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Biomedical subjects

T Fukutake

Publications and source records attributed to T Fukutake.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Recurring consciousness disturbance with elevation of endogenous benzodiazepine-like activity].

A 63-year-old man had recurrent spontaneous attacks of consciousness disturbance without toxic, metabolic, or structural brain damage. Interictal electroencephalography showed 14 Hz spindle wave-like activity; ictal electroencephalography revealed faster basic activity. Flumazenil, a benzodiazepine antagonist, promptly resolved the attacks. The endogenous benzodiazepine-like activities in plasma and cerebrospinal fluid (measured in the courtesy of P. Schoch Ph. D, F. Hoffmann-La Roche Ltd, Basel, Switzerland) increased in the interictal period and increased more strikingly in the ictal period. These findings and the clinical effects of flumazenil suggest an involvement of an endogenous benzodiazepine-like activity in the pathogenesis of the attacks in this patient, as same as in a case reported by Tinuper et al (1992).

Benzodiazepines↗
PubMed1995

Associated movement as a sequel to thoracotomy: aberrant regeneration to the latissimus dorsi muscle.

We describe two patients with unusual associated movements as a sequel to thoracotomy. The two patients developed involuntary twitchings of the latissimus dorsi, which were induced by contractions of the adjacent muscles, the serratus anterior muscle in patient 1 and the external intercostal muscle in patient 2, after lobectomy for lung cancer. Electrophysiological and radiological studies showed that aberrant regeneration from the adjacent nerves to the denervated latissimus dorsi could be responsible for the associated movements.

Electromyography↗
PubMed1995

Familial young-adult-onset arteriosclerotic leukoencephalopathy with alopecia and lumbago without arterial hypertension.

Here we review a total of 17 patients, including 4 of our own, with young-adult-onset arteriosclerotic leukoencephalopathy, alopecia and lumbago without hypertension. All were Japanese and the illness seemed to be transmitted in an autosomal recessive fashion. The male to female ratio was 7.5:1. The age of onset usually ranged from 25 to 30 years. Acute lumbago, spondylosis deformans, diffuse baldness, and progressive motor and mental deterioration were common clinical features. Cerebral arteriosclerosis and white mater disease were demonstrated pathologically or radiologically. Although the pathogenesis has remained obscure, we think this is a new clinico-pathological entity distinct from the classic type of Binswanger's disease.

Adult↗
PubMed1993

Transient unilateral catalepsy and right parietal damage.

We describe the appearance of transient catalepsy of the left upper extremity in a patient without previous psychiatric illness after a right parietal subcortical hemorrhage. This case, and five other available cases in the relevant literature, demonstrates that catalepsy can be produced by right parietal damage.

Aged↗
PubMed1993

Subjective results of laser surgery for allergic rhinitis.

Inferior turbinates of 389 patients with perennial allergic rhinitis were vaporized by a defocused carbon dioxide (CO2) laser beam, using specially designed handpieces. This laser surgery can be done under local anesthesia as an outpatient procedure, with no pain or bleeding. One month after laser surgery, 78% of 389 patients had excellent or good results, while 21 had no improvement, subjectively. Seventy-two of 389 patients were followed for over 2 years, and 61 of the 72 had excellent or good results. Twenty-seven of the 72 cases need revaporization because of recurrence. Patients with relapse less than one year after surgery had little improvement in subjective symptoms, even after revaporization; while patients with relapse more than one year after surgery responded well, and long-term results were favorable. All things considered, laser surgery is an effective treatment for perennial allergic rhinitis.

Follow-Up Studies↗
PubMed1993

Speech rehabilitation and complications of primary tracheoesophageal puncture.

Fifty-nine patients underwent tracheoesophageal puncture during laryngectomy, and a voice prosthesis was inserted into the tracheoesophageal fistula to enable alaryngeal speech. For 68% of the 59 patients, tracheoesophageal speech was feasible right after surgery, and postoperative complications occurred in 9 of these 59. The results show that primary tracheoesophageal puncture is advantageous for alaryngeal speech rehabilitation. Eighty-two percent of the 22 patients who survived more than 4 years after surgery continued with tracheoesophageal speech, and 16 complications occurred over a longer term in 13 of the 22 patients. Since 75% of these long-term complications could be overcome by surgical treatment, close observation of the tracheoesophageal fistula and adequate treatment are needed for patients with tracheoesophageal speech and making use of a voice prosthesis.

