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Biomedical subjects

S Kuroda

Publications and source records attributed to S Kuroda.

At least 361 records · Page 20Linked to original sources
PubMed1990

Infiltrating spinal angiolipoma causing myelopathy: case report.

We present a case of an infiltrating spinal angiolipoma demonstrating extension into the vertebral body and the spinal epidural space. The infiltration into the epidural space caused myelopathy. About 40 cases of spinal angiolipoma and angiomyolipoma have been reported; however, only a few cases have been the infiltrating type. The radiological findings were similar to those of vertebral hemangioma, but poor enhancement of the angiolipoma on contrast-enhanced computed tomographic scans differentiated between them. The infiltrating epidural tumor was removed, and the clinical symptoms improved remarkably. Total removal of the tumor and stabilization of the involved vertebral body using the anterolateral approach may be desirable when a diagnosis of angiolipoma or angiomyolipoma is confirmed preoperatively.

Aged↗
PubMed1990

A case of bulbospinal muscular atrophy with chief complaint of sensory disorder in the lower extremities.

A 56-year-old man was admitted to our department with a chief complaint of lower extremity dysesthesia. He described a dull numbness below the ankle and a dull pain in the nates for the past two years. Although the numbness extended to the thigh, he did not notice any muscular weakness or atrophy. Neurological examination revealed weakness and atrophy in the face, tongue and the proximal portions of all four extremities. Deep tendon reflexes were decreased. A moderate loss of vibratory sensation was noted below the knees. Electromyography showed neurogenic changes. Muscle biopsy revealed both myogenic and neurogenic changes. Sural nerve biopsy revealed a mild reduction of myelinated fibers, particularly the large-diameter fibers. Based on these findings, a diagnosis of bulbospinal muscular atrophy (BSMA) was made. In recent years, there have been some case reports of BSMA with sensory disturbances, or merely with subclinical manifestations of a sensory disturbance. This case is included in the same category as those reports, but it is interesting to note that the sensory disturbance in the lower extremities occurred as the chief complaint of the disease.

Humans↗
PubMed1990

Senile delirium with special reference to situational factors and recurrent delirium.

Factors initiating senile delirium were examined in 129 elderly inpatients (65 years or older). Sixty-eight patients were males and 61 females, with a mean age of 76.3 years. Delirium developed in most cases on the first two days of admission in the hospital, and the admission appeared to be a key factor precipitating delirium in about 30% of the patients. Delirium resolved or improved in 80% of the patients, but usually persisted in patients with dementia. Senile delirium tended to reappear repeatedly in patients whose episode of delirium lasted for more than 2 weeks, was associated with dementia, or had a prior history of delirium.

Aged↗
PubMed1990

Bunina bodies in dendrites of patients with amyotrophic lateral sclerosis.

We studied the brains of two cases of amyotrophic lateral sclerosis with dementia. Bunina bodies were found in the motor neurons of cranial nerve nuclei (trigeminal, facial and hypoglossal nerves) as well as in the spinal motoneurons. They appeared mostly in the cytoplasm and occasionally in the neuronal processes. However, the present electron microscopic study disclosed clearly that Bunina bodies were present not only in the cell body but also in the dendrites. No Bunina bodies were observed in the axons. It is inferred that the Bunina bodies were degenerative products formed as a result of a protein metabolism disorder.

Amyotrophic Lateral Sclerosis↗
PubMed1990

[Motor neuron disease with Parkinson's disease--case report].

The patient was a 64-year-old woman who showed muscle weakness and tremor of upper extremities and gait disturbance at the age of 62 years. The symptoms progressed and she was admitted to our hospital. Neurological examination revealed muscle weakness, muscle atrophy and fasciculation bilaterally in the upper extremities. The deep tendon reflexes were reduced in the upper extremities and increased in the lower extremities, but Babinski's sign was not present. There was mild hand tremor at rest (right greater than left). Muscle rigidity was also evident. Her gait was small-stepped and her trunk was bent forward. She showed hypomimia, but no dementia was detected. She died of respiratory failure 7 months after admission. The duration of the illness was about 2 years. At autopsy, macroscopic examination showed depigmentation of the substantia nigra and locus ceruleus, and atrophy of the anterior roots of the spinal cord. Microscopic examination revealed a few senile plaques in the temporal cortex. In the substantia nigra, the number of melanin-containing cells was decreased in its central parts. A few Lewy bodies were found in some of the remaining neurons, and melanin pigment migrated into the parenchyma. In the locus ceruleus and dorsal motor nucleus of vagus, abundant Lewy bodies and mild astrocytosis were seen. A few Lewy bodies were also seen in the nucleus raphe, nucleus basalis of Meynert and hypothalamic nuclei. Severe neuronal loss of the anterior horn cells was observed in the cervical segment, and to a lesser degree, in the lumbo-sacral segments. segments.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗
PubMed1990

[A case of malignant thymoma associated with Eaton-Lambert-type neuromuscular transmission block and sensorimotor neuropathy].

