1.Effect of Intraoperative Ventricular Opening on Recurrence Patterns Following Bis-Chloroethyl-Nitrosourea Wafer Implantation for Newly Diagnosed Glioblastoma
Ryosuke MATSUDA ; Ryosuke MAEOKA ; Takayuki MORIMOTO ; Tsutomu NAKAZAWA ; Noriaki TOKUDA ; Masashi KOTSUGI ; Yasuhiro TAKESHIMA ; Kentaro TAMURA ; Shuichi YAMADA ; Fumihiko NISHIMURA ; Young-Soo PARK ; Ichiro NAKAGAWA
Journal of Korean Neurosurgical Society 2025;68(1):60-66
Objective:
: To evaluate the effect of ventricular opening (VO) on recurrence patterns in patients with newly diagnosed glioblastoma (GBM) treated with bis-chloroethyl-nitrosourea (BCNU) wafer implantation.
Methods:
: This single-center retrospective study included 40 patients with newly diagnosed GBM who received BCNU wafer implantation after tumor resection between March 2013 and February 2022. The patients were categorized into two groups based on whether VO occurred during the GBM resection. While 18 patients had VO, 22 did not have VO. In cases with VO, the ventricular wall defect is closed with gelatin or oxidized regenerated cellulose and fibrin glue before BCNU wafer implantation. Recurrence patterns—classified as local, diffuse, distant, or multifocal—and time to recurrence were compared between patients with and without VO.
Results:
: The median follow-up period for the entire cohort was 32.2 months (interquartile range, 16.7–38 months). Median survival time was comparable between patients with VO and patients without VO (38 vs. 26 months, p=0.53). Recurrence occurred in 31/40 patients (77.5%) in entire cohort. The incidence of recurrence was comparable between patients with VO and patients without VO (14 [77.8%] vs. 17 [77.3%], p=1.0). No significant differences were seen between the two groups in time to recurrence (p=0.59) or recurrence patterns (p=0.35).
Conclusion
: Ventricular opening during surgery with BCNU wafer implantation does not seem to influence the recurrence patterns. Ventricular opening does not induce distant recurrence if appropriate ventricular closure is performed.
2.Effect of Intraoperative Ventricular Opening on Recurrence Patterns Following Bis-Chloroethyl-Nitrosourea Wafer Implantation for Newly Diagnosed Glioblastoma
Ryosuke MATSUDA ; Ryosuke MAEOKA ; Takayuki MORIMOTO ; Tsutomu NAKAZAWA ; Noriaki TOKUDA ; Masashi KOTSUGI ; Yasuhiro TAKESHIMA ; Kentaro TAMURA ; Shuichi YAMADA ; Fumihiko NISHIMURA ; Young-Soo PARK ; Ichiro NAKAGAWA
Journal of Korean Neurosurgical Society 2025;68(1):60-66
Objective:
: To evaluate the effect of ventricular opening (VO) on recurrence patterns in patients with newly diagnosed glioblastoma (GBM) treated with bis-chloroethyl-nitrosourea (BCNU) wafer implantation.
Methods:
: This single-center retrospective study included 40 patients with newly diagnosed GBM who received BCNU wafer implantation after tumor resection between March 2013 and February 2022. The patients were categorized into two groups based on whether VO occurred during the GBM resection. While 18 patients had VO, 22 did not have VO. In cases with VO, the ventricular wall defect is closed with gelatin or oxidized regenerated cellulose and fibrin glue before BCNU wafer implantation. Recurrence patterns—classified as local, diffuse, distant, or multifocal—and time to recurrence were compared between patients with and without VO.
Results:
: The median follow-up period for the entire cohort was 32.2 months (interquartile range, 16.7–38 months). Median survival time was comparable between patients with VO and patients without VO (38 vs. 26 months, p=0.53). Recurrence occurred in 31/40 patients (77.5%) in entire cohort. The incidence of recurrence was comparable between patients with VO and patients without VO (14 [77.8%] vs. 17 [77.3%], p=1.0). No significant differences were seen between the two groups in time to recurrence (p=0.59) or recurrence patterns (p=0.35).
Conclusion
: Ventricular opening during surgery with BCNU wafer implantation does not seem to influence the recurrence patterns. Ventricular opening does not induce distant recurrence if appropriate ventricular closure is performed.
