Tomoyuki Nomura

Niigata University, Niahi-niigata, Niigata, Japan

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Publications (6)3.26 Total impact

  • Hitoshi Okumura · Kojiro Ishioka · Hiroko Ueda · Tomoyuki Nomura
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    ABSTRACT: Objective: We report a retrospective study of 10 patients with a clinical diagnosis of granulomatosis with polyangiitis (GPA). Methods: The subjects were 10 patients who consulted our department between April 2003 and March 2011, and were diagnosed with GPA. We investigated the presence or absence of GPA-specific findings on CT of paranasal sinus and nasal mucosal biopsy. Results: CT findings of paranasal sinus in all patients: CT revealed bilateral paranasal bone thickening/destruction or mass formation in 5 patients. These findings differed from those of typical sinusitis. Biopsies from the nasal mucosa in six patients: In patients without abnormal intranasal findings, biopsy was conducted from the mucosa in an area adjacent to a paranasal shadow on CT. In 4 (67%) of the 6 patients, GPA was diagnosed. In 2 patients, a diagnosis was made based on nasal mucosal biopsy in an area in which inspection did not show any abnormalities. In 1 of these, it was impossible to perform invasive examinations due to deterioration of kidney function and general malaise. In the other, hypoxemia occurred immediately before thoracoscope-guided biopsy, which had been scheduled, making biopsy difficult. Furthermore, the two patients were negative for PR3-ANCA. Conclusions: Bilateral paranasal bone thickening/destruction or mass formation differ from those of typical sinusitis, and may be useful for the diagnosis of GPA. Biopsy of the nasal mucosa in the absence of abnormal intranasal findings may be useful for diagnosis. In particular, when several complications make invasive tests impossible, this examination should be performed.
    No preview · Article · Jan 2015
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    ABSTRACT: We report herein on a case of unique head position-induced dizziness and nystagmus. A 64-year-old man complained of recurrent dizziness during head shaking following hair washing for over 20 years. Because a medullary lesion was suspected at another clinic, he was referred to our university hospital. He showed no cochlear or abnormal neurological symptoms. Routine equilibrium function and neurological tests showed unremarkable findings. A T 2-weighted image on brain MRI revealed a high-intensity signal area on the ventral medullary surface. No abnormalities of the vertebral artery were found on MRA imaging and transcranial ultrasonography, namely disappearance, meandering, malformation, or stoppage. On examination, the patient showed down beating nystagmus and dizziness when he bent forward swiftly and shook his head in a sitting position. His nystagmus had a small amplitude and lasted for a few seconds during dizziness. From the MRI findings and a history of Fallot's tetralogy, he was diagnosed as having a congenital neuroenteric cyst. He was followed without any conservative management and surgery because his symptoms disappeared by avoidance of the dizziness-inducing head position. Downbeat nystagmus typically occurs in patients with lesions involving the caudal midline of the cerebellum and the lower brain stem. A distinct vertical head-shaking nystagmus suggests the existence of a central lesion. It is speculated in our case that the unique head position and head shaking caused temporary circulatory disturbance of the cerebellum and the lower brain stem systems.
    No preview · Article · Dec 2012 · Equilibrium Research
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    ABSTRACT: BCL11B/CTIP2 zinc-finger transcription factor is expressed in various types of cells in many different tissues. This study showed that BCL11B is expressed in the nucleus of the outer hair cells of the mouse cochlea, degeneration of which is known to cause deafness and presbycusis or age-related hearing loss (AHL). We tested whether or not Bcl11b heterozygosity would affect AHL in mice. Analysis of auditory brainstem responses revealed AHL in Bcl11b (+/-) heterozygous, but not wild-type, mice, which was evident as early as 3 months after birth. Histological abnormalities were observed in the outer hair cells of the Bcl11b (+/-) mice at 6 months of age with hearing loss. These results suggest that the AHL observed in Bcl11b (+/-) mice is the result of impairment of the outer hair cells and that BCL11B activity is required for the maintenance of outer hair cells and normal hearing.
    No preview · Article · Jan 2011 · Experimental Animals
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    ABSTRACT: We report two cases of intraoperative computer-aided surgery using magnetic resonance imaging (MRI)/computed tomography (CT) fusion imaging for inverted papilloma (IP). Case 1: IP had spread to the frontal recess/sinus so we chose a combined endoscopic sinus surgery (ESS) and external approach. Case 2: For a maxillary sinus tumor, we combined ESS and the adjuvant external (Caldwell-Luc) procedure. This is helpful to surgeons when, shifting fusion imaging when opening the frontal sinus bone to obtain CT data, and shifting to MRI to detect the tumor pedicle, then approaching the bone defect using MRI-CT fusion imaging (50-50%).
