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Biomedical subjects

Y Mano

Publications and source records attributed to Y Mano.

At least 73 records · Page 4Linked to original sources

Pulsed magnetic stimulation and F waves in Parkinson's disease.

Twenty-two patients with Parkinson's disease with predominantly unilateral signs in the upper extremities were studied by means of transcranial magnetic stimulation. The mean central motor conduction time (CMCT) on the clinically affected side determined by F wave technique was significantly shorter (p < .01) than that of the other side at rest. However, the mean CMCT during slight voluntary contraction was not significantly different in the two sides. Amplitudes of motor evoked potentials and F waves tended to be higher on the clinically affected side than on the other side. We conclude that reduced CMCT and high F wave amplitudes reflect hyperexcitability of the anterior horn cells in patients with Parkinson's disease.

Adult↗

[Distribution of androgen receptors in bulbo-spinal muscular atrophy].

Immunohistochemical staining with anti-androgen receptor (AR) antibody was performed in skeletal muscle specimens obtained from 3 cases with bulbo-spinal muscular atrophy (BSMA) and 12 cases with other neuromuscular disease. Anti-AR antibody staining was found exclusively in the muscle nuclei of Type 2A fibers in all of the 3 cases. But there was no positive staining in the muscle nuclei of other disease. As above mentioned, very specific immuno-staining of AR in skeletal muscle would be of benefit to diagnosis of BSMA in addition to identification of a mutation of AR gene.

Adult↗

Ceruletide therapy in action tremor following thalamic hemorrhage.

Two men, aged 63 and 71 years, developed a gross action tremor and dysesthesias several months after an intracerebral hemorrhage. CT and MRI showed a small hemorrhage in the posterior region of the lateral nucleus of the thalamus in each patient. The tremor occurred on movement, had frequencies of 2.5-4.5 Hz and the amplitude varied depending on the joint position of the limb. Ceruletide (a cholecystokinin analog) 0.8 micrograms/kg i.m. produced a marked reduction in the action tremor and improved motor function. This effect appeared 10-15 min after the injection, and lasted for up to 4 weeks. It is suggested that ceruletide may be of value in the treatment of action tremors following a thalamic lesion.

Aged↗

[Steele-Richardson-Olszewski syndrome].

The Steel-Richardson-Olszewski syndrome (progressive supranuclear palsy: PSP) was described over a quarter of a century age. Although the full expressed form is very typical, it is overlooked due to unusual ways without axial dystonia and opthalmic signs, with akinesia and dysequilibrium. The many reports of PSP suggested that the abnormalities of it were vaster than Parkinson's disease. The abnormalities of neurotransmitters or neuromodulators were found not only dopamine system but also serotonin and acetylcholine system. On the basis of them, the various trials of neurotransmitter replacement were done without very successful results so far. Transplantation and nerve growth factor are also tried to treat PSP now.

Diagnosis, Differential↗

A clinicophysiologic study of central and peripheral motor conduction in hereditary demyelinating motor and sensory neuropathy.

Central and peripheral motor nerve conduction were analyzed in 13 patients with hereditary demyelinating motor and sensory neuropathy using central magnetic stimulation and peripheral electrodiagnostic techniques. All patients showed a marked decrease in peripheral nerve conduction velocity. In 11 patients, the central motor conduction time was slightly prolonged but in 2 it was markedly prolonged suggesting dysfunction of the corticospinal tract. These two patients exhibited marked weakness and atrophy of distal muscles without clinical signs of upper motor neuron dysfunction, which was considered to be masked by the lower motor neuron disorder. This study suggests that in some patients with hereditary demyelinating polyneuropathy central as well as peripheral nerve fibers may be affected.

Adolescent↗

Central motor conductivity in aged people.

The conductivity of motor neurons in 26 aged females (mean age 79 years) was analyzed by the conventional conduction method and by pulsed magnetic stimulation and compared with that in 14 younger controls. In aged people, slow motor conduction velocities were found in peripheral nerves. Central motor conduction time (CMCT) in relaxed muscle was shorter in the aged people, although CMCT was normal in mildly contracted muscle. These findings coincide with the results studied in Parkinson's disease, although these subjects were not diagnosed as having Parkinson's disease. Aged people generally have an anteflexed posture, slow movements, and poor postural reflexes, and have been reported to have a decrease in the dopamine level which is relatively earlier than that of other transmitters in the basal ganglia. This may account for the present finding that aged people have neurophysiological abnormalities in CNS which are similar to those in Parkinson's disease.

Adult↗

Quadriceps myositis.

A young woman with slowly progressive muscular weakness and atrophy localized in both thighs is reported. Laboratory, electromyographic and histological findings suggested that the patient suffered from chronic myositis with a background of autoimmune disorder. Quadriceps myositis is a rare condition. The previously reported cases of this disease in the literature are reviewed.

Adult↗

[Diurnal sleep apnea in myotonic dystrophy].

