Biomedical subjects
Publications and source records attributed to Y Tokumaru.
A case of type B human botulism was found in Tochigi Prefecture in November, 1984. Botulinum type B toxin was detected in the serum and feces of the patient. The serum toxin was activated by trypsinization. Type B toxin was demonstrated in cooked meat medium cultures of the fecal specimens. The patient recovered after administration of type A, B, E and F quadrivalent antitoxin.
Hyperkinésie volitionnelle is one of the involuntary movements discriminated from intention tremor. It occurs idiopathically and with cerebral infarction, head trauma, brain tumors, multiple sclerosis, hepatolenticular degeneration and polyneuropathy. Here, we report a case of toluene intoxication presenting hyperkinésie volitionnelle. A 28-year-old painter noticed a tremor of the upper extremities on December 1979. The tremor occurred both in posture and in voluntary movements. The tremor gradually developed and appeared in the legs in May 1980. Slight titubation of the trunk and head was marked in sitting posture. He showed staggering of gait. On August 1980, he exhibited slurred speech. He was admitted to the Department of Neurology of Chiba University Hospital on January 19th, 1981. Neurological examination revealed slight mental deterioration, pendular nystagmus, bradylalia, 4-5 c/s violent postural tremor of the upper extremities, action myoclonus, head and truncal titubation, mild leg tremor in sitting posture. The tremor increased terminally on finger to nose testing, and showed fast, coarse, convulsive movement (movement oppositionniste). But there was no dysmetria. The involuntary movements, above mentioned, were summarized as hyperkinésie volitionnelle. Muscle tone was hypotonic. Muscle weakness and atrophy were not seen. Deep tendon reflexes were all exaggerated, but there was no pathological reflex. He showed wide-based ataxic gait. Sensory and autonomic functions were normal. Blood, urine and cerebrospinal fluid analysis appeared normal. Electroencephalography showed 40-50 microV, 9-10 c/s alpha waves with a few fast waves.(ABSTRACT TRUNCATED AT 250 WORDS)
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To re-evaluate the current potency tests of C. oedematiens anti-toxin that titrates only the anti-lethal activity in mice, investigations were made on neutralization of the lethal, edematizing, and hemolytic activities with different preparations of the antitoxin and on their therapeutic effects. The anti-lethal and anti-edematizing potencies of antitoxins prepared by hyperimmunization with each of crude and purified antigens were the same when titrated with either crude or purified lethal toxin as test toxin. The two antitoxins protected mice equally against the lethal and edematizing activities of crude toxin. The antitoxin prepared against highly purified hemolytic toxin contained neither anti-lethal nor anti-edematizing activity. We conclude that the lethal and edematizing activities of C. oedematiens. are borne by the same molecule and that the therapeutic effect of the antitoxin may depend entirely on the anti-lethal (or anti-edematizing) activity. The method currently used for titrating C. oedematiens antitoxin, therefore, appears to be valid.
Five patients with HSE were treated with adenine arabinoside and one additional patient with cytosine arabinoside. The diagnosis of HSE was confirmed in retrospect by the rising CF titers and the Enzyme-Linked Immunosorbent Assay (ELISA) levels in CSF (Table 2). Brain biopsy was not performed. The treatment was started promptly when HSE was strongly suspected by symptoms and signs, EEG, CT and CSF findings before the specific laboratory data were available. The clinical and laboratory data on the 6 patients were shown in Table 1. All the 5 patients of HSE treated with adenine arabinoside survived: 3 returned to normal daily life, including one having no neurological deficits, and the other 2 had mild to moderate memory disturbances. Improvement of CT abnormalities indicated a good prognosis. Age or sex did not have influence on the prognosis. The patient treated with cytosine arabinoside died of complications after being in a state of apallic syndrome for 1 year and 8 months. On the basis of the analysis of our patients, one of the crucial factors in the treatment of HSE seems to be the earliest possible use of adenine arabinoside: in our patients on the 2nd up to 9th day of onset, although there was no correlation between the day the medication was started and the morbidity. The other important factor includes the management of acute stage of HSE: the treatment of cerebral edema and generalized convulsions. The major side effects of adenine arabinoside included diarrhea (one case), elevation of GOT, GPT or LDH (one case) which all improved after the treatment. Adenine arabinoside could be an effective drug for HSE reducing the mortality and morbidity with few side effects.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We have applied tegaful and uracil (UFT) treatment as adjuvant chemotherapy to patients after the completion of primary therapy. UFT was given per os at a dose of 300 or 400 mg/day for more than 1 year. A retrospective study was conducted on 15 patients, assessed as the UFT-treated group, and 24 patients assessed as the UFT-nontreated group. The 5-year survival rate in patients treated or not treated with UFT was 76.6 and 22.6%, respectively. Among those who underwent surgery in combination with other therapy, the 5-year survival rate was 74.1% with UFT and 27.3% without UFT. In patients receiving chemotherapy plus radiotherapy alone, the 5-year survival rate was 80.0% with UFT and 19.2% without UFT. In 23 patients with proven effects of neoadjuvant chemotherapy comprising 18 PR cases and 5 CR cases, a comparison was made between 10 patients treated with UFT and 13 patients not treated with UFT. As a result, the 5-year survival was 76.2 and 17.9%, respectively. In the patients with T3 disease, who occupied the majority, the 5-year survival rate was 71.4 and 23.8%, respectively. Adjuvant chemotherapy with UFT tends to show a substantial significant difference particularly in patients who were successfully treated with radiotherapy plus chemotherapy as the primary treatment. UFT was clearly shown to have a statistically significant effect, despite a small population. The findings of the present investigation point to the value of conducting further study to ascertain the effect of UFT by a randomized trial in a larger population.
BACKGROUND: Juvenile muscular atrophy of distal upper extremity is a peculiar type of cervical myelopathy affecting young people characterized by localized amyotrophy in the forearm and hand that is initially progressive, and then stabilized in a few years. The anterior horn cell damage may be induced by forward displacement of the lower cervical dural sac and spinal cord on neck flexion. We proposed that the forward displacement was one of pathogenic factors, and reported that therapeutic intervention using a cervical collar in order to minimize neck flexion halted the progressive weakness in some patients. OBJECTIVE: To examine effectiveness of cervical collar treatment for this disease and to investigate clinical and radiological profiles that predict a favorable outcome before treatment. METHODS: Thirty-eight patients who had progressive illness within 5 years after onset underwent cervical collar therapy (treatment group). Forty-five patients in a previous case series without any therapeutic intervention made up a control group. The duration of progressive phase of illness was compared between the two groups. In the treatment group, the time interval from onset and the measurements of cervical cord atrophy and its flattening on neck flexion at the introduction of treatment by CT-myelography or MRI were analyzed with respect to prognosis. RESULTS: All the patients in the treatment group showed no further progression after introduction of treatment. The duration of the progressive period was shorter in the treatment group (mean 1.8 +/- 1.2 years) than in the control group (mean 3.2 +/- 2.3 years) (p < 0.005). In the treatment group, 15 of 31 patients within 2.5 years after the onset showed not only stabilization but also improvement of muscular weakness or cold paresis. Five of 7 patients who had no or mild cord atrophy at the introduction showed improvement after treatment. CONCLUSION: Cervical collar therapy induces a premature arrest of this disease. Improvement is expected in patients who have shorter duration of illness and have mild cord atrophy in a neutral neck position. Early diagnosis and therapeutic intervention may minimize the functional disability of young patients.