Updated on 2022/09/21

写真a

 
SAITO Ryuta
 
Organization
Graduate School of Medicine Program in Integrated Medicine Clinical Neurosciences Professor
Graduate School
Graduate School of Medicine
Undergraduate School
School of Medicine Department of Medicine
Title
Professor

Degree 1

  1. 博士(医学) ( 2004.3   東北大学 ) 

Research Interests 6

  1. 集学的治療

  2. Pediatric Brain Tumor

  3. 脳腫瘍治療に向けたトランスレーショナルリサーチ

  4. 脳腫瘍免疫治療の開発

  5. surgical treatment for brain tumor

  6. convection enhanced delivery

Research Areas 2

  1. Life Science / Neurosurgery

  2. Life Science / Neurosurgery  / brain tumor

Research History 12

  1. 名古屋大学脳神経外科

    2020.12

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    Country:Japan

  2. Tohoku University   Graduate School of Medicine   Lecturer

    2018

  3. 東北大学脳神経外科

    2008.9 - 2020.12

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    Country:Japan

  4. Tohoku University   Graduate School of Medicine   Assistant Professor

    2008 - 2017

  5. さいたま赤十字病院脳神経外科

    2007.6 - 2008.8

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    Country:Japan

  6. 仙台医療センター脳神経外科

    2007.4 - 2007.5

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    Country:Japan

  7. 岩手県立中央病院脳神経外科

    2006.10 - 2007.3

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    Country:Japan

  8. 広南病院脳神経外科

    2006.1 - 2006.9

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    Country:Japan

  9. 東北大学脳神経外科

    2005.4 - 2005.12

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    Country:Japan

  10. 宮城県立がんセンター

    2004.10 - 2005.3

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    Country:Japan

  11. Department of Neurological Surgery, University of California San Francisco

    2002.9 - 2004.9

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    Country:United States

  12. Department of Neurosurgery, Tohoku University

    1998.5 - 2000.4

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    Country:Japan

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Education 3

  1. Tohoku University   Department of Neurosurgery

    2000.4 - 2004.3

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    Country: Japan

  2. Tohoku University   Faculty of Medicine

    - 1998.3

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    Country: Japan

  3. Tohoku University   Faculty of Medicine

    - 1998.3

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    Country: Japan

Professional Memberships 23

  1. 日本脳神経外科コングレス   理事・運営委員

    2000

  2. 日本脳神経外科学会   理事・中部支部長

    1998

  3. American Society of Clinical Oncology

    2022.4

  4. 愛知県脳卒中対策推進委員会   委員長

    2022.4

  5. 愛知県脳卒中協会   副会長

    2021

  6. 脳神経外科手術と機器学会   理事

    2000.12

  7. Society for Neurooncology

  8. 日本脳卒中の外科学会   評議員

  9. 日本脳卒中学会

  10. 日本小児脳神経外科学会

  11. 日本神経内視鏡学会

  12. 日本癌学会

  13. 日本がん治療学会

  14. 日本脳腫瘍病理学会

  15. 日本脳腫瘍の外科学会

  16. 日本脳腫瘍学会   理事

  17. The Japan Neurosurgical Society

  18. THE JAPAN SOCIETY OF BRAIN TUMOR PATHOLOGY

  19. 日本脳腫瘍の外科学会

  20. THE JAPAN STROKE SOCIETY

  21. THE JAPANESE SOCIETY ON SURGERY FOR CEREBRAL STROKE

  22. 日本小児脳神経外科学会

  23. 日本脳腫瘍病理学会   理事・事務局長

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Committee Memberships 1

  1. 名古屋大学脳とこころの研究センター   副センター長  

    2022.4   

 

Papers 109

  1. Dural Arteriovenous Fistula Mimicking a Brain Tumor on Methionine-positron Emission Tomography: A Case Report

    HANYU Taketo, NISHIHORI Masahiro, IZUMI Takashi, MOTOMURA Kazuya, OHKA Fumiharu, GOTO Shunsaku, ARAKI Yoshio, YOKOYAMA Kinya, UDA Kenji, SAITO Ryuta

    NMC Case Report Journal   Vol. 9 ( 0 ) page: 289 - 294   2022.12

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    Language:English   Publisher:The Japan Neurosurgical Society  

    <p>In this article, we report a case wherein a brain tumor was suspected based on computed tomography and magnetic resonance imaging findings. We made an initial diagnosis of malignant brain tumor based on methionine-positron emission tomography (PET) findings, but the correct diagnosis was dural arteriovenous fistula (DAVF). The patient was a 45-year-old man with DAVF who developed headache. Methionine-PET imaging showed high methionine uptake in the lesion. Although the tumor was strongly suspected from the findings of methionine-PET, the diagnosis of DAVF could be made correctly only by interpreting digital subtraction angiography and computed tomographic angiography. The findings of methionine-PET, which is considered useful in the diagnosis and denial of brain tumors, made the diagnosis of DAVF more difficult. The increased uptake of methionine-PET in DAVF is an important finding because, to our knowledge, this study is the first to report such finding. The results of this study might be useful for differential diagnoses when the diagnosis is uncertain.</p>

    DOI: 10.2176/jns-nmc.2022-0055

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  2. Delayed Recurrence of Choroid Plexus Carcinoma in the Sacral Spinal Cord 17 Years after Its Initial Presentation

    NAGAI Arata, KANAMORI Masayuki, SHIMODA Yoshiteru, WATANABE Mika, SAITO Ryuta, KUMABE Toshihiro, AIZAWA Toshimi, TOMINAGA Teiji

    NMC Case Report Journal   Vol. 9 ( 0 ) page: 301 - 306   2022.12

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    Language:English   Publisher:The Japan Neurosurgical Society  

    <p>Choroid plexus carcinomas (CPCs) are rare malignant tumors of neuro-ectodermal origin, accounting for less than 1% of all intracranial tumors. The recurrence rates of CPCs are very high and typically occur in the short-term following surgery, even after gross total removal. Here we present a rare case of CPC with spinal metastasis, which occurred long after its initial presentation. A 25-year-old woman with a history of increased intracranial pressure underwent resection for a tumor of the fourth ventricle, with a histopathological diagnosis of CPC. After tumor resection, she received 30 Gy of radiation therapy to the craniospinal axis and 20 Gy to the primary site, followed by nimustine hydrochloride chemotherapy. The residual lesion completely responded to these treatments. She suffered sensory loss in the sacral region 13 years later, followed by refractory skin ulcer in the sacral region 17 years after the initial treatments. Magnetic resonance imaging at 17 years after the initial treatments showed tumor in the sacral region, which was enlarged upon follow-up after 18 months, causing incontinence and loss of urinary intention. She underwent tumor resection, with a histological diagnosis of recurrent CPC. She received salvage re-irradiation. This case shows that CPC can spread via the cerebrospinal fluid pathways and cause spinal metastasis, with relatively slow clinical course. The present case suggests that patients with CPCs may need long-term follow-up imaging of the total neural axis to identify late recurrence at both the primary site and spinal metastasis.</p>

    DOI: 10.2176/jns-nmc.2022-0056

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  3. Diagnosis and Treatment Strategies for Arachnoiditis Ossificans Following Subarachnoid Hemorrhage: A Case Report

    NAGASHIMA Yoshitaka, NISHIMURA Yusuke, ITO Hiroshi, NISHII Tomoya, OYAMA Takahiro, SAITO Ryuta

    NMC Case Report Journal   Vol. 9 ( 0 ) page: 295 - 299   2022.12

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    Language:English   Publisher:The Japan Neurosurgical Society  

    <p>Arachnoiditis ossificans (AO) is a rare disease, wherein ossified lesions in the subarachnoid space obstruct the flow of spinal fluid or compress the spinal cord, thereby causing myelopathy. Here we describe a rare case of AO and discuss the diagnosis and treatment strategies for this disease. A 66-year-old man with a history of subarachnoid hemorrhage presented with gait disturbance and dysuria for 7 months. Spinal magnetic resonance imaging and computed tomography (CT) myelography showed syringomyelia at the T5-T8 level and dorsally tethered spinal cord at the T8-T10 level. Preoperative noncontrast CT was not performed. The patient was diagnosed with adhesive arachnoiditis and underwent arachnoidolysis. However, intraoperative findings showed the presence of ossification lesions on the dorsal surface of the spinal cord, and intraoperative ultrasound (IOU) showed a hyperintense lesion with acoustic shadowing on the dorsal surface of the spinal cord, with limited visibility of the spinal cord. After removal of the lesions, IOU showed untethered and well-decompressed spinal cord and restoration of cerebrospinal fluid pulsation. Based on these findings, the patient was finally diagnosed with AO, which is an extremely rare disease, with an unknown frequency of occurrence. Therefore, all patients with adhesive spinal arachnoiditis require a preoperative noncontrast CT scan to evaluate for ossification lesions. In this case, we were fortunate to be able to treat AO with IOU, which demonstrated specific findings.</p>

    DOI: 10.2176/jns-nmc.2022-0036

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  4. Wearable sensor device-based detection of decreased heart rate variability in Parkinson's disease

    Suzuki Masashi, Nakamura Tomohiko, Hirayama Masaaki, Ueda Masamichi, Hatanaka Mai, Harada Yumiko, Nakatochi Masahiro, Nakatsubo Daisuke, Maesawa Satoshi, Saito Ryuta, Fujiwara Koichi, Katsuno Masahisa

    JOURNAL OF NEURAL TRANSMISSION   Vol. 129 ( 10 ) page: 1299 - 1306   2022.10

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    Language:Japanese   Publisher:Journal of Neural Transmission  

    The evidence that heart rate variability (HRV) decreases during early Parkinson's disease (PD) largely depends on electrocardiogram data. In this study, we examined HRV in PD using wearable sensors and assessed various evaluation methods for detecting disease-related alterations. We evaluated 27 patients with PD and 23 disease controls. The wearable sensors POLAR V800 HR and POLAR H10 were used for the HRV measurements. The participants wore the two sensors for approximately 24 h, and long-term HRV data were acquired. We analyzed the standard deviation of normal R-R intervals (SDNN) and coefficient of variation of R-R intervals (CVRR) for every 100 consecutive beats. Focusing on the fluctuation of SDNN and CVRR, we extracted the minimum, first decile, first quartile, and median values of SDNN and CVRR. The area under the receiver operating characteristic curve (AUC) for each HRV parameter was calculated to differentiate PD from the disease controls. The minimum values of SDNN and CVRR had the highest AUC (SDNN: AUC 0.90, 95% confidence interval [CI] 0.78–0.96; CVRR: AUC 0.90, CI 0.76–0.96) among the evaluation methods tested. The minimum values of SDNN and CVRR were significantly decreased in PD (SDNN: 9.5 ± 4.0 ms vs. 4.4 ± 2.0 ms, p < 0.0001; CVRR: 1.15 ± 0.33% vs. 0.65 ± 0.24%, p < 0.0001). We detected decreased HRV in PD using wearable sensors. Analyzing the minimum values of the HRV parameter in long-term recordings appears to be appropriate for detecting the decrease in HRV in PD.

    DOI: 10.1007/s00702-022-02528-y

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  5. Endoscopic Trans-Mini-Cylinder Biopsy for Intraparenchymal Brain Lesions.

    Takeuchi K, Ohka F, Nagata Y, Maeda S, Tanahashi K, Araki Y, Yamamoto T, Sasaki H, Mizuno A, Harada H, Saito R

    World neurosurgery     2022.9

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    DOI: 10.1016/j.wneu.2022.08.147

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  6. Magnetic resonance imaging scans of cervical spinal cord ependymoma with changing radiological features over a short period of time.

    Nagashima Y, Nishimura Y, Saito R

    World neurosurgery     2022.8

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    DOI: 10.1016/j.wneu.2022.08.116

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  7. Human herpesvirus 6 DNA was not detected in a brain specimen from a patient with mesial temporal sclerosis after status epilepticus due to human herpesvirus 6 infection

    Kawamura Yoshiki, Maesawa Satoshi, Numoto Shingo, Saito Ryuta, Yoshikawa Tetsushi, Okumura Akihisa

    EPILEPSIA OPEN     2022.8

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    Language:Japanese   Publisher:Epilepsia Open  

    We performed virological analysis of resected brain tissues from a patient with temporal lobe epilepsy associated with mesial temporal sclerosis after febrile status epilepticus caused by human herpesvirus 6 infection. The patient had febrile status epilepticus at 9 months of age associated with human herpesvirus 6 infection. Magnetic resonance imaging revealed reduced water diffusion in the right temporal lobe and hippocampus. Polymerase chain reaction analysis detected 1.6 × 105 copies/μg of human herpesvirus 6 DNA in whole blood, but none in the cerebrospinal fluid. The patient developed temporal lobe epilepsy associated with mesial temporal sclerosis at 67 months of age, necessitating surgical treatment. Anterior temporal lobectomy was performed at 171 months of age. Real-time polymerase chain reaction analysis of resected brain tissues revealed no viral DNA. In our patient, human herpesvirus 6 infection triggered febrile status epilepticus, while direct evidence to prove contribution of HHV-6 to the development of MTS was not obtained.

    DOI: 10.1002/epi4.12634

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  8. 経鼻頭蓋底術後髄液漏の検討

    竹内 和人, 永田 雄一, 佐々木 博勇, 水野 晃宏, 齋藤 竜太

    日本内分泌学会雑誌   Vol. 98 ( S.HPT ) page: 25 - 27   2022.8

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    Language:Japanese   Publisher:一般社団法人 日本内分泌学会  

    DOI: 10.1507/endocrine.98.s.hpt_25

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  9. ラトケ嚢胞に類似した所見を示した頭蓋咽頭腫の一例

    原田 英幸, 竹内 和人, 永田 雄一, 棚橋 邦明, 佐々木 博勇, 水野 晃宏, 井下 尚子, 齋藤 竜太

    日本内分泌学会雑誌   Vol. 98 ( S.HPT ) page: 72 - 73   2022.8

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    Language:Japanese   Publisher:一般社団法人 日本内分泌学会  

    DOI: 10.1507/endocrine.98.s.hpt_72

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  10. Primary central nervous system malignant lymphoma in a patient with rheumatoid arthritis receiving tocilizumab: illustrative case.

    Ohno M, Kuramitsu S, Iwakoshi A, Yamaguchi J, Ohka F, Saito R

    Journal of neurosurgery. Case lessons   Vol. 4 ( 6 )   2022.8

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    DOI: 10.3171/CASE22256

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  11. Antiplatelet therapy discontinuation after stent-assisted coil embolization for intracranial aneurysms: a single-center, long-term, retrospective, observational study.

    Goto S, Izumi T, Nishihori M, Imai T, Araki Y, Kanamori F, Uda K, Yokoyama K, Saito R

    Journal of neurosurgery     page: 1 - 8   2022.8

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    DOI: 10.3171/2022.6.JNS22815

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  12. Radiological Analysis of Minimally Invasive Microscopic Laminectomy for Lumbar Canal Stenosis with a Focus on Multilevel Stenosis and Spondylolisthesis.

    Awaya T, Nishimura Y, Eguchi K, Nagashima Y, Ando R, Akahori S, Yoshikawa S, Haimoto S, Hara M, Takayasu M, Saito R

    World neurosurgery   Vol. 164   page: e224 - e234   2022.8

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    Language:English   Publisher:World Neurosurgery  

    Objective: We retrospectively compared the radiological and clinical outcomes of two different surgical techniques (lumbar spinous process splitting laminectomy [LSPSL] and unilateral laminotomy for bilateral decompression [ULBD]) to treat lumbar spinal canal stenosis (LCS). Methods: We performed a retrospective comparative study of 141 consecutive patients with an average age of 70.8 ± 9.4 years who had undergone LSPSL or ULBD for LCS between April 2015 and April 2019. None of the patients had developed remote fractures of the spinous processes using either technique. These cases were divided into 2 groups: group L, 73 patients who had undergone LSPSL from April 2015 to April 2017; and group U, 68 patients who had undergone ULBD from May 2017 to April 2019. The clinical and radiological outcomes and surgical complications at the 1-year postoperative follow-up period were evaluated. Results: We found no significant differences in the operative time between the 2 groups. However, group U had had significantly less blood loss than group L. The facet joints were significantly well preserved in group U. We examined the multilevel and spondylolisthesis cases separately and found that both surgical procedures were equally effective and that the visual analog scale scores for back or leg pain and Japanese Orthopaedic Association scores had significantly improved postoperatively in each group. Group U showed better outcomes in terms of LCS recurrence, with 3 patients in the group L requiring repeat surgery. Conclusions: We found both ULBD and LSPSL to be safe and effective techniques for LCS, even for patients with spondylolisthesis and multilevel disease. ULBD was superior in terms of recurrence prevention, preservation of the facet joints, and less blood loss.

    DOI: 10.1016/j.wneu.2022.04.079

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  13. Role of the parietooccipital fissure and its implications in the pathophysiology of posterior medial temporal gliomas. International journal

    Ichiyo Shibahara, Ryuta Saito, Masayuki Kanamori, Yukihiko Sonoda, Sumito Sato, Takuichiro Hide, Teiji Tominaga, Toshihiro Kumabe

    Journal of neurosurgery   Vol. 137 ( 2 ) page: 505 - 514   2022.8

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    OBJECTIVE: The parietooccipital fissure is an anatomical landmark that divides the temporal, occipital, and parietal lobes. More than 40% of gliomas are located in these three lobes, and the temporal lobe is the most common location. The parietooccipital fissure is located just posterior to the medial temporal lobe, but little is known about the clinical significance of this fissure in gliomas. The authors investigated the anatomical correlations between the parietooccipital fissure and posterior medial temporal gliomas to reveal the radiological features and unique invasion patterns of these gliomas. METHODS: The authors retrospectively reviewed records of all posterior medial temporal glioma patients treated at their institutions and examined the parietooccipital fissure. To clarify how the surrounding structures were invaded in each case, the authors categorized tumor invasion as being toward the parietal lobe, occipital lobe, isthmus of the cingulate gyrus, insula/basal ganglia, or splenium of the corpus callosum. DSI Studio was used to visualize the fiber tractography running through the posterior medial temporal lobe. RESULTS: Twenty-four patients with posterior medial temporal gliomas were identified. All patients presented with a parietooccipital fissure as an uninterrupted straight sulcus and as the posterior border of the tumor. Invasion direction was toward the parietal lobe in 13 patients, the occipital lobe in 4 patients, the isthmus of the cingulate gyrus in 19 patients, the insula/basal ganglia in 3 patients, and the splenium of the corpus callosum in 8 patients. Although the isthmus of the cingulate gyrus and the occipital lobe are located just posterior to the posterior medial temporal lobe, there was a significantly greater preponderance of invasion toward the isthmus of the cingulate gyrus than toward the occipital lobe (p = 0.00030, McNemar test). Based on Schramm's classification for the medial temporal tumors, 4 patients had type A and 20 patients had type D tumors. The parietooccipital fissure determined the posterior border of the tumors, resulting in a unique and identical radiological feature. Diffusion spectrum imaging (DSI) tractography indicated that the fibers running through the posterior medial temporal lobe toward the occipital lobe had to detour laterally around the bottom of the parietooccipital fissure. CONCLUSIONS: Posterior medial temporal gliomas present identical invasion patterns, resulting in unique radiological features that are strongly affected by the parietooccipital fissure. The parietooccipital fissure is a key anatomical landmark for understanding the complex infiltrating architecture of posterior medial temporal gliomas.

    DOI: 10.3171/2021.7.JNS21990

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  14. Long noncoding RNA profile of the intracranial artery in patients with moyamoya disease.

    Mamiya T, Kanamori F, Yokoyama K, Ota A, Karnan S, Uda K, Araki Y, Maesawa S, Yoshikawa K, Saito R

    Journal of neurosurgery     page: 1 - 8   2022.7

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    DOI: 10.3171/2022.5.JNS22579

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  15. Magnetic resonance-guided focused ultrasound thalamotomy restored distinctive resting-state networks in patients with essential tremor.

    Kato S, Maesawa S, Bagarinao E, Nakatsubo D, Tsugawa T, Mizuno S, Kawabata K, Tsuboi T, Suzuki M, Shibata M, Takai S, Ishizaki T, Torii J, Mutoh M, Saito R, Wakabayashi T, Katsuno M, Ozaki N, Watanabe H, Sobue G

    Journal of neurosurgery     page: 1 - 12   2022.7

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    DOI: 10.3171/2022.5.JNS22411

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  16. The usefulness and safety of dexmedetomidine for postoperative sedation in pediatric patients with moyamoya disease.

    Kanamori F, Araki Y, Yokoyama K, Uda K, Kurimoto M, Shiba Y, Mamiya T, Takayanagi K, Ishii K, Nishihori M, Izumi T, Okamoto S, Saito R

    Journal of neurosurgery. Pediatrics     page: 1 - 7   2022.7

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    DOI: 10.3171/2022.6.PEDS2241

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  17. Medical Management of a Mural Thrombus Inducing Repeated Ischemic Strokes in a Patient with Congenital Afibrinogenemia

    Nishihori Masahiro, Araki Yoshio, Suzuki Nobuaki, Tamura Shogo, Hattori Mayo, Izumi Takashi, Goto Shunsaku, Yokoyama Kinya, Uda Kenji, Matsushita Tadashi, Saito Ryuta

    JOURNAL OF STROKE & CEREBROVASCULAR DISEASES   Vol. 31 ( 7 ) page: 106526   2022.7

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    Language:Japanese   Publisher:Journal of Stroke and Cerebrovascular Diseases  

    Objectives: Congenital afibrinogenemia is an autosomal recessive inherited disorder that can cause thrombotic as well as hemorrhagic events. We describe a case of repeated mild ischemic strokes due to a mural thrombus in the carotid artery and our medical treatment. Case description: A 49-year-old woman with congenital afibrinogenemia developed two minor ischemic strokes in two months. Clinical images revealed scattered fresh infarcts in the right middle cerebral artery region and mild cervical carotid artery stenosis. The risk for surgical treatment was considered to be extraordinarily high. The patient was treated with 100 mg/day of aspirin and 3 g fibrinogen infusion every two weeks. After the one-year course of medication, the mural thrombus gradually decreased, and there were no bleeding or ischemic stroke events. Conclusion: This case report highlights the successful treatment of an ischemic stroke in a patient with a congenital afibrinogenemia with an antiplatelet agent and fibrinogen replacement. There are no guidelines for managing ischemic stroke in patients with congenital afibrinogenemia, and further studies are needed.

