2024/03/18 更新

写真a

タケウチ カズヒト
竹内 和人
TAKEUCHI Kazuhito
所属
医学部附属病院 脳神経外科 病院講師
職名
病院講師
外部リンク

学位 1

  1. 博士(医) ( 名古屋大学 ) 

研究分野 1

  1. その他 / その他  / 神経内視鏡外科

経歴 1

  1. 名古屋大学   医学部附属病院 脳神経外科   病院講師

    2015年2月 - 現在

所属学協会 6

  1. 日本脳神経外科学会

  2. 日本頭蓋底外科学会

  3. 日本間脳下垂体腫瘍学会

  4. 日本神経内視鏡学会

  5. 日本内分泌学会

  6. 日本脳腫瘍の外科学会

▼全件表示

受賞 2

  1. 第24回日本脳腫瘍の外科学会 会長賞

    2019年9月   日本脳腫瘍の外科学会   脳幹部海綿状血管腫治療における内視鏡手術の応用

  2. 第22回脳腫瘍の外科学会 会長賞

    2017年9月   日本脳腫瘍の外科学会   脳幹、脳幹近傍海綿状血管腫に対する内視鏡治療の有効性

 

論文 91

  1. Safety and efficacy of the endoscopic transsphenoidal transclival approach performed using direct cortical stimulation for pontine cavernous malformations. 国際誌

    Takeuchi K, Nagata Y, Sasagawa Y, Ito E, Yamamoto T, Mizuno A, Sasaki H, Kondo T, Araki Y, Nakada M, Saito R

    Journal of neurosurgery   140 巻 ( 2 ) 頁: 469 - 477   2024年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Neurosurgery  

    OBJECTIVE Surgical treatment of brainstem cavernous malformations (CMs) is challenging. Surgery using the endoscopic transsphenoidal transclival approach (eTSTCA) is reported as a useful alternative for ventral brainstem CMs. However, CMs located in the ventral midline of the brainstem are rare, and only a small number of case reports on these CMs treated with the eTSTCA exist. The efficacy and safety of the eTSTCA have not yet been fully examined. METHODS A retrospective analysis was performed for 5 consecutive patients who underwent surgery via the eTSTCA for treating ventral pontine CMs. RESULTS The average maximum CM diameter was 26.0 mm (18–38 mm). All patients underwent MR–diffusion tensor imaging, which confirmed that the corticospinal tract (CST) deviated posteriorly or laterally to the CM. Direct brainstem cortical stimulation was performed to localize the CST before making the cortical incision. After the excision of the CM, the cavity was filled with artificial CSF to make an aqueous surgical field (wet-field technique) for observing the tumor cavity and confirming complete hemostasis and resection. Total removal was achieved in all patients. The preoperative modified Rankin Scale score was 3 in 3 patients and 4 in 2 patients, whereas it was 1 in 2 patients and 0 in 3 patients 3 months after surgery. Postoperative CSF leakage was observed in 1 patient, and transient abducens nerve palsy was observed in 1 patient. No other intra- or postoperative complications were observed. CONCLUSIONS MR–diffusion tensor imaging and direct brainstem cortical stimulation were useful to ascertain the proximity of the CST to the CM. The endoscope provides a clear view even underwater, and it was safe and effective to observe the entire CM cavity and confirm complete hemostasis without additional retraction of the brainstem parenchyma, including the CST. The eTSTCA provides a direct access point to the lesion and may be a safer alternative treatment for patients whose CST deviates laterally or posteriorly to the CM.

    DOI: 10.3171/2023.6.JNS23324

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  2. Extended Endoscopic Endonasal Transplanum and Transdorsum Sellar Approach for the Resection of Retroinfundibular Craniopharyngioma With Two-Piece Dural Opening: A Technical Case Report

    Matmusayev, M; Kariev, GM; Asadullaev, U; Takeuchi, K; Nagata, Y; Harada, H; Saito, R

    CUREUS JOURNAL OF MEDICAL SCIENCE   16 巻 ( 1 ) 頁: e51850   2024年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.7759/cureus.51850

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  3. Endoscopic debulking canalization for optic pathway glioma with obstructive hydrocephalus 国際誌

    Takeuchi, K; Ohka, F; Nagata, Y; Ito, E; Harada, H; Saito, R

    CHILDS NERVOUS SYSTEM   39 巻 ( 12 ) 頁: 3421 - 3425   2023年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Child's Nervous System  

    Optic pathway gliomas (OPGs) are benign tumors that can stop growing or even shrink. In recent years, surgical resection has not been considered the first-line treatment because of its high risk of complications. Chemotherapy is the mainstay of treatment for growing OPGs. Surgical treatment for OPGs with obstructive hydrocephalus is required. Ventriculoperitoneal shunting is effective for all types of hydrocephalus. However, long-term management is required, especially in pediatric cases, and there is a risk of shunt-related complications over a long lifespan. Debulking surgery for OPGs allows us to avoid shunt placement by creating a waterway and releasing the hydrocephalus. To reduce the surgical risk and invasiveness, we used an endoscopic canalization technique with a small-diameter cylinder. In this article, we present a case of endoscopic canalization of an obstructive hydrocephalus caused by OPGs in a 14-year-old female to illustrate our surgical technique. (Trial registration Registry name and number: Efficacy and safety of the neuro-endoscopic treatment for brain tumors (2019–0254)).

    DOI: 10.1007/s00381-023-06053-5

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  4. Deep learning based identification of pituitary adenoma on surgical endoscopic images: a pilot study

    Fuse, Y; Takeuchi, K; Hashimoto, N; Nagata, Y; Takagi, Y; Nagatani, T; Takeuchi, I; Saito, R

    NEUROSURGICAL REVIEW   46 巻 ( 1 ) 頁: 291   2023年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Neurosurgical Review  

    Accurate tumor identification during surgical excision is necessary for neurosurgeons to determine the extent of resection without damaging the surrounding tissues. No conventional technologies have achieved reliable performance for pituitary adenomas. This study proposes a deep learning approach using intraoperative endoscopic images to discriminate pituitary adenomas from non-tumorous tissue inside the sella turcica. Static images were extracted from 50 intraoperative videos of patients with pituitary adenomas. All patients underwent endoscopic transsphenoidal surgery with a 4 K ultrahigh-definition endoscope. The tumor and non-tumorous tissue within the sella turcica were delineated on static images. Using intraoperative images, we developed and validated deep learning models to identify tumorous tissue. Model performance was evaluated using a fivefold per-patient methodology. As a proof-of-concept, the model’s predictions were pathologically cross-referenced with a medical professional’s diagnosis using the intraoperative images of a prospectively enrolled patient. In total, 605 static images were obtained. Among the cropped 117,223 patches, 58,088 were labeled as tumors, while the remaining 59,135 were labeled as non-tumorous tissues. The evaluation of the image dataset revealed that the wide-ResNet model had the highest accuracy of 0.768, with an F1 score of 0.766. A preliminary evaluation on one patient indicated alignment between the ground truth set by neurosurgeons, the model’s predictions, and histopathological findings. Our deep learning algorithm has a positive tumor discrimination performance in intraoperative 4-K endoscopic images in patients with pituitary adenomas.

    DOI: 10.1007/s10143-023-02196-w

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    その他リンク: https://link.springer.com/article/10.1007/s10143-023-02196-w/fulltext.html

  5. ESTABLISHMENT OF ORGANOID MODELS OF PATIENT-DERIVED GH-PRODUCING PITUITARY ADENOMA

    Maeda, S; Ohka, F; Kanamori, F; Okumura, Y; Takeuchi, K; Nagata, Y; Motomura, K; Yamaguchi, J; Kibe, Y; Harada, H; Shimizu, H; Takido, Y; Saito, R

    NEURO-ONCOLOGY   25 巻   2023年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  6. INTRA-OPERATIVE ANALYSES OF GENETIC ALTERATIONS IN THE CENTRAL NERVOUS SYSTEM TUMORS USING RAPID QUANTITATIVE PCR DEVICE

    Ohka, F; Maeda, S; Yamaguchi, J; Shimizu, H; Motomura, K; Takeuchi, K; Nagata, Y; Nishikawa, T; Kibe, Y; Takido, Y; Saito, R

    NEURO-ONCOLOGY   25 巻   2023年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  7. Glossopharyngeal neurinoma of incidental finding in a 65-year-old female patient: case report

    Kabulo, KDM; Takeuchi, K; Yamada, Y; Sharafundeen, A; Kalangu, KKN; Kato, Y

    EGYPTIAN JOURNAL OF NEUROSURGERY   38 巻 ( 1 )   2023年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1186/s41984-023-00226-9

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  8. 再生医療実現に向けたヒト多能性幹細胞由来下垂体細胞の皮下移植

    佐々木 博勇, 須賀 英隆, 竹内 和人, 永田 雄一, 原田 英幸, 近藤 辰磨, 伊藤 英治, 有馬 寛, 齋藤 竜太

    日本内分泌学会雑誌   99 巻 ( S.HPT ) 頁: 4 - 6   2023年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本内分泌学会  

    DOI: 10.1507/endocrine.99.s.hpt_4

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  9. [Prevention of Cerebrospinal Fluid Leakage and Endocrinological Management after Transsphenoidal Surgery].

    Takeuchi K

    No shinkei geka. Neurological surgery   51 巻 ( 4 ) 頁: 697 - 705   2023年7月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:株式会社医学書院  

    DOI: 10.11477/mf.1436204803

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  10. Rapid detection of the <i>MYD88</i> L265P mutation for pre- and intra-operative diagnosis of primary central nervous system lymphoma 国際誌

    Yamaguchi, J; Ohka, F; Kitano, Y; Maeda, S; Motomura, K; Aoki, K; Takeuchi, K; Nagata, Y; Hattori, H; Tsujiuchi, T; Motomura, A; Nishikawa, T; Kibe, Y; Shinjo, K; Kondo, Y; Saito, R

    CANCER SCIENCE   114 巻 ( 6 ) 頁: 2544 - 2551   2023年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Cancer Science  

    The myeloid differentiation primary response gene 88 (MYD88) L265P mutation is a disease-specific mutation of primary central nervous system lymphoma (PCNSL) among the central nervous system tumors. Accordingly, this mutation is considered a reliable diagnostic molecular marker of PCNSL. As the intra-operative diagnosis of PCNSL is sometimes difficult to achieve using histological examinations alone, intra-operative detection of the MYD88 L265P mutation could be effective for the accurate diagnosis of PCNSL. Herein, we aimed to develop a novel rapid genotyping system (GeneSoC) using real-time polymerase chain reaction (PCR) based on microfluidic thermal cycling technology. This real-time PCR system shortened the analysis time, which enabled the detection of the MYD88 L265P mutation within 15 min. Rapid detection of the MYD88 L265P mutation was performed intra-operatively using GeneSoC in 24 consecutive cases with suspected malignant brain tumors, including 10 cases with suspected PCNSL before surgery. The MYD88 L265P mutation was detected in eight cases in which tumors were pathologically diagnosed as PCNSL after the operation, while wild-type MYD88 was detected in 16 cases. Although two of the 16 cases with wild-type MYD88 were pathologically diagnosed as PCNSL after the operation, MYD88 L265P could be detected in all eight PCNSL cases harboring MYD88 L265P. The MYD88 L265P mutation could also be detected using cell-free DNA derived from the cerebrospinal fluid of two PCNSL cases. Detection of the MYD88 L265P mutation using GeneSoC might not only improve the accuracy of intra-operative diagnosis of PCNSL but also help the future pre-operative diagnosis through liquid biopsy of cerebrospinal fluid.

    DOI: 10.1111/cas.15762

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  11. Machine learning models predict delayed hyponatremia post-transsphenoidal surgery using clinically available features 国際誌

    Fuse, Y; Takeuchi, K; Nishiwaki, H; Imaizumi, T; Nagata, Y; Ohno, K; Saito, R

    PITUITARY   26 巻 ( 2 ) 頁: 237 - 249   2023年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Pituitary  

    Purpose: Delayed hyponatremia (DHN), a unique complication, is the leading cause of unexpected readmission after pituitary surgery. Therefore, this study aimed to develop tools for predicting postoperative DHN in patients undergoing endoscopic transsphenoidal surgery (eTSS) for pituitary neuroendocrine tumors (PitNETs). Methods: This was a single-center, retrospective study involving 193 patients with PitNETs who underwent eTSS. The objective variable was DHN, defined as serum sodium levels < 135 mmol/L at ≥ 1 time between post operative days 3 and 9. We trained four machine learning models to predict this objective variable using the clinical variables available preoperatively and on the first postoperative day. The clinical variables included patient characteristics, pituitary-related hormone levels, blood test results, radiological findings, and postoperative complications. Results: The random forest (RF) model demonstrated the highest (0.759 ± 0.039) area under the curve of the receiver operating characteristic curve (ROC-AUC), followed by the support vector machine (0.747 ± 0.034), the light gradient boosting machine (LGBM: 0.738 ± 0.026), and the logistic regression (0.710 ± 0.028). The highest accuracy (0.746 ± 0.029) was observed in the LGBM model. The best-performing RF model was based on 24 features, nine of which were clinically available preoperatively. Conclusions: The proposed machine learning models with pre- and post-resection features predicted DHN after the resection of PitNETs.

    DOI: 10.1007/s11102-023-01311-w

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  12. Subcutaneous transplantation of human embryonic stem cells-derived pituitary organoids

    Sasaki, H; Suga, H; Takeuchi, K; Nagata, Y; Harada, H; Kondo, T; Ito, E; Maeda, S; Sakakibara, M; Soen, M; Miwata, T; Asano, T; Ozaki, H; Taga, S; Kuwahara, A; Nakano, T; Arima, H; Saito, R

    FRONTIERS IN ENDOCRINOLOGY   14 巻   頁: 1130465   2023年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Frontiers in Endocrinology  

    Introduction: The pituitary gland, regulating various hormones, is central in the endocrine system. As spontaneous recovery from hypopituitarism is rare, and exogenous-hormone substitution is clumsy, pituitary replacement via regenerative medicine, using pluripotent stem cells, is desirable. We have developed a differentiation method that in mice yields pituitary organoids (POs) derived from human embryonic stem cells (hESC). Efficacy of these POs, transplanted subcutaneously into hypopituitary mice, in reversing hypopituitarism was studied. Methods: hESC-derived POs were transplanted into inguinal subcutaneous white adipose tissue (ISWAT) and beneath dorsal skin, a relatively avascular region (AR), of hypophysectomized severe combined immunodeficient (SCID) mice. Pituitary function was evaluated thereafter for ¾ 6mo, assaying basal plasma ACTH and ACTH response to corticotropin-releasing hormone (CRH) stimulation. Histopathologic examination of organoids 150d after transplantation assessed engraftment. Some mice received an inhibitor of vascular endothelial growth factor (VEGF) to permit assessment of how angiogenesis contributed to subcutaneous engraftment. Results: During follow-up, both basal and CRH-stimulated plasma ACTH levels were significantly higher in the ISWAT group (p < 0.001 – 0.05 and 0.001 – 0.005, respectively) than in a sham-operated group. ACTH secretion also was higher in the ISWAT group than in the AR group. Histopathologic study found ACTH-producing human pituitary-cell clusters in both groups of allografts, which had acquired a microvasculature. POs qPCR showed expression of angiogenetic factors. Plasma ACTH levels decreased with VEGF-inhibitor administration. Conclusions: Subcutaneous transplantation of hESC-derived POs into hypopituitary SCID mice efficaciously renders recipients ACTH-sufficient.

