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Matsuoka H, Ohashi S, Narikiyo M, Nogami R, Hashimoto K, Wade M, Nagasaki H, Tsuboi Y. Optimal Treatment of C3 Lamina in Cervical Laminoplasty. World Neurosurg 2023; 180:e618-e623. [PMID: 37793608 DOI: 10.1016/j.wneu.2023.09.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/06/2023]
Abstract
STUDY DESIGN Results of C4-C6 laminoplasty with C3 laminectomy and C3-C6 laminoplasty were compared retrospectively. OBJECTIVES To clarify the difference between C3 laminectomy and C3 laminoplasty in cervical laminoplasty. SUMMARY OF BACKGROUND DATA Intraoperative damage to the semispinalis cervicis has been shown to lead to postoperative axial symptoms and reduced range of motion (ROM). To prevent this event, C3 laminectomy in cervical laminoplasty is considered superior to C3 laminoplasty. METHODS A total of 36 patients were included in this study: 20 patients (GroupA) of C3 laminectomy, C4-C6 laminoplasty compared with 16 patients (GroupB) of C3-C6 laminoplasty. We collected patient's background data, operative time, Japanese Orthopaedic Association (JOA) score, VAS score, and radiologic findings such as C2-C7 Cobb angle, ROM, C2 inter-spinous angle, and use of postoperative PRN medication were compared. RESULTS There was no statistically significant difference in the C2-C7 Cobb angles between the 2 groups before and after surgery (P = 0.315). In ROM, there was a 17.7% decrease from 31.5 preoperatively to 25.9 postoperatively in Group A, and a 6.1% decrease from 29.3 preoperatively to 27.5 postoperatively in Group B. There was no statistically significant difference in ROM (P = 0.683). Postoperative neck pain (VAS) was significantly lower in Group A than in Group B both at 1 week (P = 0.015) and 1 month (P = 0.035) after surgery. The C2 inter-spinous angle was statistically significantly smaller in Group A than in Group B (P = 0.004). Clinical outcomes and surgical outcomes did not differ significantly between groups. CONCLUSIONS If the C2 interspinous angle is wide and intraoperative semispinalis capitis damage can be minimized, it is worth trying C3 laminoplasty, but if the C2 inter-spinous angle is narrow, C3 laminectomy is recommended from the beginning.
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Affiliation(s)
- Hidenori Matsuoka
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan.
| | - So Ohashi
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Michihisa Narikiyo
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Ryo Nogami
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Keita Hashimoto
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Minami Wade
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Hirokazu Nagasaki
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Yoshifumi Tsuboi
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan
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Yoshie T, Ueda T, Hasegawa Y, Takeuchi M, Morimoto M, Tsuboi Y, Yamamoto R, Kaku S, Ayabe J, Akiyama T, Yamamoto D, Mori K, Kagami H, Ito H, Onodera H, Kaga Y, Ohtsubo H, Tatsuno K, Usuki N, Takaishi S, Yamano Y. Ischemic stroke patients with low DWI ASPECTS scores require puncture to recanalization within 30 min for large vessel occlusion. J Neurol Sci 2023; 454:120852. [PMID: 37924594 DOI: 10.1016/j.jns.2023.120852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/24/2023] [Accepted: 10/22/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND The clinical benefits of faster recanalization in acute large vessel occlusion are well recognized, but the optimal procedure time remains uncertain. The aim of this study was to identify patient characteristics that necessitate puncture-to-recanalization (P-R) time within 30 min to achieve favorable outcome. METHODS We evaluated the patients from a prospective, multicenter, observational registry of acute ischemic stroke patients. The study included patients who underwent endovascular therapy for ICA or MCA M1 occlusion and achieved successful recanalization. Patients were categorized into subgroups based on pre-treatment characteristics and the frequency of favorable outcomes was compared between P-R time < 30 min and ≥ 30 min. Interaction terms were incorporated into the models to assess the correlation between each patient characteristic and P-R time. RESULTS A total of 1053 patients were included in the study. Univariate analysis within each subgroup revealed a significant association between P-R < 30 min and favorable outcomes in patients with DWI ASPECTS ≤6, age > 85 and NIHSS ≥16. In the multivariable analysis, NIHSS, age, time from symptom recognition to puncture, and DWI ASPECTS were significant independent predictors of favorable outcomes. Notably, only DWI ASPECTS exhibited interaction terms with P-R < 30 min. The multivariable analysis indicated that P-R < 30 min was an independent predictor for favorable outcome in DWI ASPECTS ≤6 group, whereas not in DWI ≥7. CONCLUSIONS P-R time < 30 min is predictive of favorable outcomes; however, the effect depends on DWI ASPECTS. Target P-R time < 30 min is appropriate for patients with DWI ASPECTS ≤6.
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Affiliation(s)
- Tomohide Yoshie
- Department of Strokology and Neuroendovascular Therapy, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan.
| | - Toshihiro Ueda
- Department of Strokology and Neuroendovascular Therapy, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | - Yasuhiro Hasegawa
- Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Japan
| | | | - Masafumi Morimoto
- Department of Neurosurgery, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Japan
| | - Yoshifumi Tsuboi
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Japan
| | - Ryoo Yamamoto
- Department of Neurology, Yokohama Brain and Spine Center, Yokohama, Japan
| | - Shogo Kaku
- Department of Neurosurgery, Neurosurgical East Yokohama Hospital, Yokohama, Japan
| | - Junichi Ayabe
- Department of Neurosurgery, Yokosuka Kyosai Hospital, Yokohama, Japan
| | - Takekazu Akiyama
- Department of Neurosurgery, Akiyama Neurosurgical Hospital, Yokohama, Japan
| | - Daisuke Yamamoto
- Department of Neurosurgery, Kitasato University Hospital, Sagamihara, Japan
| | - Kentaro Mori
- Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Hiroshi Kagami
- Department of Neurosurgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan
| | - Hidemichi Ito
- Department of Neurosurgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hidetaka Onodera
- Department of Neurosurgery, St. Marianna University Yokohama Seibu Hospital, Yokohama, Japan
| | - Yasuyuki Kaga
- Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Japan; ESP corporation, Tokyo, Japan
| | - Haruki Ohtsubo
- Department of Strokology and Neuroendovascular Therapy, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | - Kentaro Tatsuno
- Department of Strokology and Neuroendovascular Therapy, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | - Noriko Usuki
- Department of Strokology and Neuroendovascular Therapy, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | - Satoshi Takaishi
- Department of Strokology and Neuroendovascular Therapy, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | - Yoshihisa Yamano
- Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Japan
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Nagasaki H, Narikiyo M, Ohashi S, Matsuoka H, Tsuboi Y. "Dual Internal Shunts Technique" for Carotid Endarterectomy with Carotid Vertebral Anastomosis: Technical Note. Neurol Med Chir (Tokyo) 2023; 63:490-494. [PMID: 37612119 PMCID: PMC10687672 DOI: 10.2176/jns-nmc.2023-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/22/2023] [Indexed: 08/25/2023] Open
Abstract
In revascularization of internal carotid stenosis with carotid vertebrobasilar anastomoses, attention should be paid not only to the anterior circulation but also to the posterior circulation cerebral infarction. A 74-year-old man was referred for treatment of carotid artery stenosis; NASCET 75% stenosis in the right internal carotid artery and acute cerebral infarction were confirmed. Occlusion of the left subclavian artery and vascular anastomosis between the right external carotid artery and the vertebral artery were indicated, such that the right external carotid artery may maintain blood flow to the vertebrobasilar artery. Therefore, dual shunts were used for the common and internal carotid arteries and the common and external carotid arteries to maintain blood flow during carotid endarterectomy. Management of the dual shunts is difficult due to the instable parallel placement of the common carotid artery shunt balloons. To solve this problem, the "dual internal shunts technique" was performed. The first shunt was inserted into the external and common carotid arteries, and the second into the internal and common carotid arteries. The shunt balloon on the common carotid artery side was placed distal to the first shunt balloon so that the dual balloons were placed in a tandem position. The proximal balloon was subsequently deflated gradually to improve flow in both shunts. The procedure is technically easy and safe.