    DOI: 10.1016/j.jstrokecerebrovasdis.2022.106526

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  18. 特集 癒着性くも膜炎の病態と治療法を学ぼう 術後に生じる癒着性くも膜炎

    西村 由介, 永島 吉孝, 齋藤 竜太

    脊椎脊髄ジャーナル   Vol. 35 ( 2 ) page: 99 - 105   2022.6

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    Publisher:三輪書店  

    DOI: 10.11477/mf.5002201799

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  19. Efficacy and safety of the endoscopic "wet-field" technique for removal of supratentorial cavernous malformations

    Takeuchi Kazuhito, Nagata Yuichi, Tanahashi Kuniaki, Araki Yoshio, Mizuno Akihiro, Sasaki Hiroo, Harada Hideyuki, Ito Keishi, Saito Ryuta

    ACTA NEUROCHIRURGICA     2022.6

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    Language:Japanese   Publisher:Acta Neurochirurgica  

    Objective: Cerebral cavernous malformations (CMs) presenting with focal neurological symptoms or mass effects require surgical removal. In recent years, cylindrical retractors have been widely utilized for the removal of deep-seated lesions during both microscopic and endoscopic surgery. In the present study, we evaluated the efficacy and safety of endoscopic transcylinder removal of CMs using a novel wet-field technique. Methods: We included 13 patients with supratentorial CMs who had undergone endoscopic transcylinder surgery between April 2013 and March 2022. One patient experienced recurrence of the CM and underwent a second endoscopic transcylinder surgery. Therefore, we retrospectively evaluated 14 procedures. The surgical field was continuously irrigated with artificial cerebrospinal fluid to maintain expansion and visualization of the tumor bed. We termed this method as the “wet-field technique.” Patient characteristics, symptoms, and pre- and postoperative magnetic resonance imaging results were obtained from medical records. Results: The average maximum CM diameter was 35.3 mm (range: 10–65 mm). Cylinder diameters were 6 mm in eight procedures, 10 mm in four procedures, and 17 mm in one procedure. Wet-field technique was applied in all cases. The endoscope provided a bright field of view even under water. Continuous water irrigation made it easier to observe the entire tumor bed which naturally expanded by water pressure. Gross total resection was achieved in 13 procedures, while subtotal resection was achieved in one procedure. No surgical complications were observed. Conclusions: The endoscopic transcylinder removal using wet-field technique is safe and effective for the removal of symptomatic intracranial supratentorial CMs.

    DOI: 10.1007/s00701-022-05273-z

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  20. The first-in-human phase I study of a brain-penetrant mutant IDH1 inhibitor DS-1001 in patients with recurrent or progressive IDH1-mutant gliomas

    Natsume Atsushi, Arakawa Yoshiki, Narita Yoshitaka, Sugiyama Kazuhiko, Hata Nobuhiro, Muragaki Yoshihiro, Shinojima Naoki, Kumabe Toshihiro, Saito Ryuta, Motomura Kazuya, Mineharu Yohei, Miyakita Yasuji, Yamasaki Fumiyuki, Matsushita Yuko, Ichimura Koichi, Ito Kazumi, Tachibana Masaya, Kakurai Yasuyuki, Okamoto Naoko, Asahi Takashi, Nishijima Soichiro, Yamaguchi Tomoyuki, Tsubouchi Hiroshi, Nakamura Hideo, Nishikawa Ryo

    NEURO-ONCOLOGY     2022.6

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  21. Direct intracranial invasion of eccrine spiradenocarcinoma of the scalp: a case report and literature review

    Kibe Yuji, Tanahashi Kuniaki, Ohtakara Kazuhiro, Okumura Yuka, Ohka Fumiharu, Takeuchi Kazuhito, Nagata Yuichi, Motomura Kazuya, Akahori Sho, Mizuno Akihiro, Sasaki Hiroo, Shimizu Hiroyuki, Yamaguchi Junya, Nishikawa Tomohide, Yokota Kenji, Saito Ryuta

    BMC NEUROLOGY   Vol. 22 ( 1 ) page: 223   2022.6

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    Language:Japanese   Publisher:BMC Neurology  

    Background: Eccrine spiradenocarcinoma (SC), also known as malignant eccrine spiradenoma, is a rare malignant cutaneous adnexal neoplasm arising from long-standing benign eccrine spiradenoma. Malignant skin tumors rarely show direct intracranial invasion. However, once the intracranial structure is infiltrated, curative excision with sufficient margins can become extremely difficult, particularly when the venous sinuses are involved. No effective adjuvant therapies have yet been established. Here, we report an extremely rare case of scalp eccrine SC with direct intracranial invasion, which does not appear to have been reported previously. Case presentation: An 81-year-old woman presented with a large swelling on the parietal scalp 12 years after resection of spiradenoma from the same site. The tumor showed intracranial invasion with involvement of the superior sagittal sinus and repeated recurrences after four surgeries with preservation of the sinus. The histopathological diagnosis was eccrine SC. Adjuvant high-precision external beam radiotherapy (EBRT) proved effective after the third surgery, achieving remission of the residual tumor. The patient died 7 years after the first surgery for SC. Conclusions: Scalp SC with direct intracranial invasion is extremely rare. Radical resection with tumor-free margins is the mainstay of treatment, but the involvement of venous sinuses makes this unfeasible. High-precision EBRT in combination with maximal resection preserving the venous sinuses could be a treatment option for local tumor control.

    DOI: 10.1186/s12883-022-02749-4

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  22. The prognosis and treatment effectiveness of de novo aneurysm formation after radiation therapy for brain tumor

    Shinoda Satoshi, Muraoka Shinsuke, Shimizu Hiroyuki, Koketsu Naoki, Araki Yoshio, Saito Ryuta

    NEUROSURGICAL REVIEW     2022.6

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    Radiation therapy is a well-established, minimally invasive method of treating brain tumors. In recent years, the number of post-radiotherapy patients has increased, and delayed side effects are evident. De novo aneurysm formation after radiation often manifests as fatal subarachnoid hemorrhage (SAH), resulting in severe clinical outcomes. Nevertheless, the prognosis and therapeutic efficacy of radiation-induced aneurysms (RIAs) remain unclear. Using the PubMed database from 1980 to 2021, we screened 45 articles (53 individual cases) on RIAs; approximately 70% of RIAs were diagnosed after rupture. Of 38 ruptured RIAs, 12 (31.6%) had modified Rankin scale (mRS) 5–6. On the other hand, all unruptured RIAs (15 cases) recovered without neurological deficits (p = 0.012). Ten of the 39 ruptured RIAs were treated surgically, and 22 were treated endovascularly. There was no significant difference in mRS between treatment modalities (p = 0.393), but conservative therapy was significantly related to unfavorable outcomes (p = 0.025). To improve clinical outcomes, RIAs need to be diagnosed before rupture. Surgeons should be aware of de novo aneurysm formation in patients long after radiation therapy.

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  23. Changes in cerebral blood flow in the postoperative chronic phase after combined cerebral revascularization for moyamoya disease with ischaemic onset

    Araki Yoshio, Mamiya Takashi, Fujita Naotoshi, Uda Kenji, Yokoyama Kinya, Kanamori Fumiaki, Takayanagi Kai, Ishii Kazuki, Nishihori Masahiro, Takeuch Kazuhito, Tanahashi Kuniaki, Nagata Yuichi, Nishimura Yusuke, Tanei Takafumi, Sumitomo Masaki, Okamoto Sho, Izumi Takashi, Kato Katsuhiko, Saito Ryuta

    NEUROSURGICAL REVIEW   Vol. 45 ( 3 ) page: 2471 - 2480   2022.6

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    The purpose of this study was to examine the effects of combined revascularization for ischaemic-onset moyamoya disease (MMD) on cerebral haemodynamics by comparing cerebral blood flow (CBF) during the postoperative chronic phase with preoperative CBF. A retrospective cohort of 24 MMD patients (representing 31 surgeries) who received single photon emission computed tomography (SPECT) before and more than 6 months after surgery was investigated. The CBF value of each vascular territory was extracted from SPECT data, and the value relative to the ipsilateral cerebellar value (relative CBF, or RCBF) was calculated. The correlation between the revascularization effect and the proportional change in RCBF before and after surgery (calculated as post-RCBF/pre-RCBF (“post/pre-RCBF”)) was analysed. Furthermore, the relationships between changes in neurological symptoms and post/pre-RCBF were investigated. Preoperative and postoperative mean RCBF values were 0.92 ± 0.15 and 0.96 ± 0.13 (p = 0.619) in the anterior cerebral artery territory, 0.99 ± 0.17 and 1.01 ± 0.17 (p = 0.598) in the middle cerebral artery territory and 1.15 ± 0.22 and 1.14 ± 0.19 (p = 0.062) in the posterior cerebral artery territory, respectively. No significant correlation was found between the revascularization score and post/pre-RCBF. The revascularization score and post/pre-RCBF were not significant predictors of worsening neurological symptoms postoperatively. No significant change in RCBF was observed in any vascular territory in the chronic phase after revascularization. Combined revascularization may assist in the redirection of blood flow from the internal to the external carotid system and contribute to CBF maintenance.

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  24. Quick and simple dural threading technique for transsphenoidal surgery - dural tenting, haemostasis and skull base reconstruction

    Takeuchi Kazuhito, Nagata Yuichi, Tanahashi Kuniaki, Saito Ryuta

    ACTA NEUROCHIRURGICA   Vol. 164 ( 6 ) page: 1619 - 1622   2022.6

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    Background: Dural suturing is one of the most robust reconstruction methods in transsphenoidal surgery; however, the technique is considered difficult, primarily due to the restricted range of needle movement. Method: We performed dural threading during transsphenoidal surgery by holding the needle with forceps as a hook and moving the needle in a distal to proximal direction. Conclusion: Our dural suturing technique is simple and quick. It can be used not only for dural closure but also for other procedures, such as controlling haemostasis from the intercavernous sinus and dural tenting.

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  25. Evaluation of the differences in pressure applied to the vessel wall by different types of balloon remodeling microcatheters in an experimental model

    Ikezawa Mizuka, Izumi Takashi, Nishihori Masahiro, Tsukada Tetsuya, Tamari Yosuke, Araki Yoshio, Yokoyama Kinya, Uda Kenji, Goto Shunsaku, Kropp Asuka E., Otsuka Takafumi, Kato Naoki, Nakano Mizuki, Saito Ryuta

    INTERVENTIONAL NEURORADIOLOGY   Vol. 28 ( 3 ) page: 323 - 331   2022.6

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    Background: We examined compliance differences among balloon remodeling microcatheters, which have not been established previously. Methods: Straight and 120° angulated vascular models were created in a 3 mm diameter tube with 3 mm hole (vascular model A), a tube with a 4 mm hole (vascular model B), and a 4 mm diameter tube (vascular model C). We compared the pressure exerted when each balloon was herniated 1 or 2 mm between three compliant balloons (SHOURYU SR, TransForm C, and Scepter C) and four super-compliant balloons (HyperForm, SHOURYU HR, TransForm SC, and Scepter XC). Results: In vascular model A, there was a significant difference in the pressure exerted by compliant balloons and super-compliant balloons in both the straight and angulated models. In the straight model (1 and 2 mm), the lowest pressure was exerted by HyperForm (super-compliant balloons group) and SHOURYU SR (compliant balloons group). The lowest pressure was exerted in the angulated model by HyperForm (super-compliant balloons group) and Scepter C (compliant balloons group). The Scepter balloon exerted higher pressure in the straight model than other balloon remodeling microcatheters but less in the angulated model. In vascular model B, the pressure decreased in all balloons compared with model A. In vascular model C, the pressure increased in all balloons compared with model A. Conclusions: Pressure differed across balloon remodeling microcatheters. In addition, vessel shape and diameter, and hole size, affected the results. Our findings can help select balloon remodeling microcatheters.

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  26. Recent Molecular and Genetic Findings in Intramedullary Spinal Cord Tumors

    Nagashima Yoshitaka, Nishimura Yusuke, Eguchi Kaoru, Yamaguchi Junya, Haimoto Shoichi, Ohka Fumiharu, Takayasu Masakazu, Saito Ryuta

    NEUROSPINE   Vol. 19 ( 2 ) page: 262 - 271   2022.6

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    The study of genetic alterations and molecular biology in central nervous system (CNS) tumors has improved the accuracy of estimations of patient prognosis and tumor categorization. Therefore, the updated 2021 World Health Organization (WHO) classification includes various diagnostic genes, molecules, and pathways for diagnosis, as well as histological findings. These findings are expected both to have diagnostic applications and to facilitate new targeted therapies that target tumor-specific genetic changes and molecular biology. Intramedullary spinal cord tumors (IMSCTs) are rare CNS tumors that are difficult to treat because they occur in eloquent areas. Although the genetic underpinnings of IMSCTs remain unclear compared to their intracranial counterparts, the genetic characteristics of these tumors are gradually being revealed. Here, we describe the major changes in the new 2021 WHO classification and review the major types of IMSCTs, with an emphasis on their clinical features and genetic alterations.

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  27. Supratotal Resection of Gliomas With Awake Brain Mapping: Maximal Tumor Resection Preserving Motor, Language, and Neurocognitive Functions

    Motomura Kazuya, Ohka Fumiharu, Aoki Kosuke, Saito Ryuta

    FRONTIERS IN NEUROLOGY   Vol. 13   page: 874826   2022.5

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    Gliomas are a category of infiltrating glial neoplasms that are often located within or near the eloquent areas involved in motor, language, and neurocognitive functions. Surgical resection being the first-line treatment for gliomas, plays a crucial role in patient outcome. The role of the extent of resection (EOR) was evaluated, and we reported significant correlations between a higher EOR and better clinical prognosis of gliomas. However, recurrence is inevitable, even after aggressive tumor removal. Thus, efforts have been made to achieve extended tumor resection beyond contrast-enhanced mass lesions in magnetic resonance imaging (MRI)-defined areas, a process known as supratotal resection. Since it has been reported that tumor cells invade beyond regions visible as abnormal areas on MRI, imaging underestimates the true spatial extent of tumors. Furthermore, tumor cells have the potential to spread 10–20 mm away from the MRI-verified tumor boundary. The primary goal of supratotal resection is to maximize EOR and prolong the progression-free and overall survival of patients with gliomas. The available data, as well as our own work, clearly show that supratotal resection of gliomas is a feasible technique that has improved with the aid of awake functional mapping using intraoperative direct electrical stimulation. Awake brain mapping has enabled neurosurgeons achieve supratotal resection with favorable motor, language, and neurocognitive outcomes, ensuring a better quality of life in patients with gliomas.

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  28. Cutoff values for the best management strategy for magnetic resonance-guided focused ultrasound ablation for essential tremor.

    Torii J, Maesawa S, Nakatsubo D, Tsugawa T, Kato S, Ishizaki T, Takai S, Shibata M, Wakabayashi T, Tsuboi T, Suzuki M, Saito R

    Journal of neurosurgery     page: 1 - 12   2022.5

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  29. Blood flow stagnation after treatment of a giant internal carotid artery aneurysm: a computed fluid dynamics analysis

    Muraoka Shinsuke, Takagi Reiya, Araki Yoshio, Uda Kenji, Sumitomo Masaki, Okamoto Sho, Nishihori Masahiro, Izumi Takashi, Nakamura Masanori, Saito Ryuta

    SCIENTIFIC REPORTS   Vol. 12 ( 1 ) page: 7283   2022.5

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    Balloon test occlusion (BTO) is an angiographic test to evaluate ischemic tolerance after permanent occlusion of an internal carotid artery (ICA). BTO can simulate ischemia caused by parent artery occlusion and can be used to select a suitable bypass surgery using specific criteria. On the other hand, a postoperative thrombus can form despite proper case selection, optimal radiological evaluation, and an appropriate surgical strategy. Postoperative ischemic complications related to perforating branches are clinically significant. This simulation study aimed to analyze postoperative flow characteristics and elucidate the cause of ischemic complications related to the perforating branch using computational fluid dynamics (CFD). An unexpected postoperative thrombus formation related to the perforating branch occurred after treating a giant aneurysm in the cavernous portion of the ICA in a patient. Three-dimensional digital subtraction angiography was used to acquire flow data and set up the CFD simulation. The flow simulations were performed at various bypass flow rates. The CFD analysis indicated flow stagnation in the ICA only when surgical treatment using a low-flow bypass graft was performed. Thrombus formation may lead to ischemic complications related to the perforating branch, such as the anterior choroidal artery. BTO did not reflect the influence of bypass blood flow. Therefore, recognizing that blood flow stagnation may occur and comprehensively deciding on the surgical strategy by CFD analysis can be helpful to prevent ischemic complications in patients with giant aneurysms.

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  30. A novel endoscopic ventriculocisternostomy and stenting technique with a transparent acryl puncture needle for a trapped temporal horn: a technical report and literature review

    Yamamoto Taiki, Takeuchi Kazuhito, Nagata Yuichi, Mizuno Akihiro, Harada Hideyuki, Saito Ryuta

    NEUROSURGICAL REVIEW   Vol. 45 ( 2 ) page: 1783 - 1789   2022.4

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    Trapped temporal horn is a rare type of noncommunicating focal hydrocephalus, and no standard treatment has been established yet for trapped temporal horn. Recent studies have shown the efficacy of endoscopic ventriculocisternostomy by opening the choroidal fissure; however, some surgical complications were reported during the procedure. Thus, we aimed to report a novel endoscopic ventriculocisternostomy and stenting technique for trapped temporal horn. In this technique, a 5.8-mm transparent acryl puncture needle with a 2.7-mm 0° rigid endoscope was used to open the choroidal fissure. It can fenestrate the choroidal fissure under real-time endoscopic observation of the critical neurovascular structures over the choroidal fissure. Moreover, the dull tip of the needle is less likely to injure the critical neurovascular structures, resulting in safer ventriculocisternostomy than the previously reported technique. Then, a stent is placed along the tract to prevent future obstruction of the stoma. Six trapped temporal horns in four patients were treated using the technique. All the patients showed improved symptoms with no surgical complications. None of the patients showed recurrence of trapped temporal horn during the mean follow-up period of 39.3 months. The combination of endoscopic ventriculocisternostomy and stenting with a transparent acryl puncture needle is a safe and effective treatment option for trapped temporal horn.

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  31. Risk Factors for Cerebral Infarction Early After Revascularization in Children Younger than 5 Years with Moyamoya Disease

    Araki Yoshio, Uda Kenji, Yokoyama Kinya, Kanamori Fumiaki, Kurimoto Michihiro, Shiba Yoshiki, Mamiya Takashi, Nishihori Masahiro, Takeuchi Kazuhito, Tanahashi Kuniaki, Nagata Yuichi, Nishimura Yusuke, Okamoto Sho, Sumitomo Masaki, Izumi Takashi, Saito Ryuta

    WORLD NEUROSURGERY   Vol. 160   page: E220 - E226   2022.4

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    Objective: Cerebral revascularization is necessary for pediatric patients younger than 5 years with moyamoya disease (MMD). However, they have a high risk of developing cerebral infarction early after surgery. This study aimed to analyze the risk factors for developing cerebral infarction among these patients. Methods: The charts of 21 consecutive patients with MMD (39 surgeries) younger than 5 years who had undergone revascularization at our hospital were retrospectively analyzed. Because cerebral infarction occurring within 1 month after surgery was the primary end point, other clinical information was evaluated, including each surgical procedure. Multivariate analysis of the risk factors for postoperative cerebral infarction was performed. Results: Cerebral infarction occurred after 7 of 39 surgeries (17.9%). Of the 39 surgeries, 23 (59%) included direct and indirect combined revascularization. The incidence of cerebral infarction did not differ significantly between the combined (21.7%) and indirect (12.5%) groups (P = 0.46). Logistic regression showed no association between the revascularization procedure and the occurrence of cerebral infarction after surgery (P = 0.3). However, younger age at surgery was correlated with a higher risk of developing cerebral infarction in the early postoperative period (P = 0.05). Conclusions: No differences were found in the risk of developing cerebral infarction early after surgery as a result of surgical procedures. However, younger patients had higher postoperative risk. Further multicenter research should examine this issue for young pediatric patients with moyamoya at high risk of developing cerebral infarction.

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  32. Modified Shoelace Dural Closure with Collagen Matrix in Extended Transsphenoidal Surgery

    NAGATA Yuichi, TAKEUCHI Kazuhito, SASAKI Hiroo, MIZUNO Akihiro, HARADA Hideyuki, TANAHASHI Kuniaki, ARAKI Yoshio, SAITO Ryuta

    Neurologia medico-chirurgica   Vol. 62 ( 4 ) page: 203 - 208   2022.4

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    <p>Extended endonasal transsphenoidal surgery (eTSS) offers a wide surgical field for various parasellar lesions; however, intraoperative high-flow cerebrospinal fluid (CSF) leakage is inevitable. Therefore, secure sellar reconstruction methods are essential to prevent postoperative CSF leakage. Although collagen matrix has been applied for dural reconstruction in neurosurgery, its suitability for application in extended eTSS remains unclear. Eighteen patients underwent modified shoelace dural closure using collagen matrix after lesionectomy via extended eTSS. In this technique, a collagen matrix, which was placed subdurally (inlay graft), was continuously sutured with both open dural edges like a shoelace. Then, another collagen matrix was placed epidurally (onlay graft), and rigid reconstruction was performed using the septal bone and a resorbable fixation mesh. Postoperative CSF leakage did not occur in 17 patients but did occur in 1 patient with tuberculum sellae meningioma. In this case, the CSF leakage point was detected just around the area between the coagulated dura and the adjacent collagen matrix. The collagen matrix harvested from this area was pathologically examined; neovascularization and fibroblastic infiltration into the collagen matrix were not detected. On the other hand, neovascularization and fibroblast infiltration into the collagen matrix were apparent on the surface of the collagen matrix harvested from the non-CSF leakage area. Our novel dural closure technique using collagen matrix could be an effective option for sellar reconstruction in extended eTSS; however, it should be applied in patients in whom normal dural edges are preserved.</p>

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  33. Challenging direct bypass surgery for very young children with moyamoya disease: technical notes

    Araki Yoshio, Uda Kenji, Yokoyama Kinya, Kanamori Fumiaki, Kurimoto Michihiro, Shiba Yoshiki, Mamiya Takashi, Nishihori Masahiro, Takeuchi Kazuhito, Tanahashi Kuniaki, Nagata Yuichi, Nishimura Yusuke, Okamoto Sho, Sumitomo Masaki, Izumi Takashi, Saito Ryuta

    NEUROSURGICAL REVIEW   Vol. 45 ( 2 ) page: 1799 - 1807   2022.4

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    Cerebral revascularization for moyamoya disease (MMD) is an effective treatment for improving cerebral ischaemia and preventing rebleeding. Although direct bypass surgery is commonly performed on older children and adults, it is challenging in very young children due to the high difficulty level of the procedure. The subjects were MMD patients under 3 years of age on whom surgery was performed by a single surgeon (Y.A.). Preoperative clinical findings, information related to direct bypass surgery, bypass patency, and the incidence of postoperative stroke were investigated. Combined revascularization, including direct bypass surgery, was performed on 3 MMD patients (3 sides) under 3 years of age. The average diameter of the grafts used in direct bypass was 0.8 mm. The average recipient diameter was 0.8 ± 0.17 (range 0.6–1) mm. In all cases, the anastomotic procedure was completed using 11–0 monofilament nylon thread, and patency was confirmed. Direct bypass for MMD patients under 3 years old is technically challenging. However, despite the anatomical differences between very young children and elderly individuals, direct bypass surgery could certainly be completed. In addition, a rapid recovery from cerebral blood flow insufficiency could yield a promising neurological outcome.

