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Obihiro, Japan

Takahashi Y.,Hokuto Hospital | Hashimoto N.,Osaka University | Akihiko H.,Saiseikai Shiga Hospital
Neurologia Medico-Chirurgica | Year: 2010

Epidural hematoma is typically caused by direct head trauma. Spontaneous epidural hematoma can be caused by infections of adjacent regions, vascular malformations of the dura mater, and disorders of blood coagulation. A 10-year-old girl with no history of head injury presented with complaints of headache and fever. On arrival at our hospital, her Glasgow Coma Scale score was 13 and neurological examination revealed right oculomotor palsy and left hemiparesis. Computed tomography (CT) showed an epidural hematoma in the right temporal base. Preoperative angiography identified no specific vascular lesions. Removal of the hematoma was undertaken immediately. Retrospective evaluation of the preoperative CT revealed sphenoid sinusitis and a bone defect between the temporal base and the sphenoid sinus. The epidural hematoma was probably caused by the spread of inflammation from the sphenoid sinus. Sphenoid sinusitis is one of the possible causes of acute epidural hematoma, especially if no traumatic episodes or risk factors can be identified.

Takeda N.,Hokkaido University | Isu K.,Hokkaido Cancer Center | Hiraga H.,Hokkaido Cancer Center | Minami A.,Hokkaido University | Kamata H.,Hokuto Hospital
Journal of Orthopaedic Science | Year: 2012

Background: Renal cell carcinoma (RCC) is thought to respond unreliably to radiotherapy (RT). Zoledronic acid significantly reduces the risk of skeletal complications. This study investigated whether RT with zoledronic acid prolonged the time to bone-lesion progression in comparison with RT alone. Method: Twenty-seven patients (34 lesions) with bone metastases secondary to RCC undergoing treatment with RT with or without zoledronic acid were retrospectively evaluated at two institutions between 1999 and 2009. Twelve patients were treated with RT alone from 1999 to 2008 (RT group). Fifteen patients were treated with RT and zoledronic acid from 2006 to 2009 (RT + Z group). The time to skeletal-related events and pain progression were assessed from patients' medical records. Results: The median (range) follow-up was 26 (3-75) and 24 (3-55) months in the RT and RT + Z groups, respectively. Three patients (three lesions) in the RT + Z group had skeletal-related events (SREs). In contrast, six patients (eight lesions) in the RT group had SREs. SREs comprised pathological fractures in five, additional surgeries in three, spinal cord or cauda equine compression in two, and repeat RT in one. There was a significant difference in SRE-free survival time and duration of site-specific pain response between groups. Conclusions: RT combined with zoledronic acid significantly prolonged SRE-free survival and duration of pain response compared with RT alone in the treatment of osseous metastases from RCC. © 2012 The Japanese Orthopaedic Association.

Takahashi Y.,Inada Inc | Bandoh N.,Hokuto Hospital | Miyamoto A.,Hokuto Hospital | Kamada H.,Hokuto Hospital
Journal of Oral and Maxillofacial Surgery | Year: 2016

Ameloblastic carcinoma (AC) is a rare malignant odontogenic tumor. Surgical resection of the tumor is the mainstay of its treatment. To date, radiotherapy for this tumor remains controversial. This report describes a case of AC with intracranial extension and provides the first report of the efficacy of single-fraction helical tomotherapy for the treatment of residual AC after surgical resection. © 2016 American Association of Oral and Maxillofacial Surgeons.

Bandoh N.,Hokuto Hospital | Goto T.,Hokuto Hospital
Practica Oto-Rhino-Laryngologica | Year: 2012

We report on two cases of a fistula of the first branchial cleft. A 15-year-old female complained of swelling and tenderness of the temporal, postauricular and parotid gland regions. A large abscess revealed on a CT scan was incised and drained immediately. After the patient had left the hospital, we identified secretion from the external ear canal following pressure to the postauricular region, prompting us to consider the existence of a fistula of the first branchial cleft, opening onto the canal. We extracted the fistula located in the temporal and postauricular region and extending to the parotid gland deep lobe, after identification of the main trunk of the facial nerve. A 5-year-old male complained of swelling and tenderness of the parotid gland region. As the formation of the abscess recurred repeatedly, he underwent surgery. The fistula was located in the parotid gland superficial lobe and had adhered firmly to the cartilage of the external ear canal. After identification of facial nerve we extracted the fistula. After surgery, neither facial nerve palsy nor recurrence has been identified in either case.

Arima H.,Kyoto University | Kurata M.,Hokuto Hospital | Imai Y.,Kobe City Medical Center | Takahashi T.,Shinko Hospital.
Leukemia and Lymphoma | Year: 2013

We assessed the prognostic impact of occult bone marrow involvement, determined by flow cytometry and/or polymerase chain reaction, in a population of 117 consecutive patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) treated with rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). Twenty-four (20.5%) had morphologically diagnosed and 16 (13.7%) had occult marrow involvement, and 77 (65.8%) had no marrow involvement. Although the pretreatment characteristics of the negative or occult marrow involvement group were similar, severe hematological toxicity after R-CHOP was more frequent in the occult marrow involvement group. Progression-free survival (PFS; p = 0.015) and overall survival (OS; p = 0.035) for the occult marrow involvement group were significantly shorter than those for the negative group, and were comparable to those of the morphologic marrow involvement group, independent of the International Prognostic Index score for PFS. Occult bone marrow involvement predicts severe hematological toxicity and negatively impacts on the PFS and OS of R-CHOP therapy. © 2013 Informa UK, Ltd.

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