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Biomedical subjects

T Kuboki

Publications and source records attributed to T Kuboki.

At least 55 records · Page 3Linked to original sources
PubMed1999

Alexithymic traits as predictors of difficulties with adjustment in an outpatient cohort of expatriates in Tokyo.

The purpose of this study was to examine whether alexithymic characteristics, which are thought to be related to poor coping with stress, would be associated with variables thought to reflect adjustment to life abroad. The subjects were 56 expatriates living in Tokyo, Japan. The Expatriate Adaptation Inventory, the Toronto Alexithymia Scale, and the Social Support Questionnaire of the Stress and Coping Inventory were given to the subjects. Scores on alexithymia were significantly associated with dissatisfaction with life abroad, higher satisfaction with life in one's home country prior to departure, and higher ratings on the perception of poor social support. An alexithymia variable, difficulty identifying feelings, was a significant predictor of dissatisfaction with life abroad and satisfaction with life in the home country. The results suggest that, because alexithymia was associated with lower satisfaction with life abroad and higher satisfaction in the home country prior to departure, it may be a predictor of adjustment difficulties when individuals live abroad. Empirical confirmation is needed.

Adaptation, Psychological↗
PubMed1999

Effect of occlusal appliances and clenching on the internally deranged TMJ space.

AIMS: Stabilization appliances and mandibular anterior repositioning appliances have been used to treat patients with internal derangement of the temporomandibular joint (TMJ) based on the assumption that these appliances work by decompressing the TMJ. The purpose of this study was to indirectly test this assumption. METHODS: Bilateral TMJ tomograms of 7 subjects with unilateral anterior disc displacement without reduction (ADDwor) were taken during comfortable closure and during maximum clenching in maximum intercuspation; tomograms were also taken with the 2 types of occlusal appliances in use. Outlines of the condyle and the temporal fossa were automatically determined by an edge-detection protocol, and the minimum joint space dimension of the joints with and without ADDwor was automatically measured for each experimental condition as the outcome variable. RESULTS: Upon comfortable closure and maximum clenching, the minimum joint space dimensions of the ipsilateral and contralateral joints with the use of stabilization appliances and mandibular anterior repositioning appliances were not significantly different from those seen in maximum intercuspation. CONCLUSION: These findings do not indicate that these appliances induce an increase in joint space during closing and clenching in joints with ADDwor.

Adult↗
PubMed1999

[Recurrent bleeding tendency due to factor VIII inhibitor during therapy for bullous pemphigoid].

A 67-year-old woman with bullous pemphigoid (who had no history of hemorrhagic disease or blood transfusion) experienced extensive ecchymosis of the trunk and extremities and marked submucosal bleeding of the pharynx and larynx with risk of obstruction and suffocation. This bleeding tendency was the manifestation of a coagulation disorder due to factor VIII inhibitor. Immunosuppressive therapy, steroid pulse therapy, prednisolone (PSL), and cyclophosphamide (CPA) alleviated the bleeding and yielded negative assays for factor VIII inhibitor. However, because the patient stopped treatment, the bleeding recurred and was especially severe from a large hematoma with ruptured skin on the right hand. The bleeding was mitigated by transfusion of factor VIII concentrate combined with steroid pulse therapy. This was followed by CPA pulse therapy and oral PSL and CPA, resulting in the disappearance of factor VIII inhibitor again. We reported this case because factor VIII inhibitor complication of bullous pemphigoid is very rare and immunosuppressive therapy consisting of PSL, CPA, and pulse therapy was effective.

Aged↗
PubMed1998

Severe motor-dominant neuropathy with IgM M-protein binding to the NeuAcalpha2-3Galbeta- moiety.

We report the occurrence of a relapsing, severe predominantly motor neuropathy in a 75-year-old man with an IGM-K M-protein binding to gangliosides GM2, GM3, GM4, GD1a, GT1b and LM1. Motor nerve conduction velocities were slowed with conduction block. A superficial peroneal nerve biopsy specimen revealed segmental demyelination and remyelination. The patient improved after repeated plasma exchanges, and the antibody titer decreased in association with clinical recovery. This IgM M-protein has a unique, previously unreported binding specificity for terminal NeuAcalpha2-3Galbeta- moiety in common to all gangliosides bound by the antibody except GM2. M-proteins with this affinity may be involved in the pathogenesis of this and other cases of motor-dominant demyelinating neuropathy.