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  34. Advantages of petrosectomy for superficial temporal artery to superior cerebellar artery bypass based on three-dimensional distance measurements using cadaver heads

    Uda Kenji, Tanahashi Kuniaki, Mamiya Takashi, Kanamori Fumiaki, Yokoyama Kinya, Nishihori Masahiro, Izumi Takashi, Araki Yoshio, Saito Ryuta

    NEUROSURGICAL REVIEW   Vol. 45 ( 2 ) page: 1617 - 1624   2022.4

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    Superficial temporal artery (STA) to superior cerebellar artery (SCA) bypass is usually performed via the subtemporal approach (StA), anterior transpetrosal approach (ApA), or combined petrosal approach (CpA), but no study has yet reported a quantitative comparison of the operative field size provided by each approach, and the optimal approach is unclear. The objective of this study is to establish evidence for selecting the approach by using cadaver heads to measure the three-dimensional distances that represent the operative field size for STA–SCA bypass. Ten sides of 10 cadaver heads were used to perform the four approaches: StA, ApA with and without zygomatic arch osteotomy (ApA-ZO− and ApA-ZO+), and CpA. For each approach, the major-axis length and the minor-axis length at the anastomosis site (La-A and Li-A), the major-axis length and the minor-axis length at the brain surface (La-B and Li-B), the depth from the brain surface to the anastomosis site (Dp), and the operating angles of the major axis and the minor axis (OAa and OAi) were measured. Shallower Dp and wider operating angle were obtained in the order CpA, ApA-ZO+, ApA-ZO−, and StA. In all parameters, ApA-ZO− extended the operative field more than StA. ApA-ZO+ extended La-B and OAa more than ApA-ZO−, whereas it did not contribute to Dp and OAi. CpA significantly decreased Dp, and widened OAa and OAi more than ApA-ZO+. ApA and CpA greatly expanded the operative field compared with StA. These results provide criteria for selecting the optimal approach for STA-SCA bypass in light of an individual surgeon’s anastomosis skill level.

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  35. 特集 脊椎脊髄疾患の再手術症例における手術のコツと留意点 頸椎症における再手術

    西村 由介, 永島 吉孝, 齋藤 竜太

    脊椎脊髄ジャーナル   Vol. 34 ( 12 ) page: 896 - 901   2022.3

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    DOI: 10.11477/mf.5002201765

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  36. Increased Risk of Thyroid Dysfunction by PD-1 and CTLA-4 Blockade in Patients Without Thyroid Autoantibodies at Baseline

    Iwama Shintaro, Kobayashi Tomoko, Yasuda Yoshinori, Okuji Takayuki, Ito Masaaki, Ando Masahiko, Zhou Xin, Yamagami Ayana, Onoue Takeshi, Kawaguchi Yohei, Miyata Takashi, Sugiyama Mariko, Takagi Hiroshi, Hagiwara Daisuke, Suga Hidetaka, Banno Ryoichi, Hase Tetsunari, Morise Masahiro, Wakahara Keiko, Yokota Kenji, Kato Masashi, Nishio Naoki, Tanaka Chie, Miyata Kazushi, Ogura Atsushi, Ito Takanori, Sawada Tsunaki, Shimokata Tomoya, Niimi Kaoru, Ohka Fumiharu, Ishigami Masatoshi, Gotoh Momokazu, Hashimoto Naozumi, Saito Ryuta, Kiyoi Hitoshi, Kajiyama Hiroaki, Ando Yuichi, Hibi Hideharu, Sone Michihiko, Akiyama Masashi, Kodera Yasuhiro, Arima Hiroshi

    JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM   Vol. 107 ( 4 ) page: E1620 - E1630   2022.3

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    Background: Previous studies showed that although the risk of thyroid dysfunction [thyroid immune-related adverse events (irAEs)] induced by anti-programmed cell death-1 antibodies (PD-1-Ab) was as low as 2% to 7% in patients negative for anti-thyroid antibodies (ATAs) at baseline, it was much higher (30%-50%) in patients positive for ATAs. However, whether a similar increase occurs with combination therapy using PD-1-Ab plus anti-cytotoxic T-lymphocyte antigen-4 antibody (CTLA-4-Ab) is unknown. Methods: A total of 451 patients with malignancies treated with PD-1-Ab, CTLA-4-Ab, or a combination of PD-1-Ab and CTLA-4-Ab (PD-1/CTLA-4-Abs) were evaluated for ATAs at baseline and for thyroid function every 6 weeks for 24 weeks after treatment initiation and then observed until the last clinical visit. Results: Of the 451 patients, 51 developed thyroid irAEs after immunotherapy [41 of 416 (9.9%) treated with PD-1-Ab, 0 of 8 (0%) treated with CTLA-4-Ab, and 10 of 27 (37.0%) treated with PD-1/CTLA-4-Abs]. The cumulative incidence of thyroid irAEs was significantly higher in patients who were positive vs negative for ATAs at baseline after both PD-1-Ab [28/87 (32.2%) vs 13/329 (4.0%), P < 0.001] and PD-1/CTLA-4-Abs [6/10 (60.0%) vs 4/17 (23.5%), P < 0.05] treatments. The risk of thyroid irAEs induced by PD-1/CTLA-4Abs, which was significantly higher than that induced by PD-1-Ab, in patients negative for ATAs at baseline was not statistically different from that induced by PD-1-Ab in patients positive for ATAs at baseline. Conclusions: This study showed that the incidence of thyroid irAEs was high and not negligible after PD-1/CTLA-4-Abs treatment even in patients negative for ATAs at baseline.

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  37. [Diffuse midline glioma].

    Saito R

    No shinkei geka. Neurological surgery   Vol. 50 ( 1 ) page: 29 - 38   2022.1

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  38. Multitier Network Analysis Using Resting-state Functional MRI for Epilepsy Surgery

    MAESAWA Satoshi, BAGARINAO Epifanio, NAKATSUBO Daisuke, ISHIZAKI Tomotaka, TAKAI Sou, TORII Jun, KATO Sachiko, SHIBATA Masashi, WAKABAYASHI Toshihiko, SAITO Ryuta

    Neurologia medico-chirurgica   Vol. 62 ( 1 ) page: 45 - 55   2022.1

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    <p>Resting-state functional MRI (rs-fMRI) has been utilized to visualize large-scale brain networks. We evaluated the usefulness of multitier network analysis using rs-fMRI in patients with focal epilepsy. Structural and rs-fMRI data were retrospectively evaluated in 20 cases with medically refractory focal epilepsy, who subsequently underwent surgery. First, structural changes were examined using voxel-based morphometry analysis. Second, alterations in large-scale networks were evaluated using dual-regression analysis. Third, changes in cortical hubs were analyzed and the relationship between aberrant hubs and the epileptogenic zone (EZ) was evaluated. Finally, the relationship between the hubs and the default mode network (DMN) was examined using spectral dynamic causal modeling (spDCM). Dual-regression analysis revealed significant decrease in functional connectivity in several networks including DMN in patients, although no structural difference was seen between groups. Aberrant cortical hubs were observed in and around the EZ (EZ hubs) in 85% of the patients, and a strong degree of EZ hubs correlated to good seizure outcomes postoperatively. In spDCM analysis, facilitation was often seen from the EZ hub to the contralateral side, while inhibition was seen from the EZ hub to nodes of the DMN. Some cognition-related networks were impaired in patients with focal epilepsy. The EZ hub appeared in the vicinity of EZ facilitating connections to distant regions in the early phase, which may eventually generate secondary focus, while inhibiting connections to the DMN, which may cause cognitive deterioration. Our results demonstrate pathological network alterations in epilepsy and suggest that earlier surgical intervention may be more effective.</p>

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  39. Reliability of IDH1-R132H and ATRX and/or p53 immunohistochemistry for molecular subclassification of Grade 2/3 gliomas

    Nishikawa Tomohide, Watanabe Reiko, Kitano Yotaro, Yamamichi Akane, Motomura Kazuya, Ohka Fumiharu, Aoki Kosuke, Hirano Masaki, Kato Akira, Yamaguchi Junya, Maeda Sachi, Kibe Yuji, Saito Ryuta, Wakabayashi Toshihiko, Kato Yukinari, Sato Shuta, Ogino Tomoyoshi, Natsume Atsushi, Ito Ichiro

    BRAIN TUMOR PATHOLOGY   Vol. 39 ( 1 ) page: 14 - 24   2022.1

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    Since the World Health Organization 2016 classification (2016 WHO), genetic status has been incorporated into the diagnosis of Grade 2/3 gliomas (lower-grade gliomas). Therefore, immunohistochemistry (IHC) of IDH1-R132H, ATRX, and p53 have been used in place of genetic status. We report the associations between histological findings, IHC, and genetic status. We performed IHC of IDH1-R132H, ATRX, and p53 in 76 lower-grade gliomas and discussed its validity based on the 2016 WHO and the upcoming 2021 WHO classification. The sensitivity and specificity of anti-ATRX, p53, and IDH1-R132H IHC were 40.9%/98.1%, 78.6%/85.4%, and 90.5%/84.6%, respectively. Among 21 IDH1-mutant gliomas without 1p/19q codeletion, two gliomas (9.5%) mimicked the so-called classic for oligodendroglioma (CFO) in their morphology. Of the 42 gliomas with 1p/19q codeletion, four cases were difficult to diagnose as oligodendroglioma through morphological examination. Moreover, there were three confusing cases with ATRX mutations but with retained ATRX-IHC positivity. The lessons learned from this study are as follows: (1) ATRX-IHC and p53-IHC should be supplementary to morphological diagnosis, (2) rare IDH mutations other than IDH1 R132H should be considered, and (3) there is no complete alternative test to detect molecular features of glioblastoma under the 2021 WHO classification.

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  40. Spontaneous regression of asymptomatic tumefactive perivascular spaces in the anterior temporal lobe

    Hashida M., Nagashima Y., Nishimura Y., Eguchi K., Taoka T., Kawai H., Saito R.

    Nagoya Journal of Medical Science   Vol. 84 ( 3 ) page: 678 - 685   2022

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    Perivascular spaces are fluid-filled spaces that surround the perforating vessels of the brain and are normal findings on brain imaging. These are usually asymptomatic and are considered a manifestation of aging. Perivascular spaces occasionally undergo significant enlargement and are referred to as tumefactive perivascular spaces, which are often indistinguishable from neoplastic lesions. Spontaneous regression of tumefactive perivascular spaces during follow-up is rare. We report the imaging findings and clinical course of a patient who showed spontaneous regression of tumefactive perivascular spaces in the anterior temporal lobe, together with a literature review and discussion regarding the characteristics and pathogenesis of spontaneous regression of tumefactive perivascular spaces. Most studies in the available literature report tumefactive perivascular spaces in the anterior temporal lobe; in our view, the characteristics of anterior temporal lobe tumefactive perivascular spaces may differ from those of tumefactive perivascular spaces that occur at other locations.

    DOI: 10.18999/nagjms.84.3.678

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  41. A successful case of surgical embolectomy for acute large vessel occlusion after thoracic endovascular aortic repair

    Muramatsu Yusuke, Fuse Yutaro, Ota Shinji, Nakamura Shigekazu, Kurimoto Futoshi, Watanabe Kazuhiko, Saito Ryuta

    Japanese Journal of Stroke   Vol. advpub ( 0 )   2022

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    <p>Here, we report a case of acute MCA occlusion in a patient who underwent thoracic endovascular aortic repair (TEVAR) for a thoracic aortic aneurysm 2 years ago. An 83-year-old man presented with sudden right hemiparesis and aphasia. CT with contrast revealed occlusion of the left MCA, and MRI revealed mild hyperintense signals in the left MCA area. The aortic arch stent graft partially overlapped the origin of the left common carotid artery on the contrast CT. Therefore, we decided not to perform mechanical thrombectomy via the transaortic approach. Instead, the patient underwent a surgical embolectomy with frontotemporal craniotomy. His symptoms improved remarkably, and he was discharged with only mild aphasia, dysarthria, and disorientation. In a case where mechanical thrombectomy via the transaortic approach is expected to be difficult, surgical embolectomy can be an alternative choice.</p>

    DOI: 10.3995/jstroke.11028

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  42. Atypical Incomplete Detachment Following PulseRider Deployment

    Goto Shunsaku, Izumi Takashi, Nishihori Masahiro, Araki Yoshio, Yokoyama Kinya, Uda Kenji, Saito Ryuta

    Journal of Neuroendovascular Therapy   Vol. 16 ( 8 ) page: 409 - 412   2022

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    <p><b>Objective</b>: Owing to the limited time since the introduction of the PulseRider (PR), inconsequential or rare complications that clinicians should be aware of remain unreported yet. Here, we report a rare complication of incomplete detachment.</p><p><b>Case Presentation</b>: A 50-year-old male underwent PR-assisted coil embolization for a basilar tip aneurysm. Coiling was completed, and the detachment procedure was performed using a detachment machine; the success signal was observed. The delivery microcatheter was subsequently advanced back up to the proximal markers, and no reapproximation of the proximal markers, which indicates successful detachment, was observed. However, only one of the proximal markers returned to the microcatheter, and incomplete detachment of only one leg was detected. Ultimately, electrical detachment was not possible, and physical separation by tension was achieved.</p><p><b>Conclusion</b>: Our case report presents a rare case of a detachment problem in the PR. The PR could not be detached, although the signal revealed successful detachment. Therefore, careful withdrawal of the delivery wire by checking not only the proximal markers but also the behavior of the entire PR and coil complex is important.</p>

    DOI: 10.5797/jnet.cr.2021-0095

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  43. Contrast-Enhanced Magnetic Resonance Imaging Suggested a Possibility of Transvenous Embolization in the Superior Petrosal Sinus Dural Arteriovenous Fistula: A Case Report

    Nishihori Masahiro, Izumi Takashi, Tsukada Tetsuya, Kato Yutaka, Uda Kenji, Yokoyama Kinya, Araki Yoshio, Saito Ryuta

    Journal of Neuroendovascular Therapy   Vol. 16 ( 3 ) page: 163 - 169   2022

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    <p><b>Objective</b>: Superior petrosal sinus dural arteriovenous fistula (SPS-DAVF) is a rare subtype of intracranial DAVF that sometimes leads to hemorrhagic symptoms following deep venous drainage. Here we report the case of SPS-DAVF with retrograde venous reflux to the cerebellar vein. Preoperative contrast-enhanced MRI was a decisive factor in a safe and effective treatment.</p><p><b>Case Presentation</b>: A 37-year-old woman was referred to our hospital with abnormal MRI findings, which was performed when she had a mild headache during her check-up. DSA revealed left-sided SPS-DAVF, which was diagnosed as Cognard type IIb. Both CTA and DSA could not detect the whole SPS but only the shunt pouch. Using contrast-enhanced MRI, we were able to visualize the presence of the SPS and its continuity within the shunt pouch. 3D-T1 turbo spin echo (SPACE) showed a low-intensity area in the SPS, which was not seen in the 3D-T1 fast field echo (FFE). During the procedure, there was a point where it was difficult to advance the microcatheter, which coincided with the low-intensity area. We achieved effective transvenous embolization from the occluded venous access by devising a surgical technique.</p><p><b>Conclusion</b>: In addition to the contrast-enhanced 3D-T1 FFE, 3D-T1 SPACE might provide beneficial information for endovascular therapy in the evaluation of venous sinuses, which could not be detected by standard examinations.</p>

    DOI: 10.5797/jnet.cr.2021-0029

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  44. A Case of Isolated ACTH Deficiency with Suspected Origin from Cervical Spondylotic Myelopathy

    Saito Tsuyoshi, Yoshida Mitsuhiro, Nakabayashi Kiyo, Aimi Yuri, Ishida Mamoru, Hamasaki Hajime, Terao Kazuichi, Nakajima Shoko, Nawashiro Tomoki, Saito Ryuta

    Spinal Surgery   Vol. 36 ( 1 ) page: 88 - 93   2022

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    <p>  The patient was a 46-year-old man who presented with fatigue for 6 months. His activities of daily living (ADL) gradually worsened and he was transported to our hospital’s emergency room because of difficulty in walking due to muscle weakness in the extremities. His weight had decreased by 20 kg in 6 months, and he was almost bedridden. Upon arrival, he presented with emaciation, hypotension, and muscle weakness predominantly in the proximal portions. However, he showed no clumsiness in the hands, pain, sensory disorders, or bladder-rectal disturbances. Only Hoffman’s reflex was positive. Deep tendon reflexes were almost normal in his upper limbs but flaccid in his lower limbs. The Japan Orthopaedic Association (JOA) score was 14/17. Images of the cervical spine showed a developmental narrow canal, cervical spondylotic changes at C4-7 levels, and cervical spinal cord compression with myelomalacia at C4-6 levels. These findings suggested cervical spondylotic myelopathy (CSM). However, laboratory data showed mild hyponatremia (sodium 135 mmol/L) and hypothyroidism (free thyroxine [T4] 1.00 ng/ml, thyroid-stimulating hormone [TSH] 6.62 µIU/ml). Based on radiology, endocrinology, and neurology consultations, the patient was diagnosed with an isolated adrenocorticotropic hormone (ACTH) deficiency. Hydrocortisone (20 mg/day) administration dramatically improved his symptoms and ADL. The JOA score improved to 17/17 over a few months, and the patient returned to his daily life. He has been followed-up without surgery until now.</p><p>  Several differential diagnoses other than CSM involve muscle weakness of the extremities. Even if there is a clear cervical spine lesion on imaging, it is important to consider whether it is a lesion actually responsible for the symptoms. Cooperation with other departments is also necessary. In particular, if a patient has endocrine diseases, such as in this case, it can cause fatal complications during surgery. Therefore, we should pay attention to these patients and initiate prophylactic measures if the patient needs surgery.</p>

    DOI: 10.2531/spinalsurg.36.88

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  45. Laminectomy triggers symptomatic growth of spinal schwannoma in a patient with schwannomatosis.

    Oyama T, Nishimura Y, Nagashima Y, Nishii T, Hara M, Takayasu M, Sakakibara A, Saito R

    Surgical neurology international   Vol. 13   page: 261   2022

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    DOI: 10.25259/SNI_453_2022

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  46. Clinical and Radiological Clues of Traumatic Craniocervical Junction Injuries Requiring Occipitocervical Fusion to Early Diagnosis

    Shiraishi Daimon, Nishimura Yusuke, Aguirre-Carreno Isaac, Hara Masahito, Yoshikawa Satoshi, Eguchi Kaoru, Nagashima Yoshitaka, Ito Hiroshi, Haimoto Shoichi, Yamamoto Yu, Ginsberg Howard J., Takayasu Masakazu, Saito Ryuta

    NEUROSPINE   Vol. 18 ( 4 ) page: 741 - 748   2021.12

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    Objective: The purpose of this study is to find the clinical and radiographic characteristics of traumatic craniocervical junction (CCJ) injuries requiring occipitocervical fusion (OC fusion) for early diagnosis and surgical intervention. Methods: We retrospectively reviewed 12 patients with CCJ injuries presenting to St. Mi-chaels Hospital in Toronto who underwent OC fusion and looked into the following vari-ables; (1) initial trauma data on emergency room arrival, (2) associated injuries, (3) imaging characteristics of computed tomography (CT) scan and magnetic resonance imaging (MRI), (4) surgical procedures, surgical complications, and neurological outcome. Results: All patients were treated as acute spinal injuries and underwent OC fusion on an emergency basis. Patients consisted of 10 males and 2 females with an average age of 47 years (range, 18–82 years). All patients sustained high-energy injuries. Three patients out of 6 patients with normal BAI (basion-axial interval) and BDI (basion-dens interval) values showed visible CCJ injuries on CT scans. However, the remaining 3 patients had no clear evidence of occipitoatlantal instability on CT scans. MRI clearly described several findings indicating occipitoatlantal instability. The 8 patients with normal values of ADI (atlanto-dens interval interval) demonstrated atlantoaxial instability on CT scan, however, all MRI more clearly and reliably demonstrated C1/2 facet injury and/or cruciate ligament injury. Conclusion: We advocate measures to help recognize CCJ injury at an early stage in the present study. Occipitoatlantal instability needs to be carefully investigated on MRI in addition to CT scan with special attention to facet joint and ligament integrity.

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  47. Two cases of solitary fibrous tumor/hemangiopericytoma with different clinical features according to the World Health Organization classification: case report and review of the literature.

    Nishii T, Nagashima Y, Nishimura Y, Ito H, Oyama T, Matsuo M, Sakakibara A, Shimada S, Saito R

    Journal of spine surgery (Hong Kong)   Vol. 7 ( 4 ) page: 532 - 539   2021.12

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  48. A Super-selective Wada Test Successfully Detected an Artery That Supplied Broca's Area in a Case of Left Frontal Lobe Glioblastoma: Technical Case Report.

    Shota Yamashita, Ryuta Saito, Shin-Ichiro Osawa, Kuniyasu Niizuma, Kazushi Ukishiro, Masayuki Kanamori, Kazuo Kakinuma, Kyoko Suzuki, Teiji Tominaga

    Neurologia medico-chirurgica   Vol. 61 ( 11 ) page: 661 - 666   2021.11

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    In cases of malignant gliomas located at language eloquent area, it is often difficult to preoperatively detect those area with functional MRI. Awake surgery is often used to spare the language eloquent area during surgery for such tumors; it is not available for a patient whose intracranial pressure is elevated due to the malignant tumor. The Wada test involves infusing anesthetic agents into the internal carotid artery to determine language dominancy before surgery for epilepsy or brain tumor. The super-selective Wada test is a technique to detect more detailed functional localization by infusing anesthetics into far distal middle cerebral artery branches. We present a 37-year-old man suffering from a left frontal lobe glioblastoma, in whom detection of an artery supplying Broca's area was attempted by a super-selective Wada test. The super-selective Wada test successfully detected the branch of middle cerebral artery supplying Broca's area. Total resection of the contrast-enhancing area was achieved without damaging the artery supplying Broca's area without any neurological sequelae. This is the first report describing the usefulness of the super-selective Wada test in glioblastoma treatment. Our findings suggest that the super-selective Wada test is a powerful and useful means to distinguish the artery that supplies the language area from the tumor feeding artery in cases of tumors in the language eloquent area.

