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Biomedical subjects

T Fuchigami

Publications and source records attributed to T Fuchigami.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Effectiveness of haloperidol in the treatment of chorea minor].

Chorea minor is the most curious manifestation of rheumatic fever, first described by Sydenham in 1686. Subsequent evidence showed that chorea could be a late manifestation of rheumatic fever, often occurring several months after a streptococcal infection in contrast to other major manifestations. During the ten-year period between 1984 and 1993, 11 children with rheumatic fever were seen at our hospital, two cases of these being accompanied with chorea minor. Case 1, a male aged 12, presented with involuntary movements. He was diagnosed as having rheumatic fever because of chorea and systolic ejection murmur at the apex of the heart. Plain cranial CT was normal. However, positron emission computed tomography revealed an increased 11C-glucose uptake in the caudate nucleus as compared with the cerebral cortex. Case 2, a female aged 14, presented with involuntary movements. Plain cranial CT was normal, but single photon emission CT showed a difference between the right and left brain. These two patients were given penicillin G (PCG), predonisolone (PSL) and haloperidol. Haloperidol was administered, because PCG and PSL had no effect to improve the clinical manifestations. After administer decreased to a half with a clinical improvement, but the level of GABA did not change. Haloperidol seemed to be an effective and useful agent for motor manifestations of the disease.

Adolescent↗
PubMed1994

Postoperative recurrence in patients with intestinal Behçet's disease.

PURPOSE: The postoperative course of intestinal Behçet's disease was studied in nine patients who had undergone a total of 15 operations due to intestinal ulcers. METHODS: These patients were followed up for an average of 6.0 years (range, 1 year, 3 months to 13 years, 10 months) after each operation and they were repeatedly examined by double-contrast radiography and/or colonofiberscopy. RESULTS: Recurrence of intestinal ulcers was observed in 12 (80 percent) of the 15 surgical cases. The incidence (50 percent) of postoperative recurrence in six cases in which intraoperative endoscopy revealed no abnormality in the retained intestine was lower than that (100 percent) in nine cases without this examination. Recurrent intestinal lesions in most cases were demonstrated as multiple aphthoid ulcers in the ileum near the ileocolectomy, or as one or two deep ulcers at the ileocolectomy site. The recurrent ulcers were successfully treated by various medical therapies, but the effectiveness of these therapies was only temporary. CONCLUSION: In the case of this disease, intraoperative endoscopy may be useful for preventing postoperative recurrence and periodic follow-up examination with radiography and endoscopy should be performed, even after surgery.

Adult↗
PubMed1994

Clinical course and long-term prognosis of Crohn's disease in Japan.

The long-term outcome of Crohn's disease was reviewed in 74 patients who had a history of more than 10 years (range 10.8-27.3) since disease onset. The observation period was between 4.3 and 18.5 years, the mean and SD being 10.6 +/- 3.1 years. The means and SD of age at onset and final observation were 21 +/- 7 and 37 +/- 8 years, respectively. Fifty-eight of the 74 patients had not undergone bowel resection at the time of diagnosis; of these 58, 31 (53.4%) had an operation for the disease during the follow-up period. Thus, of the 74 patients, 47 (63.5%) (these 31, plus the 16 who had undergone bowel resection at the time of diagnosis) had an operation at least once during a follow-up period of 10 years or more. The cumulative operation rates 5, 10, and 15 years after onset in the 74 and 58 patients above were 18.9%, 6.9%, and 40.8%, and 34.8%, 49.1%, and 46.0%, respectively. The corresponding figures 5 and 10 years after diagnosis in all 74 patients and the 58 patients were 32.3% and 28.6% and 47.3% and 46.3%, respectively. There were no significant differences in the incidence of operation rate in relation to anatomical involvement. Cumulative reoperation rates 1, 3, 5, and 10 years after the first operation in the 31 patients who were operated on during the follow-up period were 3.4%, 6.9%, 25.5%, and 51.7%, respectively. Three patients died, the causes of death in one being directly related to Crohn's disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Intestinal and extraintestinal complications of Crohn's disease: predictors and cumulative probability of complications.

