Research Interests:
Research Interests:
Research Interests:
A 63-year-old man with clinical features of typical ataxic hemiparesis is reported. CT scan and magnetic resonance imaging showed a small infarction in the contralateral semioval center near the parietal cortex. Of note is the previously... more
A 63-year-old man with clinical features of typical ataxic hemiparesis is reported. CT scan and magnetic resonance imaging showed a small infarction in the contralateral semioval center near the parietal cortex. Of note is the previously unreported site of the lesion relative to this syndrome. The neuroanatomical basis for the ataxic hemiparesis syndrome is discussed.
Research Interests:
Herpes simplex virus (HSV) antibody titers and IgG, IgM and IgA concentrations in the cerebrospinal fluid were serially measured in a patient with HSV encephalitis during a follow-up period of 32 months. HSV antibody titers, all classes... more
Herpes simplex virus (HSV) antibody titers and IgG, IgM and IgA concentrations in the cerebrospinal fluid were serially measured in a patient with HSV encephalitis during a follow-up period of 32 months. HSV antibody titers, all classes of immunoglobulins and Ig% showed significant elevation during the course of illness, though IgM% and IgA% gradually declined after the acute phase. Autopsied brain tissue failed to yield a virus isolate, but conspicuous perivascular lymphocyte infiltrate, which is compatible with HSV encephalitis, was seen. These observations suggest the occurrence of HSV persistence and persistent antigen stimulation in the central nervous system, analogous to the well-recognized latent condition within the trigeminal ganglion.
Research Interests:
In order to clarify the pathophysiology of dementia due to multiple infarction in the territory of the perforating artery, the reactivity of cerebral vessels to increased carbon dioxide tension was examined in patients with multiple... more
In order to clarify the pathophysiology of dementia due to multiple infarction in the territory of the perforating artery, the reactivity of cerebral vessels to increased carbon dioxide tension was examined in patients with multiple cerebral infarction with or without dementia. The subjects studied were 11 patients with multi-infarct dementia (MID) (age 57-82 years old, mean +/- S.D. 72 +/- 8) and 16 patients with multiple infarction without dementia (MI) (age 51-81 years old, mean +/- S.D. 69 +/- 9). The diagnosis of cerebral infarction was based on the clinical signs and symptoms and findings of magnetic resonance imaging (MRI). Only patients with cerebral infarction located in the perforator territories were included in this study. Dementia was diagnosed by DSM-IIIR criteria. The extent of periventricular high intensity area (PVH) on the T2-weighted image of MRI was classified into 3 subgroups by the criteria of Gerard et al with some modifications. Cerebral blood flow (CBF) was measured by the 133Xe intravenous injection method using a Cerbrograph (Novo), and gray matter flow (F1) and initial slope index (ISI) were calculated. The cerebrovascular reactivity to CO2 was estimated as the increase in F1 or ISI per unit increase in PaCO2 (delta F1/delta PaCO2 or delta ISI/delta PaCO2, respectively) during inhalation of 5% CO2 and as %increase in F1 or ISI per unit increase in PaCO2 (delta F1%/delta PaCO2 or delta ISI%/delta PaCO2, respectively) during inhalation of 5% CO2. 1. CO2 reactivity in both groups. delta F1/delta PaCO2 in the MI and MID groups were 3.2 +/- 1.4 ml/100 g/min/mmHg and 2.0 +/- 1.4, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Research Interests:
We report a 65-year-old woman, who suffered from clumsiness of the left hand for 6 years. Gait disturbance, body balance impairment and rigidity of the left arm appeared progressively. Anti-parkinsonian drugs such as 1-dopa, doroxidopa,... more
We report a 65-year-old woman, who suffered from clumsiness of the left hand for 6 years. Gait disturbance, body balance impairment and rigidity of the left arm appeared progressively. Anti-parkinsonian drugs such as 1-dopa, doroxidopa, amantadine and bromocriptine were ineffective. Magnetic resonance imaging showed brain atrophy, especially in the right fronto-parietal lobes. Positron emission tomography (18F-fluoro-2-deoxy-D-glucose) showed decreased glucose metabolism in the right cerebral cortex, putamen and thalamus. A diagnosis of corticobasal degeneration was made, based on the clinical manifestations, MRI and PET findings. She also showed anisocoria, vertical gaze palsy and abnormal pupillary reactions. Her left pupil showed an oval figure shifted from the center position. The pupils exhibited denervation supersensitivity in the 0.125% pilocarpine test. We consider that her pupillary abnormalities may be related to her midbrain lesion (midbrain corectopia) associated with corticobasal degeneration.
