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Biomedical subjects

T Yanagi

Publications and source records attributed to T Yanagi.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Double crush syndrome in patients with cervical spondylosis or ossification of posterior longitudinal ligament--a clinicophysiological study].

To clarify the clinical characteristics of double crush syndrome (DCS), we evaluated 207 patients with cervical spondylosis (CS) and 19 with ossification of posterior longitudinal ligament of the cervical spine (OPLL) clinicophysiologically. A diagnosis of DCS was based on the following criteria; 1) radiological evidence of CS or OPLL on X-ray films; 2) definite spinal cord compression on cervical magnetic resonance imaging (MRI); 3) neurological deficits in the upper extremities resulting from CS or OPLL; and 4) clinical and/or electrophysiological evidence of entrapment neuropathies in the upper extremities, namely carpal tunnel syndrome (CaTS), Guyon's tunnel syndrome (GTS), and/or cubital tunnel syndrome (CuTS). Pressure-provocative tests were used to confirm clinical entrapment neuropathies. Nerve conduction velocities were also examined. We found 28 patients with DCS (23 CS, 5 OPLL; 12.8% of all patients). There were 9 patients with clinical and electrophysiological DCS, 5 with clinical DCS, and 14 with electrophysiological DCS. Of the total number of patients with DCS, 21 proved to have CaTS, 4 had CuTS, 1 had GTS, 1 had both CaTS and CuTS, and 1 had both CaTS and GTS. Definite spinal cord compression was seen at C5/6 (23 patients), C4/5 (21), C3/4 (13) and C6/7 (10) on cervical MRI. In the majority of patients, neurological deficits of the upper extremities did not result from a single peripheral nerve lesion. It is well known that a discrepancy between neurological manifestation and neuro-imaging sometimes occurs in CS and OPLL, and circulatory disturbance in the spinal cord has been considered a possible pathogenetic mechanism of the disorder.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[The significance of elevated Mn SOD level in cerebrospinal fluid of patients with bacterial meningitis--its relation to cytokine].

We measured cerebrospinal fluid (CSF) levels of manganese superoxide dismutase (Mn SOD) using an enzyme immunoassay method in 19 patients with bacterial meningitis (BM), 33 with aseptic meningitis (AM) and 13 with encephalitis (EN), and examined the significance of their elevations, especially in BM. 1) In BM, the Mn SOD levels were obviously high, ranging from 10.4 to 1179.2 ng/ml. The mean level of Mn SOD was 234.6 +/- 306.7 (SD) ng/ml and 18 patients showed abnormal levels of Mn SOD (more than 13.1 ng/ml). On the other hand, in the remaining 2 diseases, the elevation of SOD levels was not remarkable: the mean levels of Mn SOD in AM and EN were 20.6 +/- 11.6 ng/ml and 41.9 +/- 23.6 ng/ml, respectively. 2) In AM and EN, Mn SOD levels well correlated with NSE or S-100b levels which are the markers of nervous tissue damages. But there was no correlation between the Mn SOD levels in BM and these markers. 3) In BM, there was a positive relationship between Mn SOD and total protein levels, but the disease days showing peak levels were different between them. In addition, Mn SOD levels showed no correlation with cell counts in CSF. 4) In BM, CSF levels of TNF-alpha and IL-1 alpha were remarkably high, whereas in AM and EN, the increases of these cytokines were not marked. And these cytokines in BM showed the peak values in the disease day before or when Mn SOD reached the peak levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[123I-MIBG myocardial scintigraphical analysis in patients with and without autonomic disorder].

We investigated cardiac sympathetic nerve abnormalities using 123I-metaiodobenzylguanidine (MIBG) in patients with and without autonomic failure (AF), presenting mainly with orthostatic hypotension. 123I-MIBG myocardial scintigraphy was performed in 7 patients with AF, in 10 patients without AF and in 5 normal subjects. Absence of myocardial damage was confirmed in all of the subjects using 210thallium scintigraphy and ultrasound. All of the patients with AF and 4 without AF showed extremely diminished MIBG uptake. 123I-MIBG myocardial scintigraphy is generally useful for detecting adrenergic nervous system dysfunction. Possible confounding factors such as drugs or myocardial beta-receptor dysfunction should be carefully eliminated in patients without AF, because false-negative uptake of MIBG may be seen in some of them.

