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Tadao Nose

Publications and source records attributed to Tadao Nose.

At least 19 recordsLinked to original sources
PubMed2006

Subarachnoid hemorrhage not due to ruptured aneurysm in moyamoya disease.

A patient with moyamoya disease presenting with subarachnoid hemorrhage (SAH) is reported. A 38-year-old Japanese woman developed a sudden onset headache and nausea during hospitalization for a cerebral infarct in the right frontal lobe. CT scan showed SAH in the left frontal sulci. Cerebral angiogram showed stenosis of the distal bilateral internal carotid arteries with moyamoya vessels, and significant transdural anastamoses from the left external carotid artery to cortical arteries on the left frontal cortex. The patient was kept normotensive and underwent a right-sided surgical revascularization procedure, remaining well for three years. SAH not due to ruptured aneurysm in moyamoya disease is rare. The cause of the SAH was thought to be disruption of the transdural anastomotic vessels. Recognition of these fragile vessels in moyamoya disease is essential.

Adult↗
PubMed2006

[Prediction of stroke, coronary heart disease, cardiovascular disease, cancer, and total death based on results of annual health checkups].

OBJECTIVE: We aimed to predict mortality rate from the findings of annual health checkups for men and women. METHOD: The subjects were 31,053 men and 61,224 women who were living in Ibaraki prefecture (Japan), aged 40 to 79 years, without history of any stroke and coronary heart disease, and who participated in annual health checkups in 1993. They were followed until the end of 2001, with a systemic review of resident registration and death certificates. The Cox's proportional hazards model with step-down procedure was used to estimate predictive model. RESULTS: During the 8.0 years follow-up, there were 5260 deaths (710 from stroke, 389 from coronary heart disease and 2,322 from cancer). The predictive factors for all causes were advanced age, high systolic blood pressure, medication for hypertension, low serum HDL cholesterol, high or low serum creatinine, high AST or ALT, diabetes, low body mass index, current smoking, heavy drinking, and urinary protein among men. The predictive factors for cardiovascular disease were advanced age, high systolic blood pressure, medication for hypertension, low or high serum total cholesterol, low serum HDL cholesterol, high serum creatinine, diabetes, low body mass index, current smoker, and urinary protein, and those for cancer were advanced age, medication for hypertension, low serum HDL cholesterol, low serum creatinine, high AST or ALT, diabetes, low body mass index, current smoking, heavy drinking and urinary protein. Furthermore, those for stroke were advanced age, high systolic blood pressure, medication for hypertension, low serum HDL cholesterol, high serum creatinine, high AST or ALT, low body mass index, current smoking, while for coronary heart disease they were advanced age, high systolic blood pressure, high serum total cholesterol, low serum HDL cholesterol, diabetes, current smoking, and urinary protein among men. For women, similar predictive factors were obtained, although some of them did not reach statistical significance. CONCLUSION: We could construct predictive models for 5-year mortality rate from results of annual health checkups. These findings should prove useful for computerized health education on the prevention of stroke, coronary heart disease, and cancer.

Adult↗
PubMed2005

Traumatic central cord syndrome: analysis of factors affecting the outcome.

BACKGROUND: The indications and timing of treatment, as well as the best treatment method for traumatic central cord syndrome (CCS), remain controversial. The aims of this study are to determine the prognostic factors of traumatic CCS and to determine appropriate surgical indications. METHODS: We reviewed the clinical and radiological data of 47 patients with this syndrome. The data collected included age, neurological status as measured on a scale defined by the Japanese Orthopaedic Association (JOA), anteroposterior (AP) diameter of the spinal canal on computed tomography, signal intensity change of the spinal cord on T2-weighted magnetic resonance imaging (MRI), associated spinal diseases, and the type of treatment received. The correspondence between the clinical and radiological findings and the neurological outcome was investigated. RESULTS: The patient's age, JOA score on admission, signal intensity change of the spinal cord on MRI, and associated spinal diseases were not significant in predicting the patient's recovery. On the other hand, the AP diameter of the spinal canal (P = .0402) and the interval between injury and surgery (P < .0001) were factors predictive of excellent recovery. In the surgical treatment group, timely surgery was found to improve the outcome, while conservative treatment did not improve the outcome of patients with a low JOA score, a relatively small AP diameter of the spinal canal, or a positive signal intensity change of the spinal cord on T2-weighted MRI. CONCLUSION: The AP canal diameter of the spinal canal and the interval between injury and surgery may be reliable predictors of excellent recovery in patients with CCS. We recommend timely surgery, preferably within 2 weeks of injury, to achieve a better functional outcome in selected patients.

