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Ryūgasaki, Japan

Matsubara T.,University of Tsukuba | Ayuzawa S.,University of Tsukuba | Aoki T.,Ryugasaki Saiseikai Hospital | Ikeda G.,University of Tsukuba | And 2 more authors.
Neurologia Medico-Chirurgica | Year: 2014

Ventriculoperitoneal shunting (VPS) is a simple procedure, but there are several potential complications. We describe the first reported case of cerebral venous thrombosis (CVT) after VPS. A 69-year-old man suffering from normal pressure hydrocephalus underwent left VPS. Two months later he developed CVT and cerebral venous hemorrhage in the left frontal lobe. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed the thrombus formation just adjacent to the shunt tube. One possible cause is compression of the cortical vein after brain shift and/or tension of the cortical vein due to intracranial hypotension (IH). A protein C deficiency was also detected. Surgeons should be aware that cerebral venous thrombosis can occur after VPS.

Kurihara Y.,University of Tsukuba | Hitomi S.,University of Tsukuba | Oishi T.,Tokyo Medical University | Kondo T.,Tsuchiura Kyodo General Hospital | And 3 more authors.
Journal of Infection and Chemotherapy | Year: 2013

Although Proteus mirabilis is a common human pathogen, bacteremia caused by the organism, especially strains producing extended-spectrum beta-lactamase (ESBL), has rarely been investigated. We examined 64 cases of P. mirabilis bacteremia identified in the Minami Ibaraki Area, Japan, between 2001 and 2010 and compared the characteristics of cases with ESBL-producing and ESBL-non-producing strains (13 and 51 cases, respectively). All ESBL-producing strains with the gene encoding the CTX-M-2-group were genetically nonidentical. Isolation of ESBL-producing strains was significantly associated with onset in a hospital (p = 0.030), receiving hemodialysis (p = 0.0050), and previous antibiotic use within 1 month (p = 0.036; especially penicillin and/or cephalosporin (p = 0.010) and fluoroquinolone (p = 0.0069)). Isolation was also associated with inappropriate antibiotic therapy on the 1st and 4th days (p = 0.011 and 0.032, respectively) but not with mortality on the 30th day. These findings indicate that, for P. mirabilis bacteremia, isolation of ESBL-producing strains causes delay of initiating appropriate antimicrobial therapy but may not be associated with mortality. © 2013 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases.

Matsubara T.,University of Tsukuba | Ayuzawa S.,University of Tsukuba | Aoki T.,Ryugasaki Saiseikai Hospital | Fujiomto A.,Seirei Hamamatsu General Hospital | And 2 more authors.
Epilepsy and Behavior Case Reports | Year: 2013

Patients with a porencephalic cyst frequently develop intractable temporal lobe epilepsy (TLE). We report a surgically-treated male patient with intractable mesial TLE (mTLE) secondary to a porencephalic cyst. Although magnetic resonance imaging showed no hippocampal abnormalities, long-term video-electrocorticography revealed seizure onset discharges in the hippocampus. Temporal lobectomy brought an end to the patient's seizures. Hippocampal sclerosis was histopathologically confirmed (dual pathology). Careful evaluation of hippocampal epileptogenicity is required, and temporal lobectomy, which is less invasive than hemispherectomy, can be a treatment of choice for patients with mTLE secondary to a porencephalic cyst. © 2013 The Authors.

Hasegawa Y.,University of Tsukuba | Okamoto F.,University of Tsukuba | Nakano S.,Ryugasaki Saiseikai Hospital | Hiraoka T.,University of Tsukuba | Oshika T.,University of Tsukuba
Journal of Cataract and Refractive Surgery | Year: 2013

Purpose To compare the Acrysof IQ toric intraocular lens (IOL) and the Acrysof IQ aspheric nontoric IOL and evaluate the effect of preoperative corneal astigmatism orientation on results. Setting Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan. Design Comparative case series. Methods This retrospective chart review comprised patients with cataract and preoperative corneal astigmatism between 1.0 diopter (D) and 2.5 D having toric IOL (toric group) or aspheric nontoric IOL (nontoric group) implantation. Eyes were grouped depending on the preoperative axis of corneal astigmatism; that is, with the rule (WTR), against the rule (ATR), and oblique. Preoperative and postoperative analyses included uncorrected (UDVA) and corrected (CDVA) distance visual acuities and cylindrical power preoperatively and 3 months postoperatively. Results The postoperative CDVA was not significantly different between the 2 IOLs; however, the postoperative UDVA was significantly better in the toric group than in the nontoric group (P<.0001). The postoperative residual cylindrical power was significantly smaller in the toric group (P<.0001). In eyes with ATR and oblique astigmatism, the mean postoperative UDVA was significantly better in the toric group, whereas there were no differences between the 2 groups in patients with WTR astigmatism. Conclusions There was significant improvement in postoperative cylinder and UDVA with toric IOLs compared with nontoric IOLs. With a superior corneal incision, the benefits of astigmatism correction with the toric IOL were more significant in patients with ATR and oblique astigmatism than in those with WTR astigmatism. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned. © 2013 ASCRS and ESCRS.

Watanabe M.,University of Tsukuba | Furusho K.,Ryugasaki Saiseikai Hospital | Takahashi T.,Tohoku University | Tamaoka A.,University of Tsukuba
Neurologist | Year: 2015

This is the first report of a case of galactorrhea in a patient with neuromyelitis optica spectrum disorder (NMOSD) diagnosed on the basis of antiaquaporin-4 antibody seropositivity. The hypothalamus is becoming known as an area highly expressing aquaporin-4 and frequently involved in intracranial lesions of patients with neuromyelitis optica (NMO). We reviewed cases of hypothalamic endocrinopathy among patients with NMO, NMOSD, and the Japanese opticospinal form of MS. Among these cases, galactorrhea was the second most common symptom. Signs of hypothalamic endocrinopathies may be obscured by the grave neurological deficits caused by NMO. We recommend paying special attention to hypothalamic endocrinopathies among patients with NMO or NMOSD, irrespective of brain MRI findings. © Copyright 2015 Wolters Kluwer Health, Inc. All rights reserved.

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