Faculty Profiles - SAITO Ryuta

Papers - SAITO Ryuta

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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

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

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.

DOI： 10.1007/s00701-021-04984-z

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

Satoshi Maesawa, Daisuke Nakatsubo, Takahiko Tsugawa, Sachiko Kato, Masashi Shibata, Sou Takai, Jun Torii, Tomotaka Ishizaki, Toshihiko Wakabayashi, Ryuta Saito

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

Language：English Publishing type：Research paper (scientific journal) Publisher：The Japan Neurosurgical Society

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. International journal Open Access

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

Neuro-oncology Vol. 23 ( 11 ) page： 1936 - 1948 2021.11

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

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. International journal Open Access

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

Biochemical and biophysical research communications Vol. 574 page： 8 - 13 2021.10

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

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 of the Flow-diverter Device. Open Access

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

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

Language：English Publishing type：Research paper (scientific journal) Publisher：The Japan Neurosurgical Society

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.

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 Vol. 97 ( S.HPT ) page： 49 - 51 2021.9

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

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

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

Cancer research Vol. 81 ( 18 ) page： 4861 - 4873 2021.9

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

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 genome-wide 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. SIGNIFICANCE: A mathematical model successfully estimates malignant transformation-free survival and reveals a link between genetic alterations and progression, identifying precision medicine approaches for optimal treatment of IDH-mutant low-grade gliomas.

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. Open Access

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 2021.8

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

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.

DOI： 10.2176/nmc.tn.2021-0054

Open Access

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

Satoshi Maesawa, Daisuke Nakatsubo, Takahiko Tsugawa, Sachiko Kato, Masashi Shibata, Sou Takai, Jun Torii, Toshihiko Wakabayashi, Ryuta Saito

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

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

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

PubMed

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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

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

In previous studies, isocitrate dehydrogenase (IDH) mutations were associated with tumor-associated epilepsy (TAE) and venous thromboembolism (VTE). We examined the relationship between IDH mutations in grade II/III astrocytomas and TAE/VTE according to the 2016 World Health Organization classification. The clinical data of patients with newly diagnosed grade II/III gliomas who were treated at Tohoku University Hospital from January 2010 to December 2018 were reviewed. Associations between TAE or VTE and the clinical/biological characteristics, histology, and IDH1/2 mutational status in patients with grade II/III gliomas were evaluated. Of the initial 137 patients (290 hospitalizations), 117 patients (203 hospitalizations) were included in the TAE group and 124 patients (213 hospitalizations) were included in the VTE group. Seventy-eight patients (66.7%) in the TAE group were diagnosed with astrocytoma and 38/78 (48.3%) presented with TAE. According to the multivariable analysis, the IDH mutational status and male sex were associated independently with an increased risk of TAE (p < 0.05). Eighty-five patients (68.5%) in the VTE group were diagnosed with astrocytoma. VTE was observed in 16/161 (9.9%) hospitalizations. According to the multivariable analysis, age, diffuse astrocytoma histology, and resection were associated independently with an increased risk of VTE. The decision tree analysis showed that TAE was more frequent in younger patients while VTE was more frequent in older patients. This study demonstrated that the IDH mutational status was associated with TAE but not with VTE. Therefore, a future large-scale study is needed to provide sufficient evidence. TAE was more common in young patients, while VTE was more common in the elderly.