Research Interests: Medicine, Movement disorders, Humans, Cerebral Cortex, Female, and 4 morePubmed, Clinical Sciences, Aged, and Atrophy
A contribution of cerebral cortical damage to the development of intellectual impairment in patients with Parkinson's disease (PD) has been suspected. We studied the relationship between intellectual impairment and cerebral cortical blood... more
A contribution of cerebral cortical damage to the development of intellectual impairment in patients with Parkinson's disease (PD) has been suspected. We studied the relationship between intellectual impairment and cerebral cortical blood flow in 28 treated idiopathic parkinsonian patients. Mean IQ score as evaluated by applying the Suzuki-Binet test in patients with PD was 70.7 (+/- 12.7) and 78.6% of the patients showed abnormal score (below 80). The intellectual deficits were characterized by impairment of memory and abstract thinking, and showed a significant correlation with the severity of motor symptoms. Mean hemispheric cortical blood flow measured by using the 133xenon intravenous injection technique in patients with PD was significantly lower than that for 18 age-matched controls. Prefrontal cortical blood flow in PD was also significantly reduced compared with that in age-matched controls, showing a partial loss of hyperfrontal pattern. However, there was no significant correlation between IQ score and either mean hemispheric cortical blood flow or prefrontal cortical blood flow values. These results suggest that, although the patients with PD demonstrated a high prevalence of intellectual impairment, the impairment is not necessarily of cortical origin.
Research Interests:
Neuroradiological findings of a patient with paretic neurosyphilis are described. A 50-year-old male patient showed personality changes, severe dementia and some neurological deficits. Serological analysis of serum and cerebrospinal fluid... more
Neuroradiological findings of a patient with paretic neurosyphilis are described. A 50-year-old male patient showed personality changes, severe dementia and some neurological deficits. Serological analysis of serum and cerebrospinal fluid demonstrated the presence of antibodies to Treponema pallidum. Computed tomography showed diffuse cerebral cortical atrophy and ventricular dilatation, and magnetic resonance (MR) imaging revealed some small abnormal signals in the white matter. Single photon emission tomography using [123I] N-isopropyl-p-iodoamphetamine (IMP-SPECT) indicated decreased activities, most markedly in the right frontal and bitemporal cortices. Although the neuroradiological findings were nonspecific, the MR imaging and IMP-SPECT findings were interesting because they have not been described previously to our knowledge.
Research Interests:
Research Interests:
Research Interests:
Smooth pursuit eye movement was quantitatively evaluated in 99 chronic alcoholics and in 100 nonalcoholic control subjects. In both groups the smooth pursuit was increasingly impaired with advancing age, but in chronic alcoholics the... more
Smooth pursuit eye movement was quantitatively evaluated in 99 chronic alcoholics and in 100 nonalcoholic control subjects. In both groups the smooth pursuit was increasingly impaired with advancing age, but in chronic alcoholics the smooth pursuit eye movement was more frequently (42.4%) impaired than in age-matched controls (20.0%, p less than 0.005). The characteristic feature of the impairment observed in chronic alcoholics was prominent saccadic movement of the eyes; ataxic pursuit was less common. It is suggested that the impairment of smooth pursuit eye movement in alcoholics is probably attributable to 'premature aging' of the cerebral cortex caused by chronic alcohol abuse.
Research Interests:
Research Interests:
Research Interests: Magnetic Resonance Imaging, Medicine, Multivariate Analysis, Brain, Humans, and 15 moreBlood Glucose, Glucose Metabolism, Cerebral Cortex, Female, Male, Clinical Sciences, Aged, Middle Aged, Metabolic rate, Adult, Cognitive Function, Basal ganglia, Asymptomatic, Brain Diseases, and Magnetic resonance image
Research Interests:
Research Interests:
We studied the production of and response to interleukin-2 (IL-2) by cultured peripheral blood mononuclear cells (PBMC) and the soluble IL-2 receptor levels in 10 patients with GBS (eight men and two women) aged 23-67 years. The first... more
We studied the production of and response to interleukin-2 (IL-2) by cultured peripheral blood mononuclear cells (PBMC) and the soluble IL-2 receptor levels in 10 patients with GBS (eight men and two women) aged 23-67 years. The first blood sample was obtained within seven days of the onset of neuropathic symptoms, and blood samples were collected serially after treatment with plasma exchange. PBMC from GBS patients were found to produce little IL-2 and to have a low response to IL-2 soon after the onset, but marked improvement was seen within one month, concomitantly with improvement of neuropathic symptoms. Serum soluble IL-2 receptor levels were increased at the onset, but gradually decreased thereafter. Our findings suggest that primary immune response in acute-stage GBS may be downregulated via a decrease in the function of PBMC that had previously been activated by interacting with the antigen.
