研究者詳細 - 竹内　和人

論文 - 竹内　和人

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Intra-aneurysmal Thrombectomy Using Exo-endoscopic 2-step Approach for Thrombosed Vertebral Artery Aneurysm: A Technical Case Report Open Access

KENCANA I Gusti Ketut Agung Surya, IWAMI Kenichiro, NISHIHORI Masahiro, TAKEUCHI Kazuhito, NAGATA Yuichi, OKUMURA Eriko, SATO Yoshiki, NIRYANA I Wayan, MAHADEWA Tjokorda Gde Bagus, SAITO Ryuta

NMC Case Report Journal 13 巻 ( 0 ) 頁： 91 - 96 2026年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：The Japan Neurosurgical Society

Although rare, thrombosed vertebral artery aneurysms can lead to severe symptoms and are challenging to treat due to their proximity to vital structures. The location of a thrombosed aneurysm on the anterior aspect of the brainstem poses a significant challenge to conventional microscopic approaches. We herein report a 78-year-old man with a thrombosed right vertebral artery aneurysm who developed progressive quadriparesis, dysphagia, and respiratory failure despite prior interventions, including flow diverter stent placement, parent artery occlusion, and microscopic thrombectomy. Given worsening medullary compression and poor clinical status, intra-aneurysmal thrombectomy was performed using an exo-endoscopic 2-step approach. The procedure involved reopening the previous suboccipital craniotomy, partial condylectomy, and C1 hemilaminectomy. Exoscopic thrombus de-bulking was followed by endoscopic evacuation of the residual thrombus compressing the ventral brainstem. Postoperatively, no complication was observed, and the patient demonstrated gradual neurological improvement, including recovery of spontaneous respiration and the ability to wean from mechanical ventilation within 3 weeks. Follow-up imaging confirmed resolution of medullary compression without thrombus recurrence. The exo-endoscopic 2-step approach is a viable option for surgical decompression of thrombosed vertebral artery aneurysms that cause brainstem compression. This enhances surgical access and visualization, particularly in the ventral brainstem, while potentially minimizing brainstem manipulation. Further investigation is warranted to better define the indications, efficacy, and safety of the management of complex thrombosed aneurysms.

DOI： 10.2176/jns-nmc.2025-0316

Open Access

CiNii Research

Rapid intraoperative boundary diagnosis of somatotroph pituitary neuroendocrine tumors using real-time PCR. Open Access

Sato Y, Takeuchi K, Ohka F, Nagata Y, Maeda S, Matsuyama T, Hirose T, Deguchi S, Okumura E, Iwami K, Saito R

Acta neuropathologica communications 2026年2月

Organoid-Based Evaluation of Therapeutic Responses in Atypical Choroid Plexus Papilloma

Maeda, S; Ohka, F; Takeuchi, K; Nagata, Y; Aoki, K; Saito, R

CANCER SCIENCE 117 巻頁： 846 - 846 2026年1月

Two-stage surgery for cystic craniopharyngiomas: a purely endoscopic strategy and outcomes 国際誌

Sato, Y; Takeuchi, K; Nagata, Y; Matsuyama, T; Hirose, T; Okumura, E; Iwami, K; Saito, R

PITUITARY 29 巻 ( 1 ) 頁： 21 - 21 2025年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Pituitary

Purpose: This study aimed to evaluate the effectiveness and safety of two-stage endoscopic surgery for the complete resection of cystic craniopharyngiomas. Methods: We retrospectively evaluated 11 patients who underwent two-stage endoscopic surgery between March 2020 and July 2025. The lesions showed suprasellar and lateral extension toward the optic chiasm or the foramen of Monro, resulting in visual impairment or obstructive hydrocephalus. Cyst fenestration (CF) was initially performed using a transventricular approach with a flexible endoscope. One to two months later, endoscopic transsphenoidal surgery (eTSS) was performed to achieve complete resection. Tumor size (vertical diameter, horizontal diameter, and volume) was measured at three time points: pre-CF, post-CF (≤ 4 days), and pre-eTSS. Extent of resection, recurrence, and pituitary and hypothalamic function were assessed post-eTSS. Results: Complete resection was achieved in 10 of 11 patients, with no recurrence during a median follow-up of 22.8 months (range, 3.6–65.3). At a median interval of 54 days (range, 27–86) between CF and eTSS, the mean linear reduction was 45.3% superiorly and 39.3% laterally; mean tumor volume decreased by 68.0%. In some cases, areas typically difficult to access via eTSS alone decreased in size. All preoperative symptoms, except for hypopituitarism and diabetes insipidus, improved immediately after CF. No hypothalamic dysfunction was observed. Conclusion: Two-stage endoscopic surgery for cystic craniopharyngiomas is effective and safe, enabling complete resection with low recurrence during short- to mid-term follow-up.

