The Experts below are selected from a list of 69 Experts worldwide ranked by ideXlab platform
Hiroaki Hoshi - One of the best experts on this subject based on the ideXlab platform.
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Gradual Recovery from Nonambulatory Quadriparesis Caused by Metastatic Epidural Cervical Cord Compression in an Octogenarian Gallbladder Carcinoma Patient Treated with Image-Guided Three-Dimensional Conformal Radiotherapy Alone Using a Field-in-Field Tech
2016Co-Authors: Kazuhiro Ohtakara, Hiroaki HoshiAbstract:License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Radiotherapy for acute metastatic epidural spinal cord compression (MESCC) involves conventional techniques and dose fractionation schemes, as it needs to be initiated quickly. However, even with rapid intervention, few paraplegic patients regain ambulation. Here, we describe the case of a mid-octogenarian who presented with severe pain and nonambulatory quadriparesis attributable to MESCC at the Fifth Cervical Vertebra, which developed 10 months after the diagnosis of undifferentiated carcinoma of the gallbladder. Image-guided three-dimensional conformal radiotherapy (IG-3DCRT) was started with 25Gy in 5 fractions followed by a boost of 12Gy in 3 fractions, for which a field-in-field (FIF) technique was used to optimize the dose distribution. Despite the fact that steroids were not administered, the patient reported significant pain reduction and showed improved motor function 3 and 4 weeks after the IG-3DCRT, respectively. Over the following 4 months, her neurological function gradually improved, and she was consequently able to eat and change clothes without assistance and to walk slowly for 10–20m using a walker. She succumbed to progression of abdominal disease 8.5 months after the IG-3DCRT. This case demonstrates that image-guided FIF radiotherapy with a dose-escalated hypofractionated regimen can potentially improve functional outcome and loca
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Gradual Recovery from Nonambulatory Quadriparesis Caused by Metastatic Epidural Cervical Cord Compression in an Octogenarian Gallbladder Carcinoma Patient Treated with Image-Guided Three-Dimensional Conformal Radiotherapy Alone Using a Field-in-Field Technique
Hindawi Limited, 2014Co-Authors: Kazuhiro Ohtakara, Hiroaki HoshiAbstract:Radiotherapy for acute metastatic epidural spinal cord compression (MESCC) involves conventional techniques and dose fractionation schemes, as it needs to be initiated quickly. However, even with rapid intervention, few paraplegic patients regain ambulation. Here, we describe the case of a mid-octogenarian who presented with severe pain and nonambulatory quadriparesis attributable to MESCC at the Fifth Cervical Vertebra, which developed 10 months after the diagnosis of undifferentiated carcinoma of the gallbladder. Image-guided three-dimensional conformal radiotherapy (IG-3DCRT) was started with 25 Gy in 5 fractions followed by a boost of 12 Gy in 3 fractions, for which a field-in-field (FIF) technique was used to optimize the dose distribution. Despite the fact that steroids were not administered, the patient reported significant pain reduction and showed improved motor function 3 and 4 weeks after the IG-3DCRT, respectively. Over the following 4 months, her neurological function gradually improved, and she was consequently able to eat and change clothes without assistance and to walk slowly for 10–20 m using a walker. She succumbed to progression of abdominal disease 8.5 months after the IG-3DCRT. This case demonstrates that image-guided FIF radiotherapy with a dose-escalated hypofractionated regimen can potentially improve functional outcome and local control
Kazuhiro Ohtakara - One of the best experts on this subject based on the ideXlab platform.
