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  • 1
    Online Resource
    Online Resource
    The Prevalence of Cerebral Microbleeds in HIV-Infected Hemophilia Patients
    OMICS Publishing Group ; 2017
    In:  Journal of AIDS & Clinical Research Vol. 8, No. 11 ( 2017)
    Details
    In: Journal of AIDS & Clinical Research, OMICS Publishing Group, Vol. 8, No. 11 ( 2017)
    Type of Medium: Online Resource
    ISSN: 2155-6113
    URL: Journal
    URL: Article
    DOI: 10.4172/2155-6113
    DOI: 10.4172/2155-6113.1000747
    Language: Unknown
    Publisher: OMICS Publishing Group
    Publication Date: 2017
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  • 2
    Online Resource
    Online Resource
    Prevalence of and risk factors for enlarged perivascular spaces in adult patients with moyamoya disease
    Springer Science and Business Media LLC ; 2017
    In:  BMC Neurology Vol. 17, No. 1 ( 2017-12)
    Details
    In: BMC Neurology, Springer Science and Business Media LLC, Vol. 17, No. 1 ( 2017-12)
    Type of Medium: Online Resource
    ISSN: 1471-2377
    URL: Article
    DOI: 10.1186/s12883-017-0935-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
    detail.hit.zdb_id: 2041347-6
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  • 3
    Online Resource
    Online Resource
    A validation study for wide-range remote assessment of cognitive functions in the healthy older Japanese population: a pilot randomised crossover trial
    Springer Science and Business Media LLC ; 2023
    In:  BMC Geriatrics Vol. 23, No. 1 ( 2023-09-19)
    Details
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-09-19)
    Abstract: The assessment of a wide range of cognitive functions using video teleconference (VTC) systems cannot be applied in practice yet. We aimed to determine the feasibility and reliability of previously unvalidated remote cognitive function tests in Japan using common information and communication technology (ICT) devices, software, and VTC systems compared with face-to-face (FTF) assessment. Methods The sample consisted of 26 participants from senior citizens clubs and an employment service centre in Sapporo Japan, including 11 females and 15 males (age averaged 78.6 ± 6.8 years). Tests included the RCPM, Story recall, 10/36 spatial recall, selective reminding test, SDMT, PASAT, FAB, TMT-A, TMT-B, visual cancellation task, digit span, tapping span. The experimental design was a counterbalanced crossover randomised controlled trial. Intraclass correlations (ICCs), paired-samples t-tests, Cohen’s Kappa (κ) coefficients, and Wilcoxon signed-rank test were calculated to compare the scores between VTC and FTF assessments. Results All ICCs were significant and ranged from 0.47 (RCPM time) to 0.92 (RCPM score and PASAT), with a mean ICC of 0.75. Digit span using Cohen’s Kappa (κ) coefficient was significant, but the tapping span was not. Paired samples t-test showed statistically significant differences in SDMT, RCPM time, and cancellation time. Conclusions The results suggest that remote video conference-based neuropsychological tests even using familiar devices and software may be able to assess a wide range of cognitive functions in the Japanese older population. As for the processing speed tasks, we need to create our own standards for the remote condition. For the tapping span, we should consider increasing the number of trials.
