{"title":"[Carotid and coronary artery disease associated with brain infarction].","authors":"Yasushi Okada","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19163,"journal":{"name":"No to shinkei = Brain and nerve","volume":"58 10","pages":"823-30"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26349184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Megumi Ueda, Yutaka Takayama, Yoshie Koyama, Hisao Osada
{"title":"[A detection of very mild Alzheimer's disease and MCI by memory complaints and deterioration of IADL in a questionnaire for a memory clinic].","authors":"Megumi Ueda, Yutaka Takayama, Yoshie Koyama, Hisao Osada","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and purpose: </strong>There have been very few studies trying to explain about daily life features of patients with very mild Alzheimer disease (AD) and of those with mild cognitive impairment (MCI). The purpose of this study was 1) to clarify characteristics of very mild AD and MCI in their daily life, and 2) to examine items in a questionnaire that can be useful for detecting subjects of suspected AD.</p><p><strong>Subjects and methods: </strong>Subjects were 111 patients of the memory clinic in National Center Hospital for Mental, Nervous, and Muscular Disorders, National Center of Neurology and Psychiatry, Japan; 39 normal range, 28 MCI, and 44 very mild AD. On their first visits, they were asked to fill out a questionnaire consisted of 103 items. Thirty five items in a questionnaire were selected, 15 memory-complaint items and 20 items of instrumental activities of daily living (IADL), and examined retrospectively. At first we compared each set of groups using the chi-square test. Then a logistic regression analysis was used to observe which items contributed to judge a person to be suspected of AD. And further, sensitivity and specificity for discriminating between an AD suspected and a normal range were examined.</p><p><strong>Results: </strong>None of the items showed statistical significance between MCI group and very mild AD group. Then, we combined these two groups into one group (n = 72), and made comparison between this new group and normal range group (n = 39). There were 18 items that showed statistical significance between the two groups. And five of them, 'dysfunction of memory: noticed by others', 'dysfunction of memory: getting worse', 'unable to utilize the memorandum', 'forget incidents occurred a few days ago' and 'unable to locate unfamiliar places' showed significantly high odds ratio in judgment on a person to be suspected of AD. In addition to preceding 5 items we adopted two items, 'dysfunction of memory: unnoticeable by her/himself' and 'unable to manage household expenses', which were not included in the logistic regression analysis, but were essential for the discrimination between the two groups. The sum of score of these 7 items showed high specificity and sensitivity for dividing between the two groups.</p><p><strong>Conclusion: </strong>These findings indicated that an exploration of memory complaints and deteriorations of IADL was useful for the detection of MCI and very mild AD, especially 7 items described above could be used as a simple questionnaire for the elderly.</p>","PeriodicalId":19163,"journal":{"name":"No to shinkei = Brain and nerve","volume":"58 10","pages":"865-71"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26349068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Masahiro Yasaka, Yasushi Okada, Tooru Inoue, Hiromasa Yoshikawa, Motonori Saku
{"title":"[The questionnaire survey to clarify correspondence of medical doctors and dentists in Fukuoka City, Japan, for warfarin therapy at the dental extraction].","authors":"Masahiro Yasaka, Yasushi Okada, Tooru Inoue, Hiromasa Yoshikawa, Motonori Saku","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>The questionnaire survey was performed in order to clarify correspondence of medical doctors and dentists working at hospital service for warfarin therapy at the dental extraction.</p><p><strong>Methods: </strong>For 17 senior dentists in 17 hospitals and 142 senior physicians in 82 hospitals in Fukuoka City, we investigated using the questionnaire whether they supported dental extraction under warfarin therapy or not in patients having warfarin treatment with past history of cardioembolic stroke due to non-valvular atrial fibrillation (NVAF). Specialty and experience of stroke after withdrawal of warfarin were also asked in medical doctors.