Kashima-shi, Japan
Kashima-shi, Japan

Time filter

Source Type

Horikawa E.,Center for Comprehensive Community Medicine | Hirotsu T.,Yuai Kai Oda Hospital
Internal Medicine | Year: 2014

Objective The distribution of the Mini-Mental State Examination (MMSE) scores by age and educational level was investigated in subjects that underwent comprehensive brain examinations.Methods This cross-sectional study included 1,414 adults without neurological disorders who underwent health-screening tests of the brain, referred to as the “Brain Dock,” in our center. The MMSE scores were compared between age groups (40-44, 45-49, 50-54, 55-59, 60-64, 65-69, or _70 years) and educational levels [the low education level group (6-12 years) and the high education level group (_13 years)].Results The median age was 59 years, and 763 (54%) were women. There was no significant difference in the MMSE total score between women and men. The stepwise method of the multiple linear regression analysis confirmed that a higher age [β value, -0.129; standard error (S.E.), 0.020; p<0.001], low education level (6-12 years) (β value, -0.226; S.E., 0.075; p=0.003), and women (β values, 0.148; S.E., 0.066; p=0.024) was significantly associated with decreased MMSE score. In general, both the percentile scores and mean scores decreased with aging and were lower in the low education level group than in the high education level group. The degree of decrement in scores with age was stronger in the low education level group than in the high education level group.Conclusion The provided data for age- and education-specific reference norms will be useful for both clinicians and investigators who perform comprehensive brain examinations to assess the cognitive function of subjects. © 2014 The Japanese Society of Internal Medicine.


Yakushiji Y.,Saga University | Yakushiji Y.,University College London | Noguchi T.,Saga University | Charidimou A.,University College London | And 8 more authors.
Journal of Stroke and Cerebrovascular Diseases | Year: 2015

Background We previously showed that global cognitive function was associated with deep or infratentorial (D/I) cerebral microbleeds (CMBs) in a Japanese healthy cohort. We continually recruited participates and performed further investigation to focus on the impact of different distributions of D/I CMBs on gradient-echo magnetic resonance imaging on global cognitive function. Methods A total of 1392 subjects including subjects without CMBs (n = 1335), with D/I CMBs limited to the basal ganglia (BG; BG group, n = 33), thalamus (thalamus group, n = 14), and infratentorial area (infratentorial group, n = 10) were included in analyses. Subjects with strictly lobar CMBs (n = 43) were excluded, but subjects in the BG, thalamus, and infratentorial groups could also have lobar CMBs. The mini-mental state examination (MMSE) was administered to determine global cognitive function; scores less than 27 or more than 1.5 standard deviations (SDs) below the age-education-related mean were regarded as impaired. Results In the multivariable logistic regression analyses, hypertension and severe white matter hyperintensities were associated with the BG group and the thalamus group. In multivariable logistic regression analysis of the association between D/I CMBs classification and impaired MMSE score, only the BG group consistently displayed associations with both MMSE score less than 27 (odds ratio [OR], 5.96; 95% confidence interval [CI], 2.08-17.09) and MMSE score more than 1.5 SDs below the age-education-related mean (OR, 3.34; 95% CI, 1.24-8.99). In the BG group, adjusted mean scores of total MMSE and "attention and calculation" were lower compared with subjects without CMBs. Conclusions In our study of D/I CMBs, only BG CMBs have strong association with global cognitive function. This association was independent of CMBs in other location. © 2015 National Stroke Association.


PubMed | Saga University, Yuai Kai Oda Hospital and University College London
Type: Journal Article | Journal: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association | Year: 2015

We previously showed that global cognitive function was associated with deep or infratentorial (D/I) cerebral microbleeds (CMBs) in a Japanese healthy cohort. We continually recruited participates and performed further investigation to focus on the impact of different distributions of D/I CMBs on gradient-echo magnetic resonance imaging on global cognitive function.A total of 1392 subjects including subjects without CMBs (n = 1335), with D/I CMBs limited to the basal ganglia (BG; BG group, n = 33), thalamus (thalamus group, n = 14), and infratentorial area (infratentorial group, n = 10) were included in analyses. Subjects with strictly lobar CMBs (n = 43) were excluded, but subjects in the BG, thalamus, and infratentorial groups could also have lobar CMBs. The mini-mental state examination (MMSE) was administered to determine global cognitive function; scores less than 27 or more than 1.5 standard deviations (SDs) below the age-education-related mean were regarded as impaired.In the multivariable logistic regression analyses, hypertension and severe white matter hyperintensities were associated with the BG group and the thalamus group. In multivariable logistic regression analysis of the association between D/I CMBs classification and impaired MMSE score, only the BG group consistently displayed associations with both MMSE score less than 27 (odds ratio [OR], 5.96; 95% confidence interval [CI], 2.08-17.09) and MMSE score more than 1.5 SDs below the age-education-related mean (OR, 3.34; 95% CI, 1.24-8.99). In the BG group, adjusted mean scores of total MMSE and attention and calculation were lower compared with subjects without CMBs.In our study of D/I CMBs, only BG CMBs have strong association with global cognitive function. This association was independent of CMBs in other location.


