1.Analysis of stress proteins ioduced by acupuncture stimulation.
Kazuko KOBAYASHI ; Takahiro SHIMAZU ; Mika OTA ; Masamori IIBOSHI
Journal of the Japan Society of Acupuncture and Moxibustion 1990;40(4):365-368
We show here that stress proteins (Mr 70K, 85K and 100K) were induced by both electroacupuncture and moxibustion.
Rats (Wister strain, male, 250g) were cauterized with moxa on the hip, and the subcutaneous and intramuscular temperatures of the hip were kept at 45°C and at 39-40°C for 15 minutes. While, another group of rats were electrically stimulated for 15min inserting acupuncture needles as electrodes into the muscle of the hips in the depth of 1cm and using current pulse acupuncture system (5Hz, 3-5mA). Both groups of rats were sacrificed under deep anesthesia and the muscular tissues were excised 3 hours after the stimulations. The proteins extracted from the homogenized and centrifuged tissues in the two groups of rats and control rats were analyzed by two-dimensional gel electrophoreses. The heat shock proteins with molecular weight of 70000 (Mr 70K, hsp 70), 85000 (Mr 85K, hsp 85) and 100000 (Mr 100K, hsp 100) were detected in the rats stimulated by moxibustion. The stress proteins of molecular mass 70000, 85000 and 100000 similar to hsps induced by moxibustion were found in the rats stimulated by electroacupuncture.
2.A tuberculosis contact investigation involving a large number of contacts tested with interferon-gamma release assay at a nursing school: Kanagawa, Japan, 2012
Masako Tasaka ; Tamae Shimamura ; Mami Iwata ; Takahiro Toyozawa ; Masaki Ota
Western Pacific Surveillance and Response 2018;9(3):4-8
In May 2012, a teacher of a nursing school with about 300 staff members and students in Japan was diagnosed with sputum smear-positive pulmonary tuberculosis (TB), leading to an investigation involving nearly 300 contacts. We describe the contacts’ closeness to the index TB patient and the likelihood of TB infection and disease.
A case of TB was defined as an individual with positive bacteriological tests or by a physician diagnosis of TB. A latent TB infection (LTBI) case was defined as an individual who had a positive interferon-gamma release assay (IGRA).
A total of 283 persons screened with IGRA were analysed. Eight persons (2.8%, 95% confidence interval [CI]: 1.2–5.4) tested positive by IGRA; one student who had intermediate (less than 10 hours) contact with the index patient was found to have pulmonary TB by chest X-ray. The positivity in IGRA among staff members with very close contact with the index patient (4 of 21, 19%, 95% CI: 5.4–42%) with a statistically significant relative risk of 17 (95% CI: 2.0–140) was high compared with that of the intermediate contacts (1 of 88, 1.1% [95% CI: 0.028–6.2]). There was a statistically significant trend in the risk of TB infection and closeness with the index patient among the staff members and students (P < 0.00022).
In congregate settings such as schools, the scope of contact investigation may have to be expanded to detect a TB case among those who had brief contact with the index patient.
3.Significance of Surgical Treatment for Metastatic Brain Tumor in a Patient with Terminal Cancer
Takahisa KANO ; Yoshinobu MORITOKI ; Ikuo TAKAHASHI ; Keisuke OTA ; Hirotada KATAOKA ; Tomomi KAWAGUCHI ; Takahiro SUZUKI ; Kota HIRAGA ; Hikaru TSUZUKI
Journal of the Japanese Association of Rural Medicine 2020;69(4):399-
We performed gamma knife treatment for multiple brain metastases including a left frontal lobe lesion in a patient in his 60s who had renal cell carcinoma. After treatment, the left frontal lobe lesion initially shrank but then began to grow again, resulting in extensive edema, right hemiparesis, impaired activities of daily living (ADL), and decreased motivation. Although the renal cell carcinoma was in the terminal stage, we judged that recovery of ADL could be expected by removing the left frontal lobe lesion and therefore performed craniotomy tumor removal. As a result, the patient’s motivation and right hemiplegia markedly improved and ADL dramatically improved. Although the period from craniotomy tumor removal to death was as short as 2 months, significant improvement of ADL during this time was achieved by removing the tumor. Tumor resection for metastatic brain tumors is rarely performed in the setting of end-stage cancer. However, this case highlights the potential of brain tumor resection as palliative treatment that can be considered for improving ADL even in patients with terminal cancer.