Research Interests:
Research Interests:
Research Interests: Evidence Based Medicine, Global Health, Health Education, Drug development, Health Services Research, and 15 moreHealth Policy, Executive Function, Continuing Medical Education, Brain, Clinical research, Biomedical Research, Cerebrovascular Disease, Chronic Disease, Animals, Cerebrovascular diseases, Clinical Sciences, Health Priorities, Cooperative Behavior, guidelines as topic, and Cardiovascular medicine and haematology
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
We report a case of 30-year-old man with generalized seizure, who had received phenytoin (PHT) for more than 6 years, but developed decrease in sperm count and motility. After PHT had been discontinued and valproate (VPA) had been... more
We report a case of 30-year-old man with generalized seizure, who had received phenytoin (PHT) for more than 6 years, but developed decrease in sperm count and motility. After PHT had been discontinued and valproate (VPA) had been administered for 3 months, his sperm activity became normalized. The decrease in sperm motility was the most important cause of his infertility. Sperm motility has been reported to be inversely correlated with the ratio of the concentrations of antiepileptic drugs in the plasma and semen. In our case, the ratio was 0.21 for PHT and 0.08 for VPA. We wish to emphasize the importance of measuring the concentration of antiepileptic drugs in the semen of infertile young males if they are on anticonvulsants.
Research Interests: Infertility, Medicine, Humans, Anticonvulsant, Pubmed, and 9 moreSperm, Male, Clinical Sciences, Valproic Acid, Adult, Semen, Sperm Motility, Phenytoin, and Oligospermia
Research Interests:
Research Interests:
Background and Purpose— In Japan, alteplase at 0.6 mg/kg was approved in October 2005 for use within 3 hours of stroke onset by the Ministry of Health, Labor and Welfare (MHLW). The aim of the Japan post-Marketing Alteplase Registration... more
Background and Purpose— In Japan, alteplase at 0.6 mg/kg was approved in October 2005 for use within 3 hours of stroke onset by the Ministry of Health, Labor and Welfare (MHLW). The aim of the Japan post-Marketing Alteplase Registration Study (J-MARS), which was requested by MHLW at the time of approval, was to assess the safety and efficacy of 0.6 mg/kg alteplase in routine clinical practice for the Japanese. Methods— A total of 7492 patients from 942 centers were enrolled in the J-MARS, an open-label, nonrandomized, observational study, from October 2005 to October 2007. Primary outcome measures were symptomatic intracranial hemorrhage (a deterioration in NIHSS score ≥4 from baseline) and favorable outcome (modified Rankin Scale score, 0–1) at 3 months after stroke onset. Results— The proportion of patients with symptomatic intracranial hemorrhage in 7492 patients (safety analysis) was 3.5% (95% confidence interval [CI], 3.1%–3.9%) within 36 hours and 4.4% (95% CI, 3.9%–4.9%) at 3...
Research Interests: Japan, Medicine, Clinical Practice, Stroke, Humans, and 15 moreFemale, Male, Brain Ischemia, Registries, Clinical Sciences, Aged, Middle Aged, Observational Study, Acute Ischemic Stroke, Neurosciences, Thrombolytic Therapy, Confidence Interval, Thrombolysis, modified Rankin Scale, and Cardiovascular medicine and haematology
Research Interests:
Research Interests: Magnetic Resonance Imaging, Medicine, Family history, Neurodegenerative Diseases, Case Report, and 15 moreHumans, Cerebellum, Cerebral Cortex, Female, Brainstem, Middle Aged, Atrophy, Image Enhancement, Adult, Globus Pallidus, Degeneration, Chromosome Disorders, Chromosome aberrations, Medical and Health Sciences, and adult onset
Described herein is a patient with Wilson's disease who had tremor as a prominent neurological manifestation. T2-weighted magnetic resonance imaging showed abnormal high signal intensities in the bilateral lenticular nuclei,... more
Described herein is a patient with Wilson's disease who had tremor as a prominent neurological manifestation. T2-weighted magnetic resonance imaging showed abnormal high signal intensities in the bilateral lenticular nuclei, thalami, and red nuclei of the midbrain. Improvement of tremor with copper chelating agents was well correlated with a decrease of the abnormal signals in the thalami and the red nuclei.
