YOSHIOKA Hiromasa

    Department of Medicine Lecturer in Medical School
Last Updated :2024/03/24

Researcher Information

J-Global ID

Research Areas

  • Life sciences / Neurosurgery

Academic & Professional Experience

  • 2017/11 - Today  近畿大学病院脳神経外科
  • 2016/04 - 2017/10  近畿大学医学部堺病院脳神経外科
  • 2015/04 - 2016/03  近畿大学医学部附属病院脳神経外科
  • 2014/04 - 2015/03  医療法人讃和会 友愛会病院脳神経外科
  • 2011/04 - 2014/03  近畿大学医学附属病院脳神経外科

Association Memberships

  • 日本脳腫瘍学会   日本老年脳神経外科学会   日本旅行医学会   日本神経内視鏡学会   日本認知症学会   日本正常圧水頭症学会   日本中性子捕捉療法学会   日本脳卒中学会   日本脳神経外科学会   

Published Papers

  • Hiromasa Yoshioka; Takeshi Okuda; Takayuki Nakao; Mitsugu Fujita; Jun C Takahashi
    Anticancer research 42 (8) 4173 - 4178 2022/08 
    BACKGROUND/AIM: Standard treatment options for primary central nervous system lymphoma (PCNSL) include high-dose methotrexate (HD-MTX)-based drug therapy and whole-brain radiation therapy. However, there are many cases in which these standard treatment options are not tolerated for various reasons. In the present study, five cases of refractory/relapsed PCNSL that are difficult to treat with standard treatment were successfully treated by tirabrutinib. PATIENTS AND METHODS: A total of 5 patients (4 women, 1 man) with refractory (n=3) and relapsed (n=2) PCNSL were included. The patients had a median age of 76 years and a median Karnofsky performance status (KPS) of 40. The reasons why standard treatment cannot be given to these patients are the low KPS, renal dysfunction, and resistance to HD-MTX. Administration of a drug via the oral route was challenging in three patients; thus, these patients were administered tirabrutinib in suspension through a nasogastric tube. RESULTS: Imaging findings showed that the patients achieved a 100% response rate to tirabrutinib, with a median survival of 8 months. As symptoms improved, 2 of the 3 patients who were initially administered tirabrutinib via a nasogastric tube were able to receive the drug via the oral route. Three patients developed adverse reactions; however, treatment was not interrupted because they were manageable. CONCLUSION: Tirabrutinib was effective in the treatment of patients who were unable to receive standard treatment options. Tirabrutinib may be considered one of the novel treatment strategies that could improve the prognosis of PCNSL patients in the future.
  • Fukawa Norihito; Nakagawa Nobuhiro; Tsuji Kiyoshi; Yoshioka Hiromasa; Furukawa Kentaro; Nagatsuka Kazuhiro; Kubota Hisashi; Nakano Naoki; Takahashi Jun C.
    JNET: Journal of Neuroendovascular Therapy (NPO)日本脳神経血管内治療学会 16 (2) 127 - 134 1882-4072 2022/02 
    「目的」direct carotid-cavernous fistula(direct CCF)に対する経動脈的塞栓術(TAE)の残存シャントには、経静脈的塞栓術(TVE)の併用が少なからず行われる。我々のTVEによる追加塞栓について報告する。「症例」direct CCF連続5例。原因:動脈瘤2例、頭部外傷3例。TAEで治療を開始し、シャントが残存する場合は、TVEを追加した。TVEは、海綿静脈洞から動脈瘤あるいはfistulaを通過し、内頸動脈に留置させたmicrocatheterを引き戻してTAEのコイル塊に留置し(pull-back法)、コイルを追加充填した。2例は、TAEのみでシャントが消失、残り3例は、残存シャントに対してpull-back法で追加塞栓を行い、シャントが消失した。全例で、症状は改善し、合併症はなかった。「結論」pull-back法を用いたTVE併用療法は、残存シャントに対して効率的な追加塞栓が可能である。(著者抄録)
  • 高齢発症てんかんに対する調査票を用いたスクリーニング効果の検証
    吉岡 宏真; 奥田 武司; 中岡 良介; 藤田 貢; 高橋 淳
    Geriatric Neurosurgery 日本老年脳神経外科学会 35 59 - 63 1343-4233 2022
  • Hiromasa Yoshioka; Takeshi Okuda; Takayuki Nakao; Mitsugu Fujita; Jun C Takahashi
    International cancer conference journal 10 (4) 290 - 293 2021/10 
