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Carotid artery stenting (CAS) is performed as a treatment for carotid artery stenosis. However, lipid-rich plaques cause embolic complications and sequelae. Near-infrared spectroscopy (NIRS) can identify lipid components by applying a near-infrared absorption pattern, and the distribution of lipid components can be evaluated as the maximum lipid core burden index (maxLCBI). Intravascular ultrasound (IVUS) equipped with NIRS has been clinically applied recently, and its diagnostic usefulness and validation have been reported for coronary arteries; however, its consistency with actual pathological diagnosis in carotid artery lesions has not been validated. In this study, we investigated the consistency between the maxLCBI values and histopathological diagnoses. Patients with cervical carotid artery stenosis who underwent carotid endarterectomy (CEA) were examined in this prospective study. Pathological diagnosis was determined after NIRS evaluation, which was performed on the extracted plaques ex vivo. The histological slices of decalcified and paraffin-embedded sections were stained by hematoxylin-eosin (HE) and Elastica van Gieson (EVG), and for low-density lipoprotein (LDL), C-reactive protein (CRP), CD68, and glycophorin A. The correlation between maxLCBI values and histological findings. Seventy lesions assessed by NIRS were pathologically analyzed. There was a positive linear correlation between maxLCBI values and pathological findings as determined by HE (angle), HE (area%), EVG, CRP, and CD68 staining (respectively, r = 0.624, p, 博士（医学）・乙第1482号・令和2年12月24日, Copyright© 2020 by The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License(https://creativecommons.org/licenses/by-nc-nd/4.0/).

Balloon test occlusion (BTO) is a useful examination for evaluating ischemic tolerance to internal carotid artery (ICA) occlusion. The aim of this study was to investigate the relationships between intraoperative motor evoked potential (MEP) monitoring and the results of preoperative BTO. Between 2013 and 2017, 32 patients undergoing surgery under general anesthesia with intraoperative MEP monitoring, in whom preoperative BTO was performed, were identified. A receiver operator characteristic (ROC) analysis was performed to determine the appropriate cutoff value of MEP amplitude for BTO-positive. Furthermore, the accuracy of MEP monitoring for BTO-positive was compared with electroencephalogram (EEG) and somatosensory evoked potential (SEP) monitoring. Four of 32 (12.5%) patients were BTO-positive. The cutoff value of MEP amplitude for BTO-positive was a > 80% reduction from the baseline level, which showed sensitivity of 100% and specificity of 100%. Thus, the sensitivity and specificity for BTO-positive were significantly higher for MEP than for EEG (100% and 72.0%, p = 0.02) in 28 patients, but they were not significantly different compared with SEP (33.3% and 100%, p = 0.48) in 21 patients. MEP monitoring might be one of the alternatives for evaluating ischemic tolerance to ICA occlusion during surgery. The cutoff value of MEP amplitude was a > 80% reduction., 博士（医学）・乙第1483号・令和2年12月24日, © Springer Nature B.V. 2020, This is a post-peer-review, pre-copyedit version of an article published in Journal of clinical monitoring and computing. The final authenticated version is available online at: http://dx.doi.org/10.1007/s10877-020-00573-0.

Background. Transvenous embolization (TVE) for dural arteriovenous fistula (DAVF) is difficult depending on an accessible route. Reported herein is a case of transvenous embolization using a balloon and a coil as “walls.” Case Description. A 56-year-old male patient presented with a 1-month history of mild motor aphasia. The magnetic resonance imaging showed a hemorrhagic lesion in his left temporal lobe, and the cerebral angiography showed a DAVF, with parasinus shunt points near the torcula and the left transverse sinus. Access to the shunt point was very difficult; however, TVE was performed using a balloon as a wall. Furthermore, all lesion embolization was possible using a coil as a wall. Conclusions. Using a balloon or coil as a wall during a TVE is useful.

