2025/07/29 更新

写真a

サクライ セイラ
櫻井 星羅
Sakurai Seira
所属
付属病院 脳卒中集中治療科 助教
職名
助教

論文

  • Anti-N-methyl-d-aspartate Receptor Encephalitis Caused by a Teratoma Arising From the Retroperitoneum.

    Serika Yamamoto, Kentaro Suzuki, Jun Shioda, Shunsuke Kido, Mariko Terakado, Seira Hatake, Akihito Kutsuna, Tomonari Saito, Naofumi Okuda, Masafumi Toyoshima, Mika Terasaki, Hiroshi Nagayama, Kazumi Kimura

    Internal medicine (Tokyo, Japan)   64 ( 7 )   1097 - 1100   2025年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is an autoimmune encephalitis, and 46% of women with anti-NMDAR encephalitis have tumors, of which 94% are ovarian teratomas. Patients with anti-NMDAR encephalitis rarely have extra-ovarian teratomas, particularly extra-ovarian mature cystic teratomas arising from the retroperitoneum. We herein report a 27-year-old woman who was diagnosed with anti-NMDAR encephalitis caused by a teratoma arising from the retroperitoneum. In patients with anti-NMDAR encephalitis, it is important to perform a systemic search, including for extra-ovarian teratomas. Plasma exchange significantly improved the patient's clinical symptoms.

    DOI: 10.2169/internalmedicine.4028-24

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  • Incidence Rate and Risk Factors for In-Hospital Ischemic Stroke among 83,990 Hospitalized Patients.

    Seira Sakurai, Kentaro Suzuki, Takuya Nishino, Daisuke Hayashi, Tomonari Saito, Yuki Sakamoto, Junya Aoki, Yasuhiro Nishiyama, Kazumi Kimura

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   92 ( 2 )   181 - 187   2025年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Details of in-hospital stroke are unknown. This study aimed to clarify the incidence rate and risk factors for in-hospital stroke among all inpatients. METHODS: This retrospective single-center study included consecutive patients admitted to our hospital. Patients aged <18 years, discharged within 24 h, and admitted to the neurology and neurosurgery departments were excluded. The incidence rate for in-hospital stroke was calculated, and patients were divided into stroke and control groups based on ischemic stroke occurrence, and the risk factors were assessed using multivariate analysis. RESULTS: Of the 83,990 enrolled patients, 101 (0.12%) developed stroke. The stroke group had a higher proportion of patients with older age (76 vs 69 years; P <.01), hypertension (49% vs 26%; P <.01), diabetes mellitus (34% vs 22%; P =.01), atrial fibrillation (25% vs 8%; P <.01), cardiovascular disease (20% vs 11%; P =.01), and emergency admission (68% vs 32%; P <.01) compared to the control group. The risk factors for in-hospital stroke were old age (odds ratio [OR], 1.03; P <.01), hypertension (OR, 1.57; P =.04), diabetes mellitus (OR, 1.61; P =.03), atrial fibrillation (OR, 2.43; P <.01), emergency admission (OR, 3.38; P <.01), and low serum albumin (OR, 0.66; P =.03). CONCLUSION: The incidence rate of in-hospital stroke was 0.12% and the independent risk factors were old age, history of hypertension, diabetes mellitus, atrial fibrillation, emergency admission, and low serum albumin.

    DOI: 10.1272/jnms.JNMS.2025_92-209

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  • Nerve sonography to detect intraneural microvascularity in patients with peripheral neuropathy. 国際誌

    Toshiyuki Hayashi, Noriko Matsumoto, Seira Hatake, Yuho Takeshi, Kentaro Suzuki, Yasuhiro Nishiyama, Hiroshi Nagayama, Kazumi Kimura

    Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology   166   244 - 249   2024年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: We assessed microvessel flow within peripheral nerves using nerve sonography in patients with peripheral neuropathy. METHODS: This study included consecutive patients with peripheral neuropathy who were admitted to our hospital. The patients were divided into two groups: inflammatory neuropathies for immune-mediated neuropathies, such as Guillain - Barré syndrome and chronic inflammatory demyelinating polyneuropathy, and the rest were defined as non-inflammatory neuropathies. We assessed nerve size and intraneural blood flow at four sites on each median and ulnar nerve. Blood flow was evaluated using color Doppler imaging, advanced dynamic flow (ADF), and superb microvascular imaging (SMI) techniques. RESULTS: Thirty-nine patients (median age, 60.0 years; 20 male) were enrolled in this study. An increase in intraneural blood flow was observed in five patients when evaluated by color Doppler, five patients by ADF, and 13 patients by SMI. An overall analysis of the three methods showed that intraneural blood flow was significantly higher in patients with inflammatory neuropathy than in those with non-inflammatory neuropathy (54.2% vs. 0%, p = 0.0005). CONCLUSIONS: Intraneural hypervascularization is more frequent in patients with inflammatory neuropathy than in those with non-inflammatory neuropathy. SIGNIFICANCE: Evaluation of microvessel flow within peripheral nerves may contribute to the diagnosis of peripheral neuropathy.

