研究者詳細 - 齋藤　竜太

論文 - 齋藤　竜太

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Unilateral laminotomy for bilateral decompression and balloon kyphoplasty to decompress lumber canal stenosis aggravated by osteoporotic vertebral compression fractures: A technical note. 国際誌 Open Access

Nagashima Y, Nishimura Y, Ishii M, Nishii T, Fukaya N, Oyama T, Abe T, Kato H, Tsukamoto E, Tanei T, Saito R

Surgical neurology international 13 巻頁： 538 - 538 2022年

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

Background: The optimal treatment of lumbar canal stenosis (LCS) associated with osteoporotic vertebral fractures (OVFs) remains unclear. Here, we have combined a minimally invasive unilateral laminotomy for bilateral decompression (ULBD) alone with balloon kyphoplasty (BKP) for LCS aggravated by OVF. Methods: ULBD with BKP was performed in three patients who showed LCS associated with OVFs on MR images with progressive lower extremity neurological deficits. Clinical outcomes were assessed using the numerical rating scale (NRS) and the Japanese Orthopaedic Association (JOA) score. Radiological outcomes were evaluated using multiple parameters (i.e., fractured vertebral body height, lumbar lordosis [LL], and focal angle of the fractured vertebral body). Results: Over 6 postoperative months, the NRS and JOA scores were clearly improved while radiological parameters remained maintained (i.e., loss of fractured vertebral body height was only 0.3-1.4 mm in all cases). Two of the three cases showed restoration of LL and focal angle postoperatively. Conclusion: The combination of ULBD with BKP is an effective option for LCS aggravated by OVF.

DOI： 10.25259/SNI_971_2022

壊血病により非外傷性硬膜外血腫に至った1例

滝戸悠平, 長倉正宗, 加藤美穂子, 齋藤竜太

小児の脳神経 47 巻 ( 3 ) 頁： 309 - 313 2022年

記述言語：日本語出版者・発行元：一般社団法人日本小児神経外科学会

<p>壊血病はVit.C欠乏により易出血性を呈する疾患であるが，先進国では食料事情の改善でほとんど認められなくなった．症例は4歳女児，下肢の疼痛症状で歩行困難となり骨髄炎や歯肉腫脹を来していた．頭痛が出現し外傷歴のない硬膜外血腫を指摘され手術を施行した．入院経過中に極度の偏食であることが判明し，Vit.C欠乏が示唆され壊血病の診断に至った．Vit.Cの補充により急速に症状は改善し良好な転帰を得た．本疾患は多彩な症状を呈し診断困難な場合があるが，偏食などの病歴を把握し診断・治療へつなげることが重要である．</p>

DOI： 10.34544/jspn.47.3_309

CiNii Research

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脊椎脊髄疾患における3Dプリンター活用の実際と現状

永島吉孝, 西村由介, 赤堀翔, 竹内和人, 宇田憲司, 伊藤洋, 齋藤竜太

脊髄外科 36 巻 ( 3 ) 頁： 296 - 301 2022年

Symptomatic hyperperfusion after combined revascularization surgery in patients with pediatric moyamoya disease: patient series Open Access

Araki Y, Mamiya T, Fujita N, Yokoyama K, Uda K, Kanamori F, Takayanagi K, Ishii K, Nishihori M, Takeuchi K, Tanahashi K, Nagata Y, Nishimura Y, Tanei T, Muraoka S, Izumi T, Kato K, Saito R

Journal of Neurosurgery: Case Lessons 3 巻 ( 19 ) 2022年

掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Neurosurgery: Case Lessons

BACKGROUND Symptomatic hyperperfusion after cerebral revascularization for pediatric moyamoya disease (MMD) is a rare phenomenon. The authors report a series of patients with this condition. OBSERVATIONS In all three patients in this case series, the combined revascularization was on the left side, the patency of bypass grafts was confirmed after surgery, and focal hyperemia around the anastomotic site was observed on single photon emission computed tomography (SPECT). On the first to eighth days after surgery, all of the patients developed neurological manifestations, including motor aphasia, cheiro-oral syndrome, motor weakness of their right upper limbs, and severe headaches. These symptoms disappeared completely approximately 2 weeks after surgery, and all patients were discharged from the hospital. Quantitative SPECT was performed to determine the proportional change in cerebral blood flow (DRCBF) (to ipsilateral cerebellar ratio (denoted DRCBF) in the region of interest around the anastomoses, and the mean value was 1.34 (range, 1.29–1.41). LESSONS This rare condition, which develops soon after surgery, requires an accurate diagnosis by SPECT. One indicator is that the DRCBF has risen to 1.3 or higher. Subsequently, strategic blood pressure treatment and fluid management could prevent the development of hemorrhagic stroke.