DOI： 10.1007/s11102-025-01618-w

Rapid intraoperative genetic analysis of adult-type diffuse gliomas using a microfluidic real-time polymerase chain reaction device 査読有り国際誌 Open Access

Maeda, S; Kitano, Y; Ohka, F; Motomura, K; Aoki, K; Deguchi, S; Shiba, Y; Seki, M; Ikeda, Y; Shimizu, H; Iwami, K; Takeuchi, K; Nagata, Y; Yamaguchi, J; Kimura, K; Takido, Y; Yamamoto, R; Nakamura, A; Ito, S; Shinjo, K; Kondo, Y; Miyagi, S; Karube, K; Saito, R

NEURO-ONCOLOGY 27 巻 ( 12 ) 頁： 3161 - 3173 2025年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Neuro Oncology

Background. The 5th edition of the World Health Organization Classification of Tumors of the CNS introduced a subclassification of tumors based on key molecular markers. In adult-type diffuse gliomas, isocitrate dehydrogenase (IDH) and telomerase reverse transcriptase (TERT) promoter mutations play pivotal roles in the molecular classification. This study developed a rapid genotyping system using GeneSoC, a real-time PCR platform with microfluidic thermal cycling capable of completing 50 cycles of PCR within 20 min. Methods. To establish optimal analytical conditions, frozen tumor tissues from 67 patients and artificial DNA vectors were analyzed using this system. This system demonstrated a detection limit of at least 5% variant allele frequency for the IDH1 R132H and TERT promoter C228T/C250T mutations. Subsequently, intraoperative testing was performed in 120 cases using this system. Results. The sensitivity and specificity of IDH1 R132H mutation were 0.985 and 0.982, respectively, whereas those of TERT promoter C228T/C250T mutation were 1.000 and 1.000, respectively. These mutations were detected intraoperatively within approximately 25 min after tumor tissue collection. Furthermore, this assay identified tumor boundaries in an IDH-mutated glioma case, where IDH1 R132H mutations could not be detected. Conclusions. The GeneSoC®︎-based rapid genotyping system may be effective not only for intraoperative diagnosis of diffuse glioma but also for detecting tumor boundaries.

DOI： 10.1093/neuonc/noaf188

[Endoscopic Treatment of Pediatric Brain Tumors]. 査読有り

Takeuchi K

No shinkei geka. Neurological surgery 53 巻 ( 6 ) 頁： 1100 - 1111 2025年11月

Surgical Strategies for Giant Pituitary Adenomas to Minimize Postoperative Hematoma Formation 査読有り Open Access

Nagata, Y; Takeuchi, K; Iwami, K; Okumura, E; Sato, Y; Hirose, T; Saito, R

NEUROLOGIA MEDICO-CHIRURGICA 65 巻 ( 11 ) 頁： 532 - 539 2025年11月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本脳神経外科学会

