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100 results on '"Yonekura, Masahiro"'

6. Early intervention to promote oral feeding in patients with intracerebral hemorrhage: a retrospective cohort study

Author

Nagata Izumi, Baba Hiroshi, Tsutsumi Keisuke, Takahata Hideaki, and Yonekura Masahiro

Subjects
Neurology. Diseases of the nervous system, RC346-429
Abstract

Abstract Background Stroke is a major cause of dysphagia, but little is known about when and how dysphagic patients should be fed and treated after an acute stroke. The purpose of this study is to establish the feasibility, risks and clinical outcomes of early intensive oral care and a new speech and language therapist/nurse led structured policy for oral feeding in patients with an acute intracerebral hemorrhage (ICH). Methods A total of 219 patients with spontaneous ICH who were admitted to our institution from 2004 to 2007 were retrospectively analyzed. An early intervention program for oral feeding, which consisted of intensive oral care and early behavioral interventions, was introduced from April 2005 and fully operational by January 2006. Outcomes were compared between an early intervention group of 129 patients recruited after January 2006 and a historical control group of 90 patients recruited between January 2004 and March 2005. A logistic regression technique was used to adjust for baseline differences between the groups. To analyze time to attain oral feeding, the Kaplan-Meier method and Cox proportional hazard model were used. Results The proportion of patients who could tolerate oral feeding was significantly higher in the early intervention group compared with the control group (112/129 (86.8%) vs. 61/90 (67.8%); odds ratio 3.13, 95% CI, 1.59-6.15; P < 0.001). After adjusting for baseline imbalances, the odds ratio was 4.42 (95% CI, 1.81-10.8; P = 0.001). The incidence of chest infection was lower in the early intervention group compared with the control group (27/129 (20.9%) vs. 32/90 (35.6%); odds ratio 0.48, 95% CI, 0.26-0.88; P = 0.016). A log-rank test found a significant difference in nutritional supplementation-free survival between the two groups (hazard ratio 1.94, 95% CI, 1.46-2.71; P < 0.001). Conclusions Our data suggest that the techniques can be used safely and possibly with enough benefit to justify a randomized controlled trial. Further investigation is needed to solve the eating problems that are associated with patients recovering from a severe stroke.

Published
2011
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8. Coexistence of Chiari 2 malformation and moyamoya syndrome in a 17-year-old girl

Author

Suyama, Kazuhiko, Yoshida, Koichi, Hayashi, Kentaro, Takahata, Hideaki, Yonekura, Masahiro, and Nagata, Izumi

Subjects
Tomography, Emission-Computed, Single-Photon, Middle Cerebral Artery, Meningomyelocele, Adolescent, Chiari 2 malformation, Anastomosis, Surgical, Collateral Circulation, Cerebral Infarction, Ventriculoperitoneal Shunt, Arnold-Chiari Malformation, Cerebral Angiography, Frontal Lobe, Temporal Arteries, Acetazolamide, Paresis, Parietal Lobe, Humans, Female, Genetic Predisposition to Disease, Agenesis of Corpus Callosum, Moyamoya Disease, Carotid Artery, Internal, Encephalocele
Abstract

A 17-year-old female with Chiari 2 malformation developed cerebral infarction with angiographically typical bilateral moyamoya vessels manifesting as sudden onset of moderate left hemiparesis. Magnetic resonance imaging revealed multiple infarcts in the right frontal lobe, agenesis of the corpus callosum, upward herniation of the dorsal cerebellum, tectal beak of the midbrain, and downward herniation of the cerebellar vermis. Cerebral angiography demonstrated occlusion of the bilateral internal carotid arteries and basal moyamoya vessels. Single photon emission computed tomography showed significantly reduced regional cerebral blood flow in the right frontoparietal cortex. The cerebral vascular reactivity to acetazolamide was diminished in both cerebral hemispheres. She underwent superficial temporal artery-middle cerebral artery anastomosis combined with encephalo-myo-synangiosis on the right, and on the left 6 months later. Cerebral angiography performed 4 months after the second operation showed good patency of the bypasses and substantial collateral vessels in both cerebral hemispheres. This association may have happened by chance, and a common etiology is uncertain, but a currently undetermined genomic component might have contributed to the disease progression., Neurologia Medico-Chirurgica, 49(1), pp.47-49; 2009

Published
2009

10. Subarachnoid Clot Clearance Using Intermittent Intracisternal Urokinase Injection Therapy Combined with Arachnoid Plasty

Author

TSUTSUMI, Keisuke, primary, TOYOTA, Keisuke, additional, HIRAO, Tomohito, additional, MOROFUJI, Yoichi, additional, KAWAHARA, Ichiro, additional, UMENO, Tetsuya, additional, FUJIMOTO, Takashi, additional, MATSUNAGA, Yuki, additional, TANEDA, Chieko, additional, ONO, Tomonori, additional, TAKAHATA, Hideaki, additional, TODA, Keisuke, additional, BABA, Hiroshi, additional, and YONEKURA, Masahiro, additional

Published
2013
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13. Current Management of Asymptomatic Small (^|^lt;5 mm) Unruptured Intracranial Aneurysms (UIAs): Analysis of Cases from a Single Center Experience and the Nagasaki UIA Registry

Author

TSUTSUMI, Keisuke, primary, UMENO, Tetsuya, additional, MOROFUJI, Yoichi, additional, KAWAHARA, Ichiro, additional, TAKAHATA, Hideaki, additional, ONO, Tomonori, additional, TODA, Keisuke, additional, BABA, Hiroshi, additional, YONEKURA, Masahiro, additional, KAMINOGO, Makio, additional, and NAGATA, Izumi, additional