4.Mechanical Thrombectomy Versus Intravenous Thrombolysis in Distal Medium Vessel Acute Ischemic Stroke: A Multinational Multicenter Propensity Score-Matched Study
Hamza Adel SALIM ; Vivek YEDAVALLI ; Basel MUSMAR ; Nimer ADEEB ; Muhammed Amir ESSIBAYI ; Kareem El NAAMANI ; Nils HENNINGER ; Sri Hari SUNDARARAJAN ; Anna Luisa KÜHN ; Jane KHALIFE ; Sherief GHOZY ; Luca SCARCIA ; Benjamin Y.Q. TAN ; Benjamin PULLI ; Jeremy J. HEIT ; Robert W. REGENHARDT ; Nicole M. CANCELLIERE ; Joshua D. BERNSTOCK ; Aymeric ROUCHAUD ; Jens FIEHLER ; Sunil SHETH ; Ajit S. PURI ; Christian DYZMANN ; Marco COLASURDO ; Xavier BARREAU ; Leonardo RENIERI ; João Pedro FILIPE ; Pablo HARKER ; Razvan Alexandru RADU ; Thomas R. MAROTTA ; Julian SPEARS ; Takahiro OTA ; Ashkan MOWLA ; Pascal JABBOUR ; Arundhati BISWAS ; Frédéric CLARENÇON ; James E. SIEGLER ; Thanh N. NGUYEN ; Ricardo VARELA ; Amanda BAKER ; David ALTSCHUL ; Nestor R. GONZALEZ ; Markus A. MÖHLENBRUCH ; Vincent COSTALAT ; Benjamin GORY ; Christian Paul STRACKE ; Mohammad Ali AZIZ-SULTAN ; Constantin HECKER ; Hamza SHAIKH ; David S. LIEBESKIND ; Alessandro PEDICELLI ; Andrea M. ALEXANDRE ; Illario TANCREDI ; Tobias D. FAIZY ; Erwah KALSOUM ; Boris LUBICZ ; Aman B. PATEL ; Vitor Mendes PEREIRA ; Adrien GUENEGO ; Adam A. DMYTRIW ;
Journal of Stroke 2024;26(3):434-445
Background:
and Purpose The management of acute ischemic stroke (AIS) due to distal medium vessel occlusion (DMVO) remains uncertain, particularly in comparing the effectiveness of intravenous thrombolysis (IVT) plus mechanical thrombectomy (MT) versus IVT alone. This study aimed to evaluate the safety and efficacy in DMVO patients treated with either MT-IVT or IVT alone.
Methods:
This multinational study analyzed data from 37 centers across North America, Asia, and Europe. Patients with AIS due to DMVO were included, with data collected from September 2017 to July 2023. The primary outcome was functional independence, with secondary outcomes including mortality and safety measures such as types of intracerebral hemorrhage.
Results:
The study involved 1,057 patients before matching, and 640 patients post-matching. Functional outcomes at 90 days showed no significant difference between groups in achieving good functional recovery (modified Rankin Scale 0–1 and 0–2), with adjusted odds ratios (OR) of 1.21 (95% confidence interval [CI] 0.81 to 1.79; P=0.35) and 1.00 (95% CI 0.66 to 1.51; P>0.99), respectively. Mortality rates at 90 days were similar between the two groups (OR 0.75, 95% CI 0.44 to 1.29; P=0.30). The incidence of symptomatic intracerebral hemorrhage was comparable, but any type of intracranial hemorrhage was significantly higher in the MT-IVT group (OR 0.43, 95% CI 0.29 to 0.63; P<0.001).
