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  • Ovid Technologies (Wolters Kluwer Health)  (5)
  • Mitaki, Shingo  (5)
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  • Ovid Technologies (Wolters Kluwer Health)  (5)
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  • 1
    Online Resource
    Online Resource
    Abstract WP231: High Serum Homocysteine is a Risk of Future Stroke in Neurologically Normal Japanese Cohort
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Stroke Vol. 50, No. Suppl_1 ( 2019-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. Suppl_1 ( 2019-02)
    Abstract: Introduction: Homocysteine is reportedly involved with direct endothelial damage that seems to cause vascular damage. Considering the racial differences in homocysteine levels and the atherosclerotic process in cerebral arteries, the impact of risk factors on stroke are likely different from those in Caucasians, however, to date, there are no Japanese cohort studies on the relationship between homocysteine levels and incidence of stroke. Therefore, we aimed to clarify the relationship between serum homocysteine levels and stroke risk in neurologically normal Japanese cohort. Materials and Methods: From January 2000 to December 2016, a total of 4,552 Japanese subjects voluntarily participated in a health checkup. Among the 4,552 subjects, the final analysis included 412 subjects (203 men and 209 women) aged 32-89 years (mean 65.1 ± 9.2) from whom we could obtain serum homocysteine levels and follow-up information with a mean interval of 7.6 years after the initial examination. The follow-up information about health conditions was obtained by annual mail inquiries. Homocysteine levels were categorized in quartiles of the baseline distribution, and the associations between the homocysteine level and demographics, vascular risk factors, asymptomatic lesions on MRI, cognitive functions, and incidence rates for stroke and all-cause of death were investigated. Results: After adjustment for the traditional cardiovascular risk factors, a higher homocysteine level was associated with silent brain infarctions [odds ratio for the highest vs the lowest quartile of homocysteine, 3.71 (95% confidence interval (CI): 1.04-13.2, P=0.04)] at baseline evaluation. During follow-up, there were 13 documented cases of stroke and 16 all-cause cases of deaths. In a Cox hazard model, homocysteine levels were significantly associated with incidence of stroke when fully adjusted for traditional cardiovascular risk factors. Participants with a higher homocysteine level had a 10.7-fold increased risk for stroke (95% CI, 1.09-104.1, P=0.04); however, there was no association between homocysteine levels and all-cause death. Conclusions: High serum homocysteine level was significantly associated with silent brain infarctions and incidence of stroke in Japanese.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.50.suppl_1.WP231
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 1467823-8
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  • 2
    Online Resource
    Online Resource
    Abstract 2513: Intraventricular Administration of Cystatin C Attenuates White Matter Injury In Rat Chronic Ischemia
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Stroke Vol. 43, No. suppl_1 ( 2012-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. suppl_1 ( 2012-02)
    Abstract: Background and Purpose Cerebral white matter lesions (WMLs) contribute to elderly cognitive deterioration and are usually caused by chronic ischemic insult. Experimental studies have shown that proteases are highly expressed in activated astrocyte and microglia, which are thought to be crucial in the development of WMLs. Cystatin C (CSTC) functions as a major extracellular cysteine protease inhibitor in mammals. Since the concentration of CSTC is 5 times higher in CSF than in plasma, CSTC is thought to be a major inhibitor of cysteine proteases in the central nervous system. We have shown that polymorphisms in the CSTC gene, which results in a decrease of plasma CSTC level, are significantly associated with prevalence of WMLs. However, direct impact of CSTC on the development of WMLs has not been elucidated yet. Here we studied whether direct administration of CSTC into brain has a protective effect on the pathophysiology of WMLs produced by chronic cerebral hypoperfusion in a rat model of permanent bilateral common carotid artery occlusion. Methods Adult Wister rats underwent ligation of bilateral common carotid arteries (LBCCA) and were divided into three groups; the CSTC group in which CSTC was injected continuously into the ventricle 