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Search Results: 1 - 10 of 679 matches for " Hidehiro Oka "
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Outcome of Vision Impairment and Diabetes Insipidus in Suprasellar Region Germinoma  [PDF]
Satoshi Utsuki, Hidehiro Oka, Yoshiteru Miyajima, Chihiro Kijima, Kiyotaka Fujii, Shinichi Kan
International Journal of Clinical Medicine (IJCM) , 2011, DOI: 10.4236/ijcm.2011.22016
Abstract: Aim: Many cases of suprasellar region germinoma occurs in diabetes insipidus (DI), but a patient initially may come to the hospital for the chief complaint of visual impairment. The aim of this study is to determine the etiology of initial symptom presentation and the outcomes of visual impairment and DI in suprasellar region germinoma. Methods: We investigated eleven cases of single lesion suprasellar germinomas that were diagnosed and treated in our hospital. For each, a magnetic resonance imaging (MRI) was performed. Results: At the hospital visit, decreased visual acuity was found in 5/11 cases, while DI was found in all cases. The decreased visual acuity was improved in 4/5 cases by treatment, but DI improved in only 2/11 cases. In 10 cases, DI occurred earlier than visual impairment. As the initial symptom, visual impairment occurred earlier than DI in only one case and did not improve by treatment. In this case, a pituitary stalk of the normal thickness could be identified by MRI, and the optic nerve was swollen. In ten cases except this case, no significant enlargement of optic nerve was detected, and a swollen pituitary stalk was confirmed. Conclusions: In suprasellar germinomas, it is rare, but the optic nerve can significantly swell at onset, while the pituitary stalk may be intact. In such cases, visual impairment occurs earlier than DI, and visual impairment may not be improved.
Effect of Postoperative Administration of Saireito for Bilateral Chronic Subdural Hematomas  [PDF]
Satoshi Utsuki, Hidehiro Oka, Chihiro Kijima, Madoka Inukai, Katsutoshi Abe, Kimitoshi Sato, Sachio Suzuki, Kiyotaka Fujii
International Journal of Clinical Medicine (IJCM) , 2011, DOI: 10.4236/ijcm.2011.23047
Abstract: The aim of this retrospective study was to investigate the efficacy of saireito for bilateral chronic subdural hematomas (B-CSDH). Between April 2006 and March 2010, a total of 18 patients undergoing unilateral burr hole drainage for B-CSDH took part in a controlled clinical study. Postoperative status of the nonsurgical side was subsequently evaluated, with (n = 10) and without (n = 8) saireito administration. Two in the saireito-treated group patients and four in the control group patients ultimately required contralateral surgical intervention. The remainder, including eight saireito-treated hematomas, resolved without further surgery, generally within eight weeks of the surgical side procedure. However, two of the four resolving control lesions took longer to regress. The hydragogue and anti-inflammatory/steroid-evoking properties ascribed to saireito may facilitate hematoma resolution. After unilateral surgery for B-CSDH, saireito administration may prevent symptomatic deterioration of a contralateral low-density CSDH, preempting subsequent surgery.
Preoperative Prediction of Whether Intraoperative Fluorescence of Protoporphyrin IX Can Be Achieved by 5-Aminolevulinic Acid Administration  [PDF]
Satoshi Utsuki, Hidehiro Oka, Chihiro Kijima, Madoka Inukai, Kiyotaka Fujii, Masahiro Ishizuka, Kiwamu Takahashi, Katsushi Inoue
International Journal of Clinical Medicine (IJCM) , 2012, DOI: 10.4236/ijcm.2012.32026
Abstract: Protoporphyrin IX (PPIX) fluorescence-guided brain tumor resection, using 5-aminolevulinic acid (5-ALA), is among the most valuable tools for determining tumor removal area. However, PPIX fluorescence is not necessarily achieved during an operation visually even when 5-ALA is used, and we do not know until tumor exposure to the excitation light of the ultraviolet region whether PPIX fluorescence has been achieved. When a particular biopsy and frozen section diagnosis is made, the reason for lack of PPIX fluorescence in the tissue cannot be judged. We do not know whether the tumor fails to fluoresce or no fluorescence is seen because it is not the main body of the tumor. We investigated whether the presence or absence of tumor fluorescence could be predicted by examining urinary porphyrin before surgery, at the time of intraoperative fluorescence diagnosis using 5-ALA. The urine of brain tumor patients 2 hours after 5-ALA administration was irradiated with a 405 ± 1 nm laser light. The patients were divided into a fluorescent urine group and negative fluorescent urine group. Red fluorescence was observed in response to the 405 ± 1 nm laser beam for all tumors in the fluorescent urine group. Clear red fluorescence was not observed even with 405 ± 1 nm laser beam irradiation in any tumors in the negative fluorescent urine group. Preoperative prediction of the intraoperative fluorescence of PPIX can be achieved by observation of urine 2 hours after 5-ALA administration with exposure to a 405 ± 1 nm laser light.
