2021/05/15 更新

写真a

サノ マサカズ
佐野 正和
SANO Masakazu
所属
医歯学総合病院 脳神経外科 助教
職名
助教
外部リンク

学位

  • 博士(医学) ( 2008年3月   新潟大学 )

経歴(researchmap)

  • 新潟大学医歯学総合病院   脳神経外科

    2016年10月 - 現在

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経歴

  • 新潟大学   医歯学総合病院 脳神経外科   助教

    2016年10月 - 現在

学歴

  • 新潟大学大学院   医歯学総合研究科   分子細胞医学専攻

    2004年4月 - 2008年3月

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  • 新潟大学   医学部   医学科

    - 2001年3月

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論文

  • De Novo Pineal Region Germinoma in the Seventh Decade of Life: A Case Report.

    Masakazu Sano, Shinya Jinguji, Junichi Yoshimura, Kouichirou Okamoto, Yukihiko Fujii

    NMC case report journal6 ( 3 ) 75 - 78   2019年8月

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    記述言語:英語  

    Germ cell tumors typically occur in children and adolescents. We here report a rare case of de novo pineal region germinoma in the seventh decade of life. A 62-year-old man presented with double vision. Computerized tomography and magnetic resonance imaging (MRI) identified a heterogeneously enhanced tumor with calcification in the pineal region with ventricular dilatation due to aqueduct stenosis. The tumor had not been observed at all on MRI obtained 2 years previously. The patient underwent endoscopic biopsy and third ventriculostomy for the obstructive hydrocephalus. The tumor was histopathologically diagnosed as a pure germinoma. The patient underwent radiomonotherapy, resulting in his complete remission, which was confirmed by a series of follow-up MRI studies and hematological examinations. Intracranial germinoma should be considered in the differential diagnosis of pineal region tumors regardless of age, even though the tumor was undetectable on the previous neuroimaging.

    DOI: 10.2176/nmccrj.cr.2018-0221

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  • Polysomnography as an indicator for cervicomedullary decompression to treat foramen magnum stenosis in achondroplasia. 国際誌

    Masakazu Sano, Nao Takahashi, Keisuke Nagasaki, Makoto Oishi, Junichi Yoshimura, Yukihiko Fujii

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery34 ( 11 ) 2275 - 2281   2018年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: Management of cervicomedullary compression due to foramen magnum stenosis in achondroplasia remains controversial, especially for patients with no symptoms or mild symptoms. We examined the effectiveness of polysomnography (PSG) as an indicator for cervicomedullary decompression treatment. METHODS: We retrospectively reviewed nine achondroplasia cases (mean age 1 year and 9 months) treated from 2008 to 2015. All patients were examined by PSG, magnetic resonance imaging (MRI), and otolaryngeal fibroscopy. We analyzed demographic data, clinical presentation, degree and type of respiratory impairment, severity of foramen magnum stenosis and concomitant cervicomedullary compression, treatment (conservative or surgical), and clinical outcome. RESULTS: Eight of nine patients presented with no severe symptoms in the daytime. However, MRI revealed four severe, four moderate, and one mild case of cervicomedullary compression, and PSG demonstrated severe sleep apnea in four cases and moderate sleep apnea in five cases. All sleep apnea cases were obstructive or obstructive-dominant. Fibroscopy revealed no upper airway stenosis in six cases and mild stenosis in three cases. Four patients who had severe sleep-related respiratory disturbance on PSG and severe or moderate cervicomedullary compression were treated by cervicomedullary decompression. Three of these patients demonstrated improved sleep respiration soon after surgery, while one required temporary tracheostomy due to bilateral vocal cord paralysis caused by compression during intratracheal intubation. CONCLUSION: Polysomnography can be a useful indicator for cervicomedullary decompression surgery, especially in cases of seemingly asymptomatic achondroplasia with severe foramen magnum stenosis.

    DOI: 10.1007/s00381-018-3880-0

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  • The prevalence of calcification around odontoid process and the incidence of crowned dens syndrome in the neurosurgical ward: A single institution's analysis. 国際誌

    Masakazu Sano, Shinya Yamashita, Toyotaka Aiba

    Modern rheumatology28 ( 1 ) 182 - 187   2018年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: The objective of this study is to assess the prevalence and natural history of odontoid calcification and to identify factors related to its progression to crowned dens syndrome (CDS). METHODS: We reviewed a consecutive series of patients who underwent head CT upon admission to the neurosurgical ward of Niigata Prefectural Shibata Hospital. We evaluated the relationship between the presence of odontoid calcification and the patient's age, sex, and primary disorder for admission. The incidence of CDS was also determined, and factors related to the progression of odontoid calcification to CDS were analyzed. RESULTS: Odontoid calcifications were found in 88 out of 554 patients (15.9%) undergoing CT scans. Age, female, and stroke were predictive of odontoid calcification. The odds ratios (95% CIs) for age, female, and stroke estimated from the logistic analysis were 1.084 (1.054-1.114; p < .0001), 1.746 (1.06-2.875; p = .029), and 1.909 (1.123-3.247; p = .017), respectively. Eleven (12.5%) of the 88 patients with odontoid calcification developed CDS. The age, sex, and primary disorder for admission were not associated with the onset of CDS. CONCLUSIONS: Odontoid calcification is observed incidentally on head CT. Clinicians should keep in mind that patients with odontoid calcification might develop CDS, even if they are asymptomatic at the time of CT examination.

