[Repeated Bow hunter's stroke by artery-to-artery embolism from the vertebral artery dissecting aneurysm formed by head rotation: A case report].

A 55-year-old woman suffered from diplopia and occipital pain after shoveling snow. She was diagnosed with the right vertebral artery dissecting aneurysm at the level of the axial vertebra and repeatedly had cerebral infarctions in the posterior circulation. She had subluxation of the atlantoaxial vertebra as an underlying disease.

Japan Trevo Registry: Real-world Registry of Stent Retriever Alone or in Combined Therapy with Aspiration Catheter for Acute Ischemic Stroke in Japan.

Endovascular therapy (EVT) for real-world patients after extended time frames is associated with concerns about its efficacy and safety. We conducted a prospective registry at 77 centers between November 2019 and October 2020. The registry criteria included patients treated with Trevo Retriever alone or in combined therapy with an aspiration catheter.

Endovascular Therapy for Acute Stroke with a Large Ischemic Region.

Background: Endovascular therapy for acute ischemic stroke is generally avoided when the infarction is large, but the effect of endovascular therapy with medical care as compared with medical care alone for large strokes has not been well studied.

Methods: We conducted a multicenter, open-label, randomized clinical trial in Japan involving patients with occlusion of large cerebral vessels and sizable strokes on imaging, as indicated by an Alberta Stroke Program Early Computed Tomographic Score (ASPECTS) value of 3 to 5 (on a scale from 0 to 10, with lower values indicating larger infarction). Patients were randomly assigned in a 1:1 ratio to receive endovascular therapy with medical care or medical care alone within 6 hours after they were last known to be well or within 24 hours if there was no early change on fluid-attenuated inversion recovery images.

Safety, Pharmacokinetics and Pharmacodynamics of DS-1040, in Combination with Thrombectomy, in Japanese Patients with Acute Ischemic Stroke.

Background And Objectives: DS-1040 is a novel inhibitor of the activated form of thrombin-activatable fibrinolysis inhibitor that may have therapeutic potential in thromboembolic diseases, such as acute ischemic stroke (AIS) or pulmonary embolism. We undertook a Phase I clinical trial to investigate the safety, pharmacokinetics, and pharmacodynamics of DS-1040 in Japanese patients who were eligible for thrombectomy following AIS.

Methods: The trial enrolled patients with AIS due to large vessel occlusion, who were planned for thrombectomy within 8 h of symptom onset.

Development of a Method for Scaffold-Free Elastic Cartilage Creation.

Microtia is a congenital aplasia of the auricular cartilage. Conventionally, autologous costal cartilage grafts are collected and shaped for transplantation. However, in this method, excessive invasion occurs due to limitations in the costal cartilage collection.

A novel electron emission-based cell culture device promotes cell proliferation and differentiation of pre-osteoblastic MC3T3-E1 cells.

In this report we demonstrate the effect of a novel electron emission-based cell culture device on the proliferation and differentiation of pre-osteoblastic MC3T3-E1 cells. Our device has an electron emission element that allows, for the first time, stable emission of electrons into an atmosphere. Atmospheric electrons react with gas molecules to generate radicals and negative ions, which induce a variety of biochemical reactions in the attached cell culture system.

East-West paths to unconventional computing.

Unconventional computing is about breaking boundaries in thinking, acting and computing. Typical topics of this non-typical field include, but are not limited to physics of computation, non-classical logics, new complexity measures, novel hardware, mechanical, chemical and quantum computing. Unconventional computing encourages a new style of thinking while practical applications are obtained from uncovering and exploiting principles and mechanisms of information processing in and functional properties of, physical, chemical and living systems; in particular, efficient algorithms are developed, (almost) optimal architectures are designed and working prototypes of future computing devices are manufactured.

Clinical characteristics of arteriovenous malformations in the cerebellopontine angle cistern.

OBJECTIVE Arteriovenous malformations (AVMs) in the cerebellopontine angle cistern (CPAC) are specific lesions that can cause neurovascular compression syndromes as well as intracranial hemorrhage. Although case reports describing the CPAC AVMs, especially those presenting with trigeminal neuralgia (TN), have been accumulating by degrees, the pathophysiology of CPAC AVMs remains obscure. The authors' purpose in the present study was to evaluate the clinical and radiographic features of CPAC AVMs as well as the treatment options.

