Publications by authors named "Yasuhiro Yamada"

304 Publications

Abiraterone acetate versus bicalutamide in combination with gonadotropin releasing hormone antagonist therapy for high risk metastatic hormone sensitive prostate cancer.

Sci Rep 2021 May 12;11(1):10094. Epub 2021 May 12.

Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine (KPUM), Kyoto, Kyoto, 602-8566, Japan.

The objective of this study was to compare the efficacy of abiraterone acetate with that of bicalutamide in combination with gonadotropin-releasing hormone (GnRH) antagonist treatment for patients with high-risk metastatic hormone-sensitive prostate cancer (mHSPC). A total of 149 patients with mHSPC who underwent treatment at our hospital and affiliated hospitals between December 2013 and July 2020 were retrospectively identified. Fifty patients were administered abiraterone acetate (1000 mg/day) plus prednisolone (5 mg/day) with a GnRH antagonist (degarelix) (group A), and 99 patients were administered bicalutamide (80 mg/day) with a GnRH antagonist (group B). The prostate-specific antigen (PSA) progression-free survival (PSA-PFS) was significantly longer in group A than in group B. Abiraterone acetate therapy and Gleason score were significant independent factors of PSA-PFS. Using propensity score matching, 56 matched patients were obtained. The PSA-PFS (p < 0.001) and overall survival (OS) (p = 0.0071) of patients with high-risk mHSPC were significantly longer in group A of matched patients. Abiraterone acetate therapy and Gleason score were significant independent factors for PSA-PFS in matched patients. The PSA-PFS and OS of patients treated with abiraterone acetate in combination with a GnRH antagonist were significantly better than those treated with bicalutamide.
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http://dx.doi.org/10.1038/s41598-021-89609-2DOI Listing
May 2021

Subseafloor sulphide deposit formed by pumice replacement mineralisation.

Sci Rep 2021 Apr 23;11(1):8809. Epub 2021 Apr 23.

Institute for Marine-Earth Exploration and Engineering, Japan Agency for Marine-Earth Science and Technology (JAMSTEC), 2-15 Natsushima-cho, Yokosuka, Kanagawa, 237-0061, Japan.

Seafloor massive sulphide (SMS) deposits, modern analogues of volcanogenic massive sulphide (VMS) deposits on land, represent future resources of base and precious metals. Studies of VMS deposits have proposed two emplacement mechanisms for SMS deposits: exhalative deposition on the seafloor and mineral and void space replacement beneath the seafloor. The details of the latter mechanism are poorly characterised in detail, despite its potentially significant role in global metal cycling throughout Earth's history, because in-situ studies require costly drilling campaigns to sample SMS deposits. Here, we interpret petrographic, geochemical and geophysical data from drill holes in a modern SMS deposit and demonstrate that it formed via subseafloor replacement of pumice. Samples from the sulphide body and overlying sediment at the Hakurei Site, Izena Hole, middle Okinawa Trough indicate that sulphides initially formed as aggregates of framboidal pyrite and matured into colloform and euhedral pyrite, which were replaced by chalcopyrite, sphalerite and galena. The initial framboidal pyrite is closely associated with altered material derived from pumice, and alternating layers of pumiceous and hemipelagic sediments functioned as a factory of sulphide mineralisation. We infer that anhydrite-rich layers within the hemipelagic sediment forced hydrothermal fluids to flow laterally, controlling precipitation of a sulphide body extending hundreds of meters.
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http://dx.doi.org/10.1038/s41598-021-87050-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8065033PMC
April 2021

Multisystem Inflammatory Syndrome in Adults after Mild SARS-CoV-2 Infection, Japan.

Emerg Infect Dis 2021 Apr 6;27(6). Epub 2021 Apr 6.

In Japan, a 51-year-old man had minimally symptomatic severe acute respiratory syndrome coronavirus 2 infection. Multisystem inflammatory syndrome was diagnosed ≈5 weeks later; characteristics included severe inflammation, cardiac dysfunction, and IgG positivity. Clinicians should obtain detailed history and examine IgG levels for cases of inflammatory disease with unexplained cardiac decompensation.
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http://dx.doi.org/10.3201/eid2706.210728DOI Listing
April 2021

Three-dimensional-printed soft kidney model for surgical simulation of robot-assisted partial nephrectomy: A proof-of-concept study.

Int J Urol 2021 Apr 5. Epub 2021 Apr 5.

Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

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http://dx.doi.org/10.1111/iju.14560DOI Listing
April 2021

High-dose-rate brachytherapy with external beam radiotherapy versus low-dose-rate brachytherapy with or without external beam radiotherapy for clinically localized prostate cancer.

Sci Rep 2021 Mar 17;11(1):6165. Epub 2021 Mar 17.

Department of Radiology, Kansai Medical University, Hirakata, 573-1010, Japan.