    We report that tirabrutinib was administered via nasogastric tubes to treat an elderly patient with primary central nervous system lymphoma (PCNSL). The patient was a 76-year-old woman who underwent endoscopic biopsy of multiple intracerebral masses, which resulted in the diagnosis of diffuse large B-cell lymphoma. The patient was diagnosed with PCNSL and was started on an induction regimen of systemic chemotherapy with rituximab in combination with high-dose methotrexate. However, after the second cycle of chemotherapy, the tumor grew rapidly, and the patient went into a coma. As a result, the treatment was changed to nasogastric tube administration of tirabrutinib suspension. After 1 week of tirabrutinib administration, the patient's level of consciousness improved, and furthermore, after 2 weeks of tirabrutinib administration, the patient was able to take tirabrutinib orally. Although oral administration is the standard route of administration for tirabrutinib, this case study showed that the nasogastric tube administration of tirabrutinib suspension is a therapeutic option for patients with impaired consciousness or dysphagia.
  • Hiromasa Yoshioka; Takeshi Okuda; Takayuki Nakao; Mitsugu Fujita; Jun C Takahashi
    Anticancer research 41 (8) 4169 - 4172 2021/08 
    BACKGROUND/AIM: Leptomeningeal carcinomatosis (LMC) with hydrocephalus is particularly difficult to treat, and its prognosis is extremely poor. The therapeutic outcomes of 14 patients with LMC-associated hydrocephalus who were treated with cerebrospinal fluid shunting are reported. PATIENTS AND METHODS: The study subjects were 14 LMC patients with solid primary cancer who had developed hydrocephalus. RESULTS: Postoperatively, both symptoms and Karnofsky performance status improved in 100% of patients. Postoperative therapy consisted of whole-brain radiotherapy in 4 cases and molecular targeted therapy in 4, with 6 patients not receiving any postoperative treatment. Median overall survival was 3.7 months, with no significant difference between those who underwent postoperative therapy and those who did not. However, two of those who received molecular targeted therapy survived for more than one year. CONCLUSION: Cerebrospinal fluid shunting for LMC-associated hydrocephalus is an effective therapeutic procedure from the palliative viewpoint. Patients for whom molecular targeted therapy is indicated may have better long-term survival.
  • Takayuki Nakao; Takeshi Okuda; Hiromasa Yoshioka; Mitsugu Fujita
    Anticancer research 40 (8) 4801 - 4804 2020/08 
    BACKGROUND/AIM: Recent advances in systemic chemotherapy, including molecularly targeted therapy, have dramatically improved survival for patients with advanced non-small cell lung cancer. We retrospectively analyzed the clinical outcomes of surgical resection for brain metastases of non-small cell lung cancer cases performed at the Department of Neurosurgery of Kindai University Hospital, Osaka, Japan. PATIENTS AND METHODS: Craniotomy and tumor resection were performed for 56 patients with brain metastases of non-small cell lung cancer. Adenocarcinoma was the most common histological type, appearing in 40 cases, of which 18 were positive for driver gene mutations. RESULTS: Median survival for all 56 patients was 14.5 months, and single brain metastasis and adenocarcinoma were identified as favorable prognostic factors. Analysis limited to the 40 cases of adenocarcinoma identified single