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1.
Colorectal Dis ; 19(1): O34-O38, 2017 Jan.
Article in English | MEDLINE | ID: mdl-27943576

ABSTRACT

AIM: This study aimed to assess the ability of preoperative axial computed tomography (CT) to predict surgical difficulty in bringing the ileal pouch to the level of the anus during restorative proctocolectomy (RPC). METHOD: Patients who underwent RPC with an ileal pouch-anal anastomosis (or ileal pouch-anal canal anastomosis) in our institution between January 2008 and April 2014 were enrolled. The patients were divided into two groups, including those in whom CT indicated potential difficulty in extending the pouch downwards (extension difficult (ED) group) and patients with no CT evidence of potential difficulty (normal group). The groups were compared for clinical factors and the thickness of the slices of CT showing the root of the superior mesenteric artery, the point of communication of the ileocaecal artery with the marginal artery (tICA) and the anal verge (AV). Receiver-operating characteristic analysis was performed, and a cut-off value was calculated for predicting the degree of difficulty in bringing the ileal pouch down to the anal canal. RESULTS: Thirty-four patients were entered in the study. The ED group included significantly taller patients and more with familial adenomatous polyposis than the normal group. The distance between tICA and AV was significantly longer in the ED group, with a cut-off of 21 cm giving a sensitivity of 100% and a specificity of 83.3%. CONCLUSION: The distance between tICA and AV measured by axial CT can be a useful predictor for the difficulty in bringing the ileal pouch down to the anus during RPC.


Subject(s)
Colonic Pouches , Intraoperative Complications/etiology , Preoperative Care/statistics & numerical data , Proctocolectomy, Restorative/adverse effects , Tomography, X-Ray Computed/statistics & numerical data , Adenomatous Polyposis Coli/complications , Adenomatous Polyposis Coli/surgery , Adult , Aged , Anal Canal/diagnostic imaging , Anal Canal/surgery , Anastomosis, Surgical/adverse effects , Anastomosis, Surgical/methods , Body Height , Female , Humans , Ileum/diagnostic imaging , Ileum/surgery , Male , Middle Aged , Predictive Value of Tests , Preoperative Care/methods , Proctocolectomy, Restorative/methods , Tomography, X-Ray Computed/methods , Young Adult
2.
Clin Exp Dermatol ; 35(4): e123-6, 2010 Jun.
Article in English | MEDLINE | ID: mdl-19925486

ABSTRACT

Schnitzler's syndrome is a rare disorder of unknown aetiology characterized by a chronic urticarial eruption, intermittent fever and monoclonal gammopathy. We encountered an interesting patient with this syndrome, who had been misdiagnosed for 10 years as having Sweet's syndrome because of the histopathological picture, which was a prominent perivascular and interstitial neutrophilic infiltrate in the dermis with leucocytoclasia but without vasculitis. An urticarial eruption with this histopathological feature has recently been categorized as neutrophilic urticarial dermatosis, and it is strongly indicative of an associated systemic disease, mainly Schnitzler's syndrome and other inflammatory diseases. We therefore need to be cautious not to confuse Schnitzler's syndrome with Sweet's syndrome. Further, the serum interleukin (IL)-6 levels, but not those of other cytokines and chemokines, correlated with the disease activity in our patient, suggesting that IL-6 may be involved in some of the disease processes, including neutrophil infiltration.


Subject(s)
Neutrophil Infiltration , Paraproteinemias/diagnosis , Sweet Syndrome/diagnosis , Urticaria/diagnosis , Diagnosis, Differential , Humans , Male , Middle Aged , Paraproteinemias/pathology , Syndrome , Urticaria/pathology
3.
J Neuropsychiatry Clin Neurosci ; 15(4): 422-30, 2003.
Article in English | MEDLINE | ID: mdl-14627768

ABSTRACT

A recent publication based on a meta-analysis concluded that there was no association between poststroke depression (PSD) and lesion location. This study, therefore, was undertaken to reappraise the hypothesis using meta-analysis of the correlation between severity of depression following stroke and proximity of the lesion to the frontal pole, an issue that was not examined in the prior meta-analysis. Results showed there was a significant inverse correlation between severity of depression and distance of the lesion from the frontal pole among 163 patients with left hemisphere stroke but not among 106 patients with right hemisphere stroke. This study supports the hypothesis that risk of poststroke depression is related to the location of brain injury.