Aged↗
PubMed1993

[Neurological problems in the diagnosis of brain death--observation of spinally-mediated movements in brain-dead patients and proposal of a "brain death judging doctor" system].

We report two cases in which neurological examination met the Second Tentative Criteria for Brain Death of Chiba University Medical School, except for spontaneous contractions of the rectus abdominis muscle during apnea testing. In Case 1, a 54-year-old man with brainstem infarction, judgement of brain death was suspended initially, but was ultimately declared after the contractions were deemed to be spinal in origin. MRI findings after declaration and autopsy were compatible with brain death. In Case 2, a 27-year-old man with fulminant hepatitis and subsequent severe brain edema, judgement was postponed due to detection of the contractions at the second testing, and was ceased with family intent. Several cases of abnormal gross and fine movements in brain-dead patients have been reported. These paradoxical phenomena may confuse an inexperienced examiner and delay the declaration of brain death. Whether brain death should be considered real death of the person or not, neurologists should be aware of the occasional presence of neurological problems in the diagnosis of brain death, such as spinally-mediated movements. Since the major opposition to brain death is the distrust of medical doctors, we propose a pilot system of a "brain death judging doctor".

Adult↗
PubMed1993

[Alloesthesia without impairment of consciousness after right putaminal small hemorrhage].

Alloesthesia is a condition in which a sensory stimulus, given on one side of the body, is perceived to be at the corresponding area on the opposite side. In our previous study (Kawamura, Hirayama et al., 1987), we suggested that it may be useful for localization because this phenomenon was observed most frequently in patients with a right putaminal hemorrhage of medium or large size, an average of 42 ml on CT scans, presenting a slight disturbance of consciousness and, in about half of the patients, anosognosia. We also suggested that since alloesthesia is produced not only in cerebral but also in spinal cord lesions, it seems to represent an elementary sensory disturbance of sensory pathways, not a higher cortical dysfunction. We recently observed alloesthesia in two other patients with smaller right putaminal hemorrhages, 7 ml and 6 ml, respectively, who exhibited no disturbance of consciousness, but had impairment not only of superficial but also of proprioceptive sensations. In Patient 1, superficial sensations were intact on admission, except those on the left side of the face. Cortical somatosensory evoked potentials (SEPs) after stimulating the median nerve were measured on Patient 1 on the 11th hospital day when a left hemihypalgesia had developed due to enlargement of the hematoma from 7 to 14 ml. Stimulation of the clinically affected side (left) evoked no N20 from the contralateral scalp. Right-sided stimulation was normal. The fact that both patients showed alloesthesia with no accompanying disturbance of consciousness supported our view of its mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Magnetic resonance imaging in chronic toluene abuse, and volitional hyperkinesia].

We described the central nervous system impairments and findings of magnetic resonance imaging (MRI) of the brain in three chronic toluene abusers. Patient 1 and 2 had a history of chronic toluene inhalation for 1 or 2 years and patient 3 has a history of it for 16 years. The patients were evaluated after an abstinence period of at least 4 weeks, to avoid neurologic effects of acute intoxication. Neurologic signs included cerebellar, cognitive and pyramidal dysfunctions in all 3 patients and hyperkinésie volitionnelle (HV; volitional hyperkinesia) in patient 3 who had a long history of toluene inhalation. This HV was found to be tremulous by surface electromyography. Appearance of HV in chronic toluene abuse seems to be related to a period or quantity of inhalation of toluene. T2-weighted MRI in the 3 patients revealed the following abnormalities: (1) increased signal intensity of middle cerebellar peduncle and cerebellar white matter, deep cerebral white matter, and posterior limb of internal capsule; and (2) decreased signal intensity of thalamus and basal ganglia. Proton-weighted MRI in patient 3 with HV showed decreased signal intensity of lateral portion of the thalamus and tegmentum of the brainstem. These MRI findings correlate remarkably well with the neurologic signs seen in the 3 patients. Cerebellar, cognitive, and pyramidal dysfunctions appear to be related to involvement of middle cerebellar peduncle (cerebellar white matter), deep cerebral white matter, and internal capsule, respectively, and HV seems to correlate with involvement of the thalamus or tegmentum of the brainstem, especially the latter.

