基本情報
- 所属
- 自治医科大学 脳卒中センター/脳神経内科 教授
- 学位
- 医学博士(順天堂大学)
- J-GLOBAL ID
- 201801014716622915
- researchmap会員ID
- B000293355
順天堂大学神経学講座で臨床神経学の基礎を学び、その後脳卒中の臨床研究と基礎研究、特に脳梗塞の病態解析、新規治療薬の探索研究を行ってきました。学位取得後、2003年よりUniversity of Calgary (Canada)で神経幹細胞を用いた脳梗塞治療の研究に従事。帰国後順天堂大学に復職、2018年4月より自治医科大学に赴任。地域の脳卒中急性期、神経内科疾患に対する最先端の治療を提供できるよう心がけています。また、臨床研究では脳梗塞の再発予防、脳血管疾患と認知症、基礎研究では新規脳保護薬の開発と実用化をメインテーマに研究を行っています。
研究キーワード
12研究分野
1経歴
11-
2023年1月 - 現在
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2018年4月 - 現在
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2011年4月 - 2017年3月
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2008年10月 - 2011年3月
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2008年4月 - 2008年9月
学歴
1-
- 1996年3月
委員歴
7-
2019年4月 - 現在
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2018年4月 - 現在
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- 現在
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- 現在
受賞
1論文
209-
Neurology. Clinical practice 13(3) e200165 2023年6月BACKGROUND AND OBJECTIVES: Gynecologic diseases such as uterine fibroids, endometriosis, and adenomyosis are common in women of reproductive age. Case reports and small case series have reported ischemic stroke in women with such common noncancerous gynecologic diseases, and their cause of stroke is frequently attributed to cryptogenic stroke or unconventional mechanisms related to hypercoagulability. However, stroke etiology and prognosis are not well known. We assessed the prevalence of and stroke mechanisms related to common noncancerous gynecologic diseases using hospital-based clinical data. METHODS: We retrospectively identified consecutive female patients with common noncancerous gynecologic diseases (uterine fibroids, endometriosis, and adenomyosis) diagnosed with ischemic stroke/transient ischemic attack (TIA) between the ages of 20 and 59 years admitted to 10 stroke centers in Japan by reviewing prospectively collected data between 2017 and 2019. The clinical, laboratory, and neuroimaging features were evaluated and compared between patients with conventional stroke mechanisms (CSMs) (large artery atherosclerosis, small vessel occlusion, cardioembolism, and other determined etiology) and non-CSMs (cryptogenic stroke and causes related to hypercoagulability such as nonbacterial thrombotic endocarditis and paradoxical embolism) according to the Trial of Org 10172 in Acute Stroke Treatment criteria. RESULTS: Of the 470 female patients with ischemic stroke/TIA, 39 (8%) (37 ischemic stroke and 2 TIA) had common noncancerous gynecologic diseases. The most common gynecologic diseases were uterine fibroids in 24 (62%) patients, followed by endometriosis in 9 (23%) and adenomyosis in 6 (15%). Twenty patients (51%) were assigned to the non-CSMs group, and 19 patients (49%) were assigned to the CSMs group. Adenomyosis and endometriosis were more frequent in the non-CSMs group than in the CSMs group. CA125 and D-dimer levels were higher in the non-CSMs group than in the CSMs group. Multiple vascular territory infarcts were frequent in patients with adenomyosis (60%) and endometriosis (43%) in the non-CSMs group. No stroke recurrence or death was observed within 3 months after discharge in both the CSMs and non-CSMs groups. Outcomes at 3 months after discharge were similar in both groups. DISCUSSION: In patients with common noncancerous gynecologic diseases, hypercoagulopathy may play a role in the pathogenesis of ischemic stroke/TIA without CSMs.
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Internal medicine (Tokyo, Japan) 2023年2月22日Objective In recent decades, living conditions have changed drastically. However, there are few data regarding the interaction between living conditions and the risk of ischemic stroke (IS) in young adults. The present study explored the association between living conditions or marital status and the risk factors, etiology, and outcome of IS in young adults. Methods We prospectively enrolled patients with incident IS who were 20-49 years old from 37 clinical stroke centers. We collected the demographic data, living conditions, marital status, vascular risk factors, disease etiology, treatment, and outcomes at discharge. A comparison group was established using the official statistics of Japan. We categorized patients into the two groups based on living conditions: solitary group and cohabiting group. Clinical characteristics were then compared between living conditions. Results In total, 303 patients were enrolled (224 men; median age at the onset: 44 years old). Significant factors associated with the incidence of IS were as follows: solitary status, body mass index >30 kg/m2, current smoking, heavy alcohol consumption, hypertension, diabetes mellitus, and dyslipidemia. Furthermore, in the solitary group, the proportions of men, unmarried individuals, and current smokers were significantly higher than in the cohabiting group. In addition, poor outcomes (modified Ranking Scale ≥ 4) of IS were more common in the solitary group than in the cohabiting group. Conclusion Our study showed that not only conventional vascular risk factors but also living conditions, especially living alone while unmarried, were independent risk factors for IS in young adults.
