Ryosuke Hanaya

@kagoshima-u.ac.jp

Department of Neurosurgery
Kagoshima University

RESEARCH INTERESTS

neurosurgery, epilepsy surgery

126

Scopus Publications

Scopus Publications

  • Secondary hypophysitis associated with Rathke’s cleft cyst resembling a pituitary abscess
    Eri Inoue, Irfan Kesumayadi, Shingo Fujio, Ryutaro Makino, Tomoko Hanada, Keisuke Masuda, Nayuta Higa, Shigeru Kawade, Yuichiro Niihara, Hirosuke Takagi,et al.

    Scientific Scholar
    Background: Although rare, cases of hypophysitis resembling a pituitary abscess (PA) have been reported. Differential diagnosis between hypophysitis and PA is crucial as the two diseases require different treatments. Case Description: A 38-year-old woman with headaches underwent head magnetic resonance imaging (MRI), which revealed an 11-mm mass lesion in the sella turcica. Due to breastfeeding, contrast-enhanced MRI was avoided. Pituitary adenomas and Rathke’s cleft cyst (RCC) were suspected, and she was initially treated conservatively. Five months later, she acquired syndrome coronavirus two infections, and while the fever subsided with acetaminophen, the headache persisted. One month later, the headache worsened, followed by fever and diabetes insipidus. MRI revealed a pituitary cystic mass with ring-shaped contrast enhancement on T1-weighted MRI and increased signal intensity on diffusion-weighted imaging (DWI). PA was suspected, and emergency endoscopic transsphenoidal surgery was performed. The microbiological examination of the yellowish-brown content drained from the cystic mass was negative. Microscopically, the cystic lesion was covered with ciliated columnar epithelium and stratified squamous epithelium, with a dense inflammatory cell infiltrate consisting mainly of lymphocytes and plasma cells observed around the cyst. This supported the diagnosis of secondary hypophysitis associated with RCC without PA. Conclusion: We report a case of hypophysitis secondary to RCC resembling PA with ring-shaped contrast enhancement on MRI and increased signal intensity on DWI. This case emphasizes the need for cautious diagnosis of secondary hypophysitis due to RCC in individuals with MRIs and clinical manifestations resembling an abscess.

  • Differentiating primary central nervous system lymphoma from glioblastoma by time-dependent diffusion using oscillating gradient
    Kiyohisa Kamimura, Tsubasa Nakano, Tomohito Hasegawa, Masanori Nakajo, Chihiro Yamada, Yoshiki Kamimura, Kentaro Akune, Fumitaka Ejima, Takuro Ayukawa, Hiroaki Nagano,et al.

    Springer Science and Business Media LLC
    Abstract Background This study aimed to elucidate the impact of effective diffusion time setting on apparent diffusion coefficient (ADC)-based differentiation between primary central nervous system lymphomas (PCNSLs) and glioblastomas (GBMs) and to investigate the usage of time-dependent diffusion magnetic resonance imaging (MRI) parameters. Methods A retrospective study was conducted involving 21 patients with PCNSLs and 66 patients with GBMs using diffusion weighted imaging (DWI) sequences with oscillating gradient spin-echo (Δeff = 7.1 ms) and conventional pulsed gradient (Δeff = 44.5 ms). In addition to ADC maps at the two diffusion times (ADC7.1 ms and ADC44.5 ms), we generated maps of the ADC changes (cADC) and the relative ADC changes (rcADC) between the two diffusion times. Regions of interest were placed on enhancing regions and non-enhancing peritumoral regions. The mean and the fifth and 95th percentile values of each parameter were compared between PCNSLs and GBMs. The area under the receiver operating characteristic curve (AUC) values were used to compare the discriminating performances among the indices. Results In enhancing regions, the mean and fifth and 95th percentile values of ADC44.5 ms and ADC7.1 ms in PCNSLs were significantly lower than those in GBMs (p = 0.02 for 95th percentile of ADC44.5 ms, p = 0.04 for ADC7.1 ms, and p < 0.01 for others). Furthermore, the mean and fifth and 95th percentile values of cADC and rcADC were significantly higher in PCNSLs than in GBMs (each p < 0.01). The AUC of the best-performing index for ADC7.1 ms was significantly lower than that for ADC44.5 ms (p < 0.001). The mean rcADC showed the highest discriminating performance (AUC = 0.920) among all indices. In peritumoral regions, no significant difference in any of the three indices of ADC44.5 ms, ADC7.1 ms, cADC, and rcADC was observed between PCNSLs and GBMs. Conclusions Effective diffusion time setting can have a crucial impact on the performance of ADC in differentiating between PCNSLs and GBMs. The time-dependent diffusion MRI parameters may be useful in the differentiation of these lesions.

