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Yuichi Inoue

Publications and source records attributed to Yuichi Inoue.

66 records · Page 4Linked to original sources
PubMed2002

Clinical significance of cataplexy and HLADR1501 in narcolepsy.

Clinical symptoms and multiple sleep latency test (MSLT) measures among narcoleptic patients with both cataplexy and HLADR1501 were compared with cataplexy-free narcoleptic patients with a positive finding of HLADR1501 and cataplexy-free patients without HLADR1501. Both mean sleep onset latencies and rapid eye movement (REM) latencies on MSLT were shorter in the patients with cataplexy compared with the cataplexy-free patients. In four cataplexy-free patients without HLADR1501, nocturnal sleep was remarkably long and their excessive daytime sleepiness did not respond to treatment. The findings suggest that the severity and disease mechanism of narcolepsy might become heterogenous when cataplexy and HLADR1501 are considered.

Analysis of Variance↗
PubMed2002

Cavernous sinus metastasis from thyroid papillary adenocarcinoma.

We report here an extremely rare case of cavernous sinus metastasis from thyroid papillary adenocarcinoma presenting long after initial diagnosis. A 41-year-old patient presented with a cavernous sinus tumor causing progressive diplopia 10 years after treatment for a papillary adenocarcinoma of the thyroid. After 5 years of close observation, subarachnoid hemorrhage developed from the cavernous sinus tumor extending to the cerebellopontine angle, at which point the patient underwent surgical removal of the tumor followed by gamma knife radiosurgery. The pathological diagnosis was papillary adenocarcinoma, indicating the distant metastasis from the thyroid. This case illustrates the unique event of a cavernous sinus metastasis long after initial treatment of the primary cancer.

Adenocarcinoma, Papillary↗
PubMed2002

Hydroxyapatite laminar spacers and titanium miniplates in cervical laminoplasty.

OBJECTIVE: The authors describe a new surgical technique for cervical laminoplasty that was performed in 25 patients. The posterior elements along with the various ligaments are removed en bloc and are stabilized in a lift-up position by placing hydroxyapatite (HA) laminar spacers and titanium miniplates and screws. The procedure and clinical results are discussed. METHODS: The posterior spinal elements, including the lamina(e), spinous process(es), and various attached ligaments, are removed en bloc by incising the lamina in its lateral aspect. Trapezoid-shaped HA spacers are placed between the cut ends of the laminae or between the laminae and lateral masses bilaterally at each level. Malleable titanium miniplates and screws are used for fixation of the spacers. The fixation of transected laminae was judged to be successful. Postoperative care included application of a soft neck collar for 1 week but no further restriction of activity. Surgery-related outcome was assessed in the 21 patients who attended more than 6 months of follow up after laminoplasty. There were 18 men and three women who ranged in age from 27 to 81 years. Cervical stenotic myelopathy was demonstrated in 15 patients who underwent decompressive and expansive laminoplasty, and spinal tumors were documented in six patients who underwent a nonexpansive laminoplasty. Postoperative and follow-up computerized tomography scans demonstrated no hardware failure. Bone formation around the spacers was observed either at 6- or at 9-month follow-up examination in all 21 patients. Fusion of the reconstructed laminae was found to be completed at 12 months in all 18 patients able to attend follow up for this duration. Spinal alignment and the range of motion of the cervical spine were well preserved. In patients with stenotic cervical myelopathy, neurological and anatomical outcome of canal expansion were satisfactory. CONCLUSIONS: This technique enables rigid laminoplasty while maintaining anatomical and biomechanical integrity of posterior elements of cervical spine. Expansive and nonexpansive laminoplasty procedures are possible.

Adult↗
PubMed2002

[Clinical usefulness of multi-planar reconstruction images of three-dimensional computed tomographic angiography for internal carotid artery aneurysms].