Conclusion
The results of this study indicate that while MT-IVT and IVT alone show similar functional and mortality outcomes in DMVO patients, MT-IVT presents a higher risk of hemorrhagic complications, thus MT-IVT may not routinely offer additional benefits over IVT alone for all DMVO stroke patients. Further prospective randomized trials are needed to identify patient subgroups most likely to benefit from MT-IVT treatment in DMVO.
5.Mechanical Thrombectomy Versus Intravenous Thrombolysis in Distal Medium Vessel Acute Ischemic Stroke: A Multinational Multicenter Propensity Score-Matched Study
Hamza Adel SALIM ; Vivek YEDAVALLI ; Basel MUSMAR ; Nimer ADEEB ; Muhammed Amir ESSIBAYI ; Kareem El NAAMANI ; Nils HENNINGER ; Sri Hari SUNDARARAJAN ; Anna Luisa KÜHN ; Jane KHALIFE ; Sherief GHOZY ; Luca SCARCIA ; Benjamin Y.Q. TAN ; Benjamin PULLI ; Jeremy J. HEIT ; Robert W. REGENHARDT ; Nicole M. CANCELLIERE ; Joshua D. BERNSTOCK ; Aymeric ROUCHAUD ; Jens FIEHLER ; Sunil SHETH ; Ajit S. PURI ; Christian DYZMANN ; Marco COLASURDO ; Xavier BARREAU ; Leonardo RENIERI ; João Pedro FILIPE ; Pablo HARKER ; Razvan Alexandru RADU ; Thomas R. MAROTTA ; Julian SPEARS ; Takahiro OTA ; Ashkan MOWLA ; Pascal JABBOUR ; Arundhati BISWAS ; Frédéric CLARENÇON ; James E. SIEGLER ; Thanh N. NGUYEN ; Ricardo VARELA ; Amanda BAKER ; David ALTSCHUL ; Nestor R. GONZALEZ ; Markus A. MÖHLENBRUCH ; Vincent COSTALAT ; Benjamin GORY ; Christian Paul STRACKE ; Mohammad Ali AZIZ-SULTAN ; Constantin HECKER ; Hamza SHAIKH ; David S. LIEBESKIND ; Alessandro PEDICELLI ; Andrea M. ALEXANDRE ; Illario TANCREDI ; Tobias D. FAIZY ; Erwah KALSOUM ; Boris LUBICZ ; Aman B. PATEL ; Vitor Mendes PEREIRA ; Adrien GUENEGO ; Adam A. DMYTRIW ;
Journal of Stroke 2024;26(3):434-445
Background:
and Purpose The management of acute ischemic stroke (AIS) due to distal medium vessel occlusion (DMVO) remains uncertain, particularly in comparing the effectiveness of intravenous thrombolysis (IVT) plus mechanical thrombectomy (MT) versus IVT alone. This study aimed to evaluate the safety and efficacy in DMVO patients treated with either MT-IVT or IVT alone.
Methods:
This multinational study analyzed data from 37 centers across North America, Asia, and Europe. Patients with AIS due to DMVO were included, with data collected from September 2017 to July 2023. The primary outcome was functional independence, with secondary outcomes including mortality and safety measures such as types of intracerebral hemorrhage.
Results:
The study involved 1,057 patients before matching, and 640 patients post-matching. Functional outcomes at 90 days showed no significant difference between groups in achieving good functional recovery (modified Rankin Scale 0–1 and 0–2), with adjusted odds ratios (OR) of 1.21 (95% confidence interval [CI] 0.81 to 1.79; P=0.35) and 1.00 (95% CI 0.66 to 1.51; P>0.99), respectively. Mortality rates at 90 days were similar between the two groups (OR 0.75, 95% CI 0.44 to 1.29; P=0.30). The incidence of symptomatic intracerebral hemorrhage was comparable, but any type of intracranial hemorrhage was significantly higher in the MT-IVT group (OR 0.43, 95% CI 0.29 to 0.63; P<0.001).
Conclusion
The results of this study indicate that while MT-IVT and IVT alone show similar functional and mortality outcomes in DMVO patients, MT-IVT presents a higher risk of hemorrhagic complications, thus MT-IVT may not routinely offer additional benefits over IVT alone for all DMVO stroke patients. Further prospective randomized trials are needed to identify patient subgroups most likely to benefit from MT-IVT treatment in DMVO.
