17 results on '"Yanagaki S"'
Search Results
2. A comparative study of high-dose and low-dose ACTH therapy for West syndrome
- Author
-
Yanagaki, S., Oguni, H., Hayashi, K., Imai, K., Funatuka, M., Tanaka, T., Yanagaki, M., and Osawa, M.
- Published
- 1999
- Full Text
- View/download PDF
3. Cost-effectiveness analysis of segmental adrenal venous sampling with radiofrequency ablation for primary aldosteronism in Japan.
- Author
-
Yanagaki S, Omata K, Oguro S, Ota H, Sato T, Kamada H, Tannai H, Tezuka Y, Ono Y, Sato M, Ohbe H, and Takase K
- Abstract
Purpose: The purpose of this study was to evaluate the cost-effectiveness of comprehensive treatment strategy, including segmental adrenal venous sampling (sAVS) and radiofrequency ablation (RFA), versus medication-only strategy for primary aldosteronism., Materials and Methods: A Markov decision model was developed to compare the cost-effectiveness of a comprehensive treatment strategy and a medication-only strategy for 50-year-old men and women with stage I-III hypertension. The comprehensive treatment strategy included aldosterone/renin ratio measurement, two loading tests, computed tomography, sAVS, drugs, surgery, and RFA. We built a model with a yearly cycle over 32- and 38-year time horizons for men and women, respectively, and four health states: hypertension, heart failure, stroke, and death. The incremental cost-effectiveness ratio (ICER), expressed as Japanese yen per quality-adjusted life-years (QALYs), was estimated, and strategy preference was determined on the basis of 5 million Japanese yen per QALY societal willingness-to-pay threshold., Results: The ICERs of the comprehensive treatment strategy over the medication-only strategy were 201,482 and 3,399 JPY per QALY for men and women, respectively. The resultant ICER was less than the 5 million JPY societal willingness-to-pay threshold. Deterministic sensitivity analysis and probabilistic sensitivity analysis revealed that the results varied with the input values, but the comprehensive strategy was likely to be more cost-effective than the medication-only strategy., Conclusion: This cost-effectiveness study revealed that a comprehensive treatment strategy including sAVS and RFA was favorable compared with the medication-only strategy for managing stage I-III hypertension in 50-year-old men and women, with acceptable willingness-to-pay thresholds. This cost-effectiveness study revealed that a comprehensive treatment strategy for primary aldosteronism that included segmental adrenal sampling and radiofrequency ablation was favorable compared with the medication-only strategy for managing stage I-III hypertension in 50-year-old men and women, with acceptable willingness-to-pay thresholds., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
4. Leptomeningeal carcinomatosis from breast cancer initially mimicking cerebral infarction on MRI.
- Author
-
Satani N, Matsuura T, Yanagaki S, Ishikawa Y, Watanabe G, Fukuda H, and Yamada T
- Abstract
A female patient in her early 50s with breast cancer underwent breast-conserving surgery, followed by radiation therapy. She developed multiple lung and bone metastases and was started on chemotherapy with bevacizumab and paclitaxel 3 years later. After 6 months of chemotherapy, she developed a decline in conversation and memory. Magnetic resonance imaging (MRI) was conducted and showed multiple cortical and subcortical lesions and nodules with restricted diffusion but with no contrast enhancement on gadolinium (Gd) enhanced T1-weighted image, raising a suspicion of Trousseau's syndrome. A follow-up MRI revealed unchanged signal intensity of the lesions but with minimal enlargement. The cerebrospinal fluid cytology was negative for malignancy. Consequently, an open biopsy of the cortical lesion was conducted. Histopathology showed that the tumor cells were morphologically similar to the primary breast cancer extending from the brain surface along the Virchow-Robin spaces, which yielded a diagnosis of leptomeningeal carcinomatosis from breast cancer. Contrast enhancement on Gd-MRI may be impaired in case of tumor spread along the perivascular space or in patients treated with bevacizumab., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
- Published
- 2024
- Full Text
- View/download PDF
5. Transvenous Radiofrequency Catheter Ablation for an Aldosterone-Producing Tumor of the Left Adrenal Gland: A First in Human Case Report.
