研究者詳細 - 齋藤　竜太

論文 - 齋藤　竜太

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下垂体神経内分泌腫瘍(PitNET)オルガノイドモデルの樹立(Establishment of a pituitary neuroendocrine tumor organoid model)

前田紗知, 大岡史治, 齋藤竜太

日本癌学会総会記事 83回巻頁： P - 1283 2024年9月

脳腫瘍に対する全ゲノム解析(Whole-genome sequencing analysis of brain tumors)

鈴木啓道, 中島拓真, 舟越勇介, 金森政之, 柴原一陽, 鈴木智成, 木下学, 園田順彦, 荒川芳輝, 永根基雄, 田中將太, 石田穣治, 齋藤竜太, 花谷亮典, 吉本幸司, 成田善孝

日本癌学会総会記事 83回巻頁： S08 - 3 2024年9月

Intracranial Myeloid Sarcoma Arising Intraaxially From Acute Myeloid Leukemia: A Case Report and Literature Review 査読有り Open Access

Kageyama, A; Motomura, K; Motomura, A; Nakajima, Y; Tsujiuchi, T; Matsuo, M; Akahori, S; Watarai, M; Kojima, I; Saito, R

CUREUS JOURNAL OF MEDICAL SCIENCE 16 巻 ( 8 ) 頁： e67884 2024年8月

神経内視鏡画像における機能性下垂体腫瘍を含めた手術支援AIシステムの構築

布施佑太郎, 竹内和人, 橋本典明, 永田雄一, 永谷哲也, 竹内一郎, 齋藤竜太

日本内分泌学会雑誌 100 巻 ( S.HPT ) 頁： 19 - 21 2024年8月

The indication of palliative whole-brain radiotherapy for patients with brain metastases: a simple prognostic scoring system in the era of stereotactic radiosurgery 査読有り

Hirose, T; Deguchi, S; Yasui, K; Inoue, M; Onoe, T; Ogawa, H; Asakura, H; Mitsuya, K; Harada, H; Murayama, S; Hayashi, N; Nishimura, T; Saito, R

BMC CANCER 24 巻 ( 1 ) 頁： 940 2024年8月

記述言語：英語出版者・発行元：BMC Cancer

Background: Stereotactic irradiation has become the mainstay treatment for brain metastases (BM), and whole-brain radiotherapy (WBRT) is often used for symptom palliation. However, the survival time of patients with BM undergoing palliative WBRT (pWBRT) is limited, making it difficult to select patients who should receive treatment. Methods: We collected patient data from 2016 to 2022 at the Shizuoka Cancer Center and retrospectively analyzed the factors related to survival time. Overall survival (OS) was defined as the survival time after WBRT. Results: A total of 301 patients (median age, 66 years) who underwent pWBRT were included. The primary cancers were lung, breast, gastrointestinal tract, and other cancers in 203 (67%), 38 (13%), 33 (11%), and 27 (9%) patients, respectively. Median OS of all patients was 4.1 months. In the multivariate analysis, male sex (hazard ratio [HR]:1.4), Karnofsky Performance Status (KPS) ≤ 60 (HR:1.7), presence of extracranial metastasis (ECM) (HR:1.6), neutrophil-lymphocyte ratio (NLR) ≥ 5 (HR:1.6), and lactate dehydrogenase (LDH) ≥ upper limit of normal (ULN) (HR:1.3) were significantly associated with shorter OS (all P < 0.05). To predict the OS, we created a prognostic scoring system (PSS). We gave one point to each independent prognostic factor. Median OS for patients with scores of 0–2, 3, and 4–5 were 9.0, 3.5 and 1.7 months, respectively (P < 0.001). Conclusions: Male sex, KPS ≤ 60, presence of ECM, NLR ≥ 5, and LDH ≥ ULN were poor prognostic factors for patients with BM undergoing pWBRT. By PSS combining these factors, it may be possible to select patients who should undergo pWBRT.