  • Indocyanine green endoscopic evaluation of pituitary stalk and gland blood flow in craniopharyngiomas
    Ryutaro Makino, Shingo Fujio, Jun Sugata, Masanori Yonenaga, Tomoko Hanada, Nayuta Higa, Hitoshi Yamahata, and Ryosuke Hanaya

    Springer Science and Business Media LLC

  • Intravenous perampanel as an alternative to the oral formulations in Japanese patients with epilepsy
    Ryosuke Hanaya, Yuichi Kubota, Masahiro Mizobuchi, Koji Iida, Tomonori Ono, Hiromichi Motooka, Naoki Nakano, Ayataka Fujimoto, Masaki Iwasaki, Masafumi Fukuda,et al.

    Wiley
    AbstractObjectivePerampanel is an oral anti‐seizure medication, which is approved in Japan for focal‐onset seizures, with/without focal to bilateral tonic–clonic seizures, as monotherapy/adjunctive therapy in patients aged 4 years and older. Treatment for generalized tonic–clonic seizures as adjunctive therapy in patients aged 12 years and older is approved as well. We evaluated the feasibility of intravenous (IV) administration of perampanel as an alternative to oral administration.MethodsStudy 240 (NCT03754582) was an uncontrolled, open‐label study of IV perampanel, conducted in 21 Japanese patients with epilepsy who received a stable dose of 8–12 mg/day of oral perampanel. Patients received 30‐minute IV infusions at equivalent daily doses of oral perampanel for 4 days, then were switched back to oral perampanel. Safety, tolerability, plasma concentration, and maintenance of efficacy throughout the transition between IV and oral dosing of perampanel were assessed. As supportive data, a subgroup analysis was also conducted using data from healthy Japanese subjects (n = 18) who were enrolled in Study 050 (NCT03376997) investigating the pharmacokinetics and safety of IV perampanel in healthy subjects who received an IV infusion (30‐, 60‐, or 90‐minute) of perampanel 12 mg and a single oral administration of perampanel 12‐mg tablet.ResultsIn Study 240, the transition between 30‐minute IV and oral perampanel dosing was associated with a ≤1.4‐fold increase in the mean change in maximum observed concentration of perampanel. Seizure outcomes demonstrated no considerable changes in efficacy before, during, or after 30‐minute IV dosing of perampanel. The safety profiles were similar between IV and oral formulations. In Study 050, the pharmacokinetics of 30‐ or 60‐minute IV infusion of perampanel further support the interchangeability between oral and IV formulations in the Japanese subjects.SignificanceThese results support that 30‐minute IV perampanel may be a potential short‐term alternative to oral formulations for patients with epilepsy.

  • A case of glioblastoma harboring non-amplified epidermal growth factor receptor variant III: Critical molecular detection using RNA-based panel analysis
    Mari Kirishima, Toshiaki Akahane, Tomoko Takajo, Nayuta Higa, Hajime Yonezawa, Hiroyuki Uchida, Kiyohisa Kamimura, Ryosuke Hanaya, Koji Yoshimoto, Michiyo Higashi,et al.

    Elsevier BV

  • Clinicopathologic analysis of pineal parenchymal tumors of intermediate differentiation: a multi-institutional cohort study by the Kyushu Neuro-Oncology Study Group
    Shinji Yamashita, Hideo Takeshima, Nobuhiro Hata, Hiroyuki Uchida, Naoki Shinojima, Kiyotaka Yokogami, Yoshiteru Nakano, Kiyohiko Sakata, Hirotaka Fudaba, Toshiyuki Enomoto,et al.

