Visualizing Intraoperative Transcranial Motor-Evoked Potentials During Glioma Surgery for Predicting Postoperative Paralysis Prognosis.

Objective: The primary goals of glioma surgery are maximal tumor resection and preservation of brain function. Intraoperative motor-evoked potential (MEP) monitoring is commonly used to predict and minimize postoperative paralysis. However, studies on intraoperative MEP trends and postoperative paralysis are scarce.

"Apathetic look" is a valuable indicator of intraoperative supplementary motor area syndrome during awake craniotomy.

Resection of a glioma from the dorsomedial frontal lobe, including the supplementary motor area (SMA), can result in postoperative SMA syndrome. SMA syndrome may occur during awake craniotomies. However, it is often difficult to intraoperatively distinguish between motor dysfunction due to pyramidal tract damage from that due to SMA syndrome.

3D evaluation model of facial aesthetics based on multi-input 3D convolution neural networks for orthognathic surgery.

Background: Quantitative evaluation of facial aesthetics is an important but also time-consuming procedure in orthognathic surgery, while existing 2D beauty-scoring models are mainly used for entertainment with less clinical impact.

Methods: A deep-learning-based 3D evaluation model DeepBeauty3D was designed and trained using 133 patients' CT images. The customised image preprocessing module extracted the skeleton, soft tissue, and personal physical information from raw DICOM data, and the predicting network module employed 3-input-2-output convolution neural networks (CNN) to receive the aforementioned data and output aesthetic scores automatically.

Precise Brain-shift Prediction by New Combination of W-Net Deep Learning for Neurosurgical Navigation.

Brain tissue deformation during surgery significantly reduces the accuracy of image-guided neurosurgeries. We generated updated magnetic resonance images (uMR) in this study to compensate for brain shifts after dural opening using a convolutional neural network (CNN). This study included 248 consecutive patients who underwent craniotomy for initial intra-axial brain tumor removal and correspondingly underwent preoperative MR (pMR) and intraoperative MR (iMR) imaging.

Surgery assistance system for continuous resection of brain tumors-proposal of continuous tumor resection forceps, tumor cell separation, dehydration, and isolation mechanism.

The tumor resection ratio must be improved due the increased possibility of recurrence or malignancy. The purpose of this study was to develop a system that includes forceps with a continuous suction function and flow cytometry to diagnose the malignancy of the tumor for safe, accurate, and effective surgery. A newly developed continuous tumor resection forceps consists of a triple pipe structure, which enables continuous suction of the tumor by integrating the reflux water and suction system.

Relationship between characteristics of glioma treatment and surgical site infections.

Purpose: Surgical site infections (SSIs) after neurosurgery are common in daily practice. Although numerous reports have described SSIs in neurosurgery, reports specific to gliomas are limited. This study aimed to investigate the relationship between SSIs and glioma treatment characteristics, such as reoperations, radiation therapy, and chemotherapy.

The actual status of drug prices and adjustment factors for drug price calculation: an analysis of ultra-orphan drug development in Japan.

Background: Extremely high prices facilitate drug development for ultra-rare diseases (ultra-orphan drugs). However, various problems arise in terms of healthcare financing and fairness, and the status of ultra-orphan drug pricing remains ambiguous. In this study, we investigated ultra-orphan drug prices in Japan relative to that of other drugs.

Construction of brain area risk map for decision making using surgical navigation and motor evoked potential monitoring information.

Purpose: Surgical devices or systems typically operate in a stand-alone manner, making it difficult to perform integration analysis of both intraoperative anatomical and functional information. To address this issue, the intraoperative information integration system OPeLiNK was developed. The objective of this study is to generate information for decision making using surgical navigation and intraoperative monitoring information accumulated in the OPeLiNK database and to analyze its utility.

A trial to visualize perforators images from CTA with a tablet device: experience of operating on minipigs.

A reliable method for precise perforator mapping can be extremely valuable in perforator flap surgery. In this study, we attempted to map perforator location using 3-dimensional computed tomography angiography (CTA), a newly developed application, and a tablet device. Preliminary examinations to test the device were conducted in mini-pigs.

The high incidence and risk factors of levetiracetam and lacosamide-related skin rashes in glioma patients.

Objective: Antiseizure drug (ASD)-induced skin rash remains the main side effect of seizure management in patients with glioma. New generations of ASDs, such as levetiracetam (LEV) and lacosamide (LCM) are associated with less frequent skin rashes than conventional ASDs. However, there are few reports regarding the incidence of skin rashes by LEV and LCM in patients with glioma.

Machine-learning-based approach for predicting postoperative skeletal changes for orthognathic surgical planning.

Background: Manually surgical planning becomes an increasing workload of surgeons because of the fast-growing patient population. This study introduced a machine-learning-based approach to assist surgical planning in orthognathic surgery.

Methods: Both preoperative and one-year-later postoperative computerised tomography images of 56 patients were collected.

