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Article ; Online: Boltless nylon-suture technique for stereotactic electroencephalography as a safe, effective alternative when the anchor bolt is inappropriate.

Mutoh, Manabu / Maesawa, Satoshi / Nakatsubo, Daisuke / Ishizaki, Tomotaka / Tanei, Takafumi / Torii, Jun / Ito, Yoshiki / Hashida, Miki / Saito, Ryuta

Acta neurochirurgica

2024 Volume 166, Issue 1, Page(s) 18

Abstract: Background: The use of anchor bolts to secure electrodes to the skull can be difficult in some clinical situations. Herein, we present the boltless technique to secure electrodes to the scalp using nylon sutures to overcome the problems associated with ... ...

Abstract	Background: The use of anchor bolts to secure electrodes to the skull can be difficult in some clinical situations. Herein, we present the boltless technique to secure electrodes to the scalp using nylon sutures to overcome the problems associated with anchor bolts. We investigated the safety, accuracy errors, and patient-related and operative factors affecting errors in the boltless technique. Methods: This single-institution retrospective series analyzed 103 electrodes placed in 12 patients. The target-point localization error (TPLE), entry-point localization error (EPLE), radial error (RE), and depth error (DE) of the electrodes were calculated. Results: The median of the mean operative time per electrode was 9.3 min. The median TPLE, EPLE, RE, and absolute DE value were 4.1 mm, 1.6 mm, 2.7 mm, and 1.9 mm, respectively. Positive correlations were observed between the preoperative scalp thickness, mean operative time per electrode, EPLE, RE, and the absolute value of DE versus TPLE (r = .228, p = .02; r = .678, p = .015; r = .228, p = .02; r = .445, p < .01; r = .630, p < .01, respectively), and electrode approach angle versus EPLE (r = .213, p = .031). Multivariate analysis revealed that the absolute value of DE had the strongest influence on the TPLE, followed by RE and preoperative scalp thickness, respectively (β = .938, .544, .060, respectively, p < .001). No complications related to SEEG insertion and monitoring were encountered. Conclusion: The boltless technique using our unique planning and technical method is a safe, effective, and low-cost alternative in cases where anchor bolts are contraindicated.
MeSH term(s)	Humans ; Nylons ; Retrospective Studies ; Electroencephalography ; Scalp ; Suture Techniques ; Sutures
Chemical Substances	Nylons
Language	English
Publishing date	2024-01-17
Publishing country	Austria
Document type	Journal Article
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-024-05889-3
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Article ; Online: The effect of off-label use of reduced-dose direct oral anticoagulants therapy in the treatment of pulmonary embolism comparable to standard-dose therapy.

Yamazoe, Shinji / Imai, Hajime / Ogawa, Yasuhiro / Kano, Naoaki / Murase, Yosuke / Mamiya, Keita / Ikeda, Tomoyo / Hiramatsu, Kei / Torii, Jun / Kawaguchi, Katsuhiro

Heart and vessels

2024 Volume 39, Issue 4, Page(s) 365–372

Abstract: Direct oral anticoagulants (DOACs) have been shown to be effective and safe in preventing pulmonary embolism recurrence. In this single-center retrospective observational study, we aimed to evaluate the efficacy and safety of reduced-dose DOACs in 86 ... ...

