1.Effects of the Artificial CO2 Bathing on the Parkinson's Disease with Autonomic Nerve Disturbance.
Katsura MASAKI ; Masaharu MAEDA ; Koji YORIZUMI ; Tatsushi NUKAZAWA ; Masatoshi MATSUOKA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1993;56(4):227-234
The effect of the artificial CO2-bathing on the blood pressure in patients with Parkinson's disease with autonomic disorder was investigated and the conclusions were obtained as follows;
1. Regardless of the extent of the autonomic disorder and the contents in the bath, the slight increase in the blood pressure was observed immediatly after the bathing.
2. Systolic blood pressure within 100-150mmHg before the bathing decreased gradually during the bathing and the degree of the decrease was proportional to the extent of the autonomic disorder. The variation of the blood pressere during the bathing was within 30mmHg.
3. Furthermore, when the artificial CO2-bathing liquid was used, the decrease in the blood pressure after the bathing was salient in proportion to the extent of the autonomic disorder and it was observed that the restoration of the blood pressure to the level before the bathing was remarkably delayed compared with the tap water bathing. This phenomenon was similar in patient with Shy-Drager syndrome characterized by severe autonomic disorder.
4. From the above results, it was suggested that the close management of the blood pressure and the attention to the change of position are necessary during and after the artificial CO2-bathing in patient with Parkinson's disease with severe autonomic disorders and patients with Shy-Drager syndrome.
2.Effect of Inhalation of CO2 Gas during Artificial CO2-Bathing for Cerebral Blood Flow in CVA Patients.
Masatoshi MATSUOKA ; Masaharu MAEDA ; Katsura MASAKI ; Koji YORIZUMI ; Tatsushi NUKAZAWA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1994;57(2):129-134
Purpose
To investigate the effect of CO2-inhalation on the cerebral circulation of CVA patients during artificial CO2-bathing, controlled examinations were made with 99mTc-hexamethyl propyleneamine oxime SPECT (hereinafter abbreviated as HM-PAO-SPELT).
Subject and Methods
HM-PAO-SPECT was conducted on four CVA patients without CO2-inhalation as a control. 0.5g of artificial CO2-bath tablet (Kao Bub®) was them added to 2l of hot tapwater at 40°C to provide an ordinary bathing concentration. The patients inhaled the CO2 generated for 3min at a height of 20cm above the water level, which was immediately followed by HM-PAO-SPECT. Similar examinations were performed at a higher bathing concentration provided by adding 50g of artificial CO2-bath tablet (Kao Bub®) to 2l of water. To compare results with systemic circulation, blood pressure and blood gas were measured before and after the CO2-inhalation.
Results
HM-PAO-SPECT showed a remarkable increase in blood flow in two of the four patients when 0.5g of artificial CO2-bath tablet was used to provide an ordinary bathing concentration. At a concentration 100 times higher than ordinary concentration using 50g of artificial CO2-bath tablet, obvious increase in blood flow was found in three of the patients. At both concentrations, the remaining patient showed a decrease on blood flow, with no change in blood pressure or blood gas.
Discussion
CO2 is considered as one of the most potent factors involved in cerebral blood flow. In these examinations, the effect of CO2-inhalation from artificial CO2-bath tablet in increasing blood flow was confirmed by means of HM-PAO-SPECT. Its usefulness was thus proven. The subject who showed a decrease in blood flow may have been in a period of steal phenomenon, or luxury perfusion, when he underwent the examination. Future studies must be performed on the relationship between the increase in blood flow and the improvement of symptom, timing of artificial CO2 bathing, and between the effect of artificial bathing and the CO2 concentration.
3.Psychological Distress Associated with Patient-Reported Outcomes in Preoperative Patients with Lumbar Spinal Stenosis
Tomoko KITANO ; Mamoru KAWAKAMI ; Yuyu ISHIMOTO ; Masatoshi TERAGUCHI ; Daisuke FUKUI ; Toshiko MATSUOKA ; Yukihiro NAKAGAWA
Asian Spine Journal 2021;15(4):533-538
Cross-sectional study. The purpose of this study was to investigate the effects of psychotic symptoms such as anxiety and fear in patients undergoing lumbar spinal canal stenosis. Recently, patients with spinal disorders have not only been evaluated objectively for their disease, but also for patient-reported outcomes (PROs) including pain, physical function, and quality of life (PROs). Since depression has been previously associated with surgical outcomes, several studies have indicated that psychological problems may worsen the effects of pain and make treatment increasingly difficult. A questionnaire survey was conducted on 346 lumbar spinal stenosis (LSS) patients who visited our hospital from 2010 to 2016. The content of the questionnaire included questions on PROs (Japanese Orthopedic Association Back Pain Evaluation Questionnaire [JOABPEQ], Roland–Morris Disability Questionnaire, Japanese version [RDQ], and Zurich Claudication Questionnaire [ZCQ]) and psychological evaluation (Self-rating Questionnaire of Depression, Pain Catastrophizing Scale, Pain Anxiety Symptoms Scale-20 [PASS-20], Hospital Anxiety and Depression Scale, and Brief Scale for Psychiatric Problems in Orthopedic Patients). IBM SPSS Statistics (IBM Corp., Armonk, NY, USA) was used for statistical analysis and Spearman’s rank correlation coefficient, Mann-Whitney No significant correlations were found between psychological factors and PROs ( Preoperative psychological factors in patients with LSS were associated with their RDQ, JOABEPQ, and ZCQ scores. These results suggest that factors such as catastrophic thoughts on pain, anxiety, depression, and fear that may affect the clinical outcomes in patients with LSS should be evaluated before surgery to facilitate psychological interventions.