Aged↗
PubMed1998

Cold pressor stimulus temperature and resting masseter muscle haemodynamics in normal humans.

Cold pressor stimulation reportedly increases sympathetic nerve activity in human skeletal muscles. This study examined the effect of cold pressor stimulation on the resting haemodynamics of the right masseter muscle in normal individuals, using near-infrared spectroscopy. Nine healthy non-smoking males with no history of chronic muscle pain or vascular headaches participated. Their right hand was immersed in a water bath (4, 10, 15 degrees C) for exactly 1 min. Each trial lasted 7 min (1 min before, 1 min during, 5 min after stimulation) and a strictly random order was utilized for the three test temperatures and the mock trial. Masseter muscle haemoglobin concentration and oxygen saturation, as well as heart rate and blood pressure, were continuously recorded in each trial. After completing the four trials, each participant produced and sustained a 30-s maximum voluntary clench in the intercuspal position. Data across the four trials were baseline-corrected and then magnitude-normalized to the individual's highest absolute haemoglobin and oxygen signal during the 30-s maximal clenching effort. Haemoglobin and oxygen saturation increased progressively during cold pressor stimulation as the water temperature decreased (Hb, p < 0.0001; O2, p = 0.0327); very little effect was seen during the mock trial. Heart rate and blood pressure also increased progressively during the stimulation as the temperature decreased (heart rate, p = 0.0013; systolic blood pressure, p = 0.0042; diastolic blood pressure, p = 0.0156). These data suggest that cold pressor, stimulation induces a strong increase in intramuscular blood volume which appears to be due to both a local vasodilative response and increased cardiac output.

Adult↗
PubMed1998

Mental arithmetic is a useful diagnostic evaluation in white coat hypertension.

It remains unclear whether patients with white coat hypertension are more susceptible to mental stress than are those with essential hypertension. To compare the pressor responses to mental arithmetic between the two types of hypertension, 21 untreated female outpatients, aged 42 to 64 (mean 55) years, with hypertension, were studied. After 2 weeks of self-monitoring blood pressure, 11 patients were diagnosed as having white coat hypertension and the remaining 10 patients were diagnosed as having essential hypertension. The systolic and diastolic blood pressure responses to mental arithmetic testing were significantly greater in the patients with white coat hypertension (+38 +/- 18/+24 +/- 13 mm Hg) than in those with essential hypertension (+21 +/- 8/+13 +/- 6 mm Hg). These differences also were statistically significant in controlling for the effects of age and baseline blood pressures. These data suggest that mental arithmetic testing may be a useful tool for the diagnosis of white coat hypertension.

Adult↗
PubMed1998

The validity of clinical examination for diagnosing anterior disk displacement with reduction.

OBJECTIVE: The objective of this study was to evaluate the diagnostic accuracy of a clinical examination for diagnosing anterior disk displacement with reduction. STUDY DESIGN: A series of 273 consecutive patients with temporomandibular disorders were clinically examined according to well-defined criteria. The patients were examined for clicking by digital palpation during maximal mouth opening and closing (the Clicking test). When clicking was identified, two additional tests were performed: one determined whether the clicking was eliminated at a protruded position, and the other determined whether the clicking became louder when the patient's mandible was manipulated toward the eminences. Bilateral magnetic resonance images were subsequently obtained from all patients; the clinical examination findings were then compared to the imaging-based diagnoses of the temporomandibular joint status to assess the diagnostic accuracy of the clinical findings. RESULTS: Although the predictability of identifying anterior disk displacement with reduction by clicking was relatively low, it increased to an acceptable level when the additional tests were used. The overall accuracy for the Clicking test combined with either of the other tests was about 90%. CONCLUSION: Our results suggest that anterior disk displacement with reduction can be diagnosed with considerable accuracy through the use of a clinical examination only.