Yakushiji Y.,Saga University | Yakushiji Y.,National Hospital for Neurology and Neurosurgery | Charidimou A.,National Hospital for Neurology and Neurosurgery | Hara M.,Saga University | And 8 more authors.
Neurology | Year: 2014

Objective: We investigated whether the topography of MRI-visible perivascular spaces (PVS) is associated with markers of specific underlying small vessel disease, including cerebral microbleed (CMB) distribution, in neurologically healthy adults. Methods: We analyzed baseline data of an ongoing Japanese population-based cohort study. PVS were rated in the basal ganglia (BG-PVS) and centrum semiovale (CSO-PVS) on axial T2-weighted MRI using a validated rating scale (score 0-4). BG-PVS degree was classified as low (score ,2) or high (score $2). CSO-PVS degreewas classified as low (score,3) or high (score$3). Independent demographic, clinical, and imaging factors for high degree of BG-PVS and CSO-PVS were investigated. Results: A total of 1,575 neurologically healthy adults were included (mean age 57.1 years, SD 9.7; 47% male). In multivariable analyses, high degree of BG-PVS (n 5 212, 14%) was associated with deep or infratentorialCMBs (odds ratio [OR] 2.77, 95%confidence interval [CI] 1.62-4.74), amarker of hypertensive arteriopathy; by contrast, high degree of CSO-PVS (n 5 357, 23%) was associated with strictly lobar CMBs (OR 2.49, 95% CI 1.35-4.61), which share risk factors with cerebral amyloid angiopathy. Both high degree of BG-PVS and CSO-PVS were associated with hypertension (OR 2.03, 95% CI 1.46-2.82 and OR 1.39, 95% CI 1.07-1.81, respectively), lacunes (OR 3.35, 95% CI 1.92-5.86; OR 1.83 95% CI 1.08-3.08), and severe white matter hyperintensities (OR 2.17, 95% CI 1.42-3.31; OR 1.35, 95%CI 0.93-1.96), but these associations were stronger for high degree of BG-PVS. Conclusions: In a neurologically healthy cohort, the associations of PVS differ according to their topography. PVS distribution may be useful for the early detection and classification of small vessel disease. ©2014 American Academy of Neurology.


Sawatsubashi M.,Kyushu University | Murakami D.,Kyushu University | Oda M.,Yuai kai Oda Hospital | Komune S.,Kyushu University
The Journal of laryngology and otology | Year: 2015

OBJECTIVE: The present study investigates the indications for transnasal endoscopic surgery in treating post-operative maxillary cysts.METHODS: In this retrospective study, the records of 118 patients with post-operative maxillary cysts (88 unilateral and 30 bilateral) consisting of 148 procedures were reviewed.RESULTS: A transnasal endoscopic approach was performed in 144 lesions (97.3 per cent). A combined endonasal endoscopic and canine fossa (external) approach was performed in 4 of 148 lesions, because the cysts were located distant from the nasal cavity and had a thick bony wall. A ventilation stent was placed in four patients (four cysts) to avoid post-operative meatal antrostomy stenosis. Recurrence was observed in five patients (4.2 per cent), all of whom subsequently underwent transnasal endoscopic revision surgery.CONCLUSION: Transnasal endoscopic surgery is an effective treatment for post-operative maxillary cyst with the exception of cysts located distant from the nasal cavity.


PubMed | Yuai kai Oda Hospital and Kyushu University
Type: | Journal: The Journal of laryngology and otology | Year: 2015

The present study investigates the indications for transnasal endoscopic surgery in treating post-operative maxillary cysts.In this retrospective study, the records of 118 patients with post-operative maxillary cysts (88 unilateral and 30 bilateral) consisting of 148 procedures were reviewed.A transnasal endoscopic approach was performed in 144 lesions (97.3 per cent). A combined endonasal endoscopic and canine fossa (external) approach was performed in 4 of 148 lesions, because the cysts were located distant from the nasal cavity and had a thick bony wall. A ventilation stent was placed in four patients (four cysts) to avoid post-operative meatal antrostomy stenosis. Recurrence was observed in five patients (4.2 per cent), all of whom subsequently underwent transnasal endoscopic revision surgery.Transnasal endoscopic surgery is an effective treatment for post-operative maxillary cyst with the exception of cysts located distant from the nasal cavity.