DOI： 10.1186/s12885-024-12729-1

Web of Science

Scopus

PubMed

Tertiary Lymphoid Structures in Brain Metastases of Lung Cancer: Prognostic Significance and Correlation With Clinical Outcomes 査読有り国際誌

Nohira, S; Kuramitsu, S; Ohno, M; Fujita, M; Yamashita, K; Nagasaka, T; Haimoto, S; Sakakura, N; Matsushita, H; Saito, R

ANTICANCER RESEARCH 44 巻 ( 8 ) 頁： 3615 - 3621 2024年8月

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

Background/Aim: The prognosis of patients with brain metastases (BMs) originating from lung cancer remains poor, despite advancements in treatment strategies. The role of tertiary lymphoid structures (TLSs) within the tumor immune microenvironment of BMs has not been extensively explored. Patients and Methods: This study utilized patient-derived clinical samples from 17 patients with histologically confirmed BMs of lung cancer, undergoing surgical resection. Immunohistochemistry was employed to analyze the presence and characteristics of TLS and tumor-infiltrating lymphocytes (TILs) within BM tissues, correlating these with clinical outcomes. Results: TLSs, albeit in their immature form, were identified within BM tissues, distinguishing them from their mature counterparts in primary lung cancer tissues. A significant correlation between TLS density (but not TIL density) and improved postoperative survival was observed, underscoring the potential of TLS density as an independent prognostic marker. Furthermore, TLS density did not correlate with the Graded Prognostic Assessment (GPA) index, suggesting its unique prognostic value beyond conventional predictors. Conclusion: Our findings reveal the presence of TLSs in lung cancer-derived BMs and highlight their prognostic significance, independent of the GPA index. The identification of TLS within the unique central nervous system tumor microenvironment offers new insights into the immune landscape of BMs and suggests potential avenues for immunotherapeutic interventions targeting these structures to improve patient outcomes.

DOI： 10.21873/anticanres.17184

Clinical and molecular features of patients with <i>IDH1</i> wild-type primary glioblastoma presenting unexpected short-term survival after gross total resection 査読有り

Toyoda, M; Shibahara, I; Shigeeda, R; Fujitani, K; Tanihata, Y; Hyakutake, Y; Handa, H; Komai, H; Sato, S; Inukai, M; Hide, T; Shimoda, Y; Kanamori, M; Endo, H; Saito, R; Matsuda, KI; Sonoda, Y; Kumabe, T

JOURNAL OF NEURO-ONCOLOGY 169 巻 ( 1 ) 頁： 39 - 50 2024年8月

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

Background: This study investigated the factors influencing short-term survivors (STS) after gross total resection (GTR) in patients with IDH1 wild-type primary glioblastoma. Methods: We analyzed five independent cohorts who underwent GTR, including 83 patients from Kitasato University (K-cohort), and four validation cohorts of 148 patients from co-investigators (V-cohort), 66 patients from the Kansai Molecular Diagnosis Network for the Central Nervous System tumors, 109 patients from the Cancer Genome Atlas, and 40 patients from the Glioma Longitudinal AnalySiS. The study defined STS as those who had an overall survival ≤ 12 months after GTR with subsequent radiation therapy, and concurrent and adjuvant temozolomide (TMZ). Results: The study included 446 patients with glioblastoma. All cohorts experienced unexpected STS after GTR, with a range of 15.0–23.9% of the cases. Molecular profiling revealed no significant difference in major genetic alterations between the STS and non-STS groups, including MGMT, TERT, EGFR, PTEN, and CDKN2A. Clinically, the STS group had a higher incidence of non-local recurrence early in their treatment course, with 60.0% of non-local recurrence in the K-cohort and 43.5% in the V-cohort. Conclusions: The study revealed that unexpected STS after GTR in patients with glioblastoma is not uncommon and such tumors tend to present early non-local recurrence. Interestingly, we did not find any significant genetic alterations in the STS group, indicating that such major alterations are characteristics of GB rather than being reliable predictors for recurrence patterns or development of unexpected STS.