    DOI: 10.3389/fendo.2023.1130465

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  13. <i>CD79B</i> Y196 mutation is a potent predictive marker for favorable response to R-MPV in primary central nervous system lymphoma 国際誌

    Yamaguchi, J; Ohka, F; Lushun, C; Motomura, K; Aoki, K; Takeuchi, K; Nagata, Y; Ito, S; Mizutani, N; Ohno, M; Suzaki, N; Takasu, S; Seki, Y; Kano, T; Wakabayashi, K; Oyama, H; Kurahashi, S; Tanahashi, K; Hirano, M; Shimizu, H; Kitano, Y; Maeda, S; Yamazaki, S; Wakabayashi, T; Kondo, Y; Natsume, A; Saito, R

    CANCER MEDICINE   12 巻 ( 6 ) 頁: 7116 - 7126   2023年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Cancer Medicine  

    Background: Rituximab, high-dose methotrexate (HD-MTX), procarbazine and vincristine (R-MPV), has significantly prolonged the survival of patients with primary central nervous system lymphoma (PCNSL), but predictive factors for response to R-MPV have not yet been investigated. Herein, we investigated the correlation of MYD88 L265P and CD79B Y196 mutations, which are the most frequently found molecular alterations in PCNSL, with prognosis of patients with PCNSL treated with R-MPV. Methods: We investigated the long-term clinical course and status of MYD88 and CD79B genes in 85 patients with PCNSL treated with R-MPV or HD-MTX treatment, and the correlation of these genetic mutations with prognosis. Results: R-MPV achieved an excellent tumor control rate (61.6% and 69.9% of 5-year progression-free and overall survival rates, respectively). While MYD88 L265P mutation had no significant effect on survival, patients with CD79B Y196 mutations exhibited prolonged survival (p < 0.05). However, the association of CD79B Y196 mutation with a better prognosis was not observed in the HD-MTX cohort, which indicated that CD79B Y196 mutation was a predictive marker for a favorable response to R-MPV. Furthermore, we established an all-in-one rapid genotyping system for these genetic mutations. Conclusions: In conclusion, CD79B Y196 mutation is a potent predictive marker for favorable response to R-MPV in PCNSL. The rapid identification of MYD88 L265P and CD79B Y196 mutations can be helpful not only for the accurate molecular diagnosis of PCNSL but also for the prediction of response to R-MPV.

    DOI: 10.1002/cam4.5512

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  14. The importance of preserving the superior hypophyseal artery infundibular branch in craniopharyngioma surgery 国際誌

    Sasaki, H; Takeuchi, K; Nagata, Y; Tanahashi, K; Mizuno, A; Harada, H; Kishida, Y; Watanabe, T; Nagatani, T; Saito, R

    ACTA NEUROCHIRURGICA   165 巻 ( 3 ) 頁: 667 - 675   2023年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Acta Neurochirurgica  

    Purpose: Postoperative pituitary dysfunction, a critical problem in the treatment of craniopharyngiomas, can occur even when the pituitary stalk is preserved. We hypothesized that compromise of the primary superior hypophyseal artery (pSHA) might be related to this occurrence. Methods: We performed a retrospective review of 131 patients with craniopharyngioma who underwent surgery from April 2009 to September 2021. The inclusion criteria were initial surgery, endoscopic transsphenoidal surgery, preoperative normal pituitary function or pituitary dysfunction in one axis, and morphological preservation of the pituitary stalk. The branches of the pSHA consist mainly of the chiasmatic branches (Cb), infundibular branches (Ib), and descending branches (Db). We analyzed the association between postoperative pituitary function and preservation of these branches. Results: Twenty patients met the criteria. Preoperative anterior pituitary function was normal in 18 patients, and there was isolated growth hormone deficiency in two patients. No patient had preoperative diabetes insipidus (DI). Anterior pituitary function was unchanged postoperatively in eight patients. Of these eight patients, bilateral preservation of pSHA Ib was confirmed in seven patients. Bilateral preservation of pSHA Ib was the only factor associated with preserved anterior pituitary function (p < 0.01). Fifteen patients were free of permanent DI, and the preservation of any given pSHA branch produced no significant difference in the postoperative occurrence of permanent DI. Conclusions: Our study shows that bilateral preservation of pSHA Ib provides favorable postoperative anterior pituitary function in craniopharyngioma surgery; however, such preservation may have little effect on the postoperative occurrence of DI.

    DOI: 10.1007/s00701-022-05415-3

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  15. 脊椎脊髄疾患における3Dプリンター活用の実際と現状

    永島 吉孝, 西村 由介, 赤堀 翔, 竹内 和人, 宇田 憲司, 伊藤 洋, 齋藤 竜太

    脊髄外科   36 巻 ( 3 ) 頁: 296 - 301   2022年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本脊髄外科学会  

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  16. 脊椎脊髄疾患における3Dプリンター活用の実際と現状

    永島 吉孝, 西村 由介, 赤堀 翔, 竹内 和人, 宇田 憲司, 伊藤 洋, 齋藤 竜太

    脊髄外科   36 巻 ( 3 ) 頁: 296 - 301   2022年12月

  17. Endoscopic Trans-Mini-Cylinder Biopsy for Intraparenchymal Brain Lesions 国際誌

    Takeuchi, K; Ohka, F; Nagata, Y; Maeda, S; Tanahashi, K; Araki, Y; Yamamoto, T; Sasaki, H; Mizuno, A; Harada, H; Saito, R

    WORLD NEUROSURGERY   167 巻   頁: E1147 - E1153   2022年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:World Neurosurgery  

    Objective: The biopsy procedure is intended to obtain an adequate specimen volume from the targeted area while ensuring minimal damage to the normal brain. We performed navigation-guided endoscopic biopsy using a small-diameter cylinder to reduce the invasiveness of the biopsy procedure and ensure a sufficient amount of tissue is collected. We examined whether it is possible to reduce brain tissue injury by using a small-diameter cylinder and improve safety and effectiveness by using an endoscope to directly observe the lesion and achieve hemostasis. Methods: Patients who underwent endoscopic biopsy surgery using a 6-mm-diameter cylinder for intraparenchymal lesions were enrolled in this study. Postoperative hematoma formation and the extent of trajectory scarring were assessed. Results: Fifty-two procedures performed on 51 patients were analyzed in this study. Postoperative neurological deterioration was not observed in any patient. A pathological diagnosis was made for all patients. Postoperative computed tomography revealed no hematoma after 49 procedures and a small hematoma after 3 procedures, and no patients required additional treatment. A postoperative trajectory scar less than 5 mm in diameter was observed after 30 procedures, a scar of 5–10 mm was observed after 19 procedures, a scar larger than 10 mm was observed after 3 procedures at 1 week after surgery, and 40, 6 and 0 scars were observed at 3 months after surgery. Conclusions: Endoscopic biopsy using a small-diameter cylinder is a possible alternative biopsy technique for intraparenchymal lesions. This surgical technique is useful, especially in patients at risk of hemorrhagic complications.

    DOI: 10.1016/j.wneu.2022.08.147

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  18. ROLE OF CD79B Y196 MUTATION IN PCNSL AS A POTENT PREDICTIVE MARKER FOR FAVORABLE RESPONSE TO R-MPV TREATMENT AND DEVELOPMENT OF RAPID ALL-IN-ONE GENOTYPING SYSTEM FOR MOLECULAR MARKERS OF PCNSL

    Yamaguchi, J; Ohka, F; Lushun, C; Motomura, K; Aoki, K; Takeuchi, K; Nagata, Y; Ito, S; Mizutani, N; Ohno, M; Suzaki, N; Takasu, S; Seki, Y; Tanahashi, K; Hirano, M; Shimizu, H; Kitano, Y; Maeda, S; Yamazaki, S; Wakabayashi, T; Kondo, Y; Saito, R

    NEURO-ONCOLOGY   24 巻   頁: 18 - 18   2022年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  19. Efficacy and safety of the endoscopic "wet-field" technique for removal of supratentorial cavernous malformations 国際誌

    Takeuchi, K; Nagata, Y; Tanahashi, K; Araki, Y; Mizuno, A; Sasaki, H; Harada, H; Ito, K; Saito, R

    ACTA NEUROCHIRURGICA   164 巻 ( 10 ) 頁: 2587 - 2594   2022年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Acta Neurochirurgica  

    Objective: Cerebral cavernous malformations (CMs) presenting with focal neurological symptoms or mass effects require surgical removal. In recent years, cylindrical retractors have been widely utilized for the removal of deep-seated lesions during both microscopic and endoscopic surgery. In the present study, we evaluated the efficacy and safety of endoscopic transcylinder removal of CMs using a novel wet-field technique. Methods: We included 13 patients with supratentorial CMs who had undergone endoscopic transcylinder surgery between April 2013 and March 2022. One patient experienced recurrence of the CM and underwent a second endoscopic transcylinder surgery. Therefore, we retrospectively evaluated 14 procedures. The surgical field was continuously irrigated with artificial cerebrospinal fluid to maintain expansion and visualization of the tumor bed. We termed this method as the “wet-field technique.” Patient characteristics, symptoms, and pre- and postoperative magnetic resonance imaging results were obtained from medical records. Results: The average maximum CM diameter was 35.3 mm (range: 10–65 mm). Cylinder diameters were 6 mm in eight procedures, 10 mm in four procedures, and 17 mm in one procedure. Wet-field technique was applied in all cases. The endoscope provided a bright field of view even under water. Continuous water irrigation made it easier to observe the entire tumor bed which naturally expanded by water pressure. Gross total resection was achieved in 13 procedures, while subtotal resection was achieved in one procedure. No surgical complications were observed. Conclusions: The endoscopic transcylinder removal using wet-field technique is safe and effective for the removal of symptomatic intracranial supratentorial CMs.

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  20. Effect of cilia-induced surface velocity on cerebrospinal fluid exchange in the lateral ventricles 国際誌

    Yoshida, H; Ishida, S; Yamamoto, T; Ishikawa, T; Nagata, Y; Takeuchi, K; Ueno, H; Imai, Y

    JOURNAL OF THE ROYAL SOCIETY INTERFACE   19 巻 ( 193 ) 頁: 20220321 - 20220321   2022年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of the Royal Society Interface  

    Ciliary motility disorders are known to cause hydrocephalus. The instantaneous velocity of cerebrospinal fluid (CSF) flow is dominated by artery pulsation, and it remains unclear why ciliary dysfunction results in hydrocephalus. In this study, we investigated the effects of cilia-induced surface velocity on CSF flow using computational fluid dynamics. A geometric model of the human ventricles was constructed using medical imaging data. The CSF produced by the choroid plexus and cilia-induced surface velocity were given as the velocity boundary conditions at the ventricular walls. We developed healthy and reduced cilia motility models based on experimental data of cilia-induced velocity in healthy wild-type and Dpcd-knockout mice. The results indicate that there is almost no difference in intraventricular pressure between healthy and reduced cilia motility models. Additionally, it was found that newly produced CSF from the choroid plexus did not spread to the anterior and inferior horns of the lateral ventricles in the reduced cilia motility model. These findings suggest that a ciliary motility disorder could delay CSF exchange in the anterior and inferior horns of the lateral ventricles.

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  21. ラトケ嚢胞に類似した所見を示した頭蓋咽頭腫の一例

    原田 英幸, 竹内 和人, 永田 雄一, 棚橋 邦明, 佐々木 博勇, 水野 晃宏, 井下 尚子, 齋藤 竜太

    日本内分泌学会雑誌   98 巻 ( Suppl.HPT ) 頁: 72 - 73   2022年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

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  22. 経鼻頭蓋底術後髄液漏の検討 失敗を活かすために

    竹内 和人, 永田 雄一, 佐々木 博勇, 水野 晃宏, 齋藤 竜太

    日本内分泌学会雑誌   98 巻 ( Suppl.HPT ) 頁: 25 - 27   2022年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

    経鼻的内視鏡下頭蓋底手術は下垂体腫瘍をはじめとする傍鞍部腫瘍に対する第一選択の外科的治療法であるが、合併症として術後髄液鼻漏の危険性が伴う。今回、当院と関連施設で2016~2021年に本手術が施行された506例を対象とし、原疾患、手術方法、再建方法、原疾患、術後髄液漏の発生頻度などについて調査し、術後髄液漏発生例について詳細な検討を行った。原疾患は下垂体腺腫294例、頭蓋咽頭腫59例、鞍結節髄膜腫48例、ラトケ嚢胞33例、くも膜嚢胞12例、脊索腫11例などであった。再建方法は通常閉鎖法(鞍内に補綴物を充填し硬膜の縫合を行う)が349例、靴紐閉鎖法(硬膜切開部に補綴物を挟み込むように連続縫合を行う)が116例、パッチ閉鎖法(硬膜欠損部を補綴物でパッチ状に縫合閉鎖する)が41例であった。術後髄液漏は11例(2.2%)に発生し、原疾患の内訳は下垂体腺腫3例、頭蓋咽頭腫3例、鞍結節髄膜腫2例、脊索腫1例、くも膜嚢胞1例、リンパ腫1例であった。再建方法は通常閉鎖法4例、靴紐閉鎖法5例、パッチ閉鎖法2例であった。髄液漏の発生要因について検討した結果、術者側の要因としてグラフトの量や種類・位置に関するものが多く、患者側の要因として多動や放射線治療、脳室腹腔シャント挿入などが考えられた。

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  23. Direct intracranial invasion of eccrine spiradenocarcinoma of the scalp: a case report and literature review 国際誌

    Kibe, Y; Tanahashi, K; Ohtakara, K; Okumura, Y; Ohka, F; Takeuchi, K; Nagata, Y; Motomura, K; Akahori, S; Mizuno, A; Sasaki, H; Shimizu, H; Yamaguchi, J; Nishikawa, T; Yokota, K; Saito, R

    BMC NEUROLOGY   22 巻 ( 1 ) 頁: 223 - 223   2022年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BMC Neurology  

    Background: Eccrine spiradenocarcinoma (SC), also known as malignant eccrine spiradenoma, is a rare malignant cutaneous adnexal neoplasm arising from long-standing benign eccrine spiradenoma. Malignant skin tumors rarely show direct intracranial invasion. However, once the intracranial structure is infiltrated, curative excision with sufficient margins can become extremely difficult, particularly when the venous sinuses are involved. No effective adjuvant therapies have yet been established. Here, we report an extremely rare case of scalp eccrine SC with direct intracranial invasion, which does not appear to have been reported previously. Case presentation: An 81-year-old woman presented with a large swelling on the parietal scalp 12 years after resection of spiradenoma from the same site. The tumor showed intracranial invasion with involvement of the superior sagittal sinus and repeated recurrences after four surgeries with preservation of the sinus. The histopathological diagnosis was eccrine SC. Adjuvant high-precision external beam radiotherapy (EBRT) proved effective after the third surgery, achieving remission of the residual tumor. The patient died 7 years after the first surgery for SC. Conclusions: Scalp SC with direct intracranial invasion is extremely rare. Radical resection with tumor-free margins is the mainstay of treatment, but the involvement of venous sinuses makes this unfeasible. High-precision EBRT in combination with maximal resection preserving the venous sinuses could be a treatment option for local tumor control.

