The effects of the traditional chinese medicine, "Banxia Houpo Tang (Hange-Koboku To)" on the swallowing reflex in Parkinson's disease.

Swallowing disorder is common in Parkinson's disease (PD). We studied the swallowing disorder in PD, and tested the efficacy of Banxia Houpo Tang (BHT, a Chinese traditional medicine) in improving the swallowing reflex of PD patients. The Swallowing reflex test is a simple method used to detect swallowing disorders in patients with cerebrovascular disease. Because we observed previously that BHT significantly improved the swallowing reflex in cerebrovascular patients, we studied whether BHT was also effective in improving the swallowing disorder in patients with PD. 23 PD patients (13 males, 10 females, mean age 66.0+/-9.3, Hoehn & Yahr (H-Y) mean score = 2.8) were evaluated for swallowing reflex and the concentration of substance-P in their saliva before and after 4 weeks of BHT treatment. The swallowing reflex before treatment was significantly delayed, according to the H-Y score (Spearman's p = 0.014, R2 = 0.463). The swallowing reflex before BHT treatment was 3.66+/-0.98 sec, and after BHT treatment, it improved significantly, to 2.27+/-0.54 sec (p < 0.0001). Substance-P concentration in PD patients saliva before treatment was significantly lower than in healthy controls (p = 0.007), but showed no significant change after BHT treatment. Our research shows that the swallowing reflex is an effective method to evaluate the swallowing disorder in PD. BHT can significantly improved the swallowing reflex in PD patients, and therefore can be a hopeful candidate for preventing aspiration pneumonia in PD.

Identification of deoxymiroestrol as the actual rejuvenating principle of "Kwao Keur", Pueraria mirifica. The known miroestrol may be an artifact.

Miroestrol (1) has been isolated previously as an active principle from "Kwao Keur" (Pueraria mirifica), a rejuvenating folk medicine from Thailand. Reinvestigation using bioassay-guided purification has resulted in the isolation of a new potent phytoestrogen, deoxymiroestrol (2). The facile aerial oxidation of 2 into 1 suggests the possibility that 1 may be an artifact.

[A survey of current nutrition therapy for the ALS patients in Japanese national sanatoriums].

To evaluate the current nutrition therapy for the patients of amyotrophic lateral sclerosis (ALS) in Japan, we sent questionnaires to 53 Japanese national sanatoriums (hospitals) and were able to collect replies from 42 institutes. In these replies, information on 466 patients (262 inpatients and 204 outpatients) was reported, accounting for about 10% of all Japanese ALS patients. Patients who ate orally were more frequent (p < 0.001, chi 2 test) in the outpatients (76.0%) than in the inpatients (39.7%). When the subjects were limited to non-orally nourished cases, gastrostomy was more frequently performed (p < 0.05, chi 2 test) in the outpatients (49%) than in the inpatients (29.1%), but no significant differences were observed between the above two groups as to the quantity of daily caloric intake; the mode was 1000-1200 Cal. About a quarter of non-orally nourished patients received supplemental sodium chloride, and fewer were supplemented copper and/or zinc. The consent of the patients as well as the clinical findings weighed heavily in the determination of the feeding route. Most physicians were disinclined to encourage tube feeding in the early stage of dysphagia, but were supportive of the operation of percutaneous endoscopic gastrostomy when non-oral nutrition therapy became necessary. Although the efficacy of vitamins for ALS has not been proved, 45 of 58 physicians agreed to subscribe vitamins to their patients, especially vitamin B12, E and C.

Choto-san in the treatment of vascular dementia: a double-blind, placebo-controlled study.

In an earlier placebo-controlled study, we demonstrated that a kampo (Japanese herbal) medicine called Choto-san (Diao-Teng-San in Chinese) was effective in treating vascular dementia. To evaluate its efficacy using more objective criteria, we carried out a multi-center, double-blind study of Choto-san extract (7.5 g/day) and a placebo, each given three times a day for 12 weeks to patients suffering from this condition. The study enrolled and analyzed 139 patients, 50 males and 89 females, with a mean age of 76.6 years. Choto-san was statistically superior to the placebo in global improvement rating, utility rating, global improvement rating of subjective symptoms, global improvement rating of psychiatric symptoms and global improvement rating of disturbance in daily living activities. Such items as spontaneity of conversation, lack of facial expression, decline in simple mathematical ability, global intellectual ability, nocturnal delirium, sleep disturbance, hallucination or delusion, and putting on and taking off clothes were significantly improved at one or more evaluation points in those taking Choto-san compared to those taking the placebo. Furthermore, the change in revised version of Hasegawa's dementia scale from the beginning point in Choto-san group was tended to be higher than that in placebo group with no statistical significance. These results suggest that Choto-san is effective in the treatment of vascular dementia.

