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  • 1
    In: Pathobiology, S. Karger AG, Vol. 81, No. 2 ( 2014), p. 94-99
    Abstract: 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 Gene expression patterns differ in the two types of skeletal muscle fiber. The Wnt signaling pathway, which includes low-density lipoprotein receptor-related protein 6 (LRP6), has been associated with cell differentiation and glucose metabolism in skeletal muscles. We examined the relationships between muscle fiber types and LRP6 expression. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Adenosine triphosphatase was assayed histochemically, and the levels of expression of LRP6 and myosin were analyzed immunohistochemically, in frozen sections of muscle fiber obtained from 16 muscle biopsy samples. The expression pattern of LRP6 in C2C12 cells was assayed by immunocytochemistry. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 LRP6 was expressed only in type II fibers. Type IIc fibers showed variations in LRP6 expression. Expression of LRP6 was observed at the stage of myoblast differentiation. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Antibody to LRP6 may be useful for identifying type II skeletal muscle fibers. LRP6 may influence glucose metabolism in type II fibers of human skeletal muscles.
    Type of Medium: Online Resource
    ISSN: 1015-2008 , 1423-0291
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1483541-1
    SSG: 12
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  • 2
    In: European Neurology, S. Karger AG, Vol. 79, No. 1-2 ( 2018), p. 90-99
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The aim of this study was to elucidate the influence of insular infarction on blood pressure (BP) variability and outcomes according to the region of the insular cortex affected. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 90 patients 〈 b 〉 〈 i 〉 〈 /i 〉 〈 /b 〉 diagnosed with acute unilateral ischemic stroke were registered. The BP variability was calculated over 24 h after admission (hyperacute) and for 2–3 days after admission (acute). Patients were classified into groups of right and left, and then right anterior, right posterior, left anterior, and left posterior insular infarction. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Patients with insular infarction showed a significantly larger infarct volume, higher modified Rankin scale scores, and lower SD and coefficient of variation (CV) of ­systolic BP in the hyperacute phase than shown by patients without insular infarction ( 〈 i 〉 p  & #x3c; 〈 /i 〉 0.01, 〈 i 〉 p  & #x3c; 〈 /i 〉 0.01, 〈 i 〉 p = 〈 /i 〉 0.02, and 〈 i 〉 p = 〈 /i 〉 0.03, respectively). The SD and CV of systolic BP in the hyperacute phase showed significant differences among the 3 groups with right insular infarction, with left insular infarction, and without insular infarction ( 〈 i 〉 p  & #x3c; 〈 /i 〉 0.05 and 〈 i 〉 p  & #x3c; 〈 /i 〉 0.05, respectively). There was a tendency for the systolic BP variability to be lower in patients with right anterior insular infarction than in patients with infarcts in other areas. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The right insular cortex, especially the anterior part, might be a hub for autonomic nervous regulation.
    Type of Medium: Online Resource
    ISSN: 0014-3022 , 1421-9913
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1482237-4
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  • 3
    In: Case Reports in Neurology, S. Karger AG, Vol. 5, No. 1 ( 2013-3-29), p. 68-73
    Abstract: Diabetic hemichorea-hemiballism with non-ketotic hyperglycemia is usually a benign syndrome. Here, we report a 78-year-old woman with persistent hemichorea (HC) for longer than 1 year with a recurrence after rapid correction of hyperglycemia. Following the disappearance of the characteristic T1 hyperintensity at 3 months after onset, an MRI demonstrated T2* hypointensity and atrophic changes in the contralateral striatum, suggesting irreversible neuronal loss and some vascular proliferation. The electrophysiological examination using transcranial magnetic stimulation revealed significantly shorter cortical silent periods (CSPs) on the contralateral primary motor cortex (M1), possibly in relation to cortical hyperexcitability. We have applied 10 daily sessions of low-frequency repetitive transcranial magnetic stimulation (rTMS) over the contralateral M1 to reduce the hyperexcitability. The HC was suppressed during and for several minutes after rTMS with prolongation of CSPs. After rehabilitation therapy, the patient was able to walk independently with a walker. We suggest that the combination of low-frequency rTMS and rehabilitation therapy may be a possible choice in medically refractory involuntary movements.
