Biomedical subjects

N Hanyu

Publications and source records attributed to N Hanyu.

At least 19 recordsLinked to original sources

PubMed1995

An index to predict outcome of surgery for reflux esophagitis based on the AFP classification.

Fifteen patients with reflux esophagitis were treated surgically from July 1990 to April 1994. We evaluated these patients using the anatomic-functional-pathologic (AFP) classification both prior to and following the operation. An objective index for surgical outcome was devised. By using the grades Ai, Fj, and Pk, the i2 + j2 + k2 score was determined. The scores ranged from 3 to 22 (mean 9.1 +/- 5.4) prior to the operation. Postoperatively, 12 (80%) of 15 patients showed a complete recovery with a numerical score of 0, and their symptoms also disappeared. The scores of these 12 patients prior to the operation ranged between 3 and 11. However, the other 3 patients did not exhibit a complete recovery. Their scores prior to the operation ranged between 17 and 22, and the symptoms in 2 of these 3 patients persisted following the operation. These results suggest that surgical treatment for reflux esophagitis can be expected to be successful if the preoperative AFP score is less than 11.

Adult↗

PubMed1995

Auditory brain-stem responses and MRI findings in patients with olivo-ponto-cerebellar (Dejerine-Thomas)-type and cerebello-olivary (Holmes)-type spino-cerebellar degeneration.

Auditory brain-stem responses (ABRs) and magnetic resonance imaging (MRI) findings were investigated in 10 patients with olivo-ponto-cerebellar atrophy (OPCA: Dejerine-Thomas type) and in 5 patients with Holmes-type cerebello-olivary degeneration. In patients with OPCA, (1) the III-V interpeak latency (IPL) was shortened significantly (P < 0.05) as compared with normal subjects when the decrease in longitudinal distance of the pons was within 20% of that of normal controls, (2) the I-III IPL was elongated (P < 0.05), the III-V IPL was shortened (P < 0.01), and the amplitude of the V wave was reduced (P < 0.05) when the decrease in longitudinal distance of the pons was more than 20% of that of normal controls. Patients with Holmes-type degeneration showed no significant difference in any component of ABRs or in the size of any part of the brain-stem, as compared with normal subjects. We conclude that abnormalities in the I-III IPL or the III-V IPL in patients with OPCA were produced by changes in the volume conduction in the pons and midbrain. This study also suggests that differences of IPL appear between OPCA and Holmes-type degeneration.

Acoustic Stimulation↗

PubMed1995

[Comparative study of the efficacy of plasma exchange, immunoadsorption plasmapheresis and corticosteroid administration in the treatment of Guillain-Barré syndrome].

We have retrospectively compared the efficacy of plasma exchange (PE), immunoadsorption plasmapheresis therapy (IAPP), corticosteroid administration and no treatment in the treatment of the Guillain-Barré Syndrome (GBS). Forty-two patients with GBS and clinical functional grades of more than Hughes 3 were admitted to Shinshu University Hospital, Nagano Red-cross Hospital and Saku General Hospital between 1978 and 1994. These patients were treated with either PE, IAPP, corticosteroids or no therapy. Eight were treated with PE, eleven with IAPP, twelve with corticosteroids and eleven were untreated. None of the patients were received combined therapy. The four groups of patients were compared on the following points; duration of the deteliocation in symptoms, duration of the worst symptoms, period of the ability to walk after onset, minimum motor nerve conduction velocity (MCV) over the course, maximum cerebrospinal fluid (CSF) protein concentration over the course, and CSF protein concentration improvement 6 weeks after onset as compared with 2 weeks after onset. The results revealed that the duration of the worst symptoms was shortened more in the IAPP-treated and PE-treated groups than in the other groups. Decreases in CSF protein concentration were more significant in the IAPP-treated and PE-treated groups than in the other groups. There were no significant differences in the other parameters among the groups. Furthermore the clinical symptoms of GBS improved more rapidly with PE and IAPP than with supportive care alone or corticosteroid therapy, especially in the early phase of the disease. IAPP and PE are equally effective.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1994

Hemiballism with striatal hyperintensity on T1-weighted MRI in diabetic patients: a unique syndrome.

