Department of Neurosurgery
Takaaki Kirino, MD, DMSc
Associate Professor
Akio Morita, MD, DMSc, Nobutaka Kawahara, MD, DMSc
Tomoki Todo, MD, DMSc, Kensuke Kawai, MD, DMSc,
Yasushi Ino, MD, DMSc
Kazuhide Furuya, MD, DMSc, Minoru Tanaka,MD, DMSc,
Junichi Tanaka, MD, Shigeo Sora, MD,
Masahiro Shin, MD, DMSc, Akira Iijima,MD,
Kyosuke Kamada, MD, DMSc, Keisuke Maruyama, MD, DMSc

The Department of Neurosurgery at the University of Tokyo Hospital consists of 14 staff neurosurgeons, who participate in the three major academic activities: patient care, research and education. The staffs include a professor/chairman, an associate professor, two lecturer and nine associates.
Clinical ward for Neurosurgery in our university hospital was founded in 1951 as the first Neurosurgical clinic in Japan. Dr. Keiji Sano, as the founding professor, established the Department of Neurosurgery in 1962. Dr. Kintomo Takakura served as the second professor from 1981 to 1992. The incumbent professor, Dr. Takaaki Kirino, has been serving as the third professor since 1992.

Clinical Activities
General and specialized outpatient clinics are open three days a week (Monday, Wednesday and Friday). New patient are accepted two days a week (Tuesday and Thursday). Specialized outpatient clinics are open for patient with brain tumors, pituitary disease, spinal disease, cerebrovascular disease, epilepsy, and gamma knife treatment. From April 2002 through March 2004, 2562 new and 23090 follow-up patients were treated at the outpatient clinics.
The Neurosurgery Ward has 35 beds on the seventh floor of the New Hospital Building opened in Sept. 2001. From April 2002, through March 2004, 573 surgical procedures were performed. In addition, 182 patients were treated by the gamma knife during the same period. Nursing staffs consists of a head nurse, 19 registered nurses, 2 assistant nurses and a clinical assistant. Clinical conference and professor's rounds are held in the morning three times a week. Radiation oncologists and neuropathologists join our conference. Our practice covers a wide variety of Neurosurgical disease including malignant and benign brain tumors, hemorrhagic and occlusive cerebrovascular disease, spinal disorders, epilepsy, pain and movement disorders.
Our department is affiliated with 42 neurosurgical institutions in and around the city of Tokyo including 15 university medical centers, where our residents and students are exposed to various pathologies. Surgical case volume in all hospitals exceeds 4000cases.

Teaching Activities
Medical students take lectures of clinical neurosurgery in their second year. Clinical case studies and bedside teaching are scheduled in the third and fourth years. The lecturers introduce general Neurosurgery as well as the state-of-art Neurosurgical practice to the students. At the bedside teaching and clinical clerkship, they are offered opportunities to learn clinical management of Neurosurgical patients in the hands-on style, and also are exposed to practice in various subspecialties in neurosurgery through special seminars given by experts in the fields.
We accepted 8 residents in 2002 and 10 in 2003. These residents are trained in the university hospital and affiliated hospitals to experience every aspects of neurosurgical practice for five years in average. Our residency training is finalized after the sixth year, when the finishing residents serve as senior resident at the university hospital for 12months. Academic training is provided through numerous intramural clinical and research conference, journal clubs seminars as well as quarterly regional meeting of Japan Neurosurgical Society. After the residents finish their training, or during training, they can choose to be admitted into the Ph.D. course at the graduate school of Medicine, University of Tokyo, to be involved in advanced basic research activities for 4 year. After complete training, our graduates stay in the department to be an associate in our or other university hospitals or become clinical staff in our affiliated hospitals.

Research Activities
Clinical research in these two years have mainly focused on treatment of acoustic neurinoma techniques of skull base surgery, treatment of malignant brain tumors, radiosurgery and epilepsy surgery. The results were presented at domestic and international meetings including Annual Meetings of the Japan Neurosurgical Society and Annual Meetings of American Association of Neurological Surgeons. .
Our department has been keeping prominent basic research activities as well. The three main fields of our current research are 1) pathogenesis of cerebral ischemia and neuronal regeneration after ischemic brain damage, 2) molecular biology and viral therapy of brain tumors and 3) translational research with department of engineering including development of microsurgical robotic system, etc. As a Neurosurgical laboratory, one of the features is in vivo experiment using our fine microsurgical techniques on small animals. In addition, we are rapidly expanding our research facility to take advantage of state-of-art technique in molecular biology in all aspects of our research.
The results of our clinical and basic research were presented in a variety of domestic and international meetings. Following in the lists of papers published in peer reviewed journals in the years 2002 and 2003.