4.Psychological Distress Associated with Patient-Reported Outcomes in Preoperative Patients with Lumbar Spinal Stenosis
Tomoko KITANO ; Mamoru KAWAKAMI ; Yuyu ISHIMOTO ; Masatoshi TERAGUCHI ; Daisuke FUKUI ; Toshiko MATSUOKA ; Yukihiro NAKAGAWA
Asian Spine Journal 2021;15(4):533-538
Cross-sectional study. The purpose of this study was to investigate the effects of psychotic symptoms such as anxiety and fear in patients undergoing lumbar spinal canal stenosis. Recently, patients with spinal disorders have not only been evaluated objectively for their disease, but also for patient-reported outcomes (PROs) including pain, physical function, and quality of life (PROs). Since depression has been previously associated with surgical outcomes, several studies have indicated that psychological problems may worsen the effects of pain and make treatment increasingly difficult. A questionnaire survey was conducted on 346 lumbar spinal stenosis (LSS) patients who visited our hospital from 2010 to 2016. The content of the questionnaire included questions on PROs (Japanese Orthopedic Association Back Pain Evaluation Questionnaire [JOABPEQ], Roland–Morris Disability Questionnaire, Japanese version [RDQ], and Zurich Claudication Questionnaire [ZCQ]) and psychological evaluation (Self-rating Questionnaire of Depression, Pain Catastrophizing Scale, Pain Anxiety Symptoms Scale-20 [PASS-20], Hospital Anxiety and Depression Scale, and Brief Scale for Psychiatric Problems in Orthopedic Patients). IBM SPSS Statistics (IBM Corp., Armonk, NY, USA) was used for statistical analysis and Spearman’s rank correlation coefficient, Mann-Whitney No significant correlations were found between psychological factors and PROs ( Preoperative psychological factors in patients with LSS were associated with their RDQ, JOABEPQ, and ZCQ scores. These results suggest that factors such as catastrophic thoughts on pain, anxiety, depression, and fear that may affect the clinical outcomes in patients with LSS should be evaluated before surgery to facilitate psychological interventions.
5.Human Leukocyte Antigens and Biomarkers in Type 1 Diabetes Mellitus Induced by Immune-Checkpoint Inhibitors
Hidefumi INABA ; Yosuke KAIDO ; Saya ITO ; Tomonao HIROBATA ; Gen INOUE ; Takakazu SUGITA ; Yuki YAMAMOTO ; Masatoshi JINNIN ; Hiroaki KIMURA ; Tomoko KOBAYASHI ; Shintaro IWAMA ; Hiroshi ARIMA ; Takaaki MATSUOKA
Endocrinology and Metabolism 2022;37(1):84-95
Background:
Type 1 diabetes mellitus induced by immune-checkpoint inhibitors (ICI-T1DM) is a rare critical entity. However, the etiology of ICI-T1DM remains unclear.
Methods:
In order to elucidate risk factors for ICI-T1DM, we evaluated the clinical course and immunological status of patients with ICI-T1DM who had been diagnosed during 2016 to 2021.
Results:
Seven of 871 (0.8%, six men and one woman) patients developed ICI-T1DM. We revealed that the allele frequencies of human leukocyte antigen (HLA)-DPA1*02:02 and DPB1*05:01 were significantly higher in the patients with ICI-T1DM In comparison to the controls who received ICI (11/14 vs. 10/26, P=0.022; 11/14 vs. 7/26, P=0.0027, respectively). HLA-DRB1*04:05, which has been found to be a T1DM susceptibility allele in Asians, was also observed as a high-risk allele for ICI-T1DM. The significance of the HLA-DPB1*05:01 and DRB1*04:05 alleles was confirmed by an analysis of four additional patients. The absolute/relative neutrophil count, neutrophils-lymphocyte ratio, and neutrophil-eosinophil ratio increased, and the absolute lymphocyte count and absolute/relative eosinophil count decreased at the onset as compared with 6 weeks before. In two patients, alterations in cytokines and chemokines were found at the onset.
Conclusion
Novel high-risk HLA alleles and haplotypes were identified in ICI-T1DM, and peripheral blood factors may be utilized as biomarkers.