3-Iodobenzylguanidine↗
PubMed1994

Prognostic value of cerebrospinal fluid neuron-specific enolase and S-100b protein in Guillain-Barré syndrome.

We measured the cerebrospinal fluid (CSF) concentrations of neuron-specific enolase (NSE) and S-100b protein (S-100b) using enzyme immunoassay methods, in 24 patients with Guillain-Barré syndrome and 46 controls, and examined their prognostic values. Sixteen of 24 patients showed elevated levels (> the mean + 2SD levels of controls) of NSE, S-100b, or both, and in those with higher NSE or S-100b levels there was a rather longer duration of disease, whereas 8 patients with the normal levels showed an early recovery. Further, NSE or S-100b levels were significantly correlated with months to recovery. Thus, NSE and S-100b in CSF may be useful markers for predicting the outcome of Guillain-Barré syndrome.

Adolescent↗
PubMed1994

[Common carotid artery thrombosis--clinical and radiological evaluation].

Common carotid artery thrombosis (CCAT) is not common. We studied 4 patients with CCAT to clarify the clinical and radiological features of this disorder. Case 1 had only episodes of TIA. Case 2 was diagnosed by chance as having CCAT at the time of admission due to cerebellar infarction. On the contrary, Cases 3 and 4 were admitted because of disturbance of consciousness and hemiparesis. Case 4 died soon after his stroke because of complications. We evaluated cases 1, 2 and 3 using head CT, head MRI, neck MRI, MR angiography, SPECT and cerebral angiography. Case 4, who was evaluated with head CT and cerebral angiography, was autopsied to confirm the occlusion of the common carotid artery. The clinical severity of CCAT varies from asymptomatic to severe, because each differs in the time taken for complete occlusion of the common carotid artery; the development of collateral circulation; and hemodynamics of the brain. As for the collaterals their contribution is variable; for example, the thyrocervical and other arteries function as the bypass. We can diagnose CCAT easily and noninvasively using MR angiography and neck MRI based on disappearance of the flow void in the common carotid artery or internal carotid artery. On physical examination, it is important to detect faded pulsation of the superficial temporal artery that is ipsilateral to the occluded common carotid artery.

Aged↗
PubMed1993

[MRI findings in patients with acute autonomic and sensory neuropathy].

Acute autonomic and sensory neuropathy (AASN), characterized by acute onset of extensive autonomic dysfunction and severe sensory deficits, was first described by Colan et al. (1978). We present two female patients with AASN in whom magnetic resonance imaging (MRI) confirmed such findings in the posterior column of the spinal cord. One patient was a 44-year-old woman who developed an upper respiratory tract infection followed in 2 weeks by numbness of the limbs and gait disturbance. There was orthostatic hypotension with syncope, paretic ileus, anhidrosis and urinary retention. There was a loss of sensation over the entire body, including the face, and deep tendon reflexes were generally absent. Neurophysiologic studies showed that sensory nerve action potentials and SSEPs were not evoked in the nerves examined. Sural nerve biopsy demonstrated severe axonal degeneration of the myelinated and unmyelinated fibers. Our second patient, a 27-year-old woman, exhibited similar clinical and laboratory features. The autonomic dysfunction in both patients improved gradually without drug treatment, but the sensory deficits--predominantly a loss of deep sensation--persisted for several years. In both patients, MRI revealed the T2*-weighted high intensity area in the fasciculus gracilis of the posterior column of the spinal cord. Such high intensity areas were present in all spinal segments. The severe and persistent sensory disturbance in these patients may have been caused by a lesion of the posterior column of the spinal cord following the involvement of the dorsal root ganglion cells, or ganglioneuronopathy, as demonstrated by MRI.

