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Biomedical subjects

M Kuniyoshi

Publications and source records attributed to M Kuniyoshi.

At least 19 recordsLinked to original sources
PubMed1999

[A patient with intractable myasthenia gravis successfully treated with total lymphoid irradiation].

We report a 20-year-old man with intractable myasthenia gravis successfully treated with total lymphoid irradiation (TLI). An encapsulated thymoma in the anterior mediastinum was resected as extended thymectomy by video-assisted thoracoscopic surgery at 2 months after the onset of ptosis and muscle weakness. Following treatments, such as ambenonium hydrochloride, an immunosuppression therapy (prednisolone and azatioprine), 5 courses of immunoadsorption therapy, and a high dose of cyclophosphamide and methylprednisolone, did not make persistent improvement of myasthenic symptoms. Ageusia occurred twice prior to myasthenic crises and subsided with other myasthenic symptoms after treatments. Steroid psychosis and secondary Cushing's syndrome made us to reduce the dose of prednisolone. Post-operative residual, recurrent, or metastatic thymus was not unveiled, then we added the low dose fractionated irradiation (1.5 Gy x 12 = 18 Gy) to the mediastinum. Three months after the irradiation, however, a crisis occurred and the titer of anti-acetylcholine receptor antibody increased up to 100 nmol/l. Therefore, we performed TLI (Mantle; 1.5 Gy x 9 = 13.5 Gy, paraaortic and inverted-Y; 1.5 Gy x 14 = 21 Gy), which brought about persistent improvement of myasthenic symptoms with decrease in the titer of anti-acetylcholine receptor antibody.

Adult↗
PubMed1995

[Mass screening for osteoporosis in Nansei--the Nansei Study (the second report)].

We performed screening for osteoporosis for the early detection of a decrease in the bone mineral density. The subjects consisted of 852 inhabitants (308 males and 544 females) aged 40 years or more in Nansei (population, 12, 107) in Mie Prefecture. Interviews, measurement of height and body weight, blood examination, and determination of the bone mineral density by the MD method were performed. In addition, a questionnaire on diet was carried out. The bone mineral density was decreased in 76 subjects (8.9%), of whom females were the majority. Height and body weight were significantly lower in the group with decreased bone mineral density than in the group with normal bone mineral density. The serum calcium (Ca), alkaline phosphatase (ALP), and inorganic phosphorus (P) levels were similar in the two groups. Concerning the family profile, the percentage of subjects living alone was significantly higher (p < 0.05) in the group with decreased bone mineral density (13.5%) than in the group with normal bone mineral density (3.6%). Screening for osteoporosis is still in the trial stage and involves various problems that require further studies. As subjects for screening, females before, during, and immediately after menopause are important.

Adult↗
PubMed1994

Effectiveness of concomitant setiptiline maleate (Tecipul) on negative symptoms of schizophrenia.

1. Setiptiline maleate was administered to schizophrenic patients with the object of improving their negative symptoms. 2. Moderate improvements were observed in 58% of the treated patients, thus usefulness of this drug was demonstrated. 3. There was no aggravation of symptoms, and side effects were minor. 4. Measurements of plasma monoamine metabolites showed a tendency of MHPG to decrease and a significant decrease in 5-HIAA, but no change in the level of HVA was observed, suggesting a relationship between the negative symptoms and noradrenaline and/or serotonin systems.

Adult↗
PubMed1994

[Hilar type squamous cell carcinoma confined within the bronchial wall with hilar lymph node metastasis: a case report].

A 60-year-old male patient visited our hospital for evaluation of positive sputum cytology. A chest X-ray film revealed no abnormal shadows. Bronchofiberscopy showed a protruding lesion at the spur between left B8 and B9. Histological findings indicated squamous cell carcinoma. Left lower lobectomy with hilar and mediastinal lymph node dissection was performed. The tumor did not infiltrate beyond the bronchial cartilage on postoperative histologic examination. However, hilar lymph node (#12 l) metastasis was identified. Surgical resection with lymph node dissection is mandatory even in the hilar type lung cancer confined within the bronchial wall.