- Author
-
Oguro S, Ota H, Yanagaki S, Kawabata M, Kamada H, Omata K, Tezuka Y, Ono Y, Morimoto R, Satoh F, Toyama H, Tanimoto K, Konno D, Yamauchi M, Niwa Y, Miyamoto H, Mori K, Tanaka T, Ishihata H, and Takase K
- Subjects
- Humans, Aldosterone, Adrenal Glands diagnostic imaging, Adrenal Glands surgery, Adrenal Glands blood supply, Catheters adverse effects, Adrenal Gland Neoplasms diagnostic imaging, Adrenal Gland Neoplasms surgery, Catheter Ablation methods, Hyperaldosteronism etiology, Hyperaldosteronism surgery, Hyperaldosteronism diagnosis
- Abstract
Purpose: To describe a novel technique of transvenous radiofrequency catheter ablation of an aldosterone-producing adenoma (APA) of the left adrenal gland using the GOS System (Japan Lifeline, Tokyo, Japan). Using the GOS system, a flexible radiofrequency tip catheter can be inserted into the adrenal central and tributary veins, the drainers for functional tumors., Materials and Methods: An APA at the left adrenal gland, which was diagnosed by segmental adrenal venous sampling following administration of 0.25 mg cosyntropin, was ablated using the GOS catheter inserted into adrenal tributary veins via a right femoral vein 7-Fr sheath. The effect of radiofrequency ablation on APA was assessed using the international consensus on surgical outcomes for unilateral primary aldosteronism (PA)., Results: No device-related complications were observed. The patient was deeply sedated under blood pressure and heart rate control with continuous administration of β-blockers. Then, the tumor and surrounding adrenal gland were cauterized at 7000 J two times each in sequence. The output time was 7-11 min for each ablation and 80 min in total. For blood pressure and pulse rate control, esmolol hydrochloride and phentolamine mesylate were used. The contrast enhancement of APA disappeared on dynamic CT immediately after the procedure. PA was biochemically cured until 12 months after the procedure., Conclusion: Using the radiofrequency device with the GOS catheter and system is a method for cauterizing adrenal tumors from blood vessels. This approach resulted in a marked reduction in aldosterone concentrations and a complete biochemical cure of PA over the observation period., (© 2023. The Author(s).)
- Published
- 2023
- Full Text
- View/download PDF
6. Utility of Carbon Dioxide Venography and Intraprocedural CT for Adrenal Venous Sampling in Patients with an Allergy to Iodinated Contrast Media.
- Author
-
Kamada H, Seiji K, Oguro S, Ota H, Yanagaki S, Omata K, Tezuka Y, Ono Y, Morimoto R, Satoh F, and Takase K
- Subjects
- Humans, Phlebography methods, Contrast Media adverse effects, Carbon Dioxide adverse effects, Tomography, X-Ray Computed methods, Adrenal Glands diagnostic imaging, Adrenal Glands blood supply, Retrospective Studies, Aldosterone, Iodine adverse effects, Hypersensitivity, Hyperaldosteronism diagnostic imaging
- Abstract
Purpose: To assess the diagnostic performance of carbon dioxide (CO
2 ) and intraprocedural unenhanced computed tomography (CT) for adrenal venous sampling (AVS) (CO2 -intraprocedural unenhanced CT-AVS) in patients with primary aldosteronism (PA) and a history of iodine contrast medium allergy., Materials and Methods: CO2 -intraprocedural unenhanced CT-AVS was performed in 18 patients with iodine contrast media allergies at the authors' hospital between December 2015 and January 2021. CT and noncontrast magnetic resonance angiography were used to evaluate the preoperative adrenal vein anatomy. CO2 venography was performed to confirm adrenal vein catheterization. Additionally, intraprocedural unenhanced CT was also performed to confirm catheter position in the right adrenal gland., Results: In all cases in which CO2 -intraprocedural unenhanced CT-AVS was performed, the right and left adrenal veins were catheterized appropriately, leading to a localized diagnosis. Catheterization of the left adrenal vein was confirmed using CO2 venography in all cases. In 7 of the 18 cases, CO2 venography demonstrated selection of the right adrenal vein. In 15 of 18 cases, intraprocedural unenhanced CT demonstrated selection of the right adrenal vein., Conclusions: CO2 -intraprocedural unenhanced CT-AVS demonstrated the same diagnostic ability for PA localization as conventional AVS with iodine contrast media. The proposed method is clinically feasible for AVS, in which iodine contrast media use is restricted., (Copyright © 2023 SIR. Published by Elsevier Inc. All rights reserved.)- Published
- 2023
- Full Text
- View/download PDF
7. A case of percutaneous transhepatic portal vein stenting without using iodinated contrast media for post pancreatectomy portal vein obstruction.