Subject(s)
Brain Injuries/complications , Depression/etiology , Depressive Disorder/etiology , Dominance, Cerebral , Stroke/complications , Brain Mapping , Diagnostic Imaging , Female , Humans , MEDLINE , Male , Neuropsychological Tests , Psychiatric Status Rating Scales , Severity of Illness Index , Statistics as Topic , Time Factors
4.
Arthritis Rheum ; 45(1): 35-41, 2001 Feb.
Article in English | MEDLINE | ID: mdl-11308059

ABSTRACT

OBJECTIVE: To analyze abnormal gait patterns in patients with rheumatoid arthritis involving the knee joint. METHODS: In 2 patient groups with rheumatoid arthritis, changes in relevant angular parameters in the sagittal plane were analyzed by an electromagnetic tracking instrument. One group consisted of patients with knee joint involvement and severe inflammation without progressive destruction; the other group had knee joint involvement with progressive destruction and low disease activity. Knee angle was measured as the projected angle in the sagittal plane formed by 3 sensors (hip-knee-ankle); the changing mean angle, angular velocity, and angular acceleration were displayed. Furthermore, the angle formed by the vector element's endpoints for each sensor's displacement (designated alpha angle) was measured continuously. RESULTS: Compared with age-matched controls, patients with severe inflammatory knee joint involvement showed limitation of alpha angle change in the stance phase, and patients with knee joint destruction had shortened swing phase duration and decreased alpha angle change in the swing phase. A sharpened alpha angular velocity change curve was observed in the latter. Characteristic differences between groups with inflammation and destruction were more clearly evident from the alpha angle than from the knee angle itself. CONCLUSION: We observed gait differences between rheumatoid arthritis patients with active inflammatory arthritic knee joint involvement without progressive destruction and those with joint destruction and minimal inflammation. Features of gait disturbance in rheumatoid arthritis were not simple, even with a single major site. Therefore, techniques such as biokinetic gait analysis can provide practical information about functional joint integrity in this patient population that could aid in therapeutic decision making.


Subject(s)
Arthritis, Rheumatoid/physiopathology , Gait Disorders, Neurologic/physiopathology , Gait/physiology , Knee Joint/physiopathology , Adult , Aged , Female , Humans , Middle Aged
5.
Neurol Med Chir (Tokyo) ; 40(9): 458-62, 2000 Sep.
Article in English | MEDLINE | ID: mdl-11021077

ABSTRACT

A 4-year-old boy presented with chopstick penetration into the cerebellum via the temporal squamosa and tentorium cerebelli, which resulted in a cerebellar abscess 1.5 years after the injury. The neuroimaging appearance of the wooden chopstick were unusual, hyperdense on computed tomography, and isointense on T2-weighted and hypointense on T2-weighted magnetic resonance imaging. Abscess aspiration and continuous drainage was performed with real-time intraoperative ultrasound guidance. The chopstick fragment was surgically removed and the patient discharged with minor neurological deficits. Wooden foreign body may show changes in properties after a long period of intraparenchymal retention. Extra care is required to remove wooden foreign bodies because of the high risk of infection.