Of 238 patients with Crohn's disease seen at our clinics from April 1973 to August 1988, 203 patients were selected for this study, since they fulfilled the following criteria: they had been followed up for more than 6 months as outpatients or had been treated as inpatients for more than 1 month. They were studied to elucidate: (a) the different types and incidence of various complications, (b) the factors related to complications present at the time of diagnosis, (c) predictors of new complications arising after diagnosis, and (d) the cumulative incidence of complications occurring during the course of the disease from the times of onset and diagnosis. Of the intestinal complications, perianal fistula was most common (33%), followed by strictures with dilatations of the proximal bowel (21%), and internal fistula (14%). Of the extraintestinal complications, menstrual disturbance was the most common (18% of the female patients), followed by arthritis (10%), and aphthous stomatitis (10%). As for the factors influencing complications present at the time of diagnosis, the pattern of bowel involvement was significantly correlated with the presence of intestinal stricture, while the erythrocyte sedimentation rate was significantly correlated with the presence of perianal fistula. A significant predictor of new complications arising after diagnosis was the general well-being of patients at the time of diagnosis. Patients who, at diagnosis, already have complications such as stricture, abdominal abscess, internal or external fistula, massive hemorrhage, and free perforation or anal lesions are more likely to develop new complications in addition to those present at diagnosis, compared with patients without any complications at diagnosis (P = 0.055).

Adult↗
PubMed1994

Gastrointestinal amyloidosis: radiologic features by chemical types.

PURPOSE: To determine the correlation between the radiographic and histologic findings of amyloidosis according to chemical type of amyloid protein. MATERIALS AND METHODS: The 49 patients with amyloidosis were examined radiographically, and gastrointestinal tract biopsy specimens were studied histologically. RESULTS: Considerable differences were found between amyloid proteins. On immunohistochemical studies, amyloid A produced a coarse mucosal pattern with innumerable fine granular elevations, which reflected expansion of the lamina propria by amyloid deposits. Polypoid protrusions and invariable thickening of the folds were evident only in light chain protein, correlating with massive amyloid deposits in the muscularis mucosae and submucosa. beta 2-Microglobulin produced marked delay in transit time and dilatation of the small and large intestines, relating to extensive amyloid deposits in the muscularis propria. The prevalence of these radiographic changes was highest in the small intestine for every chemical type. CONCLUSION: Characteristic radiographic changes of each chemical type of amyloid protein can be detected well in the small intestine.

Adult↗
PubMed1993

Assessment of body composition measured by bioelectrical impedance in children.

Bioelectrical impedance methods have been found to be a valid and reliable way of estimating per cent body fat (%BF) in adults. We applied them to healthy children and compared them with conventional anthropometry methods. One thousand two hundred and sixteen children participated in this study. Impedance and skinfold thickness were measured, and %BF was estimated using these values. Bodyweight and height were measured, and per cent obesity (%OB) and body mass index (BMI) were obtained. The values of %BF by the bioelectrical impedance method (%BFi) were 8.6 +/- 4.0% in the junior male group, 14.2 +/- 2.8% in the junior female group, 7.9 +/- 4.7% in the senior male group and 16.1 +/- 2.9% in the senior female group. The %BFi correlated strongly with skinfold thickness, %OB and BMI. Thus %BFi correlated strongly with variables from conventional methods. It was concluded that it is a reliable way of assessing lipid storage in children.

Adolescent↗
PubMed1993

Auditory event-related potentials and reaction time in children: evaluation of cognitive development.

The authors studied age-related correlations of auditory event-related potentials (ERPs) using the conventional 'oddball' paradigm and reaction time in 175 normal subjects, aged between four and 21 years. From four years, the latencies of N100, N200 and P300 in ERP progressively shortened until about 16 to 17 years, after which they reached adult level, but with a slight tendency to prolongation towards 20 years; there was no trend for amplitude changes. The reaction time was more rapid than that of P300 latency. These findings indicate that the cognitive function of children improves rapidly until 16 to 17 years. A reduced difference between P300 latency and reaction time with age implies additional progress in motor skill. Combining P300 latency and reaction-time studies may provide more detailed information for the evaluation of the development of cognitive function and motor skill.

Adolescent↗
PubMed1993

Intestinal Behçet disease: serial changes at radiography.

