記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Magnetic resonance-guided focused ultrasound thalamotomy (FUS-T) is an emerging treatment for essential tremor (ET). OBJECTIVE: To determine the predictors of outcomes after FUS-T. METHODS: Two treatment groups were analyzed: 75 ET patients enrolled in the pivotal trial, between 2013 and 2015; and 114 patients enrolled in the postpivotal trials, between 2015 and 2016. All patients had medication-refractory, disabling ET, and underwent unilateral FUS-T. The primary outcome (hand tremor score, 32-point scale with higher scores indicating worse tremor) and the secondary outcome variables (Clinical Rating Scale for Tremor Part C score: 32-point scale with higher scores indicating more disability) were assessed at baseline and 1, 3, 6, and 12 mo. The operative outcome variables (ie, peak temperature, number of sonications) were analyzed. The results between the 2 treatment groups, pivotal and postpivotal, were compared with repeated measures analysis of variance and adjusted for confounding variables. RESULTS: A total of 179 patients completed the 12-mo evaluation. The significant predictors of tremor outcomes were patient age, disease duration, peak temperature, and number of sonications. A greater improvement in hand tremor scores was observed in the postpivotal group at all time points, including 12 mo (61.9% ± 24.9% vs 52.1% ± 24.9%, P = .009). In the postpivotal group, higher energy was used, resulting in higher peak temperatures (56.7 ± 2.5 vs 55.6 ± 2.8°C, P = .004). After adjusting for age, years of disease, number of sonications, and maximum temperature, the treatment group was a significant predictor of outcomes (F = 7.9 [1,165], P = .005). CONCLUSION: We observed an improvement in outcomes in the postpivotal group compared to the pivotal group potentially reflecting a learning curve with FUS-T. The other associations of tremor outcomes included patient age, disease duration, peak temperature, and number of sonications.

DOI： 10.1093/neuros/nyz417

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.24659/gsr.6.2_75

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Skull density ratio (SDR) assesses the transparency of the skull to ultrasound. Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy in essential tremor (ET) patients with a lower SDR may be less effective, and the risk for complications may be increased. To address these questions, the authors analyzed clinical outcomes of MRgFUS thalamotomy based on SDRs. METHODS: In 189 patients, 3 outcomes were correlated with SDRs. Efficacy was based on improvement in Clinical Rating Scale for Tremor (CRST) scores 1 year after MRgFUS. Procedural efficiency was determined by the ease of achieving a peak voxel temperature of 54°C. Safety was based on the rate of the most severe procedure-related adverse event. SDRs were categorized at thresholds of 0.45 and 0.40, selected based on published criteria. RESULTS: Of 189 patients, 53 (28%) had an SDR < 0.45 and 20 (11%) had an SDR < 0.40. There was no significant difference in improvement in CRST scores between those with an SDR ≥ 0.45 (58% ± 24%), 0.40 ≤ SDR < 0.45 (i.e., SDR ≥ 0.40 but < 0.45) (63% ± 27%), and SDR < 0.40 (49% ± 28%; p = 0.0744). Target temperature was achieved more often in those with an SDR ≥ 0.45 (p < 0.001). Rates of adverse events were lower in the groups with an SDR < 0.45 (p = 0.013), with no severe adverse events in these groups. CONCLUSIONS: MRgFUS treatment of ET can be effectively and safely performed in patients with an SDR < 0.45 and an SDR < 0.40, although the procedure is more efficient when SDR ≥ 0.45.

DOI： 10.3171/2019.2.JNS183517

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We examined whether baPWV could be affected by pork collagen peptide (CP) ingestion. Seventy subjects were randomized into two groups (2.5 g/day CP and 2.5 g/day placebo). A significant reduction in baPWV was observed in the CP group compared to the placebo group. This study demonstrated that pork CP may contribute to the prevention of atherosclerosis in elderly.

DOI： 10.1080/09168451.2018.1434406

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Magnetic resonance imaging-guided focused ultrasound thalamotomy is approved by the U.S. Food and Drug Administration for treatment of essential tremor. Although this incisionless technology creates an ablative lesion, it potentially avoids serious complications of open stereotactic surgery. OBJECTIVE: To determine the safety profile of magnetic resonance imaging-guided focused ultrasound unilateral thalamotomy for essential tremor, including frequency, and severity of adverse events, including serious adverse events. METHODS: Analysis of safety data for magnetic resonance imaging-guided focused ultrasound thalamotomy (186 patients, five studies). RESULTS: Procedure-related serious adverse events were very infrequent (1.6%), without intracerebral hemorrhages or infections. Adverse events were usually transient and were commonly rated as mild (79%) and rarely severe (1%). As previously reported, abnormalities in sensation and balance were the commonest thalamotomy-related adverse events. CONCLUSION: The overall safety profile of magnetic resonance imaging-guided focused ultrasound thalamotomy supports its role as a new option for patients with medically refractory essential tremor. © 2018 International Parkinson and Movement Disorder Society.

DOI： 10.1002/mds.27401

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Although time-of-flight (TOF)-magnetic resonance angiography (MRA) can clearly depict intracranial arteries, the arterial flow of middle cerebral artery (MCA) is occasionally not detected. We evaluated this phenomenon with reference to cerebrovascular dynamics. MATERIALS AND METHODS: Seventeen patients with suspected occlusion of MCA or internal carotid artery on TOF-MRA were enrolled. All patients underwent CT angiography (CTA) and quantitative cerebral blood flow (CBF) examination for measurement of resting CBF and cerebrovascular reactivity (CVR). Depending on appearance, patients were categorized into three groups. Group A (n=6) had MCA delineation on both MRA and CTA, while groups B (n=6) and C (n=5) had no signal on MRA, but Group B had a MCA delineation on CTA. RESULTS: No significant difference between resting CBF and CBF after the administration of acetazolamide was seen among 3 groups. In contrast, mean CVR in group B was -19.7±18.1%, which was significantly lower than group A [36.4±21.7% (p<0.05)], but not than group C (21.4±35.2%). Furthermore, all patients in group B displayed a so-called steal phenomenon. CONCLUSION: This study is the first to show that visualization of MCA on TOF-MRA closely correlates with CVR, and that a vascular pattern showing no MCA signal intensity on MRA but with MCA delineation on CTA indicates a critical cerebrovascular condition.

