Biomedical subjects

Takahide Nagashima

Publications and source records attributed to Takahide Nagashima.

5 recordsLinked to original sources

PubMed2006

[A case of aseptic meningitis caused by relapsing polychondritis].

We report a patient of relapsing polychondritis (RP) with antecedent aseptic meningitis. A 65-year-old man has developed headache and fever. Neurological examination showed meningeal signs, and cerebrospinal fluid (CSF) examination revealed meningeal inflammation which contained 450 polymorphonuclear cells/microl, 302 mononuclear cells/microl, and 0 red cells/microl, with 79 mg protein/dl. Serologic testing for autoimmune disease as well as the culture and cytology of CSF were negative. He admitted our hospital as having aseptic meningitis and experienced antibiotic therapy. However, his pyrexia continued and he developed repeating visual and hearing impairment reacting to steroid. Three months later, he became behaviorally deaf, and bilateral auricular chondritis occurred with nonerosive seronegative inflammatory polyarthritis. The result of condral biopsy was consistent with the diagnosis of RP showing cartilage surrounded by an intense inflammatory cell response with a decreased number of chondrocytes. A clinical diagnosis was made and prednisolone 60 mg/day was begun with the result of resolution of the auricular chondritis, and slight improvement of his deafness. Aseptic meningitis is a rare complication of RP. Only one report detailed RP patient who had preceding meningitis. RP is a potentially lethal disease resulting from suffocation by airway collapse, the complications of a cardiac large vessel, and so on. For improvement of a life prognosis, an early diagnosis and treatment are indispensable. Although RP is a rare discovery, it is necessary that RP should be taken into consideration and be differentiated as a cause of relapsing aseptic meningitis.

Aged↗

PubMed2004

Various immunization protocols for an acute motor axonal neuropathy rabbit model compared.

Various ganglioside immunization protocols were examined to refine the procedure for establishing an animal model of acute motor axonal neuropathy. The most effective was subcutaneous injection of an emulsion of 2.5mg of bovine brain ganglioside mixtures, keyhole lympet hemocyanin, and complete Freund's adjuvant to Japanese white rabbits, repeated at 3-week intervals. Under that protocol, all the rabbits developed marked flaccid paralysis associated with plasma anti-GM1 IgG antibody. This acute motor axonal neuropathy rabbit model also could be reproduced by the use of incomplete Freund's adjuvant, methylated bovine serum albumin, and New Zealand white rabbits. These results provide useful information for the confirmation of and further research on the model.

Acute Disease↗

PubMed2004

Clinical correlates of serum anti-GT1a IgG antibodies.

Patients with the pharyngeal-cervical-brachial variant (PCB) of Guillain-Barré syndrome (GBS) have anti-GT1a IgG with or without GQ1b reactivity, whereas those with Fisher syndrome (FS) or Bickerstaff's brainstem encephalitis (BBE) have anti-GQ1b IgG antibodies which cross-react with GT1a. The nosological relationship between these conditions has yet to be established. To investigate the relationships between each manifestation and between clinical features and the coexistence of anti-GQ1b IgG, we reviewed neurological signs present during illnesses of 140 patients who had anti-GT1a IgG. Based on our criteria, FS was diagnosed for 64 (46%) patients, GBS for 22 (16%), BBE for 14 (10%), and PCB for 6 (4%). Overlapping conditions were diagnosed for some patients: FS and GBS (5%), PCB and FS (5%), BBE and GBS (4%), and PCB and BBE (1%). Patients who initially had bulbar palsy developed not only PCB but FS or BBE. The population of anti-GT1a-positive patients frequently had ophthalmoplegia, ataxia, and areflexia, whereas the subpopulation who had anti-GT1a IgG without GQ1b reactivity frequently had preceding diarrhea as well as oropharyngeal, neck, and limb weakness. Patients with anti-GT1a IgG presented a variety of clinical conditions, indicative of a continuous clinical spectrum. A major part of this clinical variation was due to the coexistence of anti-GQ1b IgG. The presence of a common autoantibody (anti-GT1a IgG) and overlapping illnesses suggests that PCB is closely related not only to GBS but to FS and BBE as well.

Adolescent↗

PubMed2004

[Outcome after Guillain-Barré syndrome: comparison of motor function status and changes in social life].

Effects on the motor function and social life of the patients after Guillain-Barré syndrome (GBS) were studied. A letter of inquiry was sent to the patients in November 2001; 98 patients responded validly. The questionnaire had questions with 3 possible answers related to situations at work, at home, and about leisure activities. The Hughes functional grade, which evaluates physical conditions, and arm disability scale scores were assessed. Although the assessments showed good recovery in most patients who had had a job, 31% had to quit work, and 17% had to discontinue their leisure activities. These physical assessments accurately reflected the severity of the conditions of the patients given in-home care (8%) because daily life activities depend on muscle strength. Of the 75 patients who had no, or minimal, neurological symptoms or signs in both assessments, 53% reported one or more changes in their social lives. We conclude that the questionnaire answers show that GBS patients may have serious psychosocial outcomes that are not measurable by the usual physical assessments. These findings may be a help when considering the rehabilitation of GBS patients and their return to social life.

Activities of Daily Living↗

PubMed2002

[A case of pharyngeal-cervical-brachial weakness suggestive of the nosological continuity between acute oropharyngeal palsy].

A 68-year-old man without history of antecedent infection experienced nasal voice (day 1), and the developed dysphagia on day 9. Eleven days after the onset, he developed ophthalmoplegia, and on day 13 mild weakness in the neck and the upper limbs. Cerebrospinal fluid examination revealed albuminocytologic dissociation on day 19. Motor nerve conduction velocities and compound muscle action potentials were normal, but terminal latency was slightly prolonged in the median nerve. Enzyme-linked immunosorbent assay showed that the patient's anti-GT1 a IgG antibody fiter was high and that the antibody cross-reacts with GQ1b. We considered that this patient showed acute oropharyngeal palsy at the onset, and then evolved into pharyngeal-cervical-brachial weakness. The presence of this case suggested the nosological continuity between acute oropharyngeal palsy and pharyngeal-cervical-brachial weakness in both clinical and serological aspects.

Aged↗