Relationship between histologic features and outcomes of carotid revascularization for radiation-induced stenosis.

Objective: This study aimed to elucidate the relationships between preoperative carotid imaging results, histologic characteristics, and surgical treatment outcomes of radiation-induced carotid stenosis (RICS), using control subjects without RICS for comparison.

Methods: We retrospectively reviewed records of 17 patients who underwent carotid revascularization for 22 instances of RICS, including 10 cases of carotid artery stenting (CAS), 11 cases of carotid endarterectomy (CEA), and 1 case of CEA with retrograde CAS, between July 2004 and April 2013. The controls were 475 patients with no history of radiation therapy who underwent carotid revascularization in a similar period.

Consciousness level and off-hour admission affect discharge outcome of acute stroke patients: a J-ASPECT study.

Background: Poor outcomes have been reported for stroke patients admitted outside of regular working hours. However, few studies have adjusted for case severity. In this nationwide assessment, we examined relationships between hospital admission time and disabilities at discharge while considering case severity.

Empirical analysis of the long-term effects of telecare use in Nishi-aizu Town, Fukushima Prefecture, Japan.

This paper examined the long-term effects of the use of telecare (e-Health) on the residents of Nishi-aizu Town, Fukushima, Japan, between 2002 and 2010. We compared medical expenditure and days of treatment between telecare users (treatment group) and non-users (control group) based on receipt data obtained from the National Health Insurance, which is operated by the government. In previous studies, we used receipt data obtained for the years 2002 to 2006; this study expands the analysis period four more years with respect to respondents who were included in previous analyses.

Long-term follow-up of intra-aneurysmal coil embolization for unruptured paraclinoid aneurysms.

Objectives: The selection of therapeutic modalities, including endovascular coil embolization and surgical clipping, for management of unruptured paraclinoid aneurysms, remains controversial. Detailed long-term outcome data for endovascular coil embolization of unruptured paraclinoid aneurysms are still lacking. Thus, we evaluated the safety and efficacy of coil embolization of unruptured paraclinoid aneurysms.

Intra-aneurysmal coil embolization for large or giant carotid artery aneurysms in the cavernous sinus.

This study evaluated the effectiveness of intra-aneurysmal coil embolization for large or giant carotid artery aneurysms in the cavernous sinus in seven patients treated by intra-aneurysmal coil embolization from 2001 to 2010. Only one patient showed improved neurological symptoms caused by aneurysmal mass effect during the mean follow-up period of 53.4 ± 27.

Blood pressure measurement in the artery proximal and distal to an intra-arterial embolus during thrombolytic therapy.

Background And Aim: When a cerebral embolism occurs, pressure gradients in the arteries between sites proximal and distal to the embolus exert hydromechanical forces that push the embolus distally, and potentially affect successful revascularization during clot removal. We investigated the relationships between blood pressures that occur immediately distal and proximal to the embolus, systemic blood pressure and clinical variables.

Methods: 36 patients with embolism of the internal carotid artery (13 patients) or the proximal middle cerebral artery (23 patients) were treated using intra-arterial thrombolysis.

Flow impairment during filter-protected carotid artery stent placement: frame-by-frame evaluation of digital subtraction angiography images.

Objective: To evaluate quantitatively flow impairment of contrast medium on digital subtraction angiography (DSA) performed before and after filter retrieval following carotid artery stent (CAS) placement with distal filter protection.

Methods: Retrospective analysis was performed of 55 CAS placement procedures with distal filter protection in 51 patients. From a qualitative analysis, the operators determined if there was flow reduction of contrast medium on digital subtraction angiography (DSA) before filter retrieval.

Allocation of absorbed light energy in PSII to thermal dissipations in the presence or absence of PsbS subunits of rice.

The thermal dissipation (TD) of absorbed light energy in PSII is considered to be an important photoprotection process in photosynthesis. A major portion of TD has been visualized through the analysis of Chl fluorescence as energy quenching (qE) which depends on the presence of the PsbS subunit. Although the physiological importance of qE-associated TD (qE-TD) has been widely accepted, it is not yet clear how much of the absorbed light energy is dissipated through a qE-associated mechanism.

Routine aspiration method during filter-protected carotid stenting: histological evaluation of captured debris and predictors for debris amount.

