Evaluation of contour of unruptured cerebral aneurysm using three-dimensional CT cisternogram.

Angiography is gold standard technique as preoperative examination for unruptured aneurysmal surgery. Neurosurgeons have observed the unexpected irregular shape and size of the aneurysmal dome and neck in many cases of unruptured cerebral aneurysms during aneurysmal microsurgery, and known the discrepancy between the findings of angiography and operative view. We could not find out the report described the preoperative evaluation of outer-wall (contour) of aneurysm. In the present study, we attempted to evaluate the outer-wall of an unruptured cerebral aneurysm using three-dimensional CT cisternogram (3D-CTC) to provide useful preoperative information. The study was performed on three cases of unruptured cerebral aneurysm that were identified incidentally by MR angiography. We performed three-dimensional CT aniography (3D-CTA) and 3D-CTC for each patient. In the present study, we visualized the contours of vessels and aneurysms using a 3D-CTC in three cases of unruptured cerebral aneurysm. We found the discrepancy between the 3D-CTC contour image and the intra-luminal image 3D-CTA image. This method may be useful for the decision of the surgical approach and have the potential to evaluate the anatomical structure of aneurysmal dome and neck preoperatively.</p

RAISE-3 for Agile On-Orbit Demonstration of Innovative Satellite Technologies: Mission Definition and Conceptual Design

The Japan Aerospace Exploration Agency (JAXA) has selected on-orbit demonstration missions for the Innovative Satellite Technology Demonstration-3 project in May 2020, as part of the Innovative Satellite Technology Demonstration Program. Seven on-orbit demonstration missions were selected in a category of parts, components and subsystems and those missions will be demonstrated onboard the RApid Innovative payload demonstration SatellitE-3 (RAISE-3). This 100kg-class satellite developed by JAXA is a flagship of the Innovative Satellite Technology Demonstration-3 fleet. This paper describes an overview of the demonstration missions and system specifications of RAISE-3, as well as results of conceptual design of the satellite and a partial application of digital development process to an initial phase of the project. Further, project plan and technical challenges to be studied in a project implementation phase are also discussed

The Usefulness of CT-Diffusion Weighted Image Mismatch in Patients with Mild to Moderate Traumatic Brain Injury

Traumatic brain injury (TBI) has a complex and heterogeneous pathology. It is frequently difficult to predict the neurological deterioration of patients with TBI, and unpredictable change may occur even when TBI is mild to moderate. When computed tomography (CT) findings are considered to be inconsistent with the traumatic origin or with the neurological deterioration of patients observed on admission, magnetic resonance imaging (MRI) is employed based on the standards of our ethical committee. In this retrospective study, we compared CT and diffusion weighted imaging (DWI) of patients with mild to moderate TBI in the very acute phase. When the high-intensity lesions on DWI are larger than the high-density lesions on CT images, we defined the imaging finding as a ʻCT-DWI mismatchʼ. Between January 2010 and December 2013, 92 patients were inspected using both CT and MRI at admission, and we detected a CT-DWI mismatch in 35 patients. CT-DWI mismatch was 92.6 (95 confidence interval 79.8-97.9) sensitive and 84.6 (95 confidence interval 79.3-86.3) specific for the prediction of enlargement of the hemorrhagic lesions on repeat CT. CT-DWI mismatch is considered to be useful as one of the predictors of the enlargement of hemorrhagic lesions in patients with mild to moderate TBI

Current Status and Future Potential of Robotic Surgery for Gastrointestinal Cancer

　Robotic surgery has built on innovations in areas such as medical engineering and optical technology. Laparoscopic surgery has been successfully adapted for gastric, colon, and rectal cancer surgeries over the past two decades with numerous clinical trials showing oncological results comparable to those of open surgery. These trials have also shown that the laparoscopic approach shortens postoperative recovery time and decreases complication rates. Another advantage of minimally invasive techniques for the resection of gastric, colon, and rectal cancers is improved visualization of the surgical field. Despite the near absence of tactile feedback, robotic surgery has overcome many of the challenges inherent in laparoscopic surgery through features such as 3D vision, stable magnification, EndoWrist instruments, physiological tremor filtering, and motion scaling. Robotic surgery is not yet widely used in esophageal cancer surgery or in a pancreaticoduodenectomy for pancreatic cancer due to anatomical difficulties and the lack of a suitable approach.　Comparative studies of robotic and laparoscopic surgery have shown similar results in terms of perioperative management, oncologic evaluation, and functional outcomes. However, it is also true that the high cost and lack of tactile feedback in robotic surgery are major limitations in terms of current robotic technology becoming the worldwide standard for minimally invasive surgery. The future of robotic surgery will require cost reduction, the development of new platforms and technologies, the creation and validation of curricula and virtual simulators, and confirmation through appropriate randomized controlled clinical trials