シロスタゾール ワ ノウソッチュウ イハッショウセイ コウケツアツ シゼン ハッショウ ラット ノウ ニ オケル ショウケッカン ビョウヘン ト ハクシツ ビョウヘン オ ヨクセイスル

京都大学0048新制・課程博士博士(医学)甲第14472号医博第3317号新制||医||976(附属図書館)UT51-2009-D184京都大学大学院医学研究科脳統御医科学系専攻(主査)教授 金子 武嗣, 教授 中尾 一和, 教授 三森 経世学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDA

Pincer nail deformity in a patient with amyotrophic lateral sclerosis

Although several manifestations of skin involvement in cases of amyotrophic lateral sclerosis (ALS) have been reported, the pincer nail deformity has not been previously reported in a patient with ALS. The pincer nail deformity is characterized by distortion of the shape of the nail with transverse over curvature and may be associated with systemic diseases and certain medications. We herein describe the case of a patient presenting with a pincer nail deformity associated with rapidly advancing ALS. This case suggests a potential link between quickly advancing disease and the pincer nail deformity

Paradoxical contralateral hemiparesis in spontaneous spinal epidural hematoma: a case report

Abstract Background Hemiparesis associated with spontaneous spinal epidural hematoma (SSEH) usually occurs ipsilateral to the hematoma. We here report the case of a patient with paradoxical hemiparesis contralateral to a spinal lesion due to SSEH. Case presentation A 70-year-old woman was identified in routine clinical practice; she presented with acute-onset neck pain and left hemiparesis. Neurological examination showed left-sided sensory-motor hemiparesis without facial involvement. Cervical MRI showed a dorsolateral epidural hematoma compressing the spinal cord at the C2 to C3 level. Axial imaging demonstrated a crescent hematoma on the right side, which is contralateral to the hemiparesis, and lateral displacement of the spinal cord. Spinal angiography revealed no abnormal vessels. Based on clinical presentation and MRI findings, a diagnosis of SSEH was made. The patient was managed conservatively. The symptoms completely resolved without any neurological deficits, and the hematoma disappeared on the follow-up MRI. Conclusions Paradoxical contralateral hemiparesis is one of the possible presenting symptoms in patients with SSEH. This case demonstrates the existence of the paradoxical contralateral hemiparesis associated with spinal compressive lesions. A plausible mechanism of the phenomenon is discussed

In vivo imaging of brain ischemia using an oxygen-dependent degradative fusion protein probe.

Within the ischemic penumbra, blood flow is sufficiently reduced that it results in hypoxia severe enough to arrest physiological function. Nevertheless, it has been shown that cells present within this region can be rescued and resuscitated by restoring perfusion and through other protective therapies. Thus, the early detection of the ischemic penumbra can be exploited to improve outcomes after focal ischemia. Hypoxia-inducible factor (HIF)-1 is a transcription factor induced by a reduction in molecular oxygen levels. Although the role of HIF-1 in the ischemic penumbra remains unknown, there is a strong correlation between areas with HIF-1 activity and the ischemic penumbra. We recently developed a near-infrared fluorescently labeled-fusion protein, POH-N, with an oxygen-dependent degradation property identical to the alpha subunit of HIF-1. Here, we conduct in vivo imaging of HIF-active regions using POH-N in ischemic brains after transient focal cerebral ischemia induced using the intraluminal middle cerebral artery occlusion technique in mice. The results demonstrate that POH-N enables the in vivo monitoring and ex vivo detection of HIF-1-active regions after ischemic brain injury and suggest its potential in imaging and drug delivery to HIF-1-active areas in ischemic brains

Selective white matter abnormalities in a novel rat model of vascular dementia.

Rats subjected to bilateral common carotid artery (CCA) occlusion or 2-vessel occlusion (2VO) have been used as animal models of subcortical ischemic vascular dementia. However, this model possesses an inherent limitation in that cerebral blood flow (CBF) drops too sharply and substantially after ligation of CCAs. To circumvent such hypoxic-ischemic conditions, we tested implantation of the ameroid constrictor device on bilateral CCAs of male Wistar-Kyoto rats and more precisely replicated chronic cerebral hypoperfusion by gradual narrowing of the CCAs (2-vessel gradual occlusion; 2VGO). The acute cerebral blood flow reduction and resultant inflammatory responses observed in the 2VO rats were eliminated in the 2VGO rats. Thus, chronic cerebral hypoperfusion was segregated, and induced selective white matter changes with relatively preserved neurovascular coupling and substantially less metabolic and histological derangements in the gray matter including the hippocampus. This led to significant spatial working memory impairment of a magnitude similar to the 2VO rats at 28 days postoperation. The 2VGO model may more closely mimic cognitive impairment subsequent to selective white matter damage

Stabilization of POH-N under hypoxic conditions.

<p>SH-SY5Y neuroblastoma cells cultured under normoxic (N) or hypoxic (H) conditions were treated with POH probe. (A) HIF-1α protein levels were analyzed by western blotting (a representative blot is shown). (B) The fluorescence intensity of POH probe in cells was measured. (C) Representative fluorescence images are shown. *<i>P</i><0.02 (vs. normoxic condition).</p

Experimental design.

<p>(A) Cranial window in a C57/BL6 mouse. Experimental design of the closed cranial window. (B) Experimental design (upper panel). Representative two-dimensional images of cerebral blood flow measured by laser speckle perfusion imaging before MCAO (a), during MCAO (b), and after reperfusion (c) are shown in the lower panels. MCAO: middle cerebral artery occlusion.</p