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Affiliation(s)
| | | | - So Ohashi
- Department of Neurosurgery, Kawasaki Saiwai Hospital
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Ishikawa S, Miyake S, Akimoto T, Nakai Y, Amano Y, Yamamoto R, Amari K, Yamamoto T, Takeuchi M, Morimoto M, Tsuboi Y, Kaku S, Ayabe J, Akiyama T, Yamamoto D, Ito H, Onodera H, Hagiwara Y, Takaishi S, Hasegawa Y, Ueda T. Increased door-to-puncture time during off-duty hours results in poor treatment outcomes for acute ischemic stroke: A subanalysis of the K-NET registry. Interv Neuroradiol 2023:15910199231205050. [PMID: 37807815 DOI: 10.1177/15910199231205050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND For patients who undergo endovascular treatment for acute ischemic stroke, the total time for treatment may increase during off-duty hours leading to worse outcomes. The present study compared endovascular treatment outcomes for on-duty and off-duty hours and examined factors that could be responsible for the prolonged treatment of patients in a multicenter registry. METHODS The study group comprised 1571 patients listed in the multicenter stroke registry (K-NET) who had undergone endovascular treatment between January 2018 and June 2020. The modified Rankin Scale (mRS), evaluated at 90 days after stroke onset, was utilized as the primary outcome. Patients were divided into on-duty and off-duty patients based on admission time. Multivariate logistic regression analysis was used to identify the independent factors that increased the time from admission to puncture during the off-duty period. RESULTS The mean mRS score at 90 days after stroke onset was 2.9, similar in both on-duty and off-duty patients, with no significant difference (p = 0.77); however, significant differences were observed in time from door-to-puncture (74.7 vs. 88.8, p < 0.01). Additionally, the mRS score at 90 days worsened significantly for door-to-puncture time >60 min in the off-duty period. Multivariate logistic regression analysis revealed that a low National Institute of Health Stroke Scale (NIHSS) score, high pre-mRS score, posterior circulation, and diabetes were independent indicators of door-to-puncture time >60 min during the off-duty period. CONCLUSION Door-to-puncture time >60 min during off-duty hours was associated with poor outcomes related to low NIHSS, high pre-mRS, posterior circulation, and diabetes.
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Affiliation(s)
- Shun Ishikawa
- Department of Neurosurgery, Yokohama Brain, and Spine Center, Yokohama, Kanagawa, Japan
| | - Shigeta Miyake
- Department of Neurosurgery, Yokohama Brain, and Spine Center, Yokohama, Kanagawa, Japan
| | - Taisuke Akimoto
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yasunobu Nakai
- Department of Neurosurgery, Yokohama Brain, and Spine Center, Yokohama, Kanagawa, Japan
| | - Yu Amano
- Department of Neurology, Yokohama Brain, and Spine Center, Yokohama, Kanagawa, Japan
| | - Ryoo Yamamoto
- Department of Neurology, Yokohama Brain, and Spine Center, Yokohama, Kanagawa, Japan
| | - Kazumitsu Amari
- Department of Neurosurgery, Yokohama Brain, and Spine Center, Yokohama, Kanagawa, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masataka Takeuchi
- Department of Neurosurgery, Seisho Hospital, Odawara, Kanagawa, Japan
| | - Masafumi Morimoto
- Department of Neurosurgery, Yokohamashintoshi Neurosurgical Hospital, Yokohama, Kanagawa, Japan
| | - Yoshifumi Tsuboi
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Shogo Kaku
- Department of Neurosurgery, Neurosurgical East Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Junichi Ayabe
- Department of Neurosurgery, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan
| | - Takekazu Akiyama
- Department of Neurosurgery, Akiyama Neurosurgical Hospital, Yokohama, Kanagawa, Japan
| | - Daisuke Yamamoto
- Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Hidemichi Ito
- Department of Neurosurgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Hidetaka Onodera
- Department of Neurosurgery, St Marianna University Yokohama Seibu Hospital, Yokohama, Kanagawa, Japan
| | - Yuta Hagiwara
- Department of Neurology, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Satoshi Takaishi
- Department of Strokology and Neurointerventional Therapy, St Marianna University School of Medicine Toyoko Hospital, Kawasaki, Kanagawa, Japan
| | - Yasuhiro Hasegawa
- Department of Neurology, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Toshihiro Ueda
- Department of Strokology and Neurointerventional Therapy, St Marianna University School of Medicine Toyoko Hospital, Kawasaki, Kanagawa, Japan
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Yamamoto K, Matsuoka H, Ohashi S, Yamashiro K, Kazami K, Hirokawa Y, Narikiyo M, Nagasaki H, Tsuboi Y. Retroperitoneal hematoma: A rare complication of percutaneous pedicle screw in an osteoporotic patient. Surg Neurol Int 2023; 14:345. [PMID: 37810303 PMCID: PMC10559495 DOI: 10.25259/sni_701_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
Background Percutaneous pedicle screw (PPS) placement is an established technique for minimally invasive surgery. However, life-threatening hematomas may occur in osteoporotic patients undergoing percutaneous screw placement. Case Description An 80-year-old female with an osteoporotic T10 chance fracture developed a life-threatening hematoma following a T8-L3 posterior fusion performed with PPS. Prompt angiography diagnosed a life-threatening hematoma attributed to laceration of the left third lumbar artery occurring following pedicle screw (PS) placement into an osteoporotically fractured left L3 transverse process. This was immediately and successfully embolized. Conclusion An 80-year-old female with multiple lumbar osteoporotic fractures developed a life-threatening hematoma during a T8-L3 PS fusion. When the lumbar computed tomography angiography diagnosed a laceration of the left L3 lumbar artery, immediate transarterial embolization proved life-saving.
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Affiliation(s)
- Kohei Yamamoto
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kanagawa, Japan
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Suda S, Katano T, Kitagawa K, Iguchi Y, Fujimoto S, Ono K, Kano O, Takekawa H, Koga M, Ihara M, Morimoto M, Yamagami H, Terasaki T, Yamaguchi K, Okubo S, Ueno Y, Ohara N, Kamiya Y, Takeuchi M, Yazawa Y, Terasawa Y, Doijiri R, Tsuboi Y, Sonoda K, Nomura K, Shimoyama T, Kutsuna A, Kimura K. Detection of Atrial Fibrillation Using Insertable Cardiac Monitors in Patients With Cryptogenic Stroke in Japan (the LOOK Study): Protocol for a Prospective Multicenter Observational Study. JMIR Res Protoc 2023; 12:e39307. [PMID: 37052993 PMCID: PMC10141259 DOI: 10.2196/39307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 01/06/2023] [Accepted: 01/24/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Paroxysmal atrial fibrillation (AF) is a probable cause of cryptogenic stroke (CS), and its detection and treatment are important for the secondary prevention of stroke. Insertable cardiac monitors (ICMs) are clinically effective in screening for AF and are superior to conventional short-term cardiac monitoring. Japanese guidelines for determining clinical indications for ICMs in CS are stricter than those in Western countries. Differences between Japanese and Western guidelines may impact the detection rate and prediction of AF via ICMs in patients with CS. Available data on Japanese patients are limited to small retrospective studies. Furthermore, additional information about AF detection, including the number of episodes, cumulative episode duration, anticoagulation initiation (type and dose of regimen and time of initiation), rate of catheter ablation, role of atrial cardiomyopathy, and stroke recurrence (time of recurrence and cause of the recurrent event), was not provided in the vast majority of previously published studies. OBJECTIVE In this study, we aim to identify the proportion and timing of AF detection and risk stratification criteria in patients with CS in real-world settings in Japan. METHODS This is a multicenter, prospective, observational study that aims to use ICMs to evaluate the proportion, timing, and characteristics of AF detection in patients diagnosed with CS. We will investigate the first detection of AF within the initial 6, 12, and 24 months of follow-up after ICM implantation. Patient characteristics, laboratory data, atrial cardiomyopathy markers, serial magnetic resonance imaging findings at baseline, 6, 12, and 24 months after ICM implantation, electrocardiogram readings, transesophageal echocardiography findings, cognitive status, stroke recurrence, and functional outcomes will be compared between patients with AF and patients without AF. Furthermore, we will obtain additional information regarding the number of AF episodes, duration of cumulative AF episodes, and time of anticoagulation initiation. RESULTS Study recruitment began in February 2020, and thus far, 213 patients have provided written informed consent and are currently in the follow-up phase. The last recruited participant (May 2021) will have completed the 24-month follow-up in May 2023. The main results are expected to be submitted for publication in 2023. CONCLUSIONS The findings of this study will help identify AF markers and generate a risk scoring system with a novel and superior screening algorithm for occult AF detection while identifying candidates for ICM implantation and aiding the development of diagnostic criteria for CS in Japan. TRIAL REGISTRATION UMIN Clinical Trial Registry UMIN000039809; https://tinyurl.com/3jaewe6a. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39307.