3.Effect of Intraoperative Ventricular Opening on Recurrence Patterns Following Bis-Chloroethyl-Nitrosourea Wafer Implantation for Newly Diagnosed Glioblastoma
Ryosuke MATSUDA ; Ryosuke MAEOKA ; Takayuki MORIMOTO ; Tsutomu NAKAZAWA ; Noriaki TOKUDA ; Masashi KOTSUGI ; Yasuhiro TAKESHIMA ; Kentaro TAMURA ; Shuichi YAMADA ; Fumihiko NISHIMURA ; Young-Soo PARK ; Ichiro NAKAGAWA
Journal of Korean Neurosurgical Society 2025;68(1):60-66
Objective:
: To evaluate the effect of ventricular opening (VO) on recurrence patterns in patients with newly diagnosed glioblastoma (GBM) treated with bis-chloroethyl-nitrosourea (BCNU) wafer implantation.
Methods:
: This single-center retrospective study included 40 patients with newly diagnosed GBM who received BCNU wafer implantation after tumor resection between March 2013 and February 2022. The patients were categorized into two groups based on whether VO occurred during the GBM resection. While 18 patients had VO, 22 did not have VO. In cases with VO, the ventricular wall defect is closed with gelatin or oxidized regenerated cellulose and fibrin glue before BCNU wafer implantation. Recurrence patterns—classified as local, diffuse, distant, or multifocal—and time to recurrence were compared between patients with and without VO.
Results:
: The median follow-up period for the entire cohort was 32.2 months (interquartile range, 16.7–38 months). Median survival time was comparable between patients with VO and patients without VO (38 vs. 26 months, p=0.53). Recurrence occurred in 31/40 patients (77.5%) in entire cohort. The incidence of recurrence was comparable between patients with VO and patients without VO (14 [77.8%] vs. 17 [77.3%], p=1.0). No significant differences were seen between the two groups in time to recurrence (p=0.59) or recurrence patterns (p=0.35).
Conclusion
: Ventricular opening during surgery with BCNU wafer implantation does not seem to influence the recurrence patterns. Ventricular opening does not induce distant recurrence if appropriate ventricular closure is performed.
4.Effect of Intraoperative Ventricular Opening on Recurrence Patterns Following Bis-Chloroethyl-Nitrosourea Wafer Implantation for Newly Diagnosed Glioblastoma
Ryosuke MATSUDA ; Ryosuke MAEOKA ; Takayuki MORIMOTO ; Tsutomu NAKAZAWA ; Noriaki TOKUDA ; Masashi KOTSUGI ; Yasuhiro TAKESHIMA ; Kentaro TAMURA ; Shuichi YAMADA ; Fumihiko NISHIMURA ; Young-Soo PARK ; Ichiro NAKAGAWA
Journal of Korean Neurosurgical Society 2025;68(1):60-66
Objective:
: To evaluate the effect of ventricular opening (VO) on recurrence patterns in patients with newly diagnosed glioblastoma (GBM) treated with bis-chloroethyl-nitrosourea (BCNU) wafer implantation.
Methods:
: This single-center retrospective study included 40 patients with newly diagnosed GBM who received BCNU wafer implantation after tumor resection between March 2013 and February 2022. The patients were categorized into two groups based on whether VO occurred during the GBM resection. While 18 patients had VO, 22 did not have VO. In cases with VO, the ventricular wall defect is closed with gelatin or oxidized regenerated cellulose and fibrin glue before BCNU wafer implantation. Recurrence patterns—classified as local, diffuse, distant, or multifocal—and time to recurrence were compared between patients with and without VO.
Results:
: The median follow-up period for the entire cohort was 32.2 months (interquartile range, 16.7–38 months). Median survival time was comparable between patients with VO and patients without VO (38 vs. 26 months, p=0.53). Recurrence occurred in 31/40 patients (77.5%) in entire cohort. The incidence of recurrence was comparable between patients with VO and patients without VO (14 [77.8%] vs. 17 [77.3%], p=1.0). No significant differences were seen between the two groups in time to recurrence (p=0.59) or recurrence patterns (p=0.35).
Conclusion
: Ventricular opening during surgery with BCNU wafer implantation does not seem to influence the recurrence patterns. Ventricular opening does not induce distant recurrence if appropriate ventricular closure is performed.
