/kg i.v.) produced dose-dependent increase in arterial pressure and bradycardia in anesthetized and conscious SHRs and WKYs. L-Arginine, a precursor of NO, inhibited the pressor response to L-NMMA. The L-NMMA-induced increases in arterial pressure in both 5- to 6- and 12- to 13-week (wk)-old anesthetized SHRs were similar to those of age-matched WKY controls; rather, the increase was significantly larger in 53- to 54-wk-old SHRs than in the age-matched WKYs. In conscious SHRs (13-14 wk-old), L-NMMA induced larger hypertensive effect than in the age-matched WKYs. The amplitude of acetylcholine (ACh)-induced hypotension was somewhat larger in 5- to 6- and 12- to 13-wk-old anesthetized SHRs compared with the age-matched WKY controls. The duration of the hypotension in 5- to 6- and 12- to 13-wk-old anesthetized SHRs was similar to the age-matched WKY controls. L-NMMA significantly reduced the duration of the ACh-induced hypotension; an effect which was recovered by L-arginine. However, L-NMMA did not decrease the amplitude of the hypotension.(ABSTRACT TRUNCATED AT 250 WORDS)
Acetylcholine↗
[Evaluation of myocardial blood flow and cardiac functional change in acromegaly].
We studied 201Tl myocardial scintigraphy and 99mTc-HSA gated blood pool scan to evaluate the influence of growth hormone on myocardial blood flow and hemodynamics in 16 patients with acromegalies. Contraction properties were almost within normal limit, but cardiac output was in high output state, because left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF) and cardiac output were 47.8 +/- 17.1%, 37.3 +/- 14.9%, and 6.4 +/- 1.7 L/min, respectively. Otherwise, 201Tl myocardial images revealed 62.5% no redistributed hypoperfusion, 18.8% redistributed hypoperfusion, 56.3% myocardial hypertrophy and 25.0% left ventricular enlargement. These data suggested the high incidence of acromegalic cardiomyopathy due to primary or secondary growth hormone effect.
Acromegaly↗
Evaluation of viral myocarditis in children by radionuclide method.
Evaluation of viral myocarditis is essential for the clinician to assess the prognosis. In this study, Tl-201 myocardial scintigraphy and Tc-99m gated cardiac blood pool scan were performed in 16 patients with myocarditis diagnosed by clinical symptoms and laboratory findings and these nuclear medicine techniques were followed up for 5 years. Exercise Tl-201 scintigraphy using a bicycle ergometer was performed in 8 patients by SPECT imaging. There were mild to severe persistent defects found in all cases (100%), but pressure rate products showed normal response. The Tl-201 defect ratio improved gradually, but did not change significantly. In the resting Tl-201 image one of 16 patients showed severe multifocal defects. LVEF increased significantly from 1 year to 5 years after onset, while RVEF measured by gated blood pool scans showed slight increases 3 years to 5 years after diagnosis. It was concluded that myocardial perfusion improved only incompletely. Cardiac function (LVEF and RVEF) improved gradually, and pressure rate products were normal. Myocarditis should therefore be followed up in order to assess the prognosis; moreover, the relationship of myocarditis to dilated cardiomyopathy needs to be further studied.
Child↗
[Evaluation of thrombus scintigraphy using 67Ga-deferoxamine-dialdehydestarch-fibrinogen in patients with internal A-V shunt].
We evaluated the diagnosis of thrombus and the effect of antithrombic therapy by using 67Ga-DFO-DAS-Fibrinogen (67Ga-Fbg.) scintigraphy in vivo. The 11 patients with chronic renal failure had the operation of the internal A-V shunt. The two groups were divided the group I (the patients were injected 67Ga-Fbg. within 5 days after the operation of A-V shunt) from the group II (the patients were injected 67Ga-Fbg. from 7 months to 6 years after A-V shunt). We examined 72 h after the injection of 67Ga-Fbg. in all patients. In group I, the scintigraphy showed the deposition of 67Ga-Fbg. in all 5 patients, but 3 patients were given dipyridamole (75-300 mg). The scintigraphy examined 3 weeks after A-V shunt were negative in 2 patients in group I. In group II, the scintigraphy showed the deposition of 67Ga-Fbg. in the two of 6 patients. Within 5 day after A-V shunt, we observed there was the tendency of the thrombus formation. The scintigraphy of 67Ga-Fbg. was useful for the detection of thrombus in vivo.