    DOI: 10.1080/14397595.2017.1316461

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  • Adult Chiari Type 1 Malformation with Holocord Syringomyelia Associated with Sagittal Synostosis.

    Masakazu Sano, Junichi Yoshimura, Yukihiko Fujii

    NMC case report journal5 ( 1 ) 27 - 30   2018年1月

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    記述言語:英語  

    Craniosynostosis associated with Chiari malformation (CM) is usually found in infants with an underdeveloped posterior fossa. We here present a case of adult craniosynostosis, CM, and symptomatic syringomyelia caused by the protrusion of the posterior rim of the foramen magnum without a tight posterior fossa. A 22-year-old woman with an abnormal head shape and forearm hypesthesia was given a diagnosis of sagittal suture synostosis with CM and syringomyelia caused by foramen magnum stenosis. She underwent foramen magnum decompression with a C1 laminectomy without cranial vault expansion or duraplasty. Her symptoms and radiographical findings improved after surgery. In cases of non-operative craniosynostosis with CM, clinicians should be alert to late-onset syringomyelia and choose surgical strategies according to the pathophysiology.

    DOI: 10.2176/nmccrj.cr.2017-0013

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  • Third Ventricle Germ Cell Tumor Originating from the Infundibulum with Rapidly Expansive Enlargement. 国際誌

    Yuichiro Yoneoka, Junichi Yoshimura, Masakazu Sano, Masayasu Okada, Akiyoshi Kakita, Yukihiko Fujii

    Pediatric neurosurgery53 ( 1 ) 49 - 54   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We present a pediatric case of a rapidly expanding third ventricle germ cell tumor (GCT). A 14-year-old boy suffered from gradual-onset central diabetes insipidus (DI) and received desmopressin treatment. Magnetic resonance imaging (MRI) showed nonspecific findings of the pituitary-hypothalamic axis. Nine months after the initial DI diagnosis, he developed progressively worsening headache. MRI demonstrated a third ventricle tumor causing noncommunicating hydrocephalus, although an MRI 16 weeks before admission did not show the lesion. We performed gross total resection (GTR) of the tumor in 2 stages: a translamina terminalis approach and an extended transsphenoidal approach. The lesion was histologically diagnosed as immature teratoma with some germinoma. His noncommunicating hydrocephalus resolved after surgery. Through postoperative radiochemotherapy (whole ventricle: 23.4 Gy/13 fractions, tumor bed: 27.0 Gy/15 fractions, and 3 courses of carboplatin-etoposide), he has was in complete remission at the 3-year follow-up and has continued his high school program. This case suggests the following: (1) a mixed GCT originating from the neurohypophysis/infundibulum can show rapidly expansive growth in a child with central DI; (2) GTR and adjuvant radiochemotherapy can result in a good therapeutic outcome in rapidly expanding GCT; and (3) the extended transsphenoidal approach is a complementary approach to transcranial resection of anterior third ventricle GCTs.

    DOI: 10.1159/000480021

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  • Long-term survivors of primary central nervous system lymphoma. 国際誌

    Ryuya Yamanaka, Ken Morii, Masakazu Sano, Jumpei Homma, Naoki Yajima, Yoshihiro Tsukamoto, Ryouske Ogura, Manabu Natsumeda, Hiroshi Aoki, Katsuhiko Akiyama, Takafumi Saitoh, Hiroaki Hondoh, Atsushi Kawaguchi, Hitoshi Takahashi, Yukihiko Fujii

    Japanese journal of clinical oncology47 ( 2 ) 101 - 107   2017年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Objective: In this study, we provide long-term outcome data of patients with primary central nervous system lymphoma. Methods: The long-term outcomes of PCNSL patients diagnosed between 1982 and 2006 were reviewed. Neurological late neurotoxicity symptoms, neuroradiological brain atrophy and leukoencephalopathy were evaluated. Surviving patients completed the Quality of Life Questionnaire-30 and Brain Cancer Module-20. The differences in overall survival were assessed using the Kaplan-Meier method and log-rank test. The differences between groups in terms of each investigated parameter were analyzed using the Wilcoxon signed-rank test. Results: Among 112 PCNSL patients, there were 33 (29.4%) long-term (> 5 years) survivors. The median survival of all long-term survivors was 105.7 months; of these, 8 (7.1%) were alive at the latest follow-up, with a mean survival time of 170.2 months (range, 121.8–286.4). Clinical assessment revealed severe neurotoxicity in 14 patients (42.4%), moderate neurotoxicity in 5 (15.1%), and normal status in 14 (42.4%). Correlations were seen between the neuroradiological imaging score changes and neurocognitive condition (P=0.0001), neurocognitive condition and the whole brain irradiation dose (P=0.0004), and atrophy and the whole brain irradiation dose (P=0.0035). Conclusions: A more severe clinical condition was found to be associated with increasing age and whole brain irradiation dose in long-term survivors with PCNSL.

