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K Negoro

Publications and source records attributed to K Negoro.

50 records · Page 3Linked to original sources

[A case of multiple cerebral infarctions associated with hemichorea induced by amantadine hydrochloride].

We report an 80-year-old woman with hemichorea probably due to amantadine hydrochloride. She visited our hospital because of gait disturbance and decreased mental activity. She was diagnosed as multiple cerebral infarctions and treated with 100 mg/day of amantadine hydrochloride. After two weeks she showed choreic movement of the face and right arm and leg. Haloperidol was administered and her choreic movement disappeared. Brain MRI showed multiple cerebral infarctions in the white matter. There was no lesion in the left basal ganglia. SPECT showed hyperperfusion in the left basal ganglia when choreic movement appeared. After choreic movement disappeared, SPECT showed no asymmetrical blood flow. These findings suggest hemichorea was related to hyperfunction of dopaminergic neurons in the left basal ganglia.

Aged↗

[Clinical and MRI correlation in multiple system atrophy].

By using magnetic resonance imaging (MRI), we studied 11 patients with multiple system atrophy (MSA): 5 olivo-pontocerebellar atrophy (OPCA), 2 Shy-Drager syndrome (SDS), and 4 striatonigral degeneration (SND). The diagnoses of OPCA, SDS and SND were clinically made. The MR images were performed on 1.5 tesla MRI unit (Siemens Asahi Medical, Magnetom H15), using a T2-weighted spin echo (SE) sequence (TR: 2000-3000ms, TE: 80-90ms), a T1-weighted SE sequence (TR: 550, TE: 15), and a proton density-weighted (PD) SE sequence (TR: 2000-3000, TE: 12-22). In the patients with OPCA, MRI revealed cerebellar and brainstem atrophy and degeneration of pontine transverse fibers more marked than in the patients with SDS and SND. T2-weighted images showed low intensity in posterolateral putamina in one OPCA patient and all of SDS and SND patients. PD images demonstrated the abnormal slit-like high signals in posterolateral putamina in three SND. The degree of cerebellar ataxia was not well correlated with cerebellar and brainstem atrophy and degeneration of pontine transverse fibers. There was a positive correlation between the atrophy of cerebellum and brainstem and the duration of cerebellar ataxia. In most of the patients with parkinsonism, MRI demonstrated abnormal low signals in putamina on T2-weighted images. There were positive correlations between the abnormal low signals putamina and the duration and severity of parkinsonism. Though abnormal low signals in lateral putamina may be seen in normal aging and other disorders on T2-weighted images, it is useful to evaluate parkinsonism in MSA.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[A case of isolated adrenocorticotropic hormone deficiency with adrenocorticosteroid-responsive brain edema and repeated confusions].

A 60-year-old man developed confusional state with severely abnormal electroencephalogram and brain edema on computed tomography (CT) of brain. Adrenocorticosteroid therapy was dramatically effective for the confusional state and brain edema. The reduction of adrenocorticosteroid induced confusional states, and they disappeared with the increase of adrenocorticosteroid. When brain edema on CT disappeared, T 2-weighted magnetic resonance imagings revealed diffuse high signal in the white matter. A diagnosis of isolated adrenocorticotropic hormone deficiency was made by endocrinological examinations and clinical features. We suggest that brain edema in this patient is due to deficiency of glucocorticoid. High intensity area in the white matter may show the degeneration of the white matter following brain edema.

Adrenocorticotropic Hormone↗

[MRI and SPECT of adrenoleukodystrophy (cerebello-brainstem dominant form)--a case report].

We reported a 28-year-old man with adrenoleukodystrophy showing neurological features of olivopontocerebellar atrophy. He had a 11-year history of Addison's disease. ACTH stimulation produced no rise in the plasma cortisol level. The ratios of C24:0/C22:0, C25:0/C22:0, and C26:0/C22:0 in fatty acids of sphingomyelin from plasma were all increased. MRI showed the atrophy of brainstem and cerebellum and the abnormal hyperintense lesions of the bilateral pyramidal tracts in the brainstem and internal capsule. 99mTc-HM PAO SPECT showed hypoperfusion of the deep white matter, frontal lobes, temporal lobes, and cerebellum. We suggest that SPECT may be useful for detection of subclinical lesions in ALD.

Adrenoleukodystrophy↗

[Clinical analysis of paralytic shellfish poisoning following ingestion of oysters].

We describe five patients of paralytic shellfish poisoning (PSP) following ingestion of oysters in January 1991, in Nagato, Yamaguchi. The five patients (four men and one woman, age range:37-80 years) developed symptoms three-nine hours after consuming oysters. Symptoms included paresthesia of the mouth and tongue (three), paresthesia of the extremities (five), and quadriparesis (five). The median duration of neurological symptoms was 16 hours. All five patients completely recovered. Although PSP is rare as compared with globe fish poisoning in Japan, the fatality rate of PSP is 8%-9%, with deaths occurring in one-12 hours secondary to respiratory failure. PSP is an important disorder for differential diagnosis of acute paralytic illnesses, such as globe fish poisoning, botulism, acute polyradiculoneuropathy, fisher syndrome, myasthenia gravis, and periodic paralysis.

Adult↗

[A case of cough headache with Chiari malformation (type I)].

A 38-year-old woman complained for about 5 years of attacks of headache elicited by coughing, sneezing, and laughing. These attacks became more frequent and more severe. Physical examination showed a short and broad neck. Neurological examination revealed no abnormality. Magnetic resonance imaging demonstrated the Chiari malformation (type I) and the cerebral venous angioma in left frontal white matter. A posterior decompression by suboccipital craniectomy with C1 laminectomy was performed. The headache completely disappeared. Before and after the operation, we measured the intracranial subdural pressure by a small pressure transducer. The raised cranial pressure by the Valsalva's maneuver prolonged for more than one minute. Postoperatively, the raised cranial pressure by the Valsalva's maneuver decreased rapidly. We consider that the cough headache of this patient was associated with a valve-like blockage by the Chiari malformation (type I) at the foramen magunum, resulting in cranio-spinal pressure dissociation by interference with downward pulsation. We believe that there was no correlation between the cough headache and the cerebral venous angioma.

Adult↗

[Isolated inferior rectus muscle paresis from midbrain infarction].

A 74-year-old woman, with hypertension and dilated cardiomyopathy, presented with sudden onset of diplopia without vertigo and other neurological symptom. Examination revealed left inferior rectus muscle paresis. Other neurological findings were normal. She had no cerebellar ataxia and sensori-motor dysfunction. Magnetic resonance imaging showed increased signal intensity on T2-weighted and proton density-weighted images in the right ventral midbrain, compatible with infarction involving the fascicular oculomotor fibers. Complete resolution of the diplopia and normal ocular motility were noted 3 months after the onset of the diplopia. Focal ischemic midbrain lesions should be considered in cases of isolated partial oculomotor nerve paresis.

Aged↗

Antitumor agents, 79. Cytotoxic antileukemic alkaloids from Brucea antidysenterica.

Two cytotoxic antileukemic alkaloids, the new 1,11-dimethoxycanthin-6-one (3) and the known 11-hydroxycanthin-6-one (1), as well as the known canthin-6-one (2) were isolated from the stem of Brucea antidysenterica. The structures of 1-3 were determined from their spectral data and X-ray analysis of the o-bromobenzoate of 1.

Alkaloids↗