We report 3 diabetic patients who developed hemiballism without involvement of the subthalamic nucleus. Each patient exhibited vigorous, flinging, ballistic involuntary movements in the extremities and slight facial grimacing involving one side of the body. Although diabetes was poorly controlled in all 3, each patient was nonketotic at the onset of hemiballism. Magnetic resonance imaging (MRI), in these patients showed abnormalities in the striatum contralateral to the hemiballism that were characterized by an increase in intensity on T1-weighted images and a slight decrease in intensity on T2-weighted images, and these changes persisted for more than 2 months. The striatal lesions are presumed to have developed following mild ischemia in the territory of the lateral striate branches of the middle cerebral artery. This combination of hemiballism and striatal lesions in diabetic patients may constitute a unique syndrome.

Aged↗

PubMed1994

Efficacy of steroid therapy on liver metastasis of thymic carcinoid.

We present a 61-year-old man who was hospitalized because of dyspnea, abdominal pain and liver dysfunction accompanied by ascites due to hepatic metastasis of a thymic carcinoid 20 years after the primary tumor was excised. His symptoms and liver function were well controlled by prednisolone, 30 to 60 mg daily, for the next 2 years, with a reduction in the size of the hepatic tumors and in the accumulation of ascites. He subsequently contracted pneumonia due to methicillin-resistant staphylococci, developed disseminated intravascular coagulation (DIC) and died. Thus, prednisolone should be considered for treating patients with metastasis of a thymic carcinoid.

Carcinoid Tumor↗

PubMed1994

[An approach to home therapy for cancer pain patients].

Recently, in consideration of cost performance and improvement in quality of life (QOL) of the patient, the significance of home care and outpatient treatment has also been recognized in Japan. A terminal cancer patient who had local recurrence in the pelvic region after surgery for rectum carcinoma, was treated for cancer pain by us with a continuous epidural infusion of morphine by means of a prolonged operating continuous infusion device. The treatment made home therapy possible and allowed the patient to return to normal social activities. Based on this case, the significance of and issues regarding home therapy are discussed in this study.

Costs and Cost Analysis↗

PubMed1993

[Effects of various histamine H2-receptor antagonists on gastrointestinal motility and gastric emptying].

Effects of various histamine H2-receptor antagonists (H2-RA) on gastrointestinal motility and gastric emptying were investigated. Ranitidine, nizatidine and cimetidine dose dependently induced contractions over the entire gastrointestinal tract, and the order of their effects was ranitidine > nizatidine > cimetidine. Roxatidine or famotidine had no effects on motility of the gastrointestinal tract. Ranitidine and nizatidine also induced contractions during the postprandial period and facilitated gastric emptying, while cimetidine, roxatidine or famotidine did not influence gastric emptying. Since acid reduction is thought to be the most important element of the treatment of peptic ulcer and reflux esophagitis, it was inferred that administration of a H2-RA selected with consideration of its property of facilitating gastrointestinal motility is effective in the treatment of patients with abnormal gastrointestinal motility.

Animals↗

PubMed1993

Event-related potentials, reaction time, and cognitive state in patients with Parkinson's disease.

ERPs, RT, and cognitive state in 53 patients with PD were studied. The peak latency of P300 and the RT in PD patients were significantly prolonged in the advanced stage of illness. The cognitive state in PD patients was characterized by impairment of attention, recent memory, and constructional ability in categories of the Folstein Mini-Mental State Examination. The significant association between neurophysiological and neuropsychological measurements suggests that these measurements reflect a disrupted aspect of cognitive function in PD patients.

Aged↗

PubMed1992

Characterization of a transthyretin-related amyloid fibril protein from cerebral amyloid angiopathy in type I familial amyloid polyneuropathy.