To compare the outcomes of localized prostate cancer treatment with high-dose-rate brachytherapy (HDR-BT) and low-dose-rate brachytherapy (LDR-BT), we examined 924 patients treated with HDR-BT + external beam radiotherapy (EBRT) and 500 patients treated with LDR-BT ± EBRT using multi-institutional retrospective data. The HDR-BT treated advanced disease with more hormonal therapy than LDR-BT. To reduce background selection bias, we performed inverse probability of treatment weighting (IPTW) analysis using propensity scores and excluded patients with T3b-4 disease/ initial prostate-specific antigen (PSA) levels > 50 ng/ml. The actuarial 5-year biochemical control rates (5y-bNED) were 96.3% and 95.7% in the HDR-BT and LDR-BT groups, respectively. The corresponding values were 100% and 96.5% in the low-risk group; 97.4% and 97.1% in the intermediate-risk group (97.2% and 97% in the higher titer group and 97.5% and 94.6% in the lower titer group, respectively); and 95.7% and 94.9% in the selected high-risk group, respectively. IPTW correction indicated no significant difference among the groups. The 5y-bNED in the HDR-BT + EBRT, LDR-BT + EBRT, and LDR-BT alone groups were 96.3%, 95.5%, and 97%, respectively (P = 0.3011). The corresponding values were 97.4%, 94.7%, and 96.6% (P = 0.1004) in the intermediate-risk group (97.5%, 100%, and 94.5% in the lower titer group [P = 0.122] and 97.2%, 96.2%, and 100% [P = 0.664] in the higher titer group, respectively) and 95.7%, 95.5%, and 100% (P = 0.859) in the high-risk group, respectively. The HDR-BT group showed a lower incidence of acute grade ≥ 2 genitourinary toxicities; the incidence of other early and late grade ≥ 2 toxicities were similar between the HDR-BT and LDR-BT groups. Acute genitourinary toxicity predicted the occurrence of late genitourinary toxicity. EBRT increased the risk of grade ≥ 2 gastrointestinal toxicity. HDR-BT + EBRT is a good alternative to LDR-BT ± EBRT for low-, intermediate-, and selected high-risk patients.
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http://dx.doi.org/10.1038/s41598-021-85682-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969770PMC
March 2021

High-Flow Bypass with Radial Artery Graft for Cavernous Carotid Aneurysms: A Case Series.

Asian J Neurosurg 2020 Oct-Dec;15(4):863-869. Epub 2020 Dec 21.

Department of Gastroenterological Surgery, Fujita Health University School of Medicine, Bantane Hospital, Nagoya, Japan.

Background: The incidence of cavernous carotid aneurysms (CCAs) of intracranial aneurysms is low. Majority of cases presented as incidental findings with benign natural progression. The most common presenting symptoms are multiple cranial neuropathies among symptomatic patients. The treatment modalities for symptomatic patients include direct surgical clipping, endovascular coil embolization, or placement of flow diverter, or indirect procedures such as occlusion of parent artery with and without revascularization techniques. The advancement in the microsurgical treatments and endovascular devices have enable a high success rate in the treatment of patients with CCAs with low morbidity and mortality rates.

Objective: To study the surgical outcomes of patients with cavernous aneurysm who underwent high-flow bypass between 2015 and 2020 in our institution.

Materials And Methods: A total of six patients in a single institution presented with CCAs who were treated with high-flow bypass surgery were included in this case-series. A single-case illustration was presented focusing on the details of surgical case management of CCA. The intraoperative middle cerebral artery (MCA) pressure monitoring during bypass surgery was also described.

Results: All five female patients and one male patient who were diagnosed with cavernous carotid aneurysms were studied. The mean age was 68.8 years old (range: 24-84 years old) and the mean size of the aneurysm was 19.6mm (range: 9.7 - 30mm). There were successfully treated with high flow bypasses using radial artery graft without any neurological sequelae.

Conclusion: The surgical treatments of cavernous carotid aneurysms should be limited to experienced neurosurgeons in view of significant risk of morbidity and mortality. Endovascular procedures may be the main stay of treatments. The success shown in this case series with parent artery occlusion and bypass surgery may provide an safe alternative to the endovascular treatment.
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http://dx.doi.org/10.4103/ajns.AJNS_289_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869276PMC
December 2020

Endoscopic Microvascular Decompression for Hemifacial Spasm.

Asian J Neurosurg 2020 Oct-Dec;15(4):833-838. Epub 2020 Oct 18.

Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan.

Introduction And Objective: Hemifacial spasm (HFS) is a condition, characterized by painless, involuntary unilateral tonic or clonic contractions of the facial muscles innervated by the ipsilateral facial nerve. HFS starts with contractions in the orbicularis oculi muscle with subsequent eyelid closure and/or eyebrow elevation, but may spread to involve muscles of the frontalis, platysma, and orbicularis oris muscles. Microvascular decompression (MVD) is reliable and accepted surgical treatment for HFS. MVD is the standard surgical technique now for HFS treatment with long-term success rates.

Materials And Methods: We performed fully endoscopic MVD technique for 1 patient with HFS (a 83-year-old female) at our institution. HFS was diagnosed based on the clinical history and presentation, a neurologic examination, and additional imaging findings. Respectively, the durations of HFS were 3 years, respectively. The patient had been previously treated with repeated botulinum toxin injections. Preoperative evaluation was done with magnetic resonance imaging; three-dimensional computed tomography fusion images examinations had identified the anterior inferior cerebellar artery (AICA) as the offending vessel in this patient.

Results: The patient with HFS was treated by fully endoscopic MVD technique. The AICA, which had been identified as the offending vessel by preoperative magnetic resonance imaging, was successfully decompressed. No surgery-related complications occurred and had excellent outcomes with the complete resolution of HFS immediately after the operation.

Conclusions: Endoscopic surgery can provide a more panoramic surgical view than conventional microscopic surgery. Fully endoscopic MVD is both safe and effective in the treatment of HFS. This method minimizes the risks of brain retraction and extensive dissection often required for microscopic exposure. Endoscopic MVD is safe and has advantage over microscope in terms of visualization of structure, identification of neurovascular conflict, but it has a learning curve and technically challenging.
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http://dx.doi.org/10.4103/ajns.AJNS_152_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869256PMC
October 2020

Bromination Reactivity of Oxygen-Terminated Edges of Graphene.

