研究者詳細 - 竹内　和人

論文 - 竹内　和人

分割表示 139 件中 61 - 80 件目／全件表示 >>

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

Endoscopic Trans-Mini-Cylinder Biopsy for Intraparenchymal Brain Lesions 国際誌 Open Access

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

担当区分：筆頭著者,　責任著者記述言語：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

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

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

担当区分：筆頭著者,　責任著者記述言語：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.

DOI： 10.1007/s00701-022-05273-z

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

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

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.

DOI： 10.1098/rsif.2022.0321

ラトケ嚢胞に類似した所見を示した頭蓋咽頭腫の一例 Open Access

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

経鼻頭蓋底術後髄液漏の検討失敗を活かすために Open Access

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

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。

DOI： 10.1507/endocrine.98.s.hpt_25

Open Access

J-GLOBAL

researchmap

頭蓋底腫瘍に対する開頭手術と経鼻内視鏡手術の使いわけについて正中部頭蓋底腫瘍でも硬膜内腫瘍の内頸動脈・脳神経の外側進展例では開頭手術を推奨

阿久津博義, 竹内和人

日本医事新報 ( 5127 ) 頁： 53 - 53 2022年7月

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

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

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.

DOI： 10.1186/s12883-022-02749-4

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

担当区分：筆頭著者,　責任著者記述言語：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.

DOI： 10.1007/s00701-022-05227-5

脳内病変に対する内視鏡手術の有用性とは?【内視鏡では周辺の正常脳の損傷を抑えた手術治療が可能である】

竹内和人, 西田南海子

日本医事新報 ( 5120 ) 頁： 51 - 51 2022年6月

Symptomatic hyperperfusion after combined revascularization surgery in patients with pediatric moyamoya disease: patient series Open Access

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

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.

DOI： 10.3171/CASE2274

Open Access

Web of Science

Scopus

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

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

担当区分：責任著者記述言語：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.

DOI： 10.1007/s10143-021-01634-x

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

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.

DOI： 10.1007/s10143-021-01685-0

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

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.

DOI： 10.1016/j.wneu.2021.12.115

Modified Shoelace Dural Closure with Collagen Matrix in Extended Transsphenoidal Open Access

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

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.

DOI： 10.2176/jns-nmc.2021-0355

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