    Springer Science and Business Media LLC

  • Bibliometric Analysis of the Neurosurgery Publication Productivity of Southeast Asia in 2011–2020
    Muhammad Kamil, Zainal Muttaqin, Ryosuke Hanaya, Kazunori Arita, and Koji Yoshimoto

    Elsevier BV

  • Posterior cerebral artery stenosis related to implanted intracranial electrodes for temporal lobe epilepsy: A case report
    Daiki Matsuda, Takuichiro Higashi, Masanori Sato, Hiroshi Hosoyama, Toshiaki Otsubo, and Ryosuke Hanaya

    Elsevier BV

  • Difficult differential diagnosis of ectopic germinoma from multiple sclerosis: A case report and literature review
    Keisuke Masuda, Nayuta Higa, Hajime Yonezawa, Hiroyuki Uchida, and Ryosuke Hanaya

    Elsevier BV

  • Delayed postoperative hyponatremia in patients with acromegaly: incidence and predictive factors
    Ryutaro Makino, Shingo Fujio, Tomoko Hanada, Masanori Yonenaga, Shigeru Kawade, Hiroshi Hashiguchi, Yoshihiko Nishio, Nayuta Higa, Kazunori Arita, Koji Yoshimoto,et al.

    Springer Science and Business Media LLC

  • Patients of idiopathic normal-pressure hydrocephalus have small dural sac in cervical and upper thoracic levels: A supposed causal association
    Takashi Kawahara, Kazunori Arita, Shingo Fujio, Nayuta Higa, Hiroki Hata, FM Moinuddin, and Ryosuke Hanaya

    Scientific Scholar
    Background: Idiopathic normal pressure hydrocephalus (iNPH) is a neurological disorder presenting a triad including dementia and ventricular enlargement. The mechanism causing excessive cerebrospinal fluid (CSF) accumulation in the ventricles in iNPH is poorly understood. We hypothesized that the age-related degradation of the spinal shock-absorbing system composed of a spinal dural sac (SDS) and surrounding soft tissue, preventing ventricular enlargement caused by wide CSF pulsation driven by heartbeats, may be involved in the ventricular enlargement observed in iNPH. Methods: Sixty-four patients with iNPH in their seventies who underwent a lumboperitoneal shunt and a control group of 79 people in the same age group who underwent brain check-ups were included in the study. We compared the sizes of the cervical and upper parts of the thoracic SDS using magnetic resonance imaging between the two groups. Results: The anterior-posterior distances of the dural sac at C5 were shorter in patients with iNPH of both sexes than those in the control group (P = 0.0008 in men and P = 0.0047 in women). The number of disc levels with disappeared CSF space surrounding the cervical cord was more in iNPH (P = 0.0176 and P = 0.0003). The midsagittal area of the upper part of the spinal sac, C2-Th4, was smaller in iNPH (P = 0.0057 and P = 0.0290). Conclusion: Narrowing of the cervical dural sac and midsagittal area in the upper part of the SDS in patients with iNPH may reflect the degradation of the shock-absorbing mechanism for CSF pressure pulsations, which may cause iNPH or at least aggravate iNPH by other unknown causes.

  • Alterations in EGFR and PDGFRA are associated with the localization of contrast-enhancing lesions in glioblastoma
    Ryutaro Makino, Nayuta Higa, Toshiaki Akahane, Hajime Yonezawa, Hiroyuki Uchida, Tomoko Takajo, Shingo Fujio, Mari Kirishima, Taiji Hamada, Hitoshi Yamahata,et al.

    Oxford University Press (OUP)
    Abstract Background Glioblastoma (GBM) is a malignant brain tumor, with radiological and genetic heterogeneity. We examined the association between radiological characteristics and driver gene alterations. Methods We analyzed the driver genes of 124 patients with IDH wild-type GBM with contrast enhancement using magnetic resonance imaging. We used a next-generation sequencing panel to identify mutations in driver genes and matched them with radiological information. Contrast-enhancing lesion localization of GBMs was classified into 4 groups based on their relationship with the subventricular zone (SVZ) and cortex (Ctx). Results The cohort included 69 men (55.6%) and 55 women (44.4%) with a mean age of 66.4 ± 13.3 years. EGFR and PDGFRA alterations were detected in 28.2% and 22.6% of the patients, respectively. Contrast-enhancing lesion touching both the SVZ and Ctx was excluded because it was difficult to determine whether it originated from the SVZ or Ctx. Contrast-enhancing lesions touching the SVZ but not the Ctx had significantly worse overall survival than non-SVZ lesions (441 days vs. 897 days, P = .002). GBM touching only the Ctx had a better prognosis (901 days vs. 473 days, P < .001) than non-Ctx lesions and was associated with EGFR alteration (39.4% vs. 13.2%, P = .015). Multiple contrast lesions were predominant in PDGFRA alteration and RB1-wild type (P = .036 and P = .031, respectively). Conclusions EGFR alteration was associated with cortical lesions. And PDGFRA alteration correlated with multiple lesions. Our results suggest that clarifying the association between driver genes and tumor localization may be useful in clinical practice, including prognosis prediction.