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Affiliation(s)
- Satoshi Suda
- Department of Neurology, Nippon Medical School, Tokyo, Japan
| | - Takehiro Katano
- Department of Neurology, Nippon Medical School, Tokyo, Japan
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shigeru Fujimoto
- Division of Neurology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Osamu Kano
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
| | | | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masafumi Morimoto
- Department of Neurosurgery, Yokohamashintoshi Neurosurgical Hospital, Kanagawa, Japan
| | - Hiroshi Yamagami
- Department of Stroke Neurology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Tadashi Terasaki
- Department of Neurology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | - Keiji Yamaguchi
- Department of Neurology, Ichinomiya Nishi Hospital, Aichi, Japan
| | - Seiji Okubo
- Department of Cerebrovascular Medicine, NTT Medical Center Tokyo, Tokyo, Japan
| | - Yuji Ueno
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Nobuyuki Ohara
- Department of Neurology, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Yuki Kamiya
- Department of Neurology, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | | | - Yukako Yazawa
- Department of Stroke Neurology, Kohnan Hospital, Miyagi, Japan
| | - Yuka Terasawa
- Department of Neurology, Brain Attack Center Ota Memorial Hospital, Hiroshima, Japan
| | - Ryosuke Doijiri
- Department of Neurology, Iwate Prefectural Central Hospital, Iwate, Japan
| | - Yoshifumi Tsuboi
- Department of Neurosurgery, Kawasakisaiwai Hospital, Kanagawa, Japan
| | - Kazutaka Sonoda
- Department of Neurology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Koichi Nomura
- Department of Neurology, Shioda Hospital, Chiba, Japan
| | | | | | - Kazumi Kimura
- Department of Neurology, Nippon Medical School, Tokyo, Japan
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Yoshie T, Ueda T, Takeuchi M, Morimoto M, Tsuboi Y, Yamamoto R, Kaku S, Ayabe J, Akiyama T, Ishima D, Hasegawa Y. Abstract WMP90: Is Endovascular Thrombectomy More Effective Than IV-tPA For Distal Vessel Occlusions? Propensity Score-matched Analysis From K-net Registry. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.wmp90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background and Purpose:
The benefit of endovascular thrombectomy (EVT) for acute ischemic stroke due to primary distal vessel occlusions is unclear. We assessed whether outcome of acute ischemic stroke patients treated with EVT for primary distal vessel occlusions was better than intravenous tissue-type plasminogen activator (IV-tPA) alone.
Materials and Methods:
We investigated data from K-NET Registry, which is a prospective, multicenter, observational registry of acute ischemic stroke patients treated with EVT or IV t-PA in Kanagawa, Japan. We evaluated the patients who had primally distal vessel occlusion and were treated with EVT (with or without IV-tPA) or IV tPA alone. Distal vessel occlusion was defined as middle cerebral artery M2-M3, anterior cerebral artery or posterior cerebral artery occlusion. Propensity score-matched analysis was conducted to compare outcomes between EVT and IV-tPA alone. Primary outcome was good outcome at 90 days, defined as mRS of 0 to 2 or not worsening compared to pre-stroke mRS. Safety outcome was the occurrence of all hemorrhage and symptomatic hemorrhage.
Results:
703 patients with distal vessel occlusion (MCA M2, 436 cases, M3, 167 cases, ACA 48 cases, PCA 52 cases) were included in this study. 461 cases were treated with EVT and 242 were IV-tPA alone. Propensity-score matching paired 110 patients with EVT and 110 patients with IV-tPA. There were no significant differences in good clinical outcome (EVT 65.4%, IV-tAP 60.0%), all hemorrhage (EVT 15.4%, IV-tAP 11.8%) and symptomatic hemorrhage (EVT 4.5%, IV-tAP 1.8%). Dividing EVT group into EVT with IV-tPA and EVT alone, there were no significant differences in outcomes compared to IV-tPA alone.
Conclusions:
The benefit of EVT for acute primary distal vessel occlusions was similar as IV-tPA alone. Although IV-tPA is a first line treatment for primary distal vessel occlusions, EVT is a feasible treatment for patients who have contraindication to IV-tPA.
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Affiliation(s)
- Tomohide Yoshie
- Dept of Neuroendovascular therapy, ST. Marianna Univ Toyoko Hosp, Kawasaki, Japan
| | | | | | | | | | - Ryoo Yamamoto
- Dept of Neurology, Yokohama Brain and Spine Cntr, Yokohama, Japan
| | - Shogo Kaku
- Neurosurgical East Yokohama Hosp, Yokohama, Japan
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Ohtsubo H, Ueda T, Hasegawa Y, TAKEUCHI MASATAKA, MORIMOTO MASAFUMI, Tsuboi Y, Yamamoto R, Kaku S, Ayabe J, Akiyama T, Ishima D. Abstract WMP56: Selection Of Magnetic Resonance Imaging Or Computed Tomography Before Mechanical Thrombectomy For Acute Ischemic Stroke. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.wmp56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Introduction:
Evaluation of ischemic core and penumbra by magnetic resonance imaging (MRI) or computed tomography (CT) is useful in determining the indication for mechanical thrombectomy (MT) for acute ischemic stroke, however, it is still uncertain which imaging modality is superior. In this study, we compared the clinical outcomes after MT by imaging modality in the K-NET registry (Kanagawa intravenous and endovascular treatment of acute ischemic stroke registry).
Methods:
The K-NET registry (January 2018 to December 2021) is a Japanese multicenter prospective registry study of patients treated with Intravenous thrombolysis with recombinant tissue plasminogen activator (alteplase), endovascular treatment of cerebral infarction, or both for acute ischemic stroke. Patients who were enrolled by December 2020 and underwent MT were included in the study. We compared the favorable outcome at 90 days (modified Rankin Scale [mRS] score 0-2 or mRS shift [prestroke - day 90] = 0) between the MRI group and the CT alone group.
Results:
Of the 2348 patients enrolled in K-NET, 1763 underwent MT. Median age was 77 years (70-84) and 745 (42.2%) were female. There were 1311 patients in the MRI group and 452 in the CT group. There were no notable differences in patient characteristics. Despise the time from presentation to imaging was significantly shorter in the CT group (MRI: 14 minutes [9-21]; CT: 8 minutes [4-15]; P<0.001), there was no difference in time from presentation to recanalization. The rate of favorable outcome at 90 days was higher in the MRI group (MRI: 46.4%; CT: 40.7%; P=0.03). There was no difference in outcome between the two groups within 6 hours of onset, however, after 6 hours, the MRI group had a better outcome (MR 41.1%; CT: 28.2%; P=0.05). Compared due to SSS-TOAST classification, the MRI group had a better outcome in atherothrombotic patients (MRI group: 53.8%; CT group: 40.3%; P=0.04), while other subtypes of stroke did not show any difference.
Conclusions:
MRI imaging before MT was associated with favorable outcome. In addition, patients after 6 hours of onset and those with atherothrombotic disease had more favorable outcomes in the MRI group, suggesting that MRI may be useful as an imaging modality before thrombus retrieval in these patients.
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Affiliation(s)
| | | | | | | | | | | | | | - Shogo Kaku
- Neurosurgical East Yokohama Hosp, Yokohama, Japan
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Ueda T, TAKEUCHI MASATAKA, MORIMOTO MASAFUMI, Tsuboi Y, Yamamoto R, Kaku S, Ayabe J, Akiyama T, Ishima D, Yoshie T, Hasegawa Y. Abstract WP162: Primary Results Of Mechanical Thrombectomy For Acute Ischemic Stroke In Clinical Practice: K-net Registry. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.wp162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background:
Endovascular treatment (EVT) for acute large vessel occlusion has been found to be effective in several randomized controlled trials. We conducted a prospective cohort study to evaluate the real-world efficacy of EVT in patients with acute ischemic stroke in a metropolitan area with a high population density and a large number of comprehensive stroke centers.
Methods:
We analyzed the Kanagawa Intravenous and Endovascular Treatment of Acute Ischemic Stroke registry, a prospective, multicenter observational study of patients treated by EVT and/or intravenous tissue-type plasminogen activator (tPA), in Kanagawa, Japan. Of the 2488 patients enrolled from January 2018 to June 2020, 1764 patients treated with EVT were included. The primary outcome was a good outcome, which was defined as a modified Rankin Scale (mRS) of 0 to 2 at 90 days. Secondary analysis included predicting a good outcome using multivariate logistic regression analysis.
Results:
The median age was 77 years and the median National Institute of Health Stroke Scale (NIHSS) score was 18. Pretreatment mRS score 0-2 was 87%, and direct transport was 92%. The rate of occlusion in anterior circulation was 90.3%. Successful recanalization was observed in 88.7%. The median time from onset to recanalization was 193 minutes. Good outcomes at 90 days were 43.3% in anterior circulation and 41.9% in posterior circulation. Furthermore, 49.3% of patients with anterior circulation obstruction who had pre-stroke mRS 0-2 had good outcome, which was higher than the HERMES trial. Overall mortality was 12.6%. Significant predictors for a good outcome were: age, male, direct transfer, NIHSS score, Alberta Stroke Program Early Computed Tomography Score, intravenous tPA, and successful recanalization.
Conclusions:
EVT in routine clinical use in a metropolitan area showed comparable good outcomes and lower mortality compared to previous registries and RCTs, despite the high proportion of patients with older age, pretreatment mRS score of > 2, posterior circulation occlusion, and higher NIHSS. Those results may have been associated with more direct transport and faster onset-to-recanalization times.
