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Continuous Vagus Nerve Monitoring during Carotid Endarterectomy

Open Journal of Modern Neurosurgery 2017年第1期7卷 1-9页

作者： Tamaki Tomonori Kubota Minoru Node Yoji morita akio Departmrnt of Neurological Surgery Nippon Medical School Tamanagayama Hospital Tokyo Japan Department of Clinical Laboratory Nippon Medical School Tamanagayama Hospital Tokyo Japan Departmrnt of Neurological Surgery Nippon Medical School Tokyo Japan

Backgrounds: Injury to the vagus nerve or one of its branches during carotid endarterectomy can result in vocal fold paralysis but the exact mechanism of injury responsible for vocal fold paralysis after carotid endarterectomy is unclear. Aims: This study was performed to identify potential predictors of vagus nerve injury and obtain feedback by application of intraoperative continuous vagus nerve monitoring. Materials and Methods: Seventy-four patients undergoing carotid endarterectomy were enrolled. A new vagus nerve electrode was designed for less invasive continuous vagus nerve stimulation and monitoring of the vocal fold electromyogram without disturbing the surgical procedure. The device was rectangular (13 mm × 9 mm), with two small round electrodes set on a flexible silicon plate and tube. The electrode was fully implantable during carotid endarterectomy and was positioned at the most distal site of the vagus nerve by suturing to the connective tissue without nerve dissection. All patients underwent laryngoscopy to assess postoperative vocal fold and pharyngeal wall palsy at one week after carotid endarterectomy. Results: Sudden loss of the vocal fold electromyogram was noted in two patients (during plaque removal and during arterial wall suture in one each). In these two patients, incomplete vocal fold and pharyngeal palsy was confirmed by laryngoscopy. The cause of vagus nerve injury may have been traction at the time of distal internal carotid artery manipulation. The vocal fold electromyogram remained normal during the operation in the other 72 patients. However laryngoscopy revealed postoperative vocal fold and pharyngeal palsy in six patients. These findings suggested that delayed vagus nerve injury can occur after carotid endarterectomy. Conclusion: The continuous vagus nerve monitoring may be worthwhile for elucidating the mechanism of vagus nerve injury related to carotid endarterectomy.

关键词： Carotid Endarterectomy Vagus Nerve Vocal Fold Neuromonitoring Complication

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Three-Dimensional Cerebral Aneurysm Models for Surgical Simulation and Education—Development of Aneurysm Models with Perforating Arteries and for Application of Fenestrated Clips

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Open Journal of Modern Neurosurgery 2014年第2期4卷 59-63页

作者： Tatsuya Ishikawa akio morita Takanori Fukushima Hidenori Ono Department of Neurological Surgery Nippon Medical School Tokyo Japan Department of Neurosurgery Duke University Medical Center & Duke Raleigh Community Hospital & West Virginia University Medical Center Durham USA Department of Surgical Neurology Research Institute for Brain & Blood Vessels Akita Japan Ono & Co. Ltd. Tokyo Japan

We modified a three-dimensional cerebral aneurysm model for surgical simulation and educational demonstration. Novel models are made showing perforating arteries arising around the aneurysm. Information about perforating arteries is difficult to obtain from individual radiological data sets. Perforators are therefore reproduced based on previous anatomical knowledge instead of personal data. Due to their fragility, perforating arteries are attached to the model using hard materials. At the same time, hollow models are useful for practicing clip application. We made a model for practicing the application of fenestrated clips for paraclinoid internal carotid aneurysms. Situating aneurysm models in the fissure of a brain model simulates the real surgical field and is helpful for educational demonstrations.

关键词： Three-Dimensional Cerebral Aneurysm Model Clipping Surgery Simulation Perforating Artery Fenestrated Clip

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Rabies Control in Japan Past,Present,and Future

Rabies Control in Japan Past,Present,and Future

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2010全国狂犬病防控高层论坛

作者： akio YAMADA Satoshi INOUE Takeshi morita Kensuke NAKAJIMA National Institute of Infectious Diseases(Japan)

History of rabies in Japan In the ancient law called"Yoro-ritsuryo"(养老律令、Yoro Code)enacted in 717,the description on"destruction ofmad dogs"is found,suggesting the presence ofrabies at that time. Similar description is found in the"Shorui Awaremi no Rei"established in 1692,also suggesting that small outbreaks ofrabies-like illness in dogs were sustained for nearly a hundred years.

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A unique case of a calcifying cystic odontogenic tumor

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Open Journal of Stomatology 2013年第6期3卷 314-317页

作者： Shoko Gamoh Yukako Nakashima Hironori Akiyama Kimishige Shimizutani Takuro Sanuki Junichiro Kotani Koji Yamada Shosuke morita Kazuya Tominaga Masahiro Wato akio Tanaka Department of Anesthesiology Osaka Dental University Osaka Japan Department of Oral and Maxillofacial Surgery Osaka Dental University Osaka Japan Department of Oral Pathology Osaka Dental University Osaka Japan Department of Oral Radiology Osaka Dental University Osaka Japan

The calcifying odontogenic cyst was first reported by Gorlin et al. in 1962. At that time, it was classified as a cyst related to the odontogenic apparatus, although it was later renamed as a calcifying cystic odontogenic tumor by the WHO calcification in 2005 due to its histological complexity, morphological diversity and aggressive proliferation [2]. Here, we describe a case of a calcifying cystic odontogenic tumor in a 4- year-old boy. The lesion was surgically removed, and the histopathological examination revealed it to be a cystic tumor with ghost cells, a stellate reticulum and small amount of dentinoid tissue in the cystic wall.

关键词： Calcifying Cystic Odontogenic Tumor Diagnostic Imaging Computed Tomography

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Immunohistochemical study of the lining epithelium in keratocystic odontogenic tumor, orthokeratinized odontogenic cyst and dentigerous cyst

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中国口腔颌面外科杂志 2008年第B5期6卷 158-158页

作者： Kaname Tsuji Masahiro Wato Sakiko Matsuda akio Tanaka Shosuke morita First Department of Oral and Maxillofacial Surgery Osaka Dental University. Hirakata 573-1121 Japan Department of Oral Pathology Osaka Dental University. Hirakata 573-1121 Japan

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