Glioblastoma without Remarkable Contrast Enhancement on Magnetic Resonance Imaging  [PDF]
Satoshi Utsuki, Hidehiro Oka, Yoshiteru Miyajima, Chihiro Kijima, Yoshie Yasui, Kiyotaka Fujii
International Journal of Clinical Medicine (IJCM) , 2012, DOI: 10.4236/ijcm.2012.36082
Abstract: This is the report of a histological and clinical investigation of 4 cases of glioblastoma, a rare tumor, in whom poor contrast enhancement of the tumor was visualized on magnetic resonance imaging (MRI). Among the 94 patients with first-occurrence glioblastoma treated between January 2000 and August 2011, 4 were enrolled in this retrospective study. There were 2 men and 2 women, ranging in age from 41 to 70 years (mean, 57 years). All the patients underwent tumor resection, postoperative irradiation, and chemotherapy. One died of local tumor recurrence after 36 months; the remaining three remain alive as of 25 to 72 months after the initial treatment. The histopathology was glioblastoma with nuclear pleomorphism and pseudopalisading necrosis in all cases. However, the typical vascular endothelial proliferation was not found in 3 cases. All glioblastomas were immunopositive for p53 and immunonegative for epidermal growth factor receptor (EGFR) and isocitrate dehydrogenase 1 (IDH1). These glioblastomas showing unclear contrast enhancement on MRI had similar clinical and pathological characteristics, but differed in characteristics from glioblastoma patients showing marked contrast enhancement of the tumor on MRI.
Late intrathoracic relapse of pineal germinoma connected to intraspinal canal
Utsuki Satoshi,Oka Hidehiro,Sagiuchi Takao,Fujii Kiyotaka
Neurology India , 2007,
Abstract: Extraneural metastases of intracranial germinoma are rarely reported. The authors describe the first case of metastatic lung germinoma of the thoracic spine. A 27-year-old man presented with right shoulder pain and right upper limb weakness. He had a history of repetitive radiation therapy - nine (whole-abdomen; 15Gy), 12 (whole brain; 30Gy, whole spine 42Gy) and 14 years ago (local; 32Gy) - for abdominal metastasis, temporal and fourth ventricle metastasis and spinal dissemination and metastatic pineal germinoma, respectively. Magnetic resonance imaging revealed a lung mass invading the thoracic spine that was diagnosed as a germinoma by tumor biopsy. He was treated by irradiation with 54Gy and two cycles of chemotherapy with cisplatin and etoposide. He did not have any sign of tumor eight years later.
Usefulness of gamma knife pituitary surgery to control thalamic pain after treatment of thalamic malignant lymphoma and report of pathology of gamma knife lesions
Utsuki Satoshi,Oka Hidehiro,Miyajima Yoshiteru,Fujii Kiyotaka
Neurology India , 2009,
Abstract: Here, we describe the first reported autopsy findings following gamma knife surgery for thalamic pain. A 62-year-old man presented with thalamic pain after treatment for thalamic malignant lymphoma. He was treated with narcotic drugs, but his pain was uncontrollable. Treatment using gamma knife surgery on the pituitary gland using a maximum dose of 180 Gy, led to the control of his intractable pain with lower doses of drugs. His death was pain-free and was caused by a recurrence of the tumor, six months after gamma knife surgery. An autopsy was performed and necrosis was present in the area of the pituitary gland where it borders the pituitary stalk. Half of the adenohypophysis was not necrotic, and necrosis was not found in the pituitary stalk.
An Operation in the Park Bench Position Complicated by Massive Tongue Swelling
Hiroyuki Koizumi,Satoshi Utsuki,Madoka Inukai,Hidehiro Oka,Shigeyuki Osawa,Kiyotaka Fujii
Case Reports in Neurological Medicine , 2012, DOI: 10.1155/2012/165860
Abstract: This paper presents a case of massive tongue swelling as a complication after an operation in the park bench position. A 43-year-old male who had undergone a resection of a mass in the petrous bone of the clivus showed massive tongue swelling after the surgery in the left park bench position. A direct compression of the bite block caused the swelling of tongue. Tongue swelling may become fatal if it progresses to an airway obstruction; therefore the intraoperative and postoperative management is important.