brain metastasis as a favorable prognostic factor. Although no significant difference was found for systemic chemotherapy, patients who received molecularly targeted therapy showed a better prognosis than those who received cytotoxic chemotherapy. Analyses of both the entire group and of adenocarcinoma patients alone found that whole-brain radiotherapy showed no significant association with survival. CONCLUSION: Single brain metastasis and adenocarcinoma were identified as favorable prognostic factors, but did not confirm any benefit from whole-brain radiotherapy. These results suggest that multimodal treatment strategies utilizing various methods of treatment, including systemic chemotherapy, may help prolong patient survival in the future.
  • 内山 卓也; 吉岡 宏真; 布川 知史; 加藤 天美
    脳神経外科ジャーナル 日本脳神経外科コングレス 26 (12) 882 - 891 0917-950X 2017/12 
    痙縮は脳卒中・頭部外傷などの中枢神経障害に伴う筋緊張亢進を主体とし、脳神経外科医が日常診療でしばしば遭遇する神経症状である。日本での痙縮の正確な有病率はわかっていないが、海外の報告では、脳卒中の35%以上、重度の頭部外傷の75%の患者が痙縮を呈すると報告されている。日本の脳卒中患者は2014年の調査では約118万人と報告されており、痙縮患者だけでも41万人以上いることとなる。また脳卒中後以外の原因に基づく重度痙縮症例も8万人以上いると推計されている。現在までボツリヌス療法は約5万症例、ITB療法は約1,700症例にとどまっており、これらの治療の恩恵を受けている患者はまだ少ないと考える。痙縮治療を発展させるためには、痙縮に対する治療法の特徴を知り、患者および患者家族、メディカルスタッフを含めた痙縮治療教育とリハビリテーションを中心とした地域連携の体制作りが重要である。(著者抄録)
  • Takeshi Okuda; Takayuki Tasaki; Susumu Nakata; Kimihiro Yamashita; Hiromasa Yoshioka; Shuichi Izumoto; Amami Kato; Mitsugu Fujita
    Anticancer research 37 (7) 3871 - 3876 2017/07 
    BACKGROUND: Glioblastoma multiforme (GBM) is a malignant brain tumor with an extremely poor prognosis. GBM tissues frequently express mesenchymal-epithelial transition factor (MET), which induces cell division, growth and migration. In addition, angiogenesis is a significant feature of GBM, attributable to the overexpression of vascular endothelial growth factor (VEGF). Although the VEGF inhibitor bevacizumab was recently highlighted as the second-line drug for GBM treatment, GBMs often recur even with bevacizumab therapy. Based on these findings, we hypothesized that inhibition of both MET and VEGF would exhibit a synergistic effect on MET-overexpressing GBM. MATERIALS AND METHODS: As we observed MET expression at high levels in some patients with GBM, we designed GL261 murine glioma-based experiments. GL261 cells were transfected with siRNAs specific for MET and VEGF in vitro, and the cell growth ratios were evaluated. Simultaneously, transfected GL261 cells were transplanted into the brain of C57BL/6 mice, and their survival was monitored. RESULTS: GBM tissues frequently overexpressed MET protein at high levels compared with lower-grade gliomas. These GBMs at first responded to bevacizumab, but often eventually recurred. When GL261 cells were co-transfected with both MET-specific siRNA and VEGF-specific siRNA, the in vitro tumor cell growth significantly decelerated compared to single siRNA transfection. Consistently, when mice were transplanted with co-transfected GL261 cells, their survival was significantly prolonged compared to those given cells transfected with single siRNA. CONCLUSION: The current data indicate that the inhibition of both MET and VEGF exhibits efficient therapeutic effects of GBM-bearing hosts.
  • Hisashi Kubota; Yasuhiro Sanada; Kazuhiro Nagatsuka; Hiromasa Yoshioka; Michihiro Iwakura; Amami Kato
    Surgical Neurology International Medknow Publications 7 (15) S427 - S429 2152-7806 2016/11 [Refereed]
     
