In this paper (Cell 95[6], 829-837), we described the direction of the nodal cilia rotation as counterclockwise (Figure 6B). However, our recent analyses with higher spatiotemporal resolution revealed that the actual direction is clockwise when seen from the ventral side (above the nodal pit cells). In our previous observation with lower temporal resolution (10 frames per second), the direction of the rapid rotation ‫01ف(‬ rounds per second) of the nodal cilia was misinterpreted due to the artifact caused by the strobe effect. It should be noted that this artifact only affects the apparent direction of the rotary movement. Thus, the direction of the linear movement of the beads in the extraembryonic fluid or the direction of the nodal flow is leftward albeit the low temporal resolution of our previous analysis. Therefore, the clockwise rotation of the nodal cilia causes the leftward nodal flow. For further details, refer to our recent paper Y. Okada et al. (Molecular Cell, 1999, in press).

Background and Purpose-About one half of those who develop adult-onset moyamoya disease experience intracranial hemorrhage. Despite the extremely high frequency of rebleeding attacks and poor prognosis, measures to prevent rebleeding have not been established. The purpose of this study is to determine whether extracranial-intracranial bypass can reduce incidence of rebleeding and improve patient prognosis. Methods-This study was a multicentered, prospective, randomized, controlled trial conducted by 22 institutes in Japan.Adult patients with moyamoya disease who had experienced intracranial hemorrhage within the preceding year were given either conservative care or bilateral extracranial-intracranial direct bypass and were observed for 5 years. Primary and secondary end points were defined as all adverse events and rebleeding attacks, respectively. Results-Eighty patients were enrolled (surgical, 42; nonsurgical, 38). Adverse events causing significant morbidity were observed in 6 patients in the surgical group (14.3%) and 13 patients in the nonsurgical group (34.2%). Kaplan-Meier survival analysis revealed significant differences between the 2 groups (3.2%/y versus 8.2%/y; P=0.048). The hazard ratio of the surgical group calculated by Cox regression analysis was 0.391 (95% confidence interval, 0.148-1.029).Rebleeding attacks were observed in 5 patients in the surgical group (11.9%) and 12 in the nonsurgical group (31.6%), significantly different in the Kaplan-Meier survival analysis (2.7%/y versus 7.6%/y; P=0.042). The hazard ratio of the surgical group was 0.355 (95% confidence interval, 0.125-1.009). Conclusions-Although statistically marginal, Kaplan-Meier analysis revealed the significant difference between surgical and nonsurgical group, suggesting the preventive effect of direct bypass against rebleeding. Clinical Trial Registration