Effect of deaerated water on serum biochemical values and on the cecum concentration of short-chain fatty acids in the rat.

The effects of drinking deaerated water on serum biochemical values, and on the concentrations of short-chain fatty acids (SCFAs) derived from bacterial fermentation in the colon were examined in rats. Drinking deaerated water decreased the levels of serum alkaline phosphatase (SAP) and serum urea nitrogen (SUN), and increased the serum potassium (SK) and serum phosphorus (SP) levels. Although the concentration of propionic acid in the cecum was decreased by drinking deaerated water, the concentrations of isobutyric, valeric, and isovaleric acid in the cecum were increased.

[Clinical study of autologous blood transfusion in pregnant women].

The effect of autologous blood donation during the third trimester of pregnancy on the maternal circulation, the properties of blood collected in a phosplatebuffered citrate anticoagulant solution, and the clinical outcome of autologous blood donation and transfusion for pregnant women were investigated in this study. Thirty-four pregnant women with placenta previa or previous cesarean delivery underwent phlebotomies in an autologous transfusion program. Three hundred ml of blood was collected under the observation of fetal heart rate patterns and uterine contractions from 3 weeks prior to the planned date of cesarean section and a total of 900 ml of blood was stored. Electronic fetal monitoring tracings were all normal and changes in blood pressure and pulse rates were minimal during the blood donation. The decrease in hemoglobin after the removal of 900 ml of blood was only 0.6g/dl on average during the 3 weeks, since the concentration of erythropoietin in serum and the counts of reticlocyte increased in a few days after blood removal. But there were no significant changes in TAT levels in serum. Twelve out of 34 pregnant women received the autologous blood transfusion during or after cesarean delivery and the homologous transfusions were avoided. The results of this study suggested that autologous blood transfusion for pregnant women with a high incidence of blood loss at delivery, such as placenta previa or previous cesarean delivery was safe and advantageous in avoiding homologous blood transfusion.

Autologous blood transfusion for the patient with placenta previa complicated by placenta increta: a case report.

The patient, who was 34 years of age, had previously had a transverse incision of the lower uterine segment cesarean section because of placenta previa. She was admitted to the hospital due to placenta previa again at 27 weeks of gestation in the current pregnancy. Ultrasound examination revealed placenta increta as well as placenta previa. In an attempt to avoid homologous blood transfusion at the time of profuse hemorrhage anticipated to occur during cesarean section, an autologous blood transfusion was planned. Fifteen hundred ml of autologous blood was collected by a leap-frog method during the 8 weeks prior to cesarean section. A cesarean hysterectomy was performed at 37 weeks of gestation because of placenta increta. Blood loss was estimated at 1,830 ml, and 1,500 ml of autologous blood was transfused. A leap-frog method of autologous blood collection for this pregnant woman with risk of massive hemorrhage was simple and beneficial, resulting in the preservation of more than 1,500 ml of autologous blood for transfusion.

Synthesis and in vivo evaluation of [11C]semotiadil, a benzothiazine calcium antagonist.

A carbon-11 labeled benzothiazine calcium antagonist, (+)-(R)-2-[5-methoxy-2-[3-[methyl[2-[(3,4- methylenedioxy)phenoxy]ethyl]amino]propoxy]phenyl]-4-methyl-2H-1,4- benzothiazin-3(4H)-one (semotiadil), and its enantiomer were prepared by N-methylation of the corresponding norderivatives with 11CH3I: decay-corrected radiochemical yields of 16-27% based on 11CH3I, radiochemical, chemical and optical purity of > 99%, sp. act. of 11-50 GBq/mumol and preparation time of 35-40 min. In mice, saturable and stereo-selective uptake in the hippocampus, striatum and hypothalamus was observed. The potential of the compound to visualize the regional brain calcium channels in vivo by positron emission tomography was indicated; however, no promising sign was found in the myocardium.

[Influence of selenium on human health. Part 2. Relationship between selenium concentration in whole blood and physiological functions of the human body].

In order to study the influence of selenium (Se) on human health, the relationships between Se concentrations in whole blood and human body functions were studied in 331 healthy subjects living in Nagano Prefecture. The subjects with low concentrations of Se had lower values for hemoglobin, hematocrit, red blood corpuscles, and for the function of pulmonary ventilation, as well as lower concentrations of glucose and albumin. A lowered concentration of Se may result in anemia, even though a deficiency of iron cannot be observed. On the other hand, the subjects with high concentrations of Se had higher concentrations of uric acid, glucose and total cholesterol, higher values for diastolic blood pressure and the thickness of fat under skin, as well as a higher index of liver function. Moreover, these subjects had a good index of physical constitution and strength, and presented a large total consumption energy value. These results may show that in man, high Se concentrations in whole blood, indicate higher element concentrations in serum and better indexes of physical constitution and strength.

