Publications by authors named "Tomura N"
Article Synopsis
- Hypertension is a known risk factor for atrial fibrillation (AF) and strokes, but there is limited research on AF screening in hypertensive patients and its link to blood pressure levels.
- A study involving over 4,000 hypertensive patients aged 60 and older in Japan measured their electrocardiograms (ECG) and blood pressure (BP) at home for three months.
- The study found that 5.8% of participants had undiagnosed AF, with no significant differences in AF detection rates based on different baseline BP categories or the use of antihypertensive medication.
Article Synopsis
- Segmental arterial mediolysis (SAM) is a rare vascular disease linked to cerebral aneurysms, predominantly affecting East Asian individuals aged 40-50, often presenting as subarachnoid hemorrhage (SAH).
- A systematic review identified 41 cases, showing that 75% of the aneurysms were dissecting types, with a significant risk of complications such as intra-abdominal hemorrhage (IAH) and a high mortality rate.
- Early diagnosis and timely surgical intervention are crucial for improving patient outcomes, as those who undergo surgery generally have a favorable prognosis.
Article Synopsis
- Atrial fibrillation (AF) is categorized by duration into paroxysmal, persistent, and long-standing persistent types, with longer durations increasing the risk of recurrence during catheter ablation treatment.
- The study aims to enhance the diagnosis accuracy of AF duration through a predictive model, utilizing data from 272 patients to train a machine learning algorithm.
- Results showed the model achieved 81.8% accuracy in predicting AF duration, significantly improving cardiologists' diagnostic performance from 63.9% to 71.6% after using the model's insights.
Article Synopsis
- The case study discusses a 57-year-old woman with diplopia and a mass lesion in the clivus that resembled a chordoma, which is a type of tumor.
- Imaging tests revealed a complex lesion that changed over a decade, leading to a preoperative diagnosis of chordoma or chondroma.
- Ultimately, the tumor was surgically removed and diagnosed as a primary intraosseous cavernous hemangioma, emphasizing the challenges in diagnosing such lesions before surgery.
Key Clinical Message: This case highlights the pitfalls and provides tips for the extraction of deeply implanted lumenless leads, and encourages careful lead selection in the current era of widespread left bundle branch area pacing.
Abstract: The extraction of cardiovascular implantable electronic device leads is sometimes complicated. We describe a case with difficult but successful extraction of SelectSecure, a lumenless permanent pacemaker lead, implanted deep in the ventricular septum, highlighting its pitfalls and tips in the current era of left bundle branch area pacing.
Cerebral amyloid angiopathy-related inflammation is a rare encephalopathy characterized by inflammation against amyloid protein accumulated in cerebral small vessels. A 50-year-old man was presented with a subacute consciousness disorder. Brain MRI revealed high intensity lesions in the white matter of the right parietal and occipital lobes on fluid-attenuated inversion recovery sequences and cerebral microbleeds in the right parietal and occipital lobes on T2*-weighted images.
View Article and Find Full Text PDFBackground: The impact of sleep apnea (SA) on heart rate variability (HRV) in atrial fibrillation (AF) patients has not been investigated.
Methods and results: Of 94 patients who underwent AF ablation between January 2021 and September 2022, 76 patients who had a nocturnal Holter electrocardiography and polysomnography conducted simultaneously were included in the analysis. A 15-min duration of HRV, as determined by an electrocardiogram during apnea and non-apnea time, were compared between patients with and without AF recurrence at 12 months' postoperatively.
Background: While internal mammary artery (IMA) has become a major conduit of coronary artery bypass graft (CABG) surgery, subclavian artery stenosis (SAS) could cause subsequent coronary events due to ischemia of myocardial territory supplied by IMA. Clinical characteristics and cardiovascular outcomes of SAS-related IMA failure (SAS-IMAF) remain to be fully determined yet. Therefore, the current study was designed to characterize SAS-IMAF in patients receiving CABG with IMA.
View Article and Find Full Text PDFBackground: Vertebral artery origin stenosis (VAOS) is a major cause of ischemic stroke of the posterior circulation. Aggressive medical treatment using dual antiplatelet therapy is the most common treatment approach to symptomatic VAOS; however, the effectiveness of endovascular treatment (EVT) for VAOS has recently been reported. Here, we report a case of VAOS treated with percutaneous transluminal angioplasty (PTA) under flow reversal protection using Mo.
View Article and Find Full Text PDFBackground: Several factors that predict new-onset atrial fibrillation (AF) have been investigated using the 24-hour Holter electrocardiogram (ECG) and 12-lead ECG; however, these have been based on each test independently. The aim of this study was to combine findings from the two tests to create a comprehensive, easy-to-use score and to examine its validity.
Methods And Results: A total of 502 patients underwent 24-hour Holter ECG and 12-lead ECG were followed up for 6.
Purpose: Little is known about the outcomes of patients with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI) who undergo coronary artery bypass grafting (CABG) in the current percutaneous coronary intervention (PCI) era.
