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Article: [Neurological Complications Associated with Kidney Disease].

Akiyama, Hisanao

Brain and nerve = Shinkei kenkyu no shinpo

2024 Volume 76, Issue 3, Page(s) 231–238

Abstract: The kidneys filter the blood to excrete waste products and excess salt from the body as urine, while reabsorbing what the body needs and keeping it in the body. For this reason, when the function of the kidneys deteriorates, urine cannot be produced, and ...

Abstract	The kidneys filter the blood to excrete waste products and excess salt from the body as urine, while reabsorbing what the body needs and keeping it in the body. For this reason, when the function of the kidneys deteriorates, urine cannot be produced, and homeostasis of electrolytes and acid-bases cannot be maintained. As a result, waste products accumulate in the body, resulting in uremia and the need for dialysis induction or kidney transplant. This paper provides an overview of the neurological complications that appear in kidney disease and their treatment.
MeSH term(s)	Humans ; Kidney Diseases/complications ; Kidney ; Uremia/complications ; Uremia/therapy ; Renal Dialysis ; Waste Products
Chemical Substances	Waste Products
Language	Japanese
Publishing date	2024-03-21
Publishing country	Japan
Document type	English Abstract ; Journal Article
ZDB-ID	390389-8
ISSN	1344-8129 ; 1881-6096 ; 0006-8969
ISSN (online)	1344-8129
ISSN	1881-6096 ; 0006-8969
DOI	10.11477/mf.1416202593
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Article: [Varicella-Zoster Myelitis with Medullary Infarction: A Case Report].

Hoshino, Masashi / Itoh, Aoi / Shimizu, Takahiro / Akiyama, Hisanao / Yamano, Yoshihisa

Brain and nerve = Shinkei kenkyu no shinpo

2023 Volume 75, Issue 3, Page(s) 269–273

Abstract: We present the case of a 62-year-old woman who was receiving treatment for herpes zoster and experienced paraplegia, and bladder and bowel disturbance. The brain MRI diffusion-weighted image showed an abnormal hyperintense signal and apparent diffusion ... ...

Abstract	We present the case of a 62-year-old woman who was receiving treatment for herpes zoster and experienced paraplegia, and bladder and bowel disturbance. The brain MRI diffusion-weighted image showed an abnormal hyperintense signal and apparent diffusion coefficient decreased in left medulla oblongata. The spinal cord MRI T2-weighted image showed abnormal hyperintense lesions in the left side of cervical spinal cord and thoracic spinal cord. We diagnosed varicella-zoster myelitis with medullary infarction, because varicella-zoster virus DNA was detected in the cerebrospinal fluid by polymerase chain reaction. The patient recovered with early treatment. This case shows the importance of evaluating not only skin lesions, but also distant lesions. (Received 15 November, 2022; Accepted 12 Jaunuary, 2023; Published 1 March, 2023).
MeSH term(s)	Female ; Humans ; Middle Aged ; Herpesvirus 3, Human/genetics ; Chickenpox/complications ; Herpes Zoster/complications ; Herpes Zoster/drug therapy ; Myelitis/diagnosis ; Medulla Oblongata/diagnostic imaging
Language	Japanese
Publishing date	2023-02-21
Publishing country	Japan
Document type	Case Reports ; English Abstract ; Journal Article
ZDB-ID	390389-8
ISSN	1344-8129 ; 1881-6096 ; 0006-8969
ISSN (online)	1344-8129
ISSN	1881-6096 ; 0006-8969
DOI	10.11477/mf.1416202319
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Article ; Online: Effectiveness of the traditional Japanese Kampo medicine Yokukansan for chronic migraine: A case report.

Akiyama, Hisanao / Hasegawa, Yasuhiro

Medicine

2019 Volume 98, Issue 36, Page(s) e17000

Abstract: Rationale: The traditional Japanese Kampo medicine Yokukansan (TSUMURA Yokukansan extract granules) was originally used to treat neurosis, insomnia, night crying, and irritability and/or agitation in infants and recently it has also been used for ... ...