    DOI: 10.1093/jjco/hyw171

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  • Late relapse of primary central nervous system lymphoma. 国際誌

    Ryuya Yamanaka, Ken Morii, Yoshikatsu Shinbo, Masakazu Sano, Jumpei Homma, Naoto Tsuchiya, Naoki Yajima, Yoshihiro Tsukamoto, Ryouske Ogura, Manabu Natsumeda, Hiroshi Aoki, Katsuhiko Akiyama, Takafumi Saitoh, Tetsuro Tamura, Hiroaki Hondoh, Atsushi Kawaguchi, Hitoshi Takahashi, Yukihiko Fujii

    Leukemia & lymphoma58 ( 2 ) 475 - 477   2017年2月

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    記述言語:英語  

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  • Long-term outcomes in patients with pineal nongerminomatous malignant germ cell tumors treated by radical resection during initial treatment combined with adjuvant therapy. 国際誌

    Shinya Jinguji, Junichi Yoshimura, Kenichi Nishiyama, Yuichiro Yoneoka, Masakazu Sano, Masafumi Fukuda, Yukihiko Fujii

    Acta neurochirurgica157 ( 12 ) 2175 - 83   2015年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: For pineal nongerminomatous malignant germ cell tumors (NGMGCTs), we mainly performed radical tumor resection during initial treatment combined with adjuvant therapy. METHODS: We retrospectively analyzed 17 patients treated for pineal NGMGCTs between 1986 and 2007 at the University of Niigata. RESULTS: Twelve patients underwent total or subtotal resection of their tumor via the occipital transtentorial approach. Five patients underwent partial resection, and four of them later underwent total resection by salvage surgery. After surgery, eight patients were treated with combined radiochemotherapy including whole-brain irradiation, two received radiation monotherapy, one had chemotherapy with local irradiation, and six were treated with chemotherapy alone. The median follow-up period for surviving patients was 179 months. The 10-year overall survival and progression-free survival rates for the radiochemotherapy group were both 75.0 % (two patients had a recurrence and died); the rates for other adjuvant therapies were 77.8 % (two died) and 22.2 % (seven had a recurrence), respectively. Radiochemotherapy was significantly associated with an increased rate of progression-free survival compared with the other adjuvant therapies (p = 0.0396). CONCLUSIONS: For pineal NGMGCTs, initial treatment strategies including gross total resection of the tumor before or after whole-brain irradiation and chemotherapy provided good therapeutic outcomes. Obtaining complete remission of the primary tumor, irrespective of the timing of surgical resection (i.e., before or after adjuvant therapies), or complete response by neoadjuvant radiochemotherapy during an initial treatment appears to be essential for improving therapeutic outcomes of intracranial NGMGCTs.

    DOI: 10.1007/s00701-015-2614-2

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  • Successful removal of a huge hypervascular tentorial cavernous angioma after preoperative endovascular embolization. 国際誌

    Junichi Yoshimura, Yoshihiro Tsukamoto, Masakazu Sano, Hitoshi Hasegawa, Kazuhiko Nishino, Akihiko Saito, Masafumi Fukuda, Kouichirou Okamoto, Yukihiko Fujii

    Journal of neurosurgery. Pediatrics14 ( 1 ) 43 - 7   2014年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The authors report a rare case of a huge hypervascular tentorial cavernous angioma treated with preoperative endovascular embolization, followed by successful gross-total removal. A 15-year-old girl presented with scintillation, diplopia, and papilledema. Computed tomography and MRI studies revealed a huge irregularly shaped tumor located in the right occipital and suboccipital regions. The tumor, which had both intra- and extradural components, showed marked enhancement and invasion of the overlying occipital bone. Angiography revealed marked tumor stain, with blood supply mainly from a large branch of the left posterior meningeal artery. Therefore, this lesion was diagnosed as a tentorium-based extraaxial tumor. For differential diagnosis, meningioma, hemangiopericytoma, and malignant skull tumor were considered. Tumor feeders were endovascularly embolized with particles of polyvinyl alcohol. On the following day, the tumor was safely gross totally removed with minimum blood loss. Histopathological examination confirmed the diagnosis of cavernous angioma. To date, there have been no reports of tentorium-based cavernous angiomas endovascularly embolized preoperatively. A tentorial cavernous angioma is most likely to show massive intraoperative bleeding. Therefore, preoperative embolization appears to be quite useful for safe maximum resection. Hence, the authors assert that the differential diagnosis of tentorium-based tumors should include tentorial cavernous angioma, for which preoperative endovascular embolization should be considered.

    DOI: 10.3171/2014.4.PEDS13628

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  • Intraspinal lesions associated with sacrococcygeal dimples. 国際誌

    Atsuko Harada, Kenichi Nishiyama, Junichi Yoshimura, Masakazu Sano, Yukihiko Fujii

