著者
Minori Kurosaki Masahiko Tosaka Yoko Ibe Hironori Arii Junichi Tomono Masayuki Tazawa Tatsuya Shimizu Masanori Aihara Yuhei Yoshimoto Naoki Wada
出版者
The Japanese Association of Rehabilitation Medicine
雑誌
Progress in Rehabilitation Medicine (ISSN:24321354)
巻号頁・発行日
vol.7, pp.20220039, 2022 (Released:2022-08-04)
参考文献数
27

Objectives: Stroke patients with hemiplegia can sometimes achieve independent life at home or in light care facilities after rehabilitation. This study examined the outcomes of rehabilitation in stroke patients with severe hemiplegia.Methods: This study included 50 patients with Brunnstrom recovery stage I–II hemiplegia at the start of rehabilitation for stroke. Good outcome after rehabilitation was defined as independent life with functional independence measure (FIM) score of 100 or greater. Predictors for post-rehabilitation functional recovery were statistically analyzed.Results: FIM scores of 100 or greater in 12 of 50 patients (24%) allowed independent life after stroke rehabilitation. According to univariate analysis, factors associated with a FIM score of 100 or greater and good prognosis after rehabilitation were younger age (<70 years), paralysis caused by intracerebral hematoma (ICH), no cortical lesions, short time from admission to comprehensive inpatient rehabilitation (CIR) for stroke (within 1 month), and good status at the start of early rehabilitation and CIR. Eleven of the 12 patients with good prognosis (FIM ≥100) had ICH and a basal ganglia lesion with no cortical damage. Analysis of the location of lesions suggested that many patients with basal ganglia ICH lesions and little cortical involvement have good prognoses.Conclusions: Stroke patients with severe hemiplegia showed a slightly different distribution of lesions between ICH and cerebral ischemia. Cortical involvement may be a prognostic factor for outcome after rehabilitation in stroke patients with severe hemiplegia. More aggressive rehabilitation interventions may be important for patients with severe hemiplegia, especially without cortical involvement.
著者
Shintaro Ichikawa Utaroh Motosugi Kazuyuki Sato Tatsuya Shimizu Tetsuya Wakayama Hiroshi Onishi
出版者
Japanese Society for Magnetic Resonance in Medicine
雑誌
Magnetic Resonance in Medical Sciences (ISSN:13473182)
巻号頁・発行日
pp.mp.2020-0064, (Released:2020-08-28)
参考文献数
30
被引用文献数
6

Purpose: To investigate whether shortened acquisition or multiple arterial phase acquisition improves image quality of the arterial phase compared with conventional protocol.Methods: This retrospective study was approved by the relevant Institutional Review Board. A total of 615 consecutive patients who underwent gadoxetate disodium-enhanced MRI including one of the following three sequences in three different periods were included: (i) conventional liver acquisition with volume acceleration (LAVA) (between October 2014 and January 2015, n = 149), (ii) Turbo-LAVA (between March and August 2016, n = 216), and (iii) differential sub-sampling with Cartesian ordering (DISCO) (between January and September 2015, n = 250). We monitored the respiratory bellows waveform during breath holding for each patient and recorded breath-hold fidelity of the patients. Two radiologists independently evaluated the degree of respiratory artifact and scan timing on the arterial phase and compared them between the three protocols (i.e., conventional LAVA, Turbo-LAVA, and DISCO), with conventional LAVA as control.Results: The ratio of patients with breath-hold failure was not significantly different among the three protocols (P = 0.6340 and 0.1085). Respiratory artifact was significantly lower in DISCO than in conventional LAVA (P = 0.0424), while there was no significant difference between Turbo-LAVA and conventional LAVA (P = 0.2593). The ratio of adequate scan timing and diagnosable image defined as no or mild artifact and adequate scan timing were higher in DISCO than in conventional LAVA (P = 0.0025 and 0.0019), while there was no significant difference between Turbo-LAVA and conventional LAVA (P = 0.0780 and 0.0657).Conclusion: Compared with conventional protocol, multiple arterial phase acquisition (DISCO) obtained a higher number of diagnosable images by reducing respiratory motion artifact and optimizing the scan timing of arterial phase.
著者
Naoko MIYAMOTO Isao NAITO Tatsuya SHIMIZU Yuhei YOSHIMOTO
出版者
The Japan Neurosurgical Society
雑誌
Neurologia medico-chirurgica (ISSN:04708105)
巻号頁・発行日
vol.55, no.2, pp.163-172, 2015 (Released:2015-02-15)
参考文献数
29
被引用文献数
14 16