J Nanosci Nanotechnol 2021 May;21(5):3004-3009

Graduate School of Engineering, Chiba University, 1-33 Yayoi, Inage, Chiba, 263-8522, Japan.

The bromination reactivity of various types of polycyclic aromatic hydrocarbons (PAHs) with oxygen atoms and graphene with oxygen atoms was estimated by density functional theory calculation and experimentally clarified by analyzing bromination of PAHs using gas chromatography-mass spectrometry. In the experimental and theoretical bromination reactivity of PAHs, the presence of hydroxyl group increased the reactivity of PAHs because of electron-donating nature of the hydroxyl group but the other oxygen-containing functional groups such as lactone, ether, and ketone decreased the reactivity due to the electron-withdrawing nature of those groups. These effects of functional groups on the reactivity were also confirmed in graphene. The tendency of theoretical bromination reactivity of graphene was graphene with hydroxyl group > graphene with no group > graphene with lactone group > graphene with ether group > graphene with ketone group. Our study on the estimation of bromination reactivity of graphene edges provides the groundwork for the bromination of graphene edges.
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http://dx.doi.org/10.1166/jnn.2021.19128DOI Listing
May 2021

In-beam Mössbauer spectra of Mn implanted into lithium aluminum hydride.

Appl Radiat Isot 2021 Apr 20;170:109582. Epub 2021 Jan 20.

National Institute of Radiological Sciences, Inage, Chiba, Japan.

In-beam Mössbauer spectra of Mn implanted into LiAlH were measured at different temperatures between 17 and 300 K. The Mössbauer spectrum measured at 17 K showed two sets of doublets, which were assigned to Fe atoms at substitutional sites at Al and Li sites. The Debye temperatures θ for the Fe atoms at Al-substituted and Li-substituted sites were estimated to be 194 K and 117 K, respectively. The assignments were confirmed by density functional theory calculations.
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http://dx.doi.org/10.1016/j.apradiso.2020.109582DOI Listing
April 2021

Heptagons in the Basal Plane of Graphene Nanoflakes Analyzed by Simulated X-ray Photoelectron Spectroscopy.

ACS Omega 2021 Jan 13;6(3):2389-2395. Epub 2021 Jan 13.

Graduate School of Engineering, Chiba University, 1-33 Yayoi, Inage, Chiba 263-8522, Japan.

The performance of graphene-based electronic devices depends critically on the existence of topological defects such as heptagons. Identifying heptagons at the atomic scale is important to completely understand the electronic properties of these materials. In this study, we report an atomic-scale analysis of graphene nanoflakes with two to eight isolated or connected heptagons, using simulated C 1s X-ray photoelectron spectroscopy (XPS) to estimate the XPS profiles depending on the density and the position of the heptagons. The introduction of up to 24% of isolated heptagons shifted the peak position toward high binding energies (284.0 to 284.3 eV), whereas the introduction of up to 39% of connected heptagons shifted the calculated peak position toward low binding energies (284.0 to 283.5 eV). The presence of heptagons also influenced the full width at half-maximum (FWHM). The introduction of 24% of isolated heptagons increased the FWHMs from 1.25 to 1.50 eV. However, the introduction of connected heptagons did not increase the FWHMs above 1.40 eV. The FWHMs increased to 1.40 eV for 19% of connected heptagons, but did not increase further as the percentage of connected heptagons increased to 39%. Based on the calculated results, the XPS profiles of graphene nanoflakes containing heptagons with different densities and positions can be obtained. Our precise identification of heptagons in graphene nanoflakes by XPS lays the groundwork for the analysis of graphene.
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http://dx.doi.org/10.1021/acsomega.0c05717DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7841947PMC
January 2021

Epithelial expression of Gata4 and Sox2 regulates specification of the squamous-columnar junction via MAPK/ERK signaling in mice.

Nat Commun 2021 01 25;12(1):560. Epub 2021 Jan 25.

Department of Life Science Frontiers, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, 606-8507, Japan.

The squamous-columnar junction (SCJ) is a boundary consisting of precisely positioned transitional epithelium between the squamous and columnar epithelium. Transitional epithelium is a hotspot for precancerous lesions, and is therefore clinically important; however, the origins and physiological properties of transitional epithelium have not been fully elucidated. Here, by using mouse genetics, lineage tracing, and organoid culture, we examine the development of the SCJ in the mouse stomach, and thus define the unique features of transitional epithelium. We find that two transcription factors, encoded by Sox2 and Gata4, specify primitive transitional epithelium into squamous and columnar epithelium. The proximal-distal segregation of Sox2 and Gata4 expression establishes the boundary of the unspecified transitional epithelium between committed squamous and columnar epithelium. Mechanistically, Gata4-mediated expression of the morphogen Fgf10 in the distal stomach and Sox2-mediated Fgfr2 expression in the proximal stomach induce the intermediate regional activation of MAPK/ERK, which prevents the differentiation of transitional epithelial cells within the SCJ boundary. Our results have implications for tissue regeneration and tumorigenesis, which are related to the SCJ.
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http://dx.doi.org/10.1038/s41467-021-20906-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835245PMC
January 2021

Temperature limits to deep subseafloor life in the Nankai Trough subduction zone.

Science 2020 12;370(6521):1230-1234

Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.