DOI： 10.3349/ymj.2018.59.1.80

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Life Science Publishing Co. Ltd  

Objectives Although vaccination is effective method to prevent influenza infection, current influenza vaccines have inadequate efficacy in general populations. For these reasons a supplement that prevent influenza infection is keenly anticipated. In basic research, it is demonstrated that kuromoji (Lindera umbellate Thunb.) extract has an effectiveness preventing influenza infection. The aim of this study was to assess whether kuromoji extract has a protective effect on influenza infection in clinical settings. Methods In a randomized, double-blind, placebo-controlled, parallel-group study, 135 adult volunteers, they are healthy nursing staff and are met inclusion and exclusion criteria, partici-pated in this study. Sixty-seven participants received test candy (containing 67 mg/day of kuromoji extract), and another 68 participants received placebo candy. Results Test candy significantly reduced influenza infection after 12 weeks compared with placebo candy. Conclusions This is the first clinical study to assess the effectiveness of kuromoji extract in the prevention of influenza infection. Our results suggest that kuromoji extract is a safe supplement for the prevention of influenza infection.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: It is well known that consumption of isoflavones reduces the risk of cardiovascular disease. However, the effectiveness of isoflavones in preventing dementia is controversial. A number of intervention studies have produced conflicting results. One possible reason is that the ability to produce equol, a metabolite of a soy isoflavone, differs greatly in individuals. In addition to existing data, we sought to confirm whether an apparent beneficial effect in cognitive function is observed after soy consumption in equol producers compared with non-producers. METHODS: The present study was a cross-sectional, observational study of 152 (male/female = 61/91, mean age 69.2 ± 9.2 years) individuals. Participants were divided into two groups according to equol production status, which was determined using urine samples collected after a soy challenge test. Cognitive function was assessed using two computer-based questionnaires (touch panel-type dementia assessment scale [TDAS] and mild cognitive impairment [MCI] screen). RESULTS: Overall, 60 (40%) of 152 participants were equol producers. Both TDAS and prevalence of MCI were significantly higher in the equol producer group than in the non-producer group. In univariate analyses, TDAS significantly correlated with age, serum creatinine, estimated glomerular filtration rate and low-density lipoprotein cholesterol. In multiple regression analysis using TDAS as a dependent variable, equol producer (β = 0.236, P = 0.005) was selected as an independent variable. In addition, multiple logistic regression analysis to assess the presence of MCI showed that being an equol producer was an independent risk factor for MCI (odds ratio 3.961). CONCLUSIONS: Compared with equol non-producers, equol producers showed an apparent beneficial effect in cognitive function after soy intake. Geriatr Gerontol Int 2017; 17: 2103-2108.

DOI： 10.1111/ggi.13029

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To develop a risk score that estimates 3-year and 5-year absolute risks for aneurysm growth. METHODS: From 10 cohorts of patients with unruptured intracranial aneurysms and follow-up imaging, we pooled individual data on sex, population, age, hypertension, history of subarachnoid hemorrhage, and aneurysm location, size, aspect ratio, and shape but not on smoking during follow-up and family history of intracranial aneurysms in 1,507 patients with 1,909 unruptured intracranial aneurysms and used aneurysm growth as outcome. With aneurysm-based multivariable Cox regression analysis, we determined predictors for aneurysm growth, which were presented as a risk score to calculate 3-year and 5-year risks for aneurysm growth by risk factor status. RESULTS: Aneurysm growth occurred in 257 patients (17%) and 267 aneurysms (14%) during 5,782 patient-years of follow-up. Predictors for aneurysm growth were earlier subarachnoid hemorrhage, location of the aneurysm, age >60 years, population, size of the aneurysm, and shape of the aneurysm (ELAPSS). The 3-year growth risk ranged from <5% to >42% and the 5-year growth risk from <9% to >60%, depending on the risk factor status. CONCLUSIONS: The ELAPSS score consists of 6 easily retrievable predictors and can help physicians in decision making on the need for and timing of follow-up imaging in patients with unruptured intracranial aneurysms.

DOI： 10.1212/WNL.0000000000003865

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Accumulation of advanced glycation endproducts (AGEs) is thought to be involved in the pathogenesis of dementia, especially Alzheimer's disease. Tissue AGE accumulation can be estimated using the relative simple noninvasive measurement of skin autofluorescence (SAF), a method based on the fluorescent properties of some AGEs. However, possible involvement of tissue AGE accumulation in mild cognitive impairment (MCI) has not been fully investigated. OBJECTIVE: We investigated whether tissue AGE accumulation estimated by SAF is associated with mild cognitive impairment. METHODS: We analyzed 226 community-dwelling subjects. In addition to several atherosclerosis-related clinical parameters, MCI screening test, assessment of brain atrophy, and SAF were performed on people aged > 40 years. MCI was assessed using the Japanese version of the MCI screening method. Atrophy of the brain was assessed by examining the temporal horn area (THA) by brain MRI. RESULTS: SAF was significantly higher in participants with MCI than in those with normal cognitive function (2.56±0.55 versus 2.10±0.41; p < 0.001). Logistic regression analyses with adjustment for confounding factors including age and THA showed that high SAF > 2.27 was significantly related to the presence of MCI (odds, 6.402; 95% CI, 1.590-25.773, p = 0.009). CONCLUSION: We found an association between SAF and MCI, which was independent of brain atrophy, in healthy subjects.

DOI： 10.3233/JAD-160917

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: We evaluated the utility of 3-dimensional (3-D) ultrasound imaging for assessment of carotid artery stenosis, as compared with similar assessment via magnetic resonance angiography (MRA). METHODS: Subjects comprised 58 patients with carotid stenosis who underwent both 3-D ultrasound imaging and MRA. We studied whether abnormal findings detected by ultrasound imaging could be diagnosed using MRA. Ultrasound images were generated using Voluson 730 Expert and Voluson E8. RESULTS: The degree of stenosis was mild in 17, moderate in 16, and severe in 25 patients, according to ultrasound imaging. Stenosis could not be recognized using MRA in 4 of 17 patients diagnosed with mild stenosis using ultrasound imaging. Ultrasound imaging showed ulceration in 13 patients and mobile plaque in 6 patients. When assessing these patients, MRA showed ulceration in only 2 of 13 patients and did not detect mobile plaque in any of these 6 patients. Static 3-D B mode images demonstrated distributions of plaque, ulceration, and mobile plaque, and static 3-D flow images showed flow configuration as a total structure. Real-time 3-D B mode images demonstrated plaque and vessel movement. Carotid artery stenting was not selected for patients diagnosed with ulceration or mobile plaque. CONCLUSIONS: Ultrasound imaging was necessary to detect mild stenosis, ulcerated plaque, or mobile plaque in comparison with MRA, and 3-D ultrasound imaging was useful to recognize carotid stenosis and flow pattern as a total structure by static and real-time 3-D demonstration. This information may contribute to surgical planning.