Central Cord Syndrome↗
PubMed2005

Age-specific relationship between blood pressure and the risk of total and cardiovascular mortality in Japanese men and women.

To examine the impact of age on the relationship between blood pressure (BP) levels and each of cardiovascular disease mortality and all-cause mortality, a total of 30,226 men and 58,798 women aged 40-79 years who had no history of stroke or heart disease underwent health checkups in Ibaraki-ken, Japan, in 1993 and were followed through 2002. Risk ratios for mortality by BP category based on the 1999 WHO-ISH guidelines were calculated by age subgroups (40-59 years, 60-79 years) using a Cox proportional hazards model. Compared with optimal BP levels, the multivariate risk ratios of cardiovascular mortality for stage 2 or 3 hypertension were 5.99 (95% confidence interval: 2.13-16.8) in middle-aged men and 4.09 (1.70-9.85) in middle-aged women. These excess cardiovascular mortality risks were larger in the 40-59 years age group than in the 60-79 years age group for both genders (p for interaction = 0.01 for both). In men, the population attributable risk percents of cardiovascular mortality were 60% for younger men and 28% for older men, while for women they were 15% for younger women and 7% for older women. Weaker but significant excess risks of total mortality were observed for stage 2 or 3 hypertension in men of both age groups and in the older age group for women. The impact of BP on the risk of cardiovascular mortality was larger among middle-aged persons than among the elderly in both men and women. Our findings indicate the importance of BP control to prevent cardiovascular disease among middle-aged individuals.

Adult↗
PubMed2005

Effect of J coupling and T2 Relaxation in Assessing of Methyl Lactate Signal using PRESS Sequence MR Spectroscopy.

PURPOSE: This work was aimed at quantification of lactate concentration using proton MR spectroscopy (MRS). We carried out a basic study to clarify the characteristics of signal change and T2 relaxation time of lactate that occur by J coupling in point resolved spectroscopy (PRESS) sequence. MATERIALS AND METHODS: Proton MRS was done for a water phantom containing 10 mmol/L creatine and lactate on a clinical 1.5 T MR system by using an asymmetric PRESS sequence. The coupling constant J was 7.35 Hz. In acquisitions, TE was varied from 68 ms up to 544 ms, with an increment of 68 ms (1/2J) and TR was fixed to 10000 ms. RESULTS: The shape and signal intensity of the lactate signal vary depending on its phase. The lactate signal intensity at TE 272 ms was higher than at TE 136 ms despite the longer TE. T2 relaxation times of lactate in the negative in-phase (TE 136 ms, TE 408 ms) and positive in-phase (TE 272 ms, TE 544 ms) were 1033 ms and 1042 ms, respectively (no significant differences), so that when the same phase was used, regardless of the phase condition, T2 relaxation behavior was not different. We considered that our results included over expression and loss of lactate signal depending on the phase. CONCLUSIONS: For evaluation of the lactate peak, we recommend the use of the positive in-phase signal because it is larger than the negative in-phase signal. The influence of the asymmetric PRESS sequence, which may cause loss and over expression of lactate signal, should be considered in the calculation of the quantification. The T2 relaxation time should be also considered in the calculation of the lactate value since it affects the value considerably.

Humans↗
PubMed2005

[Development of a tool for assessment of local government health policy].

OBJECTIVE: A tool was developed for assessment of health status in communities to help formulate health policy of local governments and allow estimates of magnitude of changes in mortality with modification of selected risk variables. MATERIALS AND METHODS: A total of 25,201 men and 51,776 women aged 40-69 years who underwent health checkups in Ibaraki-ken, Japan, in 1993 were followed through 2002. Risk ratios for all cause, cardiovascular disease, cerebrovascular disease, ischemic heart disease, all cancer, and lung cancer deaths were calculated according to smoking, heavy alcohol consumption, obesity, hypertension, hypercholesterolemia, low high-density lipoprotein cholesterol, and diabetes using a Cox proportional hazards model. Regression coefficients for body mass index, systolic blood pressure, serum total cholesterol, serum high-density lipoprotein cholesterol, and plasma glucose were also calculated by the model with quadratic terms. On the basis of the results, we developed a tool using Microsoft EXCEL, allowing estimation of the magnitude of changes in death rates according to variation in mean and standard deviation values for risk factors by impact fraction. RESULTS: The developed tool facilitates estimation of magnitude of changes in death rates with alteration in exposure rates and means/standard deviations of risk variables with intervention. The best magnitude of decline for all cause mortality with a 50% reduction of exposure to smoking was 10% in men. The magnitudes of decline in cardiovascular disease mortality with a 50% reduction in hypertension were 12% in men and 11% in women. Furthermore, the magnitude of decline in cardiovascular disease mortality if a 10% lowering of mean systolic blood pressure were achieved would be 22% in men and 18% in women. CONCLUSIONS: Our developed tool may be useful to assess health status in communities with cooperation between municipal and prefectural governments.

