High urinary albumin/creatinine ratio at admission predicts poor functional outcome in patients with acute ischaemic stroke.

Aim: Albuminuria and a low estimated glomerular filtration rate (eGFR) are widely recognized indices of kidney dysfunction and have been linked to cardiovascular events, including stroke. We evaluated albuminuria, measured using the urinary albumin/creatinine ratio (UACR), and the eGFR in the acute phase of ischaemic stroke, and investigated the clinical characteristics of ischaemic stroke patients with and those without kidney dysfunction.

Methods: The study included 422 consecutive patients admitted between June 2010 and May 2012.

Low serum n-3 polyunsaturated fatty acid/n-6 polyunsaturated fatty acid ratio predicts neurological deterioration in Japanese patients with acute ischemic stroke.

Background: Epidemiological and clinical trials have shown that n-3 polyunsaturated fatty acids (PUFAs) reduce the incidence of coronary heart disease or stroke. However, the association between PUFAs and acute-phase stroke has not yet been thoroughly studied. We investigated the impact of serum PUFAs on early neurological deterioration (END) in patients with acute ischemic stroke.

Carotid hemodynamic parameters are useful for discriminating between atherothrombotic infarction and lacunar infarction.

Using ultrasound, we investigated whether carotid parameters differed among subtypes of ischemic stroke and evaluated the usefulness of these parameters in discriminating among subtypes. Patients with ischemic stroke admitted to Nippon Medical School Hospital were consecutively recruited and grouped into 3 subtypes based on the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification: cardioembolism (group CE), large-artery atherosclerosis (group LAA), and small-vessel occlusion (group SVO). All subjects underwent carotid ultrasonography to determine maximum intima-media thickness (IMT), maximum systolic velocity (Vmax), minimum diastolic velocity (Vmin), mean velocity, and pulsatility index (PI).

Correlation between insulin resistance and white matter lesions among non-diabetic patients with ischemic stroke.

Objective: We investigated whether a correlation exists between insulin resistance and the severity of cerebral white matter lesions among non-diabetic patients with ischemic stroke.

Methods: The subjects were 105 consecutive patients without diabetes who were hospitalized due to non-cardioembolic stroke. The insulin resistance was evaluated by a homeostasis model assessment of insulin resistance (HOMA-IR).

Acute disseminated encephalomyelitis developed after Mycoplasma pneumoniae infection complicating subclinical measles infection.

A 26-year-old man developed acute disseminated encephalomyelitis (ADEM) after Mycoplasma pneumoniae infection, and was admitted after developing disturbed consciousness. Magnetic resonance images revealed lesions in the midbrain, bilateral internal capsules, left corona radiata, white matter of the left occipital lobe, and thoracic spinal cord. He was diagnosed with subclinical measles infection since no anthema was observed despite the fact that his serum and cerebrospinal fluid samples were positive for measles IgM antibodies.

Cerebral infarction in a patient with macrothrombocytopenia with leukocyte inclusions (MTCP, May-Hegglin anomaly/Sebastian syndrome).

We report on a 78-year-old woman patient with macrothrombocytopenia with leukocyte inclusions (MTCP, May-Hegglin anomaly/Sebastian syndrome), who had no history of hemorrhagic symptoms and had a platelet count of 10,000 or less, but had a cerebral infarction. The patient was found to have idiopathic thrombocytopenic purpura, hypertension, and atrial fibrillation 16 years ago, yet received no medication. She was found to have had a cerebral infarction with aphasia as the chief complaint and was admitted to our hospital.

Effects of long-term administration of HMG-CoA reductase inhibitor, atorvastatin, on stroke events and local cerebral blood flow in stroke-prone spontaneously hypertensive rats.

The objective of this study was to determine whether the long-term administration of an HMG-CoA reductase inhibitor, atorvastatin, confers protective effects against stroke events in stroke-prone spontaneously hypertensive rats (SHRSPs). Atorvastatin (2 mg/kg, 20 mg/kg) or vehicle was orally administered to 8-week-old SHRSPs for 11 weeks. The survival ratio and stroke incidence were calculated, and plasma lipids and plasma levels of asymmetric dimethylarginine (ADMA), a circulating endogenous competitive inhibitor of NO synthase, were measured after sacrifice.

[Case report of Wegener's granulomatosis presenting with multiple cranial nerve palsy and hypertrophic cranial pachymeningitis].

We report a 41-year-old man whose initial neurological symptoms are atypical of Wegener's granulomatosis. The patient was admitted because he developed left ocular pain, headache, bilateral visual loss and left abducens nerve palsy. He was initially diagnosed with optic neuritis at ophthalmological department and steroid therapy was started.

[A case of infarction in brainstem and cerebellum as a initial symptom with bilateral hearing loss].

A 56-year old male presented with a sudden onset of bilateral hearing difficulty. He complained of dizziness and gait disturbance at the onset and subsequently developed bilateral hearing loss and tinnitus. Brain MRI revealed multiple infarcts in bilateral middle cerebellar peduncles, bilateral cerebellar hemispheres and the right cerebral peduncle.

Effect of ischemic preconditioning on cerebral blood flow after subsequent lethal ischemia in gerbils.

Ischemic tolerance, the phenomenon where a sublethal ischemic preconditioning protects the brain against a subsequent lethal ischemia, has been widely studied. Studies have been done on cerebral blood flow levels prior to the lethal ischemia, but the hemodynamic pattern after global ischemia with ischemic preconditioning has not been reported. Sequential changes in regional cerebral blood flow (rCBF) in gerbil hippocampus after 5 min global ischemia with or without 2 min ischemic preconditioning were studied to determine if ischemic preconditioning affects rCBF.

Enzyme replacement therapy for Fabry disease: morphologic and histochemical changes in the urinary sediments.

Background: Fabry disease is an X-linked lysosomal storage disease resulting from deficient activity of the enzyme alpha-galacotsidase A. Accumulation of glycosphingolipids, especially globotriaosylceramide, leads to renal damage in Fabry disease. In patients with Fabry disease, the urinary sediment contains excreted glycosphingolipids.

Long-term measurement of cerebral blood flow and metabolism in a rat chronic hypoperfusion model.

1. Rat bilateral common carotid artery occlusion (BCAO) was used as a chronic cerebral hypoperfusion model. We observed autoradiographically the long-term changes in regional cerebral blood flow (rCBF) and regional cerebral glucose utilization (rCGU) after 2 days and 1, 4 and 8 weeks of BCAO and in controls.

Neuroprotective effect of NS-7, a novel Na+ and Ca2+ channel blocker, in a focal ischemic model in the rat.

NS-7 is a novel, voltage-dependent Na(+) and Ca(2+) channel blocker. This study evaluated the in vivo neuroprotective effect of NS-7 in a rat transient focal ischemic model when administered during occlusion. Left middle cerebral artery occlusion was induced in adult male Sprague-Dawley rats for 120 min using an intraluminal thread method.