Abstract	Rationale: The traditional Japanese Kampo medicine Yokukansan (TSUMURA Yokukansan extract granules) was originally used to treat neurosis, insomnia, night crying, and irritability and/or agitation in infants and recently it has also been used for neuropsychiatric symptoms in Alzheimer's disease or other dementia in Japan. Furthermore, several recent studies have reported the efficacy of Kampo medicines for various types of headache. Here, we report a case of severe chronic migraine refractory to prophylactic therapy using various western medicines and Japanese Kampo medicines that had resulted in a leave of absence from work, but for which the frequency and severity were markedly decreased by Yokukansan (2.5 g 3 times/d), enabling the patient to return to work fully. Patient concerns: The patient was a 39-year-old woman with a diagnosis of migraine without aura, which started around the age of 17 years and had been well managed with oral triptan preparations. However, due to lifestyle changes after childbirth, the frequency and severity of migraine increased at 38 years of age, prompting her to visit our hospital. Diagnoses: Our initial examination found no neurological abnormality, and our diagnosis was also migraine without aura based on the International Classification of Headache Disorders version 3. Interventions: Her migraine had become refractory to several western medicines (lomerizine hydrochloride, propranolol, sodium valproate, amitriptyline, and duloxetine) and 2 Japanese Kampo medicines (Goshuyuto and Chotosan). The migraine episodes worsened, and consequently she took a leave of absence from work. Outcomes: Yokukansan was then tried, and this markedly improved the chronic migraine, enabling her full return to work. Lessons: Yokukansan might have exerted a prophylactic effect on chronic migraine via its action on the glutamatergic and serotonergic systems, inhibitory action on orexin A secretion, and anti-inflammatory action. Yokukansan might be useful as a prophylactic for migraine worldwide, and a future large-scale clinical study is warranted.
MeSH term(s)	Adult ; Chronic Disease ; Drugs, Chinese Herbal/therapeutic use ; Female ; Humans ; Medicine, Kampo ; Migraine Disorders/drug therapy
Chemical Substances	Drugs, Chinese Herbal ; Yi-Gan San
Language	English
Publishing date	2019-09-05
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000017000
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Article ; Online: Inconsistent detection of subhyaloid hemorrhage in the globe using computed tomography.

Akiyama, Hisanao

Emergency radiology

2012 Volume 19, Issue 3, Page(s) 269–272

MeSH term(s)	Aged ; Diagnosis, Differential ; Fatal Outcome ; Humans ; Male ; Middle Aged ; Retinal Hemorrhage/complications ; Retinal Hemorrhage/diagnostic imaging ; Subarachnoid Hemorrhage/complications ; Subarachnoid Hemorrhage/diagnostic imaging ; Tomography, X-Ray Computed
Language	English
Publishing date	2012-02-17
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1425144-9
ISSN	1438-1435 ; 1070-3004
ISSN (online)	1438-1435
ISSN	1070-3004
DOI	10.1007/s10140-012-1021-8
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Article ; Online: A trial case of medical treatment for primary headache using telemedicine.

Akiyama, Hisanao / Hasegawa, Yasuhiro

Medicine

2018 Volume 97, Issue 9, Page(s) e9891

Abstract: Rationale: Video-based treatment in telemedicine is a potential alternative to face-to-face treatment. We describe our trial use of telemedicine to treat a patient with primary headache.: Patient concerns: A 25-year-old woman visited our branch ... ...

