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Masao Nagayama

Publications and source records attributed to Masao Nagayama.

9 recordsLinked to original sources
PubMed2005

Persistent but reversible coma in encephalitis.

INTRODUCTION: Nontraumatic coma in adults has a poor prognosis, and late recovery of consciousness is unlikely. Functional recovery is usually extremely poor. However, a few nontraumatic comatose patients have shown late recovery of both awareness and function. METHODS: A retrospective survey was conducted by reviewing the medical records of all inpatients to our department during the 1990s. Patients with persistent but reversible nontraumatic coma were identified according to the following criteria: (a) deep coma with a Glasgow Coma Scale (GCS) score of 7 or less on admission; (b) nontraumatic cause; (c) persistence of unconsciousness for longer than 1 month; and (d) subsequent recovery of GCS (total) to normal. The clinical spectrum of patients meeting these criteria was evaluated. RESULTS: Six patients (ages 16-75 years) met the criteria. Viral encephalitis was diagnosed in five (two with herpes simplex virus, two with cytomegalovirus, and one with Epstein-Barr virus or cytomegalovirus). Two young female patients with encephalitis manifested extremely protracted coma persisting for 3 and 18 months, respectively. Complications included nonconvulsive status epilepticus in two patients and relative overdose of clonazepam in one patient. CONCLUSION: Recognition of the clinical spectrum of persistent but reversible nontraumatic coma is important.

Adolescent↗
PubMed2005

Critical role of the "Doctor-Heli" system on cerebral infarction in the superacute stage--report of a outstanding pilot case.

In Japan, the physician staffed helicopter ambulance system, "Doctor-Heli" System, was first founded in our University Hospital in 1999. In this system, a helicopter is based at an Emergency Medical Center at all times and dispatch with both emergency physicians and a nurse upon a request by paramedics. This system has made possible a critically earlier development of the initial management at the point of care and rapid transport to the hospital. We presented the case suffering from acute cerebral infarction was transported by the "Doctor-Heli" and received the intervention for thrombolysis successfully. It was less than three hours from the onset to the completion of the intervention. The "DoctorHeli" system has a potential benefit for patients with acute cerebral infarction because of it enables quite early clinical diagnosis and rapid transport.

Acute Disease↗
PubMed2005

Eosinophilic pleurisy induced by dantrolene.

A 70-year-old male developed eosinophilic pleurisy fifteen years after dantrolene sodium had been started for his spastic paraplegia due to spinocerebellar degeneration. Drug lymphocyte stimulation test (DLST) for dantrolene was positive. After discontinuance of dantrolene, pleural effusion gradually decreased and inflammatory reaction improved. During two-year observation, we have found no relapse of pleurisy without special medication. We present this case and compare this case with other 10 reported cases.

Aged↗
PubMed2004

Post-ischemic delayed expression of hepatocyte growth factor and c-Met in mouse brain following focal cerebral ischemia.

We investigated long-term changes in the expression of protein and mRNA of hepatocyte growth factor (HGF) and its receptor c-Met in mouse brain after permanent occlusion of the middle cerebral artery, by using immunohistochemistry and quantitative reverse transcription-polymerase chain reaction. HGF-immunopositive cells were observed in the periinfarct region from 4 days after occlusion, peaking at 14-28 days. The area containing HGF-immunopositive cells continued to expand until 28 days after occlusion. c-Met-immunopositive cells were observed exclusively at the periinfarct region at 7 and 14 days after occlusion. At 28 days after occlusion, there were many c-Met-immunopositive cells in the widespread periinfarct region. Triple immunohistochemical staining by using confocal laser scanning microscopy (CLSM) demonstrated that most of the HGF-immunopositive cells were localized to reactive astrocytes. The c-Met-immunopositive cells were also localized to reactive astrocytes. HGF mRNA was upregulated exclusively in the periinfarct region at 14 days. c-Met mRNA was upregulated in the periinfarct region from as late as 28 days after occlusion. Thus, HGF and c-Met show delayed expression in the periinfarct region at both protein and mRNA levels after induction of ischemia. Because HGF was recently shown to play critical roles in angiogenesis and neurotrophic activities, the temporal profiles of their expression may imply the involvement of HGF in the process of post-ischemic brain tissue repair.