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Affiliation(s)
| | | | | | | | | | - Shogo Kaku
- Neurosurgical East Yokohama Hosp,, Yoskohama, Japan
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10
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Nogami R, Tsuboi Y, Narikiyo M, Kawagoe T, Hashimoto K, Ohashi S, Matsuoka H, Nagasaki H. [Three cases of mechanical thrombectomy in patients over 100 years old]. Nihon Ronen Igakkai Zasshi 2023; 60:67-75. [PMID: 36889725 DOI: 10.3143/geriatrics.60.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND While several cases involving mechanical thrombectomy in patients >90 years old have been reported, only 1 case involving a patient >100 years old has been described. We herein report 3 cases of mechanical thrombectomy performed in patients >100 years old, along with a review of the literature.Case 1: A 102-year-old woman with a National Institute of Health Stroke Scale (NIHSS) score of 20 and diffusion weighted imaging (DWI)-Alberta Stroke Program Early Computed Tomography Score (ASPECTS) of 8 points showed M1 occlusion. She was treated with tissue plasminogen activator followed by mechanical thrombectomy. Recanalization of thrombosis in cerebral infarction (TICI)-3 was obtained at 1 pass. After 90 days, her modified Rankin Scale (mRS) was 2, and she returned to living independently.Case 2: A 104-year-old woman with a NIHSS score of 13 and DWI-ASPECTS of 9 points showed M1 occlusion, so mechanical thrombectomy was performed. Recanalization of TICI-3 was obtained. She was admitted with an mRS of 5.Case 3: A 101-year-old woman with an NIHSS score of 8 and DWI-ASPECTS of 10 points showed right internal carotid artery occlusion, so mechanical thrombectomy was performed. Direct puncture of the right common carotid artery was performed due to access difficulties. Recanalization of TICI-3 was obtained. She was admitted with an mRS of 5. CONCLUSION In all cases, occlusion access using techniques such as direct carotid puncture was possible, but two of the three patients had an mRS of 5, resulting in a poor prognosis. The indication for treatment in patients >100 years old should be carefully considered.
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Affiliation(s)
- Ryo Nogami
- Department of Neurosurgery, Kawasaki Saiwai Hospital
| | | | | | | | | | - So Ohashi
- Department of Neurosurgery, Kawasaki Saiwai Hospital
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11
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Nogami R, Matsuoka H, Ohashi S, Narikiyo M, Nagasaki H, Tsuboi Y. Spinal subarachnoid hemorrhage after percutaneous kyphoplasty: a case report and literature review. J Spine Surg 2022; 8:491-496. [PMID: 36605992 PMCID: PMC9808104 DOI: 10.21037/jss-22-60] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/18/2022] [Indexed: 11/20/2022]
Abstract
Background Spinal intradural (subdural and subarachnoid) hematoma following percutaneous kyphoplasty is an extremely rare complication. In this report, we describe a case of subarachnoid hemorrhage with delayed paralysis after kyphoplasty and review the literature on similar cases to describe the complications of kyphoplasty and vertebroplasty (VP). Case Description An 80-year-old man underwent percutaneous kyphoplasty at a local hospital an osteoporotic vertebral fracture (OVF) at the T12 and L1 level. On the second day after kyphoplasty for T12 OVF, he developed paralysis of the lower limbs. At his initial visit to our clinic, he had a complete loss of sensation below T11 and complete paralysis of both lower extremities. Thoracolumbar magnetic resonance imaging revealed an intradural hematoma on the ventral side of the spinal cord, in the spinal canal from T5 to T12, compressing the spinal cord. Thoracolumbar computed tomography showed a fracture line in the medial cortex of the right pedicle at T12 and a tract from the spinal canal to the vertebral body. An emergency posterior decompression from T11 to L1 was performed. A small hole was found on the right side of the pedicle at T12, and tear of the nerve and subarachnoid hematoma were observed in the vicinity of the T11 nerve root. The subarachnoid hematomas were removed. Postoperatively, the neurological symptoms improved rapidly. Eventually, he was able to walk and was transferred for rehabilitation. Conclusions Percutaneous surgery through the pedicle might cause hematoma and bone cement leakage into the spinal canal. This can be a serious complication: hence prevention is important.
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Affiliation(s)
- Ryo Nogami
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Japan
| | - Hidenori Matsuoka
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Japan
| | - So Ohashi
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Japan
| | | | - Hirokazu Nagasaki
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Japan
| | - Yoshifumi Tsuboi
- Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Japan
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12
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Ueda T, Hasegawa Y, Takeuchi M, Morimoto M, Tsuboi Y, Yamamoto R, Kaku S, Ayabe J, Akiyama T, Ishima D, Mori K, Kagami H, Ito H, Onodera H, Doi H, Tsumoto T, Hataoka S, Noda M, Tomura N, Masuo O, Yoshida Y, Kaga Y, Tatsuno K, Yoshie T, Takaishi S, Yamano Y. Primary results of mechanical thrombectomy for acute ischemic stroke: The K-NET registry in the Japanese metropolitan area. Int J Stroke 2022; 18:607-614. [PMID: 36305084 DOI: 10.1177/17474930221138014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Endovascular treatment (EVT) for acute large vessel occlusion has proven to be effective in randomized controlled trials. We conducted a prospective cohort study to evaluate the real-world efficacy of EVT in a metropolitan area with a large number of comprehensive stroke centers and to compare it with the results of other registries and randomized controlled trials (RCTs). METHODS We analyzed the Kanagawa Intravenous and Endovascular Treatment of Acute Ischemic Stroke registry, a prospective, multicenter observational study of patients treated by EVT and/or intravenous tissue-type plasminogen activator (tPA). Of the 2488 patients enrolled from January 2018 to June 2020, 1764 patients treated with EVT were included. The primary outcome was a good outcome, which was defined as a modified Rankin Scale (mRS) of 0-2 at 90 days. Secondary analysis included predicting a good outcome using multivariate logistic regression analysis. RESULTS The median age was 77 years, and the median National Institute of Health Stroke Scale (NIHSS) score was 18. Pretreatment mRS score 0-2 was 87%, and direct transport was 92%. The rate of occlusion in anterior circulation was 90.3%. Successful recanalization was observed in 88.7%. The median time from onset to recanalization was 193 min. Good outcomes at 90 days were 43.3% in anterior circulation and 41.9% in posterior circulation. Overall mortality was 12.6%. Significant predictors for a good outcome were as follows: age, male, direct transfer, NIHSS score, Alberta Stroke Program Early Computed Tomography Score, intravenous tPA, and successful recanalization. CONCLUSION EVT in routine clinical use in a metropolitan area showed comparable good outcomes and lower mortality compared to previous studies, despite the high proportion of patients with older age, pretreatment mRS score of >2, posterior circulation occlusion, and higher NIHSS. Those results may have been associated with more direct transport and faster onset-to-recanalization times.
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Affiliation(s)
- Toshihiro Ueda
- Department of Strokology and Neuroendovascular Therapy, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | | | | | | | | | | | - Shogo Kaku
- Neurosurgical East Yokohama Hospital, Yokohama, Japan
| | | | | | | | | | | | - Hidemichi Ito
- St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hidetaka Onodera
- St. Marianna University Yokohama Seibu Hospital, Yokohama, Japan
| | - Hiroshi Doi
- Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | - Shunsuke Hataoka
- National Hospital Organization, Yokohama Medical Center, Yokohama, Japan
| | - Masayuki Noda
- Yokohama Shinmidori General Hospital, Yokohama, Japan
| | | | - Osamu Masuo
- Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | | | - Yasuyuki Kaga
- St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kentaro Tatsuno
- Department of Strokology and Neuroendovascular Therapy, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | - Tomohide Yoshie
- Department of Strokology and Neuroendovascular Therapy, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | - Satoshi Takaishi
- Department of Strokology and Neuroendovascular Therapy, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
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Matsuoka H, Narikiyo M, Ohashi S, Nogami R, Nagasaki H, Tsuboi Y. Closure of a dural defect as a cause of superficial siderosis: does early dural repair lead to a better outcome? Illustrative case. J Neurosurg Case Lessons 2022; 4:CASE22315. [PMID: 36377127 PMCID: PMC9664243 DOI: 10.3171/case22315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Superficial hemosiderosis (SS) of the central nervous system is a rare condition that is caused by chronic, repeated hemorrhage into the subarachnoid space. The subsequent deposition of hemosiderin in the brain and spinal cord causes neurological deterioration. In this report, the authors describe a repair procedure for SS associated with a dural defect in the thoracic spine. OBSERVATIONS A 75-year-old man presented with tinnitus symptoms that began about 1 year prior. Subsequently, his hearing loss progressed, and he gradually became unsteady on walking. Magnetic resonance imaging (MRI) of the head showed diffuse hemosiderin deposition on the surface of the cerebellum. Thoracic MRI showed ventral cerebrospinal fluid leakage of T2-7, and computed tomography myelography showed leakage of contrast medium that appeared to be a dural defect. Dural closure was successful, and MRI showed decreased fluid collection ventral to the dura. The patient's symptoms of wobbliness on walking and tinnitus improved dramatically from the postoperative period. LESSONS Dural abnormalities of the spine must always be considered as one of the causes of SS. Early dural closure is an effective means of preventing the progression of symptoms.