The patient is a 73-year-old male. In January 1988, he noticed sensory disturbance and muscular weakness of his extremities. His thymoma was found in July 1988, and in October 1988, he was admitted to our hospital for treatment. Neurological examination showed muscular weakness, muscular atrophy, fasciculation, and distal dominant sensory disturbance of his right upper extremity and his bilateral lower extremities. The immunological examination showed an increase in serum IgG, gamma-globulin, OKT3 and OKT4 lymphocytes. Electromyographic studies showed severe waxing by repeated stimulations (200% by 10 Hz; 330% by 20 Hz), very low M wave amplitude by single stimulation, and post-tetanic exhaustion. An Eaton-Lambert-type neuromuscular transmission block was thus thought to exist. Concentric needle electromyography showed a neurogenic pattern. The sensory and motor nerve conduction velocity was delayed. Microscopic examination of biopsied skeletal muscle showed neurogenic change. A sural nerve biopsy specimen showed a decrease in the number of myelinated fibers (fiber density 4333/mm2), segmental demyelination, remyelination, and mild axonal change. Thymectomy was performed and pathological examination showed invasive thymoma of predominantly the epithelial type. His muscular weakness and sensory disturbance improved gradually after thymectomy. On the postoperative immunological examination, serum IgG, gamma-globulin, OKT3 and OKT4 lymphocytes were normalized. On the other hand, OKT8 lymphocytes were increased and the OKT4 to OKT8 ratio was decreased. The electromyographic studies showed no waxing, normal M wave amplitude, and no post-tetanic exhaustion. Therefore, we consider that an Eaton-Lambert-type neuromuscular transmission block and sensorimotor neuropathy in this case were caused by the immunological abnormality accompanying malignant thymoma.

Aged↗
PubMed1990

[Complete occlusion of right middle cerebral artery by radiation therapy after removal of pituitary adenoma: case report].

Radiation angiopathy is a well-known complication accompanying irradiation. But the majority of effected vessels are small vessels. Cases of intracranial major arteries being effected are not so numerous. We report the case of a 47-year-old female patient. The removal of pituitary adenoma was carried out on her in 1982. After that, 4500rad irradiation was performed. It was about six years after irradiation that the first angiography was made. Right MCA occlusion, multiple stenosis of both ACAs and Moya-Moya like vessels were discovered. On admission light paresis on her left lower extremity was recognized and hyperlipidemia was noted. It was interesting that the multiple stenosis was found in an area outside the irradiation field. MCA-STA anastomosis was performed and the prognosis was good. The authors described this case and reviewed the pertinent literature.

Adenoma↗
PubMed1990

A multipurpose dye laser photocoagulation system.

We modified a single argon/dye laser photocoagulator by adding two optical fibers so that it could be used with a slit-lamp microscope, an operating microscope, and with an endophotocoagulation probe. One fiber is attached to a nearby slit-lamp microscope; the other extends approximately 70 m and can be connected to either an operating microscope or an endophotocoagulation probe. An electrically-operated mirror inside the machine controls which of the two fibers the laser beam passes through. Separate control boxes for each fiber permit direct regulation of the photocoagulation process in all situations.

Argon↗
PubMed1990

[Diagnosis of hemodynamic compromise in patients with chronic cerebral ischemia; the detection of impaired vasodilatory capacity with 133Xe SPECT and acetazolamide (Diamox) test].

To evaluate the efficacy of 133Xe SPECT and Diamox test, for selecting patients with hemodynamic compromise, tests using 133Xe inhalation method and single photon emission computed tomography (SPECT) with acetazolamide (Diamox) were performed in twenty-three patients with chronic cerebral ischemia, before and after extracranial-intracranial bypass surgery or carotid-endarterectomy. All patients complained of TIA, RIND, or minor completed stroke, and cerebral angiography of all patients demonstrated severe stenosis or occlusion in the ipsilateral internal carotid artery or middle cerebral artery. Cerebral blood flow (CBF) was also measured 15 minutes after intravenous administration of 10-12 mg/kg Diamox, which is known as a cerebral vasodilatory agent (Diamox test). Our results revealed that all patients could be divided into four types according to the findings of their resting rCBF and Diamox reactivity. The patients who had normal resting rCBF and normal Diamox reactivity (type 1) were considered to have well-developed collateral circulation and normal cerebral perfusion pressure (CPP) in spite of severe occlusive lesions in the carotid system. Moderate vasodilatation due to reduced CPP was considered to occur in patients who had normal resting rCBF and decreased Diamox reactivity (type 2). The resting rCBF remained unchanged, but Diamox reactivity improved to the normal range after surgery in the patients of type 2 (p less than 0.01), which indicated the improvement of CPP and the resolution of the autoregulatory vasodilatation. Maximum vasodilatation or dysautoregulation was considered to occur due to the inadequate collateral flow and the severely reduced CPP in patients whose findings revealed decrease in the resting rCBF and impaired Diamox reactivity (type 3).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetazolamide↗
PubMed1990