[The efficacy of combined use of 1 alpha-hydroxyvitamin D3 with calcium supplements in the treatment of osteoporosis].

Synthetic analogue of active vitamin D metabolite, 1 alpha (OH) D3, has been widely used in the treatment of osteoporosis. However, the most effective method of treatment is yet to be established. Importance of calcium supplement to improve the calcium metabolism in osteoporosis is also reported by many authors. We have studied the combined effects of 1 alpha (OH)D3 with calcium supplement in preventing progressive decrease of bone mass in patients with osteoporosis. Sixty-six cases of postmenopausal and senile osteoporosis were divided into two groups: one treated with calcium alone 1,000 mg a day and the other treated with calcium 1,000 mg and 1 alpha (OH)D3 0.5 microgram a day, and both groups were followed for 24 months. Bone mass was evaluated by microdensitometry of the roentgenograms of the second metacarpal bone. The results revealed that the combined use of 1 alpha (OH)D3 with calcium has a significantly more favorable effect than the use of calcium alone in preventing bone loss. Therefore, 1 alpha (OH)D3 with calcium is useful in the treatment of osteoporosis. The conclusion would be further confirmed with longer term study and a more accurate method of measuring bone mass.

[Sequential changes of autoregulation in experimental focal cerebral ischemia--pathophysiology at the center, periphery and outside of the focal cerebral ischemia].

In order to elucidate the relationship between the degree of autoregulatory loss and the intensity or the duration of ischemia, and the difference of locations in and around the ischemic focus, we used the canine thalamic infarction model and studied the sequential changes of rCBF and autoregulation during 6 hours following vascular occlusion. The value of rCBF was measured by the hydrogen clearance method and autoregulation was tested by raising the blood pressure with drip infusion of angiotensin II. In the center of ischemic focus, autoregulation was impaired after 1, 3 and 5 hours following occlusion in the animals with moderate ischemia. In the animals with mild and severe ischemia, autoregulation was preserved during occlusion, but in the latter we thought it false autoregulation. In the periphery of infarctic focus with severe ischemia, autoregulation was impaired after 3 and 5 hours following occlusion. Outside of the infarctic focus with severe ischemia, autoregulation was preserved during occlusion, but in 2 of 6 animals rCBF decreased despite of raising blood pressure and it was thought to be paradoxical response.

Hemodynamics in hemorrhagic infarction--an experimental study.

Using the canine thalamic infarction model, hemodynamics, CO2 responses and thalamic EEG changes were studied in 7 dogs. Of the 7 animals, 4 showed hemorrhagic infarction and 3 did not, following recirculation after 6 hours of vascular occlusion. 1) The rCBF threshold for producing hemorrhagic infarction when recirculation following 6 hours of vascular occlusion was approximately 50% of the pre-occlusion level. 2) rCBF of the animals showing hemorrhagic infarction included hyperperfusion due to recirculation, and then fell to a level below the pre-occlusion level in a relatively short period. The CO2 response became disturbed both during occlusion and after release of occlusion. Thalamic EEG was nearly flat during vascular occlusion and recovery was not seen following recirculation. 3) rCBF of the animals not showing hemorrhagic infarction recovered rapidly to the pre-occlusion level due to recirculation. The CO2 response was somewhat disturbed during occlusion, but recovered following recirculation. Thalamic EEG was well preserved both during occlusion and after release.

The CO2 response in focal cerebral ischemia--sequential changes following recirculation.

The study was undertaken to determine the effects of various levels of ischemia on the CO2 response and on the development of infarction using the canine thalamic infarction model. Three groups were studied: those with severe ischemia (rCBF below 40% of the pre-occlusion levels), moderate ischemia (between 40% and 70%) and mild ischemia (greater than 70%). The CO2 response was measured after 30 minutes, 1, 2 and 6 hours of occlusion and then for 4 hours after recirculation. The CO2 response recovered after 30 minutes of occlusion in the severely ischemic animals, but in 8 of the 9 animals with 1 or more hours of occlusion, an impaired CO2 reactivity was found during occlusion and during recirculation. Among moderately ischemic animals, many showed impaired CO2 reactivity during occlusion, but following recirculation no single trend was observed. Among mildly ischemic animals, almost no abnormalities in the CO2 response were seen either during 6 hours of occlusion or thereafter. Among the 11 animals from all 3 groups which showed impaired CO2 reactivity, 10 developed infarction, while among the 10 animals which showed no impaired CO2 reactivity, in 9 infarction did not arise.