MISC
106-
Journal of Thrombosis and Thrombolysis 49(4) 681-684 2020年5月 査読有りCerebral amyloid angiopathy-related inflammation is a syndrome of reversible encephalopathy with cerebral amyloid angiopathy, however the pathology is not well understood. We clear a part of the pathology through the first case of an 80-year-old man with cerebral amyloid angiopathy-related inflammation induced by relapsing polychondritis (RP) analysis. An 80-year-old man was diagnosed with RP by auricular cartilage biopsy. Almost no abnormality including intracranial microbleeding was detected by cranial magnetic resonance image (MRI) at diagnosis. However, he developed a headache and hallucination after five months. Seven-month cranial MRI showed novel, multiple, intracranial microbleeding, especially in the bilateral but asymmetry posterior, temporal, and parietal lobes. 123I-N-isopropyl-p-iodoamphetamine single-photon emission computed tomography showed increased cerebral blood flow in the bilateral posterior lobes. After treatment, both of his neurological symptoms and increased cerebral blood flow improved to mild. Photon emission computed tomography using Pittsburgh compound B (PiB) for evaluation of brain amyloidosis at 12 months after onset showed an amyloid deposit in the bilateral frontal lobes, but a lack of uptake corresponded to the RP lesions. Our case suggests that inflammation coupled with an amyloid deposit, induced the multiple intracranial bleeding, and resulted in the lack of PiB uptake. Findings from our case show that inflammation including excess blood flow coupled with an amyloid deposit synergistically facilitate intracranial bleeding.
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脳卒中 40(2) 100-104 2018年3月潜因性脳梗塞の頻度は稀ではなく、その病態は多岐にわたる。潜因性脳梗塞はcryptogenic strokeとして提言され、心エコー検査を主体とした塞栓源診断で卵円孔開存や弓部大動脈プラークの発症機序への関与が明らかにされてきた。特に、経食道心エコー(transthoracic echocardiography:TEE)は半侵襲的な検査であるが、これらの塞栓源の検出には有用である。近年では、潜因性脳梗塞に対してembolic stroke of undetermined source(ESUS)という新たな概念が提唱された。ESUSは診断の標準化という立場から、半侵襲的な検査であるTEEによる塞栓源診断は必須ではない。しかし、逆説的にいえば、ESUSはTEEで診断される種々の塞栓源疾患が含まれる。我々は、ESUSの診断基準を満たしTEEを実施した症例を対象に、脳梗塞再発や心血管イベント発症の有無を後方視的に調査し、塞栓源疾患や臨床的特徴と予後の関連性を検討した。(著者抄録)
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脳循環代謝 30(1) 65-69 2018年脳梗塞後の軸索再生は、損傷後の組織再構築において重要な役割を担い、機能回復とも関連する。筆者は、ラット中大脳動脈閉塞モデルのperi-infarct areaにおいて、7日後の急性期に脱落した軸索や樹状突起は56日後の慢性期では再生していることを確認した。In vitroでは、虚血後軸索の再生にはphosphatase tensin homolog deleted on chromosome 10/Akt/Glycogen synthase kinase 3βシグナルが関わることを報告した。ラット慢性脳低灌流モデルでは、L-carnitine経口投与により脳白質において軸索再生とoligodendrocyteの再生によるミエリンの増強が生じ、慢性脳虚血ラットの認知機能障害が改善した。脳梗塞後の軸索再生、機能回復のメカニズムは多岐にわたり、今後軸索再生を目的とした脳梗塞新規治療薬の開発、実用化が期待される。(著者抄録)
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順天堂醫事雑誌 = Juntendo medical journal 63(1) 17-21 2017年2月
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JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM 36 503-504 2016年6月
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JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM 36 269-270 2016年6月
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JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM 36 480-481 2016年6月
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MOVEMENT DISORDERS 31 S84-S84 2016年3月
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臨床神経学 55(Suppl.) S219-S219 2015年12月
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臨床神経学 55(Suppl.) S450-S450 2015年12月
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INTERNATIONAL JOURNAL OF STROKE 10 199-199 2015年4月
書籍等出版物
7所属学協会
13共同研究・競争的資金等の研究課題
5-
日本学術振興会 科学研究費助成事業 基盤研究(C) 2021年4月 - 2024年3月
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日本学術振興会;科学研究費助成事業 基盤研究C 2016年4月 - 2018年3月
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日本学術振興会;科学研究費助成事業 基盤研究C 2013年4月 - 2016年3月
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日本学術振興会;科学研究費助成事業 挑戦的萌芽研究 2012年4月 - 2013年3月
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日本学術振興会;科学研究費助成事業 若手研究B 2007年4月 - 2008年3月