The usefulness of multi-planar reconstruction (MPR) images of three-dimensional computed tomographic angiography (3D-CTA) for the diagnosis of internal carotid artery (ICA) aneurysms is described. Eleven unruptured ICA aneurysms including six cases of IC-cavernous aneurysm, two cases of IC-ophthalmic artery aneurysm, two cases of IC-posterior communicating artery aneurysm and one cases of IC-anterior choroidal artery aneurysm, were examined by magnetic resonance angiography (MRA), digital subtraction angiography (DSA), 3D-CTA and its MPR images. 3D-CTA and DSA were useful to identify the aneurysmal neck in small aneurysms, but it was difficult to identify the aneurysmal neck in small aneurysms by 3D-CTA-MPR images. DSA and MRA were not useful for identifying the aneurysmal neck in aneurysms more than 10 mm in diameter, as a precise viewing of the neck could not be found due to their large size. For large aneurysms, neither was 3D-CTA useful for identifying the aneurysmal neck when their large size and surrounding bony structures overlapped the aneurysmal neck. On the other hand, 3D-CTA-MPR was very useful for identifying the aneurysmal neck without overlapping by surrounding bony structures. 3D-CTA-MPR images clearly visualized the calcification of the wall. 3D-CTA-MPR images are obtained from 3D-CTA source images without any additional stress to the patients, and they are more useful for the diagnosis as well as demonstration of the aneurysmal neck particularly in more than large aneurysms.

Adolescent↗
PubMed2002

[Radiofrequency ablation of pulmonary malignancies].

Radiofrequency ablation (RFA) with a maximum output of < or = 70 W was used under CT guidance to treat 14 tumors (median diameter 1.5 cm, range 0.8 to 2.4 cm) in 6 patients. Primary lung cancer was treated in 2 patients, and metastatic lung tumors were treated in 4 patients. Good response was confirmed in 6 tumors on CT images, in one tumor on PET images, and in 2 tumors by histologic examination. In the other 5 tumors, curative effect was not determined because consolidation shadows surrounded the tumors. Complications were mild (pneumothoraces, 5; sputum cruentum, 4; subcutaneous emphysema, 3) except for one case of pleurisy. RFA of pulmonary malignancies appears to be a safe, effective treatment if a low output of less than 70 W is applied.

Aged↗
PubMed2002

[Not Available].

Explore the source record for details and available documents.

Journal Article↗
PubMedDate not supplied

Radiofrequency ablated lesion in the normal porcine lung: long-term follow-up with MRI and pathology.

PURPOSE: To evaluate the effectiveness of magnetic resonance imaging (MRI) in reflecting histopathologic changes after radiofrequency ablation (RFA) to the lung and to assess accurately the extent of tissue necrosis for evaluating untreated lesions. METHODS: Percutaneous RFA was performed on 72 lung regions in 12 pigs under computed tomographic guidance. After performing MRI, the animals were divided into three experimental phases: in the acute phase, 4 pigs were killed immediately after the procedure; in the subacute phase, 4 pigs were killed at 1 week; and in the chronic phases, 2 pigs were killed at 4 and 8 weeks after the procedure, respectively. MRI-histopathologic correlation was performed. RESULTS: In the acute phase, the inner zone showed hypointensity on T2-weighted images and isointensity on T1-weighted images, with a lack of enhancement on contrast-enhanced T1-weighted images, representing early changes in coagulative necrosis on histopathologic examination. The outer zone showed hyperintensity on T2-weighted images and isointensity on T1-weighted images, with ring-like enhancement on contrast-enhanced T1-weighted images. The histopathologic section showed alveolar fluid collections and congestion. In the subacute phase the MR zone pattern was essentially similar to that of the acute phase, but the ablated lesion showed extensive coagulative necrosis with a fibrovascular rim on histopathologic examination. In the chronic phase, there was no change in the zone pattern on MRI. The lesions showed gradual resorption of coagulative necrosis. The area of coagulative necrosis correlated closely with the histopathologic size (p < 0.05). CONCLUSIONS: MRI effectively visualized the histopathologic changes after RFA and accurately determined the extent of the necrotic lesion. MRI is potentially a useful modality for evaluating therapeutic efficacy after RFA to the lung.

Animals↗
PubMedDate not supplied

Dual balloon-occluded retrograde transvenous obliteration of gastric varix draining into the left adrenal vein and left inferior phrenic vein.

A 66-year-old woman with a gastric varix, draining into a dilated left adrenal vein and a left inferior phrenic vein, was treated with dual balloon-occluded retrograde transvenous obliteration (B-RTO). Under balloon occlusion of the left adrenal vein and the left inferior phrenic vein, retrograde injection of a sclerosant (5% ethanolamine oleate) into the gastric varix was performed. Two weeks later, disappearance of flow in the gastric varix was confirmed on endoscopic ultrasound examination.