Research Interests:
Research Interests:
Research Interests: Neuroimaging, Magnetic Resonance Imaging, Medicine, Humans, Anoxia, and 15 moreGlucose, Glucose Metabolism, Female, Follow-up studies, Clinical Sciences, Middle Aged, Clinical Imaging, Single Photon Emission Computed Tomography, Myocardial Infarction, Basal ganglia, Hypotension, X ray Computed Tomography, Putamen, Encephalopathy, and Magnetic resonance image
Research Interests:
Research Interests:
Alzheimer’s disease (DAT) is a degenerative disorder of the central nervous system that results in a progressive loss of memory and other intellectual functions beginning in middle to late life. Certain neuropathological lesions, such as... more
Alzheimer’s disease (DAT) is a degenerative disorder of the central nervous system that results in a progressive loss of memory and other intellectual functions beginning in middle to late life. Certain neuropathological lesions, such as senile plaque and neurofibrillar tangles, characterize the brains of DAT patients. Recently, two approaches — molecular cloning and immunochemical analysis — have identified one of the components of the amyloid deposits in the senile plaque of Alzheimer’s disease as the serine protease inhibitor, α1-antichymotrypsin (ACT) [1]. In addition, the evidence of expression of ACT mRNA in astrocytes of DAT patients might support the hypothesis that ACT contributes to the pathological processes of DAT [2]. On the other hand, the cause of so-called multi-infarct dementia (MID) is believed to be ischemic insults of the brain, and the pathological findings are different from those in Alzheimer’s disease. However, because of the lack of diagnostic markers, the differential diagnosis of MID and DAT is often clinically very difficult, although Amari et al. [3] insist that there is a significant elevation of serum ACT in patients with DAT.
Research Interests:
Research Interests:
A 49-year-old man developed bilateral sudden hearing loss followed by cerebral infarction and cytomegalovirus (CMV) encephalitis. Autopsy confirmed intravascular malignant lymphomatosis (IML). A literature review indicates that hearing... more
A 49-year-old man developed bilateral sudden hearing loss followed by cerebral infarction and cytomegalovirus (CMV) encephalitis. Autopsy confirmed intravascular malignant lymphomatosis (IML). A literature review indicates that hearing loss can be the initial manifestation of IML and also that CMV infection is more than an opportunistic infection and may participate in the cognitive manifestations in IML.
Research Interests:
Research Interests:
ABSTRACT
Research Interests:
Research Interests:
Research Interests: Aphasia, Magnetic Resonance Imaging, Medicine, Humans, Cerebral Cortex, and 15 moreFemale, Neuroimage, Male, Hemiplegia, Middle Aged, Blood Flow, Basal ganglia, Cerebral Blood Flow, Frontal Lobe, Cerebral Infarction, Flumazenil, Magnetic resonance image, diaschisis, internal capsule, and Medical and Health Sciences
Research Interests:
Multiple sclerosis, myasthenia gravis, and Guillain-Barre syndrome are neurological diseases induced by abnormal autoimmunity. Since these dis- eases show characteristic clinical courses and neurological symptoms, they can be diagnosed... more
Multiple sclerosis, myasthenia gravis, and Guillain-Barre syndrome are neurological diseases induced by abnormal autoimmunity. Since these dis- eases show characteristic clinical courses and neurological symptoms, they can be diagnosed with appropriate examinations. However, it is necessary to note that the common types of these diseases in Japan are not always the same as those in Western countries. Based on an increasing knowledge of the pathological mecha- nisms of the diseases, various immune therapies are being developed.
Research Interests:
Described herein is a patient with Wilson's disease who had tremor as a prominent neurological manifestation. T2‐weighted magnetic resonance imaging showed abnormal high signal intensities in the bilateral lenticular nuclei, thalami,... more
Described herein is a patient with Wilson's disease who had tremor as a prominent neurological manifestation. T2‐weighted magnetic resonance imaging showed abnormal high signal intensities in the bilateral lenticular nuclei, thalami, and red nuclei of the midbrain. Improvement of tremor with copper chelating agents was well correlated with a decrease of the abnormal signals in the thalami and the red nuclei.