Abstract	Direct oral anticoagulants (DOACs) have been shown to be effective and safe in preventing pulmonary embolism recurrence. In this single-center retrospective observational study, we aimed to evaluate the efficacy and safety of reduced-dose DOACs in 86 consecutive patients with acute pulmonary embolism. Patients were divided into standard-dose and reduced-dose DOACs groups. Initial clot volume did not significantly differ between the two groups (standard-dose DOACs vs. reduced-dose DOACs, 18.8 [Q1-Q3 7.3-30.8] mL vs. 10.0 [Q1-Q3 3.2-27.9] mL, p = 0.1). Follow-up computed tomography (CT) within 30 days showed a higher rate of clot volume reduction or disappearance in the standard-dose group compared to the reduced-dose group (standard-dose DOACs vs. reduced-dose DOACs, 81.6% vs. 53.9%, p = 0.02). However, at the final follow-up CT, there was no significant difference in clot volume change between the two groups (standard-dose DOACs vs. reduced-dose DOACs, 91.5% vs. 82.0%, p = 0.19). Major bleeding occurred in two patients in the standard-dose group (4.3%) and three patients in the reduced-dose DOACs group (7.7%) (p = 0.5). In conclusion, while standard-dose DOACs demonstrated superior efficacy in early clot reduction, reduced doses of apixaban and edoxaban showed comparable efficacy and safety profiles in long-term treatment of acute pulmonary embolism in certain patients.
MeSH term(s)	Humans ; Off-Label Use ; Anticoagulants ; Pulmonary Embolism/diagnosis ; Pulmonary Embolism/drug therapy ; Hemorrhage/chemically induced ; Retrospective Studies ; Administration, Oral ; Atrial Fibrillation/drug therapy ; Stroke/prevention & control
Chemical Substances	Anticoagulants
Language	English
Publishing date	2024-02-21
Publishing country	Japan
Document type	Observational Study ; Journal Article
ZDB-ID	89678-0
ISSN	1615-2573 ; 0910-8327 ; 0935-736X
ISSN (online)	1615-2573
ISSN	0910-8327 ; 0935-736X
DOI	10.1007/s00380-023-02339-5
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Article ; Online: Connectivity alteration in thalamic nuclei and default mode network-related area in memory processes in mesial temporal lobe epilepsy using magnetoencephalography.

Ishizaki, Tomotaka / Maesawa, Satoshi / Nakatsubo, Daisuke / Yamamoto, Hiroyuki / Torii, Jun / Mutoh, Manabu / Natsume, Jun / Hoshiyama, Minoru / Saito, Ryuta

Scientific reports

2023 Volume 13, Issue 1, Page(s) 10632

Abstract: This work aimed to investigate the involvement of the thalamic nuclei in mesial temporal lobe epilepsy (MTLE) and identify the influence of interictal epileptic discharges on the neural basis of memory processing by evaluating the functional connectivity ...

Abstract	This work aimed to investigate the involvement of the thalamic nuclei in mesial temporal lobe epilepsy (MTLE) and identify the influence of interictal epileptic discharges on the neural basis of memory processing by evaluating the functional connectivity (FC) between the thalamic nuclei and default mode network-related area (DMNRA) using magnetoencephalography. Preoperative datasets of nine patients with MTLE with seizure-free status after surgery and those of nine healthy controls were analyzed. The FC between the thalamic nuclei (anterior nucleus [ANT], mediodorsal nucleus [MD], intralaminar nuclei [IL]), hippocampus, and DMNRA was examined for each of the resting, pre-spike, spike, and post-spike periods in the delta to ripple bands using magnetoencephalography. The FC between the ANT, MD, hippocampus, and medial prefrontal cortex increased in the gamma to ripple bands, whereas the FC between the ANT, IL, and DMNRA decreased in the delta to beta bands, compared with that of the healthy controls at rest. Compared with the rest period, the pre-spike period had significantly decreased FC between the ANT, MD, and DMNRA in the ripple band. Different FC changes between the thalamic nuclei, hippocampus, and DMNRA of specific connections in a particular band may reflect impairment or compensation in the memory processes.
MeSH term(s)	Humans ; Epilepsy, Temporal Lobe/diagnostic imaging ; Magnetoencephalography ; Default Mode Network ; Thalamic Nuclei ; Memory
Language	English
Publishing date	2023-06-30
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-37834-2
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Article ; Online: Clinical Impacts of Stereotactic Electroencephalography on Epilepsy Surgery and Associated Issues in the Current Situation in Japan.

Maesawa, Satoshi / Ishizaki, Tomotaka / Mutoh, Manabu / Ito, Yoshiki / Torii, Jun / Tanei, Takafumi / Nakatsubo, Daisuke / Saito, Ryuta

Neurologia medico-chirurgica

2023 Volume 63, Issue 5, Page(s) 179–190

Abstract: Stereotactic electroencephalography (SEEG) is receiving increasing attention as a safe and effective technique in the invasive evaluation for epileptogenic zone (EZ) detection. The main clinical question is whether the use of SEEG truly improves outcomes. ...