5.Early Rehabilitation Interventions by Physical Therapists for Severe COVID-19 Patients Were Associated With Decreased Incidence of Post-ICU Physical Impairment
Shinya OKU ; Junji HATAKEYAMA ; Keibun LIU ; Kentaro TOJO ; Masafumi IDEI ; Shigeaki INOUE ; Kazuma YAMAKAWA ; Takeshi NISHIDA ; Shinichiro OHSHIMO ; Satoru HASHIMOTO ; Shuhei MARUYAMA ; Yoshitaka OGATA ; Daisuke KAWAKAMI ; Hiroaki SHIMIZU ; Katsura HAYAKAWA ; Yuji FUJINO ; Taku OSHIMA ; Tatsuya FUCHIGAMI ; Hironori YAWATA ; Kyoji OE ; Akira KAWAUCHI ; Hidehiro YAMAGATA ; Masahiro HARADA ; Yuichi SATO ; Tomoyuki NAKAMURA ; Kei SUGIKI ; Takahiro HAKOZAKI ; Satoru BEPPU ; Masaki ANRAKU ; Noboru KATO ; Tomomi IWASHITA ; Hiroshi KAMIJO ; Yuichiro KITAGAWA ; Michio NAGASHIMA ; Hirona NISHIMAKI ; Kentaro TOKUDA ; Osamu NISHIDA ; Kensuke NAKAMURA
Annals of Rehabilitation Medicine 2025;49(1):49-59
Objective:
To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment.
Methods:
An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors.
Results:
The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006).
Conclusion
Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.
6.Early Rehabilitation Interventions by Physical Therapists for Severe COVID-19 Patients Were Associated With Decreased Incidence of Post-ICU Physical Impairment
Shinya OKU ; Junji HATAKEYAMA ; Keibun LIU ; Kentaro TOJO ; Masafumi IDEI ; Shigeaki INOUE ; Kazuma YAMAKAWA ; Takeshi NISHIDA ; Shinichiro OHSHIMO ; Satoru HASHIMOTO ; Shuhei MARUYAMA ; Yoshitaka OGATA ; Daisuke KAWAKAMI ; Hiroaki SHIMIZU ; Katsura HAYAKAWA ; Yuji FUJINO ; Taku OSHIMA ; Tatsuya FUCHIGAMI ; Hironori YAWATA ; Kyoji OE ; Akira KAWAUCHI ; Hidehiro YAMAGATA ; Masahiro HARADA ; Yuichi SATO ; Tomoyuki NAKAMURA ; Kei SUGIKI ; Takahiro HAKOZAKI ; Satoru BEPPU ; Masaki ANRAKU ; Noboru KATO ; Tomomi IWASHITA ; Hiroshi KAMIJO ; Yuichiro KITAGAWA ; Michio NAGASHIMA ; Hirona NISHIMAKI ; Kentaro TOKUDA ; Osamu NISHIDA ; Kensuke NAKAMURA
Annals of Rehabilitation Medicine 2025;49(1):49-59
Objective:
To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment.
Methods:
An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors.
Results:
The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006).
Conclusion
Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.
7.Early Rehabilitation Interventions by Physical Therapists for Severe COVID-19 Patients Were Associated With Decreased Incidence of Post-ICU Physical Impairment
Shinya OKU ; Junji HATAKEYAMA ; Keibun LIU ; Kentaro TOJO ; Masafumi IDEI ; Shigeaki INOUE ; Kazuma YAMAKAWA ; Takeshi NISHIDA ; Shinichiro OHSHIMO ; Satoru HASHIMOTO ; Shuhei MARUYAMA ; Yoshitaka OGATA ; Daisuke KAWAKAMI ; Hiroaki SHIMIZU ; Katsura HAYAKAWA ; Yuji FUJINO ; Taku OSHIMA ; Tatsuya FUCHIGAMI ; Hironori YAWATA ; Kyoji OE ; Akira KAWAUCHI ; Hidehiro YAMAGATA ; Masahiro HARADA ; Yuichi SATO ; Tomoyuki NAKAMURA ; Kei SUGIKI ; Takahiro HAKOZAKI ; Satoru BEPPU ; Masaki ANRAKU ; Noboru KATO ; Tomomi IWASHITA ; Hiroshi KAMIJO ; Yuichiro KITAGAWA ; Michio NAGASHIMA ; Hirona NISHIMAKI ; Kentaro TOKUDA ; Osamu NISHIDA ; Kensuke NAKAMURA
Annals of Rehabilitation Medicine 2025;49(1):49-59
Objective:
To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment.
Methods:
An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors.
Results:
The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006).
Conclusion
Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.