To clarify the characteristic radiographic findings and serial radiographic changes in nonsurgical cases of intestinal Behçet disease (BD), seven patients were followed up for an average of 4 1/2 years (range, 8 months to 11 years 4 months). They underwent repeated examination with barium meal studies and double-contrast barium enema meal studies and double-contrast barium enema radiography. Initial radiography revealed one to three deep ulcers in the terminal ileum or ileocecal region in five patients. The ulcers healed while patients were treated with medical therapy but recurred during the follow-up period. In four of these five patients, follow-up radiography demonstrated various changes within each case: At each examination, an enlarged ulcer or a newly developed ulcer was often found in conjunction with a healed ulcer. In the other two patients, multiple shallow ulcers or innumerable aphthoid ulcers were seen throughout the entire colon, and these ulcers showed a good response to medical treatment. These results indicate that serial radiographic changes in patients with intestinal BD may mimic those in patients with Crohn disease, with findings in the terminal ileum and colon that wax and wane with medical treatment.

Adult↗
PubMed1993

[The long-term follow-up study of Japanese patients with ulcerative colitis].

To elucidate the long-term outcome of the ulcerative colitis we analyzed 124 patients suffering for more than 10 years concerning the long-term prognosis, cumulative rate of colectomy, cumulative risk of cancer development and cumulative survival rate. Long-term prognosis were divided to three categories as good, fair and poor, according to present disease activities, social availability and subjective judgement. One hundred and twenty four patients were divided to 66 patients with good prognosis, 27 fair and 31 poor (2:1:1). The rate of patients having active disease at each year were followed-up annually for 10 years according to final three categories of the prognosis. The serial curve of annual rate of having active disease of the patients with poor prognosis was the highest, fair prognosis the second, good prognosis the lowest. The factors affecting the final prognosis were the period before initiation of proper treatment, the severity of the first attack or the elder age (> 40 year old) at the first attack. Twenty six patients were undergone colectomy in relation to ulcerative colitis. The cumulative colectomy rate was 16.5% at 10 years and 38.5% at 15 years after the onset. Malignant disease or severe dysplasia of the colon developed in 4 patients 10 to 14 years after the onset. Cumulative survival rate was equal to the expected survival curve during 16 years. The main causes of death were intracranial hemorrhage and colorectal malignant disease.

Adolescent↗
PubMed1992

Clinicopathologic evaluation of recurrence in early gastric cancer.

Five hundred ninety-two patients with early gastric cancer underwent surgical resection from 1970 to 1986 in our hospital, and 13 died from a recurrence of their disease. A careful analysis of these 13 patients suggests that carcinomas which invaded to the submucosa tend to recur more often than those confined to the mucosa. Well differentiated and papillary adenocarcinomas characterized by protruded or elevated lesions tend to recur earlier than poorly differentiated or signet-ring cell carcinomas characterized by depressed or excavated lesions. However, both types recurred from hematogenous metastases, with the liver being the most common site. Therefore, the macroscopic and histological features presently used to characterize early gastric cancer do not provide sufficient information to accurately predict which patients are at most risk for recurrence.

Adenocarcinoma↗
PubMed1992

Radiographic features in ischemic jejunoileitis: serial changes and comparison with pathologic findings.

Serial radiographic examinations of the small intestine, including double-contrast studies, were performed in 13 patients with ischemic jejunoileitis, nine with the stricturing form and four with the transient form. Thumbprinting was observed in five (38%) patients and thickening of the folds in four (31%) at the acute stage of the disease. Tubular narrowing with irregular contours and dilated proximal bowel was observed in six (46%) patients and appeared on day 27 or later. Pathologic findings of the resected specimen in eight patients with the stricturing form revealed annular stricture with relatively shallow ulcers; the irregular contours of the tubular narrowing on radiographs were consistent with a granular or nodular appearance and/or multiple fissures on pathologic study. Eccentric deformity and sacculation were demonstrated in only one patient with the stricturing form. In addition, double-contrast study revealed small ulcers in three (23%) patients. Our results indicate that radiographic findings accurately reflect the clinical course and pathologic findings in this disease.

Adult↗
PubMed1992

Recovery functions of common peroneal, posterior tibial and sural nerve somatosensory evoked potentials.

