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Biomedical subjects

N Wakata

Publications and source records attributed to N Wakata.

At least 19 recordsLinked to original sources
PubMed2001

Bupivacaine hydrochloride induces muscle fiber necrosis and hydroxyl radical formation-dimethyl sulphoxide reduces hydroxyl radical formation.

We induced acute skeletal muscle necrosis in rats using bupivacaine hydrochloride and found that both 2,5- and 2,3-dihydroxybenzoic acid significantly increased in skeletal muscle. A single administration of dimethyl sulphoxide, a free radical scavenger, significantly lowered concentrations of 2,5- and 2,3-dihydroxybenzoic acid. These results suggest that dimethyl sulphoxide is an effective hydroxyl radical scavenger and may be useful in the treatment of myopathy.

Anesthetics, Local↗
PubMed2001

[A thyrotoxic myopathy accompanied with unusual muscle symptoms and MRI muscle findings].

We report a patient with thyrotoxic myopathy associated with unusual muscle symptoms. A 29-year-old man developed hyperhidrosis, diarrhea, increase in appetite, and excitability in July, 1999. In August, he experienced muscle stiffness in bilateral lower extremities after maintaining postures such as driving a car or sitting on a chair. He was admitted to our hospital, in January, 2000. On physical examination, goiter was noted. Neurological examination was normal except for proximal muscle weakness. Laboratory test showed elevated free T3 and free T4, decreased TSH. TSH receptor antibody was increased. MRI of lower extremities revealed atrophy of bilateral biceps femoris. Muscle strength increased gradually after an oral administration of thiamazole 30 mg/day, and muscle stiffness disappeared. The clinical features of this patient and differential diagnosis were discussed.

Adult↗
PubMed2000

IDPN-induced monoamine and hydroxyl radical changes in the rat brain.

beta-beta'-iminodipropionitrile (IDPN)-induced monoamine and hydroxyl radical changes in the rat brains were studied. IDPN caused decreases in 5-HT and 5-HIAA levels in all brain regions, strongly indicating that IDPN's neurotoxicity primarily affects 5-HT containing neurons. Dopamine and its metabolites' levels decreased in the some regions, most likely due to depression of dopamine metabolic turnover. Our results more clearly demonstrate IDPN-induced monoamine alterations in the rat brain more than previous reports. To clarify one of the pathogenesis of IDPN-induced neurological disorders, we measured hydroxyl radical levels. 2,3-DHBA increased at 1st day, and decreased in some regions at 7th days after discontinuing IDPN. We conclude, hydroxyl radical formation causes neuronal damage, and monoamine changes contribute to IDPN-induced neurological disorder.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1999

[Treatment of myasthenia gravis].

The strategy of myasthenia gravis has been progressed during recent 30 years. Extended thymectomy and alternate-day prednisolone administration remarkably improved therapeutic effect in myasthenia gravis. Besides of these therapies, plasmapheresis and immunoadsorption plasmapheresis extremely improved mortality in myasthenia gravis. 1. Corticosteroid therapy Usually initial doses of PSL is 20-30 mg every other day in the morning after thymectomy, and increased 5 mg every on-day. Maximum PSL doses is 80-100 mg alternate-day, then this doses will be maintained over 4 weeks. After these procedures, PSL is gyradually decreased and discontinued within 2-3 years. 2. Thymectomy Extended transsternal thymectomy is the most useful method, because many authors have reported that re-thymectomy reveals re-appearance of thymus. 3. Invasive thymoma Although this type of thymoma has been called malignant thymoma, it should be called as invasive thymoma since any thymoma can invade surrounding tissues for a long subclinical period. Strategy of treating invasive thymoma is PSL administration, radiation and chemotherapy. Chemotherapy should be performed depend on histopathological findings of thymoma. CHOP therapy is useful for the lymphocytic cell predominant type of thymoma, however CHOP + cis-platin therapy is useful for the epithelial cell predominant type. Treatment of myasthenia gravis has been improved, however it is still unclear that how to treat invasive thymoma, and how to prevent re-appearance of symptoms by decrease or discontinuity of PSL administration.

Adrenal Cortex Hormones↗
PubMed1998

Satoyoshi's syndrome in an adult: a review of the literature of adult onset cases.

Satoyoshi syndrome consists of painful intermittent muscle spasms, alopecia and diarrhea. The age of onset is commonly less than 20 years of age. Adult onset of this syndrome is rare. We report a 65-year-old Japanese woman with Satoyoshi's syndrome of adult onset. Satoyoshi's syndrome of adult onset shows no skeletal abnormalities, in comparison with the classical pediatric cases. The clinical features in our patient revealed the benign and long-term course of muscle spasm and alopecia. This progression differed markedly from the other patients of adult onset. Thus, the severity of Satoyoshi's syndrome is variable in adult onset cases, and this diagnosis should be considered in adults with various and unexplained muscle spasms.

Age of Onset↗
PubMed1998

[A case of eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis with unique brain MRI findings].

A 17-year-old Japanese girl was admitted to our hospital because of meningeal irritation, hyperesthesia of extremities, and disturbance of consciousness after having traveled to Okinawa in February, 1996. Examination on admission revealed pleocytosis of CSF with many eosinophils (65%) and increased eosinophils (25%) in the peripheral blood. The history and clinical symptoms were suggestive of a parasitic infection. We diagnosed the patient as having eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis, which was confirmed by immunological tests of double diffusion, counterimmuno-electrophoresis, and ELISA. Magnetic resonance imaging (MRI) of the brain demonstrated multiple small high intensity areas on Gd-DTPA-enhanced T1-weighted images. MRI findings suggested tissue reactions to dead or dying worms, and local vasodilatation associated with minimal thrombus formation.