- Author
-
Anaba H, Oguro S, Ota H, Yanagaki S, Sato T, Nakagawa K, Unno M, and Takase K
- Abstract
Postoperative portal vein obstruction could occur as a complication of portal vein reconstruction during hepatic lobectomy or pancreaticoduodenectomy. We report a case of patient with postoperative portal vein obstruction treated with percutaneous transhepatic portal vein stenting without using iodinated contrast media owing to a history of severe allergic reactions. Under ultrasound guidance, carbon dioxide angiography, and appropriate device selection, successful stenting was achieved without serious adverse events. After the operation, portal vein blood flow and clinical symptoms improved, enabling adjuvant chemotherapy. To the best of our knowledge, this is the first case report wherein percutaneous transhepatic portal vein stenting was successfully performed in a patient with an iodine allergy., (© 2023 The Authors. Published by the British Institute of Radiology.)
- Published
- 2023
- Full Text
- View/download PDF
8. Risk Analysis of Breast Cancer by Using Bilateral Mammographic Density Differences: A Case-Control Study.
- Author
-
Zhang Z, Zhang X, Chen J, Takane Y, Yanagaki S, Mori N, Ichiji K, Kato K, Yanagaki M, Ebata A, Miyashita M, Ishida T, and Homma N
- Abstract
The identification of risk factors helps radiologists assess the risk of breast cancer. Quantitative factors such as age and mammographic density are established risk factors for breast cancer. Asymmetric breast findings are frequently encountered during diagnostic mammography. The asymmetric area may indicate a developing mass in the early stage, causing a difference in mammographic density between the left and right sides. Therefore, this paper aims to propose a quantitative parameter named bilateral mammographic density difference (BMDD) for the quantification of breast asymmetry and to verify BMDD as a risk factor for breast cancer. To quantitatively evaluate breast asymmetry, we developed a semi-automatic method to estimate mammographic densities and calculate BMDD as the absolute difference between the left and right mammographic densities. And then, a retrospective case-control study, covering the period from July 2006 to October 2014, was conducted to analyse breast cancer risk in association with BMDD. The study included 364 women diagnosed with breast cancer and 364 matched control patients. As a result, a significant difference in BMDD was found between cases and controls (P < 0.001) and the case-control study demonstrated that women with BMDD > 10% had a 2.4-fold higher risk of breast cancer (odds ratio, 2.4; 95% confidence interval, 1.3-4.5) than women with BMDD ≤ 10%. In addition, we also demonstrated the positive association between BMDD and breast cancer risk among the subgroups with different ages and the Breast Imaging Reporting and Data System (BI-RADS) mammographic density categories. This study demonstrated that BMDD could be a potential risk factor for breast cancer.
- Published
- 2023
- Full Text
- View/download PDF
9. Significance of systolic-phase imaging on full-phase ECG-gated CT angiography to detect intimal tears in aortic dissection.