Subject(s)
Brain Abscess/diagnosis , Brain Injuries/diagnosis , Foreign Bodies/diagnosis , Head Injuries, Penetrating/diagnosis , Brain/diagnostic imaging , Brain/pathology , Brain/surgery , Brain Abscess/complications , Brain Injuries/complications , Child, Preschool , Foreign Bodies/surgery , Head Injuries, Penetrating/complications , Humans , Magnetic Resonance Imaging , Male , Tomography, X-Ray Computed , Wood
6.
Clin Neurol Neurosurg ; 102(3): 124-8, 2000 Sep.
Article in English | MEDLINE | ID: mdl-10996708

ABSTRACT

We retrospectively evaluated the MRI from 17 patients with primary brain stem injury obtained in the acute stage. Clinical and radiological findings were analyzed in these 17 patients. T2-weighted imaging proved to be most sensitive and specific for the diagnosis of primary brain stem injury. We found two patterns of brain stem injury. The good prognosis group showed ventral brain stem lesions or dorsal superficial brain stem lesions. On the other hand the poor prognosis group showed deep dorsal brain stem lesions. These acute stage findings are seen only temporally in many cases so that it is most important to examine MRI findings in the acute stage to evaluate the prognosis of the patient. MRI was valuable in predicting the outcome. The possible mechanism of brain stem injury in patients with head injury is briefly discussed.


Subject(s)
Brain Injuries/diagnosis , Brain Stem/injuries , Diffuse Axonal Injury/diagnosis , Magnetic Resonance Imaging , Acute Disease , Adolescent , Adult , Aged , Brain Injuries/diagnostic imaging , Brain Injuries/pathology , Brain Stem/diagnostic imaging , Brain Stem/pathology , Diagnosis, Differential , Diffuse Axonal Injury/complications , Diffuse Axonal Injury/diagnostic imaging , Female , Glasgow Coma Scale , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Tomography, X-Ray Computed , Treatment Outcome
7.
Nihon Kokyuki Gakkai Zasshi ; 38(6): 480-4, 2000 Jun.
Article in Japanese | MEDLINE | ID: mdl-10979289

ABSTRACT

A 59-year-old woman was admitted to our hospital with exertional dyspnea. Linear and reticular opacities in the middle and lower fields of both lungs were observed on chest roentgenograms and chest computed tomograms (CT). The presence of anti RNP-antibody and Raynaud's phenomenon, sclerosis of the fingers, and leukopenia yielded a diagnosis of mixed connective tissue disease associated with interstitial pneumonia. The symptoms and lung involvement were alleviated after the administration of prednisolone (40 mg/day). However, the patient experienced the sudden onset of dyspnea during pulmonary function tests. A chest X-ray film disclosed mediastinal air around the left pulmonary artery, and a chest CT scan demonstrated some blebs in the left lower lung field. After tapering the dosage of prednisolone in 5 mg increments per week, the pneumomediastinum disappeared without treatment. The clinical features and laboratory data findings suggested the patient's interstitial pneumonia was associated with systemic lupus erythematosus rather than with progressive systemic sclerosis or dermatomyositis. The pneumomediastinum may have been due to the rupture of blebs secondary to interstitial pneumonia during pulmonary function tests or as a result of steroid therapy.


Subject(s)
Anti-Inflammatory Agents/adverse effects , Lung Diseases, Interstitial/drug therapy , Mediastinal Emphysema/etiology , Mixed Connective Tissue Disease/complications , Prednisolone/adverse effects , Acute Disease , Female , Humans , Middle Aged , Respiratory Function Tests
8.
Neurol Med Chir (Tokyo) ; 40(6): 295-9; discussion 299-300, 2000 Jun.
Article in English | MEDLINE | ID: mdl-10892265

ABSTRACT

Cerebellar hemorrhage is regarded as a neurosurgical emergency. However, patients with deteriorating consciousness are very likely to die irrespective of the choice of therapy, and it is not clear if surgical intervention can benefit patients in a deeply comatose state. We reviewed 20 patients with a Glasgow Coma Scale score of 3 at admission to ascertain the salvage rate and determine the prognostic factors. Four patients who were managed conservatively died within 2 days. Sixteen patients underwent decompressive suboccipital craniectomy and hematoma evacuation. At discharge, three patients were moderately disabled, three were severely disabled, four were persistently vegetative, and six had died. The overall mortality was 50%. The mean interval between the onset of symptoms and the operation was 1.67 +/- 0.29 hours in patients with favorable outcome, and significantly longer at 2.42 +/- 0.49 hours in patients with an unfavorable outcome (p = 0.025). Immediate evacuation of the hematoma reduces morbidity and mortality even in deeply comatose patients, especially if the time interval between the onset and surgery is within 2 hours.