    Journal of neurosurgery. Pediatrics14 ( 1 ) 81 - 6   2014年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    UNLABELLED: OBJECT.: Sacrococcygeal dimples in the gluteal fold, also known as coccygeal pits, are observed in 2%-4% of newborns. Sacrococcygeal dimples are not generally considered to be associated with a significant risk of intraspinal anomalies and therefore are not thought to require further radiographic evaluation. Accordingly, the precise incidence and nature of intraspinal lesions that may be associated with sacrococcygeal dimples is unclear. This study was conducted to determine the incidence of intraspinal lesions in patients with intergluteal dimples. METHODS: In this study, the authors used MRI to evaluate 103 children who were seen at the Niigata University Medical and Dental Hospital between 2006 and 2011 because of skin abnormalities in the lumbosacral region. Of these children, 14 were excluded as having a subcutaneous fatty mass, and 5 were excluded because the dimples were above the gluteal fold or did not end at the coccyx. The remaining 84 patients were classified according to whether the bottom of the dimple was visible (shallow) or not (deep). The authors also retrospectively examined other skin abnormalities and coexisting anomalies. RESULTS: The mean age at the time of MRI evaluation was 11.7 months. Magnetic resonance imaging led to the identification of fibrolipoma of the terminal filum (FTF) in 14 cases (16.7%); 6 of these patients also had a low conus. Classified by depth, there were 58 cases with shallow and 26 with deep dimples. Fibrolipoma of the terminal filum was found in significantly more patients with deep dimples (9 [34.6%]) than in those with shallow dimples (5 [8.6%]). The frequency of other congenital anomalies was significantly higher in patients with FTF-associated dimples (6 [42.9%] of 14) than in those with dimples that were not associated with FTF (9 [12.9%] of 70). CONCLUSIONS: Fibrolipoma of the terminal filum was identified by MRI in 16.7% of patients with sacrococcygeal dimples. The risk of FTF increased when the dimples were deeply excavated or were accompanied by congenital anomalies. Magnetic resonance imaging should be performed to identify intraspinal lesions when there are high risk factors for intraspinal abnormalities, or when an ultrasound screening suggests intraspinal abnormalities.

    DOI: 10.3171/2014.4.PEDS13431

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  • Entrapment of the inferior horns of the lateral ventricle with enlargement of the bilateral choroid plexus. 国際誌

    Ryosuke Ogura, Junichi Yoshimura, Masakazu Sano, Shouichi Kawasaki, Kenichi Nishiyama, Kouichirou Okamoto, Hitoshi Takahashi, Yukihiko Fujii, Akiyoshi Kakita

    Neuropathology : official journal of the Japanese Society of Neuropathology34 ( 2 ) 210 - 3   2014年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/neup.12072

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  • Gene expression signature-based prognostic risk score in patients with glioblastoma. 国際誌

    Atsushi Kawaguchi, Naoki Yajima, Naoto Tsuchiya, Jumpei Homma, Masakazu Sano, Manabu Natsumeda, Hitoshi Takahashi, Yukihiko Fujii, Tatsuyuki Kakuma, Ryuya Yamanaka

    Cancer science104 ( 9 ) 1205 - 10   2013年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The present study aimed to identify genes associated with patient survival to improve our understanding of the underlying biology of gliomas. We investigated whether the expression of genes selected using random survival forests models could be used to define glioma subgroups more objectively than standard pathology. The RNA from 32 non-treated grade 4 gliomas were analyzed using the GeneChip Human Genome U133 Plus 2.0 Expression array (which contains approximately 47 000 genes). Twenty-five genes whose expressions were strongly and consistently related to patient survival were identified. The prognosis prediction score of these genes was most significant among several variables and survival analyses. The prognosis prediction score of three genes and age classifiers also revealed a strong prognostic value among grade 4 gliomas. These results were validated in an independent samples set (n = 488). Our method was effective for objectively classifying grade 4 gliomas and was a more accurate prognosis predictor than histological grading.

    DOI: 10.1111/cas.12214

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  • Endoscopic biopsies of lesions associated with a thickened pituitary stalk. 国際誌

    Shinya Jinguji, Kenichi Nishiyama, Junichi Yoshimura, Yuichiro Yoneoka, Atsuko Harada, Masakazu Sano, Yukihiko Fujii

    Acta neurochirurgica155 ( 1 ) 119 - 24   2013年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Lesions associated with a thickened pituitary stalk (TPS lesions) revealed by magnetic resonance imaging have a diverse pathology. Accordingly, for clinical decision-making, it is necessary to make a diagnosis based on histopathological examination of the TPS lesions. The objectives of this study were to review endoscopic biopsies of TPS lesions and to assess the surgical strategy for treating these lesions. METHODS: Eleven patients (four males and seven females) aged from 6 to 75 years underwent endoscopic biopsy of a TPS lesion between 2006 and 2011 at University of Niigata. The relationships of the extent of lesions with surgical approaches were retrospectively examined. RESULTS: Among the 11 patients, a biopsy was performed via an endoscopic transsphenoidal approach for five with intrasellar lesions; via an endoscopic extended transsphenoidal approach for two with localized TPS lesions; and via an endoscopic intraventricular approach for four with the lesion protruding from the infundibulum. Histopathological examinations of all the lesions confirmed diagnoses of germinoma in four patients, hypophysitis in three, Langerhans cell histiocytosis in two, craniopharyngioma in one, and cancer metastasis in one. None of the 11 patients had further deterioration of pituitary function postoperatively. CONCLUSIONS: Endoscopic biopsy of TPS lesions is a less invasive alternative to open biopsy requiring transcranial surgery. The endoscopic transsphenoidal approach is most suitable for biopsies of TPS lesions associated with intrasellar lesions. Otherwise, the endoscopic intraventricular approach seems reasonable for intraventricular lesions protruding from the infundibulum, and the endoscopic extended transsphenoidal approach appears appropriate for localized TPS lesions.