    Type of Medium: Online Resource
    ISSN: 1471-2318
    URL: Article
    DOI: 10.1186/s12877-023-04275-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2059865-8
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  • 4
    Online Resource
    Online Resource
    Incidence and Clinical Features of Disease Progression in Adult Moyamoya Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2005
    In:  Stroke Vol. 36, No. 10 ( 2005-10), p. 2148-2153
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 36, No. 10 ( 2005-10), p. 2148-2153
    Abstract: Background and Purpose— The progression of occlusive lesions in the major intracranial arteries was believed to be very rare in adult patients with moyamoya disease. The present study aims to clarify the incidence and clinical features of disease progression in adult moyamoya disease. Methods— For the past 15 years, 120 adult Japanese patients were diagnosed with moyamoya disease. Of these, 63 patients were enrolled in this historical prospective cohort study on a total of 86 nonoperated hemispheres. All were followed up with a mean period of 73.6 months. MRI and magnetic resonance angiography were repeated every 6 to 12 months, and cerebral angiography was performed when disease progression was suspected on MRI and magnetic resonance angiography. Results— Disease progression occurred in 15 of 86 nonoperated hemispheres (17.4% per hemisphere) or in 15 of 63 patients (23.8% per patient) during the follow-up period. Occlusive arterial lesions progressed in both anterior and posterior circulations, in both symptomatic and asymptomatic patients, and in both bilateral and unilateral types. Eight of 15 patients developed ischemic or hemorrhagic events in relation to disease progression. Multivariate analysis revealed that the odds ratio conferred by a male patient was 0.20 (95% CI, 0.04 to 0.97). Conclusions— The incidence of disease progression in adult moyamoya disease is much higher than recognized before, and female patients may be at higher risk for it than male patients. Careful follow-up would be essential to prevent additional stroke occurrence in medically treated adult patients with moyamoya disease, even if they are asymptomatic or are diagnosed as having unilateral moyamoya disease.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.0000182256.32489.99
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2005
    detail.hit.zdb_id: 1467823-8
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  • 5
    Online Resource
    Online Resource
    Effects of Surgical Revascularization on Outcome of Patients With Pediatric Moyamoya Disease
    Ovid Technologies (Wolters Kluwer Health) ; 1997
    In:  Stroke Vol. 28, No. 6 ( 1997-06), p. 1170-1173
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 28, No. 6 ( 1997-06), p. 1170-1173
    Abstract: Background and Purpose We reviewed surgically treated patients with pediatric moyamoya disease and examined whether vasoreconstructive surgeries reduced the risk of recurrent ischemic attacks and changed overall outcomes in terms of the patients’ performance and intellectual status. Methods Sixty-four hemispheric sides in 34 pediatric moyamoya disease patients who received surgical treatment were examined. We performed superficial temporal artery to middle cerebral artery (STA-MCA) bypass and encephalo-duro-arterio-myo-synangiosis (EDAMS) on 48 sides (combined group) and indirect bypass surgery such as EDAMS on 16 sides (indirect group). These 34 patients were observed postoperatively from 1 to 14 years (mean±SD, 6.6±3.8 years) and were examined for the incidence of recurrent ischemic attack. Of the 34 patients, 23 were followed up for 〉 5 postoperative years, and their overall outcomes in terms of their performance and intellectual status were determined. Results Perioperative ischemic events (≤2 weeks after surgery) occurred in 5 surgeries (31%) of the indirect group and in 6 (13%) of the combined group ( P =NS). The incidence of postoperative ischemic events ( 〉 2 weeks after surgery) was significantly reduced in the combined group (10%) compared with the indirect group (56%; P 〈 .01). Of the 23 patients observed 〉 5 years, 7 patients (30%) were mentally retarded and regarded as having a fair outcome. Conclusions Combined surgery (STA-MCA bypass with EDAMS) for pediatric moyamoya disease was effective in reducing the risk of postoperative ischemic attacks compared with indirect surgery. Surgical revascularization may be effective in preventing intellectual deterioration and improving overall outcome.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.28.6.1170
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1997
    detail.hit.zdb_id: 1467823-8
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  • 6
    Online Resource
    Online Resource
    Increased Expression of Hepatocyte Growth Factor in Cerebrospinal Fluid and Intracranial Artery in Moyamoya Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2004
    In:  Stroke Vol. 35, No. 12 ( 2004-12), p. 2837-2842
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 35, No. 12 ( 2004-12), p. 2837-2842