Animals↗
PubMed2004

[Bulbovascular compression by megadolichobasilar artery manifested as neurogenic and refractory hypertension].

A 37-year-old man with juvenile and refractory hypertension was admitted to our hospital for progressive left hearing loss, vertigo, and dizziness. Neurological examination revealed left hearing loss and exaggerated deep tendon reflexes and vestibular dysfunction. MRI and cerebral angiography disclosed megadolichobasilar artery (MDBA). Moreover, modified MR cisternography at the medulla disclosed marked compression and deformity of the left rostral ventrolateral medulla (RVLM) by the dolichoectatic right vertebral artery. In the literatures, bulbovascular compression has been reported in 4 among 9 patients with MDBA (including the present patient), for whom MRI of the medulla was presented. All 4 patients suffered from hypertension, and at least 3 of them showed juvenile and refractory hypertension. Ipsilateral pyramidal tract disturbance (Opalski syndrome) was observed in 3 patients. Considering the recent concept that the cardiovascular center can be localized at the RVLM, juvenile and refractory hypertension, and possibly Opalski syndrome in the present patient can be attributed to bulbovascular compression by MDBA. In the patients with MDBA and hypertension or Opalski syndrome, MR cisternography of the medulla is warranted to evaluate compression by MDBA.

Adult↗
PubMed2003

[Critical care neurology--present and future directions].

In Japan, we have first alerted the necessity of critical care neurology (CCN) and neuro-ICU in 2000, however, CCN is still unrecognized. In the United States and Germany, CCN has become recognized as one of the important subspecialty in neurology, and also, there is progressive increase of neuro-intensive care unit (neuro-ICU) after 1990s. In this symposium, the present status, problems, and future direction of clinical study and practice in CCN were reviewed from the standpoints as follows; 1 Quantitative and sequential analysis of literatures in CCN: MEDLINE search disclosed marked increase in CCN-related literatures since 1990s. 2 Categorical analysis of important literatures selected by German Society of CCN. 3 Analysis of clinical practice in CCN through neuro-ICU simulation study: in 442 inpatients who admitted to our department during 1998. 4 Analysis of requisites in critical care in neurology practice both in diagnostic and therapeutic aspects. 5 Historical development of CCN. 6 Evaluation of the effect of neuro-ICU. 7 Short-term and long-term problems for the activation of CCN. In conclusion, 1) CCN is still immature in Japan, and needs early establishment, including neuro-ICU and educational system for developing neurointensivist, 2) Extraction of problems, decision-making, and rapid differential diagnosis are critical to prevent and manage life-threatening neurological conditions.

Cerebrovascular Disorders↗
PubMed2002

[Guidelines for the management of stroke].

For the evidence-based management of stroke, the first guideline was produced at 1994 from the American Heart Association, and also at 2000 from the United Kingdom. However, there is no such guidelines created in Japan yet. Due to the differences in therapeutic agents, disease subtypes, and races between our and other countries, we must create our own guidelines, taking into consideration of the evidences and situations from/in Japan. In this presentation, we addressed the following issues; 1) Historical overview regarding the evidence-based guidelines for the management of stroke. 2) Details about the Japan Joint Committee on Guidelines for the Management of Stroke (Chairman: Yukito Shinohara, Secretary-General: Masao Nagayama) which was established in October 2000 with the initiative of stroke-related societies in Japan. 3) Analysis of the recommendations and literatures describe-cited in the first draft of the Guidelines and the Evidence tables. 4) Problems and future directions in the therapeutic research of stroke management.

Humans↗