Subject(s)
Cerebellum/pathology , Cerebellum/surgery , Coma/etiology , Decompression, Surgical/methods , Intracranial Hemorrhage, Hypertensive/surgery , Adult , Aged , Analysis of Variance , Female , Glasgow Coma Scale , Hematoma/surgery , Humans , Intracranial Hemorrhage, Hypertensive/complications , Male , Middle Aged , Retrospective Studies , Survival Analysis , Time Factors , Treatment Outcome
9.
J Gastroenterol ; 35 Suppl 12: 38-41, 2000.
Article in English | MEDLINE | ID: mdl-10779216

ABSTRACT

Helicobacter pylori and nonsteroidal antiinflammatory drugs (NSAIDs) are considered the major causes of peptic ulcer. If ulcers are not attributable to H. pylori, most are thought to be attributable to NSAIDs. We have previously reported that rheumatoid arthritis (RA) patients taking NSAIDs long term (NSAIDs group) are more likely to develop gastric ulcers, which commonly occur in the gastric antrum. In addition, the morphology of gastric ulcers in the NSAIDs group differs from that in the non-NSAIDs group (control group), in whom NSAIDs are not involved in the occurrence of gastric ulcers. In this study, we compared gastric ulcers in the NSAIDs group with those in the control group in terms of H. pylori infection. The positive rate of H. pylori in gastric ulcers was significantly lower in the NSAIDs group than in control group (53.6% vs 91.5%). At the ulcer site they were seen significantly less often in the antrum than in either the angle or body of the stomach (35% vs 100%) in the NSAIDs group. On the other hand, the H. pylori-positive rate for ulcers in the antrum did not differ significantly from that in the angle and body of the stomach (81.8% vs 93.8%) in the control group. These findings suggest that H. pylori plays little role in antral ulcers in those taking NSAIDs.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Arthritis, Rheumatoid/drug therapy , Helicobacter Infections/diagnosis , Helicobacter pylori , Stomach Ulcer/chemically induced , Adult , Aged , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Female , Humans , Male , Middle Aged , Risk Factors , Stomach Ulcer/microbiology
10.
No Shinkei Geka ; 28(4): 337-43, 2000 Apr.
Article in Japanese | MEDLINE | ID: mdl-10769832

ABSTRACT

Peripherally located aneurysms of the posterior circulation are extremely rare. The outcome of patients with peripherally located aneurysms has been poor, and the treatment of such aneurysms has been surgically challenging. We report a consecutive series of peripherally located ruptured aneurysms in the posterior circulation, and discuss in this article the optimal treatment strategy for such lesions. Clinical presentation, neuroradiological findings, treatment method, and the outcome were reviewed retrospectively. Two cases with distal posterior cerebral artery aneurysm, two with distal posterior inferior cerebellar artery aneurysm, two with anterior inferior cerebellar aneurysm, and one with superior cerebellar artery aneurysm were included in this study (mean age, 59.3 +/- 16.0, M:F = 1:6). Three patients with good neurological status on admission who underwent clipping of the aneurysmal neck via craniotomy showed a favorable outcome. In contrast, four patients with poor neurological status on admission who underwent endovascular proximal occlusion of the parent artery showed an unfavorable outcome. Although the outcome of patients who underwent endovascular surgery was poor, endovascular proximal occlusion was effective in preventing re-rupture of the aneurysms. Proximal occlusion of the parent artery has several shortcomings such as cerebral infarction, but proximal occlusion at the very distal area of the parent arteries would not be critical because of good collateral circulation. Thus, endovascular proximal occlusion may provide us another option in the treatment of peripherally located aneurysms especially in patients with poor neurological status. Further data is needed to discover the optimal treatment for patients with peripherally located cerebral aneurysms.