    Background: Sylvian dissection is an essential microneurosurgical skill for neurosurgeons. The safe and accurate opening of the sylvian fissure is desirable for a good prognosis. Methods: The aim of this report is to demonstrate the use of indocyanine green (ICG) videoangiography to recognize the superficial sylvian vein (SSV) and thus enable a wide opening of the sylvian fissure, especially in patients with subarachnoid hemorrhage (SAH). Results: The small tributary flowing into the SSV was distinguishable from a passing one, which deeply entered the insula. In addition, an entering point of a tributary to the SSV, which ran perpendicular to the insula, was occasionally determined. SSV, which was barely discernable in a reddish SAH involving the sylvian fissure, was clearly demarcated using ICG videoangiography. Two representative cases of sylvian dissection are herein presented. Conclusion: The performance of ICG videoangiography before sylvian dissection is a simple and useful method for identifying a vital approach route for safe and accurate sylvian dissection, and it reduces the risk of causing any accidental injury to the veins in the sylvian fissure.
  • Takayuki Tasaki; Mitsugu Fujita; Takeshi Okuda; Azusa Yoneshige; Susumu Nakata; Kimihiro Yamashita; Hiromasa Yoshioka; Shuichi Izumoto; Amami Kato
    Anticancer research 36 (7) 3571 - 7 2016/07 
    BACKGROUND: Glioblastoma multiforme (GBM) is the most frequent and the most malignant tumor among adult brain tumors. Previous reports led us to hypothesize that the proto-oncogene mesenchymal-epithelial transition (MET) expressed in glioma stem cell-like cells (GSCs) would be a potent therapeutic target for GBM. PATIENTS AND METHODS: To address this question, we analyzed 113 original samples of tumors from patients based on immunohistochemistry. During this process, we were able to establish GSC lines from patients with GBM that were MET-positive and MET-negative. Using these cells, we tested the therapeutic impact of a MET inhibitor, crizotinib, both in vitro and in vivo. RESULTS: Patients with MET-positive GBM exhibited poor survival. GSC-based experiments revealed that treatment with crizotinib, both in vitro and in vivo, exhibited therapeutic efficacy particularly against MET-positive GSCs. CONCLUSION: Based on these findings, we conclude that MET expressed in GSCs might be a potent therapeutic target for GBM.
  • Hisashi Kubota; Yasuhiro Sanada; Kazuhiro Nagatsuka; Hiromasa Yoshioka; Michihiro Iwakura; Amami Kato
    Surgical neurology international 7 (Suppl 14) S427-9  2016 
    BACKGROUND: Sylvian dissection is an essential microneurosurgical skill for neurosurgeons. The safe and accurate opening of the sylvian fissure is desirable for a good prognosis. METHODS: The aim of this report is to demonstrate the use of indocyanine green (ICG) videoangiography to recognize the superficial sylvian vein (SSV) and thus enable a wide opening of the sylvian fissure, especially in patients with subarachnoid hemorrhage (SAH). RESULTS: The small tributary flowing into the SSV was distinguishable from a passing one, which deeply entered the insula. In addition, an entering point of a tributary to the SSV, which ran perpendicular to the insula, was occasionally determined. SSV, which was barely discernable in a reddish SAH involving the sylvian fissure, was clearly demarcated using ICG videoangiography. Two representative cases of sylvian dissection are herein presented. CONCLUSION: The performance of ICG videoangiography before sylvian dissection is a simple and useful method for identifying a vital approach route for safe and accurate sylvian dissection, and it reduces the risk of causing any accidental injury to the veins in the sylvian fissure.
  • 田崎 貴之; 奥田 武司; 岡本 邦男; 吉岡 宏真; 藤田 貢; 泉本 修一; 中川 和彦; 加藤 天美
    脳神経外科ジャーナル 日本脳神経外科コングレス 24 (3) 192 - 198 0917-950X 2015/03 
    62歳、男性。右側頭葉膠芽腫にて開頭腫瘍摘出術施行。肉眼的全摘出後にテモゾロミドを併用した放射線化学療法を追加した。以後はテモゾロミド単独の維持化学療法を行った。術後17ヵ月で摘出腔内側に再発を認め、その後、大量胸水にて緊急入院となった。胸部CTにて胸膜に多発する腫瘤を認め、生検による病理診断の結果、膠芽腫の胸膜への血行性転移と判明した。(著者抄録)
  • Takayuki Tasaki; Takeshi Okuda; Kunio Okamoto; Hiromasa Yoshioka; Mitsugu Fujita; Shuichi Izumoto; Kazuhiko Nakagawa; Amami Kato
    Japanese Journal of Neurosurgery Japanese Congress of Neurological Surgeons 24 (3) 192 - 197 0917-950X 2015 [Refereed]
     