Mixed Reality Needle Guidance Application on Smartglasses Without Pre-procedural CT Image Import with Manually Matching Coordinate Systems.

Purpose: To develop and assess the accuracy of a mixed reality (MR) needle guidance application on smartglasses.

Materials And Methods: An MR needle guidance application on HoloLens2, without pre-procedural CT image reconstruction or import by manually matching the spatial and MR coordinate systems, was developed. First, the accuracy of the target locations in the image overlay at 63 points arranged on a 45 × 35 × 21 cm box and needle angles from 0° to 80°, placed using the MR application, was verified.

Effectiveness of drug postmarketing all-case surveillance as a safety measure in Japan.

Introduction: The drug pharmacovigilance system in Japan is similar to those in the European Union (EU) and the United States. As a unique Japanese pharmacovigilance program, postmarketing all-case surveillance (PMACS) is required. PMACS plays a key role for postmarketing activities, but there are challenges that place much burden on PMACS conduct.

Robotic Technology in Operating Rooms: a Review.

Purpose Of Review: With the rapid growth and development of robotic technology, its implementation in medical fields has also been significantly increasing, with the transition from the period of mainly using surgical robots to the era with combinations of multiple types of robots. Therefore, this paper introduces the newest robotic systems and technology applied in operating rooms as well as their architectures for integration.

Recent Findings: Besides surgical robots, other types of robotic devices and machines such as diagnostic and treatment devices with robotic operating tables, robotic microscopes, and assistant robots for surgeons emerge one after another, improving the quality of surgery from different aspects.

Current Landscape of Sonodynamic Therapy for Treating Cancer.

Recent advancements have tangibly changed the cancer treatment landscape. However, curative therapy for this dreadful disease remains an unmet need. Sonodynamic therapy (SDT) is a minimally invasive anti-cancer therapy involving a chemical sonosensitizer and focused ultrasound.

A Three-dimensionally Printed Acrylonitrile Butadiene Styrene Model for the Reduction of Nasomaxillary Fracture.

The successful reduction of a nasomaxillary fracture was performed using a three-dimensional printed model. A 16-year-old boy was struck in the left orbit by a baseball; subsequently, he was diagnosed with the nasal bone fracture at a hospital, and was referred to the authors' department. A left nasomaxillary fracture and nasal bone fracture were diagnosed by computed tomography.

Learning effectiveness of using augmented reality technology in central venous access procedure: an experiment using phantom and head-mounted display.

Purpose: Augmented reality (AR) technology improves the learning process in interventional radiology. This study hypothesized that using AR to train for central venous access is superior to using ultrasound alone.

Methods: This study used an AR central venous catheterization phantom with an internal jugular vein (IJV) and subclavian vein (SCV) made of resin body and soft tubing.

Locally operated assistant manipulators with selectable connection system for robotically assisted laparoscopic solo surgery.

Purpose: By integrating locally operated surgical assistant robots in a sterilized area, a surgeon can perform safe robotically assisted laparoscopic solo surgery while controlling a laparoscope-holding robot and a forceps robot. At present, there is no leader-follower control system with switchable connection for the leader device in which each assistant follower robot can provide the manipulation intuitively and easily. In the present study, a new locally operated leader-follower selectable control system has been developed.

Development of a Semiautomatic Dura Mater Suturing Device for Preventing Cerebrospinal Fluid Leakage in Transsphenoidal Surgery.

Dural suturing in transsphenoidal surgery requires well-honed technical skills. We have developed a semiautomatic dural suturing device and confirmed its effectiveness by comparing it with the conventional method. This device significantly shortens the suturing time compared with the conventional method.

Video-based neonatal state assessment method for timing of procedures.

Background: Procedures should be performed when an infant is most receptive to disruptions in order to reduce the stress on the infant. However, frequent direct observations place a heavy burden on medical staff. There is therefore a need for a method for quantitatively and automatically evaluating the neonatal state.

Reliability of Residual Tumor Estimation Based on Navigation Log.

The mass of residual tumors has previously been estimated using time-series records of the position of surgical instruments acquired from neurosurgical navigation systems (navigation log). This method has been shown to be useful for rapid evaluation of residual tumors during resection. However, quantitative analysis of the method's reliability has not been sufficiently reported.

Automatic 3D landmarking model using patch-based deep neural networks for CT image of oral and maxillofacial surgery.

Background: Manual landmarking is a time consuming and highly professional work. Although some algorithm-based landmarking methods have been proposed, they lack flexibility and may be susceptible to data diversity.

Methods: The CT images from 66 patients who underwent oral and maxillofacial surgery (OMS) were landmarked manually in MIMICS.

Prediction of lower-grade glioma molecular subtypes using deep learning.

Introduction: It is useful to know the molecular subtype of lower-grade gliomas (LGG) when deciding on a treatment strategy. This study aims to diagnose this preoperatively.

Methods: A deep learning model was developed to predict the 3-group molecular subtype using multimodal data including magnetic resonance imaging (MRI), positron emission tomography (PET), and computed tomography (CT).