Bronchi↗
PubMed1993

Ectopic intrapulmonary thyroid.

An 83-year-old woman underwent resection of a pulmonary tumor. Histologic examination of the tumor demonstrated thyroid follicles without evidence of malignancy or teratomatous elements. Developmental anomaly may account for the ectopic intrapulmonary thyroid, which, to our knowledge, has not been reported in the literature.

Aged↗
PubMed1992

A case of tardive Tourette-like syndrome.

We have had experience in treating tardive Tourette-like syndrome on a chronic schizophrenic patient. The patient was a 38-year-old woman. A diagnosis of schizophrenia was made in 1971 and she received repeated medications for 17 years. In 1989, she began to show vocal tic with coprolalia and motor tic. The medications were haloperidol 18 mg, zotepine 200 mg, levomepromazine 100 mg, biperiden 3 mg and nitrazepam 10 mg at the beginning of Tourette-like syndrome. We have tried to change the medications but this tardive Tourette-like syndrome continued to hang on. However, the symptoms gradually improved after a change in drugs; cessation of biperiden 3 mg and the administration of clonazepam 3 mg. The present case suggested that tardive Tourette-like syndrome might be a subtype of neuroleptic-associated tardive syndromes which might be treated with clonazepam.

Adult↗
PubMed1991

Three cases of respiratory dyskinesia.

We present here three cases of respiratory dyskinesia (RD). RD was observed with a video recording and other recordings were made of a respiratory airflow with a thermistor, and abdominal movement with a strain gauge. Neurological findings and CT scanning indicated marked organic changes in the brain in these 3 cases. RD was complicated with tardive dyskinesia of the tongue and lips, and the symptoms were aggravated during stress and absent during sleeping, which are the characteristic features of extrapyramidal symptoms. The symptoms of the three cases have improved by decreasing the dose of butyrophenone derivatives and discontinuing anti-parkinsonian drugs, which suggested that an intracerebral imbalance of DA and ACh may be the cause of RD.

Acetylcholine↗
PubMed1989

Parkinsonism manifesting depression as the first sign.

We have had experience in treating two patients with parkinsonism of which the first manifestation was depression. Case 1 was a 61-year-old woman. A diagnosis of depression had been made and repeated medication consisting mainly of antidepressants was given. However, the depressive state persisted and the signs of parkinsonism gradually became evident. The initial treatment with antidepressant drugs was replaced with one based on L-DOPA (400 mg a day). Subsequently, the symptoms of parkinsonism and depression diminished relatively rapidly. Case 2 was a 66-year-old man. His parkinsonism was suspected shortly after the onset, although the symptoms of depression were predominant. Similarly, the treatment based on L-DOPA (400 mg a day) relieved the symptoms of depression and parkinsonism rapidly. The present study described above indicates that parkinsonism should be suspected in cases of persistent depression and in patients who have depressive symptoms resistant to antidepressants, since parkinsonism may first manifest itself as depression.

Aged↗
PubMed1989

Panic anxiety after abrupt discontinuation of mianserin.

We observed a case of withdrawal after abrupt discontinuation of mianserin. A 41-year-old woman was treated according to a diagnosis of depression, which was her 6th episode. Mianserin 30 mg/day, etizolam 1 mg/day and flunitrazepam 1 mg/day were administered. When the patient discontinued taking the drugs by herself because of subsiding of these symptoms, severe panic anxiety appeared. This panic anxiety was not relieved by taking etizolam and flunitrazepam again, but subsided rapidly by the re-administration of mianserin 30 mg/day, and because of that the depressive symptom also disappeared. From these experiences panic anxiety seemed to be a withdrawal symptom, and involvement of the noradrenergic system in panic anxiety as well as serotonergic system was suggested.

Adult↗
PubMed1987

Nondominant temporal lobe epilepsy with depressive reaction.