Recently, it has been reported that transthyretin (TTR)-immunoreactive amyloid deposition with cerebral amyloid angiopathy in central nervous system is a common pathological finding in type I familial amyloid polyneuropathy (FAP). In the present study, we performed isolation and sequence analysis of TTR-related amyloid fibril protein from the meninges of a patient with type I FAP. Purified major amyloid fibril protein had a molecular weight of 15 kDa. Complete sequence analysis revealed that this amyloid fibril protein was a variant TTR with a single amino acid substitution of methionine for valine at position 30. This variant TTR is a previously unrecognized as cerebrovascular amyloid fibril protein. Furthermore, the patients with type I FAP are well known to have the variant TTR in the serum. These suggest that cerebrovascular amyloid fibril protein in type I FAP may derive from a serum precursor.

Amino Acid Sequence↗

PubMed1992

Serial computed tomographic and electroencephalographic studies in Creutzfeldt-Jakob disease.

The serial changes in computed tomography (CT) as correlated with the clinical and electroencephalographic findings were evaluated in 3 patients with Creutzfeldt-Jakob disease. The disease was subsequently confirmed histologically in 2. CT revealed that brain atrophy began in an early clinical stage and was prominent even before the state of akinetic mutism. Periodic synchronous discharges (PSDs) were observed either before or simultaneous with the observation of myoclonus. With progressive brain atrophy, the frequency of PSDs and the degree of myoclonus both decreased and disappeared 8 to 15 months after the onset of disease.

Aged↗

PubMed1992

Leukoencephalopathy induced by tegafur: serial studies of somatosensory evoked potentials and cerebrospinal fluid.

A case of leukoencephalopathy induced by tegafur, an antineoplastic derivative of 5-FU, is reported. The patient received 600 mg of tegafur p.o. for 16 days before excision of rectal cancer. After the operation, gait disturbance and mental abnormalities appeared. He became akinetic and mute within a few days following readministration of tegafur. Serial studies of brain CT, somatosensory evoked potentials (SEP) were made, and myelin basic proteins (MBP) in the cerebrospinal fluid were measured. The level of MBP was about twice the normal value and the central conduction time (CCT) of SEP was prolonged at admission. The value of MBP and CCT improved with recovery from akinetic mutism.

Akinetic Mutism↗

PubMed1991

Effect of two new cholecystokinin antagonists on gallbladder emptying in opossums.

In this investigation we evaluated the effect of two new cholecystokinin (CCK) antagonists, CR 1409 and L364,718, on gallbladder emptying in the opossum. Gallbladder emptying was elicited by both exogenous and endogenous CCK. The three test challenges were 1) intravenous infusion of CCK octapeptide (OP) (10 ng.kg-1.min-1), 2) feeding, and 3) intraduodenal infusion of Isocal (0.4 ml/min), a fat-containing nutrient. During control conditions each test challenge elicited approximately 60% gallbladder emptying within 30 min and 70% emptying by 60 min. At given doses both CR 1409 and L364,718 substantially antagonized or abolished the gallbladder emptying elicited by each of the test challenges. The antagonism for postprandial gallbladder emptying was diminished between 30 and 50 min compared with that for CCK-OP infusion and intraduodenal infusion of Isocal. Unexpectedly, the gallbladder emptying induced by infusion of motilin (5 micrograms.kg-1.h-1) was antagonized by either CR 1409 or L364,718. In anesthetized animals, gallbladder contraction was induced by a variety of agonists, such as bethanechol, histamine phosphate, 5-hydroxytryptamine, and phenylephrine. In this later model CR 1409 and L364,718 functioned solely as selective antagonists. We conclude that for the opossum gallbladder 1) the CCK antagonists CR 1409 and L364,718 antagonize or abolish gallbladder emptying induced by exogenous or endogenous CCK; 2) the pattern of CCK antagonism after feeding suggests that the early phase of postprandial gallbladder emptying is mediated by a mechanism other than endogenous CCK, whereas late postprandial emptying is mediated by release of endogenous CCK; and 3) CR 1409 and L364,718 are not totally specific antagonists for gallbladder CCK receptors alone but also antagonize gallbladder contraction induced by motilin.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1991

Muscular pseudohypertrophy in an adult case with centronuclear myopathy.