Subject(s)
Intracranial Aneurysm/surgery , Adult , Aged , Aged, 80 and over , Aneurysm, Ruptured/physiopathology , Aneurysm, Ruptured/surgery , Female , Humans , Intracranial Aneurysm/physiopathology , Male , Middle Aged , Retrospective Studies , Treatment Outcome
11.
Neurosurgery ; 45(6): 1323-7; discussion 1327-8, 1999 Dec.
Article in English | MEDLINE | ID: mdl-10598699

ABSTRACT

OBJECTIVE: The outcomes for patients with cerebellar hemorrhage are thought to be influenced by anatomic damage to the brainstem. In this study, we investigated the magnetic resonance imaging findings in the brainstem, to examine the relationship between the degree of brainstem damage and the outcomes for patients with spontaneous cerebellar hemorrhage who are in poor-grade condition. METHODS: The results for 31 patients with spontaneous cerebellar hemorrhage, with Glasgow Coma Scale scores of 8 or less at admission, who underwent magnetic resonance imaging examinations were reviewed. All patients underwent surgical intervention. The patients were divided into two groups according to their Glasgow Outcome Scale scores at the time of discharge, i.e., patients who experienced good recoveries or exhibited moderate disabilities (Group I, n = 8) and patients who exhibited severe disabilities, were in a persistent vegetative state, or had died (Group II, n = 23). We investigated obliteration of the fourth ventricle and the perimesencephalic cistern and the presence of hydrocephalus in initial computed tomographic scans and the presence of areas of high signal intensity in the brainstem in T2-weighted images. RESULTS: Eight patients experienced good outcomes, and 23 patients experienced poor outcomes. The overall mortality rate was 32.3%. There were no significant differences between groups with respect to computed tomographic findings such as hematoma size, but the incidence of high signal intensities in the pons and midbrain in T2-weighted images for Group II was significantly higher than that for Group I (P < 0.01). CONCLUSION: Magnetic resonance imaging clearly demonstrated brainstem damage, and high signal intensity in the brainstem was a significant prognostic factor for determining outcomes for patients with spontaneous cerebellar hemorrhage who were in poor-grade condition.


Subject(s)
Brain Damage, Chronic/diagnosis , Brain Stem/pathology , Cerebellar Diseases/diagnosis , Cerebral Hemorrhage/diagnosis , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Aged , Brain Damage, Chronic/pathology , Brain Damage, Chronic/surgery , Cerebellar Diseases/mortality , Cerebellar Diseases/surgery , Cerebral Hemorrhage/mortality , Cerebral Hemorrhage/surgery , Craniotomy , Decompression, Surgical , Disability Evaluation , Female , Glasgow Coma Scale , Humans , Male , Middle Aged , Postoperative Complications/diagnosis , Postoperative Complications/mortality , Survival Rate
12.
Neurol Med Chir (Tokyo) ; 39(7): 502-8; discussion 508-9, 1999 Jul.
Article in English | MEDLINE | ID: mdl-10437378

ABSTRACT

Image-guided procedures, such as computed tomography (CT)-guided stereotactic and ultrasound-guided methods, can assist neurosurgeons in localizing the relevant pathology. The characteristics of image-guided procedures are important for their appropriate use, especially in brain biopsy. This study reviewed the results of various image-guided brain biopsies to ascertain the advantages and disadvantages. Brain biopsies assisted by CT-guided stereotactic, ultrasound-guided, Neuronavigator-guided, and the combination of ultrasound and Neuronavigator-guided procedures were carried out in seven, eight, one, and three patients, respectively. Four patients underwent open biopsy without a guiding system. Twenty of 23 patients had a satisfactory diagnosis after the initial biopsy. Three patients failed to have a definitive diagnosis after the initial procedure, one due to insufficient volume sampling after CT-guided procedure, and two due to localization failure by ultrasound because the lesions were nonechogenic. All patients who underwent biopsy using the combination of ultrasound and Neuronavigator-guided methods had a satisfactory result. The CT-guided procedure provided an efficient method of approaching any intracranial target and was appropriate for the diagnosis of hypodense lesions, but tissue sampling was sometimes not sufficient to achieve a satisfactory diagnosis. The ultrasound-guided procedure was suitable for the investigation of hyperdense lesions, but was difficult to localize nonechogenic lesions. The combination of ultrasound and Neuronavigator methods improved the diagnostic accuracy even in nonechogenic lesions such as malignant lymphoma. Therefore, it is essential to choose the most appropriate guiding method for brain biopsy according to the radiological nature of the lesions.