Acute Disease↗
PubMed1992

Sequence variation in the tripeptide repeats and T cell epitopes in P190 (MSA-1) of Plasmodium falciparum from field isolates.

The N-terminal part of p190, the precursor to the major merozoite surface antigens of Plasmodium falciparum, contains the T and B cell epitopes and tripeptide repeats. The p190 gene exhibits allelic dimorphism, but the tripeptide repeat-encoding region is the only exception to the dimorphic variations of the gene. To date, sequences available to document variations in the epitopes are very limited. Thus, in this study, the extent of the variation in these regions was analyzed using the polymerase chain reaction to amplify the DNA fragment encompassing these regions, followed by sequencing. Twenty-five gene clones were obtained from 19 isolates from the Mae Sod district in Thailand and their sequences were compared with those reported elsewhere. Results reveal 3 sequence types in the tripeptide-encoding region, and each contains a novel repetitive consensus nucleotide sequence. On the other hand, almost all nucleotide substitutions in block III are dimorphic. Identification of linkages of the dimorphic substitutions has led us to postulate 6 potential crossover sites, where intragenic recombinations of p190 alleles could occur. Sequences of T and B cell epitopes are highly conserved among these wild isolates and those from geographically diverse culture-adapted parasites.

Amino Acid Sequence↗
PubMed1992

[Pharmacokinetic and clinical studies of cefprozil fine granules in children].

Cefprozil (CFPZ, BMY-28100) is a new oral cephem antibiotic without an ester linkage. Pharmacokinetic and clinical studies using CFPZ 10% fine granules were performed in pediatric patients. 1. Pharmacokinetic investigation Peak serum concentrations of CFPZ after dose of 7.5 mg/kg and 10 mg/kg were, respectively, 3.65 +/- 0.24 micrograms/ml and 6.38 +/- 3.23 micrograms/ml at 1-2 hours. The average half-life with 7.5 mg/kg administration was 0.90 +/- 0.16 hours and that with 10 mg/kg was 1.29 +/- 0.50 hours. The urinary excretion of CFPZ was about 45% (35.3-50.0%) in 6 hours. 2. Clinical investigation Enrolled in the study were 22 patients including 4 with pharyngitis, 3 with tonsillitis, 3 with bronchitis, 5 with pneumonia, 4 with urinary tract infection, and 1 each with pertussis, purulent lymphadenitis and otitis media. Responses were excellent in 14 patients, good in 5 patients and fair in 1 patient. In the assessment of the bacteriological efficacy, 8 out of 17 strains of organism identified previous to the treatment were eradicated, 5 strains were found replaced by other bacteria and 4 strains persisted, hence the eradication rate was 76.5%. 3. No adverse reactions attributable to the drug were observed. From the above results, it has been concluded that CFPZ is a highly effective and safe agent for moderate respiratory and urinary tract infections in children.

Administration, Oral↗
PubMed1992

[Clinical significance of carotid and ocular bruits in cerebrovascular disease].

We investigated the clinical significance of carotid and ocular bruits in 250 consecutive patients with cerebrovascular disease (CVD). The incidence of bruits was compared with that in 100 age- and sex-matched neurological controls without CVD. In the cerebrovascular disease group, carotid bruits alone were found in 12 patients, both carotid and ocular bruits in 7, and ocular bruits alone in 2. Carotid bruits were found only in 3 controls. We then evaluated cerebrovascular disease in the 25 patients (16 men and 9 women) who had bruits. The patients ranged from 55 to 81 years in age (mean: 70.6 years). The patients with carotid bruits alone constituted the largest group, and those with ocular bruits alone were the smallest group. Carotid bruits were heard and abnormal blood flow was observed in 19/28 arteries of the 21 patients who underwent echo-flow studies. Carotid artery stenosis/occlusion was detected in 24/31 arteries (77%) in 23 patients who underwent digital subtraction angiography (DSA). Thus, the sensitivity was 0.77 and specificity of a carotid bruit 0.91, respectively. In 9/10 patients with unilateral ocular bruits, ipsilateral or contralateral carotid artery stenosis/occlusion was detected. Diminished cerebral blood flow was observed in 10/15 patients with bruits who underwent SPECT. Of these 8 had reduced cerebral blood flow ipsilaterally to the bruit. Blood flow was reduced in the carotid artery territory in all of the patients, and watershed reductions were commonest. Among the 25 patients, some showed neurological semiology of the vertebrobasilar territory in addition to that of the carotid territory.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