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14
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Matsuoka H, Ohashi S, Narikiyo M, Nogami R, Nagasaki H, Tsuboi Y. Dysphagia after occipital cervical fusion for retro-odontoid pseudotumor with ossification of the anterior longitudinal ligament. Surg Neurol Int 2022; 13:184. [PMID: 35509553 PMCID: PMC9063022 DOI: 10.25259/sni_286_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 04/06/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Ossification of the anterior longitudinal ligament (OALL) of the cervical spine is a relatively rare disease. If patients present with dysphagia, hoarseness, and/or dyspnea, they may require surgery. Case Description: Over a 7-month period, a 55-year-old female with a history of cerebral palsy developed a progressive quadriparesis accompanied by diffuse sensory loss (i.e., clumsiness of the hand/legs and gait disturbance). The cervical spine X-rays showed atlanto-axial subluxation with instability, while the cervical MRI demonstrated “pseudotumor in the retro-odontoid” region. Following an occipital cervical fusion (C0-C2) surgery, her quadriparesis resolved. Nevertheless, she had persistent dysphagia that worsened over 6 months. Video fluoroscopy revealed severe mechanical stenosis of the pharynx, which was attributed to OALL extending from the C3-C6 levels. Following OALL resection through a right anterior approach utilizing diamond burrs and an ultrasonic bone curette, the dysphagia rapidly resolved. Conclusion: We report a rare case of retro-odontoid pseudotumor successfully treated with a posterior C0-C2 cervical fusion. Additional symptomatic C3-C6 OALL, responsible for progressive dysphagia, was later managed with focal anterior OALL resection.
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15
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Tsuboi Y, Narikiyo M, Ohashi S, Kawagoe T, Nogami R, Hashimoto K, Matsuoka H, Nagasaki H, Murayama Y. Repeated-Manual Aspiration with Maximum Pressure (r-MAX): A New Technique of Mechanical Thrombectomy Using Syringe Aspiration. J Neuroendovasc Ther 2022; 16:431-437. [PMID: 37502639 PMCID: PMC10370637 DOI: 10.5797/jnet.tn.2021-0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/02/2022] [Indexed: 07/29/2023]
Abstract
Objective We report a new contact aspiration technique using syringe aspiration called repeated-manual aspiration with maximum pressure (r-MAX). Case Presentation From January 2020 to May 2021, 18 patients underwent mechanical thrombectomy with r-MAX for occlusion of the internal carotid artery, the first division of the middle cerebral artery (M1), and basilar artery occlusion. In this method, the aspiration catheter is first guided to the occlusion site, and then, two VacLok syringes are connected to the aspiration catheter. Next, the three-way stopcock is released in one direction. After 15 seconds, the direction of the three-way stopcock is switched. In the meantime, negative pressure is reapplied through the syringe, and the direction of the three-way stopcock is switched again. After reapplying negative pressure through the syringe and switching the three-way stopcock two more times, the aspiration catheter is removed. First-pass thrombolysis in cerebral infarction (TICI) scale 3 recanalization was achieved in 11 out of 18 patients (61.1%). In all, 11 patients (61.1%) achieved modified Rankin Scale scores of 0-2 at 90 days. Asymptomatic hemorrhage was observed in two patients (11.1%), and no patients had symptomatic hemorrhage. Conclusion The r-MAX technique using syringe aspiration can be employed as one of the methods of contact aspiration.
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Affiliation(s)
- Yoshifumi Tsuboi
- Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Michihisa Narikiyo
- Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - So Ohashi
- Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Takashi Kawagoe
- Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Ryo Nogami
- Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Keita Hashimoto
- Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Hidenori Matsuoka
- Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Hirokazu Nagasaki
- Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Yuichi Murayama
- Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan
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16
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Tsuboi Y, Narikiyo M, Kojima A, Hashimoto K, Ohashi S, Nagasaki H, Wade M, Kambayashi C. COVID-19 Countermeasures in Acute Stroke. J Neuroendovasc Ther 2021; 15:479-483. [PMID: 37502762 PMCID: PMC10370588 DOI: 10.5797/jnet.sr.2021-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/23/2021] [Indexed: 07/29/2023]
Abstract
The impact of coronavirus disease 2019 (COVID-19) is continuing, and the most important issue facing medical staff is how to provide medical care while preventing nosocomial infections. Since acute stroke treatment, particularly mechanical thrombectomy, is urgent, infection protection measures may not always be followed, which increases the risk of infection exposure. The measures and methods for patient screening, transport, zoning, and use of personal protective equipment (PPE) employed to prevent nosocomial infections of COVID-19 at our facility are described herein.
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Affiliation(s)
- Yoshifumi Tsuboi
- Neurovascular Center, Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Michihisa Narikiyo
- Neurovascular Center, Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Alisonkenji Kojima
- Neurovascular Center, Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Keita Hashimoto
- Neurovascular Center, Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - So Ohashi
- Neurovascular Center, Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Hirokazu Nagasaki
- Neurovascular Center, Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Minami Wade
- Neurovascular Center, Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
| | - Chisaku Kambayashi
- Neurovascular Center, Department of Neurosurgery, Kawasakisaiwai Hospital, Kawasaki, Kanagawa, Japan
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17
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van Wamelen DJ, Sauerbier A, Leta V, Rodriguez-Blazquez C, Falup-Pecurariu C, Rodriguez-Violante M, Rizos A, Tsuboi Y, Metta V, Bhidayasiri R, Bhattacharya K, Borgohain R, Prashanth LK, Rosales R, Lewis S, Fung V, Behari M, Goyal V, Kishore A, Lloret SP, Martinez-Martin P, Chaudhuri KR. Cross-sectional analysis of the Parkinson's disease Non-motor International Longitudinal Study baseline non-motor characteristics, geographical distribution and impact on quality of life. Sci Rep 2021; 11:9611. [PMID: 33953218 PMCID: PMC8100281 DOI: 10.1038/s41598-021-88651-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 04/12/2021] [Indexed: 01/20/2023] Open
Abstract
Growing evidence suggests that non-motor symptoms (NMS) in Parkinson’s disease (PD) have differential progression patterns that have a different natural history from motor progression and may be geographically influenced. We conducted a cross-sectional analysis of 1607 PD patients of whom 1327 were from Europe, 208 from the Americas, and 72 from Asia. The primary objective was to assess baseline non-motor burden, defined by Non-Motor Symptoms Scale (NMSS) total scores. Other aims included identifying the factors predicting quality of life, differences in non-motor burden between drug-naïve and non-drug-naïve treated patients, and non-motor phenotypes across different geographical locations. Mean age was 65.9 ± 10.8 years, mean disease duration 6.3 ± 5.6 years, median Hoehn and Yahr stage was 2 (2–3), and 64.2% were male. In this cohort, mean NMSS scores were 46.7 ± 37.2. Differences in non-motor burden and patterns differed significantly between drug-naïve participants, those with a disease duration of less than five years, and those with a duration of five years or over (p ≤ 0.018). Significant differences were observed in geographical distribution (NMSS Europe: 46.4 ± 36.3; Americas: 55.3 ± 42.8; Asia: 26.6 ± 25.1; p < 0.001), with differences in sleep/fatigue, urinary, sexual, and miscellaneous domains (p ≤ 0.020). The best predictor of quality of life was the mood/apathy domain (β = 0.308, p < 0.001). This global study reveals that while non-motor symptoms are globally present with severe NMS burden impacting quality of life in PD, there appear to be differences depending on disease duration and geographical distribution.
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Affiliation(s)
- Daniel J van Wamelen
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. .,Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK. .,Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands. .,Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
| | - Anna Sauerbier
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Neurology, Faculty of Medicine University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Valentina Leta
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
| | - Carmen Rodriguez-Blazquez
- National Center of Epidemiology, Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Cristian Falup-Pecurariu
- Department of Neurology, Faculty of Medicine, County Emergency Clinic Hospital, Transilvania University, Braşov, Romania
| | | | - Alexandra Rizos
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
| | - Y Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Vinod Metta
- Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
| | | | - Kalyan Bhattacharya
- Formerly RG Kar Medical College and Institute of Neuroscience, Kolkata, India
| | | | - L K Prashanth
- Center for Parkinson's Disease and Movement Disorders Clinic, Vikram Hospitals, Bangalore, India.,Parkinson's Disease and Movement Disorders Clinic, Bangalore, India
| | | | - Simon Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Victor Fung
- Movement Disorders Unit, Neurology Department, Westmead Hospital, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Madhuri Behari
- Department of Neurology, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Vinay Goyal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Asha Kishore
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Santiago Perez Lloret
- Biomedical Research Center, Interamerican Open University (CAECIHS-UAI), National Research Council (CONICET), Buenos Aires, Argentina.,Department of Physiology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
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18
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Matsuoka Y, Taniguchi Y, Keisuke M, Onishi H, Tsuboi Y, Otake H, Emoto N, Hirata K. The assessment of lung function and residual hypoxemia after balloon pulmonary angioplasty for patients with chronic thromboembolic hypertension. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
It has been reported that balloon pulmonary angioplasty (BPA) could dramatically improve hemodynamics in patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, some patients have shown poor response in oxygenation and lung function even after BPA. The aim of our study was to evaluate the efficacy of BPA using clinical indicators and to investigate lung function and residual hypoxemia.