We investigated diurnal sleep apnea in myotonic dystrophy with respiratory inductive plethysmography. Five of eight patients met criteria for sleep apnea syndrome and had central apnea mainly. In a case showing periodic breathing with apnea like Cheyne-Stokes type breathing, the duration of apnea and breath was even and the tidal volume went waxing and waning regularly. In the other four cases, central apneas were observed in sequence, but the duration of apnea and the tidal volume changed variously. Large breaths between apneas elevated arterial oxygen saturation rather than stable breaths without apnea. We suspected that hypoxemia, which exacerbated by involvement of respiratory muscles, supine position and sleep, initiated the hyperventilation between apneas. And then the saturation of oxygen raised by hyperventilation would cause central sleep apnea.

Adult↗

[Aggravation of hypoxemia in supine position in myotonic dystrophy].

Myotonic dystrophy (MyD) involves a variety of systems. Respiratory disorders are common, namely elevation of diaphragm, alveolar hypoventilation, aspiration pneumonia and sleep apnea. We evaluated respiratory involvement. The subjects were 11 patients with MyD. Also 6 patients with limb girdle muscular dystrophy (LG) were examined to be compared with MyD. Both groups had the similar activities of daily living. All of them never complained of dyspnea. Arterial blood gas studies were performed in supine position and standing position. A new evidence was found that hypoxemia was aggravated and alveolar-arterial oxygen pressure difference was increased in supine position in MyD. Next, pulmonary function tests were done in supine position and sitting position. Functional residual capacity (FRC) were more reduced in supine position in MyD compared with LG. The value to subtract closing capacity from FRC was negative in supine position in MyD, showing closing phenomenon. We propose the mechanism of the aggravation of hypoxemia may be the following. The reduction of FRC caused by respiratory muscle involvement brings out the closing phenomenon. Abnormal uneven distribution of ventilation-perfusion ratio happens and then hypoxemia is worsened in supine position in MyD.

Adult↗

[X-ray computed tomographic scans of lower limb and trunk muscles in facioscapulohumeral muscular dystrophy].

X-rays computed tomographic (CT) scans of muscles of the lower limbs and the trunk in 14 patients with facioscapulohumeral muscular dystrophy (FSH) were studied. The CT scans showed that the affected muscles were decreased in density and size. The laterality of muscular involvement was sometimes observed. The muscular lesions in the lower limbs showed proximal distribution. In the thigh, the hamstrings were affected first, the adductor muscles second, and then the muscular involvement progressed to the quadriceps femoris muscle. In the lower leg, the gastrocnemius and soleus muscles were relatively spared as compared with the tibialis anterior muscle. In the lumbar girdle, the abdominal muscles were involved first, the gluteal muscles second, the back muscles third, and the psoas major muscle were relatively spared. The muscular weakness of this distribution exacerbated lumbar lordosis. The neck muscles were less affected than those of the lumbar girdle. The CT scans in FSH demonstrated the characteristic pattern of muscular involvement, which differed from the inherited muscular diseases such as Duchenne muscular dystrophy, myotonic dystrophy, and others.

Adolescent↗

[Mechanism to induce scoliosis in Duchenne muscular dystrophy--a study of paraspinal muscle by X-ray computed tomography].

We studied mechanism to induce scoliosis in Duchenne muscular dystrophy (DMD) by use of X-ray computed tomography (CT) of paraspinal muscles. CT examination of paraspinal muscles was performed on 15 DMD patients at the following six levels; 1. Th3 vertebrae (upper thoracic spine level) 2. Th6 vertebrate (middle thoracic spine level) 3. Th10 vertebrae (lower thoracic spine level) 4. L1 vertebrae (upper lumbar spine level) 5. L3 vertebrae (middle lumbar spine level) 6. L5 vertebrae (lower lumbar spine level). We evaluated the degeneration of paraspinal muscle by a decrease in radio-density of the muscle which indicates infiltration of fatty tissue. The degeneration of the lateral portion of paraspinal muscle was more marked than that of the medial portion. The muscle was most severely affected at the middle lumbar spine level, showing a tendency to increase degeneration at the lower level of the spine. In cases showing laterality of the degeneration of paraspinal muscle, the less affected muscle on CT was located at the convex site of scoliosis. We speculate that the scoliosis occurs when DMD patients have asymmetrical paraspinal muscle degeneration, leading them to take compensatory posture.

Adolescent↗

[A new method of gait analysis in Duchenne muscular dystrophy].

We assessed gait in Duchenne muscular dystrophy (DMD) mainly by determining alteration of foot pressure using a new gait analyzing procedure. DMD patients showed a characteristic foot pressure pattern according to their degree of dysfunction. In stage I disease, the observed pattern was the same as that of normal controls. In stage II, the period during which the center of foot pressure was seen in the front part of the foot was prolonged. This change became more marked in stage III. In stage IV, the center of foot pressure began at the head of the ossis metatarsalis primi and moved back and toward the lateral side. Thereafter, the center of foot pressure again moved forward along the outside of the foot. These changes were considered to be the result of talipes equinus and waddling gait, which are commonly demonstrated in patients with DMD.

Adolescent↗

[Pathogenesis of juvenile muscular atrophy of unilateral upper extremity in reference to venous congestion of epidural space].