- Author
-
Yanagaki S, Masuda A, Ota H, Kojima M, Hattori T, Mihara W, Takase K, and Ueda T
- Subjects
- Aorta, Thoracic, Electrocardiography, Hematoma therapy, Humans, Retrospective Studies, Ulcer, Aortic Dissection diagnostic imaging, Computed Tomography Angiography
- Abstract
Purpose: For patients with aortic dissection (AD) and intramural hematoma (IMH), the optimal cardiac phase to detect intimal tears (IT) and ulcer-like projections (ULP) on retrospective electrocardiogram (ECG)-gated computed tomography angiography (CTA) remains unclear. The purpose of this study was to compare the accuracy of retrospective ECG-gated CTA for detecting IT in AD and ULP in IMH between each cardiac phase., Materials and Methods: A total of 75 consecutive patients with AD and IMH of the thoracic aorta were enrolled in this single-center retrospective study. The diagnostic performance to detect IT and ULP in the thoracic aortic regions (including the ascending aorta, aortic arch, and proximal and distal descending aorta) was compared in each cardiac phase on retrospective ECG-gated CTA., Results: In the systolic phase (20%), the accuracy, sensitivity, and specificity to detect IT in AD was 64% (95% confidence interval [CI] 56-72%), 69% (95%CI 60-78%), and 25% (95%CI 3.3-45%), respectively. In the diastolic phase (70%), the accuracy, sensitivity, and specificity to detect IT in AD was 52% (95%CI 43-60%), 52% (95%CI 42-61%), and 50% (95%CI 25-75%), respectively. The accuracy to detect IT in AD on ECG-gated CTA was significantly higher in the systolic phase than that in the diastolic phase (P = 0.025). However, there were no differences in the accuracy (83%; 95%CI 78-89%), sensitivity (71%; 95%CI 62-80%), or specificity (100%; 95%CI 100%) to detect ULP in IMH between the cardiac cycle phases., Conclusion: Although it is currently recommended for routine diagnosis of AD and IMH, single-diastolic-phase ECG-gated CTA has risk to miss some IT in AD that are detectable in the systolic phase on full-phase ECG-gated CTA. This information is critical for determining the optimal treatment strategy for AD., (© 2022. The Author(s).)
- Published
- 2022
- Full Text
- View/download PDF
10. Detection of the intimal tear in aortic dissection and ulcer-like projection in intramural hematoma: usefulness of full-phase retrospective ECG-gated CT angiography.
- Author
-
Yanagaki S, Ueda T, Masuda A, Ota H, Onaka Y, Kojima M, Hattori T, Mihara W, and Takase K
- Subjects
- Adult, Aged, Aged, 80 and over, Aortic Dissection complications, Aorta diagnostic imaging, Aortic Aneurysm complications, Cohort Studies, Electrocardiography methods, Female, Hematoma complications, Humans, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Ulcer complications, Aortic Dissection diagnostic imaging, Aortic Aneurysm diagnostic imaging, Computed Tomography Angiography methods, Hematoma diagnostic imaging, Tunica Intima diagnostic imaging, Ulcer diagnostic imaging
- Abstract
Purpose: To compare the accuracy of non-electrocardiogram (ECG)-gated CT angiography (CTA), single-diastolic-phase ECG-gated CTA, and full-phase ECG-gated CTA in detecting the intimal tear (IT) in aortic dissection (AD) and ulcer-like projection (ULP) in intramural hematoma (IMH)., Materials and Methods: A total of 81 consecutive patients with AD and IMH of the thoracic aorta were included in this single-center retrospective study. Non-ECG-gated CTA, single-diastolic-phase ECG-gated CTA, and full-phase ECG-gated CTA were used to detect the presence of the IT and ULP in thoracic aortic regions including the ascending aorta, aortic arch, and proximal and distal descending aorta., Results: The accuracy of detecting the IT and ULP was significantly greater using full-phase ECG-gated CTA (88% [95% CI: 100%, 75%]) than non-ECG-gated CTA (72% [95% CI: 90%, 54%], P = 0.001) and single-diastolic-phase ECG-gated CTA (76% [95% CI: 93%, 60%], P = 0.008)., Conclusion: Full-phase ECG-gated CTA is more accurate in detecting the IT in AD and ULP in IMH, than non-ECG-gated CTA and single-diastolic-phase ECG-gated CTA.