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Gradual Recovery from Nonambulatory Quadriparesis Caused by Metastatic Epidural Cervical Cord Compression in an Octogenarian Gallbladder Carcinoma Patient Treated with Image-Guided Three-Dimensional Conformal Radiotherapy Alone Using a Field-in-Field Tech
2016Co-Authors: Kazuhiro Ohtakara, Hiroaki HoshiAbstract:License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Radiotherapy for acute metastatic epidural spinal cord compression (MESCC) involves conventional techniques and dose fractionation schemes, as it needs to be initiated quickly. However, even with rapid intervention, few paraplegic patients regain ambulation. Here, we describe the case of a mid-octogenarian who presented with severe pain and nonambulatory quadriparesis attributable to MESCC at the Fifth Cervical Vertebra, which developed 10 months after the diagnosis of undifferentiated carcinoma of the gallbladder. Image-guided three-dimensional conformal radiotherapy (IG-3DCRT) was started with 25Gy in 5 fractions followed by a boost of 12Gy in 3 fractions, for which a field-in-field (FIF) technique was used to optimize the dose distribution. Despite the fact that steroids were not administered, the patient reported significant pain reduction and showed improved motor function 3 and 4 weeks after the IG-3DCRT, respectively. Over the following 4 months, her neurological function gradually improved, and she was consequently able to eat and change clothes without assistance and to walk slowly for 10–20m using a walker. She succumbed to progression of abdominal disease 8.5 months after the IG-3DCRT. This case demonstrates that image-guided FIF radiotherapy with a dose-escalated hypofractionated regimen can potentially improve functional outcome and loca
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Gradual Recovery from Nonambulatory Quadriparesis Caused by Metastatic Epidural Cervical Cord Compression in an Octogenarian Gallbladder Carcinoma Patient Treated with Image-Guided Three-Dimensional Conformal Radiotherapy Alone Using a Field-in-Field Technique
Hindawi Limited, 2014Co-Authors: Kazuhiro Ohtakara, Hiroaki HoshiAbstract:Radiotherapy for acute metastatic epidural spinal cord compression (MESCC) involves conventional techniques and dose fractionation schemes, as it needs to be initiated quickly. However, even with rapid intervention, few paraplegic patients regain ambulation. Here, we describe the case of a mid-octogenarian who presented with severe pain and nonambulatory quadriparesis attributable to MESCC at the Fifth Cervical Vertebra, which developed 10 months after the diagnosis of undifferentiated carcinoma of the gallbladder. Image-guided three-dimensional conformal radiotherapy (IG-3DCRT) was started with 25 Gy in 5 fractions followed by a boost of 12 Gy in 3 fractions, for which a field-in-field (FIF) technique was used to optimize the dose distribution. Despite the fact that steroids were not administered, the patient reported significant pain reduction and showed improved motor function 3 and 4 weeks after the IG-3DCRT, respectively. Over the following 4 months, her neurological function gradually improved, and she was consequently able to eat and change clothes without assistance and to walk slowly for 10–20 m using a walker. She succumbed to progression of abdominal disease 8.5 months after the IG-3DCRT. This case demonstrates that image-guided FIF radiotherapy with a dose-escalated hypofractionated regimen can potentially improve functional outcome and local control
Glenn J Minster - One of the best experts on this subject based on the ideXlab platform.
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fractures of the second through the Fifth Cervical Vertebra with multilevel bilateral pedicle involvement a case report
Journal of Bone and Joint Surgery American Volume, 2003Co-Authors: Wesley P Phipatanakul, Glenn J MinsterAbstract:The potential for injury to the spinal cord is substantial when multiple levels of the Cervical spine are fractured. We treated a patient who sustained a unique injury involving fractures of the Vertebral bodies of C2 and C5, laminar fractures at C3 and C5, and bilateral pedicle fractures at C3 and C4. This pattern of injury was grossly unstable and required careful management. We believe that the challenges encountered in the treatment of this patient provide valuable lessons in the management of complex trauma to the Cervical spine. To our knowledge, multilevel bilateral pedicle fracture without facet dislocation has not been reported previously. Our patient was informed that data concerning the case would be submitted for publication. A twenty-two-year-old woman was transferred to the Orthopaedic Spine Service at Detroit Receiving Hospital from an initial treatment facility after she was involved as a restrained driver in a motor-vehicle rollover collision. The chief symptom was neck and shoulder pain with bilateral upper-extremity weakness. She had no history of medical problems. The area over the Cervical spine was tender to palpation during the physical examination. Bilateral upper-extremity motor strength was graded as 5 of 5 in the triceps, the finger flexors, and the finger abductor muscles according to the classification of the American Spinal Injury Association (ASIA) 1. Deltoid and biceps muscle strength was graded as 1 of 5 bilaterally, and wrist extension strength was graded as 2 of 5 bilaterally. Sensation to light touch and pinprick was intact in all dermatomes. Normal sphincter tone was present. The bulbocavernosus reflex was not checked at the …
Wesley P Phipatanakul - One of the best experts on this subject based on the ideXlab platform.