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  49. Resting State Networks Related to the Maintenance of Good Cognitive Performance During Healthy Aging

    Maesawa Satoshi, Mizuno Satomi, Bagarinao Epifanio, Watanabe Hirohisa, Kawabata Kazuya, Hara Kazuhiro, Ohdake Reiko, Ogura Aya, Mori Daisuke, Nakatsubo Daisuke, Isoda Haruo, Hoshiyama Minoru, Katsuno Masahisa, Saito Ryuta, Ozaki Norio, Sobue Gen

    FRONTIERS IN HUMAN NEUROSCIENCE   Vol. 15   page: 753836   2021.11

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    Purpose: Maintenance of cognitive performance is important for healthy aging. This study aims to elucidate the relationship between brain networks and cognitive function in subjects maintaining relatively good cognitive performance. Methods: A total of 120 subjects, with equal number of participants from each age group between 20 and 70 years, were included in this study. Only participants with Addenbrooke’s Cognitive Examination – Revised (ACE-R) total score greater than 83 were included. Anatomical T1-weighted MR images and resting-state functional MR images (rsfMRIs) were taken from all participants using a 3-tesla MRI scanner. After preprocessing, several factors associated with age including the ACE-R total score, scores of five domains, sub-scores of ACE-R, and brain volumes were tested. Morphometric changes associated with age were analyzed using voxel based morphometry (VBM) and changes in resting state networks (RSNs) were examined using dual regression analysis. Results: Significant negative correlations with age were seen in the total gray matter volume (GMV, r = −0.58), and in the memory, attention, and visuospatial domains. Among the different sub-scores, the score of the delayed recall (DR) showed the highest negative correlation with age (r = −0.55, p < 0.001). In VBM analysis, widespread regions demonstrated negative correlation with age, but none with any of the cognitive scores. Quadratic approximations of cognitive scores as functions of age showed relatively delayed decline compared to total GMV loss. In dual regression analysis, some cognitive networks, including the dorsal default mode network, the lateral dorsal attention network, the right / left executive control network, the posterior salience network, and the language network, did not demonstrate negative correlation with age. Some regions in the sensorimotor networks showed positive correlation with the DR, memory, and fluency scores. Conclusion: Some domains of the cognitive test did not correlate with age, and even the highly correlated sub-scores such as the DR score, showed delayed decline compared to the loss of total GMV. Some RSNs, especially involving cognitive control regions, were relatively maintained with age. Furthermore, the scores of memory, fluency, and the DR were correlated with the within-network functional connectivity values of the sensorimotor network, which supported the importance of exercise for maintenance of cognition.

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  50. Aphasic status epilepticus after glioma resection: two case reports. International journal

    Yoshiteru Shimoda, Masayuki Kanamori, Ryuta Saito, Shinichiro Osawa, Shunji Mugikura, Teiji Tominaga

    Acta neurochirurgica   Vol. 163 ( 11 ) page: 3109 - 3113   2021.11

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    Aphasic status epilepticus (ASE) is a subtype of focal nonconvulsive status epilepticus, in which language disturbance is the only objective clinical manifestation. We present two cases of patients who experienced delayed onset of temporal aphasia after the removal of glioma at the language-dominant hemisphere. In both cases, arterial spin labeling was useful for diagnosis and antiepileptic drug was effective. ASE should be considered a cause of persistent aphasia after glioma resection at or near the language area.

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  51. Techniques, Indications, and Outcomes in Magnetic Resonance-guided Focused Ultrasound Thalamotomy for Tremor

    MAESAWA Satoshi, NAKATSUBO Daisuke, TSUGAWA Takahiko, KATO Sachiko, SHIBATA Masashi, TAKAI Sou, TORII Jun, ISHIZAKI Tomotaka, WAKABAYASHI Toshihiko, SAITO Ryuta

    Neurologia medico-chirurgica   Vol. 61 ( 11 ) page: 629 - 639   2021.11

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    <p>Magnetic resonance (MR)-guided focused ultrasound surgery (MRgFUS) is the latest minimally invasive stereotactic procedure, and thalamotomy using this novel modality has demonstrated its effectiveness and safety, especially for patients with essential tremor (ET) and Parkinson’s disease (PD). In Japan, the application of MRgFUS to treat ET and PD has recently been covered by health insurance. Technically, the transducer with 1024 elements emits ultrasound beams, which are then focused on the target with a phase control, resulting in optimal ablation by thermal coagulation. The technical advantages of MRgFUS are continuous intraoperative monitoring of clinical symptoms and MR images and fine adjustment of the target by the steering function. Postoperative tremor control is compatible with other modalities, although long-term follow-up is necessary. The adverse effects are usually transient and acceptable. Prognostic factors for good tremor control include high temperature and large lesion size. A high skull density ratio is a factor to achieve high temperature and large lesioning, but it may not be necessary and sufficient for clinical outcomes. For patients with advanced symptoms such as bilateral tremor or head/neck tremor, deep brain stimulation may be recommended because of the adjustability of stimulation and the possibility of bilateral treatment. Patients have high expectations of MRgFUS because of its non-invasiveness. To perform this treatment safely and effectively, physicians need to understand the technological aspects, the physiological principles. To choose the appropriate modality, physicians also should recognize the clinical advantages and disadvantages of MRgFUS compared to other modalities.</p>

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  52. Newly established patient-derived organoid model of intracranial meningioma

    Yamazaki Shintaro, Ohka Fumiharu, Hirano Masaki, Shiraki Yukihiro, Motomura Kazuya, Tanahashi Kuniaki, Tsujiuchi Takashi, Motomura Ayako, Aoki Kosuke, Shinjo Keiko, Murofushi Yoshiteru, Kitano Yotaro, Maeda Sachi, Kato Akira, Shimizu Hiroyuki, Yamaguchi Junya, Adilijiang Alimu, Wakabayashi Toshihiko, Saito Ryuta, Enomoto Atsushi, Kondo Yutaka, Natsume Atsushi

    NEURO-ONCOLOGY   Vol. 23 ( 11 ) page: 1936 - 1948   2021.11

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    Background: Recent comprehensive studies have revealed several molecular alterations that are frequently found in meningiomas. However, effective treatment reagents targeting specific molecular alterations have not yet been identified because of the limited number of representative research models of meningiomas. Methods: We performed organoid cultures using meningioma cells and meningioma tumor tissues. Using immunohistochemistry and molecular analyses consisting of whole-exome sequencing, RNA-seq, and DNA methylation analyses, we compared the histological findings and molecular profiling of organoid models with those of parental tumors. Further, using these organoid models together with a public database of meningiomas, we explored molecular alterations, which are a potent treatment target for meningioma. Results: We established 18 organoid models comprising of two malignant meningioma cells (HKBMM and IOMM-Lee), 10 benign meningiomas, four malignant meningiomas, and two solitary fibrous tumors (SFTs). The organoids exhibited consistent histological features and molecular profiles with those of the parental tumors. Using a public database, we identified that upregulated forkhead box M1 (FOXM1) was correlated with increased tumor proliferation. Overexpression of FOXM1 in benign meningioma organoids increased organoid proliferation; depletion of FOXM1 in malignant organoids decreased proliferation. Additionally, thiostrepton, a FOXM1 inhibitor combined with radiation therapy, significantly inhibited the proliferation of malignant meningioma organoid models. Conclusions: An organoid model for meningioma enabled us to elucidate the tumor biology of meningioma along with potent treatment targets for meningioma.

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  53. Effects of oxytocin on responses to nociceptive and non-nociceptive stimulation in the upper central nervous system

    Saito Hidehisa, Hidema Shizu, Otsuka Ayano, Suzuki Jun, Kumagai Michio, Kanaya Akihiro, Murakami Toru, Takei Yusuke, Saito Kazutomo, Sugino Shigekazu, Toyama Hiroaki, Saito Ryuta, Tominaga Teiji, Nishimori Katsuhiko, Yamauchi Masanori

    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS   Vol. 574   page: 8 - 13   2021.10

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    Oxytocin is known as a social bonding hormone, but it also functions as an anxiolytic or analgesic neurotransmitter. When oxytocin regulates pain or anxiousness centrally as a neurotransmitter, it is secreted by neurons and directly projected to targeted regions. Although the function of oxytocin at the spinal level is well studied, its effects at the supraspinal level are poorly understood. We aimed to investigate the effect of oxytocin at the supraspinal level in vivo using C57BL/6J (wild-type [WT]), oxytocin-deficient (Oxt−/−), oxytocin receptor-deficient (Oxtr−/−), and oxytocin receptor-Venus (OxtrVenus/+) mice lines. Response thresholds in Oxtr−/− mice in Hargreaves and von-Frey tests were significantly lower than those in WT mice, whereas open field and light/dark tests showed no significant differences. Moreover, response thresholds in Oxt−/− mice were raised to those in WT mice after oxytocin administration. Following the Hargreaves test, we observed the co-localisation of c-fos with Venus or the oxytocin receptor in the periaqueductal gray (PAG), medial amygdala (MeA), and nucleus accumbens (NAc) regions in OxtrVenus/+ mice. Furthermore, in the PAG, MeA, and NAc regions, the co-localisation of oxytocin with c-fos and gamma-aminobutyric acid was much stronger in Oxtr−/− mice than in WT mice. However, following von-Frey test, the same findings were observed only in the MeA and NAc regions. Our results suggest that oxytocin exerts its analgesic effect on painful stimulation via the PAG region and a self-protective effect on unpleasant stimulation via the MeA and NAc regions.

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  54. Triggering of Carotid Sinus Reflex during Deployment of the Flow-diverter Device

    GOTO Shunsaku, IZUMI Takashi, NISHIHORI Masahiro, TSUKADA Tetsuya, ARAKI Yoshio, UDA Kenji, YOKOYAMA Kinya, SAITO Ryuta

    Neurologia medico-chirurgica   Vol. 61 ( 10 ) page: 583 - 590   2021.10

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    <p>The carotid sinus reflex (CSR) is a rare complication of the Pipeline Embolization Device (PED) deployment. No study has assessed the potential risk factors in a case series. The purpose of this study was to examine CSR triggering during PED deployment. Thirty-seven consecutive patients who underwent PED deployment were included. All procedures were performed under local anesthesia with mild sedation. We retrospectively analyzed patient characteristics, PED deployment time, and vital signs during the procedure. The vital signs included the pulse rate (PR) and systolic blood pressure (SBP) obtained at three timepoints (pre-deployment, during deployment, post-deployment). We examined the triggering of the CSR during PED deployment by comparing the vital signs at the three timepoints. Moreover, risk factors for CSR were analyzed with univariate analysis. The patients’ average age was 66.3 years. The average size of the aneurysm was 18.0 mm. Six patients (16.2%) showed a decline in the SBP or PR defined as CSR. One patient had a transient cardiac arrest and two had severe transient bradycardia. Deployment into the ophthalmic segment of the internal carotid artery (C2 segment) aneurysm (p = 0.022), prolonged PED deployment time more than 14.5 minutes (p = 0.005), and an acute angle of the anterior genu less than 51.5 degrees (p = 0.005) were risk factors in triggering CSR. CSR may be triggered during PED deployment under local anesthesia with mild sedation. Deployment to the C2 segment aneurysm, prolonged PED deployment time, and an acute angle of the anterior genu were associated with CSR triggering.</p>

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  55. Sellar arachnoid cystに対する経鼻内視鏡手術

    永田 雄一, 竹内 和人, 山本 太樹, 水野 晃宏, 永谷 哲也, 齋藤 竜太

    日本内分泌学会雑誌   Vol. 97 ( S.HPT ) page: 49 - 51   2021.9

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    DOI: 10.1507/endocrine.97.s.hpt_49

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  56. 内視鏡下経鼻頭蓋底手術後の再建戦略

    竹内 和人, 永田 雄一, 山本 太樹, 原田 英幸, 齋藤 竜太

    日本内分泌学会雑誌   Vol. 97 ( S.HPT ) page: 16 - 18   2021.9

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    DOI: 10.1507/endocrine.97.s.hpt_16

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  57. Mathematical Modeling and Mutational Analysis Reveal Optimal Therapy to Prevent Malignant Transformation in Grade II IDH-Mutant Gliomas

    Aoki Kosuke, Suzuki Hiromichi, Yamamoto Takashi, Yamamoto Kimiyo N., Maeda Sachi, Okuno Yusuke, Ranjit Melissa, Motomura Kazuya, Ohka Fumiharu, Tanahashi Kuniaki, Hirano Masaki, Nishikawa Tomohide, Shimizu Hiroyuki, Kitano Yotaro, Yamaguchi Junya, Yamazaki Shintaro, Nakamura Hideo, Takahashi Masamichi, Narita Yoshitaka, Nakada Mitsutoshi, Deguchi Shoichi, Mizoguchi Masahiro, Momii Yasutomo, Muragaki Yoshihiro, Abe Tatsuya, Akimoto Jiro, Wakabayashi Toshihiko, Saito Ryuta, Ogawa Seishi, Haeno Hiroshi, Natsume Atsushi

    CANCER RESEARCH   Vol. 81 ( 18 ) page: 4861 - 4873   2021.9

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    Isocitrate dehydrogenase-mutant low-grade gliomas (IDHmut- LGG) grow slowly but frequently undergo malignant transformation, which eventually leads to premature death. Chemotherapy and radiotherapy treatments prolong survival, but can also induce genetic (or epigenetic) alterations involved in transformation. Here, we developed a mathematical model of tumor progression based on serial tumor volume data and treatment history of 276 IDHmut- LGGs classified by chromosome 1p/19q codeletion (IDHmut/ 1p19qcodel and IDHmut/1p19qnoncodel) and performed genomewide mutational analyses, including targeted sequencing and longitudinal whole-exome sequencing data. These analyses showed that tumor mutational burden correlated positively with malignant transformation rate, and chemotherapy and radiotherapy significantly suppressed tumor growth but increased malignant transformation rate per cell by 1.8 to 2.8 times compared with before treatment. This model revealed that prompt adjuvant chemoradiotherapy prolonged malignant transformation-free survival in small IDHmut-LGGs (≤ 50 cm3). Furthermore, optimal treatment differed according to genetic alterations for large IDHmut-LGGs (> 50 cm3); adjuvant therapies delayed malignant transformation in IDHmut/1p19qnoncodel but often accelerated it in IDHmut/1p19qcodel. Notably, PI3K mutation was not associated with malignant transformation but increased net postoperative proliferation rate and decreased malignant transformation-free survival, prompting the need for adjuvant therapy in IDHmut/1p19qcodel. Overall, this model uncovered therapeutic strategies that could prevent malignant transformation and, consequently, improve overall survival in patients with IDHmut-LGGs.

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  58. [Magnetic Resonance-guided Focused Ultrasound Ablation:Techniques and Neurological Applications].

    Maesawa S, Nakatsubo D, Tsugawa T, Kato S, Shibata M, Takai S, Torii J, Wakabayashi T, Saito R

    No shinkei geka. Neurological surgery   Vol. 49 ( 4 ) page: 847 - 856   2021.7

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    DOI: 10.11477/mf.1436204463

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  59. Association between IDH mutational status and tumor-associated epilepsy or venous thromboembolism in patients with grade II and III astrocytoma

    Yoshinari Osada, Ryuta Saito, Satoshi Miyata, Takuhiro Shoji, Ichiyo Shibahara, Masayuki Kanamori, Yukihiko Sonoda, Toshihiro Kumabe, Mika Watanabe, Teiji Tominaga

    Brain Tumor Pathology   Vol. 38 ( 3 ) page: 218 - 227   2021.7

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    DOI: 10.1007/s10014-021-00406-1

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    Other Link: https://link.springer.com/article/10.1007/s10014-021-00406-1/fulltext.html

  60. 頭蓋内胚腫治療後にてんかんを発症した症例群の検討

    下田 由輝, 金森 政之, 大沢 伸一郎, 齋藤 竜太, 園田 順彦, 隈部 俊宏, 中里 信和, 冨永 悌二

    てんかん研究   Vol. 39 ( 2 ) page: 305 - 305   2021.7

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  61. Impact of the extent of resection on the survival of patients with grade II and III gliomas using awake brain mapping

    Motomura Kazuya, Chalise Lushun, Ohka Fumiharu, Aoki Kosuke, Tanahashi Kuniaki, Hirano Masaki, Nishikawa Tomohide, Yamaguchi Junya, Shimizu Hiroyuki, Wakabayashi Toshihiko, Saito Ryuta

    JOURNAL OF NEURO-ONCOLOGY   Vol. 153 ( 2 ) page: 361 - 372   2021.6

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    Language:Japanese   Publisher:Journal of Neuro-Oncology  

    Purpose: The aim of this study was to assess the effect of the extent of resection (EOR) of tumors on survival in a series of patients with grade II and III gliomas (GII/III-gliomas) who underwent awake brain mapping. Methods: We retrospectively analyzed 126 patients with GII/III-gliomas in the dominant and non-dominant hemisphere who underwent awake brain surgery at the same institution between December 2012 and May 2020. Results: EOR cut-off values for improved progression-free survival (PFS) were determined by a receiver operator characteristic (ROC) analysis of 5-year PFS. The ROC for EOR showed a cut-off value of ≥ 85.3%. The median PFS rate of patients with GII/III-gliomas in the group with an EOR ≥ 100%, including supratotal resection (n = 47; median survival [MS], not reached), was significantly higher than that in the group with an EOR < 90% (n = 52; MS, 43.1 months; 95% CI 37.7–48.5 months; p = 0.03). In patients with diffuse astrocytomas and anaplastic astrocytomas, the group with EOR ≥ 100%, including supratotal resection (n = 25; MS, not reached), demonstrated a significantly better PFS rate than did the group with an EOR < 100% (n = 45; MS, 35.8 months; 95% CI 19.9–51.6 months; p = 0.03). Supratotal or gross total resection was correlated with better PFS in IDH-mutant type of diffuse astrocytomas and anaplastic astrocytomas (n = 19; MS, not reached vs. n = 35; MS, 40.6 months; 95% CI 22.3–59.0 months; p = 0.02). By contrast, supratotal or gross total resection was not associated with longer PFS rates in patients with IDH-wild type of diffuse astrocytomas and anaplastic astrocytomas. Conclusions: The present study demonstrates a significant association between tumor EOR and survival in patients with GII/III gliomas. The EOR cut-off value for 5-year PFS was ≥ 85.3%. It is noteworthy that supratotal or gross total resection significantly correlated with better PFS in IDH-mutant type of WHO grade II and III astrocytic tumors. In light of our finding that EOR did not correlate with PFS in patients with aggressive IDH-wild type of diffuse astrocytomas and anaplastic astrocytomas, we suggest treatments that are more intensive will be needed for the control of these tumors.

    DOI: 10.1007/s11060-021-03776-w

    Web of Science

    Scopus

    PubMed

  62. Orengedokuto and shosaikoto for intractable intracranial carmustine implant-induced fever in a patient with brain tumor: A case report. International journal

    Satoko Suzuki, Shin Takayama, Akiko Kikuchi, Ryutaro Arita, Michiaki Abe, Ryuta Saito, Masayuki Kanamori, Teiji Tominaga, Tadashi Ishii

    Explore (New York, N.Y.)   Vol. 17 ( 3 ) page: 236 - 238   2021.5

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    INTRODUCTION: Anaplastic astrocytoma has a dismal prognosis with conventional treatment. Multidisciplinary treatment is needed to control the disease; however, side effects of the treatment reduce a patient's quality of life (QOL). Carmustine-impregnated wafers (Gliadel®, Eisai Co., Ltd., Tokyo, Japan), one of the treatment modalities for anaplastic astrocytoma, has been reported to have drug-induced fever as a side effect. CASE REPORT: A 36-year-old man underwent excision for a recurrent brain tumor. Histopathological examination established a diagnosis of anaplastic astrocytoma and an intracranial carmustine implant was placed for local chemotherapy. Postoperatively, the patient developed high fever, which could not be controlled using antipyretics. The high fever ameliorated dramatically after the administration of Kampo medicines, specifically orengedokuto and shosaikoto, and the patient could continue chemotherapy. CONCLUSION: To the best of our knowledge, this is the first report of successful treatment of intractable carmustine implant-induced fever using Kampo medicine. In this case, Kampo medicine led to an improvement of QOL.

    DOI: 10.1016/j.explore.2020.08.014

    PubMed

  63. Postcentral gyrus resection of opercular gliomas is a risk factor for motor deficits caused by damaging the radiologically invisible arteries supplying the descending motor pathway

    Ichiyo Shibahara, Sumito Sato, Takuichiro Hide, Ryuta Saito, Masayuki Kanamori, Yukihiko Sonoda, Teiji Tominaga, Toshihiro Kumabe

    Acta Neurochirurgica   Vol. 163 ( 5 ) page: 1269 - 1278   2021.5

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Springer Science and Business Media LLC  

    DOI: 10.1007/s00701-021-04737-y

    PubMed

    Other Link: https://link.springer.com/article/10.1007/s00701-021-04737-y/fulltext.html

  64. [Chemotherapy for Glioma].

    Saito R

    No shinkei geka. Neurological surgery   Vol. 49 ( 3 ) page: 588 - 596   2021.5

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    Language:Japanese   Publisher:株式会社医学書院  

    DOI: 10.11477/mf.1436204432

    PubMed

    CiNii Research

  65. Effect of endoscope flexibility on tissue dissection profile assessed with pulsed water jet device: ensuring safety, efficacy, and handling of thin devices for neuroendoscopic surgery. International journal

    Tetsuya Kusunoki, Tomohiro Kawaguchi, Atsuhiro Nakagawa, Yuta Noguchi, Shin-Ichiro Osawa, Hidenori Endo, Toshiki Endo, Ryuta Saito, Masayuki Kanamori, Kuniyasu Niizuma, Teiji Tominaga

    BMC research notes   Vol. 14 ( 1 ) page: 64 - 64   2021.2

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    OBJECTIVE: We developed an actuator-driven pulsed water jet device (ADPJ) for flexible neuroendoscopy to achieve effective tissue dissection with vasculature preservation. Although flexibility is a strong advantage for minimally invasiveness, the effect of the ductile curvature on the dissection profiles remains unknown. The purpose of this study was to clarify the impact of the curvature change of the ADPJ connecting tube on the dissection safety and efficacy. RESULTS: Three ADPJ connecting tubes with different inner diameters (1.0, 0.75, 0.5 mm) were used to dissect the brain phantom. They were bent at 3 angles: 0°, 60°, and 120°. The dissection profiles were evaluated using the mean depth and coefficient of variation (CV) for efficacy and safety, respectively.The larger inner diameter connecting tube dissected more deeply. The dissection depth was not changed regardless of the curvature degree in each tube. There was no significant difference in CVs regardless of inner diameter and curvature. The ductile curvature of the flexible neuroendoscope did not affect the efficacy and safety of the ADPJ dissection profile. Among the numerous instruments, tube-formed devices, including suction and injecting devices such as ADPJ, can be used safely and effectively without flexibility-related limitations.