Subject(s)
Biopsy/methods , Brain Diseases/diagnosis , Brain/pathology , Stereotaxic Techniques , Aged , Brain/diagnostic imaging , Brain Diseases/diagnostic imaging , Brain Diseases/pathology , Diagnostic Errors , Echoencephalography/methods , Female , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Male , Patient Selection , Reoperation , Tomography, X-Ray Computed
13.
J Neurosurg ; 91(1 Suppl): 121-3, 1999 Jul.
Article in English | MEDLINE | ID: mdl-10419358

ABSTRACT

Although the craniovertebral junction is one of the most common sites at which anomalies develop, spina bifida occulta of the axis (C-2) associated with cervical myelopathy is extremely rare. The authors present the case of a 46-year-old man who developed progressive tetraparesis caused by a cervical canal stenosis at the level of the axis. The spinal cord was compressed by an invaginated bifid lamina of the axis. The patient made a remarkable recovery after undergoing decompressive laminectomy of C-3 and removal of the bifid posterior arch of the axis.


Subject(s)
Axis, Cervical Vertebra/abnormalities , Spina Bifida Occulta/complications , Spinal Cord Compression/etiology , Axis, Cervical Vertebra/surgery , Decompression, Surgical , Humans , Laminectomy , Male , Middle Aged , Quadriplegia/etiology , Spina Bifida Occulta/surgery , Spinal Cord Compression/surgery , Spinal Stenosis/etiology
14.
Nihon Kokyuki Gakkai Zasshi ; 37(1): 45-50, 1999 Jan.
Article in Japanese | MEDLINE | ID: mdl-10087876

ABSTRACT

Sarcoidosis was diagnosed in a 55-year-old non-smoking woman because biopsy specimens of a subcutaneous tumor in her right cheek disclosed a noncaseating epithelioid granuloma. The patient had experienced exertional dyspnea and palpitation. Two months later, she was admitted because a Holter electrocardiogram (ECG) revealed bradycardia, 2:1 atrioventricular block (Mobitz II type) and ventricular premature beat (1.091 beats/day). ECG findings on admission changed from 2nd-degree to 3rd-degree atrioventricular block. A permanent pacemaker was implanted and the patient's symptoms subsided. Mediastinal uptake of Gallium-67 was observed and a defect of the cardiac septum was disclosed by Thalium-201 scintigram. Closer examination of the first Holter ECG revealed a Mobitz II type 2:1 atrioventricular block for about 3 minutes a day. Although the findings of the first Holter ECG initially disclosed a 2nd-degree atrioventricular block in our patient, a complete block developed within about 2 months after admission. In the follow-up of sarcoidosis patients, it therefore seems important to not only evaluate Holter ECG findings carefully, but repeat the examination at regular intervals.


Subject(s)
Cardiomyopathies/diagnosis , Electrocardiography, Ambulatory , Heart Block/diagnosis , Sarcoidosis/diagnosis , Cardiac Pacing, Artificial , Female , Heart Block/therapy , Heart Septal Defects/diagnostic imaging , Humans , Middle Aged , Radionuclide Imaging
15.
No Shinkei Geka ; 27(1): 67-71, 1999 Jan.
Article in Japanese | MEDLINE | ID: mdl-10024987

