[A patient with recurrent hepatic encephalopathy and chronic renal failure treated successfully with long-term hemodialysis (author's transl)].
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Biomedical subjects
Publications and source records attributed to Y Sugai.
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The diurnal rhythm of plasma aldosterone concentration (PA), plasma renin activity (PRA), plasma cortisol (PC) and serum growth hormone (GH) were examined in 5 cases of normotensive acromegaly and the results were compared with the observations in normal subjects. Moreover, the response of PA to angiotensin-II infusion was studied in 6 cases of normotensive acromegaly. A normal diurnal rhythm with the lowest values in the evening or midnight and the highest values in the morning was observed in 3 of 5 cases in PA and 3 of 4 cases in PC. On the other hand, no apparent rhythm of GH was observed in any cases and that of PRA in 4 of 5 cases. Although there was a significant positive correlation between PA and PC, no significant correlation was demonstrated between PA and PRA. The response of PA to angiotensin-II fusion was significantly suppressed in normotensive acromegaly as compared to the normal subjects in spite of normal levels of PRA except for 1 case. The above observations were interpreted to suggest that the aldosterone regulation system is slightly altered in a certain number of patients with normotensive acromegaly in contrast to the normal subjects in which PRA is the main contributing factor. The low PA and suppressed response of PA toangiotensin-II infusion may suggest the defective action of angiotensin-II infusion on the adrenal gland.
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OBJECTIVE: The purpose of this study was to determine the accuracy of high resolution CT (HRCT) in the detection of facial canal dehiscence and semicircular canal fistula, the preoperative evaluation of both of which is clinically very important for ear surgery. MATERIALS AND METHODS: We retrospectively reviewed the HRCT findings in 61 patients who underwent mastoidectomy at Yamagata University between 1989 and 1993. The HRCT images were obtained in the axial and semicoronal planes using 1 mm slice thickness and 1 mm intersection gap. RESULTS: In 46 (75%) of the 61 patients, the HRCT image-based assessment of the facial canal dehiscence coincided with the surgical findings. The data for the facial canal revealed sensitivity of 66% and specificity of 84%. For semicircular canal fistula, in 59 (97%) of the 61 patients, the HRCT image-based assessment and the surgical findings coincided. The image-based assessment in the remaining two patients, who both had massive cholesteatoma, was false-positive. CONCLUSION: HRCT is useful in the diagnosis of facial canal dehiscence and labyrinthine fistula, but its limitations should also be recognized.
This study investigated the ability of recognizing emotion in dementia. Twenty-five patients with dementia of the Alzheimer type (DAT), 25 patients with vascular dementia (VD), and 12 normal control subjects were evaluated as to general cognition, visuoperception and emotion recognition. The score on the emotion recognition task significantly correlated with that of the Mini-Mental State Examination for VD patients while this was not the case for DAT patients. Moreover, VD patients performed significantly worse than DAT patients on the emotion recognition task in spite of the fact that there was no difference in the general cognitive and visuoperceptual abilities between them. The result of this study coupled with the past studies led to the hypothesis that the relationship between intellectual deficits and the deterioration in recognizing emotions differs according to type of dementia. Caregivers in nursing homes and hospitals need to take into account their patients' intellectual deficits but also their deteriorating ability of identifying emotions.
PURPOSE: The present prospective survey was performed to obtain information on delayed adverse reactions (DARs) to five types of low-osmolar iodinated contrast media, including their frequency, common manifestations, and the patient's history of allergy. METHODS: We investigated data from 15,890 consecutive patients who underwent contrast-enhanced computed tomography (CT) during a 15-month period. All patients were given a questionnaire asking about the occurrence of DARs, their symptoms and duration, and asked to consult a dermatologist if they had a skin reaction. RESULTS: Of 11,121 patients who returned the questionnaire (response rate, 70.0%), DARs were observed in 1,058 patients (9.5%). DARs tended to occur with higher incidence in patients with no previous history of examinations using contrast media, with past adverse reactions caused by contrast media, with a history of allergy, or with a serum creatinine level greater than 2.0 mg/dl. Among the 331 patients who reported skin reactions, 41 patients consulted a dermatologist. Skin reactions were observed significantly more frequently in patients for whom iotrolan was used, and 60% of these reactions were severe or moderate. CONCLUSIONS: Four risk factors for DARs were identified in the present investigation.
We developed a new technique using hand-operated table movement during digital angiography (DA) for the study of vascular disease of the pelvis and lower extremities. Digital video memory (DVM) is used in this technique to digitize, record, and display fluorographic images without subtraction in real time. This allows free table movement and the imaging of a large area with a single injection of contrast medium. Forty-five examinations for vascular disease of the pelvis and lower extremities were performed by this DA technique. Good images of an extensive area from the lower abdomen to the lower leg were obtained in a single study.