Abstract	Rationale: Video-based treatment in telemedicine is a potential alternative to face-to-face treatment. We describe our trial use of telemedicine to treat a patient with primary headache. Patient concerns: A 25-year-old woman visited our branch hospital with a chief complaint of recurrent headache. Our branch hospital had no headache specialist, so a headache specialist at our main hospital provided treatment remotely. Diagnoses: She was diagnosed with migraine without aura by the headache specialist using telemedicine. Interventions: The branch hospital physician and the headache specialist used video conferencing to interview and examine the patient and share cranial magnetic resonance imaging (MRI). Audio and camera angle/zoom could be adjusted during interviews, and high-quality video was continuously displayed at both hospitals simultaneously without lag between audio and video. Temporal/spatial resolution was sufficient for proper neurological evaluation. MRI had sufficient image quality and resolution for detailed interpretation. A prescription for medication was issued by the branch hospital physician and confirmed by the headache specialist. Outcomes: Zolmitriptan was effective in treating her migraine. Lessons: Telemedicine was useful for treating this primary headache patient and can contribute to regional health care. Future challenges in telemedicine include expanding its use to other areas within the purview of general physicians and headache specialists, covering implementation and maintenance costs, providing adequate explanations to patients and family members, ensuring security of video transmissions, maintaining patient medical records, and supervising treatment.
MeSH term(s)	Adult ; Female ; Humans ; Migraine without Aura/diagnosis ; Migraine without Aura/therapy ; Telemedicine/methods ; Videoconferencing
Language	English
Publishing date	2018-02-22
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000009891
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Article ; Online: Awareness of atrial fibrillation in Japan: A large-scale, nationwide Internet survey of 50 000 Japanese adults.

Akiyama, Hisanao / Hasegawa, Yasuhiro

Geriatrics & gerontology international

2018 Volume 18, Issue 7, Page(s) 1100–1107

Abstract: Aim: Atrial fibrillation (AF) is the most common underlying cause of cardiogenic cerebral embolism. To prevent cardiogenic cerebral embolism, it is important to determine the level of awareness of AF in Japan.: Methods: We used survey monitor ... ...

Abstract	Aim: Atrial fibrillation (AF) is the most common underlying cause of cardiogenic cerebral embolism. To prevent cardiogenic cerebral embolism, it is important to determine the level of awareness of AF in Japan. Methods: We used survey monitor attribute data to sample 172 824 Japanese adults aged ≥50 years from all 47 Japanese prefectures. Next, we carried out an Internet survey to determine these individuals' level of awareness of AF. Results: We obtained valid responses from 53 128 respondents. There were 13 119 respondents (27.5%) spanning all age groups who had never heard the term AF (no prior knowledge), just 1791 respondents (3.8%) who knew AF well and 27 351 respondents (57.3%) who knew the name of the condition, but did not understand the disease or its treatment. No prior knowledge was highest in Kochi Prefecture (36.0%) and lowest in Yamanashi Prefecture. Knowing AF well was highest in Kyoto Prefecture (5.1%) and lowest in Tottori Prefecture, and knowing only the name was highest in Aomori Prefecture (63.0%). Factors contributing significantly to having "no prior knowledge" of AF included younger age, male sex and smaller population size (rural region), but not the numbers of arrhythmia or stroke specialists. Conclusions: Currently, 3.8% of Japanese adults had high awareness of AF, and we find this value very low. We also noted age-, sex- and region-related differences in awareness level. We believe that awareness initiatives that take into account age- and sex-related differences and prioritize prefectures with lower awareness of AF will be important for preventing cardiogenic cerebral embolism in the future. Geriatr Gerontol Int 2018; 18: 1100-1107.
MeSH term(s)	Adult ; Age Distribution ; Aged ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Awareness ; Cross-Sectional Studies ; Female ; Humans ; Japan/epidemiology ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Prevalence ; Prognosis ; Risk Assessment ; Sex Distribution ; Stroke/epidemiology ; Stroke/prevention & control ; Surveys and Questionnaires ; Survival Analysis ; Young Adult
Language	English
Publishing date	2018-03-30
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2113849-7
ISSN	1447-0594 ; 1444-1586
ISSN (online)	1447-0594
ISSN	1444-1586
DOI	10.1111/ggi.13318
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Article ; Online: Efficacy of perampanel for anti-N-methyl-D-aspartate receptor encephalitis: A case report.