DOI： 10.3171/CASE2274

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(11)C-methionine- and (18)F-FDG-PET double-negative metastatic brain tumor from lung adenocarcinoma with paradoxical high (18)F-FDG uptake: A case report. 国際誌 Open Access

Tanahashi K, Hirano M, Chalise L, Tsugawa T, Okumura Y, Hase T, Ohka F, Motomura K, Takeuchi K, Nagata Y, Nakahara N, Hashimoto N, Saito R

Surgical neurology international 13 巻頁： 372 - 372 2022年

記述言語：英語出版者・発行元：Surgical Neurology International

Background: Imaging with 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and 11C-methionine (MET)-PET can delineate primary and metastatic brain tumors. Lesion size affects the sensitivity of both scans and histopathological features can also influence FDG-PET, but the effects on MET-PET have not been elucidated. Case Description: We report an unusual case of metastatic brain tumors without accumulation of FDG or MET, contrasting with high FDG uptake in the primary lung lesion. The brain lesions were identified as adenocarcinoma with a more mucus-rich background, contributing to the indistinct accumulation of both FDG and MET. Conclusion: Histopathological characteristics can affect both MET and FDG accumulation, leading to findings contradicting those of the primary lesion.

DOI： 10.25259/SNI_264_2022

Atypical radiographic case of arachnoid web without scalpel sign. 国際誌 Open Access

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

Surgical neurology international 13 巻頁： 108 - 108 2022年

記述言語：英語出版者・発行元：Surgical Neurology International

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

Spinal Cord Stimulation for Neuropathic Pain following a Spinal Cord Lesion with Past Spinal Surgical Histories Using a Paddle Lead Placed on the Rostral Side of the Lesion: Report of Three Cases.

Fukaya N, Tanei T, Nishimura Y, Hara M, Hata N, Nagashima Y, Maesawa S, Araki Y, Saito R

NMC case report journal 9 巻 ( 0 ) 頁： 349 - 355 2022年

Clinical and Radiological Clues of Traumatic Craniocervical Junction Injuries Requiring Occipitocervical Fusion to Early Diagnosis 国際誌 Open Access

Shiraishi, D; Nishimura, Y; Aguirre-Carreno, I; Hara, M; Yoshikawa, S; Eguchi, K; Nagashima, Y; Ito, H; Haimoto, S; Yamamoto, Y; Ginsberg, HJ; Takayasu, M; Saito, R

NEUROSPINE 18 巻 ( 4 ) 頁： 741 - 748 2021年12月

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

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.

DOI： 10.14245/ns.2142860.430

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. 国際誌 Open Access

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

Journal of spine surgery (Hong Kong) 7 巻 ( 4 ) 頁： 532 - 539 2021年12月

記述言語：英語出版者・発行元：Journal of Spine Surgery

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

Resting State Networks Related to the Maintenance of Good Cognitive Performance During Healthy Aging 国際誌 Open Access

Maesawa, S; Mizuno, S; Bagarinao, E; Watanabe, H; Kawabata, K; Hara, K; Ohdake, R; Ogura, A; Mori, D; Nakatsubo, D; Isoda, H; Hoshiyama, M; Katsuno, M; Saito, R; Ozaki, N; Sobue, G

FRONTIERS IN HUMAN NEUROSCIENCE 15 巻頁： 753836 - 753836 2021年11月

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

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.

DOI： 10.3389/fnhum.2021.753836

Aphasic status epilepticus after glioma resection: two case reports. 国際誌

Shimoda Y, Kanamori M, Saito R, Osawa S, Mugikura S, Tominaga T

Acta neurochirurgica 163 巻 ( 11 ) 頁： 3109 - 3113 2021年11月

Techniques, Indications, and Outcomes in Magnetic Resonance-guided Focused Ultrasound Thalamotomy for Tremor Open Access

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

NEUROLOGIA MEDICO-CHIRURGICA 61 巻 ( 11 ) 頁： 629 - 639 2021年11月

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

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.