    DOI: 10.1186/s13104-021-05475-1

    PubMed

  66. Hepatitis B virus reactivation during temozolomide administration for malignant glioma.

    Takuhiro Shoji, Masayuki Kanamori, Jun Inoue, Ryuta Saito, Yoshinari Osada, Yoshiteru Shimoda, Masashi Chonan, Hiroshi Uenohara, Atsushi Masamune, Teiji Tominaga

    International journal of clinical oncology   Vol. 26 ( 2 ) page: 305 - 315   2021.2

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    INTRODUCTION: The purpose of this study is to clarify the clinical features of temozolomide (TMZ)-related hepatitis B virus (HBV) reactivation and to identify HBV reactivation predictive factors. METHOD: We retrospectively reviewed the clinical course of 145 patients newly diagnosed or with recurrent malignant glioma treated with TMZ. Before treatment, we screened patients for HB surface antigen (HBsAg) positivity (HBV carrier) and HBsAg negativity. Patients were also screened for antibody for HB core antigen (anti-HBc) positivity and/or for HB surface antigen positivity (resolved HBV infection). The patients were monitored by HBV DNA, alanine, and aspartate aminotransaminase during and after the completion of TMZ. HBV carriers and those with resolved HBV infections with HBV reactivation received preemptive entecavir treatment. In those with resolved HBV infections, we analyzed clinical characters for the predictive factors for HBV reactivation. RESULTS: In one of two HBV carriers, HBV DNA turned positive 8 months after the completion of TMZ and entecavir. In four (16.7%) of 24 resolved HBV infections, HBV DNA turned detectable at completion of concomitant radiation and TMZ or during monthly TMZ. HBV DNA turned negative with entecavir in all patients without liver dysfunction. In resolved HBV infections, those with a high anti-HBc titer had significantly higher incidence of HBV reactivation than those with low anti-HBc titers (60% vs. 5.3%: p = 0.018). CONCLUSION: Screenings, monitoring, and preemptive entecavir were important for preventing TMZ-related HBV reactivations. Anti-HBc titers could be the predictive markers for HBV reactivation in the those with resolved HBV infections.

    DOI: 10.1007/s10147-020-01814-7

    PubMed

  67. H3K27M and TERT promoter mutations are poor prognostic factors in surgical cases of adult thalamic high-grade glioma

    Yoshinari Osada, Ryuta Saito, Ichiyo Shibahara, Keisuke Sasaki, Takuhiro Shoji, Masayuki Kanamori, Yukihiko Sonoda, Toshihiro Kumabe, Mika Watanabe, Teiji Tominaga

    Neuro-Oncology Advances   Vol. 3 ( 1 ) page: vdab038   2021.1

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    <title>Abstract</title>
    <sec>
    <title>Background</title>
    Thalamic high-grade gliomas (HGGs) are rare tumors with a dismal prognosis. H3K27M and telomerase reverse transcriptase promoter (TERTp) mutations reportedly contribute to poor prognoses in HGG cases. We investigated the outcomes of surgically treated adult thalamic HGGs to evaluate the prognostic significance of H3K27M and TERTp mutations.


    </sec>
    <sec>
    <title>Methods</title>
    We retrospectively analyzed 25 adult patients with thalamic HGG who underwent maximum surgical resection from January 1997 to March 2020. The histological and molecular characteristics, progression-free survival (PFS), and overall survival (OS) of the patients were compared. For molecular characteristics, target sequencing was used to determine the H3F3A, HIST1H3B, and TERTp mutations.


    </sec>
    <sec>
    <title>Results</title>
    H3K27M mutations were detected in 12/25 (48.0%) patients. TERTp mutations were not detected in H3K27M-mutant gliomas but were detected in 8/13 (61.5%) of H3 wild-type gliomas. Although it was not significant, H3K27M-mutant gliomas tended to have a shorter PFS (6.7 vs 13.1 months; P = .2928) and OS (22.8 vs 24.4 months; P = .2875) than H3 wild-type gliomas. Moreover, the prognosis of TERTp-mutant gliomas was as poor as that of H3K27M-mutant gliomas. Contrary, 5 gliomas harboring both H3 and TERTp wild-type showed a better median PFS (59.2 vs 6.4 months; P = .0456) and OS (71.8 vs 24.4 months; P = .1168) than those harboring H3K27M or TERTp mutations.


    </sec>
    <sec>
    <title>Conclusions</title>
    TERTp-mutant gliomas included in the H3 wild-type glioma group limited patient survival as they exhibited an aggressive course similar to H3K27M-mutant gliomas. Comprehensive molecular work-up for the H3 wild-type cases may further confirm this finding.


    </sec>

    DOI: 10.1093/noajnl/vdab038

    PubMed

    Other Link: http://academic.oup.com/noa/article-pdf/3/1/vdab038/37929606/vdab038.pdf

  68. Corpus Callosum Swelling after Resection of Intraventricular Central Neurocytoma.

    Aburakawa D, Kanamori M, Akashi T, Sato S, Saito R, Tominaga T

    NMC case report journal   Vol. 8 ( 1 ) page: 535 - 543   2021

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    DOI: 10.2176/nmccrj.cr.2020-0369

    PubMed

  69. 覚醒下手術中痙攣発作コントロールにおけるレベチラセタム・ペランパネル併用療法の有効性について

    本村 和也, 齋藤 竜太

    神経治療学   Vol. 38 ( 6 ) page: S211 - S211   2021

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    DOI: 10.15082/jsnt.38.6_s211

    CiNii Research

  70. An Approach to Superior Petrosal Sinus via Contralateral Superior Petrosal Sinus in a Case of Dural Arteriovenous Fistulas with Difficulty in Access

    SUZUKI Keita, NISHIHORI Masahiro, IZUMI Takashi, SUZUKI Osamu, MUTO Manabu, ARAKI Yoshio, UDA Kenji, YOKOYAMA Kinya, SAITO Ryuta

    No Kekkannai Chiryo   Vol. 6 ( 3 ) page: 161 - 168   2021

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    Language:Japanese   Publisher:The Japanese Society for Neuroendovascular Therapy  

    <p><b>Objective</b>: Herein, we report a case of multiple dural arteriovenous fistulas (DAVFs) in the left superior petrosal sinus (SPS) successfully treated by transvenous embolization via the right SPS.</p><p><b>Case Presentation</b>: A 60-year-old woman was diagnosed with multiple DAVFs with deep venous reflux to evaluate consciousness disturbance. We performed packing of the left transverse sinus, which was chiefly involved in reflux to the straight sinus. However, consciousness continued to be mildly disturbed, and DSA was performed again. A shunt was inserted into the left SPS, and the subsequently occurring deep venous reflux was clearly revealed. Because the ipsilateral transverse sinus and both inferior petrosal sinuses were already occluded and unavailable as access routes, we used the contralateral SPS and both cavernous sinuses to navigate the microcatheter into the shunt. We achieved occlusion of the SPS and stopped the reflux by inserting the intermediate catheter firmly into the bilateral SPS.</p><p><b>Conclusion</b>: An access route through the contralateral SPS might successfully enable transvenous embolization of DAVF cases without an ipsilateral access route.</p>

    DOI: 10.20626/nkc.tn.2021-0009

    CiNii Research

  71. Unilateral chronic subdural hematoma due to spontaneous intracranial hypotension: a report of four cases. Reviewed International journal

    Osada Y, Shibahara I, Nakagawa A, Sakata H, Niizuma K, Saito R, Kanamori M, Fujimura M, Suzuki S, Tominaga T

    British journal of neurosurgery   Vol. 34 ( 6 ) page: 632 - 637   2020.12

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    Background: Chronic subdural hematoma (CSDH) is a common neurosurgical disease. A subset of patients with CSDH may exhibit underlying spontaneous intracranial hypotension (SIH). Bilateral CSDH has a causal relationship with SIH, but there is no known causal relationship between unilateral CSDH and SIH.Case description: We encountered four cases of unilateral CSDH due to SIH. The patients' age ranged between 44 and 64 years; there were three males and one female. All patients presented with headache as their initial symptom, and then became comatose. Computed tomography demonstrated unilateral CSDH and transtentorial herniation in all patients. Treatments were emergency epidural blood patch (EBP) and evacuation of CSDH. The site of cerebrospinal fluid leak could not be identified in three patients; therefore, EBP was performed at upper and lower spine. All patients recovered from SIH; however, one patient experienced poor outcome due to Duret hemorrhage and ischemic complications of transtentorial herniation. Cranial asymmetry was present in all four patients, and unilateral CSDH was located on the side of the most curved cranial convexity.Conclusions: Unilateral CSDH, asymmetric cranial morphology, and transtentorial herniation in relatively young patients may indicate underlying SIH.

    DOI: 10.1080/02688697.2019.1667482

    PubMed

  72. A multinodular and vacuolating neuronal tumor in the right temporal lobe with positive methionine uptake: A case report

    Taketo Nishizawa, Ryuta Saito, Masashi Chonan, Masayuki Kanamori, Kentaro Takanami, Mika Watanabe, Teiji Tominaga

    Interdisciplinary Neurosurgery: Advanced Techniques and Case Management   Vol. 22   2020.12

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    Multinodular and vacuolating neuronal tumor (MVNT) is a recently recognized type of neural tumor that was first documented in 2013. This tumor type is characterized by multiple nodules of neuronal cells with vacuolar degeneration localized in the subcortical white matter. Here, we report a case of MVNT in the right temporal lobe of a 26-year-old female. Magnetic resonance imaging (MRI) revealed a high-intensity lesion on a T2- weighted image of the right temporal lobe without contrast enhancement. Positron emission tomography revealed increased 11C-methionine uptake in the lesion, which was pathologically diagnosed as MVNT.

    DOI: 10.1016/j.inat.2020.100861

    Scopus

  73. TERT promoter mutation confers favorable prognosis regardless of 1p/19q status in adult diffuse gliomas with IDH1/2 mutations.

    Arita H, Matsushita Y, Machida R, Yamasaki K, Hata N, Ohno M, Yamaguchi S, Sasayama T, Tanaka S, Higuchi F, Iuchi T, Saito K, Kanamori M, Matsuda KI, Miyake Y, Tamura K, Tamai S, Nakamura T, Uda T, Okita Y, Fukai J, Sakamoto D, Hattori Y, Pareira ES, Hatae R, Ishi Y, Miyakita Y, Tanaka K, Takayanagi S, Otani R, Sakaida T, Kobayashi K, Saito R, Kurozumi K, Shofuda T, Nonaka M, Suzuki H, Shibuya M, Komori T, Sasaki H, Mizoguchi M, Kishima H, Nakada M, Sonoda Y, Tominaga T, Nagane M, Nishikawa R, Kanemura Y, Kuchiba A, Narita Y, Ichimura K

    Acta neuropathologica communications   Vol. 8 ( 1 ) page: 201   2020.11

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    DOI: 10.1186/s40478-020-01078-2

    PubMed

  74. がん遺伝子パネル検査でSMARCB1変異を認め、INI-1蛋白陽性のAT/RTと考えられた一例(Clinical sequencing revealed two distinct mutations in SMARCB1, in an INI-1 positive AT/RT)

    Kaino Akira, Niizuma Hidetaka, Moriya Kunihiko, Katayama Saori, Irie Masahiro, Rikiishi Takeshi, Saito Ryuta, Kanamori Masayuki, Sasahara Yoji, Kure Shigeo

    日本小児血液・がん学会雑誌   Vol. 57 ( 4 ) page: 245 - 245   2020.10

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  75. Frequent Clinical and Radiological Progression of Optic Pathway/Hypothalamic Pilocytic Astrocytoma in Adolescents and Young Adults. Reviewed

    Takuhiro Shoji, Masayuki Kanamori, Ryuta Saito, Yuko Watanabe, Mika Watanabe, Miki Fujimura, Yoshikazu Ogawa, Yukihiko Sonoda, Toshihiro Kumabe, Shigeo Kure, Teiji Tominaga

    Neurologia medico-chirurgica   Vol. 60 ( 6 ) page: 277 - 285   2020.6

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    Most cases of optic hypothalamic pilocytic astrocytoma (OHPA) develop during childhood, so few cases of histologically verified OHPA have been described in adolescents and young adults (AYA). To elucidate the clinical features of OHPA with histological verification in AYA, we reviewed the clinical and radiological finding of OHPA treated at our institute from January 1997 and July 2017. AYA are aged between 15 and 39 years. The clinical courses of 11 AYA patients with optic hypothalamic glioma (OHG) without neurofibromatosis type 1 were retrospectively reviewed. About six patients were diagnosed in childhood and followed up after 15 years of age, and five patients developed OHPA during AYA. Histological diagnosis, verified at initial presentation or recurrence, was pilocytic astrocytoma in 10 and pilomyxoid astrocytoma in one. After initial treatment including debulking surgery and/or chemotherapy, tumor progression occurred 16 times in seven patients as cyst formation, tumor growth, and intratumoral hemorrhage. Five of 10 patients suffered deterioration of visual function during AYA. One of 10 cases had endocrinopathies requiring hormone replacement at last follow-up examination. In conclusion, histological diagnoses of OHG before and in AYA were pilocytic astrocytoma or pilomyxoid astrocytoma. Both pediatric and AYA-onset OHPA demonstrate high incidences of tumor progression and visual dysfunctions in AYA, so that long-term follow up is essential after the completion of treatment for pediatric and AYA-onset OHPA. The optimal timing of debulking surgery and radiation therapy should be established to achieve the long-term tumor control and to preserve the visual function.

    DOI: 10.2176/nmc.oa.2019-0208

    PubMed

  76. Regression of Recurrent Spinal Cord High-Grade Glioma After Convection-Enhanced Delivery of Nimustine Hydrochloride: Case Reports and Literature Review.

    Endo T, Inoue T, Sugiyama S, Saito R, Tominaga T

    Operative neurosurgery (Hagerstown, Md.)   Vol. 18 ( 4 ) page: 451 - 459   2020.4

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    DOI: 10.1093/ons/opz172

    PubMed

  77. 髄芽腫の放射線療法中に合併した難治性ITPに対し,rituximabが奏功した一例

    戒能 明, 新妻 秀剛, 入江 正寛, 片山 紗乙莉, 森谷 邦彦, 力石 健, 齋藤 竜太, 金森 政之, 笹原 洋二, 呉 繁夫

    日本小児科学会雑誌   Vol. 124 ( 2 ) page: 321 - 321   2020.2

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  78. 髄芽腫の放射線療法中に合併した難治性ITPに対し,rituximabが奏功した一例

    戒能 明, 新妻 秀剛, 入江 正寛, 片山 紗乙莉, 森谷 邦彦, 力石 健, 齋藤 竜太, 金森 政之, 笹原 洋二, 呉 繁夫

    日本小児科学会雑誌   Vol. 124 ( 2 ) page: 321 - 321   2020.2

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  79. Experience of Low Dose Perampanel to Add-on in Glioma Patients with Levetiracetam-uncontrollable Epilepsy. Reviewed

    Chonan M, Saito R, Kanamori M, Osawa SI, Watanabe M, Suzuki H, Nakasato N, Tominaga T

    Neurologia medico-chirurgica   Vol. 60 ( 1 ) page: 37 - 44   2020.1

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    Language:English   Publishing type:Research paper (scientific journal)  

    DOI: 10.2176/nmc.oa.2018-0245

    PubMed

  80. Phase I trial of convection-enhanced delivery of nimustine hydrochloride (ACNU) for brainstem recurrent glioma

    Ryuta Saito, Masayuki Kanamori, Yukihiko Sonoda, Yoji Yamashita, Kenichi Nagamatsu, Takaki Murata, Shunji Mugikura, Toshihiro Kumabe, Eva Wembacher-Schröder, Rowena Thomson, Teiji Tominaga

    Neuro-Oncology Advances   Vol. 2 ( 1 ) page: vdaa033   2020.1

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Oxford University Press (OUP)  

    <title>Abstract</title>
    <sec>
    <title>Background</title>
    Treatment options for patients suffering brainstem gliomas are quite limited as surgery is not an option against intrinsic tumors at brainstem and chemotherapy generally failed to demonstrate its efficacy. Intracerebral convection-enhanced delivery (CED) is a novel approach for administering chemotherapy to patients with brain tumors. We present the results of phase I trial of CED of nimustine hydrochloride (ACNU), designed to determine the maximum tolerable concentration of ACNU, for patients with recurrent brainstem gliomas.


    </sec>
    <sec>
    <title>Methods</title>
    Sixteen patients, aged 3–81 years old, suffering from recurrent brainstem gliomas, including diffuse intrinsic pontine glioma patients as well as patients with recurrent gliomas that originated from non-brainstem sites, were enrolled in this trial between February 2011 and April 2016. The dose/concentration escalation trial included 3 dose/concentration groups (0.25, 0.5, and 0.75 mg/mL, all at 7 mL) to determine the safety and tolerability of CED of ACNU. Real-time monitoring of drug distribution was performed by mixing gadolinium-tetraazacyclododecanetetraacetic acid (Gd-DOTA) in the infusion solution. CED of ACNU was given in combination with oral or intravenous temozolomide chemotherapy.


    </sec>
    <sec>
    <title>Results</title>
    CED of ACNU demonstrated antitumor activity, as assessed by radiographic changes and prolonged overall survival. The recommended dosage was 0.75 mg/mL. Drug-associated toxicity was minimal.


    </sec>
    <sec>
    <title>Conclusions</title>
    Intracerebral CED of ACNU under real-time monitoring of drug distribution, in combination with systemic temozolomide, was well tolerated among patients with recurrent brainstem gliomas. The safety and efficacy observed suggest the clinical benefits of this strategy against this devastating disease. Based on this phase I study, further clinical development of ACNU is warranted.


    </sec>

    DOI: 10.1093/noajnl/vdaa033

    PubMed

    Other Link: http://academic.oup.com/noa/article-pdf/2/1/vdaa033/33171642/vdaa033.pdf

  81. TERT promoter mutation associated with multifocal phenotype and poor prognosis in patients with IDH wild-type glioblastoma

    Zensho Kikuchi, Ichiyo Shibahara, Tetsu Yamaki, Ema Yoshioka, Tomoko Shofuda, Rintaro Ohe, Ken-ichiro Matsuda, Ryuta Saito, Masayuki Kanamori, Yonehiro Kanemura, Toshihiro Kumabe, Teiji Tominaga, Yukihiko Sonoda

    Neuro-Oncology Advances   Vol. 2 ( 1 ) page: vdaa114   2020.1

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Oxford University Press (OUP)  

    <title>Abstract</title>
    <sec>
    <title>Background</title>
    Although mutations in the promoter region of the telomerase reverse transcriptase (TERTp) gene are the most common alterations in glioblastoma (GBM), their clinical significance remains unclear. Therefore, we investigated the impact of TERTp status on patient outcome and clinicopathological features in patients with GBM over a long period of follow-up.


    </sec>
    <sec>
    <title>Methods</title>
    We retrospectively analyzed 153 cases of GBM. Six patients with isocitrate dehydrogenase 1 (IDH1) or H3F3A gene mutations were excluded from this study. Among the 147 cases of IDH wild-type GBM, 92 (62.6%) had the TERTp mutation. Clinical, immunohistochemical, and genetic factors (BRAF, TP53 gene mutation, CD133, ATRX expression, O6-methylguanine-DNA methyltransferase [MGMT] promoter methylation) and copy number alterations (CNAs) were investigated.


    </sec>
    <sec>
    <title>Results</title>
    GBM patients with the TERTp mutation were older at first diagnosis versus those with TERTp wild type (66.0 vs. 60.0 years, respectively, P = .034), and had shorter progression-free survival (7 vs. 10 months, respectively, P = .015) and overall survival (16 vs. 24 months, respectively, P = .017). Notably, magnetic resonance imaging performed showed that TERTp-mutant GBM was strongly associated with multifocal/distant lesions (P = .004). According to the CNA analysis, TERTp mutations were positively correlated with EGFR amp/gain, CDKN2A deletion, and PTEN deletion; however, these mutations were negatively correlated with PDGFR amp/gain, CDK4 gain, and TP53 deletion.


    </sec>
    <sec>
    <title>Conclusions</title>
    TERTp mutations were strongly correlated with multifocal/distant lesions and poor prognosis in patients with IDH wild-type GBM. Less aggressive GBM with TERTp wild type may be a distinct clinical and molecular subtype of IDH wild-type GBM.


    </sec>

    DOI: 10.1093/noajnl/vdaa114

    PubMed

    Other Link: http://academic.oup.com/noa/article-pdf/2/1/vdaa114/35106481/vdaa114.pdf

  82. Cystic Glioblastoma Rupturing into the Ventricle.

    Sato Y, Saito R, Kanamori M, Tominaga T

    NMC case report journal   Vol. 7 ( 1 ) page: 39-41   2020.1

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    DOI: 10.2176/nmccrj.cr.2019-0043

    PubMed

  83. A multicenter randomized phase III study for newly diagnosed maximally resected glioblastoma comparing carmustine wafer implantation followed by chemoradiotherapy with temozolomide with chemoradiotherapy alone; Japan Clinical Oncology Group Study JCOG1703 (MACS study). International journal

    Tomohiro Kadota, Ryuta Saito, Toshihiro Kumabe, Junki Mizusawa, Hiroshi Katayama, Minako Sumi, Hiroshi Igaki, Manabu Kinoshita, Takashi Komori, Koichi Ichimura, Yoshitaka Narita, Ryo Nishikawa

    Japanese journal of clinical oncology   Vol. 49 ( 12 ) page: 1172 - 1175   2019.12

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    A randomized phase III trial in Japan commenced in June 2019. The present standard treatment for newly diagnosed glioblastoma is maximal resection followed by chemoradiotherapy with temozolomide. The purpose of this study is to confirm the superiority of maximal resection with carmustine wafer implantation followed by chemoradiotherapy with temozolomide over the standard maximal resection followed by chemoradiotherapy with temozolomide in terms of overall survival for newly diagnosed glioblastoma. A total of 250 patients will be accrued from 35 Japanese institutions in 5.5 years. Patients with >90% surgical resection will be registered and randomly assigned to each group with 1:1 allocation. The primary endpoint is overall survival and the secondary endpoints are progression-free survival, loco-regional progression-free survival and incidence of adverse events. This trial has been registered in the Japan Registry of Clinical Trial, as jRCT1031190035 [https://jrct.niph.go.jp/en-latest-detail/jRCT1031190035].

    DOI: 10.1093/jjco/hyz169

    Web of Science

    PubMed

  84. 超選択的Wada testによる血管解剖と機能解剖のハイブリッド評価 Reviewed

    大沢 伸一郎, 鈴木 匡子, 新妻 邦泰, 浮城 一司, 柿沼 一雄, 上利 大, 神 一敬, 斎藤 竜太, 金森 政之, 中里 信和, 冨永 悌二

    脳血管内治療   Vol. 4 ( Suppl. ) page: S383 - S383   2019.11

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  85. Coexistence of Intracranial Germ Cell Tumor with Growing Arteriovenous Fistula.

    Ishida T, Endo H, Saito R, Kanamori M, Sato K, Matsumoto Y, Endo T, Fujimura M, Tominaga T

    World neurosurgery   Vol. 127   page: 126 - 130   2019.7

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    DOI: 10.1016/j.wneu.2019.04.015

    PubMed

  86. Phase I study of a brain penetrant mutant IDH1 inhibitor DS-1001b in patients with recurrent or progressive IDH1 mutant gliomas.