MRI and dynamic CT studies were performed in a young male with juvenile muscular atrophy of unilateral upper extremity (JM) with onset at age 15 and clinical course of 2 years. The mechanism of development of congestion in vertebral venous plexus was considered. Dynamic CT of the head in the neck flexion showed rapid reflux of blood from the intervertebral veins into the posterior internal vertebral venous plexus at the C5-C6 level and consequent congestion. It is speculated that in this patient some mechanism associated with head anteflexion led to a reflux into the valveless posterior internal vertebral venous plexus and congestion as well. Furthermore, it could be considered that anterior shift of the dural sac at the time of head anteflexion plays an important role in the development of this internal vertebral venous plexus congestion in JM.

Adolescent↗

[A case of Japanese encephalitis demonstrating characteristic changes in MRI].

A 40-year-old woman developed high fever and headache. Five days later, she was admitted because of consciousness disturbance and tremulous movements in upper extremities. The paired sera showed more than fourfold elevation in complement fixation titer to Japanese encephalitis virus. She was diagnosed as Japanese encephalitis from the clinical features and serological tests. Magnetic resonance imaging (MRI), which was performed about seven months after the onset, revealed abnormal intensity areas bilaterally in the thalamus, hippocampus, substantia nigra, globus pallidus and white matter around the lateral ventricle. Eight months after the onset, she was left with bradykinesia, disturbance of rightening reflex, emotional lability and impairment of recent memory with a long period of amnesia, including not only her illness and subsequent events but also about several years before her illness. The characteristic memory dysfunction seems to be due to disorder of bilateral hippocampus, where MRI revealed abnormal intensity areas. And disorder of medial thalamic nucleus would be related to emotional liability. The relation between the clinical features and MRI findings is also discussed.

Adult↗

Magnetic stimulation study in mirror movements.

A young man with congenital mirror movements was studied by non-invasive magnetic stimulation. Radiological examination showed no craniocervical or pituitary abnormality except for mild atrophy of the right hippocampus. Magnetic stimulation of the motor cortex caused large amplitudes in the ipsilateral hand muscles, indicating the possibility of functional disorder in the motor pathways from the motor cortex to muscles in the upper extremities.

Adult↗

[Working ability between air and trimix breathing gas under 8 ATA air condition].

Pneumatic caisson work in Japan has come into operation since 1924. Afterward, this technique of compressed air work has been widely utilized in the construction of foundation basements, shafts of the bottom tunnel shields for subway and so forth. While using this technique of compressed air work means that workers have to be exposed to hyperbaric environment, this technique has risks of not only decompression sickness (DCS) but also toxicity of poisonous gas and/or oxygen deficiency. However, this technique is independent of city construction work and the operation of compressed air work higher than 5ATA (4.0 kg/cm2G) is actually been planning recently. Accordingly unmanned caisson work is considered as a better technique for such higher pressurized work, even though workers must enter into hyperbaric working fields for maintenance or repair of unmanned operated machinery and materials. This research is to establish the safe work under hyperbaric air environment at 8ATA.

Adult↗

[Amyotrophic lateral sclerosis and mercury--preliminary report].

The mercury and selenium content in the hair of 13 ALS cases was studied by neutron activation analysis. The total mercury content of the hair was 3.70 +/- 2.73 ppm (mean +/- standard deviation) in the ALS patients as a whole, 4.46 +/- 3.16 ppm in the ALS patients from the middle of Kii Peninsula, and 2.49 +/- 1.38 ppm in the ALS patients from other region. As the comparison, mercury content was 2.43 +/- 0.79 ppm in the patients with Parkinsonism, and 2.10 +/- 1.13 ppm in the patients with multiple sclerosis (MS). The selenium content of the hair was 0.36 +/- 0.35 ppm for all ALS patients as a whole, 0.45 +/- 0.25 ppm in the ALS patients from the middle of the Kii Peninsula, and 0.21 +/- 0.47 ppm in the ALS from other region. There were no cases with higher values than mean values of control group, except one case from other regions. It is well known that the selenium decreases the toxicity of mercury in the human body. From these data mercury with low content of selenium might be one of the environmental factors which are thought to be involved in producing of ALS.

Amyotrophic Lateral Sclerosis↗

[MRI findings of the tongue in neurodegenerative diseases with bulbar sign].

We examined the magnetic resonance image (MRI) of the tongue in cases of amyotrophic lateral sclerosis (ALS), bulbo-spinal muscular atrophy (SBMA) and Shy-Drager syndrome (SDS) with sleep apnea. ALS case with severe bulbar disorder showed atrophic, irregularly margin tongue with increased signal intensity in T1-weighted MRI. ALS with less severe bulbar disorder demonstrated mixed hyperintensity and normointensity areas in the tongue. ALS without lingual symptoms showed increased intensity of tongue which suggested subclinical involvement of lingual muscle. BSMA case also showed atrophic tongue with diffusely increased signal intensity. SDS case with sleep apnea was revealed to have round shaped tongue without increased signal intensity, but his tongue fell into the posterior oral cavity, indicating hypotonus of genioglossus muscle. We concluded that MRI of the tongue is useful to determine the bulbar symptoms due to lower neuron disorder or not.

Aged↗