    DOI: 10.1007/s00701-012-1543-6

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  • Gene expression signature-based prognostic risk score in patients with primary central nervous system lymphoma. 国際誌

    Atsushi Kawaguchi, Yasuo Iwadate, Yoshihiro Komohara, Masakazu Sano, Koji Kajiwara, Naoki Yajima, Naoto Tsuchiya, Jumpei Homma, Hiroshi Aoki, Tsutomu Kobayashi, Yuko Sakai, Hiroaki Hondoh, Yukihiko Fujii, Tatsuyuki Kakuma, Ryuya Yamanaka

    Clinical cancer research : an official journal of the American Association for Cancer Research18 ( 20 ) 5672 - 81   2012年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Better understanding of the underlying biology of primary central nervous system lymphomas (PCNSL) is critical for the development of early detection strategies, molecular markers, and new therapeutics. This study aimed to define genes associated with survival of patients with PCNSL. EXPERIMENTAL DESIGN: Expression profiling was conducted on 32 PCNSLs. A gene classifier was developed using the random survival forests model. On the basis of this, prognosis prediction score (PPS) using immunohistochemical analysis is also developed and validated in another data set with 43 PCNSLs. RESULTS: We identified 23 genes in which expressions were strongly and consistently related to patient survival. A PPS was developed for overall survival (OS) using a univariate Cox model. Survival analyses using the selected 23-gene classifiers revealed a prognostic value for high-dose methotrexate (HD-MTX) and HD-MTX-containing polychemotherapy regimen-treated patients. Patients predicted to have good outcomes by the PPS showed significantly longer survival than those with poor predicted outcomes (P < 0.0001). PPS using immunohistochemical analysis is also significant in test (P = 0.0004) and validation data set (P = 0.0281). The gene-based predictor was an independent prognostic factor in a multivariate model that included clinical risk stratification (P < 0.0001). Among the genes, BRCA1 protein expressions were most strongly associated with patient survival. CONCLUSION: We have identified gene expression signatures that can accurately predict survival in patients with PCNSL. These predictive genes should be useful as molecular biomarkers and they could provide novel targets for therapeutic interventions.

    DOI: 10.1158/1078-0432.CCR-12-0596

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  • An organic light-emitting diode display for use in neuroendoscopic surgery in the ventricle. 国際誌

    Kenichi Nishiyama, Masakazu Sano, Shinya Jinguji, Atsuko Harada, Junichi Yoshimura, Yukihiko Fujii

    Acta neurochirurgica154 ( 8 ) 1523 - 5   2012年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The organic light-emitting diode (OLED) display delivers a bright and high-contrast image compared to the liquid crystal display. The first experience of neuroendoscopic surgery using an OLED display was reported and its stereoscopic effect emphasized.

    DOI: 10.1007/s00701-012-1348-7

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  • Identification and validation of a gene expression signature that predicts outcome in malignant glioma patients. 国際誌

    Atsushi Kawaguchi, Naoki Yajima, Yoshihiro Komohara, Hiroshi Aoki, Naoto Tsuchiya, Jumpei Homma, Masakazu Sano, Manabu Natsumeda, Takeo Uzuka, Akihiko Saitoh, Hideaki Takahashi, Yuko Sakai, Hitoshi Takahashi, Yukihiko Fujii, Tatsuyuki Kakuma, Ryuya Yamanaka

    International journal of oncology40 ( 3 ) 721 - 30   2012年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Better understanding of the underlying biology of malignant gliomas is critical for the development of early detection strategies and new therapeutics. This study aimed to define genes associated with survival. We investigated whether genes selected using random survival forests model could be used to define subgroups of gliomas objectively. RNAs from 50 non-treated gliomas were analyzed using the GeneChip Human Genome U133 Plus 2.0 Expression array. We identified 82 genes whose expression was strongly and consistently related to patient survival. For practical purposes, a 15-gene set was also selected. Both the complete 82 gene signature and the 15 gene set subgroup indicated their significant predictivity in the 3 out of 4 independent external dataset. Our method was effective for objectively classifying gliomas, and provided a more accurate predictor of prognosis. We assessed the relationship between gene expressions and survival time by using the random survival forests model and this performance was a better classifier compared to significance analysis of microarrays.

    DOI: 10.3892/ijo.2011.1240

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  • Results of treatment of 112 cases of primary CNS lymphoma. 国際誌

    Ryuya Yamanaka, Ken Morii, Yoshikatsu Shinbo, Junpei Homma, Masakazu Sano, Naoto Tsuchiya, Naoki Yajima, Tetsuro Tamura, Hiroaki Hondoh, Hitoshi Takahashi, Tatsuyuki Kakuma, Ryuichi Tanaka