    Natsume Atsushi, Wakabayashi Toshihiko, Miyakita Yasuji, Narita Yoshitaka, Mineharu Yohei, Arakawa Yoshiki, Yamasaki Fumiyuki, Sugiyama Kazuhiko, Hata Nobuhiro, Muragaki Yoshihiro, Nishikawa Ryo, Shinojima Naoki, Kumabe Toshihiro, Saito Ryuta, Ito Kazumi, Tachibana Masaya, Kakurai Yasuyuki, Nishijima Soichiro, Tsubouchi Hiroshi

    JOURNAL OF CLINICAL ONCOLOGY   Vol. 37 ( 15 ) page: .   2019.5

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    Web of Science

  87. 脳幹部神経膠腫診断におけるメチオニンPET検査の有用性

    齋藤 竜太, 金森 政之, 高浪 健太郎, 園田 順彦, 冨永 悌二

    Brain Tumor Pathology   Vol. 36 ( Suppl. ) page: 090 - 090   2019.5

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  88. Coexistence of an intracranial germ cell tumor with a growing arteriovenous fistula: a case report. Reviewed

    Ishida T, Endo H, Saito R, Kanamori M, Sato K, Matsumoto Y, Endo T, Fujimura M, Tominaga T

        2019.4

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  89. Incidence of initial spinal metastasis in glioblastoma patients and the importance of spinal screening using MRI. Reviewed International journal

    Ichiyo Shibahara, Ryuta Saito, Yoshinari Osada, Masayuki Kanamori, Yukihiko Sonoda, Toshihiro Kumabe, Shunji Mugikura, Mika Watanabe, Teiji Tominaga

    Journal of neuro-oncology   Vol. 141 ( 2 ) page: 337 - 345   2019.1

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    PURPOSE: Intracranial glioblastomas with simultaneous spinal lesions prior to chemoradiation therapy or craniotomy, defined as initial spinal metastasis, are not well understood. Herein, we investigated intracranial glioblastoma and demonstrated the importance of spinal screening using gadolinium enhanced spinal magnetic resonance imaging (Gd-MRI). METHODS: Consecutive adult patients with intracranial glioblastoma were treated between 2010 and 2014 and received spinal screening using Gd-MRI. Spinal screening was performed regardless of spine-related symptoms, and patients presenting with and without initial spinal metastasis (spinal and non-spinal groups, respectively) were compared based on patient demographics, tumor characteristics, radiological and molecular features, and overall survival (OS). RESULTS: During the study period, 116 glioblastoma cases were treated and 87 of these (76%) underwent spinal screening. Among these patients, 11 (13%) were included in the spinal group, and 76 (87%) were included in the non-spinal group. All patients of the spinal group were free of symptoms related to spinal lesions. Compared with the non-spinal group, intracranial lesions of the spinal group presented higher incidences of intracranial dissemination and were located at subventricular zones (P = 0.0012 and 0.020, respectively). MIB-1 labeling index, molecular alterations such as IDH1 mutation, TERT promoter mutation, and immunoreactivity of ATRX and MGMT did not differ between two groups. OS was significantly shorter in the spinal group than in the non-spinal group (P = 0.0054). CONCLUSIONS: This study revealed a relatively high incidence of spinal metastasis. A subset of glioblastoma patients benefited from spinal screening, through which early detection of asymptomatic spinal metastasis was achieved.

    DOI: 10.1007/s11060-018-03036-4

    PubMed

  90. Significance of molecular classification of ependymomas: C11orf95-RELA fusion-negative supratentorial ependymomas are a heterogeneous group of tumors. Reviewed International journal

    Kohei Fukuoka, Yonehiro Kanemura, Tomoko Shofuda, Shintaro Fukushima, Satoshi Yamashita, Daichi Narushima, Mamoru Kato, Mai Honda-Kitahara, Hitoshi Ichikawa, Takashi Kohno, Atsushi Sasaki, Junko Hirato, Takanori Hirose, Takashi Komori, Kaishi Satomi, Akihiko Yoshida, Kai Yamasaki, Yoshiko Nakano, Ai Takada, Taishi Nakamura, Hirokazu Takami, Yuko Matsushita, Tomonari Suzuki, Hideo Nakamura, Keishi Makino, Yukihiko Sonoda, Ryuta Saito, Teiji Tominaga, Yasuhiro Matsusaka, Keiichi Kobayashi, Motoo Nagane, Takuya Furuta, Mitsutoshi Nakada, Yoshitaka Narita, Yuichi Hirose, Shigeo Ohba, Akira Wada, Katsuyoshi Shimizu, Kazuhiko Kurozumi, Isao Date, Junya Fukai, Yousuke Miyairi, Naoki Kagawa, Atsufumi Kawamura, Makiko Yoshida, Namiko Nishida, Takafumi Wataya, Masayoshi Yamaoka, Naohiro Tsuyuguchi, Takehiro Uda, Mayu Takahashi, Yoshiteru Nakano, Takuya Akai, Shuichi Izumoto, Masahiro Nonaka, Kazuhisa Yoshifuji, Yoshinori Kodama, Masayuki Mano, Tatsuya Ozawa, Vijay Ramaswamy, Michael D Taylor, Toshikazu Ushijima, Soichiro Shibui, Mami Yamasaki, Hajime Arai, Hiroaki Sakamoto, Ryo Nishikawa, Koichi Ichimura

    Acta neuropathologica communications   Vol. 6 ( 1 ) page: 134 - 134   2018.12

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    Extensive molecular analyses of ependymal tumors have revealed that supratentorial and posterior fossa ependymomas have distinct molecular profiles and are likely to be different diseases. The presence of C11orf95-RELA fusion genes in a subset of supratentorial ependymomas (ST-EPN) indicated the existence of molecular subgroups. However, the pathogenesis of RELA fusion-negative ependymomas remains elusive. To investigate the molecular pathogenesis of these tumors and validate the molecular classification of ependymal tumors, we conducted thorough molecular analyses of 113 locally diagnosed ependymal tumors from 107 patients in the Japan Pediatric Molecular Neuro-Oncology Group. All tumors were histopathologically reviewed and 12 tumors were re-classified as non-ependymomas. A combination of RT-PCR, FISH, and RNA sequencing identified RELA fusion in 19 of 29 histologically verified ST-EPN cases, whereas another case was diagnosed as ependymoma RELA fusion-positive via the methylation classifier (68.9%). Among the 9 RELA fusion-negative ST-EPN cases, either the YAP1 fusion, BCOR tandem duplication, EP300-BCORL1 fusion, or FOXO1-STK24 fusion was detected in single cases. Methylation classification did not identify a consistent molecular class within this group. Genome-wide methylation profiling successfully sub-classified posterior fossa ependymoma (PF-EPN) into PF-EPN-A (PFA) and PF-EPN-B (PFB). A multivariate analysis using Cox regression confirmed that PFA was the sole molecular marker which was independently associated with patient survival. A clinically applicable pyrosequencing assay was developed to determine the PFB subgroup with 100% specificity using the methylation status of 3 genes, CRIP1, DRD4 and LBX2. Our results emphasized the significance of molecular classification in the diagnosis of ependymomas. RELA fusion-negative ST-EPN appear to be a heterogeneous group of tumors that do not fall into any of the existing molecular subgroups and are unlikely to form a single category.

    DOI: 10.1186/s40478-018-0630-1

    PubMed

  91. Development and evaluation of ultrasound-facilitated drug delivery device Reviewed

    Inoue Kenji, Sato Aya, Saito Ryuta, Jia Wenting, Okuno Saori, Ohashi Yuji, Kamada Kei, Yoshikawa Akira, Tominaga Teiji

    JAPANESE JOURNAL OF APPLIED PHYSICS   Vol. 57 ( 11 )   2018.11

  92. DEVELOPMENT OF ULTRASOUND-FACILITATED DRUG DELIVERY DEVICE FOR LOCAL DRUG INFUSION AGAINST BRAIN TUMORS Reviewed

    Saito Ryuta, Sato Aya, Inoue Kenji, Jia Wenting, Okuno Saori, Ohashi Yuji, Kamada Kei, Yoshikawa Akira, Tominaga Teiji

    NEURO-ONCOLOGY   Vol. 20   page: 88   2018.11

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  93. SMART (stroke-like migraine attacks after radiation therapy) syndrome responded to steroid pulse therapy: Report of a case and review of the literature. Reviewed International journal

    Wenting Jia, Ryuta Saito, Masayuki Kanamori, Naoya Iwabuchi, Masaki Iwasaki, Teiji Tominaga

    eNeurologicalSci   Vol. 12   page: 1 - 4   2018.9

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    This report presents a case of stroke-like migraine attacks after radiation therapy (SMART) syndrome in a 31-year-old man in whom symptoms and radiological findings resolved with steroid pulsed therapy and reviews the literatures with special emphasis on the use of steroids against SMART syndrome. The patient had a past history of left temporal anaplastic astrocytoma and was treated with surgery followed by local 72 Gy radiation therapy and chemotherapy using Nimustine Hydrochloride. Four years after the surgery, he was suffering from subacute progressing symptoms of headache, right hemianopia, right hemiparesis and aphasia from 2 to 4 days before admission to our hospital. At first he was diagnosed as symptomatic epilepsy but after extensive examination, the final diagnosis was SMART syndrome. His symptoms soon improved with steroid pulse therapy. In the literature, steroid pulse therapy is not necessarily a standard of care for SMART syndrome, but it seemed to decrease the need of biopsy. As the lesions of SMART syndrome require differential diagnosis from recurrences, biopsy was performed in some cases. However, lack of benefit and possible detriment is reported with biopsy of SMART lesions. Through this experience we suggest that steroid pulse therapy may provide speedy recovery from symptoms, and it should be considered before other invasive investigations or treatments.

    DOI: 10.1016/j.ensci.2018.05.003

    PubMed

  94. Indications for salvage surgery during treatment for intracranial germ cell tumors. Reviewed International journal

    Masayuki Kanamori, Toshihiro Kumabe, Mika Watanabe, Masashi Chonan, Ryuta Saito, Yoji Yamashita, Yoshikazu Ogawa, Yukihiko Sonoda, Teiji Tominaga

    Journal of neuro-oncology   Vol. 138 ( 3 ) page: 601 - 607   2018.7

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    This study retrospectively reviewed our single institute experience to clarify the optimal indication and timing of salvage surgery. Retrospective analysis of 159 consecutive cases with germ cell tumors identified 20 cases with salvage surgery. These cases were classified based on the radiological response to neoadjuvant treatment before salvage surgery into increase (growing group, five cases), no change (stable group, seven cases), and decrease (shrinkage group, eight cases) in tumor size. Changes in tumor markers, histological findings, and the pattern of failure after salvage surgery were reviewed. Growing teratoma syndrome (GTS) is defined as enlargement of tumor consisting of mature teratoma after chemotherapy with normalization of tumor markers. In growing group, two cases presented GTS, whereas other three cases did not fulfill the criteria for GTS. All cases in stable and shrinkage group had elevated levels of tumor markers at presentation and decreased levels after neoadjuvant treatment. Histologically, sparse components of mature teratoma with extensive fibrosis were found in cases with GTS and seven of eight cases in shrinkage group, whereas mature teratoma without fibrosis was found in six of seven cases in stable group. Six cases recurred after salvage surgery. We identified three factors as risks for recurrence after salvage surgery, as follows: (1) growing lesion which did not fulfill the criteria for GTS, (2) non-normalized level of tumor marker before salvage surgery, and (3) residual germinoma component. In conclusion, salvage surgery is recommended for patients with GTS, or with normalized tumor markers in stable or shrinkage group.

    DOI: 10.1007/s11060-018-2827-3

    PubMed

  95. [A Case of Ventriculoperitoneal Shunt Dysfunction in an Adult Secondary to Constipation]. Reviewed

    Nakamura L, Saito R, Kanamori M, Morita T, Tashiro R, Tominaga T

    No shinkei geka. Neurological surgery   Vol. 46 ( 5 ) page: 385 - 389   2018.5

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    INTRODUCTION: Ventriculoperitoneal(VP)shunts function because of the pressure differential between the intracranial space and the peritoneal cavity. Although chronic constipation is often a cause of VP shunt dysfunction in children, it is not well recognized in adults. We present a case of shunt dysfunction that not only resolved after resolution of constipation but also resulted in overdrainage. CASE REPORT: A 28-year-old woman who had a VP shunt placed 11 years prior for hydrocephalus was referred to our department because of an enlarged ventricle diagnosed with computed tomography(CT). She had a previous history of pineal germinoma and a VP shunt was placed to treat the associated hydrocephalus. At presentation, she complained of headache and somnolence. Shunt dysfunction was suspected, but no problem was detected in the shunt system, including pressure settings. As constipation was detected, we treated this condition. Soon after, her symptoms resolved and ventricle size normalized. She was discharged without any deficit, but overdrainage was detected with CT obtained 1 month later. CONCLUSION: Although constipation is not a common cause of shunt dysfunction in adult patients, it is important to consider to avoid unnecessary shunt revision. In the present case, resolution of chronic constipation resulted in resolution of shunt dysfunction. This suggests the importance of resolution of constipation in case of shunt adjustment, even in adult cases.

    DOI: 10.11477/mf.1436203739

    PubMed

  96. Clinical Features of Precocious, Synchronous, and Metachronous Brain Metastases and the Role of Tumor Resection. Reviewed International journal

    Ichiyo Shibahara, Masayuki Kanamori, Takashi Watanabe, Akihiro Utsunomiya, Hiroyoshi Suzuki, Ryuta Saito, Yukihiko Sonoda, Hidefumi Jokura, Hiroshi Uenohara, Teiji Tominaga

    World neurosurgery   Vol. 113   page: e1 - e9   2018.5

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    OBJECTIVE: The purpose of this study was to clarify clinical features, outcomes, and the role of tumor resection in precocious, synchronous, and metachronous brain metastases. METHODS: Brain metastases were found before primary cancer detection in the precocious group, within 2 months after primary cancer detection in the synchronous group, and 2 months or later after primary cancer detection in the metachronous group. RESULTS: Of 471 patients with brain metastases, 93 (20%) were included in the precocious group, 76 (16%) in the synchronous group, and 302 (64%) in the metachronous group. The precocious group tended to be symptomatic, show a low Karnofsky Performance Status, and have a large single tumor, infrequent extracranial metastases, and frequent tumor resection compared with the other 2 groups. There were no differences in overall survival from the detection of brain metastases among the 3 groups in univariate and multivariate analyses. Of 471 cases, 97 (21%) underwent surgeries. Among this surgical cohort, overall survival from surgery was significantly shorter in the precocious group than in the metachronous group (P = 0.039). After adjustment for age, sex, tumor size, primary cancer, and the Graded Prognostic Assessment score, the hazard ratio for metachronous metastases was 0.52 (confidence interval, 0.29-0.95; P = 0.035). CONCLUSIONS: The timing of brain metastasis diagnosis is not a modifiable factor but affects patient demographics and treatment strategies. In particular, the precocious group is a unique subset of brain metastases that require special consideration during clinical decision making.

    DOI: 10.1016/j.wneu.2017.10.145

    PubMed

  97. [Results for Treatment of Newly-Diagnosed Glioblastoma Using Carmustine Wafers(Gliadel<sup>®</sup>)]. Reviewed

    Kumabe T, Shibahara I, Saito R

    No shinkei geka. Neurological surgery   Vol. 46 ( 5 ) page: 367 - 376   2018.5

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    DOI: 10.11477/mf.1436203736

    PubMed

  98. Rapid detection of mutation in isocitrate dehydrogenase 1 and 2 genes using mass spectrometry. Reviewed

    Masayuki Kanamori, Masamitsu Maekawa, Ichiyo Shibahara, Ryuta Saito, Masashi Chonan, Miki Shimada, Yukihiko Sonoda, Toshihiro Kumabe, Mika Watanabe, Nariyasu Mano, Teiji Tominaga

    Brain tumor pathology   Vol. 35 ( 2 ) page: 90 - 96   2018.4

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    The 2016 World Health Organization classification of tumors of the central nervous system was recently revised. Mutations in the isocitrate dehydrogenase 1 (IDH1) and IDH2 genes and chromosome 1p/19q codeletion are especially important for both the integrated diagnosis and the determination of surgical strategy. To establish a method for intraoperative molecular diagnosis, a simple, rapid method was developed for the measurement of 2-hydroxyglutarate (2-HG), a specific oncometabolite formed in the presence of IDH gene mutation, using liquid chromatography/electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS). This method requires only 10 min to measure the level of 2-HG from tissue preparation to completion of examination. Using this method, the level of 2-HG was analyzed in 105 patients with diffuse infiltrating glioma, and showed that IDH mutated glioma had significantly higher level of 2-HG compared to IDH wild-type glioma. Receiver operating characteristic curve analysis showed the area under the curve, sensitivity, and specificity were 0.9815, 97.5, and 100%, respectively. In contrast, tumor grade and presence of chromosome 1p/19q codeletion in the IDH mutated glioma could not be predicted from the level of 2-HG. Measurement of 2-HG level using LC/ESI-MS/MS can provide rapid and accurate information of mutation status in the IDH gene.

    DOI: 10.1007/s10014-018-0317-0

    PubMed

  99. Three case reports of radiation-induced glioblastoma after complete remission of acute lymphoblastic leukemia Reviewed

    Takumi Kajitani, Masayuki Kanamori, Ryuta Saito, Yuko Watanabe, Hiroyoshi Suzuki, Mika Watanabe, Shigeo Kure, Teiji Tominaga

    Brain Tumor Pathology   Vol. 35 ( 2 ) page: 114 - 122   2018.4

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    Radiation therapy is sometimes performed to control intracranial acute lymphoblastic leukemia (ALL), but may lead to radiation-induced malignant glioma. The clinical, radiological, histological, and molecular findings are described of three cases of radiation-induced glioblastoma after the treatment for ALL. They received radiation therapy at age 6–8 years. The latency from radiation therapy to the onset of radiation-induced glioblastoma was 5–10 years. Magnetic resonance imaging demonstrated diffuse lesions with multiple small enhanced lesions in all cases. Histological examination showed that the tumors consisted of mainly small round astrocytic atypical cells in one case, and astrocytic atypical cells with elongated cytoplasm and nuclear pleomorphism with small cell component in two cases. Microvascular proliferation was present in all cases. Immunohistochemical analysis for B-Raf V600E, and mutational analysis for the isocitrate dehydrogenase (IDH) 1, IDH2, and H3F3A gene revealed the wild-type alleles in all three cases. The integrated diagnoses were IDH wild-type glioblastoma, and local irradiation and concomitant temozolomide were performed. After the initial treatment, significant shrinkage of the diffuse lesion and enhanced lesion was found in all cases. Radiation-induced glioblastoma occurring after the treatment for ALL had unique clinical, radiological, histological, and molecular characteristics in our three cases.

    DOI: 10.1007/s10014-018-0316-1

    Scopus

    PubMed

  100. Convection-enhanced delivery of sulfasalazine prolongs survival in a glioma stem cell brain tumor model. Reviewed International journal

    Shinya Haryu, Ryuta Saito, Wenting Jia, Takuhiro Shoji, Yui Mano, Aya Sato, Masayuki Kanamori, Yukihiko Sonoda, Oltea Sampetrean, Hideyuki Saya, Teiji Tominaga

    Journal of neuro-oncology   Vol. 136 ( 1 ) page: 23 - 31   2018.1

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    Expression of CD44 in glioma cells was previously correlated with tumor grade and is considered a stem cell marker. CD44 stabilizes the cystine-glutamate transporter (xCT) and inhibits apoptosis in cancer stem cells (CSCs). Recently it was found that Sulfasalazine (SSZ), an anti-inflammatory drug, acts as an inhibitor of xCT and therefore has potential as a targeted therapy for CSCs. In this study, we tested an efficacy of SSZ against glioma stem cell model developed in rats. As poor penetration of blood-brain barrier resulted in insufficient efficacy of systemic SSZ treatment, SSZ was delivered locally with convection-enhanced delivery (CED). In vitro, expression of CD44 in glioma cells and efficacy of SSZ against glioma cells and glioma stem cells were confirmed. SSZ demonstrated anti-proliferative activity in a dose dependent manner against these cells. This activity was partially reversible with the addition of antioxidant, N-acetyl-L-cysteine, to the medium. In vivo, CED successfully delivered SSZ into the rat brain parenchyma. When delivered at 5 mM concentration, which was the highest possible concentration when SSZ was dissolved in water, CED of SSZ resulted in almost no tissue damage. Against highly malignant bRiTs-G3 brain tumor xenografted rat model; the glioma stem cell model, CED of SSZ at 5 mM concentration induced apoptosis and prolonged survival. Consequently, CED of SSZ induced glioma stem cell death without evidence of tissue damage to normal brain parenchyma. This strategy may be a promising targeted treatment against glioma stem cells.

    DOI: 10.1007/s11060-017-2621-7

    PubMed

  101. Fingolimod-associated PML with mild IRIS in MS: A clinicopathologic study. Reviewed International journal

    Shuhei Nishiyama, Tatsuro Misu, Yukiko Shishido-Hara, Kazuo Nakamichi, Masayuki Saijo, Yoshiki Takai, Kentarou Takei, Naoki Yamamoto, Hiroshi Kuroda, Ryuta Saito, Mika Watanabe, Teiji Tominaga, Ichiro Nakashima, Kazuo Fujihara, Masashi Aoki

    Neurology(R) neuroimmunology & neuroinflammation   Vol. 5 ( 1 ) page: e415   2018.1

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    Objective: To clarify the clinical, neuropathologic, and virologic characteristics of progressive multifocal leukoencephalopathy (PML) and its immune reconstitution inflammatory syndrome (IRIS) in a patient with fingolimod-treated MS. Methods: A case study. Results: A 34-year-old patient with MS using fingolimod for 4 years had a gradual progression of right hemiparesis and aphasia with a new subcortical white matter lesion in the precentral gyrus by initial MRI. Blood tests were normal, except for lymphopenia (160 cells/μL). One month after the cessation of fingolimod, brain MRI depicted a diffusely exacerbated hyperintensity on fluid-attenuated inversion recovery and diffusion-weighed imaging in the white matter with punctate gadolinium enhancement, suggesting PML-IRIS. A very low level of JC virus (JCV)-DNA (15 copies/mL) was detected in the CSF as judged by quantitative PCR. Brain tissues were biopsied from the left frontal lesion, which showed some small demyelinated foci with predominant loss of myelin-associated glycoprotein with infiltrations of lymphocytes and macrophages, but clear viral inclusion was not observed with hematoxylin-eosin staining. JCV-DNA was uniquely detectable in an active inflammatory demyelinating lesion by in situ hybridization, possibly suggesting an early phase of PML. DNA extracted from the brain sample was positive for JCV-DNA (151 copies/cell). It took 3 months to normalize the blood lymphocyte count. The patient was treated with 1 g of IV methylprednisolone for 3 days and a weekly oral dose (375 mg) of mefloquine, and her symptoms gradually improved. Conclusion: Low CSF JCV-DNA and unfound viral inclusions initially made her diagnosis difficult. The clinical course of fingolimod-associated PML may be associated with mild immune reconstitution.