Background: A routine aspiration method in filter-protected carotid artery stenting (CAS) has been reported recently in which the proximal internal carotid artery (ICA) blood column was aspirated using an aspiration catheter after postdilatation regardless of flow state on digital subtraction angiography. We examined the debris particles captured by this method.

Methods: The routine aspiration method was used in 71 CAS procedures.

Obstruction of pores in distal protection filters and angiographically-documented flow impairment during carotid artery stenting.

Purpose: To determine any relationship between angiographically documented flow impairment associated with the Angioguard XP cerebral protection filter during carotid artery stenting (CAS) and the condition of the pores in the retrieved filter.

Methods: To obtain baseline characteristics of the Angioguard XP, an unused filter was fully expanded and examined photographically from the cephalad end of the device to determine the structure of the pores in the filter basket. Ten pores assembled in a hexagonal pattern made up a pore group, several of which were arranged in 4 concentric rings surround a central hub that did not have any pores.

Routine use of debris aspiration before retrieval of distal filter protection devices in carotid arterial stenting: analysis of captured debris and evaluation of clinical results.

Background: Distal filter protection allows for continuous cerebral perfusion during carotid artery stenting (CAS), although a higher risk of debris migrating into the cerebral arteries compared with other protection systems has been reported.

Objective: To improve the extent of debris capture, we used routine aspiration of blood located proximal to the filter in the internal carotid artery blood column before retrieval of the filter device.

Methods: Of 71 CAS procedures with distal filter protection, routine aspiration was performed in 41 procedures.

Change in cortical vein appearance on susceptibility-weighted MR imaging before and after carotid artery stenting.

Objectives: Susceptibility-weighted (SW) magnetic resonance (MR) imaging is a sensitive test to detect intravenous deoxygenated blood. On SW images, dilated appearing draining veins in tissue with perfusion impairment occur due to an increase in intravenous deoxyhemoglobin levels, and could indicate poor perfusion areas in which there is an elevated oxygen extraction fraction. In this study, patients with possible chronic ischemia caused by internal carotid artery stenosis underwent carotid artery stenting (CAS).

Long-term follow up of patients with good outcome after intra-arterial thrombolysis for major arterial occlusion in the carotid territory: clinical and magnetic resonance imaging evaluation.

Long-term clinical symptoms, including extrapyramidal signs, and magnetic resonance (MR) imaging studies were retrospectively analyzed in 21 patients with good outcome (modified Rankin scale scores 0-2) after successful recanalization of occluded major arteries by intra-arterial thrombolysis with mechanical disruption. Changes in high intensity areas (HIAs) and cerebral atrophy in the ischemic hemisphere were evaluated on follow-up fluid-attenuated inversion recovery MR images. Extrapyramidal signs, short-stepped gait and/or masked face, were observed in 12 of 21 patients during the follow-up period (11 to 68 months, mean 42 months).

Thin-section diffusion-weighted imaging of the infratentorium in patients with acute cerebral ischemia without apparent lesion on conventional diffusion-weighted imaging.

False-negative diffusion-weighted (DW) imaging findings are often encountered during the acute stage of cerebral ischemia. The types of acute ischemia most likely to be missed by conventional DW imaging, and the utility of additional thin-section DW imaging of the infratentorium were investigated in 192 consecutive patients admitted within 24 hours of the onset of ischemic symptoms. If 6-mm section DW imaging at admission showed no obvious lesion, additional 3-mm section DW imaging of the infratentorium was performed.

Predictors of hematoma enlargement in patients with intracerebral hemorrhage treated with rapid administration of antifibrinolytic agents and strict blood pressure control.

Object: Hematoma enlargement is a major cause of poor outcome in patients with intracerebral hemorrhage (ICH). A combination of rapid administration of antifibrinolytics and strict blood pressure (BP) control for prevention of hematoma enlargement has been recently reported. The authors examined the incidence and predictors of hematoma enlargement in patients with ICH who were treated with this therapy.

Meningeal hemangiopericytoma manifesting as massive intracranial hemorrhage--two case reports.

Meningeal hemangiopericytoma is rare, and only seven cases have manifested as intracranial hemorrhage. We treated two patients with meningeal hemangiopericytoma manifesting as life-threatening massive intracerebral hemorrhage. Case 1: A 66-year-old woman presented with consciousness disturbance and left hemiparesis.