Biomedical subjects

N Yuki

Publications and source records attributed to N Yuki.

292 records · Page 17Linked to original sources

PubMedDate not supplied

Manifestations of temporary symptoms during endoscopic variceal sclerotherapy using thrombin as a sclerosant.

We performed 93 sclerotherapy sessions on liver cirrhosis patients with recurrent variceal bleedings. In each session, hypertonic glucose, thrombin and 1% polidocanol were consecutively injected into the varices, and changes in the hemostatic system were examined in relation to the symptoms observed during the treatment. Patients underwent sclerotherapy with no complaints in 62 (67%) sessions, and complained of slight symptoms of general fatigue and headache in 19 (20%). In the other 12 (13%) sessions, the procedure was discontinued due to marked manifestations of these symptoms. All symptoms were temporary and disappeared completely after the procedure. These temporary symptoms were closely related to changes in coagulation tests similar to those of disseminated intravascular coagulation, which were observed just after the treatment. Possible activation of the renal kallikrein-kinin system following injection sclerotherapy was also demonstrated.

Endoscopy↗

PubMedDate not supplied

[The number of plasma exchanges in Guillain-Barré syndrome: evaluation by the removal rate of immunoglobulin G].

The optimal number of plasma exchanges in Guillain-Barré syndrome had not been established. Recently, a clinical trial by the French Cooperative Group showed that 2 exchanges were sufficient for mild case of Guillain-Barré syndrome, but all others 4 exchanges were optimal. The supplementary examination is needed to validate the conclusion, but a certain period should be taken. As the second best way to determine the appropriate number of plasma exchanges, we simply examined the reduction rate of IgG on each session. Wilcoxon signed-ranks test showed that removal rates of IgG differed between the first and second sessions, and between the second and third sessions. At least, 2 exchanges seemed to be needed for Guillain-Barré syndrome. Our results confirmed that IgG is the most relevant factor in the pathogenesis of the syndrome.

Adult↗

PubMedDate not supplied

[Anti-GD1b IgG antibody-related Guillain-Barré syndrome initially mimicking brainstem infarction].

We described a 58-year-old woman with Guillain-Barré syndrome, who initially showed rapid progression of brainstem infarction-like signs. She developed superficial sensory disturbance on the left side, dysarthria, and left-predominant limb weakness within a few hours. She showed bilateral extensor plantar responses and head CT scan detected no abnormality. It was difficult to be distinguished from brainstem infarction until symmetrical limb weakness and generalized areflexia appeared. Serum anti-GD1b IgG antibody with cross-reactivity with GM1b was detected. Cerebrospinal fluid examination revealed albuminocytologic dissociation on day 5. After 5 sessions of immunoadsorption therapy, her symptoms gradually lessened. Anti-GD1b antibody has been detected in patients with sensory ataxic neuropathy. Our patient, however, was characterized with early involvement of brainstem with ataxia of cerebellar type. Our case suggests that anti-GD1b antibody-associated neuropathy has a broad spectrum of clinical features, which are related to cross-reactivity of this antibody.

Brain Stem Infarctions↗

PubMedDate not supplied

Abducens nerve enhancement in acute ophthalmoparesis.

Acute ophthalmoparesis (AO) is a monophasic disease characterized by acute onset of paresis of the extraocular muscles without ataxia or areflexia. Here we report a case of AO with gadolinium enhancement in the cisternal portion of the abducens nerves using contrast-enhanced three-dimensional magnetic resonance imaging.

Abducens Nerve↗