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  24. Quick and simple dural threading technique for transsphenoidal surgery - dural tenting, haemostasis and skull base reconstruction 国際誌

    Takeuchi, K; Nagata, Y; Tanahashi, K; Saito, R

    ACTA NEUROCHIRURGICA   164 巻 ( 6 ) 頁: 1619 - 1622   2022年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Acta Neurochirurgica  

    Background: Dural suturing is one of the most robust reconstruction methods in transsphenoidal surgery; however, the technique is considered difficult, primarily due to the restricted range of needle movement. Method: We performed dural threading during transsphenoidal surgery by holding the needle with forceps as a hook and moving the needle in a distal to proximal direction. Conclusion: Our dural suturing technique is simple and quick. It can be used not only for dural closure but also for other procedures, such as controlling haemostasis from the intercavernous sinus and dural tenting.

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  25. Symptomatic hyperperfusion after combined revascularization surgery in patients with pediatric moyamoya disease: patient series

    Araki Y., Mamiya T., Fujita N., Yokoyama K., Uda K., Kanamori F., Takayanagi K., Ishii K., Nishihori M., Takeuchi K., Tanahashi K., Nagata Y., Nishimura Y., Tanei T., Muraoka S., Izumi T., Kato K., Saito R.

    Journal of Neurosurgery: Case Lessons   3 巻 ( 19 )   2022年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Neurosurgery: Case Lessons  

    BACKGROUND Symptomatic hyperperfusion after cerebral revascularization for pediatric moyamoya disease (MMD) is a rare phenomenon. The authors report a series of patients with this condition. OBSERVATIONS In all three patients in this case series, the combined revascularization was on the left side, the patency of bypass grafts was confirmed after surgery, and focal hyperemia around the anastomotic site was observed on single photon emission computed tomography (SPECT). On the first to eighth days after surgery, all of the patients developed neurological manifestations, including motor aphasia, cheiro-oral syndrome, motor weakness of their right upper limbs, and severe headaches. These symptoms disappeared completely approximately 2 weeks after surgery, and all patients were discharged from the hospital. Quantitative SPECT was performed to determine the proportional change in cerebral blood flow (DRCBF) (to ipsilateral cerebellar ratio (denoted DRCBF) in the region of interest around the anastomoses, and the mean value was 1.34 (range, 1.29–1.41). LESSONS This rare condition, which develops soon after surgery, requires an accurate diagnosis by SPECT. One indicator is that the DRCBF has risen to 1.3 or higher. Subsequently, strategic blood pressure treatment and fluid management could prevent the development of hemorrhagic stroke.

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  26. 術中所見はラトケ嚢胞、されど病理は頭蓋咽頭腫

    永田 雄一, 竹内 和人, 棚橋 邦明, 佐々木 博勇, 原田 英幸, 井下 尚子, 齋藤 竜太

    Brain Tumor Pathology   39 巻 ( Suppl. ) 頁: 110 - 110   2022年5月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本脳腫瘍病理学会  

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  27. A novel endoscopic ventriculocisternostomy and stenting technique with a transparent acryl puncture needle for a trapped temporal horn: a technical report and literature review 国際誌

    Yamamoto, T; Takeuchi, K; Nagata, Y; Mizuno, A; Harada, H; Saito, R

    NEUROSURGICAL REVIEW   45 巻 ( 2 ) 頁: 1783 - 1789   2022年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Neurosurgical Review  

    Trapped temporal horn is a rare type of noncommunicating focal hydrocephalus, and no standard treatment has been established yet for trapped temporal horn. Recent studies have shown the efficacy of endoscopic ventriculocisternostomy by opening the choroidal fissure; however, some surgical complications were reported during the procedure. Thus, we aimed to report a novel endoscopic ventriculocisternostomy and stenting technique for trapped temporal horn. In this technique, a 5.8-mm transparent acryl puncture needle with a 2.7-mm 0° rigid endoscope was used to open the choroidal fissure. It can fenestrate the choroidal fissure under real-time endoscopic observation of the critical neurovascular structures over the choroidal fissure. Moreover, the dull tip of the needle is less likely to injure the critical neurovascular structures, resulting in safer ventriculocisternostomy than the previously reported technique. Then, a stent is placed along the tract to prevent future obstruction of the stoma. Six trapped temporal horns in four patients were treated using the technique. All the patients showed improved symptoms with no surgical complications. None of the patients showed recurrence of trapped temporal horn during the mean follow-up period of 39.3 months. The combination of endoscopic ventriculocisternostomy and stenting with a transparent acryl puncture needle is a safe and effective treatment option for trapped temporal horn.

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  28. Risk Factors for Cerebral Infarction Early After Revascularization in Children Younger than 5 Years with Moyamoya Disease 国際誌

    Araki, Y; Uda, K; Yokoyama, K; Kanamori, F; Kurimoto, M; Shiba, Y; Mamiya, T; Nishihori, M; Takeuchi, K; Tanahashi, K; Nagata, Y; Nishimura, Y; Okamoto, S; Sumitomo, M; Izumi, T; Saito, R

    WORLD NEUROSURGERY   160 巻   頁: E220 - E226   2022年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:World Neurosurgery  

    Objective: Cerebral revascularization is necessary for pediatric patients younger than 5 years with moyamoya disease (MMD). However, they have a high risk of developing cerebral infarction early after surgery. This study aimed to analyze the risk factors for developing cerebral infarction among these patients. Methods: The charts of 21 consecutive patients with MMD (39 surgeries) younger than 5 years who had undergone revascularization at our hospital were retrospectively analyzed. Because cerebral infarction occurring within 1 month after surgery was the primary end point, other clinical information was evaluated, including each surgical procedure. Multivariate analysis of the risk factors for postoperative cerebral infarction was performed. Results: Cerebral infarction occurred after 7 of 39 surgeries (17.9%). Of the 39 surgeries, 23 (59%) included direct and indirect combined revascularization. The incidence of cerebral infarction did not differ significantly between the combined (21.7%) and indirect (12.5%) groups (P = 0.46). Logistic regression showed no association between the revascularization procedure and the occurrence of cerebral infarction after surgery (P = 0.3). However, younger age at surgery was correlated with a higher risk of developing cerebral infarction in the early postoperative period (P = 0.05). Conclusions: No differences were found in the risk of developing cerebral infarction early after surgery as a result of surgical procedures. However, younger patients had higher postoperative risk. Further multicenter research should examine this issue for young pediatric patients with moyamoya at high risk of developing cerebral infarction.

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  29. Modified Shoelace Dural Closure with Collagen Matrix in Extended Transsphenoidal

    Nagata, Y; Takeuchi, K; Sasaki, H; Mizuno, A; Harada, H; Tanahashi, K; Araki, Y; Saito, R

    NEUROLOGIA MEDICO-CHIRURGICA   62 巻 ( 4 ) 頁: 203 - 208   2022年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本脳神経外科学会  

    Extended endonasal transsphenoidal surgery (eTSS) offers a wide surgical field for various parasellar lesions; however, intraoperative high-flow cerebrospinal fluid (CSF) leakage is inevitable. Therefore, se-cure sellar reconstruction methods are essential to prevent postoperative CSF leakage. Although collagen matrix has been applied for dural reconstruction in neurosurgery, its suitability for application in extended eTSS remains unclear. Eighteen patients underwent modified shoelace dural closure using collagen matrix after lesionectomy via extended eTSS. In this technique, a collagen matrix, which was placed subdurally (inlay graft), was continuously sutured with both open dural edges like a shoelace. Then, another collagen matrix was placed epidurally (onlay graft), and rigid reconstruction was performed using the septal bone and a resorbable fixation mesh. Postoperative CSF leakage did not occur in 17 patients but did occur in 1 patient with tuberculum sellae meningioma. In this case, the CSF leakage point was detected just around the area between the coagulated dura and the adjacent colla-gen matrix. The collagen matrix harvested from this area was pathologically examined; neovasculari-zation and fibroblastic infiltration into the collagen matrix were not detected. On the other hand, ne-ovascularization and fibroblast infiltration into the collagen matrix were apparent on the surface of the collagen matrix harvested from the non-CSF leakage area. Our novel dural closure technique using collagen matrix could be an effective option for sellar reconstruction in extended eTSS; however, it should be applied in patients in whom normal dural edges are preserved.

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  30. Challenging direct bypass surgery for very young children with moyamoya disease: technical notes 国際誌

    Araki, Y; Uda, K; Yokoyama, K; Kanamori, F; Kurimoto, M; Shiba, Y; Mamiya, T; Nishihori, M; Takeuchi, K; Tanahashi, K; Nagata, Y; Nishimura, Y; Okamoto, S; Sumitomo, M; Izumi, T; Saito, R

    NEUROSURGICAL REVIEW   45 巻 ( 2 ) 頁: 1799 - 1807   2022年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Neurosurgical Review  

    Cerebral revascularization for moyamoya disease (MMD) is an effective treatment for improving cerebral ischaemia and preventing rebleeding. Although direct bypass surgery is commonly performed on older children and adults, it is challenging in very young children due to the high difficulty level of the procedure. The subjects were MMD patients under 3 years of age on whom surgery was performed by a single surgeon (Y.A.). Preoperative clinical findings, information related to direct bypass surgery, bypass patency, and the incidence of postoperative stroke were investigated. Combined revascularization, including direct bypass surgery, was performed on 3 MMD patients (3 sides) under 3 years of age. The average diameter of the grafts used in direct bypass was 0.8 mm. The average recipient diameter was 0.8 ± 0.17 (range 0.6–1) mm. In all cases, the anastomotic procedure was completed using 11–0 monofilament nylon thread, and patency was confirmed. Direct bypass for MMD patients under 3 years old is technically challenging. However, despite the anatomical differences between very young children and elderly individuals, direct bypass surgery could certainly be completed. In addition, a rapid recovery from cerebral blood flow insufficiency could yield a promising neurological outcome.

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  31. 3D培養法を用いた新規下垂体腺腫オルガノイドモデルの作成

    佐々木 博勇, 竹内 和人, 棚橋 邦明, 永田 雄一, 水野 晃宏, 原田 英幸, 須賀 英隆, 齋藤 竜太

    日本内分泌学会雑誌   98 巻 ( 1 ) 頁: 329 - 329   2022年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

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  32. 頭蓋咽頭腫術後下垂体機能温存に上下垂体動脈血流が重要である

    竹内 和人, 永田 雄一, 水野 晃宏, 佐々木 博勇, 原田 英幸, 齋藤 竜太

    日本内分泌学会雑誌   98 巻 ( 1 ) 頁: 309 - 309   2022年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

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  33. 機能性下垂体腺腫に対する外科治療 術前評価から根治切除に向けて

    永田 雄一, 竹内 和人, 棚橋 邦明, 佐々木 博勇, 水野 晃宏, 原田 英幸, 齋藤 竜太

    日本内分泌学会雑誌   98 巻 ( 1 ) 頁: 278 - 278   2022年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

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  34. 小児頭蓋咽頭腫の長期成績からみた課題と展望 小児頭蓋咽頭腫に対する神経内視鏡治療の実際と展望

    竹内 和人, 永田 雄一, 加藤 美穂子, 佐々木 博勇, 齋藤 竜太

    小児の脳神経   47 巻 ( 2 ) 頁: 201 - 201   2022年4月

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  35. Spatially separate cerebral infarction in the posterior cerebral artery territory after combined revascularization of the middle cerebral artery territory in an adult patient with moyamoya disease and fetal-type posterior communicating artery: illustrative case. 国際誌

    Araki Y, Yokoyama K, Uda K, Kanamori F, Mamiya T, Takayanagi K, Ishii K, Nishihori M, Takeuchi K, Tanahashi K, Nagata Y, Tanei T, Nishimura Y, Izumi T, Saito R

    Journal of neurosurgery. Case lessons   3 巻 ( 12 )   2022年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Neurosurgery: Case Lessons  

    BACKGROUND Remote cerebral infarction after combined revascularization of the middle cerebral artery (MCA) territory is rare in patients with moyamoya disease (MMD) with a fetal-type posterior communicating artery (PCoA). OBSERVATIONS A 57-year-old woman developed numbness in her right upper limb and transient motor weakness and was diagnosed with MMD. She also had a headache attack and a scintillating scotoma in the right visual field. Preoperative magnetic resonance angiography (MRA) showed stenosis of the left posterior cerebral artery (PCA). Combined revascularization was performed for the left MCA territory. No new neurological deficits were observed for 2 days after the operation, but right hemianopia, alexia, and agraphia appeared on postoperative day (POD) 4. Magnetic resonance imaging showed a new left occipitoparietal lobe infarction, and MRA showed occlusion of the distal left PCA. After that point, the alexia and agraphia gradually improved, but right hemianopia remained at the time of discharge on POD 18. LESSONS Cerebral ischemia in the PCA territory may occur after combined revascularization of the MCA territory in patients with fetal-type PCoA. For these cases, a double-barrel bypass or indirect revascularization to induce a slow conversion could be considered on its own as a treatment option.

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  36. Paradoxical symptomatic cerebral blood flow decreases after combined revascularization surgery for patients with pediatric moyamoya disease: illustrative case. 国際誌

    Araki Y, Yokoyama K, Uda K, Kanamori F, Kurimoto M, Shiba Y, Mamiya T, Takayanagi K, Ishii K, Nishihori M, Takeuchi K, Tanahashi K, Nagata Y, Nishimura Y, Okamoto S, Sumitomo M, Izumi T, Saito R

    Journal of neurosurgery. Case lessons   3 巻 ( 3 )   2022年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Neurosurgery: Case Lessons  

    BACKGROUND Transient neurological deficits (TNDs) develop after cerebral revascularization in patients with moyamoya disease (MMD). The authors report a rare pediatric MMD case with extensive decreased cerebral blood flow (CBF) and prolonged TNDs after combined revascularization. OBSERVATIONS A 9-year-old boy presented with transient left upper limb weakness, and MMD was diagnosed. A right-sided combined surgery was performed. Two years after the surgery, frequent but transient facial (right-sided) and upper limb weakness appeared. The left internal carotid artery terminal stenosis had progressed. Therefore, a left combined revascularization was performed. The patient’s motor aphasia and right upper limb weakness persisted for approximately 10 days after surgery. Magnetic resonance angiography showed that the direct bypass was patent, but extensive decreases in left CBF were observed using single photon emission tomography. With adequate fluid therapy and blood pressure control, the neurological symptoms eventually disappeared, and CBF improved. LESSONS The environment of cerebral hemodynamics is heterogeneous after cerebral revascularization for MMD, and the exact mechanism of CBF decreases was not identified. TNDs are significantly associated with the onset of stroke during the early postoperative period. Therefore, appropriate treatment is desired after determining complex cerebral hemodynamics using CBF studies.