    Abstract: Background and Purpose— The etiology of moyamoya disease still remains unknown. This study was aimed to explore the role of hepatocyte growth factor (HGF), a strong inducer of angiogenesis, in development of moyamoya disease. Methods— We studied cerebrospinal fluid (CSF) from 39 patients with moyamoya disease (24 children and 15 adults), 6 control patients with cervical spondylosis, and 7 control patients with internal carotid artery occlusion. CSF level of HGF was determined by enzyme-linked immunosorbent assay technique. We also evaluated the distribution of HGF and its cellular receptor c-Met in the carotid fork obtained from 2 patients with moyamoya disease and 2 control patients. Results— CSF level of HGF was 408.2±201.6 pg/mL and 443.2±193.5 pg/mL in patients with cervical spondylosis and internal carotid artery occlusion, respectively (mean±SD). On the other hand, CSF level of HGF was 820.3±319.0 pg/mL in patients with moyamoya disease, being significantly higher than those in 2 control groups ( P 〈 0.01). Both HGF and c-Met were widely distributed in the media and thickened intima of the carotid fork in patients with moyamoya disease but not in control patients. Conclusions— This study revealed that HGF is densely found in the carotid fork, and its CSF level is markedly elevated in moyamoya disease, suggesting that HGF may be a key protein for pathogenesis of moyamoya disease.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.0000148237.13659.e6
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2004
    detail.hit.zdb_id: 1467823-8
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  • 7
    Online Resource
    Online Resource
    Abstract 2941: Wide Variability of Cerebral Blood Volume Response in the Area with Impaired Cerebrovascular Reactivity to Acetazolamide due to Occlusive Carotid Artery Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Stroke Vol. 43, No. suppl_1 ( 2012-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. suppl_1 ( 2012-02)
    Abstract: Background and Purpose - Recent studies have suggested that hemodynamic and metabolic responses to reduced cerebral perfusion pressure (CPP) are not so simple in patients with occlusive carotid artery disease. Autoregulatory vasodilation reaches maximal and cerebral blood flow (CBF) starts to fall, when CPP critically falls beyond autoregulatory capacity. Theoretically, cerebral blood volume (CBV) is expressed as maximally elevated in the conditions that cerebrovascular reactivity (CVR) to acetazolamide (ACZ) is impaired. However, there are almost no studies that denote whether CBV is maximally elevated in the area with reduced CBF and CVR to ACZ (Kuroda’s Type 3 ischemia). Therefore, this study was aimed to investigate the CBV response to ACZ in the area with reduced CBF and CVR due to occlusive carotid artery disease. Methods- This study included totally 24 hemispheres of 20 patients with reduced CBF and CVR on 15 O-gas PET due to occlusive carotid artery disease. There were 8 men and 12 women with a mean age of 57.9 years ranging from 33 to 72 years. All of them were admitted to our hospital between 2004 and 2010. In all 20 patients, CBF, CBV, cerebral metabolic rate for oxygen (CMRO 2 ) and oxygen extraction fraction (OEF) were quantitatively measured, using 15 O-gas PET. Subsequently, ACZ was intravenously injected to determine the reactivity of CBF and CBV. Results- Both CBF and CVR were reduced in all 24 hemispheres (Type 3). Of these, OEF was elevated in 7 hemispheres (29%). Compared with normal control (3.4 ± 0.5 mL/100g), baseline CBV were significantly elevated both in elevated OEF group (5.2 ± 1.2 mL/100g) and normal OEF group (4.5 ± 0.9 mL/100g). Intravenous administration of ACZ further increased CBV in 4 of 7 hemispheres with elevated OEF and in all 17 hemispheres with normal OEF. %CBV reactivity was 9.5 ± 12% in elevated OEF group, being significantly lower than 22 ± 13% in normal OEF group (P = 0.04, un-paired t). CBV did not increase in patients with steal phenomenon after ACZ injection in elevated OEF group, but increased in normal OEF group. Conclusion- These findings strongly suggest that baseline CBV increases, but does not reach maximal in the area with reduced CBF and CVR due to occlusive carotid artery disease, indicating that CBF response to ACZ may imply more complicated mechanisms in the severe ischemic brain.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.43.suppl_1.A2941
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
    detail.hit.zdb_id: 1467823-8
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  • 8
    Online Resource
    Online Resource
    Dual Antiplatelet Therapy With Cilostazol for Secondary Prevention in Lacunar Stroke: Subanalysis of the CSPS.com Trial
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Stroke Vol. 54, No. 3 ( 2023-03), p. 697-705
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 54, No. 3 ( 2023-03), p. 697-705
    Abstract: The effectiveness of long-term dual antiplatelet therapy (DAPT) to prevent recurrent strokes in patients with lacunar stroke remains unclarified. Therefore, this study aimed to compare and to elucidate the safety and effectiveness of DAPT and single antiplatelet therapy (SAPT) in preventing recurrence in chronic lacunar stroke. Methods: CSPS.com (Cilostazol Stroke Prevention Study for Antiplatelet Combination) was a prospective, multicenter, randomized controlled trial. In this prespecified subanalysis, 925 patients (mean age, 69.5 years; 69.4% men) with lacunar stroke were selected from 1884 patients with high-risk noncardioembolic stroke, enrolled in the CSPS.com trial after 8 to 180 days following stroke. Patients were randomly assigned to receive either SAPT or DAPT using cilostazol and were followed for 0.5 to 3.5 years. The primary efficacy