研究者詳細 - 杉生　憲志

論文 - 杉生　憲志

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NADH fluorescence imaging and the histological impact of cortical spreading depolarization during the acute phase of subarachnoid hemorrhage in rats 査読国際誌

Tomohisa Shimizu, Tomohito Hishikawa, Shingo Nishihiro, Yukei Shinji, Yuji Takasugi, Jun Haruma, Masafumi Hiramatsu, Hirokazu Kawase, Sachiko Sato, Ryoichi Mizoue, Yoshimasa Takeda, Kenji Sugiu, Hiroshi Morimatsu, Isao Date

Journal of Neurosurgery 128 ( 1 ) 137 - 143 2018年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：American Association of Neurological Surgeons

OBJECTIVE Although cortical spreading depolarization (CSD) has been observed during the early phase of subarachnoid hemorrhage (SAH) in clinical settings, the pathogenicity of CSD is unclear. The aim of this study is to elucidate the effects of loss of membrane potential on neuronal damage during the acute phase of SAH. METHODS Twenty-four rats were subjected to SAH by the perforation method. The propagation of depolarization in the brain cortex was examined by using electrodes to monitor 2 direct-current (DC) potentials and obtaining NADH (reduced nicotinamide adenine dinucleotide) fluorescence images while exposing the parietal-temporal cortex to ultraviolet light. Cerebral blood flow (CBF) was monitored in the vicinity of the lateral electrode. Twenty-four hours after onset of SAH, histological damage was evaluated at the DC potential recording sites. RESULTS Changes in DC potentials (n = 48 in total) were sorted into 3 types according to the appearance of ischemic depolarization in the entire hemisphere following induction of SAH. In Type 1 changes (n = 21), ischemic depolarization was not observed during a 1-hour observation period. In Type 2 changes (n = 13), the DC potential demonstrated ischemic depolarization on initiation of SAH and recovered 80% from the maximal DC deflection during a 1-hour observation period (33.3 ± 15.8 minutes). In Type 3 changes (n = 14), the DC potential displayed ischemic depolarization and did not recover during a 1-hour observation period. Histological evaluations at DC potential recording sites showed intact tissue at all sites in the Type 1 group, whereas in the Type 2 and Type 3 groups neuronal damage of varying severity was observed depending on the duration of ischemic depolarization. The duration of depolarization that causes injury to 50% of neurons (P50) was estimated to be 22.4 minutes (95% confdence intervals 17.0-30.3 minutes). CSD was observed in 3 rats at 6 sites in the Type 1 group 5.1 ± 2.2 minutes after initiation of SAH. On NADH?uorescence images CSD was initially observed in the anterior cortex∗it propagated through the entire hemisphere in the direction of the occipital cortex at a rate of 3 mm/minute, with repolarization in 2.3 ± 1.2 minutes. DC potential recording sites that had undergone CSD were found to have intact tissue 24 hours later. Compared with depolarization that caused 50% neuronal damage, the duration of CSD was too short to cause histological damage. CONCLUSIONS CSD was successfully visualized using NADH?uorescence. It propagated from the anterior to the posterior cortex along with an increase in CBF. The duration of depolarization in CSD (2.3 ± 1.2 minutes) was far shorter than that causing 50% neuronal damage (22.4 minutes) and was not associated with histological damage in the current experimental setting.

DOI： 10.3171/2016.9.JNS161385

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Coil Embolization through Collateral Pathway for Ruptured Vertebral Artery Dissecting Aneurysm with Bilateral Vertebral Artery Occlusion 査読国際誌

Satoshi Murai, Kenji Sugiu, Tomohito Hishikawa, Masafumi Hiramatsu, Shingo Nishihiro, Naoya Kidani, Yu Takahashi, Isao Date

Journal of Stroke and Cerebrovascular Diseases 27 ( 9 ) e215-e218 2018年

Endovascular treatment for vasospasm after aneurysmal subarachnoid hemorrhage based on data of JR-NET3