Microorganisms in marine subsurface sediments substantially contribute to global biomass. Sediments warmer than 40°C account for roughly half the marine sediment volume, but the processes mediated by microbial populations in these hard-to-access environments are poorly understood. We investigated microbial life in up to 1.2-kilometer-deep and up to 120°C hot sediments in the Nankai Trough subduction zone. Above 45°C, concentrations of vegetative cells drop two orders of magnitude and endospores become more than 6000 times more abundant than vegetative cells. Methane is biologically produced and oxidized until sediments reach 80° to 85°C. In 100° to 120°C sediments, isotopic evidence and increased cell concentrations demonstrate the activity of acetate-degrading hyperthermophiles. Above 45°C, populated zones alternate with zones up to 192 meters thick where microbes were undetectable.
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http://dx.doi.org/10.1126/science.abd7934DOI Listing
December 2020

Elucidating Influence of Mg- and Cu-Doping on Electrochemical Properties of O3-Na [Fe,Mn]O for Na-Ion Batteries.

Small 2020 Dec 23;16(50):e2006483. Epub 2020 Nov 23.

Tokyo University of Science, 1-3 Kagurazaka, Shinjuku, Tokyo, 162-8601, Japan.

Although O3-NaFe Mn O delivers a large capacity of over 150 mAh g in an aprotic Na cell, its moist-air stability and cycle stability are unsatisfactory for practical use. Slightly Na-deficient O3-Na Fe Mn O (O3-Na FeMn) and O3-Na Fe Mn Me O (Me = Mg or Cu, O3-FeMnMe) are newly synthesized. The Cu and Mg doping provides higher moist-air stability. O3-Na FeMn, O3-FeMnCu, and O3-FeMnMg deliver first discharge capacities of 193, 176, and 196 mAh g , respectively. Despite partial replacement of Fe with redox inactive Mg, oxide ions in O3-FeMnMg participate in the redox reaction more apparently than O3-Na FeMn. X-ray diffraction studies unveil the formation of a P-O intergrowth phase during charging up to >4.0 V.
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http://dx.doi.org/10.1002/smll.202006483DOI Listing
December 2020

Endoscopic-assisted paramedian infratentorial supracerebellar approach for pineal cyst - How I do it Video clip.

Surg Neurol Int 2020 15;11:336. Epub 2020 Oct 15.

Department of Gastroenterology, Fujita Health University Banbuntane Hospital, Nagoya, Aichi, Japan.

Background: The endoscopic supracerebellar-infratentorial (SCIT) approach is a viable method to access pathology of the posterior incisura, but a narrow working space and frequent instrument conflict can potentially limit its surgical efficacy. We planned an endoscopic-assisted paramedian infratentorial supracerebellar approach for pineal cyst.

Case Description: Patient was placed in prone position under general anesthesia. His head was rotated to the left side slightly. The location of the transverse sinus was detected with navigation system. A 5 cm linear skin incision was performed, and a 2 cm craniectomy was performed about 2 cm left of the median. The transverse sinus was little bit exposed. Dura was incised in a U-shaped incision with the transverse sinus at the base. The endoscope was advanced along with the culmen. At that time, we observed inferior and superior vermian vein. After reaching to the thick arachnoid near by galenic system, the arachnoid membrane was incised and the CSF was evacuated. After that, the cerebellum became soft and the surgical corridor became large. The arachnoid membrane was incised widely. Pineal cyst, precentral cerebellar vein, bilateral internal occipital vein and great vein of galen were exposed. There were some small veins on the pineal cyst, but the adhesion was not so severe. The cyst was dissected from these small veins. There was no adhesion between the cyst and surrounding brain except for the pineal recess. Bilateral ICV was seen behind the cyst. There was feeding artery and draining vein on the antero-lateral part of the cyst. These vessels were coagulated and cut, then the cyst was removed. After the removal, we confirmed complete removal of the cyst and hemostasis.

Conclusion: Endoscopic-assisted paramedian SCIT approach for pineal cyst in prone position is a reasonable and efficient access for posterior third ventricular lesions. The learning curve, maneuverability in small space, and instrument conflict limit efficacy.
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http://dx.doi.org/10.25259/SNI_354_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656027PMC
October 2020

Rare Cases of Contrast-Induced Encephalopathies.

Asian J Neurosurg 2020 Jul-Sep;15(3):786-793. Epub 2020 Aug 28.

Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.

Cortical blindness (CB) due to contrast-induced encephalopathy is a rare complication in endovascular procedure. Although exact mechanism is not known, disruption of blood-brain barrier (BBB) by contrast agent is supposed to be caused. We report two cases of contrast-induced encephalopathies after coil embolization of unruptured aneurysm. A 68-year-old woman with unruptured basilar artery aneurysm was treated with endovascular stent-assisted coil embolization. The procedure was successfully accomplished within 172 min using about 160 ml of contrast medium (iopamidol). However, she manifested with CB 3 h after the procedure and seizure on the next day. Immediate computed tomography revealed the cortical enhancement in both occipital lobes. Diffusion-weighted imaging-magnetic resonance imaging and fluid-attenuated inversion recovery sequence 1 day after the procedure revealed edema in both occipital lobes with no findings of ischemia or hyperperfusion. Electroencephalography showed sharp and slow waves in both occipital lobes. She required endotracheal intubation on day 2 to maintain airways and breathing. Her sensorium improved 4 days after the procedure with administration of steroid and anticonvulsant. She was extubated on day 4 after the procedure. She was discharged with persisting CB as a sequel.
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http://dx.doi.org/10.4103/ajns.AJNS_68_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591187PMC
August 2020

Analysis of the Surgical Outcome of Unruptured Intracranial Saccular Aneurysms in Octogenarians (80-89 Years).

Asian J Neurosurg 2020 Jul-Sep;15(3):640-643. Epub 2020 Aug 28.

Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.

Background: The prevalence of unruptured intracranial aneurysms is increasing in elderly population in Japan. Octogenarians (80-89 years) are more prone to complications due to increased age, comorbidities, increased risk of vasospasm, and treatment risks.

Aim: The aim is to study the surgical outcome of unruptured intracranial saccular aneurysms in elderly patients aged between 80 and 89 years.

Patients And Methods: A retrospective study was conducted involving all the cases of unruptured intracranial saccular aneurysms operated surgically in elderly patients aged between 80 and 89 years. All the cases operated between January 2017 and October 2019 were included in the study. The preoperative neurological status was assessed using the Glasgow Coma Scale (GCS). The comorbidities and risk factors involved were assessed. Postoperative neurological status was assessed by (1) postoperative GCS score and by the (2) presence or absence of the motor weakness of limbs.

Results: Thirty-three aneurysms were operated in 27 patients. Two patients were operated two times at separate occasions for different aneurysms during the study period and hence making a total of 29 surgeries. The age range was 80-88 years, with a mean of 82.4 years ± 2.64 standard deviation (SD). There were 7 (24.1%) males and 22 (75.86%) females. All the patients had a preoperative GCS score of 15/15 without focal neurological deficit. The mean size (mm) of the aneurysms was 6.57 ± 4.04 SD. There were 31 (93.94%) aneurysms in the anterior circulation and 2 (6.06%) aneurysms in the posterior circulation. The comorbidities and risk factors were analyzed and found to be not influencing the outcome of the patients. Clipping was done in 32 aneurysms. One case of posterior inferior cerebellar artery (PICA) aneurysm underwent occipital artery to PICA bypass surgery. The postoperative complications include chronic subdural hematoma (CSDH) in 7 (24.13%) patients, extradural hematoma in 1 (3.4%), meningitis in 1 (3.4%), and lower cranial nerve palsy in 1 (3.4%) patient. All the patients were discharged with GCS score 15/15 without motor weakness of the limbs. The mean duration of stay was 16.62 days ± 9.98 SD.

Conclusion: Surgery for unruptured saccular aneurysms in octogenarians has got a good result in the tertiary care facility. Advanced age alone should not be considered for preferring coiling over clipping. Octogenarians are more prone to developing postoperative CSDH.
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http://dx.doi.org/10.4103/ajns.AJNS_44_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591182PMC
August 2020

A Practice Survey to Compare and Identify the Usefulness of Neuroendoscope and Exoscope in the Current Neurosurgery Practice.

Asian J Neurosurg 2020 Jul-Sep;15(3):601-607. Epub 2020 Aug 28.

Department of Neurosurgery, Bantane Hospital, Fujita Health University, Nagoya, Japan.

Background: The present era is of new tools and technique. Handling of new challenges require, better understanding of microscopic anatomy, which requires better magnification and light. Microscope has played significant role in this, use of endoscope and introduction of exoscope have given new dimensions to this field.

Aim: This study aims to compare and see the advantages, disadvantages of endoscope with exoscope, will analyze the difference in terms of ergonomics, learning curve, opportunities for training, operating time, magnification, and image quality.

Materials And Methods: This study was conducted in the Department of Neurosurgery, Bantane Hospital Fujita Health University, Japan. Apart from comparing the specifications of available systems, we conducted a worldwide survey of the two systems through sending questionnaire through mail collected responses and analyzed them.

Results: Learning curve, magnification, image quality, and ergonomics favors exoscope but depth perception and maneuverability, hand eye coordination, tactile sensation, and usage of different angulation tubes favored endoscope to be superior to exoscope.

Conclusion: There is more scope for modifications and research in both the instruments. These instruments are not replacement of either and should be used according to their indications.
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http://dx.doi.org/10.4103/ajns.AJNS_339_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591211PMC
August 2020

EC-IC Bypass; Our Experience of Cerebral Revascularization with Intraoperative Dual-Image Video Angiography (Diva).

Asian J Neurosurg 2020 Jul-Sep;15(3):499-506. Epub 2020 Aug 28.

Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.

Background: Extracranial-intracranial (EC-IC) arterial bypass has been used in the treatment of various cerebrovascular ischemic disease due to atherosclerosis or Moyamoya disease, skull base tumors encasing large IC artery or complex IC aneurysms.

Aim: The aim is to analyze surgical technique (EC-IC bypass) and its outcome with intraoperative use of dual image video angiography (DIVA) and Doppler ultrasound.

Materials And Methods: We studied in this article a series of 23 patients operated in Banbuntane Hotokukai Hospital, Fujita Health University, for which a superficial temporal artery-middle cerebral artery anastomosis was done for steno-occlusive disease, giant IC aneurysm or Moyamoya disease. The study was conducted between 2018 and 2020. We used dual-image video angiography (DIVA) and Doppler ultrasound to assess the luminal patency of anastomosis during the procedure.

Results: In this study, three patients presented with Moyamoya disease, 4 had aneurysm, whereas 16 patients presented with the vascular steno-occlusive disease. The patients were divided into three categories (steno-occlusive disease, Moyamoya, and flow replacement for giant aneurysm). Dual image video angiography, along with intraoperative Doppler, helped us in the assessment of luminal patency of the anastomosis.

Conclusion: Hemodynamic recovery after cerebrovascular bypass brings about a better outcome in ischemic stroke. The result of surgery improves with proper selection of patients with hemodynamic impairment (in Stage 2). With various modalities such as intraoperative Doppler, DIVA (Dual-image Video Angiography) and improved surgical techniques may aid in the reduction of complications and improve clinical outcome.
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http://dx.doi.org/10.4103/ajns.AJNS_84_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591183PMC
August 2020

Institutional Experience of Microsurgical Management in Posterior Circulation Aneurysm.

