Publications by authors named "Futoshi Eto"

4 Publications

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p.R4810K (c.14429G > A) Variant Determines Anatomical Variations of the Circle of Willis in Cerebrovascular Disease.

Front Aging Neurosci 2021 15;13:681743. Epub 2021 Jul 15.

Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan.

Introduction: Dysregulation of the RING finger protein 213 gene impairs vascular formation in experimental animal models. In addition, vascular abnormalities in the circle of Willis are associated with cerebrovascular disease. Here, we evaluated the relationship between the East Asian founder variant p.R4810K and consequent anatomical variations in the circle of Willis in cerebrovascular disease.

Patients And Methods: The present study is an observational cross-sectional study. It included patients with acute anterior circulation non-cardioembolic stroke admitted to our institution within 7 days of symptom onset or last-known-well from 2011 to 2019, and those who participated in the National Cerebral and Cardiovascular Center Biobank. We compared anatomical variations of the vessels constituting the circle of Willis between p.R4810K (c.14429G > A) variant carriers and non-carriers using magnetic resonance angiography and assessed the association between the variants and the presence of the vessels constituting the circle of Willis. Patients with moyamoya disease were excluded.

Results: Four hundred eighty-one patients [146 women (30%); median age 70 years; median baseline National Institutes of Health Stroke Scale score 5] were analyzed. The p.R4810K variant carriers ( = 25) were more likely to have both posterior communicating arteries (PComAs) than the variant non-carriers ( = 456) (56% vs. 13%, < 0.01). Furthermore, variant carriers were less likely to have an anterior communicating artery (AComA) than non-carriers (68% vs. 84%, = 0.04). In a multivariate logistic regression analysis, the association of p.R4810K variant carriers with the presence of both PComAs and the absence of AComA remained significant.

Conclusion: Our findings suggest that the p.R4810K variant is an important factor in determining anatomical variations in the circle of Willis.
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http://dx.doi.org/10.3389/fnagi.2021.681743DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8322682PMC
July 2021

Atherosclerotic Components in Thrombi Retrieved by Thrombectomy for Internal Carotid Artery Occlusion Due to Large Artery Atherosclerosis: A Case Report.

Front Neurol 2021 28;12:670610. Epub 2021 May 28.

Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.

The correlation between the composition of thrombi retrieved by mechanical thrombectomy (MT) and stroke etiology is inconclusive. We describe a case with atherosclerotic components in thrombi retrieved by MT for acute internal carotid artery (ICA) occlusion. A 69-year-old man with acute onset of global aphasia and right hemiplegia was transferred to our institute. His baseline National Institutes of Health Stroke Scale score was 24. Magnetic resonance imaging demonstrated acute ischemic stroke in the left parietal lobe. Magnetic resonance angiography revealed occlusion of the left ICA. MT was attempted for acute left ICA occlusion. The initial angiography showed occlusion of the proximal ICA, while intraprocedural angiography revealed a large thrombus that extended from the cervical ICA to the intracranial ICA. Successful reperfusion was achieved by five passes using stent retrievers and an aspiration catheter. A large volume of red thrombus was retrieved by each pass. The final angiogram showed successful reperfusion with modified Thrombolysis in Cerebral Ischemia grade 2b and severe stenosis in the proximal ICA. Neck magnetic resonance imaging showed severe left ICA stenosis with a vulnerable plaque. Hence, his stroke etiology was determined as large artery atherosclerosis. Histopathological examination of the retrieved thrombi revealed atheromatous components, including cholesterol clefts, foam cells, and a necrotic core. Atherosclerotic components in retrieved thrombi might provide useful clues for diagnosing stroke pathogenesis. Further studies are warranted to clarify the utility of assessing atheromatous components in retrieved thrombi in diagnosing stroke etiology.
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http://dx.doi.org/10.3389/fneur.2021.670610DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8194065PMC
May 2021

[A case of lower urinary tract dysfunction due to acute hemorrhage in the lateral medulla oblongata].

Rinsho Shinkeigaku 2021 Jun 20;61(6):392-397. Epub 2021 May 20.

Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.

A 67-year-old woman was transported to our hospital with abnormal sensation in the left temporal region and unstable gait. She had a history of increased urinary frequency without medication. Head CT showed intracerebral hemorrhage in the left dorsal medulla oblongata. On the day of admission, she became aware of difficulty in urination and the volume of residual urine was 100 ml. Cystometry revealed normal voiding sensation and relatively lower intravesical pressure during voiding effort. The maximum cystometric capacity was also mildly decreased. The lower urinary tract dysfunction in this patient was diagnosed as detrusor underactivity. An α1-adrenoreceptor antagonist, urapidil, was started and her residual urine was decreased. Urapidil was terminated on the 14th day of onset, but her lower urinary tract symptoms did not recur thereafter. The brain MR imaging with magnetization-prepared 2 rapid acquisition gradient-echoes (MP2RAGE) clearly demonstrated a small hematoma in the dorsolateral medulla with surrounding edema. The perihematomal edema initially spread to involve the left lateral tegmentum of the medulla, but it almost disappeared in the follow-up MP2RAGE imaging on the 21st day. At the medulla level, the descending tract from the pontine micturition center is assumed to lie lateral tegmentum. The lower urinary tract dysfunction in this case was presumed to be caused by damage to the descending tract from the pontine micturition center, and the disappearance of perihematomal edema and the compensation by the contralateral tract would have contributed to the early improvement of symptoms.
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http://dx.doi.org/10.5692/clinicalneurol.cn-001580DOI Listing
June 2021

Multijoint Pain and Pulmonary Calcification with Long-term Hemodialysis.

Intern Med 2018 Oct 18;57(20):3063-3064. Epub 2018 May 18.

Department of Neurology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Japan.

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http://dx.doi.org/10.2169/internalmedicine.0443-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232024PMC
October 2018
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