Biomedical subjects

Yasushi Takase

Publications and source records attributed to Yasushi Takase.

6 recordsLinked to original sources

PubMed2005

[Cluster headache].

Cluster headaches are characterized by attacks of strictly unilateral severe pain which is orbital, supraorbital, temporal or in any combination of these sites associated with one or more of the following, ipsilateral conjunctival injection, lacrimation, nasal congestion, rhinorrhea, forehead and facial sweating, miosis, ptosis, and eyelid edema. Most patients are usually unable to lie down, restless or agitated during an attack. The attacks last 15-180 minutes and occur from once every other day to 8 times a day. Cluster periods usually last for weeks or months separated by remission periods, however about 10-15% of patients have chronic symptoms without remission. Age at onset is usually 20-40 years and prevalence is 3-4 times higher in men than in women. Acute attacks involve activation of the posterior hypothalamic gray matter. Pharmacological treatment for cluster headache can be abortive, prophylactic, or a combination of both methods.

Adult↗

PubMed2005

[Long-term prognosis of analgesics abuse headache].

OBJECTIVE: To evaluate the long-term prognosis of analgesics abuse headache. METHODS: Ninety-five consecutive patients with analgesics abuse headache were treated in Toyonaka Municipal Hospital. Seventy-three patients (76.8%) had migraine, eighteen (19.0%) had tension-type headache and four (4.2%) new daily persistent headache. Seventy-seven (81.1%) were females and eighteen (18.9%) males. All patients were treated for six years from November 1997 to October 2003 and a total of sixty-nine patients were available for interview as of October 2004 at a mean time interval of 41.5 months after drug withdrawal therapy. Twenty-two patients were admitted to our inpatient withdrawal unit, twenty-five patients were treated by outpatient withdrawal therapy. Tapering analgesics gradually in conjunction with instituting preventive therapy treated twenty-two patients. RESULTS: Inpatient-Nine cases (41%) reported intake of analgesics on < or = 8 days/month, five cases (23%) on 9-15 days/month and eight cases (36%) > 15 days/month. Three cases (14%) developed recurrent analgesic abuse. Outpatient (abrupt discontinuation)--Twelve cases (48%) reported intake of analgesics on < or = 8 days/month, five cases (20%) on 9-15 days/month and eight cases (32%) >15 days/month. One case (4%) reported on recurrent analgesic abuse. Outpatient (tapering analgesics gradually)--One case (5%) reported intake of analgesics on < or = 8 days/month and twenty-one cases (95%) reported daily intake. Fifteen cases (68%) reported continuous analgesic abuse. Comparison between migraine and tension-type headache suggested that patients with migraine showed a tendency towards a better prognosis than patients with tension-type headache. CONCLUSIONS: These results demonstrate the efficacy of withdrawal treatment in difficult cases suffering from analgesics abuse headache. If patients cannot be safely or adequately treated as outpatients, inpatient treatment may be needed.

Adult↗

PubMed2004

[Chronic daily headache and medication-induced headache].

Chronic daily headache (CDH) and medication-induced headache are refractory headaches to treatment. I evaluate the classification and pharmacological treatment of CDH and medication-induced headache. The subjects of this study are 508 patients with CDH (out of 2,241 patients with chronic headache who were examined and treated in Toyonaka Municipal Hospital for six years from November 1997 to October 2003). CDH was classified into three types of chronic migraine in 232 cases (45.7%), chronic tension-type headache in 223 cases (43.9%) and new daily-persistent headache in 53 cases (10.4%). 245 cases overused medication (analgesic in 230 cases, ergotamine in eight cases and triptan in seven cases). 108 cases abused medication (analgesic in 95 cases, ergotamine in seven cases and triptan in six cases). For treatment, muscle relaxants, calcium-channel blockers, tricyclic antidepressants, selective serotonin reuptake inhibitors, antiepleptic drugs and leukotriene receptor antagonists were administered to 231 patients for two months from September to October 2003. Awareness of CDH and medication-induced headache is important to physicians who treat patients with headache.

Chronic Disease↗

PubMed2003

[Primary new daily persistent headache (NDPH): clinical characteristics of forty-three cases in Japan].

Although the primary chronic daily headache is subdivided into chronic migraine, chronic tension-type headache, hemicrania continua, and new daily persistent headache (NDPH), the characteristics of NDPH have not been well studied in Japan. The purpose of this study is to investigate the clinical characteristics of the primary NDPH. Twenty-one men and twenty-two women with primary NDPH, aged 14 to 73 years were diagnosed at Toyonaka Municipal Hospital from November 1997 to April 2003. Age of the onset ranged from 13 to 73 years (mean, 34.8). The onset of headache occurred in relation to a stressful life event in 16%, a systemic infection in 12% and an extracranial surgery in 7%. Any precipitating events could not be identified in approximately two-third of patients (65%). Quality of the headache was described as dull and/or pressure-like sensation in 91%, throbbing and/or pulsating sensation in 28%. NDPH needs further study, because it appears to be one of the most refractory headaches.

Adolescent↗

PubMed2002

[A case of CIDP with diabetes mellitus who had good response to intravenous immune globulin].

A 64 year-old man began to feel numbness on his bilateral feet in 1990. He was diagnosed as diabetes mellitus with a high fasting glucose level of 580 mg/dl in 1993 and he received oral hypoglycemic agents. Since then, his blood glucose levels had been in good control under diet therapy and medication. However, his numbness worsened and progressive weakness of bilateral lower legs occurred in 1997. Bilateral anterior tibial muscles were atrophic and deep tendon reflexes were decreased on bilateral upper and lower limbs. Protein level of his cerebrospinal fluid was 63 mg/dl. Nerve conduction study fulfilled the electrophysiological diagnostic criteria of CIDP. Superficial peroneal nerve biopsy showed loss of myelinated fibers, small amount of onion bulbs and thickening of the basement membrane of arterioles. Demyelination was predominant in teased fiber study. These findings were compatible with CIDP combined with diabetes mellitus (DM-CIDP). His numbness and leg weakness improved after intravenous high dose immune globulin therapy. DM-CIDP must be distinguished from diabetic peripheral polyneuropathy because immunological therapy may be effective in DM-CIDP patients.

Diabetic Neuropathies↗

PubMed2002

[A case of bilateral perisylvian polymicrogyria with epileptic attacks of focal inhibitory seizure followed by complex partial seizure].

A 20 year-old woman began to have epileptic attacks of focal inhibitory seizure with paralysis and hypesthesia of her left or right upper limb followed by complex partial seizure several times a week since age 19. She was born by breech presentation and umbilical cord was coiling around her neck at birth. EEG showed spike foci on P 3, O1 and T5. Cerebral MRI with 4 mm-section inversion recovery image revealed bilaterally symmetrical polymicrogyria involving the posterior portion of sylvian fissure extending posteriorly to the inner cortex of the postcentral gyrus and the supramarginal gyrus, and she was diagnosed as bilateral perisylvian polymicrogyria. 99mTc-ECD SPECT showed increased cerebral blood flow over the bilateral polymicrogyric lesion. On cerebral MRA, bilateral middle cerebral arteries were narrow all way through. Epileptic attacks were controlled with zonisamide and carbamazepin. This is a rare case of bilateral perisylvian polymicrogyria because epileptic attacks were the only manifestation and the patient showed neither mental retardation nor neurological abnormality.

Adult↗