</p><p><strong>Result: </strong>The reply was obtained from 14 dentists (82.4%) and 66 doctors (46.5%). The number of dentists and doctors who pull out a tooth under warfarin treatment continuation were 12 persons (85.7%) and 32 persons (48.5%), respectively. The rates in doctors whose specialty was stroke, cardiovascular disease, and others were 78.6% (11/14), 36.0% (9/25), and 44.4% (12/27), respectively. The rate in stroke specialists was significantly higher than that in cardiovascular disease specialists (p = 0.019). The stroke specialists had experience of stroke after withdrawal of warfarin more frequently than the cardiovascular disease specialists (57.1% vs. 20.0%, p = 0.033).</p><p><strong>Conclusion: </strong>The rates of acceptance in tooth extraction under warfarin treatment continuation of the dentist were high in Fukuoka city, while that of the medical doctors were not. Rate of doctor's acceptance differed according to the specialties, and may be affected by experience of stroke after cessation of warfarin therapy.</p>","PeriodicalId":19163,"journal":{"name":"No to shinkei = Brain and nerve","volume":"58 10","pages":"857-63"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26349067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Quality assurance of medical treatment and preventable trauma death].","authors":"Yukihiro Maeda, Yoshimasa Umesato, Hisashi Ohmichi, Kenji Dohi, Yasuhumi Miyake, Tohru Aruga, Norio Nakamura","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19163,"journal":{"name":"No to shinkei = Brain and nerve","volume":"58 10","pages":"849-55"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26349066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[A case of Tolosa-Hunt syndrome demonstrated by fat-suppression MR images].","authors":"Katsunori Akiyama, Fumiko Kita, Akiko Hatano, Yutaka Kametsu, Shigeharu Takagi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19163,"journal":{"name":"No to shinkei = Brain and nerve","volume":"58 10","pages":"899-900"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26349073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Cerebral artery lesion in a patient with infective endocarditis: serial MRI and MRA findings of cerebral artery stenosis].","authors":"Yoshiharu Taguchi, Shutaro Takashima, Kyo Noguchi, Nobuhiro Dougu, Koutaro Tanaka","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We reported a case of infective endocarditis (IE) complicated with bacterial meningitis and cerebral artery stenosis. A 22-year-old man was admitted to our hospital because of IE. Although benzylpenicillin administration was continued, he abruptly developed consciousness disturbance on the seventh day. His cerebrospinal fluid indicated bacterial meningitis. MRI with gadolinium (Gd) enhancement showed septic embolism in the left parietal lobe and bi-linear enhancement on the right middle cerebral artery (MCA). MRA demonstrated narrowing of the MCA at the same site as the bi-linear Gd enhancement. We considered that these findings show narrowing of the MCA was due to cerebral arteritis. Intravenous administration of ampicillin and cefpirome gradually improved both IE and cerebral artery stenosis. We wish to emphasize that combination of MRI with Gd enhancement and MRA may be useful not only for diagnosis of cerebral artery stenosis but also for evaluation of treatment effect.</p>","PeriodicalId":19163,"journal":{"name":"No to shinkei = Brain and nerve","volume":"58 10","pages":"879-83"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26349070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Parkinsonism secondary to chronic subdural hematoma. A case report].","authors":"Masayuki Sugie, Kenji Ishihara, Yuzou Horibe, Mitsuru Kawamura","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We described a case of secondary parkinsonism due to chronic subdural hematoma (CSH). An 83-year-old man developed memory impairment and gait disturbance gradually since one year ago, and these symptoms subacutely deteriorated after he fell down and hit his head. On admission he had moderate cognitive impairment, gait disturbance (wide-based, small steps and initial freezing), postual instability, akinesia and right-sided rigidity. He did not have resting tremor. A CT scan showed a right-sided CSH with marked compression on the left hemisphere, and remarkable decrease of the blood flow in the left cerebral hemisphere was revealed by single photon emission computed tomography. His neurological condition improved gradually through the decrease of the CSH, which suggested the diagnosis of secondary parkinsonism due to CSH. We thought that the CSH in the right hemisphere caused right-sided parkinsonism through mechanical compression to the left hemisphere, which was shown in the SPECT image, in this case. Elderly people suffering from subacute progressive parkinsonism, should undergo CT studies be to differentiate the parkinsonism secondary to CSH.