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Current Use and Future Needs of Noninvasive Ambulatory Electrocardiogram Monitoring.
Authors: Ikeda T Abstract Remarkable progress has been seen in monitoring systems using noninvasive ambulatory electrocardiograms (ECGs). In the Holter ECG system, 12-channel formats have been utilized as diagnostic tools, particularly for the detection of transient or silent myocardial ischemia and dynamic electrical disorders. In patients diagnosed with cryptogenic stroke, despite negative results on standard ECG tests, continuous ambulatory ECG monitoring for up to 30 days has been shown to increase the detection rate of transient atrial fibrillation. At present, a waterproof Holter ECG system is available. Rece...
Source: Internal Medicine - August 15, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Callosal Aphasia after Stroke.
Authors: Aiba Y, Sakakibara R, Iwakawa M, Ogata T PMID: 32788525 [PubMed - as supplied by publisher]
Source: Internal Medicine - August 15, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

An Autopsy Case of Lambl's Excrescences with Trousseau Syndrome that Caused Cardioembolic Stroke.
Authors: Hirayama T, Morioka H, Fujiwara H, Iwamoto K, Kiyozuka T, Takeo H, Ikeda K, Kano O Abstract The frequency and risk of embolism by Lambl's excrescences (LEs) remain unclear. We herein report an autopsy case of LEs that caused cardioembolic stroke. A 74-year-old man with colon cancer was hospitalized for ischemic stroke. His D-dimer levels were elevated. Thus, a diagnosis of ischemic stroke with Trousseau syndrome was made. At the autopsy, we found LEs in the aortic valves and thromboembolism of the brain blood vessels. This finding demonstrated that fibrin clots had adhered to the LEs because of coagulation...
Source: Internal Medicine - August 14, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Rotatory Vertigo Caused by a Small Hemorrhage in the Superior Temporal Gyrus.
Authors: Araki K, Takeuchi R, Katada F, Fukutake T Abstract Rotatory vertigo is known to have not only peripheral causes, e.g., Meniere's disease, vestibular neuritis, and benign paroxysmal positional vertigo, but also central causes, e.g., stroke, hemorrhage, and tumor. In most cases, central rotatory vertigo is caused by a lesion in the brainstem or cerebellum, but rare cases with a cerebral lesion have also been reported. We herin describe a unique case with acute rotatory vertigo following a small hemorrhage in the left superior temporal gyrus, which probably led to a dysfunction of the visual-vestibular system...
Source: Internal Medicine - August 14, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Ischemic Stroke Caused by Carotid Stump at the Common Carotid Artery.
Authors: Hashimoto G, Wada S, Morita T, Tomohara S, Hara K, Kumabe M, Matsushima T, Kadowaki M, Hamaguchi M, Kuwashiro T, Yasaka M, Okada Y Abstract An 84-year-old man developed motor aphasia and right hemiparesis on postoperative day 1 after orchiectomy for suspected malignant lymphoma. He had a history of thoracic endovascular aortic repair for aortic aneurysm using a bypass graft from the right subclavian artery to the left common carotid artery (CCA); however, the graft had become occluded six months later. Brain magnetic resonance imaging revealed acute cerebral infarctions in the left frontal lobe. Carotid ul...
Source: Internal Medicine - August 1, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Isolated Cerebral Vasculitis in the Unilateral Middle Cerebral Artery in a Case with SLE.
Authors: Takeshita S, Ogata T, Tsugawa J, Tsuboi Y Abstract A 47-year-old woman, who was diagnosed to have systemic lupus erythematosus (SLE), was admitted because she suffered a severe ischemic stroke three weeks after experiencing a transient attack of aphasia. Diffusion-weighted MR imaging revealed high intensity at the borderzone of the middle cerebral artery (MCA), while the proximal portion of the left MCA was occluded with its vascular wall enhanced by gadolinium. Intravenous methylprednisolone and heparin were administrated without any symptomatic benefit. She developed severe right hemiparesis with aphasia...
Source: Internal Medicine - July 29, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Impact of Metabolic Syndrome on the Mortality Rate among Participants in a Specific Health Check and Guidance Program in Japan.
Conclusions The death rate was found to be significantly higher among the participants with metabolic syndrome. PMID: 32669499 [PubMed - as supplied by publisher]
Source: Internal Medicine - July 18, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

