Publications by authors named "Okuda B"
Direct to consumer orthodontics: Exploring patient demographic trends and preferences.
Am J Orthod Dentofacial Orthop
February 2021
Introduction: This study aimed to evaluate market trends on the demographics most likely to select direct to consumer orthodontics and the reasoning behind their decisions.
Methods: An internet-based cross-sectional survey was conducted. Data analysis was carried out using logistic regression models.
A 49-year-old man had developed gradually personality change, gait disturbance, and hearing loss for five years. On admission, he presented with frontal release signs, stuttering, vertical gaze palsy, sensorineural deafness, muscle rigidity, ataxia, and sensory disturbance with areflexia in the lower extremities. Brain MRI demonstrated atrophy in the cerebellum and midbrain tegmentum as well as cerebral atrophy, predominantly in the frontal lobe.
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- Crowned dens syndrome is a rare condition characterized by calcification around the odontoid process, which can be diagnosed through specific imaging techniques like CT and MRI.
- A 61-year-old male patient experienced severe headache and neck stiffness, and was found to have significant calcification detected via a CT scan.
- After treatment with oral nonsteroidal anti-inflammatory drugs, the patient's symptoms improved dramatically within five days, indicating the effectiveness of this treatment for the syndrome.
Article Synopsis
- A study was conducted to evaluate the effectiveness of early superficial temporal artery-middle cerebral artery (STA-MCA) double anastomoses in patients suffering from progressing stroke due to atherosclerotic blockages.
- Nine patients, primarily middle-aged men with occlusions, were examined after undergoing the procedure despite receiving maximum medical treatment.
- Results showed that the procedure was safe, led to significant neurological improvement, and is recommended for patients with specific blood flow ratios even in subacute stages.
Introduction: We report a patient treated successfully via endovascular surgery within 24h after intravenous thrombolysis using recombinant tissue plasminogen activator for acute cervical internal carotid artery occlusion.
Presentation Of Case: A 68-year-old man was admitted to our hospital. Neurological examination revealed severe left-sided motor weakness.
Useless hand syndrome with astereognosis in multiple sclerosis.
Mult Scler Relat Disord
January 2015
We report on a patient with multiple sclerosis (MS) who developed bilateral useless hand syndrome (UHS) and astereognosis. Clinical features of UHS in our patient are similar to limb-kinetic apraxia with astereognosis. Cervical T1-weighted magnetic resonance imaging revealed a gadolinium-enhanced lesion at the level of C3-C4, mainly involving the posterior cord.
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- A 74-year-old man experienced involuntary levitation and clumsiness in his right arm, which showed a strange tendency to elevate without his control, especially during complex movements.
- MRI and SPECT scans revealed significant brain abnormalities, particularly in the left cerebral cortex and frontal regions, coinciding with his motor disturbances and sensory issues.
- Ultimately, he was diagnosed with Creutzfeldt-Jakob disease after the initial symptoms evolved into rapid dementia and other neurological signs, highlighting how CJD can initially mimic other disorders like corticobasal degeneration.
Clinical correlates of anhedonia in patients with Parkinson's disease.
Clin Neurol Neurosurg
December 2013
Article Synopsis
- The study examined how common anhedonia is in patients with Parkinson's disease and its effects on their quality of life (QOL).
- 15% of the 117 patients showed signs of anhedonia, which was linked to higher levels of depression and anxiety, assessed through multiple scales.
- The findings suggest that anhedonia negatively impacts QOL in Parkinson's patients, highlighting the importance of identifying and addressing this symptom.
Article Synopsis
- - The study aimed to assess the prevalence of anxiety and depression in Parkinson's disease (PD) patients and how these conditions affect their quality of life (QOL).
- - Out of 117 patients, 55% were found to have anxiety and 56% had depression, with a notable overlap where 41% experienced both conditions.
- - The results suggested that both anxiety and depression negatively impact QOL in PD patients, regardless of the severity of their motor symptoms, highlighting the need for proper recognition and management of these mental health issues.
Article Synopsis
- A 75-year-old man experienced SMA seizures characterized by brief episodes of inability to speak or move, while remaining aware of his surroundings.
- Physical exam revealed symptoms like difficulty with eye movement, stiffness, and trouble walking, alongside a history of discomfort in his head before seizures.
- Brain imaging indicated changes consistent with progressive supranuclear palsy, and seizures resolved after treatment with carbamazepine, highlighting the need for awareness of SMA seizures in older adults.
Article Synopsis
- * Out of 150 patients, 60% had apathy, 56% had depression, with 43% experiencing both; this indicates a significant overlap between the two.
- * The analysis showed that while both conditions negatively impact quality of life, depression is more linked to emotional issues, while apathy relates more to cognitive challenges and social stigma, suggesting they can be treated as separate issues in PD.
[A case of Creutzfeldt-Jakob disease with stroke-like episode as an initial symptom].
Nihon Ronen Igakkai Zasshi
September 2009
A 79-year-old woman was admitted to our hospital, due to acute onset of left hemiparesis and disturbance of consciousness. Although her symptoms improved temporarily, she developed gait disturbance and cognitive deterioration 2 months after the onset. After that, she presented with myoclonus and startle response, followed by akinetic mutism within 8 months after the onset.