Adolescent↗
PubMed1998

The validity of clinical examination for diagnosing anterior disk displacement without reduction.

OBJECTIVE: The objective of this study was to evaluate the diagnostic accuracy of patient history and clinical signs as confirmed by magnetic resonance imaging examination for diagnosing anterior disk displacement without reduction. STUDY DESIGN: A series of 273 consecutive patients with temporomandibular disorders were clinically examined according to well-defined criteria. Patients were first asked if they had a history of clicking. The following clinical characteristics of anterior disk displacement without reduction were then assessed: (1) maximal mouth opening less than 40 mm; (2) deflection of the mandible to the affected side at the maximal mouth opening position; (3) limitation of condylar translation on palpation during maximal mouth opening; (4) preauricular pain during mandibular movements; and (5) crepitation. Bilateral magnetic resonance images were obtained for all patients, and the magnetic resonance imaging interpretation was compared with the clinical examination findings to assess the diagnostic accuracy of the clinical findings. RESULTS: The sensitivity was considerably low in contrast with the relatively high specificity for all six clinical parameters tested. The overall accuracies of the clinical parameters ranged from 71% to 81%. CONCLUSION: Our results suggest that the predictability of historical or clinical findings to differentiate anterior disk displacement without reduction from other diagnoses is not high.

Adolescent↗
PubMed1998

Concurrent cervical and craniofacial pain. A review of empiric and basic science evidence.

Because many patients present themselves for treatment with both craniofacial and craniocervical pain, 2 questions arise: (1) What are the sensory and motor consequences of dysfunction in either of these areas on the other? (2) Do craniofacial and craniocervical pain have a similar cause? These questions formed the impetus for this review article. The phenomenon of concurrent pain in craniofacial and cervical structures is considered, and clinical reports and opinions are presented regarding theories of cervical-to-craniofacial and craniofacial-to-cervical pain referral. Because pain referral between these 2 areas requires anatomic and functional connectivity between trigeminally and cervically innervated structures, basic neurophysiologic and neuroanatomic literature is reviewed. The published data clearly demonstrate neurophysiologic and structural convergence of cervical sensory and muscle afferent inputs onto trigeminal subnucleus caudalis nociceptive and non-nociceptive neurons. Moreover, changes in metabolic activity and blood flow in the brainstem and cervical dorsal horn of the spinal cord in both monkeys and cats have been demonstrated after electric stimulation of the V1-innervated superior sagittal sinus. In conclusion, the animal experimental data support the findings of human empiric and experimental studies, which suggest that strong connectivity exists between trigeminal and cervical motor and sensory responses.

Animals↗
PubMed1998

Diagnostic value of 4 criteria to interpret temporomandibular joint normal disk position on magnetic resonance images.

OBJECTIVE: This study was undertaken to evaluate different criteria to establish normal disk position on magnetic resonance images. STUDY DESIGN: Magnetic resonance image findings of 137 consecutive patients with temporomandibular disorders and 23 asymptomatic volunteers were used in this study. Three calibrated observers interpreted the images individually. Four closed-mouth and 1 open-mouth criteria were tested for their ability to define normal and abnormal temporomandibular joint disk positions on magnetic resonance images. RESULTS: For the 46 joints in the asymptomatic volunteers, the criterion that yielded the highest percentage of normal disk position diagnoses was the disk's intermediate zone (93.5%). Clock face criteria produced the following declining percentages of normal disk position diagnoses: 10 o'clock, 82.6%; 11 o'clock, 63.0%; and 12 o'clock, 39.1%. Similar results were obtained for the patients with temporomandibular disorders. In both groups, as the number of normal disk position diagnoses declined, the percentage of joints with a diagnosis of disk displacement with reduction increased. Conversely, the percentage of joints with a diagnosis of disk displacement without reduction (in the group of patients with temporomandibular disorders) did not appear to be substantially affected by the 4 closed-mouth disk position criteria. CONCLUSIONS: These results suggest that the intermediate zone criterion for disk displacement is the more stringent criterion and the one that would yield the lowest number of false positives when the disk position is being judged in the closed-mouth sagittal view.