outcome was the first recurrence of ischemic stroke. The safety outcomes were severe or life-threatening bleeding. Results: The DAPT group receiving cilostazol and either aspirin or clopidogrel and SAPT group receiving aspirin or clopidogrel alone comprised 464 (50.2%) and 461 (49.8%) patients, respectively. Ischemic stroke occurred in 12 of 464 patients (1.84 per 100 patient-years) in the DAPT group and 31 of 461 patients (4.42 per 100 patient-years) in the SAPT group, during follow-up. After adjusting for multiple potential confounding factors, ischemic stroke risk was significantly lower in the DAPT group than in the SAPT group (hazard ratio, 0.43 [95% CI, 0.22–0.84]). The rate of severe or life-threatening hemorrhage did not differ significantly between the groups (2 patients [0.31 per 100 patient-years] versus 6 patients [0.86 per 100 patient-years] in the DAPT and SAPT groups, respectively; hazard ratio, 0.36 [95% CI, 0.07–1.81] ). Conclusions: In patients with lacunar stroke, DAPT using cilostazol had significant benefits in reducing recurrent ischemic stroke incidence compared with SAPT without increasing the risk of severe or life-threatening bleeding. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01995370. URL: https://www.umin.ac.jp/ctr ; Unique identifier: UMIN000012180.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.122.039900
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1467823-8
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  • 9
    Online Resource
    Online Resource
    Effects of Surgical Revascularization on Cerebral Oxygen Metabolism in Patients With Moyamoya Disease : An 15 O-Gas Positron Emission Tomographic Study
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Stroke Vol. 45, No. 9 ( 2014-09), p. 2717-2721
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. 9 ( 2014-09), p. 2717-2721
    Abstract: This prospective study was aimed to evaluate the effects of surgical revascularization on cerebral oxygen metabolism in moyamoya disease. Methods— This study included totally 69 hemispheres of 42 patients who underwent superficial temporal artery to middle cerebral artery anastomosis and indirect bypass for moyamoya disease between 2000 and 2011. There were 12 children and 30 adults. MRI and 15 O-gas positron emission tomography were performed before and 3 to 4 months after surgery. Hemodynamic and metabolic parameters were precisely quantified and statistically analyzed. Results— Preoperative positron emission tomographic scans revealed that cerebral blood flow was decreased, cerebral blood volume was increased, and cerebral metabolic rate for oxygen was decreased in both pediatric and adult patients. Cerebral metabolic rate for oxygen reduction was observed in ≈80% of pediatric (16/21; 76%) and adult hemispheres (38/48; 79%). Surgical revascularization resolved hemodynamic compromise in all operated hemispheres. Cerebral metabolic rate for oxygen significantly improved in pediatric patients without parenchymal lesions (n=8), but not those with parenchymal lesions (n=8). Multivariate analysis revealed that cerebral metabolic rate for oxygen significantly improved in younger adult patients without parenchymal lesions ( P =0.0264; odds ratio, 0.88; 95% confidence interval, 0.79–0.99). Conclusions— Cerebral oxygen metabolism is significantly depressed in ≈80% of the involved hemispheres of moyamoya disease and improves in pediatric and younger adult patients without parenchymal lesions after bypass surgery. Cerebral oxygen metabolism may be reversibly depressed in response to cerebral ischemia in them although the underlying mechanisms are still unclear.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.114.006009
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1467823-8
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  • 10
    Online Resource
    Online Resource
    Incidence, Locations, and Longitudinal Course of Silent Microbleeds in Moyamoya Disease : A Prospective T2*-Weighted MRI Study
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Stroke Vol. 44, No. 2 ( 2013-02), p. 516-518
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. 2 ( 2013-02), p. 516-518
    Abstract: Clinical significance of silent microbleeds is unknown in moyamoya disease. This study was aimed to clarify the incidence, locations, and longitudinal course. Methods— This prospective cohort study included 78 nontreated patients with moyamoya disease. The incidence and locations of silent microbleeds were evaluated on T2*-weighted MRI. MR examinations were repeated every 6 or 12 months during a mean follow-up period of 43.1 months. Results— T2*-weighted MRI identified silent microbleeds in 17 (29.3%) of 58 adult patients with moyamoya disease, but in none of 20 pediatric patients. During follow-up periods, de novo silent microbleeds developed in 4 (6.9%) of 58 adult patients. Hemorrhagic stroke occurred in 4 patients (6.9%), all of who had silent microbleeds on initial examination. The presence of silent microbleeds was a significant predictor for subsequent hemorrhagic stroke in adult moyamoya disease ( P 〈 0.001). Conclusions— Careful and long-term follow-up of silent microbleeds would be essential to improve their outcome in adult patients with moyamoya disease.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.112.678805
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
    detail.hit.zdb_id: 1467823-8
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