Abstract	Stereotactic electroencephalography (SEEG) is receiving increasing attention as a safe and effective technique in the invasive evaluation for epileptogenic zone (EZ) detection. The main clinical question is whether the use of SEEG truly improves outcomes. Herein, we compared outcomes in our patients after three types of intracranial EEG (iEEG): SEEG, the subdural electrode (SDE), and a combined method using depth and strip electrodes. We present here our preliminary results from two demonstrative cases. Several international reports from large epilepsy centers found the following clinical advantages of SEEG: 1) three-dimensional analysis of structures, including bilateral and multilobar structures; 2) low rate of complications; 3) less pneumoencephalopathy and less patient burden during postoperative course, which allows the initiation of video-EEG monitoring immediately after implantation and does not require resection to be performed in the same hospitalization; and 4) a higher rate of good seizure control after resection. In other words, SEEG more accurately identified the EZ than the SDE method. We obtained similar results in our preliminary experiences under limited conditions. In Japan, as of August 2022, dedicated electrodes and SEEG accessories have not been approved and the use of the robot arm is not widespread. The Japanese medical community is hopeful that these issues will soon be resolved and that the experience with SEEG in Japan will align with that of large epilepsy centers internationally.
MeSH term(s)	Humans ; Stereotaxic Techniques ; Japan ; Electrodes, Implanted ; Epilepsy/diagnosis ; Epilepsy/surgery ; Electroencephalography/methods
Language	English
Publishing date	2023-03-31
Publishing country	Japan
Document type	Journal Article
ZDB-ID	604061-5
ISSN	1349-8029 ; 0470-8105
ISSN (online)	1349-8029
ISSN	0470-8105
DOI	10.2176/jns-nmc.2022-0271
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Article ; Online: Outcomes and Prognostic Factors of Magnetic Resonance-guided Focused Ultrasound Thalamotomy for Essential Tremor at 2-year Follow-up.

Hashida, Miki / Maesawa, Satoshi / Kato, Sachiko / Nakatsubo, Daisuke / Tsugawa, Takahiko / Torii, Jun / Tanei, Takafumi / Ishizaki, Tomotaka / Mutoh, Manabu / Ito, Yoshiki / Tsuboi, Takashi / Mizuno, Satomi / Suzuki, Masashi / Wakabayashi, Toshihiko / Katsuno, Masahisa / Saito, Ryuta

Neurologia medico-chirurgica

2024 Volume 64, Issue 4, Page(s) 137–146

Abstract: Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is an effective treatment for essential tremor (ET). However, its long-term outcomes and prognostic factors remain unclear. This study aimed to retrospectively investigate 38 patients with ...

Abstract	Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is an effective treatment for essential tremor (ET). However, its long-term outcomes and prognostic factors remain unclear. This study aimed to retrospectively investigate 38 patients with ET who underwent MRgFUS thalamotomy and were followed up for >2 years. The improvement in tremor was evaluated using the Clinical Rating Scale for Tremor (CRST). Adverse events were documented, and correlations with factors, such as skull density ratio (SDR), maximum mean temperature (T-max), and lesion size, were examined. Furthermore, the outcomes were compared between two groups, one that met the cutoff values, which was previously reported (preoperative CRST-B ≤ 25, T-max ≥ 52.5°C, anterior-posterior size of lesion ≥ 3.9 mm, superior-inferior [SI] size of lesion > 5.5 mm), and the other that did not. The improvement rate was 59.4% on average at the 2-year follow-up. Adverse events, such as numbness (15.8%), dysarthria (10.5%), and lower extremity weakness (2.6%), were observed even after 2 years, although these were mild. The factors correlated with tremor improvement were the T-max and SI size of the lesion (p < 0.05), whereas the SDR showed no significance. Patients who met the aforementioned cutoff values demonstrated a 69.8% improvement at the 2-year follow-up, whereas others showed a 43.6% improvement (p < 0.05). In conclusion, MRgFUS is effective even after 2 years. The higher the T-max and the larger the lesion size, the better the tremor control. Previously reported cutoff values clearly predict the 2-year prognosis, indicating the usefulness of MRgFUS.
MeSH term(s)	Humans ; Follow-Up Studies ; Essential Tremor/diagnostic imaging ; Essential Tremor/surgery ; Retrospective Studies ; Tremor ; Prognosis ; Thalamus/diagnostic imaging ; Thalamus/surgery ; Magnetic Resonance Imaging ; Treatment Outcome ; Magnetic Resonance Spectroscopy
Language	English
Publishing date	2024-02-15
Publishing country	Japan
Document type	Journal Article
ZDB-ID	604061-5
ISSN	1349-8029 ; 0470-8105
ISSN (online)	1349-8029
ISSN	0470-8105
DOI	10.2176/jns-nmc.2023-0202
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Article: Radiofrequency Ablation of Re-entrant Atrial Tachycardia Originating from the Superior Vena Cava with a High-resolution, 3-dimensional Mapping System.