Chi-Square Distribution↗
PubMed1998

The relationship between signs and symptoms of temporomandibular disorders and bilateral occlusal contact patterns during lateral excursions.

The relationship between signs and symptoms of temporomandibular disorders (TMD) and bilateral occlusal contact patterns was investigated in 143 TMD patients (mean age: 34.0 +/- 15.9 years; 38 male and 105 female). In addition to an interview regarding chief complaints and accompanying symptoms, various muscles and the temporomandibular joints were palpated bilaterally and occlusal analyses were made. Only 5 out of 108 paired variables were found to be significantly associated by using the chi-squared test. Medial pterygoid muscle pain on palpation showed significant associations with the occlusal contact pattern (P < 0.005), especially working side contacts (interocclusal tooth contacts on the working side) (P < 0.005), during contralateral excursions; sternocleidomastoid muscle pain on palpation showed a significant association with balancing side contacts (interocclusal tooth contacts on the balancing side) during ipsilateral excursions P < 0.05); shoulder stiffness and pain in the eye showed significant associations with balancing side contacts during contralateral excursions (P < 0.05). The results show only a weak relationship between some TMD symptomatology and bilateral occlusal contact patterns during lateral excursions. The findings suggesting the specific laterality of a few TMD signs and symptoms associated with particular occlusal contacts may deserve closer case-control study.

Adult↗
PubMed1998

Macroscopic osseous changes in the temporomandibular joint related to dental attrition in Japanese macaque skull.

The purpose of this study was to investigate the relationship between osseous changes in the temporomandibular joint (TMJ) and dental attrition in the Japanese macaque. One hundred and thirty Japanese macaque skulls (54 male and 76 female) from animals which had been bred in the same environment, were randomly sampled from a collection at the Primate Research Institute of Kyoto University. The age at death had been recorded in all cases. TMJ osseous changes were independently evaluated by three examiners, and were defined as an irregular surface or a perforated compact bone layer with a markedly irregular surface on either the temporal or condylar components. Age was a significant factor in predicting TMJ osseous changes (P < 0.001). A strong relation was observed between age and dental attrition (P < 0.001), while dental attrition was not a significant factor in predicting TMJ osseous changes (P = 0.334). The prevalence TMJ osseous changes in male animals was slightly higher than in females (P = 0.057). The results of this study suggest that osseous changes in the macaque TMJ are mainly related to age, not to dental attrition.

Age Factors↗
PubMed1998

Fatigue mood as an indicator discriminating between anorexia nervosa and bulimia nervosa.

In order to clarify the differences in mood states between anorexia and bulimia nervosa, the Profile of Mood States (POMS) with tension-anxiety, depression, anger-hostility, vigour, fatigue and confusion scales was administered to 32 female patients with anorexia nervosa (age range 14 to 32 years, mean age 20 years), 49 female patients with bulimia nervosa (age range 15 to 33 years, mean age 23 years) and 410 'normal' female subjects (age range 14 to 35 years, mean age 23 years). The scores on the depression, fatigue and confusion scales for both anorexia and bulimia nervosa and those on the tension-anxiety and anger-hostility scales for bulimia nervosa were significantly higher than those for the control subjects. The score on the fatigue scale for bulimia nervosa was significantly higher than that for anorexia nervosa. Moreover, the result of the multiple logistic regression analysis including all of the POMS scales indicated that the fatigue scale significantly discriminated between the two disorders. Fatigue mood appears to be a principal indicator for differentiating between the two disorders.

Adolescent↗
PubMed1998

Assessment of patients by DSM-III-R and DSM-IV in a Japanese psychosomatic clinic.