Treatment of multiple sclerosis with anti-measles cow colostrum.

Previous virological and immunological studies have suggested that multiple sclerosis (MS) is an auto-immune disease triggered by a virus infection. In order to inhibit the growth of measles virus in the patient's jejunum, we obtained an IgA-rich cow colostrum containing anti-measles lactoglobulin resistant to proteases. This colostrum was orally administered to patients with MS to investigate its effect on the course of the disease. Measles-positive antibody colostrum was orally administered every morning to 15 patients with MS at a daily dosage of 100 ml for 30 days. Similarly, measles-negative antibody (less than 8) control colostrum was orally administered to 5 patients. As a clinical assessment, disability scores developed by the International Federation of Multiple Sclerosis Societies were used. As a result, of 7 high NT titre (512-5120) anti-measles colostrum recipients 5 patients improved and 2 remained unchanged. Among 8 low NT titre (8-32) anti-measles colostrum recipients 5 patients improved and 3 remained unchanged. However, of 5 negative NT titre (less than 8) colostrum recipients 2 patients remained unchanged and 3 worsened. No side-effects were observed in colostrum recipients. These findings suggest the efficacy of orally administered anti-measles colostrum in improving the condition of MS patients (P less than 0.05).

[Hemodynamics in hemorrhagic infarction--an experimental study].

Using our previously reported "thalamic infarction model in the dogs", it was found that hemorrhagic infarction can be produced at a high frequency following recirculation after 6-12 hours of vascular occlusion. In the present study, in order to elucidate the pathophysiology of hemorrhagic infarction, we have undertaken a study of the relations among the histological findings, degree of ischemia, circulatory dynamics, CO2 response and EEG findings after vascular occlusion of 6 hours. In all animals where rCBF was found to fall to less than 50% due to vascular occlusion, hemorrhagic infarction was found. The hemodynamics of those animals presenting hemorrhagic infarction was such that reflow resulted in a transient increase in rCBF followed by decrease within a short period. After a few hours, rCBF values had fallen to pre-occlusion levels. During the 6 hours occlusion, electrical activity became almost flat, and recovery following reflow was not seen. The CO2 response was found to be disturbed immediately following vascular occlusion and also did not recover following reflow. In contrast, among the animals in which hemorrhagic foci were not found, reflow resulted in recovery of rCBF to pre-occlusion levels within a short period. Electrical activity of the brain and CO2 response were found to be maintained throughout the period of occlusion and thereafter in these animals.

Chronological relationship between neurological signs and electrophysiological changes in rats with methylmercury poisoning - special reference to selenium protection.

In order to see chronological relationship between electrophysiological changes and "early" neurological sign (tail rotation) elicited in rats poisoned with methylmercury, we made serial measurements of amplitude of compound action potential and sensory nerve conduction velocity of the tail nerve in rats with five dose schedules [methylmercury vs selenium, (1)20 ppm:0.1 ppm, (2)20: 0.3, (3)20: 0.6, (4)10: 0.1, (5)10: 0.6]. We observed the following sequence in the onset of neuro-electro-physiolo-somatic signs: fall in compound action potential greater than decrease in sensory nerve conduction velocity greater than tail rotation greater than weight loss. Protective potency of dietary selenium against neurotoxicity of methylmercury was observed with regard to both electrophysiological changes and neurological signs.

Influence of music on memory and education, and the application of its underlying principles to acupuncture.

The interrelations among learning, brain waves, music and the relief of pain by acupuncture are discussed from the standpoint of an educator, who has some practical experience in suggestive-accelerative learning and teaching (S.A.L.T.). Through the diverse fields of science, e.g. educational psychology, physiology, electronics and acoustics, the principal law governing the l/f fluctuations (where f is frequency), or the inverse frequency distribution of the power spectrum, seems to play an important role in their phenomenological mechanism. The author totally explained in this paper such relations and he arranged the related phenomena into physical, physiological, psychological and pedagogical fields. Finally, he referred to an interesting example of the application of l/f fluctuations to the relief of pain by acupuncture.

[Effect of mannitol on rCBF in canine thalamic ischemia-an experimental study (author's transl)].

We already reported in our experimental studies that mannitol acts to inhibit cerebral infarction. The purpose of this study was to investigate the efficacy of mannitol as assessed in terms of rCBF. The experiments were carried out with the thalamic infarction model in dogs, an experimental model developed and reported by us previously. The rCBF in the thalamus was measured by the initial slope method of hydrogen clearance curves. Following administration of 20% mannitol (2 g/kg) over a period of 10 minutes, slight increases in rCBF occurred during arterial occlusion. However the effect was more pronounced in mild than in severe ischemia. The length of time required for rCBF to return to its premedication level was almost 60 minutes.