DOI： 10.2176/nmc.ra.2021-0187

Newly established patient-derived organoid model of intracranial meningioma 国際誌 Open Access

Yamazaki, S; Ohka, F; Hirano, M; Shiraki, Y; Motomura, K; Tanahashi, K; Tsujiuchi, T; Motomura, A; Aoki, K; Shinjo, K; Murofushi, Y; Kitano, Y; Maeda, S; Kato, A; Shimizu, H; Yamaguchi, J; Adilijiang, A; Wakabayashi, T; Saito, R; Enomoto, A; Kondo, Y; Natsume, A

NEURO-ONCOLOGY 23 巻 ( 11 ) 頁： 1936 - 1948 2021年11月

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

Background: 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.

DOI： 10.1093/neuonc/noab155

Effects of oxytocin on responses to nociceptive and non-nociceptive stimulation in the upper central nervous system 国際誌 Open Access

Saito, H; Hidema, S; Otsuka, A; Suzuki, J; Kumagai, M; Kanaya, A; Murakami, T; Takei, Y; Saito, K; Sugino, S; Toyama, H; Saito, R; Tominaga, T; Nishimori, K; Yamauchi, M

BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS 574 巻頁： 8 - 13 2021年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Biochemical and Biophysical Research Communications

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.

DOI： 10.1016/j.bbrc.2021.08.042

Triggering of Carotid Sinus Reflex during Deployment the Flow-diverter Device Open Access

Goto, S; Izumi, T; Nishihori, M; Tsukada, T; Araki, Y; Uda, K; Yokoyama, K; Saito, R

NEUROLOGIA MEDICO-CHIRURGICA 61 巻 ( 10 ) 頁： 583 - 590 2021年10月

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

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 univar-iate 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 aneu-rysm, prolonged PED deployment time, and an acute angle of the anterior genu were associated with CSR triggering.

DOI： 10.2176/nmc.oa.2021-0049

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 97 巻 ( S.HPT ) 頁： 49 - 51 2021年9月

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 97 巻 ( S.HPT ) 頁： 16 - 18 2021年9月

Mathematical Modeling and Mutational Analysis Reveal Optimal Therapy to Prevent Malignant Transformation in Grade II IDH-Mutant Gliomas 国際誌 Open Access

Aoki, K; Suzuki, H; Yamamoto, T; Yamamoto, KN; Maeda, S; Okuno, Y; Ranjit, M; Motomura, K; Ohka, F; Tanahashi, K; Hirano, M; Nishikawa, T; Shimizu, H; Kitano, Y; Yamaguchi, J; Yamazaki, S; Nakamura, H; Takahashi, M; Narita, Y; Nakada, M; Deguchi, S; Mizoguchi, M; Momii, Y; Muragaki, Y; Abe, T; Akimoto, J; Wakabayashi, T; Saito, R; Ogawa, S; Haeno, H; Natsume, A

CANCER RESEARCH 81 巻 ( 18 ) 頁： 4861 - 4873 2021年9月

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

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.

DOI： 10.1158/0008-5472.CAN-21-0985

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.

Yamashita S, Saito R, Osawa SI, Niizuma K, Ukishiro K, Kanamori M, Kakinuma K, Suzuki K, Tominaga T

Neurologia medico-chirurgica 61 巻 ( 11 ) 頁： 661 - 666 2021年8月

[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 49 巻 ( 4 ) 頁： 847 - 856 2021年7月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：株式会社医学書院

Magnetic resonance(MR)-guided focused ultrasound ablation(FUS)is a minimally invasive technique for targeted tissue thermo-ablation and is promising for neuromodulation in various neurological disorders. The effectiveness and safety of this technique have been recognized worldwide. In Japan, the applications of FUS for the treatment of essential tremors and Parkinson's disease have recently been covered under health insurance. The FUS system is composed of a phased-array transducer with 1024 elements, with a beam of ultrasound emerging from each element. The phase and amplitude of the beam are computed and controlled to focus on the target with the calculation of computed tomography(CT)profiles, resulting in optimal thermo-ablation. To utilize FUS safely and effectively, a deep understanding of the physics of this technology is necessary. Furthermore, the technique should be compared with other options including deep brain stimulation(DBS)and radiofrequency thermo-ablation. Although FUS has received attention because of minimally invasive characteristics and a possibility of procedural target refinement, DBS has some advantages on bilateral implantation, a potential of postoperative adjustment, and control of head/leg tremors. In this article, we first reviewed the physics of FUS and demonstrated the typical treatment protocols. Second, we reviewed the outcomes from the existing literature, and revealed the advantages and disadvantages of this procedure, with the evaluation of the optimal condition for FUS.

DOI： 10.11477/mf.1436204463

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論文 - 齋藤 竜太

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論文 - 齋藤　竜太