Asian J Neurosurg 2020 Jul-Sep;15(3):484-493. Epub 2020 Aug 28.

Department of Neurosurgery, Bantane Hospital, Fujita Health University, Nagoya, Japan.

Introduction: Posterior circulation aneurysm constitutes 15%-20% of all intracerebral aneurysms. With the advancement of endovascular techniques, the microsurgery for posterior circulation aneurysms has been pushed back a little. Even the International Subarachnoid Aneurysmal Trial gave support to the concepts of endovascular procedures, but microsurgical modality should not be discouraged. We present our institutional experience of microsurgical techniques on posterior circulation aneurysms.

Materials And Methods: We performed a retrospective analysis of 37 patients of posterior circulation aneurysm from 2015 to 2019, referred to Bantane Hospital, Japan. We included all posterior circulation aneurysms such as basilar tip, basilar trunk, and vertebral artery-posterior inferior cerebellar artery (VA-PICA) aneurysms, admitted and treated with clipping or bypass and trapping. We assessed the outcome as measured by modified Rankin Score (mRS), complications, and mortality.

Results: Out of 37 patients, 10 cases were a basilar tip, one case was the basilar trunk, and 26 cases were VA-PICA aneurysm. Intraoperatively, neuromonitoring, indocyanine green dye, dual-image videoangiography (DIVA), and neuro endoscope were used. Two patients of basilar tip aneurysm developed third cranial nerve paresis and six patients of VA-PICA aneurysm developed lower cranial nerve paresis which resolved spontaneously. All the patients were discharged with mRS of 0 or 1. No mortality was recorded in our study.

Conclusion: Microsurgical clipping of posterior circulation aneurysm is safe in unruptured aneurysm with a very low risk of mortality and morbidity under experienced hands. All postoperative complications in our study were transient and resolved with time with no residual deficits. Preoperative simulation, intraoperative neuromonitoring, DIVA, and neuro endoscope help achieve complete obliteration of aneurysmal sac and avoid complications.
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http://dx.doi.org/10.4103/ajns.AJNS_69_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591165PMC
August 2020

[iPS Cell Technology for Dissecting Mechanisms of Cancer Development].

Gan To Kagaku Ryoho 2020 Oct;47(10):1407-1410

Division of Stem Cell Pathology, Center for Experimental Medicine and Systems Biology, The Institute of Medical Science, The University of Tokyo.

Seminal studies by Dr. Shinya Yamanaka revealed that reprogramming technology was able to convert differentiated somatic cells to self-renewing and pluripotent stem cells. Although reprogramming process does not require changes in the genome information, cellular reprogramming elicits dynamic changes of epigenetic regulation. Therefore, reprogramming technology is a powerful tool for the modifying epigenetic regulation. Previous studies have reported that epigenetic regulation plays a critical role on both the development and maintenance of cancer cells. Taking advantage of reprogramming technology, previous studies have actively modified the epigenome of cancer cells and revealed the importance of the coordinated interactions between genetic abnormalities and epigenetic regulation in cancer cells. In this review, we describe advances and challenges in the use of reprogramming technology for studying cancer biology.
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October 2020

Usefulness of a novel device to divide core needle biopsy specimens in a spatially matched fashion.

Sci Rep 2020 10 13;10(1):17098. Epub 2020 Oct 13.

Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.

We developed a novel dividing device that can split needle biopsy tissues along longitude axis aiming to achieve definitive molecular-biological and genetical analysis with reference of pathological diagnosis of the side-by-side divided tissue as spatially matched information. The aim of this study was to evaluate the feasibility and potential usefulness of the novel dividing device to provide the appropriate materials for molecular diagnosis. The new device was examined using mouse xenograft tumors. Real-time quantitative PCR and genetic test were performed to evaluate the feasibility and usefulness of the device. All the samples from needle biopsy were successfully divided into two pieces. Quality and quantity from divided samples harbor high enough to perform gene expression analysis (real-time PCR) and genetic test. Using two divided samples obtained from xenograft tumor model by needle biopsy, the % length of xenograft tumor (human origin) was significantly correlated with the % human genomic DNA (p = 0.00000608, r = 0.987), indicating that these divided samples were spatially matched. The novel longitudinally dividing device of a needle biopsy tissue was useful to provide the appropriate materials for molecular-biological and genetical analysis with reference of pathological diagnosis as spatially matched information.
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http://dx.doi.org/10.1038/s41598-020-74136-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7555856PMC
October 2020

Generation of a p16 Reporter Mouse and Its Use to Characterize and Target p16 Cells In Vivo.

Cell Metab 2020 11 18;32(5):814-828.e6. Epub 2020 Sep 18.

Division of Molecular Regulation of Inflammatory and Immune Diseases, Research Institute of Biomedical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba 278-0022, Japan.

Cell senescence plays a key role in age-associated organ dysfunction, but the in vivo pathogenesis is largely unclear. Here, we generated a p16-Cre-tdTomato mouse model to analyze the in vivo characteristics of p16 cells at a single-cell level. We found tdTomato-positive p16 cells detectable in all organs, which were enriched with age. We also found that these cells failed to proliferate and had half-lives ranging from 2.6 to 4.2 months, depending on the tissue examined. Single-cell transcriptomics in the liver and kidneys revealed that p16 cells were present in various cell types, though most dominant in hepatic endothelium and in renal proximal and distal tubule epithelia, and that these cells exhibited heterogeneous senescence-associated phenotypes. Further, elimination of p16 cells ameliorated nonalcoholic steatohepatitis-related hepatic lipidosis and immune cell infiltration. Our new mouse model and single-cell analysis provide a powerful resource to enable the discovery of previously unidentified senescence functions in vivo.
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http://dx.doi.org/10.1016/j.cmet.2020.09.006DOI Listing
November 2020

Ancient Jomon genome sequence analysis sheds light on migration patterns of early East Asian populations.