6.Mechanical Thrombectomy Versus Intravenous Thrombolysis in Distal Medium Vessel Acute Ischemic Stroke: A Multinational Multicenter Propensity Score-Matched Study
Hamza Adel SALIM ; Vivek YEDAVALLI ; Basel MUSMAR ; Nimer ADEEB ; Muhammed Amir ESSIBAYI ; Kareem El NAAMANI ; Nils HENNINGER ; Sri Hari SUNDARARAJAN ; Anna Luisa KÜHN ; Jane KHALIFE ; Sherief GHOZY ; Luca SCARCIA ; Benjamin Y.Q. TAN ; Benjamin PULLI ; Jeremy J. HEIT ; Robert W. REGENHARDT ; Nicole M. CANCELLIERE ; Joshua D. BERNSTOCK ; Aymeric ROUCHAUD ; Jens FIEHLER ; Sunil SHETH ; Ajit S. PURI ; Christian DYZMANN ; Marco COLASURDO ; Xavier BARREAU ; Leonardo RENIERI ; João Pedro FILIPE ; Pablo HARKER ; Razvan Alexandru RADU ; Thomas R. MAROTTA ; Julian SPEARS ; Takahiro OTA ; Ashkan MOWLA ; Pascal JABBOUR ; Arundhati BISWAS ; Frédéric CLARENÇON ; James E. SIEGLER ; Thanh N. NGUYEN ; Ricardo VARELA ; Amanda BAKER ; David ALTSCHUL ; Nestor R. GONZALEZ ; Markus A. MÖHLENBRUCH ; Vincent COSTALAT ; Benjamin GORY ; Christian Paul STRACKE ; Mohammad Ali AZIZ-SULTAN ; Constantin HECKER ; Hamza SHAIKH ; David S. LIEBESKIND ; Alessandro PEDICELLI ; Andrea M. ALEXANDRE ; Illario TANCREDI ; Tobias D. FAIZY ; Erwah KALSOUM ; Boris LUBICZ ; Aman B. PATEL ; Vitor Mendes PEREIRA ; Adrien GUENEGO ; Adam A. DMYTRIW ;
Journal of Stroke 2024;26(3):434-445
Background:
and Purpose The management of acute ischemic stroke (AIS) due to distal medium vessel occlusion (DMVO) remains uncertain, particularly in comparing the effectiveness of intravenous thrombolysis (IVT) plus mechanical thrombectomy (MT) versus IVT alone. This study aimed to evaluate the safety and efficacy in DMVO patients treated with either MT-IVT or IVT alone.
Methods:
This multinational study analyzed data from 37 centers across North America, Asia, and Europe. Patients with AIS due to DMVO were included, with data collected from September 2017 to July 2023. The primary outcome was functional independence, with secondary outcomes including mortality and safety measures such as types of intracerebral hemorrhage.
Results:
The study involved 1,057 patients before matching, and 640 patients post-matching. Functional outcomes at 90 days showed no significant difference between groups in achieving good functional recovery (modified Rankin Scale 0–1 and 0–2), with adjusted odds ratios (OR) of 1.21 (95% confidence interval [CI] 0.81 to 1.79; P=0.35) and 1.00 (95% CI 0.66 to 1.51; P>0.99), respectively. Mortality rates at 90 days were similar between the two groups (OR 0.75, 95% CI 0.44 to 1.29; P=0.30). The incidence of symptomatic intracerebral hemorrhage was comparable, but any type of intracranial hemorrhage was significantly higher in the MT-IVT group (OR 0.43, 95% CI 0.29 to 0.63; P<0.001).
Conclusion
The results of this study indicate that while MT-IVT and IVT alone show similar functional and mortality outcomes in DMVO patients, MT-IVT presents a higher risk of hemorrhagic complications, thus MT-IVT may not routinely offer additional benefits over IVT alone for all DMVO stroke patients. Further prospective randomized trials are needed to identify patient subgroups most likely to benefit from MT-IVT treatment in DMVO.