- Published
- 2020
- Full Text
- View/download PDF
11. Ruptured Pseudoaneurysm in the Inferior Pancreaticoduodenal Artery.
- Author
-
Yanagaki S, Yamamoto Y, and Nagasawa T
- Published
- 2016
- Full Text
- View/download PDF
12. Extremely low-dose ACTH step-up protocol for West syndrome: maximum therapeutic effect with minimal side effects.
- Author
-
Oguni H, Yanagaki S, Hayashi K, Imai K, Funatsuka M, Kishi T, and Osawa M
- Subjects
- Adrenocorticotropic Hormone adverse effects, Child, Preschool, Dose-Response Relationship, Drug, Electroencephalography methods, Female, Follow-Up Studies, Hormones adverse effects, Humans, Infant, Male, Spasms, Infantile classification, Spasms, Infantile physiopathology, Time Factors, Treatment Outcome, Adrenocorticotropic Hormone therapeutic use, Hormones therapeutic use, Spasms, Infantile drug therapy
- Abstract
We studied the effectiveness of our new ACTH treatment strategy for West syndrome (WS), which was based on the results of our previous extremely low-dose ACTH study. The subjects were 31 infants with WS (cryptogenic WS in nine; symptomatic WS in 22). Synthetic ACTH-Z in a dose of 0.005 mg (= 0.2 IU)/kg/day was injected once every morning for at least 2 weeks, up to a maximum of 3 weeks. When this first treatment course achieved full seizure and EEG control, ACTH was tapered to zero over the subsequent 1 or 2 weeks. In the absence of a documented response, the dosage was increased to 0.025 mg (= 1.0 IU)/kg/day for the next 2 weeks (second treatment course). We analyzed the short-term as well as long-term effects, and the incidence of side effects. The first treatment course successfully controlled both spasms and hypsarrhythmia in 17 patients (55%), only spasms in one, and hypsarrhythmia in two. The second treatment course was then introduced in eight of the remaining 14 patients, providing complete suppression of WS in an additional two patients. Regarding the long-term effects, 13 patients (48%), with excellent short-term results and a longer than 1-year follow-up, remained seizure-free. Side effects of a mild degree were seen in 13 patients during ACTH treatment. Our new ACTH step-up method brought 61 and 48% of the patients into short-term and long-term remission, respectively, without significant side effects. The dose of ACTH required to control WS appears to be unexpectedly smaller than the dose we previously used.
- Published
- 2006
- Full Text
- View/download PDF
13. Zonisamide for West syndrome: a comparison of clinical responses among different titration rate.
- Author
-
Yanagaki S, Oguni H, Yoshii K, Hayashi K, Imai K, Funatsuka M, and Osawa M
- Subjects
- Anticonvulsants blood, Drug Administration Schedule, Humans, Infant, Isoxazoles blood, Zonisamide, Anticonvulsants administration & dosage, Isoxazoles administration & dosage, Spasms, Infantile drug therapy
- Abstract
We administered zonisamide (ZNS) to patients with West syndrome in different titration protocols and compared their short-term therapeutic effects. We designed three protocols to raise the serum ZNS concentration (SZC): (1) increase the dose in three steps, from 3 to 10 mg/kg every 3 days, (2) increase the dose from 5 to 10 mg/kg over 3-7 days, and (3) start with 10 mg/kg and maintain this dosage for 2 weeks. The subjects were 23 infants with West syndrome, 8 of whom comprised the 1st group, 5 the 2nd group, and the remaining 10, the 3rd group. As a result, excellent and good effects were obtained in a total of seven patients (30.4%) and one patient, respectively (1/8 in the 1st step-up group, 3/5 in the 2nd step-up group, and 4/10 in the 3rd group). The maximum SZC was higher in the excellent and good effect groups (n=8; 32.0+/-8.0 microg/ml) than in the ineffective group (n=15; 22.4+/-8.2 microg/ml) (P<0.05). The period of time required for cessation of spasms appeared shorter in the 3rd group (n=4; mean=5.7 days) than in the 1st and 2nd groups (n=4; mean=10.3 days). There were few side effects except for transient hyperthermia and gastrointestinal symptoms. Our new protocol of starting with 10 mg/kg of ZNS can be introduced safely and make a therapeutic judgment feasible within 2 weeks.
- Published
- 2005
- Full Text
- View/download PDF
14. [Urolithiasis induced by combined ACTH and zonisamide treatment in a patient with startle induced epilepsy].