BACKGROUND: The aim of this study was to investigate the clinical features of psychosomatic disorders in Japan. METHODS: A total of 1,432 outpatients (515 males and 917 females; 9-95 years of age, mean age 36) attending a psychosomatic clinic for the first time were assessed by the DSM-III-R or DSM-IV semistructured interview. RESULTS: Major ICD-10 diagnoses found were eating disorder, other anxiety disorders, autonomic nervous dysfunction, somatoform disorders, and irritable bowel syndrome. The most frequent diagnosis on the DSM-III-R and DSM-IV axis I was 'somatoform disorders not otherwise specified', followed by bulimia nervosa, 'depressive disorder not otherwise specified', anorexia nervosa, conversion disorder, major depression or depressive disorder, 'panic disorder with agoraphobia', and 'psychological factors affecting physical or medical condition'. On axis II, 11-17% of the patients met the criteria for personality disorder. On axis IV, 78-80% had mild or moderate psychosocial stress; major psychosocial and environmental problems classified by the DSM-IV were the problems with primary supports and occupation. CONCLUSIONS: The results seem to reinforce the belief that the diagnoses on the DSM-III-R and DSM-IV axis I are inadequate for describing psychosomatic phenomena. A new diagnostic system in combination with the multidimensional assessments by the DSM-III-R and DSM-IV is needed to form the common guidelines of diagnoses and therapies in psychosomatic medicine.

Adolescent↗
PubMed1997

Hemodynamic and endocrine responsiveness to mental arithmetic task and mirror drawing test in patients with essential hypertension.

To evaluate the reactivity to psychological stress in patients with essential hypertension we investigated hemodynamic and endocrinologic changes during a mental arithmetic task (MAT) and a mirror drawing test (MDT) in 10 hypertensive subjects. Hemodynamic changes were assessed continuously using an ambulatory radionuclide cardiac detector. There were significant increases in systolic blood pressure (deltaSBP: +37.8 +/- 11.1 and +41.0 +/- 9.4 mm Hg during MAT and MDT, respectively, P < .01) and diastolic blood pressure (deltaDBP: +17.5 +/- 3.1 and +21.2 +/- 3.9 mm Hg, P < .01) and in heart rate (deltaHR: +17.1 +/- 5.3 and +12.5 +/- 2.9 beats/min, P < .01) during both tasks in association with an increase in cardiac output (CO). The plasma levels of norepinephrine and epinephrine increased during both the MAT (deltaNE: +0.074 +/- 0.022 ng/mL, P < .01; deltaEP: +0.068 +/- 0.025 ng/mL, P < .01) and the MDT (deltaNE: +0.067 +/- 0.034 ng/mL, P < .01; deltaEP: +0.030 +/- 0.011 ng/mL, .05 < P < .1). Although the deltaNE was similar in response to the MAT and MDT, the deltaEP during the MDT tended to be less than half the deltaEP during the MAT (.05 < P < .10). The deltaEP was positively correlated with the deltaDBP and the deltaCO during both tasks and with the deltaSBP and the deltaHR during the MAT. These findings suggest that MAT- and MDT-induced increases in BP were attributable mainly to an increase in CO, possibly as the result of stimulation of the sympathoadrenomedullary system. However, the sympathoadrenomedullary system appeared to be more closely associated with the hemodynamic responses during the MAT than during the MDT.

Adrenocorticotropic Hormone↗
PubMed1997

The influence of observer calibration in temporomandibular joint magnetic resonance imaging diagnosis.

OBJECTIVE: This study was undertaken to investigate the potential of reducing observer variation through a calibration program. STUDY DESIGN: The study was based on three sets of randomly selected temporomandibular joint magnetic resonance images. Each set consisted of bilateral images from 20 consecutive patients with temporomandibular disorders. As a baseline, three well-experienced noncalibrated investigators interpreted the images individually for disk position and disk configuration. After the initial interpretation, interobserver agreement was calculated as a kappa index and presented to the examiners. On the same occasion, the investigators analyzed agreement between them on the criteria to be used. RESULTS: Overall data in this study showed an increase in the frequency of interobserver agreement with regard to disk position after the calibration trials were instituted. With regard to disk configuration, substantial interindividual variations were observed even after the observers reached consensus as to the criteria to be used. CONCLUSIONS: These data suggest that after calibration trials, it is possible for three examiners to obtain reliable and reproducible results in reporting temporomandibular joint disk position on magnetic resonance images.

Adult↗