المؤلفون: Shibata, Soichiro, Sakurai, Kenzo, Tachikawa, Keiji, Ko, Riyoko, Hino, Sakae, Fukano, Takayuki, Isahaya, Kenji, Haraguchi, Takafumi, Yamauchi, Junji, Tanabe, Kenichiro, Nagasaka, Misako, Hagiwara, Yuta, Shimizu, Takahiro, Akiyama, Hisanao, Kobayashi, Yasuyuki, Hasegawa, Yasuhiro, Yamano, Yoshihisa

المصدر: Neurology International. 14(4)

مصطلحات موضوعية: ASPECTS, acute cerebral infarction, artificial intelligence, recombinant tissue plasminogen activator therapy

الوصف: PURPOSE: This study aimed to investigate the accuracy and clinical significance of an artificial intelligence (AI)-based automated Alberta Stroke Program Early Computed Tomography (ASPECT) scoring software of head CT for the indication of intravenous recombinant tissue plasminogen activator (rt-PA) therapy. METHODS: This study included two populations of acute ischemic stroke: one comprised patients who had undergone head CT within 48 h of presentation (Population #1, n = 448), while the other included patients within 4.5 h from onset (Population #2, n = 132). The primary endpoint was the concordance rate of ASPECTS of the neurologists and AI software against the benchmark score. The secondary endpoints were to validate the accuracy of the neurologist and AI software in assessing the ability to rule out extensive infarction (ASPECTS of 0-5) in population #2. RESULTS: The reading accuracy of AI software was comparable to that of the board-certified vascular neurologists. The detection rate of cardiogenic cerebral embolism was better than that of atherothrombotic cerebral infarction. By excluding extensive infarction, AI-software showed a higher specificity and equivalent sensitivity compared to those of experts. CONCLUSIONS: The AI software for ASPECTS showed convincing agreement with expert evaluation and would be supportive in determining the indications of intravenous rt-PA therapy.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/56h8j9nhTest

المؤلفون: Kimura, Miyuna, Yamauchi, Junji, Sato, Tomoo, Yagishita, Naoko, Araya, Natsumi, Aratani, Satoko, Tanabe, Kenichiro, Horibe, Erika, Watanabe, Toshiki, Coler-Reilly, Ariella, Nagasaka, Misako, Akasu, Yukari, Kaburagi, Kei, Kikuchi, Takayuki, Shibata, Soichiro, Matsumoto, Hirofumi, Koseki, Akihito, Inoue, Soichiro, Takata, Ayako, Yamano, Yoshihisa

مصطلحات موضوعية: HTLV-1, HTLV-1-associated myelopathy, SF-36, SF-6D, quality of life

الوصف: BACKGROUND: Human T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy (HAM) is a neuroinflammatory disease, causing various neurological symptoms, including motor, sensory, and bladder and bowel dysfunctions. This study was designed to reveal the impact of HAM and related symptoms on health-related quality of life (HRQoL). METHODS: We analyzed the Short Form-36 (SF-36) and clinical data of 538 patients with HAM registered in the HAM-net, a nationwide patient registry for HAM in Japan. HRQoL was evaluated using the SF-6D (a health state utility value calculated from the SF-36) and eight SF-36 subscales. A general liner model was used to estimate the impact of major HAM-related symptoms, including gait dysfunction, sensory disturbance in the legs (pain and numbness), urinary dysfunction, and constipation, on the SF-6D and SF-36 subscale scores. RESULTS: The mean age and disease duration were 62.0 and 16.5 years, respectively. Of the patients, 73.2% needed walking aid; 42.7 and 67.1% had leg pain and numbness, respectively; 92.1% had urinary dysfunction; and 77.9% had constipation. The mean SF-6D score was 0.565, which was significantly lower than the national average (0.674 in the 60-69 years age group; p < 0.001), exceeding the minimal important difference (0.05-0.1). All the major symptoms were significantly associated with a decrease in the SF-6D score. The SF-36 subscale scores were significantly lower than the national standard of 50 (p ≤ 0.001), except for mental health (MH). Gait dysfunction was associated with lower scores in physical functioning (PF), limitations on role functioning because of physical health, bodily pain, general health perception (GH), vitality (VT), and social functioning; however, no association was observed between gait dysfunction and limitations on role functioning because of emotional problems and MH. Meanwhile, sensory disturbance in the legs was associated with a decrease in scores in all subscales. Urinary dysfunction was associated with worse PF, GH, VT, and MH. Constipation was associated only with PF. CONCLUSION: HRQoL of patients with HAM was worse than that of the general population and was associated with all major symptoms. Thus, patients should be comprehensively managed to achieve better HRQoL.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/0pk544dpTest