    Glioblastoma multiforme (GBM) often infiltrates surrounding tissues, an action which is known as a clinical characteristic of this deadly disease. In contrast, extracranial metastases of GBM rarely occur. Consequently, the underlying mechanisms and prognosis of GBM metastasis remain unclear. In this regard, we here present a case of GBM with pleural metastases and discuss the relevant literature. The patient was a 62-year-old male who was originally diagnosed with GBM in the right temporal lobe and underwent craniotomy for tumor removal. Gross total resection was successfully performed. The patient received postoperative chemoradiotherapy with temozolomide, followed by maintenance chemotherapy with temozolomide alone. He showed a good postoperative course until a small recurrence occurred in the resection cavity at 17 months after the surgery. At 21 months, the patient developed thoracodorsal pain due to a large volume of pleural effusion with pleural masses. An intrathoracic biopsy revealed that the pleural lesions were metastases of the GBM. Simultaneously, intracranial imaging studies indicated tumor spread into the right cavernous sinus. These findings suggest that the GBM may have infiltrated into the cavernous sinus via the dura surrounding the cavernous sinus adjacent to the resection cavity and metastasized hematogenously to the pleural cavity
  • Hisashi Kubota; Yasuhiro Sanada; Hiromasa Yoshioka; Takayuki Tasaki; Jun Shiroma; Masaharu Miyauchi; Rokuya Tanikawa; Mitsuru Matsuki; Toshiho Ohtsuki; Amami Kato
    Acta neurochirurgica 157 (1) 43 - 8 2015/01 
    BACKGROUND: The preoperative imaging diagnosis of the distal portion of the internal carotid artery (ICA) is extremely important for carotid endarterectomy (CEA). Herein the authors defined a line from the C1 transverse process to the hyoid bone (C1-H line) and evaluated whether the line can be used to predict an accessible ICA in CEA. METHODS: A cross point between the C1-H line and distal ICA was analyzed using three-dimensional computerized tomographic angiography (3D-CTA) in 20 patients. The C1-H line was compared to the line drawn from the mastoid process to the mandible (M-M line). Intraoperative exposure of the distal ICA was evaluated using both lines. Furthermore, the distance of each line from the C2 vertebra was measured to identify the distance difference of each line in relation to the cervical posture. RESULTS: A distal ICA exposed at a cross point of the C1-H line corresponded well with the intraoperative findings. The cross point between the C1-H line and distal ICA was positioned at an average of 7.0 ± 0.7 mm cranially in comparison to the M-M line. The C1-H line showed smaller distance differences at different cervical positions than the M-M line. The C1-H line moved an average of 2.8 ± 2.5 mm from a cervical neutral position to an extensional one in the perpendicular direction. CONCLUSION: The C1-H line measured by 3D-CTA is a simple and useful indicator of the distal ICA exposure in the preoperative diagnosis for CEA.
  • Yasuhiro Sanada; Tomonari Yabuuchi; Hiromasa Yoshioka; Hisashi Kubota; Amami Kato
    Neurologia medico-chirurgica 55 (3) 210 - 3 2015 