We describe a 40-year-old male case with centronuclear myopathy showing a unique clinical picture of generalized muscular pseudohypertrophy. CT scan, ultrasound imaging and histopathological studies of muscles revealed that muscle enlargement in this case might be caused by marked intrafascicular fatty infiltration. It is suggested that muscular pseudohypertrophy may occur in adult centronuclear myopathy cases with a long clinical course and that CT and ultrasound scans are very useful for the evaluation of diseased muscles.

Adipose Tissue↗

PubMed1991

[Diagnosis of familial amyloid polyneuropathy--gene analysis with primer-directed enzymatic amplification of DNA, isolation of plasma variant prealbumin and immunohistochemical identification of tissue amyloid protein].

Type I familial amyloid polyneuropathy (FAP) is an autosomal dominant hereditary generalized amyloidosis characterized by polyneuropathy and autonomic nerve failure. The main component of the amyloid fibril protein in this disorder has been shown to be a variant prealbumin with a single substitution of a methionine residue for valine at position 30. In the present study we have investigated 19 patients with FAP aged 31 to 67 and an asymptomatic family member using gene analysis with primer-directed enzymatic amplification (PCR) of DNA, isolation of plasma variant prealbumin and immunohistochemical identification of tissue amyloid protein. All patients and a symptom-free boy in the affected family had the mutant prealbumin gene showing abnormal DNA fragments by treatment with restriction endonuclease Bal I, and plasma variant prealbumin was also detected in all of them by reverse-phase high performance liquid chromatography. Rectum biopsies obtained from 9 patients showed amyloid deposits which were specifically immunostained by anti-human prealbumin antiserum. However, an asymptomatic carrier at the age of 16 showed no rectal amyloid deposition. Recent studies of FAP have disclosed that the expression of type I FAP is closely associated with the gene mutation of prealbumin. Accordingly, a simple and rapid method to detect this gene abnormality using PCR technique is considered to be very useful for diagnosis of type I FAP and can also provide valuable information for the genetic counselling of the family members at risk.

Adolescent↗

PubMed1991

[Gallbladder function and CCK after gastrectomy].

Postgastrectomy cholelithiasis has become a problem and biliary tract dyskinesia has been cited as an etiologic factor. CCK is the most important gut hormone with respect to biliary tract function, so we conducted an experimental study of postgastrectomy gallbladder function and CCK levels which gave the following results: 1. Although postprandial gallbladder contraction for the most part occurred in response to endogenous CCK, another mechanism (the gastro-cholecystic reflex) seemed to be responsible for some of them. 2. The postgastrectomy decrease in postprandial gallbladder contraction appeared to be due to disappearance of this gastro-cholecystic reflex. 3. Gallbladder contraction occurred in association with postprandial CCK secretion following total gastrectomy and Roux-en-Y reconstruction, but the altered food passage route caused changes in the dynamics of CCK secretion, and this is believed to have had an influence on the gallbladder contractile response.

Animals↗

PubMed1990

Cholecystokinin-induced contraction of opossum sphincter of Oddi. Mechanism of action.

In this study, we evaluated the mechanism of action whereby cholecystokinin increases spike-burst rate of the opossum sphincter of Oddi (SO). Each spike burst corresponds to a peristaltic SO contraction. Two types of animal preparations were evaluated: (1) awake chronic animal preparations and (2) anesthetized animals. A total of 19 chronic animals were prepared by implantation of electrodes on the SO, gastric antrum, duodenum, and jejunum. SO spike-burst rate was stimulated by intravenous infusion of CCK-OP (10 ng/kg/min), feeding, or intraduodenal infusion of fat-containing nutrient. Each stimulus was begun 20 min after cessation of phase III duodenal MMC activity and caused an increase in SO spike-burst rate from about 2 to 6/min that lasted for less than or equal to 1 hr. Such increases were antagonized substantially by hexamethonium, atropine, or methysergide. The CCK antagonist, L364718, antagonized the excitatory SO response to CCK-OP infusion or intraduodenal infusion of fat-containing nutrient (Isocal) but did not antagonize the response to feeding; CR1409 had no antagonistic effect on SO response to any of the three types of stimuli. In the acute studies in anesthetized animals, an intravenous bolus dose of CCK-OP (800 ng/kg) caused a substantial increase in SO spike-burst rate that was antagonized by CR1409 but not by atropine, hexamethonium, methysergide, L364718, or TTX.(ABSTRACT TRUNCATED AT 250 WORDS)

Ampulla of Vater↗

PubMed1990

Mechanism of cholecystokinin-induced contraction of the opossum gallbladder.