[Cervical root avulsion presenting proximal segmental muscular atrophy of unilateral upper extremity].

A 56-year-old woman noticed non-progressive weakness in the proximal part of the right upper extremity from her childhood. At the age of 37 years, she was diagnosed as "spinal muscular atrophy" by an orthopedic surgeon. At the age of 56, neurological examinations revealed muscular atrophy and weakness confined to the right deltoid, biceps brachii and brachioradialis together with minor sensory disturbance in the lateral side of the right shoulder and forearm without pyramidal sign in the lower extremities. The neurological features of this case differed from those of juvenile type of distal and segmental muscular atrophy of upper extremities in distribution of muscular atrophy, and simulated those of cervical spondylotic amyotrophy. Myelography demonstrated root avulsion of the right C5 and C6 roots. CT myelography revealed traumatic meningocele. Therefore a clinical diagnosis of cervical root avulsion resulting from unrecognized birth injury was made. The reason of motor dominant pictures of this case may be vulnerability of the anterior nerve roots to traction injury.

Arm↗
PubMed1992

[Neuron-specific enolase (NSE) and S-100b protein in cerebrospinal fluid of patients with cervical spondylosis--the relations with MRI findings and the changes of NSE and S-100b protein levels through Glisson's traction].

We have previously reported that NSE and S-100b protein (S-100) could be used as reliable markers to evaluate the damage of the spinal cord in cervical spondylosis (CS) and ossification of posterior longitudinal ligament (OPLL). In the present study we made MRI in 21 patients with CS. There was a positive correlation between the NSE level in CSF and the degree of the spinal cord compression shown by MRI. In 10 cases of CS we examined these specific protein levels in CSF before and after the Glisson's traction therapy for one month. In seven of them the NSE levels decreased with the clinical improvements. On the other hand, 2 cases showed the rise of NSE levels after the traction. One of them became clinically worse during the therapy, while in another case the NSE levels changed within the normal range. The level of NSE in the other case was unchanged. In 57-year-old patient with CS myelopathy we examined the NSE levels chronologically. The NSE level changed in parallel with his clinical features. We suggest that NSE level in CSF may be a useful marker to estimate the change of the degree of the spinal cord damage in CS.

Female↗
PubMed1992

["Dynamic" MR imaging of the cervical cord in patients with cervical spondylosis and ossification of the posterior longitudinal ligament--significance of dynamic cord compression].

This investigation was designed to assess the influence of dynamic cord compression on severity and course of myelopathy. Sixty-seven patients studied comprised 54 cases of cervical spondylosis and 13 cases of ossification of the posterior longitudinal ligament. These patients underwent "dynamic" MR imaging of the cervical spine. MR images in the sagittal view were obtained in three different neck positions: flexion, neutral, and extension. MR imaging was performed with a 0.15 T resistive unit. For technical reasons, the body coil was used. The pulse sequence was 500/30 (Tr msec/echo time msec) for T1 images. The spinal cord compression was accelerated in 32 cases when extended, in 2 cases when flexed, and in 4 cases when both extended and flexed. In 21 cases, we compared myelograms with MR images in a same neck position. Findings of myelograms well corresponded with those of MR images on 83 percent of intervertebral levels. The patients with dynamic cord compression were proved to have severer long tract signs, and their disability was regressive or progressive case by case for an average of 21-month follow-up. The "dynamic" MR imaging can provide dynamic nature of spinal cord compression, and prognostic clues.