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  37. (11)C-methionine- and (18)F-FDG-PET double-negative metastatic brain tumor from lung adenocarcinoma with paradoxical high (18)F-FDG uptake: A case report. 査読有り 国際誌

    Tanahashi K, Hirano M, Chalise L, Tsugawa T, Okumura Y, Hase T, Ohka F, Motomura K, Takeuchi K, Nagata Y, Nakahara N, Hashimoto N, Saito R

    Surgical neurology international   13 巻   頁: 372 - 372   2022年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  38. The preoperative focal cerebral blood flow status may be associated with slow flow in the bypass graft after combined surgery for moyamoya disease. 国際誌

    Araki Y, Yokoyama K, Uda K, Kanamori F, Mamiya T, Takayanagi K, Ishii K, Shintai K, Nishihori M, Tsukada T, Takeuchi K, Tanahashi K, Nagata Y, Nishimura Y, Tanei T, Nagashima Y, Muraoka S, Izumi T, Seki Y, Saito R

    Surgical neurology international   13 巻   頁: 511 - 511   2022年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Surgical Neurology International  

    Background: The aim of this study was to investigate the association between early postoperative slow flow in bypass grafts and preoperative focal cerebral blood flow (CBF) in patients who underwent combined surgery for moyamoya disease (MMD). Methods: The subjects were 18 patients (22 surgeries) who underwent single photon emission computed tomography (SPECT) before surgery. The CBF value of the middle cerebral artery territory was extracted from the SPECT data, and the value relative to the ipsilateral cerebellar CBF (relative CBF, or RCBF) was calculated. The association between RCBF and early postoperative slow flow in the bypass graft was investigated. In addition, the correlation between the revascularization effect and preoperative RCBF was analyzed. Results: In four of 22 surgeries (18.2%), slow flow in the bypass graft was identified in the early postoperative period. Preoperative RCBF in the slow flow and patent groups was 0.86 ± 0.15 and 0.87 ± 0.15, respectively, with no significant difference (P = 0.72). The signal intensity of four slow-flowed bypasses was improved in all cases on magnetic resonance angiography images captured during the chronic phase (mean of 3.3 months postoperatively). The revascularization scores were 2 ± 0.82 and 2.1 ± 0.68 in the slow flow and patent groups, respectively, and did not differ significantly (P = 0.78). A significant correlation was not observed between preoperative RCBF and the revascularization effect. Conclusion: No significant association was observed between preoperative RCBF and early postoperative slow flow in bypass grafts in patients with MMD undergoing combined surgery. Given the high rate of improved depiction of slow-flowed bypass in the chronic postoperative phase, the conceptual significance of an opportune surgical intervention is to maintain CBF by supporting the patient's own intracranial-extracranial conversion function.

    DOI: 10.25259/SNI_772_2022

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  39. Case of a Pregnant Woman with Capillary Hemangioma of the Parasellar Region. 査読有り

    Ishikawa T, Takeuchi K, Nagata Y, Ito K, Yamamoto T, Kabeya R

    NMC case report journal   9 巻   頁: 77 - 82   2022年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2176/jns-nmc.2021-0326

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  40. 脊椎脊髄疾患における3Dプリンター活用の実際と現状

    永島 吉孝, 西村 由介, 赤堀 翔, 竹内 和人, 宇田 憲司, 伊藤 洋, 齋藤 竜太

    脊髄外科   36 巻 ( 3 ) 頁: 296 - 301   2022年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本脊髄外科学会  

    DOI: 10.2531/spinalsurg.36.296

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  41. Sellar arachnoid cystに対する経鼻内視鏡手術

    永田 雄一, 竹内 和人, 山本 太樹, 水野 晃宏, 永谷 哲也, 齋藤 竜太

    日本内分泌学会雑誌   97 巻 ( Suppl.HPT ) 頁: 49 - 51   2021年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

    内視鏡下経鼻術(TSS)を行ったSellar arachnoid cyst(sAC)14例17手術(男性5例、女性9例、平均年齢49.6歳)の手術成績を報告した。初回手術例は13例、再発例は1例で、術前症状は視機能障害13例、動眼神経麻痺1例、汎下垂体前葉機能低下2例であり、嚢胞最大径は平均26.9mmであった。手術法はconventional TTS:9手術、extended TTS:8手術で、下垂体柄を温存しつつ可及的な嚢胞開窓を行い、視機能障害と動眼神経麻痺は全例改善した。TSSはsACに対して安全かつ有用な外科的治療法であり、術前画像や術中所見に基づいて下垂体柄と下垂体組織を温存するよう嚢胞開窓を行うことで、良好な術後下垂体機能が期待できる。また、下垂体柄が嚢胞前方に位置する症例は術後再発をきたしやすく、手術法の工夫や注意深いフォローアップが必要である。

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    その他リンク: https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J01160&link_issn=&doc_id=20210929320015&doc_link_id=%2Fcs6hypop%2F2021%2F0097s1%2F016%2F0049-0051%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcs6hypop%2F2021%2F0097s1%2F016%2F0049-0051%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  42. 内視鏡下経鼻頭蓋底手術後の再建戦略 失敗症例から学ぶDuragenの適応と限界

    竹内 和人, 永田 雄一, 山本 太樹, 原田 英幸, 齋藤 竜太

    日本内分泌学会雑誌   97 巻 ( Suppl.HPT ) 頁: 16 - 18   2021年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

    新規再建材料であるDuragenを用いた経鼻頭蓋底手術後再建120症例を対象として、Duragenの適応と限界について検討した。再建方法は通常法77例(通常再建法73例、靴紐再建法4例)、拡大法43例(靴紐再建法30例、パッチワーク再建法13例)で、このうち自家組織を用いずにDuragen単独で再建した症例は通常法45例、拡大法9例であり、Duragen単独再建群の1例(1.9%)に術後髄液漏を認めたため、再手術を行った。髄液漏再建手術時に採取したDuragenの病理組織学的検討では、inlay graftとして硬膜内に留置されたものには線維芽細胞、新生血管がみられたが、onlay graftとして硬膜外に留置されたものには新生血管はなく癒着も弱かった。硬膜欠損の少ない症例や硬膜焼灼のない症例はDuragen単独での再建が有効と考えられた。

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    その他リンク: https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J01160&link_issn=&doc_id=20210929320005&doc_link_id=10.1507%2Fendocrine.97.S.HPT_16&url=https%3A%2F%2Fdoi.org%2F10.1507%2Fendocrine.97.S.HPT_16&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  43. A new primate model of hypophyseal dysfunction 国際誌

    Kawabata, T; Suga, H; Takeuchi, K; Nagata, Y; Sakakibara, M; Ushida, K; Ozone, C; Enomoto, A; Kawamoto, I; Itagaki, I; Tsuchiya, H; Arima, H; Wakabayashi, T

    SCIENTIFIC REPORTS   11 巻 ( 1 ) 頁: 10729 - 10729   2021年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Scientific Reports  

    For pituitary regenerative medicine, the creation of a hypophyseal model in monkeys is necessary to conduct future preclinical studies; however, previous studies reported that hypophysectomy in monkeys is not always safe or satisfactory. This study aimed to create a hypophyseal dysfunction model in a cynomolgus monkey using a safer surgical technique and establish the protocol of pituitary hormone replacement therapy for this model. Surgical resection of the pituitary gland of a 7.8-year-old healthy adult cynomolgus male monkey weighing 5.45 kg was performed to create a hypophyseal dysfunction model for future regenerative studies. Endoscopic transoral transsphenoidal surgery was used to perform hypophysectomy under navigation support. These procedures were useful for confirming total removal of the pituitary gland without additional bone removal and preventing complications such as cerebrospinal fluid leakage. Total removal was confirmed by pathological examination and computed tomography. Hypopituitarism was verified with endocrinological examinations including stimulation tests. Postoperatively, the monkey’s general condition of hypopituitarism was treated with hormone replacement therapy, resulting in long-term survival. The success of a minimally invasive and safe surgical method and long-term survival indicate the creation of a hypophyseal dysfunction model in a cynomolgus monkey; hence, this protocol can be employed in the future.

    DOI: 10.1038/s41598-021-90209-3

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  44. 機能性下垂体腺腫に対する前葉peel off resectionの意義

    永田 雄一, 水野 晃宏, 竹内 和人

    日本内分泌学会雑誌   97 巻 ( 1 ) 頁: 256 - 256   2021年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

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  45. 神経内視鏡の発展 "内視鏡でもできる"から"内視鏡ならできる"へ

    竹内 和人

    小児の脳神経   46 巻 ( 2 ) 頁: 109 - 109   2021年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本小児神経外科学会  

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  46. Trautmann-focused mastoidectomy for a simple, safe presigmoid approach: technical note 国際誌

    Tanahashi, K; Uda, K; Araki, Y; Takeuchi, K; Choo, J; Chalise, L; Motomura, K; Ohka, F; Wakabayashi, T; Natsume, A

    JOURNAL OF NEUROSURGERY   134 巻 ( 3 ) 頁: 843 - 847   2021年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Neurosurgery  

    The presigmoid approach (PSA) is selected to obtain more lateral access to cerebellopontine angle tumors, brainstem cavernous malformations, or vertebrobasilar artery aneurysms than the standard retrosigmoid approach. However, mastoidectomy for the PSA can be considered time-consuming and to carry a higher risk of complications due to the anatomical complexity of the region. The authors established a method of minimized mastoidectomy focused on exposing Trautmann’s triangle as the corridor for the PSA while maximizing procedural simplicity and safety and maintaining a sufficient operative view. The authors present their method of minimized mastoidectomy in a cadaver dissection and operative cases, showing potential as a useful option for the PSA.

    DOI: 10.3171/2020.1.JNS193179

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  47. Importance of Hydrostatic Pressure and Irrigation Hemostasis in Neuroendoscopic Surgery

    Ishikawa, T; Takeuchi, K; Yamamoto, T; Nagata, Y; Natsume, A

    NEUROLOGIA MEDICO-CHIRURGICA   61 巻 ( 2 ) 頁: 117 - 123   2021年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本脳神経外科学会  

    Recently neurosurgical operations have been carried out with water irrigation such as endoscopic third ventriculostomy and tumor resections in ventricles. Water irrigation is one of several published methods that promote hemostasis; however, not enough experimental evidence exists on its efficacy. In this study, we investigate whether hydrostatic pressure and persistent irrigation promote hemostasis in neuroendoscopic surgery. We dissected tails of 12–16-week-old C57BL/6 male mice at 5 mm proximal from the tip and checked for bleeding times under dry and wet conditions at pressures of 0 cmH2 O, 10 cmH2 O, 15 H2 O, and 20 cmH2 O without persistent irrigation to bleeding point and 10 cmH2 O with persistent irrigation. We then examined the dissected edge with hematox-ylin–eosin staining and measured the size of vessels. The average bleeding time of each group is as follows: dry: 203.4 sec, wet: 164.4 sec, 5 cmH2 O: 138.6 sec, 10 cmH2 O: 104.6 sec (P <0.001), 20 cmH2 O: 56 sec (P <0.001), and 10 cmH2 O with persistent irrigation: 72.8 sec (P <0.01 compared to 10 cmH2 O without persistent irrigation). The maximum caliber of mice’s tail artery was 50–60 μm. Hydrostatic pressure and irrigation are important factors contributing to hemostasis.

    DOI: 10.2176/nmc.oa.2020-0278

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  48. Novel Endoscopic Technique for Inserting a Sheath into a Slit Ventricle: The Water-Slide Technique 国際誌

    Yamamoto, T; Takeuchi, K; Nagata, Y; Mizuno, A; Wakabayashi, T

    WORLD NEUROSURGERY   145 巻   頁: 1 - 4   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:World Neurosurgery  

    Background: The efficacy and safety of endoscopic procedures for slit ventricle syndrome (SVS) have been presented in recent studies. However, inserting a sheath into a target ventricle is essential in the beginning of endoscopic procedures for SVS, and this maneuver is challenging owing to the quite narrow ventricular space. We report a novel flexible endoscopic technique, the water-slide technique, that can effectively guide a sheath into a slit ventricle without the use of other adjunctive devices, such as a neuronavigation system and an ultrasound machine. Methods: Ten endoscopic procedures using the water-slide technique were performed in 9 patients with SVS. All patients had undergone ventriculoperitoneal shunt placement. Using the technique, the sheath was first placed on the flexible endoscope. The endoscope was then inserted into the lateral ventricle along the tract around the pre-existing ventricular catheter with irrigation of artificial cerebrospinal fluid via the working channel of the endoscope. After the endoscope reached the ventricle, the sheath was inserted into the ventricle along the endoscope. The endoscope was then used as a stylet. The endoscopic procedure was performed afterward. Continuous irrigation of artificial cerebrospinal fluid via the working channel is important when using this technique. Results: In all cases, the sheath was successfully introduced to the slit ventricle without the use of adjunctive devices. There were no postoperative complications correlated with the maneuver. Conclusions: This novel endoscopic technique is effective and safe for inserting a sheath into a target ventricle in the management of SVS.

    DOI: 10.1016/j.wneu.2020.08.206

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  49. A Case of Primary Leptomeningeal Lymphoma Presenting with Hydrocephalus Characterized by Disproportionately Large Fourth Ventricle. 査読有り

    Nohira S, Shimato S, Yamanouchi T, Takeuchi K, Yamamoto T, Ito M, Kato K, Nishizawa T

    NMC case report journal   8 巻 ( 1 ) 頁: 399 - 404   2021年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2176/nmccrj.cr.2020-0215

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  50. Fully Endoscopic Transcylinder Trans-Magendie Foraminal Approach for Fourth Ventricular Cavernoma: A Technical Case Report 国際誌

    Nagata, Y; Takeuchi, K; Yamamoto, T; Mizuno, A; Wakabayashi, T

    WORLD NEUROSURGERY   142 巻   頁: 104 - 107   2020年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:World Neurosurgery  

    Background: Neuroendoscopy offers wide and close surgical views with fine illumination, even in deep surgical sites. Furthermore, transcylinder surgery has the advantage that a tubular retractor can protect critical neurovascular structures in the surgical corridor. These advantages of neuroendoscopy and transcylinder surgery can contribute to safer and less invasive surgical approaches for deep-seated fourth ventricular lesions, for which various critical neurovascular structures exist along the surgical route. Case Description: A 54-year-old man with a fourth ventricular cavernoma underwent tumor resection via the endoscopic transcylinder trans-Magendie foraminal approach. A 6.8-mm transparent sheath (cylinder) was introduced into the fourth ventricle via the foramen of Magendie without incisions in the inferior medullary velum or the tela choroidea, resulting in the minimal retraction of and trauma to critical neurovascular structures in the surgical corridor. Under the view of a 2.7-mm rigid neuroendoscope, the lesion was completely removed with preservation of a venous anomaly on the ventral side of the aqueduct of Sylvius. Neuroendoscopy could offer a fine surgical view even under continuous irrigation with artificial cerebrospinal fluid; it prevented collapse of the fourth ventricle and facilitated anatomic understanding by the surgeons. The postoperative course was uneventful. Conclusions: Our novel approach can be an effective surgical option for fourth ventricular lesions with minimal cerebellar retraction and injury.