Method
Consecutive 103 patients who underwent BPA from September 2011 to August 2018 were enrolled. We evaluated hemodynamics with right heart catheterization, respiratory function test, arterial blood gas examination, and exercise capacity with 6 minute-walk-distance (6MWD).
Result
At the median 12-month follow-up after the final BPA session, following examination findings were significantly improved. Mean pulmonary artery pressure (39.0±8.2mmHg, 23.2±8.4mmHg, p<0.001), Pulmonary vascular resistance (782±378 dynes / sec / cm-5, 331±187 dynes / sec / cm-5, p<0.001), 6 MWD (310±94 m, 363±119 m, p<0.001), PaO2 (63.1±15.8 mmHg, 68.5±13.6 mmHg, p=0.044),%VC (88.5±17.1, 91±16.3, p=0.036). However, the following examination findings did not improve after BPA. Oxygen desaturation during 6MWD test (−11.9±6.3, 12±7.9, p=0.65), %DLCO (64.2 17.1, 61.3 16.8, p=0.147).
Conclusion
BPA could dramatically improve hemodynamics and exercise tolerance. However, arterial oxygenation was not normalized after BPA. Moreover, oxygen desaturation in exercise, and %DLCO were almost unchanged. These observations might suggest the remaining arteriopathy in capillary level of pulmonary artery, but further research is needed.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | | | | | | | - H Otake
- Kobe University, Kobe, Japan
| | - N Emoto
- Kobe University, Kobe, Japan
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Miwa K, Taniguchi Y, Sumimoto K, Matsuoka Y, Izawa Y, Onishi H, Tsuboi Y, Toba T, Kobayashi S, Emoto N, Hirata K. Microvasculopathy evaluated by dual-energy computed tomography in chronic thromboembolic pulmonary hypertension and pulmonary arterial hypertension. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
It has been previously reported that poor subpleural perfusion (PSP) in dual-energy computed tomography (DE-CT) might suggest the microvasculopathy in patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, it remains unclear whether pathological findings of microvasculopathy in CTEPH and pulmonary arterial hypertension (PAH) are equivalent. The aim is to evaluate the microvasculopathy in CTEPH and PAH by using clinical parameters and DE-CT.
Methods
We retrospectively reviewed PSP (defined as subpleural spaces either not or minimally perfused in all segments) of consecutive treatment-naïve 89 CTEPH patients and 20 PAH patients who underwent DECT from Feb. 2015 to Dec. 2019.
We also evaluated hemodynamic parameters and DE-CT parameters including quantitative evaluation of pulmonary blood volume (PBV) which was calculated as the average of entire lung iodine density.
Results
PSP was observed in 49.4% of patients in CTEPH group versus 5.0% in PAH group (p<0.01).
There were no significant differences in hemodynamics and lung PBV between CTEPH group and PAH group (mean pulmonary arterial pressure; 36.4±10.4mmHg vs 38.3±8.5mmHg p=0.464, pulmonary vascular resistance; 700±388dyne*sec/cm5 vs 805±440 dyne*sec/cm5 p=0.288, lung PBV; 24.9±6.4 Hounsfield Unit vs 22.0±6.6 Hounsfield Unit p=0.06, respectively), however diffusing capacity for carbon monoxide (%DLCO/VA) was significantly lower (69.5±16.8% vs 45.7±23.7% p<0.01) in PAH group.
Conclusion
PSP in DE-CT, which was observed more frequently in patients with CTEPH, might suggest the different mechanism of microvasculopathy from PAH in patients with CTEPH. Microvasculopathy in CTEPH would be diffuse very distal thrombosis. DE-CT is effective modality to detect microvasculopathy of diffuse distal thrombosis in patients with CTEPH.
DECT, Poor subpleural perfusion
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Miwa
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Taniguchi
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Sumimoto
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Matsuoka
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Izawa
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Onishi
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Tsuboi
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - T Toba
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - S Kobayashi
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - N Emoto
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Hirata
- Kobe University Graduate School of Medicine, Kobe, Japan
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Onishi H, Taniguchi Y, Miwa K, Sumimoto K, Matsuoka Y, Izawa Y, Tsuboi Y, Otake H, Kobayashi S, Emoto N, Hirata K. Efficacy of interventional treatment for patients with chronic thromboembolic pulmonary hypertension with microvasculopathy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The existence of microvasculopathy in chronic thromboembolic pulmonary hypertension (CTEPH) had been suggested. However, the impact of microvasculopathy for pathophysiology had been unknown. Recently dual-energy computed tomography (DECT) can produce a sensitive iodine distribution map in lung fields to quantify lung perfusion, which may indicate the existence of microvasculopathy according to poor subpleural perfusion.
This study aimed to examine the therapeutic efficacy of interventional treatment (pulmonary endarterectomy or/and balloon pulmonary angioplasty) in CTEPH with microvasculopathy.
Methods
We retrospectively reviewed poor subpleural perfusion (defined as subpleural spaces either not or minimally perfused in all segments) and hemodynamics of 70 consecutive CTEPH patients who underwent DECT before and after interventional therapy from January 2014 to January 2020.
Patients were divided according to poor subpleural perfusion in DECT images before treatment: a microvasculopathy group (MV group, n=37) or a non-microvasculopathy group (Non-MV group, n=33).
We evaluated clinical parameters as WHO functional class (WHO-Fc), 6-min walk distance, respiratory function test, cardiopulmonary exercise test, hemodynamic parameters, and DECT parameters at baseline and after the treatments. DECT parameters as quantitative evaluation of pulmonary blood volume (PBV) calculated as the average of entire lung iodine density.
Results
After interventional treatments, WHO-Fc improved in 33 patients in MV group, and 27 patients in Non-MV group (p=0.50).
In MV group, baseline mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance (PVR) and VE/VCO2 slope were higher (38.3±9.3 vs. 33.2±10.8 mmHg p=0.04, 818±394 vs. 539±289 dyne*sec/cm5 p<0.01 and 43.7±11.3 vs. 35.2±6.9 p<0.01, respectively) and PBV were lower (43.7±11.3 vs. 35.2±6.9 Hounsfield Unit p<0.01) After the treatments, mPAP, PVR, VE/VCO2 slope and PBV showed almost equivalent between the groups (19.5±4.1 vs. 20.6±5.1 mmHg p=0.35, 272±111 vs 251±109 dyne*sec/cm5 p=0.42, 29.2±6.3 vs. 26.0±6.1 p=0.06 and 27.1±6.6 vs. 29.6±6.6 Hounsfield Unit p=0.13).
Diffusing capacity for carbon monoxide (%DLCO/VA) did not improve after treatment in both groups (MV group: 59.5±13.1 to 58.8±11.9% p=0.43. Non-MV group: 77.8±13.4% to 70.5±10.8% P<0.01).
Conclusion
Hemodynamics, pulmonary perfusion, exercise capacities significantly improved after the treatments in spite of the existence or absence of microvasculopathy. However, DLCO which might indicate the existence of microvasculopathy did not improve. Interventional treatments could not improve microvasculopathy because of their limit of accessibilities.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Onishi
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Taniguchi
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Miwa
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Sumimoto
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Matsuoka
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Izawa
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Tsuboi
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Otake
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - S Kobayashi
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - N Emoto
- Kobe Pharmaceutical University, Department of Clinical Pharmacy, Kobe, Japan
| | - K Hirata
- Kobe University Graduate School of Medicine, Kobe, Japan
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21
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Sato A, Tanabe M, Tsuboi Y, Ito Y, Akiyama F, Takahashi S, Murakami Y, Seto Y. PIK3CA mutations and predicting the therapeutic effects of neoadjuvant chemotherapy in primary breast cancer. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30720-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Murai H, Nakamura Y, Matsushita T, Kitamoto T, Tsuboi Y, Sanjo N, Yamada M, Mizusawa H. Epidemiological study of Gerstmann-Sträussler-Scheinker disease with codon 102 mutation in Japan. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Tamaki K, Sato T, Tsugawa J, Fujioka S, Yagishita N, Araya N, Yamauchi J, Nagasaka M, Tsutsumi S, Yamano Y, Tsuboi Y. Cerebrospinal fluid CXCL10 as a surrogate marker of therapy-response and therapy-predict for HTLV-1-Associated myelopathy/tropical spastic paraparesis. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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24
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Ogawa M, Izawa KP, Satomi-Kobayashi S, Tsuboi Y, Komaki K, Gotake Y, Yoshida N, Wakida K, Uchida J, Sakai Y, Okita Y. Effects of postoperative dietary intake on functional recovery of patients undergoing cardiac surgery. Nutr Metab Cardiovasc Dis 2019; 29:90-96. [PMID: 30522928 DOI: 10.1016/j.numecd.2018.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/20/2018] [Accepted: 10/10/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIM Among elderly patients undergoing cardiac surgery, malnutrition is very common and related to muscle wasting known as sarcopenia. Cardiac surgery causes a further decline of nutritional status due to reduced dietary intake (DI); however, the impact of postoperative DI on functional recovery is unclear. METHODS AND RESULTS We enrolled 250 consecutive patients undergoing cardiac surgery. Daily DI was measured between postoperative days 3 and 7. Patients were categorized as having sufficient or insufficient DI based on whether their DI met or was less than estimated total energy requirements. Functional capacity was measured using the 6-minute walking distance (6MWD) preoperatively and at discharge. Mean postoperative DI was 22.4 ± 3.0 kcal/kg/day, and postoperative DI was insufficient in 92 patients (36.8%). The prevalence of sarcopenia was not different by postoperative DI. Although there was no significant difference in preoperative 6MWD results (P = 0.65), the sufficient DI group had longer 6MWD at discharge than the insufficient DI group (P = 0.04). In multivariate regression analysis, preoperative poor nutritional status (β = -0.29), duration of surgery (β = -0.18), and postoperative DI (β = 0.40) remained statistically significant predictors for improvement of 6MWD (P < 0.0001, adjusted R2 = 0.41). CONCLUSIONS Postoperative DI was independently associated with functional recovery, but preoperative sarcopenia was not. Regardless of preoperative nutritional status or the presence of sarcopenia, aggressive nutritional intervention in the early stage after surgery helps support functional recovery.
