Japanese Versus Non-Japanese Patients with Transient Ischemic Attack or Minor Stroke: Subanalysis of TIA registry.org

BackgroundTIAregistry.org is an international cohort of patients with transient ischemic attack (TIA) or minor stroke within 7 days before enrollment in the registry. Main analyses of 1-year follow-up data have been reported.⁵ We conducted subanalysis on the baseline and 1-year follow-up data of Japanese patients.MethodsThe patients were classified into 2 groups based on Japanese ethnicity, Japanese (345) and non-Japanese (3238), and their baseline data and 1-year event rates were compared. We also determined risk factors and predictors of 1-year stroke.ResultsCurrent smoking, regular alcohol drinking, intracranial arterial stenosis, and small vessel occlusion; and hypertension, dyslipidemia, coronary artery disease, and extracranial arterial stenosis were more and less common among Japanese patients, respectively. Stroke risk was higher and TIA risk was lower at 1-year follow-up among Japanese patients. The baseline risk factors for recurrent stroke were diabetes, alcohol drinking, and large artery atherosclerosis. Independent predictors of 1-year stroke risk were prior congestive heart failure and alcohol consumption.ConclusionsThe two populations of patients featured differences in risk factors, stroke subtypes, and outcome events. Predictors of recurrent stroke among Japanese patients included congestive heart failure and regular alcohol drinking. Strategies to attenuate residual risk of stroke aside from adherence to current guidelines should take our Japanese-patient specific findings into account.     

Agminated fibroblastic connective tissue nevus in a 1‐year‐old boy

Fibroblastic connective tissue nevus (FCTN) is a benign cutaneous mesenchymal lesion characterized by proliferation of CD34‐positive fibroblastic/myofibroblastic spindle‐shaped cells. We report a case of agminated FCTN on the right lower abdomen of a 1‐year‐old boy.     

A nationwide survey on transient hyperammonemia in newborn infants in Japan: prognosis of life and neurological outcome.

A nationwide survey of transient hyperammonemia in newborns was carried out in Japan. A total of 18 patients, consisting of 12 male and 6 female infants, were reported from 11 facilities. These neonates exhibited hyperammonemia with plasma ammonia levels in the range from 124 to 6256 micrograms/dl. Four newborn infants of the 18 died in the neonatal period, and an additional one died in the early infancy. Among the 13 infants who were alive at the time of this survey, 6 had neurological sequelae, including mental retardation, spastic quadriplegia and epilepsy. The multivariate analysis revealed that the Apgar score at 1 minute, peak plasma ammonia concentration, birth weight and sex were significant factors affecting the prognosis of life.     

Follow-up cytology in the management of urotheliomas

Ninety-one patients with operation history for urotheliomas were followed-up by urinary cytology for 17.5 months on the average. Cytologically, fresh urine was examined every month and vesical irrigation fluid every three months. Cystoscopy was also performed every three months, IVP every six months, and biopsy was performed when carcinoma or dysplasia was suspected. As a result, cases were classified into four groups. Group 1: All cytological examination were negative. Group 2: Cytology was positive for two or three months after TUR-Bt during which period vesical instillation therapy of anti-cancer drugs was performed, but was negative after this period. Group 3: Positive and negative cytology were diagnosed irregularly. Group 4: All cytological examinations were positive. The numbers of cases classified into these groups were 27 (29.7%), 7 (7.7%), 43 (47.3%) and 14 (15.4%), respectively. Tumor recurrence was seen in 1/27 (3.7%), 0/7, 12/43 (27.9%) and 4/14 (28.6%) cases, respectively. Metastasis was seen in only five cases of the group 4. Tumor recurrence and positive urinary cytology at the same time were seen in nine cases (20.9%) of group 3, and eight cases (57.1%) of group 4. Thirty four cases (79.1%) with discrepancy of cytological and endoscopic findings in group 3, in which cases 20 cases had only positive irrigation cytology and 11 cases had positive fresh urine and irrigation specimens, were more suspicious of temporary existence of in situ carcinomas or dysplastic urothelium. Of six cases with the discrepancy in group 4, three cases were in situ carcinoma diagnosed by random biopsies, and four cases had positive cytologies after TUR-Bt continuously.(ABSTRACT TRUNCATED AT 250 WORDS)