    DOI: 10.1016/j.clinph.2024.08.011

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  • Fisher症候群における眼球運動障害の臨床的特徴

    深澤 美樹, 中根 俊成, 畠 星羅, 林 俊行, 藤澤 洋輔, 永山 寛, 木村 和美

    臨床神経学   63 ( Suppl. )   S303 - S303   2023年9月

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    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

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  • FLAMES with Elevated Myelin Basic Protein Followed by Myelitis.

    Hiroyuki Hokama, Yuki Sakamoto, Toshiyuki Hayashi, Seira Hatake, Mizuho Takahashi, Hiroto Kodera, Akihito Kutsuna, Chikako Nito, Shunya Nakane, Hiroshi Nagayama, Toshiyuki Takahashi, Kazumi Kimura

    Internal medicine (Tokyo, Japan)   61 ( 23 )   3585 - 3588   2022年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The pathophysiology of unilateral cortical fluid-attenuated inversion recovery (FLAIR)-hyperintense lesions in anti-myelin oligodendrocyte glycoprotein (MOG)-associated encephalitis with seizures (FLAMES) is unclear. A 26-year-old man was referred because of a seizure. FLAIR showed an increased signal intensity and swelling of the right frontal cortex. His symptoms and imaging abnormalities were improved after intravenous methylprednisolone therapy. MOG antibody was detected both in serum and cerebrospinal fluid (CSF). Therefore, the patient was diagnosed with FLAMES. Myelin basic protein (MBP) was elevated in CSF. The high MBP value in the CSF in the present case suggested that demyelination as well as inflammation can occur in some FLAMES patients.

    DOI: 10.2169/internalmedicine.9439-22

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  • ギラン・バレー症候群のサブタイプ調査とその臨床的特徴の検討

    深澤 美樹, 中根 俊成, 畠 星羅, 林 俊行, 藤澤 洋輔, 永山 寛, 木村 和美

    臨床神経学   62 ( Suppl. )   S212 - S212   2022年10月

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    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

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  • 自己免疫性神経筋疾患での免疫グロブリン大量静注療法の副作用による汗疱の出現頻度

    畠 星羅, 清水 文崇, 本田 真也, 高橋 志織, 古賀 道明, 木村 和美, 神田 隆

    臨床神経学   62 ( 4 )   267 - 271   2022年4月

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    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

    【目的】自己免疫性神経筋疾患に免疫グロブリン大量静注療法(intravenous immunoglobulin,以下IVIgと略記)を施行後,汗疱が出現した疾患別の頻度を明らかにする.【方法】山口大学附属病院でIVIgを施行した自己免疫性神経筋疾患92例の汗疱が出現した患者の臨床情報を収集した.【結果】汗疱出現は10例で,多巣性感覚運動型(multifocal acquired demyelinating sensory and motor,以下MADSAMと略記)と多巣性運動ニューロパチー(multifocal motor neuropathy,以下MMNと略記)で有意に筋炎より汗疱の出現率が高かった.【考察】IVIgにより増加した血清IgGが近接する皮膚に沈着し,末梢神経髄鞘に対して炎症細胞が誘導されているMADSAMやMMNでは,表皮内/真皮上層での血管周囲の炎症細胞集簇が惹起されることで汗疱を出現させる機序を考えた.(著者抄録)

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    その他リンク: https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J01550&link_issn=&doc_id=20220414380002&doc_link_id=10.5692%2Fclinicalneurol.cn-001681&url=https%3A%2F%2Fdoi.org%2F10.5692%2Fclinicalneurol.cn-001681&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • 長時間の肩関節屈曲外旋姿位での発声訓練で両側性腕神経叢障害を発症した遺伝性圧脆弱性ニューロパチーの18歳男性例

    畠 星羅, 清水 文崇, 大石 真莉子, 木村 和美, 神田 隆

    臨床神経学   61 ( 10 )   676 - 680   2021年10月

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    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

    家族歴のない18歳男性.自衛隊での発声訓練で,左肘を曲げ左手を腰にあて両胸を張った姿勢を維持した後,左上肢の筋力低下と感覚障害が出現した.その1ヵ月後に右側で同一の姿勢を維持した後,右上肢の筋力低下と感覚障害が出現した.神経学的には左優位の上肢の広範な筋力低下と,両前腕尺側の感覚障害を認めた.神経伝導検査で両側正中神経と右尺骨神経に脱髄所見があり,臨床所見と針筋電図を併せて腕神経叢障害と診断した.長時間の肩関節外転伸展姿位により肋鎖間隙や小胸筋下間隙が狭小化し,下神経幹を中心とした腕神経叢の絞扼が生じたと考えた.末梢神経脆弱性の存在を疑い,遺伝子検査により遺伝性圧脆弱性ニューロパチーと診断した.(著者抄録)

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    その他リンク: https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01550&link_issn=&doc_id=20211013350005&doc_link_id=10.5692%2Fclinicalneurol.cn-001619&url=https%3A%2F%2Fdoi.org%2F10.5692%2Fclinicalneurol.cn-001619&type=Crossref&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00002_2.gif