Miyamae, Kiichi / Murase, Yosuke / Ogawa, Yasuhiro / Imai, Hajime / Kano, Naoaki / Mamiya, Keita / Ikeda, Tomoyo / Yamazoe, Shinji / Torii, Jun / Yamanaka, Kazuyuki / Kawaguchi, Katsuhiro

The Journal of innovations in cardiac rhythm management

2023 Volume 14, Issue 8, Page(s) 5546–5551

Abstract: An 80-year-old man with no previous history of catheter ablation or cardiac surgery underwent catheter ablation for atrial tachycardia (AT). We suspected that the mechanism causing AT was re-entry indicated by the entrainment phenomenon during AT and ... ...

Abstract	An 80-year-old man with no previous history of catheter ablation or cardiac surgery underwent catheter ablation for atrial tachycardia (AT). We suspected that the mechanism causing AT was re-entry indicated by the entrainment phenomenon during AT and through activation mapping with a 3-dimensional mapping system (EnSite™ X EP system; Abbott, Chicago, IL, USA). We used a multipolar catheter (Advisor™ HD Grid Mapping Catheter; Abbott) inserted into the superior vena cava (SVC) to accomplish activation mapping. The AT circuit was localized inside the SVC with a fractionated potential recorded on its right lateral wall. A similar fractionated potential was observed in the surrounding area. These areas functioned as the critical isthmus of the AT. Radiofrequency (RF) catheter ablation at these sites eliminated the tachycardia. After RF delivery, no tachycardia was induced by programmed stimulation, even during isoproterenol infusion. Consequently, there was no recurrence of tachycardia even after catheter ablation.
Language	English
Publishing date	2023-08-15
Publishing country	United States
Document type	Case Reports
ISSN	2156-3977
ISSN	2156-3977
DOI	10.19102/icrm.2023.14083
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Article: [A Case of Unilateral Multiple Cerebral Edema 4 Weeks after Coil Embolization].

Torii, Jun / Tanei, Takafumi / Naito, Takehiro / Katoh, Takenori / Ishii, Kazuki / Tsukamoto, Eisuke / Hasegawa, Toshinori

No shinkei geka. Neurological surgery

2020 Volume 48, Issue 2, Page(s) 123–130

Abstract: Coil embolization for cerebral aneurysms can lead to various complications, such as aneurysm rupture and cerebral embolism. In recent years, foreign substance embolisms-caused by peeling off of coating materials from therapeutic devices-have been ... ...

