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H Nogaki

Publications and source records attributed to H Nogaki.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Brain stem glioma induced by radiotherapy: report of a case].

A case of brain stem glioma following radiotherapy for brain tumor is presented. A 44-year-old female was admitted with chief complaints of gait disturbance and disturbed consciousness. She had received radiation therapy with 60Gy following resection of a right temporal astrocytoma 20 years before, but until admission this time follow up CT scan had shown no regrowth. On admission CT scan and MRI showed an enhanced mass (2 x 2.5cm) in the mid-brain. Tumor biopsy was performed using the subtemporal approach. The histological diagnosis showed a fibrillary astrocytoma grade III. The patient received postoperative synchronized chemotherapy but expired 8 months after admission. The growth of glioma appeared in the previous radiation field after a long latent period. This case should be considered not as a case of the regrowth of a tumor but as a case of a radiation induced tumor. Although 77 cases of gliomas following radiation for intracranial tumor have been reported, this case of radiation-induced brain stem glioma is extremely rare.

Adult↗
PubMed1994

[Clinical analysis of benign transient shuddering-like involuntary movement in elderly people].

We described 9 patients who developed acute onset benign transient shuddering-like involuntary movement in elderly people. There was no consciousness disturbance or sensorimotor dysfunction. There were finger tremor, dysarthria, or gait disturbance in some patients. Asterixis was observed in the upper extremities in 2 patients. Duration of an involuntary movement was less than 1 second, and the series of the involuntary movements continued for several days. This state appeared acutely and disappeared within 0.5 -4 days in the natural course without any sequelae. Oral administration of clonazepam was very effective to suppress this tremulousness. Seven of 9 patients developed recurrence. Although the cause of this syndrome remains unknown, we believe that this condition is clinically important for differential diagnosis of acute onset involuntary movements in elderly people.

Aged↗
PubMed1994

[A case of painful involuntary contraction of the left latissimus dorsi muscle, successfully treated with left thoracodorsal nerve resection].

A 66-year-old Japanese man underwent the resection of the upper lobe of the left lung for primary lung cancer. One year later, his back muscles neighboring the operation scar gradually began to twitch upwards intermittently. The involuntary muscle twitch was accompanied with severe local pain, and intensity of the pain and contraction slowly increased. The abnormal muscle contractions were confined to the left latissimus dorsi muscle on needle EMG. The pain and movement ceased by blocking of either thoracodorsal nerve or brachial plexus, and disappeared finally by resection of the nerve. The impulses causing involuntary, painful contractions were thought to originate in the damaged thoracodorsal nerve, transmitted to CNS and re-transmitted to the thoracodorsal nerve.

Aged↗
PubMed1994

[18p-syndrome with bilateral pyramidal tract signs, dystonia of the lower extremities and concentric visual field defect].

A case, diagnosed as 18p-syndrome by typical clinical appearance and by chromosomal analysis, presented with multiple nervous system defects consisting of bilateral pyramidal tract signs, weakness and focal dystonia of the lower extremities, and concentric visual field defect. Chromosomal analysis revealed karyotype 46, X, dic (Y;18) (p11;p11), inv(9) (p11q13), and the points of chromosomal breakages were thought to be in the short arm of chromosome 18 and in the short arm of Y chromosome. 18p-syndrome is caused by a chromosomal deletion, and presents with a wide variety of clinical appearances. Many cases have been reported since the original descriptions by de Grouchy in 1963, though with few mentions of neurological deficits other than mental retardation. Furthermore, there have been no reports of pyramidal tract signs, weakness and focal dystonia of the lower extremities, or visual field defect, without recognizable anatomical abnormalities. Our case of 18p-syndrome is quite rare because of multiple nervous system abnormalities mentioned above, not accompanied by malformations of the central nervous system.

Adult↗
PubMed1993

[Intravascular ultrasound imaging on the endarterectomized coronary arteries in two patients].

Intravascular ultrasound imaging on the endarterectomized coronary arteries in two patients are reported with a review of the literature. Case 1, a 62-year-old male and case 2, a 64-year-old male underwent endarterectomy of the right coronary artery (#3--#4PD, 4AV) combined with coronary arterial bypass grafting. Coronary arteriography (CAG) and intravascular ultrasound imaging (IVUS) were performed one month after operation. CAG revealed bypass grafts and endarterectomized coronary arteries to be patent together, and IVUS revealed endarterectomized coronary arteries had two layers, outer layer to be hyperechoic and inner layer to be heterogenously echoic in both cases. The histological examination of specimens suggests this heterogenously echoic area represents media, thrombus and irregularly proliferated intima. Therefore, anticoagulant therapy after endarterectomy should be strictly performed.

