Search PubMed⌕ Search

Biomedical subjects

T Kachi

Publications and source records attributed to T Kachi.

At least 37 records · Page 2Linked to original sources
PubMed1996

Pain-related somatosensory evoked potentials in dementia.

Pain-related somatosensory evoked potentials (pain SEPs) were examined in 25 demented and non-demented patients to investigate the cognitive function for pain in the progression of dementia. Pain SEPs by CO2 laser stimulation were recorded together with auditory event-related potentials (auditory ERPs). P340 in pain SEPs and P300 in auditory ERPs were analysed. The latency of P300 evoked in mildly demented patients was inversely correlated with the Mini-Mental state examination score, and the latency of P340 was also inversely correlated to that score but to a lesser extent. Pain SEPs were not recorded in 4 of 7 severely demented patients. These results indicate that the P340 component of pain SEPs is apparently different from the P300 component of auditory ERPs and suggest that the pain perception in severely demented patients may be abnormal.

Adult↗
PubMed1995

X-linked recessive bulbospinal neuronopathy: clinical phenotypes and CAG repeat size in androgen receptor gene.

Clinical phenotypes and the CAG repeat size of the androgen receptor gene were assessed in 95 Japanese patients with X-linked recessive bulbospinal neuronopathy. There was an age- and duration-dependent deterioration of muscle strength, ADL scores, and plasma creatine kinase levels. However, there was no correlation between the presence of absence of gynecomastia or diabetes mellitus and the age at onset or duration of illness. Correlations were present between the CAG repeat size and the age at onset (P < 0.0001) as well as the presence or absence of gynecomastea (P < 0.05). Muscular weakness and ADL scores were also correlated with the CAG repeat size only when they were adjusted by the age at examination not by the duration of illness. These findings suggest that CAG repeat size is one of the determinant factors of disease progression. However, extensive variation in phenotypic severity in patients with the same size of CAG repeat was present even among the siblings, suggesting that other factors than CAG repeat size influence the phenotypic manifestation. The average gain of CAG repeat size expansion was a 1.4 repeat in paternal transmission which was more unstable than that in maternal transmission, but the magnitude of the expansion in paternal transmission was much smaller than is presently known for other diseases in which CAG repeat expansion is the responsible gene defect.

Adolescent↗
PubMed1995

Magnetic resonance imaging of the corticospinal tracts in amyotrophic lateral sclerosis.

In 13 patients with amyotrophic lateral sclerosis (ALS), corticospinal tract lesions on spinal cord, brain and brain stem were examined by MR imaging. In 9 patients, areas of high signal intensity located in the dorsolateral columns coinciding with the lateral corticospinal tracts, were detected on axial T2*-weighted MR imaging of the cervical spinal cord using a gradient echo technique. In two patients, these spinal cord MR abnormalities corresponded well to the postmortem pathological findings of lateral corticospinal tract degeneration. T2-weighted abnormal MR signals along the corticospinal tract at the brain and brain stem were detected in 4 patients, all of whom also showed abnormal signals on cervical cord MR imaging. Four of 13 patients did not show any abnormal signals on brain and brain stem or spinal cord MR imaging. Spinal cord MR imaging provides a useful information regarding upper motor neuron lesions in ALS.

Adult↗
PubMed1995

Pain-related and electrically stimulated somatosensory evoked potentials in patients with stroke.

BACKGROUND AND PURPOSE: Pain-related somatosensory evoked potentials (SEPs) were applied to study abnormality of pain sensation in stroke, together with electrically stimulated SEPs for deep sensation. METHODS: We recorded pain-related SEPs after CO2 laser stimulation to the dorsum of the hand and electrically stimulated SEPs after median nerve stimulation at the wrist in 12 patients with stroke. We analyzed P340 in pain-related and parietal N20 in electrically stimulated SEPs. RESULTS: In 5 patients with a putaminal lesion, P340 was absent or its latency was delayed, and N20 was absent or reduced in amplitude. In 3 patients with a thalamic lesion, P340 and N20 showed various patterns according to the involved sites. In 4 patients with a lesion in the corona radiata, P340 and N20 were normal. CONCLUSIONS: Abnormalities of P340 and N20 in the stroke location were related to impairment of the pain and vibration senses, respectively. Thus, pain-related and electrically stimulated SEPs were useful to investigate the sensory function of each structure in the central nervous system in patients with stroke.

Aged↗
PubMed1995

[Clinical and physiological studies on senile tremor].

