-
Akihiko Morita,
Yasuyuki Okuma,
Satoshi Kamei,
Fumihito Yoshii,
Toshimasa Yamamoto, Shiori Hashimoto,
Hiroya Utsumi,
Taku Hatano,
Nobutaka Hattori,
Miyuki Matsumura,
Kazushi Takahashi,
Shigeru Nogawa,
Yuka Watanabe,
Tomoyuki Miyamoto,
Masayuki Miyamoto,
Koichi Hirata
[show abstract]
[hide abstract]
ABSTRACT: The aim of this multicenter cross-sectional study was to assess the relation between fatigue in a large number of Japanese patients with Parkinson's disease (PD) and drugs taken to treat PD.
We used the 16-item Parkinson Fatigue Scale (PFS-16), which was designed to assess fatigue exclusively associated with PD. Multiple logistic regression analyses were used to assess the relation between antiparkinson drugs and fatigue in PD.
A total of 350 non-demented PD patients were enrolled. Fatigue (PFS score of ≥4) was revealed in 319 patients (91%). Pramipexole was administered to 24% of PD patients. Multiple logistic regression analysis revealed that the administration of Pramipexole was significantly related to low rates of fatigue in PD patients with Hoehn and Yahr stage <3 (p=0.011, odds ratio=5.23, 95% confidence interval; 1.47-18.63).
The reduced fatigue in PD patients was observed in taking Pramipexole.
Internal Medicine 01/2011; 50(19):2163-8. · 0.94 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To clarify the effects of altitude acclimatization on postural instability at altitudes, six female climbers stood with their eyes open or closed on a force-measuring platform under normoxia (NC) and hypobaric hypoxia, equivalent to a 5,000 m altitude (HC), before and after an expedition to Mt. Cho-Oyu (8,201 m). The expedition extended over 84 days. We recorded sways in the center of foot pressure, electromyograms (EMGs) of lower-leg muscles, blood components and arterial oxygen saturation (SpO(2)). Before the expedition, the maximum amplitude of sway with the eyes open and integrated EMG from the medial gastrocnemius increased for HC. After the expedition, red blood cell (from 423.4 ± 15.4 to 498.0 ± 24.5 × 10(4) μl(-1)), hemoglobin content (from 12.6 ± 0.32 to 14.5 ± 1.00 g/dl) and 2,3-diphosphoglycerate (from 1.93 ± 0.21 to 2.24 ± 0.34 μmol/ml) increased. The SpO(2) under HC increased from 69.2 ± 9.6 to 77.2 ± 10.0%. The maximum amplitude of sway with the eyes open decreased for HC. No difference in the sway path length and integrated EMGs was observed between NC and HC. These results suggest that acclimatization can improve the impaired postural stability on initial arrival at altitudes. However, it is still unclear how long acclimatization period is needed. Further studies are needed to reveal this point.
Arbeitsphysiologie 10/2010; 110(3):539-47. · 2.15 Impact Factor
-
Internal Medicine 01/2010; 49(4):351. · 0.94 Impact Factor
-
Yasuyuki Okuma,
Satoshi Kamei,
Akihiko Morita,
Fumihito Yoshii,
Toshimasa Yamamoto, Shiori Hashimoto,
Hiroya Utsumi,
Taku Hatano,
Nobutaka Hattori,
Miyuki Matsumura,
Kazushi Takahashi,
Shigeru Nogawa,
Yuka Watanabe,
Tomoyuki Miyamoto,
Masayuki Miyamoto,
Koichi Hirata
[show abstract]
[hide abstract]
ABSTRACT: The objective of this multicenter cross-sectional study was to determine the prevalence of fatigue and factors contributing to it in a large sample of Japanese patients with Parkinson's disease (PD). We used the 16-item Parkinson Fatigue Scale (PFS-16), which was designed to assess fatigue exclusively associated with PD. We carried out this study using PFS-16, the Unified Parkinson's Disease Rating Scale, Zung's Self-Rating Depression Scale, Parkinson's Disease Sleep Scale (PDSS), and the PD quality of life (QOL) scale (PDQ-39) by interview using questionnaires and physical examination by neurologists in 361 nondemented PD patients. Fatigue (an average PFS score of 3.3 or greater) was revealed in 151 patients (41.8%). Multiple logistic regression analysis indicated that the significant independent variables related to the presence of fatigue were the scores of PDSS and PDQ-39. Depression score was not a significant contributing factor. Our study revealed that the prevalence of fatigue in Japanese PD patients is as high as that in Western countries, and that fatigue is a relatively independent symptom, although sleep disturbance may be associated with fatigue. Since fatigue is significantly related to QOL reduction, therapeutic interventions including treatment of sleep disturbance are important.
Movement Disorders 09/2009; 24(13):1977-83. · 4.51 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Antiphopholipid syndrome (APS) is a major cause of ischemic stroke in young adults. In our study, stroke patients with antiphospholipid antibodies (APL) were significantly younger and were more likely to be women than stroke patients without APL. Valvular heart disease, neurological complications, and hematological disorders were more frequent in the APL-positive group. The mean value of thrombin-antithrombin III complex was significantly lower in the APL-positive group. beta2-Glyoprotein I (beta2-GPI) is the antigen primarily responsible for APL. At the DNA level, 4 different types of allelic polymorphisms have been detected in beta2-GPI. The allele at position 247 has codes for either valine (V) or leucine (L), which results in genotypic expression of VV, VL, or LL. In our study, the V and VL genotypes were more frequent in patients with cerebral infarction than in normal controls. The VL genotype was more frequent among patients aged less than 60 years than in those aged more than 60 years. The mean values of beta-thromboglobulin and platelet factor 4 in patients with the VL genotype were significantly higher than those with the LL genotype. The results suggested that V247 beta2-GPI allele is one of the genetic risk factors for the development of cerebral infarction through platelet activation.