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fractures of the second through the Fifth Cervical Vertebra with multilevel bilateral pedicle involvement a case report
Journal of Bone and Joint Surgery American Volume, 2003Co-Authors: Wesley P Phipatanakul, Glenn J MinsterAbstract:The potential for injury to the spinal cord is substantial when multiple levels of the Cervical spine are fractured. We treated a patient who sustained a unique injury involving fractures of the Vertebral bodies of C2 and C5, laminar fractures at C3 and C5, and bilateral pedicle fractures at C3 and C4. This pattern of injury was grossly unstable and required careful management. We believe that the challenges encountered in the treatment of this patient provide valuable lessons in the management of complex trauma to the Cervical spine. To our knowledge, multilevel bilateral pedicle fracture without facet dislocation has not been reported previously. Our patient was informed that data concerning the case would be submitted for publication. A twenty-two-year-old woman was transferred to the Orthopaedic Spine Service at Detroit Receiving Hospital from an initial treatment facility after she was involved as a restrained driver in a motor-vehicle rollover collision. The chief symptom was neck and shoulder pain with bilateral upper-extremity weakness. She had no history of medical problems. The area over the Cervical spine was tender to palpation during the physical examination. Bilateral upper-extremity motor strength was graded as 5 of 5 in the triceps, the finger flexors, and the finger abductor muscles according to the classification of the American Spinal Injury Association (ASIA) 1. Deltoid and biceps muscle strength was graded as 1 of 5 bilaterally, and wrist extension strength was graded as 2 of 5 bilaterally. Sensation to light touch and pinprick was intact in all dermatomes. Normal sphincter tone was present. The bulbocavernosus reflex was not checked at the …
Masahito Tsubota - One of the best experts on this subject based on the ideXlab platform.
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vestibular migraine patients show lack of habituation in auditory middle latency responses to repetitive stimuli comparison with meniere s disease patients
Frontiers in Neurology, 2020Co-Authors: Toshihisa Murofushi, Fumiyuki Goto, Masahito TsubotaAbstract:Objectives: To compare habituation in auditory middle latency response (AMLR) to repetitive stimuli of vestibular migraine (VM) patients with Meniere's disease (MD) patients and healthy controls (HC) and to assess usefulness of AMLR for diagnosis of VM. Subjects: Thirteen unilateral definite MD patients (2 men, 11 women, mean age 50.6), 13 definite VM patients (3 men, 10 women, mean age 45.5), and 8 HC subjects (2 men, 6 women, mean age 37.1) were enrolled. Methods: The electrodes were placed on the vertex and the spinal process of the Fifth Cervical Vertebra. Binaural click stimulation (0.1 ms, 70 dBnHL) was presented. A total of 800 responses were averaged. Averaged responses were divided into four sets (S1 to S4) according to the temporal order. No, Po, Na, and Pa were identified, and amplitudes and latencies were measured. Results: Concerning latencies, HC subjects showed a tendency of shorter latencies. However, there was no clear effect of repetitive stimulation. Concerning No-Po amplitudes, no significant differences were observed. Raw amplitudes of Na-Pa showed statistically significant differences in S1 and S2 among the groups (p < 0.01 one-way ANOVA). Differences were shown in MD vs. VM and HC vs. VM in S1 (smaller in VM) (p < 0.01 Bonferroni's test) and in MD vs. VM in S2 (smaller in VM) (p < 0.01 Bonferroni test). Relative amplitudes of Na-Pa to S1 showed statistically significant differences in S4 (p < 0.01 one-way ANOVA). Differences were shown in MD vs. VM and HC vs. VM (larger in VM) (p < 0.01 Bonferroni's test). Differences of Na-Pa amplitudes in S2 to S4 from Na-Pa amplitude in S1 were significant in S4 of VM patients (Dunnett's test). Conclusions: VM patients showed lack of habituation (potentiation) of Na-Pa amplitude in AMLR to repetitive stimuli while MD patients and HC subjects showed habituation. Observation of lack of habituation has high diagnostic accuracy for differential diagnosis of VM from MD.