A Case of Moyamoya Syndrome with Subdural and Intracerebral Hematoma due to Different Bleeding Sources

One case with a moyamoya syndrome is reported in which each of an intracerebral and subdural hematoma was caused by different bleeding sources. At first, an intracerebral hematoma was made by rupture of moyamoya vessels per se. Then, distortion of the brain would have resulted in tearing of an aneurysm which had been formed by a overloading to its wall at one of transdural anastomotic channels. Thus a subdural hematoma was developed

Applicability of the Movement Assessment Battery for Children-Second Edition (MABC-2) for Japanese Children Aged 3–6 Years: A Preliminary Investigation Emphasizing Internal Consistency and Factorial Validity

This study investigated the applicability of the Movement Assessment Battery for Children – Second Edition (MABC-2) for 3- to 6-year-old Japanese children, particularly addressing its internal consistency and factorial validity. The MABC-2 test set for 3- to 6-year-old children was administered to 252 children. Differences between Japanese children and those of the original normative sample (i.e. United Kingdom children) were investigated along with sex differences. The Japanese children aged 3–6 years were found to have higher Manual Dexterity and Balance component scores than children of the normative sample. Girls scored higher than boys on the Balance component. Results of several analyses showed good internal consistency of the MABC-2. Confirmatory factor analysis revealed that a theoretical three-component model of the MABC-2 was not fitted to Japanese children aged 3–6 years. Instead, a new three-component model was postulated and discussed. The new three-component model of the MABC-2, with Manual Dexterity, Static Balance and Ball Skills, and Dynamic Balance, has high factorial validity in Japanese children aged 3–6 years

Progressive perianeurysmal edema preceding the rupture of a small basilar artery aneurysm.

We herein report the first case of progressive perianeurysmal edema preceding the rupture of a small saccular aneurysm, without any intervention or intraluminal thrombosis. A 71-year-old woman was incidentally noted to have a cerebral aneurysm (5mm in diameter) at the lower basilar artery. Twelve months later, magnetic resonance (MR) imaging showed a T2-elongated area around a dome of the aneurysm buried in the brain stem, suggesting perianeurysmal edema formation. Interestingly, the edema progressed with the formation of a bleb, in addition to an increase in size of the aneurysm over the following 3-year period. The aneurysm eventually ruptured as a brain stem hemorrhage without any subarachnoid clots 3 days after the final check-up with MR imaging, by which a significant increase of edema formation with an increase in size of the aneurysm and a marked expansion of the bleb was observed. These findings raise the possibility that bleb formation and an enlargement of a small cerebral aneurysm might also be associated with perianeurysmal edema and a subsequent aneurysmal rupture. In addition to the pulsatile flow and/or compression from the expanded aneurysm, local inflammation in the aneurysm wall may play an important role in such edema formation

Combination of Serine Protease Inhibitor FUT-175 and Thromboxane Synthetase Inhibitor OKY-046 Decreases Cerebral Vasospasm in Patients with Subarachnoid Hemorrhage

クモ膜下出血後(SAH)の脳血管攣縮発現に補体活性化を介する炎症反応が関与するとの考えらか、抗補体活性化作用を有するserine protease inhibitor(FUT-175)を従来の抗攣縮治療であるTXA2合成阻害薬(OKY-046)とともに使用し、その有効性に関しFisher group 3の高度なクモ膜下出血症例を対象として検討した。その結果FUT-175とOKY-046の併用は、OKY-046単独使用に比べ、Hunt and Hess IIIとIVの症例において有意に血管攣縮発現を抑制し(<0.02)、Hunt and Hess Vを除くoverallの予後を有意に改善した(<0.05)。FUTの使用はSAH発症48時間以内、1日80mg以上が有効であった。The preventive effect of the serine protease inhibitor FUT-175 (nafamostat mesilate), a potent inhibitor of the complement system, against vasospasm was evaluated in 34 high risk patients with thick and diffuse subarachnoid hemorrhage (SAH) demonstrated by computed tomography corresponding to Fisher group 3. All patients underwent surgery within 96 hours following SAH and received the thromboxane A_2 synthetase inhibitor, OKY-046, as part of standard care. FUT-175 (40-160 mg/day) was administered during the initial 4 days following surgery. 455 patients treated without FUT-175 in the Nagasaki SAH Data Bank (non-FUT group) formed the control group. FUT-175 significantly decreased the incidence of symptomatic vasospasm in patients with severe neurological grade (Hunt and Hess grade 3, p<0.02 ; Hunt and Hess grade 4, p<0.02). The incidence of favorable outcome was 76.5% in the FUT group and 60.4% in the non-FUT group, but not statistically different. However, when patients of Hunt and Hess grade 5 were excluded, the FUT group had a significantly improved outcome (p<0.05). This study suggests that FUT-175 has an additive effect to OKY-046 in preventing vasospasm in high risk patients with severe SAH

Cognitive Orientation to Daily Occupational Performance : A Randomized Controlled Trial Examining Intervention Effects on Children with Developmental Coordination Disorder Traits

Children with traits of developmental coordination disorder (DCD-t) may experience occupational performance problems that go unrecognized and therefore may not be adequately supported. The cognitive orientation to daily occupational performance (CO-OP) approach has been effective in interventions for developmental coordination disorder (DCD). Based on an open-label, randomized controlled trial design, this study evaluated the effects of CO-OP on the occupational performance and motor skills of older kindergarten children with DCD-t using the School Assessment of Motor and Process Skills (S-AMPS) and the Movement Assessment Battery for Children, Second Edition. Children with a total DCDQ score of less than 40 or M-ABC2 scores in the 5th to 16th percentile were considered to have DCD-t. Furthermore, children with DCD-t and S-AMPS process skills less than 0.7 were considered to have DAMP (Deficits in Attention, Motor control and Perception)-t. After 3 months of CO-OP intervention, the performance and motor skills of children with DCD-t improved significantly. However, there were no significant changes noted in the motor skills of children with DAMP-t, although their occupational performance improved. These results suggest that CO-OP is effective even for older kindergarten children with DCD-t. However, further improvement of the CO-OP approach or a different strategy is required for children with ADHD comorbidity.Peer reviewe

Experimental demonstration of position-controllable topological interface states in high-frequency Kitaev topological integrated circuits

Abstract Topological integrated circuits are integrated-circuit realizations of topological systems. Here we show an experimental demonstration by taking the case of the Kitaev topological superconductor model. An integrated-circuit implementation enables us to realize high resonant frequency as high as 13GHz. We explicitly observe the spatial profile of a topological edge state. In particular, the topological interface state between a topological segment and a trivial segment is the Majorana-like state. We construct a switchable structure in the integrated circuit, which enables us to control the position of a Majorana-like interface state arbitrarily along a chain. Our results contribute to the development of topological electronics with high frequency integrated circuits