An Operation in the Park Bench Position Complicated by Massive Tongue Swelling
Hiroyuki Koizumi,Satoshi Utsuki,Madoka Inukai,Hidehiro Oka,Shigeyuki Osawa,Kiyotaka Fujii
Case Reports in Neurological Medicine , 2012, DOI: 10.1155/2012/165860
Abstract: This paper presents a case of massive tongue swelling as a complication after an operation in the park bench position. A 43-year-old male who had undergone a resection of a mass in the petrous bone of the clivus showed massive tongue swelling after the surgery in the left park bench position. A direct compression of the bite block caused the swelling of tongue. Tongue swelling may become fatal if it progresses to an airway obstruction; therefore the intraoperative and postoperative management is important. 1. Introduction Intraoperative or postoperative complications of surgeries performed in the park bench position, such as bedsores, paralysis of the brachial plexus, and cervical cord injury, have been previously reported. This paper presents a case of massive tongue swelling which was a rare postoperative complication after the extirpation of a mass lesion in the petrous bone of the clivus which was performed in the park bench position. 2. Case Report A 43-year-old male experienced a dull pain at the right back of his head. The headache thereafter evolved into right orbital pain. The patient subsequently developed gradually progressive diplopia. Cerebral magnetic resonance imaging (MRI) showed a mass lesion in the right clivus that was suspected to be a meningioma. The patient was admitted for surgery. A neurological examination showed no abnormalities other than right abducent nerve paralysis. Cerebral computed tomography (CT) revealed a tumor with homogenous enhancement which came in contact with the petrous bone from the right clivus. However, no osseous proliferative change was observed. Cerebral MRI revealed a mass appearing as homogeneously hypointense on T1, and hyperintense on T2-weighted images. T1-weighted MRI with gadolinium showed a heterogeneously enhanced mass in the petrous bone from the right clivus (Figure 1). Figure 1: (a) Cerebral T1-weighted MRI shows a homogeneous, low-signal mass in the petrous bone from the right clivus. (b) Cerebral T2-weighted MRI reveals a homogeneous, high-signal mass in the petrous bone from the right clivus. (c) Cerebral T1-weighted MRI with gadolinium shows a heterogeneously enhanced mass in the petrous bone from the right clivus. The patient underwent a resection of the mass via a left suboccipital craniotomy. Oral intubation was done with I.D 7.5 spiral tube using the Macintosh laryngoscope blade. Intubation was easy. The endotracheal tube was secured at a depth of 23?cm with a bite block and adhesive tape. The patient was then placed in the left park bench position, and the head was fixed with neck
Impact of Platelet Transfusion on Survival of Patients with Intracerebral Hemorrhage after Administration of Anti-Platelet Agents at a Tertiary Emergency Center
Yuhko Suzuki, Takao Kitahara, Kazui Soma, Shingo Konno, Kimitoshi Sato, Sachio Suzuki, Hidehiro Oka, Masaru Yamada, Kiyotaka Fujii, Yukio Kitahara, Yuji Yamamoto, Takashi Otsuka, Yoshihiro Sugiura, Yuhsaku Kanoh, Yoshiko Tamai, Hitoshi Ohto
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0097328
Abstract: This study examined the impact of platelet transfusion (PLT) on the survival of intracerebral hemorrhage (ICH) patients who had been administered anti-platelet agents (APA). This retrospective cohort analysis investigated 432 patients (259 men, 60%) who were newly diagnosed with ICH between January 2006 and June 2011 at the tertiary emergency center of Kitasato University Hospital. Median age on arrival was 67.0 years (range, 40–95 years). ICH was subcortical in 72 patients (16.7%), supratentorial in 233 (53.9%), and infratentorial in 133 (30.8%). PLT was performed in 16 patients (3.7%). Within 90 days after admission to the center, 178 patients (41.2%) had died due to ICH. Before the onset of ICH, 66 patients had been prescribed APA because of atherosclerotic diseases. Multivariate regression analysis indicated APA administration was an independent risk factor for death within 7 days (odds ratio, 5.12; P = 0.006) and within 90 days (hazard ratio, 1.87; P = 0.006) after arrival. Regarding the effect of a PLT in ICH patients with APA, no patient with PLT died. PLT had a survival benefit on patients with ICH, according to our analysis. Further prospective analysis is necessary to confirm the effects of PLT on survival in ICH with APA.
Age and gender differences of psychogenic fever: a review of the Japanese literature
Takakazu Oka, Kae Oka
BioPsychoSocial Medicine , 2007, DOI: 10.1186/1751-0759-1-11
Abstract: To achieve this goal, we searched Medline and Ichushi WEB, a Japanese medical database, and added other publications that were not included in these databases. Thus, we reviewed 195 Japanese cases of psychogenic fever published in 62 papers.Psychogenic fever patients ranged from 3 to 56 years old, with the highest number of cases occurring in 13 year-olds in both sexes. The male: female ratio of 1: 1.19 suggested a slight predominance of female cases. Psychogenic fever accounted for 18% of fever cases of unknown origin in children and 2–6% of the psychosomatic diseases of pediatric patients. Patients with psychogenic fever were not only found in pediatrics departments, but also in psychosomatic medicine, psychiatry, internal medicine, anesthesiology, dentistry, and obstetrics/gynecology departments.The age of psychogenic fever patients ranged from 3 to 56 years old and the male: female ratio was 1:1.19. Psychogenic fever is seen especially in adolescence in Japan.Psychogenic fever is one of the most common psychosomatic diseases; physical diseases affected by psychosocial factors. Psychogenic fever is diagnosed when (1) there is no organic disease that accounts for the fever and (2) the fever develops in a psychologically stressful situation or (3) emotionally stressful stimuli induce acute or persistent increases in core temperature (Tc) above the upper limit of normal body temperature (37°C). Although numerous case reports on psychogenic fever have been published, the mechanisms by which psychological stress increases core temperature are not fully understood, and epidemiological studies are limited. Therefore, our primary objective was to investigate the age distribution and gender differences of psychogenic fever in Japan by reviewing the published literature.To achieve this goal, on January 15th, 2007 using the key words "psychogenic fever" we performed electronic searches of Medline (1960–2006) and Ichushi WEB (1983 (the beginning of the service)-2006), a data
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