  • Favorable prognostic impact of phosphatase and tensin homolog alterations in wild-type isocitrate dehydrogenase and telomerase reverse transcriptase promoter glioblastoma
    Nayuta Higa, Toshiaki Akahane, Seiya Yokoyama, Ryutaro Makino, Hajime Yonezawa, Hiroyuki Uchida, Tomoko Takajo, Mari Kirishima, Taiji Hamada, Naoki Noguchi,et al.

    Oxford University Press (OUP)
    Abstract Background Telomerase reverse transcriptase promoter (TERTp) mutations are a biological marker of glioblastoma; however, the prognostic significance of TERTp mutational status is controversial. We evaluated this impact by retrospectively analyzing the outcomes of patients with isocitrate dehydrogenase (IDH)- and TERTp-wild-type glioblastomas. Methods Using custom next-generation sequencing, we analyzed 208 glioblastoma samples harboring wild-type IDH. Results TERTp mutations were detected in 143 samples (68.8%). The remaining 65 (31.2%) were TERTp-wild-type. Among the TERTp-wild-type glioblastoma samples, we observed a significant difference in median progression-free survival (18.6 and 11.4 months, respectively) and overall survival (not reached and 15.7 months, respectively) in patients with and without phosphatase and tensin homolog (PTEN) loss and/or mutation. Patients with TERTp-wild-type glioblastomas with PTEN loss and/or mutation were younger and had higher Karnofsky Performance Status scores than those without PTEN loss and/or mutation. We divided the patients with TERTp-wild-type into 3 clusters using unsupervised hierarchical clustering: Good (PTEN and TP53 alterations; lack of CDKN2A/B homozygous deletion and platelet-derived growth factor receptor alpha (PDGFRA) alterations), intermediate (PTEN alterations, CDKN2A/B homozygous deletion, lack of PDGFRA, and TP53 alterations), and poor (PDGFRA and TP53 alterations, CDKN2A/B homozygous deletion, and lack of PTEN alterations) outcomes. Kaplan–Meier survival analysis indicated that these clusters significantly correlated with the overall survival of TERTp-wild-type glioblastoma patients. Conclusions Here, we report that PTEN loss and/or mutation is the most useful marker for predicting favorable outcomes in patients with IDH- and TERTp-wild-type glioblastomas. The combination of 4 genes, PTEN, TP53, CDKN2A/B, and PDGFRA, is important for the molecular classification and individual prognosis of patients with IDH- and TERTp-wild-type glioblastomas.

  • A Case of Atypical Absence Status Controlled by Corpus Callosotomy
    Chihiro Yonee, Shinsuke Maruyama, Mayumi Matsufuji, Nozomi Sano, Masanori Sato, Hiroshi Hosoyama, and Ryosuke Hanaya

    The Japan Epilepsy Society

  • Distribution and favorable prognostic implication of genomic EGFR alterations in IDH-wildtype glioblastoma
    Nayuta Higa, Toshiaki Akahane, Taiji Hamada, Hajime Yonezawa, Hiroyuki Uchida, Ryutaro Makino, Shoji Watanabe, Tomoko Takajo, Seiya Yokoyama, Mari Kirishima,et al.

    Wiley

  • IDH-mutant astrocytoma with an evolutional progression to CDKN2A/B homozygous deletion and NTRK fusion during recurrence: A case report
    Mari Kirishima, Toshiaki Akahane, Nayuta Higa, Shinsuke Suzuki, Shinichi Ueno, Hajime Yonezawa, Hiroyuki Uchida, Ryosuke Hanaya, Koji Yoshimoto, Shohei Shimajiri,et al.

    Elsevier BV

  • Impact of COVID-19 pandemic on epilepsy care in Japan: A national-level multicenter retrospective cohort study
    Naoto Kuroda, Takafumi Kubota, Toru Horinouchi, Naoki Ikegaya, Yu Kitazawa, Satoshi Kodama, Izumi Kuramochi, Teppei Matsubara, Naoto Nagino, Shuichiro Neshige,et al.

    Wiley
    The impact of the coronavirus disease 2019 (COVID‐19) pandemic on epilepsy care across Japan was investigated by conducting a multicenter retrospective cohort study.