  1. Asai, A, Tanahashi, N, Qiu, JH, Saito, N, Chi, S, Kawahara, N, Tanaka, K, Kirino, T: Selective proteasomal dysfunction in the hippocampal CA1 region after transient forebrain ischemia. J Cereb Blood Flow Metab 22:705-710 (2002).
  2. Kawahara, N, Kawai, K, Toyoda, T, Nakatomi, H, Furuya, K, Kirino, T: Cardiac arrest cerebral ischemia model in mice failed to cause delayed neuronal death in the hippocampus. Neurosci Lett 322:91-94 (2002).
  3. Kirino, T: Ischemic tolerance. J Cereb Blood Flow Metab 22:1283-1296 (2002).
  4. Maruyama, K, Shin, M, Kurita, H, Tago, M, Kirino, T: Stereotactic radiosurgery for dural arteriovenous fistula involving the superior sagittal sinus. Case report. J Neurosurg 97(5 Suppl):481-483 (2002).
  5. Mukasa, A, Ueki, K, Matsumoto, S, Tsutsumi, S, Nishikawa, R, Fujimaki, T, Asai, A, Kirino, T, Aburatani, H: Distinction in gene expression profiles of oligodendrogliomas with and without allelic loss of 1p. Oncogene 21:3961-3968 (2002).
  6. Nakatomi, H, Kuriu, T, Okabe, S, Yamamoto, S, Hatano, O, Kawahara, N, Tamura, A, Kirino, T, Nakafuku, M: Regeneration of hippocampal pyramidal neurons after ischemic brain injury by recruitment of endogenous neural progenitors. Cell 110:429-441 (2002).
  7. Saito, N, Sasaki, T, Chikui, E, Yuyama, R, Kirino, T: Anterior transpetrosal approach for pontine cavernous angioma--case report. Neurol Med Chir (Tokyo) 42:272-274 (2002).
  8. Shin, M, Ueki, K, Kurita, H, Kirino, T: Malignant transformation of a vestibular schwannoma after gamma knife radiosurgery. Lancet 360:309-310 (2002).
  9. Shin, M, Kawamoto, S, Kurita, H, Tago, M, Sasaki, T, Morita, A, Ueki, K, Kirino, T: Retrospective analysis of a 10-year experience of stereotactic radio surgery for arteriovenous malformations in children and adolescents. J Neurosurg 97:779-784 (2002).
  10. Monobe H, Morita A, Murofushi T: Remarkable restrotation of speech discrimination after removal of jugular foramen schwannoma: a case report. Eur Arch Otolaryngol 259: 170-171, 2002
  11. Sekhar LN, Chanda A, Morita A.: The preservation and reconstruction of cerebral veins and sinuses. J Clin Neurosci. 9(4):391-9, 2002
  12. Asano, S, Kawahara, N, Kirino, T: Intradural spinal seeding of a clival chordoma. Acta Neurochir (Wien) 145:599-603 (2003).
  13. Hoya, K, Asai, A, Sasaki, T, Nagata, K, Kimura, K, Kirino, T: Expression of myosin heavy chain isoforms by smooth muscle cells in cerebral arteriovenous malformations. Acta Neuropathol (Berl) 105:455-461 (2003).
  14. Ohata, K, Saito, K, Sekhar, LN, Morita, A, Kirino, T: ["How I do it" no. 6, a case with a giant petroclival meningioma presented with progressive ataxia: how should this case be managed?]. No Shinkei Geka 31:1125 (2003).
  15. Watanabe, K, Saito, N, Taniguchi, M, Kirino, T, Sasaki, T: Analysis of taste disturbance before and after surgery in patients with vestibular schwannoma. J Neurosurg 99:999-1003 (2003).
  16. Furuya, K, Kawahara, N, Morita, A, Momose, T, Aoki, S, Kirino, T: Focal hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis in a patient with moyamoya disease. Case report. J Neurosurg 100:128-132 (2004).
  17. Furuya, K, Kawahara, N, Kawai, K, Toyoda, T, Maeda, K, Kirino, T: Proximal occlusion of the middle cerebral artery in C57Black6 mice: relationship of patency of the posterior communicating artery, infarct evolution, and animal survival. J Neurosurg 100:97-105 (2004).
  18. Kawahara, N, Wang, Y, Mukasa, A, Furuya, K, Shimizu, T, Hamakubo, T, Aburatani, H, Kodama, T, Kirino, T: Genome-wide gene expression analysis for induced ischemic tolerance and delayed neuronal death following transient global ischemia in rats. J Cereb Blood Flow Metab 24:212-223 (2004).
  19. Mukasa, A, Ueki, K, Ge, X, Ishikawa, S, Ide, T, Fujimaki, T, Nishikawa, R, Asai, A, Kirino, T, Aburatani, H: Selective expression of a subset of neuronal genes in oligodendroglioma with chromosome 1p loss. Brain Pathol 14:34-42 (2004).
  20. Yonekura, I, Kawahara, N, Nakatomi, H, Furuya, K, Kirino, T: A model of global cerebral ischemia in C57 BL/6 mice. J Cereb Blood Flow Metab 24:151-158 (2004).
  21. Iwasaki S, Ito K, Takai Y, Morita A, Murofushi T: Chondroid chordoma at the Jugular Foramen Causing Retrolabyrinthine lesions in both the cochlear and vestibula branches of the eighth cranial nerve. Ann Otl Rhinol Laryngol: 113:82-86, 2004
  22. Maruyama K, Kondziolka D, Niranjan A, Flickinger JC, Lunsford LD.: Stereotactic radiosurgery for brainstem arteriovenous malformations: factors affecting outcome. J Neurosurg. 100(3):407-13. 2004

Annual Report of the Graduate School of Medicine and The Faculty of Medicine The University of Tokyo Reports for the Period April 2002 - March 2004