ABSTRACT

A 65-year-old female was admitted to our hospital with a 6-month history of a gradually enlarging subcutaneous mass in the frontal region. Neurological examination on admission showed no significant abnormality. Skull X-P showed an osteolytic lesion of the frontal bone. External carotid angiogram demonstrated a tumor stain fed by the middle meningeal artery. Computed tomography (CT) showed a slightly high density mass with a marked homogeneous enhancement. MRI revealed an iso-intensity mass on both T1- and T2-weighted images. Gd-DTPA-enhanced T1-weighted images showed a mass with a marked homogeneous enhancement with the "dural tail sign" in the dura adjacent to the tumor. The tumor was totally removed; this mass was diagnosed as a multiple myeloma. No tumor cells were seen in the dura adjacent to the tumor and the mechanism of dural enhancement around the tumor was not clear. However, it is possible that the "dural tail" is due to increased vascular permeability of the dural vessels. Although the "dural tail" sign has been considered as a highly specific feature of meningioma, multiple myeloma can show the same findings on MRI. Therefore, it is important to consider the possibility of multiple myeloma in the differential diagnosis of meningeal tumors.


Subject(s)
Meningeal Neoplasms/diagnosis , Multiple Myeloma/diagnosis , Aged , Diagnosis, Differential , Female , Gadolinium DTPA , Humans , Magnetic Resonance Imaging , Multiple Myeloma/diagnostic imaging , Multiple Myeloma/pathology , Tomography, X-Ray Computed
16.
Compr Psychiatry ; 39(6): 386-91, 1998.
Article in English | MEDLINE | ID: mdl-9829147

ABSTRACT

Eighty inpatients and 20 outpatients with ICD-10 schizophrenia were assessed with the Manchester Scale (MS) and the scale for the assessment of Subjective Experience of Deficits in Schizophrenia (SEDS). A factor analysis on MS scores yielded a three-factor solution: negative symptoms, positive symptoms, and anxious-depressive factor. On the other hand, a factor analysis on SEDS scores provided a seven-factor solution. The first factor, "awareness of social incompetence (ASI)," positively correlated with the anxious-depressive factor. ASI may reflect a negative cognitive attitude of persons who easily become depressive. The second factor, "subjective cognitive disturbance (SCD)," positively correlated with the positive-symptoms factor. SCD might represent a subtle disturbance, which can also produce positive symptoms. We found no factor on SEDS that correlated with the negative-symptoms factor. It was noted that a selection and comparison of items and the cultural background of subjects should be considered.


Subject(s)
Schizophrenia/diagnosis , Adolescent , Adult , Aged , Antipsychotic Agents/therapeutic use , Anxiety Disorders/complications , Anxiety Disorders/diagnosis , Anxiety Disorders/psychology , Chlorpromazine/therapeutic use , Depressive Disorder/complications , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Schizophrenia/complications , Schizophrenia/drug therapy , Schizophrenic Psychology
17.
Biochem Biophys Res Commun ; 249(1): 161-5, 1998 Aug 10.
Article in English | MEDLINE | ID: mdl-9705849

ABSTRACT

When tetanized frog skeletal muscle fibers are subjected to moderate-velocity stretches (< 1 L0/s), the tension developed above the level of isometric tension starts to decay after a sudden reduction of stretch velocity by more than 40-50%, though the fibers are still being stretched. We analysed the decay of tension response caused by the sudden reduction of stretch velocity, by applying three different types of stretch to a tetanized fiber, i.e., a 1.5% stretch with velocity V1 (stretch-1), a 1.5% stretch with velocity V2 < V1 (stretch-2), and a 3% stretch consisting of stretch-1 and stretch-2 applied in succession (stretch-3) and comparing the corresponding tension responses, TR-1, TR-2, and TR-3. It was found that TR-3 to stretch-3 resulted from algebraical summation of TR-1 to the preceding stretch-1 and TR-2 to the subsequent stretch-2. These results can be accounted for by assuming two distinct cross-bridge populations in stretched fibers.