We examined 6 male and 10 female patients with senile tremor which started at 60 years of age or older. The patients' age on examination ranged from 66 to 82 years (mean: 73.4; SD: 5.4 years). The surface electromyogram (EMG) was recorded from the bilateral biceps brachii, triceps brachii, forearm flexor and forearm extensor muscles. The frequency of the tremor was counted and patterns of grouping discharges were analysed. The effect of mechanical perturbation to the affected muscle on tremor rhythm was also examined. The same investigations were performed in 15 male and 7 female patients with essential tremor with onset age before 60 years as control patients. The mean frequency was 6.2 Hz (SD: 1.3 Hz) in senile tremor and 7.3 Hz (SD: 1.5 Hz) in essential tremor. There was a significant difference between the two groups. The mean frequency in control patients whose age on examination was 60 years or over was, however, 6.0 Hz (SD: 0.8 Hz), and there was no difference from the mean frequency in senile tremor. The frequency in both groups was inversely correlated to the patient's age on examination. The antagonist muscles were reciprocally discharged in 15 patients in the senile tremor group and in 7 in the controls. Mechanical perturbation of the affected muscle re-set the tremor rhythm in all patients examined. Thus, senile tremor had characteristics resembling tremor in the control patients, suggesting that senile tremor may be a subtype of essential tremor.

Aged↗
PubMed1995

[Osteoporosis and fractures in Parkinson's disease].

We investigated osteoporosis and fractures in Parkinson's disease in stage II to V according to Hoehn and Yahr's disability scale. The bone mineral density (BMD) of the lumbar spine was measured in 82 patients (24 males and 58 females) and in 99 age-matched controls (28 males and 71 females) using dual energy X-ray absorptiometry, and compression fractures of the vertebrae were assessed on X-ray films. BMD decreased with age in females and was lower in females 60 years of age or over than in males at the same age. BMD in the female patients was significantly lower than in the female controls. The female patients in stage III to V had lower BMD than those in stage II. Both male and female patients with a body mass index (BMI) below 21 showed a lower BMD than those with a BMI of 21 or more. Five male (20.8%) and 37 female (63.8%) patients were diagnosed as osteoporosis. In particular 77.8% of the females aged 60 years or older had osteoporosis. Thirty-three patients (7 males and 26 females) had experienced fractures or were found to have vertebral compression fractures on X-ray films. These results suggested that osteoporosis and fractures are common in female patients with Parkinson's disease and that prevention of fractures must be important especially for patients with osteoporosis.

Adult↗
PubMed1995

[Videofluorographic analysis of the swallowing disorders in spinocerebellar degeneration].

Clinical and videofluorographic (VF) studies of swallowing were performed in 11 patients with spinocerebellar degeneration (SCD). Eight patients had a subjective symptom of dysphagia. In VF study, seven patients represented abnormal findings in an oral phase such as residue on the tongue (2 patients), reduced tongue control (3 patients), uncontrolled bolus or premature loss of liquid (6 patients), and piecemeal deglutition (4 patients). Seven patients showed abnormality in a pharyngeal phase such as vallecular residue after swallow (5 patients), residue in pyriform sinuses after swallow (4 patients), delayed onset of laryngeal elevation (5 patients), and aspiration during swallow (5 patients). Aspiration was more obvious when barium liquid was swallowed. When the patients aspirated, techniques such as the chin down posture and the supraglottic swallow were tried in 4 of the 5 patients with the evidence of aspiration. The aspiration was prevented in 2 patients. It was suggested that in SCD the change in the form and volume of food is recommended for prevention of aspiration and that the rehabilitation techniques such as the chin down posture and the supraglottic swallow may also improve the dysphagia.

Adult↗
PubMed1995

Immunohistochemical studies on supporting cells in the adrenal medulla and pineal gland of adult rat, especially on S-100 protein, glial fibrillary acidic protein and vimentin.

In the adrenal medulla and pineal gland, the morphological and chemical nature of supporting cells were examined immunohistochemically. In the adrenal medulla, supporting cells in noradrenaline (NA)-cell regions showed similar and intense immunoreactivities to the three glial marker proteins, S-100 protein, glial fibrillary acidic protein (GFAP) and vimentin, forming a network, while those in adrenaline (A)-cell regions were less numerous and their immunoreactivity was positive to S-100 protein but negative to GFAP and, at least in part, negative to vimentin. In the pineal gland, supporting cells in the stalk and the proximal region of the body portion formed a network and showed immunoreactivities to the three antibodies, while those in the distal region of the body portion were less numerous and their immunoreactivity was positive to S-100 protein and vimentin, but negative to GFAP. Thus, the distribution pattern and chemical nature of supporting cells showed regional differences in both glands. There were several similarities in supporting cells between those in NA-cell regions of the adrenal medulla and in the stalk and the proximal region of the body portion of the pineal gland, and also between in A-cell regions of the adrenal medulla and in the distal region of the body portion of the pineal gland, respectively. The biological and functional significances of these results are discussed.