Coronary Artery Bypass↗
PubMed1992

[A statistical analysis of factors influencing standing balance, activity of daily living and ambulation in hemiplegic patients].

This study was undertaken to investigate several factors influencing standing balance, activity of daily living and ambulation in hemiplegic patients after cerebro-vascular diseases. A statistical analysis of 121 hemiplegic patients with unilateral supratentorial lesions showed that age, severity of muscle weakness of involved or uninvolved extremities, unilateral spatial neglect and the sense of toe position had influence on standing balance, activity of daily living or ambulation. The patients were divided into five groups based on the degree of unilateral spatial neglect, evaluated by their copies of two daisies who omitted more than three quarters, three quarters, half, one quarter and none of the figures were defined as the USN-4, USN-3, USN-2, USN-1 and no involvement groups, respectively. Those who belonged to the USN-2 group had significantly lower scores for activity of daily living than those who belonged to the no involvement group. In the USN-2 group, 7 of the 8 patients could not keep standing for 50 seconds, while in the no involvement group, this was the case in only 1 of the 15 patients. Activity of daily living scores or sway area during standing showed no statistically significant differences between the USN-1 and no involvement groups. These results suggested that severe or moderate unilateral spatial neglect is one of the most important factors influencing standing balance and activity of daily living.

Activities of Daily Living↗
PubMed1992

[A case of choreoathetoid movements induced by anticholinergic drugs, trihexyphenidyl HCl and dosulepin HCl].

We report a 72-year-old woman who showed marked orolingual dyskinesia and choreoathetoid movements of the neck, with rolling and nodding of the head. She had been treated for postural tremor and other complaints with multiple drugs, including trihexyphenidyl HCl (THP) 6 mg/day for about two years. Moreover, two months before admission to our hospital, a doctor added tricyclic antidepressant, dosulepin HCl (DL) because of her state of anxiety. Two weeks following DL administration, the persistent dyskinesia described above appeared. Suspecting the dyskinesia to be induced by anticholinergics, we withdrew THP, which decreased the intensity of the dyskinesia. Then, when DL was ceased the dyskinesia almost completely disappeared, slightly recurring only during calculating, when excited or writing. In order to confirm that anticholinergics were the cause of the dyskinesia, we administered THP 6 mg/day again. In a few days the same dyskinesia reappeared, disappearing following THP withdrawal. In this case the overlap of anticholinergics might have resulted in the dyskinesia, because both THP and DL have anticholinergic effects. It should be stressed that inappropriate administration of anticholinergics could cause severe dyskinesia in the elderly.

Aged↗
PubMed1992

[Multiple system atrophy with macro square wave jerks and pendular nystagmus].

A 51-year-old woman was admitted to our hospital because of gait disturbance and dysuria. Neurological examination revealed limb and truncal ataxia, orthostatic hypotension, cogwheel rigidity in all limbs, generalized hyperreflexia without pathological reflex, and horizontal gaze nystagmus. She became progressively worse and bedridden at age 52. Then she developed abnormal eye movements. Electrooculogram revealed vertical, horizontal or oblique macro square wave jerks and pendular nystagmus. Macro square wave jerks appeared during fixation and disappeared with eye closure or in the dark room. Macro square wave jerks were characterized by a duration of about 200 msec and an amplitude of 10 to 15 degrees. Pendular nystagmus with a duration of several seconds and amplitude of 5 to 15 degrees appeared when she changed her fixation or the point of fixation disappeared. Macro square wave jerks and pendular nystagmus were mildly suppressed after the intramuscular injection of 100 mg of phenobarbital, the oral intake of sodium valproate of 600 mg/day or baclofen of 60 mg/day. They were almost completely depressed after the intravenous injection of 3 mg of diazepam or the oral intake of clonazepam of 1.5 mg/day. We suggested that both macro square wave jerks and pendular nystagmus in this patient might be caused by the dysfunction of GABAergic system in the saccadic eye movement system.

Atrophy↗
PubMed1992

[A case of invasive thymoma with retroperitoneal recurrence].