A MELAS Patient Developing Fatal Acute Renal Failure with Lactic Acidosis and Rhabdomyolysis.
Authors: Ito H, Fukutake S, Odake S, Okeda R, Tokunaga O, Kamei T Abstract We herein present a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), who developed serious acute renal failure with lactic acidosis, followed by rhabdomyolysis. Despite receiving intensive care, he suffered multiple cardiopulmonary arrests and died 10 days after presentation due to a sudden deterioration of his symptoms. Renal pathology revealed diffuse tubular necrosis with interstitial edema and tubular dilatation on light microscopy, and a severe degeneration of intracellular organell...
Source: Internal Medicine - July 11, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Cigarette Smoking Cessation Temporarily Enhances the Release of Phosphorylated-HSP27 from Human Platelets.
Conclusion Cigarette smoking cessation temporarily enhances the collagen-stimulated release of phosphorylated-HSP27 from human platelets in the short term. PMID: 32350194 [PubMed - as supplied by publisher]
Source: Internal Medicine - May 2, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Diagnostic Yield of Early Examination for Venous Thrombosis in Patients with Cryptogenic Stroke and a Right-to-left Shunt.
Conclusion CS patients, especially those with multi-territory lesions, should be immediately examined for DVT and PE. PMID: 32295996 [PubMed - in process]
Source: Internal Medicine - April 17, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Long-term Clinical Outcomes of Elective Carotid Artery Stenting in Patients Undergoing Maintenance Hemodialysis.
Conclusion CAS in maintenance hemodialysis patients may be feasible and effective for the prevention of stroke with proper case selection, appropriate technique and strict perioperative management. The most common causes of death during the follow-up of maintenance hemodialysis patients were diseases other than stroke. PMID: 32062623 [PubMed - in process]
Source: Internal Medicine - February 19, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Heat Stroke Lesions in the Globus Pallidus.
Authors: Hirayama I, Inokuchi R, Ueda Y, Doi K PMID: 31915313 [PubMed - as supplied by publisher]
Source: Internal Medicine - January 11, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

The Association between Earlobe Creases and Cardiovascular Events in Japanese Hemodialysis Patients: A Prospective Cohort Study.
Conclusion Earlobe creases were not independently associated with cardiovascular events among Japanese hemodialysis patients, suggesting that these marks are simply indicative of advanced age. PMID: 31839659 [PubMed - as supplied by publisher]
Source: Internal Medicine - December 18, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Irreversible Vasculopathy Proceeds Rapidly in POEMS Syndrome.
Authors: Sakuta K, Mukai T, Suzuki K, Nishiwaki K, Yaguchi H Abstract A 48-year-old woman with POEMS syndrome suddenly presented with numbness of her right upper limb. Magnetic resonance imaging showed multiple acute infarctions in her left cerebrum, and magnetic resonance angiography (MRA) showed multiple intra-cranial vascular lesions, which contrasted with previously normal MRA results obtained eight months prior to the stroke. After completing successful treatment for POEMS syndrome, there were no recurrent stroke episodes. A six-month follow-up scan showed that although the vascular lesions did not progress, t...
Source: Internal Medicine - August 3, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Risk Stratification of Cardiovascular Events in Very Elderly Patients with Known or Suspected Coronary Artery Disease Who had Normal Single-photon Emission Computed Tomographic Myocardial Perfusion Imaging Findings.
Conclusion The MCV event rate was high in very elderly patients despite their normal SPECT MPI findings at baseline. Therefore, very elderly patients with multivariate risks should be carefully followed to avoid a poor prognosis. PMID: 31366795 [PubMed - as supplied by publisher]
Source: Internal Medicine - August 3, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

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