Subject(s)
Muscle Contraction , Muscle Fibers, Skeletal/physiology , Muscle, Skeletal/cytology , Muscle, Skeletal/physiology , Animals , Anura
18.
J Neurosurg ; 88(3): 601-4, 1998 Mar.
Article in English | MEDLINE | ID: mdl-9488321

ABSTRACT

The authors describe the case of a 16-year-old boy presenting with clinical onset of subarachnoid hemorrhage. The patient was found to have a small aneurysm arising from the distal portion of a basal perforating branch of the anterior cerebral artery (ACA), lying within a cavum septi pellucidi. Neuroimaging demonstrated a hematoma within the cavum septi pellucidi and the aneurysm was resected via a transcallosal approach guided by an intraoperative portable digital subtraction angiography (DSA) system. The origin of the aneurysm was presumed to be idiopathic. This report is the first to describe an aneurysm of a basal perforating artery arising from the ACA that resulted in an intracaval hematoma. When approaching small vascular lesions during surgery, intraoperative DSA is the method of choice to identify the precise trajectory and distance to the lesions.


Subject(s)
Intracranial Aneurysm/diagnostic imaging , Septum Pellucidum/blood supply , Adolescent , Angiography, Digital Subtraction , Cerebral Angiography , Cerebral Arteries/pathology , Cerebral Hemorrhage/diagnostic imaging , Corpus Callosum/surgery , Humans , Intracranial Aneurysm/surgery , Intraoperative Care , Male , Radiography, Interventional , Subarachnoid Hemorrhage/diagnostic imaging
19.
Neurol Med Chir (Tokyo) ; 38(12): 836-42; discussion 842-3, 1998 Dec.
Article in English | MEDLINE | ID: mdl-10063357

ABSTRACT

Atherosclerosis is a generalized disease which afflicts a considerable number of patients in both the carotid and coronary arteries. Although the risk of stroke or death use to combined carotid endarterectomy (CEA) and coronary artery bypass graft (CABG) is thought to be higher than that of each individual operation, the combined procedure is generally preferred over staged operations to treat such patients. We performed the combined procedure safely with the aid of intraoperative portable digital subtraction angiography (DSA). This report describes our experience with the operative strategy of simultaneous CEA and CABG. Ninety CEA and 404 CABG were carried out between January 1989 and December 1997. A total of six patients received the combined procedure with the aid of intraoperative DSA; they were studied retrospectively. Postoperative mortality and morbidity after the combined procedure was 0%. In the combined procedure, neurological complications are difficult to detect after CEA because the patient must be maintained under general anesthesia and extracorporeal circulation during the subsequent CABG. However, intraoperative DSA can confirm patency of the internal carotid artery and absence of flap formation after CEA, and the CABG can be performed safely. Intraoperative portable DSA between CEA and CABG is helpful in preventing perioperative stroke in the combined procedure.


Subject(s)
Carotid Stenosis/surgery , Coronary Artery Bypass , Coronary Artery Disease/surgery , Endarterectomy, Carotid , Aged , Angiography, Digital Subtraction , Carotid Stenosis/diagnostic imaging , Cerebral Angiography , Combined Modality Therapy , Coronary Artery Disease/diagnostic imaging , Female , Humans , Male , Middle Aged , Postoperative Complications/diagnostic imaging , Postoperative Complications/etiology
20.
Ryumachi ; 37(3): 493-8, 1997 Jun.
Article in Japanese | MEDLINE | ID: mdl-9256034

ABSTRACT

We report 2 elderly patients who present with a relatively acute onset of a severe symmetrical synovitis affecting the flexor digitorum tendon sheaths and wrist joints with pitting edema of the dorsum of both hands. These patients were seronegative for rheumatoid factor and responded to treatment with low dose predonisone (10 mg daily) without relapse. These presenting features were closely linked with the RS3PE syndrome originally described by McCarty.


Subject(s)
Edema/etiology , Synovitis/complications , Aged , Anti-Inflammatory Agents/administration & dosage , Female , Foot , Hand , Humans , Male , Middle Aged , Prednisolone/administration & dosage , Purpura/drug therapy
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