Adult↗
PubMed2004

Surgery improves vision and cosmetic appearance of an adult patient with fibrous dysplasia of the frontal bone.

A 31-year-old woman with fibrous dysplasia (FD) of the left forehead was reported. Visual acuity impairment and diplopia were slowly progressive for 6 months associated with marked protrusion of her left forehead. Removal of left forehead lesion including the orbital ridge and total decompression of the optic canal and superior orbital fissure improved these visual symptoms dramatically. Reconstructive cranioplasty using artificial bone made by hydroxyapatite (Apaceram) was very satisfactory in cosmetic appearance. Surgical indication and neuroradiological findings of cranial FD are discussed as well as a review of the literatures.

Adult↗
PubMed2004

Transient long segment spinal cord hyperintensity after anterior cervical discectomy.

A 69-year-old man was admitted to our hospital with progressive numbness in both feet and gait disturbance. MR imaging revealed a large cervical disc herniation resulting in significant spinal cord compression with hyperintensity of the spinal cord on T2-weighted images at C-5/6. Immediately after undergoing anterior cervical discectomy, the patient developed severe weakness of his left hand and lower extremities. MR imaging obtained 5 days after surgery revealed a long segment hyperintensity between C-3 and T-2 on T2-weighted images. This long segment hyperintensity disappeared after 2 weeks of steroid administration. We suspect that the persistent, localised, patchy C-5/6 cord hyperintensity represents spinal cord degeneration due to ischaemia and trauma resulting from the disc herniation. However, the transient long segment hyperintensity may represent oedema, probably due to minor trauma of an already compromised cord, during the decompression surgery. Clinicians should be aware that even careful surgery can result in a significant change in radiological studies and neurological condition.

Aged↗
PubMed2004

Traumatic acute subdural hygroma mimicking acute subdural hematoma.

Subdural hygroma is a frequent delayed complication of head trauma. Most hygromas are clinically 'silent' and a few cases have shown slow deterioration in the chronic stage. We report a case of subdural hygroma showing unique radiological findings and rapid deterioration. A 74-years-old female presented with a mild headache and consciousness disturbance after head injury. Computed tomography showed a midline shift as a result of two components piling up in the subdural space; the outer components showed low density, the inner components high density. Magnetic resonance imaging demonstrated that these two subdural components were subdural hygroma and subarachnoid hematoma. Simple burr hole irrigation, rather than large craniotomy, was thought to be more appropriate treatment to reduce the mass effect. Simple burr hole irrigation was performed to remove the subdural hygroma and the patient showed an excellent recovery. Careful examination of the radiological findings prevented an unnecessary procedure in this case. A possible mechanism of this phenomenon is discussed.

Acute Disease↗
PubMed2004

Management of unruptured cerebral aneurysms in patients with polycystic kidney disease.

BACKGROUND: Autosomal dominant polycystic kidney disease (PKD) is a hereditary disorder characterized by bilateral multiple renal cysts and early onset chronic renal failure. PKD patients tend to suffer their subarachnoid hemorrhage at a younger age. Unruptured aneurysms in PKD patients are not always innocuous, and proactive treatment has been indicated for these lesions. However, the management of PKD patients undergoing unruptured cerebral aneurysm surgery has been documented on only a few occasions. The purpose of this study was to better define the management of unruptured cerebral aneurysms in patients with PKD. METHODS: We present a retrospective review of the management of unruptured cerebral aneurysms in 16 patients with PKD. Eight patients were maintained through chronic hemodialysis whereas the remaining 8 patients did not require hemodialysis, at the time of treatment of their cerebral aneurysms. The mean follow-up period was 24 months. RESULTS: In the nonhemodialysis patients prophylactic hemodialysis was routinely performed after cerebral angiography to prevent deterioration of the pre-existing renal dysfunction. Microsurgical clipping of the aneurysm was performed in 15 patients (7 nonhemodialysis and 8 hemodialysis patients) and intravascular coil embolization was performed in 1 nonhemodialysis patient. One nonhemodialysis patient who underwent microsurgical clipping required a temporary hemodialysis after surgery, but the patient was not shifted to chronic hemodialysis. No patients developed postprocedural complications, and each showed an excellent recovery. CONCLUSION: PKD patients with unruptured cerebral aneurysms can be safely treated with an appropriate treatment strategy including the use of prophylactic hemodialysis.