DOI： 10.1016/j.jstrokecerebrovasdis.2014.08.007

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Cerebral microbleeds (CMBs) detected on T2*-weighted MRI gradient-echo have been associated with increased risk of cerebral infarction. We evaluated risk factors for these lesions in a cohort of first-time ischemic stroke patients. METHODS: Presence of CMBs in consecutive first-time ischemic stroke patients was evaluated. The location of CMBs was classified by cerebral region as strictly lobar (lobar CMBs) and deep or infratentorial (deep CMBs). Logistic regression analysis was performed to determine the contribution of lipid profile to the presence of CMBs. RESULTS: One hundred and sixteen patients with a mean age of 70±10years were recruited. CMBs were present in 74 patients. The deep CMBs group had significantly lower HDL-C levels than those without CMBs. In univariable analysis, advanced periventricular hyperintensity grade (PVH>2) and decreased HDL-C were significantly associated with the deep but not the lobar CMB group. On logistic regression analysis, HDL-C (beta=-0.06, p=0.002) and PVH grade >2 (beta=3.40, p=0.005) were independent determinants of deep CMBs. CONCLUSIONS: Low HDL-C may be a risk factor of deep CMBs, including advanced PVH status, in elderly patients with acute ischemic stroke. Management of HDL-C levels might be a therapeutic target for the prevention of recurrence of stroke.

DOI： 10.1016/j.jns.2012.12.022

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Although rupture of unruptured intracranial aneurysms (UIAs) is closely associated with UIA growth during follow-up, few studies have investigated how UIAs grow during observation. Hypertension appears to affect the formation of intracranial aneurysms. However, few studies have investigated the association of blood pressure variability with UIA growth. Visit-to-visit variability (VVV) in systolic blood pressure (SBP) is a newly defined concept which appears to be a good predictor of stroke. With this factor in mind, here we conducted a prospective analysis of the results of 2 years of observation of UIAs by magnetic resonance angiography (MRA) and sought to identify risk factors for UIA growth and rupture. METHODS: From December 2006 through June 2010, two hundred patients with 212 UIAs were followed for 2 years. Patient ages ranged from 31 to 91 years. Putative risk factors for the growth of UIAs were evaluated. Subjects were divided into two groups: a UIA growth group consisting of patients whose UIAs increased by 1 mm or more in size or who developed subarachnoid hemorrhage (SAH), and an unchanged group. Brachial blood pressure values were recorded at the time of diagnosis and during follow-up in the outpatient clinic. All blood pressure values were then averaged, and the VVV of SBP was defined as the standard deviation (SD) of a minimum of 5 blood pressure measurements at outpatient visits. RESULTS: UIA growth occurred in 20 patients and SAH occurred in 1 patient. Current smoking tended to be more prevalent in the UIA growth group (p < 0.01). Five of the 12 patients with multiple UIAs showed UIA growth within 2 years and multiplicity was a significant risk factor for UIA growth (p < 0.01). The mean baseline size in the UIA growth group was larger than that in the unchanged group (p = 0.01) and 7 of the 18 patients with large UIAs, categorized as having an initial diameter of 7 mm or more, had an increase in UIA size over the 2 years (p < 0.01). On multivariable logistic regression analysis, current smoking, multiplicity, and UIA size ≥7 mm were significant risk factors for UIA growth. Although no significant difference was seen between the UIA growth and unchanged groups in office SBP during the observation period, VVV in SBP was significantly higher in the UIA growth group than in the unchanged group, and it was significantly and independently associated with UIA growth. CONCLUSIONS: VVV in SBP is a novel risk factor for the growth of UIAs and may be a key factor for the prevention of UIA rupture. Future research is needed to confirm that SBP stability prevents UIA rupture.

DOI： 10.1159/000356217

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Given the very poor outcome of ruptured intracranial aneurysms, detection and treatment of unruptured intracranial aneurysms by a less invasive examination have become important. For this purpose, 3-tesla (3T) magnetic resonance imaging (MRI) is the most suitable candidate, owing to its high signal/noise ratio and frequency resolution. However, few reports have investigated the prevalence of intracranial aneurysms with high-tesla MRI. Here, we evaluated the prevalence of intracranial aneurysms and the effectiveness of a 3T MRI system in their detection. METHODS: During a 1-year period, a total of 3,414 consecutive patients undergoing MR angiography with 3T MRI for the first time were enrolled. Diagnosis of intracranial aneurysm was made by two neuroradiologically trained medical doctors under complete blinding to patient information. When intracranial aneurysm was suspected, volume-rendering images were created for more accurate diagnosis. RESULTS: Surprisingly, 317 unruptured intracranial aneurysms were identified in 286 of 3,414 cases (8.4%); 151 unruptured aneurysms (47.6%) occurred in the internal carotid artery, 85 (26.8%) in the middle cerebral artery, 54 (17.0%) in the anterior cerebral artery, and 27 (8.5%) in the posterior circulation. Of these, 152/317 (47.9%) were <3 mm, 104 (32.8%) ranged from 3 to 5 mm, 5 (11.0%) from 5 to 7 mm, and 26 (8.2%) were >7 mm. No significant difference in size was seen among the four locations. CONCLUSIONS: For the first time, this study assessed the detection rate of intracranial aneurysms using 3T MRI. Results showed a higher detection rate than previously documented. The reason for this higher rate is likely the improved ability of this modality to detect unruptured aneurysms in the internal carotid artery and those <3 mm.

DOI： 10.1159/000336015

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Cerebral microbleed (CMB), which is conspicuous on gradient-echo T2-weighted magnetic resonance imaging, is a risk factor of intracerebral hemorrhage (ICH). CMBs have been detected even in neurologically healthy persons, who also seem prone to be affected by stroke, not only ICH but also cerebral infarction. METHODS AND RESULTS: The presence of CMB was investigated in brain dock participants, making reference to silent lacunar infarction (SLI). Participants comprised 377 neurologically healthy persons and 21 (5.6%) had CMB detected, which was associated with a high incidence of hypertension, other conventional risk factors having no significant correlation with CMB. In a simple correlation analysis, CMB showed a positive association with age and systolic blood pressure (SBP). Logistic regression analysis revealed that SLI was the factor most strongly associated with CMB. Moreover, individuals who had both CMB and SLI had higher SBP than other groups. CONCLUSIONS: The etiology of CMB is similar to that of SLI.

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記述言語：日本語   出版者・発行元：(一社)日本脳卒中学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

In acute stroke, the target of therapy is the severely hypoxic but salvageable tissue. Previous human studies using 18F-fluoromisonidazole and positron emission tomography (18F-FMISO PET) have shown high tracer retention indicative of tissue hypoxia, which had normalized at repeat scan >48 h later. In the only validation study of 18F-FMISO, using ex vivo autoradiography in thread middle cerebral artery occluded (MCAo) rats, there was unexpected high uptake as late as 22 h after reperfusion, raising questions about the use of 18F-FMISO as a hypoxia tracer. Here we report a pilot study of 18F-FMISO PET in experimental stroke. Spontaneous hypertensive rats were subjected to distal clip MCAo. Three-hour dynamic PET was performed in 7 rats: 3 normals, 1 with permanent MCAo (two sessions: 30 mins and 48 h after clip), and 3 with temporary MCAo (45 mins, n=1; 120 mins, n=2; scanning started 30 mins after clip removal). Experiments were terminated by perfusion-fixation for standard histopathology. Late tracer retention was assessed by both compartmental modelling and simple side-to-side ratios. In the initial PET session of the permanent MCAo rat, striking trapping of 18F-FMISO was observed in the affected cortex, which had normalized 48 h later; histopathology revealed pannecrosis. In contrast, there was no demonstrable tracer retention in either temporary MCAo models, and histopathology showed ischemic changes only. These results document elevated 18F-FMISO uptake in the stroke area only in the early phase of MCAo, but not after early reperfusion nor when tissue necrosis has developed. These findings strongly support the validity of 18F-FMISO as a marker of viable hypoxic tissue/penumbra after stroke.