Adrenal Medulla↗
PubMed1995

[Pathophysiology of involuntary movements--dystonia and myoclonus. Symptomatological view].

Among involuntary movements, dystonia is defined as abnormal posturing produced by slow sustained muscle contractions. On the contrary, myoclonus is characterized by sudden shock-like contractions of a muscle or a group of muscles. The electromyogram (EMG) in dystonia shows continuous activity lasting 5 seconds or more. The muscles usually co-contract in the antagonists. In myoclonus the muscle bursts on EMG last usually between 10 and 50 ms. In some cases the bursts last longer, but they are 200 ms at most. Thus, the characteristics of myoclonus is quite different from those of dystonia. There are, however, unusual combination of dystonia and myoclonus. Myoclonic dystonia, in which myoclonic jerks are so severe that crucial dystonic posturing may be ignored, has been reported. Essential tremor, writing tremor and writer's cramp (writing dystonia) and myoclonic writer's cramp are sometimes seen in one family in various combination. It is suggested that there may be pathophysiological relationship between dystonia and myoclonus, although these two movement disorders have different clinical characteristics.

Dystonia↗
PubMed1994

Differences between adrenaline and noradrenaline cells in cellular association with supporting cells in the adrenal medulla of the pig: an immunohistochemical study.

Location and morphology of glial supporting cells in the pig adrenal medulla were examined immunohistochemically by the ABC method using antibody to S-100 protein. In noradrenaline (NA)-cell regions, S-100-positive cells were located in both marginal and internal portions of the parenchyma, extending fine cytoplasmic processes between NA cells and/or enveloping large surface areas of NA cells. In adrenaline (A)-cell regions, S-100-positive cells were present less frequently than in NA-cell regions, mostly in the marginal portion of the parenchyma. It is surmised that differences between A cells and NA cells in cellular association with supporting cells reflect those in biological characteristics.

Adrenal Medulla↗
PubMed1994

Aberrant androgen action and increased size of tandem CAG repeat in androgen receptor gene in X-linked recessive bulbospinal neuronopathy.

Plasma levels of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) after 3 or 6 days of administration of the synthetic androgenic hormone fluoxymesterone (10 mg/day) were measured in 26 patients with X-linked recessive bulbospinal neuronopathy (X-BSNP) and 22 age-matched male controls. The testosterone, LH and FSH levels in the controls were markedly suppressed after administration, but in the patients with X-BSNP, they were suppressed significantly less. The level of suppression varied considerably with the patients, and those of plasma testosterone and FSH were significantly correlated with the number of CAG repeats in the androgen receptor gene. These findings suggest that the androgen action was aberrantly transduced in the target organs in the patients with X-BSNP and which is related to the elongated CAG repeat in the androgen receptor gene.

Adult↗
PubMed1994

Sensory conduction study in chronic sensory ataxic neuropathy.

Sensory conduction was studied in six patients with chronic sensory ataxic neuropathy of an idiopathic type and associated with Sjögren's syndrome. Motor nerve conduction velocities were normal in most cases, but sensory nerve potentials could not be evoked in a routine peripheral nerve conduction study. Cortical and cervical somatosensory evoked potentials (SEPs) and evoked potentials from Erb's point were barely recorded by median nerve stimulation at the wrist. When the median nerve was stimulated at more proximal points, clear potentials were recorded from Erb's point, but cortical SEPs were still hardly elicited. Thus the sensory nerves are centrally and peripherally involved in this condition, and the involvement is more prominent in the distal portion in the peripheral nerve. These findings suggest that central-peripheral distal axonopathy is a process involved in this illness and that the dorsal root ganglia may be primarily involved, in accord with previous pathological studies.

Aged↗
PubMed1994

Humoral hypercalcemia of malignancy associated with parathyroid hormone-related protein producing transitional cell carcinoma of the ureter.

A 78-year old male with ureteral carcinoma manifesting hypercalcemia is reported. He was diagnosed as having ureteral carcinoma of the left side 2 years previously and was treated by nephrectomy with ureterovesicostomy. In October 1991, he was admitted for anorexia. A clinical examination revealed recurrence of the ureteral carcinoma with metastasis to the rectum and liver. His serum calcium level was elevated (13.9 mg/dl). In addition to rehydration and furosemide, treatment with eel-calcitonin and prednisolone failed to decrease his serum calcium level. Finally, he was administered mithramycin but he died 13 days later. He had no evidence of bone metastasis or hyperparathyroidism. Nephrogenic cAMP and urinary parathyroid hormone-related protein (PTHrP) were markedly elevated. Immunohistochemical study demonstrated expression of PTHrP in the tumor cells. Thus, the hypercalcemia was thought to be mediated by PTHrP secreted from the neoplastic tumor. Although there have been several reports of ureteral carcinoma associated with humoral hypercalcemia of malignancy, this is considered to be the first case associated with elevation of PTHrP.