Hirotoshi Imamura, Nobuyuki Sakai, Tetsu Satow, Koji Iihara, Masayuki Ezura, Akio Hyodo, Shigeru Miyachi, Susumu Miyamoto, Yoji Nagai, Kunihiro Nishimura, Kazunori Toyoda, Toshiyuki Fujinaka, Toshio Higashi, Masaru Hirohata, Akira Ishii, Yasushi Ito, Naoya Kuwayama, Hidenori Oishi, Yuji Matsumaru, Yasushi Matsumoto, Ichiro Nakahara, Chiaki Sakai, Kenji Sugiu, Tomoaki Terada, Shinichi Yoshimura, JR-NET investigators

Neurologia Medico-Chirurgica 58 ( 12 ) 495 - 502 2018年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Japan Neurosurgical Society

Endovascular treatments for vasospasm after subarachnoid hemorrhage are typically performed for patients who are refractory to recommended medical therapies. We analyzed the current status of endovascular treatments based on the data of Japanese Registry of Neuroendovascular Therapy (JR-NET)3, and evaluated factors related to improvement of imaging findings and neurological condition, and to mechanical hemorrhage complications. We collected data of 1211 treatments performed from 2010 to 2014. Target vessels for treatments were anterior circulation (n = 1079), posterior circulation (n = 91), and both (n = 32)
the distribution of vasospasm was the proximal vessel (n = 754) to the Circle of Willis, distal vessel (n = 329), and both (n = 119). Of the treatments, 948 cases (78.3%) were intra-arterial administration of vasodilators and 259 (21.4%) were percutaneous transluminal angioplasty (PTA)
879 cases were the first intervention. The treatment time from onset was within 3 h in 378 (31.2%) cases, between 3 and 6 h in 349 (28.8%) cases, and over 6 h in 245 (20.2%) cases. The statistically significant factors associated with improvement on imaging findings was the first treatment, and treatment within 3 h from onset compared with that after 6 h. Additionally, the first and early treatments after the symptoms were associated with significantly improved neurological condition. All complications of mechanical hemorrhage occurred along with PTA. The findings show that endovascular treatment for vasospasm was effective, especially for cases who suffered from symptomatic vasospasm with a short interval after onset.

DOI： 10.2176/nmc.oa.2018-0212

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平松匡文, 菱川朋人, 西廣真吾, 木谷尚哉, 杉生憲志, 伊達勲

脳神経外科速報 27 ( 12 ) 1251 - 1255 2017年12月

記述言語：日本語出版者・発行元：(株)メディカ出版

もやもや病(Moyamoya disease)に対する間接血行再建術の有効性は多く報告されている一方、効果が不十分な症例も存在する。われわれは慢性脳虚血モデル(両側総頸動脈結紮ラット)に間接血行再建術(encephalo-myo-synangiosis:EMS)を加えることにより、もやもや病手術モデルとし、さらに血管新生を促進させるような遺伝子治療を加える血管新生増強療法の研究を行ってきた。最近ではapelinという新規血管新生因子とvascular endothelial growth factor(VEGF)を併用することで成熟した血管新生を生じ得ることを報告した。今後は血管新生増強療法として蛋白製剤を用い、さらに脳血流の評価も行っていくことにより、臨床応用につなげていきたいと考えている。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J03120&link_issn=&doc_id=20171204180003&doc_link_id=issn%3D0917-1495%26volume%3D27%26issue%3D12%26spage%3D1251&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0917-1495%26volume%3D27%26issue%3D12%26spage%3D1251&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