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掲載種別：研究論文（学術雑誌）  

We reported the dural AVF case with sinus stenosis, that was entirely treated through the stenting procedure. 61-year-old male had been realizing the attack which causes bilateral visual problem. He would have suffered from the intracranial hypertension caused by dural AVF in the right transverse sinus and left transverse sinus stenosis. We performed TVE and sinus stenting, then used the antiplatelet and the anticoagulant. However, six months later, he suffered from SAH due to recurrence of dural AVF. We performed TVE again, denser packing than usual. Two years later, he have no symptom, angiographically, there was no recurrence of dural AVF and patency of stented sinus. We think dense r embolizations should have performed in case of dural AVF with sinus stenting.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The thalamus degenerates following cerebral infarction in the territory supplied by the middle cerebral artery (MCA), and apoptosis is suspected to be the mechanism of this phenomenon. The author studied the role of the growth arrest and DNA damage-inducible gene (GADD) 153 in this thalamic degeneration. The MCA was occluded in stroke-prone spontaneously hypertensive rats. The expression of GADD 153 and Bcl-2, and the release of cytochrome c from the mitochondria to cytosol, were examined in the thalamus until 7 days after ischemia using in situ hybridization, immunoblot, immunohistochemistry and RT-PCR analyses. Gadd153 mRNA expression and GADD153 protein increased transiently at 2, 3, 5 and 7 days, and at 3 and 5 days after ischemia. Bcl-2 mRNA expression and Bcl-2 protein decreased at 3 and 5 days. The release of cytochrome c from the mitochondria was detected at 5 days. These results suggest that increased GADD 153 suppresses Bcl-2 expression, which causes the release of cytochrome c from the mitochondria and leads to thalamic degeneration.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Dynamic MR imaging provides hemodynamic information about normal and pathologic tissue of the brain. The purpose of our study was to evaluate the usefulness of dynamic MR imaging in the assessment of tumor vascularity and the tumor tissue blood flow of meningiomas. We studied 13 patients with meningiomas using dynamic spin-echo MR imaging. The histological subtypes of meningioma were confirmed by the examination of surgical specimens in all patients, and tumors were meningothelial in 9 cases, fibrous in 2, transitional in 1, and psammomatous in 1. Serial images were obtained every 18-24 sec for 8 minutes and 30 seconds after rapid injection of gadolinium diethylenetriaminepentaacetic acid. Different parameters (time to peak, maximum of signal intensity and the washout ratio) were calculated directly from signal intensity curves. As an indicator of tumor vascularity, microvessel density was counted based on immunohistochemically stained sections and tumor tissue blood flow was measured using an xenon-CT system. The maximum of signal intensity corresponded to the tumor vascularity. With dynamic MR imaging, the time intensity curves (TI curves) were divided into two patterns; type 1 had a steep increase with a peak and type 2 had a slow increase to a peak followed by plateau. The maximum of signal intensity measured from TI curve of dynamic MR imaging correlated significantly with microvessel density (R2 = 0.840, p < 0.0001). Linear regression revealed a significant positive relation between the washout ratio and the tumor tissue blood flow in group showed type 1 on TI curve (R2 = 0.961, p < 0.001). There was also a significant negative correlation between the time to peak and the tumor tissue blood flow (R2 = 0.792, p < 0.01). We suggest that dynamic MR imaging is useful for evaluating hemodynamics of meningiomas.

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掲載種別：研究論文（学術雑誌）  

It was previously reported that prosaposin possesses neurotrophic activity that is ascribed to an 18-mer peptide comprising the hydrophilic sequence of the rat saposin C domain. To evaluate the effect of the 18-mer peptide on ischemic neuronal damage, the peptide was infused in the left lateral ventricle immediately after occlusion of the left middle cerebral artery (MCA) in stroke-prone spontaneously hypertensive (SP-SH) rats. The treatment ameliorated the ischemia-induced space navigation disability and cortical infarction and prevented secondary thalamic degeneration in a dose- dependent manner. In culture experiments, treatment with the 18-mer peptide attenuated free radical-induced neuronal injury at low concentrations (0.002 to 2 pg/mL), and the peptide at higher concentrations (0.2 to 20 ng/mL) protected neurons against hypoxic insult. Furthermore, a saposin C fragment comprising the 18-mer peptide bound to synaptosomal fractions of the cerebral cortex, and this binding decreased at the 1st day after MCA occlusion and recovered to the preischemic level at the 7th day after ischemia. These findings suggest that the 18-mer peptide ameliorates neuronal damage in vivo and in vitro through binding to the functional receptor, although the cDNA encoding prosaposin receptor has not been determined yet.

DOI： 10.1097/00004647-199903000-00008

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掲載種別：研究論文（学術雑誌）  

Erythropoietin (EPO) prevents the ischemia-induced delayed neuronal death in the hippocampal CA1 field in gerbils. EPO receptor (EPOR) is also expressed in the cerebral cortex but its function is not known. To examine whether EPO has a neuroprotective action in the cortex, EPO was infused into the cerebroventricles of stroke-prone spontaneously hypertensive rats with permanent occlusion of the left middle cerebral artery. Morris water maze test indicated that EPO infusion alleviated the ischemia-induced place navigation disability. The left (ischemic)-to-right (contralateral nonischemic) (L/R) ratio of cerebrocortical area in the EPO-infused ischemic group was larger than that in the vehicle-infused ischemic group. The occlusion caused secondary thalamic degeneration but infusion of EPO prevented the decrease in the L/R ratio of thalamic area and supported neuron survival in the ventroposterior thalamic nucleus. In situ hybridization indicated that EPOR mRNA was upregulated in the periphery (ischemic penumbra) of a cerebrocortical infarct after occlusion of the middle cerebral artery, suggesting that an increased number of EPOR in neurons facilitates the EPO signal transmission, thereby preventing the damaged area from enlarging.