DOI： 10.1007/s11060-024-04687-2

その他リンク： https://link.springer.com/article/10.1007/s11060-024-04687-2/fulltext.html

Microsurgical Management of Craniocervical Dural Arteriovenous Fistula: A Case Report and Literature Review 査読有り Open Access

Araki, Y; Putra, MB; Tsukada, T; Niryana, IW; Saito, R

CUREUS JOURNAL OF MEDICAL SCIENCE 16 巻 ( 7 ) 頁： e65547 2024年7月

The Potential Role of Preoperative Posterior Cerebral Artery Involvement in Predicting Postoperative Transient Neurological Deficits and Ischemic Stroke After Indirect Revascularization in Patients With Moyamoya Disease 査読有り国際誌

Araki, Y; Yokoyama, K; Uda, K; Kanamori, F; Takayanagi, K; Ishii, K; Nishihori, M; Goto, S; Tsukada, T; Takeuchi, K; Tanahashi, K; Nagata, Y; Nishimura, Y; Tanei, T; Nagashima, Y; Muraoka, S; Izumi, T; Seki, Y; Saito, R

WORLD NEUROSURGERY 187 巻頁： E610 - E619 2024年7月

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

Objective: Transient neurological deficits (TNDs) are known to develop after direct bypass for Moyamoya disease and may be risk factors for subsequent stroke. However, the factors involved in the development of TNDs and stroke after indirect revascularization alone, including their association with subsequent stroke, remain unclear. The purpose of this study was to investigate this issue. Methods: The subjects of the study were 30 patients with Moyamoya disease who underwent a total of 40 indirect revascularization procedures at our institution. Clinical and radiological data were collected retrospectively. To examine factors associated with the development of postoperative TND/stroke/asymptomatic disease, the clinical characteristics of each group were statistically compared. Results: The mean age at surgery was 7 years (range 1–63). TNDs developed after surgery in 9 out of 40 patients (22.5%). Stroke in the acute postoperative period occurred in 3 patients (7.5%), all of whom experienced cerebral infarctions. Demographic data and preoperative clinical information were not different between the groups. However, posterior cerebral artery involvement on preoperative imaging was significantly associated with the development of TNDs and stroke (P = 0.006). Furthermore, postoperative stroke was associated with unfavorable outcomes (P = 0.025). Conclusions: Posterior cerebral artery involvement is significantly associated with the occurrence of TNDs. In contrast, TNDs after indirect revascularization have little relationship with the subsequent development of stroke. TNDs usually resolve without new strokes, and a better understanding of this particular pathology could help establish an optimal treatment regimen.

DOI： 10.1016/j.wneu.2024.04.135

[Prediction of the Natural Course of Meningioma Using CT and MR Images]. 査読有り

Deguchi S, Mitsuya K, Saito R

No shinkei geka. Neurological surgery 52 巻 ( 4 ) 頁： 699 - 704 2024年7月

Decreased heart rate variability in sympathetic dominant states in Parkinson's disease and isolated REM sleep behavior disorder 査読有り国際誌 Open Access

Suzuki, M; Nakamura, T; Ohba, C; Hatanaka, M; Tsuboi, T; Hirayama, M; Nakatsubo, D; Maesawa, S; Saito, R; Katsuno, M

PARKINSONISM & RELATED DISORDERS 124 巻頁： 107020 - 107020 2024年7月

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

Introduction: Parkinson's disease (PD) presents with decreased heart rate variability (HRV) from its early stages. However, most of its evidence originates from HRV measurements in parasympathetic dominant states. In this study, we aimed to examine whether HRV in sympathetic dominant states during the head-up tilt table test (HUT) serves as a marker of autonomic dysfunction in PD and isolated REM sleep behavior disorder (iRBD). Methods: We retrospectively assessed 102 patients with PD, 10 patients with iRBD, and 43 healthy controls. We then measured the coefficient of variation of RR intervals as an HRV parameter in sympathetic dominant states (CVRR-S) and parasympathetic dominant states (CVRR-P). Furthermore, we evaluated parameters of cardiac autonomic function, including HUT and the heart-to-mediastinum (H/M) ratio of cardiac metaiodobenzylguanidine scintigraphy. Results: Patients with iRBD and PD at Hoehn and Yahr stage I exhibited a significantly decreased CVRR-S compared to healthy controls (controls vs. iRBD vs. PD; 1.82 ± 0.64 % vs. 1.13 ± 0.41 % vs. 1.15 ± 0.51 %, p < 0.001), although no further deterioration was observed in PD at more severe Hoehn and Yahr stages. CVRR-S showed a significant correlation with the H/M ratio in PD (r = 0.51, p < 0.001). Additionally, receiver operating characteristic (ROC) analysis revealed a larger area under the ROC curve in CVRR-S compared to that in CVRR-P for discriminating PD or iRBD from healthy controls. Conclusion: HRV in sympathetic dominant states shows the potential to be a marker of autonomic dysfunction in iRBD and early-stage PD, aiding in early diagnosis and patient stratification.