We studied recovery functions of the somatosensory evoked potentials (SEPs) of common peroneal (CPN), posterior tibial (PTN) and sural nerves (SN) using a paired conditioning-test paradigm. The interstimulus interval (ISI) of paired stimuli ranged from 2 to 400 msec. In all SEPs with ISIs of 12-20 msec, the amplitude recovery was close to or beyond 100% of the control response, though their latencies and wave forms were not the same as the control. Further increases of the ISI resulted in significant depression of SEP (late phase suppression), most markedly in CPN, and less prominently in SN-SEP. With a longer than 50 msec ISI there was progressive recovery of SEP, but full recovery differed depending on the nerve stimulated; 400 msec ISI was required for CPN-, 250 msec for PTN- and 100 msec for SN-SEP. The peroneal nerve block by local anesthetic injected just distal to the stimulus electrodes abolished the late phase SEP suppression observed before the nerve block. These findings suggest that the late phase SEP suppression is attributable to the "secondary" afferents as a result of activation of peripheral receptors (muscle, joint and/or cutaneous) by the efferent volley initiated from the stimulus point. The greater and longer duration of peripheral receptor activation in CPN than in PTN or SN stimulation could explain the more pronounced and the longer duration of late phase suppression in CPN-SEP.

Adult↗
PubMed1991

Double-contrast radiographic features in primary small intestinal lymphoma of the 'western' type: correlation with pathological findings.

Eighteen patients with 20 primary lesions of small intestinal lymphoma of the 'Western' type were examined to determine the double-contrast radiographic features of the disease with pathological correlation. The radiographic appearances on double-contrast study were divided into five groups: polypoid (3 lesions), stricturing (6), non-stricturing (3), aneurysmal (3), and intussusception (5). In the first four groups, ulceration, signs of submucosal tumour, and displacement of adjacent loops were frequent. Two early lesions confined to the submucosal layer were also seen. There was a close association between the radiographic appearance and macroscopic findings of the resected specimens, including the cross section of the tumour, but no correlation with the cell type. These results indicate that the double-contrast study accurately reflects the morphological changes of primary small intestinal lymphoma.

Adolescent↗
PubMed1991

The effect of stimulus rate upon common peroneal, posterior tibial, and sural nerve somatosensory evoked potentials.

We examined the effect of stimulus rate on somatosensory evoked potentials (SEPs) following stimulation of the common peroneal nerve (CPN) at the knee, and the posterior tibial nerve (PTN) and sural nerve (SN) at the ankle. We measured the amplitude of P40-N50 and N50-P60 in the PTN-SEP and corresponding amplitude of CPN-SEP and SN-SEP at the rate of 2.3, 3.4, 4.1, and 5.1 Hz. When the stimulation rate was increased from 2.3 to 5.1 Hz, the P40-N50 amplitude decreased by 50% for the CPN-SEP and 20% for the PTN-SEP. Also, the N50-P60 amplitude was reduced by 30% in the CPN-SEP and 20% in the PTN-SEP. In contrast, this change in stimulus rate produced no significant amplitude decline in the SN-SEP. Blocking the peroneal nerve with lidocaine just distal to the stimulating electrodes eliminated the descending peroneal nerve volley and abolished the amplitude attenuation observed with the faster stimulus rate. The findings suggest that at higher rates of stimulation, the afferent volleys induced by the movements that follow mixed nerve stimulation interfere with the SEP produced by electrical activation of the sensory afferents. The interference is greater when the more proximal site of the mixed nerve is stimulated.

Adult↗
PubMed1991

Amyloidosis of the small intestine: findings on double-contrast radiographs.

The appearance of the small intestinal mucosa on double-contrast barium examinations was studied in 26 patients with proved intestinal amyloidosis. Findings included innumerable fine granular densities 1-3 mm in diameter (16 patients), multiple nodular densities 3-4 mm in diameter (four patients), multiple polypoid protrusions 4-10 mm in diameter (three patients), irregularities of Kerckring folds (12 patients), and multiple erosions (eight patients). The multiple nodular densities and erosions disappeared after the patients were treated with total parenteral nutrition. The other abnormalities remained unchanged on follow-up examinations. Our results indicate that double-contrast radiographic findings of the small intestine in patients with amyloidosis include mucosal abnormalities that vary according to the pathologic type of amyloid deposition.

Amyloidosis↗