DOI： 10.1006/bbrc.1998.9748

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掲載種別：研究論文（学術雑誌）  

The authors report a rare case of glioblastoma in which the patient's condition rapidly deteriorated due to a massive leptomeningeal gliomatosis without definite growth of the primary lesion. A 48-year-old man was hospitalized with complaints of occipital and nuchal pains. CT and MRI on admission showed a small tumor in the lateral wall of the right trigone partially projecting into the ventricle without any finding of leptomeningeal gliomatosis. Subsequently, his consciousness level worsened gradually with rapidly developed leptomeningeal gliomatosis which was demonstrated on enhanced MRI. He received intrathecal chemotherapy through an Ommaya catheter and by lumbar puncture, without any effects on gliomatosis. He died 7 weeks after admission. At autopsy, an intraparenchymal tumor, 5 x 10 x 15 mm in diameter, was found in the deep white matter of the right parietal lobe facing and extending into the right lateral ventricle. The ependymal layer in the region of the tumor had been destroyed. Infiltration of tumor cells was seen diffusely in the leptomeninges of the surface of the brain and spinal cord, but not in the ventricular walls. Histopathological patterns of the intraparenchymal and leptomeningeal tumors were similar and compatible with the typical features of glioblastoma. However, immunohistological study demonstrated different findings for both lesions; the leptomeningeal tumor was more poorly differentiated (GFAP(-), PCNA 94 %) than the intraparenchymal tumor (GFAP(+), PCNA 42 %). It is suggested that the biological characteristics may play a part in the development of leptomeningeal gliomatosis in addition to the anatomical characteristics.

DOI： 10.7887/jcns.7.298

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掲載種別：研究論文（学術雑誌）  

The effect of platelet factor 4 (PF4) on myoblast cultures with or without basic fibroblast growth factor (bFGF) or other growth factors was investigated in the present in vitro experiments, with reference to bFGF binding to myoblast membrane fraction. When PF4 was added to the culture medium 1 day after myoblast cultivation, the nuclei of both myoblasts and myotubes were markedly reduced in number in a dose-dependent manner, whereas the inhibitory effect of PF4 on myoblast development was not observed when PF4 was added to the culture medium 3, 7, or 14 days after myoblast cultivation. In contrast, bFGF significantly increased the numbers of myoblast and myotube nuclei. When bFGF and PF4 were simultaneously added to the culture medium, PF4 abolished the facilitatory effects of bFGF on myogenesis. The real-time biospecific interaction analysis (BIA) core system showed that the myoblast membrane fraction at 1 day after cultivation contains hFGF-binding elements which are blocked by PF4 in a dose-dependent manner. Moreover, [125I]-bFGF binding experiments indicated the existence of both high and low affinity binding sites on myoblast membranes, although the high affinity binding sites decreased in number and the dissociation constant increased in value as the culture period was prolonged. Among the six other growth factors examined, acidic fibroblast growth factor and platelet-derived growth factor-BB stimulated myogenesis, and their effects were blocked by PF4 treatment. These findings suggest that: 1) PF4 inhibits myoblast proliferation and myotube formation only for a limited initial period of cultivation, possibly because of the time-dependent down-regulation of high affinity bFGF receptors: and 2) PF4 may be used as a tool to investigate the function of endogenous heparin-binding growth factors upregulated transiently at a certain developmental stage or in case of tissue damage and repair, even though it is not monospecific to bFGF.

DOI： 10.1679/aohc.60.163

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PubMed

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掲載種別：研究論文（学術雑誌）  

Preoperative thallium-201 (201Tl) single photon emission computed tomography (SPECT) was used to evaluate the histological malignancy in 24 patients with brain tumors. A corrected L/E ratio was calculated based on the ratio of thallium uptake in the tumor on early images versus the tumor in the delayed images (L/E ratio) corrected for thallium uptake in the contralateral cerebral hemisphere. The corrected L/E ratio in benign brain tumors was 0.79 ± 0.23, significantly different to 1.32 ± 0.25 in high grade astrocytomas (p < 0.01) and 1.19 ± 0.05 in metastatic brain tumors (p < 0.01), respectively. The corrected L/E ratio in low grade astrocytomas was 0.64. ± 0.32, significantly lower than that in high grade astrocytomas (p < 0.01) and metastatic brain tumors (p < 0.05). There was one false positive result among 24 patients using a threshold of 1.0 to separate malignant and benign tumors. 201Tl SPECT using the corrected L/E ratio is effective for determining the malignant viability of tumors.

DOI： 10.2176/nmc.36.434

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掲載種別：研究論文（学術雑誌）  

Interleukin-6 (IL-6) has been shown to have potent neurotrophic activity on peripheral and central neurons in vitro. However, it remains to be determined whether or not IL-6 rescues hippocampal CA1 neurons from lethal ischemia and prevents ischemia-induced learning disability. In the present in vivo study, we infused IL-6 continuously for 7 days into the lateral ventricle of gerbil starting 2 h before 3-min forebrain ischemia. IL-6 infusion prevented the occurrence of ischemia-induced learning disability in a dose-dependent manner as revealed by a step-down passive avoidance task. Subsequent light and electron microscopic examinations showed that pyramidal neurons in the CA1 region of the hippocampus as well as synapses within the strata moleculare, radiatum and oriens of the region were significantly more numerous in gerbils infused with IL-6 than in those receiving vehicle infusion. These findings suggest that IL-6 has a trophic effect on ischemic hippocampal neurons.

DOI： 10.1016/0304-3940(96)12340-5

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

A case of dural arteriovenous malformation (AVM) in the posterior cranial fossa detected after STA-MCA anastomosis surgery. A 52-year-old male consulted a neighbourhood hospital for sudden headache and vomiting. He was diagnosed as having intraventricular hemorrhage on CT scan. Though the obstruction of the right internal carotid artery was revealed angiographically, his symptoms improved after conservative therapy. Two weeks after onset, his consciousness deteriorated and he developed left hemiparesis. Thereafter, he was transferred to our hospital. After thorough examination, right STA-MCA anastomosis surgery was performed. Approximately 2 months after surgery, right tinnitus developed and gradually exacerbated. Since it was thought to be due to increased blood flow in the right superficial temporal artery, it was kept under observation. On angiogram, 8 months after surgery, good blood flow supplied from the right superficial temporal artery to the territory of the right middle cerebral artery was shown, and a dural AVM fed by the right occipital artery was found. Fourteen months after the surgery, an enlarged dural AVM with backflow to the superficial by the enlarged right occipital artery and right ascending pharyngeal artery was revealed. Embolization therapy to the right occipital and ascending pharyngeal artery was performed using coils and ivalon, and irradiation of 30 Gy was added. After this treatment right tinnitus improved. On angiography 2 years later transverse sinus was slightly visible via the right occipital artery and ascending pharyngeal artery, but the dural AVM was significantly reduced. The origin of dural AVMs remains controversial. In our case, dural AVM was not found before the STA-MCA anastomosis surgery, and sinus thrombosis was not found throughout the course of observation. It is thought that the occult dural AVM was disclosed and enlarged by the increased blood flow through the external carotid artery via the STA-MCA anastomosis. Therefore, the dural AVM seemed to be congenital in origin.