DOI： 10.1016/j.parkreldis.2024.107020

Epilepsy in Patients with Gliomas Open Access

Ehara, T; Ohka, F; Motomura, K; Saito, R

NEUROLOGIA MEDICO-CHIRURGICA 64 巻 ( 7 ) 頁： 253 - 260 2024年7月

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

Brain tumor-related epilepsy (BTRE) is a complication that significantly impairs the quality of life and course of treatment of patients with brain tumors. Several recent studies have shed further light on the mechanisms and pathways by which genes and biological molecules in the tumor microenviron-ment can cause epilepsy. Moreover, epileptic seizures have been found to promote the growth of brain tumors, making the control of epilepsy a critical factor in treating brain tumors. In this study, we summarize the previous research and recent findings concerning BTRE. Expectedly, a deeper under-standing of the underlying genetic and molecular mechanisms leads to safer and more effective treatments for suppressing epileptic symptoms and tumor growth.

DOI： 10.2176/jns-nmc.2023-0299

Navigation-assisted occipitocervical fixation and decompression in a patient with polyostotic fibrous dysplasia 査読有り国際誌 Open Access

Nagashima, Y; Nishimura, Y; Abe, T; Saito, R

JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 15 巻 ( 3 ) 頁： 380 - 383 2024年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Craniovertebral Junction and Spine

Fibrous dysplasia (FD) is a rare skeletal disorder characterized by the replacement of normal bone with fibrous connective tissue, leading to abnormal bone formation. This case report details the successful treatment of a 61-year-old woman with FD at the craniovertebral junction (CVJ). The patient, who had a history of intracranial meningioma and had already been diagnosed with FD, experienced worsening gait disturbance and muscle weakness following a fall. Imaging studies revealed extensive polyostotic FD lesions in the skull and cervical spine, along with a C2 odontoid fracture causing spinal cord compression. The patient underwent occipitocervical fixation and decompression surgery. Intraoperative O-arm navigation was used to ensure accurate screw placement and effective decompression. This procedure allowed for proper positioning of the C2 and C3 pedicle screws, resection of the hyperplastic occipital bone and C1 posterior arch, and placement of the occipital plate with avoiding the cyst components. At a 2-year follow-up, there were no signs of screw loosening, and the patient showed marked clinical improvement. This case emphasizes the importance of tailored surgical strategies and the use of advanced navigational technologies in managing complex FD cases, particularly those involving the CVJ. It also highlights the challenges of treating polyostotic FD, where complete resection is often unfeasible. The successful outcome in this case supports the use of decompressive surgery combined with stabilization to relieve symptoms and prevent further complications.

DOI： 10.4103/jcvjs.jcvjs_104_24

振戦特性に基づくジストニア性振戦とパーキンソン病の臨床的鑑別

坪井崇, 澤田桂都, 星野聖奈, 樋口萌花, 橋田美紀, 武藤学, 伊藤芳記, 石崎友崇, 加藤祥子, 中坪大輔, 津川隆彦, 前澤聡, 佐藤茉紀, 福島大喜, 玉腰大悟, 平賀経太, 植松高史, 鈴木将史, 齋藤竜太, 勝野雅央

パーキンソン病・運動障害疾患コングレスプログラム・抄録集 18回巻頁： 104 - 104 2024年7月

Case report: Endoscopic endonasal transposterior clinoid approach for resection of posterior clinoid process meningioma: technical notes and literature review 査読有り国際誌 Open Access

Awyono, S; Takeuchi, K; Ito, E; Nagata, Y; Golden, N; Mahadewa, TGB; Saito, R

FRONTIERS IN ONCOLOGY 14 巻頁： 1368277 - 1368277 2024年6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 Oncology

