Successful endoscopic approach for peripheral neuroblastic tumors in children.

Background: Recently, reports of endoscopic approaches for neuroblastoma, ganglioneuroblastoma, and ganglioneuroma (peripheral neuroblastic tumor; PNTs) have been increasing. This study aimed to clarify the indications for endoscopic surgery for PNTs.

Methods: Pediatric patients who underwent endoscopic surgery for PNTs at our institution were included in this study.

Surgical outcome and prognosis of pediatric solid-pseudopapillary neoplasm.

Background: The aim of this study was to clarify the characteristics and outcomes of pediatric patients with solid pseudopapillary neoplasms (SPNs) who underwent pancreatectomy.

Methods: Pediatric patients with SPNs who underwent pancreatectomy at our institution between 1995 and 2020 were included in the study.

Results: During the period under review, 12 patients underwent pancreatectomy for SPNs (median age: 10 years; range: 6-15 years).

Palisading-like arrangement of immature ganglion cell in myenteric ganglia is a unique pathological feature of immaturity of ganglia.

Background: Immaturity of ganglia (IG), an allied disorder of Hirschsprung disease (AD-HSCR), develops as neonatal ileus, but the dysmotility spontaneously resolves after several months. The diagnosis of IG using HE staining is often difficult. We herein report a new pathological finding of IG called the 'palisading-like pattern', which may be helpful for improving the diagnostic accuracy.

Brainstem Infarctions Caused by a Proximal Marker of the PulseRider Device Obstructing the Origin of a Perforator.

The PulseRider (Cerenovus, Johnson & Johnson Medical Devices, New Brunswick, NJ, USA) is a neck reconstruction device that is used for the treatment of unruptured wide-necked bifurcation aneurysms. Herein, we describe the case of a 51-year-old male patient with a basilar apex aneurysm who was treated with PulseRider but had post-procedural brainstem infarctions caused by one of the proximal markers covering the origin of a perforator. In such cases, repositioning of the PulseRider should be performed to avoid infarctions.

Intracranial chondrosarcoma located in the region of the posterior clinoid process: a case report.

Intracranial chondrosarcomas located in the region of the posterior clinoid process have not been focused on. Here, we report the case of a 29-year-old woman with a skull base tumor in that region. Seven years after the diagnosis, the tumor had grown and showed calcification and tumor stain; chondrosarcoma, posterior clinoid meningioma, and chordoma were suspected.

λ stenting: a novel technique for posterior communicating artery aneurysms with fetal-type posterior communicating artery originating from the aneurysm dome.

Purpose: Endovascular treatment of posterior communicating artery aneurysms with fetal-type posterior communicating artery originating from the aneurysm dome is often challenging because, with conventional techniques, dense packing of aneurysms for posterior communicating artery preservation is difficult; moreover, flow-diversion devices are reportedly less effective. Herein, we describe a novel method called the λ stenting technique that involves deploying stents into the internal carotid artery and posterior communicating artery.

Methods: Between January 2018 and September 2020, the λ stenting technique was performed to treat eight consecutive cases of aneurysms.

Single incision laparoscopic repair for late-onset congenital diaphragmatic hernia using oval-shaped multichannel port device (E•Z ACCESS oval type)-2 months infantile case of Bochdalek hernia.

Introduction: Late-onset congenital diaphragmatic hernia constitutes 10%-36% of congenital diaphragmatic hernias. They qualify for endoscopic treatment including both thoracoscopic and laparoscopic approaches because this type of patient is in relatively stable condition compared with neonatal cases. However, single incision laparoscopic approach has not been reported.

Reevaluation of concurrent acetylcholinesterase and hematoxylin and eosin staining for Hirschsprung's disease.

Background: Acetylcholinesterase (AChE) histochemistry has been widely performed for the histopathological diagnosis of Hirschsprung's disease (HD). However, we occasionally come across diagnostic difficulties. We conducted concurrent AChE histochemistry and hematoxylin and eosin (HE) staining to validate the ancillary value of this technique.

Acetylcholinesterase staining for the pathological diagnosis of Hirschsprung's disease.

Hirschsprung's disease (HD) is a congenital disease manifesting various degrees of functional bowel obstruction caused by the absence of enteric ganglion cells, which are usually absent in the colonic segment of the HD patient. Because the aganglionic segment of HD always includes the rectum, pathological diagnosis can be made using a rectal sample. HD should be diagnosed as early as possible because serious complications, such as acute enterocolitis or toxic megacolon, can develop without a definitive diagnosis and appropriate treatment.

Modification of hemodynamics in basilar artery aneurysm by the single and Y stent placement1.

Background: Stent placement can change the hemodynamics in basilar artery aneurysms. However, the effects of the stent placement can depend on the angle of vessel bifurcation.

Objective: The hemodynamics in and near the aneurysm are investigated for two angles of vessel bifurcation and two stent models.

Hybrid stent device of flow-diverting effect and stent-assisted coil embolization formed by fractal structure.