14 consecutive days after LBCCA (n=10), the PBS group in which PBS was injected continuously into the ventricle 14 consecutive days after LBCCA (n=10), and the sham group (n=10). All rats were perfused on 14 days after LBCCA. The severity of WMLs and accumulation of microglia and astrocytes in the corpus callosum (CC) and optic nerve (ON) were evaluated. Furthermore, the activity of cathepsin B, one of the major proteases, was measured in the tissue lysates of CC and ON using the assay kit. Results Continuous intraventricular infusion of CSTC significantly reduced the severity of WMLs (CC; p 〈 0.001 vs. PBS, ON; p 〈 0.001 vs. PBS) and inhibited the accumulation and activation of microglia (CC; p=0.03 vs. PBS, ON; p 〈 0.001 vs. PBS) and astrocytes (CC; p=0.003 vs. PBS, ON; p=0.04 vs. PBS) both in CC and ON. There were no alterations in cathepsin B activity in these regions. Conclusions The present study indicates that CSTC could suppress chronic ischemia-induced WMLs and the inhibition of proteases other than cathepsin B may be implicated in this beneficial effect.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.43.suppl_1.A2513
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
    detail.hit.zdb_id: 1467823-8
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  • 3
    Online Resource
    Online Resource
    Abstract WP205: C-reactive Protein Levels Are Associated With Cerebral Small Vessel-related Lesions
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Stroke Vol. 47, No. suppl_1 ( 2016-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. suppl_1 ( 2016-02)
    Abstract: Introduction: Arteriosclerosis is characterized by the loss of smooth muscle cells and a hyalinized thickened wall, and concentric narrowing of the lumen in penetrating arteries causes cerebral small vessel disease, including lacunar infarcts, deep white matter lesions, and cerebral microbleeds mainly in the basal ganglia. Although infrequently fatal, lacunar infarcts and deep white matter lesions, which account for 30% of ischemic strokes in Japan, are associated with a high risk of recurrence and cognitive impairment. Basic studies have reported on the importance of inflammation in the pathogenesis of arteriosclerosis. Hypothesis: We investigated the hypothesis that serum high sensitive C-reactive protein (hs-CRP) levels have some effect on cerebral small vessel (CSV)-related lesions. Methods: From January 2008 to March 2013, a total of 1,362 Japanese subjects voluntarily participated in the health checkup system. We selected 519 neurologically normal subjects (284 males and 235 females) aged 29-90 years (mean, 63.5 ± 10.3 years) from these participants for inclusion. All the participants underwent MRI, and their CSV-related lesions (i.e., lacunar infarcts, cerebral microbleeds, deep white matter hyperintensity, and periventricular hyperintensity) were evaluated. The serum levels of hs-CRP were evaluated as common inflammatory markers. Results: Subjects with higher hs-CRP levels had more lacunar infarcts (p = 0.02). After adjusting for the traditional cardiovascular risk factors, higher hs-CRP levels were still associated with the presence of lacunar infarcts (odds ratio for the highest vs. the lowest tertile of hs-CRP, 3.57 [95% confidence interval: 1.30-9.80]). These associations did not change when the logarithmically transformed values for hs-CRP were included. Furthermore, subjects with higher CRP levels had more cerebral microbleeds (p = 0.03), more severe deep white matter hyperintensity (p = 0.04), and periventricular hyperintensity (p = 0.04); however, these associations were not observed after adjusting for the cardiovascular risk factors. Conclusions: Higher levels of hs-CRP were associated with lacunar infarcts. Thus, inflammatory processes may be involved in the pathogenesis of small vessel disease.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.47.suppl_1.wp205
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 1467823-8
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  • 4
    Online Resource
    Online Resource
    Abstract T P418: The Association Of Cognitive Decline With Cerebral Microbleeds Appearance And Its Risk Factors: 9 Years Follow-up Study
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Stroke Vol. 46, No. suppl_1 ( 2015-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. suppl_1 ( 2015-02)