The efficacy and limitations of transarterial acrylic glue embolization for the treatment of intracranial dural arteriovenous fistulas (DAVFs) were investigated. Thirty-four DAVFs treated by transarterial embolization using n-butyl cyanoacrylate were retrospectively reviewed. The locations of DAVFs were the transverse-sigmoid sinus in 11, tentorium in 10, cranial vault in 9, and superior sagittal sinus, jugular bulb, foramen magnum, and middle cranial fossa in 1 each. Borden classification was type I in 7, type II in 3, and type III in 24. Eight patients had undergone prior transvenous coil embolization. Complete obliteration rate was 56% immediately after embolization, 71% at follow-up angiography, and 85% after additional treatments (1 transvenous embolization and 4 direct surgery). Complications occurred in three patients, consisting of asymptomatic vessel perforations during cannulation in two patients and leakage of contrast medium resulting in medullary infarction in one patient. Transarterial glue embolization is highly effective for Borden type III DAVF with direct cortical venous drainage, but has limitations for Borden type I and II DAVFs in which the affected sinus is part of the normal venous circulation. Onyx is a new liquid embolic material and is becoming the treatment of choice for DAVF. The benefits of glue embolization compared to Onyx embolization are high thrombogenicity, and relatively low risks of cranial nerve palsies and of excessive migration into the draining veins of high flow fistula. Transarterial glue embolization continues to be useful for selected patients, and complete cure can be expected in most patients with fewer complications if combined with transvenous embolization or direct surgery.
著者
Koichiro Miura Katsuhisa Matsuura Yu Yamasaki Itoyama Daisuke Sasaki Takuma Takada Yoshiyuki Furutani Emiko Hayama Masamichi Ito Seitaro Nomura Hiroyuki Morita Masashi Toyoda Akihiro Umezawa Kenji Onoue Yoshihiko Saito Hiroyuki Aburatani Toshio Nakanishi Nobuhisa Hagiwara Issei Komuro Tatsuya Shimizu
出版者
International Heart Journal Association
雑誌
International Heart Journal (ISSN:13492365)
巻号頁・発行日
vol.63, no.2, pp.338-346, 2022-03-30 (Released:2022-03-30)
参考文献数
35

Dilated cardiomyopathy (DCM) is caused by various gene variants and characterized by systolic dysfunction. Lamin variants have been reported to have a poor prognosis. Medical and device therapies are not sufficient to improve the prognosis of DCM with the lamin variants. Recently, induced pluripotent stem (iPS) cells have been used for research on genetic disorders. However, few studies have evaluated the contractile function of cardiac tissue with lamin variants. The aim of this study was to elucidate the function of cardiac cell sheet tissue derived from patients with lamin variant DCM. iPS cells were generated from a patient with lamin A/C (LMNA) -mutant DCM (LMNA p.R225X mutation). After cardiac differentiation and purification, cardiac cell sheets that were fabricated through cultivation on a temperature-responsive culture dish were transferred to the surface of the fibrin gel, and the contractile force was measured. The contractile force and maximum contraction velocity, but not the maximum relaxation velocity, were significantly decreased in cardiac cell sheet tissue with the lamin variant. A qRT-PCR analysis revealed that mRNA expression of some contractile proteins, cardiac transcription factors, Ca2+-handling genes, and ion channels were downregulated in cardiac tissue with the lamin variant.Human iPS-derived bioengineered cardiac tissue with the LMNA p.R225X mutation has the functional properties of systolic dysfunction and may be a promising tissue model for understanding the underlying mechanisms of DCM.