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Affiliation(s)
- M Ogawa
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan; Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - K P Izawa
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan.
| | - S Satomi-Kobayashi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Tsuboi
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - K Komaki
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - Y Gotake
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - N Yoshida
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Wakida
- Department of Nutrition, Kobe University Hospital, Kobe, Japan
| | - J Uchida
- Nutrition Management Department, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Y Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Okita
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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25
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Mishima T, Fujioka S, Yamaguchi Y, Hayashi Y, Onozawa R, Fukae J, Tsuboi Y. Role of anticholinergic medications in the treatment of Parkinson’s disease. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Nose K, Fujioka S, Yoshida R, Hayashi Y, Kitano K, Maruyama S, Kikuchi H, Tsuboi Y. A potential therapeutic option for postural deformities in Parkinson disease. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Komiya H, Shimizu K, Noma N, Tsuboi Y, Honda K, Kanno K, Ohara K, Shinoda M, Ogiso B, Iwata K. Role of Neuron-Glial Interaction Mediated by IL-1β in Ectopic Tooth Pain. J Dent Res 2017; 97:467-475. [PMID: 29131694 DOI: 10.1177/0022034517741253] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Although many reports have demonstrated that ectopic pain develops in the orofacial region following tooth pulp inflammation, which often causes misdiagnosis and inappropriate treatment for patients with pulpitis, the precise mechanism remains unknown. In the present study, we hypothesized that the functional interaction between satellite glial cells and neurons mediated by interleukin 1β (IL-1β) in the trigeminal ganglion (TG) is involved in ectopic orofacial pain associated with tooth pulp inflammation. The digastric muscle electromyogram (D-EMG) activity elicited by capsaicin administration into the maxillary second molar tooth pulp was analyzed to evaluate the noxious reflex and was significantly increased in rats with inflammation of the maxillary first molar (M1) versus rats injected with saline. A significant increase in the expression of connexin43 (Cx43), a gap junction containing protein, was observed in activated satellite glial cells surrounding second molar-innervating neurons in the TG after M1 pulpitis. Daily administration of Gap26, a Cx43 mimetic peptide and inhibitor, in the TG significantly suppressed the enhancement of capsaicin-induced D-EMG activity and the percentage of Fluoro-Gold (FG)-labeled cells encircled by glial fibrillary acid protein-immunoreactive (IR) + Cx43-IR cells after M1 pulp inflammation ( P < 0.01). The percentage of FG-labeled cells encircled by glial fibrillary acid protein-IR + IL-1β-IR cells, IL-1 type I receptor-IR cells labeled with FG, and TRPV1-IR cells labeled with FG significantly increased after M1 pulp inflammation ( P < 0.01). Daily administration of IL-1ra, an IL-1 receptor antagonist, into the TG significantly reduced the enhancement of capsaicin-induced D-EMG activity and the percentage of TRPV1-IR neurons labeled with FG after M1 pulp inflammation ( P < 0.01). The present findings suggest that satellite glial cell is activated in the TG via activated gap junctions composed of Cx43 following tooth pulp inflammation, which leads to the hyperactivation of remote neurons via IL-1β mechanisms and results in ectopic tooth pulp pain in the adjacent tooth.
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Affiliation(s)
- H Komiya
- 1 Department of Endodontics, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan
| | - K Shimizu
- 1 Department of Endodontics, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,2 Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - N Noma
- 3 Department of Oral Diagnostic Sciences, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,4 Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Y Tsuboi
- 5 Department of Physiology, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,6 Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - K Honda
- 5 Department of Physiology, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan
| | - K Kanno
- 1 Department of Endodontics, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan
| | - K Ohara
- 1 Department of Endodontics, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan
| | - M Shinoda
- 5 Department of Physiology, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,6 Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - B Ogiso
- 1 Department of Endodontics, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,2 Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - K Iwata
- 5 Department of Physiology, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,6 Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
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28
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Nose K, Nose K, Fujioka S, Mishima T, Higuchi M, Ouma S, Tsugawa J, Fukae J, Tsuboi Y. The prevalence of levodopa induced motor complications and the associated factors in Parkinson disease patients: Study in a Japanese single center for movement disorder. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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29
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Fukae J, Yamaiuchi A, Kataoka Y, Tsuboi Y. Uric acid protect dopamine neurons from 6-hydroxydopamine. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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30
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Ogura H, Fujioka S, Mishima T, Tsugawa J, Fukae J, Tsuboi Y, Aoki M, Nabeshima K, Tsugu H. Comparison of pathology in MS and NMO with tumefactive demyelinating lesions. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Ogata T, Watanabe J, Inoue T, Arima H, Tsuboi Y. The impact of degree of stenosis on cognitive function in patients with cerebral large artery disease. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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32
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Ouma S, Tsuboi Y, Mawatari S, Yamada T, Asada T, Wakana C, Fujino T. Effectiveness of blood plasmalogen in differentiation among mild cognitive impairment, Mild Alzheimer's disease and normal elderly. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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33
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Mishima T, Koga S, Lin W, Kasanuki K, Castanedes-Casey M, Wszolek Z, Oh S, Tsuboi Y, Dickson D. Perry syndrome is a distinctive type of TDP-43 proteinopathy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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34
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Shinsuke F, Tsuboi Y. FTLD: Genotypes and phenotypes. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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35
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Ogata T, Tsuboi Y, Kimura S. Successful early swallowing rehabilitation in a patients with Wallenberg syndrome. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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36
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Mishima T, Ishikawa T, Imamura K, Kondo T, Koshiba Y, Takahashi R, Takahashi J, Watanabe A, Fujii N, Tsuboi Y, Inoue H. Human iPSC disease modeling of Perry syndrome. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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37
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Takeshita S, Tsuboi Y, Ogata T, Fukuhara K. Clinical feature of young adults with ischemic stroke -single center analysis-. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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38
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Aoyagi R, Fujioka S, Mishima T, Tsuboi Y. Probable multiple system atrophy presenting motor fluctuation: Clinical characteristics in three cases. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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39
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Hayashi Y, Higuchi M, Morishita T, Mishima T, Inoue T, Tsuboi Y. The efficacy and safety of unilateral deep brain stimulation for patients with Parkinson’s disease. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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40
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Ogata T, Dohgu S, Inoue T, Arima H, Watanabe J, Takata F, Kataoka Y, Tsuboi Y. The influence of VEGF on cerebral microbleeds in patients with cerebral large artery disease. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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41
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Koh M, Tsuboi Y, Fukuda O. [A Case of Juvenile Cerebral Infarction due to Reversible Cerebral Vasoconstriction Syndrome]. No Shinkei Geka 2017; 44:965-969. [PMID: 27832620 DOI: 10.11477/mf.1436203409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A 19-year-old woman had a thunderclap headache, followed by left hemiparesis and left homonymous hemianopsia. Laboratory tests showed no signs of infection and immunological test results were unremarkable. MRI revealed a cerebral infarction in the right posterior cerebral artery territory, and digital subtraction angiography(DSA)showed right posterior cerebral artery stenosis on day 2. The first follow-up DSA demonstrated an irregular, bead-like appearance on day 9, but the stenotic lesion returned to normal on day 21. Reversible cerebral vasoconstriction syndrome should be suspected in cases of rapid resolution of symptoms.