Akiyama, Hisanao / Sasaki, Rie / Hasegawa, Yasuhiro

Medicine

2019 Volume 98, Issue 2, Page(s) e14033

Abstract: Rationale: We report this 1st case because perampanel may be effective against the seizures and abnormal behavior that occur in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.: Patient concerns: The patient was a healthy 26-year-old woman ... ...

Abstract	Rationale: We report this 1st case because perampanel may be effective against the seizures and abnormal behavior that occur in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Patient concerns: The patient was a healthy 26-year-old woman who suddenly developed seizures and exhibited abnormal behavior. Diagnoses: NMDAR encephalitis was diagnosed based on positive NMDAR antibody on cerebrospinal fluid analysis. Interventions: Treatment with anticonvulsants and sedatives was started immediately, along with steroid pulse therapy and plasmapheresis, but these measures did not adequately control the repeated seizures and abnormal behavior. However, with the addition of oral perampanel, an α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist, the seizures and abnormal behavior promptly disappeared. Outcomes: The patient was transferred to the rehabilitation hospital and returned to her job. Lessons: It appears that perampanel rapidly eliminated these clinical features by inhibiting inflow of abnormal glutamic acid and attenuating nerve hyperexcitability by acting as a selective and noncompetitive antagonist of AMPA receptors that had increased in the postsynaptic membrane due to anti-NMDAR encephalitis. To the best of our knowledge, there are no other reports showing that perampanel was effective against anti-NMDAR encephalitis. This case suggests that perampanel may be effective against the seizures and abnormal behavior that occur in anti-NMDAR encephalitis.
MeSH term(s)	Adult ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis/diagnosis ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis/drug therapy ; Central Nervous System Agents/therapeutic use ; Female ; Humans ; Nitriles ; Pyridones/therapeutic use ; Seizures/diagnosis ; Seizures/drug therapy
Chemical Substances	Central Nervous System Agents ; Nitriles ; Pyridones ; perampanel (H821664NPK)
Language	English
Publishing date	2019-01-10
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000014033
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Article: Barriers to continued administration of direct oral anticoagulants between acute hospital and subacute or chronic hospitals and geriatric health services facilities in Japan.

Akiyama, Hisanao / Nukui, Saki / Hasegawa, Yasuhiro

Hospital practice (1995)

2019 Volume 47, Issue 5, Page(s) 249–253

Abstract: ... ...

Abstract	Objectives
MeSH term(s)	Administration, Oral ; Anticoagulants/administration & dosage ; Continuity of Patient Care ; Health Services for the Aged ; Hospitals ; Humans ; Japan ; Patient Transfer ; Surveys and Questionnaires
Chemical Substances	Anticoagulants
Language	English
Publishing date	2019-11-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2570453-9
ISSN	2377-1003 ; 2154-8331 ; 8750-2836
ISSN (online)	2377-1003
ISSN	2154-8331 ; 8750-2836
DOI	10.1080/21548331.2019.1684650
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Article ; Online: A novel NODAL variant in a young embolic stroke patient with visceral heterotaxy.

Kaburagi, Kei / Hagiwara, Yuta / Tachikawa, Keiji / Miyake, Noriko / Akiyama, Hisanao / Kawai, Yosuke / Omae, Yosuke / Tokunaga, Katsushi / Yamano, Yoshihisa / Shimizu, Takahiro / Mitsuhashi, Satomi

BMC neurology

2024 Volume 24, Issue 1, Page(s) 119

Abstract: Background: Ischemic stroke in young adults can be caused by a variety of etiologies including the monogenic disorders. Visceral heterotaxy is a condition caused by abnormal left-right determinations during embryonic development. We aimed to determine ... ...