  • CIDP30例の臨床病型と長期経過

    根本 壌, 清水 文崇, 畠 星羅, 前田 敏彦, 佐藤 亮太, 大石 真莉子, 竹下 幸男, 松尾 欣也, 佐野 泰照, 古賀 道明, 神田 隆

    神経免疫学   26 ( 1 )   160 - 160   2021年10月

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    記述言語:日本語   出版者・発行元:(一社)日本神経免疫学会  

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  • A case of pure bilateral horizontal gaze palsy due to multiple sclerosis

    Seira Hatake, Masanori Sakamaki, Masahiro Mishina, Minako Kitazato, Shizuka Goto, Yasuhiro Nishiyama, Hiroshi Nagayama, Kazumi Kimura

    NEUROLOGY AND CLINICAL NEUROSCIENCE   8 ( 4 )   215 - 217   2020年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    A 30-year-old woman presented with paresthesia in her left lower limb and blurred vision. She had bilateral horizontal gaze palsy with the absence of cranial nerve symptoms such as horizontal saccades, pursuit, and facial nerve palsy. Considering her convalescence, we speculated that her pure bilateral horizontal gaze palsy was mainly caused by disturbance in paramedian pontine reticular formation (PPRF). Pure horizontal gaze palsy may also be a characteristic feature of multiple sclerosis.

    DOI: 10.1111/ncn3.12395

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  • 認知症ケア回診の教育効果

    三品 雅洋, 窪田 裕子, 上原 嘉子, 三浦 幸, 鈴木 弓弦葉, 酒巻 雅典, 鈴木 静香, 畠 星羅, 木村 和美

    臨床神経学   59 ( Suppl. )   S290 - S290   2019年11月

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    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

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  • 糖質・鉱質コルチコイドが奏功した、治療可能な認知症についての検討

    酒巻 雅典, 三品 雅洋, 八木 孝, 鈴木 静香, 畠 星羅, 阿部 新, 水越 元気, 石川 真由美, 木村 和美

    臨床神経学   59 ( Suppl. )   S268 - S268   2019年11月

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    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

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  • 外眼筋麻痺症状を欠いたBickerstaff脳幹脳炎の21歳男性例

    柚木 真, 酒巻 雅典, 畠 星羅, 鈴木 静香, 三品 雅洋, 木村 和美

    臨床神経学   59 ( 7 )   470 - 470   2019年7月

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    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

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  • Emergent Large Vessel Occlusion Screen Is an Ideal Prehospital Scale to Avoid Missing Endovascular Therapy in Acute Stroke. 国際誌

    Kentaro Suzuki, Nobuhito Nakajima, Kenta Kunimoto, Seira Hatake, Yuki Sakamoto, Hiroyuki Hokama, Koichi Nomura, Toshiyuki Hayashi, Junya Aoki, Satoshi Suda, Yasuhiro Nishiyama, Kazumi Kimura

    Stroke   49 ( 9 )   2096 - 2101   2018年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background and Purpose- The strong evidence of endovascular therapy in acute ischemic stroke patients with large vessel occlusion (LVO) is revealed. Such patients are required to direct transport to the hospital capable of endovascular therapy. There are several prehospital scales available for paramedics to predict LVO. However, they are time consuming, and several of them include factors caused by other types than LVO. Therefore, we need a fast, simple, and reliable prehospital scale for LVO. Methods- We developed a new prehospital stroke scale, emergent large vessel occlusion (ELVO) screen, for paramedics to predict LVO. The study was prospectively performed by multistroke centers. When paramedics referred to stroke center to accept suspected stroke patients, we obtain the following information over the telephone. ELVO screen was designed focusing on cortical symptoms: 1 observation; presence of eye deviation and 2 questions; paramedics show glasses, what is this? and paramedics show 4 fingers, how many fingers are there? If the presence of eye deviation or ≥1 of the 2 items were incorrect, ELVO screen was identified as positive. We evaluated between results of ELVO screen and presence of LVO on magnetic resonance angiography at hospital arrival. Results- A total of 413 patients (age, 74±13 years; men, 234 [57%]) were enrolled. Diagnosis was ischemic stroke, 271 (66%); brain hemorrhage 73 (18%); subarachnoid hemorrhage, 7 (2%); and not stroke, 62 (15%). One hundred fourteen patients had LVO (internal carotid artery, 33 [29%]; M1, 52 [46%]; M2, 21 [18%]; basilar artery, 5 [4%]; P1, 3 [3%]). Sensitively, specificity, positive predictive value, negative predictive value, and accuracy for ELVO screen to predict LVO were 85%, 72%, 54%, 93% and 76%, respectively. Among 233 patients with negative ELVO screen, only 17 (7%) had LVO, which indicated to be an ideal scale to avoid missing endovascular therapy. Conclusions- The ELVO screen is a simple, fast, and reliable prehospital scale for paramedics to identify stroke patients with LVO for whom endovascular therapy is an effective treatment.

    DOI: 10.1161/STROKEAHA.118.022107

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