  • Prognostic impact of PDGFRA gain/amplification and MGMT promoter methylation status in patients with IDH wild-type glioblastoma
    Nayuta Higa, Toshiaki Akahane, Seiya Yokoyama, Hajime Yonezawa, Hiroyuki Uchida, Tomoko Takajo, Ryosuke Otsuji, Taiji Hamada, Kei Matsuo, Mari Kirishima,et al.

    Oxford University Press (OUP)
    Abstract Background Platelet-derived growth factor receptor alpha (PDGFRA) is the second most frequently mutated tyrosine kinase receptor in glioblastoma (GBM). However, the prognostic impact of PDGFRA amplification on GBM patients remains unclear. Herein, we evaluated this impact by retrospectively analyzing outcomes of patients with IDH wild-type GBM. Methods Using a custom-made oncopanel, we evaluated PDGFRA gain/amplification in 107 GBM samples harboring wild-type IDH, along with MGMT promoter (MGMTp) methylation status. Results We detected PDGFRA gain/amplification in 31 samples (29.0%). PDGFRA gain/amplification predicted poor prognosis (P = .003). Compared to unamplified PDGFRA, PDGFRA gain/amplification in GBM was associated with higher patient age (P = .031), higher Ki-67 score (P = .019), and lower extent of surgical resection (P = .033). Unmethylated MGMTp also predicted poor prognosis (P = .005). As PDGFRA gain/amplification and unmethylated MGMTp were independent factors for poor prognosis in multivariate analyses, we grouped GBM cases based on PDGFRA and MGMTp status: poor (PDGFRA gain/amplification and unmethylated MGMTp), intermediate (PDGFRA gain/amplification or unmethylated MGMTp), and good (PDGFRA intact and methylated MGMTp) prognosis. The Kaplan-Meier survival analysis indicated that these groups significantly correlated with the OS of GBM patients (P < .001). Conclusions Here we report that PDGFRA gain/amplification is a predictor of poor prognosis in IDH wild-type GBM. Combining PDGFRA gain/amplification with MGMTp methylation status improves individual prognosis prediction in patients with IDH wild-type GBM.

  • The collagen matrix dural substitute graft prevents postoperative cerebrospinal fluid leakage after ventriculoperitoneal shunt surgery in patients aged <1 year
    Masanori Sato, Tatsuki Oyoshi, Hirofumi Iwamoto, Natsuko Tanoue, Soichiro Komasaku, Nayuta Higa, Hiroshi Hosoyama, Hiroshi Tokimura, Satoshi Ibara, Ryosuke Hanaya,et al.

    Scientific Scholar
    Background: Cerebrospinal fluid (CSF) leakage is a common complication of ventriculoperitoneal shunt (VPS) and has the potential to induce shunt infection. Especially in infants and children, these are serious complications. DuraGen is a collagen matrix dural substitute used to reduce the risk of CSF leakage in various neurosurgeries. We report our VPS procedure with DuraGen for preventing postoperative CSF leakage in patients aged <1 year. Methods: We used DuraGen to prevent postoperative CSF leakage in six VPS surgeries. Antibiotic-impregnated shunt catheters and programmable valves with anti-siphon devices were also used in all cases. DuraGen was placed inside and atop the burr hole. All cases had an initial shunt pressure of 5 cmH2O. Fibrin glue was not used. Results: The patients underwent follow-up for a year after VPS surgery. There was no postoperative subcutaneous CSF collection or leakage after all six VPS surgeries. Furthermore, no postoperative shunt infections or DuraGen-induced adverse events were noted. Conclusion: We speculate that DuraGen has a preventive effect on postoperative CSF leakage in VPS cases aged <1 year.

