著者

Kohei CHIDA Tatsuhiko TAKAHASHI Suguru IGARASHI Kentaro FUJIMOTO Yasushi OGASAWARA Shunrou FUJIWARA Takahiro KOJI Yoshitaka KUBO Kuniaki OGASAWARA

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.9, pp.95-100, 2022-12-31 (Released:2022-04-28)

参考文献数

19

被引用文献数

3

---

The coronavirus disease 2019 (COVID-19) pandemic continues to spread around the world, and widespread vaccination is considered the most effective way to end it. Although the efficacy of COVID-19 vaccines has been confirmed, their safety remains a concern. In this paper, we report two cases of ruptured vertebral artery dissecting aneurysm (VADA) immediately after messenger RNA (mRNA) anti-COVID-19 vaccination. In Case 1, a 60-year-old woman experienced sudden headache 3 weeks before her first dose of the Moderna mRNA-1273 COVID-19 vaccine. Magnetic resonance imaging showed dilatation of the right vertebral artery (VA) without intracranial hemorrhage. A day after the vaccination, she developed subarachnoid hemorrhage with pulmonary effusion due to a ruptured right VADA. She underwent endovascular internal trapping and parent artery occlusion under general anesthesia. In Case 2, a 72-year-old woman with a previous history of the left VA occlusion due to arterial dissection developed subarachnoid hemorrhage 7 days after the first dose of the Pfizer-BioNTech BNT162b2 COVID-19 mRNA vaccine due to a ruptured right VADA and underwent stent-assisted coil embolization under general anesthesia. The postoperative courses of these two cases were uneventful. The accumulation of more cases and further study are warranted to clarify the relationship between COVID-19 mRNA vaccination and ruptured intracranial dissecting aneurysms.

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

1 227

---

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

5

---

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

Kunihiro Nishimura Kuniaki Ogasawara Takanari Kitazono Koji Iihara on behalf of the J-ASPECT Study Collaborators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-1214, (Released:2021-08-13)

参考文献数

27

被引用文献数

1

---

Background:The degree of association between mortality and case volume/physician volume is well known for many surgical procedures and medical conditions. However, the link between physician volume and death rate in patients hospitalized for stroke remains unclear. This study analyzed the correlation between in-hospital stroke mortality and physician volume per hospital, considering board certification status.Methods and Results:For this retrospective registry-based cohort study, data were obtained from the Japanese nationwide registry on patients hospitalized for ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) between 2010 and 2016. The number of stroke care physicians and relevant board-certified physicians was also obtained. Odd ratios (ORs) of 30-day in-hospital mortality were estimated after adjusting for institutional and patient differences using generalized mixed logistic regression. From 295,150 (ischemic stroke), 98,657 (ICH), and 36,174 (SAH) patients, 30-day in-hospital mortality rates were 4.4%, 16.0%, and 26.6%, respectively. There was a correlation between case volume and physician volume. A higher number of stroke care physicians was associated with a reduction in 30-day mortality after adjusting for stroke case volume and comorbidities for all stroke types (all P for trend<0.05).Conclusions:An increased number of stroke care physicians was associated with reduced in-hospital mortality for all types of stroke. The volume threshold of board-certified physicians depends on the specialty and stroke type.

