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Nishi-Tokyo-shi, Japan

Nakamura T.,Tokyo Womens Medical University | Nakamura T.,Itabashi Chuo Medical Center | Tsutsumi Y.,Tokyo Womens Medical University | Shimizu Y.,Tokyo Womens Medical University | Uchiyama S.,Tokyo Womens Medical University
Journal of Stroke and Cerebrovascular Diseases | Year: 2013

The presence of ulcerated carotid plaques is a risk factor for ischemic stroke, which is associated with thromboembolism. We evaluated the relationship between ulcerated carotid plaques and cerebrovascular events in patients with acute ischemic stroke or transient ischemic attack. We extracted 48 consecutive patients with ulcerated carotid plaques from a cohort of 1111 patients with acute ischemic stroke or transient ischemic attack. All patients were evaluated by carotid ultrasonography and diffusion-weighted magnetic resonance imaging. We defined thromboembolic events by excluding potential cardiac sources of embolism, stroke in posterior circulation, contralateral lesions, and single and small (<1.5 cm) subcortical lesions, and we considered the remaining patients with cortical lesions or multiple or large subcortical lesions as having experienced a thromboembolic cerebrovascular event. We compared ultrasonographic findings in the patients with and those without a thromboembolic cerebrovascular event. A relationship with thromboembolic events was suspected in 10 patients (21%) with ulcerated carotid plaques. The proportion of smokers was significantly higher in the group of patients with a thromboembolic event (90% vs 53%; P =.03). Logistic regression demonstrated a significant association between thromboembolic events and the presence of echolucent ulcerated plaques (odds ratio, 9.34, 95% confidence interval, 1.65-53.0), even though maximum intima-media thickness and other variables of ulcerated plaques (eg, depth of ulcers, thickness of the plaque, or the degree of stenosis) did not differ significantly between the 2 groups. Our findings indicate that although cerebrovascular events are closely associated with echolucent ulcerated carotid plaques, the prevalence of thromboembolism was not very high (∼20%) in our cohort of Japanese patients with ulcerated carotid plaques. © 2013 by National Stroke Association.

Kanenishi K.,Kagawa University | Hanaoka U.,Kagawa University | Noguchi J.,Kagawa Prefectural College of Health Sciences | Marumo G.,Itabashi Chuo Medical Center | Hata T.,Kagawa University
International Journal of Gynecology and Obstetrics | Year: 2013

Objective To assess the frequency of fetal facial expressions at 25-27 weeks of gestation using 4D ultrasound. Methods Twenty-four normal fetuses were examined using 4D ultrasound. The face of each fetus was recorded continuously for 15 minutes. The frequencies of tongue expulsion, yawning, sucking, mouthing, blinking, scowling, and smiling were assessed and compared with those observed at 28-34 weeks of gestation in a previous study. Results Mouthing was the most common facial expression at 25-27 weeks of gestation; the frequency of mouthing was significantly higher than that of the other 6 facial expressions (P < 0.05). Yawning was significantly more frequent than the other facial expressions, apart from mouthing (P < 0.05). The frequencies of yawning, smiling, tongue expulsion, sucking, and blinking differed significantly between 25-27 and 28-34 weeks (P < 0.05). Conclusion The results indicate that facial expressions can be used as an indicator of normal fetal neurologic development from the second to the third trimester. 4D ultrasound may be a valuable tool for assessing fetal neurobehavioral development during gestation. © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

In the KDIGO CKD-MBD guideline, the disorder "renal osteodystrophy" is defined as bone histological changes, which can be diagnosed only by bone biopsy. New bone diagnosis method, "TMV classification" is introduced instead of classical classification system. In order to diagnose TMV classification, undecalcified bone specimen after tetracycline double labeling is required. In TMV classification, "T" stands for bone turnover and is evaluated by bone formation rate (BFR/BS) or activation frequency (Acf) . "M" stands for bone mineralization and is evaluated by mean osteoid thickness (O.Th) and mineralization lag time (Mlt) . "V" stands for cancellous bone volume and is diagnosed by total bone volume (BV/TV) .

Nakashima M.,Itabashi Chuo Medical Center
Therapeutic Research | Year: 2011

Upper limbs swelling and jugular vein dilatation are well known complication caused by obstruction or stenosis of subclavian vein, after implantation of pacing lead. We experienced one case of subacute transient left external jugular vein dilatation without left limb swelling after pacemaker implantation. Postoperative venography revealed no obstruction nor stenosis in both subclavian and external jugular vein. External jugular vein dilatation might be resulting from displacement of subclavian vein concomitant with pacing lead insertion.

Hata T.,Kagawa University | Hanaoka U.,Kagawa University | Mashima M.,Kagawa University | Ishimura M.,GE Yokogawa Medical Systems | And 2 more authors.
Journal of Medical Ultrasonics | Year: 2013

Background: Our objective was to present our experience of fetal facial expressions reconstructed employing the four-dimensional (4D) HDlive rendering mode. Methods: A total of 23 normal fetuses at 18-36 weeks' gestation were studied using the 4D HDlive rendering mode. Results: The 4D HDlive rendering mode provided extraordinarily realistic features of the fetal face. In particular, blinking, mouthing, swallowing, yawning, tongue expulsion, and sucking were clearly noted. Moreover, various realistic fetal emotional expressions such as smiling-like and crying-like movements were recognized. The 4D HDlive rendered images of fetal facial expressions seem to be more readily discernible than those obtained by conventional 4D ultrasonography. Conclusion: Observation of facial expressions using the 4D HDlive rendering mode is considered to reflect the normal and abnormal neurological development of the fetus. Therefore, the 4D HDlive rendering mode may assist in evaluation of fetal brain function, and offer potential advantages relative to conventional 4D ultrasonography. © 2013 The Japan Society of Ultrasonics in Medicine.

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