Aged↗
PubMed1994

[The corticospinal tract lesion of amyotrophic lateral sclerosis--magnetic resonance imaging of the spinal cord].

Magnetic resonance imaging by gradient echo method demonstrated lesions of the lateral corticospinal tract at cervical cord levels in three ALS patients. Patient 1 was a 43-year-old woman with common form of ALS. She developed right-side predominant pyramidal signs, and right-side predominant prolongation of central motor conduction time. MRI showed hypersignal intensity areas in the dorsal region of the lateral column at the 4th and 5th cervical segments with right-side predominancy. Patient 2 was a 65-year-old man with pseudopolyneurtic form of ALS, who showed lower motor neuron signs without a pyramidal sign. MRI of the 3rd and 4th cervical cord segments demonstrated bilateral hypersignal intensity areas in the dorsal part of the lateral column. Patient 3 was a 62-year-old man with common form of ALS, who showed marked bilateral pyramidal signs with Babinski's sign. MRI of the 5th cervical spinal cord segment demonstrated bilateral hypersignal intensity areas in the dorsolateral column. Thus obtained MR images of the spinal cord corresponded well to the postmortem-confirmed degeneration of the spinal corticospinal tract. MRI of the spinal cord performed by gradient echo method would provide additional information on the upper motor neuron involvement in ALS.

Adult↗
PubMed1994

[A case of ruptured hepatocellular carcinoma with rapid growth after the interferon therapy in chronic hepatitis].

A 75-year-old man who had had a long history of chronic hepatitis C virus liver disease underwent interferon (IFN) therapy for three months. After three months of the last IFN injection, he presented with a sudden attack of epigastralgia. Abdominal US and CT revealed a tumor about 9 x 10 cm in the right lobe of the liver. Serum AFP level was 8,499 ng/ml. Spontaneous hemoperitoneum due to ruptured hepatocellular carcinoma (HCC) was suspected. Hepatectomy was carried out on 35 days postembolization. Pathological examination revealed HCC of trabecular type. Although the relation between the rapid growth and IFN is not clear, US examination should be performed once a month for the patient.

Aged↗
PubMed1993

Differences between adrenomedullary adrenaline and noradrenaline cells: quantitative electron-microscopic evaluation of their differential cellular association with supporting cells.

Quantitative differences in cellular association of adrenomedullary chromaffin cells with other types of cells, mainly supporting cells, were studied. Adrenaline (A) and noradrenaline (NA) cells were compared. Electron micrographs (12000 x) of profiles of A and NA cells, bordering against other types of cells, were used for quantitative evaluation. Supporting cells constituted the majority of the non-chromaffin cell types. Occurrence frequencies of chromaffin cells contiguous with other types of cells were: (1) higher for A cells (68.9%, 199/289) than for NA cells (11.0%, 34/309) in case of small contact regions (chi 2-test: P < 0.001), and (2) higher for NA cells (68.3%, 211/309) than for A cells (9.7%, 28/289) in case of extended contact regions (P < 0.001). In conclusion, the extent of cellular association with supporting cells was remarkably lower in A cells than in NA cells. Such an arrangement is likely to be appropriate for the extensive, homogeneous control and amplified response characteristic of A cells, and for the close range, complex control and more diverse responses characteristic of NA cells.

Adrenal Medulla↗
PubMed1993

Chronic progressive sensory ataxic neuropathy: clinicopathological features of idiopathic and Sjögren's syndrome-associated cases.

Eleven patients with chronic progressive sensory ataxic neuropathy were examined clinicopathologically. Three cases were associated with primary Sjögren's syndrome (SS-SAN) and the others were considered to be idiopathic (ISAN). The major clinical symptom in both was loss of proprioceptive and kinesthetic sensation with some impairment of superficial sensation, with multifocal and asymmetrical distribution and progression. The truncal and trigeminal nerves were frequently involved. The motor system was substantially preserved. These somatic sensory and motor symptoms did not differ between ISAN and SS-SAN, but autonomic nervous system signs were more frequent in SS-SAN. Polyclonal elevations of serum IgG and/or IgA were seen in 8 patients. One autopsied case with ISAN combined with previous reports suggested that systemic T- and B-cell infiltration into the nervous tissues, as well as a wide variety of the visceral organs, may be a common finding in ISAN and SS-SAN, and could participate in the cause of this neuropathy and polyclonal hypergammaglobulinaemia.

Aged↗