顔面痙攣を呈した椎骨動脈瘤に対して血管内治療を行った一例

坪井伸成, 杉生憲志, 菱川朋人, 平松匡文, 西廣真吾, 木谷尚哉, 高橋悠, 村井智, 伊達勲

脳血管内治療 2 ( Suppl. ) S283 - S283 2017年11月

後方循環の症候性未破裂脳動脈瘤に対する血管内治療の長期成績

高橋悠, 杉生憲志, 菱川朋人, 平松匡文, 西廣真吾, 木谷尚哉, 村井智, 伊達勲

脳血管内治療 2 ( Suppl. ) S122 - S122 2017年11月

75歳以上の破裂脳動脈瘤に対するコイル塞栓術

菱川朋人, 杉生憲志, 村井智, 高橋悠, 木谷尚哉, 西廣真吾, 平松匡文, 伊達勲

脳血管内治療 2 ( Suppl. ) S92 - S92 2017年11月

内頸動脈閉塞試験(balloon test occlusion:BTO)における合併症と妥当性の検討

木谷尚哉, 杉生憲志, 菱川朋人, 平松匡文, 西廣真吾, 高橋悠, 村井智, 伊達勲

脳血管内治療 2 ( Suppl. ) S105 - S105 2017年11月

椎骨動脈解離性動脈瘤に対する血管内治療

木谷尚哉, 杉生憲志, 菱川朋人, 平松匡文, 西廣真吾, 高橋悠, 村井智, 伊達勲

脳血管内治療 2 ( Suppl. ) S51 - S51 2017年11月

頭蓋内腫瘍に対する術前塞栓術の治療成績

西廣真吾, 杉生憲志, 菱川朋人, 平松匡文, 木谷尚哉, 高橋悠, 村井智, 伊達勲

脳血管内治療 2 ( Suppl. ) S84 - S84 2017年11月

脳動静脈奇形に対する塞栓術

菱川朋人, 杉生憲志, 村井智, 高橋悠, 木谷尚哉, 西廣真吾, 平松匡文, 伊達勲

脳血管内治療 2 ( Suppl. ) S31 - S31 2017年11月

硬膜動静脈瘻に対する経静脈塞栓術の治療成績

平松匡文, 杉生憲志, 菱川朋人, 西廣真吾, 木谷尚哉, 高橋悠, 村井智, 伊達勲

脳血管内治療 2 ( Suppl. ) S47 - S47 2017年11月

ラット慢性脳虚血モデルに対するHMGB1投与を併用した間接バイパス術の治療効果の検討

西廣真吾, 菱川朋人, 杉生憲志, 平松匡文, 木谷尚哉, 高橋悠, 村井智, 伊達勲

脳循環代謝 29 ( 1 ) 178 - 178 2017年11月

成人虚血型もやもや病の手術成績と長期予後

菱川朋人, 平松匡文, 杉生憲志, 伊達勲

脳循環代謝 29 ( 1 ) 153 - 153 2017年11月

内頸動脈閉塞試験(balloon test occlusion:BTO)における合併症と妥当性の検討

木谷尚哉, 杉生憲志, 菱川朋人, 平松匡文, 西廣真吾, 高橋悠, 村井智, 伊達勲

脳循環代謝 29 ( 1 ) 168 - 168 2017年11月

Lvisステントを4本留置して治療したserpentine basilar aneurysmの1例

高橋悠, 杉生憲志, 菱川朋人, 平松匡文, 西廣真吾, 木谷尚哉, 村井智, 伊達勲

脳血管内治療 2 ( Suppl. ) S285 - S285 2017年11月

3D-DSA fusion画像で仮性動脈瘤の位置を同定しtarget embolizationを行い得た破裂AVMの1例

村井智, 杉生憲志, 菱川朋人, 平松匡文, 西廣真吾, 木谷尚哉, 高橋悠

脳血管内治療 2 ( Suppl. ) S324 - S324 2017年11月

外傷性脳動脈瘤に対してステント併用コイル塞栓術を施行した一例

西廣真吾, 杉生憲志, 菱川朋人, 安原隆雄, 春間純, 久壽米木亮, 平松匡文, 木谷尚哉, 高橋悠, 村井智, 伊達勲

脳血管内治療 2 ( Suppl. ) S251 - S251 2017年11月

Flow Diverter留置にて根治が得られた外傷性内頸動脈瘤の1例

春間純, 杉生憲志, 岡哲生, 有澤正, 高橋悠, 木谷尚哉, 西廣真吾, 平松匡文, 菱川朋人, 伊達勲

脳血管内治療 2 ( Suppl. ) S252 - S252 2017年11月

Posterior condylar canal近傍のdural AVFに対し経静脈的塞栓術を施行した一例

河内哲, 杉生憲志, 菱川朋人, 平松匡文, 西廣真吾, 木谷尚哉, 高橋悠, 村井智, 伊達勲

脳血管内治療 2 ( Suppl. ) S205 - S205 2017年11月

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