7.Mechanical Thrombectomy Versus Intravenous Thrombolysis in Distal Medium Vessel Acute Ischemic Stroke: A Multinational Multicenter Propensity Score-Matched Study
Hamza Adel SALIM ; Vivek YEDAVALLI ; Basel MUSMAR ; Nimer ADEEB ; Muhammed Amir ESSIBAYI ; Kareem El NAAMANI ; Nils HENNINGER ; Sri Hari SUNDARARAJAN ; Anna Luisa KÜHN ; Jane KHALIFE ; Sherief GHOZY ; Luca SCARCIA ; Benjamin Y.Q. TAN ; Benjamin PULLI ; Jeremy J. HEIT ; Robert W. REGENHARDT ; Nicole M. CANCELLIERE ; Joshua D. BERNSTOCK ; Aymeric ROUCHAUD ; Jens FIEHLER ; Sunil SHETH ; Ajit S. PURI ; Christian DYZMANN ; Marco COLASURDO ; Xavier BARREAU ; Leonardo RENIERI ; João Pedro FILIPE ; Pablo HARKER ; Razvan Alexandru RADU ; Thomas R. MAROTTA ; Julian SPEARS ; Takahiro OTA ; Ashkan MOWLA ; Pascal JABBOUR ; Arundhati BISWAS ; Frédéric CLARENÇON ; James E. SIEGLER ; Thanh N. NGUYEN ; Ricardo VARELA ; Amanda BAKER ; David ALTSCHUL ; Nestor R. GONZALEZ ; Markus A. MÖHLENBRUCH ; Vincent COSTALAT ; Benjamin GORY ; Christian Paul STRACKE ; Mohammad Ali AZIZ-SULTAN ; Constantin HECKER ; Hamza SHAIKH ; David S. LIEBESKIND ; Alessandro PEDICELLI ; Andrea M. ALEXANDRE ; Illario TANCREDI ; Tobias D. FAIZY ; Erwah KALSOUM ; Boris LUBICZ ; Aman B. PATEL ; Vitor Mendes PEREIRA ; Adrien GUENEGO ; Adam A. DMYTRIW ;
Journal of Stroke 2024;26(3):434-445
Background:
and Purpose The management of acute ischemic stroke (AIS) due to distal medium vessel occlusion (DMVO) remains uncertain, particularly in comparing the effectiveness of intravenous thrombolysis (IVT) plus mechanical thrombectomy (MT) versus IVT alone. This study aimed to evaluate the safety and efficacy in DMVO patients treated with either MT-IVT or IVT alone.
Methods:
This multinational study analyzed data from 37 centers across North America, Asia, and Europe. Patients with AIS due to DMVO were included, with data collected from September 2017 to July 2023. The primary outcome was functional independence, with secondary outcomes including mortality and safety measures such as types of intracerebral hemorrhage.
Results:
The study involved 1,057 patients before matching, and 640 patients post-matching. Functional outcomes at 90 days showed no significant difference between groups in achieving good functional recovery (modified Rankin Scale 0–1 and 0–2), with adjusted odds ratios (OR) of 1.21 (95% confidence interval [CI] 0.81 to 1.79; P=0.35) and 1.00 (95% CI 0.66 to 1.51; P>0.99), respectively. Mortality rates at 90 days were similar between the two groups (OR 0.75, 95% CI 0.44 to 1.29; P=0.30). The incidence of symptomatic intracerebral hemorrhage was comparable, but any type of intracranial hemorrhage was significantly higher in the MT-IVT group (OR 0.43, 95% CI 0.29 to 0.63; P<0.001).
Conclusion
The results of this study indicate that while MT-IVT and IVT alone show similar functional and mortality outcomes in DMVO patients, MT-IVT presents a higher risk of hemorrhagic complications, thus MT-IVT may not routinely offer additional benefits over IVT alone for all DMVO stroke patients. Further prospective randomized trials are needed to identify patient subgroups most likely to benefit from MT-IVT treatment in DMVO.