    Japanese journal of clinical oncology38 ( 5 ) 373 - 80   2008年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Chemotherapy with or without radiotherapy is the mainstay of treatment for primary central nervous system lymphoma (PCNSL). High-dose methotrexate (MTX) is the most effective drug available to treat these lesions, either as a single agent or in combination with other drugs. Due to the lack of well-conducted randomized trials, the optimal treatment remains controversial. Available retrospective studies are difficult to discuss, however, some common themes can be found. METHODS: One hundred and twelve patients with PCNSL were treated with four different regimens over a period of 24 years. Treatment regimens were: whole-brain irradiation (WBI) alone, MVP (MTX, vincristine, and predonisolone), ProMACE-MOPP hybrid (cyclophosphamide, pirarubicin, etoposide, vincristine, procarbazine, prednisone, and MTX) and R-MTX (rituximab, MTX, pirarubicin, procarbazine, and prednisone) combined-modality therapy. RESULTS: The median failure-free survival was 16 months, and the median overall survival (OS) was 24 months. The 2- and 5-year actuarial probability of survival was 52.4 +/- 4.8% [95% confidence intervals (CI)] and 30.2 +/- 4.8% (95% CI), respectively. The ProMACE-MOPP protocol, Karnofsky performance status (KPS), MTX dose and WBI were associated with good OS by univariate models. By multivariate analysis, MTX dose, WBI dose, and its square dose were significantly associated with good OS. 20-30 Gy WB, and 500 mg/m(2) of MTX dose appeared important determinants of OS. CONCLUSIONS: A modest dose of MTX (500 mg/m(2)) followed by reduced-dose WBI for patients who respond appears a feasible treatment approach that minimizes serious toxicity.

    DOI: 10.1093/jjco/hyn027

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  • [A case of solitary fibrous tumor in the cerebral convexity indicating its non-dural origin].

    Masakazu Sano, Akihiko Saito, Yasushi Nishihira, Makoto Oishi, Akiyoshi Kakita, Hitoshi Takahashi, Yukihiko Fujii

    No shinkei geka. Neurological surgery35 ( 7 ) 697 - 702   2007年7月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    We report a case of solitary fibrous tumor (SFT) in the cerebral convexity, and present characteristic radiological and surgical findings to determine its origin. The patient was a 59-year-old man with mental dullness and mild gait disturbance. CT scan and MR images showed a highly enhanced large mass lesion mimicking a meningioma in the left parietal convexity. However, neither dural enhancement nor tail sign indicative of meningioma was observed. Angiography showed prominent feedings from branches of the internal carotid and basilar arteries rather than the external carotid artery. For this reason, presurgically, we suggested hemangiopericytoma or other specific meningiomas as a differential diagnoses. Surgery confirmed that the tumor had no attachment to the dura mater and was covered by the arachnoid membrane. The bottom of the tumor adhered tightly to brain tissue. The origin was considered to be the brain surface, pia mater or a part of the arachnoid membrane. Histopathologically, the tumor was diagnosed as a SFT with findings of "attemless pattern" and diffuse CD34 staining. The radiological and surgical findings of the present case indicated in the cerebral convexity as a unique site of origin of SFT.

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  • Salvage immuno-chemotherapy with a combination of rituximab, high-dose cytarabine, mitoxantrone and dexamethasone for patients with primary CNS lymphoma: a preliminary study. 国際誌

    Ryuya Yamanaka, Junpei Homma, Masakazu Sano, Naoto Tsuchiya, Naoki Yajima, Hideaki Takahashi, Yoshikatsu Shinbo, Akira Hasegawa, Takashi Saitoh, Ryuichi Tanaka

    Leukemia & lymphoma48 ( 7 ) 1429 - 33   2007年7月

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    記述言語:英語  

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  • Salvage therapy and late neurotoxicity in patients with recurrent primary CNS lymphoma treated with a modified ProMACE-MOPP hybrid regimen. 国際誌

    Ryuya Yamanaka, Yoshikatsu Shinbo, Masakazu Sano, Jumpei Homma, Naoto Tsuchiya, Naoki Yajima, Tetsuro Tamura, Hiroaki Hondoh, Hideaki Takahashi, Ken Morii, Kiyoshi Onda, Ryuichi Tanaka

    Leukemia & lymphoma48 ( 6 ) 1119 - 26   2007年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We report the efficacy of salvage therapy with a modified ProMACE-MOPP combined with radiation in patients with primary central nervous system lymphoma (PCNSL). Thirty-two immunocompetent patients were treated with a regimen of pirarubicin, cyclophosphamide, etoposide, vincristin, and methotrexate (MTX: 500 mg/m(2)) administered in 21-day cycles. Patients received 20 Gy of whole-brain radiotherapy after three cycles of chemotherapy. A single cycle of chemotherapy was repeated every four months for two years. Nine patients with CNS relapse were retreated with additional cycles of the ProMACE-MOPP hybrid regimen with a 90% objective response rate. Median complete response (CR) duration was 13.2 months and median survival time (MST) for the nine patients treated after initial relapse was 30 months. One of 17 patients (5.8%) who had less than 20 Gy of whole brain irradiation developed dementia. In contrast, six of seven (85.7%) patients who had more than 30 Gy of whole brain radiotherapy became demented. Maintaining a moderate dose of MTX, while adding chemotherapeutic agents and 20 Gy of whole brain radiation therapy, improved disease control and overall survival and lowered the incidence of delayed neurologic toxicity in patients with PCNSL. Additional treatment with a ProMACE-MOPP hybrid regimen is still effective for relapsed disease.