A 56-year-old woman was admitted to our hospital because of insomnia and psychomotor retardation. This is her second admission. She was diagnosed as having depression and began to receive antidepressants. Her conditions got better after the treatment but the depressive state occurred again after she stopped taking those drugs. As EEG showed some spike discharges at the nondominant temporal lobe area, she was given anticonvulsants this time. Her depressive state improved rapidly by taking anticonvulsants instead of the antidepressants. The spike discharges at the nondominant temporal lobe area disappeared when the clinical symptoms improved.

Depressive Disorder↗
PubMed1985

[Clinical experience with cefmenoxime (CMX) in complicated urinary tract infections].

Cefmenoxime (CMX) was intravenously administered to 106 patients with complicated urinary tract infection at a daily dose of 2-4 g for 5 days. An excellent response in overall clinical efficacy was seen in 15 cases (18.3%), a moderate response in 46 cases (56.1%) and poor response in 21 cases (25.6%). Pyuria was cleared in 20 cases (24.4%), decreased in 22 cases (26.8%) and unchanged in 40 cases (48.8%). Bacteriuria was eliminated in 41 cases (50.0%), decreased in 17 cases (20.7%), relapsed in 7 cases (8.5%) and unchanged in 17 cases (20.7%). Bacteriologically, 74 (76.8%) of the 95 strains isolated were eradicated by CMX, and 22 (23.2%) persisted. Side effects were observed in 3 (abdominal pain, diarrhea and elevation of trans amylase) of the 106 cases. Judging from the above results, CMX is considered to be a useful drug in the treatment of complicated urinary tract infections.

Adolescent↗
PubMed1984

Comparison of the effect of 3- and 5-day hypothermic perfusion of dog kidneys on metabolism of tissue slices.

Hypothermic perfusion effectively preserves the viability of kidneys for 3 days. Long-term preservation (5 days or greater) has not been consistently obtained. In this study, the differences between kidneys perfused for 3 and 5 days were compared by determining the "integrated-metabolic" capabilities of tissue slices incubated in vitro at 30 degrees C. The "integrated-metabolic" parameters determined include (1) respiration rates, (2) cell volume regulation [total tissue water (TTW) and saccharide permeable space], (3) rate of reaccumulation of K+ and pumping of Na+, (4) maintenance of ATP concentrations, and (5) mitochondrial functions. Conditions that result in high and low concentrations of ATP following perfusion of kidneys for 5 days were also compared for effects on tissue slice metabolism. The results indicate that energy metabolism in tissue slices is well preserved under all conditions and times of perfusion of kidneys. This includes average respiration rates (315 +/- 50, 275 +/- 35, and 255 +/- 45 mumol O2/hr/g dry wt at 0, 3, and 5 days, respectively, mitochondrial function [respiratory control ratio (RCR) = 4.6, 4.0, and 4.1 for 0, 3, and 5 days, respectively], and steady-state concentration of ATP in slices after incubation (4.0 +/- 1.45, 3.9 +/- 1.28, and 3.3 +/- 0.81 mumol/g/dry wt, for 0, 3, and 5 days, respectively). The primary differences between 3- and 5-day perfused kidneys were the capability of the slices to regulate cell volume and reaccumulate K+. Slices from kidneys perfused for 3 days maintained the TTW at 3.8 kg/kg dry wt, a value similar to that of control tissue slices. However, slices from 5-day perfused kidneys remained swollen (TTW = 4.6 kg/kg dry wt). Also, slices from the 5-day perfused kidney pumped K+ at less than one-half the rate found in slices from control or 3-day preserved kidneys. No significant differences were apparent in the permeability properties of the tissue slices from kidneys perfused for 3 and 5 days to radiolabeled saccharides. The defects in membrane-linked transport functions, resulting from long-term kidney perfusion, were reduced in kidneys containing a high concentration of ATP. The results suggest that one factor which may limit successful preservation of kidneys is the increased membrane permeability (to electrolytes) which is partially prevented by maintaining elevated concentrations of tissue ATP during perfusion.

Adenosine Triphosphate↗