Commun Biol 2020 08 25;3(1):437. Epub 2020 Aug 25.

Kitasato University School of Medicine, Sagamihara, Japan.

Anatomically modern humans reached East Asia more than 40,000 years ago. However, key questions still remain unanswered with regard to the route(s) and the number of wave(s) in the dispersal into East Eurasia. Ancient genomes at the edge of the region may elucidate a more detailed picture of the peopling of East Eurasia. Here, we analyze the whole-genome sequence of a 2,500-year-old individual (IK002) from the main-island of Japan that is  characterized with a typical Jomon culture. The phylogenetic analyses support multiple waves of migration, with IK002 forming a basal lineage to the East and Northeast Asian genomes examined, likely representing some of the earliest-wave migrants who went north from Southeast Asia to East Asia. Furthermore, IK002 shows strong genetic affinity with the indigenous Taiwan aborigines, which may support a coastal route of the Jomon-ancestry migration. This study highlights the power of ancient genomics to provide new insights into the complex history of human migration into East Eurasia.
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http://dx.doi.org/10.1038/s42003-020-01162-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447786PMC
August 2020

Robot-assisted laparoscopic partial nephrectomy for horseshoe kidney: A case report.

IJU Case Rep 2019 Nov 23;2(6):308-311. Epub 2019 Jul 23.

Department of Urology Kyoto Prefectural University of Medicine Kyoto Japan.

Introduction: Horseshoe kidney has unique anatomical features, such as a complex blood supply. We report a patient with renal cell carcinoma in a horseshoe kidney, who underwent tumor resection by robot-assisted laparoscopic partial nephrectomy based on preoperative three-dimensional computed tomography.

Case Presentation: A 66-year-old man was referred to our hospital with a 2-cm enhancing mid-pole mass in the left moiety of a horseshoe kidney. The clinical diagnosis was renal cell carcinoma cT1aN0M0 (R.E.N.A.L. nephrometry score: 1 + 2 + 3 + 3 = 9p). Robot-assisted laparoscopic partial nephrectomy was performed with selective clamping based on reconstructed three-dimensional images. The warm ischemia time was 13 min. Pathologic examination confirmed a diagnosis of pT1a clear cell renal cell carcinoma with negative surgical margins. At 6 months postoperatively, computed tomography showed no local recurrence or metastasis and renal function was intact.

Conclusion: Robot-assisted laparoscopic partial nephrectomy with preoperative three-dimensional computed tomography may have advantages for resection of tumors in patients with horseshoe kidney.
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http://dx.doi.org/10.1002/iju5.12108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292058PMC
November 2019

Moving away from systematic biopsies: image-guided prostate biopsy (in-bore biopsy, cognitive fusion biopsy, MRUS fusion biopsy) -literature review.

World J Urol 2021 Mar 29;39(3):677-686. Epub 2020 Jul 29.

Department of Urology, Istanbul Medipol University, Istanbul, Turkey.

Objective: To compare the detection rate of clinically significant cancer (CSCa) by magnetic resonance imaging-targeted biopsy (MRI-TB) with that by standard systematic biopsy (SB) and to evaluate the role of MRI-TB as a replacement from SB in men at clinical risk of prostate cancer.

Methods: The non-systematic literature was searched for peer-reviewed English-language articles using PubMed, including the prospective paired studies, where the index test was MRI-TB and the comparator text was SB. Also the randomized clinical trials (RCTs) are included if one arm was MRI-TB and another arm was SB.

Results: Eighteen prospective studies used both MRI-TB and TRUS-SB, and eight RCT received one of the tests for prostate cancer detection. In most prospective trials to compare MRI-TB vs. SB, there was no significant difference in any cancer detection rate; however, MRI-TB detected more men with CSCa and fewer men with CISCa than SB.

Conclusion: MRI-TB is superior to SB in detection of CSCa. Since some significant cancer was detected by SB only, a combination of SB with the TB technique would avoid the underdiagnosis of CSCa.
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http://dx.doi.org/10.1007/s00345-020-03366-xDOI Listing
March 2021

Targeted Focal Cryoablation for Prostate Cancer With Real-time Transrectal Ultrasound-guided Free-hands Technique: A Step-by-step Technique.

Urology 2020 Oct 17;144:261-262. Epub 2020 Jul 17.

Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Objective: For targeted prostate cryoablation, template-grid technique is widely adapted. As long as using template-grid, the angle of cryoprobe placement is limited in 1 direction through grid-hole. Accordingly, the neurovascular bundles are injured by the ice-ball formation outside of the prostate. The free-hands technique allows the ice-ball to cover the entire cancer and preserve neurovascular bundles because of the ideal ice-ball formation within prostate and along with the prostate contour.

Material And Methods: Primary localized prostate cancer which has typically single focus of Gleason 7 cancer is targeted, which is MRI-visible targeted-biopsy proven clinically significant cancer. The procedure is performed with real-time transrectal ultrasound-guided free-hands technique. Three cryoprobes are used, including the main probe to target the center of the image-visible lesion, and other 2 probes to cover the safety margins. The entry of the probe into the prostate is achieved in the apex level and then the angle of the insertion is changed laterally to hit the center of the cancer. The ice-ball formation is aiming lethal temperature to cover the entire cancer lesion, with minimizing of the thermal injury in the functional anatomies such as neurovascular bundles and sphincter.

