All issues
Volume 43, Issue 4
Displaying 1-5 of 5 articles from this issue
- |<
- <
- 1
- >
- >|
-
Shingo Hori1994 Volume 43 Issue 4 Pages 185-191
Published: 1994
Released on J-STAGE: August 24, 2009
JOURNAL FREE ACCESSSyncope is a common medical problem, which accounts for 3.5% of emergency room visits. It includes diverse clinical etiologies, from cardiac origin with poor prognosis to reflex-mediated hypotension with benign clinical course. Trauma is not rare in patients with syncope, e.g. bruises or lacerations on the head and face were recognized in 17%. Accordingly, patients presenting with syncope may have a risk of sudden cardiac death, or risk of trauma if the episodes are repetitive. It is a physician's task to diagnose syncope and identify its cause. The history is an essential part of the initial evaluation. Electrocardiography (ECG) is necessary in every case. However, organic disease as a cause is identified in 20% of syncope in routine work-up, and the remaining cases are reflex induced hypotension (neurocardiogenic syncope), misdiagnosed arrhythmia, coronary spasm or unknown. Recent investigations suggest the usefulness of provocation to diagnose neurocardiogenic syncope. Two important non-invasive provocations to reproduce syncope are carotid sinus compression and tilt table test. In patients with syncope who visited emergency room, tilt test was positive in 25%, whereas the response to carotid sinus compression was positive in 21%. One or both of the tests was positive in 39%, suggesting that neurally-mediated syncope accounts for a significant number of patients.View full abstractDownload PDF (622K) -
Winston W Shen1994 Volume 43 Issue 4 Pages 192-200
Published: 1994
Released on J-STAGE: August 24, 2009
JOURNAL FREE ACCESSThis is a review paper covering the American current status of pharmacotherapy of schizophrenia. The author lists all available antipsychotic agents on the market in the United States and describes the American prescribing pattern of antipsychotic agents. This includes a brief history of antipsychotic use in America, acute treatment and chronic maintenance with antipsychotic drugs, the recent advent of atypical antipsychotic agents, and management of antipsychotic-induced side-effects. The characteristics of prescribing American antipsychotics in America are described, and they are then compared with Japanese prescribing practices. The author also makes brief remarks about the uncovered issues in antipsychotic pharmacotherapy and about atypical antipsychotic agents in the context of the future pharmaceutical development.View full abstractDownload PDF (811K) -
Hiroshi Fujishima1994 Volume 43 Issue 4 Pages 201-205
Published: 1994
Released on J-STAGE: August 24, 2009
JOURNAL FREE ACCESSThe pathogenesis of allergic conjunctivitis is largely conjectural. We investigated the possible involvement of respiratory syncytial virus (RSV), a ubiquitous respiratory pathogen, in the development of allergic conjunctivitis through immune mechanisms. Brush cytology technique was used to obtain conjunctival cells from 30 patients with allergic conjunctivitis and 20 controls. Samples were assayed for the presence of RSV sequences with the reverse transcription polymerase chain reaction (RT-PCR) and the nested polymerase chain reaction (nested PCR). In order to further investigate the relation of RSV and allergic conjunctivitis, we performed an animal study. BALB/c mice were either infected with live RSV or sham infected intranasally. The mice were exposed to ovalbumin (OVA) with alum adjuvant. At differing intervals, levels of OVA concentration in serum and IgG-anti-OVA antibody were measured by ELISA and IgE-anti OVA antibody in serum was assessed by passive cutaneous anaphylaxis. RSV sequences were detected in 7 (23%) of 30 patient samples and 1 (5%) of 20 control samples. IgG and IgE antibody responses to OVA in serum were demonstrable only in RSV-infected mice immunized with OVA and alum. Our results proved that PCR could detect RSV sequences in conjunctival samples. RSV may be a significant pathogenic factor in allergic conjunctivitis.View full abstractDownload PDF (5530K) -
Yoshio Izumi, Yasuo Fukuuchi, Atsuo Koto, Naoki Ishihara, Hisao Tachib ...1994 Volume 43 Issue 4 Pages 206-210
Published: 1994
Released on J-STAGE: August 24, 2009
JOURNAL FREE ACCESSA 36-year-old man who suffers from gait disturbance is reported. He noticed deformity of his feet at the age of 15. When he was 32 years old, he complained of heaviness in his lower extremities. Since then his legs have been always stiff. He had no previous illness or familial neuromuscular diseases. Neurological examination revealed no impairment of mental function or cranial nerves. Marked weakness and wasting of the feet were noted. The legs showed an inverted champagne bottle shape and pes cavus deformity was evident. Deep tendon reflexes were normal in the arms but abnormally brisk in the legs. Bilateral Babinski sign and ankle clonus were elicited. The patient tended to walk on his toes and the legs scissored. The motor nerve velocities were less than normal. Sural nerve biopsy showed reduced myelinated fiber density and increased endoneurial connective tissue. Electron microscopy showed axonal swellings filled with neurofilaments. Distal wasting and weakness involving the legs more than the arms resembled that of Charcot-Marie-Tooth disease. According to the classification by Dyck, this disorder could be referred to as hereditary motor and sensory neuropathy type V. Spastic paraplegia with amyotrophy is rare, but should be identified as a distinct disorder. Recognition of this disorder would imply the clinical and genetic heterogeneity of Charcot-Marie-Tooth disease.View full abstractDownload PDF (5763K) -
Gert-Jan B van Ommen1994 Volume 43 Issue 4 Pages 211-213
Published: 1994
Released on J-STAGE: August 24, 2009
JOURNAL FREE ACCESSA diverse scala of refined molecular techniques, developed during early positional cloning and the Human Genome project, has caused a rapid increase of our insight into the cause of genetic diseases. Nowadays, from cytogenetic rearrangements to point mutations can be readily detected by a variety of techniques. This not only has broadened our understanding, but has also enormously assisted in providing rapid and specific diagnosis, hence reducing uncertainty and improving the choices for those concerned with genetic disease in their family. While initially restricted to the DNA-level, diagnostic technology has gradually been tailored to suit the specifics of the diseases in question, incorporating RNA and protein analysis. The latest development in the analysis of genetic disease is reviewed.View full abstractDownload PDF (264K)
- |<
- <
- 1
- >
- >|