Adult↗
PubMed2004

Cerebral metastasis from angiosarcoma of the aortic wall: case report.

BACKGROUND: Primary or metastatic cerebral angiosarcoma is extremely rare, and only limited cases have been reported. The authors here describe a case of angiosarcoma, which was initially identified and diagnosed by the cerebral metastatic lesion; later examinations suggested that the primary site was the abdominal aorta. CASE DESCRIPTION: A 53-year-old man, who had suffered an abdominal aortic aneurysm 2 months earlier, experienced a sudden onset of left-sided hemifacial convulsion and dysarthric speech. Computed tomography (CT) showed a hemorrhagic mass lesion with perifocal edema in the right frontal lobe. Magnetic resonance imaging (MRI) showed a regionally marked hypointensity in the mass lesion on both T1- and T2-weighted images, which might suggest hemosiderin deposition. The tumor was removed in its entirety. Pathologic examination revealed an old hematoma with a hemosiderin deposit containing markedly atypical tumor cells, and angiosarcoma was diagnosed. Resection of the abdominal aortic aneurysm and iliac bone biopsy were performed and angiosarcoma was recognized in each surgical specimen. Based on clinical and pathologic findings, the primary site was considered to be the abdominal aorta. CONCLUSIONS: Clinicians should be aware of this rare histologic type of tumor. Unique MRI findings such as those obtained in our case might be useful for differentiating this condition from other intracranial neoplasms.

Aorta, Abdominal↗
PubMed2004

Intratumoral injection of IL-2-activated NK cells enhances the antitumor effect of intradermally injected paraformaldehyde-fixed tumor vaccine in a rat intracranial brain tumor model.

Combined therapy with a fixed-tumor cell vaccine and intratumoral injection of NK cells induced strong tumor regression of rat glioma. Rat 9L glioma cells were inoculated into syngeneic male rats at the flank (subcutaneous tumor model) or at the basal ganglia of the right hemisphere (intracranial tumor model). Rats were intradermally injected three times with vaccine comprising fixed 9L cells, IL-2- and GMCSF-microparticles, and tuberculin prior to (protective studies) or after (therapeutic studies) challenge with live 9L cells. In the protective studies, the vaccine alone achieved significant tumor growth inhibition and elongation of mean life span in both the subcutaneous and intracranial tumor models. No therapeutic effect was observed in the intracranial tumor model with the vaccine alone. However, intratumoral injection of rat NK cells strongly assisted the therapeutic effect of the vaccine in the brain tumor model and resulted in a statistically significant elongation of life span. We propose that intratumoral injection of NK cells may not only kill brain tumor cells directly, but also trigger a strong immune response in the focal lesion of the brain after vaccination.

Animals↗
PubMed2003

Stable nitroxide Tempol ameliorates brain injury by inhibiting lipid peroxidation in a rat model of transient focal cerebral ischemia.

Oxygen free radicals have been implicated in the pathogenesis of cerebral ischemia and reperfusion injury. 4-Hydroxy-2,2,6,6-tetramethylpiperidene-1-oxyl (Tempol) has been reported as a stable nitroxide and a membrane-permeable free radical scavenger. This study was performed to investigate the mechanism of Tempol in attenuating ischemia-reperfusion injury in a rat model of transient focal cerebral ischemia. We measured the cerebral 2,3-dihydroxybenzoic acid (DHBA) level as the amount of hydroxyl radical production using a microdialysis technique with salicylic acids trapping during ischemia and reperfusion. The concentration of cerebral thiobarbituric acid reactive substances (TBARS), representing the extent of lipid peroxidation by free radicals, and the area of cerebral infarction were also measured. The level of cerebral 2,3-DHBA was increased during ischemia and reperfusion, especially during the early reperfusion stage at the periphery of the infarct area (nearly 500-fold). Intravenous administration of Tempol at the time of reperfusion reduced 2,3-DHBA production (Vehicle group: 472.2+/-196.2, Tempol group: 238.3+/-77.2) and the cerebral TBARS level (Vehicle group: 541.7+/-84.7, Tempol group: 339.0+/-147.2 nmol/g), and decreased the size of the cerebral infarction (Vehicle group: 202.2+/-98.4, Tempol group: 98.5+/-13.7 mm(3)). In contrast, Tempol administered 15 min prior to reperfusion reduced neither the TBARS level nor the size of the infarction. These results indicate that Tempol administration at the time of reperfusion reduced lipid peroxidation by scavenging free radicals, resulting in a reduction of the infarct size.

Animals↗