    DOI: 10.1016/j.wneu.2020.06.171

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  51. 機能性下垂体腺腫に対するsupratotal resectionの有用性

    永田 雄一, 竹内 和人, 水野 晃宏, 尾上 剛史, 高木 博史, 有馬 寛

    日本内分泌学会雑誌   96 巻 ( 2 ) 頁: 509 - 509   2020年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

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  52. 閉塞性水頭症により認知機能低下をきたした一例

    毛利 尚裕, 橋詰 淳, 竹内 和人, 熱田 直樹, 勝野 雅央

    臨床神経学   60 巻 ( 10 ) 頁: 720 - 720   2020年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本神経学会  

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  53. 下垂体、下垂体近傍病変術後低ナトリウム血症の解析

    竹内 和人, 永田 雄一, 山本 太樹, 水野 晃宏, 若林 俊彦

    日本内分泌学会雑誌   96 巻 ( 1 ) 頁: 266 - 266   2020年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

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  54. 経鼻内視鏡手術における閉創法の工夫

    永田 雄一, 竹内 和人, 山本 太樹, 水野 晃宏, 若林 俊彦

    日本内分泌学会雑誌   96 巻 ( Suppl.HPT ) 頁: 38 - 39   2020年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

    著者等は内視鏡下経鼻経蝶形骨手術(TSS)における硬膜閉創法のアルゴリズムとして、conventional TSSでは腫瘍摘出腔への脂肪充填および硬膜縫合を行い、硬膜欠損を伴わないextended TSSでは腹部から採取した遊離脂肪片を用いたshoelace closure、硬膜欠損を伴うextended TSSでは遊離腹直筋膜片の硬膜へのpatch縫合+硬膜外での脂肪片貼付+硬性再建を原則としている。今回、その妥当性について検討するため、2013~2019年にTSSを行った383例の術後髄液漏発生率について調査した。手術法の内訳はconventional TSSが278例、extended TSSが105例で、術後髄液瘻は計7例(発生率1.8%)であり、この数値は他報告(1.2~2.2%)と同程度で良好な成績と考えられた。

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  55. 下垂体腺腫に対する手術操作と中枢性尿崩症の発生についての検討

    永田 雄一, 竹内 和人, 山本 太樹, 水野 晃宏, 若林 俊彦

    日本内分泌学会雑誌   96 巻 ( 1 ) 頁: 238 - 238   2020年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

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  56. 下垂体腺腫における手術操作と術後中枢性尿崩症の発生についての検討

    永田 雄一, 竹内 和人, 山本 太樹, 水野 晃宏, 若林 俊彦

    日本内分泌学会雑誌   96 巻 ( Suppl.HPT ) 頁: 40 - 41   2020年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

    当院で2017年2月~2019年10月に内視鏡下経鼻経蝶形骨手術を行った下垂体腺腫59例を対象とし、手術手技と術後中枢性尿崩症(DI)発生との関連性を調べ、DIをきたしやすい因子について検討した。その結果、腺腫の鞍上進展が強く手術で頭蓋内操作を要した症例ではDI発生率が有意に高かった。一方、手術手技のうち「腺腫の被膜外摘出」はDI発生の危険因子ではなかったことから、特に機能性下垂体腺腫において完全な腫瘍摘出を目指す意味での「被膜外摘出」は有用な手技であると考えられた。

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  57. 下垂体機能温存を目的とした頭蓋咽頭腫摘出への挑戦

    竹内 和人, 永谷 哲也, 渡邉 督, 岸田 悠吾, 永田 雄一, 山本 太樹, 水野 晃宏, 若林 俊彦

    日本内分泌学会雑誌   96 巻 ( Suppl.HPT ) 頁: 8 - 10   2020年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

    頭蓋咽頭腫の外科治療では腫瘍摘出率の向上と機能温存との両立が求められ、これまで内分泌機能の温存を目的とした下垂体組織・下垂体茎の温存が試みられてきたが、下垂体茎を温存しても下垂体機能は維持されないことが多い。上下垂体動脈(SHA)は視神経と下垂体茎を栄養する血管であり、内視鏡下拡大経鼻経蝶形骨手術(extended eTSS)はSHA・視神経下面・下垂体茎などを一視野に収めることが可能である。今回、当院と関連施設で2009~2019年にextended eTSSを施行した頭蓋咽頭腫69例のうち、初回手術例で、かつ術前に内分泌機能が維持され、術中に下垂体茎が温存され、術中映像を確認できた14例を対象とし、SHA infundibular branchが両側とも温存された群(6例)、片側温存群(5例)、温存不可群(3例)に分け、術後の下垂体前葉機能および後葉機能について群間比較した。結果、前葉機能は両側温存群の4例(67%)が術後も維持されたのに対し、片側温存群と温存不可群では全例に機能低下があり、有意な群間差を認めた。後葉機能は両側温存群の5例(83%)、片側温存群の2例(40%)、温存不可群の1例(33%)で維持され、有意な群間差は認めなかった。

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  58. Endoscopic Treatment Strategy for a Disproportionately Large Communicating Fourth Ventricle: Case Series and Literature Review

    Kawabata, T; Takeuchi, K; Nagata, Y; Ishikawa, T; Choo, J; Wakabayashi, T

    NEUROLOGIA MEDICO-CHIRURGICA   60 巻 ( 7 ) 頁: 351 - 359   2020年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本脳神経外科学会  

    An isolated fourth ventricle (IFV) is characterized by fourth ventricular dilation due to obstruction of its inlet and outlet. A disproportionately large communicating fourth ventricle (DLCFV) is a rare subtype of IFV, characterized by dilation of the fourth ventricle, regardless of the size of the lateral ventricles, with no apparent obstruction of the cerebral aqueduct. To our knowledge, this is the first case series describing endoscopic diagnosis and treatment strategy for DLCFV. We retrospectively reviewed six cases of DLCFV in which endoscopic surgery was performed at our institution and affiliated facilities between June 2013 and March 2017. DLCFV was diagnosed using radiographic imaging and intraoperative endoscopy. We also conducted a PubMed search and included only original studies related to DLCFV treatment written in English in our review of the literature. Endoscopic third ventriculostomy (ETV) was performed in all patients. Additional endoscope-assisted placement of a fourth ventriculoperitoneal (VP) shunt was performed in two patients who could not be managed with ETV alone because of severe adhesion of the interpeduncular cistern due to subarachnoid hemorrhage (SAH). The patients’ symptoms and the size of the fourth ventricle improved with surgical treatment, without complications. Endoscopic surgery for DLCFV appears to be a safe and effective treatment. Based on our treatment strategy, ETV is the first-line treatment for DLCFV. Endoscope-assisted placement of the fourth VP shunt can be treatment for severe adhesion of the interpeduncular cistern.

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  59. Steroid-responsive recurrent tumefactive demyelination with multiple petechial hemorrhages along non-displaced medullary veins 国際誌

    Tsuboi, T; Harada, Y; Suzuki, M; Ando, T; Atsuta, N; Ohka, F; Takeuchi, K; Taoka, T; Ohba, S; Nakaguro, M; Abe, M; Nakashima, I; Yoshida, M; Katsuno, M

    CLINICAL NEUROLOGY AND NEUROSURGERY   193 巻   頁: 105764 - 105764   2020年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Clinical Neurology and Neurosurgery  

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  60. <i>H3F3A</i> mutant allele specific imbalance in an aggressive subtype of diffuse midline glioma, H3 K27M-mutant 国際誌

    Maeda, S; Ohka, F; Okuno, Y; Aoki, K; Motomura, K; Takeuchi, K; Kusakari, H; Yanagisawa, N; Sato, S; Yamaguchi, J; Tanahashi, K; Hirano, M; Kato, A; Shimizu, H; Kitano, Y; Yamazaki, S; Yamashita, S; Takeshima, H; Shinjo, K; Kondo, Y; Wakabayashi, T; Natsume, A

    ACTA NEUROPATHOLOGICA COMMUNICATIONS   8 巻 ( 1 ) 頁: 8 - 8   2020年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Acta Neuropathologica Communications  

    Diffuse midline glioma, H3 K27M-mutant is a lethal brain tumor located in the thalamus, brain stem, or spinal cord. H3 K27M encoded by the mutation of a histone H3 gene such as H3F3A plays a pivotal role in the tumorigenesis of this type of glioma. Although several studies have revealed comprehensive genetic and epigenetic profiling, the prognostic factors of these tumors have not been identified to date. In various cancers, oncogenic driver genes have been found to exhibit characteristic copy number alterations termed mutant allele specific imbalance (MASI). Here, we showed that several diffuse midline glioma, H3 K27M-mutant exhibited high variant allele frequency (VAF) of the mutated H3F3A gene using droplet digital polymerase chain reaction (ddPCR) assays. Whole-genome sequencing (WGS) revealed that these cases had various copy number alterations that affected the mutant and/or wild-type alleles of the H3F3A gene. We also found that these MASI cases showed a significantly higher Ki-67 index and poorer survival compared with those in the lower VAF cases (P < 0.05). Our results indicated that the MASI of the H3F3A K27M mutation was associated with the aggressive phenotype of the diffuse midline glioma, H3 K27M-mutant via upregulation of the H3 K27M mutant protein, resulting in downregulation of H3K27me3 modification.

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  61. トルコ鞍部病変に対する経鼻内視鏡術後低ナトリウム血症の検討

    竹内 和人, 永田 雄一, 山本 太樹, 若林 俊彦

    日本内分泌学会雑誌   95 巻 ( 3 ) 頁: 1106 - 1106   2020年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

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  62. 機能性下垂体腺腫に対する経鼻手術の工夫

    永田 雄一, 竹内 和人, 山本 太樹, 若林 俊彦

    日本内分泌学会雑誌   95 巻 ( 3 ) 頁: 1102 - 1102   2020年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

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  63. Endoscopic-assisted paramedian infratentorial supracerebellar approach for pineal cyst - How I do it Video clip. 査読有り 国際誌

    Tanaka R, Takeuchi K, Ansari A, Sasaki K, Miyatani K, Yamada Y, Kawase T, Kato Y, Horiguchi A

    Surgical neurology international   11 巻   頁: 336 - 336   2020年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  64. Preservation of Olfactory Function Following Endoscopic Single-Nostril Transseptal Transsphenoidal Surgery 国際誌

    Kawabata, T; Takeuchi, K; Nagata, Y; Ishikawa, T; Choo, J; Sato, Y; Tambara, M; Teranishi, M; Wakabayashi, T

    WORLD NEUROSURGERY   132 巻   頁: E665 - E669   2019年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:World Neurosurgery  

    Objective: Olfactory dysfunction is a significant postoperative complication related to endoscopic transsphenoidal surgery (TSS). This study aimed to determine the impact of endoscopic TSS on olfactory function. Methods: We conducted a prospective study of 32 patients with sellar or parasellar tumors who were treated with endoscopic TSS between December 2013 and October 2016. TSS was performed via a right transseptal approach. We performed the Toyota and Takagi olfactometer test and the venous olfaction test for the evaluation of olfactory function preoperatively and at 1 and 3 months postoperatively. Results: The results of the Toyota and Takagi test showed that olfactory function deteriorated in 4 of 32 (12.5%) patients 1 month postoperatively and improved to preoperative baseline levels in all patients 3 months after the procedure. Olfactory function deteriorated in 1 of 31 (3.2%) patients 3 months after the procedure. The venous olfaction test revealed no response in 1 of 31 (3.2%) patients 1 month postoperatively, with no improvement 3 months after the procedure. Conclusions: Endoscopic single-nostril transseptal TSS for sellar or parasellar tumor resection has minimal impact on olfactory function.

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  65. Three types of dural suturing for closure of CSF leak after endoscopic transsphenoidal surgery 国際誌

    Ishikawa, T; Takeuchi, K; Nagata, Y; Choo, J; Kawabata, T; Ishizaki, T; Wakabayashi, T

    JOURNAL OF NEUROSURGERY   131 巻 ( 5 ) 頁: 1625 - 1631   2019年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Neurosurgery  

    OBJECTIVE Transsphenoidal surgery (TSS) is commonly used for anterior skull base surgery, especially in the sella turcica (sellar) region. However, because of its anatomical position, CSF leakage is a major complication of this approach. The authors introduced a new grading reconstruction strategy for anterior skull base surgery with continuous dural suturing in 2013. In this paper the authors report on their methods and results. METHODS All patients with sellar or anterior skull base lesions that were removed with TSS or extended TSS by a single neurosurgeon between April 2013 and March 2017 at Nagoya University Hospital and several cooperating hospitals were retrospectively identified. Three methods of suturing dura were considered, depending on the dural defect. RESULTS There were 176 TSS cases (141 conventional TSS cases and 35 extended endoscopic TSS cases) and 76 cases of Esposito's grade 2 or 3 intradural high-flow CSF leakage. In the high-flow CSF leak group, there were 3 cases of CSF leakage after the operation. The rates of CSF leakage after surgery corresponding to grades 2 and 3 were 2.9% (1/34) and 4.7% (2/42), respectively. CONCLUSIONS Dural suturing is a basic and key method for reconstruction of the skull base, and continuous suturing is the most effective approach. Using this approach, the frequency of cases requiring a nasoseptal flap and lumbar drainage can be reduced.

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  66. Peel-off resection of the pituitary gland for functional pituitary adenomas: pathological significance and impact on pituitary function 国際誌

    Nagata, Y; Takeuchi, K; Yamamoto, T; Ishikawa, T; Kawabata, T; Shimoyama, Y; Inoshita, N; Wakabayashi, T

    PITUITARY   22 巻 ( 5 ) 頁: 507 - 513   2019年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Pituitary  

    Purpose: Functional pituitary adenomas (FPAs) lacking a well-defined pseudocapsule can invade the adjacent pituitary gland. In such situations, peel-off resection of the adjacent pituitary gland after selective adenomectomy might lead to complete tumor removal, resulting in optimal endocrinological outcomes. Here, we present the significance of peel-off resection of the pituitary gland in patients with FPA in whom complete extracapsular tumor removal cannot be achieved. Methods: We performed a retrospective review of 21 patients with FPA who underwent transsphenoidal surgery (TSS). After selective adenomectomy, peel-off resection of the adjacent pituitary gland was performed in 13 patients because complete extracapsular resection could not be achieved, while peel-off resection was not performed in the remaining 8 patients because complete extracapsular resection was accomplished. The clinical outcomes of these groups were compared. The pituitary tissues obtained by peel-off resection were pathologically examined for tumor cells. Results: Early postoperative biochemical remission was achieved in 20 patients (95.2%). Anterior pituitary functions were not aggravated postoperatively in any patient: however, transient diabetes insipidus (DI) occurred in 2 patients. There were no statistically significant differences in the clinical outcomes of the two groups. A pseudocapsule was pathologically detected in the adjacent anterior pituitary even in patients in whom no pseudocapsule was intraoperatively detected. Tumor cells were pathologically detected in 7 (58.3%) of 12 pituitary tissues examined. Conclusions: Peel-off resection of the pituitary gland, which can remove a small tumor cell remnant in the adjacent pituitary, might maximize the effectiveness of TSS with minimal impact on postoperative pituitary function.