Methods: We analyzed 25120 acute myocardial infarction (AMI) patients hospitalized between January 2011 and December 2016. In-hospital outcomes were compared between patients who underwent CABG during hospitalization and those who did not undergo CABG in the STEMI group (n = 19428) and NSTEMI group (n = 5692).
Acquired coronary artery fistula complicated with a pseudo-false aneurysm after percutaneous coronary intervention for myocardial infarction is quite rare. In this clinical vignette, we describe the case of a 79-year-old man who was diagnosed by multimodality imaging, especially transthoracic echocardiography, and is doing well after left ventricle reconstruction. ().
View Article and Find Full Text PDFF-Fluorodeoxy Glucose and C-Methionine Accumulation in Demyelinating Lesions.
World J Nucl Med
December 2022
Few studies have evaluated the accumulation of F-fluorodeoxyglucose (FDG), C-methionine (MET), and other positron emission tomography (PET) tracers in patients with demyelinating disease. This study aimed to investigate the accumulation of FDG-PET/computed tomography (CT) and MET-PET/CT in demyelinating lesions. A retrospective search of the patient database in our hospital identified five patients with demyelinating disease in whom PET studies performed in the past 10 years revealed accumulation of FDG or MET.
View Article and Find Full Text PDFBackground: Endovascular treatment (EVT) for acute large vessel occlusion has proven to be effective in randomized controlled trials. We conducted a prospective cohort study to evaluate the real-world efficacy of EVT in a metropolitan area with a large number of comprehensive stroke centers and to compare it with the results of other registries and randomized controlled trials (RCTs).
Methods: We analyzed the Kanagawa Intravenous and Endovascular Treatment of Acute Ischemic Stroke registry, a prospective, multicenter observational study of patients treated by EVT and/or intravenous tissue-type plasminogen activator (tPA).
It is sometimes difficult to identify the culprit lesion and treatment strategy in patients with acute coronary syndrome who have complex coronary lesions and jeopardized left internal mammary artery graft. This report describes a heart team approach for a non-ST-segment elevation myocardial infarction case with complex coronary vasculature. A 73-year-old man presented to the emergency department with crescendo angina.
View Article and Find Full Text PDFPurpose: To determine if functional connectivity measured with resting-state functional MRI could be used as a tool to assess unilateral spatial neglect during stroke recovery.
Methods: Resting-state functional MRI was performed on 13 stroke patients with lesions in the right cerebral hemisphere and 31 healthy subjects. The functional connectivity score was defined as a correlation of a target region with the right inferior parietal lobule.
Background: Few reports have examined the feasibility of a post-contrast double inversion recovery (DIR) magnetic resonance (MR) sequence in patients with multiple sclerosis (MS) because of partial or complete signal loss of enhancing MS lesions.
Purpose: To compare subtracted images of DIR (pre-contrast - post-contrast DIR images) with contrast enhanced T1-weighted (CE-T1W) images in the depiction of contrast enhancement of MS lesions.
Material And Methods: In total, 27 patients were included.
Background: Positron emission tomography (PET) findings for gliomatosis and lymphomatosis have been rarely reported.
Purpose: To compare PET/computed tomography (CT) findings using C-methionine (MET) from PET/CT findings using F-fluorodeoxy glucose (FDG) for patients with lymphomatosis or gliomatosis of the brain.
Material And Methods: Participants comprised all 10 patients with lymphomatosis or gliomatosis of the brain treated at our institution in the past 12 years.
Background: In many cases, the cause of exercise-induced cardiopulmonary arrest in young persons is thought to be fatal arrhythmia, and one of the causes is ischaemic heart disease. Left main coronary artery atresia (LMCAA) is an extremely rare disease in which there is a congenital defect of the left main coronary artery, causing heart failure and exercise-induced angina attacks at a young age. Thus, it is disease that should be differentiated when examining young persons with chest pain.
View Article and Find Full Text PDFObjective: We report a case of dissecting aneurysm developed after traumatic vertebral artery dissection (VAD) treated by stenting combined with coil embolization.
Case Presentation: A 47-year-old man was injured in a fall and presented with left VAD associated with central spinal injury due to C2 fracture. One week after admission, magnetic resonance imaging (MRI) demonstrated contralateral VAD with a dissecting aneurysm.
Objective: Silent magnetic resonance angiography (MRA) was compared with time-of-flight (TOF)-MRA in imaging of arteriovenous malformations (AVMs) of the brain.
Methods: Thirty-five consecutive patients with AVMs of the brain were included. Quantitative analyses were performed by measuring both signal-to-noise ratio and contrast-to-noise ratio of the nidus.
Background: Direct surgery is commonly selected for the treatment of cranio-cervical junction dural arteriovenous fistula and its outcome is more satisfactory than that of embolization. Intraoperative treatment evaluation is relatively easy in embolization, whereas in direct surgery it can be difficult.
Case Description: A 67-year-old male suffered a subarachnoid hemorrhage.