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記述言語：日本語   出版者・発行元：愛媛医学会  

【目的】脳神経外科手術の術中画像診断法としてMRI、CT、血管撮影、超音波(US)イメージング等がある。我々は、ナビゲーションとリンクした2次元(2D)US機器に加えて4D-US機器も使用しているので、その意義について報告する。【対象および方法】手術中に4D-US機器を使用した121例を対象とした。内訳は、腫瘍性病変81例(神経膠腫:29、髄膜腫:16、神経鞘腫:14、転移性腫瘍:11、他:11)、血管性病変40例(頸動脈狭窄:17、脳動脈瘤:16、血管奇形:3、他:4)であった。4D-US装置はVoluson 730 ExpertまたはE8を用い、一部の例では2D-US装置とナビゲーションをリンクしたソノナブシステムを併用した。【結果】1)4D-US装置による2D画像は従来の2D-US装置に比べて明瞭であり、立体画像表示により、病変や血管の全体像を描出できた。またボリュームデータから、様々な方向の断面像が得られた。2)US画像単独では病変の描出が不良で判読の困難な例もあったが、ソノナブシステムでのUS像と同一断面のナビゲーションMRI・CT像との比較や両画像の重ね合わせにより、正確な読影ができた。3)術中MRIなどに比べてUS装置は簡便に随時使用できるため、術中の脳シフトや状況変化をリアルタイムに観察しながら、安全かつ確実に病変へ到達し、手術操作の完了を確認できた。4)US画像は手術終盤には様々なアーティファクトのために判読の難しい例や、頸動脈検査に用いる4Dプローベが大きいために実施の困難な例があった。【結論】4D-US機器による術中USイメージングは、リアルタイムに状況変化を明瞭かつ立体的に描出でき、安全で確実な手術遂行に有用であった。今後は、専用プローベ、ナビゲーションシステムとのリンクや、新たなUS画像解析法の開発が望まれる。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本脳循環代謝学会  

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記述言語：日本語   出版者・発行元：(一社)日本脳循環代謝学会  

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記述言語：日本語   出版者・発行元：(一社)日本脳循環代謝学会  

3T MRIを用いて、中大脳動脈(MCA)狭窄症例の血管壁描出の可否を検討した。片側MCA狭窄12例および非狭窄例10例を対象とし、両側MCA水平部を、3T MRIのT1-CUBE法で撮像した。狭窄例の最狭窄部と健常側、および非狭窄例の血管壁描出能とその厚さ、狭窄率との関係を検討した。全症例で動脈壁は高信号として描出された。血管壁の厚さは、狭窄例の病変側1.57±0.27mmに対し、健常側1.19±0.08mmであり、2群間に有意差を認めた(p<0.05)。一方、非狭窄例は、0.85±0.23mmであり、狭窄例の病変側、健常側双方と比較して、有意に低値であった(各々p<0.001、p<0.05)。また、狭窄率と血管壁厚の間には相関関係を認めた(R=0.69、p=0.019)。3T MRIにより、頭蓋内主幹動脈狭窄症例における血管壁の肥厚が観察され、内膜の動脈硬化性変化を反映していると考えられた。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J02631&link_issn=&doc_id=20140922420006&doc_link_id=10.16977%2Fcbfm.25.2_37&url=https%3A%2F%2Fdoi.org%2F10.16977%2Fcbfm.25.2_37&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：(株)医薬情報研究所  

バルプロ酸ナトリウム(バルプロ酸)投与中の脳卒中後遺症患者における血中アンモニア濃度について検討した。脳卒中発症後に、てんかん発作の予防的で6ヵ月以上バルプロ酸を内服している26例を対象とした。バルプロ酸の投与量は200〜800mg/日の通常使用量であった。バルプロ酸血中濃は平均37.9±17.0μg/mL(最高値61.1μg/mL)と基準値内であった。2例に血中アンモニア濃度の基準値上限である86μg/dLを超える高アンモニア血症を認めたが、血中アンモニア濃度は140μg/dL未満で、疲労感・傾眠・食欲不振などの症状はなかった。バルブロ酸投与量およびバルプロ酸血中濃度と血中アンモニア濃度との間には有意な相関はなかったが、血清中性脂肪および血清クレアチニン(Cr)とは有意な正の相関、血清HDL-Cとは有意な負の相関を認めた。ステップワイズ重回帰分析で、血清中性脂肪および血清Crを抽出した。

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記述言語：日本語   出版者・発行元：日本脳神経CI学会  

頸動脈狭窄性病変に対し三次元超音波イメージング(3D-US)を施行した70例を対象に、他の画像診断法の結果と比較した。狭窄率に関して、USで軽度(50%未満)とした20例では、MR angiography(MRA)施行19例中15例で狭窄病変を指摘できたが、4例は確認できなかった。一方、CTAまたはDigital subtraction angiography(DSA)を行った3例では確認できた。USで中等度(50〜69%)の20例および高度(70%以上)の30例では、MRA、CTA、DSAとも存在を確認できた。潰瘍はUSで14例に確認されたが、MRAは12例中2例のみ検出され、CTAおよびDSAは施行10例で確認できた。可動性プラークはUSでは6例に認め、MRA、CTA、DSAでは検出できなかった。なおCEA施行15例において、脆弱なプラークで組織学的にコレステリン、脂質沈着や出血を認めた10例のうち9例はUSで低輝度を主体としたプラークとして描出され、他の5例は等〜高輝度であった。

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記述言語：日本語   出版者・発行元：(一社)日本脳神経超音波学会  

頸動脈狭窄性病変のスクリーニングのために、三次元超音波(3D-US)イメージングによる超音波診断(US)を行った235例中、MRアンギオグラフィー(MRA)、CTアンギオグラフィー(CTA)、血管撮影(DSA)のいずれかの診断法を合わせて行った51例を対象に、頸動脈狭窄性病変の評価において、3Dイメージング併用のUSの果たす役割について検討した。従来の2DイメージングではBモードとカラードップラー等のフローイメージを併せて評価しながら、適切な断面を決めて描出した。3Dイメージングでは狭窄部を全体像として一画面に描出した。Bモードの静的3Dイメージングでは血管内腔を観察したような画像が得られるため、潰瘍を伴うプラークや可動性プラークを任意の方向から立体的に観察できた。また、フローイメージの3Dイメージングではフローの全体像を作成できるため、CTAやDSAの3D表示に似た画像が得られた。Bモードの動的3Dイメージングではプラークを含めた血管内腔の動きを全体像として観察できた。頸動脈狭窄性病変に対する3D-USイメージングは狭窄部の全体像を描出できるため形態学的評価を容易にした。また、2Dと3Dを併せたUSイメージングはMRAでの軽度狭窄や潰瘍の検出、DSAやCTAでの可動性プラーク検出の欠点を補えると思われた。

