Binocular stereo-navigation for three-dimensional thoracoscopic lung resection

BACKGROUND: This study investigated the efficacy of binocular stereo-navigation during three-dimensional (3-D) thoracoscopic sublobar resection (TSLR). METHODS: From July 2001, the authors’ department began to use a virtual 3-D pulmonary model on a personal computer (PC) for preoperative simulation before thoracoscopic lung resection and for intraoperative navigation during operation. From 120 of 1-mm thin-sliced high-resolution computed tomography (HRCT)-scan images of tumor and hilum, homemade software CTTRY allowed sugeons to mark pulmonary arteries, veins, bronchi, and tumor on the HRCT images manually. The location and thickness of pulmonary vessels and bronchi were rendered as diverse size cylinders. With the resulting numerical data, a 3-D image was reconstructed by Metasequoia shareware. Subsequently, the data of reconstructed 3-D images were converted to Autodesk data, which appeared on a stereoscopic-vision display. Surgeons wearing 3-D polarized glasses performed 3-D TSLR. RESULTS: The patients consisted of 5 men and 5 women, ranging in age from 65 to 84 years. The clinical diagnoses were a primary lung cancer in 6 cases and a solitary metastatic lung tumor in 4 cases. Eight single segmentectomies, one bi-segmentectomy, and one bi-subsegmentectomy were performed. Hilar lymphadenectomy with mediastinal lymph node sampling has been performed in 6 primary lung cancers, but four patients with metastatic lung tumors were performed without lymphadenectomy. The operation time and estimated blood loss ranged from 125 to 333 min and from 5 to 187 g, respectively. There were no intraoperative complications and no conversion to open thoracotomy and lobectomy. Postoperative courses of eight patients were uneventful, and another two patients had a prolonged lung air leak. The drainage duration and hospital stay ranged from 2 to 13 days and from 8 to 19 days, respectively. The tumor histology of primary lung cancer showed 5 adenocarcinoma and 1 squamous cell carcinoma. All primary lung cancers were at stage IA. The organs having metastatic pulmonary tumors were kidney, bladder, breast, and rectum. No patients had macroscopically positive surgical margins. CONCLUSIONS: Binocular stereo-navigation was able to identify the bronchovascular structures accurately and suitable to perform TSLR with a sufficient margin for small pulmonary tumors

A novel and simple method for identifying the lung intersegmental plane with an infrared thermography

25th WSCTS Annual Meeting and Exhibiotion 2015 2015年09月21日 Edinburgh, Scotlan

A novel and simple method for identifying the lung intersegmental plane with an infrared thermography

25th WSCTS Annual Meeting and Exhibiotion 2015 2015年09月21日 Edinburgh, Scotlan

Chemogenetic dissection of the primate prefronto-subcortical pathways for working memory and decision-making

「何を買うんだっけ」と「どれにしよう」を処理する2つの脳回路を明らかに --霊長類の生体脳で神経経路を可視化・操作する技術で解明、高次脳機能の理解へ大きく前進--. 京都大学プレスリリース. 2021-06-24.The primate prefrontal cortex (PFC) is situated at the core of higher brain functions via neural circuits such as those linking the caudate nucleus and mediodorsal thalamus. However, the distinctive roles of these prefronto-subcortical pathways remain elusive. Combining in vivo neuronal projection mapping with chemogenetic synaptic silencing, we reversibly dissected key pathways from dorsolateral part of the PFC (dlPFC) to the dorsal caudate (dCD) and lateral mediodorsal thalamus (MDl) individually in single monkeys. We found that silencing the bilateral dlPFC-MDl projections, but not the dlPFC-dCD projections, impaired performance in a spatial working memory task. Conversely, silencing the unilateral dlPFC-dCD projection, but not the unilateral dlPFC-MDl projection, altered preference in a decision-making task. These results revealed dissociable roles of the prefronto-subcortical pathways in working memory and decision-making, representing the technical advantage of imaging-guided pathway-selective chemogenetic manipulation for dissecting neural circuits underlying cognitive functions in primates

Multiscale chemogenetic dissection of fronto-temporal top-down regulation for object memory in primates