Background: Posterior clinoid process (PCP) meningioma is an exceedingly rare entity. It remains the most challenging skull base lesion for neurosurgeons due to its treacherous location that insinuates amongst critical neurovascular structures. This article will describe the technical notes using the endoscopic endonasal approach that provide the earliest devascularization and detachment of the tumor PCP meningioma. Methods: We are introducing the surgical implementation of an endoscopic endonasal approach to removing PCP meningioma. Furthermore, we perform a literature review of posterior clinoid process meningioma that undergoes surgical intervention, then summarize the benefits and limitations of each approach. Results: We present a case of right PCP meningioma that was removed using an endoscopic endonasal approach through the transposterior clinoid corridor in a 52-year-old-woman. We describe the technical notes in performing this approach to have the earliest devascularization and detachment of the tumor by performing posterior clinoidectomy. Safe tumor removal is performed with a wide and clear view of the surrounding neurovascular structure. Based on our database search, we found nine articles reported on the surgical management of PCP meningiomas, with a total number of 15 cases. All of the reported cases performed the tumor removal using the transcranial approach. Conclusion: The endoscopic endonasal transposterior clinoid approach circumvents all disadvantages faced by the traditional transcranial approach, providing the earliest approach to devascularized and detaching the tumor from its attachment at PCP. This approach demonstrates safety and efficacy, making it an acceptable alternative for PCP meningioma resections.

DOI： 10.3389/fonc.2024.1368277

特集頭蓋頸椎移行部病変頭蓋頸椎移行部の解剖学的特徴(正常解剖)

西村由介, 齋藤竜太

脊椎脊髄ジャーナル 37 巻 ( 4 ) 頁： 216 - 223 2024年5月

Protective Mechanism of Stem Cells from Human Exfoliated Deciduous Teeth in Treating Spinal Cord Injury 査読有り

Nishii, T; Osuka, K; Nishimura, Y; Ohmichi, Y; Ohmichi, M; Suzuki, C; Nagashima, Y; Oyama, T; Abe, T; Kato, H; Saito, R

JOURNAL OF NEUROTRAUMA 41 巻 ( 9-10 ) 頁： 1196 - 1210 2024年5月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Neurotrauma

Spinal cord injury (SCI) induces devastating permanent deficits. Recently, cell transplantation therapy has become a notable treatment for SCI. Although stem cells from human exfoliated deciduous teeth (SHED) are an attractive therapy, their precise mechanism of action remains to be elucidated. In this study, we explored one of the neuroprotective mechanisms of SHED treatment at the subacute stage after SCI. We used a rat clip compression SCI model. The animals were randomly divided into three groups: SCI, SCI + phosphate-buffered saline (PBS), and SCI + SHED. The SHED or PBS intramedullary injection was administered immediately after SCI. After SCI, we explored the effects of SHED on motor function, as assessed by the Basso-Beattie-Bresnahan score and the inclined plane method, the signal transduction pathway, especially the Janus kinase (JAK) and the signal transducer and activator of transcription 3 (STAT3) pathway, the apoptotic pathway, and the expression of neurocan, one of the chondroitin sulfate proteoglycans. SHED treatment significantly improved functional recovery from Day 14 relative to the controls. Western blot analysis showed that SHED significantly reduced the expression of glial fibrillary acidic protein (GFAP) and phosphorylated STAT3 (p-STAT3) at Tyr705 on Day 10 but not on Day 5. However, SHED had no effect on the expression levels of Iba-1 on Days 5 or 10. Immunohistochemistry revealed that p-STAT3 at Tyr705 was mainly expressed in GFAP-positive astrocytes on Day 10 after SCI, and its expression was reduced by administration of SHED. Moreover, SHED treatment significantly induced expression of cleaved caspase 3 in GFAP-positive astrocytes only in the epicenter lesions on Day 10 after SCI but not on Day 5. The expression of neurocan was also significantly reduced by SHED injection on Day 10 after SCI. Our results show that SHED plays an important role in reducing astrogliosis and glial scar formation between Days 5 and 10 after SCI, possibly via apoptosis of astrocytes, ultimately resulting in improvement in neurological functions thereafter. Our data revealed one of the neuroprotective mechanisms of SHED at the subacute stage after SCI, which improved functional recovery after SCI, a serious condition.