Adrenal Glands↗
PubMedDate not supplied

Detection of portal perfusion abnormalities: comparison of 3 ferucarbotran-enhanced magnetic resonance imaging sequences.

OBJECTIVE: To estimate the accuracy, sensitivity, and specificity of 3 ferucarbotran-enhanced magnetic resonance (MR) imaging sequences prospectively for the detection of nontumoral portal perfusion abnormalities. METHODS: Thirty-nine noncirrhotic patients with liver metastases underwent computed tomography during arterial portography (CTAP) and MR imaging comprising T1-weighted gradient recalled echo (GRE), T2-weighted fast spin echo (FSE), and T2*-weighted GRE sequences with and without ferucarbotran. Magnetic resonance images were reviewed by 4 blinded observers for rating based on the confidence scale. The accuracy, sensitivity, and specificity for each sequence were measured by receiver operating characteristic analysis. Contrast-to-noise ratio (CNR) and relative signal-to-noise ratio changes were statistically compared. RESULTS: Thirty-nine nontumoral perfusion defects were observed in 22 patients by CTAP. Receiver operating characteristic analysis showed the accuracy was higher for T2*-weighted GRE (0.884) than for T1-weighted GRE (0.572) and T2-weighted FSE (0.597). T2*-weighted imaging achieved the highest sensitivity (81.4%) and the lowest specificity (86.6%). Postenhanced T2*-weighted imaging achieved the highest CNR (19.3 +/- 9.2). CONCLUSIONS: T2*-weighted imaging was the most accurate and sensitive method for detecting portal perfusion abnormalities compared with T1- or T2-weighted imaging, whereas T1- or T2-weighted imaging is superior in specificity to T2*-weighted imaging during ferucarbotran-enhanced MR imaging.

Contrast Media↗
PubMedDate not supplied

Risperidone withdrawal-related respiratory dyskinesia: a case diagnosed by spirography and fibroscopy.

Risperidone is a frequently used member of a new class of atypical antipsychotics-the serotonin-dopamine antagonists (SDAs)-due to its comparatively high efficacy and low D2/5HT2 binding ratio, which results in a low incidence of extrapyramidal side effects including tardive dyskinesia (TD). The authors present an elderly patient with mixed dementia who developed TD at multiple sites, (including respiratory dyskinesia [RD], limb dyskinesia, and orofacial dyskinesia) following abrupt withdrawal of risperidone therapy. RD is not a rare condition, but is often misdiagnosed and is potentially lethal. Therefore, clinicians should pay close attention to possible onset of RD in patients with multiple risk factors for TD, even when SDA therapy is used. If RD is suspected, assessment should include spirography combined with fibroscopy for examination of irregularities in the rate, rhythm, and depth of respiration.

Aged↗
PubMedDate not supplied

The influence of radiofrequency ablation on hepatic vessels in porcine liver.

BACKGROUND/AIMS: The objective of this study was to clarify the influence of radiofrequency ablation on the portal and hepatic vein. METHODOLOGY: Hepatic radiofrequency ablation was performed on 18 swine (mean weight, 22 kg). The livers were removed immediately, 1 week or 3 weeks following ablation. Vessel patency and diameter were determined by computed tomography, and the severity of endothelial injuries was determined histopathologically. RESULTS: The patency rate for portal and hepatic veins with diameters less than 3.0 mm decreased sequentially. At three weeks following ablation, the patency rate for vessels with diameters more than 3.0 mm was significantly higher (P<0.05) compared to those with diameters less than 2.0 mm. In portal and hepatic veins contiguous to ablated hepatic parenchyma, the endothelium with intimal thickening was found at 1 to 3 weeks following ablation, although its detection rate was decreased until 3 weeks. CONCLUSIONS: The portal and hepatic vein with diameters more than 3.0 mm in radiofrequency lesions maintained high patency. The endothelium seems to play an important role for maintaining vessels patency and the distal hepatic tissue following ablation. We believe that this maintained vascular patency may be the advantage of radiofrequency ablation over the PEIT.

Animals↗