    No preview · Article · Jan 2010 · Nippon Jibiinkoka Gakkai Kaiho
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    ABSTRACT: Isolated sphenoid sinusitis is rare and difficult to diagnose. The difficulty arises because it is located in the deepest part of the nasal sinuses and the associated inflammation does not lead to typical symptoms of sinusitis. There are many important structures in the vicinity of the sphenoid sinus: the internal carotid artery, cavernous sinus and cranial nerves. Therefore, sphenoid sinusitis causes severe complications. From January 2003 to December 2007, we encountered 15 patients with isolated sphenoid sinusitis. Its incidence in all sinus diseases is 2. 2%. Many patients complain of headaches, and they often visit neurologists or neurosurgeons. The pathological spectrum included 10 cases of bacterial sinusitis (5 acute sinusitis, 3 chronic sinusitis and 2 asymptomatic sinusitis), 3 fungal sinusitis, 1 mucocele and 1 retention cyst. When we diagnose isolated sphenoid sinusitis, CT and endoscopy are essential. CT becomes a more useful tool for performing a differential diagnosis when we independently change the window height and width. The endoscopic findings regarding draining from the sphenoethmoidal recess may indicate the severity of inflammation. A detailed observation with CT and endoscopy is the most important to accurately diagnose the pathology of isolated sphenoid sinusitis.
    No preview · Article · Jul 2009
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    ABSTRACT: A region in the vicinity of D17Mit119 on mouse chromosome 17 harbors a susceptibility gene, designated as Ahl3, to age-related hearing loss (AHL). We produced congenic lines of C57BL/6 background that substituted regions around D17Mit119 with MSM-derived ones, and examined auditory brainstem response (ABR) thresholds for their hearing capacity at 6 and 12months of age. Three congenic lines carrying the approximately 14-Mb region between D17Mit274 and D17Mit183 retained normal hearing at 12months of age whereas two congenic lines not carrying this region tended to lose hearing at that age. We also investigated noise-induced hearing loss (NIHL) in congenic lines at 1, 7 and 14days after exposure to the noise of 100dB for 1h. Most congenic mice carrying the 14-Mb region did not exhibit permanent threshold shift (PTS) whereas mice not carrying this region exhibited a strong tendency of PTS, indicating the role of Ahl3 in susceptibility to NIHL. These results indicate that Ahl3 exists within the 14-Mb region and affects not only AHL but also NIHL.
    Full-text · Article · Apr 2007 · Biochemical and Biophysical Research Communications
  • Tomoyuki Nomura · Sugata Takahashi · Tatsuo Ushiki
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    ABSTRACT: The three-dimensional cytoarchitecture of the normal rat olfactory epithelium was examined by scanning electron microscopy (SEM) of KOH digested tissues as well as by light and transmission electron microscopy of plastic sections. Observations specimens from the lateral side of the olfactory epithelium allowed identification of four cell types by their surface structure: olfactory neurons, supporting cells, basal cells, and duct cells of the Bowman's gland. The olfactory neurons were characterized by the presence of a thick apical process (i.e., dendrite) and a thin basal process (i.e., axon). These olfactory neurons tended to be aligned along the vertical axis of the epithelium. Immature olfactory neurons were present at the basal part of the epithelium and had a pear-shaped cell body with a thin and long axon and a short dendrite which failed to reach the epithelial surface. Supporting cells were roughly columnar in shape and occupied the full length of the epithelium. They became thinner in the basal two thirds of their length but had branched foot processes spreading on the basal surface of the epithelium. Basal cells located in the basal epithelial region were oval, round or cuboidal and present among the foot processes of the supporting cells. The ducts of the Bowman's gland entered the epithelium from the lamina propria and took straight, perpendicular courses within the epithelium. These intraepithelial ducts were composed of several slender cells. The acinar cells are sometimes present in the epithelium and appeared as a globular bulge of the duct at the basal part of the epithelium. SEM observation of the basal surface of the olfactory epithelium also clearly showed that axon bundles were surrounded by the sheet-like processes of Schwann cells, the investment being found at the base of the epithelium just before axon bundles leave the epithelium.
    No preview · Article · Jul 2004 · Archives of Histology and Cytology