- Author
-
Saito Y, Yanagaki S, Oguni H, Hayashi K, Katsumori H, Nagafuchi H, Jo K, and Osawa M
- Subjects
- Child, Preschool, Drug Therapy, Combination, Humans, Male, Zonisamide, Adrenocorticotropic Hormone administration & dosage, Adrenocorticotropic Hormone adverse effects, Anticonvulsants administration & dosage, Anticonvulsants adverse effects, Epilepsy drug therapy, Isoxazoles administration & dosage, Isoxazoles adverse effects, Kidney Calculi chemically induced, Kidney Pelvis, Reflex, Startle
- Abstract
A 5-year-old boy had periodic spasms and startle-induced drop attacks. Zonisamide (ZNS) was partially effective for the former seizures, and propranolol for the latter. An add-on therapy with ACTH resulted in a transient disappearance of seizures and an improvement of EEG. However, the patient developed urolithiasis with resultant hematuria and pyelectasis during ACTH therapy. ZNS can induce urolithiasis by increasing urinary pH and calcium (Ca) excretion, and ACTH may facilitate this rare adverse effect of ZNS by further increasing the urinary Ca. Hydrochlorothiazide could resolve the urolithiasis by decreasing the urinary Ca excretion.
- Published
- 2002
15. [A case of Klüver-Bucy syndrome after acute encephalopathy treated with selective serotonin reuptake inhibitor (fluvoxamine)].
- Author
-
Usugi T, Saito Y, Yanagaki S, Ohtsu M, Yazaki E, Michizu H, Katsumori H, Hayashi K, and Osawa M
- Subjects
- Acute Disease, Child, Preschool, Female, Humans, Kluver-Bucy Syndrome etiology, Remission Induction, Brain Diseases complications, Fluvoxamine therapeutic use, Kluver-Bucy Syndrome drug therapy, Selective Serotonin Reuptake Inhibitors therapeutic use
- Published
- 2002
16. [A case of acute theophylline intoxication with repeated status convulsivus].
- Author
-
Itoh Y, Nagaki S, Kuyama N, Hirano K, Sunahara M, Funatsuka M, Yanagaki S, Yoshida M, Hirano Y, Osawa M, and Fukuyama Y
- Subjects
- Brain pathology, Female, Humans, Infant, Magnetic Resonance Imaging, Recurrence, Bronchodilator Agents poisoning, Status Epilepticus chemically induced, Theophylline poisoning
- Abstract
We report a 6-month-old female infant with status convulsivus which appeared during intravenous drip infusion of aminophylline. She had an extremely high serum theophylline concentration (79 micrograms/ml), which was effectively reduced by plasmapheresis and dialysis. Three days later, she developed status convulsivus again, though her serum theophylline was undetectable at that time. A CT on 14th day of illness revealed mild widening of frontal sulci and Sylvian fissure. The patient apparently recovered her healthy condition, but psychomotor developmental delay, especially in speech and social behavior, was noted at the age of 2 years 6 months (DQ = 55). A delay of myelination was observed on brain MRI at 4 year 1 months, suggesting an irreversible brain injury caused by theophylline intoxication.
- Published
- 1999
17. Chronic localized encephalitis (Rasmussen's syndrome) preceded by ipsilateral uveitis: a case report.
- Author
-
Fukuda T, Oguni H, Yanagaki S, Fukuyama Y, Kogure M, Shimizu H, and Oda M
- Subjects
- Adult, Cataract etiology, Cataract Extraction, Electroencephalography, Encephalitis, Viral etiology, Encephalitis, Viral pathology, Epilepsies, Partial diagnosis, Female, Follow-Up Studies, Fundus Oculi, Humans, Encephalitis, Viral complications, Epilepsies, Partial etiology, Functional Laterality, Uveitis complications
- Abstract
Chronic localized encephalitis (Rasmussen's syndrome) developed in an 11-year-old girl 1 month after operation for residual cataract due to chronic uveitis that had appeared at age 9 years ipsilateral to the affected cerebral hemisphere. Although the pathogenesis of Rasmussen's syndrome remains unknown, our case provides additional evidence indicating that a viral ocular infection is a possible cause or part of the disorder.
- Published
- 1994
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.