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Biomedical subjects

Hiroshi Okudera

Publications and source records attributed to Hiroshi Okudera.

7 recordsLinked to original sources
PubMed2006

Subtle computed tomography abnormalities in cerebral deep sinus thrombosis.

A patient with cerebral deep sinus thrombosis, which was not diagnosed on the first examination, is reported. A 46-year-old woman presented with headache and vomiting. Neurological examination and a brain computed tomography (CT) scan showed no obvious abnormal findings. The patient suffered disturbed consciousness on the day after the examination, and was admitted to our emergency centre. A CT scan and magnetic resonance imaging revealed an ischaemic lesion in the left basal ganglia, suggesting deep sinus occlusion. Anticoagulant therapy was administered. One day after admission, a CT scan showed a haematoma and severe brain swelling in the same region. Cerebral angiography demonstrated a straight sinus occlusion. Intracranial pressure was not controlled with hypothermia, and the patient died 25 days after admission. Review of the initial CT scan revealed subtle, early findings of deep venous thrombosis that were missed on first examination.

Anticoagulants↗
PubMed2006

Description and first clinical application of AirWay Scope for tracheal intubation.

We have developed a novel airway apparatus, AirWay Scope, which we have used in the orotracheal intubation of 10 consecutive patients requiring general anesthesia before neurosurgical procedures. The characteristic shape of the introducer (INTLOCK), the tube guiding function and the sighting device of the AirWay Scope has possibility to facilitate tracheal intubation. Here, we report the first clinical application of this system and describe potential advantages of the apparatus.

Adult↗
PubMed2003

Significant elevation of urinary trypsin inhibitor in patients with brain contusion--a preliminary report.

Urinary trypsin inhibitor (UTI) is a protease inhibitor, which is produced in the liver. The correlation between UTI level and head injury has not been evaluated. This study was designed to investigate UTI levels in patients with severe head injury. We measured UTI in the urine of patients with brain contusion. UTI was significantly higher in those patients compared to the control group. The results suggest that UTI may be useful for assessing the severity of head injury and also as a treatment marker in patients with brain contusion.

Adult↗
PubMed2002

Clinical features on nerve gas terrorism in Matsumoto.

Clinical features on the first unexpected nerve gas terrorism using sarin (isopropyl methylphosphonofluoridate) on citizens in the city of Matsumoto is described. The nerve gas terrorism occurred at midnight on 27 June, 1994. About 600 people including residents and rescue staff were exposed to sarin gas. Fifty-eight victims were admitted to hospitals and seven died. Theoretically, sarin inhibits systemic acetylcholinesterase and damages all the autonomic transmission at the muscarinic and nicotinic acetylcholine receptor. Miosis was the most common finding in the affected people. In cases with severe poisoning, organophosphate may affect the central nervous system and cause cardiomyopathy. A few of the victims complained of arrhythmia and showed a decreased cardiac contraction. Abnormal electroencephalograms were recorded in two patients. The clinical features and follow-up studies are discussed with reference to the Tokyo subway terrorism and related articles.

Arrhythmias, Cardiac↗
PubMed2002

NeuRobot: telecontrolled micromanipulator system for minimally invasive microneurosurgery-preliminary results.

OBJECTIVE: Microneurosurgery can be performed less invasively with the recent advances in neuronavigation and neuroendoscopy. For even less invasive microneurosurgery, we have developed a telecontrolled micromanipulator system. METHODS: The NeuRobot telecontrolled micromanipulator system was developed. With the use of this system, surgical simulations were performed with a human cadaveric head. RESULTS: The system consists of four main parts, i.e., a micromanipulator (slave manipulator), a manipulator-supporting device, an operation-input device (master manipulator), and a three-dimensional display monitor. Three 1-mm forceps and a three-dimensional endoscope, which could be remotely controlled with three degrees of freedom (rotation, neck swinging, and forward/backward motion), were installed in the slave manipulator. All surgical procedures were accurately performed with this system. CONCLUSION: The use of telecontrolled manipulator systems in neurosurgery is very promising, and we are convinced that this system will facilitate more accurate, less invasive microneurosurgery. The details of the NeuRobot system and preliminary results are presented.

Cadaver↗
PubMed2002

Modified, multipurpose, radiolucent sugita head frame for intraoperative cerebral angiography.

OBJECTIVE: Although several radiolucent head-fixation devices have been developed to allow intraoperative cerebral angiography, no device provides satisfactory freedom to obtain the most suitable head position. We recently designed a multipurpose radiolucent Sugita head frame (modified radiolucent Sugita frame) with satisfactory degrees of freedom and rigidity for intraoperative head positioning and head holding, respectively. DESCRIPTION OF INSTRUMENTATION: A short arm and a ring joint, made of engineering plastic, were added to the prototype radiolucent Sugita frame, to permit side-tilting movements of the frame. The shape of all handles at the joints was also changed and the size was enlarged, to facilitate adjustment of the head position. EXPERIENCE AND RESULTS: We used this modified radiolucent Sugita frame in 20 cases involving aneurysms or arteriovenous malformations. The frame performed satisfactorily in all cases, in terms of firm head fixation and unrestrained freedom of head positioning at the surgeon's request. The modified radiolucent Sugita frame was evaluated with respect to its resistance to physical forces. The physical strength of the modified radiolucent Sugita frame is almost equivalent to that of the metallic Sugita frame and is considered sufficient for clinical usage. CONCLUSION: With its rigidity, satisfactory degrees of freedom, and ease of handling, the clinical applicability of the dramatically improved radiolucent head frame enables us to obtain satisfactory intraoperative angiograms.

Cerebral Angiography↗