著者
Hiroshi KARIBE Toshiaki HAYASHI Ayumi NARISAWA Motonobu KAMEYAMA Atsuhiro NAKAGAWA Teiji TOMINAGA
出版者
社団法人 日本脳神経外科学会
雑誌
Neurologia medico-chirurgica (ISSN:04708105)
巻号頁・発行日
pp.st.2017-0058, (Released:2017-07-05)
参考文献数
65
被引用文献数
63

In recent years, instances of neurotrauma in the elderly have been increasing. This article addresses the clinical characteristics, management strategy, and outcome in elderly patients with traumatic brain injury (TBI). Falls to the ground either from standing or from heights are the most common causes of TBI in the elderly, since both motor and physiological functions are degraded in the elderly. Subdural, contusional and intracerebral hematomas are more common in the elderly than the young as the acute traumatic intracranial lesion. High frequency of those lesions has been proposed to be associated with increased volume of the subdural space resulting from the atrophy of the brain in the elderly. The delayed aggravation of intracranial hematomas has been also explained by such anatomical and physiological changes present in the elderly. Delayed hyperemia/hyperperfusion may also be a characteristic of the elderly TBI, although its mechanisms are not fully understood. In addition, widely used pre-injury anticoagulant and antiplatelet therapies may be associated with delayed aggravation, making the management difficult for elderly TBI. It is an urgent issue to establish preventions and treatments for elderly TBI, since its outcome has been remained poor for more than 40 years.
著者
Hidekazu AOKI Shunji MUGIKURA Reizo SHIRANE Toshiaki HAYASHI Tomomi KIMIWADA Kiyohide SAKAI Keiko AINOYA Hideki OTA Kei TAKASE Yoshihisa SHIMANUKI
出版者
The Japan Neurosurgical Society
雑誌
Neurologia medico-chirurgica (ISSN:04708105)
巻号頁・発行日
pp.2023-0002, (Released:2023-08-30)
参考文献数
22

Closed spinal dysraphism (CSD) encompasses a heterogeneous group of spinal cord deformities, which can be accompanied by several types of skin stigmata. These skin stigmata may include inconspicuous features, such as sacral dimples and deformed gluteal clefts, but the association between such mild skin stigmata and CSD is uncertain. This study aimed to reevaluate the indication for magnetic resonance imaging (MRI) in patients with skin stigmata while considering the indication for surgery. A retrospective analysis was conducted on magnetic resonance images of 1255 asymptomatic children with skin stigmata between 2003 and 2015. Skin stigmata classification was based on medical chart data. All subtypes of CSDs except for filum terminale lipomas (FTL), FTL thicker than 2 mm or with low conus medullaris, were considered to meet the surgical indication. CSD prevalence was estimated while considering the surgical indications and assessed after excluding all FTL cases. Skin stigmata were classified into seven types, dimple, deformed gluteal cleft, hair, subcutaneous mass, appendage, discoloration, and protruding bone, and included 1056 isolated and 199 complex ones. The prevalence of CSD was 19.5%, 6.8%, and 0.5% among patients with isolated dimples (n = 881) and 13.9%, 5.8%, and 0.7% among those with isolated deformed gluteal clefts (n = 136) for all cases, surgical indications, and patients without FTL, respectively. Dimples and deformed gluteal clefts had a low prevalence of CSD requiring surgical intervention, and cases without FTL were rare. Asymptomatic patients with mild skin stigmata may not require immediate MRI.
著者
TOSHIAKI HAYASHI TAKAO NOTO YOSHIHARU NAWATA HIROSHI OKAZAKI MIKIO SAWADA KUNIO ANDO
出版者
JAPAN ANTIBIOTICS RESEARCH ASSOCIATION
雑誌
The Journal of Antibiotics (ISSN:00218820)
巻号頁・発行日
vol.35, no.7, pp.771-777, 1982 (Released:2006-04-12)
参考文献数
17
被引用文献数
16 25

A new antibiotic, cyanocycline A, was isolated from the fermentation broth of Streptomyces flavogriseus strain No. 49, a soil isolate. The molecular formula of cyanocycline A was determined to be C22H26N4O5. The antibiotic has a cyano group and a N-heterocyclic quinone moiety in its structure. Cyanocycline A was found to have broad spectrum antimicrobial and antitumor activity.