A case of invasive thymoma with retroperitoneal recurrence is reported. A 55-year-old man with invasive thymoma (Masaokas classification, Stage IVa) underwent thymo-thymectomy, partial resection of left upper lobe, resection of phrenic nerve and partial resection of parietal pleura on March 14, 1989. Histological findings revealed thymoma with predominantly lymphocytic type. Two years after the operation, the tumor of retroperitoneal recurrence was discovered in abdominal CT. This retroperitoneal tumor was huge in size (16 x 12 cm) and extended into posterior mediastinum via aortic hiatus. The patient underwent resection of tumor through thoracotomy and laparotomy on April 23, 1991, after two cycles of chemotherapy. Histological findings revealed thymoma with predominantly lymphocytic type. This case was rare among patients with recurrence of thymoma as far as the site of recurrence is concerned.

Humans↗
PubMed1991

[Disproportionately large, communicating fourth ventricle. Case report].

A 39-year-old male was admitted because of slowly progressive disturbance of consciousness, diplopia, and ataxia after laparotomy. Ventriculoperitoneal shunting and removal of an arteriovenous malformation had been performed previously. Neurological examination on admission revealed drowsiness, rotatory nystagmus, Parinaud's sign, and truncal ataxia. Computed tomography scan revealed extraordinary dilatation of the fourth ventricle compared with other dilated ventricles, and old low-density areas in the cerebellar hemispheres. After an external ventricular drainage (EVD) was inserted, all the ventricles decreased in size and the symptoms disappeared. The authors confirmed the patency of the aqueductal canal. One week later, the EVD was replaced by a ventriculoperitoneal shunt. A disproportionately large, communicating fourth ventricle (DLCFV) should be differentiated from an isolated fourth ventricle, which consists of marked enlargement of the fourth ventricle with obstruction of both the inlet and outlet of the fourth ventricle. The authors propose the importance of the fragility to pressure of the brain parenchyma and cerebellar hemispheres around the fourth ventricle as the mechanism of producing DLCFV.

Adult↗
PubMed1991

[Binswanger's disease with normal pressure hydrocephalus. Case report].

A 72-year-old hypertensive male was hospitalized with progressive gait disturbance (small step gait), urinary incontinence, and dementia. Computed tomography (CT) showed ventriculomegaly with periventricular lucency. T2-weighted magnetic resonance imaging revealed wide periventricular high-signal intensity and small infarctions in the basal ganglia. CT cisternography demonstrated ventricular stasis and convexity stasis of the contrast medium. Continuous intracranial pressure monitoring showed increased B wave percentage, low pressure volume index, and high outflow resistance. These findings indicated the coexistence of normal pressure hydrocephalus. After ventriculoperitoneal shunting, gait disturbance was greatly improved and urinary incontinence disappeared. The development of Binswanger's disease may be partially due to disturbed cerebrospinal fluid (CSF) dynamics. The possible pathophysiology of CSF dynamics in relation to Binswanger's disease is discussed. Detailed investigations of CSF dynamics are important in patients with Binswanger's disease, especially in the early stage.

Aged↗
PubMed1991

[Intraosseous meningioma. Case report].

An 82-year-old female was admitted with slowly progressive aphasia and right hemiparesis, accompanied by a hard, 5 x 5 cm subcutaneous swelling in the left frontotemporal region. Plain X-ray film showed a well-circumscribed round radiolucency in the left pterional region. Computed tomography (CT) scans showed an intraosseous mass lesion, homogeneously enhanced postcontrast, extending to the intracranial cavity. Bone CT demonstrated a concave appearance and partial destruction of the inner table, strongly suggesting an intradiploic origin of the tumor. Left carotid angiography revealed the mass supplied by the middle meningeal artery. Left frontotemporal craniectomy demonstrated that the inner surface of the skull was destroyed, and the dura was compressed but not invaded. Histological examination found meningotheliomatous meningioma with many psammoma bodies.

Aged↗
PubMed1991

[Statistical analysis of post-stroke patients in a rehabilitation institution].

A retrospective analysis of 312 stroke patients (200 men, 112 women; average age 65) admitted to Yamaguchi Rehabilitation Hospital during the past three years showed the following results. 1) After an average period of stay of 244 days 225 patients were discharged to home, general hospitals, extended care facilities, or nursing homes. 2) The group of patients over 80 years of age at admission had a lower ratio of home returns than in other groups (p less than 0.01). 3) Patients who returned home had higher scores not only on discharge Barthel index scores but on admission Barthel index scores, compared with other discharged patients (p less than 0.01). 4) The higher the admission Barthel index score, the shorter the period of stay (p less than 0.01). Concerning discharge Barthel index scores, patients who stayed over two years had lower scores than patients who stayed less than two years (p less than 0.01). The results of this analysis suggest the importance of determining goals and programs taking admission Barthel index scores as well as other available factors into consideration for patients with stroke admitted to rehabilitation institutions.

Aged↗