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  67. 高齢非機能性下垂体腺腫における手術成績の検討

    川端 哲平, 竹内 和人, 山本 太樹, 石崎 友崇, 永田 雄一, 若林 俊彦

    日本内分泌学会雑誌   95 巻 ( Suppl.HPT ) 頁: 45 - 47   2019年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

    当院で2012~2018年に初発非機能性下垂体腺腫に対して内視鏡下経鼻的経蝶形骨手術を行った78例のうち、65歳以上の33例を高齢群、65歳未満の45例を若年群とし、手術成績を群間比較した。全摘出できた割合は高齢群70%、若年群73%で有意差は認めなかった。術前にみられた症状の改善率は、頭痛が高齢群100%、若年群78%、視機能障害がそれぞれ91%、97%、下垂体前葉機能障害がそれぞれ17%、45%であり、高齢群は下垂体前葉機能障害の改善率が低かった。術後合併症の発生頻度は、低Na血症が高齢群33%、若年群7%、一過性尿崩症がそれぞれ9%、9%、永続的尿崩症がそれぞれ3%、9%、下垂体前葉機能低下がそれぞれ3%、2%、認知機能低下がそれぞれ3%、0%、廃用症候群がそれぞれ3%、0%であり、高齢群は低Na血症の発生頻度が有意に高かった。

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  68. Endoscopic clipping of intraventricular aneurysms using the "wet-field" technique 国際誌

    Takeuchi, K; Handa, T; Chu, J; Wada, K; Wakabayashi, T

    JOURNAL OF NEUROSURGERY   131 巻 ( 1 ) 頁: 104 - 108   2019年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Neurosurgery  

    Intraventricular hemorrhage and intracerebral aneurysms are relatively frequent complications associated with moyamoya disease. Prevention of aneurysm rerupture is important because it significantly decreases the morbidity and mortality rates. Aneurysms arising distal to collateral flow are sometimes observed in patients with intraventricular hemorrhage; however, the treatment of these aneurysms remains challenging because of their deep-seated location in the brain and accompanying narrow surgical corridor. The authors describe a neuroendoscopic aneurysm clipping technique performed in 2 cases using a small-diameter tubular retractor for intraventricular aneurysms of the distal lateral posterior choroidal artery. In this technique, the surgical field was continuously irrigated with artificial CSF to keep the ventricle size intact, and aneurysm clipping was performed through a tubular retractor that was introduced with neuronavigational guidance. The patients' postoperative courses were uneventful, and CT angiography revealed complete clipping of the aneurysms and patent parent arteries. Endoscopic clipping using a tubular retractor is an effective and less invasive alternative for treating intraventricular aneurysms. The wet-field endoscopic technique is performed in an aqueous field and maintains an intact ventricle size, allowing for a clear surgical view and a wider, enhanced surgical field.

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  69. Removal of the Medial Wall of the Cavernous Sinus for Functional Pituitary Adenomas: A Technical Report and Pathologic Significance 国際誌

    Nagata, Y; Takeuchi, K; Yamamoto, T; Ishikawa, T; Kawabata, T; Shimoyama, Y; Wakabayashi, T

    WORLD NEUROSURGERY   126 巻   頁: 53 - 58   2019年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:World Neurosurgery  

    Background: Removal of the medial wall of the cavernous sinus (MW) is challenging for neurosurgeons. We describe a practical method of endoscopic MW removal via endonasal transsphenoidal approach to minimalize intraoperative blood loss and postoperative morbidities. We also present the pathologic significance of this technique for functional pituitary adenomas (FPAs). Methods: We performed MW removal in patients with FPA with no well-defined pseudocapsule and a tumor in direct contact with the MW. The MW was judged to have tumor invasion based on the intraoperative appearance, and it was removed regardless of the appearance of MW involvement. Intraoperative findings and postoperative clinical, endocrinologic, and pathologic outcomes were retrospectively reviewed. Results: Fourteen patients underwent MW removal for FPA, including 12 patients with acromegaly and 2 with Cushing disease. Mean intraoperative blood loss was 170 mL (range, 32–400 mL), and none of the patients required blood transfusion. Among the 7 patients without intraoperative apparent MW involvement, 4 (57.1%) had pathologically confirmed tumor invasion into the MW (occult invasion). Biochemical remission by surgery alone was achieved in 13 patients (92.9%). Transient oculomotor palsy occurred in 1 patient (7.1%). Conclusions: Occult tumor invasion into the MW was often detected in patients with FPA without a well-defined pseudocapsule but in direct contact with the MW. Our technique can enhance the effectiveness of surgery with minimal postoperative morbidities.

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  70. 斜台内腫瘤を呈した多発性骨髄腫の一例

    景山 卓, 竹内 和人, 下山 芳江, 足立 佳也, 若林 俊彦

    臨床神経学   59 巻 ( 5 ) 頁: 320 - 320   2019年5月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本神経学会  

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  71. 脳幹部に腫瘍性病変をきたしステロイドパルス療法が有効であった脱髄性疾患の1例

    光里 翔, 天草 善信, 中村 亮一, 大岡 史治, 竹内 和人, 川頭 祐一, 熱田 直樹, 吉田 眞理, 勝野 雅央

    臨床神経学   59 巻 ( 5 ) 頁: 324 - 324   2019年5月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本神経学会  

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  72. 機能性下垂体腺腫に対する内視鏡下経鼻経蝶形骨手術の限界

    永田 雄一, 竹内 和人, 山本 太樹, 若林 俊彦

    日本内分泌学会雑誌   95 巻 ( 1 ) 頁: 492 - 492   2019年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

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  73. 頭蓋咽頭腫摘出術中下垂体茎温存症例における下垂体機能の検討

    竹内 和人, 永田 雄一, 永谷 哲也, 渡邉 督, 若林 俊彦

    日本内分泌学会雑誌   95 巻 ( 1 ) 頁: 447 - 447   2019年4月

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  74. Quality of Life Changes Before and After Transsphenoidal Surgery for Sellar and Parasellar Lesions. 国際誌

    Ishikawa T, Takeuchi K, Nagatani T, Aimi Y, Tanemura E, Tambara M, Nagata Y, Choo J, Wakabayashi T

    World neurosurgery   122 巻   頁: e1202 - e1210   2019年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:World Neurosurgery  

    Objective: Although reports regarding the relationship between surgical complications and quality of life (QOL) exist, a general consensus regarding this issue is lacking. The aim of this study was to evaluate QOL after endoscopic transsphenoidal approach. Methods: We assessed patients with sellar or parasellar lesions that were removed with endoscopic transsphenoidal approach or extended endoscopic transsphenoidal approach between January 2010 and December 2016. 36-Item Short Form Health Survey and 30-Item General Health Questionnaire QOL scores were obtained preoperatively and 1 month and 6 months postoperatively. Results: We analyzed 89 patients with nonfunctioning pituitary adenoma (NFPA) and 39 patients with acromegaly. Physical QOL decreased 1 month after surgery but recovered after 6 months in both groups. Mental QOL improved postoperatively compared with preoperatively. Patients with acromegaly had a worse Physical Component Summary (PCS) on 36-Item Short Form Health Survey (48.7, 28.9, and 41.0) at 6 months than patients with NFPA. The low preoperative PCS group did not improve until 6 months postoperatively. Multiple regression analysis revealed the following factors were key to postoperative QOL: age (NFPA PCS 6 months postoperatively; correlation coefficient = −0.489), preoperative Mental Component Summary (MCS) (NFPA MCS 6 months postoperatively, correlation coefficient = 0.573), body mass index (acromegaly PCS 6 months postoperatively; correlation coefficient = −0.376), preoperative PCS (acromegaly PCS 6 months postoperatively; correlation coefficient = 0.905), and preoperative MCS (acromegaly MCS 6 months postoperatively; correlation coefficient = 0.726). Conclusions: Endoscopic transsphenoidal approach can improve QOL in patients by 6 months postoperatively. In patients with acromegaly with significant QOL impairments preoperatively, surgery sometimes may be unable to normalize QOL.

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  75. Quality of Life Changes Before and After Transsphenoidal Surgery for Sellar and Faros llar Lesions 査読有り

    Ishikawa Takayuki, Takeuchi Kazuhito, Nagatani Tetsuya, Aimi Yuri, Tanemura Eriko, Tambara Masao, Nagata Yuichi, Choo Jungsu, Wakabayashi Toshihiko

    WORLD NEUROSURGERY   122 巻   頁: E1202-E1210   2019年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  76. 高度な壊死所見と髄液細胞数増多を伴ったTumefactive demyelinating lesionの一例

    原田 祐三子, 坪井 崇, 熱田 直樹, 勝野 雅央, 大岡 史治, 竹内 和人

    臨床神経学   58 巻 ( 11 ) 頁: 709 - 709   2018年11月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本神経学会  

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  77. 傍鞍部腫瘍術後遅発性低Na血症の発症と予防法の検討

    竹内 和人, 川端 哲平, 永田 雄一, 秋 禎樹, 石川 隆之, 高木 博史, 有馬 寛, 若林 俊彦

    日本内分泌学会雑誌   94 巻 ( Suppl.HPT ) 頁: 37 - 40   2018年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

    当院で傍鞍部腫瘍に対しeTSS(内視鏡下経鼻経蝶形骨手術)を施行した98例(男性50例、女性48例、平均年齢55.9歳)を対象に、術後の遅発性低Na血症(DHN)発症について検討した。その結果、DHNは37例(37.8%)に認められた。DHN発症患者ではDHN発症時のAVP分泌が抑制されていないことが確認された。また、術後7日目においてDHN非発症患者では約3%程度の体重低下を認めるのに対し、DHN発症例では体重減少は1%程度と軽微であり、体内への水分貯留が示唆された。術前より尿崩症が認められた患者群ではDHN発症が少なかったものの、DHN発症例では渇感中枢障害を伴っていた。これは術後の脱水を危惧したADH補充による医原性のものと考えられた。以上、傍鞍部腫瘍の術後DHNの発症にはSIADHが強く関与していることが考えられた。尚、術後早期からの水分制限はDHN発症予防に有効と考えられたが、より適切なプロトコールならびに予測法の確立が必要である。

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  78. Neuroendoscopic Cylinder Surgery and 5-Aminolevulinic Acid Photodynamic Diagnosis of Deep-Seated Intracranial Lesions 国際誌

    Choo, J; Takeuchi, K; Nagata, Y; Ohka, F; Kishida, Y; Watanabe, T; Satoh, Y; Nagatani, T; Kato, K; Wakabayashi, T; Natsume, A

    WORLD NEUROSURGERY   116 巻   頁: E35 - E41   2018年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:World Neurosurgery  

    Background: Microscopic detection of intracranial brain tumors with 5-aminolevulinic acid (5-ALA) has proven extremely useful, and reports the use of 5-ALA have recently increased. However, few reports have described 5-ALA photodynamic diagnosis (PDD) using a neuroendoscope. We performed neuroendoscopic 5-ALA PDD for various brain lesions and present a procedure using only a neuroendoscope. Methods: We describe the diagnosis of 20 intracranial brain lesion cases with a 5-ALA–guided fluorescence endoscope. A light-emitting diode that emitted either white light or 400- to 410-nm violet light was attached to a neuroendoscope. We performed cylinder surgery with a transparent sheath under observation with a rigid neuroendoscope. Results: Neuroendoscopic biopsies were performed in 11 patients, and resections were performed in 9 patients. All lesions were observed with a neuroendoscope under sequential white light and violet light. We confirmed the presence of a red fluorescent lesion under violet light in 15 patients, including 4 of 5 glioblastoma cases (80%); 1 of 2 anaplastic astrocytoma cases (50%); 4 of 5 diffuse large B cell lymphoma cases (80%); 2 of 2 metastatic brain tumors; 1 of 1 case each of diffuse astrocytoma, pilocytic astrocytoma, inflammatory change, and germinoma (100%); and no cases of anaplastic ependymoma or cysticercosis. Pretargeted lesions were accurately harvested from all biopsy specimens. Gross total resection was achieved in 5 of 9 patients using a resection procedure. Conclusions: Our described method offers a promising technique for achieving precise brain tumor biopsies and safe resection.

    DOI: 10.1016/j.wneu.2018.03.112

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  79. 残存・コントロール不良成長ホルモン産生腫瘍に対する内視鏡手術の有効性

    竹内 和人, 永田 雄一, 秋 禎樹, 川端 哲平, 石川 隆之, 石崎 友崇, 若林 俊彦

    日本内分泌学会雑誌   94 巻 ( 1 ) 頁: 417 - 417   2018年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

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  80. Long-standing overt ventriculomegaly without aqueductal stenosis: A case report

    Ikumi Kazuhiro, Tsuboi Takashi, Atsuta Naoki, Takeuchi Kazuhito, Koike Haruki, Katsuno Masahisa

    NEUROLOGY AND CLINICAL NEUROSCIENCE   6 巻 ( 2 ) 頁: 42-44 - 44   2018年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Neurology and Clinical Neuroscience  

    We report a case of long-standing overt ventriculomegaly without aqueductal stenosis. A 66-year-old woman developed progressive gait disturbance. Her gait was wide-based, with a difficulty in turning. Prominent macrocephaly was present, which suggests the presence of long-standing hydrocephalus since childhood. Cognitive impairments were detected on neuropsychological tests. Cerebral magnetic resonance imaging revealed marked enlargement of the third and lateral ventricles. Aqueductal stenosis was not apparent; however, endoscopic third ventriculostomy partly ameliorated gait disturbance. Endoscopic third ventriculostomy can be a therapeutic option for long-standing overt ventriculomegaly even if the aqueduct is patent.

    DOI: 10.1111/ncn3.12176

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  81. Fully endoscopic combined transsphenoidal and supraorbital keyhole approach for parasellar lesions 国際誌

    Nagata, Y; Watanabe, T; Nagatani, T; Takeuchi, K; Chu, J; Wakabayashi, T

    JOURNAL OF NEUROSURGERY   128 巻 ( 3 ) 頁: 685 - 694   2018年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Neurosurgery  

    OBJECTIVE: Parasellar tumors that extend far laterally beyond the internal carotid artery or that are fibrous and adhere firmly to critical structures are difficult to remove totally via the endoscopic transsphenoidal approach alone. In such cases, a combined transsphenoidal-transcranial approach is effective to achieve maximal resection in a single stage. In this paper, a new minimally invasive surgical technique for complicated parasellar lesions, a fully endoscopic combined transsphenoidal-supraorbital keyhole approach, is presented. METHODS: A retrospective review of patients who had been treated via a fully endoscopic combined transsphenoidal-supraorbital keyhole approach for complicated parasellar lesions was performed. The data for resection rate, perioperative mortality and morbidity, and postoperative outcomes were analyzed. RESULTS: A total of 12 fully endoscopic combined transsphenoidal-supraorbital keyhole approaches were performed from March 2013 to February 2016; 10 were for pituitary adenomas and 2 were for craniopharyngiomas. Gross-total resection or near-total resection was achieved in 7 of 12 cases. Among the 11 patients who had presented with preoperative visual disturbances, 7 had visual improvement. However, 1 patient showed deterioration in visual function. No patient experienced postoperative hemorrhage, needed additional surgical treatment, or had postoperative CSF leakage. CONCLUSIONS: In the combined transsphenoidal and transcranial approach, safe and effective cooperative manipulation with 2 surgical corridors can be performed for complicated parasellar lesions. The goal of this procedure is not to achieve gross-total resection, but to achieve safe resection. Moreover, this new surgical approach offers neurosurgeons a simpler operative field with less invasiveness than the conventional microscopic combined approach. The fully endoscopic combined endonasal-supraorbital keyhole approach is an efficacious procedure for complicated parasellar lesions with acceptable results.