المؤلفون: Umemura, Takeji, Joshita, Satoru, Shibata, Soichiro, Sugiura, Ayumi, Yamazaki, Tomoo, Fujimori, Naoyuki, Matsumoto, Akihiro, Tanaka, Eiji

المصدر: Medicine ; volume 98, issue 6, page e14475 ; ISSN 0025-7974 1536-5964

الوصف: Although renal impairment is a frequent complication in cirrhosis that is associated with a poor prognosis, little has been reported on the clinical significance of renal impairment in cirrhosis in Japan. This retrospective study assessed the impact of renal impairment on mortality in Japanese cirrhosis patients taking conventional diuretics. A total of 157 patients with cirrhosis receiving diuretic treatment were evaluated for the presence and status of renal impairment, defined as an increase in serum creatinine of ≥ 0.3 mg/dL or by ≥ 50%, and then classified according to the International Club of Ascites (ICA)-Acute Kidney Injury (AKI) staging system. Eighty of 157 (51%) patients fulfilled the criteria for renal impairment. Thirty-four (43%) patients had ICA-AKI stage 1, 32 (40%) stage 2, and 14 (18%) stage 3. Multivariate analysis revealed female gender (hazard ratio [HR] = 0.407, 95% confidence interval = 0.193–0.857; P = .018), ALT ≥35 IU/L (HR = 3.841, 95% confidence interval = 1.785–8.065; P = .001), and the presence of renal impairment (HR = 4.275, 95% confidence interval = 1.962–9.312; P < .001) as independent factors significantly increasing the risk of mortality. Cumulative survival rates increased significantly with ICA–AKI stage (log-rank test, P = .009). Renal impairment was a predictive marker of mortality in Japanese patients with cirrhosis. Stratification according to ICA–AKI criteria of kidney function impairment may be a good prognostic indicator of cirrhosis outcome.

الإتاحة: https://doi.org/10.1097/md.0000000000014475Test
https://journals.lww.com/00005792-201902080-00096Test

المؤلفون: Kikuchi, Takayuki, Takao, Naoki, Sato, Tomoo, Kenji, Isahaya, Hino, Sakae, Mayumi, Kaburagi, Keiji, Tachikawa, Riyoko, Ko, Shibata, Soichiro, Kaburagi, Kei, Iijima, Naoki, Mizukami, Heisuke, Sakurai, Kenzo, Yamauchi, Junji, Kimura, Akio, Shimohata, Takayoshi, Yamano, Yoshihisa

المصدر: Clinical & Experimental Neuroimmunology; Feb2023, Vol. 14 Issue 1, p61-68, 8p

مصطلحات موضوعية: GLIAL fibrillary acidic protein, CHEMOKINES, STEROID drugs, MAGNETIC resonance imaging, CENTRAL nervous system, CENTRAL nervous system viral diseases

مستخلص: Objectives: To examine the chemokine profile in the cerebrospinal fluid (CSF) of patients with glial fibrillary acidic protein astrocytopathy (GFAP‐A), central nervous system immune‐related adverse event (CNS‐irAE), neurosarcoidosis (NS), neuromyelitis optica spectrum disorders (NMOSD), multiple sclerosis (MS), and human T‐cell leukemia virus‐1 (HTLV‐1)‐associated myelopathy (HAM). Methods: The study included 38 patients presenting to St. Marianna University Hospital between May 2013 and November 2021 with GFAP‐A, CNS‐irAE, NMOSD, MS, NS, HAM and noninflammatory neurological diseases (NIND). We recorded the age, sex, duration of disease, brain/spinal lesions on magnetic resonance imaging (MRI), blood data, and measured chemokines (CXCL9, −10, −13, CCL3, −4, −17, −20, −22) in CSF. In patients with GFAP‐A, clinical symptoms, and CSF CXCL10 levels were compared before and after steroid treatment. Results: Patients with GFAP‐A had higher CSF levels of CXCL10, CXCL13, and CCL22 (10736.1 [8786.7–149079.0] pg/ml (p <.05), 378.4 [239.9–412.2] pg/ml (p <.01) and 159.9 [130.5–413.9] pg/ml (p <.01), respectively). The CSF levels of CXCL10 improved from 10736.1 [8786.7–149079.0] pg/ml to 1879.0 [783.9–4360.0] pg/ml in patients with GFAP‐A by steroid therapy. Conclusion: CSF CXCL10 levels were particularly high in GFAP‐A, and changes in levels after treatment correlated with clinical improvements, suggesting CXCL10 involvement in GFAP‐A pathogenesis. [ABSTRACT FROM AUTHOR]