    Abstract: Aims: Cumulative evidence indicates that the presence of cerebral microbleeds (CMB) is a highly strong risk factor for future brain hemorrhage. Our recent longitudinal study demonstrated the odds ratio of CMB for future brain hemorrhage was 50.2 (95% CI, 16.7 to 150.9). Since small vessel disease underlies CMB as a histopathological basis, the control of hypertension is supposed to be essential for preventing the occurrence of CMB. It remains unknown whether new appearance of CBM affects cognitive functions. We performed a longitudinal cohort study to clarify risk factors accounting for the appearance of CMB and its effects on cognitive functions. Methods: In this study we followed up 97 healthy subjects (mean age 63 y.o. at the entry), who had undertaken brain MRI 9 years ago in our brain check-up system. No subjects had neurological symptoms at the first and second check-up. We assessed the changes of CMB in MRI and risk factors for the appearance or increase of asymptomatic lesions were examined. Cognitive function tests (a concise version of WAIS-R) were also performed at the entry and follow-up time. Age was used as a covariate in all statistics. Results: During the 9-year follow-up period, we observed new appearance of CMB in 19 subjects (19.6 %: worsening group). The worsening group showed significantly higher values of systolic blood pressure at the time of entry compared to the no-change group (p=140) is 4.21 (p 〈 0.05). In addition, the worsening group showed significant deterioration in cognitive function tests (p 〈 0.05). Conclusions: The present study demonstrates that the optimal control of blood pressure are critical for prevention of CMB appearance, which would contribute to prevention of future cognitive deterioration in addition to brain hemorrhage.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.46.suppl_1.tp418
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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    Online Resource
  • 5
    Online Resource
    Online Resource
    Abstract WP235: Improved Paramedic Identification of Stroke: Utility of the Izumo Prehospital Apoplexy Scale and Prehospital Stroke Registry
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Stroke Vol. 44, No. suppl_1 ( 2013-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. suppl_1 ( 2013-02)
    Abstract: Background and Purpose In Japan, rt-PA has been approved for use since 2005 for treating acute ischemic stroke within 3 hr of onset. Since emergency medical service (EMS) is often the first medical contact for stroke patients, EMS is an important step in stroke recovery. Recently, we developed the Izumo Prehospital Apoplexy Scale (IPAS) and started the prehospital stroke registry, including IPAS scores and information on diagnosis, therapy, and prognosis. We share this registry with EMS and exchange the data electronically; this helps providing regular feedback to EMS on accurate diagnosis, treatment, and prognosis of patients. The purpose of this study is to determine the effects of our feedback system on stroke care. Methods We retrospectively reviewed the prehospital stroke registry to identify all patients evaluated using the IPAS and transported by EMS to our hospital between January 2010 and June 2011. We divided the patients into 2 groups: those evaluated between January 2010 and September 2010 (first period) and between October 2010 and June 2011 (second period). Sensitivity, specificity, and positive and negative predictive values of IPAS were determined. To assess the utility of IPAS on shortening of the duration from stroke onset to hospital arrival, we performed two comparisons; first, the comparison before and after IPAS introduction, second, the comparison between first and second period after IPAS introduction. Results During the study period, 220 patients evaluated with IPAS were transported to our hospital. The sensitivity (0.86 versus 0.95, p = 0.03 ) and positive predict value (0.65 versus 0.78, p = 0.02 ) of the paramedic’s stroke/TIA identification significantly improved in the second period than in the first period. The duration from onset to arrival at the emergency department was significantly shorter in the second period (2.2 h versus 1.9 h, p = 0.04 ). Moreover, the duration was significantly shorter with IPAS use than without (3.8 h versus 2.2 h, p = 0.005 ). Conclusions Sharing the prehospital stroke registry with EMS resulted in a 9% increase in sensitivity for identifying stroke patients in the prehospital setting. Moreover, feedback system contributed to shortening the duration from stroke onset to arrival at the emergency department.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.44.suppl_1.AWP235
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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    Online Resource
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