This paper presents a novel hybrid medical stent device. This hybrid stent device formed by fractal mesh structures provides a flow-diverting effect and stent-assisted coil embolization. Flow-diverter stents decrease blood flow into an aneurysm to prevent its rupture.

The study of flow diversion effects on aneurysm using multiple enterprise stents and two flow diverters.

Background: Computer-based simulation is necessary to clarify the hemodynamics in brain aneurysm. Specifically for endovascular treatments, the effects of indwelling intravascular devices on blood stream need to be considered. The most recent technology used for cerebral aneurysm treatment is related to the use of flow diverters to reduce the amount of flow entering the aneurysm.

In vitro strain measurements in cerebral aneurysm models for cyber-physical diagnosis.

Background: The development of new diagnostic technologies for cerebrovascular diseases requires an understanding of the mechanism behind the growth and rupture of cerebral aneurysms. To provide a comprehensive diagnosis and prognosis of this disease, it is desirable to evaluate wall shear stress, pressure, deformation and strain in the aneurysm region, based on information provided by medical imaging technologies.

Methods: In this research, we propose a new cyber-physical system composed of in vitro dynamic strain experimental measurements and computational fluid dynamics (CFD) simulation for the diagnosis of cerebral aneurysms.

Computational fluid dynamic analysis following recurrence of cerebral aneurysm after coil embolization.

Hemodynamic factors are thought to play important role in the initiation, growth, and rupture of cerebral aneurysms. However, hemodynamic features in the residual neck of incompletely occluded aneurysms and their influences on recanalization are rarely reported. This study characterized the hemodynamics of incompletely occluded aneurysms that had been confirmed to undergo recanalization during long-term follow-up using computational fluid dynamic analysis.

Transvenous embolization in spontaneous direct carotid-cavernous fistula in childhood.

Carotid cavernous fistula (CCF) is an abnormal arteriovenous communication in the cavernous sinus. Direct CCF results from a tear in the intracavernous carotid artery. Typically, it has a high flow and usually presents with oculo-orbital venous congestive features such as exophthalmos, chemosis, and sometimes oculomotor or abducens cranial nerve palsy.

Usefulness of a simplified management scheme for paraclinoid aneurysms based on a modified classification.

Background: Our objective was to set up a management-oriented classification for paraclinoid aneurysms, and then design and apply a simplified management scheme according to each group defined by this classification.

Methods: Paraclinoid aneurysms were classified as group I (supraophthalmic artery), group II (ophthalmic artery) and group III (infraophthalmic artery) aneurysms intradurally. Between January 2005 and December 2006, 86 cases with 89 paraclinoid aneurysms were treated.

Management of complex, surgically intractable intracranial aneurysms: the option for intentional reconstruction of aneurysm neck followed by endovascular coiling.

Background: A limited series of patients with aneurysm were reviewed retrospectively to analyze strategies for integrating microsurgical and endovascular techniques in the management of complex, surgically intractable aneurysms.

Methods: Four patients were managed in Fujita Health University with a multimodality approach: intentional reconstruction of the aneurysm neck followed by endovascular coiling.

Results: A total of 5 aneurysms were treated, of which 3 were large or giant in size, and 3 were fusiform or multilobulated.

An in vitro patient-tailored model of human cerebral artery for simulating endovascular intervention.

An in vitro patient-tailored reproduction model of cerebral artery, a hardware platform for simulating endovascular intervention for making diagnoses and surgical trainings is presented. 3-D configuration of vessel lumen is reproduced as vessel model with 13 microm modeling resolution, using CT and MRI information. Physical characteristics of cerebral artery, such as elastic modulus and friction coefficient, are also reproduced.

CT angiography with electrocardiographically gated reconstruction for visualizing pulsation of intracranial aneurysms: identification of aneurysmal protuberance presumably associated with wall thinning.

Electrocardiographically (ECG) gated multisection helical CT images were obtained in 23 patients with ruptured intracranial aneurysms. 4D-CTA (3D CT angiography plus phase data) images were generated by ECG-gated reconstruction. Four patients showed pulsation of an aneurysmal bleb.

Treatment of a spontaneous intracranial dissecting aneurysm with stent-assisted coil embolization.

Arterial dissection is now recognized as an important cause of stroke. Most reported dissections involve the extracranial portion of the internal carotid artery (ICA) and vertebral arteries. Spontaneous dissecting aneurysms of the intracranial ICA are uncommon.

Preliminary results of Tc-99m ECD SPECT to evaluate cerebral collateral circulation during balloon test occlusion.

Purpose: The authors obtained noninvasive quantitative measurements of regional cerebral blood flow using Tc-99m L,L-ethyl cysteinate dimer (Tc-99m ECD) SPECT to evaluate cerebral collateral circulation during balloon test occlusion (BTO) of the internal carotid artery and vertebral artery (VA).

Methods: Five cases associated with an aneurysm and a brain tumor were investigated. After 10 minutes of BTO, a bolus of Tc-99m ECD was injected intravenously and radionuclide angiography was performed.