Results: The most technically challenging procedure is to treat the caner lesion in contact with prostate posterior margin. Ice-ball extension needs to extend over 5 mm extraprostate toward the rectal wall, in order to achieve the lethal temperature in contact with posterior prostate capsule. The cryo-prove would be fixed in the prostate tissues completely by freezing-effect. By the lift-up manipulation of the probe anteriorly, we can easily lift the prostate upward, resulting in making of the Denonviellie space wider.

Conclusion: This video provides a step-by-step targeted cryoablation for prostate cancer that can be performed safely and effectively. This approach minimizes the thermal injury in the functional anatomies such as neurovascular bundles and sphincter.
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http://dx.doi.org/10.1016/j.urology.2020.07.005DOI Listing
October 2020

Acute Coils Migration Causing Significant M3 Branch Occlusion: A Case Report of Rescue Surgery with Superficial Temporal Artery-Middle Cerebral Artery Bypass.

Asian J Neurosurg 2020 Apr-Jun;15(2):428-430. Epub 2020 May 29.

Department of Neurosurgery, Bantane Hospital, Fujita Health University, Nagoya, Japan.

We describe an uncommon case of acute coils migration with significant occlusion of M3 branch and our management of this complication. Ballon-assisted coil placement was performed for an unruptured intracavernous internal carotid artery aneurysm in a 62-year-old woman. After coil placement and balloon deflection, we observed coils migration with significant occlusion of M3 branch. After early clinical deterioration without other neurological symptoms, we decided to perform superficial temporal artery-middle cerebral artery (STA-MCA) bypass to ensure blood flow distal to the occlusion. The patient was discharged without neurological deficit. To the best of our knowledge, this is the first case report about STA-MCA bypass to treat acute coils migration. This technique could represent a successful rescue therapy in case of acute coils migration that cannot be retrieved by endovascular tools or in case where distal and deep location of migrated coils controindicate surgical removal.
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http://dx.doi.org/10.4103/ajns.AJNS_349_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335151PMC
May 2020

Visual Outcomes after Surgery for Paraclinoid Aneurysms: A Fujita Experience.

Asian J Neurosurg 2020 Apr-Jun;15(2):363-369. Epub 2020 May 29.

Department of Neurosurgery, Banbuntane Hotokukai Hospital, Otobashi, Nagoya, Japan.

Introduction: The surgical strategies for clipping of paraclinoid aneurysms are diverse. These aneurysms are unique in their location, as they closely abut the anterior clinoid process (ACP) and the optic nerve. The ultimate goal of clipping encompasses the exposure of neck of the aneurysm which is seldom complete without the manipulation of optic nerve and the ACP. This manipulation may result in disturbances of vision postoperatively. We analyze our results of visual outcomes in the surgery for paraclinoid aneurysms in this retrospective study.

Materials And Methods: All patients with paraclinoid aneurysms who underwent surgery from June 2014 to June 2019 were included in the study. Surgical procedure was uniform in all patients which included anterior clinoidectomy and clipping of aneurysms as per the Bantane protocol. Glasgow Outcome Scale as well as vision was assessed at discharge and at 1 month and 6 months.

Results: There were 77 cases of paraclinoid aneurysms operated during the abovementioned period. All patients had no symptoms related to vision preoperatively. Visual deterioration was noted in two patients. All patients were discharged with a good outcome on the Glasgow Outcome Scale.

Conclusion: Paraclinoid aneurysm has a good outcome when treated with surgery. The visual deterioration following surgery can be minimized with extradural anterior clinoidectomy and careful handling of the vessels and nerve.
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http://dx.doi.org/10.4103/ajns.AJNS_39_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335145PMC
May 2020

Hearing Outcomes after Microvascular Decompression for Hemifacial Spasm: An Institutional Experience.

Asian J Neurosurg 2020 Apr-Jun;15(2):344-348. Epub 2020 Apr 7.

Department of Neurosurgery, Fujita Health University Banbuntane Hospital, Nagoya, Japan.

Introduction: Hearing loss following microvascular decompression (MVD) for hemifacial spasm is one of the most dreaded complications. Several factors such as stretching of VIII cranial nerve, vasospasm of labyrinthine artery, and acoustic trauma due to drill noise may be considered in its causation. We evaluated the incidence and severity of hearing loss following MVD in hemifacial spasm and the factors which might be responsible for this complication.

Methods: A retrospective analysis of 30 patients operated for hemifacial spasm between January 1, 2014, and December 31, 2018, with at least 3 months of follow-up were included in the study. Retromastoid craniotomy was made, and Teflon was placed between involved vessel and VII nerve.

Results: Freedom from hemifacial spasm was noted in 27 of 30 patients. Moderate spasm persisted in one patient, which was controlled with medications. The recurrence was noted in 3 patients at 6 months follow-up. Postoperatively, hearing loss was found in one female patient. The offending vessel was both anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) loop, which was transpositioned during surgery, and the patient was spasm free postoperatively.

Conclusion: The incidence of hearing loss following MVD can be minimized using proper surgical techniques and various intraoperative adjuncts such as brainstem auditory evoked responses monitoring, use of endoscope, and indocyanine green or dual-image video angiography.
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http://dx.doi.org/10.4103/ajns.AJNS_362_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335139PMC
April 2020