Brain and nerve = Shinkei kenkyū no shinpo 12/2008; 60(11):1333-8.
-
[show abstract]
[hide abstract]
ABSTRACT: The purpose of the present study was to clarify the olfactory functions of Japanese patients with idiopathic Parkinson's disease (IPD) using the odor stick identification test for Japanese (OSIT-J).
Fifty-four non-demented IPD patients (33 men and 21 women), ranging in age from 43 to 81 years (69.7+/-8.1 years) and 50 age- and gender-matched healthy controls who reported having no olfactory complaints were enrolled. OSIT-J consisted of 12 odorants familiar to Japanese subjects. Each subject sniffed each odor that was applied to paraffin paper. Next the subject chose 1 of 6 answers: 4 pictures associated with the odors labeled with their names, one of which was correct, and 2 other ones ("unknown" and "not detected").
The number of correct answers was significantly lower in the IPD group (4.4+/-2.7) than in the normal group (8.3+/-2.2) (p<0.0001). Even in IPD patients who could smell normal strength odors in subjective symptom, the number of correct answers decreased. The number of correct answers was not correlated with motor function, disease duration, or medication.
The present study demonstrated that the smell identification ability of Japanese IPD patients was impaired based on the OSIT-J.
Internal Medicine 01/2008; 47(21):1887-92. · 0.94 Impact Factor
-
Nippon rinsho. Japanese journal of clinical medicine 08/2007; 65(7):1239-42.
-
Nō to shinkei = Brain and nerve 12/2006; 58(11):953-60.
-
[show abstract]
[hide abstract]
ABSTRACT: A 78 year-old woman was admitted to our hospital because of subacutely progressive dysarthria, dysphagia, proximally dominant muscle weakness and erythema in the neck and back. She was diagnosed as having rheumatoid arthritis (RA) at the age of 60 and treated with bucillamine (BUC) for 8 years. Laboratory tests included a rheumatoid factor of 1,472U/ml. Serum creatine kinase level was slightly elevated. The activated T cells in the peripheral blood were markedly increased. Needle EMG demonstrated myogenic changes. The magnetic resonance image of the left upper arm showed diffuse muscle atrophy and inflammatory changes in the triceps muscle. The muscle biopsy revealed perivascular inflammatory cell infiltraton and type II fiber atrophy. A biopsy from the skin showed mild perivascular inflammatory cell infiltraton. According to the results of these findings, she was thought to have dermatomyositis due to BUC. After withdrawal of BUC followed by the administration of prednisolone 1mg/kg, her symptoms improved and activated T cells in the peripheral blood were decreased. In Japan, BUC is widely accepted as an effective drug in the treatment of RA, even though it is known to induce some autoimmune diseases. However, the mechanism of the development of autoimmune disease is unclear. We considered that the long-term use of bucillamine could trigger an autoimmune response such as an increase in activated T cells and the development of dermatomyositis-like clinical features in our patient. In conclusion, when RA patients treated with BUC show a clinical picture compatible with dermatomyositis, its causative relationship has to be considered.
Rinsho shinkeigaku = Clinical neurology 02/2005; 45(1):45-8.
-
[show abstract]
[hide abstract]
ABSTRACT: Antiphospholipid syndrome is important as a cause of ischemic stroke, although clinical characteristics of the syndrome are not well documented.
We analyzed differences in clinical characteristics between 40 antiphospholipid-antibody (aPL)-positive and 40 aPL-negative stroke patients.
Stroke patients with aPL were significantly younger and were more likely to be women in comparison with stroke patients without aPL. Valvular heart disease, neurological complications and hematological disorders were more frequent in the aPL-positive group. The mean value of thrombin-antithrombin III complex was significantly lower in the aPL-positive group. Cerebral infarctions in the carotid system were less and large-artery lesions more frequent in the aPL-positive patients.
Stroke patients with aPL have clinical characteristics distinct from stroke patients without aPL.
Cerebrovascular Diseases 02/2005; 19(6):384-90. · 2.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A 67-year-old man under hemodialysis treatment developed neck stiffness, fever and conscious disturbances. The patient was infected with Methicilin-resistant Staphylococcus aureus (MRSA) sepsis caused by an infection on a dialysis shunt. On admission, he was diagnosed with bacterial meningoencephalitis and underwent a series of antibiotic chemotherapies. The treatment brought cell count in the cerebrospinal fluid to a subnormal level but his clinical status did not improve. The patient continued to have high level of cerebrospinal fluid protein (898 mg/dl). Cervical MRI demonstrated two abscesses deep in the neck as well as in the epidural region of the cervical spinal cord, from C2 to C5 vertebral levels. Based on these findings, spinal epidural abscess (SEA) was diagnosed. Intensive antibiotic chemotherapy especially targeted for MRSA could eradicate abscesses and improve clinical status. However, persistent high protein level in the cerebrospinal fluid could suggest SEA.
Nō to shinkei = Brain and nerve 10/2004; 56(9):805-9.