[Diagnosis of hemodynamic compromise in patients with chronic cerebral ischemia; measurement of cerebral blood volume (CBV) with 99mTc-RBC SPECT].

To evaluate the efficacy of tests for selecting patients with hemodynamic compromise, measurement of cerebral blood volume (CBV) with 99mTc-RBC single photon emission computed tomography (SPECT) was performed in thirteen patients with occlusive cerebrovascular disease, and was compared with results obtained by 133Xe SPECT and acetazolamide (Diamox) test. All patients in our study suffered TIA, RIND, or minor complete stroke. Cerebral angiography demonstrated severe stenosis or occlusion in the ipsilateral internal carotid artery or middle cerebral artery, although plain CT scan or MRI revealed no or, if any, only localized infarcted lesions. Regional cerebral blood volume (rCBV) was measured with 99mTc-RBC SPECT and regional cerebral blood flow (rCBF) was measured with 133Xe SPECT before and after intravenous injection of 10 - 12 mg/kg acetazolamide (Diamox). Our results suggest that the ipsilateral rCBV/rCBF (mean transit time) is a more sensitive index of the cerebral perfusion reserve than the use of only rCBV or rCBF of the ipsilateral hemisphere. Also, the ipsilateral rCBV/rCBF is significantly correlated (r = -0.72) with the Diamox reactivity of rCBF, which is considered to represent the cerebral vasodilatory capacity in patients with chronic cerebral ischemia. Postoperative SPECT study revealed remarkable improvement of ipsilateral rCBV/rCBF and Diamox reactivity in four patients who underwent EC/IC bypass surgery to improve the hemodynamic compromise. In conclusion, our results suggest that the measurement of rCBV/rCBF with 133Xe SPECT and 99mTc-RBC SPECT is useful for detecting the hemodynamic compromise in patients with occlusive cerebrovascular disease.

Acetazolamide↗
PubMed1989

Kinetic analysis of the binding of guanine nucleotides to bovine brain rhoB p20, a ras p21-like GTP-binding protein.

We have investigated the kinetics of the binding of guanine nucleotides to bovine brain rhoB p20, a ras p21-like GTP-binding protein with GTPase activity. The initial velocities of the binding of guanosine 5'-(3-O-thio)triphosphate (GTP gamma S) to GDP-bound rhoB p20 and the dissociation of GDP from this protein were markedly increased by decreasing Mg2+ concentrations. The initial velocity of the binding of GTP gamma S to GDP-free rhoB p20 was not affected by changing Mg2+ concentrations. These results indicate that the dissociation of GDP from rhoB p20 limits the binding of GTP to this protein, and suggest that there is a factor stimulating the dissociation of GDP from rhoB p20 and thereby stimulating the binding of GTP to this protein in mammalian tissues. Consistently, the factor stimulating the dissociation of GDP, but not of GTP gamma S, from rhoB p20 was detected in bovine brain cytosol.

Animals↗
PubMed1989

Kinetic analysis of the binding of guanine nucleotide to bovine brain smg p25A.

Bovine brain smg p25A, a guanine nucleotide-binding protein with a Mr of about 25,000, bound specifically GTP, guanosine 5'-(3-O-thio)triphosphate (GTP gamma S) and GDP. The initial velocities of the binding of GTP gamma S to GDP-bound smg p25A and the dissociation of GDP from this protein increased by decreasing Mg2+ concentrations or increasing NaCl concentrations. The initial velocity of the binding of GTP gamma S to GDP-free smg p25A was not affected by changing Mg2+ concentrations. These results indicate that the dissociation of GDP from smg p25A limits the binding of GTP to this protein, and suggest that there is a protein stimulating the dissociation of GDP from smg p25A and thereby stimulating the binding of GTP to this protein in mammalian tissues. In fact, the protein stimulating the dissociation of GDP, but not of GTP gamma S, from smg p25A was detected in bovine brain cytosol.