Postoperative hematoma formation is one of the most life-threatening complications associated with giant pituitary adenomas, and various surgical methods have been proposed to mitigate this risk. This study aims to report our surgical outcomes in patients with giant pituitary adenomas and to identify risk factors associated with postoperative hematoma formation. We retrospectively reviewed 45 patients with giant pituitary adenomas who underwent surgical treatment. The surgical approaches included conventional transsphenoidal surgery in 24 patients, extended transsphenoidal surgery in 9, and simultaneous combined transsphenoidal surgery and transcranial surgery in 12. Intracapsular resection was performed in 28 patients, while extracapsular resection was carried out in 17 patients. Postoperative hematoma formation was observed in 17 patients; among them, 2 experienced neurological deterioration and subsequently required reoperation for hematoma evacuation. The mean maximum tumor diameter was significantly larger in patients with postoperative hematoma (54 mm) compared to those without (45.3 mm) (p = 0.008). Other tumor characteristics were not significantly associated with postoperative hematoma formation. Combined transsphenoidal surgery and transcranial surgery were more frequently performed in patients who developed postoperative hematoma (p = 0.007), whereas extracapsular resection was more common in those without hematoma (p = 0.001). However, these differences in postoperative hemorrhage incidence among surgical techniques may have been substantially influenced by selection bias. Giant pituitary adenomas with extensive intracranial extension and involvement of critical neurovascular structures remain challenging to manage regardless of the surgical approach. Nevertheless, it is essential to tailor surgical strategies to individual cases to minimize postoperative complications.

DOI： 10.2176/jns-nmc.2025-0106

膠芽腫に対する交流電場腫瘍療法における再発様式の検討

大岡史治, 滝戸悠平, 出口彰一, 本村和也, 三矢幸一, 芝良樹, 竹内和人, 永田雄一, 齋藤竜太

日本癌治療学会学術集会抄録集 63回巻頁： O24 - 4 2025年10月

Intravenous perampanel in clinical practice: A multicenter prospective registry study 査読有り国際誌

Sato, Y; Iwami, K; Okumura, E; Ohka, F; Takeuchi, K; Deguchi, S; Nagata, Y; Muraoka, S; Ishizaki, T; Nagashima, Y; Shiba, Y; Kato, T; Tanbara, M; Kano, T; Nishizawa, T; Yamamoto, Y; Saito, R

SEIZURE-EUROPEAN JOURNAL OF EPILEPSY 131 巻頁： 334 - 339 2025年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Seizure

Purpose: This study aimed to evaluate the efficacy and safety of intravenous perampanel (IV-PER) in routine clinical practice. Methods: Patients who received IV-PER at Nagoya University Hospital or one of the 21 affiliated institutions between June 2024 and March 2025 were included. Indications for IV-PER included treatment for epileptic seizures, particularly acute symptomatic seizures, and prophylactic use before or after surgery. The primary endpoint was the seizure suppression rate within 7 days of treatment initiation, and the secondary endpoint was the incidence of adverse events (AEs). Clinical data were recorded daily, and blood tests were conducted within 2 weeks of administration. Enrolled patients were categorized into three groups based on the underlying etiology: cerebrovascular disease (CD), brain tumor (BT), and traumatic brain injury (TBI). Treatment efficacy and safety were assessed across these groups. Results: Of the 237 patients, 74, 116, and 47 were classified into the CD, BT, and TBI groups, respectively. The overall seizure suppression rate within 7 days was 89.0 %. Rates by group were 87.8 % (CD), 96.6 % (BT), and 72.3 % (TBI). When stratified by indication, the rates were 99.3 % for prophylactic use, 69.4 % for focal seizures, and 74.4 % for generalized seizures. Regarding AEs, somnolence was reported in 3 patients and irritability in one. Laboratory abnormalities included anemia, elevated liver enzymes, elevated creatine kinase, and hyponatremia. A total of 71 patients experienced one of these. Conclusions: This large multicenter prospective registry demonstrates that IV-PER can be safely used for seizure management during the 7-day acute phase in real-world clinical settings.