    DOI: 10.3171/2016.11.JNS161833

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  82. 小児のう胞性疾患に対する内視鏡治療

    竹内 和人, 加藤 美穂子, 波多野 寿, 大澤 弘勝, 近藤 五郎, 栗本 路弘, 秋 禎樹, 若林 俊彦

    小児の脳神経   43 巻 ( 1 ) 頁: 20 - 24   2018年3月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本小児神経外科学会  

    内視鏡技術の進歩により、のう胞性疾患に対して内視鏡を使用する報告が増えている。内視鏡手術を適応することで症例によっては髄液短絡術を回避でき、回避できない症例においてもシャントシステムをよりシンプルにすることで続発するシャントトラブルを軽減することにつながると考えられる。しかし、標準的手術法がなく個々の症例で治療方針の検討が必要である。また光学機器についても、軟性鏡、硬性鏡のどちらを使用するのか、あるいは併用するのか検討する必要がある。それぞれの光学機器の特徴を踏まえ、その治療成績について報告する。(著者抄録)

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  83. A Novel Dissection Method Using a Flexible Neuroendoscope for Resection of Tumors Around the Aqueduct of Sylvius 国際誌

    Ishikawa, T; Takeuchi, K; Tsukamoto, N; Kawabata, T; Wakabayashi, T

    WORLD NEUROSURGERY   110 巻   頁: 391 - 396   2018年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:World Neurosurgery  

    Background Flexible endoscopes have both a wide range of movement and a wide field of view and are therefore widely used for endoscopic third ventriculostomy and biopsy. However, tumor resection around the aqueduct of Sylvius using flexible endoscopes has scarcely been reported. Case Description We report 2 cases of tumor resection around the aqueduct of Sylvius. The first case is a 38-year-old man presenting with progressive headache, nausea, and diplopia. Magnetic resonance imaging (MRI) revealed a 1.4 cm nonenhancing mass at the entry of the aqueduct of Sylvius and occlusive hydrocephalus. We performed tumor resection and endoscopic third ventriculostomy (ETV) simultaneously. His symptoms disappeared after the operation. Final pathologic diagnosis was ancient schwannoma. The second case is a 78-year-old woman presenting with progressive disturbance of consciousness (coma). MRI showed 0.7 cm nonenhancing mass at the entry of the aqueduct of Sylvius and occlusive hydrocephalus. We performed tumor resection and ETV similarly. Her consciousness improved after the operation. Final tumor diagnosis was cavernous malformation. In both cases there was no additional neurologic deficit after the surgery. Conclusions By using a flexible endoscope for tumor dissection, resection of a tumor without a neck, which cannot be removed through aspiration alone, becomes possible. To our knowledge, the presented cases are the first to describe the effectiveness of complete resection of a tumor in the third ventricle using flexible endoscopy.

    DOI: 10.1016/j.wneu.2017.11.044

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  84. 骨髄移植後に左後頭葉および胸髄に脱髄性病変を来した1例

    村上 あゆ香, 中村 亮一, 川頭 祐一, 熱田 直樹, 小池 春樹, 竹内 和人, 寺倉 精太郎, 吉田 眞理, 勝野 雅央

    臨床神経学   57 巻 ( 12 ) 頁: 808 - 808   2017年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本神経学会  

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  85. 中脳水道狭窄を伴わなかったlong-standing overt ventriculomegaly in adults(LOVA)様水頭症の1例

    井汲 一尋, 坪井 崇, 田中 康博, 川端 哲平, 秋 禎樹, 永田 雄一, 竹内 和人, 若林 俊彦, 伊藤 瑞規, 勝野 雅央

    臨床神経学   57 巻 ( 10 ) 頁: 613 - 613   2017年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本神経学会  

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  86. 経蝶形骨術中髄液漏における硬膜下血腫

    竹内 和人, 永谷 哲也, 渡邉 督, 岸田 悠吾, 永田 雄一, 秋 禎樹, 川端 哲平, 石川 隆之, 若林 俊彦

    日本内分泌学会雑誌   93 巻 ( Suppl.HPT ) 頁: 87 - 89   2017年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本内分泌学会  

    経蝶形骨手術または拡大経蝶形骨法が施行され、術中に髄液漏を認めた61例を対象とし、術後に硬膜下血腫を認めた10例(A群)と認めなかった51例(B群)に分け検討した。年齢、性別、腫瘍の病理・最大径、術前内分泌機能等の患者背景に加えて、脳室拡大の程度を術前MRIでのEvans' indexを用いて評価した。また、術中髄液漏れの程度についてEsposito分類を用いて評価し、硬膜下血腫の発生について術翌日、1週間後、1ヵ月後、3ヵ月後に撮影されたCTまたはMRIを用いて評価した。その結果、A群はB群に比べ年齢、術前下垂体前葉機能低下の合併頻度、Evans' indexが有意に高かった。その他の項目に両群間で有意差は認めなかった。多変量解析を行ったところ、65歳以上、術前下垂体前葉機能低下、Evans' index≧0.28が術後硬膜下血腫発生の有意なリスク因子であった。

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  87. The Multiscope Technique for Microvascular Decompression 国際誌

    Nagata, Y; Watanabe, T; Nagatani, T; Takeuchi, K; Chu, J; Wakabayashi, T

    WORLD NEUROSURGERY   103 巻   頁: 310 - 314   2017年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:World Neurosurgery  

    Background Endoscopic surgery has rapidly become widespread in neurosurgery in recent years. Endoscopy can offer close and panoramic surgical views with fine illumination, even in the deep intracranial area. However, it also has the following serious drawback: an intracranial blind area between the field lens of the endoscope and the site of the dural opening. This blind area cannot be viewed on the endoscopic monitor, and several surgical complications, including accidental intracranial neurovascular structural injury, can occur in this area. In this article, we report a new multiscope surgical technique that can compensate for this serious disadvantage of endoscopic surgery. Methods In the multiscope technique, endoscopic and exoscopic systems are used simultaneously with 2 monitors. Microvascular decompression (MVD) is performed fully endoscopically using an exoscope that compensates for the intracranial blind area of the endoscopic view. Two high-definition monitors for the endoscope and exoscope are placed side-by-side in front of the primary surgeon. Results Two patients with hemifacial spasm were treated by endoscopic MVD with the multiscope technique. In these procedures, fine surgical views were obtained by both the endoscope and exoscope. Two monitors were placed side-by-side in front of the surgeon; as a result, the physician could easily view them simultaneously during the operation. No surgery-related complications occurred. Conclusions The multiscope technique can facilitate the performance of safer neuroendoscopic surgery than conventional endoscopic surgery. This technique can also be adopted in other skull base surgeries, in which the importance of endoscopy is growing.

    DOI: 10.1016/j.wneu.2017.04.059

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  88. 小児悪性脳腫瘍の集学的治療 総論 サバイバーたちの苦悩 悪性脳腫瘍治療後には複雑な頭蓋奇形が生じる 二次性縫合縫合癒合のリスク因子と診断マーカー

    近藤 五郎, 栗本 路弘, 竹内 和人, 川端 哲平, 秋 禎樹, 荒木 芳生, 夏目 敦至, 若林 俊彦

    小児の脳神経   42 巻 ( 2 ) 頁: 124 - 124   2017年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本小児神経外科学会  

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  89. 術後に糖代謝の改善を認めたGH・TSH産生下垂体腫瘍の一例

    川口 頌平, 竹内 和人, 半田 克成, 片岡 祐子, 山川 文子, 林 正幸

    糖尿病   60 巻 ( Suppl.1 ) 頁: S - 247   2017年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本糖尿病学会  

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  90. 脳幹部海綿状血管腫に対する内視鏡手術

    秋 禎樹, 竹内 和人, 渡邊 督, 永田 雄一, 若林 俊彦

    脳神経外科ジャーナル   26 巻 ( 3 ) 頁: 216 - 224   2017年3月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:(一社)日本脳神経外科コングレス  

    脳幹部海綿状血管腫(BSCM)は、高い出血率を有する血管奇形の1つとして知られている。出血や増大傾向を示すBSCMは神経学的予後に影響するため外科的治療が必要となるが、脳幹部への外科的治療は少しの正常組織への侵襲も術後の神経予後を大きく悪化させる可能性がある。今回筆者らは2例(橋腹側1例、中小脳脚1例)の症候性BSCMに対して内視鏡的に摘出を行った。どちらの症例もMR diffusion tensor image(DTI)を用いて病変部や錐体路の位置を把握した。術中は内視鏡下にwet field methodを用いて摘出および摘出腔内の止血を行い、術後、神経学的な改善が得られた。これらの技術により、今後、脳幹部病変に対しての内視鏡を用いた治療が正確かつ安全に行われるようになると考える。(著者抄録)

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  91. Endoscopic resection of Brain stem cavernous malformations (BSCMs): Two illustrative cases and surgical methods employed

    Chu J., Takeuchi K., Watanabe T., Nagata Y., Wakabayashi T.

    Japanese Journal of Neurosurgery   26 巻 ( 3 ) 頁: 216 - 226   2017年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Journal of Neurosurgery  

    Brain stem cavernous malformations (BSCMs) are associated with a high rate of hemorrhagic events. Though BSCMs that bleed or grow in size are indicated for resection, the surgical procedure usually involves a high risk of damage to the normal brain. We successfully achieved total resection, in two cases of symptomatic BSCMs, using a neuroendoscope. The BSCM was localized in the ventral part of the pons in the first case and in the middle cerebellar peduncle in the second case. In both cases, diffusion tensor images (DTI) were taken with an MRI to confirm the localization of the BSCM in relation to the pyramidal tracts. We resected the BSCMs using a Vet field method' which renders the surgical fields clear without using suction tubes. The wet field provides the operator with an increased range of manipulation even in a tight space. With our technique, the indications of endoscopic surgery have widened. We have shown that neuro-endoscopic surgery can safely and effectively replace conventional craniotomy for certain brain stem lesions.

    DOI: 10.7887/jcns.26.216

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▼全件表示

書籍等出版物 3

  1. 脳神経外科学レビュー2023−24:鏡視下手術の展望

    竹内和人( 担当: 共著)

    総合医学社  2022年10月 

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    記述言語:日本語 著書種別:学術書

  2. 医事新報:プロからプロへ

    竹内和人( 担当: 共著)

    2022年6月 

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    記述言語:日本語

  3. 脳神経外科速報:脳腫瘍手術戦略⑦脳幹部海綿状血管腫

    竹内和人

    2022年3月 

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    総ページ数:7   担当ページ:317-377   記述言語:日本語 著書種別:学術書

MISC 31

  1. Simultaneous Aneurysmal Subarachnoid Hemorrhage and Epistaxis in an Untreated Prolactinoma: A Case Report and Literature Review.

    Nishihori M, Izumi T, Takeuchi K, Goto S, Kanamori F, Uda K, Yokoyama K, Araki Y, Saito R  

    NMC case report journal10 巻 ( 0 ) 頁: 163 - 168   2023年

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    記述言語:英語   出版者・発行元:一般社団法人 日本脳神経外科学会  

    DOI: 10.2176/jns-nmc.2022-0355

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  2. ヒトES細胞由来下垂体細胞のマウス皮下移植の有効性

    佐々木博勇, 竹内和人, 永田雄一, 原田英幸, 近藤辰磨, 伊藤英治, 三輪田勤, 淺野友良, 須賀英隆, 有馬寛, 齋藤竜太  

    日本内分泌学会雑誌99 巻 ( 1 )   2023年

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  3. 機能性PitNETに対する治療戦略

    永田雄一, 竹内和人, 伊藤英治, 佐々木博勇, 原田英幸, 近藤辰磨, 齋藤竜太  

    日本内分泌学会雑誌99 巻 ( 1 )   2023年

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  4. 巨大下垂体腺腫摘出後の還流止血による術後血腫形成予防効果の検討

    原田英幸, 竹内和人, 永田雄一, 伊藤英治, 佐々木博勇, 近藤辰磨, 齋藤竜太  

    日本間脳下垂体腫瘍学会プログラム・抄録集33rd 巻   2023年

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  5. 小児頭蓋咽頭腫治療における神経内視鏡の有用性

    竹内和人, 永田雄一, 原田英幸, 伊藤英治, 齋藤竜太  

    小児の脳神経(Web)48 巻 ( 2 )   2023年

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  6. 前床突起に発生した結節性筋膜炎の1例

    伊藤英治, 棚橋邦明, 竹内和人, 永田雄一, 原田英幸, 近藤辰磨, 齋藤竜太  

    Brain Tumor Pathology. Supplement40 巻   2023年

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  7. 再生医療実現に向けたヒト多能性幹細胞由来下垂体細胞の皮下移植

    佐々木博勇, 須賀英隆, 竹内和人, 永田雄一, 原田英幸, 近藤辰磨, 伊藤英治, 有馬寛, 齋藤竜太  

    日本間脳下垂体腫瘍学会プログラム・抄録集33rd 巻   2023年

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  8. 傍鞍部腫瘍に対する内視鏡下経鼻頭蓋底手術有効性と安全性の向上のための工夫

    竹内和人, 永田雄一, 伊藤英治, 原田英幸, 近藤辰磨, 齋藤竜太  

    日本頭蓋底外科学会プログラム・抄録集35th 巻   2023年

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  9. 機能性PitNETに対する治療戦略

    永田雄一, 竹内和人, 伊藤英治, 佐々木博勇, 原田英幸, 近藤辰磨, 齋藤竜太  

    日本間脳下垂体腫瘍学会プログラム・抄録集33rd 巻   2023年

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  10. 頭蓋咽頭腫に対する神経内視鏡治療-機能温存と根治性-

    竹内和人, 永田雄一, 伊藤英治, 佐々木博勇, 原田英幸, 齋藤竜太  

    日本内分泌学会雑誌99 巻 ( 1 )   2023年

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  11. 頭蓋咽頭腫に対する内視鏡治療の役割 長期成績と内分泌機能保持への挑戦

    竹内和人, 永田雄一, 伊藤英治, 佐々木博勇, 原田英幸, 近藤辰磨, 齋藤竜太  

    日本間脳下垂体腫瘍学会プログラム・抄録集33rd 巻   2023年

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  12. 脳幹背側病変に対する内視鏡下trans-Magendie foraminal approach

    永田雄一, 竹内和人, 伊藤英治, 原田英幸, 近藤辰磨, 齋藤竜太  

    日本頭蓋底外科学会プログラム・抄録集35th 巻   2023年

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  13. 脳室拡大を伴わない髄液吸収障害のために視力機能低下を来したNF2の2例

    伊藤英治, 齋藤清, 竹林成典, LUSHUN Chalise, 竹内和人, 永田雄一, 齋藤竜太  

    日本頭蓋底外科学会プログラム・抄録集35th 巻   2023年

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  14. 機能性PitNETに対する海綿静脈洞内側壁摘出の病理学的意義

    永田雄一, 竹内和人, 伊藤英治, 原田英幸, 近藤辰磨, 齋藤竜太  

    Brain Tumor Pathology. Supplement40 巻   2023年

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  15. ラトケ嚢胞に類似した所見を示した頭蓋咽頭腫の一例

    原田 英幸, 竹内 和人, 永田 雄一, 棚橋 邦明, 佐々木 博勇, 水野 晃宏, 井下 尚子, 齋藤 竜太  

    日本内分泌学会雑誌98 巻 ( S.HPT ) 頁: 72 - 73   2022年8月

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    記述言語:日本語   出版者・発行元:一般社団法人 日本内分泌学会  

    DOI: 10.1507/endocrine.98.s.hpt_72

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  16. 経鼻頭蓋底術後髄液漏の検討―失敗を活かすために―

    竹内 和人, 永田 雄一, 佐々木 博勇, 水野 晃宏, 齋藤 竜太  

    日本内分泌学会雑誌98 巻 ( S.HPT ) 頁: 25 - 27   2022年8月

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    記述言語:日本語   出版者・発行元:一般社団法人 日本内分泌学会  

    DOI: 10.1507/endocrine.98.s.hpt_25

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  17. 脳幹部海綿状血管腫—神経解剖を理解した脳腫瘍手術戦略と合併症対応 ; 脳腫瘍手術戦略

    竹内 和人  

    脳神経外科速報 : 臨床医の人生に伴走するlifetime journal32 巻 ( 3 ) 頁: 371 - 377   2022年5月

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    記述言語:日本語  

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  18. Case of a Pregnant Woman with Capillary Hemangioma of the Parasellar Region.