    DOI: 10.1212/NXI.0000000000000415

    PubMed

  102. Glioblastoma in neurofibromatosis 1 patients without IDH1, BRAF V600E, and TERT promoter mutations. Reviewed

    Ichiyo Shibahara, Yukihiko Sonoda, Hiroyoshi Suzuki, Akifumi Mayama, Masayuki Kanamori, Ryuta Saito, Yasuhiro Suzuki, Shoji Mashiyama, Hiroshi Uenohara, Mika Watanabe, Toshihiro Kumabe, Teiji Tominaga

    Brain tumor pathology   Vol. 35 ( 1 ) page: 10 - 18   2018.1

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    Pilocytic astrocytomas and low-grade gliomas are more common compared with glioblastomas in patients with neurofibromatosis 1 (NF1). A recent genome-wide analysis has shown frequent NF1 gene alterations in the mesenchymal subtype of a glioblastoma; however, little is known about clinicopathological features of glioblastomas in NF1 patients (NF1 glioblastomas). We analyzed four NF1 glioblastomas. Radiographical and intraoperative findings showed well-circumscribed tumors from surrounding brain. Pathological analysis presented a paucity of processes with an eosinophilic cytoplasm, bizarre nuclei, xanthomatous-like appearance, multinucleated giant cells, and histiocytoid appearance. During the follow-up period, one patient died at 49 months and others remained alive for 60, 87, and 106 months; thus, patients with NF1 glioblastoma presented a relatively favorable survival. None of the NF1 glioblastomas harbored isocitrate dehydrogenase 1 (IDH1) gene mutation, v-RAF murine sarcoma viral oncogene homolog B1 (BRAF) gene mutation, and telomerase reverse transcriptase (TERT) gene promoter mutation. We identified that NF1 glioblastoma is a unique subset of glioblastoma.

    DOI: 10.1007/s10014-017-0302-z

    PubMed

  103. Opening the ventricle during surgery diminishes survival among patients with newly diagnosed glioblastoma treated with carmustine wafers: a multi-center retrospective study Reviewed

    Yukihiko Sonoda, Ichiyo Shibahara, Ken-ichiro Matsuda, Ryuta Saito, Tomoyuki Kawataki, Masaya Oda, Yuichi Sato, Hirokazu Sadahiro, Sadahiro Nomura, Toshio Sasajima, Takaaki Beppu, Masayuki Kanamori, Kaori Sakurada, Toshihiro Kumabe, Teiji Tominaga, Hiroyuki Kinouchi, Hiroaki Shimizu, Kuniaki Ogasawara, Michiyasu Suzuki

    JOURNAL OF NEURO-ONCOLOGY   Vol. 134 ( 1 ) page: 83 - 88   2017.8

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    Carmustine wafers (CW) were approved in Japan for newly diagnosed and recurrent malignant gliomas during 2013. The ventricle is often opened during surgery to achieve maximum resection. While not generally recommended in such situations, CW might be safely achieved by occluding an opened ventricle using gelform or collagen sheets. However, whether CW implantation actually confers a survival benefit for patients who undergo surgery with an open ventricle to treat glioblastoma remains unclear. Clinical, imaging, and survival data were collected in this multicenter retrospective study of 122 consecutive patients with newly diagnosed glioblastoma to determine adverse events and efficacy. Overall, 54 adverse events of all grades developed in 35 (28.6%) patients, with the most common being new seizures (16%). Adverse events did not significantly differ between patients with opened and closed ventricles during surgery. The 10- and 21.7-month, median, progression-free (PFS) and overall survival (OS), respectively did not significantly differ according to resection rates. However, median PFS and OS were significantly longer among patients with closed, than open ventricles (12.8 vs. 7.4 months; p = 0.0039 and 26.9 vs. 18.6 months; p = 0.011, respectively). Implanting CW into the resection cavity during concomitant radiochemotherapy with temozolomide seems to yield better survival rates without increased adverse events. Occlusion of the ventricular opening during surgery might be safe for CW implantation, but less so for treating patients with newly diagnosed glioblastoma.

    DOI: 10.1007/s11060-017-2488-7

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    PubMed

  104. Distant recurrences limit the survival of patients with thalamic high-grade gliomas after successful resection Reviewed

    Ryuta Saito, Toshihiro Kumabe, Masayuki Kanamori, Yukihiko Sonoda, Teiji Tominaga

    NEUROSURGICAL REVIEW   Vol. 40 ( 3 ) page: 469 - 477   2017.7

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    The indications of surgery for thalamic high-grade gliomas are not well established. The present study investigated the outcome of 21 patients treated by surgery and reports the high incidence of distant recurrences including disseminations after successful removal. Twenty-one patients with thalamic high-grade gliomas not invading the pyramidal tract or midbrain underwent cytoreductive surgery at our institute from June 1997 to August 2015. Surgery was performed with the aid of a neuronavigation system, electrophysiological monitoring, and fluorescence navigation. Tumor histology included 12 cases of the World Health Organization grade III and nine cases of grade IV. Gross total resection was achieved in six cases, subtotal in 13, and partial in two. Motor weakness accompanied by sensory disturbance deteriorated immediately after surgery in 13 patients. However, five patients were determined to show deterioration at 2 months after surgery. Postoperative radiation and chemotherapy were given to every patient, and median progression-free survival of patients with grade III and IV tumors was 12.1 and 7.0 months, respectively. Median overall survival of patients with grade III and IV tumors was 25.6 and 12.6 months, respectively. High incidence of distant recurrences was found, with distant lesions at recurrence in 13 of 19 patients with recurrence, suggesting the life-restricting factor in these patients. Thalamic high-grade glioma without invasion into the pyramidal tract and brainstem can be considered as a candidate for surgical resection. Distant lesion limits the survival of patients after successful resection.

    DOI: 10.1007/s10143-016-0804-x

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  105. Convection-enhanced delivery of a hydrophilic nitrosourea ameliorates deficits and suppresses tumor growth in experimental spinal cord glioma models Reviewed

    Shogo Ogita, Toshiki Endo, Shinichiro Sugiyama, Ryuta Saito, Tomoo Inoue, Akira Sumiyoshi, Hiroi Nonaka, Ryuta Kawashima, Yukihiko Sonoda, Teiji Tominaga

    ACTA NEUROCHIRURGICA   Vol. 159 ( 5 ) page: 939 - 946   2017.5

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    Convection-enhanced delivery (CED) is a technique allowing local infusion of therapeutic agents into the central nervous system, circumventing the blood-brain or spinal cord barrier.
    To evaluate the utility of nimustine hydrochloride (ACNU) CED in controlling tumor progression in an experimental spinal cord glioma model.
    Toxicity studies were performed in 42 rats following the administration of 4 mu l of ACNU CED into the mid-thoracic spinal cord at concentrations ranging from 0.1 to 10 mg/ml. Behavioral analyses and histological evaluations were performed to assess ACNU toxicity in the spinal cord. A survival study was performed in 32 rats following the implantation of 9 L cells into the T8 spinal cord. Seven days after the implantation, rats were assigned to four groups: ACNU CED (0.25 mg/ml; n = 8); ACNU intravenous (i.v.) (0.4 mg; n = 8); saline CED (n = 8); saline i.v. (n = 8). Hind limb movements were evaluated daily in all rats for 21 days. Tumor sizes were measured histologically.
    The maximum tolerated ACNU concentration was 0.25 mg/ml. Preservation of hind limb motor function and tumor growth suppression was observed in the ACNU CED (0.25 mg/ml) and ACNU i.v. groups. Antitumor effects were more prominent in the ACNU CED group especially in behavioral analyses (P &lt; 0.05; log-rank test).
    ACNU CED had efficacy in controlling tumor growth and preserving neurological function in an experimental spinal cord tumor model. ACNU CED can be a viable treatment option for spinal cord high-grade glioma.

    DOI: 10.1007/s00701-017-3123-2

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  106. Intraoperative Visualization of Subependymal Arteries at the Atrium Supplying the Descending Motor Pathway Reviewed

    Mitsuto Hanihara, Sumito Sato, Ichiyo Shibahara, Ryuta Saito, Masayuki Kanamori, Yukihiko Sonoda, Hiroyuki Kinouchi, Teiji Tominaga, Toshihiro Kumabe

    WORLD NEUROSURGERY   Vol. 101   page: 296 - 303   2017.5

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    OBJECTIVE: We previously disclosed that damage to the subependymal arteries (SEAs) caused by coagulation of the choroid plexus at the atrium can result in infarction within the lateral posterior choroidal artery territory, followed by hemiparesis. The present study describes the intra-operative anatomical findings of the SEAs and choroid plexus at the atrium, which were verified only by a few cadaveric studies.
    METHODS: Locations of the SEA and descending motor pathway were determined with the neuronavigation system and subcortical electrical stimulation in 8 cases of periatrial brain tumor. Indocyanine green videoangiography was performed to verify the blood flowin the choroid plexus and SEAs.
    RESULTS: Intraoperative visualization of the SEAs was performed successfully in all patients. The neuronavigation system and subcortical electrical stimulation mapping demonstrated that these SEAs penetrated into the descending motor pathway. Indocyanine green depicted the blood flow of the SEAs entering the wall of the lateral ventricle and adjacent brain parenchyma. The blood flow directions between the SEAs and choroid plexus were not uniform, because the SEAs were filled ahead of the choroid plexus in 3 cases, whereas the choroid plexus was filled first in the other 2 cases.
    CONCLUSIONS: Manipulations to the inner side of the choroid plexus at the transition from the atrium to the body of lateral ventricle can damage the SEAs. Not only coagulation of the SEAs themselves, but also coagulation of choroid plexus itself may reduce the blood flow in the SEAs, resulting in ischemic complications at descending motor pathway.

    DOI: 10.1016/j.wneu.2017.02.022

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  107. 術中迅速診断へのmass spectrometryの応用

    金森 政之, 前川 正充, 柴原 一陽, 斎藤 竜太, 園田 順彦, 渡辺 みか, 冨永 悌二

    Brain Tumor Pathology   Vol. 34 ( Suppl. ) page: 105 - 105   2017.5

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  108. Convection-enhanced Delivery of Therapeutics for Malignant Gliomas Reviewed

    Ryuta Saito, Teiji Tominaga

    NEUROLOGIA MEDICO-CHIRURGICA   Vol. 57 ( 1 ) page: 8 - 16   2017.1

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    Convection-enhanced delivery (CED) circumvents the blood-brain barrier by delivering agents directly into the tumor and surrounding parenchyma. CED can achieve large volumes of distribution by continuous positive-pressure infusion. Although promising as an effective drug delivery method in concept, the administration of therapeutic agents via CED is not without challenges. Limitations of distribution remain a problem in large brains, such as those of humans. Accurate and consistent delivery of an agent is another challenge associated with CED. Similar to the difficulties caused by immunosuppressive environments associated with gliomas, there are several mechanisms that make effective local drug distribution difficult in malignant gliomas. In this review, methods for local drug application targeting gliomas are discussed with special emphasis on CED. Although early clinical trials have failed to demonstrate the efficacy of CED against gliomas, CED potentially can be a platform for translating the molecular understanding of glioblastomas achieved in the laboratory into effective clinical treatments. Several clinical studies using CED of chemotherapeutic agents are ongoing. Successful delivery of effective agents should prove the efficacy of CED in the near future.

    DOI: 10.2176/nmc.ra.2016-0071

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  109. Extremely Late Recurrence 21 Years after Total Removal of Immature Teratoma: A Case Report and Literature Review Reviewed

    Yui Mano, Masayuki Kanamori, Toshihiro Kumabe, Ryuta Saito, Mika Watanabe, Yukihiko Sonoda, Teiji Tominaga

    NEUROLOGIA MEDICO-CHIRURGICA   Vol. 57 ( 1 ) page: 51 - 56   2017.1

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    Immature teratoma (IMT) is normally treated by resection and adjuvant therapy. The present unusual case of recurrent germinoma occurred 21 years after total resection of pineal IMT. A 3-year-old boy presented with headache, disturbance of consciousness, and Parinaud's syndrome. Magnetic resonance (MR) imaging revealed a pineal mass lesion, and total resection of the tumor was achieved. The histological diagnosis was mature teratoma. He did not receive further treatment, and did well without recurrence for 20 years. However, he suffered headache 21 years after resection, and MR imaging revealed a homogeneously enhanced pineal mass with low minimum apparent diffusion coefficient value and proton MR spectroscopy showed a huge lipid peak. The levels of tumor markers were not elevated. Cerebrospinal fluid (CSF) cytology found atypical cells with large nuclei and irregularly shaped nucleoli. To elucidate the relationship between the primary and recurrent tumors, we reviewed the histological specimens and CSF cytology at the initial treatment and found a subset of incompletely differentiated components resembling fetal tissues in the histological specimen and atypical large cells in the CSF. Based on these radiological and histological findings, we presume that the recurrent disease was disseminated germinoma after the resection of disseminated IMT. He received chemotherapy and craniospinal radiation therapy, and the enhanced lesion and atypical cells in the CSF disappeared. This case demonstrates that disseminated IMT can be controlled for the long term without adjuvant therapy, but may recur as germinoma. Tumor dormancy may account for this unusual course.

    DOI: 10.2176/nmc.cr.2016-0241

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MISC 21

  1. Medical Management of a Mural Thrombus Inducing Repeated Ischemic Strokes in a Patient with Congenital Afibrinogenemia.

    Nishihori M, Araki Y, Suzuki N, Tamura S, Hattori M, Izumi T, Goto S, Yokoyama K, Uda K, Matsushita T, Saito R

    Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association   Vol. 31 ( 7 ) page: 106526   2022.7

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    Objectives: Congenital afibrinogenemia is an autosomal recessive inherited disorder that can cause thrombotic as well as hemorrhagic events. We describe a case of repeated mild ischemic strokes due to a mural thrombus in the carotid artery and our medical treatment. Case description: A 49-year-old woman with congenital afibrinogenemia developed two minor ischemic strokes in two months. Clinical images revealed scattered fresh infarcts in the right middle cerebral artery region and mild cervical carotid artery stenosis. The risk for surgical treatment was considered to be extraordinarily high. The patient was treated with 100 mg/day of aspirin and 3 g fibrinogen infusion every two weeks. After the one-year course of medication, the mural thrombus gradually decreased, and there were no bleeding or ischemic stroke events. Conclusion: This case report highlights the successful treatment of an ischemic stroke in a patient with a congenital afibrinogenemia with an antiplatelet agent and fibrinogen replacement. There are no guidelines for managing ischemic stroke in patients with congenital afibrinogenemia, and further studies are needed.

    DOI: 10.1016/j.jstrokecerebrovasdis.2022.106526

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  2. Atypical radiographic case of arachnoid web without scalpel sign.

    Nagashima Y, Nishimura Y, Ito H, Oyama T, Nishii T, Gonda T, Kato H, Saito R

    Surgical neurology international   Vol. 13   page: 108   2022

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    Background: Spinal arachnoid webs (SAW) occur when abnormally thickened bands of arachnoid membranes commonly located dorsal to the thoracic spine cause blockage of normal cerebrospinal fluid (CSF) flow, resulting in focal cord compression and myelopathy. The pathognomonic MR finding for SAW is the "positive scalpel sign"comprised of an enlarged dorsal CSF space with a normal ventral subarachnoid space. The main differential diagnostic consideration for SAW is idiopathic spinal cord herniation (ISCH); however, for ISCH, MR studies classically demonstrate ventral displacement of the spinal cord through an anterior dural defect. Here, we describe a 60-year-old female with an atypical SAW at the T3-T4 level (i.e., the preoperative MR failed to demonstrate the "positive scalpel sign"). Nevertheless, at surgery, intraoperative ultrasonography confirmed that SAW was present and was decompressed/marsupialized/removed. Case Description: A 60-year-old female presented with sensory impairment to both lower extremities. The thoracic MR images showed an enlarged dorsal CSF space at the T3-T4 level but without the "scalpel sign"suggesting "interruption"of CSF flow by thickened bands of focal dorsal arachnoidal tissues. Although the initial preoperative diagnosis was ISCH, intraoperative ultrasound (IOUS) confirmed the presence of a thickened arachnoid band, confirming the diagnosis of a SAW that was appropriately decompressed/resected. Conclusion: Correctly, establishing the preoperative diagnosis of a SAW based on MR imaging may sometimes be difficult as the typical "scalpel sign"may not be present in all patients. Notably, in cases like this one, IOUS may critically confirm the diagnosis of SAW thus leading to appropriate SAW decompression/removal.

    DOI: 10.25259/SNI_179_2022

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  3. Two cases of solitary fibrous tumor/hemangiopericytoma with different clinical features according to the World Health Organization classification: case report and review of the literature.

    Nishii T, Nagashima Y, Nishimura Y, Ito H, Oyama T, Matsuo M, Sakakibara A, Shimada S, Saito R

    Journal of spine surgery (Hong Kong)   Vol. 7 ( 4 ) page: 532 - 539   2021.12

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    Solitary fibrous tumors (SFTs) and hemangiopericytomas (HPCs) have been classified as one entity by the World Health Organization in 2016 due to gene fusion between NAB2 and STAT6. In the Central Nervous System (CNS), a hypocellular, collagenized tumor with a classic SFT phenotype is considered grade I, whereas more densely cellular tumors mostly corresponding to the HPC phenotype are classified as grade II or III (anaplastic) depending in mitotic count (<5 vs. >5 mitoses per 10 high-power fields). Herein, we report two cases of targeted SFT/HPC in which pathological differences and WHO grading affect clinical features. A 75-year-old woman presented with headache and had an intradural extramedullary tumor at the C1 to C2 level. The tumor was well-circumscribed and attached only to the dura mater. It was totally removed and diagnosed SFT/HPC grade I. In contrast, a 68-year-old woman presented with numbness in the right upper limb and had an intradural extramedullary tumor at the medulla to C3 levels The tumor was irregularly marginated and strongly adherent to the spinal cord and involved the vertebral artery. It was sub totally removed and diagnosed SFT/HPC grade II. To the best of our knowledge, there are only 12 cases of SFT/HPC at the craniocervical junction, including the present two cases, of which four that were adherent to the spinal cord or involved the vertebral artery were grade II or III. Although the location of the tumor was almost the same, there were significant differences in the intraoperative findings according to the WHO grading.

    DOI: 10.21037/jss-21-83

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  4. Management of Asymptomatic Vertebral Artery Injury Caused by a Cervical Pedicle Screw Malposition: Two Case Reports

    OTSUKA Takafumi, IZUMI Takashi, NISHIHORI Masahiro, TSUKADA Tetsuya, ARAKI Yoshio, YOKOYAMA Kinya, UDA Kenji, GOTO Shunsaku, IKEZAWA Mizuka, KATO Naoki, NAKANO Mizuki, SAITO Ryuta

    NMC Case Report Journal   Vol. 8 ( 1 ) page: 713 - 717   2021

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    <p>Iatrogenic vertebral artery (VA) injury in cervical fusion is an extremely rare complication but can lead to serious sequelae. We present two successful cases of internal trapping for preventing delayed-onset ischemic stroke after iatrogenic VA stenosis caused by a cervical pedicle screw. A 34-year-old female underwent posterior cervical fusion for C4/C5 dislocation fracture. No neurological deficits were observed after the operation. However, the postoperative images revealed that the left C5 pedicle screw perforated the transverse foramen, and the left VA was suspected to be occluded at the screw insertion site. Before revision surgery, we tried to embolize the injured VA with coils. A microcatheter could be navigated from the ipsilateral VA to the distal of the screw, and internal trapping was performed with coils. Another case is that of a 50-year-old male with cervical spondylosis, who underwent posterior decompression and cervical fusion. The neurological symptoms did not deteriorate after the operation. However, the postoperative computed tomography images revealed the perforation of the right C3 transverse foramen by the pedicle screw. In right vertebral angiography, about 70% stenosis was observed at the screw insertion site. Although revision surgery was not planned due to good stability, we embolized the right VA after balloon occlusion test, to prevent the delayed-onset thromboembolic complications. Both the patients recovered without any neurological deficits. Iatrogenic VA injuries, even if asymptomatic immediately after surgery, can lead to serious sequelae in case of delayed-onset ischemic stroke. Therefore, careful attention should be paid when the screw perforates the transverse foramen.</p>

    DOI: 10.2176/nmccrj.cr.2021-0062

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  5. 高齢者脳実質内腫瘍における非痙攣性てんかん重積

    金森政之, 大沢伸一郎, 下田由輝, 斎藤竜太, 冨永悌二

    日本老年脳神経外科学会プログラム・抄録集   Vol. 34th (CD-ROM)   2021

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  6. Development of Epilepsy after treating Germ cell tumor

    下田由輝, 金森政之, 大沢伸一郎, 齋藤竜太, 園田順彦, 隈部俊宏, 中里信和, 冨永悌二

    てんかん研究   Vol. 39 ( 2 )   2021

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  7. Survival Benefit of Supratotal Resection in a Long-term Survivor of <i>IDH</i>-wildtype Glioblastoma: A Case Report and Literature Review

    YAMAGUCHI Junya, MOTOMURA Kazuya, OHKA Fumiharu, AOKI Kosuke, TANAHASHI Kuniaki, HIRANO Masaki, CHALISE Lushun, NISHIKAWA Tomohide, SHIMIZU Hiroyuki, NATSUME Atsushi, WAKABAYASHI Toshihiko, SAITO Ryuta

    NMC Case Report Journal   Vol. 8 ( 1 ) page: 747 - 753   2021

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    <p>Glioblastoma multiforme (GBM) is an aggressive cancer type, with fewer than 3–5% of patients surviving for more than 3 years. We describe a 48-year-old right-handed man who presented with generalized seizure attacks. Magnetic resonance imaging (MRI) revealed a heterogeneous gadolinium-enhancing lesion in the left inferior parietal lobule. The patient underwent awake surgery, and tumor resection included abnormalities on T2-weighted MRI, with subcortical mapping used to identify the deep functional boundaries. After supratotal resection, the tumor was diagnosed as GBM without isocitrate dehydrogenase (<i>IDH</i>) 1 and 2 mutations. At a follow-up evaluation, 9 years and 2 months after the surgery, the patient appeared healthy, and no relapse or recurrence was observed. We present the case of a long-term survivor of <i>IDH</i>-wildtype GBM. This case suggests that supratotal resection with intraoperative awake brain mapping can improve survival without impairing the patient’s neurological functions.</p>

    DOI: 10.2176/nmccrj.cr.2021-0120

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  8. Postoperative Cervicothoracic Kyphosis Following Infantile Intramedullary Tumor Resection Accelerates Neurological Deterioration

    GONDA Tomomi, NAGASHIMA Yoshitaka, NISHIMURA Yusuke, ITO Hiroshi, NISII Tomoya, OYAMA Takahiro, HARA Masahito, SAITO Ryuta

    NMC Case Report Journal   Vol. 8 ( 1 ) page: 705 - 711   2021

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    <p>Intramedullary spinal cord tumors are rare in children. Regardless of the type of tumor, surgical removal is thought to improve progression-free survival. However, postoperative kyphosis is a serious problem in children, who can expect long-term survival. We present a pediatric case of neurofibromatosis type 2-related spinal ependymoma at the cervicothoracic regions where acute neurological deterioration was developed due to a combination of tumor recurrence and postoperative kyphotic deformity. In the first surgery, subtotal tumor resection was performed via osteoplastic laminotomy. Postoperative radiological evaluation at several months showed cervicothoracic junctional kyphosis, which subsequently made a significant improvement by lifestyle instructions. However, 22 months after the surgery, he exhibited rapid neurological deterioration caused by the regrowth of the recurrent tumor and re-emergence of kyphotic deformity, which led to the fixed laminar flap sank into the spinal canal. Therefore, a second surgery was performed 23 months after the first surgery, and gross total removal was achieved. Osteoplastic laminotomy is presumed to reduce the occurrence of postoperative kyphosis compared with laminectomy, but there have been no reports on the spinal cord compression by plunging of the re-fixed laminar flap into the spinal canal. The kyphosis deformity increases the chance of re-fixed laminar flap coming off, thereby accelerating neurological injury on top of the neural damage by tumor recurrence itself. Therefore, pediatric patients with spinal cord tumors should be carefully managed in terms of recurrent tumors and postoperative kyphosis, and timely surgical intervention is necessary before kyphotic deformity becomes evident.</p>

    DOI: 10.2176/nmccrj.cr.2021-0086

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  9. Epilepsy after treating Germ cell tumor

    下田由輝, 金森政之, 大沢伸一郎, 大沢伸一郎, 齋藤竜太, 園田順彦, 隈部俊宏, 中里信和, 冨永悌二

    日本てんかん外科学会プログラム・抄録集   Vol. 44th   2020

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  10. ULTRASOUND-FACILITATED DRUG DELIVERY DEVICE FOR LOCAL DRUG INFUSION AGAINST BRAIN TUMORS

    Ryuta Saito, Wenting Jia, Aya Sato, Kenji Inoue, Saori Okuno, Yuji Ohashi, Kei Kamada, Akira Yoshikawa, Teiji Tominaga

    NEURO-ONCOLOGY   Vol. 21   page: 278 - 278   2019.11

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  11. 超選択的Wada testによる血管解剖と機能解剖のハイブリッド評価

    大沢 伸一郎, 鈴木 匡子, 新妻 邦泰, 浮城 一司, 柿沼 一雄, 上利 大, 神 一敬, 斎藤 竜太, 金森 政之, 中里 信和, 冨永 悌二

    脳血管内治療   Vol. 4 ( Suppl. ) page: S383 - S383   2019.11

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  12. Phase I study of a brain penetrant mutant IDH1 inhibitor DS-1001b in patients with recurrent or progressive IDH1 mutant gliomas.

    Atsushi Natsume, Toshihiko Wakabayashi, Yasuji Miyakita, Yoshitaka Narita, Yohei Mineharu, Yoshiki Arakawa, Fumiyuki Yamasaki, Kazuhiko Sugiyama, Nobuhiro Hata, Yoshihiro Muragaki, Ryo Nishikawa, Naoki Shinojima, Toshihiro Kumabe, Ryuta Saito, Kazumi Ito, Masaya Tachibana, Yasuyuki Kakurai, Soichiro Nishijima, Hiroshi Tsubouchi

    JOURNAL OF CLINICAL ONCOLOGY   Vol. 37 ( 15 )   2019.5

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    DOI: 10.1200/JCO.2019.37.15_suppl.2004

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  13. 急性リンパ性白血病完全緩解後に発生した放射線誘発性膠芽腫の3例

    金森 政之, 斎藤 竜太, 梶谷 卓未, 渡辺 みか, 鈴木 博義, 渡辺 祐子, 呉 繁夫, 冨永 悌二

    Brain Tumor Pathology   Vol. 35 ( Suppl. ) page: 165 - 165   2018.9

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  14. Fingolimod-Associated PML with Mild Immune Reconstitution Inflammatory Syndrome in Multiple Sclerosis

    Shuhei Nishiyama, Tatsuro Misu, Yukiko Shishido-Hara, Kazuo Nakamichi, Masayuki Saijo, Yoshiki Takai, Kentarou Takei, Naoki Yamamoto, Hiroshi Kuroda, Ryuta Saito, Mika Watanabe, Teiji Tominaga, Ichiro Nakashima, Kazuo Fujihara, Masashi Aoki

    MULTIPLE SCLEROSIS JOURNAL   Vol. 24 ( 3 ) page: 381 - 382   2018.3

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  15. 小児血液・腫瘍入院患者の傾向と、診断まで時間のかかった症例の検討

    新妻 秀剛, 鈴木 資, 片山 紗乙莉, 渡辺 祐子, 入江 正寛, 力石 健, 笹原 洋二, 呉 繁夫, 齋藤 竜太, 金森 政之, 風間 理郎, 綿貫 宗則, 保坂 正美

    日本小児科学会雑誌   Vol. 122 ( 1 ) page: 93 - 93   2018.1

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  16. ACNU AS THE BEST NITROSOUREA FOR LOCAL CONVECTION-ENHANCED DELIVERY: REPORT ON PHARMACOKINETICS

    Ryuta Saito, Jia Wenting, Aya Sato, Saori Okuno, Taigen Nakamura, Masashi Chonan, Rong Zhang, Masayuki Kanamori, Teiji Tominaga

    NEURO-ONCOLOGY   Vol. 19   page: 90 - 90   2017.11

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  17. LONG-TERM OUTCOME OF CRANIOSPINAL IRRADIATION FOR RECURRENT GERMINOMA

    Masayuki Kanamori, Ryuta Saito, Yukihiko Sonoda, Toshihiro Kumabe, Teiji Tominaga

    NEURO-ONCOLOGY   Vol. 19   page: 222 - 222   2017.11

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  18. LIMITATION OF RADICAL RESECTION OF GLIOBLASTOMA INFILTRATING FROM AMYGDALA TO GLOBUS PALLIDUS: EFFECTIVENESS OF CARMUSTINE WAFERS FOR RESIDUAL TUMOR CONTROL

    Toshihiro Kumabe, Mitsuto Hanihara, Ichiyo Shibahara, Sumito Sato, Ryuta Saito, Masayuki Kanamori, Yukihiko Sonoda, Teiji Tominaga

    NEURO-ONCOLOGY   Vol. 19   page: 265 - 265   2017.11

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  19. 心因性嘔吐が疑われた膠芽腫の1例 脳腫瘍を見逃さないために

    相原 悠, 渡辺 祐子, 鈴木 佐和子, 鈴木 資, 入江 正寛, 新妻 秀剛, 力石 健, 笹原 洋二, 呉 繁夫, 齋藤 竜太, 金森 政之, 富永 悌二

    日本小児科学会雑誌   Vol. 121 ( 6 ) page: 1124 - 1124   2017.6

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  20. 東北大学病院におけるSJMB96による治療経験

    渡辺 祐子, 新妻 秀剛, 入江 正寛, 力石 健, 笹原 洋二, 渡辺 みか, 齋藤 竜太, 金森 政之, 園田 順彦, 冨永 悌二, 呉 繁夫

    小児の脳神経   Vol. 42 ( 2 ) page: 120 - 120   2017.4

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  21. Hypoxia-like Tissue Injury and Glial Response Contribute to the Development of Balo's Concentric Demyelination

    Y. Takai, T. Misu, S. Nishiyama, H. Ono, H. Kuroda, I. Nakashima, R. Saito, M. Kanamori, S. Mugikura, M. Watanabe, M. Aoki, K. Fujihara

    MULTIPLE SCLEROSIS JOURNAL   Vol. 23 ( 2 ) page: 349 - 350   2017.2

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Presentations 32

  1. 悪性グリオーマの最新治療とprecision medicineの未来

    齋藤竜太

    第42回日本脳神経外科コングレス  2022.5.13  日本脳神経外科コングレス

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    Event date: 2022.5

    Language:English   Presentation type:Symposium, workshop panel (nominated)  

  2. 摘出度を適格規準として術中ランダム化を行う膠芽腫に対する比較臨床試験

    齋藤竜太、木下 学、山崎文之、角 美奈子、井垣 浩、渋谷 誠、佐々木 惇、小森隆司、荒川芳輝、成田善孝、西川亮、関野雄太、佐々木啓太、隈部俊宏

    第39回日本脳腫瘍学会学術集会  2021.12.5  日本脳腫瘍学会

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    Event date: 2021.12

    Language:Japanese   Presentation type:Symposium, workshop panel (public)  

    Venue:兵庫  

  3. 薬剤局所投与による脳腫瘍新規治療法の開発 Invited

    齋藤竜太

    第1回東海北陸脳腫瘍セミナー  2021.11.29 

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    Event date: 2021.11

    Language:Japanese   Presentation type:Oral presentation (invited, special)  

  4. 脳腫瘍治療成績向上に向けた取り組みの現状

    齋藤竜太

    第24回日本臨床脳神経外科学会学術集会  2021.11.12  日本臨床脳神経外科学会

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    Event date: 2021.11

    Language:Japanese   Presentation type:Oral presentation (invited, special)  

    Venue:沖縄  

  5. Visualization of drug delivery in local convection-enhanced delivery against brain tumors Invited

    2021.10.30 

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    Event date: 2021.10

    Language:English  

  6. 脳腫瘍治療成績向上を目指して:摘出術を中心に Invited

    齋藤竜太

    第80回日本脳神経外科学会学術集会  2021.10.29  日本脳神経外科学会

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    Event date: 2021.10

    Language:Japanese   Presentation type:Oral presentation (invited, special)  

    Venue:横浜  

  7. 脳幹グリオーマに対するConvection-enhanced deliveryを用いた局所化学療法

    齋藤竜太

    第80回日本脳神経外科学会学術集会  2021.10.27  日本脳神経外科学会

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    Event date: 2021.10

    Language:Japanese   Presentation type:Symposium, workshop panel (nominated)  

    Venue:横浜  

  8. グリオーマ治療の現状と近未来 Invited

    齋藤竜太

    第100回日本脳神経外科学会中部支部学術集会  2021.9.18  日本脳神経外科学会中部支部

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    Event date: 2021.9

    Language:Japanese   Presentation type:Oral presentation (invited, special)  

    Venue:名古屋  

  9. 画像誘導下脳腫瘍局所治療

    齋藤竜太

    2021.5.15  日本脳神経外科コングレス

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    Event date: 2021.5

    Language:Japanese   Presentation type:Symposium, workshop panel (nominated)  

    Venue:大阪  

  10. 脳腫瘍に対する局所化学療法 Invited

    齋藤竜太

    第30回脳神経外科手術と機器学会  2021.4.24  日本脳神経外科手術と機器学会

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    Event date: 2021.4

    Language:Japanese   Presentation type:Symposium, workshop panel (nominated)  

    Venue:札幌  

  11. 脳腫瘍の局所治療 Invited

    齋藤竜太

    第99回日本脳神経外科学会中部支部学術集会  2021.4.3  日本脳神経外科学会中部支部

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    Event date: 2021.4

    Language:Japanese   Presentation type:Oral presentation (invited, special)  

    Venue:金沢  

  12. 悪性神経膠腫治療成績向上を目指して Invited

    齋藤竜太

    ニューロオンコロジーセントラル  2021.3.27  NeuroOncology Centeral/中外製薬

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    Event date: 2021.3

    Language:Japanese   Presentation type:Oral presentation (invited, special)  

    Venue:名古屋  

  13. A Pediatric Case of Left Frontal Hemorrhagic Tumor Radiographically Diagnosed as Leukoencephalopathy with Calcification and Cysts.

    Ryuta Saito, Masayuki Kanamori, Mitsugu Uematsu, Mika Watanabe, Teiji Tominaga

    ICN/BTP2018 (第36回日本脳腫瘍病理学会)  2018  日本脳腫瘍病理学会

  14. 脳腫瘍関連てんかんに対するフィコンパ投与経験

    Ryuta Saito

    Epilepsy Summit in Sendai  2018 

  15. 脳腫瘍に対するニトロソウレア剤局所投与:ACNUの有用性に関する基礎的研究

    Ryuta Saito, Jia Wenting, Aya Sato, Saori Okuno, Taigen Nakamura, Masashi Chonan, Rong Zhang, Masayuki Kanamori, Teiji Tominaga

    第18回日本分子脳神経外科学会  2017  日本分子脳神経外科学会

  16. 神経膠腫症例における症候性脳梗塞

    Ryuta Saito, Masayuki Kanamori, Masashi Chonan, Yukihiko Sonoda, Toshihiro Kumabe, Teiji Tominaga

    第43回日本脳卒中学会学術集会  2018  日本脳卒中学会

  17. 神経膠腫に対する治療戦略 -臨床と研究から-

    Ryuta Saito

    岩手県立病院医学会脳神経外科分科会  2018 

  18. 東北大学脳神経外科における悪性神経膠腫に対するベバシズマブ使用の実際

    Ryuta Saito, Masayuki Kanamori, Masashi Chonan, Yukihiko Sonoda, Teiji Tominaga

    東北地方会  2017  日本脳神経外科学会

  19. 悪性神経膠腫に対する局所化学療法

    Ryuta Saito, Masayuki Kanamori, Yukihiko Sonoda, Toshihiro Kumabe, Teiji Tominaga

    第37回日本脳神経外科コングレス  2017  日本脳神経外科学会

  20. 悪性神経膠腫における血栓塞栓症

    Ryuta Saito

    東北脳腫瘍研究会  2018 

  21. 小児第4 脳室上衣腫に対する治療戦略

    Ryuta Saito

    第23回日本脳腫瘍の外科学会  2018  日本脳腫瘍の外科学会

  22. 小児びまん性橋神経膠腫に対するConvection-enhanced deliveryを用いた塩酸ニムスチン局所投与:医師主導治験

    Ryuta Saito, Masayuki Kanamori, Aya Sato, Saori Okuno, Teiji Tominaga

    第46回日本小児神経外科学会  2018  日本小児神経外科学会

  23. 初回再発悪性神経膠腫に対する摘出術後塩酸ニムスチンconvection enhanced delivery 投与とテモゾロミド内服?Phase I/II臨床試験?.

    Ryuta Saito

    第32回日本脳腫瘍学会学術集会  日本脳腫瘍学会

  24. Venous thromboembolism in patients with malignant brain tumor: 〜management strategy to avoid mortality〜

    Ryuta Saito

    第39回日本血栓止血学会学術集会  2017  日本血栓止血学会

  25. Use of Bevacizumab against malignant glioma cases at Tohoku University Hospital: Initial experience with 100 cases

    Ryuta Saito, Masayuki Kanamori, Masashi Chonan, Yukihiko Sonoda, Teiji Tominaga

    Asian Society for Neuro-Oncology  2017 

  26. Phase I Trial of a Convection-enhanced Delivery of Nimustine Hydrochloride (ACNU) for Patients With Brainstem Recurrent Glioma

    Ryuta Saito, Yukihiko Sonoda, Masayuki Kanamori, Yoji Yamashita, Kenichi Nagamatsu, Toshihiro Kumabe, Teiji Tominaga

    Society for Neuro-oncology  2017 

  27. Convection-enhanced deliveryによる脳幹腫瘍の治療:医師主導治験に向けて

    Ryuta Saito, Masayuki Kanamori, Yukihiko Sonoda, Yoji Yamashita, Shunji Mugikura, Toshihiro Kumabe, Teiji Tominaga

    日本脳神経外科学会第76回学術総会  2017  日本脳神経外科学会

  28. Convection-enhanced deliveryによる脳幹腫瘍の治療

    Ryuta Saito, Masayuki Kanamori, Yukihiko Sonoda, Yoji Yamashita, Shunji Mugikura, Toshihiro Kumabe, Teiji Tominaga

    第22回日本脳腫瘍の外科学会  2017  日本脳腫瘍の外科学会

  29. Convection-enhanced deliveryによる局所化学療法開発の現状

    Ryuta Saito, Masayuki Kanamori, Yukihiko Sonoda, Shunji Mugikura, Toshihiro Kumabe, Teiji Tominaga

    第35回日本脳腫瘍学会学術集会  2017  日本脳腫瘍学会

  30. Convection-enhanced delivery of Nimustine Hydrochroride against brainstem gliomas.

    Ryuta Saito, Masayuki Kanamori, Yukihiko Sonoda, Toshihiro Kumabe, Teiji Tominaga

    22th International Conference on Brain Tumor Research and Therapy  2018 

  31. Convection-enhanced delivery of nimustine hydrochloride for malignant glioma.

    Ryuta Saito, Teiji Tominaga

    The Fourth International MASSIN Congress  Madjid Samii Congress of International Neurosurgeons

  32. ACNU as the best nitrosourea for local convection-enhanced delivery: report on pharmacokinetics

    Ryuta Saito, Jia Wenting, Aya Sato, Saori Okuno, Taigen Nakamura, Masashi Chonan, Rong Zhang, Masayuki Kanamori, Teiji Tominaga

    Society for Neuro-oncology  2017 

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KAKENHI (Grants-in-Aid for Scientific Research) 10

  1. Research for development of connectome-based functional neurosurgery and non-invasive simulation system

    Grant number:22H03184  2022.4 - 2027.3

    Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (B)

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    Authorship:Coinvestigator(s) 

  2. Research for clinical application of ultrasound facilitated drug delivery system

    Grant number:21H03039  2021.4 - 2024.3

    Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (B)

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    Authorship:Principal investigator 

    Grant amount:\17550000 ( Direct Cost: \13500000 、 Indirect Cost:\4050000 )

  3. 超音波併用脳内局所広範囲薬剤投与法を用いた画期的なアルツハイマー病新規治療法開発

    Grant number:20K21641  2020.7 - 2023.3

    科学研究費助成事業  挑戦的研究(萌芽)

    齋藤 竜太

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    Authorship:Principal investigator 

    Grant amount:\6240000 ( Direct Cost: \4800000 、 Indirect Cost:\1440000 )

    アルツハイマー病に関して近年、精力的に研究が進められており、アミロイド蛋白の蓄積を可視化する研究が進められている。この中で、早期におけるアミロイド蛋白の蓄積は全般性ではなく、脳のある部位に特に蓄積が多くなる傾向があることが判明しており、アミロイド蓄積部位の局所治療が功を奏する可能性が示唆される。これまでに脳内広範囲薬剤送達技術によりアミロイド蓄積を低減できる可能性を確認しており、本研究では脳局所のアミロイド沈着を解除する新規治療法の開発を行う。

  4. Development of a weak shock wave pulse jet scalpel that achieves both local control of infiltrating lesions and preservation of postoperative function

    Grant number:18H04157  2018.4 - 2021.3

    Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (A)

    Nakagawa Atsuhiro

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    Authorship:Coinvestigator(s) 

    The purpose of present study was to achieve infiltration of drug delivery to brain parenchyma through neuroendoscopic procedure by applying pulsed water jet. We have hypothesized that the penetration depth and area can be modified by applying shock wave. We have measured material property of brain and measured penetration depth and area using brain phantom and animal model. Present results showed the possibility of shock wave modified pulsed water jet can be additional treatment tool for the malignant lesion without well demarcated margin.

  5. 浸潤病変の局所制御と術後機能温存を両立する微弱衝撃波パルスジェットメスの開発

    2018.4 - 2021.3

    文部科学省  科学研究費助成事業 基盤研究(A) 

    中川 敦寛

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    Grant type:Competitive

  6. 希少・難治小児脳幹部神経膠腫に対する塩酸ニムスチン局所投薬による新規治療法開発:多施設共同医師主導治験

    2017.4 - 2020.3

    日本医療研究開発機構(AMED)  臨床研究・治験推進研究事業 

    冨永 悌二

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    Grant type:Competitive

  7. Basic Research for Development of Chemical Surgery

    Grant number:17H04299  2017.4 - 2020.3

    Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (B)

    Saito Ryuta

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    Authorship:Principal investigator 

    Grant amount:\17290000 ( Direct Cost: \13300000 、 Indirect Cost:\3990000 )

    Basic research of local convection-enhanced delivery (CED) was performed and following data were acquired. 1)Detection of local distribution and analysis of route of clearance after CED of ACNU. Mass spectrometric analysis demonstrated the robust distribution of ACNU after CED in the brain parenchyma. Radiolabeled ACNU enabled the detection of systemic clearance route after CED. 2)Establishment of MRI detection method to monitor the drug distribution without using contrast enhancing agent. We succeeded to monitor the drug distribution using T2-map based MRI. 3)The effect of pharmaceutical preparation on CED was summarized. The appropriate preparation of ACNU was defined. 4)Aiming at evaluating the effect of ultrasound on brain tissue with our newly developed ultrasound facilitated drug delivery system, acoustic characteristic of the device was analyzed by accumulation of the data measuring the conduction of ultrasound in the water.

  8. 脳内広範囲薬剤送達技術を用いたChemicalSurgery確立に向けた基礎研究

    2017.4 - 2020.3

    文部科学省  科学研究費助成事業 基盤研究(B) 

    齋藤 竜太

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    Authorship:Principal investigator  Grant type:Competitive

  9. 脳内広範囲薬剤送達 システムの開発- 塩酸ニムスチン局所投与による脳腫瘍治療法-

    2016.4 - 2017.3

    文部科学省  橋渡し研究加速ネットワークプログラム研究開発施設共用等促進費補助金 シーズB 

    冨永 悌二

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    Grant type:Competitive

  10. 幹細胞分化誘導薬を用いたCED法による膠芽腫新規治療法の開発

    2014 - 2017

    文部科学省  科学研究費助成事業 基盤研究(C) 

    園田 順彦

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    Grant type:Competitive

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Teaching Experience (On-campus) 2

  1. 医学入門

    2021

     詳細を見る

    医学部1年生に対して
    Human BiologyのSencesを担当した

  2. ポリクリ1

    2020

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    ポリクリ1で実習に来る全てのグループに対してオリエンテーション、総括を行った。

Teaching Experience (Off-campus) 1

  1. 脳腫瘍

    2021.9 Meijo University)

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    Level:Undergraduate (specialized) 

 

Social Contribution 2

  1. 日本脳神経外科学会中部支部会市民公開講座

    Role(s):Presenter

    日本脳神経外科学会中部支部会  2022.9

  2. ストップ!NO卒中プロジェクト 支部講演会in愛知

    Role(s):Presenter

    公益社団法人日本脳卒中協会/ファイザー株式会社  2021.11

Academic Activities 1

  1. 日本脳神経外科学会中部支部会

    Role(s):Planning, management, etc.

    日本脳神経外科学会中部支部会  2022.9

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    Type:Academic society, research group, etc.