The present study evaluated the mechanism of cholecystokinin-induced gallbladder contraction in awake opossums. Each of 19 chronic animal preparations had an indwelling gallbladder cannula for monitoring changes in gallbladder volume and a jugular catheter for administration of cholecystokinin octapeptide and drugs. An intraduodenal catheter allowed intraduodenal infusion of Isocal (Mead Johnson Laboratories, Evansville, Ind.). Bipolar electrodes in the stomach, duodenum, and jejunum enabled monitoring of the duodenal migratory myoelectric complex cycle. One-hour infusions of cholecystokinin octapeptide (10 ng/kg/min), intraduodenal Isocal (0.4 ml/min), or feeding were started 20 min after cessation of phase 3 duodenal migratory myoelectric complex activity. Bolus intravenous doses of potential pharmacological antagonists were given 10 min before and 20 min after the onset of cholecystokinin octapeptide infusion, Isocal infusion, or feeding. Each test challenge induced about 60% gallbladder emptying at 30 min and 70% at 60 min. Cholecystokinin octapeptide-induced gallbladder emptying was converted to filling by hexamethonium and nearly abolished by atropine. Similar results were obtained for gallbladder emptying induced by feeding or duodenal infusion of Isocal. Phentolamine caused a modest decrease of cholecystokinin octapeptide-induced gallbladder contraction at 30 min, whereas postprandial or Isocal-induced gallbladder contraction was unaffected. Cholecystokinin octapeptide-induced gallbladder contraction was not affected by pirenzepine, 4-diphenylacetoxy-N-methylpiperidine methiodide, prazosin, pyrilamine, cimetidine, methysergide, naloxone, or propranolol. In acute studies of anesthetized animals, gallbladder contraction induced by a D100 intravenous bolus of cholecystokinin octapeptide (800 ng/kg) was not antagonized by hexamethonium, atropine, or tetrodotoxin. It is concluded (a) that cholecystokinin-induced physiologic contraction of the opossum gallbladder occurs through neural mechanisms rather than by a direct action of cholecystokinin on gallbladder smooth muscle, and (b) that studies using pharmacologic bolus doses of cholecystokinin octapeptide and tetrodotoxin indicate that cholecystokinin receptors exist on the gallbladder smooth muscle which do not seem to have any physiological role in gallbladder emptying.

Animals↗

PubMed1990

[Clinical and pathological studies on two patients with adult-onset nemaline myopathy].

Clinical and pathological findings of two patients, a 44-year-old male and a 54-year-old female, with adult-onset nemaline myopathy were described. Both patients showed normal motor development through their childhood; Patient 1 ran fast and was involved in powerful heavy labor until the age of 40, and Patient 2 was in good health until 49, when they began to have progressive muscle weakness. They had no family history of neuromuscular diseases. On neurological examination, they had moderate muscle weakness and atrophy in their limb-girdle and paravertebral muscles. Because paravertebral and neck muscles were preferentially involved, they had difficulty in holding the head straight up. They stood in a lordotic posture. They had neither high-arched palate nor facio-skeletal abnormalities which were common findings in congenital nemaline myopathy. Serum enzymes derived from muscle were normal and needle electromyography showed myogenic and neurogenic changes in both patients. On CT scan of the skeletal muscles, the paravertebral muscles were markedly decreased in density suggesting advanced fat tissue replacement in large areas. In patient 2 who was in more advanced stage, the quadriceps femoris, hamstrings and soleus muscles also showed the similar CT findings. Light microscopic examination of biopsied biceps brachii (Patient 1) and quadriceps femoris (Patient 2) demonstrated abundant rod-like structures in the majority of type 1 fibers. In both patients, there was a marked variation in fiber size. Type 1 fibers were atrophic and type 2C fibers increased in number.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