Adolescent↗
PubMed1998

[Sensory disturbance of crossed oral-pedal topography in a case of lateral medullary infarction].

We report a 40-year-old man with hypertension and diabetes mellitus, who had crossed oral-pedal sensory disturbance in lateral medullary infarction. He suddenly developed dysesthesia in the right mount and the left leg. His blood pressure was 150/90 mmHg. Neurological examination showed Horner's sign in the right eye and horizontal nystagmus. Sensory function revealed decreased temperature, hypalgesia and dysesthesia in the right mouth and the left leg. Vibratory and position sense were normal. T1- and T2-weighted images disclosed a low and high signal intensity area in the lateral portion of the right medulla oblongata, respectively. Brain and neck MRA using time-of-flight sequence revealed no obvious abnormal structures. We have diagnosed him as lateral medullary infarction. The unique topography of sensory dysfunction thought to be attributed to a far-lateral lesion in the medulla oblongata. Our patient suggests that lateral medullary infarction causes variable patterns of sensory disturbance. Thus, lateral medullary infarction should be warranted when we encounter patients with miscellaneous distribution of sensory impairment, such as crossed mouth-foot hypalgesia.

Adult↗
PubMed1996

[Polymyositis after interferon beta treatment of chronic hepatitis type C].

We reported a case of polymyositis manifested after beta-interferon therapy for chronic viral hepatitis type C. In November 1992, a 62-year-old female was diagnosed as having chronic viral hepatitis type C. In January 1993, she was treated with beta-interferon(total 2.52 x 10(8)IU). In March 1993, after the treatment, she noticed weakness and atrophy of her lower extremities. Neurological examination revealed proximal dominant muscle weakness and atrophy of the extremities. Increased levels of serum CK and aldolase were disclosed on admission. By needle EMG, a low voltage with short duration interference pattern was noted. February 7, by muscle biopsy of the right quadriceps, necrotic myofibers, marked variation in fiber diameter, stromal mononuclear cell infiltration, and endomysial fibrosis was detected. The immunological stain of infiltrating cells in the muscle fibers revealed CD4:CD8 ratio as 64:55, whereas in conventional polymyositis CD8 cells dominate CD4 cells. Diagnosis of polymyositis was made and oral prednisolone 60 mg a day was started. Her symptoms and signs improved gradually and she was discharged after 2 months. Many adverse effects due to immunological disturbances caused by interferon treatment have been reported, but polymyositis due to interferon has been very rare. When interferon will be prescribed, manifestation of polymyositis should be considered.

Chronic Disease↗
PubMed1994

Tethered cord syndrome accompanied by unilateral muscle atrophy in the calf muscle.

A 40-year-old man developed slowly progressive muscle atrophy in his calf muscle. The patient became aware of asymmetry of his right big toe during in his teens; muscle atrophy was revealed at the age of 25 years. Multi-image examinations revealed "tethered cord syndrome" with spina bifida occulta. Spinal magnetic resonance image revealed a pathogenetic mechanism of asymmetry of muscle atrophy in the calf muscle. This suggested that spinal MRI imaging is one of the most useful diagnostic methods for this disease.

Adult↗
PubMed1993

Myasthenia gravis and invasive thymoma. A 20-year experience.

Over the last 20 years, 15 patients with myasthenia gravis and invasive thymoma have been treated in our department. Eight of these patients underwent either nontotal excision or were not operated on due to massive invasion, while 7 underwent total excision. These 15 cases represent 6.2% of the 242 myasthenic patients treated during this period. Six of the 8 nontotal excision cases died, and 2 of the 7 total excision cases succumbed. The prognosis of total excision cases was better than that of nontotal excision cases. The overall 5-year survival rate was 73%, and the 10-year survival rate 20%. Total excision of the thymoma, if possible, and high doses of corticosteroids and combination chemotherapy for the remaining tumor seem to be the treatments of choice.

Adult↗
PubMed1992

Myasthenia gravis developing after discovery of thymoma.

We report 4 cases of myasthenia gravis in which myasthenic symptoms developed after a thymoma was known to be present. They include 3 invasive thymomas and one thymoma. In 3 of them, myasthenic symptoms developed 2-7 months after removal of the thymoma; in 1 case, myasthenic symptoms developed 11 years after the thymoma was known to be present. We also discuss here the possible pathogenetic mechanism of post-thymomectomic myasthenia gravis, and propose that it is due to the natural course of the disease.

Adult↗
PubMed1992

Multiple liver abscesses secondary to Yersinia enterocolitica.

A 37-year-old male, a poorly-controlled insulin-dependent diabetic patient, was admitted to our hospital with complaints of high fever and confusion. Laboratory data showed hyperglycemia, positive inflammatory reaction and liver dysfunction. Blood culture demonstrated Yersinia enterocolitica. Liver CT scan showed multiple low density areas. These data were consistent with a diagnosis of liver abscess secondary to Yersinia enterocolitica. He died of disseminated intravascular coagulation; subsequent autopsy confirmed the clinical diagnosis. Liver abscess secondary to Yersinia enterocolitica with septicemia is rare, but has been reported in compromised hosts. In the mechanism of this disease, the alimentary tract has been suggested to be the port of entry in most cases.

Adult↗