    Type of Medium: Online Resource
    ISSN: 1662-680X
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2013
    detail.hit.zdb_id: 2505302-4
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  • 4
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 25, No. 1-2 ( 2008), p. 40-49
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Patients treated with ticlopidine require careful hematologic monitoring. Clopidogrel may have greater tolerability. However, no direct comparison of these two drugs has been reported and evidence of improved safety with clopidogrel is not yet established in the Japanese population. A comparison of both agents was therefore conducted in Japanese stroke patients. 〈 i 〉 Methods: 〈 /i 〉 Patients with noncardioembolic cerebral infarction were randomized to clopidogrel 75 mg or ticlopidine 200 mg once daily for 52 weeks. The primary endpoint was safety; the major secondary endpoint was the incidence of vascular events. 〈 i 〉 Results: 〈 /i 〉 Clopidogrel was associated with significantly fewer safety events than ticlopidine (7.0 versus 15.1%; p 〈 0.001) and no significant difference in efficacy between the two treatments was seen [hazard ratio 0.977 (95% confidence interval: 0.488–1.957)]. 〈 i 〉 Conclusions: 〈 /i 〉 In Japanese stroke patients, clopidogrel 75 mg is better tolerated than ticlopidine 200 mg once daily.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2008
    detail.hit.zdb_id: 1482069-9
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  • 5
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 24, No. 1 ( 2007), p. 35-42
    Abstract: 〈 i 〉 Background and Purpose: 〈 /i 〉 There is epidemiological evidence that increased carotid intima-media thickness (IMT) is a predictor of cardiovascular disease (CVD) events. However, the significance of carotid IMT in high-risk patients in whom risk factors are managed clinically has not been adequately investigated. The purpose of this study was to determine the usefulness of carotid IMT measurement in such patients. 〈 i 〉 Methods: 〈 /i 〉 The study comprised 900 outpatients with cardiovascular risk factors or established atherosclerosis. Carotid IMT was calculated as the mean bilateral IMT of the common carotid artery, bifurcation, and internal carotid artery. Baseline vascular risk factors, medications, and history of CVD were recorded at the time of enrollment. The incidence of CVD events was determined prospectively. 〈 i 〉 Results: 〈 /i 〉 During a mean follow-up period of 2.6 years, there were 64 CVD events. The relative risk (RR) of a CVD event increased with increased IMT. Association between CVD events and carotid IMT was significant after adjustment for risk factors and history of CVD, showing an increased risk per IMT tertile from the middle tertile (RR, 2.5; 95% confidence interval [CI]: 1.0–6.3) to the highest (RR, 3.6; 95% CI: 1.4–9.0). When patients with a history of CVD were excluded (n = 574), the predictive value of IMT was significant even after adjustment for risk factors (hazard ratio per 1 SD IMT increase was 1.57 [95% CI: 1.11–2.20] ). 〈 i 〉 Conclusions: 〈 /i 〉 Carotid IMT is an independent predictor of vascular events in high-risk patients in whom risk factors are managed clinically.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2007
    detail.hit.zdb_id: 1482069-9
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  • 6
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 34, No. 5-6 ( 2012), p. 385-392
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Periodontitis increases the risk of atherosclerotic cardiovascular disease and ischemic stroke. In this study, we evaluated whether serum antibody levels against individual periodontal pathogens are significantly associated with ischemic stroke subtypes and their risk factors. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Patients with acute ischemic stroke (n = 132; 74 male and 58 female, 71.3 ± 10.7 years) and patients with no previous stroke (n = 77; 38 male and 39 female, 70.7 ± 9.5 years) were consecutively enrolled in this study. Stroke subtype was evaluated based on the Trial of Org 10172 in Acute Stroke Treatment classification. Serum was obtained from each patient after obtaining their consent to participate in the study. The levels of serum antibodies against 〈 i 〉 Aggregatibacter actinomycetemcomitans 〈 /i 〉 (Aa), 〈 i 〉 Porphyromonas gingivalis 〈 /i 〉 (Pg) and 〈 i 〉 Prevotella intermedia 〈 /i 〉 (Pi) were evaluated by ELISA. Serum high-sensitivity C-reactive protein (hs-CRP) levels were measured by nephelometry. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Serum hs-CRP levels were significantly associated with acute ischemic stroke even after controlling for acute ischemic stroke, hypertension, diabetes mellitus and bulb/ internal carotid artery (ICA) atherosclerosis which were statistically selected (coefficient 0.245, 95% CI 0.142–0.347, p 〈 0.0001). The serum-antibody level of Pi was significantly higher in atherothrombotic-stroke patients than in patients with no previous stroke (p = 0.0035). Detectable serum anti-Pg antibody was significantly associated with atrial fibrillation (overall χ 〈 sup 〉 2 〈 /sup 〉 = 35.5, R 〈 sup 〉 2 〈 /sup 〉 = 0.18, n = 209, p 〈 0.0001; anti-Pg antibody: OR 4.36, 95% CI 1.71–12.10, p = 0.0017), and detectable serum anti-Pi antibody was significantly associated with bulb/ICA atherosclerosis after controlling for the statistically selected associated factors (overall χ 〈 sup 〉 2 〈 /sup 〉 = 46.1, R 〈 sup 〉 2 〈 /sup 〉 = 0.18, n = 209, p 〈 0.0001; anti-Pg antibody: OR 16.58, 95% CI 3.96–78.93, p 〈 0.0001). The levels of serum anti-Pi antibody were significantly associated with atherothrombotic stroke with the statistically selected associated factors excluding bulb/ICA atherosclerosis (overall χ 〈 sup 〉 2 〈 /sup 〉 = 77.0, R 〈 sup 〉 2 〈 /sup 〉 = 0.44, n = 129, p 〈 0.0001; anti-Pi antibody: OR 23.6, 95% CI 2.65–298.2, p = 0.008). However, when we included bulb/ICA atherosclerosis in this model, the levels of serum anti-Pi antibody were no longer significantly associated with atherothrombotic stroke (overall χ 〈 sup 〉 2 〈 /sup 〉 = 98.0, R 〈 sup 〉 2 〈 /sup 〉 = 0.56, n = 129, p 〈 0.0001; anti-Pi antibody: p = 0.107). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Our results suggest that anti-Pg antibody is associated with atrial fibrillation and that anti-Pi antibody is associated with carotid artery atherosclerosis. In addition, anti-Pi antibody may be associated with atherothrombotic stroke through its association with carotid artery atherosclerosis. Thus, periodontitis may lead to serious systemic diseases.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2012
    detail.hit.zdb_id: 1482069-9
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  • 7
    In: Neuroepidemiology, S. Karger AG, Vol. 30, No. 3 ( 2008), p. 152-160
    Abstract: 〈 i 〉 Objective: 〈 /i 〉 To determine the age-, sex-, and subtype-specific incidence of dementia and to assess the effect of education level on the incidence in a Japanese population. 〈 i 〉 Methods: 〈 /i 〉 2,286 dementia-free subjects, aged ≧60 years, were followed for 5.9 years through biennial two-phase examinations. 〈 i 〉 Results: 〈 /i 〉 206 cases of dementia were newly diagnosed based on DSM IV. The incidence per 1,000 person-years was 12.0 for men and 16.6 for women. Based on NINCDS-ADRDA criteria, 80 cases of probable Alzheimer disease (AD) and 50 cases of possible AD were diagnosed. Based on NINDS-AIREN criteria, 36 cases of probable vascular dementia (VaD) and 40 cases of possible VaD were diagnosed. Age and education showed the most statistically significant effects for all dementia. Probable AD showed the most remarkable increase with age and decreased with increasing education level (p = 0.001). Probable VaD showed significant effects of sex (p = 0.033) and sex-age interaction (p = 0.048), but not education (p = 0.26). 〈 i 〉 Conclusion: 〈 /i 〉 AD was the predominant type of dementia in this recent incidence study conducted in Japan, suggesting a reduction in VaD and an increase in AD. Age, sex, and education effects differed by dementia subtype.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2008
    detail.hit.zdb_id: 1483032-2
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  • 8
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 37, No. 5 ( 2014), p. 330-335
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The purpose of this study was to elucidate the incidence and predictors of ischemic stroke or recurrent transient ischemic attack (TIA) during acute hospitalization in patients with TIA. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We carried out a multicenter retrospective study to clarify the characteristics of in-patients with TIA. The subjects of this study were TIA patients admitted to 13 stroke hospitals within 7 days after onset between 2008 and 2009. TIA was defined as focal neurologic symptoms ascribable to a vascular etiology lasting less than 24 h. We investigated the incidence and predictors of ischemic events including ischemic stroke or recurrent TIA during hospitalization. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 464 patients with TIA (292 men, 69 ± 13 years) were registered. Of those, 400 (86.2%) were admitted within 24 h of TIA onset. The mean length of hospital stay was 13 days. During hospitalization, 8 patients had ischemic strokes and 26 had recurrent TIAs. The leading subtype of 8 ischemic strokes was small vessel disease (n = 3) followed by cardioembolism (n = 2). Multiple logistic regression analysis showed that hypertension (OR: 3.41; 95% CI: 1.23-12.3), MRI-diffusion-weighted image positivity (OR: 2.49; 95% CI: 1.15-5.25), and hemiparesis (OR: 2.30; 95% CI: 1.02-5.88) were independently associated with ischemic events during hospitalization. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 In this study, 1.7% of patients with TIA had ischemic stroke during acute hospitalization, and the most common subtype was small vessel disease. Subsequent ischemic stroke and recurrent TIA were associated with hypertension, positive DWI findings, and hemiparesis.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1482069-9
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  • 9
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 12, No. 3 ( 2001), p. 185-193
    Abstract: The Notch3 gene has been recently identified as a causative gene for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). To investigate the genetic contribution of Notch mutations in familial cases with vascular leukoencephalopathy, we screened 13 patients from 11 unrelated families, which were selected on the basis of magnetic resonance imaging findings and positive family history. We identified three different missense mutations in 5 patients from 4 families. Two (Arg90Cys and Arg133Cys) are the same as previously reported in Caucasian patients, the other (Cys174Phe) is a novel mutation causing a loss of a cysteine in epidermal-growth-factor-like repeats of Notch3. These data indicate that the CADASIL Notch3 mutations were found in approximately 35% of familial cases with leukoencephalopathy, suggesting genetic heterogeneity of the disease.
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2001
    detail.hit.zdb_id: 1482186-2
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  • 10
    In: European Neurology, S. Karger AG, Vol. 24, No. 5 ( 1985), p. 330-334
    Type of Medium: Online Resource
    ISSN: 0014-3022 , 1421-9913
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1985
    detail.hit.zdb_id: 1482237-4
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