Abstract	Background: Ischemic stroke in young adults can be caused by a variety of etiologies including the monogenic disorders. Visceral heterotaxy is a condition caused by abnormal left-right determinations during embryonic development. We aimed to determine the cause of a young ischemic stroke patient with visceral heterotaxy. Case presentation: We performed neurological, radiological, and genetic evaluations in a 17-year-old male patient presenting ischemic stroke and visceral heterotaxy to determine the underlying cause of this rare disease combination. Brain magnetic resonance imaging (MRI) showed evidence of embolic stroke, abdominal computed tomography (CT) showed visceral heterotaxy, and echocardiogram showed cardiac anomaly with right-to-left-shunt (RLS). Whole genome sequencing (WGS) revealed a heterozygous missense variant (NM_018055.5: c.1016 T > C, p.(Met339Val)) in the NODAL gene, which is essential to the determination of the left-right body axis. Conclusions: Our study highlights the importance of evaluating genetic etiology in young ischemic stroke and the need for stroke risk management in visceral heterotaxy patients with RLS. To the best of our knowledge, we report the first genetically-confirmed case of visceral heterotaxy with young embolic stroke reported to date.
MeSH term(s)	Adolescent ; Humans ; Male ; Cardiovascular Abnormalities ; Embolic Stroke ; Heterotaxy Syndrome/genetics ; Magnetic Resonance Imaging ; Stroke/diagnostic imaging ; Stroke/genetics
Language	English
Publishing date	2024-04-11
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2041347-6
ISSN	1471-2377 ; 1471-2377
ISSN (online)	1471-2377
ISSN	1471-2377
DOI	10.1186/s12883-024-03619-x
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Article ; Online: Magnetic Resonance Imaging White Matter Hyperintensity as a Predictor of Stroke Recurrence in Patients with Embolic Stroke of Undetermined Source.

Kashima, Satoru / Shimizu, Takahiro / Akiyama, Hisanao / Hasegawa, Yasuhiro

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2018 Volume 27, Issue 12, Page(s) 3613–3620

Abstract: Background and purpose: This study aimed to investigate factors associated with stroke recurrence and new-onset atrial fibrillation (AF) in patients with embolic stroke of undetermined source (ESUS).: Methods: Between January 2005 and March 2012, a ... ...

Abstract	Background and purpose: This study aimed to investigate factors associated with stroke recurrence and new-onset atrial fibrillation (AF) in patients with embolic stroke of undetermined source (ESUS). Methods: Between January 2005 and March 2012, a total of 1514 consecutive patients were admitted to our hospital with a diagnosis of acute ischemic stroke within 7 days after onset. Of these, 236 patients met the diagnostic criteria for ESUS. A retrospective analysis was performed of the following characteristics of these ESUS patients: medical history, comorbidities, and magnetic resonance imaging (MRI) findings including the deep and subcortical white matter hyperintensity (DSWMH) grade, drugs used for preventing recurrence, and clinical information such as NIH Stroke Scale scores on admission and outcomes evaluated by modified Rankin scale. The rate of recurrence after discharge and the frequency of new-onset AF were also determined. Results: There were 236 ESUS patients (141 men, mean age 70.2 ± 12.1 years). During the follow-up period, ranging from 7 days to 12.9 years (median 54.3 months), 32 (13.6%) and 44 (18.6%) of these patients had a recurrent ischemic stroke and new-onset AF, respectively. The most prevalent subtype of recurrent ischemic stroke was ESUS itself; this type of stroke occurred in 19 (59.3%) patients. AF was observed at stroke recurrence, but only 2 patients were diagnosed with cardioembolism. Multivariate analysis with a Cox proportional hazard model demonstrated that DSWMH grade greater than or equal to 3 was significantly associated with both recurrent ischemic stroke (hazard ratio 3.66, 95% confidence interval 1.69-7.92, P = .001) and new-onset AF (2.00, 1.03-3.90, .04). Conclusions: MRI classification of white matter hyperintensity could be effectively used as a predictor for recurrent ischemic stroke and new-onset AF in patients with ESUS.
MeSH term(s)	Aged ; Brain Ischemia/diagnostic imaging ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Prognosis ; Recurrence ; Retrospective Studies ; Stroke/diagnostic imaging ; White Matter/diagnostic imaging
Language	English
Publishing date	2018-09-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2018.08.033
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