</p>","PeriodicalId":19163,"journal":{"name":"No to shinkei = Brain and nerve","volume":"58 10","pages":"873-8"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26349069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[A case of pure agraphia due to left parietal lobe infarction].","authors":"Hisa Yaguchi, Masamitsu Yaguchi, Mitsuaki Bando","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We reported a case of an 86-year old woman with pure agraphia due to the left parietal lobe infarction. The characteristics of agraphia were as follows. Most errors in Kana and Kanji writing to dictation and copying were no response. She was able to write only numerals from 1 to 12 precisely. Most errors in numerals were substitution. One unrecognizable numeral was found. She succeeded in pointing to nine among ten single Kana letter named by the examiner with the systematic table of the Japanese syllabary, but missed in pointing to Kana words. It took more time for the patient to point to single Kana letter than the control. Magnetic resonance imaging showed a cerebral infarction in the left parietal lobe which included a part of superior parietal lobule and supramarginal gyrus. We classified pure agraphia with parietal lobe infarction into two types in our previous report. In one type (type 1), letters in writing are poorly formed, but the ability to make words with the methods other than writing are reserved. The only deficit of graphic motor pattern could cause Type 1 agraphia. In another type (type 2), letters in writing were well-formed, but spelling with anagram or typing was disturbed. The deficits of writing process other than graphic motor pattern could cause Type 2 agraphia. This typing seems to be effective not only in Kana but also in Kanji. In this report, we investigated the differences of lesion between two types out of some references. Type1 agraphia seems related to lesion of left superior parietal lobule, while Type 2 agraphia seems related to lesion of left supramarginal gyrus. This case had the features of type 2 agraphia at least, and the compatible lesions.</p>","PeriodicalId":19163,"journal":{"name":"No to shinkei = Brain and nerve","volume":"58 10","pages":"885-92"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26349071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Imaging of cardiac sources of cerebral embolism].","authors":"Satoshi Nakatani","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":19163,"journal":{"name":"No to shinkei = Brain and nerve","volume":"58 10","pages":"831-6"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26349185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hideki Bandai, Yukoh Ohara, Fumi Dei, Hideyuki Mitsuoka, Kuniaki Bando
{"title":"[A case of idiopathic thoracic spinal cord herniation].","authors":"Hideki Bandai, Yukoh Ohara, Fumi Dei, Hideyuki Mitsuoka, Kuniaki Bando","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report a case of idiopathic thoracic spinal cord herniation. A 63-year-old female came to our hospital complaining of a slowly progressive gait disturbance that began 5 years ago. She showed signs of a left dominant spastic paraparesis and sensory disturbance. Her left foot had already became a drop foot from 2 years ago. Magnetic resonance (MR) imaging and computed tomographic (CT) myelography demonstrated that the atrophic spinal cord had displaced to the ventral side with a dilated dorsal subarachnoid space at T2-3 level. Surgery was performed via T2-3 laminoplastic laminectomy. The ventral aspect of the spinal cord revealed a defect in the inner layer of the duplicated dura mater, into which the gliotic spinal cord herniated. The herniated spinal cord was repositioned and the dural defect was repaired using a GORE-TEX dura substitute. Postoperative course was uneventful. Although the patient showed marked improvement in the right lower limb, there was slight improvement in the left lower limb. The clinical symptoms of this disease are uncommon and progress slowly, and if left untreated will result in paraparesis. Therefore early diagnosis and operation is important to prevent the progression of symptoms and to achieve a satisfactory outcome.</p>","PeriodicalId":19163,"journal":{"name":"No to shinkei = Brain and nerve","volume":"58 10","pages":"893-7"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26349072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}