    Moyamoya disease is commonly diagnosed in children, and requires various vascular reconstruction to improve symptoms. Therefore, scar widening and hair loss after craniotomy, which sometimes occurs in this disease, are serious problems for patients. A variety of plastic surgical techniques in scalp have been reported to minimize the scar widening and hair loss. However, any neurosurgical reports describing this purpose have never been published for moyamoya disease. The objective of this study was to investigate whether these plastic surgical techniques could be applied to bypass surgery without any compromise of vascular reconstruction for moyamoya disease. We performed direct and indirect vascular reconstruction in six hemispheres of moyamoya disease patients not only in the middle cerebral artery territory but also in the anterior cerebral artery territory. The scalp incision was designed not parallel to the hair stream, and the bevelled incision was conducted not to jeopardize the hair follicles. The scar and hair loss were effectively camouflaged throughout the postoperative period in all cases. This study demonstrates that our design of scalp incision achieve effective vascular reconstruction and obscure the scar and hair loss.
  • Yoshioka Hiromasa; Okuda Takeshi; Fujita Mitsugu; Inoue Takao; Tasaki Takayuki; Izumoto Shuichi; Kato Amami
    Acta Medica Kinki University 近畿大学医学会 39 (2) 105 - 113 0386-6092 2014/12 
    神経膠腫幹細胞様細胞(GSC)は多剤耐性を示すアデノシン三リン酸結合カセット(ABC)ファミリートランスポーターのメンバーを過剰に発現することが知られている。ヒトにおけるGSCは神経膠芽腫(GBM)発症に重要な役割を果たす。Sleeping Beautyトランスポゾン媒介自発性GBMからマウスGSC株を派生させた。これら細胞株を用いて、GSC動態におけるABCトランスポーターの重要性を細胞形態学的アッセイ、フローサイトメトリー、RT-PCRによるmRNA発現の定量により調べた。siRNAを介するABCG2阻害はGSCのテモゾロミド(TMZ)に対する感受性を増強し、スフェロイド形成能を低下させた。Abcg2特異的siRNAでGSCを処理するとTMZに感受性になり、そのスフェロイド形成能が低下した。GSCの薬物トランスポーターを標的とする治療はGSCの化学感受性を増強し、GBMの長期にわたる寛解達成に有望な戦略であることが示唆された。
  • Takeshi Okuda; Juli Yamashita; Mitsugu Fujita; Hiromasa Yoshioka; Takayuki Tasaki; Amami Kato
    Acta neurochirurgica 156 (7) 1403 - 7 2014/07 
    BACKGROUND: We verified the effectiveness of training in endoscopic endonasal transsphenoidal surgery (eETSS) techniques using chicken eggs and a skull model. METHODS: We verified the area of eggshell removed by drilling when five residents and four experts used the chicken eggs and a skull model. RESULTS: When residents performed drilling on 10 eggs, a mean (± standard deviation [SD]) area of 31.2 ± 17.5 mm2 was removed from the first egg, and 104.8 ± 3.3 mm2 from the tenth and final egg, representing an increase in area and a decrease in SD. The experts performed the same drilling operation on a single egg, and removed a mean area of 257± 31.7 mm2. These results demonstrated that skills improved as a result of this training, and suggested that this method was also capable of overcoming the initial individual differences in the amount of force applied and ability. An obvious difference between residents and experts was seen in the area removed (p = 0.00011); however, this was attributed to differences in endoscopic manipulation, rather than drilling skill. CONCLUSION: Our findings suggest that this training method could be adequate for acquiring eETSS techniques. Although experts showed superior endoscopic manipulation, residents may also be able to acquire adequate endoscopic skills through further training, and our training method appears to offer an effective means of improving eETSS techniques.
  • Takeshi Okuda; Hidetoshi Hayashi; Mitsugu Fujita; Hiromasa Yoshioka; Takayuki Tasaki; Kazuhiko Nakagawa; Amami Kato
    Metallography, Microstructure, and Analysis Springer New York LLC 3 (4) 211 - 214 2192-9270 2014 [Refereed]
     