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Affiliation(s)
- Masaki Koh
- Department of Neurosurgery, Saito Memorial Hospital
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42
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Nagasaki H, Narikiyo M, Nagayama G, Nagao S, Tsuboi Y, Kambayashi C. Hybrid procedure combining clip on wrapping and stent placement for ruptured supraclinoid blood blister-like aneurysm of the internal carotid artery. Clin Case Rep 2017; 5:285-289. [PMID: 28265392 PMCID: PMC5331233 DOI: 10.1002/ccr3.799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/03/2016] [Accepted: 12/07/2016] [Indexed: 11/10/2022] Open
Abstract
Blood blister-like aneurysms of the supraclinoid portion of the internal carotid artery are rare, fragile, and thin-walled lesions with a higher rate of rebleeding. Our case underwent a hybrid procedure combining direct surgical and endovascular approach.
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Affiliation(s)
- Hirokazu Nagasaki
- Department of Neurosurgery Kawasaki Saiwai Hospital 31-27, Omiya-cho, Saiwai-ku, Kawasaki Kanagawa Japan
| | - Michihisa Narikiyo
- Department of Neurosurgery Kawasaki Saiwai Hospital 31-27, Omiya-cho, Saiwai-ku, Kawasaki Kanagawa Japan
| | - Gota Nagayama
- Department of Neurosurgery Kawasaki Saiwai Hospital 31-27, Omiya-cho, Saiwai-ku, Kawasaki Kanagawa Japan
| | - Seiya Nagao
- Department of Neurosurgery Kawasaki Saiwai Hospital 31-27, Omiya-cho, Saiwai-ku, Kawasaki Kanagawa Japan
| | - Yoshifumi Tsuboi
- Department of Neurosurgery Kawasaki Saiwai Hospital 31-27, Omiya-cho, Saiwai-ku, Kawasaki Kanagawa Japan
| | - Chisaku Kambayashi
- Department of Neurosurgery Kawasaki Saiwai Hospital 31-27, Omiya-cho, Saiwai-ku, Kawasaki Kanagawa Japan
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43
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Shitara M, Tsuboi Y, Sekizuka T, Tazumi A, Moore J, Millar B, Taneike I, Matsuda M. Genetic heterogeneity of the dnaK gene locus including transcription terminator region (TTR) in Campylobacter lari. Br J Biomed Sci 2016; 65:95-101. [DOI: 10.1080/09674845.2008.11732805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- M. Shitara
- Laboratory of Molecular Biology, Graduate School of Environmental Health Sciences, Azabu University, Fuchinobe 1-17-71, Sagamihara, 229-8501, Japan
| | - Y. Tsuboi
- Laboratory of Molecular Biology, Graduate School of Environmental Health Sciences, Azabu University, Fuchinobe 1-17-71, Sagamihara, 229-8501, Japan
| | - T. Sekizuka
- Laboratory of Molecular Biology, Graduate School of Environmental Health Sciences, Azabu University, Fuchinobe 1-17-71, Sagamihara, 229-8501, Japan
| | - A. Tazumi
- Laboratory of Molecular Biology, Graduate School of Environmental Health Sciences, Azabu University, Fuchinobe 1-17-71, Sagamihara, 229-8501, Japan
| | - J.E. Moore
- Department of Bacteriology, Northern Ireland Public Health Laboratory, Belfast City Hospital, Belfast, BT9 7AD, Northern Ireland, UK
| | - B.C. Millar
- Department of Bacteriology, Northern Ireland Public Health Laboratory, Belfast City Hospital, Belfast, BT9 7AD, Northern Ireland, UK
| | - I. Taneike
- Laboratory of Molecular Biology, Graduate School of Environmental Health Sciences, Azabu University, Fuchinobe 1-17-71, Sagamihara, 229-8501, Japan
| | - M. Matsuda
- Laboratory of Molecular Biology, Graduate School of Environmental Health Sciences, Azabu University, Fuchinobe 1-17-71, Sagamihara, 229-8501, Japan
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Murai H, Nakamura Y, Kitamoto T, Tsuboi Y, Sanjo N, Yamada M, Mizusawa H, Kira J. Clinical and epidemiological survey of gerstmann-sträussler-scheinker disease with codon 102 mutation in Japan. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Imataka G, Tsuboi Y, Kano Y, Ogino K, Tsuchioka T, Ohnishi T, Kaji Y, Wake K, Ichikawa G, Suzumura H, Arisaka O. Treatment with mild brain hypothermia for cardiopulmonary resuscitation after myoclonic seizures in infant with robertsonian type of trisomy 13. Eur Rev Med Pharmacol Sci 2015; 19:2852-2855. [PMID: 26241539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Congenital chromosomal abnormality with trisomy 13 is known to be associated with poor life prognosis and lethal. Therefore, physician advice the patients be kept in intensive treatment with resuscitation and state of the art intensive care when sudden change in the general condition with this trisomy is observed. We report herein, the treatment with mild brain hypothermia therapy for cardiopulmonary resuscitation after myoclonic seizures in infant with Robertsonian type of trisomy 13 in intensive care unit. Our study indicated that brain hypothermia therapy and steroid pulse therapy on an infant who was believed to have post-resuscitation hypoxic encephalopathy was highly effective as the patient's general condition recovered to the original state after four months.
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Affiliation(s)
- G Imataka
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan.
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Okawa T, Tatewaki I, Ishizu T, Endo H, Tsuboi Y, Saitou H. Fuel behavior analysis code FEMAXI-FBR development and validation for core disruptive accident. Progress in Nuclear Energy 2015. [DOI: 10.1016/j.pnucene.2014.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tsuboi Y, Sugimoto T, Nakatsu N, Sawa R, Saito T, Nakamura R, Murata S, Asano M, Isa T, Ebina A, Kondo Y, Hirai H, Naruse F, Ono R. The association between the disability for low back pain and metabolic syndrome in care workers and nurses. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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48
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Tsuboi Y, Honda K, Bae YC, Shinoda M, Kondo M, Katagiri A, Echizenya S, Kamakura S, Lee J, Iwata K. Morphological and functional changes in regenerated primary afferent fibres following mental and inferior alveolar nerve transection. Eur J Pain 2014; 19:1258-66. [PMID: 25523341 DOI: 10.1002/ejp.650] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND It is important to know the mechanisms underlying pain abnormalities associated with inferior alveolar nerve (IAN) regeneration in order to develop the appropriate treatment for orofacial neuropathic pain patients. However, peripheral mechanisms underlying orofacial pain abnormalities following IAN regeneration are not fully understood. METHODS Head withdrawal threshold (HWT), jaw opening reflex (JOR) thresholds, single-fibre recordings of the regenerated mental nerve (MN) fibres, calcitonin gene-related peptide (CGRP), isolectin B4 (IB4), peripherin, neurofilament-200 (NF-200) and transient receptor potential vanilloid 1 (TRPV1) expression in trigeminal ganglion (TG) cells, and electron microscopic (EM) observations of the regenerated MN fibres were studied in MN- and IAN-transected (M-IANX) rats. RESULTS HWT to mechanical or heat stimulation of the mental skin was significantly lower in M-IANX rats compared with sham rats. Mean conduction velocity of action potentials recorded from MN fibres (n = 124) was significantly slower in M-IANX rats compared with sham rats. The percentage of Fluoro-Gold (FG)-labelled CGRP-, peripherin- or TRPV1-immunoreactive (IR) cells was significantly larger in M-IANX rats compared with that of sham rats, whereas that of FG-labelled IB4- and NF-200-IR cells was significantly smaller in M-IANX rats compared with sham rats. Large-sized myelinated nerve fibres were rarely observed in M-IANX rats, whereas large-sized unmyelinated nerve fibres were frequently observed and were aggregated in the bundles at the distal portion of regenerated axons. CONCLUSIONS These findings suggest that the demyelination of MN fibres following regeneration may be involved in peripheral sensitization, resulting in the orofacial neuropathic pain associated with trigeminal nerve injury.
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Affiliation(s)
- Y Tsuboi
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - K Honda
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan.,Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, Tokyo, Japan
| | - Y C Bae
- Department of Oral Anatomy, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - M Shinoda
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - M Kondo
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - A Katagiri
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - S Echizenya
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan
| | - S Kamakura
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan
| | - J Lee
- Department of Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - K Iwata
- Department of Physiology, Nihon University School of Dentistry, Tokyo, Japan.,Division of Functional Morphology, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
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Nishio R, Tanaka H, Tsuboi Y, Shigeru M, Sawa T, Kinutani H, Taniguchi Y, Sakai Y, Emoto N, Hirata K. Utility of acute improvement of peak oxygen consumption after adding bosentan for predicting hemodynamic parameters at mid-term follow-up in patients with pulmonary arterial hypertension. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Omoto M, Suzuki S, Ikeuchi T, Ishihara T, Kobayashi T, Tsuboi Y, Ogasawara J, Koga M, Kawai M, Iwaki T, Kanda T. Autosomal dominant tauopathy with parkinsonism and central hypoventilation. Neurology 2012; 78:762-4. [DOI: 10.1212/wnl.0b013e318248e531] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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