: Copyright of Clinical & Experimental Neuroimmunology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Yamazaki, Tomoo, Joshita, Satoru, Umemura, Takeji, Usami, Yoko, Sugiura, Ayumi, Fujimori, Naoyuki, Shibata, Soichiro, Ichikawa, Yuki, Komatsu, Michiharu, Matsumoto, Akihiro, Igarashi, Koji, Tanaka, Eiji

المصدر: Scientific Reports ; volume 7, issue 1 ; ISSN 2045-2322

مصطلحات موضوعية: Multidisciplinary

الوصف: Metabolized by liver sinusoidal endothelial cells, autotaxin (ATX) is a secreted enzyme considered to be associated with liver damage. We sought to clarify the diagnostic ability of ATX for liver fibrosis in 593 biopsy-confirmed hepatitis C virus (HCV)-infected patients. The diagnostic accuracy of ATX was compared with clinical parameters and the established fibrosis biomarkers Wisteria floribunda agglutinin-positive Mac-2-binding protein, FIB-4 index, AST-to-platelet ratio, and Forn’s index. Median ATX levels were consistently higher in female controls and patients than in their male counterparts (P < 0.01). Serum ATX concentration increased significantly according to liver fibrosis stage in overall and both genders (P < 0.001). The cutoff values of ATX for prediction of fibrosis stages ≥F1, ≥F2, ≥F3, and F4 were 0.8, 1.1, 1.3, and 1.7 mg/L, respectively, in male patients and 0.9, 1.7, 1.8, and 2.0 mg/L, respectively, in female patients. The area under the receiver operating characteristic curve for ATX to diagnose fibrosis of ≥F2 (0.861) in male patients was superior to those of FIB-4 index and Forn’s index (P < 0.001), while that in female patients (0.801) was comparable with those of the other markers. ATX therefore represents a novel non-invasive biomarker for liver fibrosis in HCV-infected patients.

الإتاحة: https://doi.org/10.1038/srep46705Test
https://www.nature.com/articles/srep46705.pdfTest
https://www.nature.com/articles/srep46705Test

المؤلفون: Kikuchi, Takayuki, Takao, Naoki, Sato, Tomoo, Isahaya, Kenji, Hino, Sakae, Kaburagi, Mayumi, Tachikawa, Keiji, Ko, Riyoko, Shibata, Soichiro, Kaburagi, Kei, Iijima, Naoki, Mizukami, Heisuke, Sakurai, Kenzo, Yamauchi, Junji, Kimura, Akio, Shimohata, Takayoshi, Yamano, Yoshihisa

المصدر: Clinical and Experimental Neuroimmunology ; volume 14, issue 1, page 61-68 ; ISSN 1759-1961 1759-1961

الوصف: Objectives To examine the chemokine profile in the cerebrospinal fluid (CSF) of patients with glial fibrillary acidic protein astrocytopathy (GFAP‐A), central nervous system immune‐related adverse event (CNS‐irAE), neurosarcoidosis (NS), neuromyelitis optica spectrum disorders (NMOSD), multiple sclerosis (MS), and human T‐cell leukemia virus‐1 (HTLV‐1)‐associated myelopathy (HAM). Methods The study included 38 patients presenting to St. Marianna University Hospital between May 2013 and November 2021 with GFAP‐A, CNS‐irAE, NMOSD, MS, NS, HAM and noninflammatory neurological diseases (NIND). We recorded the age, sex, duration of disease, brain/spinal lesions on magnetic resonance imaging (MRI), blood data, and measured chemokines (CXCL9, −10, −13, CCL3, −4, −17, −20, −22) in CSF. In patients with GFAP‐A, clinical symptoms, and CSF CXCL10 levels were compared before and after steroid treatment. Results Patients with GFAP‐A had higher CSF levels of CXCL10, CXCL13, and CCL22 (10736.1 [8786.7–149079.0] pg/ml ( p < .05), 378.4 [239.9–412.2] pg/ml ( p < .01) and 159.9 [130.5–413.9] pg/ml ( p < .01), respectively). The CSF levels of CXCL10 improved from 10736.1 [8786.7–149079.0] pg/ml to 1879.0 [783.9–4360.0] pg/ml in patients with GFAP‐A by steroid therapy. Conclusion CSF CXCL10 levels were particularly high in GFAP‐A, and changes in levels after treatment correlated with clinical improvements, suggesting CXCL10 involvement in GFAP‐A pathogenesis.