著者

Atsushi Hozawa Kozo Tanno Naoki Nakaya Tomohiro Nakamura Naho Tsuchiya Takumi Hirata Akira Narita Mana Kogure Kotaro Nochioka Ryohei Sasaki Nobuyuki Takanashi Kotaro Otsuka Kiyomi Sakata Shinichi Kuriyama Masahiro Kikuya Osamu Tanabe Junichi Sugawara Kichiya Suzuki Yoichi Suzuki Eiichi N Kodama Nobuo Fuse Hideyasu Kiyomoto Hiroaki Tomita Akira Uruno Yohei Hamanaka Hirohito Metoki Mami Ishikuro Taku Obara Tomoko Kobayashi Kazuyuki Kitatani Takako Takai-Igarashi Soichi Ogishima Mamoru Satoh Hideki Ohmomo Akito Tsuboi Shinichi Egawa Tadashi Ishii Kiyoshi Ito Sadayoshi Ito Yasuyuki Taki Naoko Minegishi Naoto Ishii Masao Nagasaki Kazuhiko Igarashi Seizo Koshiba Ritsuko Shimizu Gen Tamiya Keiko Nakayama Hozumi Motohashi Jun Yasuda Atsushi Shimizu Tsuyoshi Hachiya Yuh Shiwa Teiji Tominaga Hiroshi Tanaka Kotaro Oyama Ryoichi Tanaka Hiroshi Kawame Akimune Fukushima Yasushi Ishigaki Tomoharu Tokutomi Noriko Osumi Tadao Kobayashi Fuji Nagami Hiroaki Hashizume Tomohiko Arai Yoshio Kawaguchi Shinichi Higuchi Masaki Sakaida Ryujin Endo Satoshi Nishizuka Ichiro Tsuji Jiro Hitomi Motoyuki Nakamura Kuniaki Ogasawara Nobuo Yaegashi Kengo Kinoshita Shigeo Kure Akio Sakai Seiichiro Kobayashi Kenji Sobue Makoto Sasaki Masayuki Yamamoto

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.1, pp.65-76, 2021-01-05 (Released:2021-01-05)

参考文献数

34

被引用文献数

54 66

---

Background: We established a community-based cohort study to assess the long-term impact of the Great East Japan Earthquake on disaster victims and gene-environment interactions on the incidence of major diseases, such as cancer and cardiovascular diseases.Methods: We asked participants to join our cohort in the health check-up settings and assessment center based settings. Inclusion criteria were aged 20 years or over and living in Miyagi or Iwate Prefecture. We obtained information on lifestyle, effect of disaster, blood, and urine information (Type 1 survey), and some detailed measurements (Type 2 survey), such as carotid echography and calcaneal ultrasound bone mineral density. All participants agreed to measure genome information and to distribute their information widely.Results: As a result, 87,865 gave their informed consent to join our study. Participation rate at health check-up site was about 70%. The participants in the Type 1 survey were more likely to have psychological distress than those in the Type 2 survey, and women were more likely to have psychological distress than men. Additionally, coastal residents were more likely to have higher degrees of psychological distress than inland residents, regardless of sex.Conclusion: This cohort comprised a large sample size and it contains information on the natural disaster, genome information, and metabolome information. This cohort also had several detailed measurements. Using this cohort enabled us to clarify the long-term effect of the disaster and also to establish personalized prevention based on genome, metabolome, and other omics information.

著者

Jun-ichi NOMURA Shota TSUTSUI Yuiko HATCHOME Toshinari MISAKI Hiromu KONNO Kuniaki OGASAWARA

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.9, pp.183-186, 2022-12-31 (Released:2022-06-21)

参考文献数

18

---

Aneurysms of the A1 segment of the anterior cerebral artery tend to develop in combination with various vascular anomalies of the A1 segment. Arterial branches that originate from the A1 segment and perfuse cortical regions are known to be rare. In this report, we describe a 48-year-old woman who presented with a ruptured aneurysm at the origin of an anomalous cortical artery arising from the A1 segment, for which microsurgical neck clipping was performed. Intraoperatively, the anomalous artery was seen to originate from the A1 segment, running into the interhemispheric fissure. An aneurysm was located at the bifurcation of the anomalous artery and the A1 segment. Postoperative angiography showed that the anomalous artery has branched into the fronto-orbital artery and the frontopolar artery and terminated as the anterior internal frontal arteries. We report a rare case of an aneurysm arising from an anomalous callosomarginal artery that arose from the A1 segment and perfused the cortical region. It is of significance to recognize that an aneurysm can develop at the origin of an anomalous artery that arises from the A1 segment.

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 49

---

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%.