Animals↗
PubMed1989

Efficient expression of genetically engineered hepatitis B virus surface antigen P31 proteins in yeast.

We have constructed plasmids that express modified hepatitis B virus surface antigen (HBsAg) P31-coding genes (M-P31c, d, e, f, and i) having various genetically engineered pre-S2 regions. The plasmids contain the GAPDH (gene coding for glyceraldehyde-3-phosphate dehydrogenase) promoter and the PGK (gene coding for 3-phosphoglycerate kinase) terminator, both isolated from sake brewing yeast, Saccharomyces cerevisiae Kyokai III. Expression levels of the modified HBsAg P31 proteins in yeast are greatly increased from 0.4% to 11.7% of total cell protein. However, the specific mRNAs are expressed at equal levels and the degradation rates of the modified P31 proteins do not vary significantly. Therefore, we considered that different expression levels of the modified P31 proteins are attributed to the changes of the post-translational efficiency. And it was suggested that the conformational stability of the N-terminal peptide (Met-1-Phe-46) in the endoplasmic reticulum membrane determines the expression level of modified P31 proteins.

Amino Acid Sequence↗
PubMed1989

Mitochondrial encephalomyopathy (MELAS): pathological study and successful therapy with coenzyme Q10 and idebenone.

Two patients with mitochondrial myopathy, encephalopathy, lactic acidosis and strokelike episodes (MELAS) in one family are reported. Pathological examination of case 1 showed ragged-red fibers, with 7% of the fibers being unstained by cytochrome c oxidase stain, peripheral nerve damage, multiple areas of softening in the cerebrum and midbrain, and spongy changes in the cerebrum, optic nerve and pons. Electron microscopic examination revealed abnormal accumulations of mitochondria in the skeletal muscle, smooth muscle and cardiac muscle. The activity of cytochrome c oxidase in the brain and liver showed a tendency to decrease. In case 2 (maternal aunt of case 1), muscular weakness and peripheral nerve damage improved by treatment with coenzyme Q10. By adding idebenone to the coenzyme Q10 therapy, the EEG and Wechsler's Adult Intelligence Scale (WAIS) improved. Furthermore, in the cerebral spinal fluid (CSF), the protein, lactate, and pyruvate decreased, and the monoamines and monoamine metabolites increased.

Acidosis, Lactic↗
PubMed1989

Urban-rural difference in the acceptance of mass health examination in north-eastern Japan.

Over 40,000 residents (less than or equal to 40 years of age) in a city (Sendai; the city group), a town (Shiroishi; the town group) and two villages (Wakuya and Tajiri; the village group) in Miyagi prefecture in north-eastern Japan responded in a questionnaire survey on their attitude towards mass health examinations (i.e., whether they underwent in the previous year and if so where) on 4 items of blood pressure measurement, chest x-ray examination and screening tests for stomach and cervical cancer. The coverage rates were about 70% on an average both for blood pressure measurement and for chest x-ray examination, whereas the rates for cancer screening were between 30-40%. As for the opportunity of the former two examinations, the workplace mass examination played a large role in the case of the city and town groups (especially among men but not women) in addition to visit to clinics, in contrast to the case of the village group in which people depended much on regional mass examination service. The trend was essentially reproducible in stomach cancer screening although the over-all coverage rate was low, whereas women in the three groups almost exclusively utilized clinics for cervical cancer screening with one exception that the mobile unit service appeared to be equally accepted in the village group.

Adult↗
PubMed1989

[Korsakoff's syndrome as a prominent feature of bilateral paramedian thalamic infarction--a case report].

We reported the first Japanese case of bilateral paramedian thalamic infarction associated with prominent Korsakoff's syndrome. 53-year-old man suffered from semicoma on the morning of September 16th, 1988. After recovery of consciousness disturbance, neurological examination revealed vertical eye gaze palsy, areflexia of lower extremities, apathy with hypersomnia and amnesia. Amnesia was accompanied with prominent confabulation, disorientation and lack of insight into his own disability. While X ray-CT revealed only ambiguous low density area in the bilateral thalamus, MRI of horizontal section by short spin echo revealed symmetrical low signal area restricted in the paramedian area of bilateral thalamus, and that of coronal section revealed characteristic butterfly-shaped lesion. Left BAG revealed that both posterior thalamoperforating arteries showed type 3 variation of Percheron's classification which arisen from artery arcade bridging between both side of interpeduncular segment of posterior cerebral artery. He showed gradual improvement in apathy with hypersomnia and disorientation but not in Korsakoff's syndrome nor ophthalmoplegia.

Alcohol Amnestic Disorder↗