Adolescent↗
Replantation of the distal part of the leg.
We successfully replanted five amputated legs in five patients and followed the patients for two years or more (average, six years and three months). Although some patients found it impossible to squat and to run because of joint contractures, muscle weakness, or deformities of the foot, all patients could perform other activities without difficulty. None had important pain or any intolerance to cold, and all were satisfied with the results of the replantation.
Adult↗
[A case of cardiac amyloidosis showing the ischemic change by exercise Tl-201 myocardial scintigraphy].
A case of cardiac amyloidosis, which was recognized as an ischemic change by exercise Tl-201 myocardial scintigraphy, was studied. The case was 41 year-old woman, whose initial symptom was pretibial edema and died of ventricular fibrillation. Ischemic change was ascertained by the treadmill exercise test and exercise Tl-201 myocardial scintigraphy, however, the significant coronary stenotic lesion was not detected by coronary angiography. Our data suggested that ischemic change may be related with the disturbance of microcirculation caused by deposit of amyloid in the vessels and/or around the vessels from the pathological findings.
Adult↗
[A case of cardiac ischemic lesion detected by a new myocardial perfusion imaging agent SQ30217].
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Adult↗
Macrolide compounds, ivermectin and milbemycin D, stimulate chloride channels sensitive to GABAergic drugs in cultured chick spinal neurons.
1. The effects of ivermectin (IVM) and milbemycin D (MMD) on cultured embryonic spinal neurons were investigated, using the whole-cell recording technique. 2. IVM and MMD caused Cl- current under voltage-clamp conditions. 3. The reversal potential of the MMD-evoked Cl- current was shifted in a positive direction when half of the external Cl- was substituted by isethionate. 4. The MMD-evoked current was inhibited by picrotoxinin and bicuculline, whereas it was enhanced by diazepam. 5. Different characteristics of desensitization were observed between the MMD- (IVM-) and muscimol-induced effects. 6. These results suggest that IVM and MMD directly activate the Cl- channel through their specific sites modulated by GABAergic drugs.
Animals↗
[A case of Weber-Christian disease with elevated angiotensin-converting enzyme (ACE) activity and myopathy].
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Adult↗
Release and action of epidermal growth factor on gastric secretion in humans.
Epidermal growth factor (EGF) has recently been localized in salivary, pancreatic, and Brunner's glands in humans, but little is known about its release and its action on gastric secretion. This study, performed on healthy subjects, was designed to determine the release of immunoreactive EGF in plasma and in salivary and gastric secretions under basal conditions and after modified sham feeding (MSF), ordinary feeding, and infusion of pentagastrin without and with addition of exogenous recombinant human EGF (hEGF). Under basal conditions the EGF concentrations in plasma and salivary and gastric secretions were 52 +/- 8 pg/ml, 2.5 +/- 0.3 ng/ml, and 0.12 +/- 0.03 ng/ml, respectively. MSF and ordinary feeding increased significantly EGF plasma level and salivary output but not gastric EGF output, and atropinization failed to effect these plasma and salivary EGF responses to MSF. Intravenous infusion of pentagastrin increased both plasma and salivary but not gastric EGF, and addition of exogenous hEGF in graded doses (0.25-1.0 micrograms/kg) resulted in a dose-dependent increase in the plasma level of EGF and in significant inhibition of gastric acid and pepsin outputs. The increment in plasma EGF, which resulted in significant inhibition of gastric secretion, was several times greater than that observed after MSF or feeding. EGF infused in a constant dose (0.12 or 1.0 micrograms/kg-h) resulted in an increment in plasma EGF similar to that observed after MSF alone.
Adult↗