DOI： 10.1016/j.seizure.2025.07.023

嚢胞性頭蓋咽頭腫に対する内視鏡での二期的手術 Open Access

佐藤佳輝, 竹内和人, 永田雄一, 岩味健一郎, 奥村衣里子, 近藤辰磨, 廣瀬俊明, 齋藤竜太

日本内分泌学会雑誌 101 巻 ( S.HPT ) 頁： 11 - 12 2025年8月

Giant pituitary neuroendocrine tumorに対する治療戦略 Open Access

永田雄一, 竹内和人, 岩味健一郎, 近藤辰磨, 佐藤佳輝, 廣瀬俊明, 齋藤竜太

日本内分泌学会雑誌 101 巻 ( S.HPT ) 頁： 46 - 47 2025年8月

機能性下垂体腫瘍に対するreal-time PCR法での遺伝子解析を用いた正確な境界領域診断 Open Access

佐藤佳輝, 竹内和人, 大岡史治, 永田雄一, 岩味健一郎, 奥村衣里子, 近藤辰磨, 廣瀬俊明, 齋藤竜太

日本内分泌学会雑誌 101 巻 ( S.HPT ) 頁： 75 - 77 2025年8月

Metastatic PitNET 3例の検討 Open Access

竹内和人, 永田雄一, 岩味健一郎, 佐藤佳輝, 廣瀬俊明, 齋藤竜太

日本内分泌学会雑誌 101 巻 ( S.HPT ) 頁： 39 - 42 2025年8月

Exo- and endoscopic two-step approach for recurrent vestibular schwannomas following surgical resection and radiosurgery: How I do it 国際誌 Open Access

Iwami, K; Takeuchi, K; Nagata, Y; Saito, R

ACTA NEUROCHIRURGICA 167 巻 ( 1 ) 頁： 211 - 211 2025年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Acta Neurochirurgica

Intracanalicular residual vestibular schwannoma (VS) after surgical resection is known to cause recurrence. Lesions demonstrating progression despite adjuvant stereotactic radiosurgery necessitate salvage surgery with meticulous tumour resection to prevent recurrence. We describe our exo- and endoscopic two-step approach (EETA), employing an exoscope to remove the extracanalicular component and an endoscope to remove the intracanalicular component under direct visualisation of the fundus. EETA is a viable option for treating recurrent VS, as it enables enhanced visualisation of both extra- and intracanalicular lesions, including the fundus.

DOI： 10.1007/s00701-025-06625-1

機能性下垂体腫瘍に対するreal-time PCR法での遺伝子解析を用いた正確な境界領域診断 Open Access

佐藤佳輝, 竹内和人, 大岡史治, 永田雄一, 岩味健一郎, 奥村衣里子, 近藤辰磨, 廣瀬俊明, 齋藤竜太

日本内分泌学会雑誌 101 巻 ( Suppl.HPT ) 頁： 75 - 77 2025年8月

Dpcd Induces Hydrocephalus Because of Partial Defects in the Inner Dynein Arms, With Abnormal Ciliary Motility 査読有り国際誌

Yamamoto, T; Takeuchi, K; Nagata, Y; Mizuno, A; Harada, H; Ishikawa, T; Maeda, S; Ohka, F; Yanase, R; Shiba, K; Ueno, H; Inaba, K; Saito, R

CYTOSKELETON 2025年7月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Cytoskeleton

Primary ciliary dyskinesia (PCD) is a congenital disease caused by gene mutations linked to ciliary dysfunction. PCD causes different symptoms, including chronic sinusitis, infertility, situs inversus and hydrocephalus. Motile cilia on ventricular ependymal cells are a crucial factor in cerebrospinal fluid circulation, and dysfunction of these cells causes hydrocephalus. Deleted in primary ciliary dyskinesia (Dpcd) is one genetic abnormality known to cause PCD, and its knockout leads to hydrocephalus in mice. PCD occurs in Dpcd−/− mice because of the lack of an inner dynein arm (IDA) in the motile cilia. However, how this deficiency is associated with the motility of ventricular ependymal motile cilia in Dpcd−/− mice has not been demonstrated. Herein, we show that Dpcd induces partial defects in dyneins and aberrant motility in ventricular ependymal cilia. In Dpcd−/− mice, the ependymal cilia demonstrated decreased amplitude, abnormal waveforms and low cerebrospinal fluid flow velocity. In addition, the amount of dynein axonemal heavy chains in some IDAs decreased in the ependymal cilia. In wild-type mice, Dpcd was localised in the cytoplasm and cilia of ependymal cells. Thus, abnormal ciliary movement in Dpcd−/− mice is likely attributed to a defect in IDA assembly in the ependymal cilia.