    Meningeal carcinomatosis (MC) is a refractory disease with a dismal prognosis, and no therapeutic strategy has been established to date. Herein we report a case of lung adenocarcinoma-derived MC in which the patient’s performance status was dramatically improved by administration of gefitinib suspension via a nasogastric tube. The patient was a 71-year-old woman who was originally admitted to our hospital for a progressive headache and subsequently presented with severe consciousness disturbance. Cerebrospinal fluid examination and systemic imaging studies revealed MC that was derived from lung adenocarcinoma. Moreover, epidermal growth factor receptor (EGFR) mutations were detected in the tumor cells. Since the patient suffered from hydrocephalus, a ventriculoperitoneal shunt was placed. Nevertheless, her consciousness disturbance persisted. Subsequently, gefitinib suspension was prepared and administered via nasogastric tube, which dramatically improved her consciousness level and enabled her to tolerate oral intake. She died 14 months after the disease onset. The observations in this case report suggest that gefitinib might be a therapeutic option for patients with MC derived from cancers harboring EGFR mutations even though the patient exhibited severe consciousness disturbance.
  • Takeshi Okuda; Mitsugu Fujita; Hiromasa Yoshioka; Takayuki Tasaki; Amami Kato
    Surgical neurology international 5 100 - 100 2014 
    BACKGROUND: An outstanding issue regarding the surgical treatment of cyst-type metastatic brain tumors is the incomplete resection of cyst walls. Herein we propose a novel surgical technique that can overcome this issue. During a surgical procedure for cystic tumors, autologous fibrin glue is to be injected into the tumor cysts, which solidifies the cyst lumens and cyst walls en bloc with reducing the tumor size. As a result, tumor masses and cyst walls can be removed completely in an en bloc fashion in all cases. METHODS: The illustrative case presented in this report is a patient with metastatic brain tumors in the frontal lobe. When we reached the tumor wall surgically, we first suctioned out the cyst content and subsequently injected autologous fibrin glue into the cyst lumen. The autologous fibrin glue solidified the tumor en bloc, and we resected the tumor mass and the cyst walls in an en bloc fashion. RESULTS: We have applied this technique to four cases with cyst-type metastatic brain tumors. This approach made it possible to perform ideal en bloc resection in all cases. There were no adverse events due to the autologous fibrin glue. CONCLUSION: We developed a novel surgical technique to solidify cyst-type metastatic brain tumors using autologous fibrin glue, which allows en bloc resection of tumor masses and cyst walls quite safely using inexpensive materials. Given these advantages, it appears a promising surgical strategy for cyst-type metastatic brain tumors.
  • Takeshi Okuda; Hiromasa Yoshioka; Amami Kato
    Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 19 (12) 1719 - 22 2012/12 
    We have developed a technique of fluorescence-guided surgery using high-dose fluorescein sodium (20mg/kg) with excitation and barrier filters for glioblastoma multiforme surgery. This technique was used in 10 patients, with surgery proceeding as expected in all patients. There were no complications or permanent side effects. This method uses filters to help distinguish between the usually invisible tumor and the brain surface, as well as allowing a detailed assessment of the positional relationships with tumor vessels and the surrounding normal vessels. As sufficient yellow staining was present even without filters, delicate microsurgery was also possible under a normal white-light microscope. Both environments could be used as necessary during surgery according to the requirements of resection, thereby improving the reliability and safety of surgery.
  • Takuya Uchiyama; Kinya Nakanishi; Norihito Fukawa; Hiromasa Yoshioka; Saori Murakami; Naoki Nakano; Amami Kato
    Neurologia medico-chirurgica 52 (7) 463 - 9 2012 
    Intrathecal baclofen (ITB) therapy is a treatment for intractable spasticity due to a variety of causes. Continuous intrathecal administration of baclofen, an agonist of the inhibitory neurotransmitter γ-aminobutyric acid, inhibits excitation of motor neurons at the spinal level and thus suppresses spasticity. This therapy was introduced clinically in the Europe and the United States in the 1990s, and was finally approved by the Japanese Ministry of Health, Labour and Welfare in Japan in 2005. Clinical use has been permitted since 2006, and reports of therapeutic efficacy are now appearing in Japan. ITB therapy is a non-destructive treatment that enables administration of baclofen from an implantable pump under the control of a programmer, and represents an outstanding treatment method offering both reversibility and adjustability. Indications for ITB therapy have been expanding in recent years to include not only spasticity, but also various causes dystonia. And ITB therapy can greatly improve activities of daily living and quality of life, and this treatment is attracting attention as a neuromodulatory therapy that also affects metabolic and respiratory functions and even state of consciousness. We here report the surgical methods and therapeutic outcomes for 22 patients who underwent ITB therapy for spastic and dystonic patients in our hospital, together with an investigation of the effects on metabolic and respiratory functions.
  • 今野 元博; 安田 卓司; 今本 治彦; 新海 政幸; 彭 英峰; 安田 篤; 白石 治; 岩間 密; 中森 康浩; 加藤 寛章; 荒木 麻利子; 村瀬 貴昭; 吉岡 宏真; 塩崎 均
    日本外科学会雑誌 (一社)日本外科学会 111 (臨増2) 186 - 186 0301-4894 2010/03

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