Abstract	Coil embolization for cerebral aneurysms can lead to various complications, such as aneurysm rupture and cerebral embolism. In recent years, foreign substance embolisms-caused by peeling off of coating materials from therapeutic devices-have been described. We report here a case of unilateral multiple cerebral edema four weeks after coil embolization. A 44-year-old woman presented with a subarachnoid hemorrhage from a right internal carotid-posterior communicating artery aneurysm, for which coil embolization was performed. Four weeks after the embolization, she developed numbness in the left side of her mouth and in her left upper extremity. Magnetic resonance images showed multiple edematous lesions in the right cerebral hemisphere. Subsequent treatment with steroids improved her symptoms and edematous cerebral lesions. Although definitive diagnosis by biopsy was not performed, her clinical course and imaging findings resembled a foreign substance embolism by hydrophilic coating. It is important to note that delayed cerebral edema due to foreign substance embolisms might occur after endovascular treatments.
MeSH term(s)	Adult ; Aneurysm, Ruptured/therapy ; Brain Edema/etiology ; Embolization, Therapeutic/adverse effects ; Female ; Humans ; Intracranial Aneurysm/therapy ; Subarachnoid Hemorrhage/therapy
Language	Japanese
Publishing date	2020-02-17
Publishing country	Japan
Document type	Case Reports ; Journal Article
ZDB-ID	197053-7
ISSN	1882-1251 ; 0301-2603
ISSN (online)	1882-1251
ISSN	0301-2603
DOI	10.11477/mf.1436204148
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Zs.B 1834: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 268: Show issues

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Article ; Online: Histopathological characteristics of the arrhythmogenic right ventricular cardiomyopathy presenting the electrocardiographic characteristics with Brugada syndrome.

Murase, Yosuke / Igawa, Osamu / Imai, Hajime / Ogawa, Yasuhiro / Kano, Naoaki / Mamiya, Keita / Ikeda, Tomoyo / Miyamae, Kiichi / Yamazoe, Shinji / Torii, Jun / Yamanaka, Kazuyuki / Kato, Toshimasa / Kawaguchi, Kenta / Kawaguchi, Katsuhiro

Journal of cardiovascular electrophysiology

2023 Volume 34, Issue 9, Page(s) 2006–2009

Abstract: Introduction: The histopathological characteristics of the overlapping disease states of Brugada syndrome (BrS) and arrhythmogenic right ventricular cardiomyopathy (ARVC) have not been fully elucidated.: Methods: A 71-year-old man showed coved-type ... ...

Abstract	Introduction: The histopathological characteristics of the overlapping disease states of Brugada syndrome (BrS) and arrhythmogenic right ventricular cardiomyopathy (ARVC) have not been fully elucidated. Methods: A 71-year-old man showed coved-type ST-segment elevation with the right precordial leads, and the echocardiography demonstrated right ventricular (RV) dilatation. After 11 months, he died of a polymorphic VT storm. Results: The pathological tissue demonstrated fibrofatty degeneration in the free wall of the RV outflow tract based on the heart autopsy. Conclusion: The overlapping disease states of BrS and ARVC showed histopathological characteristics consistent with ARVC.
MeSH term(s)	Male ; Humans ; Aged ; Brugada Syndrome/diagnosis ; Arrhythmogenic Right Ventricular Dysplasia/diagnosis ; Electrocardiography ; Arrhythmias, Cardiac ; Heart Ventricles ; Cardiomegaly ; Tachycardia, Ventricular
Language	English
Publishing date	2023-08-09
Publishing country	United States
Document type	Case Reports
ZDB-ID	1025989-2
ISSN	1540-8167 ; 1045-3873
ISSN (online)	1540-8167
ISSN	1045-3873
DOI	10.1111/jce.16037
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Article: [Magnetic Resonance-guided Focused Ultrasound Ablation:Techniques and Neurological Applications].

Maesawa, Satoshi / Nakatsubo, Daisuke / Tsugawa, Takahiko / Kato, Sachiko / Shibata, Masashi / Takai, Sou / Torii, Jun / Wakabayashi, Toshihiko / Saito, Ryuta

No shinkei geka. Neurological surgery

2021 Volume 49, Issue 4, Page(s) 847–856

Abstract: Magnetic resonance(MR)-guided focused ultrasound ablation(FUS)is a minimally invasive technique for targeted tissue thermo-ablation and is promising for neuromodulation in various neurological disorders. The effectiveness and safety of this technique ... ...