  • Spinal intradural solitary fibrous tumor/ hemangiopericytoma with intramedullary invasion mimicking a hemangioblastoma
    Shanta Thapa, Hitoshi Yamahata, Tomohisa Okada, Masanori Yonenaga, Madan Bajagain, Ryutaro Makino, and Ryosuke Hanaya

    Scientific Scholar
    Background: Solitary fibrous tumor/hemangiopericytomas (SFT/HPCs) are rare mesenchymal tumors of nonmeningothelial origin that comprises <1% of all central nervous system tumors. Case Description: A 45-year-old male presented with sleep apnea (apnea-hypopnea index was 17.1 events/hour) and dysesthesias of the right upper and lower extremities. The magnetic resonance demonstrated a heterogeneous intradural extra-axial C1 mass with syringobulbia and syringomyelia. The right vertebral angiography revealed a hypervascular mass (i.e., intense tumor staining). With the preoperative diagnosis of a spinal hemangioblastoma, the patient underwent tumor removal. However, intraoperative findings demonstrated that the ventral component of the tumor was intramedullary without a dural attachment. Further, the histological diagnosis was consistent with SFT/HPC (HPC phenotype). The postoperative course was uneventful, and the patient’s symptoms and the syrinxes spontaneously regressed. Conclusion: A 45-year-old male presented a rare spinal intradural lesion at C1 appeared to be a spinal hemangioblastoma, but proved to be SFT/HPC (HPC phenotype) with intramedullary invasion.

  • Molecular Genetic Profile of 300 Japanese Patients with Diffuse Gliomas Using a Glioma-tailored Gene Panel
    Nayuta HIGA, Toshiaki AKAHANE, Seiya YOKOYAMA, Hajime YONEZAWA, Hiroyuki UCHIDA, Shingo FUJIO, Mari KIRISHIMA, Kosuke TAKIGAWA, Nobuhiro HATA, Keita TOH,et al.

    Japan Neurosurgical Society

  • Dural sac shrinkage signs on spinal magnetic resonance imaging indicate overdrainage after lumboperitoneal shunt for idiopathic normal pressure hydrocephalus
    Takashi Kawahara, Masamichi Atsuchi, Kazunori Arita, Shingo Fujio, Nayuta Higa, FM Moinuddin, Koji Yoshimoto, and Ryosuke Hanaya

    Scientific Scholar
    Background: We previously found the usefulness of dural sac shrinkage signs (DSSSs), which are the anterior shift of the spinal cord and dura mater behind the cord, detected by magnetic resonance imaging (MRI) at the thoracic level for the diagnosis of spontaneous intracranial hypotension (IH). This is a retrospective survey on the usefulness of DSSSs for the early detection of iatrogenic IH caused by overdrainage through a lumboperitoneal shunt (LPS) for patients with idiopathic normal pressure hydrocephalus (INPH). Methods: Forty-five INPH patients had an LPS using a pressure programmable valve equipped with an anti-siphon device. Results: Nine patients complained of orthostatic headache after the LPS, indicating IH due to overdrainage, which persisted for more than a week in three patients and 2–7days in six patients. The headache was transient/ nonorthostatic in ten patients and absent in 26 patients. The DSSSs and accompanying enlargement of the venous plexus were observed in all three patients with prolonged orthostatic headaches. Only the anterior shift of the dura mater was observed in 1 (4%) among 25 patients who had short-term orthostatic headache, transient/ nonorthostatic headache, or absent headache, and underwent spinal MRI. A patient with prolonged severe orthostatic headache with both DSSSs eventually developed intracranial subdural effusion and underwent tandem valve surgery, which provided a quick improvement of symptoms. The DSSSs on thoracic MRI also disappeared promptly. Conclusion: DSSSs may serve as objective signs for the diagnosis of IH due to overdrainage through an LPS for INPH.

  • Prospective, Multicenter Clinical Study of Microvascular Decompression for Hemifacial Spasm
    Yoshifumi Mizobuchi, Shinji Nagahiro, Akinori Kondo, Kazunori Arita, Isao Date, Yukihiko Fujii, Takamitsu Fujimaki, Ryosuke Hanaya, Mitsuhiro Hasegawa, Toru Hatayama,et al.

    Ovid Technologies (Wolters Kluwer Health)

  • Risk factors for psychological distress in electroencephalography technicians during the COVID-19 pandemic: A national-level cross-sectional survey in Japan
    Naoto Kuroda, Takafumi Kubota, Toru Horinouchi, Naoki Ikegaya, Yu Kitazawa, Satoshi Kodama, Teppei Matsubara, Naoto Nagino, Shuichiro Neshige, Temma Soga,et al.

    Elsevier BV

  • Radiological comparison of the midpoint of the nasion-inion line and the external auditory canal for measuring the cranial center of the gravity-sagittal vertical axis
    Ryutaro Makino, Hitoshi Yamahata, Masanori Yonenaga, Shingo Fujio, Nayuta Higa, Ryosuke Hanaya, and Koji Yoshimoto

    Elsevier BV