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記述言語：日本語   出版者・発行元：(有)デジタルメディスン  

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記述言語：日本語   出版者・発行元：日本脳神経CI学会  

中等度から高度の運動麻痺を呈する初回脳梗塞患者25例(男14例、女11例、平均年齢71.5歳)を対象として、発症1週間以内に3T MRIでの3 dimensional anisotropy contrast(3DAC)法を施行し、運動機能予後に関する検討を行った。急性期の3DAC画像上における健側上下線維の面積に対する障害側上下線維内病変の面積の割合(IFR)と、発症時および3ヵ月後の徒手筋力テストをスコア化したMMTスコアについて、ピアソンの積率相関係数を求めた。発症時における上肢および下肢MMTスコアとIFRは有意な相関を認めなかった。一方、3ヵ月後の上肢および下肢MMTスコアとIFRの相関係数はそれぞれ0.4682、0.6721であり相関関係を認めた。急性期の3DAC法により、脳梗塞患者の運動機能予後を早期に予測できる可能性が示唆された。

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記述言語：日本語   出版者・発行元：愛媛医学会  

開頭術を行った未破裂脳動脈瘤症例のうち、Glasgow Outcome Scaleがgoodであった18例(男9例・女9例・平均59.6歳)を対象に、前頭葉機能の変化を検討した。術後1〜2ヵ月の高次脳機能では、IQ、Mini-Mental State Examination、レーヴン色彩マトリックス検査のスコア平均値が術前に比較して有意に増加していたが、3例ではいずれかの検査に悪化(10%以上の低下)を認めた。前頭葉機能4検査では、Digit Span逆唱とStroop test Rの平均値のみ悪化傾向がなく、Word fluency(WF) categoryでは語彙数が平均45.6個から40.4個と有意に低下し、Trail Making test Bでも増悪傾向を示した。18例中17例はこれらいずれかのテストで悪化がみられ、WF categoryでは9例で悪化がみられた。SPECTによる脳血流測定では、前頭葉安静時脳血流が術後有意に低下し、他の部位も術後に低下傾向を認めた。WF category悪化群では、前頭葉の血流低下率が頭頂葉、側頭葉と比較して有意に大きかった。

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記述言語：日本語   出版者・発行元：愛媛医学会  

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記述言語：日本語   出版者・発行元：(一社)日本脳卒中学会  

頸動脈ステント(CAS)とcarotid endarterectomy(CEA)の周術期および長期成績を明らかにするため、急性期手術、慢性期手術に分けて検討した。対象は1998年1月〜2006年10月に頸部内頸動脈血行再建術を施行した連続103例で、CAS 52例、CEA 51例であった。1)慢性期手術の周術期成績は、CAS、CEAともに永続的神経障害2.1%、死亡0例と良好であった。2)急性期成績はともに死亡例はなかったが、永続的神経障害が25%と高率であった。3)長期成績では脳梗塞の発症は慢性期・急性期を問わず、CASでは平均追跡期間36ヵ月、CEAでは平均追跡期間51ヵ月の間認めておらず、脳梗塞の予防効果が十分期待できると思われた。4)ADLを低下させた他疾患の発症は慢性期手術ではCAS 7.9%、CEA 19%であり、急性期手術ではともに0%であった。5)CASは長期成績も良好であり、CEA 症例に比べて高齢でhigh risk症例に施行されていることを考え合わせると、比較的安全に手技が行われていると思われた。

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2008&ichushi_jid=J01786&link_issn=&doc_id=20080201110002&doc_link_id=10.3995%2Fjstroke.30.7&url=https%3A%2F%2Fdoi.org%2F10.3995%2Fjstroke.30.7&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：(一社)日本脳卒中の外科学会  

脳動脈瘤における顕微鏡手術の際、手術支援システムとして内視鏡を50件、運動野刺激による筋電図モニタリングを6件、ニューロナビゲーションを6件に用いた。内視鏡で、クリッピング前には瘤ネックと親動脈との関係、瘤周囲の穿通枝の有無、他部位の動脈瘤の有無を、クリッピング後にはクリップ先端位置、クリップによる穿通枝閉塞の有無、親動脈閉塞の有無を確認した。部位別には、内頸動脈瘤で有用であった。筋電図モニタリングは、術中に電位変化は認められず、術後の運動障害もなかった。ニューロナビゲーションは、開頭時から動脈瘤位置を予測することが可能となり、開頭後、動脈瘤への到達方法や親動脈近位部の確保を確実に行えた。脳動脈瘤手術に内視鏡、電気生理学的モニタリング、ナビゲーション等の手術支援システムを併用することにより顕微鏡手術における死角部分の画像情報、機能情報、位置情報を得ることができ、ネッククリッピングをより安全、かつ確実に行える可能性が示唆された。

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記述言語：日本語   出版者・発行元：日本脳神経CI学会  

運動麻痺を呈するラクナ梗塞患者に3D tensor tractography(DTT)を施行し、患側の健常側に対する線維束数率(RF)と上肢運動機能回復の予測因子との関係を検討した。対象は15症例で、発症から3ヵ月後のmanual muscle test scoreが11以上の回復群8例と10以下の非回復群7例に分けた。DTTにおける錐体路RFは、急性期(平均1.4日目)は回復群:70.8±21.6%、非回復群:63.6±23.4%であった。亜急性期(平均18.7日目)は回復群:100.5±28.3%、非回復群:46.8±10.3%であった。ラクナ梗塞患者の発症3ヵ月後の運動機能予後は亜急性期の錐体路RFとの間に有意な相関がみられ、亜急性期のDTTにより予測できる可能性が示唆された。

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記述言語：日本語   出版者・発行元：(株)にゅーろん社  

当施設で2000年以降に緊急ないし準緊急的CEA(頸動脈内膜剥離術)を施行された4例の術前所見、施行理由、術後経過を調査し、緊急・準緊急的CEAの手術適応と術後管理について考察した。出血性合併症をきたさない症例を慎重に選択し、術後に脳循環モニタリングを指標とした厳重な血圧管理を行えば安全に施行しうると考えられた。

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記述言語：日本語   出版者・発行元：(一社)日本脳卒中の外科学会  