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

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

Impact of the extent of resection on the survival of patients with grade II and III gliomas using awake brain mapping. International journal Open Access

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

Journal of neuro-oncology Vol. 153 ( 2 ) page： 361 - 372 2021.6

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

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

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 International journal

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

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

BACKGROUND: Postoperative motor deficits are among the worst morbidities of glioma surgery. We aim to investigate factors associated with postoperative motor deficits in patients with frontoparietal opercular gliomas. METHODS: Thirty-four patients with frontoparietal opercular gliomas were retrospectively investigated. We examined the postoperative ischemic changes and locations obtained from MRI. RESULTS: Twenty-one patients (62%) presented postoperative ischemic changes. Postoperative MRI was featured with ischemic changes, all located at the subcortical area of the resection cavity. Six patients had postoperative motor deficits, whereas 28 patients did not. Compared to those without motor deficits, those with motor deficits were associated with old age, pre- and postcentral gyri resection, and postcentral gyrus resection (P = 0.023, 0,024, and 0.0060, respectively). A merged image of the resected cavity and T1-weighted brain atlas of the Montreal Neurological Institute showed that a critical area for postoperative motor deficits is the origin of the long insular arteries (LIAs) and the postcentral gyrus. Detail anatomical architecture created by the Human Connectome Project database and T2-weighted images showed that the subcortical area of the operculum of the postcentral gyrus is where the medullary arteries supply, and the motor pathways originated from the precentral gyrus run. CONCLUSIONS: We verified that the origin of the LIAs could damage the descending motor pathways during the resection of frontoparietal opercular gliomas. Also, we identified that motor pathways run the subcortical area of the operculum of the postcentral gyrus, indicating that the postcentral gyrus is an unrecognized area of damaging the descending motor pathways.

DOI： 10.1007/s00701-021-04737-y

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

[Chemotherapy for Glioma].

Ryuta Saito

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

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

Chemotherapeutic treatment of malignant gliomas is extremely challenging. Tumor accumulation of systemically-administrated chemotherapy is always hindered by the blood-brain barrier(BBB). Although temozolomide administered orally or intravenously represents the standard of care for malignant gliomas, its efficacy is unsatisfactory. Local chemotherapy bypasses the BBB and, therefore, achieves a high drug concentration at the site the drug is administered. Carmustine wafers are clinically available local chemotherapeutic agents. However, their efficacy is limited because of limited drug penetration into the tumor. Combined with the highly chemoresistant features of glioma itself, ongoing chemotherapy is far from satisfactory in terms of efficacy. This review covers several important issues regarding temozolomide chemotherapy, including the reactivation of hepatitis B virus, assessment of MGMT promoter methylation, and pseudo-progression. Local chemotherapy for newly diagnosed resectable glioblastoma cases using carmustine wafers is currently under investigation with a randomized phase 3 trial (JCOG 1703), which will also be discussed. In addition, recent progress in convection-enhanced delivery of chemotherapeutics against gliomas has also been reported. Development of an alternative strategy to effectively deliver drugs to the tumor site may improve the efficacy of chemotherapy against gliomas in the near future.

DOI： 10.11477/mf.1436204432

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高速リアルタイムPCR法を用いた迅速IDH1、H3F3A、BRAF遺伝子変異解析

大岡史治, 北野詳太郎, 本村和也, 清水浩之, 棚橋邦明, 青木恒介, 平野雅規, 山口純矢, 夏目敦至, 齋藤竜太

Brain Tumor Pathology Vol. 38 ( Suppl. ) page： 075 - 075 2021.5

中枢神経系原発悪性リンパ腫におけるMYD88/CD79b変異の臨床的意義と迅速変異検出システムの開発

山口純矢, 大岡史治, 清水浩之, 平野雅規, 青木恒介, 棚橋邦明, 本村和也, 夏目敦至, 齋藤竜太

Brain Tumor Pathology Vol. 38 ( Suppl. ) page： 072 - 072 2021.5

側脳室下角に存在する脈絡叢腫瘍に対する島下境界溝を介した摘出術

柴原一陽, 百武佑理, 豊田茉梨子, 半田肇, 猿田和貴子, 犬飼円, 佐藤澄人, 秀拓一郎, 齋藤竜太, 金森政之, 園田順彦, 冨永悌二, 隈部俊宏

小児の脳神経 Vol. 46 ( 2 ) page： 179 - 179 2021.4

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 Open Access

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

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

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

Open Access

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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

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

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

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Papers - SAITO Ryuta