Biomedical subjects

Takuya Uchiyama

Publications and source records attributed to Takuya Uchiyama.

4 recordsLinked to original sources

PubMed2003

Feasibility study of the simultaneous integrated boost (SIB) method for malignant gliomas using intensity-modulated radiotherapy (IMRT).

BACKGROUND: Intensity-modulated radiotherapy (IMRT) using the simultaneous integrated boost (SIB) method was designed for treating malignant gliomas. The purpose of this study was to investigate feasibility of this treatment. METHODS: Between December 2000 and November 2002, six patients with malignant gliomas were enrolled in this study. IMRT delivered 70 Gy/28 fractions (fr)/daily 2.5 Gy to the gross tumor volume (GTV) and 56 Gy/28 fr/daily 2.0 Gy to the surrounding edema defined as the clinical target volume annulus (CTV-a). The feasibility of the treatment was assessed from both physical and clinical points of view. RESULTS: No delay due to acute radiation toxicity was observed in any of the patients. The tumor recurred locoregionally in five of the six patients. The glioblastoma (GBM) recurred in two patients during the radiotherapy and in three patients at 5.4, 4.0 and 7.0 months after the start of radiotherapy. The sites of recurrence or progression were local in the GTV in four patients and in one patient subependymal dissemination was observed. Three patients, two with GBMs and one with anaplastic astrocytoma, died of the disease at 4, 16 and 7 months after the start of radiotherapy, respectively. CONCLUSIONS: The treatment of 70 Gy/28 fr/daily 2.5 Gy to the GTV and 56 Gy/28 fr/daily 2.0 Gy to the CTV-a was feasible both physically and clinically.

Aged↗

PubMed2003

[A case report of tuberculous meningitis: limits of detection using polymerase chain reaction (PCR) and treatments].

A 40-year-old man with intractable meningitis was transferred to our hospital 6 weeks after onset. On admission, he showed consciousness disturbance, meningeal signs and right oculomotor nerve palsy. MRI demonstrated prominent cisternal enhancement and hydrocephalus. We suspected tuberculous meningitis as the diagnosis, and treated with antituberculotics, though he died of midbrain infarction day 11 of the treatment. Before and during the admission, bacterial cultures, PCR, smear examination of cerebrospinal fluid(CSF) were repeated. But no evidence of tuberculosis was obtained. Cultures of the brainstem fragments detected mycobacterium, which was finally confirmed by a PCR method after his death. PCR provides a rapid and reliable diagnosis of tuberculous meningitis, although there is a potential for false-negative. Thus the clinical, radiological and CSF findings should be stressed. Corticosteroids treatment should be considered in cases with ischemic lesions.

Adrenal Cortex Hormones↗

PubMed2001

Dicyclopenta

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Journal Article↗

PubMed1999

Chronic motor cortex stimulation in the treatment of central and neuropathic pain. Correlations between clinical, electrophysiological and anatomical data.

Thirty-two patients with refractory central and neuropathic pain of peripheral origin were treated by chronic stimulation of the motor cortex between May 1993 and January 1997. The mean follow-up was 27.3 months. The first 24 patients were operated according to the technique described by Tsubokawa. The last 13 cases (eight new patients and five reinterventions) were operated by a technique including localisation by superficial CT reconstruction of the central region and neuronavigator guidance. The position of the central sulcus was confirmed by the use of intraoperative somatosensory evoked potentials. The somatotopic organisation of the motor cortex was established peroperatively by studying the motor responses at stimulation of the motor cortex through the dura. Ten of the 13 patients with central pain (77%) and ten of the 12 patients with neuropathic facial pain had experienced substantial pain relief (75%). One of the three patients with post-paraplegia pain was clearly improved. A satisfactory result was obtained in one patient with pain related to plexus avulsion and in one patient with pain related to intercostal herpes zooster. None of the patients developed epileptic seizures. The position of the stimulating poles effective on pain corresponded to the somatotopic representation of the motor cortex. The neuronavigator localisation and guidance technique proved to be most useful identifying the appropriate portion of the motor gyrus. It also allowed the establishment of reliable correlations between electrophysiological-clinical and anatomical data which may be used to improve the clinical results and possibly to extend the indications of this technique.

Adult↗