BACKGROUND: Perioperative thromboembolism is the main consideration in carotid artery stenting (CAS). Precise evaluation of carotid plaque components is clinically important to reduce ischaemic complications since CAS mechanically pushes plaque outwards, which releases plaque debris into the bloodstream. AIMS: This study aimed to determine whether high lipid core plaque (LCP) assessed by catheter-based near-infrared spectroscopy (NIRS) is associated with ipsilateral cerebral embolism by diffusion-weighted magnetic resonance imaging during CAS using a first-generation stent. METHODS: Carotid stenosis magnetic resonance (MR) T1-weighted plaque signal intensity ratio (T1W-SIR) followed by NIRS assessment at the time of CAS (using the carotid artery Wallstent) was performed in 117 consecutive patients. RESULTS: The maximum lipid core burden index (max-LCBI) at minimal luminal areas (MLA; max-LCBI(MLA)) and the max-LCBI for any 4 mm segment in a target lesion defined as max-LCBI(area) were significantly higher for the post-procedural new ipsilateral diffusion-weighted magnetic resonance imaging (DWI)-positive than negative patients (p

Optical phased arrays (OPAs), which manipulate an optical beam by controlling the phase of light, are optical devices characterized by high speed, small size, light weight, and high reliability that make various applications possible. In this study, an eight-channel-waveguide OPA using an electro-optic (EO) polymer for phase control was fabricated. Very high-speed optical beam scanning with a frequency of 2 MHz was demonstrated by applying a driving waveform superimposing sinusoidal and rectangular-wave voltages. Furthermore, the EO polymer OPA can be operated with a low total-operation power consumption of 0.38 mW at a scanning speed of 500 kHz.

Objective: To study clinical significance of augmentation of intraoperative motor evoked potentials (MEPs) during direct open surgery for middle cerebral artery (MCA) aneurysms. Methods: Between 2009 and 2017, 134 MCA aneurysm surgeries were performed with intraoperative MEP monitoring. The frequency and cause of augmentation with >50% increase of MEP amplitude from baseline were studied. Factors associated with MEP augmentation were investigated. Results: MEP augmentation was demonstrated in 9 patients. All 9 events were observed just after application of the temporary clip to the parent artery. The ratio of the maximum amplitude to baseline was 2.6 ± 1.1 at an mean of 2.4 ± 1.1 minutes after parent artery occlusion. Ten patients who did not show MEP augmentation after parent artery occlusion were compared with the patients showing MEP augmentation. The distance of the temporary clip point from the midline was smaller in patients with MEP augmentation compared with patients without MEP augmentation (P = 0.033). Conclusions: MEP augmentation was thought to be an early ischemic sign preceding a significant decrease in MEPs during MCA aneurysm surgery. Transient augmentation of MEPs was more frequently observed in cases with a temporary clip applied to the more proximal part of the MCA., 博士（医学）・乙第1445号・令和元年12月5日, © 2019 Elsevier Inc. All rights reserved.

BACKGROUND: Recently, 5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX fluorescence was reported to be a useful tool during total surgical resection of high-grade gliomas. However, the labeling efficacy of protoporphyrin IX fluorescence is lower in metastatic brain tumors compared to that in high-grade gliomas, and the mechanism underlying protoporphyrin IX fluorescence in metastatic brain tumors remains unclear. Lung cancer, particularly non-small cell lung cancer (NSCLC), is the most common origin for metastatic brain tumor. Therefore, we investigated the mechanism of protoporphyrin IX fluorescence in NSCLC and associated metastatic brain tumors. METHODS: Western blotting and quantitative real-time polymerase chain reaction (qRT-PCR) was employed to evaluate the protein and mRNA levels of five transporters and enzymes involved in the porphyrin biosynthesis pathway: peptide transporter 1 (PEPT1), hydroxymethylbilane synthase (HMBS), ferrochelatase (FECH), ATP-binding cassette 2 (ABCG2), and heme oxygenase 1 (HO-1). The correlation between protein, mRNA, and protoporphyrin IX levels in NSCLC cells were evaluated in vitro. Immunohistochemistry was used to determine proteins that played a key role in intraoperative protoporphyrin IX fluorescence in clinical samples from patients with NSCLC and pathologically confirmed metastatic brain tumors. RESULTS: A significant correlation between PEPT1 expression and protoporphyrin IX accumulation in vitro was identified by western blotting (P = 0.003) and qRT-PCR (P = 0.04). Immunohistochemistry results indicated that there was a significant difference in PEPT1 between the intraoperative protoporphyrin IX fluorescence-positive and protoporphyrin IX fluorescence-negative groups (P = 0.009). CONCLUSION: Expression of PEPT1 was found to be positively correlated with 5-ALA-induced protoporphyrin IX accumulation detected by photodynamic reaction in metastatic brain tumors originating from NSCLC., 博士（医学）・甲第714号・令和元年年6月26日, Copyright © 2019 Elsevier B.V. All rights reserved.

