著者
Kazuhiro ANDO Hitoshi HASEGAWA Bumpei KIKUCHI Shoji SAITO Jotaro ON Kohei SHIBUYA Yukihiko FUJII
出版者
The Japan Neurosurgical Society
雑誌
Neurologia medico-chirurgica (ISSN:04708105)
巻号頁・発行日
pp.oa.2019-0051, (Released:2019-07-04)
参考文献数
14
被引用文献数
10

We retrospectively reviewed the cases of three patients with infectious intracranial aneurysms (IIAs), and discuss the indications for surgical and endovascular treatments. We treated two men and one woman with a total of six aneurysms. The mean age was 43.3 years, ranging from 36 to 51 years. One patient presented initially with an intraparenchymal hemorrhage, one with mass effect, and the other one had four aneurysms (one causing subarachnoid hemorrhages and the other causing delayed intraparenchymal hemorrhages). The average size of all aneurysms was 12.2 mm (range, 2–50 mm). They were preferentially located in the distal posterior cerebral artery, and then, in the middle cerebral artery. All cases were caused by infective endocarditis. We selected endovascular treatments for five aneurysms and treated all but one within 24 h from detection. One aneurysm was treated by combined therapy with endovascular intervention and surgery. After treatment, none of the IIAs presented angiographical recurrence or re-bleeding. If feasible, endovascular treatment is probably the first choice, but a combined surgical and endovascular approach should be considered if surgery or endovascular treatment alone are not feasible. The method of treatment should be individualized. For cases with high risk of aneurysm rupture, treatment should be performed as soon as possible.
著者
Kohei SHIBUYA Hitoshi HASEGAWA Tomoaki SUZUKI Haruhiko TAKAHASHI Kei NISHIYAMA Makoto OISHI Yukihiko FUJII
出版者
The Japan Neurosurgical Society
雑誌
Neurologia medico-chirurgica (ISSN:04708105)
巻号頁・発行日
pp.2023-0039, (Released:2023-06-28)
参考文献数
21

In Japan, which has a super-aging society, there are increasing opportunities to perform mechanical thrombectomy for the elderly; however, there is no recorded evidence of thrombectomy for the elderly. This study examined the usefulness of thrombectomy in the elderly. We retrospectively analyzed patient data using a multicenter acute ischemic stroke registry (NGT-FAST). We examined outcomes in patients 75 years and older who underwent thrombectomies between January 1, 2021, and December 31, 2021. The patients were divided into two groups: the 75-84-year-old group and the 85+-year-old group. There was no difference in the pretreatment National Institutes of Health Stroke Scale score or Alberta Stroke Program Early Computed Tomography Score between the two groups, but the 85+-year-old group had a significantly lower rate of pre-stroke modified Rankin Scale (mRS) score of 0-2. There were no differences in time from onset to treatment or effective recanalization rate, but complications tended to be more common in the 85+-year-old group. The number of patients with a good outcome at discharge (an mRS score of 0-3) was significantly lower in the 85+-year-old group than in the 75-84-year-old group. In addition, 90.9% of patients in the 85+-year-old group with a pre-stroke mRS score of 3 deteriorated after treatment. The pre-stroke mRS score is very important in determining the indication for thrombectomy in the elderly because their preoperative condition is more likely to influence the outcome than that of younger patients.
著者
Makoto OTSUKA Hitoshi HASEGAWA Yoshihisa MATSUDA
出版者
The Pharmaceutical Society of Japan
雑誌
Chemical and Pharmaceutical Bulletin (ISSN:00092363)
巻号頁・発行日
vol.45, no.5, pp.894-898, 1997-05-15 (Released:2008-03-31)
参考文献数
19
被引用文献数
35 50

The effects of a solvent system on the pharmaceutical properties of carbamazepine (CBZ) granules containing a polymorphic form of bulk powder were investigated by X-ray diffraction analysis, thermal analysis, mercury porosimetry and Brunauer-Emmett-Teller (BET) surface area measurement. A powder mixture consisting of 20% CBZ form I, as a bulk powder, 56% crystalline α-lactose monohydrate and 24% corn starch was used as a pharmaceutical powder, with the three kinds of binder solutions (distilled water, 50% aqueous ethanol and ethanol) containing 5% hydroxypropylcellulose (HPC). After kneading with a binder solution, the granules were obtained using an extruding granulator. The X-ray diffraction and differential scanning calorimetry (DSC) results of the granules indicated that form I with 50% ethanol solution transformed into a dihydrate form during extruding granulation, but this did not occur with the distilled water or ethanol solutions. The order of hardness and specific surface area (Sw) of the granules was distilled water>50% ethanol>ethanol and 50% ethanol>ethanol>distilled water. The stress-thickness profiles of the tabletting compression processes of CBZ granules obtained using various binder solution systems were measured, and the initial compression process due to particle rearrangement was affected by the characteristics in the granules. The total pore volume of tablets obtained from 50% ethanol was the lowest, and their order was ethanol>distilled water>50% ethanol. Their order of tablet hardness reflected the total pore volume of the tablet, and was 50% ethanol>distilled water>ethanol. All pharmaceutical properties of the granules and/or tablets containing CBZ were affected by the characteristics of the solvent systems in binder solution.