Adult↗
PubMed1992

[Big-toe localizing test--clinical study of proprioceptive localization].

Certain proprioceptive sense is utilized in localizing a part of the limb passively held in space. In the previous study (Hirayama, Fukutake, et al., 1986), we demonstrated that such kind of proprioception, which we called "proprioceptive localization", could be detected by making the patient pick up the thumb with the opposite fingers (the thumb localizing test, TLT). As a further development of the TLT, another test, named a big-toe localizing test (BTLT), was devised. In the BTLT, the patient, with eyes closed and a lower limb passively immobilized by the examiner (the fixed limb), is asked to point to the big toe with the index finger of one hand or the other (the reaching limb). Firstly, we assessed the unselected series of 33 patients with thoracic or lumbar myelopathy regarding their sensory impairment and obtained the following conclusions on the BTLT similar to those in our previous study on the TLT. (1) BTLT deficits results from perceptive impairment in the fixed limb. (2) The perceptual information involved in the proprioceptive localization is different from that of the test for the appreciation of passive movement and posture. (3) On the basis of the correlation to other symptomatology, it is suggested that BTLT deficits arise from lesions of the posterior column-medical lemniscal system. (4) The BTLT is more sensitive than the test for the appreciation of passive movement and posture. Secondly, we evaluated another unselected series of 63 patients with unilateral TLT deficits due to CNS lesions. Eight patterns of BTLT deficits were identified and classified into 3 following types.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Cobb syndrome and Klippel-Trenaunay-Weber syndrome].

We reported two patients with neurocutaneous angiomatosis. Patient 1, a 36-year-old woman of Cobb syndrome had cutaneous portwine angiomas in the high back and spinal arteriovenous malformations at the level of Th4-11. She had also atrophy and livedo reticularis presenting during standing position in the left lower extremity. Patient 2, a 47-year-old man of Klippel-Trenaunay-Weber syndrome had varices in the bilateral lower extremities, cutaneous portwine angiomas in the high back and bilateral lower extremities, and hypertrophy of the bilateral legs. Neuroradiological examination revealed abnormal vessels in the spinal canal at the level of C5 and Th4. These syndromes may have no essential difference because of the presence of neural and cutaneous angiomas at the corresponding level, venous system disorders and trophic changes (hypertrophy/atrophy).

Adult↗
PubMed1991

[Striatal involvement on MRI in adrenomyeloneuropathy].

Adrenomyeloneuropathy (AMN), a clinical variant of child adrenoleukodystrophy (ALD), is an adult-onset progressive disorder which presents spastic paraparesis with peripheral nerve involvement and affects mainly the pyramidal tracts from the brainstem to the spinal cord. We report a case of AMN in which serial MRI showed unusual development of areas of high signal in the right striatum. The patient was in good health until the age of 12, when he began to lose his hair. At age 25 he started to have progressive gait disturbance and erectile impotence. In his first admission to our hospital at age 33, he showed diffuse baldness. He was intelligent but childish. His cranial nerves were normal. Muscle strength was weak (3-4/5) in the lower extremities. Deep tendon reflexes were hyperactive in the lower extremities while normal in the upper extremities. Babinski signs were elicited bilaterally. Pinprick and vibratory sensation was impaired in the lower legs. Proprioceptive sensations were normal. Co-ordination was intact. There were urinary incontinence and impairment of erection with preserved libido and ejaculation. Routine laboratory data including hematological studies, serum chemistry and urinalysis were all normal except for mild hyperlipidemia. Serum cortisol response to ACTH was low and serum levels of very long chain fatty acids were increased. Nerve conduction studies were abnormal and consistent with peripheral polyneuropathy. A biopsy specimen of left sural nerve revealed a mild loss of myelinated fibers with thinning of the myelin. These findings and the clinical features confirmed the diagnosis of AMN. MRI in SE2000/40 scans at age 34 disclosed areas of high signal in the bilateral internal capsules.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenoleukodystrophy↗