Research Interests:
The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging... more
The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental...
Research Interests: Geography, Health Behavior, Obesity, Global Health, Environmental Health, and 15 moreRisk assessment, Medicine, Humans, Metabolic diseases, Female, Male, Burden of Disease, Nutritional Status, Occupational Exposure, Risk Factors, Risk Assessment, Occupational Diseases, Environmental Exposure, Global burden of disease, and Medical and Health Sciences
Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease... more
Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally...
Research Interests: Epidemiology, Global Health, Developing Countries, General Internal Medicine, Adolescent, and 15 moreComorbidity, Child, Chronic Disease, Female, Conduct Disorder, Aged, Developed Countries, Alcohol dependence, Adult, Cutaneous Leishmaniasis, Cost of Illness, Disabled Persons, Acute Disease, Child preschool, and Attention deficit hyperactivity disorder
A 74-year-old woman, noticed sudden onset of quadriparesis when getting up in the morning on July 17th, 1992. At admission, she presented mild weakness of the limbs bilaterally, and deep tendon hyperreflexia, which were improved after... more
A 74-year-old woman, noticed sudden onset of quadriparesis when getting up in the morning on July 17th, 1992. At admission, she presented mild weakness of the limbs bilaterally, and deep tendon hyperreflexia, which were improved after about 4 hours. Serum and urinary laboratory examinations revealed no abnormal findings. Cerebrospinal fluid showed increased cells (75/mm3), and protein (58 mg/dl). Computed tomography revealed multiple low density lesions in the frontal, parietal, and occipital cortex. Magnetic resonance imaging showed low signal intensities on T1-weighted images and high signal intensities on T2-weighted images, suggesting tumorous lesions. On the gadolinium-enhanced images, the enhanced lesions were surrounded with low signal intensity. She developed hallucination and disorientation since around the 8th hospital day, and disturbance of consciousness at the 15th day, followed by coma, and she died from respiratory failure on the 17th hospital day. At autopsy, there w...
Research Interests: Pathology, Magnetic Resonance Imaging, Medicine, Brain, Humans, and 7 moreFemale, Pubmed, Clinical Sciences, Aged, Autopsy, Pathological, and Meninges
A 48-year-old women was admitted to our hospital because of gradually developed spastic gait. She showed spasticity of the lower extremities with mild weakness. Laboratory tests disclosed decreased WBC and platelet counts and mild... more
A 48-year-old women was admitted to our hospital because of gradually developed spastic gait. She showed spasticity of the lower extremities with mild weakness. Laboratory tests disclosed decreased WBC and platelet counts and mild increases of transaminase and total bilirubin. Blood manganese level was markedly increased (6.0 micrograms/dl). Abdominal ultrasound showed splenomegaly, and abdominal angiography showed a dilatation of the portal and paraumbilical veins. T1-weighted MR images showed high signal intensities at the bilateral globus pallidus and cerebral peducles, and T2-weighted images showed high signal intensities at the bilateral deep white matter, posterior limbs of the internal capsule and right upper cervical spinal cord. Following the diagnosis of IPH, splenectomy was performed. The blood level of manganese decreased thereafter and her neurological deficits gradually improved. Hepatic diseases often show high signal intensities at the basal ganglia on T1-weighted im...
Research Interests:
To clarify the hemodynamic changes in lacunar infarction, we evaluated cerebral glucose metabolism by using positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) in patients with asymptomatic and symptomatic lacunar... more
To clarify the hemodynamic changes in lacunar infarction, we evaluated cerebral glucose metabolism by using positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) in patients with asymptomatic and symptomatic lacunar infarction and in persons without cerebral infarction on MRI. Subjects in this study were 27 patients with symptomatic lacunar infarction (SCI group), 73 subjects with asymptomatic lacunar infarction (ACI group), and 134 persons without infarction (NC group). CMRgl in the ACI group was significantly lower than that in the NC group in the cerebral cortex (P < 0.05) and thalamus (P < 0.05). CMRgl in the SCI group was significantly reduced from that in the NC group in the cerebral cortex (P < 0.005), basal ganglia (P < 0.001), thalamus (P < 0.05) and white matter (P < 0.005). The reduction in CMRgl in the SCI group was more severe than that in the ACI group in basal ganglia (P < 0.05) and thalamus (P < 0.05). Our results indicated that g...