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  • Immuno-chemotherapy with a combination of rituximab, methotrexate, pirarubicin and procarbazine for patients with primary CNS lymphoma--a preliminary report. 国際誌

    Ryuya Yamanaka, Junpei Homma, Masakazu Sano, Naoto Tsuchiya, Naoki Yajima, Yoshikatsu Shinbo, Akira Hasegawa, Kiyoshi Onda, Ryuichi Tanaka

    Leukemia & lymphoma48 ( 5 ) 1019 - 22   2007年5月

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    記述言語:英語  

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  • Expression level of ECT2 proto-oncogene correlates with prognosis in glioma patients. 国際誌

    Masakazu Sano, Nobuyuki Genkai, Naoki Yajima, Naoto Tsuchiya, Junpei Homma, Ryuichi Tanaka, Toru Miki, Ryuya Yamanaka

    Oncology reports16 ( 5 ) 1093 - 8   2006年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The ECT2 (epithelial cell transforming sequence 2) proto-oncogene encodes a guanine nucleotide exchange factor for Rho GTPases, and regulates cytokinesis. ECT2 plays a critical role in Rho activation during cytokinesis, and thus may play a role in the pathogenesis of glioma. In this study, we investigated relationships between ECT2 expression, tumor histology, and prognosis in glioma patients. ECT2 mRNA expression was examined using quantitative real-time PCR, while its protein expression was examined by immunohistochemistry of 54 glioma tissue samples. Expressions of ECT2 mRNA and protein were markedly increased in high-grade gliomas compared to low-grade gliomas. Patients in whom expression of ECT2 mRNA and protein in tumor tissues was the lowest survived longer than patients who had higher expression. In vitro, ECT2 siRNA inhibited glioma cell proliferation and invasion. These data suggest that increased expression of ECT2 contribute to promotion of tumor invasiveness and progression, implying that evaluation of ECT2 expression is a prognostic marker for glioma patients.

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  • Increased expression of pituitary tumor-transforming gene (PTTG)-1 is correlated with poor prognosis in glioma patients. 国際誌

    Nobuyuki Genkai, Jumpei Homma, Masakazu Sano, Ryuichi Tanaka, Ryuya Yamanaka

    Oncology reports15 ( 6 ) 1569 - 74   2006年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Pituitary tumor-transforming gene (PTTG), which is homologous to a mammalian securin, plays a pivotal role in cell transformation and is overexpressed in numerous cancer cell lines and tissues. PTTG functions in the control of mitosis, cell transformation, DNA repair and gene regulation. In the present study, we investigated whether the expression of PTTG1 is correlated with tumorigenicity and prognosis in glioma patients. Expression of PTTG1 was confirmed in three glioma cell lines at the mRNA and protein levels using RT-PCR analysis and Western blotting, respectively. Furthermore, PTTG1 protein was detected in 44 glioma tissue samples using immunohistochemical techniques, markedly increased in high-grade gliomas compared to low-grade gliomas and associated with an unfavorable patient outcome. Moreover, siRNA against the PTTG1 gene inhibited cell proliferation and invasion in glioma cell lines. These data suggest that increased expression of PTTG1 contributes to the tumorigenicity of glioma cells and may be useful as a prognostic marker for glioma patients.

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  • Increased expression of CCAAT/enhancer binding protein beta correlates with prognosis in glioma patients. 国際誌

    Jumpei Homma, Ryuya Yamanaka, Naoki Yajima, Naoto Tsuchiya, Nobuyuki Genkai, Masakazu Sano, Ryuichi Tanaka

    Oncology reports15 ( 3 ) 595 - 601   2006年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    C/EBP beta (CCAAT/enhancer binding protein beta) is a transcriptional factor that belongs to the basic region-leucine zipper class DNA-binding proteins and plays a role in cell differentiation and inflammatory reactions. Although high tissue levels of inflammatory cytokines, such as interleukin (IL)-6, IL-8 and transforming growth factor-beta, have been observed in glioma patients, the mechanisms underlying this phenomenon remain to be elucidated. C/EBP beta induces a variety of cytokines and thus may play a role in the pathogenesis of glioma. In this study, we investigated the relationship between C/EBP beta expression, tumor histology, and prognosis in glioma. The expression of C/EBP beta mRNA was examined with quantitative real-time PCR and protein expression was examined with immunohistochemical techniques in 47 glioma tissue samples. Expression of C/EBP beta mRNA and protein was markedly increased in high grade glioma compared with low grade glioma. Patients whose expression of C/EBP beta mRNA and protein in tumor tissue was lower survived longer than those whose expressions were higher. In vitro, C/EBP beta siRNA inhibited glioma cell proliferation and invasion. Moreover, IL-8 production by glioma cells was inhibited by C/EBP beta siRNA transfection. These data suggest that increased expression of C/EBP beta may contribute to the promotion of tumor invasiveness and progression. The data imply that the comparison of C/EBP beta expression could be a prognostic marker for patients with glioma.

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  • Isolation and characterization of an N-linked oligosaccharide that is increased in glioblastoma tissue and cell lines. 国際誌

    Naoto Tsuchiya, Ryuya Yamanaka, Naoki Yajima, Jumpei Homma, Masakazu Sano, Tadashi Komata, Takeshi Ikeda, Ichiro Fujimoto, Hitoshi Takahashi, Ryuichi Tanaka, Kazuhiro Ikenaka