Hara M.,Saga University | Yakushiji Y.,Saga University | Nannri H.,Saga University | Sasaki S.,University of Tokyo | And 5 more authors.
Hypertension Research | Year: 2013

Brain microbleeds (MBs) are potential risk factors for future stroke, and hypertension is an established risk factor for MBs. However, data on other lifestyle-related risk factors and their joint effects with hypertension are limited. We enrolled 860 adults who underwent 1.5-T brain magnetic resonance imaging and had no history of stroke. Information on clinical risk factors was obtained from health-screening tests, and dietary history was assessed using a validated, brief, self-administered dietary questionnaire. Subjects were divided into three groups (no MBs, deep MBs and lobar MBs), which were compared for the potential risk factors; their joint effects with hypertension were assessed by logistic regression. Biologic interaction was estimated with the synergy index. After adjustment for possible confounders, age and systolic and diastolic blood pressures were found to be associated with the presence of MBs in a dose-dependent manner, especially in the case of deep MBs. With regard to lifestyle-related factors, current smoking status was significantly associated with deep MBs, and the odds ratio was 2.73 (95% confidence interval (CI) 1.15-6.48). We found that hypertension and current smoking status, higher alcohol consumption or lower calcium intake had joint effects on the risk of MBs and that hypertension and current smoking status had synergistic additive action (synergy index, 6.30; 95% CI 1.07-37.13). These results suggest that approaches combining lowering blood pressure and smoking cessation may greatly reduce the risk of MBs and contribute to preventing stroke.


Yakushiji Y.,Saga University | Nanri Y.,Saga University | Hirotsu T.,Yuai Kai Oda Hospital | Nishihara M.,Saga University | And 6 more authors.
Hypertension Research | Year: 2010

The relationship between kidney dysfunction, such as chronic kidney disease (CKD), and brain morphology has attracted increasing attention, but the association between kidney dysfunction and cerebral atrophy has yet to be determined. The purpose of this study was to clarify the relationship between kidney function and a substantial degree of cerebral atrophy. A total of 610 consecutive Japanese adults without neurological disorders who had undergone health screening tests of the brain were studied prospectively. Magnetic resonance imaging was performed using a 1.5-T scanner. Using a computer-assisted processing system, the percentage of cerebrum atrophy (%Cerebrum atrophy) was calculated as an index of cerebral atrophy. Atrophy was defined as >2 s.d.s below the mean %Cerebrum atrophy. The glomerular filtration rate (GFR) was estimated using the revised equations for estimated GFR from serum creatinine in Japan. Kidney function variables included the GFR value and the prevalence of subjects with GFR <60 ml min -1 per 1.73 m 2. Cerebral atrophy was found in 25 (4.1%) cases. Univariate analysis showed that age, male sex, hypertension, each kidney function variable, white matter hyperintensities and lacunae were associated with cerebral atrophy. On logistic regression analysis, GFR (odds ratio (OR), 0.64; 95% confidence interval (CI), 0.42-0.98) and GFR <60 ml min -1 per 1.73 m 2 (OR, 5.93; 95% CI, 1.82-19.27) were significantly associated with cerebral atrophy. On sub-analysis, GFR 60 ml min -1 per 1.73 m 2 was significantly associated with cortical atrophy (OR, 3.23; 95% CI, 1.15-9.11). Decreased GFR was significantly associated with cerebral atrophy, indicating that treatment of CKD may control age-related degenerative processes of the brain. © 2010 The Japanese Society of Hypertension All rights reserved.


Yakushiji Y.,Saga University | Noguchi T.,Saga University | Hara M.,Saga University | Nishihara M.,Saga University | And 7 more authors.
Stroke | Year: 2012

Background and Purpose-Brain microbleeds (MBs) are considered to be associated with cognitive decline and can be pathologically and topographically classified as cerebral amyloid angiopathy-related (located in lobar regions) and hypertensive microangiopathy-related (located in deep regions). We examined whether different effects on global cognitive function might be seen with different distributions of MBs. Methods-A total of 1279 adults without neurological disorders were studied prospectively. Subjects were divided into 4 groups: without-MBs group; lobar group; deep group; and with in both areas (diffuse group). The Mini-Mental State Examination was administered to determine global cognitive functions, with scores <27 regarded as subnormal. Results-MBs were detected in 98 subjects (8%): 36 subjects (3%) classified as lobar group, 48 subjects (4%) as deep group, and 14 subjects (1%) as diffuse group. Subnormal scores were found in 76 subjects (5.9%), associated with age, education, hypertension, severe white matter hyperintensities, and distribution and number of MBs. In the final model of logistic regression analysis, the deep group (OR, 2.79; 95% CI, 1.14-6.79) was associated with subnormal scores, whereas the lobar group (OR, 0.77; 95% CI, 0.17-3.44) was not. Trend for the diffuse group did not reach the level of significance (OR, 5.01; 95% CI, 0.88-28.41). These trends were also seen in analysis using another cut-off point for subnormal score. Scores for total Mini-Mental State Examination and attention and calculation were significantly lower in the deep group and the diffuse groups compared with the without-MBs group. Conclusions-This Japanese cross-sectional study demonstrated that MB-related global cognitive dysfunction seems to occur based on hypertensive pathogenesis rather than on cerebral amyloid angiopathy. © 2012 American Heart Association, Inc.

Loading Yuai Kai Oda Hospital collaborators
Loading Yuai Kai Oda Hospital collaborators