2000年以降に直達手術を行った無症候性未破裂脳動脈瘤50例53件(平均57.4歳)の手術成績を検討した。clipping 48件、coating 5件を行った。その結果、手術成績はmorbidity 4.0%、mortality 0%であった。術後の神経症状は14件、MRI上の脳損傷は16件、硬膜下液貯留は10件認めた。脳損傷が大きかった症例や硬膜下液貯留がthickであった症例では、術後の神経症状やWechsler Adult Intelligence Scale-Revised(WAIS-R)の悪化を高頻度に認めた。術後の神経症状、WAIS-R、脳損傷、硬膜下液貯留のいずれかの異常を認めた21件では、認めなかった例と比べて脳血流低下は有意に多かった。無症候性未破裂脳動脈瘤に対する直達手術では、MRI上の脳損傷や硬膜下液貯留は多くが一過性であるが、神経症状や高次脳機能に影響し、脳血流障害を起すことが示唆された。

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2006&ichushi_jid=J02079&link_issn=&doc_id=20061207260009&doc_link_id=%2Fcp4strok%2F2006%2F003406%2F009%2F0434-0439%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcp4strok%2F2006%2F003406%2F009%2F0434-0439%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(株)にゅーろん社  

頸動脈内膜剥離術(CEA)と冠動脈バイパス手術(CABG)の同時手術を行った5症例の治療結果について検討した.術中および術後経過において,脳血管障害の合併症はきたさず,管理上まったく問題はなかった.頸動脈狭窄と冠動脈狭窄合併例のうち,CEAのリスクが高くない症例では,CEAを先行してのCABGとの同時手術も安全に行い得ると考えられた

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記述言語：日本語   出版者・発行元：(株)にゅーろん社  

DWIを用いて虚血性合併症の発生率から血栓内膜剥離術(CEA)とステント留置術の治療成績を比較検討した.対象は頸部内頸動脈狭窄症連続52症例で,CEA27例,ステント留置術25例であった.CEA後30日以内の死亡ないしany strokeの発生率はCEA後で3.7%であり,ステント留置術後は24%であった.術後のDWI Leisonは主幹脳動脈の末梢枝・穿通枝領域にみられ,脳塞栓症であることが明らかであった.ステント留置術後にはCEA後に比べて,小さい脳塞栓症が多発する傾向を認め,無症候性および症候性DWI Lesionともにステント留置術後に有意に高く発生した.SPECTによる虚血度分類とDWI Lesionの発生率には有意な相関は認めなかった.DWI Lesionを生じた症例は生じなかった症例に比べてstump pressureが有意に低かった.hyperperfusion syndromeの発生率は6%で,全例SPECTの黒田の分類type 3に生じ,CEAでの発生率が100%であったのに対し,ステント留置術での発生率は13%であった

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記述言語：日本語   出版者・発行元：愛媛医学会  

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記述言語：日本語   出版者・発行元：(株)医学書院  

髄膜腫13例を対象にdynamic MRIの時間強度曲線(TIC)から各種パラメーターを算出し,腫瘍の組織学的血管密度(MVD)と腫瘍血流量の関与を検討した.TICは早期にピークに達し,その後徐々に下降する型(1型)と,徐々に上昇し,ピーク後の下降が認められない型(2型)に分類された.1型のMVDは,2型よりも有意に高度で,平均腫瘍血流量も有意に多かった.TICの最大値はMVDと相関関係にあり,TICの最大値に達するまでの時間は平均血流量と負の相関を示した.1型の髄膜腫ではwashout ratioと平均腫瘍血流量が正相関した.髄膜腫の造影パターンにはMVDだけでなく腫瘍血流量も関与しており,造影パターンの解析から腫瘍の局所循環動態の把握も可能と考えられた

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2002&ichushi_jid=J01231&link_issn=&doc_id=20020730130005&doc_link_id=10.11477%2Fmf.1406901971&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1406901971&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   出版者・発行元：愛媛医学会  

31歳男.冷凍庫での作業の際,急に左上肢のしびれが出現した.CTで脳幹部出血と診断された.血管奇形等の出血性病変を認めなかったため,保存的療法を施行し,症状は軽快した.画像診断により海綿状血管腫と診断し,軽度の左上肢の知覚鈍麻を認めるのみであったため,経過観察とした.左顔面を含む左半身の知覚障害が出現し,CTで脳幹部海綿状血管腫からの再出血を認めた.保存的加療を施行したが,知覚障害が増悪し,CTで脳幹部出血の拡大を認めた.出血を繰り返す危険性が高いと考え,他院にてRadiosurgeryを施行した.施行後,顔面を含む左半身の知覚障害は徐々に軽快した.その後,約2年間の経過観察を行っているが,MRI上明らかな海綿状血管腫の縮小やintensityの変化を認めないが,再出血やRadiosurgeryによる合併症の所見もなく,元気に仕事に従事できている

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記述言語：日本語   出版者・発行元：(株)メディカ出版  

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記述言語：日本語   出版者・発行元：(株)医学書院  

閉塞性脳血管障害症例及び健常成人にtime-resolved projection MRA(trpMRA)を行った.健常成人6例では,動脈相は内頸動脈より中大脳動脈(M2 segment)まで確認でき,静脈相では主要な深部静脈,脳表静脈及び静脈洞が明瞭に描出された.一方,Willis動脈輪を介する側副血行を有する内頸動脈閉塞4例では,同側の中大脳動脈の描出が遅延した.leptomeningeal吻合を介する側副血行を有する2例では,同側の中大脳動脈は描出されず,また,他の血管からの側副血行路も描出できなかった.EC/ICバイパス術後の4例では,全例でバイパスの開存性を確認できた.trpMRAは閉塞性脳血管障害症例の血行動態の評価は可能であった

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2001&ichushi_jid=J01231&link_issn=&doc_id=20010530520008&doc_link_id=10.11477%2Fmf.1406901774&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1406901774&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

CiNii Books

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記述言語：日本語   出版者・発行元：(株)医学書院  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2000&ichushi_jid=J01231&link_issn=&doc_id=20001018110013&doc_link_id=10.11477%2Fmf.1406901672&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1406901672&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   出版者・発行元：(株)医学書院  

意識障害,左不全麻痺を主訴とした52歳男で,画像診断により右内頸動脈閉塞による側副血行路が出血源となって脳室内出血を発症し,経過中に右内頸動脈系の脳血流低下により一過性の意識障害と左片麻痺を生じたと判断し,右浅側頭動脈-中大脳動脈吻合術を行った.術後2〜3ヵ月頃から右耳鳴が出現し,外頸動脈系の拡張と共に硬膜動静脈奇形が出現した.右後頭動脈を流入動脈,横静脈洞を流出静脈としていた.術後14ヵ月には動静脈奇形は増大し,脳の表在性静脈への逆流も見られた.右後頭動脈及び右上行咽頭動脈にコイル及びアイバロンを用いる塞栓術を行い,放射線照射を行った.塞栓後約2年には動静脈奇形は明らかに縮小していた

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=1996&ichushi_jid=J01228&link_issn=&doc_id=19951227870012&doc_link_id=10.11477%2Fmf.1436901150&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1436901150&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif