著者
Shinichi Kuriyama Nobuo Yaegashi Fuji Nagami Tomohiko Arai Yoshio Kawaguchi Noriko Osumi Masaki Sakaida Yoichi Suzuki Keiko Nakayama Hiroaki Hashizume Gen Tamiya Hiroshi Kawame Kichiya Suzuki Atsushi Hozawa Naoki Nakaya Masahiro Kikuya Hirohito Metoki Ichiro Tsuji Nobuo Fuse Hideyasu Kiyomoto Junichi Sugawara Akito Tsuboi Shinichi Egawa Kiyoshi Ito Koichi Chida Tadashi Ishii Hiroaki Tomita Yasuyuki Taki Naoko Minegishi Naoto Ishii Jun Yasuda Kazuhiko Igarashi Ritsuko Shimizu Masao Nagasaki Seizo Koshiba Kengo Kinoshita Soichi Ogishima Takako Takai-Igarashi Teiji Tominaga Osamu Tanabe Noriaki Ohuchi Toru Shimosegawa Shigeo Kure Hiroshi Tanaka Sadayoshi Ito Jiro Hitomi Kozo Tanno Motoyuki Nakamura Kuniaki Ogasawara Seiichiro Kobayashi Kiyomi Sakata Mamoru Satoh Atsushi Shimizu Makoto Sasaki Ryujin Endo Kenji Sobue the Tohoku Medical Megabank Project Study Group Masayuki Yamamoto
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20150268, (Released:2016-07-02)
参考文献数
64
被引用文献数
1 104

The Great East Japan Earthquake (GEJE) and resulting tsunami of March 11, 2011 gave rise to devastating damage on the Pacific coast of the Tohoku region. The Tohoku Medical Megabank Project (TMM), which is being conducted by Tohoku University Tohoku Medical Megabank Organization (ToMMo) and Iwate Medical University Iwate Tohoku Medical Megabank Organization (IMM), has been launched to realize creative reconstruction and to solve medical problems in the aftermath of this disaster. We started two prospective cohort studies in Miyagi and Iwate Prefectures: a population-based adult cohort study, the TMM Community-Based Cohort Study (TMM CommCohort Study), which will recruit 80 000 participants, and a birth and three-generation cohort study, the TMM Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study), which will recruit 70 000 participants, including fetuses and their parents, siblings, grandparents, and extended family members. The TMM CommCohort Study will recruit participants from 2013 to 2016 and follow them for at least 5 years. The TMM BirThree Cohort Study will recruit participants from 2013 to 2017 and follow them for at least 4 years. For children, the ToMMo Child Health Study, which adopted a cross-sectional design, was also started in November 2012 in Miyagi Prefecture. An integrated biobank will be constructed based on the two prospective cohort studies, and ToMMo and IMM will investigate the chronic medical impacts of the GEJE. The integrated biobank of TMM consists of health and clinical information, biospecimens, and genome and omics data. The biobank aims to establish a firm basis for personalized healthcare and medicine, mainly for diseases aggravated by the GEJE in the two prefectures. Biospecimens and related information in the biobank will be distributed to the research community. TMM itself will also undertake genomic and omics research. The aims of the genomic studies are: 1) to construct an integrated biobank; 2) to return genomic research results to the participants of the cohort studies, which will lead to the implementation of personalized healthcare and medicine in the affected areas in the near future; and 3) to contribute the development of personalized healthcare and medicine worldwide. Through the activities of TMM, we will clarify how to approach prolonged healthcare problems in areas damaged by large-scale disasters and how useful genomic information is for disease prevention.
著者
Mikito Hayakawa Yuji Matsumaru Nobuyuki Sakai Hiroshi Yamagami Koji Iihara Kuniaki Ogasawara Hidenori Oishi Yasushi Ito Kenji Sugiu Shinichi Yoshimura for the STrategy of Optimal carotid revascularization for high-risk Patients of Cerebral Hyperperfusion Syndrome (STOP CHS) study group
出版者
The Japanese Society for Neuroendovascular Therapy
雑誌
Journal of Neuroendovascular Therapy (ISSN:18824072)
巻号頁・発行日
pp.oa.2017-0009, (Released:2017-03-27)
参考文献数
30
被引用文献数
4

Objective: Cerebral hyperperfusion syndrome (CHS) including intracranial hemorrhage (ICH) is a serious complication after carotid artery stenting (CAS). Therefore, neurointerventionalists in Japan commonly stratify the risk for CHS preprocedurally in CAS candidates using various imaging tests that are available, and sometimes performed preventive methods against CHS, such as staged angioplasty (SAP), undersized-balloon angioplasty followed by delayed CAS. In the current study, we used a nationwide questionnaire survey to clarify the current status of the periprocedural management against CHS and the 30-day outcomes of patients with a high risk of CHS after undergoing CAS or endovascular carotid revascularization procedures, such as SAP or stand-alone angioplasty. This study specifically analyzed the data for the periprocedural management against CHS.Materials and Methods: Between June and August 2014, questionnaires were emailed to all of the neurointerventional specialists certified by the Japanese Society for Neuroendovascular Therapy (JSNET). If two or more specialist physicians belonged to an institute, a representative physician of the institute answered the questionnaire. This study focused on 14 items of the questionnaire that were directed at examining the preprocedural imaging tests done to evaluate the risk of CHS, the periprocedural management strategies used to prevent CHS, and the postprocedural imaging tests to detect hyperperfusion phenomenon, among others.Results: Replies were obtained from 154 institutes which represented 336 JSNET-certified neurointerventional specialists. Preprocedural imaging tests done to evaluate the risk of CHS were performed in 144 institutes (93.5%), with single-photon emission CT (SPECT) the most used modality in 88.2% of the institutes. Acetazolamide challenge was performed in 114 (89.8%) of 127 institutes that used preprocedural SPECT evaluation. Of the institutes performing preprocedural CHS-risk evaluation, general anesthesia was administered during the procedure in 44.4%, periprocedural edaravone (a free radical scavenging agent) was used in 52.1%, and periprocedural strict blood pressure control was performed in 91.7%. Postprocedural intravenous anticoagulation therapy was not used for patients with a high risk of CHS in 63.2%. Postprocedural imaging tests to detect hyperperfusion phenomenon were undertaken in 99.3% of the institutes performing preprocedural CHS-risk evaluation. The leading imaging modality, SPECT, was used in 78.3%. SAP was attempted or performed in 27.1% of the institutes.Conclusion: The present study demonstrated that Japanese practitioners attempt to prevent CHS after carotid endovascular revascularization procedures. Most Japanese neurointerventionalists preprocedurally evaluated the risk of CHS in CAS candidates primarily using SPECT with acetazolamide challenge. The penetration rate for SAP was 27.1% of the institutes.
著者
Hiroharu KATAOKA Susumu MIYAMOTO Kuniaki OGASAWARA Koji IIHARA Jun C. TAKAHASHI Jyoji NAKAGAWARA Tooru INOUE Etsuro MORI Akira OGAWA On Behalf of the JET-2 Investigators
出版者
社団法人 日本脳神経外科学会
雑誌
Neurologia medico-chirurgica (ISSN:04708105)
巻号頁・発行日
vol.55, no.6, pp.460-468, 2015 (Released:2015-06-15)
参考文献数
19
被引用文献数
3 27

The purpose of this study is to determine the true threshold of cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) for subsequent ischemic stroke without extracranial-intracranial (EC-IC) bypass surgery in patients with hemodynamic ischemia due to symptomatic major cerebral arterial occlusive diseases. Patients were categorized based on rest CBF and CVR into four subgroups as follows: Group A, 80% < CBF < 90% and CVR < 10%; Group B, CBF < 80% and 10% < CVR < 20%; Group C, 80% < CBF < 90% and 10% < CVR < 20%; and Group D, CBF < 90% and 20% < CVR < 30%. Patients were followed up for 2 years under best medical treatment by the stroke neurologists. Primary and secondary end points were defined as all adverse events and ipsilateral stroke recurrence respectively. A total of 132 patients were enrolled. All adverse events were observed in 9 patients (3.5%/year) and ipsilateral stroke recurrence was observed only in 2 patients (0.8%/year). There was no significant difference among the four subgroups in terms of the rate of both primary and secondary end points. Compared with the medical arm of the Japanese EC-IC bypass trial (JET) study including patients with CBF < 80% and CVR < 10% as a historical control, the incidence of ipsilateral stroke recurrence was significantly lower in the present study. Patients with symptomatic major cerebral arterial occlusive diseases and mild hemodynamic compromise have a good prognosis under medical treatment. EC-IC bypass surgery is unlikely to benefit patients with CBF > 80% or CVR > 10%.