DOI： 10.1089/neu.2023.0251

Risk factors for nausea and vomiting requiring the daily administration of 5-HT<sub>3</sub> receptor antagonists in radiotherapy combined with temozolomide for high-grade glioma 査読有り Open Access

Takagi, M; Sagara, A; Kumakura, Y; Watanabe, M; Inoue, R; Miyazaki, M; Ohka, F; Motomura, K; Natsume, A; Wakabayashi, T; Saito, R; Yamada, K

NAGOYA JOURNAL OF MEDICAL SCIENCE 86 巻 ( 2 ) 頁： 304 - 313 2024年5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：Nagoya Journal of Medical Science

Radiotherapy combined with temozolomide (TMZ+RT) is the primary treatment for high-grade glioma. TMZ is classified as a moderate emetic risk agent and, thus, supportive care for nausea and vomiting is important. In Nagoya University Hospital, all patients are treated with a 5-hydroxy-tryptamine 3 receptor antagonist (5-HT3RA) for the first 3 days. The daily administration of 5-HT3RA is resumed after the 4th day based on the condition of patients during TMZ+RT. Therefore, the present study investigated risk factors for nausea and vomiting in patients requiring the daily administration of 5-HT3RA. Patients with high-grade glioma who received TMZ+RT between January 2014 and December 2019 at our hospital were included. Patients were divided into two groups: a control group (patients who did not resume 5-HT3RA) and resuming 5-HT3RA group (patients who resumed 5-HT3RA after the 4th day), and both groups were compared to identify risk factors for nausea and vomiting during TMZ+RT. There were 78 patients in the control group (68%) and 36 in the resuming 5-HT3RA group (32%). A multivariate analysis of patient backgrounds in the two groups identified age <18 years, PS 2 or more, and occipital lobe tumors as risk factors for nausea and vomiting. Nausea and vomiting were attenuated in 30 patients (83%) in the resuming 5-HT3RA group following the resumption of 5-HT3RA. The results obtained highlight the importance of extracting patients with these risk factors before the initiation of therapy and the early resumption or daily administration of 5-HT3RA according to the condition of each patient.

DOI： 10.18999/nagjms.86.2.304

Hormone Concentration Measurement in Intracranial Dural Arteriovenous Fistulae 査読有り

Kropp, AE; Nishihori, M; Izumi, T; Goto, S; Yokoyama, K; Saito, R

WORLD NEUROSURGERY 185 巻頁： E451 - E460 2024年5月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：World Neurosurgery

Objective: Intracranial dural arteriovenous fistulae (DAVFs) represent a subset of cerebral vascular malformations associated with significant morbidity and mortality. In Japan, DAVF exhibits sex-based differences in anatomical distribution, with female predominance in the cavernous sinus (CS) and male predominance in the transverse sinus (TS). Nevertheless, the pathophysiology of DAVF is not fully understood, and hormonal influences are hypothesized to play a role in its development. This study aimed to investigate changes in the concentrations of sex steroid hormones between intracranial and peripheral sampling sites in patients with CS- and TS-DAVF. Methods: We recruited 19 patients with CS-DAVF (n = 12) and TS-DAVF (n = 7) in this study. Blood hormone measurements were obtained from peripheral and jugular bulb samples during endovascular intervention. Hormone concentrations were analyzed using enzyme-linked immunosorbent assay kits, and statistical analyses were performed. Results: Our study revealed a higher prevalence of CS-DAVF in females and TS-DAVF in males, which is consistent with previous studies. Estradiol concentration was significantly lower in the jugular bulb compared with in the periphery in both patients with CS- and TS-DAVF. This decrease in estradiol was observed irrespective of the patient's sex and independent of follicle-stimulating hormone levels. Conclusions: These findings indicate a local decrease in estradiol levels within the intracranial vasculature of patients with DAVF. This suggests a potential multifactorial role of estradiol in the pathomechanism of DAVFs, warranting further investigation to understand its influence on DAVF formation and potential targeted therapies, thereby enhancing patient outcomes.

DOI： 10.1016/J.WNEu.2024.02.052

Giant pituitary neuroendocrine tumor治療における合併症

永田雄一, 竹内和人, 伊藤英治, 原田英幸, 近藤辰磨, 齋藤竜太

日本内分泌学会雑誌 100 巻 ( 1 ) 頁： 332 - 332 2024年5月

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