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- * She was treated with intravenous tissue plasminogen activator (t-PA), which significantly improved her neurological symptoms shortly after administration.
- * Following a sudden pulseless arrest just after her treatment, she was revived with advanced life support, underwent mitral valve surgery, and was discharged in good condition 40 days later; this case is notable for the pulseless arrest occurring after t-PA treatment.
We report a 50-year-old man presenting with wall-eyed bilateral internuclear opthalmoplegia (WEBINO) syndrome. He had suffered from progressive double vision and tetraparesis, and been diagnosed as secondary progressive multiple sclerosis (MS). On admission, he presented with bilateral facial nerve palsy, pseudobulber palsy, and spastic tetraparesis, predominantly on the right side.
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- The study investigates the differences in clinical features between vascular parkinsonism (VP) and Parkinson's disease (PD), focusing on the value of pathological reflexes for diagnosis.
- In a sample of 132 PD patients and 55 VP patients, various reflexes were evaluated, showing that most pathological reflexes were significantly more common in VP patients compared to PD patients.
- The snout reflex (SR) and palmomental reflex (PMR) were identified as particularly helpful in distinguishing VP from PD, achieving high sensitivity and specificity rates for accurate diagnosis.
Anterior cerebral artery territory infarctions presenting with ascending tetraparesis.
J Stroke Cerebrovasc Dis
November 2007
Article Synopsis
- A patient experienced a sudden worsening from spastic paraparesis (weakness in the legs) to tetraparesis (weakness in all four limbs) after a stroke, accompanied by a lack of initiative (abulia).
- MRI scans showed new areas of damage (infarctions) in both medial frontal regions of the brain, but no issues in the brainstem or spinal cord.
- The case highlights unique symptoms of anterior cerebral artery syndrome that can resemble issues in the spinal cord or brainstem, emphasizing the complexity of diagnosing stroke-related conditions.
Article Synopsis
- A 65-year-old woman was hospitalized due to a rapid decline in cognitive function, exhibiting significant disorientation and severe impairment on cognitive tests.
- Routine tests showed normal results, but high levels of anti-thyroid antibodies indicated a potential autoimmune issue.
- A brain MRI suggested leukoencephalopathy, leading to a diagnosis of Hashimoto's encephalopathy; treatment with steroids improved her cognitive abilities and MRI findings.
Idiopathic spinal cord herniation was assumed to be a rare disease. However, the incidence of discovering this condition appears to have been increasing recently with advances in neuroradiological diagnosis using magnetic resonance imaging (MRI) and computed tomographic myelogram (CTM). We present herein an operated case of high-aged idiopathic spinal cord herniation.
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- - An adult patient developed acute anterior poliomyelitis (AAP) 28 days after his son received the oral poliovirus vaccine (OPV), revealing a possible connection between the two.
- - Neurological tests indicated that the patient's left lower limb weakness was due to a lower motor neuron disorder, confirmed by MRI showing a lesion in the left anterior horn.
- - The patient's stool tested positive for poliovirus type 3, linked to the vaccine strain, raising concerns about the safety and implications of using OPV in countries where polio is no longer prevalent.
[A clinicoanatomical study of thalamic cheiro-oral syndrome].
Nihon Ronen Igakkai Zasshi
January 2006
Article Synopsis
- Magnetic resonance imaging revealed fresh infarctions in thalamic areas responsible for sensory processing, linked to risk factors like hyperlipidemia and hypertension.
- While most patients experienced residual effects, one fully recovered, emphasizing the need for early diagnosis and intervention to prevent long-term complications.
Article Synopsis
- * MRI scans revealed abnormalities at the C3-4 level, and neurological exams showed impairments in dexterity, sensory disturbance, and difficulty with fine motor skills, particularly on the left side.
- * After receiving steroid treatment, the patient noted gradual improvement, and this case highlights that despite being rare, bilateral useless hand syndrome can occur in multiple sclerosis, emphasizing the role of high cervical regions in fine motor control.
Article Synopsis
- A 72-year-old man was hospitalized for dysuria and frequent fainting, diagnosed with neurogenic bladder and showed symptoms such as blepharoptosis, anisocoria, and sleep apnea.
- Neurological tests indicated sympathetic dysfunction, and MRI revealed lacunar infarctions but no signs of severe brain degeneration.
- Treatment with nasal CPAP improved his sleep apnea, reduced orthostatic hypotension and syncope, suggesting CPAP may help manage these symptoms in neurodegenerative conditions like pure autonomic failure.
[A case of motor neuron disease with dementia and apraxia of the upper limbs].
Rinsho Shinkeigaku
October 2002
We report a 61-year-old, right-handed woman with motor neuron disease, dementia, and apraxia of the upper limbs. The patient developed clumsiness of the right hand and dysarthria two years and a half prior to admission. Neurological examination showed limb-kinetic apraxia and ideomotor apraxia, predominantly on the right side, in addition to dementia and anarthria.
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