Abstract	Magnetic resonance(MR)-guided focused ultrasound ablation(FUS)is a minimally invasive technique for targeted tissue thermo-ablation and is promising for neuromodulation in various neurological disorders. The effectiveness and safety of this technique have been recognized worldwide. In Japan, the applications of FUS for the treatment of essential tremors and Parkinson's disease have recently been covered under health insurance. The FUS system is composed of a phased-array transducer with 1024 elements, with a beam of ultrasound emerging from each element. The phase and amplitude of the beam are computed and controlled to focus on the target with the calculation of computed tomography(CT)profiles, resulting in optimal thermo-ablation. To utilize FUS safely and effectively, a deep understanding of the physics of this technology is necessary. Furthermore, the technique should be compared with other options including deep brain stimulation(DBS)and radiofrequency thermo-ablation. Although FUS has received attention because of minimally invasive characteristics and a possibility of procedural target refinement, DBS has some advantages on bilateral implantation, a potential of postoperative adjustment, and control of head/leg tremors. In this article, we first reviewed the physics of FUS and demonstrated the typical treatment protocols. Second, we reviewed the outcomes from the existing literature, and revealed the advantages and disadvantages of this procedure, with the evaluation of the optimal condition for FUS.
MeSH term(s)	High-Intensity Focused Ultrasound Ablation ; Humans ; Japan ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Parkinson Disease
Language	Japanese
Publishing date	2021-08-10
Publishing country	Japan
Document type	Journal Article ; Review
ZDB-ID	197053-7
ISSN	1882-1251 ; 0301-2603
ISSN (online)	1882-1251
ISSN	0301-2603
DOI	10.11477/mf.1436204463
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Article ; Online: Multitier Network Analysis Using Resting-state Functional MRI for Epilepsy Surgery.

Maesawa, Satoshi / Bagarinao, Epifanio / Nakatsubo, Daisuke / Ishizaki, Tomotaka / Takai, Sou / Torii, Jun / Kato, Sachiko / Shibata, Masashi / Wakabayashi, Toshihiko / Saito, Ryuta

Neurologia medico-chirurgica

2021 Volume 62, Issue 1, Page(s) 45–55

Abstract: Resting-state functional MRI (rs-fMRI) has been utilized to visualize large-scale brain networks. We evaluated the usefulness of multitier network analysis using rs-fMRI in patients with focal epilepsy. Structural and rs-fMRI data were retrospectively ... ...

Abstract	Resting-state functional MRI (rs-fMRI) has been utilized to visualize large-scale brain networks. We evaluated the usefulness of multitier network analysis using rs-fMRI in patients with focal epilepsy. Structural and rs-fMRI data were retrospectively evaluated in 20 cases with medically refractory focal epilepsy, who subsequently underwent surgery. First, structural changes were examined using voxel-based morphometry analysis. Second, alterations in large-scale networks were evaluated using dual-regression analysis. Third, changes in cortical hubs were analyzed and the relationship between aberrant hubs and the epileptogenic zone (EZ) was evaluated. Finally, the relationship between the hubs and the default mode network (DMN) was examined using spectral dynamic causal modeling (spDCM). Dual-regression analysis revealed significant decrease in functional connectivity in several networks including DMN in patients, although no structural difference was seen between groups. Aberrant cortical hubs were observed in and around the EZ (EZ hubs) in 85% of the patients, and a strong degree of EZ hubs correlated to good seizure outcomes postoperatively. In spDCM analysis, facilitation was often seen from the EZ hub to the contralateral side, while inhibition was seen from the EZ hub to nodes of the DMN. Some cognition-related networks were impaired in patients with focal epilepsy. The EZ hub appeared in the vicinity of EZ facilitating connections to distant regions in the early phase, which may eventually generate secondary focus, while inhibiting connections to the DMN, which may cause cognitive deterioration. Our results demonstrate pathological network alterations in epilepsy and suggest that earlier surgical intervention may be more effective.
MeSH term(s)	Brain/diagnostic imaging ; Brain/surgery ; Brain Mapping ; Drug Resistant Epilepsy/diagnostic imaging ; Drug Resistant Epilepsy/surgery ; Epilepsy/diagnostic imaging ; Epilepsy/surgery ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies
Language	English
Publishing date	2021-11-10
Publishing country	Japan
Document type	Journal Article
ZDB-ID	604061-5
ISSN	1349-8029 ; 0470-8105
ISSN (online)	1349-8029
ISSN	0470-8105
DOI	10.2176/nmc.oa.2021-0173
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