DOI： 10.1002/cm.70012

Distant parenchymal recurrence during long-term use of TTFields treatment for glioblastoma 査読有り Open Access

Takido, Y; Ohka, F; Deguchi, S; Motomura, K; Mitsuya, K; Aoki, K; Shiba, Y; Takeuchi, K; Nagata, Y; Yamaguchi, J; Kibe, Y; Fuse, Y; Maeda, S; Shimizu, H; Saito, R

INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 30 巻 ( 7 ) 頁： 1309 - 1318 2025年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：International Journal of Clinical Oncology

Background: Tumor treating fields (TTFields) treatment has been an important option for the treatment of glioblastoma. The introduction of novel treatment options may lead to distinct recurrence patterns compared to those observed with conventional therapies; however, the specific recurrence pattern during TTFields treatment has not been elucidated. Methods and results: Here, we analyzed 39 cases of glioblastoma treated with TTFields. Although a usage rate of more than 75% is recommended, among 39 cases, 18 discontinued TTFields treatment owing to requests by patients with lower usage rates. In these discontinued cases, patients exhibiting sensory aphasia were more frequently included compared to those who continued TTFields (44.4%, p < 0.001). Among 21 cases involving patients who continued TTFields, tumor recurrence was observed in 15 of those cases. Five out of 15 cases (33.3%) exhibited recurrence in distant parenchyma from the primary lesion. A higher usage rate and relatively longer use of TTFields were observed in these five cases, along with more favorable progression-free survival than those in the other 10 cases (p = 0.019, p = 0.040, and p = 0.024, respectively). In one case, recurrent tumors with lower grade glioma histology but molecular markers characteristic for glioblastoma, IDH-wildtype were indentified. This tumor arose in an area that received a lower local minimum power density of TTFields compared to the primary lesion, following long-term TTFields therapy. Conclusions: Long-term use of TTFields might be correlated with a high frequency of distant parenchymal recurrence in cases with favorable response.

DOI： 10.1007/s10147-025-02775-5

新規治療標的の同定に有用な頭蓋咽頭腫オルガノイドモデルの樹立

大岡史治, 山本諒, 前田紗知, 竹内和人, 永田雄一, 青木恒介, 出口彰一, 芝良樹, 滝戸悠平, 齋藤竜太

小児の脳神経 50 巻 ( 2 ) 頁： 138 - 138 2025年6月

良性脳腫瘍オルガノイドモデルの樹立

前田紗知, 大岡史治, 加留部謙之輔, 山本諒, 竹内和人, 永田雄一, 青木恒介, 出口彰一, 芝良樹, 齋藤竜太

Brain Tumor Pathology 42 巻 ( Suppl. ) 頁： 135 - 135 2025年5月

Benchmark for Setting ACTH Cell Dosage in Clinical Regenerative Medicine for Post-Operative Hypopituitarism 査読有り国際誌 Open Access

Kondo, T; Suga, H; Takeuchi, K; Fuse, Y; Sato, Y; Hirose, T; Hideyuki, H; Nagata, Y; Saito, R

DISEASES 13 巻 ( 4 ) 2025年4月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Diseases

Background/Objectives: Our objective is to develop hormone-producing pituitary cells that can function in the same manner as the human body and provide more effective treatments than current hormone replacement therapy. We have already established a technique for generating hypothalamic–pituitary organoids using feeder-free human pluripotent stem cells (hPSCs) and demonstrated their effectiveness in vivo through transplantation into hypopituitary mouse models. To prospectively determine the upper limit of transplanting adenohypophyseal cells into humans, we investigated the human maximum secretion capacity of adrenocorticotropic hormone (ACTH) and growth hormone (GH). Methods: We analyzed data from 28 patients with pituitary adenomas, among whom 16 evinced no abnormality of ACTH secretion and 12 showed no GH secretion on corticotropin-releasing hormone (CRH) and growth hormone-releasing hormone-2 (GHRP-2) stimulation testing. Results: The average ACTH peak value after CRH stimulation tests was 97.2 pg/mL, and the average GH peak value after GHRP-2 stimulation tests was 25.1 ng/mL. Conclusions: These data will likely serve as benchmarks of ACTH and GH secretion when transplanting cultured cells into humans.

DOI： 10.3390/diseases13040112

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