Background: Surgical site infection (SSI) is common following cranioplasty after decompressive craniectomy (DC). The aim of this study was to assess the risk of SSI following cranioplasty in terms of the preservation method of autogenous bone graft (ABG), comparing preservation in 80% ethanol versus the standard method of subcutaneous ABG preservation. Material and methods: The patients who underwent cranioplasty using ABGs after DC between 2008 and 2019 were retrospectively reviewed. SSIs were compared between patients whose ABG was preserved in 80% ethanol (group A) and those whose ABG was preserved subcutaneously (group B) using inverse probability of treatment weighting (IPTW) based on propensity scores to balance measurable confounders including elderly age, sex, expanded polytetrafluoroethylene, stroke, interval to cranioplasty, and diabetes mellitus. Results: Total number of 127 patients consisted of 56 in group A and 71 in group B. SSI after cranioplasty occurred in five patients each in groups A and B (8.9% vs. 7%, p = 0.748). IPTW analysis demonstrated that preservation in 80% ethanol was associated with a lower risk of SSI (odds ratio: 0.239, 95％ confidence interval: 0.0615–0.927, p = 0.039). Conclusion: The simple and less-invasive method of preserving ABGs in 80% ethanol for cranioplasty after DC might be potentially safe from an SSI perspective., 博士（医学）・乙第1526号・令和4年3月15日, © 2022 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND licens(https://creativecommons.org/licenses/by-nc-nd/4.0/).

Objective: Brain edema after severe traumatic brain injury (sTBI) is a common occurrence in infants resulting in elevated intracranial pressure (ICP), and causing a severe or fatal state. Because of infant brain plasticity, however, appropriate treatments to improve ICP can lead to positive outcomes.[for full text, please go to the a.m. URL], 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Background/Aim: Natural killer (NK) cells are considered potential antitumor effector cells. The aim of this study was toestablish a novel type of a chimeric antigen receptor (CAR) NK cell line (CAR-KHYG-1) specific for epidermal growth factorreceptor variant III (EGFRvIII)-expressing tumors and investigate the anti-tumor activity of EGFRvIII-specific-CAR-KHYG-1(EvCAR-KHYG-1). Materials and Methods: EvCAR-KHYG-1 was established by self-inactivated lentiviral-based transduction of theEvCAR gene and magnetic bead-based purification of EvCAR-expressing NK cells. The anti-tumor effects of EvCAR-KHYG-1 wereevaluated using growth inhibition and apoptosis detection assays in glioblastoma (GBM) cell lines (EGFRvIII-expressing andnon-expressing U87MG). Results: The findings demonstrated that EvCAR-KHYG-1 inhibited GBM cell-growth via apoptosis in anEGFRvIII-expressing specific manner. Conclusion: This is the first study to establish a CAR NK cell line based on the humanNK cell line KHYG-1. Therapy with EvCAR-KHYG-1 may be an effective treatment option for GBM patients., 博士（医学）・甲第726号・令和2年3月16日, Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved., 発行元の規定により、本文の登録不可。本文は以下のURLを参照 "http://dx.doi.org/10.21873/anticanres.12824"（※全文閲覧は学内限定）