Published
2012
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17. Modality and Timing of Postoperative Evaluation after Clip Placement for Ruptured Intracranial Aneurysms: Significance of Postoperative Day 1 Imaging with CT Angiography

Author

TSUTSUMI, Keisuke, primary, UMENO, Tetsuya, additional, MOROFUJI, Yoichi, additional, HIRAO, Tomohito, additional, KAWAHARA, Ichiro, additional, TAKAHATA, Hideaki, additional, ONO, Tomonori, additional, TODA, Keisuke, additional, BABA, Hiroshi, additional, and YONEKURA, Masahiro, additional

Published
2012
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41. Early intervention to promote oral feeding in patients with intracerebral hemorrhage:a retrospective cohort study.

Author

Takahata, Hideaki, Tsutsumi, Keisuke, Baba, Hiroshi, Nagata, Izumi, and Yonekura, Masahiro

Subjects
ARTERIAL injuries, DEGLUTITION disorders, CEREBROVASCULAR disease, CLINICAL trials, ESOPHAGUS diseases
Abstract

Background: Stroke is a major cause of dysphagia, but little is known about when and how dysphagic patients should be fed and treated after an acute stroke. The purpose of this study is to establish the feasibility, risks and clinical outcomes of early intensive oral care and a new speech and language therapist/nurse led structured policy for oral feeding in patients with an acute intracerebral hemorrhage (ICH). Methods: A total of 219 patients with spontaneous ICH who were admitted to our institution from 2004 to 2007 were retrospectively analyzed. An early intervention program for oral feeding, which consisted of intensive oral care and early behavioral interventions, was introduced from April 2005 and fully operational by January 2006. Outcomes were compared between an early intervention group of 129 patients recruited after January 2006 and a historical control group of 90 patients recruited between January 2004 and March 2005. A logistic regression technique was used to adjust for baseline differences between the groups. To analyze time to attain oral feeding, the Kaplan-Meier method and Cox proportional hazard model were used. Results: The proportion of patients who could tolerate oral feeding was significantly higher in the early intervention group compared with the control group (112/129 (86.8%) vs. 61/90 (67.8%); odds ratio 3.13, 95% CI, 1.59-6.15; P < 0.001). After adjusting for baseline imbalances, the odds ratio was 4.42 (95% CI, 1.81-10.8; P = 0.001). The incidence of chest infection was lower in the early intervention group compared with the control group (27/129 (20.9%) vs. 32/90 (35.6%); odds ratio 0.48, 95% CI, 0.26-0.88; P = 0.016). A log-rank test found a significant difference in nutritional supplementation-free survival between the two groups (hazard ratio 1.94, 95% CI, 1.46-2.71; P < 0.001). Conclusions: Our data suggest that the techniques can be used safely and possibly with enough benefit to justify a randomized controlled trial. Further investigation is needed to solve the eating problems that are associated with patients recovering from a severe stroke. [ABSTRACT FROM AUTHOR]

Published
2011
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47. Tethered Cord Syndrome

Author

Yamada, Shokei, primary, Knierim, David, additional, Yonekura, Masahiro, additional, Schultz, Robert, additional, and Maeda, George, additional

Published
1983
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50. [Rupture of an internal carotid-posterior communicating artery aneurysm formerly presented with transient pupil-sparing oculomotor nerve palsy in an extremely elderly patient].

Author

Mijin T, Tsutsumi K, Fujimoto T, Takahata H, Kawahara I, Ono T, Toda K, Baba H, and Yonekura M

Subjects
Aged, 80 and over, Carotid Artery, Internal diagnostic imaging, Embolization, Therapeutic, Female, Humans, Intracranial Aneurysm complications, Intracranial Aneurysm diagnostic imaging, Intracranial Aneurysm therapy, Oculomotor Nerve diagnostic imaging, Oculomotor Nerve Diseases diagnostic imaging, Radiography, Rupture complications, Rupture diagnostic imaging, Treatment Outcome, Carotid Artery, Internal pathology, Intracranial Aneurysm diagnosis, Oculomotor Nerve pathology, Oculomotor Nerve Diseases etiology, Pupil physiology
Abstract

We recently encountered experienced a rare case of transient pupil-sparing oculomotor nerve palsy(PSONP)caused by an aneurysm at the junction of the internal carotid-and posterior communicating arteries(IC/PC AN)in an 87-year-old, non-diabetic woman. She initially presented with diplopia 4 years previously, and was diagnosed, based on incomplete right oculomotor paresis without pupil involvement(PSONP), as external ophthalmoplegia. MR-angiography revealed a long protrusion of the IC/PC AN with posterior-inferior projection, for which she chose to receive conservative management. Thirty nine months later, she presented with another transient PSONP. CT angiography(CTA)showed that the aneurysm was enlarged in the posterior-inferior direction. Two days after this last CTA imaging, the aneurysm ruptured with upward enlargement of the bleb. Despite complete external ophthalmoplegia and ptosis, her pupil involvement was still minimal and transient. By reviewing reported cases and our own case, we found that a narrow and long aneurysm body and posterior-inferior projection are characteristic for the IC/PC AN that causes PSONP, implying a possible mechanism for PSONP by upward compression of the oculomotor nerve. Though rare in its incidence, IC/PC AN could present with PSONP prior to their rupture. Therefore, immediate imaging evaluation in patients presenting with PSONP is essential to prevent devastating rupture events.

Published
2013

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