    Ishikawa T, Takeuchi K, Nagata Y, Ito K, Yamamoto T, Kabeya R  

    NMC case report journal9 巻 ( 0 ) 頁: 77 - 82   2022年

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    記述言語:英語   出版者・発行元:一般社団法人 日本脳神経外科学会  

    DOI: 10.2176/jns-nmc.2021-0326

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  19. (11)C-methionine- and (18)F-FDG-PET double-negative metastatic brain tumor from lung adenocarcinoma with paradoxical high (18)F-FDG uptake: A case report. 国際誌

    Tanahashi K, Hirano M, Chalise L, Tsugawa T, Okumura Y, Hase T, Ohka F, Motomura K, Takeuchi K, Nagata Y, Nakahara N, Hashimoto N, Saito R  

    Surgical neurology international13 巻   頁: 372 - 372   2022年

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    記述言語:英語   出版者・発行元:Surgical Neurology International  

    Background: Imaging with 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and 11C-methionine (MET)-PET can delineate primary and metastatic brain tumors. Lesion size affects the sensitivity of both scans and histopathological features can also influence FDG-PET, but the effects on MET-PET have not been elucidated. Case Description: We report an unusual case of metastatic brain tumors without accumulation of FDG or MET, contrasting with high FDG uptake in the primary lung lesion. The brain lesions were identified as adenocarcinoma with a more mucus-rich background, contributing to the indistinct accumulation of both FDG and MET. Conclusion: Histopathological characteristics can affect both MET and FDG accumulation, leading to findings contradicting those of the primary lesion.

    DOI: 10.25259/SNI_264_2022

    Scopus

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  20. 巨大下垂体腺腫に対する治療戦略

    永田雄一, 竹内和人, 伊藤英治, 佐々木博勇, 原田英幸, 齋藤竜太  

    日本脳腫瘍の外科学会プログラム・抄録集27th 巻   2022年

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  21. 内視鏡下経鼻術における硬膜縫合に基づいた鞍底再建法

    永田雄一, 竹内和人, 伊藤英治, 佐々木博勇, 原田英幸, 齋藤竜太  

    日本神経内視鏡学会プログラム・抄録集29th 巻   2022年

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  22. 中枢神経原発胚細胞腫瘍における内視鏡生検術の臨床成績

    大岡史治, 竹内和人, 本村和也, 伊藤英治, 永田雄一, 山口純矢, 佐々木博勇, 木部祐士, 原田英幸, 清水大輝, 平松拓, 鈴木一秋, 齋藤竜太  

    日本脳腫瘍の外科学会プログラム・抄録集27th 巻   2022年

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  23. シリンダー手術用機器及び操作法の開発

    竹内和人, 永田雄一, 伊藤英治, 佐々木博勇, 原田英幸, 齋藤竜太  

    日本神経内視鏡学会プログラム・抄録集29th 巻   2022年

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  24. TSS術後血腫形成に対してDuragenは有効か

    佐々木博勇, 竹内和人, 永田雄一, 原田英幸, 近藤辰磨, 伊藤英治, 齋藤竜太  

    日本神経内視鏡学会プログラム・抄録集29th 巻   2022年

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  25. 脳実質腫瘍の神経内視鏡手術における5-ALAとICGの有用性

    原田英幸, 竹内和人, 永田雄一, 伊藤英治, 佐々木博勇, 近藤辰磨, 齋藤竜太  

    日本神経内視鏡学会プログラム・抄録集29th 巻   2022年

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  26. 脳深部病変に対するシリンダー手術の現状と課題

    竹内和人, 永田雄一, 伊藤英治, 佐々木博勇, 原田英幸, 齋藤竜太  

    日本脳腫瘍の外科学会プログラム・抄録集27th 巻   2022年

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  27. 脳幹部海綿状血管腫治療における内視鏡の役割

    竹内和人, 永田雄一, 伊藤英治, 佐々木博勇, 原田英幸, 齋藤竜太  

    日本脳腫瘍の外科学会プログラム・抄録集27th 巻   2022年

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  28. シリンダー手術の世界—神経内視鏡+外視鏡up-to-date ; シリンダー手術

    竹内 和人  

    脳神経外科速報 : 臨床医の人生に伴走するlifetime journal31 巻 ( 6 ) 頁: 926 - 933   2021年11月

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    記述言語:日本語  

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  29. Sellar arachnoid cystに対する経鼻内視鏡手術

    永田 雄一, 竹内 和人, 山本 太樹, 水野 晃宏, 永谷 哲也, 齋藤 竜太  

    日本内分泌学会雑誌97 巻 ( S.HPT ) 頁: 49 - 51   2021年9月

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    記述言語:日本語   出版者・発行元:一般社団法人 日本内分泌学会  

    DOI: 10.1507/endocrine.97.s.hpt_49

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    その他リンク: https://search.jamas.or.jp/link/ui/2022074900

  30. 内視鏡下経鼻頭蓋底手術後の再建戦略―失敗症例から学ぶDuragen<sup>®</sup>の適応と限界―

    竹内 和人, 永田 雄一, 山本 太樹, 原田 英幸, 齋藤 竜太  

    日本内分泌学会雑誌97 巻 ( S.HPT ) 頁: 16 - 18   2021年9月

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    記述言語:日本語   出版者・発行元:一般社団法人 日本内分泌学会  

    DOI: 10.1507/endocrine.97.s.hpt_16

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  31. A Case of Primary Leptomeningeal Lymphoma Presenting with Hydrocephalus Characterized by Disproportionately Large Fourth Ventricle.

    Nohira S, Shimato S, Yamanouchi T, Takeuchi K, Yamamoto T, Ito M, Kato K, Nishizawa T  

    NMC case report journal8 巻 ( 1 ) 頁: 399 - 404   2021年

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    記述言語:英語   出版者・発行元:一般社団法人 日本脳神経外科学会  

    DOI: 10.2176/nmccrj.cr.2020-0215

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講演・口頭発表等 13

  1. シリンダー手術用機器及び操作法の開発

    竹内和人、永田雄一、伊藤英治、佐々木博勇、原田英幸、齋藤竜太

    第29回日本神経内視鏡学会  2022年11月4日 

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    開催年月日: 2022年11月

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

  2. 脳室内病変に対する内視鏡手術ー私の工夫ー 招待有り

    竹内和人

    第29回日本神経内視鏡学会  2022年11月3日 

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    開催年月日: 2022年11月

    記述言語:日本語   会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

  3. Endoscopic transsphenoidal surgery for craniopharyngioma 招待有り 国際会議

    Kazuhito Takeuchi

    IFNE Interim Meeting  2022年10月29日  IFNE

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    開催年月日: 2022年10月

    記述言語:英語   会議種別:シンポジウム・ワークショップ パネル(指名)  

    開催地:Hyderabad, India   国名:インド  

  4. 脳深部病変に対するシリンダー手術の現状と課題

    竹内和人、永田雄一、伊藤英治、佐々木博勇、原田英幸、齋藤竜太

    第27回日本脳腫瘍の外科学会  2022年10月14日 

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    開催年月日: 2022年10月

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

  5. 脳深部病変に対するシリンダー手術の現状と課題

    竹内和人、永田雄一、伊藤英治、佐々木博勇、原田英幸、齋藤竜太

    第27回日本脳腫瘍の外科学会  2022年10月14日 

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    開催年月日: 2022年10月

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

  6. 内視鏡下シリンダー手術の現状と課題

    竹内和人、永田雄一、伊藤英治、佐々木博勇、原田英幸、齋藤竜太

    日本脳神経外科学会第81回学術総会  2022年9月30日 

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    開催年月日: 2022年9月

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

  7. Endoscopic cylinder surgery 招待有り

    Kazuhito Takeuchi

    IFNE workshop on Neuroendoscopy  2022年7月21日  IFNE

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    開催年月日: 2022年7月

    記述言語:英語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:Naples, Itary   国名:イタリア共和国  

  8. 脳幹部海綿状血管腫に対する内視鏡手術の展望

    竹内和人、永田雄一、伊藤英治、佐々木博勇、原田英幸、齋藤竜太

    第34回日本頭蓋底外科学会  2022年7月7日 

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    開催年月日: 2022年7月

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

  9. 小児頭蓋咽頭腫に対する神経内視鏡治療の実際と展望

    竹内和人、永田雄一、伊藤英治、佐々木博勇、原田英幸、齋藤竜太

    第50回日本小児神経外科学会  2022年6月11日 

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    開催年月日: 2022年6月

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

  10. 頭蓋咽頭腫術後下垂体機能温存に上下垂体動脈血流が重要である

    竹内和人、永田雄一、伊藤英治、佐々木博勇、原田英幸、齋藤竜太

    第95回日本内分泌学会学術総会  2022年6月3日 

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    開催年月日: 2022年6月

    記述言語:日本語   会議種別:口頭発表(一般)  

  11. 脳内・脳室内病変に対する神経内視鏡手術

    竹内和人、永田雄一、佐々木博勇、原田英幸、齋藤竜太

    第42回日本脳神経外科コングレス  2022年5月12日  日本脳神経外科コングレス

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    開催年月日: 2022年5月

    開催地:大阪   国名:日本国  

  12. 内視鏡、細径シリンダーを用いた低侵襲生検術の有用性

    竹内和人、永田雄一、棚橋邦明、佐々木博勇、水野晃宏、齋藤竜太

    第31回脳神経外科手術と機器学会  2022年4月16日  脳神経外科手術と機器学会

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    開催年月日: 2022年4月

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:東京   国名:日本国  

  13. 経鼻頭蓋底術後髄液漏の検討―失敗を活かすためにー

    竹内和人、永田雄一、棚橋邦明、佐々木博勇、水野晃宏、齋藤竜太

    第32回日本間脳下垂体腫瘍学会  2022年2月17日  日本間脳下垂体腫瘍学会

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    開催年月日: 2022年2月

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:東京   国名:日本国  

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科研費 3

  1. 下垂体腫瘍に対する新規遺伝子学的診断法の探求ー術前計画と術中判断への応用ー

    研究課題/研究課題番号:23K08540  2023年4月 - 2026年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    竹内 和人, 大岡 史治, 永田 雄一, 大岡 史治, 永田 雄一

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    担当区分:研究代表者 

    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

    本研究には2つの柱が存在する。①患者由来PitNETオルガノイド培養液よりエクソソームを抽出し薬物反応性予測のバイオマーカー候補となるmiRNAを探索する。この結果をもとに、実症例の血清及び尿検体のmiRNAを測定し薬物反応性予測の新たなバイオマーカーとなり得るか検討する。②PitNETで高頻度にみられる遺伝子変異を中心に高速リアルタイムPCR法を用いた術中遺伝子解析法を樹立する。遺伝子情報による境界診断が可能かどうかについて検討を行う。本研究により分子情報に基づく機能性PitNET治療の術前・術中検討につなげる。

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  2. 脳室上衣繊毛ダイニン異常による非閉塞性水頭症の発症、増悪機序の分子学的解明

    研究課題/研究課題番号:20K17959  2020年4月 - 2023年3月

    日本学術振興会  科学研究費助成事業 若手研究  若手研究

    竹内 和人

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    担当区分:研究代表者 

    配分額:4160000円 ( 直接経費:3200000円 、 間接経費:960000円 )

    非閉塞性水頭症発症の一因として、脳室上衣の繊毛運動の機能不全による髄液還流障害が考えられている。Dpcd遺伝子異常により、脳室上衣繊毛内分子群の発現異常、構造変化が引き起こされる。Dpcdノックアウトマウスの運動繊毛ダイニンのトランスクリプトーム・プロテオーム解析を行い、非閉塞性水頭症に寄与する分子メカニズムの解明を目指す。また、Dpcdノックアウトマウスでは水頭症は経時的に増悪することも確認されている。繊毛運動障害による異常な髄液流が二次的に繊毛極性異常を引き起こすと考えられる。このメカニズムを、脳室間での違いや経時的な変化から解析し、非閉塞性水頭症の発生及び増悪の原因究明につなげる。

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  3. 線毛運動障害による髄液ダイナミクス異常とダイニンの分子生物学的解析

    研究課題/研究課題番号:17K17792  2017年4月 - 2020年3月

    日本学術振興会  科学研究費助成事業 若手研究(B)  若手研究(B)

    竹内 和人

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    担当区分:研究代表者 

    配分額:4290000円 ( 直接経費:3300000円 、 間接経費:990000円 )

    繊毛運動異常を示す水頭症モデルマウス(Dpcdノックアウトマウス)を用いて水頭症発現様式、機序について検討を行った。この水頭症は側脳室、第三脳室の脳室拡大を認めるものの、第四脳室の拡大は認めず脳室間で表現型に差異が存在することが示唆された。マウス内腕ダイニンを構成する8種の分子種のうち、Dnah1のmRNAの発現が減少し、対してDnah6は増加していることが明らかとなった。また透過型顕微鏡を用いた構造解析では内腕ダイニンの部分的な欠損が確認された。これによりDpcd遺伝子ノックアウトにより複数のダイニン分子種の遺伝子多寡と構造異常がもたらされていることが明らかとなった。

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