    International journal of oncology27 ( 5 ) 1231 - 9   2005年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We have isolated and characterized N-linked oligo-saccharides that are significantly increased in glioblastoma tissue and cell lines. The structures of N-linked oligosaccharides present in 3 human normal brain tissues, 15 patients with glio-blastoma and 3 glioma cell lines were analyzed by partially automated technique for the isolation and fluorescent labeling of N-linked sugar chains from glycoproteins. Characterization of the sugar chains was achieved with the use of a combination of HPLC columns and a highly sensitive fluorescence detector at femtomole levels. By collecting peaks which accounted for 0.1% or more, sixteen different oligosaccharide structures were characterized from glioblastoma tissue and cell lines. The 16 oligosaccharide structures accounted for 48.9% of the total N-linked oligosaccharides present in glioblastoma tissue. The major components of total oligosaccharides were similar to those of normal brain tissue. The amount of a biantennary bigalactosylated structure with one core fucosylation (A2G2F) was present in increased levels in glioblastoma tissue (mean = 2.90%) and glioma cell lines (mean = 5.60%), while being less than 0.1% in normal brain tissue. Expression of highly branched tetra-antennary N-glycans that are usually detected in lungs or hepatocellular cancer was not observed. Tissue glioma cells and cultured cells also displayed strong LCA-lectin binding, which binds to sugar chains with core fucose (including A2G2F), while normal brain tissue did not. Moreover, LCA lectin inhibited proliferation of glioma cells through induction of apoptosis. A2G2F on glioma specimens may provide a novel marker and target for the diagnosis and treatment of glioblastoma, respectively.

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  • Immunologic evaluation of personalized peptide vaccination for patients with advanced malignant glioma. 国際誌

    Naoki Yajima, Ryuya Yamanaka, Takashi Mine, Naoto Tsuchiya, Jumpei Homma, Masakazu Sano, Terukazu Kuramoto, Yayoi Obata, Nobukazu Komatsu, Yoshimi Arima, Akira Yamada, Minoru Shigemori, Kyogo Itoh, Ryuichi Tanaka

    Clinical cancer research : an official journal of the American Association for Cancer Research11 ( 16 ) 5900 - 11   2005年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: The primary goal of this phase I study was to assess the safety and immunologic responses of personalized peptide vaccination for patients with advanced malignant glioma. EXPERIMENTAL DESIGN: Twenty-five patients with advanced malignant glioma (8 grade 3 and 17 grade 4 gliomas) were evaluated in a phase I clinical study of a personalized peptide vaccination. For personalized peptide vaccination, prevaccination peripheral blood mononuclear cells and plasma were provided to examine cellular and humoral responses to 25 or 23 peptides in HLA-A24+ or HLA-A2+ patients, respectively; then, only the reactive peptides (maximum of four) were used for in vivo administration. RESULTS: The protocols were well tolerated with local redness and swelling at the injection site in most cases. Twenty-one patients received more than six vaccinations and were evaluated for both immunologic and clinical responses. Increases in cellular or humoral responses specific to at least one of the vaccinated peptides were observed in the postvaccination (sixth) samples from 14 or 11 of 21 patients, respectively. More importantly, significant levels of peptide-specific IgG were detected in the postvaccination tumor cavity or spinal fluid of all of the tested patients who showed favorable clinical responses. Clinical responses were 5 partial responses, 8 cases of stable disease, and 8 cases of progressive disease. The median overall survival for patients with recurrent glioblastoma multiforme in this study (n = 17) was 622 days. CONCLUSIONS: Personalized peptide vaccinations were recommended for the further clinical study to malignant glioma patients.

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  • Clinical evaluation of dendritic cell vaccination for patients with recurrent glioma: results of a clinical phase I/II trial. 国際誌

    Ryuya Yamanaka, Junpei Homma, Naoki Yajima, Naoto Tsuchiya, Masakazu Sano, Tsutomu Kobayashi, Seiichi Yoshida, Takashi Abe, Miwako Narita, Masuhiro Takahashi, Ryuichi Tanaka

    Clinical cancer research : an official journal of the American Association for Cancer Research11 ( 11 ) 4160 - 7   2005年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: To investigate the safety and the immunologic and clinical responses of dendritic cell therapy for patients with recurrent malignant glioma. EXPERIMENTAL DESIGN: Twenty-four patients with recurrent malignant glioma (6 grade 3 and 18 grade 4 patients) were evaluated in a phase I/II clinical study of dendritic cell therapy. All patients were resistant to the standard maximum therapy. The patient's peripheral blood dendritic cells were generated with granulocyte macrophage colony-stimulating factor, plus interleukin 4 with or without OK-432, and pulsed with an autologous tumor lysate. Dendritic cells were injected intradermally, or both intratumorally and intradermally every 3 weeks. RESULTS: The protocols were well tolerated with only local redness and swelling at the injection site in several cases. Clinical responses were as follows: 1 patient with partial response, 3 patients with minor response, 10 patients with stable disease, and 10 patients with progressive disease. The patients whose dendritic cells were matured with OK-432 had longer survival times than the dendritic cells from patients without OK-432 maturation. The patients with both intratumoral and intradermal administrations had a longer survival time than the patients with intradermal administration only. Increased ELISPOT and delayed-type hypersensitivity responses after vaccination could provide good laboratory markers to predict the clinical outcome of patients receiving dendritic cell vaccination. The overall survival of patients with grade 4 glioma was 480 days, which was significantly better than that in the control group. CONCLUSIONS: This study showed the safety and clinical response of autologous tumor lysate-pulsed dendritic cell therapy for patients with malignant glioma. Dendritic cell therapy is recommended for further clinical studies in malignant glioma patients.

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