الإتاحة: https://doi.org/10.1111/cen3.12732Test

المؤلفون: Kaburagi, Kei, Shimizu, Takahiro, Hagiwara, Yuta, Fukano, Takayuki, Shibata, Soichiro, Hoshino, Masashi, Sasaki, Naoshi, Akiyama, Hisanao, Hasegawa, Yasuhiro, Yamano, Yoshihisa

المساهمون: Practical Research Project for Rare/Intractable Diseases of the Japan Agency for Medical Research and Development, Rare and Intractable Diseases from the Ministry of Health, Labour and Welfare of Japan, Japan Society for the Promotion of Science (JSPS) KAKENHI

المصدر: Journal of Medical Ultrasonics ; volume 50, issue 1, page 103-109 ; ISSN 1346-4523 1613-2254

مصطلحات موضوعية: Radiology, Nuclear Medicine and imaging, General Medicine

الإتاحة: https://doi.org/10.1007/s10396-022-01271-xTest

المؤلفون: Kaburagi, Kei, Shimizu, Takahiro, Hagiwara, Yuta, Fukano, Takayuki, Shibata, Soichiro, Hoshino, Masashi, Sasaki, Naoshi, Akiyama, Hisanao, Hasegawa, Yasuhiro, Yamano, Yoshihisa

المصدر: Journal of Medical Ultrasonics; Jan2023, Vol. 50 Issue 1, p103-109, 7p

مستخلص: Purpose: Endovascular therapy (EVT) preceded by intravenous thrombolysis with recombinant tissue plasminogen activator (iv-rtPA) has been established as a standard treatment in patients with stroke caused by large-vessel occlusion (LVO). Primary stroke centers without EVT competence need to identify patients with residual LVO after iv-rtPA therapy and transport them to an EVT-capable facility. Carotid ultrasonography (CUS) is easily applicable at bed side and useful for detecting extra- and intracranial LVO. This study aimed to determine whether CUS findings at admission are useful to predict patients with residual LVO after iv-rtPA. Methods: Patients scheduled to undergo iv-rtPA for acute cerebral infarction were registered. Before iv-rtPA, they underwent CUS, followed by CTA or MRA evaluation within 6 h after iv-rtPA. A model that can achieve 100% sensitivity for detecting residual LVO after iv-rtPA was studied. Results: This study included 68 of 116 patients treated with iv-rtPA during the study period. National Institutes of Health Stroke Scale (NIHSS) score (cutoff value = 10) on arrival, hyperdense MCA sign on non-contrast CT, end-diastolic (ED) ratio on CUS, and eye deviation were significantly different between patients with residual LVO after iv-rtPA and those without. If any of these clinical features are positive in the screening test, residual LVO could be predicted with 100% sensitivity, 50% specificity, 64% positive predictive value, and 100% negative predictive value. Conclusion: Prediction of residual LVO with 100% sensitivity may be feasible by adding CUS to NIHSS score > 10, the presence of eye deviation, and hyperdense MCA sign. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of Medical Ultrasonics is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Shibata, Soichiro, Joshita, Satoru, Umemura, Takeji, Yamazaki, Tomoo, Fujimori, Naoyuki, Ichikawa, Yuki, Komatsu, Michiharu, Matsumoto, Akihiro, Tanaka, Eiji

المصدر: SpringerPlus ; volume 5, issue 1 ; ISSN 2193-1801

مصطلحات موضوعية: Multidisciplinary

الإتاحة: https://doi.org/10.1186/s40064-016-2708-1Test

المؤلفون: Sekiguchi, Tomohiro, Umemura, Takeji, Fujimori, Naoyuki, Shibata, Soichiro, Ichikawa, Yuki, Kimura, Takefumi, Joshita, Satoru, Komatsu, Michiharu, Matsumoto, Akihiro, Tanaka, Eiji, Ota, Masao

المساهمون: Ansari, Aftab A.

المصدر: PLOS ONE ; volume 10, issue 6, page e0131658 ; ISSN 1932-6203

الإتاحة: https://doi.org/10.1371/journal.pone.0131658Test