見た物の記憶を保持する霊長類の脳ネットワークとメカニズムを解明 --認知症の記憶障害治療への応用に期待-- .京都大学プレスリリース. 2024-07-12.Visual object memory is a fundamental element of various cognitive abilities, and the underlying neural mechanisms have been extensively examined especially in the anterior temporal cortex of primates. However, both macroscopic large-scale functional network in which this region is embedded and microscopic neuron-level dynamics of top-down regulation it receives for object memory remains elusive. Here, we identified the orbitofrontal node as a critical partner of the anterior temporal node for object memory by combining whole-brain functional imaging during rest and a short-term object memory task in male macaques. Focal chemogenetic silencing of the identified orbitofrontal node downregulated both the local orbitofrontal and remote anterior temporal nodes during the task, in association with deteriorated mnemonic, but not perceptual, performance. Furthermore, imaging-guided neuronal recordings in the same monkeys during the same task causally revealed that orbitofrontal top-down modulation enhanced stimulus-selective mnemonic signal in individual anterior temporal neurons while leaving bottom-up perceptual signal unchanged. Furthermore, similar activity difference was also observed between correct and mnemonic error trials before silencing, suggesting its behavioral relevance. These multifaceted but convergent results provide a multiscale causal understanding of dynamic top-down regulation of the anterior temporal cortex along the ventral fronto-temporal network underpinning short-term object memory in primates

Chemogenetic attenuation of cortical seizures in nonhuman primates

「てんかん」の発生を時間的・空間的にピンポイントで抑える画期的な治療法を開発 --世界で初めてサルでの有効性を実証、臨床応用に向け大きく前進--. 京都大学プレスリリース. 2023-03-01.Epilepsy is a disorder in which abnormal neuronal hyperexcitation causes several types of seizures. Because pharmacological and surgical treatments occasionally interfere with normal brain function, a more focused and on-demand approach is desirable. Here we examined the efficacy of a chemogenetic tool—designer receptors exclusively activated by designer drugs (DREADDs)—for treating focal seizure in a nonhuman primate model. Acute infusion of the GABAA receptor antagonist bicuculline into the forelimb region of unilateral primary motor cortex caused paroxysmal discharges with twitching and stiffening of the contralateral arm, followed by recurrent cortical discharges with hemi- and whole-body clonic seizures in two male macaque monkeys. Expression of an inhibitory DREADD (hM4Di) throughout the seizure focus, and subsequent on-demand administration of a DREADD-selective agonist, rapidly suppressed the wide-spread seizures. These results demonstrate the efficacy of DREADDs for attenuating cortical seizure in a nonhuman primate model

Public communication by research institutes compared across countries and sciences: building capacity for engagement or competing for visibility?

Leading academic institutions, governments, and funders of research across the world have spent the last few decades fretting publicly about the need for scientists and research organisations to engage more widely with the public and be open about their research. While a global literature asserts that public communication has changed from a virtue to a duty for scientists in many countries and disciplines, our knowledge about what research institutions are doing and what factors drive their 'going public' is very limited. Here we present the first cross-national study of N = 2,030 research institutes within universities and large scientific organisations in Brazil, Germany, Italy, Japan, the Netherlands, Portugal, the United Kingdom, and the United States of America. We find that institutes embrace communication with non-peers and do so through a variety of public events and traditional news media-less so through new media channels-and we find variation across countries and sciences, yet these are less evident than we expected. Country and disciplinary cultures contribute to the level of this communication, as do the resources that institutes make available for the effort; institutes with professionalised staff show higher activity online. Future research should examine whether a real change in the organisational culture is happening or whether this activity and resource allocation is merely a means to increase institutional visibility

Secondary Bone Grafting With Simultaneous Auto-Tooth Transplantation to the Alveolar Cleft

One of the most important purposes of secondary bone grafting of the alveolar cleft is to stabilize the maxillary alveolar arch with completion of the dental arch. We report a case of secondary bone grafting with simultaneous auto-tooth transplantation to the alveolar cleft, using particulate cancellous bone and marrow (PCBM) combined with platelet-rich plasma (PRP), which contains many growth factors. The patient was born with a bilateral cleft lip and left buccal-localized cleft alveolus. We performed bone grafting to the cleft using PCBM with PRP and transplantation of the supernumerary tooth under general anesthesia when the patient was aged 11 years, 10 months. The postoperative course was uneventful and without any complications. The orthodontic treatment was nearly complete 10 months after the operation. The transplanted tooth was stable, and a normal gingival contour was attained during the 2-year follow-up period. The case was successful in achieving a stable occlusal condition within a short period. We suggest secondary bone grafting with simultaneous auto-tooth transplantation as an option for alveolar cleft treatment