Cervical Vertebrae↗
PubMed1991

[Intramedullary high intensity lesion on T2-weighted MR images in compressive cervical myelopathy].

Magnetic resonance (MR) imaging was performed in 147 patients with compressive lesion of the cervical spinal canal. Intramedullary high intensity lesions were observed on T2-weighted or proton density spin-echo images in patients with cervical spondylotic myelopathy (20.0%) and ossification of the posterior longitudinal ligament of the cervical spine (25.7%), while such signal abnormality was not found in patients with cervical spondylotic radiculopathy. Frequency of this finding was proportional to clinical severity of myelopathy and degree of spinal cord compression. The pathophysiological basis of such signal abnormality was presumed to vary from acute edema to chronic myelomalacia. In most cases showing intramedullary high intensity lesion, the spinal cord was compressed at multiple levels, but the high intensity was usually found at a single level where the compression was maximum. There was a good correlation between the neurological level and the high intensity level on MR images. Thus the intramedullary lesion on MR images is considered to be the main site of lesion responsible for the neurological symptom.

Adult↗
PubMed1990

Effect of continuous LDL apheresis with dextran-sulfate cellulose column system on a child with homozygous familial hypercholesterolemia.

A new system for selective low density lipoprotein apheresis with an automated regenerating column using dextran-sulfate (DS) as ligand was evaluated for six months in a 13-year-old boy homozygous for familial hypercholesterolemia. Two columns each containing 150 ml of DS cellulose were alternately used after rinsing with a regenerating solution. The patient could well tolerate the volume in the system. The values of plasma total cholesterol decreased by 79.4 +/- 4.9% of the pretreatment levels after a total of 5l plasma apheresis, while those of high density lipoprotein cholesterol did not change. Although the values of CH50 decreased, no adverse reaction was seen during the period of treatment. It was concluded that the present apheresis system was highly efficacious and safe for children homozygous for the mutant LDL receptor gene.

Adolescent↗
PubMed1990

Pernicious anemia in a patient with hypogammaglobulinemia.

A 19-year-old male with pernicious anemia and hypogammaglobulinemia (common variable immunodeficiency: CVID) is reported in comparison with classical pernicious anemia. This case was characterized by an earlier onset of anemia, the absence of autoantibodies to intrinsic factor or gastric parietal cells and involvement of the pyloric antrum as well as the gastric corpus. It is suggested that dysregulation of cellular immunity produces the autoimmune lesion in the gastric mucosa, including the pyloric antrum, in a patient with CVID, and that some of such cases develop pernicious anemia.

Adult↗
PubMed1990

[Neuron-specific enolase and S-100 protein levels in cerebrospinal fluid of patients with cervical spondylosis and ossification of posterior longitudinal ligaments].

We examined the levels of neuron-specific enolase (NSE) and S-100 protein in the cerebrospinal fluid (CSF) in 39 cases of cervical spondylosis (CS), in 16 cases of ossification of posterior longitudinal ligaments (OPLL), and in 29 control subjects by means of highly sensitive enzyme immunoassay methods. The levels (mean +/- SD) of NSE and S-100 protein in the control subjects, CS cases, and OPLL cases were shown as follows: NSE = 4.7 +/- 2.1, 8.0 +/- 3.4, 6.0 +/- 3.1 ng/ml, S-100b = 0.42 +/- 0.22, 0.72 +/- 0.40, 0.67 +/- 0.27 ng/ml, respectively. CS patients with a muscle atrophy of upper limbs showed a rise in NSE levels and this was especially seen in cases of cervical spondylotic amyotrophy (CSA). There were positive correlations between the distance of the A-P diameters of the spinal canal and the amount of NSE in OPLL cases (r = -0.6915, p less than 0.01). CS patients with severe spinal cord compressions demonstrated by myelo CT showed higher levels of NSE and S-100b. These results suggest that NSE, S-100 protein can be used as reliable markers to evaluate the damage of the spinal cord in CS and OPLL.

Adult↗